scholarly journals 1169. Surveillance of Antibiotic-Resistant Bacteria Reported Among Healthcare-Associated Infections, California, 2011–2017

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S352-S353
Author(s):  
Kyle Rizzo ◽  
Sam Horwich-Scholefield ◽  
Erin Epson
Keyword(s):  
Public Health ◽  
Pseudomonas Aeruginosa ◽  
Central Line ◽  
Resistant Bacteria ◽  
Healthcare Associated Infections ◽  
Antibiotic Resistant ◽  
Local Public Health ◽  
E Coli ◽  
Extended Spectrum ◽  
Healthcare Associated

Abstract Background Antibiotic-resistant healthcare-associated infections (HAI) threaten patient safety and public health. HAI reported by California hospitals to the National Healthcare Safety Network include pathogen and antibiotic susceptibility information. We analyzed HAI data to measure regional changes in antibiotic resistance (AR) over time among select bacteria. Methods We analyzed central line-associated bloodstream infection (CLABSI) data using log binomial regression models to estimate annual change in the proportion of pathogens resistant to carbapenems, extended-spectrum cephalosporins, methicillin/oxacillin, and multidrug (MDR) combinations for the reporting years 2011–2017. We aggregated HAI CLABSI, catheter-associated urinary tract infection (CAUTI), and surgical site infection (SSI) data in 2-year increments (i.e., 2014–2015, 2016–2017) to assess changes in percent resistance by county when data for 30 or more pathogens were available. Results Among CLABSI reported from 2011 to 2017, there were no significant changes in the proportion of carbapenem-resistant Enterobacteriaceae (CRE) (Figure 1; risk ratio [RR]: 0.97, 95% CI: 0.92, 1.03; P = 0.32), methicillin/oxacillin-resistant S. aureus (MRSA) isolates (RR: 0.98, 95% CI: 0.96, 1.00; P = 0.06) or Pseudomonas aeruginosa with an MDR phenotype (RR: 1.02, 95% CI: 0.95, 1.10; P = 0.54). The proportion of E. coli with MDR and extended-spectrum β-lactamase (ESBL) phenotypes increased by 7% (RR: 1.07, 95% CI: 1.02, 1.12; P < 0.01) and 4% (RR: 1.04, 95% CI: 1.01, 1.08; P = 0.02) per year, respectively. Percentages of AR among aggregated CAUTI, CLABSI and SSI pathogens varied by county and time period (Figures 2 and 3). Conclusion Increases in antibiotic resistant phenotypes among E. coli, and unchanged prevalence of MDR Pseudomonas aeruginosa, CRE, and MRSA among reported HAI underscore the need for continued infection prevention and antibiotic stewardship efforts in California. Local public health departments can use these analyses to target coordinated AR prevention initiatives with healthcare facilities in their regions. Disclosures All authors: No reported disclosures.

scholarly journals Prevalence and Characterization of Extended-Spectrum β-Lactamase-Producing Antibiotic-Resistant Escherichia coli and Klebsiella pneumoniae in Ready-to-Eat Street Foods

Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 850
Author(s):  
Shobha Giri ◽  
Vaishnavi Kudva ◽  
Kalidas Shetty ◽  
Veena Shetty
Keyword(s):  
Escherichia Coli ◽  
Food Safety ◽  
Klebsiella Pneumoniae ◽  
Rural Areas ◽  
Significant Risk ◽  
Microbiological Quality ◽  
Resistant Bacteria ◽  
Antibiotic Resistant ◽  
E Coli ◽  
Extended Spectrum

As the global urban populations increase with rapid migration from rural areas, ready-to-eat (RTE) street foods are posing food safety challenges where street foods are prepared with less structured food safety guidelines in small and roadside outlets. The increased presence of extended-spectrum-β-lactamase (ESBL) producing bacteria in street foods is a significant risk for human health because of its epidemiological significance. Escherichia coli and Klebsiella pneumoniae have become important and dangerous foodborne pathogens globally for their relevance to antibiotic resistance. The present study was undertaken to evaluate the potential burden of antibiotic-resistant E. coli and K. pneumoniae contaminating RTE street foods and to assess the microbiological quality of foods in a typical emerging and growing urban suburb of India where RTE street foods are rapidly establishing with public health implications. A total of 100 RTE food samples were collected of which, 22.88% were E. coli and 27.12% K. pneumoniae. The prevalence of ESBL-producing E. coli and K. pneumoniae was 25.42%, isolated mostly from chutneys, salads, paani puri, and chicken. Antimicrobial resistance was observed towards cefepime (72.9%), imipenem (55.9%), cefotaxime (52.5%), and meropenem (16.9%) with 86.44% of the isolates with MAR index above 0.22. Among β-lactamase encoding genes, blaTEM (40.68%) was the most prevalent followed by blaCTX (32.20%) and blaSHV (10.17%). blaNDM gene was detected in 20.34% of the isolates. This study indicated that contaminated RTE street foods present health risks to consumers and there is a high potential of transferring multi-drug-resistant bacteria from foods to humans and from person to person as pathogens or as commensal residents of the human gut leading to challenges for subsequent therapeutic treatments.

scholarly journals Extended-spectrum beta-lactamase and ampicillin Class C beta lactamase-producing Escherichia coli from food animals: A review

2019 ◽  
pp. 65-75 ◽  
Author(s):  
Asinamai Athliamai Bitrus ◽  
Peter Anjili Mshelia ◽  
Iliya Dauda Kwoji ◽  
Mohammed Dauda Goni ◽  
Saleh Mohammed Jajere
Keyword(s):  
Public Health ◽  
Escherichia Coli ◽  
Health Concern ◽  
Resistant Bacteria ◽  
Beta Lactamase ◽  
Care Providers ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Class C

Antimicrobial resistance has gained global notoriety due to its public health concern, the emergence of multiple drug-resistant bacteria, and lack of new antimicrobials. Extended-spectrum beta-lactamase (ESBL)/ampicillin Class C (AmpC)- producing Escherichia coli and other zoonotic pathogens can be transmitted to humans from animals either through the food chain, direct contact or contamination of shared environments. There is a surge in the rate of resistance to medically important antibiotics such as carbapenem, ESBL, aminoglycosides, and fluoroquinolones among bacteria of zoonotic importance. Factors that may facilitate the occurrence, persistence and dissemination of ESBL/AmpC-Producing E. coli in humans and animal includes; 1). o ral administration of antimicrobials to humans primarily (by physician and health care providers) and secondarily to animals, 2). importation of parent stock and day-old chickens, 3). farm management practice and lack of water acidification in poultry, 4). contamination of feed, water and environment, 5). contamination of plants with feces of animals. Understanding these key factors will help reduce the level of resistance, thereby boosting the therapeutic effectiveness of antimicrobial agents in the treatment of animal and human infections. This review highlights the occurrence, risk factors, and public health importance of ESBL/AmpC-beta-lactamase producing E. coli isolated from livestock.

scholarly journals Abundance of colistin-resistant Escherichia coli harbouring mcr-1 and extended-spectrum β-lactamase-producing E. coli co-harbouring blaCTX-M-55 or -65 with blaTEM isolates from chicken meat in Vietnam

2021 ◽  
Author(s):  
Tatsuya Nakayama ◽  
Le Thi Hien ◽  
Ngo Thanh Phong ◽  
Doan Nguyen Minh Tran ◽  
Oanh Thi Hoang Nguyen ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Food Contamination ◽  
Antibiotic Resistance Genes ◽  
Chicken Meat ◽  
Health Concern ◽  
Resistant Bacteria ◽  
Antibiotic Resistant ◽  
E Coli ◽  
Carbapenem Resistant ◽  
Extended Spectrum

Abstract Although the spread of plasmid-mediated antibiotic-resistant bacteria is a public health concern, food contamination with plasmid-mediated antibiotic-resistant Escherichia coli has not been well investigated in Vietnam. The aim of this study was to describe the prevalence of colistin-resistant, carbapenem-resistant and endemic blaCTX−M in extended-spectrum β-lactamase (ESBL)-producing E. coli isolates. Colistin- and carbapenem-resistant ESBL-producing E. coli were isolated from chickens in Vietnam and Japan. The results showed that 52% and 93% of Vietnamese chicken was isolated with colistin-resistant and AmpC/ESBL-producing E. coli, respectively, while 52.7% of Japanese chickens were isolated with AmpC/ESBL-producing E. coli. Carbapenem-resistant E. coli has not been isolated in Vietnam or Japan. Genotyping revealed that colistin-resistant E. coli harboured mcr-1, and most of the AmpC/ESBL-related genes were blaCTX−M−55 and blaCTX−M−65 together with blaTEM in Vietnamese chickens, and blaCMY−2 in Japanese chickens. Multidrug resistance analysis showed that ESBL-producing E. coli isolates were more resistant to quinolones, streptomycin, and chloramphenicol compared with colistin-resistant E. coli isolates from Vietnam, suggesting selection in ESBL-producing E. coli for multiple antibiotic resistance genes. In conclusion, colistin-resistant E. coli was detected in about half of the chicken meat samples, the majority of which were found to harbour mcr-1. The high prevalence of ESBL-producing E. coli has remained constant across the last five years, and the predominant blaCTX−M for ESBL-producing E. coli was found to be blaCTX−M−55 or blaCTX−M−65, with the coexistence of blaTEM in Vietnam. Our results can be implemented in monitoring systems to combat the development of antimicrobial resistance.

scholarly journals Long-Term Persistence of blaCTX-M-15 in Soil and Lettuce after Introducing Extended-Spectrum β-Lactamase (ESBL)-Producing Escherichia coli via Manure or Water

2020 ◽  
Vol 8 (11) ◽  
pp. 1646
Author(s):  
Maria-Theresia Gekenidis ◽  
Serena Rigotti ◽  
Jörg Hummerjohann ◽  
Fiona Walsh ◽  
David Drissner
Keyword(s):  
Escherichia Coli ◽  
Food Group ◽  
Resistant Bacteria ◽  
Antibiotic Resistant ◽  
E Coli ◽  
Extended Spectrum ◽  
Infection Treatment ◽  
Human Food Chain

The number of environmental antibiotic-resistant bacteria (ARB) has increased dramatically since the start of antibiotic mass production for broad bacterial infection treatment in 1944. Nowadays, ARB and their resistance-determining genes (ARGs) are readily detected in all environments, including the human food chain. A highly relevant food group in this context is fresh produce, frequent raw consumption of which facilitates direct transfer of ARB and ARGs to the consumer. Here, we investigate the persistence of an extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli) pEK499 and its clinically most important ARG (blaCTX-M-15), after introduction via irrigation water or manure into a lettuce-growing system. Culturable ESBL-producing E. coli persisted longest in soil and when introduced via manure (until 9 weeks after introduction), while being undetectable on lettuce beyond day 7. In contrast, qPCR detection of blaCTX-M-15 was much more frequent: introduction via water significantly increased blaCTX-M-15 on lettuce until week 4, as opposed to manure, which affected the soil in the long-term (9 weeks) while leading to blaCTX-M-15 detection on lettuce until day 7 only. Our findings demonstrate long-term persistence of undesired ARB and ARG after their introduction via both irrigation and amendment. Such an understanding of the persistence kinetics of an ESBL-producing E. coli and plasmid-encoded blaCTX-M-15 aids the determination of critical actions in order to mitigate their transfer to the consumer.

scholarly journals Antimicrobial Resistance and Molecular Detection of Extended Spectrum β-Lactamase Producing Escherichia coli Isolates from Raw Meat in Greater Accra Region, Ghana

2020 ◽  
Author(s):  
Esther Dsani ◽  
Edwin Andrews Afari ◽  
Anthony Danso-Appiah ◽  
Ernest Kenu ◽  
Basil Benduri Kaburi ◽  
...  
Keyword(s):  
Total Coliform ◽  
Multi Drug Resistance ◽  
Resistant Bacteria ◽  
Antibiotic Resistant ◽  
Raw Meat ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Acceptable Limit ◽  
Extended Spectrum ◽  
Meat Samples

Abstract BackgroundTypically, raw meat can be contaminated with antibiotic resistant pathogens at unhygienic slaughter and sale points. Consumption of meat contaminated with antibiotic resistant E. coli is associated with grave health care consequences. The aim of this study was to determine the microbial quality of raw meat, the antimicrobial susceptibility and Extended Spectrum Beta Lactamase (ESBL) production in E. coli isolates from raw meat. ResultsTotal Plate Counts exceeded the acceptable limit of 5.0 log CFU/ cm2 in 60.5% (124/205) of raw meat samples. Total Coliform Counts in 70.7% (145/205) of samples were in excess of the acceptable limit of 2.5 log CFU/cm2. E. coli was detected in about half of raw meat samples (48%), ranging from 9.5% -79.0% among the slaughter sites. Isolates were susceptible to meropenem (100%), ceftriaxone (99%), cefotaxime (98%), chloramphenicol (97%), gentamycin (97%), ciprofloxacin (92%) and amikacin (92%), but resistant to ampicillin (57%), tetracycline (45%), sulfamethoxazole-trimethoprim (21%) and cefuroxime (17%). Multi-drug resistance (MDR) was identified in 22% of the isolates. The blaTEM gene was detected in 4% (4/98) of E. coli isolates in this study. ConclusionThe levels of microbial contamination of raw meat in this study were unacceptable. Meat handlers and consumers are at risk of foodborne infections from E. coli including ESBL producing E. coli that are resistant to most antibiotics in use. We recommend an enhanced surveillance for antibiotic resistance in food products for the early detection of emerging resistant bacteria species in the food chain.

scholarly journals Network memory in the movement of hospital patients carrying antimicrobial-resistant bacteria

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Ashleigh C. Myall ◽  
Robert L. Peach ◽  
Andrea Y. Weiße ◽  
Siddharth Mookerjee ◽  
Frances Davies ◽  
...  
Keyword(s):  
Memory Effects ◽  
Resistant Bacteria ◽  
Healthcare Associated Infections ◽  
Antibiotic Resistant Bacteria ◽  
Data Set ◽  
Antibiotic Resistant ◽  
Overlapping Communities ◽  
Hospital Patients ◽  
Healthcare Associated ◽  
Diffusive Processes

AbstractHospitals constitute highly interconnected systems that bring into contact an abundance of infectious pathogens and susceptible individuals, thus making infection outbreaks both common and challenging. In recent years, there has been a sharp incidence of antimicrobial-resistance amongst healthcare-associated infections, a situation now considered endemic in many countries. Here we present network-based analyses of a data set capturing the movement of patients harbouring antibiotic-resistant bacteria across three large London hospitals. We show that there are substantial memory effects in the movement of hospital patients colonised with antibiotic-resistant bacteria. Such memory effects break first-order Markovian transitive assumptions and substantially alter the conclusions from the analysis, specifically on node rankings and the evolution of diffusive processes. We capture variable length memory effects by constructing a lumped-state memory network, which we then use to identify individually import wards and overlapping communities of wards. We find these wards align closely to known hotspots of transmission and commonly followed pathways patients. Our framework provides a means to focus infection control efforts and cohort outbreaks of healthcare-associated infections.

Antimicrobial-Resistant Pathogens Associated With Healthcare-Associated Infections: Annual Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006–2007

2008 ◽  
Vol 29 (11) ◽  
pp. 996-1011 ◽  
Author(s):  
Alicia I. Hidron ◽  
Jonathan R. Edwards ◽  
Jean Patel ◽  
Teresa C. Horan ◽  
Dawn M. Sievert ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Agents ◽  
Healthcare Associated Infections ◽  
E Coli ◽  
National Healthcare ◽  
Carbapenem Resistant ◽  
National Healthcare Safety Network ◽  
Extended Spectrum ◽  
Tract Infections ◽  
Healthcare Associated

Objective.To describe the frequency of selected antimicrobial resistance patterns among pathogens causing device-associated and procedure-associated healthcare-associated infections (HAIs) reported by hospitals in the National Healthcare Safety Network (NHSN).Methods.Data are included on HAIs (ie, central line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated pneumonia, and surgical site infections) reported to the Patient Safety Component of the NHSN between January 2006 and October 2007. The results of antimicrobial susceptibility testing of up to 3 pathogenic isolates per HAI by a hospital were evaluated to define antimicrobial-resistance in the pathogenic isolates. The pooled mean proportions of pathogenic isolates interpreted as resistant to selected antimicrobial agents were calculated by type of HAI and overall. The incidence rates of specific device-associated infections were calculated for selected antimicrobial-resistant pathogens according to type of patient care area; the variability in the reported rates is described.Results.Overall, 463 hospitals reported 1 or more HAIs: 412 (89%) were general acute care hospitals, and 309 (67%) had 200-1,000 beds. There were 28,502 HAIs reported among 25,384 patients. The 10 most common pathogens (accounting for 84% of any HAIs) were coagulase-negative staphylococci (15%), Staphylococcus aureus (15%), Enterococcus species (12%), Candida species (11%), Escherichia coli (10%), Pseudomonas aeruginosa (8%), Klebsiella pneumoniae (6%), Enterobacter species (5%), Acinetobacter baumannii (3%), and Klebsiella oxytoca (2%). The pooled mean proportion of pathogenic isolates resistant to antimicrobial agents varied significantly across types of HAI for some pathogen-antimicrobial combinations. As many as 16% of all HAIs were associated with the following multidrug-resistant pathogens: methicillin-resistant S. aureus (8% of HAIs), vancomycin-resistant Enterococcus faecium (4%), carbapenem-resistant P. aeruginosa (2%), extended-spectrum cephalosporin-resistant K. pneumoniae (1%), extended-spectrum cephalosporin-resistant E. coli (0.5%), and carbapenem-resistant A. baumannii, K. pneumoniae, K. oxytoca, and E. coli (0.5%). Nationwide, the majority of units reported no HAIs due to these antimicrobial-resistant pathogens.

scholarly journals Repeated Isolation of Extended-Spectrum-β-Lactamase-Positive Escherichia coli Sequence Types 648 and 131 from Community Wastewater Indicates that Sewage Systems Are Important Sources of Emerging Clones of Antibiotic-Resistant Bacteria

2019 ◽  
Vol 63 (9) ◽  
Author(s):  
Erik Paulshus ◽  
Kaisa Thorell ◽  
Jessica Guzman-Otazo ◽  
Enrique Joffre ◽  
Patricia Colque ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Resistant Bacteria ◽  
Antibiotic Resistant Bacteria ◽  
Antibiotic Resistant ◽  
Content Type ◽  
E Coli ◽  
Extended Spectrum ◽  
Pump Station ◽  
Sequence Types

ABSTRACT Antibiotic resistance in bacteria is an emerging problem globally. Resistant bacteria are found in human and animal microbiota, as well as in the environment. Wastewater receives bacteria from all these sources and thus can provide a measurement of abundance and diversity of antibiotic-resistant bacteria circulating in communities. In this study, water samples were collected from a wastewater pump station in a Norwegian suburban community over a period of 15 months. A total of 45 daily samples were cultured and analyzed for the presence of Escherichia coli. Eighty E. coli-like colonies were collected from each daily sample and then phenotyped and analyzed for antibiotic resistance using the PhenePlate-AREB system. During the sampling period, two unique E. coli phenotypes with resistance to cefotaxime and cefpodoxime indicating carriage of extended-spectrum β-lactamases (ESBL) were observed repeatedly. Whole-genome sequencing of 15 representative isolates from the two phenotypes identified these as two distinct clones belonging to the two globally spread E. coli multilocus sequence types (STs) ST131 and ST648 and carrying blaCTX-M-15. The number of ESBL-positive E. coli strains in the community wastewater pump station was 314 of 3,123 (10%) analyzed E. coli strains. Of the ESBL-positive isolates, 37% belonged to ST648, and 7% belonged to ST131. Repeated findings of CTX-M-15-positive ST648 and ST131 over time indicate that these STs are resident in the analyzed wastewater systems and/or circulate abundantly in the community.

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