scholarly journals When Good Bugs Go Bad: Epidemiology and Antimicrobial Resistance Profiles of Corynebacterium striatum, an Emerging Multidrug-Resistant, Opportunistic Pathogen

2017 ◽  
Vol 61 (11) ◽  
Author(s):  
Allison R. McMullen ◽  
Neil Anderson ◽  
Meghan A. Wallace ◽  
Angela Shupe ◽  
Carey-Ann D. Burnham
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Opportunistic Pathogen ◽  
Central Line ◽  
Multidrug Resistant ◽  
Content Type ◽  
Corynebacterium Striatum ◽  
Infection Types

ABSTRACT Infections with Corynebacterium striatum have been described in the literature over the last 2 decades, with the majority being bacteremia, central line infections, and occasionally, endocarditis. In recent years, the frequency of C. striatum infections appears to be increasing; a factor likely contributing to this is the increased ease and accuracy of the identification of Corynebacterium spp., including C. striatum, from clinical cultures. The objective of this study was to retrospectively characterize C. striatum isolates recovered from specimens submitted as part of routine patient care at a 1,250-bed, tertiary-care academic medical center. Multiple strain types were recovered, as demonstrated by repetitive-sequence-based PCR. Most of the strains of C. striatum characterized were resistant to antimicrobials commonly used to treat Gram-positive organisms, such as penicillin, ceftriaxone, meropenem, clindamycin, and tetracycline. The MIC50 for ceftaroline was >32 μg/ml. Although there are no interpretive criteria for susceptibility with telavancin, it appeared to have potent in vitro efficacy against this species, with MIC50 and MIC90 values of 0.064 and 0.125 μg/ml, respectively. Finally, as previously reported in case studies, we demonstrated rapid in vitro development of daptomycin resistance in 100% of the isolates tested (n = 50), indicating that caution should be exhibited when using daptomycin for the treatment of C. striatum infections. C. striatum is an emerging, multidrug-resistant pathogen that can be associated with a variety of infection types.

scholarly journals Arbekacin Activity against Contemporary Clinical Bacteria Isolated from Patients Hospitalized with Pneumonia

2015 ◽  
Vol 59 (6) ◽  
pp. 3263-3270 ◽  
Author(s):  
Helio S. Sader ◽  
Paul R. Rhomberg ◽  
David J. Farrell ◽  
Ronald N. Jones
Keyword(s):  
The United States ◽  
Multidrug Resistant ◽  
Surveillance Program ◽  
Content Type ◽  
Microdilution Method ◽  
Medical Centers ◽  
Broth Microdilution Method ◽  
Mrsa Strains ◽  
Infection Types

ABSTRACTArbekacin is a broad-spectrum aminoglycoside licensed for systemic use in Japan and under clinical development as an inhalation solution in the United States. We evaluated the occurrence of organisms isolated from pneumonias in U.S. hospitalized patients (PHP), including ventilator-associated pneumonia (VAP), and thein vitroactivity of arbekacin. Organism frequency was evaluated from a collection of 2,203 bacterial isolates (339 from VAP) consecutively collected from 25 medical centers in 2012 through the SENTRY Antimicrobial Surveillance Program. Arbekacin activity was tested against 904 isolates from PHP collected in 2012 from 62 U.S. medical centers and 303 multidrug-resistant (MDR) organisms collected worldwide in 2009 and 2010 from various infection types. Susceptibility to arbekacin and comparator agents was evaluated by the reference broth microdilution method. The four most common organisms from PHP wereStaphylococcus aureus,Pseudomonas aeruginosa,Klebsiellaspp., andEnterobacterspp. The highest arbekacin MIC amongS. aureusisolates from PHP (43% methicillin-resistantS. aureus[MRSA]) was 4 μg/ml. AmongP. aeruginosaisolates from PHP, only one had an arbekacin MIC of >16 μg/ml (MIC50and MIC90, 1 and 4 μg/ml), and susceptibility rates for gentamicin, tobramycin, and amikacin were 88.0, 90.0, and 98.0%, respectively. Arbekacin (MIC50, 2 μg/ml) and tobramycin (MIC50, 4 μg/ml) were the most potent aminoglycosides tested againstAcinetobacter baumannii. AgainstEnterobacteriaceaefrom PHP, arbekacin and gentamicin (MIC50and MIC90, 0.25 to 1 and 1 to 8 μg/ml for both compounds) were generally more potent than tobramycin (MIC50and MIC90, 0.25 to 2 and 1 to 32 μg/ml) and amikacin (MIC50and MIC90, 1 to 2 and 2 to 32 μg/ml). Arbekacin also demonstrated potentin vitroactivity against a worldwide collection of well-characterized MDR Gram-negative and MRSA strains.

scholarly journals Avibactam Restores the Susceptibility of Clinical Isolates of Stenotrophomonas maltophilia to Aztreonam

2017 ◽  
Vol 61 (10) ◽  
Author(s):  
Maria F. Mojica ◽  
Krisztina M. Papp-Wallace ◽  
Magdalena A. Taracila ◽  
Melissa D. Barnes ◽  
Joseph D. Rutter ◽  
...  
Keyword(s):  
Stenotrophomonas Maltophilia ◽  
Opportunistic Pathogen ◽  
Multidrug Resistant ◽  
World Health ◽  
Combination Therapies ◽  
Content Type ◽  
Medical Need ◽  
The World ◽  
Health Organization

ABSTRACT Stenotrophomonas maltophilia is an emerging opportunistic pathogen, classified by the World Health Organization as one of the leading multidrug-resistant organisms in hospital settings. The need to discover novel compounds and/or combination therapies for S. maltophilia is urgent. We demonstrate the in vitro efficacy of aztreonam-avibactam (ATM-AVI) against S. maltophilia and kinetically characterize the inhibition of the L2 β-lactamase by avibactam. ATM-AVI overcomes aztreonam resistance in selected clinical strains of S. maltophilia, addressing an unmet medical need.

scholarly journals Comparison of Chromogenic Media for Recovery of Carbapenemase-Producing Enterobacteriaceae (CPE) and Evaluation of CPE Prevalence at a Tertiary Care Academic Medical Center

2014 ◽  
Vol 53 (2) ◽  
pp. 663-666 ◽  
Author(s):  
Morgan A. Pence ◽  
Tiffany Hink ◽  
Carey-Ann D. Burnham
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Performance Characteristics ◽  
Prevalence Study ◽  
Content Type ◽  
Academic Medical ◽  
Low Prevalence

We evaluated the performance characteristics of chromID CARBA and HardyCHROM Carbapenemase for the detection of carbapenemase-producingEnterobacteriaceae(CPE). A CPE prevalence study was conducted using chromID CARBA; this demonstrated that in low-prevalence settings, CPE screening agars may lack specificity, and confirmation of putative isolates is necessary.

scholarly journals Evaluation of the BioFire FilmArray Pneumonia Panel for Detection of Viral and Bacterial Pathogens in Lower Respiratory Tract Specimens in the Setting of a Tertiary Care Academic Medical Center

2020 ◽  
Vol 58 (7) ◽  
Author(s):  
Daniel M. Webber ◽  
Meghan A. Wallace ◽  
Carey-Ann D. Burnham ◽  
Neil W. Anderson
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Medical Center ◽  
Bacterial Pathogens ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Content Type ◽  
Standard Methods ◽  
Academic Medical ◽  
Tract Infections

ABSTRACT Our objective was to evaluate the diagnostic yield and accuracy of the BioFire FilmArray pneumonia panel (BFPP) for identification of pathogens in lower respiratory tract specimens (n = 200) from emergency department (ED) and intensive care unit (ICU) patients at a tertiary care academic medical center. Specimens were collected between January and November 2018, from patients ≥18 years of age, and culture was performed as part of standard-of-care testing. The BFPP identified a viral or bacterial target in 117/200 (58.5%) samples, including Staphylococcus aureus in 22% of samples and Haemophilus influenzae in 14%, and both a viral and bacterial target in 4% of samples. The most common viruses detected by BFPP were rhinovirus/enterovirus (4.5%), influenza A virus (3%), and respiratory syncytial virus (RSV) (2%). Overall, there was strong correlation between BFPP and standard methods for detection of viruses (99.2%) and bacteria (96.8%). Most bacteria (60/61 [98.4%]) detected by standard methods were also identified by BFPP, and 92 additional bacteria were identified by BFPP alone, including 22/92 (23.9%) additional S. aureus isolates and 25/92 (27.2%) H. influenzae isolates, which were more frequently discordant when detected at low concentrations (S. aureus, P < 0.001; H. influenzae, P < 0.0001) and in sputum-type specimens (S. aureus, P < 0.05). A potential limitation of the BFPP assay is the absence of fungal targets and Stenotrophomonas maltophilia, which were detected in 26 and 4 of 200 specimens, respectively. Real-time specimen analysis with BFPP has the potential to identify bacterial pathogens and resistance markers 44.2 and 56.3 h faster than culture-based methods. The BFPP is a rapid and accurate method for detection of pathogens from lower respiratory tract infections.

The Effect of Multiple Concurrent Central Venous Catheters on Central Line–Associated Bloodstream Infections

2014 ◽  
Vol 35 (9) ◽  
pp. 1140-1146 ◽  
Author(s):  
Cathleen Concannon ◽  
Edwin van Wijngaarden ◽  
Vanessa Stevens ◽  
Ghinwa Dumyati
Keyword(s):  
Risk Factor ◽  
Disease Severity ◽  
Independent Risk Factor ◽  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Central Line ◽  
Central Venous Catheters ◽  
Apache Ii ◽  
Central Venous

ObjectiveThe current central line–associated bloodstream infection (CLABSI) surveillance rate calculation does not account for multiple concurrent central venous catheters (CVCs). The presence of multiple CVCs creates more points of entry into the bloodstream, potentially increasing CLABSI risk. Multiple CVCs may be used in sicker patients, making it difficult to separate the relative contributions of multiple CVCs and comorbidities to CLABSI risk. We explored the relative impact of multiple CVCs, patient comorbidities, and disease severity on the risk of CLABSI.DesignCase-control study.SettingA total of 197 case patients and 201 control subjects with a CVC inserted during hospitalization at a tertiary care academic medical center from January 1, 2008, to December 31, 2010.MethodsMultiple CVCs was the exposure of interest; the primary outcome was CLABSI. Multivariable logistic regression was conducted to estimate odds ratios (ORs) and 95% confidence intervals (CIs) describing the association between CLABSI and multiple CVCs with and without controlling for Acute Physiology and Chronic Health Evaluation (APACHE) II and Charlson comorbidity index (CCI) scores as measures of disease severity and patient comorbidities, respectively.ResultsPatients with multiple CVCs (n = 78) showed a 4.2 (95% CI, 2.2–8.4) times greater risk of CLABSI compared with patients with 1 CVC after adjusting for CLABSI risk factors. When including APACHE II and CCI scores, multiple CVCs remained an independent risk factor for CLABSI (OR, 3.4 [95% CI, 1.7–6.9]).ConclusionsMultiple CVCs is an independent risk factor for CLABSI even after adjusting for severity of illness. Adjustment for this risk may be necessary to accurately compare rates between hospitals.Infect Control Hosp Epidemiol 2014;35(9):1140-1146

scholarly journals KPC-Producing, Multidrug-Resistant Klebsiella pneumoniae Sequence Type 258 as a Typical Opportunistic Pathogen

2013 ◽  
Vol 57 (10) ◽  
pp. 5144-5146 ◽  
Author(s):  
L. S. Tzouvelekis ◽  
V. Miriagou ◽  
S. D. Kotsakis ◽  
K. Spyridopoulou ◽  
E. Athanasiou ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Lethal Dose ◽  
Opportunistic Pathogen ◽  
Multidrug Resistant ◽  
Antimicrobial Treatment ◽  
Sequence Type ◽  
Content Type ◽  
Serum Killing

ABSTRACTThe virulence of a KPC-producingKlebsiella pneumoniaesequence type 258 (ST258) strain representing those circulating in Greece was assessed in a mouse septicemia model. The strain was virtually avirulent (50% lethal dose, >108and 5 × 107CFU for immunocompetent and neutropenic animals, respectively). Also, it was highly susceptible to serum killing, rapidly phagocytosedin vitro, and classified as K41, which is not among the virulent capsular types. The findings indirectly support the notion that high ST258-associated mortality is largely due to inefficient antimicrobial treatment.

Adherence to surgical antimicrobial prophylaxis: “checking-the-box” is not enough

2019 ◽  
Vol 32 (2) ◽  
pp. 470-473 ◽  
Author(s):  
Kunal Karamchandani ◽  
Kyle Barden ◽  
Jansie Prozesky
Keyword(s):  
Antimicrobial Prophylaxis ◽  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Antibiotic Administration ◽  
National Guidelines ◽  
Content Type ◽  
Surgical Antibiotic Prophylaxis ◽  
Surgical Antimicrobial Prophylaxis

PurposeThe purpose of this paper is to review surgical antimicrobial prophylaxis administration practices in a small cohort and assess compliance with national guidelines.Design/methodology/approachPatients that developed surgical site infections (SSI) in a tertiary care academic medical center over a two-year period were identified. Their electronic medical records were reviewed for compliance with national guidelines with respect to surgical antibiotic prophylaxis.FindingsOver a two-year period, 283 SSI patients were identified. An appropriate antibiotic was chosen in 80 percent, an appropriate dose was administered in 45 percent and timing complied in 89 percent. The antibiotics were appropriately re-dosed in only 9.2 percent in whom the requirement was met. The prescribing guidelines were adhered to in entirety in only 54 patients (23.8 percent).Practical implicationsTimely and appropriate antibiotic administration prior to surgery is essential to prevent SSI. Proper diligence is required to accomplish this task effectively.Originality/valueBased on the findings, it appears that merely, “checking a box” for antibiotic administration during surgery is not enough, and a multidisciplinary approach should be followed to ensure “appropriate” antibiotic administration.

scholarly journals Prevention of Biofilm Colonization by Gram-Negative Bacteria on Minocycline-Rifampin-Impregnated Catheters Sequentially Coated with Chlorhexidine

2013 ◽  
Vol 58 (2) ◽  
pp. 1179-1182 ◽  
Author(s):  
Mohamed A. Jamal ◽  
Joel S. Rosenblatt ◽  
Ray Y. Hachem ◽  
Jiang Ying ◽  
Egbert Pravinkumar ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Stenotrophomonas Maltophilia ◽  
Enterobacter Cloacae ◽  
Central Line ◽  
Multidrug Resistant ◽  
Gram Negative Bacteria ◽  
The Novel ◽  
Gram Negative ◽  
Content Type

ABSTRACTResistant Gram-negative bacteria are increasing central-line-associated bloodstream infection threats. To better combat this, chlorhexidine (CHX) was added to minocycline-rifampin (M/R) catheters. Thein vitroantimicrobial activity of CHX-M/R catheters against multidrug resistant, Gram-negativeAcinetobacter baumannii,Enterobacter cloacae,Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa, andStenotrophomonas maltophiliawas tested. M/R and CHX-silver sulfadiazine (CHX/SS) catheters were used as comparators. The novel CHX-M/R catheters were significantly more effective (P< 0.0001) than CHX/SS or M/R catheters in preventing biofilm colonization and showed better antimicrobial durability.

scholarly journals Epidemiology, Clinical Characteristics, and Antimicrobial Susceptibility Profiles of Human Clinical Isolates ofStaphylococcus intermediusGroup

2018 ◽  
Vol 56 (3) ◽  
Author(s):  
Melanie L. Yarbrough ◽  
William Lainhart ◽  
Carey-Ann D. Burnham
Keyword(s):  
Methicillin Resistance ◽  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Human Infection ◽  
Disk Diffusion ◽  
Diffusion Test ◽  
Disk Diffusion Test ◽  
Content Type

ABSTRACTThe veterinary pathogens in theStaphylococcus intermediusgroup (SIG) are increasingly recognized as causes of human infection. Shared features between SIG andStaphylococcus aureusmay result in the misidentification of SIG in human clinical cultures. This study examined the clinical and microbiological characteristics of isolates recovered at a tertiary-care academic medical center. From 2013 to 2015, 81 SIG isolates were recovered from 62 patients. Patients were commonly ≥50 years old, diabetic, and/or immunocompromised. Documentation of dog exposure in the electronic medical record was not common. Of the 81 SIG isolates, common sites of isolation included 37 (46%) isolates from wound cultures and 17 (21%) isolates from respiratory specimens. Although less common, 10 (12%) bloodstream infections were documented in 7 unique patients. The majority of SIG (65%) isolates were obtained from polymicrobial cultures. In comparison toS. aureusisolates from the same time period, significant differences were noted in proportion of SIG isolates that were susceptible to doxycycline (74% versus 97%, respectively;P< 0.001), trimethoprim-sulfamethoxazole (65% versus 97%, respectively;P< 0.001), and ciprofloxacin (78% versus 59%, respectively;P< 0.01). Methicillin resistance (MR) was detected in 12 (15%) of 81 SIG isolates. All MR isolates detected by an oxacillin disk diffusion test would have been misclassified as methicillin susceptible using a cefoxitin disk diffusion test. Thus, SIG is recovered from human clinical specimens, and distinction of SIG fromS. aureusis critical for the accurate characterization of MR status in these isolates.

Sign in / Sign up

Export Citation Format

Share Document