scholarly journals Microbiological characteristics of bacteremias among COVID-19 hospitalized patients in a tertiary referral hospital in Northern Greece during the second epidemic wave

FEMS Microbes ◽  
2021 ◽  
Author(s):  
Efthymia Protonotariou ◽  
Paraskevi Mantzana ◽  
Georgios Meletis ◽  
Areti Tychala ◽  
Angeliki Kassomenaki ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Antibiotic Susceptibility ◽  
Bacterial Species ◽  
Bloodstream Infections ◽  
Time Interval ◽  
Tertiary Referral Hospital ◽  
Northern Greece ◽  
Susceptibility Data ◽  
Microbiological Characteristics ◽  
Epidemic Wave

ABSTRACT Northern Greece was struck by an intense second COVID-19 epidemic wave during the fall of 2020. Because of the coinciding silent epidemic of MDR organisms the handling of COVID-19 patients became even more challenging. In the present study, the microbiological characteristics of bacteraemias in confirmed cases of hospitalized COVID-19 patients were determined. Data from 1165 patients hospitalized between September and December 2020 were reviewed regarding the frequency of bloodstream infections, the epidemiology and the antibiotic susceptibility profiles of the causative bacteria. The hospital's antibiotic susceptibility data for all major nosocomial pathogens isolated from bacteremias of COVID-19 patients between September-December 2020 versus September-December 2019 bacteremias were also compared. Overall, 122 patients developed bacteremia (10.47%). The average of time interval between hospitalization date and development of bacteremia was 13.98 days. Admission to ICU occurred in 98 out of 122 patients with an average time of stay 15.85 days and 90.81% in-hospital mortality. In total, 166 pathogens were recovered including 114 Gram-negative bacteria and 52 Gram-positive cocci. Acinetobacter baumannii were the most frequent (n = 51) followed by Klebsiella pneumoniae (n = 45) and Enterococcus faecium (n = 31). Bacteremias in hospitalized COVID-19 patients were related with prolonged time of hospitalization and higher in-hospital mortality and the isolated microorganisms represented the bacterial species that were present in our hospital before the COVID-19 pandemic. Worryingly, the antibiotic resistance rates were increased compared to the pre-pandemic era for all major opportunistic bacterial pathogens. The pandemic highlighted the need for continuous surveillance of patients with prolonged hospitalization.

scholarly journals Value of Time to Positivity of Blood Culture in Children with Bloodstream Infections

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Fen Pan ◽  
Wantong Zhao ◽  
Hong Zhang
Keyword(s):  
Bacterial Species ◽  
Bloodstream Infections ◽  
Blood Cultures ◽  
Drug Resistant ◽  
Gram Positive ◽  
Gram Negative ◽  
E Coli ◽  
Microbiological Characteristics ◽  
The Mean ◽  
The Relationship

Objective. This study was to investigate the microbiological characteristics and the relationship between the time to positivity (TTP) of blood cultures and different bacterial species and to assess the clinical value of TTP in children with bloodstream infections (BSIs). Methods. The TTP of all the blood cultures from children with suspected BSIs was retrospectively collected in 2016. The microbiological characteristics and the relationship between the TTP of blood cultures and different bacterial species were also analyzed. Results. A total of 808 strains were isolated from 15835 blood cultures collected, and 145 (17.9%) were Gram-negative, 636 (78.7%) were Gram-positive, and 27 (3.3%) were fungi. The bacteria were divided into definite pathogens (174), possible pathogens (592), fungi (27), and contaminants (15). The average TTP of all positive blood cultures was 30.97 and ranged from 3.23 h to 92.73 h. The TTP of Gram-negative strains was significantly shorter than that of Gram-positive strains (P<0.001) and fungi (P = 0.032). The mean TTP for E. coli (15.60 h) was shortest within the group of Gram-negative isolates, and the mean TTP for Streptococcus (17.34 h) within the group of Gram-positive isolates. Significant difference of the TTP was detected in methicillin-resistant vs methicillin-susceptible S. aureus, extended-spectrum beta-lactamases (ESBLs) positive vs negative Enterobacteriaceae, and extensive drug-resistant and non-XDR A. baumannii. The median TTP in patients with BSI was significantly shorter than in those without it (P<0.001). ROC curve analysis indicated that the TTP cutoff value of CoNS, S. aureus, E. coli, and K. pneumoniae was 22.72 h, 19.6 h, 18.58 h, and 16.43 h, respectively, with most sensitive and specific predictor of BSIs. Conclusions. Our data acknowledged that TTP is a valuable index for the early prognosis of BSIs. TTP not only provides additional utility as a general predictor of bacteria with smear result but also provides the implication of drug-resistant organisms.

scholarly journals Comparison of Microbiological Characteristics and Genetic Diversity between Burkholderia cepacia Complex Isolates from Vascular Access and Other Clinical Infections

2020 ◽  
Vol 9 (1) ◽  
pp. 51
Author(s):  
Min Yi Wong ◽  
Yuan-Hsi Tseng ◽  
Tsung-Yu Huang ◽  
Bor-Shyh Lin ◽  
Chun-Wu Tung ◽  
...  
Keyword(s):  
Genetic Diversity ◽  
Vascular Access ◽  
Burkholderia Cepacia ◽  
Bacterial Species ◽  
Diversity Indices ◽  
Burkholderia Cepacia Complex ◽  
Reca Gene ◽  
Clinical Effects ◽  
Environmental Distribution ◽  
Microbiological Characteristics

Burkholderia cepacia complex (BCC) is a group of closely related bacteria with widespread environmental distribution. BCC bacteria are opportunistic pathogens that cause nosocomial infections in patients, especially cystic fibrosis (CF). Multilocus sequence typing (MLST) is used nowadays to differentiate species within the BCC complex. This study collected 41 BCC isolates from vascular access infections (VAIs) and other clinical infections between 2014 and 2020. We preliminarily identified bacterial isolates using standard biochemical procedures and further conducted recA gene sequencing and MLST for species identification. We determined genetic diversity indices using bioinformatics software. We studied 14 isolates retrieved from patients with VAIs and observed that Burkholderia cepacia was the predominant bacterial species, and B. contaminans followed by B. cenocepacia were mainly retrieved from patients with other infections. According to MLST data, we identified that all B. contaminans isolates belonged to ST102, while a wide variety of sequence types (STs) were found in B. cenocepacia isolates. In summary, the high diversity and easy transmission of BCC increase BCC infections, which provides insights into their potential clinical effects in non-CF infections.

scholarly journals Antibiotic Susceptibility of Common Organisms Isolated from Urine Cultures of Nursing Home Residents

2020 ◽  
Vol 41 (S1) ◽  
pp. s118-s120
Author(s):  
Austin R. Penna ◽  
Taniece R. Eure Eure ◽  
Nimalie D. Stone ◽  
Grant Barney ◽  
Devra Barter ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Antibiotic Susceptibility ◽  
Clinical Decision Making ◽  
Service Providers ◽  
Urine Culture ◽  
Nursing Home Residents ◽  
Antibiotic Prescribing ◽  
E Coli ◽  
Susceptibility Data

Background: With the emergence of antibiotic resistant threats and the need for appropriate antibiotic use, laboratory microbiology information is important to guide clinical decision making in nursing homes, where access to such data can be limited. Susceptibility data are necessary to inform antibiotic selection and to monitor changes in resistance patterns over time. To contribute to existing data that describe antibiotic resistance among nursing home residents, we summarized antibiotic susceptibility data from organisms commonly isolated from urine cultures collected as part of the CDC multistate, Emerging Infections Program (EIP) nursing home prevalence survey. Methods: In 2017, urine culture and antibiotic susceptibility data for selected organisms were retrospectively collected from nursing home residents’ medical records by trained EIP staff. Urine culture results reported as negative (no growth) or contaminated were excluded. Susceptibility results were recorded as susceptible, non-susceptible (resistant or intermediate), or not tested. The pooled mean percentage tested and percentage non-susceptible were calculated for selected antibiotic agents and classes using available data. Susceptibility data were analyzed for organisms with ≥20 isolates. The definition for multidrug-resistance (MDR) was based on the CDC and European Centre for Disease Prevention and Control’s interim standard definitions. Data were analyzed using SAS v 9.4 software. Results: Among 161 participating nursing homes and 15,276 residents, 300 residents (2.0%) had documentation of a urine culture at the time of the survey, and 229 (76.3%) were positive. Escherichia coli, Proteus mirabilis, Klebsiella spp, and Enterococcus spp represented 73.0% of all urine isolates (N = 278). There were 215 (77.3%) isolates with reported susceptibility data (Fig. 1). Of these, data were analyzed for 187 (87.0%) (Fig. 2). All isolates tested for carbapenems were susceptible. Fluoroquinolone non-susceptibility was most prevalent among E. coli (42.9%) and P. mirabilis (55.9%). Among Klebsiella spp, the highest percentages of non-susceptibility were observed for extended-spectrum cephalosporins and folate pathway inhibitors (25.0% each). Glycopeptide non-susceptibility was 10.0% for Enterococcus spp. The percentage of isolates classified as MDR ranged from 10.1% for E. coli to 14.7% for P. mirabilis. Conclusions: Substantial levels of non-susceptibility were observed for nursing home residents’ urine isolates, with 10% to 56% reported as non-susceptible to the antibiotics assessed. Non-susceptibility was highest for fluoroquinolones, an antibiotic class commonly used in nursing homes, and ≥ 10% of selected isolates were MDR. Our findings reinforce the importance of nursing homes using susceptibility data from laboratory service providers to guide antibiotic prescribing and to monitor levels of resistance.Disclosures: NoneFunding: None

scholarly journals 1576. Re-Evaluation of cefepime or piperacillin-tazobactam to Decrease Use of Carbapenems in ESBL-Producing Enterobacterales BloodStream Infections (REDUCE-BSI)

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S786-S787
Author(s):  
Catherine H Vu ◽  
Veena Venugopalan ◽  
Barbara A Santevecchi ◽  
Stacy A Voils ◽  
Kartikeya Cherabuddi ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Bloodstream Infections ◽  
Causative Organism ◽  
E Coli ◽  
Development Of Resistance ◽  
Baseline Characteristics ◽  
Secondary Outcomes ◽  
Klebsiella Spp ◽  
Decrease Use ◽  
Infection Recurrence

Abstract Background The ideal therapy for treatment of bloodstream infections (BSI) due to ESBL-producing organisms is widely debated. Although prior studies have demonstrated efficacy of non-carbapenems (CBPNs) for ESBL infections, results from the MERINO study group found increased mortality associated with piperacillin/tazobactam (PT) when compared with meropenem for treatment of ESBL BSI. The goal of this study was to investigate patient outcomes associated with the use of CBPN-sparing therapies (PT and cefepime (CEF)) for ESBL BSI. The primary outcome was in-hospital mortality between non-CBPN (PT and CEF) and CBPN groups. Secondary outcomes included clinical cure, microbiologic cure, infection recurrence, and development of resistance. Methods This was a retrospective observational study of patients admitted to the hospital from May 2016 - May 2019 with a positive blood culture for an ESBL-producing organism. Patients receiving meropenem, ertapenem, PT, or CEF were included. Patients were excluded if &lt; 18 years old, receiving antibiotics for &lt; 24 hours, treated for a polymicrobial BSI, or receiving concomitant antibiotic therapy for another gram-negative (non-ESBL) infection. Results One hundred and fourteen patients were analyzed; 74 (65%) patients received CBPN therapy compared with 40 (35%) patients that received a non-CBPN (CEF N=30, PT N=10). There were no statistically significant differences in baseline characteristics between groups. The overall in-hospital mortality rate was 6% (N=7). Eight percent of patients (N=6) in the CBPN arm died compared to 3% (N=1) of patients in the non-CBPN arm, P = 0.42. No difference in mortality was detected between groups when evaluating subgroups with Pitt bacteremia score ≥4 (N=25), requiring ICU admission (N=50), non-genitourinary source (N=50), or by causative organism (N=76 E. coli; N=38 Klebsiella spp.). There was no difference between groups for secondary outcomes. Conclusion CEF and PT are reasonable options for the treatment of ESBL BSI and did not result in increased mortality or decreased clinical efficacy when compared to CBPNs in this cohort. Disclosures All Authors: No reported disclosures

scholarly journals 48. Association of Rapid Pathogen Identification and Pharmacist Intervention on Time to Optimal Antimicrobial Therapy for Bloodstream Infections at Two Community Hospitals

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S47-S47
Author(s):  
Bryant M Froberg ◽  
Nicholas Torney
Keyword(s):  
Blood Culture ◽  
Hospital Mortality ◽  
Positive Blood Culture ◽  
Antimicrobial Therapy ◽  
Length Of Hospital Stay ◽  
Bloodstream Infections ◽  
Pharmacist Intervention ◽  
Pathogen Identification ◽  
Community Hospitals ◽  
Significant Difference

Abstract Background As many as 1 in 3 patients with bloodstream infections at community hospitals receive inappropriate empiric antimicrobial therapy. Studies have shown that the coupling of real-time intervention with rapid pathogen identification improves patient outcomes and decreases health-system costs at large, tertiary academic centers. The aim of this study was to assess if similar outcomes could be obtained with the implementation of real-time pharmacist intervention to rapid pathogen identification at two smaller, rural community hospitals. Methods This was a pre-post implementation study that occurred from September of 2019 to March 2020. This study included patients ≥18 years of age admitted with one positive blood culture. Patients were excluded if they were pregnant, had a polymicrobial blood culture, known culture prior to admission, hospice consulted prior to admission, expired prior to positive blood culture, or transferred to another hospital within 24 hours of a positive blood culture. Endpoints of patients prior to intervention were compared to patients post-implementation. The primary endpoint was time to optimal antimicrobial therapy. Secondary endpoints included time to effective antimicrobial therapy, in-hospital mortality, length of hospital stay, and overall cost of hospitalization. Results Of 212 patients screened, 88 patients were included with 44 patients in each group. Both groups were similar in terms of comorbidities, infection source, and causative microbial. No significant difference was seen in the mean time to optimal antimicrobial therapy (27.3±35.5 hr vs 19.4± 30 hr, p=0.265). Patients in the post-implementation group had a significantly higher mean hospitalization cost ($24,638.87± $11,080.91 vs $32,722.07±$13,076.73, p=0.013). There was no significant difference in time to effective antimicrobial therapy, in-hospital mortality, or length of hospital stay. Conclusion There were no between-group differences in the primary outcome of time to optimal therapy, with a higher mean hospitalization cost after implementation. These results suggest further antimicrobial stewardship interventions are needed, along with larger studies conducted in the community hospital settings. Disclosures All Authors: No reported disclosures

scholarly journals Antibiotic Susceptibility Study Of Metal-Gentamicin Complexes Against Staphylococcus Aureus Biofilms

2017 ◽  
Vol 16 (2) ◽  
Author(s):  
Intan Azura Shahdan ◽  
Fatimah Zahrah Mohd Sobri ◽  
Mohammad Faiz Hizzuan Hanapi ◽  
Hanani Ahmad Yusof ◽  
Fiona N.-F. How
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Bacterial Species ◽  
Dental Biofilm ◽  
Planktonic Bacteria ◽  
Metal Contents ◽  
Susceptibility Study ◽  
Biofilm Bacteria ◽  
Dental Plaques ◽  
Conventional Antibiotics

Introduction: Dental plaque is a structurally and functionally organized biofilm. Modern molecular biological techniques have identified about 1000 different bacterial species in the dental biofilm, twice as many as can be cultured. Inherent resistance of biofilm bacteria to conventional antibiotics is alarming. It induces antibiotic resistance to an order of three or more in magnitude greater than those displayed by planktonic bacteria. Staphylococcus aureus is the most dominant bacterial species isolated from the saliva and dental plaques. One of the reasons for its pathogenicity is its ability to form biofilms. In this study, the resistance of S. aureus biofilms against a eries of metal-antibiotics, an alternative to the conventional antibiotics, was investigated. Materials and Methods: A series of metal-antibiotic complexes derived from gentamicin was synthesized to give metal-gentamicin complexes. The metal contents of all the compounds were determined using Atomic Absorption Spectroscopy (AAS). Antibiotic susceptibility testing of the gentamicin-antibiotic complexes against several strains of S. aureus biofilms was conducted using broth microdilution assay. Results: The results showed that S. aureus is susceptible against Co(II) and Fe(II) gentamicin complexes; all were tested at 0.25 to 1 mmol concentrations. Conclusion(s): Co(II) and Fe(II)-gentamicin complexes demonstrated antimicrobial activity.

scholarly journals Drug Susceptibility Distributions of Mycobacterium chimaera and Other Nontuberculous Mycobacteria

2021 ◽  
Vol 65 (5) ◽  
Author(s):  
Bettina Schulthess ◽  
Daniel Schäfle ◽  
Nicole Kälin ◽  
Tamara Widmer ◽  
Peter Sander
Keyword(s):  
Antibiotic Susceptibility ◽  
Nontuberculous Mycobacteria ◽  
Drug Susceptibility ◽  
Species Differentiation ◽  
Content Type ◽  
Susceptibility Data ◽  
Clinical Breakpoints ◽  
Antibiotic Susceptibility Patterns ◽  
Definition Of

ABSTRACT Recent outbreaks of cardiac surgery-associated Mycobacterium chimaera infections have highlighted the importance of species differentiation within the Mycobacterium avium complex and pointed to a lack of antibiotic susceptibility data for M. chimaera. Using the MGIT 960/EpiCenter TB eXiST platform, we have determined antibiotic susceptibility patterns of 48 clinical M. chimaera isolates and 139 other nontuberculous mycobacteria, including 119 members of the M. avium complex and 20 Mycobacterium kansasii isolates toward clofazimine and other drugs used to treat infections with slow-growing nontuberculous mycobacteria (NTM). MIC50, MIC90, and tentative epidemiological cutoff (ECOFF) values for clofazimine were 0.5 mg/liter, 1 mg/liter, and 2 mg/liter, respectively, for M. chimaera. Comparable values were observed for other M. avium complex members, whereas lower MIC50 (≤0.25 mg/liter), MIC90 (0.5 mg/liter), and ECOFF (1 mg/liter) values were found for M. kansasii. Susceptibility to clarithromycin, ethambutol, rifampin, rifabutin, amikacin, moxifloxacin, and linezolid was in general similar for M. chimaera and other members of the M. avium complex, but increased for M. kansasii. The herein determined MIC distributions, MIC90, and ECOFF values of clofazimine for M. chimaera and other NTM provide the basis for the definition of clinical breakpoints. Further studies are needed to establish correlation of in vitro susceptibility and clinical outcome.

Antibiotic susceptibility of bacterial isolates from 502 dogs with respiratory signs

2014 ◽  
Vol 176 (14) ◽  
pp. 357-357 ◽  
Author(s):  
M. Rheinwald ◽  
K. Hartmann ◽  
M. Hähner ◽  
G. Wolf ◽  
R. K. Straubinger ◽  
...  
Keyword(s):  
Antibiotic Susceptibility ◽  
Bacterial Species ◽  
Lavage Fluid ◽  
Respiratory Pathogen ◽  
Susceptibility Pattern ◽  
Gram Positive Bacteria ◽  
Amoxicillin Clavulanic Acid ◽  
Tract Infections ◽  
Cultured Bacteria ◽  
Privately Owned

The aim of this study was to investigate the prevalence of bacterial species isolated from bronchoalveolar lavage fluid (BALF) samples taken from dogs with respiratory signs and to determine their antibiotic susceptibility. Clinical cases were included in the study if they showed signs of respiratory disease and data relating to bacterial culture and susceptibility of BALF samples were available. The medical records of 493 privately owned dogs that were presented between January 1989 and December 2011 were evaluated retrospectively. In 35 per cent of samples, no bacteria were cultured. Bacteria isolated from culture-positive samples included Streptococcus species (31 per cent of positive cultures), Enterobacteriaceae (30 per cent, including Escherichia coli (15 per cent)), Staphylococcus species (19 per cent), Pasteurella species (16 per cent) and Pseudomonas species (14 per cent). Bordetella bronchiseptica as a primary respiratory pathogen was isolated in 8 per cent of cases. Enrofloxacin showed the best susceptibility pattern; 86 per cent of all isolates and 87 per cent of Gram-negative bacteria were susceptible to this antibiotic. Amoxicillin/clavulanic acid yielded the best susceptibility pattern in Gram-positive bacteria (92 per cent). Therefore, these antibiotics can be recommended for empirical or first-line treatment in dogs with bacterial lower respiratory tract infections.

scholarly journals 171. Rising Rates of Gram-Negative Bacilli Blood Stream (GNB-BSI) Infection in Adults

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S109-S109
Author(s):  
Leonard B Johnson ◽  
Riad Khatib ◽  
Dima Youssef ◽  
Babak Hooshmand ◽  
Mohamad G Fakih ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Susceptibility ◽  
Rate Increase ◽  
Bloodstream Infections ◽  
Blood Stream ◽  
Source Distribution ◽  
Chi Square ◽  
Gram Negative ◽  
Rate Table ◽  
Linear Trends

Abstract Background Monitoring bloodstream infections provides updates of the microbiology and antibiotic susceptibility trends. We elected to examine GNB-BSI. Methods We retrospectively studied adults (≥18 years old) inpatients with gram-negative bacilli (GNB) bloodstream infection (BSI; January 1, 2010–December 31, 2017), determined the demographics, onset place, microbiology and source. The results were stratified to study year and evaluated by the extended Mantel–Haenszel chi square for linear trends. Results GNB were encountered in 4520/14314 (31.6%) positive blood culture (BC) accounting for 2811 BSI episodes (2291 patients) with a steadily increasing rate (table). The 3 most common organisms were Escherichia coli (EC; 44.4%), Klebsiella pneumoniae (KP; 19.2%) and Pseudomonas aeruginosa (PA; 9.6%). GNB-BSI rate increase was mainly in EC-BSI (P = 0.01). The rate of other GNB-BSI did not change. Source distribution of EC-BSI did not change and antibiotic resistance did not change. Conclusion GNB-BSI is rising, primarily due to EC, without changes in source distribution or antibiotic susceptibility. Prospective studies to look at EC lineage and virulence factors are needed to determine the reason for EC-BSI rise. Disclosures All authors: No reported disclosures.

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