scholarly journals Characterization of post-surgical critical patients with infections associated with healthcare after prolonged perfusion of remifentanil

2018 ◽  
Vol 64 (8) ◽  
pp. 736-742
Author(s):  
José Luis Bonilla García ◽  
Manuel Cortiñas Sáenz ◽  
Esperanza del Pozo Gavilán
Keyword(s):  
Mechanical Ventilation ◽  
Pseudomonas Aeruginosa ◽  
Multiple Drug Resistance ◽  
Multiple Drug ◽  
Healthcare Associated Infections ◽  
Surgical Critical Care ◽  
Extended Spectrum Beta Lactamases ◽  
Critical Patients ◽  
Healthcare Associated ◽  
Epidemiological Characteristics

SUMMARY INTRODUCTION Healthcare associated infections (HAI) are the most frequent complication of hospitalized patients. The aim of this study was to describe the clinical and epidemiological characteristics of critically ill post-surgical patients with a diagnosis of healthcare associated infections, after a pattern of sedoanalgesia of at least 4 days. METHODS All patients over 18 years of age with a unit admission of more than 4 days were consecutively selected. The study population was the one affected by surgical pathology where sedation was based as analgesic the opioid remifentanil for at least 96 hours in continuous perfusion. Patients who died during admission to the unit and those with combined analgesia (peripheral or neuroaxial blocks) were excluded. Data analysis was performed using the statistical package Stata version 7.0. RESULTS The patients admitted to the Post-Surgical Critical Care Unit (PCU) during study were 1789 and the population eligible was comprised of 102 patients. 56.86% of patients suffered IACS. The most frequent IACS was pneumonia associated with mechanical ventilation (30.96 per 1000 days of mechanical ventilation), Pseudomonas aeruginosa being the most frequently isolated germ. The germs with the greatest involvement in multiple drug resistance (MDROs) were enterobacteria, mainly Klebsiella pneumoniae resistant to extended-spectrum beta-lactamases (ESBL). CONCLUSIONS Pneumonia associated with mechanical ventilation is the most prevalent HAI and Pseudomonas aeruginosa is the main etiological agent. The groups of antibiotics most frequently used were cephalosporin and aminoglycosides. It is necessary to implement the prevention strategies of the different HAI, since most of them are avoidable.

scholarly journals Multiple Mechanisms Synergistically Induce Pseudomonas Aeruginosa Multiple Drug Resistance

2021 ◽  
Author(s):  
Lulu Yang ◽  
Fangyan Jiao ◽  
Ousman Bajinka ◽  
Khalid A Abdelhalim ◽  
Guojun Wu ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Drug Resistance ◽  
Multiple Drug Resistance ◽  
Multiple Drug ◽  
Antibacterial Drug ◽  
Sequencing Analysis ◽  
Drug Resistant ◽  
Carbapenem Resistant ◽  
Resistant Genes ◽  
Epidemiological Characteristics

Abstract Background: This study was designed to detect the molecular epidemiological characteristics and resistant mechanism of carbapenem resistant Pseudomonas aeruginosa (CRPA) which provide reference for the prevention and treatment of hospital CRPA infection. Methods: 34 strains of CRPA from 2018 to 2019 were isolated and their resistance to 13 commonly used antibiotics was detected using TDR-300B Plus VitEK-2 compact automatic bacterial identification instrument. Then carbapenemase production was detected using Carbe NP test. The efflux pumps MexA and outer membrane protein OprD proteins were detected using RT-PCR and class Ⅰ integron carried with drug-resistant genes were detected using PCR and sequences analysis. Results: Among 34 strains of CRPA, 22 strains were multiple drug resistance (MDR) and 5 strains were extensively drug-resistant (XDR). The results of class Ⅰ integron carried drug-resistant gene sequencing analysis showed the class Ⅰ integron mainly carried aminoglycoside or quinolone antibacterial drug resistant genes. Conclusion: Multiple mechanisms play an important role in the formation and development of MDR or XDR resistance.

scholarly journals Effectiveness of Antimicrobial Filter Placement in ICU Taps to Prevent the Occurrence of HAIs by Pseudomonas aeruginosa (12-Months)

2020 ◽  
Vol 41 (S1) ◽  
pp. s206-s207
Author(s):  
Pablo Chico-Sánchez ◽  
Sandra Canovas-Javega ◽  
Natali J. Jimenez-Sepulveda ◽  
Edith Leutscher-Vasen ◽  
Cesar O. Villanueva-Ruiz ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Critical Care ◽  
Etiologic Agent ◽  
Incidence Density ◽  
Healthcare Associated Infections ◽  
Open Label ◽  
Filter Placement ◽  
Critical Care Units ◽  
Definition Of ◽  
Healthcare Associated

Background:Pseudomonas aeruginosa, is the third etiologic agent of healthcare associated infections, and the most frequent pathogen in ventilator-associated pneumonia (VAP). In critical care units is associated with high mortality, long hospital stay, and high healthcare-associated costs. We evaluated the effectiveness of filter placement in the water taps in critical care units to prevent the occurrence of healthcare-associated infections (HAIa) by Pseudomonas aeruginosa. Methods: This experimental study was both cross-over and open-label in nature. We included patients admitted for >24 hours in critical care units over 24 months. The study was divided into 4 periods of 6 months each. We divided the study into 2 groups: patients in units with filters and patients in units without filters. We compared the incidence density of P. aeruginosa HAIs (number of cases divided by the number of person days) according the ECDC definition of case criteria between the groups. The 2 test was used, and the magnitude of the association was calculated as a rate ratio with a 95% confidence interval, adjusted using a Poisson regression model. Results: Overall, 1,132 patients were included in the study: 595 in units with water tap filters and 537 in units without water tap filters. HAI incidence among patients in units with water tap filters was 5.3 per 1,000 person days stay; without water tap filters, HAI incidence was 4.7 per 1,000 person days stay (HR, 0.94; 95% CI, 0.47–1.90). Conclusions: The preliminary results of this study indicate a a lower incidence of P. aeruginosa HAIs in units with filters placed in water taps than in units without filters.Disclosures: NoneFunding: None

Detection of Metalo-Beta-Lactamase Gene in Carbapenem Resistant Pseudomonas Aeruginosa Isolated From Lahore, Pakistan

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Humera Kausar ◽  
Shabbir Hussain ◽  
Afia Muhammad Akram
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Multiple Drug Resistance ◽  
Diffusion Method ◽  
Multiple Drug ◽  
Carbapenem Resistant ◽  
Routine Laboratory Examination ◽  
Polymerase Chain ◽  
Biochemical Testing ◽  
Resistance Rates ◽  
Lactamase Gene

Pseudomonas aeruginosa is a widespread organism, caused severe nosocomial infection in human andassociated with multiple drug resistance (MDR) Objective: The present study was carried out to observecurrent antimicrobial resistant pattern of Pseudomonas aeruginosa in Lahore and to detect the Metallobeta-lactamase (MBL) gene in carbapenem resistant Pseudomonas aeruginosa Methods: By screening360 samples total 123 Pseudomonas aeruginosa was identified by standard microbiology techniques suchas microscopy and biochemical testing. The isolated Pseudomonas aeruginosa was evaluated for drugresistance by disc diffusion method and polymerase chain reaction (PCR) was used to identify thecarbapenem resistance causing gene (bla-VIM and bla-IMP) Results: Following antibiotic resistantpattern was observed, Gentamycin (59.00%), Ceftazidime (58.7%), Ceftriaxone (58.00%), Cefotazime(57.0%) and Ciprofloxacin (55.00%). Resistance rates to carbapenem group of antibiotics is Doripenem(30.5%) Meropenem (31.0%) and Imipenem (28.0%). Out of 123 samples of Pseudomonas aeruginosa, 28isolates were found resistant to carbapenem group of antibiotic which was supposed to be highlysensitive for this bacterium. Molecular based identification of resistance genes showed that bla-IMP genewas present in 32.1% (09) and bla-VIM was found positive in 17.8% (04) samples. Metallo-beta-lactamasesproducing genes (bla-VIM and bla-IMP), among carbapenem resistant Pseudomonas aeruginosa weredetected in 28.1% of samples. If other carbapenem resistant gene were also included this number mightbe higher Conclusions: PCR based test should be included in routine laboratory examination for quickdetection of the resistance causing genes.

scholarly journals Detection of VIM and NDM-1 metallo-beta-lactamase genes in carbapenem-resistant Pseudomonas aeruginosa clinical strains in Bahrain

2019 ◽  
Vol 11 (02) ◽  
pp. 138-143 ◽  
Author(s):  
Ronni Mol Joji ◽  
Nouf Al-Rashed ◽  
Nermin Kamal Saeed ◽  
Khalid Mubarak Bindayna
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Multiple Drug Resistance ◽  
Infectious Agent ◽  
Carbapenem Resistance ◽  
Conventional Polymerase Chain Reaction ◽  
Control Measures ◽  
Multiple Drug ◽  
Beta Lactamase ◽  
Infection Control Measures ◽  
Carbapenem Resistant

Abstract INTRODUCTION: Carbapenem-resistant Pseudomonas aeruginosa has emerged as a life-threatening infectious agent worldwide. Carbapenemase genes are reported to be some of the most common mechanisms for carbapenem resistance in P. aeruginosa. No reports are available from the Kingdom of Bahrain about carbapenem resistance and the underlying cause. In this study, we determined to study the presence of the metallo-beta-lactamase (M β L) genes of VIM family and NDM-1 in carbapenem-resistant P. aeruginosa strains. METHODOLOGY: Fifty carbapenem-resistant P. aeruginosa isolates were obtained from three main hospitals of Bahrain. They were subjected to antimicrobial susceptibility testing by disc diffusion test. Subsequently, MβL was detected by imipenem-ethylene diamine tetraacetic acid (EDTA) combined disc test and conventional polymerase chain reaction. RESULTS: Among 50 P. aeruginosa strains, 40 (80%) were imipenem resistant. Among the 40 imipenem-resistant strains, 35 (87.5%) strains were positive for the imipenem-EDTA combined disc test, and 21 (52%) were carrying MβL genes. Nineteen (47.5%) strains were positive for the VIM gene; one (2.5%) strain was carrying the NDM-1 gene, while one strain was carrying both the VIM and NDM-1 genes. None of the imipenem sensitive strains carried the VIM or NDM-1 gene. CONCLUSION: This is the first study to report the presence of the VIM family gene and NDM-1 genes in imipenem-resistant P. aeruginosa isolates in the Kingdom of Bahrain. The study also confirms the multiple drug resistance by the MβL strains, attention should therefore from now on, be focused on prevention of further spread of such isolates by firm infection control measures, and to reduce its threat to public health.

scholarly journals Detection of antibiotic resistance genes among multiple drug resistant Pseudomonas aeruginosa strains isolated from clinical sources in selected health institutions in Kwara State.

2021 ◽  
Vol 10 (1) ◽  
pp. 40-48
Author(s):  
O.C. Adekunle ◽  
A. Mustapha ◽  
G. Odewale ◽  
R.O. Ojedele
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Resistance ◽  
Resistance Genes ◽  
Multiple Drug Resistance ◽  
Antibiotic Resistance Genes ◽  
Clinical Samples ◽  
Multiple Drug ◽  
Antibiotic Resistant ◽  
Clinical Specimens ◽  
Health Institutions

Introduction: Pseudomonas aeruginosa (P. aeruginosa) is a frequent nosocomial pathogen that causes severe diseases in many clinical and community settings. The objectives were to investigate the occurrence of multiple antibiotic resistant P. aeruginosa strains among clinical samples and to detect the presence of antibiotic resistance genes in the DNA molecules of the strains.Methods: Clinical specimens were collected aseptically from various human anatomical sites in five selected health institutions within Kwara State, Nigeria. Multiple drug resistance patterns of isolated micro-organisms to different antibiotics were determined using the Bauer Kirby disc diffusion technique. The DNA samples of the multiple resistant P. aeruginosa strains were extracted and subjected to Polymerase Chain Reaction (PCR) for resistance gene determination.Results: A total of 145 isolates were identified as P. aeruginosa from the clinical samples. Absolute resistance to ceftazidime, gentamicin and ceftriaxone was observed while low resistance to ciprofloxacin, piperacillin and imipenem was documented. The prevalence of bla VIM , ,bla CTX-M and blaTEM were 34.4 %, 46.7 % and 16.7 % respectively.Conclusion: This study has shown that there is a high occurrence of metallo â-lactamase- producing and antibiotic-resistant strains of P. aeruginosa in clinical specimens from the studied area. Keywords: Metallo â-lactamase enzyme, P. aeruginosa, clinical samples, antibiotic-resistance genes

scholarly journals Activity of isolated specific bacteriophage in treatment of chronic osteomyelitis induced by multiple drug resistance Pseudomonas aeruginosa in Rabbits

2018 ◽  
Vol 41 (2) ◽  
pp. 146-156
Author(s):  
Sarhan Rashid Sarhan
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Chronic Osteomyelitis ◽  
Multiple Drug Resistance ◽  
Inflammatory Cells ◽  
Treated Group ◽  
Sewage Water ◽  
Multiple Drug ◽  
In Vivo Evaluation ◽  
Specific Bacteriophage

     This study was conducted to find out the possibility of using the Pseudomonas aeruginosa specific-bacteriophage as an alternative to antibiotics in treatment of chronic osteomyelitis in rabbits by injection of Pseudomonas aeruginosa suspension in tibia. The current study included an isolation of bacteriophage from sewage water by using agar overlay method and also an isolation of the bacteria from patients suffering from post-traumatic bone infection. The second experiment was in-vivo evaluation of phage activity in treatment of chronic osteomyelitis in rabbits. All animals of infected groups with Pseudomonas aeruginosa before treatment exhibited histopathological changes after 35 days of infection, the infected groups showed chronic osteomyelitis represented by sever chronic inflammatory cells infiltrates mainly lymphocytes, and macrophages and hemorrhage between bone trabeculae, also some sections showed extensive fibrosis in the marrow spaces. The treated group with P. aeruginosa specific – bacteriophage (1.5 ×107) PFU/ml for 10 days showed early repair elucidated by presence whorls of chondrocytes, and also the presence of multiple osteoblasts indicated bone formations. Also the presence of extensive fibrosis in the marrow space with present of osteoblasts indicated bone formations and repair.

Sign in / Sign up

Export Citation Format

Share Document