scholarly journals Community Origin and Previous Use of Antimicrobials Increase the Risk of Nosocomial Multidrug-resistant Bacteria Colonisation in the Intensive Care Unit in a Brazilian Hospital

2019 ◽  
Vol 12 (1) ◽  
pp. 449-454
Author(s):  
Debora Vandresen ◽  
Maria Helena B. Werlang ◽  
Mirian Carla B. Silva ◽  
Juliana S. Link ◽  
Paulo Cezar N. Fortes
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Antibiotic Resistant ◽  
Beta Lactamases ◽  
Hospitalised Patients ◽  
Extended Spectrum Beta Lactamases ◽  
Hospital Acquired

Background: Hospitalised patients are often surrounded by microorganisms, and antibiotic-resistant pathogens are a major and growing threat to public health. Objective: This study aimed to investigate the epidemiology and the risk factors for colonisation by multidrug-resistant organisms (MDROs) in a Brazilian hospital. Methods: Patients in the Intensive Care Unit (ICU) who underwent nasal and rectal swab cultures for the surveillance of colonisation by MDROs were evaluated in a retrospective study. MDROs were determined by routine microbiological cultures. Results: Of the 785 patients included in this study, 86 presented positive results for MDRO colonisation. Overall, the most frequently isolated organism was Klebsiella pneumoniae (41.9%), followed by Escherichia coli (33.7%). The main type of resistance was the production of extended-spectrum beta-lactamases (ESBL). The prevalence of MDRO infections was significantly associated with the patient's origin (community or hospital-acquired). Having been submitted to previous antimicrobial drug therapy was significantly associated with MDRO infection (relative risk [RR]: 4.02 [2.60 - 6.23]). Conclusion: MDRO ICU colonisation was variable, with similar frequencies as other centres, and important factors, including previous hospital stay and antibiotic use, were closely related to MDRO colonisation. Therefore, control interventions should reduce their rates, especially considering the particularities of each geographic centre.

scholarly journals The impact of hospital-acquired infections with multidrug-resistant bacteria in an oncology intensive care unit

2015 ◽  
Vol 31 ◽  
pp. 31-34 ◽  
Author(s):  
P. Cornejo-Juárez ◽  
D. Vilar-Compte ◽  
C. Pérez-Jiménez ◽  
S.A. Ñamendys-Silva ◽  
S. Sandoval-Hernández ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Multidrug Resistant Bacteria ◽  
Hospital Acquired Infections ◽  
Hospital Acquired ◽  
The Impact

scholarly journals Multidrug-resistant bacteria isolated from patients hospitalized in Intensive Care Unit in University Hospital of Constantine, Algeria (2011 - 2015)

2016 ◽  
Vol 10 (33) ◽  
pp. 1328-1336 ◽  
Author(s):  
Hecini-Hannachi Abla ◽  
Bentchouala Chafia ◽  
Lezzar Abdesselam ◽  
Laouar Houcine ◽  
Benlabed Kaddour ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Resistant Bacteria ◽  
Multidrug Resistant Bacteria

scholarly journals Characterization of ESBL-Producing Enterobacteria from Fruit Bats in an Unprotected Area of Makokou, Gabon

2020 ◽  
Vol 8 (1) ◽  
pp. 138 ◽  
Author(s):  
Pierre Philippe Mbehang Nguema ◽  
Richard Onanga ◽  
Guy Roger Ndong Atome ◽  
Jean Constant Obague Mbeang ◽  
Arsène Mabika Mabika ◽  
...  
Keyword(s):  
Resistant Bacteria ◽  
Fruit Bats ◽  
Antibiotic Resistant ◽  
Disk Diffusion Test ◽  
Beta Lactamases ◽  
E Coli ◽  
Terrestrial Mammals ◽  
Extended Spectrum Beta Lactamases ◽  
First Time

In Gabon, terrestrial mammals of protected areas have been identified as a possible source of antibiotic-resistant bacteria. Some studies on antibiotic resistance in bats have already been carried out. The main goal of our study was to detect extended-spectrum beta-lactamases (ESBLs) that are produced by enterobacteria from bats in the Makokou region in Gabon. Sixty-eight fecal samples were obtained from 68 bats caught in the forests located 1 km from the little town of Makokou. After culture and isolation, 66 Gram-negative bacterial colonies were obtained. The double-disk diffusion test confirmed the presence of ESBLs in six (20.69%) Escherichia coli isolates, four (13.79%) Klebsiella pneumoniae isolates, and one (3.45%) Enterobacter cloacae isolate. The analysis based on the nucleotide sequences of the ESBL resistance genes showed that all cefotaximase-Munichs (CTX-Ms) were CTX-M-15 and that all sulfhydryl variables (SHVs) were SHV-11: 41.67% CTX-M-15-producing E. coli, 16.67% CTX-M-15+SHV-11-producing E. coli, 8.33% CTX-M-15-producing K. pneumoniae, 25% CTX-M-15+SHV-11-producing K. pneumoniae, and 8.33% CTX-M-15-produced E. cloacae. This study shows for the first time the presence of multiresistant ESBL-producing enterobacteria in fruit bats in Makokou.

Effect of Nosocomial Infections Due to Antibiotic-Resistant Organisms on Length of Stay and Mortality in the Pediatric Intensive Care Unit

2007 ◽  
Vol 28 (3) ◽  
pp. 299-306 ◽  
Author(s):  
Elizabeth E. Foglia ◽  
Victoria J. Fraser ◽  
Alexis M. Elward
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Infections ◽  
Univariate Analysis ◽  
Pediatric Intensive Care ◽  
Resistant Bacteria ◽  
Antibiotic Resistant ◽  
Risk Of Mortality ◽  
The Mean

Objective.To determine the prevalence, risk factors, and outcomes of nosocomial infection due to antimicrobial resistant bacteria in patients treated in the pediatric intensive care unit (PICU).Design.Nested case-cohort study. Patient data were collected prospectively, and antimicrobial susceptibility data were abstracted retrospectively.Setting.A large pediatric teaching hospital.Patients.All PICU patients admitted from September 1, 1999, to September 1, 2001, unless they died within 24 hours after PICU admission, were 18 years old or older, or were neonatal intensive care unit patients receiving extracorporeal membrane oxygenation.Results.A total of 135 patients with more than 1 nosocomial bacterial infection were analyzed; 52% were male, 75% were white, the mean Pediatric Risk of Mortality score was 10.5, and the mean age was 3.5 years. Of these patients, 37 (27%) had nosocomial infections due to antibiotic-resistant organisms. In univariate analysis, transplantation (odds ratio [OR], 2.83 [95% confidence interval (CI), 1.05-7.66]) and preexisting lung disease (OR, 2.63 [95% CI, 1.18-5.88]) were associated with nosocomial infections due to antibiotic-resistant organisms. Age, Pediatric Risk of Mortality score at admission, length of hospital stay before infection, and other underlying conditions were not associated with infections due to antibiotic-resistant organisms. Patients infected with antibiotic-resistant organisms had greater mean PICU lengths of stay after infection, compared with patients infected with antibiotic-susceptible organisms (22.9 vs 12.8 days;P= .004), and higher crude mortality rates (OR, 2.40 [95% CI, 1.03-5.61]).Conclusions.Identifiable risk factors exist for nosocomial infections due to antibiotic-resistant organisms. In univariate analysis, infections due to antibiotic-resistant bacteria are associated with increased length of stay in the PICU after onset of infection and increased mortality.

scholarly journals Multidrug-resistant bacteria in unaccompanied refugee minors arriving in Frankfurt am Main, Germany, October to November 2015

2016 ◽  
Vol 21 (2) ◽  
Author(s):  
Ursel Heudorf ◽  
Bernhard Krackhardt ◽  
Maria Karathana ◽  
Niels Kleinkauf ◽  
Christian Zinn
Keyword(s):  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
German Population ◽  
Unaccompanied Refugee Minors ◽  
Frankfurt Am Main ◽  
Beta Lactamases ◽  
Extended Spectrum Beta Lactamases ◽  
Additional Resistance ◽  
Gram Negative Organisms ◽  
Refugee Minors

Many refugees arriving in Germany originate or have travelled through countries with high prevalence of multidrug-resistant Gram-negative organisms. Therefore, all unaccompanied refugee minors (<18 years-old) arriving in Frankfurt am Main between 12 October and 6 November 2015, were screened for multidrug-resistant Enterobacteriaceae in stool samples. Enterobacteriaceae with extended spectrum beta-lactamases (ESBL) were detected in 42 of 119 (35%) individuals, including nine with additional resistance to fluoroquinolones (8% of total screened), thus exceeding the prevalences in the German population by far.

scholarly journals KARAKTERISTIK ANTIBIOGRAM ISOLAT Escherichia coli DAN Klebsiella pneumoniae DARI RUANG INTENSIVE CARE UNIT DAN NON-INTENSIVE CARE UNIT DI RSUP SANGLAH SELAMA TAHUN 2018-2020

2021 ◽  
Vol 7 (1) ◽  
pp. 8
Author(s):  
Ni Luh Ranthi Kurniawathi ◽  
Indramawan Setyojatmiko ◽  
Ni Nyoman Sri Budayanti
Keyword(s):  
Escherichia Coli ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Beta Lactamases ◽  
E Coli ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases

Resistesi antibiotik meningkat secara global dalam beberapa tahun ini, terutama kejadian Escherichia coli (E.coli) dan Klebsiella pneumoniae (K.pneumoniae) penghasil Extended Spektrum Beta Lactamases (ESBL). Tujuan dari penelitian ini adalah untuk memberikan gambaran prevalensi keberadaan dan antibiogram isolat E.coli dan K. pneumoniae penghasil ESBL di rumah sakit tersier di Bali. Penelitian retrospektif potong lintang ini dlikaukan pada Januari 2018- Desember 2020 di Rumah Sakit Umum Pusat Sanglah, Bali. Identifikasi bakteri dan uji sensitivitas antibiotik dilakukan dengan alat otomatis Vitek®2 Compact. Hasil penelitian menunjukkan dari 2972 isolat, 1067 (63,82%) isolat adalah E. coli penghasil ESBL dan 902 isolat (69,39%) adalah K. pneumoniae penghasil ESBL. Isolat penghasil ESBL ditemukan terbanyak pada non-ICU (89,39%). Bakteri E.coli penghasil ESBL menunjukkan sensitivitas > 80% terhadap Amikacin, Ertapenem, Meropenem, Nitrofurantoin, Piperacillin-tazobactam, dan Tigecycline. Sedangkan, K. pneumoniae penghasil ESBL menunjukkan sensitivitas > 80% terhadap Amikacin, Ertapenem, Meropenem, dan Tigecycline. Penelitian ini menyoroti tingginya prevalensi E.coli dan K.pneumoniae penghasil ESBL di rumah sakit rujukan tersier di Bali. Analisis yang seksama dari antibiogram kedua spesies penghasil ESBL tersebut akan membantu menyusun kebijakan penggunaan antibiotik dan pencegahan, pengendalian penyebaran bakteri penghasil ESBL.Kata Kunci: Escherichia coli; Klebsiella pneumoniae; Extended Spectrum Beta Lactamases; ICU dan Non-ICU

scholarly journals Emergence of DIM-1 and KPC-1 Genes Associated Carbapenem-Resistant Pseudomonas Aeruginosa Isolates in Three Major Hospitals in Hanoi, Vietnam (2010-2015)

2021 ◽  
Author(s):  
Tran Hai Anh ◽  
Tran Huy Hoang ◽  
Vu Thi Ngoc Bich ◽  
Trinh Son Tung ◽  
Tran Dieu Linh ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Treatment Options ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Phylogenetic Tree Analysis ◽  
Antibiotic Resistant ◽  
Hospital Acquired Infection ◽  
Healthcare Settings ◽  
Carbapenem Resistant ◽  
Hospital Acquired

Abstract Background: Multidrug-resistant bacteria including carbapenem resistant Pseudomonas aeruginosa are recognised as an important cause of hospital-acquired infections worldwide. To determine the molecular characterisation and antibiotic resistant genes associated with carbapenem-resistant P. aeruginosa. Methods: we conducted whole-genome sequencing and phylogenetic analysis of 72 carbapenem-resistant P. aeruginosa isolated from hospital-acquired infection patients from 2010 to 2015 in three major hospitals in Hanoi, Vietnam. Results: We identified three variants of IMP genes, among which IMP-15 gene was the most frequent (n= 34) in comparison to IMP-26 (n= 2) and IMP-51 (n=12). We observed two isolates with imipenem MIC >128mg/L that co-harboured IMP-15 and DIM-1 genes and seven isolates (imipenem MIC> 128mg/L) with KPC-1 gene from the same hospital. MLST data showed that sequence types (ST) of 72 isolates were classified into 18 STs and phylogenetic tree analysis divided these isolates into nine groups. Conclusion: Our results provide evidence that not only IMP-26, but other variants of IMPs like IMP-15 and IMP-51 genes and several STs (ST235, ST244, ST277, ST310, ST773 and ST3151) have been disseminated in health care settings in Vietnam. Also, we report the first finding in Vietnam that two isolates belonging to ST1240 and ST3340 harboured two important carbapenemase genes (IMP-15 and, DIM-1) and seven isolates belonging to ST3151 of P. aeruginosa carried the KPC-1 gene, which could be a potential cause of seriously restricted available treatment options in healthcare settings.

scholarly journals 1099. The Correlation Between Antimicrobial Utilization and Resistance in a Medical Intensive Care Unit

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S390-S391
Author(s):  
John W Ahern ◽  
Lindsay Smith ◽  
W Kemper Alston
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Intensive Care Unit ◽  
Resistance Index ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Antimicrobial Utilization ◽  
Multidrug Resistant Organisms ◽  
Medical Intensive Care ◽  
The Relationship

Abstract Background The relationship between antimicrobial utilization and the incidence of antimicrobial-resistant pathogens can be obscured by a lack of longitudinal data. We used 9 years of antimicrobial utilization data combined with a unique metric of antimicrobial resistance to examine this relationship. Methods The medical intensive care unit (MICU) at UVMMC has 22 beds. The unit’s size and location did not change during the study. Since 2010, defined daily doses (DDD) in the MICU for ceftazidime, ceftriaxone, cefepime, ciprofloxacin, levofloxacin, piperacillin–tazobactam, meropenem, and vancomycin were measured. Concurrently, a database of positive cultures acquired in MICU, whether colonization or infection, was built for 6 selected organisms: Clostridioides difficile, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, ceftazidime-resistant Gram-negative bacilli, fluoroquinolone-resistant Pseudomonas aeruginosa (QRPA), and Stenotrophomonas maltophilia. The occurrence of these 6 organisms/1,000 patient-days is termed “resistance index.” Data for both metrics were collected in the same way, by the same person, throughout. The relationship between these 2 measures was analyzed with simple linear regression. Results From 2010 to 2018, the use of 8 broad-spectrum antibiotics fell in a linear fashion from 12.11 to 4.39 DDD/100,000 patient-days. The resistance index for the 6 multidrug-resistant organisms in MICU also fell in parallel from 6.5 to 1.5/1,000 patient-days (figure, r = 0.9, P = 0.001). For the 2 quinolones specifically, use fell from 2.26 to 0.18 DDD/100,000 patient-days, while the occurrence of QRPA fell from 1.5 to 0/1,000 patient-days (figure, r = 0.84, P = 0.004). Conclusion These longitudinal data, collected consistently over 9 years, clearly demonstrate a significant correlation between broad-spectrum antibiotic use and the occurrence of multidrug-resistant organisms in a MICU. A steep, linear decline in antibiotic use was correlated with a parallel fall in these 6 organisms. These data demonstrate that sustained, meaningful reductions in antimicrobial utilization in a MICU can result in significant reductions in the incidence of antimicrobial-resistant pathogens. Disclosures All authors: No reported disclosures.

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