scholarly journals Bloodstream Infections caused by Klebsiella pneumoniae and Serratia marcescens isolates co-harboring NDM-1 and KPC-2.

2020 ◽  
Author(s):  
Taniela Bes ◽  
Debora Nagano ◽  
Roberta Martins ◽  
Ana Paula Marchi ◽  
Lauro Perdigão Neto ◽  
...  
Keyword(s):  
Serratia Marcescens ◽  
Low Income ◽  
Case Series ◽  
Bloodstream Infections ◽  
Surgical Patient ◽  
Hematopoietic Stem ◽  
Travel History ◽  
Molecular Tests ◽  
Carbapenem Resistant ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract Carbapenem-resistant Enterobacteriaceae is a worldwide health problem, however isolates carrying both blaKPC-2 and blaNDM-1 are unusual. Here we describe microbiological and clinical characteristics of five cases of bloodstream infection (BSI) caused by carbapenem-resistant Klebsiella pneumoniae and Serratia marcescens co-harboring blaKPC-2 and blaNDM-1.Of the five blood culture isolates, three from are from hematopoietic stem cell transplantation patients, one from a renal transplant patient, and one from a soft tissue surgical patient. All patients lived in low-income neighborhoods and had no travel history. Despite antibiotic treatment, four of five patients died. The phenotypic assays showed that Meropenem added with either EDTA, PA or both showed increased zone of inhibition in comparison to Meropenem alone. Molecular tests confirmed blaKPC-2 and blaNDM-1 genes, the K. pneumoniae were assigned as ST258 and ST340 by Whole Genome Sequencing.This case-series showed high mortality of BSI caused by Enterobacteria coproducing KPC-2 and NDM-1. The detection of samples co-harboring blaKPC-2 and blaNDM-1 remains unsatisfactory with phenotypic assay. Routine microbiology laboratories must be on alert for samples co-harboring these mechanisms.

scholarly journals Bloodstream Infections caused by Klebsiella pneumoniae and Serratia marcescens isolates co-harboring NDM-1 and KPC-2.

2020 ◽  
Author(s):  
Taniela Bes ◽  
Debora Nagano ◽  
Roberta Martins ◽  
Ana Paula Marchi ◽  
Lauro Perdigão Neto ◽  
...  
Keyword(s):  
Serratia Marcescens ◽  
Low Income ◽  
Renal Transplant Patient ◽  
Bloodstream Infections ◽  
Surgical Patient ◽  
Hematopoietic Stem ◽  
Travel History ◽  
Molecular Tests ◽  
Carbapenem Resistant ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract Carbapenem-resistant Enterobacteriaceae is a worldwide health problem, however isolates carrying both blaKPC-2 and blaNDM-1 are unusual. Here we describe microbiological and clinical characteristics of five cases of bloodstream infection (BSI) caused by carbapenem-resistant K lebsiella pneumoniae and Serratia marcescens co-harboring blaKPC-2 and blaNDM-1.Of the five blood culture isolates, three from are from hematopoietic stem cell transplantation patients, one from a renal transplant patient, and one from a soft tissue surgical patient. All patients lived in low-income neighborhoods and had no travel history. Despite antibiotic treatment, four of five patients died. The phenotypic assays showed that Meropenem added with either EDTA, PA or both showed increased zone of inhibition in comparison to Meropenem alone. Molecular tests confirmed blaKPC-2 and blaNDM-1 genes, the K. pneumoniae were assigned as ST258 and ST340 by Whole Genome Sequencing.

scholarly journals Bloodstream Infections caused by Klebsiella pneumoniae and Serratia marcescens isolates co-harboring NDM-1 and KPC-2.

2020 ◽  
Author(s):  
Taniela Bes ◽  
Debora Nagano ◽  
Roberta Martins ◽  
Ana Paula Marchi ◽  
Lauro Perdigão Neto ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Serratia Marcescens ◽  
Low Income ◽  
Phenylboronic Acid ◽  
Case Series ◽  
Bloodstream Infections ◽  
Surgical Patient ◽  
Hematopoietic Stem ◽  
Molecular Tests ◽  
Carbapenem Resistant

Abstract Carbapenem-resistant Enterobacteriaceae are a worldwide health problem and isolates carrying both blaKPC-2 and blaNDM-1 are unusual. Here we describe the microbiological and clinical characteristics of five cases of bloodstream infections (BSI) caused by carbapenem-resistant Klebsiella pneumoniae and Serratia marcescens having both blaKPC-2 and blaNDM-1. Of the five blood samples, three are from hematopoietic stem cell transplantation patients, one from a renal transplant patient, and one from a soft tissue surgical patient. All patients lived in low-income neighbourhoods and had no travel history. Despite antibiotic treatment, four of five patients died. The phenotypic susceptibility assays showed that meropenem added either EDTA, phenylboronic acid (PBA) or both, increased the zone of inhibition in comparison to meropenem alone. Molecular tests showed the presence of blaKPC-2 and blaNDM-1 genes. K. pneumoniae isolates were assigned to ST258 or ST340 by whole genome sequencing. This case-series showed a high mortality among patients with BSI caused by Enterobacteriae harbouring both carbapenemases. The detection of carbapenemase-producing isolates carrying both blaKPC-2 and blaNDM-1 remains a challenge when using only phenotypic assays. Microbiology laboratories must be alert for K. pneumoniae isolates producing both KPC-2 and NDM-1.

scholarly journals Bloodstream Infections caused by Klebsiella pneumoniae and Serratia marcescens isolates co-harboring NDM-1 and KPC-2

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Taniela Bes ◽  
Debora Nagano ◽  
Roberta Martins ◽  
Ana Paula Marchi ◽  
Lauro Perdigão-Neto ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Serratia Marcescens ◽  
Low Income ◽  
Phenylboronic Acid ◽  
Case Series ◽  
Bloodstream Infections ◽  
Surgical Patient ◽  
Hematopoietic Stem ◽  
Molecular Tests ◽  
Carbapenem Resistant

AbstractCarbapenem-resistant Enterobacteriaceae are a worldwide health problem and isolates carrying both blaKPC-2 and blaNDM-1 are unusual. Here we describe the microbiological and clinical characteristics of five cases of bloodstream infections (BSI) caused by carbapenem-resistant Klebsiella pneumoniae and Serratia marcescens having both blaKPC-2 and blaNDM-1. Of the five blood samples, three are from hematopoietic stem cell transplantation patients, one from a renal transplant patient, and one from a surgical patient. All patients lived in low-income neighbourhoods and had no travel history. Despite antibiotic treatment, four out of five patients died. The phenotypic susceptibility assays showed that meropenem with the addition of either EDTA, phenylboronic acid (PBA), or both, increased the zone of inhibition in comparison to meropenem alone. Molecular tests showed the presence of blaKPC-2 and blaNDM-1 genes. K. pneumoniae isolates were assigned to ST258 or ST340 by whole genome sequencing. This case-series showed a high mortality among patients with BSI caused by Enterobacteriae harbouring both carbapenemases. The detection of carbapenemase-producing isolates carrying both blaKPC-2 and blaNDM-1 remains a challenge when using only phenotypic assays. Microbiology laboratories must be alert for K. pneumoniae isolates producing both KPC-2 and NDM-1.

scholarly journals The Effect of Continuous Screening of Carbapenem-Resistant Enterobacteriaceae on Theprevention and Control of Bloodstream Infections in Patients with Hematopoietic Stemcell Transplantation

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5606-5606
Author(s):  
Tingting Yang ◽  
Xueping Luo ◽  
Qing Yang ◽  
Hongchao Chen ◽  
Yi Luo ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Bloodstream Infections ◽  
Risk Groups ◽  
Control Group ◽  
Intervention Period ◽  
Hematopoietic Stem ◽  
Carbapenem Resistant ◽  
And Control ◽  
Carbapenem Resistant Enterobacteriaceae ◽  
Related Mortality

Carbapenem-resistant Enterobacteriaceae (CRE) bloodstream infections (BSIs) have become emerging cause of death in patients with hematopoietic stem cell transplantation (HSCT). Patients underwent HSCT from September 2017 to June 2018, and from July 2018 to February 2019, were assigned as single screening group and continuous screening group; patients transplanted from January 2016 to August 2017 were assigned as control group. Continuous screening significantly improved the CRE gut detection rate compared with single screening (10% vs 1.5%, p=0.001). The CRE infection rate in the pre-intervention period, single screening period and continuous screening period were 1.6%, 2% and 0, respectively; while related mortality was were 66.7%, 50% and 0, respectively. The time from the onset of symptoms of infection to use of tigecycline in survival patients with BSIs were shorter than died patients (24 hours vs 72 hours). For 11 CRE carriers with neutropenic fever, all received tigecycline therapy-based therapy (time from detection to therapy, -3 to 17 days) and did not develop BSIs. These results suggest that continuous screening can more effectively identify high-risk groups of CRE colonization and guide targeted preemptive treatment in the presence of infection symptoms, so as to reduce the incidence of BSIs and improve the prognosis of patients. Disclosures No relevant conflicts of interest to declare.

Infection preventionist staffing levels and rates of 10 types of healthcare-associated infections: A 9-year ambidirectional observation

2022 ◽  
pp. 1-6
Author(s):  
Robert J. Clifford ◽  
Donna Newhart ◽  
Maryrose R. Laguio-Vila ◽  
Jennifer L. Gutowski ◽  
Melissa Z. Bronstein ◽  
...  
Keyword(s):  
Control Charts ◽  
Bloodstream Infections ◽  
Central Line ◽  
Healthcare Associated Infections ◽  
Full Time ◽  
Staffing Levels ◽  
Clostridioides Difficile ◽  
Carbapenem Resistant ◽  
Healthcare Associated ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract Objective: To quantitatively evaluate relationships between infection preventionists (IPs) staffing levels, nursing hours, and rates of 10 types of healthcare-associated infections (HAIs). Design and setting: An ambidirectional observation in a 528-bed teaching hospital. Patients: All inpatients from July 1, 2012, to February 1, 2021. Methods: Standardized US National Health Safety Network (NHSN) definitions were used for HAIs. Staffing levels were measured in full-time equivalents (FTE) for IPs and total monthly hours worked for nurses. A time-trend analysis using control charts, t tests, Poisson tests, and regression analysis was performed using Minitab and R computing programs on rates and standardized infection ratios (SIRs) of 10 types of HAIs. An additional analysis was performed on 3 stratifications: critically low (2–3 FTE), below recommended IP levels (4–6 FTE), and at recommended IP levels (7–8 FTE). Results: The observation covered 1.6 million patient days of surveillance. IP staffing levels fluctuated from ≤2 IP FTE (critically low) to 7–8 IP FTE (recommended levels). Periods of highest catheter-associated urinary tract infection SIRs, hospital-onset Clostridioides difficile and carbapenem-resistant Enterobacteriaceae infection rates, along with 4 of 5 types of surgical site SIRs coincided with the periods of lowest IP staffing levels and the absence of certified IPs and a healthcare epidemiologist. Central-line–associated bloodstream infections increased amid lower nursing levels despite the increased presence of an IP and a hospital epidemiologist. Conclusions: Of 10 HAIs, 8 had highest incidences during periods of lowest IP staffing and experience. Some HAI rates varied inversely with levels of IP staffing and experience and others appeared to be more influenced by nursing levels or other confounders.

Emergence of carbapenem-resistant Enterobacteriaceae as causes of bloodstream infections in patients with hematologic malignancies

2012 ◽  
Vol 54 (4) ◽  
pp. 799-806 ◽  
Author(s):  
Michael J. Satlin ◽  
David P. Calfee ◽  
Liang Chen ◽  
Kathy A. Fauntleroy ◽  
Stephen J. Wilson ◽  
...  
Keyword(s):  
Bloodstream Infections ◽  
Hematologic Malignancies ◽  
Carbapenem Resistant ◽  
Carbapenem Resistant Enterobacteriaceae

scholarly journals Usefulness of surveillance Cultures for Carbapenem-resistant Enterobacteriaceae, Carbapenem-resistant Pseudomonas aeruginosa and Vancomycin-resistant Enterococci in Hematopoietic Stem Cell Transplant Unit

2020 ◽  
Author(s):  
Elisa Teixeira Mendes ◽  
Matias Chiarastelli Salomão ◽  
Lísia Moura Tomichi ◽  
Maura Salaroli Oliveira ◽  
Mariana Graça ◽  
...  
Keyword(s):  
Blood Stream Infection ◽  
Blood Stream ◽  
Cell Transplant ◽  
Surveillance Culture ◽  
Hematopoietic Stem ◽  
Carbapenem Resistant ◽  
Vancomycin Resistant Enterococci ◽  
Surveillance Cultures ◽  
Vancomycin Resistant ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract Surveillance strategies to detect colonization is an important tool to prevent and control the spread of microorganisms especially among Hematopoietic Stem Cell Transplant (HSCT) patients. Colonization by Multidrug-resistant organisms (MDRO) has been evaluated as a risk factor for blood stream infection (BSI) in HSCT patients. The aim of this study was to evaluate the use of routine surveillance culture to screening colonization and infection by carbapenem-resistant Enterobacteriaceae (CRE), carbapenem-resistant Pseudomonas aeruginosa (CRPa) and vancomycin-resistant enterococci (VRE) in a HSCT unit. Methods Surveillance cultures were collected from patients admitted to the HSCT unit over one-year, with swabs for cultures on admission and then weekly until discharge. We compared surveillance culture positivity for each site and agent, also clinical and epidemiological data according to the colonization status. Results 200 HSCT patients underwent surveillance, with 1.323 samples collected. Infection due to MDRO occurred in 52 (21.5%) patients, among them 45 (86.5%) were blood stream infection (BSI) and 12 (23%) had positive surveillance culture before infection. 554 (41.8%) surveillance cultures were performed for CRPa, 413 (31.2%) for VRE, and 356 (27%) for CRE. Of these, 179 (13.5%) surveillance culture were positive, with greater positivity for oropharynx (6, 35.3%) CRPa, and rectal samples (16, 20.7%) for CRE. Being colonized by any MDRO, CRE (p <0.001) and CRPa (p = 0.027) was associated with a higher risk of infection in the bivariate analysis but being colonized was not associated with risk of death. Conclusion Previous colonization by MDRO was a significant risk factor for infection by these pathogens, mainly colonization by CRE. Overall, rectal swab was the best site with the higher positivity, and the oropharynx was also an option for CRPa investigation. Feces culture showed low positivity and should be avoided. Although the impact of the strategy on the mortality of patients undergoing HSCT is not clear, VRE surveillance should be questioned in auto-HSCT patients as it has an additional cost and little impact on survival.

Sign in / Sign up

Export Citation Format

Share Document