scholarly journals Control of Multidrug Resistant Pseudomonas Aeruginosa through Hospital Construction Design and Extensive Environmental and Clinical Surveillance in an Allogeneic Transplantat Unit

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1137-1137
Author(s):  
Annelene Kossow ◽  
Frank Kipp ◽  
Gerda Silling ◽  
Andreas H Groll ◽  
Claudia Rössig ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Nosocomial Infections ◽  
Conflicts Of Interest ◽  
Genetic Relationships ◽  
Multidrug Resistant ◽  
Environmental Sampling ◽  
Aerosol Formation ◽  
Bacterial Strains ◽  
Construction Design ◽  
Clinical Surveillance

Abstract Introduction: Immunocompromised patients are increasingly threatened by multidrug resistant bacterial strains. Following allogeneic stem cell transplantation (SCT), patients are especially at risk for multidrug resistant Pseudomonas aeruginosa (MRPA) which as a pathogen can be the cause of life-threatening septicemias. A possible reservoir and source of nosocomial infections are biofilms in shower drains, sinks, and toilets. For this reason, substantial targeted renovation was performed in the bathrooms of our SCT unit. We subsequently performed extensive surveillance of patients status as carriers and took numerous environmental samples. Methods: Renovation/ conversion works of our transplant unit (2 wards with 20 HEPA filtered patients rooms, all equipped with separate shower baths) began in 2011 and included the installation of Pall-Aquasafe water filters (Pall Cooperation, Port Washington, NY) on all faucet and shower heads. Washbasins were equipped with Biorec Disinfection siphons (MoveoMed, Radebeul, Germany), which use UV and temperature together with frequent vibration and a bactericidal coating for disinfection. In addition, the toilets were replaced with rimless toilet basins and a system was developed to supply the flushing water with disinfectant at appropriate concentrations. The shower outlet drains were modified and covered by a heavy metal lid that cannot be easily removed and prevents aerosol formation. All renovation work was completed in April 2014. Cleaning and disinfection takes place once a day and the removable metal devices of the showers are sterilized once a week as well as every time a patient is discharged. In addition, extensive training of all personal in infection prevention was performed and the work of the cleaning personal was supervised closely. Environmental sampling was performed monthly in every room. Patients were screened upon admission and weekly during their treatment on the SCT unit by either anal swabs or stool cultures. Standard antibiotic prophylaxis consisted of ciprofloxacin and metronidazole for patients undergoing allogeneic SCT. Metronidazole prophylaxis was omitted in August 2013. Results: Peri-renovation environmental sampling detected MRPA in 22,6% of swabs from the toilets and 11,8% of swabs from the shower outlets in 2012. The rate decreased to 15,1% from the toilets and 4,4% from the shower outlets in 2013 and reached 10,1% from the toilets and 0,6% from the shower outlets in the first six months of 2014. In 2012, 15 out of 197 patients (7.6%), receiving an allogeneic SCT or treatment for severe post-transplant complications (mainly GvHD) were affected by MRPA. This number decreased to 13 out of 206 (6.3%) in 2013 and 2 out of 95 (2.1%) in the first half in 2014. Overall 18 patients (3.6%) were colonized only and 12 patients (2.4%) developed bacteremia from MRPA. Discussion: Environmental sources must be taken into consideration for the prevention of nosocomial infections. The implemented measures in our transplant unit can serve as an example for the reduction of biofilm, which can act as a reservoir for MRPA. Because of inconsistent local conformity of environmental and clinical isolates it still remains unclear whether the reason for colonisation and infection lays in environmental contamination and / or antibiotic selection in already precolonized patients. Further investigations will employ MRPA genotyping to determine genetic relationships between isolates from patients and environmental isolates. Disclosures No relevant conflicts of interest to declare.

scholarly journals Antimicrobial Activity of Cyclic-Monomeric and Dimeric Derivatives of the Snail-Derived Peptide Cm-p5 against Viral and Multidrug-Resistant Bacterial Strains

Biomolecules ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 745
Author(s):  
Melaine González-García ◽  
Fidel Morales-Vicente ◽  
Erbio Díaz Pico ◽  
Hilda Garay ◽  
Daniel G. Rivera ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antimicrobial Activity ◽  
Antifungal Activity ◽  
Multidrug Resistant ◽  
Moderate Activity ◽  
Dependent Manner ◽  
Bacterial Strains ◽  
Acinetobacter Baumanii ◽  
Concentration Dependent Manner ◽  
Conventional Antibiotics

Cm-p5 is a snail-derived antimicrobial peptide, which demonstrated antifungal activity against the pathogenic strains of Candida albicans. Previously we synthetized a cyclic monomer as well as a parallel and an antiparallel dimer of Cm-p5 with improved antifungal activity. Considering the alarming increase of microbial resistance to conventional antibiotics, here we evaluated the antimicrobial activity of these derivatives against multiresistant and problematic bacteria and against important viral agents. The three peptides showed a moderate activity against Pseudomonas aeruginosa, Klebsiella pneumoniae Extended Spectrum β-Lactamase (ESBL), and Streptococcus agalactiae, with MIC values > 100 µg/mL. They exerted a considerable activity with MIC values between 25–50 µg/mL against Acinetobacter baumanii and Enterococcus faecium. In addition, the two dimers showed a moderate activity against Pseudomonas aeruginosa PA14. The three Cm-p5 derivatives inhibited a virulent extracellular strain of Mycobacterium tuberculosis, in a dose-dependent manner. Moreover, they inhibited Herpes Simplex Virus 2 (HSV-2) infection in a concentration-dependent manner, but had no effect on infection by the Zika Virus (ZIKV) or pseudoparticles of Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2). At concentrations of >100 µg/mL, the three new Cm-p5 derivatives showed toxicity on different eukaryotic cells tested. Considering a certain cell toxicity but a potential interesting activity against the multiresistant strains of bacteria and HSV-2, our compounds require future structural optimization.

scholarly journals In Vitro Bactericidal Activity of Human β-Defensin 3 against Multidrug-Resistant Nosocomial Strains

2006 ◽  
Vol 50 (2) ◽  
pp. 806-809 ◽  
Author(s):  
Giuseppantonio Maisetta ◽  
Giovanna Batoni ◽  
Semih Esin ◽  
Walter Florio ◽  
Daria Bottai ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Antimicrobial Activity ◽  
Bactericidal Activity ◽  
Stenotrophomonas Maltophilia ◽  
Bactericidal Effect ◽  
Multidrug Resistant ◽  
Bacterial Strains ◽  
Gram Negative

ABSTRACT The antimicrobial activity of human β-defensin 3 (hBD-3) against multidrug-resistant clinical isolates of Staphylococcus aureus, Enterococcus faecium, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, and Acinetobacter baumannii was evaluated. A fast bactericidal effect (within 20 min) against all bacterial strains tested was observed. The presence of 20% human serum abolished the bactericidal activity of hBD-3 against gram-negative strains and reduced the activity of the peptide against gram-positive strains.

scholarly journals Frequency and Antimicrobial Susceptibility Pattern of Pseudomonas Aeruginosa in Human Pus Samples at Holy Family Hospital Rawalpindi

2021 ◽  
Vol 6 (1) ◽  
pp. 1-8
Author(s):  
Kazmi A
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Nosocomial Infections ◽  
Antibiotic Susceptibility ◽  
Antimicrobial Agents ◽  
Antibiotic Sensitivity ◽  
Recovery Process ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Resistant Strains

Background: Nosocomial infections are great threat for hospitalized patients and Pseudomonas aeruginosa has emerged as one of the most potent nosocomial pathogens along with its diverse mechanisms to counter the various antimicrobial agents such as aminoglycosides, fluoroquinolones, monobactems, third generation cephalosporins, carbapenams and broad- spectrum penicillins. P. aeruginosa is one of the well-known pyogenic bacteria and is 3rd leading cause of pyogenic infections with the variable frequency depending on geographical region and clinical setting. P. aeruginosa is intimately associated with pyogenic nosocomial infections. Objectives: Since multidrug resistant strains of P. aeruginosa have posed serious threats and are frequently implicated in nosocomial infections. Methods: Pus swab were sampled under aseptic conditions and cultured on blood and Muller Hinton agar. Gram reaction, pigment production, Oxidase, indole reaction and citrate test were used to confirm isolate. Antibiotic susceptibility was performed b Kirby Bauer technique. Results compiled by us in this cross sectional study, showed 58 cases of P. aeruginosa out of 289 cases. This included 43% males and 57% females. Majority of the patients were of young age, with mean age 38 years. Antibiotic sensitivity revealed resistance to gentamicin was 50%, amikacin was 64%, ciprofloxacin and Aztronem 66%, Cefaparazone 69%, Tzaocin 71% and meropenem and sulzone was 79%. While Colistin and Ceftazidime were the most effective in 85% and 89% of cases respectively. The multidrug resistant strains of P. aeruginosa infections accounted for 32.76% of total P. aeruginosa infections. This study reveals high prevalence of multidrug resistant organisms at the set of our study. Based on this study, we suggest adopting the strategies to minimize the risk of nosocomial infections to slow down the rapidly growing multidrug resistance. These strategies may include, stricter antiseptic measures, fastening the recovery process and reducing the hospital stay and considering other alternates. Besides this, we would like to suggest the precise use of antibiotic susceptibility facility to reduce the nosocomial infection associated complications.

scholarly journals Weekly Screening for Multidrug-Resistant Organisms Identifies High Number of Colonizations in Patients Undergoing Stem Cell Transplantation

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5703-5703
Author(s):  
Silvia Monsalvo ◽  
Pascual Balsalobre ◽  
Nieves Dorado Herrero ◽  
Laura Solán ◽  
Ana Fernandez-Cruz ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Stem Cell ◽  
Infection Control ◽  
Conflicts Of Interest ◽  
Urine Culture ◽  
Control Strategies ◽  
Multidrug Resistant ◽  
Febrile Episode ◽  
Cell Transplant ◽  
Multidrug Resistant Organisms

Abstract Introduction: Multidrug-resistant organisms (MDRO) are a challenge in patients undergoing stem cell transplant (SCT) which often result in an increase in mortality. To our knowledge, current literature defines only screening at the time of work-up for SCT-patients. The aims of the study were to assess the rate of MDRO colonization with weekly screening, rate of infection and the associated mortality in patients undergoing SCT. Patients and methods: Consecutive patients admitted at the SCT unit between January-18 to July-18 were reviewed in our institution. Screening consisted of rectal and perineal swab on admission and weekly until the date of discharge. In case of detection of MDRO , patients were isolated and infection control strategies were applied. Results: 41 patients were analysed, with 47 admissions, 6 patients had 2 admissions. The median duration of hospitalization was 27 days/patient (range 8-100). 168 rectal-and perineal swab were performed with a median of 3 swabs/patient (range 1-7). Patient characteristics are shown in Table 1. 36 patients (87%) spiked fever in a median of 8,5 days after admission (1-38days). 24,4% (n=10) had a positive screening: 2/10 patients at baseline and 8/10 patients (80%) were detected for the first time beyond baseline screen. Rate of MDRO colonization was 3% per week (95%CI 1.4-5.4). MDRO identified were : 4 patients with Extended-spectrum beta-lactamases producing E. Coli (ESBL-EC), Multidrug-resistant (MR) Pseudomonas aeruginosa (n=3), Vancomycin-resistant Enterococci (n=2) and 1 patient with carbapenem-resistant Citrobacter freundii. 6/10 patients developed MDRO infection (60%), all with previous MDRO positive detection: MR-Pseudomonas aeruginosa in urine culture (n=3) 2 treated with ceftolozane/tazobactam, 1 with meropenem+amikacin; ESBL-EC in urine culture (n=2) both treated with meropenem and 1 with Klebsiella pneumoniae carbapenemase in urine culture treated with ceftazidime/avibactam. The infection rate was 4,6% (95% CI 3.9-5.2). In 80% patients (n=8) antibiotic treatment was guided by positive screening, 3 patients were admitted to intensive care unit for sepsis. No mortality was associated to MDRO. In 76%of patients (n=28) screening was negative for MDRO. 24/28 (85%) spiked fever with a median of 10 days after admission (1-38days). None MDRO-infections in negative-screened patients were detected. Conclusions : Weekly screening for MDRO identified a high number of MDRO colonizations allowing to apply early strategies of infection control in high risk patients . Besides, MDRO infection occurred only in patients previously colonized, therefore, 80% of our cohort could benefit from guided treatment by the time of the febrile episode. Early identification of MDRO colonization might have helped to reduce MDRO related mortality. However, these findings should be confirmed with further studies, comparing baseline with weekly MDRO screening strategies. Disclosures No relevant conflicts of interest to declare.

scholarly journals Combined Resistance to Ceftolozane-Tazobactam and Ceftazidime-Avibactam in Extensively Drug-Resistant (XDR) and Multidrug-Resistant (MDR) Pseudomonas aeruginosa: Resistance Predictors and Impact on Clinical Outcomes besides Implications for Antimicrobial Stewardship Programs

Antibiotics ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. 1224
Author(s):  
Marianna Meschiari ◽  
Gabriella Orlando ◽  
Shaniko Kaleci ◽  
Vincenzo Bianco ◽  
Mario Sarti ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antimicrobial Stewardship ◽  
Multivariable Analysis ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Attributable Mortality ◽  
Retrospective Case ◽  
Comorbidity Score ◽  
Charlson Comorbidity Score ◽  
Clinical Surveillance

A retrospective case-control study was conducted at Modena University Hospital from December 2017 to January 2019 to identify risk factors and predictors of MDR/XDR Pseudomonas aeruginosa (PA) isolation with resistance to ceftazidime/avibactam (CZA) and ceftolozane/tazobactam (C/T), and of mortality among patients infected/colonized. Among 111 PA isolates from clinical/surveillance samples, 60 (54.1%) were susceptible to both drugs (S-CZA-C/T), while 27 (24.3%) were resistant to both (R-CZA-C/T). Compared to patients colonized/infected with S-CZA-C/T, those with R-C/T+CZA PA had a statistically significantly higher Charlson comorbidity score, greater rate of previous PA colonization, longer time before PA isolation, more frequent presence of CVC, higher exposure to C/T and cephalosporins, longer hospital stay, and higher overall and attributable mortality. In the multivariable analysis, age, prior PA colonization, longer time from admission to PA isolation, diagnosis of urinary tract infection, and exposure to carbapenems were associated with the isolation of a R-C/T+CZA PA strain, while PA-related BSI, a comorbidity score > 7, and ICU stay were significantly associated with attributable mortality. C/T and CZA are important therapeutic resources for hard-to-treat PA-related infections, thus specific antimicrobial stewardship interventions should be prompted in order to avoid the development of this combined resistance, which would jeopardize the chance to treat these infections.

scholarly journals Bactericidal Capacity of a Heterogeneous TiO2/ZnO Nanocomposite against Multidrug-Resistant and Non-Multidrug-Resistant Bacterial Strains Associated with Nosocomial Infections

ACS Omega ◽  
2020 ◽  
Vol 5 (21) ◽  
pp. 12027-12034 ◽  
Author(s):  
Nor Hazliana Harun ◽  
Rabiatul Basria S. M. N. Mydin ◽  
Srimala Sreekantan ◽  
Khairul Arifah Saharudin ◽  
Norfatehah Basiron ◽  
...  
Keyword(s):  
Nosocomial Infections ◽  
Multidrug Resistant ◽  
Bacterial Strains ◽  
Bactericidal Capacity

scholarly journals 2151. Biofilm and Metallo-β-Lactamase (MBL) Production Among Imipenem-Resistant Pseudomonas aeruginosa and Acinetobacter spp.

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S729-S730
Author(s):  
Yang Metok ◽  
Supram Hosuru Subramanya ◽  
Upendra Thapa Shrestha ◽  
Leandro Reus Rodrigues Perez ◽  
Nabaraj Adhikari ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Hospital Setting ◽  
Polymyxin B ◽  
Microtiter Plate ◽  
Multidrug Resistant ◽  
High Rate ◽  
Bacterial Strains ◽  
Microbiological Techniques ◽  
Acinetobacter Spp ◽  
Imipenem Resistance

Abstract Background Pseudomonas aeruginosa and Acinetobacter spp. head the list of hospital-acquired infections. Resistance to carbapenem as reserve drug is under threat with the emergence of Metallo-β-lactamase (MBL) and biofilm producing bacterial strains. This study was thus undertaken to determine the rate of MBL and biofilm production among imipenem-resistant P. aeruginosa (IRPA) and imipenem-resistant Acinetobacter spp. (IRAS) isolates. Methods A total of 79 P. aeruginosa and 117 Acinetobacter spp. were isolated from different clinical specimens of patients visiting Manipal Teaching Hospital, Pokhara Nepal from July 2016 to January 2017. Isolation, identification and antibiotic susceptibility testing of the isolates were performed by standard microbiological techniques. Combined disc test and Epsilometer test (E-test) were employed to detect MBL in IRPA and IRAS isolates. Microtiter plate using crystal violet method was employed for detection of biofilm in imipenem-resistant isolates. Results 9 (11.4%) of P. aeruginosa and 49 (41.9%) of Acinetobacter spp. were Multidrug Resistant (MDR). Similarly, 22 (27.8%) of P. aeruginosa and 23 (19.7%) of Acinetobacter spp. were Extensively Drug Resistant (XDR). Imipenem resistance was detected among 15 (19%) P. aeruginosa and 57 (48.7%) Acinetobacter spp. isolates. 8 (53.3%) of IRPA and 22 (38.6%) of IRAS isolates were MBL producers while all (100%) of IRPA and 47 (82.5%) of IRAS were biofilm producers. All the biofilm producer IRPA isolates were XDR and 62.5% of XDR IRAS strains were moderate biofilm producers. However, 80% of IRPA, 49.1% of IRAS and 63% of both MBL producer isolates were weak biofilm formers. Polymyxin B and ampicillin-sulbactam showed a better degree of susceptibility against MBL cum biofilm producer IRPA and IRAS isolates respectively. Conclusion The study showed high propensity of IRPA and IRAS to form biofilm, which is strongly associated with higher drug resistance. Such high rate of MBL and biofilm producing P. aeruginosa and Acinetobacter spp. alarms the rapid spread of such strains in our hospital setting. Disclosures All authors: No reported disclosures.

scholarly journals Surveillance of bacteria Pseudomonas aeruginosa and MRSA associated with acute suppurative otitis media (ASOM)

2017 ◽  
Vol 6 (1) ◽  
pp. 69 ◽  
Author(s):  
Kundan K. Sahu ◽  
Siba N. Rath ◽  
Rabindra N. Padhy ◽  
Rajashree Panigrahi
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Otitis Media ◽  
Bacterial Infections ◽  
Multidrug Resistant ◽  
Coagulase Negative Staphylococcus ◽  
Bacterial Strains ◽  
Suppurative Otitis Media ◽  
Intracranial Complications ◽  
Susceptibility Rate ◽  
Middle Ear Cleft

Background: Otitis media particularly with suppuration is a critical disease-causing perforation of the tympanic membrane associated with changes of the mucoperiosteum of the middle ear cleft. This surveillance includes isolation and antibiotic profiles of causative bacteria from ear discharges of patients in 3years attending outpatients of a hospital.Methods: Bacterial strains were grown in suitable media and were subjected to antibiotic profiling by the Kirby-Bauer’s method with most antibiotics of the day.Results: In total there were 1164 colonies with 1043 bacterial and 121 fungal isolates from 1230 ear discharge samples. Among 371 Pseudomonas aeruginosa isolates, tobramycin 30 µg/disk had the highest susceptibility rate as 93.2%, followed by ceftazidime 30µg/disk 91.5% and amikacin 10µg/disk 64.4%. From 359 Staphylococcus isolates, there were 236 coagulase negative Staphylococcus (CONS) + methicillin sensitive S. aureus (MSSA) and 123 methicillin resistant S. aureus (MRSA). Staphylococcus including MRSA isolates were most susceptibility to cloxacillin 15µg/disk 95.2%, followed by erythromycin 15µg/disk 83.3% and gentamicin 30µg/disk 78.5%. Of 1164, 49 patients presented post aural abscess, 12 patients had intracranial complications, 9 patients had facial palsy and 3 patients had labyrinthitis.Conclusions: Isolated bacteria, P. aeruginosa and MRSA were multidrug resistant. P. aeruginosa was most common followed by S. aureus. More than 90% P. aeruginosa and 90% S. aureus isolates were sensitive to tobramycin 30 µg/disk and cloxacillin 30 µg/disk, respectively. Therefore, these two antibiotics may be included in the formulary regimen to overcome bacterial infections involved in ASOM.

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