scholarly journals Disease burden of bloodstream infections caused by antimicrobial-resistant bacteria: a population-level study—Japan, 2015-2018

2021 ◽  
Author(s):  
Shinya Tsuzuki ◽  
Nobuaki Matsunaga ◽  
Koji Yahara ◽  
Keigo Shibayama ◽  
Motoyuki Sugai ◽  
...  
Keyword(s):  
Disease Burden ◽  
Bloodstream Infections ◽  
Population Level ◽  
Resistant Bacteria

scholarly journals Disease burden of bloodstream infections caused by antimicrobial-resistant bacteria: a population-level study—Japan, 2015-2018

2021 ◽  
Author(s):  
Shinya Tsuzuki ◽  
Nobuaki Matsunaga ◽  
Koji Yahara ◽  
Keigo Shibayama ◽  
Motoyuki Sugai ◽  
...  
Keyword(s):  
Disease Burden ◽  
Emerging Infectious Diseases ◽  
Bloodstream Infections ◽  
Population Level ◽  
Generation Cephalosporin ◽  
Resistant Bacteria ◽  
Uncertainty Interval ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Bacteriological Test

SummaryBackgroundAntimicrobial resistance (AMR) is a global health problem. However, quantitative evaluation of its disease burden is challenging. This study aimed to estimate the disease burden of bloodstream infections (BSIs) caused by major antimicrobial-resistant bacteria in Japan between 2015 and 2018 in terms of disability-adjusted life-years (DALYs).MethodsWe estimated the DALYs of BSIs caused by the six major antimicrobial-resistant bacteria in Japan by utilising comprehensive national surveillance data of all routine bacteriological test results from more than 1,400 hospitals between 2015 and 2018. We modified the methodology of a previous study by Cassini and colleagues to enable comparison of our results with those in other countries.ResultsWe estimated that 135.8 (95% uncertainty interval [UI] 128.6-142.9) DALYs per 100,000 population was attributable to BSIs caused by the six antimicrobial-resistant bacteria in 2018. Staphylococcus aureus (MRSA), fluoroquinolone-resistant Escherichia coli (FQREC), and third-generation cephalosporin-resistant E. coli (3GREC) accounted for 88.6% of the total. The burden did not decrease during the study period and was highest in people aged 65 years or older.ConclusionOur results revealed for the first time the disease burden of BSIs caused by six major antimicrobial-resistant bacteria in Japan. The estimated disease burden associated with AMR in Japan is substantial and has not begun to decrease. Notably, the burden from FQREC and 3GREC has increased steadily and that from MRSA is larger than EU/EEA area, whereas that from other bacteria was comparatively small. Our results are expected to provide useful information for healthcare policymakers for prioritising interventions for AMR.FundingMinistry of Health, Labour and Welfare research grant (20HA2003); Japan Agency for Medical Research and Development Research Program on Emerging and Re-emerging Infectious Diseases (JP19fk0108061)

scholarly journals Bloodstream Infections in the Elderly: Effects of Nursing Homes on Antimicrobial-Resistant Bacteria

2012 ◽  
Vol 6 (2) ◽  
pp. 93-100 ◽  
Author(s):  
Ming-Yuan Huang ◽  
Wen-Han Chang ◽  
Chen-Yang Hsu ◽  
Weide Tsai ◽  
Ying-Jiiin Chen ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Bloodstream Infections ◽  
The Elderly ◽  
Resistant Bacteria

scholarly journals Impact of Baseline Characteristics on Future Episodes of Bloodstream Infections: Multistate Model in Septic Patients With Bloodstream Infections

2019 ◽  
Author(s):  
M Cristina Vazquez Guillamet ◽  
Rodrigo Vazquez ◽  
Jonas Noe ◽  
Scott T Micek ◽  
Victoria J Fraser ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Culture ◽  
Bloodstream Infections ◽  
Baseline Risk ◽  
Resistant Bacteria ◽  
Beta Lactam ◽  
Candida Spp ◽  
Patients At Risk ◽  
Baseline Characteristics ◽  
Inappropriate Antibiotics

Abstract Background Looking only at the index infection, studies have described risk factors for infections caused by resistant bacteria. We hypothesized that septic patients with bloodstream infections may transition across states characterized by different microbiology and that their trajectory is not uniform. We also hypothesized that baseline risk factors may influence subsequent blood culture results. Methods All adult septic patients with positive blood cultures over a 7-year period were included in the study. Baseline risk factors were recorded. We followed all survivors longitudinally and recorded subsequent blood culture results. We separated states into bacteremia caused by gram-positive cocci, susceptible gram-negative bacilli (sGNB), resistant GNB (rGNB), and Candida spp. Detrimental transitions were considered when transitioning to a culture with a higher mortality risk (rGNB and Candida spp.). A multistate Markov-like model was used to determine risk factors associated with detrimental transitions. Results A total of 990 patients survived and experienced at least 1 transition, with a total of 4282 transitions. Inappropriate antibiotics, previous antibiotic exposure, and index bloodstream infection caused by either rGNB or Candida spp. were associated with detrimental transitions. Double antibiotic therapy (beta-lactam plus either an aminoglycoside or a fluoroquinolone) protected against detrimental transitions. Conclusion Baseline characteristics that include prescribed antibiotics can identify patients at risk for subsequent bloodstream infections caused by resistant bacteria. By altering the initial treatment, we could potentially influence future bacteremic states.

scholarly journals Trends of Bloodstream Infections in a University Greek Hospital during a Three-Year Period: Incidence of Multidrug-Resistant Bacteria and Seasonality in Gram-negative Predominance

2017 ◽  
Vol 66 (2) ◽  
pp. 171-180 ◽  
Author(s):  
Fevronia Kolonitsiou ◽  
Matthaios Papadimitriou-Olivgeris ◽  
Anastasia Spiliopoulou ◽  
Vasiliki Stamouli ◽  
Vasileios Papakostas ◽  
...  
Keyword(s):  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Blood Cultures ◽  
Diffusion Method ◽  
Resistant Bacteria ◽  
Gram Negative Bacteria ◽  
Multidrug Resistant Bacteria ◽  
Gram Positive ◽  
Gram Negative ◽  
Carbapenem Resistant

The aim of the study was to assess the epidemiology, the incidence of multidrug-resistant bacteria and bloodstream infections’ (BSIs) seasonality in a university hospital. This retrospective study was carried out in the University General Hospital of Patras, Greece, during 2011–13 y. Blood cultures from patients with clinical presentation suggestive of bloodstream infection were performed by the BacT/ALERT System. Isolates were identified by Vitek 2 Advanced Expert System. Antibiotic susceptibility testing was performed by the disk diffusion method and E-test. Resistance genes (mecA in staphylococci; vanA/vanB/vanC in enterococci; blaKPC/blaVIM/blaNDM in Klebsiella spp.) were detected by PCR. In total, 4607 (9.7%) blood cultures were positive from 47451 sets sent to Department of Microbiology, representing 1732 BSIs. Gram-negative bacteria (52.3%) were the most commonly isolated, followed by Gram-positive (39.5%), fungi (6.6%) and anaerobes bacteria (1.8%). The highest contamination rate was observed among Gram-positive bacteria (42.3%). Among 330 CNS and 150 Staphylococcus aureus, 281 (85.2%) and 60 (40.0%) were mecA-positive, respectively. From 113 enterococci, eight were vanA, two vanB and two vanC-positives. Of the total 207 carbapenem-resistant Klebsiella pneumoniae (73.4%), 202 carried blaKPC, four blaKPC and blaVIM and one blaVIM. A significant increase in monthly BSIs’ incidence was shown (R2: 0.449), which may be attributed to a rise of Gram-positive BSIs (R2: 0.337). Gram-positive BSIs were less frequent in spring (P < 0.001), summer (P < 0.001), and autumn (P < 0.001), as compared to winter months, while Gram-negative bacteria (P < 0.001) and fungi (P < 0.001) were more frequent in summer months. BSIs due to methicillin resistant S. aureus and carbapenem-resistant Gram-negative bacteria increased during the study period. The increasing incidence of BSIs can be attributed to an increase of Gram-positive BSI incidence, even though Gram-negative bacteria remained the predominant ones. Seasonality may play a role in the predominance of Gram-negative’s BSI.

scholarly journals Ten years of population-level genomic Escherichia coli and Klebsiella pneumoniae serotype surveillance informs vaccine development for invasive infections

2020 ◽  
Author(s):  
Samuel Lipworth ◽  
Karina-Doris Vihta ◽  
Kevin K Chau ◽  
James Kavanagh ◽  
Timothy Davies ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Vaccine Development ◽  
Carbapenem Resistance ◽  
Bloodstream Infections ◽  
Population Level ◽  
Small Subset ◽  
Invasive Infections ◽  
Common Serotypes ◽  
O Antigens

The incidence of bloodstream infections (BSIs) caused by Enterobacteriaceae (e.g. Escherichia coli, Klebsiella pneumoniae) continues to increase globally and the threat of untreatable disease is substantial1. Prophylactic vaccines represent an alternative approach to combating antimicrobial resistance (AMR) by reducing antibiotic usage and preventing infections caused by AMR-associated strains. To investigate their potential utility, we performed in silico serotyping on 4035 E. coli/K. pneumoniae BSI from population-level surveillance in Oxfordshire (2008-2018) in addition to 3678 isolates from previous studies. Most infections, including those associated with AMR, were caused by isolates with a small subset of O-antigens, with no evidence that the proportion of BSIs caused by these changed significantly over time. O-antigen targeted vaccines might therefore be useful in reducing the significant morbidity and mortality2 associated with BSIs. Vaccines may also have a role in preventing the spread of carbapenem resistance genes into common serotypes associated with community-onset disease.

scholarly journals Stroke in Patients with Diabetes: Is It Time to Expand Public Health Priority to Encompass High-Risk Patients with Increased Insulin Resistance?

EMJ Diabetes ◽  
2021 ◽  
pp. 84-91
Author(s):  
Sian Alexandra Bradley ◽  
Francis Muttamthottil Varghese ◽  
Bindu Menon ◽  
Man Mohan Mehndiratta ◽  
Sonu Menachem Maimonides Bhaskar
Keyword(s):  
Public Health ◽  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
High Risk ◽  
Disease Burden ◽  
Population Level ◽  
Targeted Interventions ◽  
High Risk Patients ◽  
Risk Patients ◽  
The Impact

Diabetes and stroke, with an interlinking aetiology, contribute to a growing cardiovascular disease burden and mortality around the world. Given the disproportionate prevalence and the burden of these conditions in the developing world, as well as the high risk of both Type 2 diabetes and cardiovascular disease carried by patients with metabolic syndrome, public health strategies are vital to mitigate the impact. Systematic approaches towards identifying undiagnosed patients in the community and building health systems around those targeted interventions have been implemented. However, growing evidence indicates potential for approaches to capture high-risk patients, such as those who suffer from pre-diabetes or increased insulin resistance, to provide early and optimal treatments, which could translate to population-level benefits, including reduced prevalence, disability, and disease burden.

scholarly journals 810. Resistance to the Minocycline-Rifampin-Chlorhexidine (MRCH) combination does not emerge in biofilms of Tetracycline and Rifampin resistant bacteria grown on MRCH catheters depleted below antimicrobially effective concentrations

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S448-S448
Author(s):  
Bahgat Gerges ◽  
Joel Rosenblatt ◽  
Y-Lan Truong ◽  
Ruth Reitzel ◽  
Ray Y Hachem ◽  
...  
Keyword(s):  
Bloodstream Infections ◽  
Cancer Center ◽  
Resistant Bacteria ◽  
Material Support ◽  
University Of Texas ◽  
Cook Medical ◽  
Catheter Technology ◽  
Md Anderson ◽  
The University

Abstract Background Central Line Associated Bloodstream Infections (CLABSIs) remain a significant medical problem for critically ill cancer patients who required catheters for extended durations. Minocycline (M) -Rifampin (R) loaded catheters have shown the greatest impact on reducing CLABSIs; however, there is a risk for developing antibiotic resistant organisms when exposed to catheters whose concentration becomes depleted below antimicrobially effective levels due to extended indwells. Chlorhexidine (CH) and M-R combination catheters (MRCH) have been proposed as a next generation catheter with improved performance. Here we studied whether bacteria that were Tetracycline and Rifampin resistant became resistant to MRCH when allowed to form biofilms on MRCH catheters depleted below antimicrobially effective MRCH concentrations. Methods Minimum inhibitory concentrations (MICs) of Tetracycline and/or Rifampin resistant stock isolates were measured by standard microbroth dilution methods. MRCH catheters were depleted to below antimicrobially effective concentrations by soaking in serum for 6 weeks. The resistant bacteria were then allowed to form biofilm for 24 hrs on the depleted catheters in broth. Following 24 hour incubation the adherent (breakthrough) bacteria were removed by sonication and MICs were remeasured. The same organisms grown on non-antimicrobial catheters were used as controls. Results MICs (ug/mL) of the organisms against each agent and the combination are tabulated below: MICs (ug/mL) of the organisms against each agent and the combination Conclusion The M and R resistant bacteria did not develop in vitro resistance to the MRCH combination after forming biofilms on MRCH catheters depleted below antimicrobially effective concentrations. Disclosures Joel Rosenblatt, PhD, Cook Medical (Shareholder, Other Financial or Material Support, Inventor of the MRCH catheter technology which is owned by the University of Texas MD Anderson Cancer Center and has been licensed to Cook Medical)Novel Anti-Infective Technologies (Shareholder, Other Financial or Material Support, Inventor of the MRCH catheter technology which is owned by the University of Texas MD Anderson Cancer Center and has been licensed to Cook Medical) Issam I. Raad, MD, Citius (Other Financial or Material Support, Ownership interest)Cook Medical (Grant/Research Support)Inventive Protocol (Other Financial or Material Support, Ownership interest)Novel Anti-Infective Technologies (Shareholder, Other Financial or Material Support, Ownership interest)

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