Mortality attributable to hospital acquired infections with multidrug-resistant bacteria in a large group of German hospitals

Fecal enterococci are generally not virulent; however, multidrug-resistant strains have emerged as leading causes of hospital-acquired infections. Thus, periodic enterococci monitoring should be included in highly populated cities to control the dissemination of multidrug-resistant strains to the marine environment. This study aimed to quantify enterococci bacteria from water and intertidal sediment samples in a beach located near Rio de Janeiro touristic spots. We also intended to accomplish if enterococci should be included in touristic beaches sanitary monitoring. Toward this approach, we monitored from August to December 2014 fecal indicator bacteria (FIB) at a beach close to some touristic spots through multiple tube method. Although FIB quantification was within sanitary standards of Brazilian legislation, high enterococci densities (=30 MNP.100 mL-1) were detected in the water collected in August. Thus, enterococci monitoring should be included in touristic beaches to avoid the risk of multidrug-resistant bacteria dissemination among swimmers and beachgoers.

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Infection Prevention in the ICU

Journal of Bioscience & Biomedical Engineering ◽

10.47485/2693-2504.1041 ◽

2021 ◽

Keyword(s):

Healthcare Professionals ◽

Bloodstream Infections ◽

Multidrug Resistant ◽

Morbidity And Mortality ◽

Resistant Bacteria ◽

Multidrug Resistant Bacteria ◽

Hospital Acquired Infections ◽

Hospitalised Patients ◽

Tract Infections ◽

Hospital Acquired

Hospital-acquired infections are among the most significant issues within the healthcare system, both in Greece and abroad. This is because they are associated with severe morbidity and mortality. As a rule, in Intensive Care Units (ICU), hospital-acquired infections are caused by multidrug-resistant bacteria. The spread of infections by multidrug-resistant bacteria occurs in steps. Step one is usually considered to be colonisation of the ICU host-patient via indirect contact. A transmission vehicle in these cases are the hands of healthcare professionals. The main infections in this category are the ones that affect the respiratory system, followed by bloodstream infections, mainly through endovascular catheters, and urinary tract infections. Therefore, some simple measures can limit the spread of infections, improving the clinical outcomes for hospitalised patients. These include following hand hygiene, ensuring that the medical and nursing staff change disposable gloves, keeping the ICU areas extremely clean and keeping together hospitalised patients who are colonised by the same multidrug-resistant bacteria. However, many healthcare professionals fail to consistently comply with these guidelines, which leads to the spread of multidrug-resistant bacteria, and increased morbidity and mortality.

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The impact of hospital-acquired infections with multidrug-resistant bacteria in an oncology intensive care unit

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2014.12.022 ◽

2015 ◽

Vol 31 ◽

pp. 31-34 ◽

Cited By ~ 75

Author(s):

P. Cornejo-Juárez ◽

D. Vilar-Compte ◽

C. Pérez-Jiménez ◽

S.A. Ñamendys-Silva ◽

S. Sandoval-Hernández ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Multidrug Resistant ◽

Resistant Bacteria ◽

Multidrug Resistant Bacteria ◽

Hospital Acquired Infections ◽

Hospital Acquired ◽

The Impact

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Avoiding ventilator-associated pneumonia: Curcumin-functionalized endotracheal tube and photodynamic action

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.2006759117 ◽

2020 ◽

Vol 117 (37) ◽

pp. 22967-22973

Author(s):

Amanda C. Zangirolami ◽

Lucas D. Dias ◽

Kate C. Blanco ◽

Carolina S. Vinagreiro ◽

Natalia M. Inada ◽

...

Keyword(s):

Endotracheal Tube ◽

Bacterial Infections ◽

Bacterial Resistance ◽

Multidrug Resistant ◽

Resistant Bacteria ◽

Ventilator Associated Pneumonia ◽

Hospital Acquired Infection ◽

Hospital Acquired Infections ◽

Hospitalization Costs ◽

Hospital Acquired

Hospital-acquired infections are a global health problem that threatens patients’ treatment in intensive care units, causing thousands of deaths and a considerable increase in hospitalization costs. The endotracheal tube (ETT) is a medical device placed in the patient’s trachea to assist breathing and delivering oxygen into the lungs. However, bacterial biofilms forming at the surface of the ETT and the development of multidrug-resistant bacteria are considered the primary causes of ventilator-associated pneumonia (VAP), a severe hospital-acquired infection for significant mortality. Under these circumstances, there has been a need to administrate antibiotics together. Although necessary, it has led to a rapid increase in bacterial resistance to antibiotics. Therefore, it becomes necessary to develop alternatives to prevent and combat these bacterial infections. One possibility is to turn the ETT itself into a bactericide. Some examples reported in the literature present drawbacks. To overcome those issues, we have designed a photosensitizer-containing ETT to be used in photodynamic inactivation (PDI) to avoid bacteria biofilm formation and prevent VAP occurrence during tracheal intubation. This work describes ETT’s functionalization with curcumin photosensitizer, as well as its evaluation in PDI against Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli. A significant photoinactivation (up to 95%) against Gram-negative and Gram-positive bacteria was observed when curcumin-functionalized endotracheal (ETT-curc) was used. These remarkable results demonstrate this strategy’s potential to combat hospital-acquired infections and contribute to fighting antimicrobial resistance.

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Successful Treatment of Klebsiella pneumoniae NDM Sepsis and Intestinal Decolonization with Ceftazidime/Avibactam Plus Aztreonam Combination in a Patient with TTP Complicated by SARSCoV-2 Nosocomial Infection

Medicina ◽

10.3390/medicina57050424 ◽

2021 ◽

Vol 57 (5) ◽

pp. 424

Author(s):

Francesco Perrotta ◽

Marco Paolo Perrini

Keyword(s):

Klebsiella Pneumoniae ◽

Therapeutic Option ◽

Multidrug Resistant ◽

Resistant Bacteria ◽

Multidrug Resistant Bacteria ◽

Carbapenem Resistant ◽

Global Concern ◽

Rectal Colonization ◽

Hospital Acquired ◽

Carbapenem Resistant Enterobacteriaceae

Carbapenem-resistant Enterobacteriaceae (CRE) are a serious public health threat. Infections due to these organisms are associated with significant morbidity and mortality. Among them, metallo-β-lactamases (MBLs)-producing Klebsiella pneumoniae are of global concern today. The ceftazidime/avibactam combination and the ceftazidime/avibactam + aztreonam combination currently represent the most promising antibiotic strategies to stave off these kinds of infections. We describe the case of a patient affected by thrombotic thrombocytopenic purpura (TTP) admitted in our ICU after developing a hospital-acquired SarsCoV2 interstitial pneumonia during his stay in the hematology department. His medical conditions during his ICU stay were further complicated by a K. Pneumoniae NDM sepsis. To our knowledge, the patient had no risk factors for multidrug-resistant bacteria exposure or contamination during his stay in the hematology department. During his stay in the ICU, we treated the sepsis with a combination therapy of ceftazidime/avibactam + aztreonam. The therapy solved his septic state, allowing for a progressive improvement in his general condition. Moreover, we noticed that the negativization of the hemocultures was also associated to a decontamination of his known rectal colonization. The ceftazidime/avibactam + aztreonam treatment could not only be a valid therapeutic option for these kinds of infections, but it could also be considered as a useful tool in selected patients’ intestinal decolonizations.

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Analysis of multidrug-resistant bacteria in 3223 patients with hospital-acquired infections (HAI) from a tertiary general hospital in China

Bosnian Journal of Basic Medical Sciences ◽

10.17305/bjbms.2018.3826 ◽

2019 ◽

Vol 19 (1) ◽

pp. 86-93 ◽

Cited By ~ 7

Author(s):

Meng Wang ◽

Hongyan Wei ◽

Yaxin Zhao ◽

Linlin Shang ◽

Linlin Di ◽

...

Keyword(s):

General Hospital ◽

Demographic Data ◽

Tertiary Hospital ◽

Multidrug Resistant ◽

Resistant Bacteria ◽

Extended Spectrum Beta Lactamase ◽

Hospital Acquired Infections ◽

Resistance Patterns ◽

Rational Use Of Antibiotics ◽

Hospital Acquired

The frequency of antimicrobial resistance has increased globally due to misuse and overuse of antibiotics, and multi-drug resistant (MDR) bacteria are now recognized as a major cause of hospital-acquired infections (HAI). Our aim was to investigate the prevalence, distribution, and antimicrobial susceptibility rates of MDR bacteria in patients with HAI from a tertiary hospital in China. We retrospectively evaluated all patients with a confirmed diagnosis of bacterial infection at a tertiary general hospital in Jining, for the period between January 2012 and December 2014. The following clinical and demographic data were collected: age, sex, specimens, treatment, microbiology results, and antibiotic resistance patterns of isolates. Bacterial identification and susceptibility testing were performed using VITEK 2 COMPACT system. We screened a total of 15,588 patients, out of which 7579 (48.6%) had an HAI. MDR showed 3223 out of 7579 isolates (42.5%). The most frequently isolated MDR bacteria in patients with HAI were extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (n = 1216/3223, 37.7%), MDR Pseudomonas aeruginosa (n = 627/3223, 19.5%) and MDR Acinetobacter baumannii (n = 588/3223, 18.2%). MDR-HAI were more common in males (2074/3223, 64.4%) and in elderly patients (≥60 years; 1196/3223, 37.1%). Sputum was the main source of MDR isolates (2056/3223, 63.8%). Patients with MDR-HAI were predominantly distributed in different types of intensive care units. MDR strains in our study showed resistance to most current antibiotics. Overall, patients with HAI infections attributed to MDR bacteria were widely distributed in our hospital. Enhanced surveillance of MDR bacteria is critical for guiding the rational use of antibiotics and reducing the incidence of HAI.

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Carriage of two carbapenem-resistance genes in Pseudomonas aeruginosa isolated from hospital-acquired infections in children from Costa Rica: the importance of local epidemiology

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-021-00942-7 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Cristian Pérez-Corrales ◽

Valeria Peralta-Barquero ◽

Christopher Mairena-Acuña

Keyword(s):

Pseudomonas Aeruginosa ◽

Costa Rica ◽

Resistance Genes ◽

Carbapenem Resistance ◽

Multidrug Resistant ◽

Resistant Bacteria ◽

Middle Income ◽

Hospital Acquired Infections ◽

Antimicrobial Resistance Genes ◽

Hospital Acquired

Abstract Background The assessment of Hospital-acquired infections due to multidrug-resistant bacteria involves the use of a variety of commercial and laboratory-developed tests to detect antimicrobial resistance genes in bacterial pathogens; however, few are evaluated for use in low- and middle-income countries. Methods We used whole-genome sequencing, rapid commercial molecular tests, laboratory-developed tests and routine culture testing. Results We identified the carriage of the metallo-β-lactamase blaVIM-2 and blaIMP-18 alleles in Carbapenem-Resistant Pseudomonas aeruginosa infections among children in Costa Rica. Conclusions The blaIMP-18 allele is not present in the most frequently used commercial tests; thus, it is possible that the circulation of this resistance gene may be underdiagnosed in Costa Rica.

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Drug resistance of pathogens causing nosocomial infection in orthopedics from 2012 to 2017: a 6-year retrospective study

10.21203/rs.2.9477/v1 ◽

2019 ◽

Author(s):

Bin Zhang ◽

Xiaowei Yang ◽

Runsheng Guo ◽

Banglin Xie ◽

Qi Lai ◽

...

Keyword(s):

Drug Resistance ◽

Retrospective Study ◽

Antimicrobial Resistance ◽

Multidrug Resistant ◽

Dynamic Monitoring ◽

Resistant Bacteria ◽

Clinical Microbiology Laboratory ◽

E Coli ◽

Hospital Acquired Infections ◽

Hospital Acquired

Abstract Abstract Background Hospital-acquired infections (HAIs) are an emerging global problem that increases in-hospital mortality, length of stay, and cost. Orthopedics departments experience a particularly high infection rate, partially due to their heavy reliance on invasive medical devices. We performed a 6-year retrospective study to provide valuable insight into appropriate antibiotic use in HAI cases. We also aimed to understand how hospitals could reduce pathogen drug resistance in a population that overuses antibiotics. Methods All data (2012–2017) were obtained from the Hospital Information Warehouse and Clinical Microbiology Laboratory. Results We isolated 1392 pathogen strains from patients admitted to the orthopedics department during 2012–2017. Escherichia coli (14.7%, 204/1392), Enterobacter cloacae (13.9%, 193/1392), and Staphylococcus aureus (11.3%, 157/1392) were the most common pathogens causing nosocomial infections. The dominant gram-negative bacterium was E. coli, with high resistance to ampicillin, levofloxacin, cotrimoxazole, gentamicin, and ciprofloxacin, in that order. E. coli was least resistant to amikacin, cefoperazone-sulbactam, meropenem, imipenem, and piperacillin-tazobactam. The most dominant gram-positive bacterium was S. aureus, highly resistant to penicillin and ampicillin, but not resistant to fluoroquinolones and cotrimoxazole. We also did not observe isolate resistance to nitrofurantoin, linezolid, and vancomycin. Analysis of risk factors related to multidrug-resistant bacteria showed that patients with open fractures were significantly more susceptible to methicillin-resistant S. aureus infections (p < 0.05). Additionally, extended-spectrum β-lactamase-producing E. coli infections occurred significantly more often in patients with degenerative diseases (p < 0.05). Elderly patients tended to be more susceptible to multidrug-resistant bacterial infections, but this outcome was not statistically significant. Conclusions Antimicrobial resistance is a serious problem in orthopedics. To effectively control antimicrobial resistance among pathogens, we advocate extensive and dynamic monitoring of MDR bacteria, coupled with careful use of antibiotics. Key words: hospital acquired infections; orthopedics; drug resistance; multidrug resistance

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Polymyxins Revisited

Clinical Microbiology Reviews ◽

10.1128/cmr.00006-08 ◽

2008 ◽

Vol 21 (3) ◽

pp. 449-465 ◽

Cited By ~ 347

Author(s):

David Landman ◽

Claudiu Georgescu ◽

Don Antonio Martin ◽

John Quale

Keyword(s):

Multidrug Resistant ◽

Resistant Bacteria ◽

In Vitro Testing ◽

Automated Systems ◽

Surveillance Studies ◽

Hospital Acquired Infections ◽

Optimal Dosing ◽

Clinical Responses ◽

Hospital Acquired

SUMMARY The global emergence of multidrug-resistant gram-negative bacilli has spurred a renewed interest in polymyxins. Once discarded due to concerns regarding nephrotoxicity and neurotoxicity, polymyxins now hold an important role in the antibiotic armamentarium. However, more reliable information is needed to determine the optimal dosing of these agents. Also, unanswered questions regarding in vitro testing remain, including questions regarding the reliability of automated systems and the establishment of appropriate breakpoints for defining susceptibility. Most contemporary clinical studies examining the use of these agents have involved patients with infections due to multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii strains. It has been reassuring that polymyxin therapy for resistant bacteria has resulted in clinical responses and toxicity rates similar to those for carbapenem therapy for susceptible isolates. While most surveillance studies demonstrated high rates of susceptibility, several reports noted the emergence of polymyxin-resistant nosocomial pathogens. Polymyxins have assumed an important antibiotic niche for therapy for hospital-acquired infections; further studies defining the optimal use of these agents will likely extend the duration of their clinical usefulness.

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Multidrug-resistant Bacterial Profile and Patterns for Wound Infections in Nongovernmental Hospitals of Jordan

Journal of Pure and Applied Microbiology ◽

10.22207/jpam.15.3.25 ◽

2021 ◽

Author(s):

Hashem A. Abu-Harirah ◽

Audai Jamal Al Qudah ◽

Emad Daabes ◽

Kawther Faisal Amawi ◽

Haitham Qaralleh

Keyword(s):

Multidrug Resistant ◽

Resistant Bacteria ◽

Diabetic Patients ◽

Gram Negative Bacteria ◽

Wound Infections ◽

Hospital Acquired Infections ◽

Gram Positive Bacteria ◽

Causative Agents ◽

Acinetobacter Spp ◽

Hospital Acquired

Globally, multidrug-resistant bacteria affects wound infections, both hospital-acquired infections and community-acquired infections. The main isolates cultured from 607 subjects with wound infections were methicillin-resistant Staphylococcus aureus (MRSA), Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter spp. [multidrug resistant (MDR)]. Gram-negative bacteria caused most of the infections (67%) compared with gram-positive bacteria. Diabetic patients tend to have wound infections with mixed causative agents compared with non-diabetic patients.

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