scholarly journals 2475. Incidence of Multidrug-Resistant, Extensively Drug-Resistant and Pandrug-Resistant Gram-Negative Bacteria in Brazilian Intensive Care Units

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S857-S857
Author(s):  
Gregory Lauar Souza ◽  
Rhayssa Fernanda de Andrade Rocha ◽  
Andressa Do nascimento Silveira ◽  
Handerson Dias Duarte de Carvalho ◽  
Cristóvão D M Oliveira ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Intensive Care ◽  
Multidrug Resistant ◽  
Resistance Rate ◽  
Resistant Bacteria ◽  
Drug Resistant ◽  
Pseudomonas Sp ◽  
Gram Negative ◽  
Extensively Drug Resistant ◽  
Acinetobacter Sp

Abstract Background The Centers for Disease Control and Prevention (CDC) proposed standard definitions for acquired resistance in bacterias. Resistant bacteria were categorized as multidrug-resistant (MDR), extensively drug-resistant (XDR) and pandrug-resistant (PDR). This study describes the incidence of Gram-negative MDR, XDR and PDR in 12 private and adult intensive care units (ICU’s) from Belo Horizonte, Minas Gerais, the sixth most populated city in Brazil, with approximately 3 million inhabitants. Methods Data were collected between January/2013 to December/2017 from 12 ICU’s. The hospitals used prospective healthcare-associated infections (HAI) surveillance protocols, in accordance to the CDC. Antimicrobial resistance from six Gram-negatives, causing nosocomial infections, were evaluated: Acinetobacter sp., Klebsiella sp., Proteus sp., Enterobacter sp., Escherichia coli, and Pseudomonas sp.. We computed the three categories of drug-resistance (MDR+XDR+PDR) to define benchmarks for the resistance rate of each Gram-negative evaluated. Benchmarks were defined as the superior limits of 95% confidence interval for the resistance rate. Results After a 5 year surveillance, 6,242 HAI strains were tested: no pandrug-resistant bacteria (PDR) was found. Acinetobacter sp. was the most resistant Gram-negative: 206 strains from 1,858 were XDR (11%), and 1,638 were MDR (88%). Pseudomonas sp.: 41/1,159 = 3.53% XDR; 180/1,159 = 15.53% MDR. Klebsiella sp.: 2/1,566 = 0,1% XDR; 813/1,566 = 52% MDR. Proteus sp.: 0/507 = 0% XDR; 163/507 = 32% MDR. Enterobacter sp.: 0/471 = 0% XDR; 148/471 = 31% MDR. Escherichia coli: 0/681 = 0% XDR; 157/681 = 23% MDR. Benchmarks for the global resistance rate of each Gram-negative (MDR+XDR+PDR): Acinetobacter sp. = 92%; Klebsiella sp. = 62%; Proteus sp. = 40%; Enterobacter sp. = 48%; Escherichia coli = 33%; Pseudomonas sp. = 30%. Conclusion This study has calculated the incidence of Gram-negative MDR, XDR and PDR, and found a higher incidence of MDR Acinetobacter sp., with an 88% multiresistance rate. Henceforth, developing countries healthcare institutions must be aware of an increased risk of infection by Acinetobacter sp.. Benchmarks have been defined, and can be used as indicators for healthcare assessment. Disclosures All authors: No reported disclosures.

Extensively drug-resistant and multidrug-resistant gram-negative pathogens in the neurocritical intensive care unit

2020 ◽  
Author(s):  
Marina Munari ◽  
Francesca Franzoi ◽  
Massimo Sergi ◽  
Alessandro De Cassai ◽  
Federico Geraldini ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
Gram Negative ◽  
Extensively Drug Resistant

scholarly journals Multidrug Resistant and Extensively Drug Resistant Bacteria: A Study

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Silpi Basak ◽  
Priyanka Singh ◽  
Monali Rajurkar
Keyword(s):  
Antimicrobial Resistance ◽  
Antibiotic Susceptibility ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Close Monitoring ◽  
Care Hospital ◽  
Drug Resistant ◽  
Bacterial Isolates ◽  
Bacterial Strains ◽  
Extensively Drug Resistant

Background and Objective. Antimicrobial resistance is now a major challenge to clinicians for treating patients. Hence, this short term study was undertaken to detect the incidence of multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) bacterial isolates in a tertiary care hospital.Material and Methods. The clinical samples were cultured and bacterial strains were identified in the department of microbiology. The antibiotic susceptibility profile of different bacterial isolates was studied to detect MDR, XDR, and PDR bacteria.Results. The antibiotic susceptibility profile of 1060 bacterial strains was studied. 393 (37.1%) bacterial strains were MDR, 146 (13.8%) strains were XDR, and no PDR was isolated. All (100%) Gram negative bacterial strains were sensitive to colistin whereas all (100%) Gram positive bacterial strains were sensitive to vancomycin.Conclusion. Close monitoring of MDR, XDR, or even PDR must be done by all clinical microbiology laboratories to implement effective measures to reduce the menace of antimicrobial resistance.

scholarly journals Phenotypic characterization of carbapenem non-susceptible gram-negative bacilli isolated from clinical specimens

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0256556
Author(s):  
Abera Abdeta ◽  
Adane Bitew ◽  
Surafel Fentaw ◽  
Estifanos Tsige ◽  
Dawit Assefa ◽  
...  
Keyword(s):  
Public Health ◽  
Prevention And Control ◽  
Multidrug Resistant ◽  
Gram Negative Bacteria ◽  
Drug Resistant ◽  
Gram Negative ◽  
Extensively Drug Resistant ◽  
Gram Negative Organisms ◽  
And Control ◽  
Public Health Institute

Background Multidrug resistant, extremely drug-resistant, pan-drug resistant, carbapenem-resistant, and carbapenemase-producing gram-negative bacteria are becoming more common in health care settings and are posing a growing threat to public health. Objective The study was aimed to detect and phenotypically characterize carbapenem no- susceptible gram-negative bacilli at the Ethiopian Public Health Institute. Materials and methods A prospective cross-sectional study was conducted from June 30, 2019, to May 30, 2020, at the national reference laboratory of the Ethiopian Public Health Institute. Clinical samples were collected, inoculated, and incubated for each sample in accordance with standard protocol. Antimicrobial susceptibility testing was conducted using Kirby-Bauer disk diffusion method. Identification was done using the traditional biochemical method. Multidrug-resistant and extensively drug-resistant isolates were classified using a standardized definition established by the European Centre for Disease Prevention and Control and the United States Centers for Disease Prevention and Control. Gram-negative organisms with reduced susceptibility to carbapenem antibiotics were considered candidate carbapenemase producers and subjected to modified carbapenem inactivation and simplified carbapenem inactivation methods. Meropenem with EDTA was used to differentiate metallo-β-lactamase (MBL) from serine carbapenemase. Meropenem (MRP)/meropenem + phenylboronic acid (MBO) were used to differentiate Klebsiella pneumoniae carbapenemase (KPC) from other serine carbapenemase producing gram-negative organisms. Results A total of 1,337 clinical specimens were analyzed, of which 429 gram-negative bacterial isolates were recovered. Out of 429 isolates, 319, 74, and 36 were Enterobacterales, Acinetobacter species, and Pseudomonas aeruginosa respectively. In our study, the prevalence of multidrug-resistant, extensively drug-resistant, carbapenemase-producing, and carbapenem nonsusceptible gram-negative bacilli were 45.2%, 7.7%, 5.4%, and 15.4% respectively. Out of 429 isolates, 66 demonstrated reduced susceptibility to the antibiotics meropenem and imipenem. These isolates were tested for carbapenemase production of which 34.8% (23/66) were carbapenemase producers. Out of 23 carbapenemase positive gram-negative bacteria, ten (10) and thirteen (13) were metallo-beta-lactamase and serine carbapenemase respectively. Three of 13 serine carbapenemase positive organisms were Klebsiella pneumoniae carbapenemase. Conclusion This study revealed an alarming level of antimicrobial resistance (AMR), with a high prevalence of multidrug-resistant (MDR) and extremely drug-resistant, carbapenemase-producing gram-negative bacteria, particularly among intensive care unit patients at the health facility level. These findings point to a scenario in which clinical management of infected patients becomes increasingly difficult and necessitates the use of “last-resort” antimicrobials likely exacerbating the magnitude of the global AMR crisis. This mandates robust AMR monitoring and an infection prevention and control program.

Sign in / Sign up

Export Citation Format

Share Document