scholarly journals Nosocomial infections by Klebsiella pneumoniae carbapenemase producing enterobacteria in a teaching hospital

2014 ◽  
Vol 12 (3) ◽  
pp. 282-286 ◽  
Author(s):  
Gabriela Seibert ◽  
Rosmari Hörner ◽  
Bettina Holzschuh Meneghetti ◽  
Roselene Alves Righi ◽  
Nara Lucia Frasson Dal Forno ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Teaching Hospital ◽  
Nosocomial Infections ◽  
Descriptive Study ◽  
University Hospital ◽  
Klebsiella Pneumoniae Carbapenemase ◽  
And Control ◽  
Epidemiological Characteristics ◽  
Rapid Laboratory ◽  
Tracheal Aspirates

Objective To analyze the profile of patients with microorganisms resistant to carbapenems, and the prevalence of the enzyme Klebsiella pneumoniae carbapenemase in interobacteriaceae. Methods Retrospective descriptive study. From the isolation in bacteriological tests ordered by clinicians, we described the clinical and epidemiological characteristics of patients with enterobacteria resistants to carbapenems at a university hospital, between March and October 2013. Results We included 47 isolated patients in this study, all exhibiting resistance to carbapenems, including 9 patients who were confirmed as infected/colonized with K. pneumoniae carbapenemase. Isolation in tracheal aspirates (12; 25.5%) predominated. The resistance to ertapenem, meropenem, and imipenem was 91.5%, 83.0% and 80.0%, respectively. Aminoglycosides was the class of antimicrobials that showed the highest sensitivity, 91.5% being sensitive to amikacin and 57.4% to gentamicin. Conclusion The K. pneumoniae carbapenemase was an important agent in graun isotaling in hospital intection. The limited therapeutic options emphasize the need for rapid laboratory detection, as well as the implementation of measures to prevent and control the spread of these pathogens.

Placebo use in clinical practice by nurses in an Iranian teaching hospital

2011 ◽  
Vol 18 (3) ◽  
pp. 364-373 ◽  
Author(s):  
Nayereh Baghcheghi ◽  
Hamid Reza Koohestani
Keyword(s):  
Clinical Practice ◽  
Teaching Hospital ◽  
Descriptive Study ◽  
Placebo Treatment ◽  
Self Report ◽  
University Hospital ◽  
Cross Sectional ◽  
The Past ◽  
Knowledge And Attitude

The present study was carried out to explore Iranian nurses’ use of placebos in clinical practice and their knowledge and attitude towards its use. A cross-sectional, descriptive study was conducted using self-report questionnaires. All nurses working in a university hospital in Arak (n = 342) were invited to participate in the study. Among 295 respondents, 221 (75%) reported that they had used at least one placebo within the past year and 179 (81%) told patients they were receiving actual medication. The most common reason and symptom for placebo use were after unjustified demand for medication and pain, respectively. Only 60 (20.33%) of the nurses believed that placebos should never be used. Results showed that most nurses in our study had used placebos and probably will continue to use them. Placebo use is viewed as ethically permissible among nurses. Some patients benefit from the placebos, but their use raises ethical questions. The role of placebo treatment, its mechanisms, and its ethics issues should be taught to nurses.

scholarly journals Epidemiological study of carbapenem-resistant Klebsiella pneumoniae

Open Medicine ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. 460-466 ◽  
Author(s):  
Di Lin ◽  
Jian Chen ◽  
Yan Yang ◽  
Jun Cheng ◽  
Changgui Sun
Keyword(s):  
Drug Resistance ◽  
Klebsiella Pneumoniae ◽  
Prevention And Control ◽  
Clinical Specimens ◽  
Carbapenem Resistant ◽  
Control Work ◽  
Clinical Prevention ◽  
Resistance Rates ◽  
And Control ◽  
Epidemiological Characteristics

AbstractBackgroundThis research is aimed to study the resistance and molecular epidemiological characteristics of carbapenem-resistant Klebsiella pneumoniae (CRKP).Methodology38 isolated CRKP strains were collected from clinical specimens.ResultsThe resistance rates were more than 70.0%. Ampicillin had the highest rates among them (100.0%). 34 strains (89.5%) among the 38 CRKP strains carried blaKPC-2 gene, and 3 strains (7.9%) carried blaIMP-4 gene. 36 strains (94.7%) among the 38 CRKP strains carried blaSHV gene, 29 strains (76.3%) carried blaTEM gene, and 26 strains (68.4%) carried blaCT-M gene. 7 strains (18.4%) among the 38 CRKP strains carried blaDHA-1 gene. 15 strains (39.5%) in 38 CRKP strains lost two fenestra proteins, ompK35 and ompK36, and the rest 23 strains carried ompK36 genes. 38 CRKP strains were divided into five kinds of ST types, with ST11 type as the most (86.8%, 33/38). The rest of the ST types included 2 strains of ST23 (5.3%, 2/38), one strain of ST15, ST1373 and ST1415 (2.6%, 1/38).ConclusionsCRKP resistance is severe, and the mechanism of drug resistance has become increasingly complex. Various ST types and resistance genes are related to CRKP. The clinical prevention and control work is imminent.

scholarly journals Klebsiella pneumoniae carbapenemase-producing Serratia marcescens outbreak in a university hospital

2017 ◽  
Author(s):  
Felipe Francisco Tuon ◽  
Kassia Cordova ◽  
Thayrine Mayara Dario ◽  
Luciana de Souza Nunes ◽  
Afonso Luís Barth ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Serratia Marcescens ◽  
University Hospital ◽  
Klebsiella Pneumoniae Carbapenemase

scholarly journals Gut Microbiota and Clinical Features Distinguish Colonization With Klebsiella pneumoniae Carbapenemase-Producing Klebsiella pneumoniae at the Time of Admission to a Long-term Acute Care Hospital

2018 ◽  
Vol 5 (8) ◽  
Author(s):  
Anna M Seekatz ◽  
Christine M Bassis ◽  
Louis Fogg ◽  
Nicholas M Moore ◽  
Yoona Rhee ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Gut Microbiota ◽  
Clinical Features ◽  
Acute Care Hospital ◽  
Decubitus Ulcer ◽  
Care Hospital ◽  
Klebsiella Pneumoniae Carbapenemase ◽  
Case Status ◽  
And Control

Abstract Background Identification of gut microbiota features associated with antibiotic-resistant bacterial colonization may reveal new infection prevention targets. Methods We conducted a matched, case–control study of long-term acute care hospital (LTACH) patients to identify gut microbiota and clinical features associated with colonization by Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae (KPC-Kp), an urgent antibiotic resistance threat. Fecal or rectal swab specimens were collected and tested for KPC-Kp; 16S rRNA gene-based sequencing was performed. Comparisons were made between cases and controls in calibration and validation subsamples using microbiota similarity indices, logistic regression, and unit-weighted predictive models. Results Case (n = 32) and control (n = 99) patients had distinct fecal microbiota communities, but neither microbiota diversity nor inherent clustering into community types distinguished case and control specimens. Comparison of differentially abundant operational taxonomic units (OTUs) revealed 1 OTU associated with case status in both calibration (n = 51) and validation (n = 80) subsamples that matched the canonical KPC-Kp strain ST258. Permutation analysis using the presence or absence of OTUs and hierarchical logistic regression identified 2 OTUs (belonging to genus Desulfovibrio and family Ruminococcaceae) associated with KPC-Kp colonization. Among clinical variables, the presence of a decubitus ulcer alone was independently and consistently associated with case status. Combining the presence of the OTUs Desulfovibrio and Ruminococcaceae with decubitus ulcer increased the likelihood of KPC-Kp colonization to >38% in a unit-weighted predictive model. Conclusions We identified microbiota and clinical features that distinguished KPC-Kp gut colonization in LTACH patients, a population particularly susceptible to KPC-Kp infection. These features may warrant further investigation as markers of risk for KPC-Kp colonization.

scholarly journals Infection related to Klebsiella pneumoniae producing carbapenemase in renal transplant patients

2019 ◽  
Vol 72 (3) ◽  
pp. 760-766 ◽  
Author(s):  
Monica Taminato ◽  
Dayana Fram ◽  
Rogério Rodrigues Floriano Pereira ◽  
Ricardo Sesso ◽  
Angélica Gonçalves Silva Belasco ◽  
...  
Keyword(s):  
Risk Factors ◽  
Klebsiella Pneumoniae ◽  
Case Control Study ◽  
Hospital Environment ◽  
Prevention Measures ◽  
Klebsiella Pneumoniae Carbapenemase ◽  
Transplant Patients ◽  
Sex Type ◽  
And Control ◽  
Control Study

ABSTRACT Objective: To evaluate the risk factors related to Klebsiella pneumoniae carbapenemase infection after renal transplantation. Methods: This was a retrospective epidemiological (case-control) study, conducted from October 2011 to march 2016. Transplanted patients with infection by this bacteria during hospitalization were selected as cases. The controls were paired by age, sex, type of donor and transplant time. The proportion of cases and controls was 1:2. Results: Thirty hundred and five patients were included in the study (45 cases and 90 controls). The risk factors found for infection by KPC were: time of hospitalization after the transplant (OR: 4.82; CI95% 2.46-9.44), delayed kidney function (OR: 5.60; CI95% 1.91-11.01) and previous infectious for another microorganism ( OR: 34.13 CI95% 3.52-132.00). Conclusion: The risk of acquisition of this bacterium was directly related to invasive procedures and exposure to the hospital environment. The findings reinforce the importance of prevention measures and control of infection by this microorganism.

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