Molecular epidemiology and the clinical impact of carbapenemase-producing Enterobacterales isolates among adult patients: aspects from a Romanian non-teaching hospital

AbstractIntroduction: A dramatic increase of infections induced by carbapenemase-producing Enterobacterales (CPE) has been registered worldwide. The aim of this study was to evaluate the molecular epidemiology and the clinical impact of CPE strains isolated from adult inpatients.Material and methods: A one-year, single-center, retrospective observational study including 34 consecutive patients with 37 non-duplicate CPE strains recovered from clinical specimens was accomplished. The Vitek 2 Compact, M.I.C.Evaluator strips, the modified carbapenem inactivation method (mCIM), and the combination disks test (KPC, MBL, OXA-48 Confirm kit, Rosco Diagnostica) were applied as phenotypic tests. A multiplex polymerase chain reaction (PCR) assay was used for detection of blaKPC, blaNDM, and blaOXA-48-like genes. The clonality was assessed with pulsed-field gel electrophoresis (PFGE).Results: Klebsiella pneumoniae (n=25) was the most frequent CPE encountered. The carbapenemase types were NDM (n=13), KPC (n=12), and OXA-48-like (n=12). Two distinct clonal clusters were identified among the 12 KPC positive strains. All CPE isolates exhibited non-susceptibility to carbapenems, cephalosporins, ciprofloxacin. Respiratory tract infections (n=16) and hospitalization in the intensive care unit (ICU) (n=14) were dominant. The most common comorbidity was congestive heart failure (n=11). Monotherapy was the main strategy adopted (n=15). Death occurred in 18 patients.Conclusions: Our analysis underscores the scarcity of antibiotic solutions and high mortality. Monotherapy for urinary tract infections (UTIs) is beneficial. Inter- or intrahospital dissemination of successful epidemic clones is proved. The adequate CPE infections control programs and antimicrobial policies are essential..

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Incidence of respiratory syncytial virus in hospitalized children less than 2 years of age with acute lower respiratory tract infections using multiplex real-time polymerase chain reaction in a tertiary care hospital

Asian Pacific Journal of Health Sciences ◽

10.21276/apjhs.2017.4.4.19 ◽

2017 ◽

Vol 4 (4) ◽

pp. 77-80

Author(s):

Gaganpreet Kaur Grewal ◽

Bimla Devi ◽

Pushpa Devi ◽

Karnail Singh

Keyword(s):

Respiratory Tract Infections ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Hospitalized Children ◽

Care Hospital ◽

Lower Respiratory Tract Infections ◽

Chain Reaction ◽

Polymerase Chain ◽

Syncytial Virus ◽

Tract Infections

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The value of polymerase chain reaction for the diagnosis of viral respiratory tract infections in lung transplant recipients

Journal of Clinical Virology ◽

10.1016/s1386-6532(02)00006-9 ◽

2002 ◽

Vol 25 (2) ◽

pp. 171-175 ◽

Cited By ~ 54

Author(s):

Adriana Weinberg ◽

Martin R Zamora ◽

Shaobing Li ◽

Fernando Torres ◽

Tony N Hodges

Keyword(s):

Polymerase Chain Reaction ◽

Respiratory Tract ◽

Lung Transplant ◽

Respiratory Tract Infections ◽

Transplant Recipients ◽

Chain Reaction ◽

Polymerase Chain ◽

Lung Transplant Recipients ◽

Tract Infections ◽

Viral Respiratory

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Prevalence and clinical impact of VIral Respiratory tract infections in patients hospitalized for Community-Acquired Pneumonia: the VIRCAP study

Internal and Emergency Medicine ◽

10.1007/s11739-019-02243-9 ◽

2019 ◽

Vol 15 (4) ◽

pp. 645-654 ◽

Cited By ~ 2

Author(s):

P. Tatarelli ◽

L. Magnasco ◽

M. L. Borghesi ◽

C. Russo ◽

A. Marra ◽

...

Keyword(s):

Respiratory Tract ◽

Respiratory Tract Infections ◽

Community Acquired Pneumonia ◽

Clinical Impact ◽

Tract Infections ◽

Viral Respiratory

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Cefsulodin Treatment for Serious Pseudomonas aeruginosa Infections

Journal of International Medical Research ◽

10.1177/030006058601400504 ◽

1986 ◽

Vol 14 (5) ◽

pp. 242-253 ◽

Cited By ~ 2

Author(s):

A Routman ◽

W Van Manen ◽

R Haddad ◽

B Pollock ◽

B Holmes ◽

...

Keyword(s):

Pseudomonas Aeruginosa ◽

Respiratory Tract Infections ◽

Adverse Reactions ◽

Severe Trauma ◽

Lower Respiratory Tract Infections ◽

Alcohol And Drugs ◽

Post Traumatic ◽

Satisfactory Clinical Response ◽

One Year ◽

Tract Infections

Cefsulodin, a narrow-spectrum cephalosporin with excellent antipseudomonal activity was used to treat 48 patients with 51 Pseudomonas aeruginosa infections. These included osteomyelitis, infected prostheses, post-operative and post-traumatic superficial wounds, decubitus and stasis ulcers, lower respiratory tract infections and infections of the urinary tract. Many of the patients were compromised by underlying debilitating conditions such as severe trauma, diabetes mellitus, vascular impairment, and abuse of alcohol and drugs. In cases of polymicrobial infections, a concomitant non-antipseudomonal antibiotic was sometimes administered. Cefsulodin was administered intravenously to 47 patients and by intramuscular injections to one individual. The dosage ranged from 0.5 to 2.0 g every six hr and duration of therapy was from 4 to 70 days. A satisfactory clinical response was observed in 88% of the patients. P. aeruginosa was eradicated from 76% of the infection sites. Failures, which included relapse within one year, were generally associated with prior severe trauma or vascular impairment in cases of osteomyelitis. Reinfections and superinfections developed in 12 individuals. Adverse reactions reported for two patients were nausea and vomiting. A third patient had transient increases in alkaline phosphatase and SGOT. These data indicate that cefsulodin is an effective and safe antibiotic in various types of P. aeruginosa infections.

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