scholarly journals Detection of the Novel Extended-Spectrum β-Lactamase OXA-161 from a Plasmid-Located Integron in Pseudomonas aeruginosa Clinical Isolates from Spain

2009 ◽  
Vol 53 (12) ◽  
pp. 5288-5290 ◽  
Author(s):  
C. Juan ◽  
X. Mulet ◽  
L. Zamorano ◽  
S. Albertí ◽  
J. L. Pérez ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Clinical Isolates ◽  
Class I ◽  
The Novel ◽  
Extended Spectrum

ABSTRACT Two clonally related P seudomonas aeruginosa isolates, recovered from two patients admitted to a pediatric intensive care unit, were found to harbor a new OXA-2 variant (Asn148Asp), designated OXA-161. The plasmid location of bla OXA-161 was demonstrated through electroporation to PAO1, and its codification in a class I integron (together with aacA4) was demonstrated through PCR and sequencing. bla OXA-2 and bla OXA-161 were cloned in parallel to demonstrate the extended-spectrum β-lactamase properties of OXA-161, conferring resistance to ceftazidime and reduced susceptibility to cefepime and aztreonam.

scholarly journals Dissemination of a Class I Integron Carrying VIM-2 Carbapenemase in Pseudomonas aeruginosa Clinical Isolates from a Hospital Intensive Care Unit in Annaba, Algeria

2013 ◽  
Vol 57 (5) ◽  
pp. 2426-2427 ◽  
Author(s):  
Meriem Touati ◽  
Seydina M. Diene ◽  
Mazouz Dekhil ◽  
Abdelghani Djahoudi ◽  
Abdelkarim Racherache ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Clinical Isolates ◽  
Class I ◽  
Hospital Intensive Care Unit

scholarly journals Epidemiology of Infections Due to Extended-Spectrum Beta-Lactamase–Producing Bacteria in a Pediatric Intensive Care Unit

2014 ◽  
Vol 19 (2) ◽  
pp. 83-90 ◽  
Author(s):  
Kim W. Benner ◽  
Priya Prabhakaran ◽  
Autumn S. Lowros
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Esbl Production ◽  
Klebsiella Species ◽  
E Coli ◽  
Extended Spectrum

OBJECTIVES: To determine the proportion of infections caused by extended-spectrum ß-lactamase (ESBL)–producing Klebsiella or Escherichia coli Gram-negative organisms in the pediatric intensive care unit (PICU), and to identify risk factors for these infections. METHODS: A retrospective, single-center chart review of patients admitted to a PICU in a 5-year period with infections caused by Klebsiella species or E coli was completed. Data collected include demographics, length of stay, outcome, and relevant risk factors previously defined in the literature. RESULTS: A total of 110 isolates were cultured from 94 patients. A total of 53% of the isolates were E coli, and the remainder were Klebsiella subspecies. Of the 110 isolates, 13 isolates (11.8%) in 7 patients were ESBL positive. The ESBL-producing isolates were equally distributed amongE coli and Klebsiella and were primarily cultured from tracheal aspirates. Most of the ESBL-positive isolates (9 of 13; 69%) were cultured from patients who received ceftazidime and/or cefotaxime in the preceding 30 days. Patients infected with E coli had higher PRISM 1 scores and were more likely to have a Foley catheter, whereas infections with Klebsiella were more common in mechanically ventilated males. Although not statistically significant, 80% of patients who were infected with non–ESBL-producing organisms survived to hospital discharge versus 57% of those infected with ESBL-producing E coli and Klebsiella. CONCLUSIONS: Almost 12% of E coli and Klebsiella isolates in this patient population tested positive for ESBL production. ESBL production was equally distributed between E coli and Klebsiella species. These organisms were cultured from 7% of the study patients. As reported in previous studies, patients infected with ESBL-producing organisms most often had received prior cephalosporins and had a longer length of stay in the PICU.

scholarly journals Creation of a Combination Antibiogram for Pseudomonas aeruginosa in a Pediatric Intensive Care Unit

2021 ◽  
Vol 26 (8) ◽  
pp. 828-833
Author(s):  
R. Zachary Thompson ◽  
Cheryl L. Sargel ◽  
Melissa Moore-Clingenpeel ◽  
Todd J. Karsies
Keyword(s):  
Cystic Fibrosis ◽  
Intensive Care Unit ◽  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Susceptibility Pattern ◽  
First Line ◽  
Resistance Rates ◽  
Antimicrobial Regimen

OBJECTIVE This study describes the creation of a combination antibiogram directed toward Pseudomonas aeruginosa to determine the most appropriate empiric antimicrobial regimen(s). METHODS P aeruginosa isolates were collected from all sites between January 2013 and December 2017 for patients admitted to the PICU. Patients with cystic fibrosis and isolates from the same site and susceptibility pattern obtained within 30 days were excluded. β-Lactam susceptibilities were determined and compared with the addition of an aminoglycoside or fluroquinolone and summarized in a combination antibiogram. RESULTS One hundred ninety-nine P aeruginosa isolates were included for analysis. The addition of a second agent to piperacillin-tazobactam was shown to have the most significant improvement among the β-lactams, with 70% susceptibility as monotherapy and increases to above 90% with the addition of an aminoglycoside or fluroquinolone. The addition of an aminoglycoside or fluroquinolone to cefepime and meropenem increased coverage to above 95%. The addition of a second agent was likely to increase susceptibility of a monotherapy backbone; however, as the susceptibility of the first-line agent decreased, the susceptibility of the second agent needed to be higher to achieve a 95% coverage threshold. CONCLUSIONS Our results support use of a second agent to significantly improve the likelihood of appropriate empiric coverage of P aeruginosa. Use of a combination antibiogram may be more beneficial than a simple antibiogram for units with increasing resistance rates, or for coverage of specific resistant organisms.

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