Predictive value of surveillance cultures for bacteremia caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales among patients with hematological diseases

Infection ◽  
2022 ◽  
Author(s):  
Takuya Hattori ◽  
Tatsunori Goto ◽  
Masahide Osaki ◽  
Yukiyasu Ozawa ◽  
Koichi Miyamura
Keyword(s):  
Predictive Value ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Hematological Diseases ◽  
Extended Spectrum ◽  
Surveillance Cultures

Co-Carriage Rates of Vancomycin-ResistantEnterococcusand Extended-Spectrum Beta-Lactamase-Producing Bacteria Among a Cohort of Intensive Care Unit Patients: Implications for an Active Surveillance Program

2004 ◽  
Vol 25 (2) ◽  
pp. 105-108 ◽  
Author(s):  
Anthony D. Harris ◽  
Lucia Nemoy ◽  
Judith A. Johnson ◽  
Amy Martin-Carnahan ◽  
David L. Smith ◽  
...  
Keyword(s):  
Intensive Care ◽  
Active Surveillance ◽  
Predictive Value ◽  
Resistant Bacteria ◽  
Care Hospital ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Surveillance Cultures ◽  
Colonization Rates

AbstractObjective:To assess the co-colonization rates of extended-spectrum beta-lactamase (ESBL)-producing bacteria and vancomycin-resistantEnterococcus(VRE) obtained on active surveillance cultures.Design:Prospective cohort study.Setting:Medical and surgical intensive care units (ICUs) of a tertiary-care hospital.Patients:Patients admitted between September 2001 and November 2002 to the medical and surgical ICUs at the University of Maryland Medical System had active surveillance perirectal cultures performed. Samples were concurrently processed for VRE and ESBL-producing bacteria.Results:Of 1,362 patients who had active surveillance cultures on admission, 136 (10%) were colonized with VRE. Among these, 15 (positive predictive value, 11%) were co-colonized with ESBL. Among the 1,226 who were VRE negative, 1,209 were also ESBL negative (negative predictive value, 99%). Among the 1,362 who had active surveillance cultures on admission, 32 (2%) were colonized with ESBL. Among these, 15 (47%) were co-colonized with VRE. Of the 32 patients colonized with ESBL, 10 (31%) had positive clinical cultures for ESBL on the same hospital admission. For these 10 patients, the surveillance cultures were positive an average of 2.7 days earlier than the clinical cultures.Conclusions:Patients who are colonized with VRE can also be co-colonized with other antibiotic-resistant bacteria such as ESBL-producing bacteria. Our study is the first to measure co-colonization rates of VRE and ESBL-producing bacteria. Isolating VRE-colonized patients would isolate 47% of the ESBL-colonized patients without the need for further testing. Hence, active surveillance for VRE should also theoretically diminish the amount of patient-to-patient transmission of ESBL-producing bacteria.

scholarly journals Enrichment Broth and Detection of Extended-Spectrum-Beta-Lactamase-Producing Bacteria in Throat and Rectal Surveillance Cultures of Intensive Care Unit Patients

2009 ◽  
Vol 47 (9) ◽  
pp. 3066-3067 ◽  
Author(s):  
B. M. W. Diederen ◽  
S. M. Euser ◽  
J.-L. A. N. Murk ◽  
D. L. J. Hess ◽  
C. M. J. E. Vandenbroucke-Grauls ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Beta Lactamase ◽  
Enrichment Broth ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Surveillance Cultures

Outbreak of Extended-Spectrum Beta-Lactamase–ProducingKlebsiella Pneumoniaein a Neonatal Intensive Care Unit Linked to Artificial Nails

2004 ◽  
Vol 25 (3) ◽  
pp. 210-215 ◽  
Author(s):  
Archana Gupta ◽  
Phyllis Della-Latta ◽  
Betsy Todd ◽  
Pablo San Gabriel ◽  
Janet Haas ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Multiple Logistic Regression Analysis ◽  
Invasive Disease ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Surveillance Cultures

AbstractBackground:From April to June 2001, an outbreak of extended-spectrum beta-lactamase (ESBL)–producingKlebsiella pneumoniaeinfections was investigated in our neonatal intensive care unit.Methods:Cultures of the gastrointestinal tracts of patients, the hands of healthcare workers (HCWs), and the environment were performed to detect potential reservoirs for ESBL-producingK. pneumoniae. Strains ofK. pneumoniaewere typed by pulsed-field gel electrophoresis usingXbal. Acase–control study was performed to determine risk factors for acquisition of the outbreak clone (clone A); cases were infants infected or colonized with clone A and controls (3 per case) were infants with negative surveillance cultures.Results:During the study period, 19 case-infants, of whom 13 were detected by surveillance cultures, harbored clone A. The overall attack rate for the outbreak strain was 45%; 9 of 19 infants presented with invasive disease (n = 6) or developed invasive disease (n = 3) after colonization was detected. Clone A was found on the hands of 2 HCWs, 1 of whom wore artificial nails, and on the designated stethoscope of a case-infant. Multiple logistic regression analysis revealed that length of stay per day (odds ratio [OR], 1.05; 95% confidence interval [CI95], 1.02 to 1.09) and exposure to the HCW wearing artificial fingernails (OR, 7.87; CI95, 1.75 to 35.36) were associated with infection or colonization with clone A.Conclusion:Short, well-groomed, natural nails should be mandatory for HCWs with direct patient contact.

scholarly journals Extended-spectrum beta-lactamase (ESBL) producing Enterobacterales in stool surveillance cultures of preterm infants are no risk factor for necrotizing enterocolitis: a retrospective case–control study over 12 years

Infection ◽  
2020 ◽  
Vol 48 (6) ◽  
pp. 853-860
Author(s):  
Martin Eberhart ◽  
Andrea Grisold ◽  
Michela Lavorato ◽  
Elisabeth Resch ◽  
Andreas Trobisch ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Necrotizing Enterocolitis ◽  
Gestational Age ◽  
Klebsiella Oxytoca ◽  
Case Group ◽  
Beta Lactamase ◽  
Retrospective Case ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Surveillance Cultures

Abstract Purpose Microbial dysbiosis has been found preceding necrotizing enterocolitis (NEC) in preterm infants; thus, we aimed to investigate whether there is evidence that neonates with extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) positive stool cultures are at higher risk for NEC at the NICU. Methods We included very preterm inborn infants of ≤ 32 weeks of gestational age being fecal carriers of ESBL-E and compared them with 1:1 matched (gestational age, birth weight, gender and year) controls tested negative for ESBL-E in the stool between 2005 and 2016. An association with NEC was defined as the first detection of ESBL-E before or at the time of definite diagnosis of NEC. Results During the study period, we diagnosed 217 infants with a total of 270 ESBL-E. We identified ten different species with ESBL-producing Klebsiella oxytoca being the most common one (46%) followed by Klebsiella pneumoniae (19%), and Citrobacter freundii (17%). Ten out of 217 infants had any kind of NEC in the case group compared to two of the controls (p < 0.01), but only four cases with predefined criteria were associated with NEC ≥ stage IIa (1.8 vs. 0.5%, p = 0.089, OR 4.1, CI95% 0.45–36.6). NEC mortality rate was 2/8 (25%). Conclusions We observed a threefold increase of ESBL-E in stool surveillance cultures during study time and germs were dominated by ESBL-producing Klebsiella spp. There was no evidence that preterm infants colonized with ESBL-E in the stool were at higher risk for definite NEC.

Molecular Characterization of Methicillin Resistant and Extended Spectrum β-Lactamase Staphylococcus aureus Isolated from Burn Patients

2020 ◽  
pp. 145-151
Author(s):  
Shawnm Ahmed Aziz
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Vancomycin Resistance ◽  
World Health ◽  
Molecular Technique ◽  
Burn Patients ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum

Antibiotic resistance has become a major world health challenge and has limited the ability of physician's treatment. Staphylococcus aureus the most notorious pathogens causes morbidity and mortality especially in burn patients. However, Staphylococcus aureus rapidly acquired resistance to multiple antibiotics. Vancomycin, a glycopeptide antibiotic remains a drug of choice for treatment of severe Methicillin Resistance S. aureus infections. This study aimed to detect the emergence of beta-lactam and glycopeptide resistance genes. 50 clinical specimens of S. aureus collected from burn patients in burn and plastic surgery units in Sulaimani-Iraq city. All specimens were confirmed to be positive for S. aureus. All the isolates were assessed for their susceptibility to different antibiotics depending on NCCL standards, followed by Extended Spectrum Beta Lactamase detection by double disk diffusion synergy test. The production of β- lactamases was evaluated in the isolated strains by several routine methods and polymerase chain reaction. Among the isolates 94% were Methicillin resistance and 34.28% were Extended Spectrum Beta Lactamase producer. PCR based molecular technique was done for the bla genes related to β- lactamase enzymes by the specific primers, as well as genes which related to reduced sensitivity to Vancomycin were detected. The results indicated that all isolated showed the PBP1, PBP2, PBP3, PBP4, trfA and trfB, graSR, vraS except the vraR gene and the prolonged therapy of Methicillin resistance infection with teicoplanin have been associated with progress of resistance and the rise of tecoplanin resistance may be a prologue to evolving Vancomycin resistance. In conclusion, beta-lactam over taking can rise Vancomycin- Intermediate S. aureus strains leading to appearance of Vancomycin resistance although the treatment of Vancomycin resistant infections is challenging.

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