scholarly journals Equal Efficacy of Glucoprotamin and an Aldehyde Product for Environmental Disinfection in a Hematologic Transplant Unit: A Prospective Crossover Trial

2012 ◽  
Vol 33 (11) ◽  
pp. 1077-1080 ◽  
Author(s):  
Ruth Meinke ◽  
Bernhard Meyer ◽  
Reno Frei ◽  
Jakob Passweg ◽  
Andreas F. Widmer

Background.The inanimate hospital environment has emerged as an important reservoir of nosocomial pathogens. In particular, multidrug-resistant pathogens, such as methicillin-resistant Staphylococcus aureus, Acinetobacter species, and Clostridium difficile, play a major role in the transmission of hospital-acquired infections. In Europe, aldehydes, chlorine, and quaternary ammonium compounds have been commonly used for environmental disinfection. Glucoprotamin, a newer active compound for disinfectants, has been clinically tested for disinfection of instruments but not for environmental disinfection.Objective.This study evaluated the antimicrobial effectiveness of a glucoprotamin-containing product (Incidin) compared with that of an aldehyde-containing product (Deconex), the current standard at our institution.Methods.This prospective crossover study was conducted in our access-restricted hematologic transplant unit. A total of 3,086 samples from the environment were processed and examined for overall bacterial burden as well as selectively for S. aureus, C. difficile, and gram-negative bacteria.Results.There was no significant difference in residual bacteria after disinfection between the 2 products in terms of overall burden and selected pathogens. Enterococci were the predominant pathogens recovered from surfaces, but no vancomycin-resistant enterococci were recovered. Similarly, C. difficile could not be found in the patients' environment, even in rooms, despite the use of selective media.Conclusion.The aldehyde-containing product (Deconex) and the glucoprotamin-containing product (Incidin) demonstrated similar efficacy against environmental contamination in a hematologic transplant unit with the application of selective media for C. difficile, S. aureus, and gram-negative bacteria in addition to standard medium.


2016 ◽  
Vol 82 (12) ◽  
pp. 3605-3610 ◽  
Author(s):  
Andreas F. Wendel ◽  
Sofija Ressina ◽  
Susanne Kolbe-Busch ◽  
Klaus Pfeffer ◽  
Colin R. MacKenzie

ABSTRACTReports of outbreaks concerning carbapenemase-producing Gram-negative bacteria in which the main source of transmission is the hospital environment are increasing. This study describes the results of environmental sampling in a protracted polyspecies metallo-beta-lactamase GIM-1 outbreak driven by plasmids and bacterial clones ofEnterobacter cloacaeandPseudomonas aeruginosain a tertiary care center. Environmental sampling targeting wet locations (especially sinks) was carried out on a surgical intensive care unit and on a medical ward on several occasions in 2012 and 2013. We were able to demonstrate 43blaGIM-1-carrying bacteria (mainly nonfermenters but alsoEnterobacteriaceae) that were either related or unrelated to clinical strains in 30 sinks and one hair washbasin. GIM-1 was found in 12 different species, some of which are described here as carriers of GIM-1. Forty out of 43 bacteria displayed resistance to carbapenems and, in addition, to various non-beta-lactam antibiotics. Colistin resistance was observed in twoE. cloacaeisolates with MICs above 256 mg/liter. TheblaGIM-1gene was harbored in 12 different class 1 integrons, some without the typical 3′ end. TheblaGIM-1gene was localized on plasmids in five isolates.In vitroplasmid transfer by conjugation was successful in one isolate. The environment, with putatively multispecies biofilms, seems to be an important biological niche for multidrug-resistant bacteria and resistance genes. Biofilms may serve as a “melting pot” for horizontal gene transfer, for dissemination into new species, and as a reservoir to propagate future hospital outbreaks.IMPORTANCEIn Gram-negative bacteria, resistance to the clinically relevant broad-spectrum carbapenem antibiotics is a major public health concern. Major reservoirs for these resistant organisms are not only the gastrointestinal tracts of animals and humans but also the (hospital) environment. Due to the difficulty in eradicating biofilm formation in the latter, a sustained dissemination of multidrug-resistant bacteria from the environment can occur. In addition, horizontal transfer of resistance genes on mobile genetic elements within biofilms adds to the total “resistance gene pool” in the environment. To gain insight into the transmission pathways of a rare and locally restricted carbapenemases resistance gene (blaGIM-1), we analyzed the genetic background of theblaGIM-1gene in environmental bacteria during a long-term polyspecies outbreak in a German hospital.



2015 ◽  
Vol 61 (3) ◽  
pp. 244-249 ◽  
Author(s):  
Viviane Decicera Colombo Oliveira ◽  
Fernando Góngora Rubio ◽  
Margarete Teresa Gottardo Almeida ◽  
Mara Corrêa Lelles Nogueira ◽  
Antonio Carlos Campos Pignatari

Summary Objective: a resistance of hospital-acquired bacteria to multiple antibiotics is a major concern worldwide. The objective of this study was to investigate multidrugresistant (MDR) bacteria, clinical specimens, origin of specimen and trends, and correlate these with bacterial sensitivity and consumption of antimicrobials. Methods: 9,416 bacteria of nosocomial origin were evaluated in a tertiary hospital, from 1999 to 2008. MDR was defined for Gram-negative bacteria (GNB) as resistance to two or more classes/groups of antibiotics. Results: GNB MDR increased by 3.7 times over the study period (p<0.001). Acinetobacter baumannii was the most prevalent (36.2%). Over the study period, there were significant 4.8-fold and 14.6-fold increases for A. baumannii and K. pneumoniae (p<0.001), respectively. Sixty-seven percent of isolates of MDR GNB were isolated in intensive care units. The resistance of A. baumannii to carbapenems increased from 7.4 to 57.5% during the study period and concomitant with an increased consumption. Conclusion: that decade showed prevalence of GNB and a gradual increase in MDR GNB. There was an increase in carbapenem resistance of 50.1% during the study.



2021 ◽  
Vol 34 (Suppl 1) ◽  
pp. 41-43
Author(s):  
José Tiago Silva ◽  
Francisco López-Medrano

Cefiderocol is a novel catechol-substituted siderophore cephalosporin that binds to the extracellular free iron, and uses the bacterial active iron transport channels to penetrate in the periplasmic space of Gram-negative bacteria (GNB). Cefiderocol overcomes many resistance mechanisms of these bacteria. Cefiderocol is approved for the treatment of complicated urinary tract infections, hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia in the case of adults with limited treatment options, based on the clinical data from the APEKS-cUTI, APEKS-NP and CREDIBLE-CR trials. In the CREDIBLE-CR trial, a higher all-cause mortality was observed in the group of patients who received cefiderocol, especially those with severe infections due to Acinetobacter spp. Further phase III clinical studies are necessary in order to evaluate cefiderocol´s efficacy in the treatment of serious infections.



2018 ◽  
Vol 4 (1) ◽  
pp. 25-28 ◽  
Author(s):  
Bhuiyan Mohammad Mahtab Uddin ◽  
Md Abdullah Yusuf ◽  
Zubair Ahmed Ratan

The rapid spread and dissemination of the multidrug-resistant bacteria worldwide represents a major public health problem. The development of antibiotics decreased the mortality among the human and animals leading to a better life expectancy. But the injudicious use of antimicrobials and selection pressure the microbes have developed resistance which became more prominent during last few decades. With the evolution of Methicilin-resistant Staphylococcus aureus (MRSA), Hospital-acquired MRSA, Communityacquired MRSA and MDR TB (Multidrug resistant tuberculosis) challenge for the clinicians have increased to a greater extent. The global emergence and dissemination of acquired carbapenemases among gram negative bacteria are considered a major public health problem. Gram-negative bacteria, most notably Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii, are among the most important causes of serious hospital-acquired and community-onset bacterial infections in humans, and resistance to antimicrobial agents in these bacteria has become an increasingly relevant problem. Recent development in nanotechnology based drug delivery system may prove to be solution for combating these resistant bacteria. However policies and regulations for antibiotic use should be formulated to control the further development of resistance among the microbes.Bangladesh Journal of Infectious Diseases 2017;4(1):25-28



10.3823/824 ◽  
2018 ◽  
Vol 8 (3) ◽  
Author(s):  
Abdelraouf A Elmanama ◽  
Mariam Raed Al-Reefi ◽  
Mohammed A. Albayoumi ◽  
Alaa M. Marouf ◽  
Islam F. Hassona

Background: Multidrug resistant bacteria (MDR), such as Escherichia coli and Salmonella spp. are threat to the human health care system. In recent years, these MDR bacteria have been found increasingly inside and outside the hospital environment. Food animals (meat and poultry) are increasingly colonized with MDR bacteria, thus posing an additional concern. This study is intended to determine susceptibility and resistance pattern of pathogenic Gram negative bacteria isolated from rectal swabs of chicken against 16 antibiotics. Methods: A total of 216 cloacal swab samples (Gaza strip poultry farms) and 87 frozen and fresh meat samples (from slaughter houses and retails) from June 2017 to June 2018 were collected. Isolation and identification of organisms were achieved using standard bacteriological techniques. Antimicrobial susceptibility test was performed according to standard protocols. Results: 360 Enterobacteriaceae isolates, and 56 Gram-negative non fermenter were recovered. The predominant Enterobacteriaceae isolate was Citrobacter spp. (22.6%), followed by Enterobacter spp. (17.6%) and E. coli (16.5%). High rates of resistance against Ampicillin (85.4%) and Trimethoprim/ Sulfamethoxazole (80.1%) followed by Chloramphenicol (74%) were recorded. Six samples were positive for Salmonella spp. and Shigella spp. Of the tested Enterobacteriacae isolates, 94.7% were multidrug resistant (MDR), and 31.4% of  None fermenting bacilli (NFB) were MDR. Carbapenem resistance was found to be high among isolates; 51.9% for imipenem and 1.8% for meropenem. Conclusion: Isolated bacteria in the study area were MDR and this suggests that chickens may be important reservoir of antimicrobial resistant organisms which is a major public health concern.    



2018 ◽  
Author(s):  
Aline F. R. Sereia ◽  
Patricia A. da Cunha ◽  
Daniela C. Tartari ◽  
Caetana P. Zamparette ◽  
Diana A. Estigarribia ◽  
...  

AbstractHealthcare-associated infections (HAI) are an important public health threat with the multidrug-resistant (MDR) gram-negative bacteria (GNB) being of particular concern. Here we present the antimicrobial resistance profile of HAI-related GNB (HAIrB) isolated from patients (PT), healthcare workers (HCW) and hospital environment (HE) in a six-month screening program. From the 180 sampling points distributed in six hospital units, a total of 1,080 swabs were collected allowing the isolation of 390 HAIrB: 50.5% from HE, 42.6% from PT and 6.9% from HCW. Among the HAIrB, 32.6% were characterized as MDR and 38.7% as extended-spectrum cephalosporins resistant (ESC-R), showing no differences in the distribution between PT, HE and HCW. Carbapenem resistance (CARB-R) was detected for 17.7% of all HAIrB, being higher among Acinetobacter spp. isolates (36.5%), followed by Enterobacteriaceae (14.5%) and Pseudomonas spp. (11.8%). Except for the ICU, that revealed higher MDR, CARB-R and ESC-R rates, HAIrB-resistant profiles were similarly detected within the hospital units. Prevalence of blaKPC-like and blaCTX-M-1 β-lactamases-resistance genes was higher in K. pneumoniae and E. cloacae complex, while blaOXA-23-like and blaSPM-like were higher in A. baumannii and P. aeruginosa, respectively. This study reveals that the spreading of HAIrB within a hospital environment is higher than predicted, indicating that healthcare workers, hospital areas and equipment are key players on dissemination of MDR gram-negative bacteria and shows that an active surveillance program can provide precise understanding and direct actions towards control of HAI.



2021 ◽  
pp. 71-73
Author(s):  
Malabika Biswas ◽  
Bishal Gupta ◽  
Anindita Rakshit ◽  
Netai Pramanik ◽  
Banya Chakraborty ◽  
...  

Aim: To assess the prevalence of non-fermenting gram negative bacilli(NFGNB) as nosocomial pathogens and environmental contaminants. Material and Methods: Nonfermenting gram negative bacilli were isolated from relevant patient samples and high-touch surfaces in the hospital environment. They were identied and their antibiotic susceptibility testing was done using conventional and automated methods. Result: The prevalence of nonfermenters as hospital acquired pathogens and as environmental contaminants was 25.8% and 16.3% respectively. All clinical isolates of Acinetobacter baumanii cplx and Pseudomonas aeruginosa were multidrug resistant. Cluster analysis of clinical isolates show similar antibiotic susceptibility prole indicating an ongoing cross-transmission in the hospital.



2013 ◽  
Vol 99 (3) ◽  
pp. 262-266 ◽  
Author(s):  
Konstantinos Dimitriades ◽  
Brenda May Morrow ◽  
Prakash Jeena

BackgroundNosocomially acquired multidrug-resistant (MDR) Gram-negative bacteria are important contributors to paediatric intensive care unit (PICU) mortality and morbidity, with limited treatment options.AimTo investigate the outcomes of all children treated with colistin for infection with MDR Gram-negative bacteria while admitted to PICU.MethodsRetrospective observational study of 19 months. Primary endpoints were all-cause intensive care unit mortality and safety. Secondary endpoints evaluated clinical and microbiological outcomes. Cases were stratified according to HIV status.ResultsTwenty-seven children received 30 colistin courses during the study period. Eight patients (29.6%) were HIV infected, six (22.2%) were HIV uninfected but exposed, and 11 (40.7%) were HIV uninfected and unexposed. Common MDR Gram-negative bacteria cultured were: Acinetobacter species (n=22, 81.5%), Pseudomonas aeruginosa (n=11, 40.7%) and Klebsiella pneumoniae (n=7, 25.9%). Mortality was 37%, with no significant difference between HIV strata. No adverse drug reactions were noted. A composite clinical improvement was noted in 16 courses (53.3%) of colistin. Only 30% of colistin courses used in HIV-infected children resulted in an improved clinical assessment as compared with 83.3% of courses in HIV-uninfected/unexposed children (p=0.04). In HIV-infected children, five of 10 (50%) courses of colistin showed bacteriological clearance compared to the HIV uninfected/unexposed group where all cases showed bacterial eradication (p=0.02).ConclusionsHIV-infected children had poorer clinical and bacteriological responses to colistin treatment than HIV uninfected/unexposed. These results require confirmation with prospective studies to determine whether findings are due to poor microbial response, immunodeficiency or repeated reinfections.



2021 ◽  
Vol 23 (2) ◽  
pp. 173-183
Author(s):  
Оlga U. Stetsiouk ◽  
Irina V. Andreeva ◽  
А.U. Lekmanov ◽  
Еlena V. Haykina

Abstract The increasing number of infections caused by multidrug-resistant gram-negative bacteria in children is a serious problem all over the world. Ceftazidim-avibactam is a promising antimicrobial drug recently approved in Russia for use in pediatric practice. This review provides information on the possible use of ceftazidime-avibactam in children with complicated intraabdominal infections (in combination with metronidazole); complicated urinary tract infections, including pyelonephritis; hospital-acquired pneumonia, including ventilator-associated pneumonia; infections caused by aerobic gram-negative microorganisms in patients with limited choice of antibacterial therapy. Based on the data on the in vitro activity of the drug, the results of clinical studies of pharmacokinetics, safety and efficacy of ceftazidimeavibactam for the treatment of infections in children the main clinical cases in which the use of ceftazidimeavibactam in pediatric practice is most justified and appropriate are identified.



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