scholarly journals Public Health Efforts Can Impact Adoption of Current Susceptibility Breakpoints, but Closer Attention from Regulatory Bodies Is Needed

2018 ◽  
Vol 57 (3) ◽  
Author(s):  
James A. McKinnell ◽  
S. Bhaurla ◽  
P. Marquez-Sung ◽  
A. Pucci ◽  
M. Baron ◽  
...  
Keyword(s):  
Public Health ◽  
Patient Safety ◽  
Los Angeles ◽  
Antimicrobial Susceptibility ◽  
Los Angeles County ◽  
Susceptibility Testing ◽  
Clinical Care ◽  
Public Health Intervention ◽  
Antimicrobial Susceptibility Testing ◽  
Outreach Program

ABSTRACT Microbiological testing, including interpretation of antimicrobial susceptibility testing results using current breakpoints, is crucial for clinical care and infection control. Continued use of obsolete Enterobacteriaceae carbapenem breakpoints is common in clinical laboratories. The purposes of this study were (i) to determine why laboratories failed to update breakpoints and (ii) to provide support for breakpoint updates. The Los Angeles County Department of Public Health conducted a 1-year outreach program for 41 hospitals in Los Angeles County that had reported, in a prior survey of California laboratories, using obsolete Enterobacteriaceae carbapenem breakpoints. In-person interviews with hospital stakeholders and customized expert guidance and resources were provided to aid laboratories in updating breakpoints, including support from technical representatives from antimicrobial susceptibility testing device manufacturers. Forty-one hospitals were targeted, 7 of which had updated breakpoints since the prior survey. Of the 34 remaining hospitals, 27 (79%) assumed that their instruments applied current breakpoints, 17 (50%) were uncertain how to change breakpoints, and 10 (29%) lacked resources to perform a validation study for off-label use of the breakpoints on their systems. Only 7 hospitals (21%) were familiar with the FDA/CDC Antibiotic Resistance Isolate Bank. All hospitals launched a breakpoint update process; 16 (47%) successfully updated breakpoints, 12 (35%) received isolates from the CDC in order to validate breakpoints on their systems, and 6 (18%) were planning to update within 1 year. The public health intervention was moderately successful in identifying and overcoming barriers to updating Enterobacteriaceae carbapenem breakpoints in Los Angeles hospitals. However, the majority of targeted hospitals continued to use obsolete breakpoints despite 1 year of effort. These findings have important implications for the quality of patient care and patient safety. Other public health jurisdictions may want to utilize similar resources to bridge the patient safety gap, while manufacturers, the FDA, and others determine how best to address this growing public health issue.

Antimicrobial Resistance in Campylobacter, Salmonella, and Escherichia coli Isolated from Retail Grain-Fed Veal Meat from Southern Ontario, Canada

2011 ◽  
Vol 74 (8) ◽  
pp. 1245-1251 ◽  
Author(s):  
ANGELA COOK ◽  
RICHARD J. REID-SMITH ◽  
REBECCA J. IRWIN ◽  
SCOTT A. McEWEN ◽  
VIRGINIA YOUNG ◽  
...  
Keyword(s):  
Public Health ◽  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Tetracycline Resistance ◽  
Antimicrobial Susceptibility Testing ◽  
E Coli ◽  
Testing Resistance ◽  
Resistance Patterns

This study estimated the prevalence of Salmonella, Campylobacter, and Escherichia coli isolates in fresh retail grain-fed veal obtained in Ontario, Canada. The prevalence and antimicrobial resistance patterns were examined for points of public health significance. Veal samples (n = 528) were collected from February 2003 through May 2004. Twenty-one Salmonella isolates were recovered from 18 (4%) of 438 samples and underwent antimicrobial susceptibility testing. Resistance to one or more antimicrobials was found in 6 (29%) of 21 Salmonella isolates; 5 (24%) of 21 isolates were resistant to five or more antimicrobials. No resistance to antimicrobials of very high human health importance was observed. Ampicillin-chloramphenicol-streptomycin-sulfamethoxazole-tetracycline resistance was found in 5 (3%) of 21 Salmonella isolates. Campylobacter isolates were recovered from 5 (1%) of 438 samples; 6 isolates underwent antimicrobial susceptibility testing. Resistance to one or more antimicrobials was documented in 3 (50%) of 6 Campylobacter isolates. No Campylobacter isolates were resistant to five or more antimicrobials or category I antimicrobials. E. coli isolates were recovered from 387 (88%) of 438 samples; 1,258 isolates underwent antimicrobial susceptibility testing. Resistance to one or more antimicrobials was found in 678 (54%) of 1,258 E. coli isolates; 128 (10%) of 1,258 were resistant to five or more antimicrobials. Five (0.4%) and 7 (0.6%) of 1,258 E. coli isolates were resistant to ceftiofur and ceftriaxone, respectively, while 34 (3%) of 1,258 were resistant to nalidixic acid. Ciprofloxacin resistance was not detected. There were 101 different resistance patterns observed among E. coli isolates; resistance to tetracycline alone (12.7%, 161 of 1,258) was most frequently observed. This study provides baseline prevalence and antimicrobial resistance data and highlights potential public health concerns.

scholarly journals CIM City: the Game Continues for a Better Carbapenemase Test

2019 ◽  
Vol 57 (7) ◽  
Author(s):  
Romney M. Humphries
Keyword(s):  
Antimicrobial Susceptibility ◽  
Clinical Microbiology ◽  
Susceptibility Testing ◽  
Clinical Care ◽  
Antimicrobial Susceptibility Testing ◽  
European Committee ◽  
Link Type ◽  
Clinical Laboratories ◽  
The Right

ABSTRACT The Clinical and Laboratory Standards Institute and European Committee on Antimicrobial Susceptibility Testing agree that carbapenemase testing is not necessary for clinical care, provided that the laboratory is up to date with current breakpoints. Nonetheless, publication on the development and modification of carbapenemase tests continues, as is the case in this issue of the Journal of Clinical Microbiology (R. W. Beresford and M. Maley, J Clin Microbiol 57:e01852-18, 2019, https://doi.org/10.1128/JCM.01852-18). This commentary explores modifications to the carbapenem inactivation method—but is this the right focus for clinical laboratories?

scholarly journals External Quality Assessment of Bacterial Identification and Antimicrobial Susceptibility Testing in African National Public Health Laboratories, 2011–2016

2019 ◽  
Vol 4 (4) ◽  
pp. 144 ◽  
Author(s):  
Olga Perovic ◽  
Ali A. Yahaya ◽  
Crystal Viljoen ◽  
Jean-Bosco Ndihokubwayo ◽  
Marshagne Smith ◽  
...  
Keyword(s):  
Public Health ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
External Quality Assessment ◽  
Antimicrobial Susceptibility Testing ◽  
Bacterial Identification ◽  
African Region ◽  
External Quality ◽  
Bacterial Diseases ◽  
National Public Health

Background: In 2002, the World Health Organization (WHO) launched a regional microbiology external quality assessment (EQA) programme for national public health laboratories in the African region, initially targeting priority epidemic-prone bacterial diseases, and later including other common bacterial pathogens. Objectives: The aim of this study was to analyse the efficacy of an EQA programme as a laboratory quality system evaluation tool. Methods: We analysed the proficiency of laboratories’ performance of bacterial identification and antimicrobial susceptibility testing (AST) for the period 2011–2016. The National Institute for Communicable Diseases of South Africa provided technical coordination following an agreement with WHO, and supplied EQA samples of selected bacterial organisms for microscopy (Gram stain), identification, and antimicrobial susceptibility testing (AST). National public health laboratories, as well as laboratories involved in the Invasive Bacterial Diseases Surveillance Network, were enrolled by the WHO Regional Office for Africa to participate in the EQA programme. We analysed participants’ results of 41 surveys, which included the following organisms sent as challenges: Streptococcus pneumonia, Haemophilus influenzae, Neisseria meningitidis, Salmonella Typhi, Salmonella Enteritidis, Shigella flexneri, Staphylococcus aureus, Streptococcus agalactiae, Streptococcus anginosus, Enterococcus faecium, Serratia marcescens, Acinetobacter baumannii, and Enterobacter cloacae. Results: Eighty-one laboratories from 45 countries participated. Overall, 76% of participants obtained acceptable scores for identification, but a substantial proportion of AST scores were not in the acceptable range. Of 663 assessed AST responses, only 42% had acceptable scores. Conclusion: In the African Region, implementation of diagnostic stewardship in clinical bacteriology is generally suboptimal. This report illustrates that AST is poorly done compared to microscopy and identification. It is critically important to make the case for implementation of quality assurance in AST, as it is the cornerstone of antimicrobial resistance surveillance reporting and implementation of the Global Antimicrobial Resistance Surveillance System.

scholarly journals Nasal carriage rate and antimicrobial resistance pattern of Staphylococcus aureus among the food handlers in Canton Sarajevo, Bosnia and Herzegovina

2020 ◽  
Author(s):  
Sabina Šegalo ◽  
Daniel Maestro ◽  
Zarema Obradović ◽  
Anes Jogunčić
Keyword(s):  
Public Health ◽  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Bosnia And Herzegovina ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Nasal Carriage ◽  
Antimicrobial Susceptibility Testing ◽  
Food Handlers ◽  
Carriage Rate

Introduction: The nasals and hand carriage of Staphylococcus aureus in food handlers (FHs) represent a significant source of Staphylococcal food contamination and food poisoning. Antimicrobial resistance (AMR) is a microorganism’s ability to resist the action of one or more antimicrobial agents. S. aureus has demonstrated the ability to rapidly respond to each new antimicrobial with the development of a resistance mechanism. The aim of the study was to assess the prevalence of nasal carriage rate and AMR pattern of isolated strains S. aureus among FHs in Canton Sarajevo, Bosnia and Herzegovina. Methods: The retrospective study included laboratory results of 11.139 tested subjects between January 2014 and December 2018. The study was conducted in the laboratory of the Institute of Public Health of the Federation of Bosnia and Herzegovina in Sarajevo. Samples of nasal swabs were collected from FHs, employees in companies located in Canton Sarajevo, during sanitary surveillance prescribed by applicable legal standards. S. aureus isolates were identified according to conventional microbiological methods and antimicrobial susceptibility testing was performed by the agar disk diffusion method according to the European Committee on Antimicrobial Susceptibility Testing; 2013 standard. Results: Among the 11.138 subjects, 792 (7.1%) were carriers of S. aureus. Isolated strains were tested on eight different antibiotics, and the resistance to penicillin, ampicillin, and amoxicillin was 788 (99.5%), 776 (97.9%), and 752 (94.9%), retrospectively. In total, 86.36% of isolated strains were multidrug-resistant. Conclusions: The low percentage of S. aureus carriers indicates that preventive measures of carrier control are being actively implemented within the legally prescribed measures. The emergence of numerous isolated strains with multidrug-resistance characteristics is a significant public health problem and consequently limits the range of antibiotics available for therapeutic purposes. The results of this research indicate that AMR has increased in Sarajevo Canton and it is following the trend of global growth.

scholarly journals Identification and Antimicrobial Susceptibility Testing of Campylobacter Using a Microfluidic Lab-on-a-Chip Device

2020 ◽  
Vol 86 (9) ◽  
Author(s):  
Luyao Ma ◽  
Marlen Petersen ◽  
Xiaonan Lu
Keyword(s):  
Public Health ◽  
Microfluidic Device ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Color Change ◽  
Lab On A Chip ◽  
Antimicrobial Susceptibility Testing ◽  
Antibiotic Resistant ◽  
Content Type ◽  
On Chip

ABSTRACT Campylobacter spp. have been recognized as major foodborne pathogens worldwide. An increasing frequency of antibiotic-resistant pathogens, including Campylobacter spp., have been identified to transmit from food products to humans and cause severe threats to public health. To better mitigate the antibiotic resistance crisis, rapid detection methods are required to provide timely antimicrobial resistance surveillance data for agri-food systems. Herein, we developed a polymer-based microfluidic device for the identification and antimicrobial susceptibility testing (AST) of Campylobacter spp. An array of bacterial incubation chambers were created in the microfluidic device, where chromogenic medium and antibiotics were loaded. The growth of Campylobacter spp. was visualized by color change due to chromogenic reactions. This platform achieved 100% specificity for Campylobacter identification. Sensitive detection of multiple Campylobacter species (C. jejuni, C. coli, and C. lari) was obtained in artificially contaminated milk and poultry meat, with detection limits down to 1 × 102 CFU/ml and 1 × 104 CFU/25 g, respectively. On-chip AST determined Campylobacter antibiotic susceptibilities by the lowest concentration of antibiotics that can inhibit bacterial growth (i.e., no color change observed). High coincidences (91% to 100%) of on-chip AST and the conventional agar dilution method were achieved against several clinically important antibiotics. For a presumptive colony, on-chip identification and AST were completed in parallel within 24 h, whereas standard methods, including biochemical assays and traditional culture-based AST, take several days for multiple sequential steps. In conclusion, this lab-on-a-chip device can achieve rapid and reliable detection of antibiotic-resistant Campylobacter spp. IMPORTANCE Increasing concerns of antibiotic-resistant Campylobacter spp. with regard to public health emphasize the importance of efficient and fast detection. This study described the timely identification and antimicrobial susceptibility testing of Campylobacter spp. by using a microfluidic device. Our developed method not only reduced the total analysis time, but it also simplified food sample preparation and chip operation for end users. Due to the miniaturized size of the lab-on-a-chip platform, the detection was achieved by using up to 1,000 times less of the reagents than with standard reference methods, making it a competitive approach for rapid screening and surveillance study in food industries. In addition, multiple clinically important Campylobacter species (C. jejuni, C. coli, and C. lari) could be tested by our device. This device has potential for wide application in food safety management and clinical diagnostics, especially in resource-limited regions.

scholarly journals 668. Rapid Identification and Antimicrobial Susceptibility Testing of Gram-Negative Rod Bacteremia: Impact on Duration of Hospital Admission

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S389-S389
Author(s):  
Ralph Rogers ◽  
Giannoula Tansarli ◽  
Diane Parente ◽  
Amy Brotherton ◽  
Rajeev Shah ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Hospital Admissions ◽  
Clinical Care ◽  
Rapid Identification ◽  
Blood Cultures ◽  
Antimicrobial Susceptibility Testing ◽  
Historical Cohort ◽  
Hospital System ◽  
Gram Negative

Abstract Background There are many emerging diagnostic technologies that provide rapid identification (ID) and antimicrobial susceptibility testing (AST) of blood cultures after initial microbial growth is detected. The clinical utility of having these results sooner than standard of care (SOC) ID/AST testing is less clear; one potential advantage would be shorter hospital admissions for those patients with less severe infections whose discharge planning is delayed while waiting for ID/AST results. Methods The Accelerate Pheno™ rapid ID/AST system (AP) was implemented in the clinical microbiology lab at two hospitals within our academic hospital system to run in parallel with our SOC ID/AST diagnostics for all blood cultures with Gram-negative rod (GNR) bacterial growth on initial Gram stain. Results of both diagnostic assays were uploaded to the medical record when available; our antimicrobial stewardship (AS) team discussed the AP results with clinical care teams during working hours. Length of stay (LOS) data was compared between a cohort with GNR bacteremia before and after the implementation of AP testing with AS review. Results There were 207 patients with GNR bacteremia admitted to the hospital during the first six months after implementation of AP testing with AS review (12/2019 – 05/2020). A historical cohort of 96 patients with GNR bacteremia (admitted 01/2018 – 08/2018) with SOC testing without AS review was used for comparison. Median LOS was 5.28 and 5.84 days for the AP and SOC cohorts, respectively; the distribution in the two groups differed significantly (Mann-Whitney U = 8728.5, p = 0.0446). There was also an increase in the percent of admissions shorter than 2 days between the AP and SOC cohorts (12.5% v. 5.2%, p = 0.024) [Figure1]. Figure 1 Conclusion The use of a rapid ID/AST diagnostic technology with AS review may lead to shorter hospitalizations in select patient populations. Disclosures Kimberle Chapin, MD, genmark (Scientific Research Study Investigator)

Pretreatment antimicrobial susceptibility testing is cost saving in the eradication of

2003 ◽  
Vol 1 (4) ◽  
pp. 273-278 ◽  
Author(s):  
Marco Romano ◽  
Riccardo Marmo ◽  
Antonio Cuomo ◽  
Teresa De Simone ◽  
Caterina Mucherino ◽  
...  
Keyword(s):  
Cost Saving ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Antimicrobial Susceptibility Testing

NGHIÊN CỨU SỰ NHẠY CẢM VỚI KHÁNG SINH CỦA MỘT SỐ CHỦNG VI KHUẨN GÂY VIÊM ĐƯỜNG HÔ HẤP CẤP Ở TRẺ EM DƯỚI 6 TUỔI TẠI BỆNH VIỆN NHI THANH HÓA 2009 - 2014

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Hoai Do Ngoc
Keyword(s):  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Antimicrobial Susceptibility Testing ◽  
High Rate ◽  
Isolation Rate

From 43.574 fluid nasopharynx speciments of  the chidren inpatient under six we isolated total 21.769 types bacteria with isolation rate : 49.95%. In which the highest isolation rate for H. influenza, S. pneumoniae and M. catarrhalis were 13,94%; 7,11%; 1,43% respectively. Antimicrobial susceptibility testing shown all the types of  for H. influenza, S. pneumoniae and M. catarrhalis good susses to Fosphomycine, S. pneumoniae and M. catarrhalis good susses to Imipenem, H. influenza good susses to Azithromycine, S. pneumoniae good susses to Penicilline and Piperacilline, M. catarrhalis good susses to Tobramycine and Ofloxacine. All of  H. influenza, S. pneumoniae and M. catarrhalis were reported resistance to Tri/Sulpha, Chloramphenicol, Erythromycine in high rate.

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