scholarly journals Bacterial Infections and Antimicrobial Resistance Patterns of Burn Wound Infections: A One Year Study from Burn Hospital, Isfahan, Iran

2020 ◽  
Vol 28 (128) ◽  
pp. 144-150
Author(s):  
Elham Haghighifar ◽  
Razie Kamali Dolatabadi ◽  
◽  
Keyword(s):  
Antimicrobial Resistance ◽  
Bacterial Infections ◽  
Wound Infections ◽  
Burn Wound ◽  
Resistance Patterns ◽  
One Year

scholarly journals Emerging Options for the Diagnosis of Bacterial Infections and the Characterization of Antimicrobial Resistance

2021 ◽  
Vol 22 (1) ◽  
pp. 456
Author(s):  
Simone Rentschler ◽  
Lars Kaiser ◽  
Hans-Peter Deigner
Keyword(s):  
Antimicrobial Resistance ◽  
Bacterial Infections ◽  
Point Of Care ◽  
Rapid Identification ◽  
Adequate Treatment ◽  
Resistance Patterns ◽  
Detection And Diagnosis ◽  
Patient Prognosis ◽  
Point Of Care Detection

Precise and rapid identification and characterization of pathogens and antimicrobial resistance patterns are critical for the adequate treatment of infections, which represent an increasing problem in intensive care medicine. The current situation remains far from satisfactory in terms of turnaround times and overall efficacy. Application of an ineffective antimicrobial agent or the unnecessary use of broad-spectrum antibiotics worsens the patient prognosis and further accelerates the generation of resistant mutants. Here, we provide an overview that includes an evaluation and comparison of existing tools used to diagnose bacterial infections, together with a consideration of the underlying molecular principles and technologies. Special emphasis is placed on emerging developments that may lead to significant improvements in point of care detection and diagnosis of multi-resistant pathogens, and new directions that may be used to guide antibiotic therapy.

scholarly journals Evaluation of the impact of antimicrobial use protocols in PRRS virus infected swine on phenotypic antimicrobial resistance patterns

2021 ◽  
Author(s):  
Carissa A. Odland ◽  
Roy Edler ◽  
Noelle R. Noyes ◽  
Scott A. Dee ◽  
Joel Nerem ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Longitudinal Studies ◽  
Bacterial Infections ◽  
Population Level ◽  
Control Group ◽  
Antimicrobial Use ◽  
Treatment Groups ◽  
Resistance Patterns ◽  
The Impact ◽  
Over Time

A longitudinal study was conducted to assess the impact of different antimicrobial exposures of nursery-phase pigs on patterns of phenotypic antimicrobial resistance in fecal indicator organisms throughout the growing phase. Based on practical approaches used to treat moderate to severe PRRSV-associated secondary bacterial infections, two antimicrobial protocols of differing intensity of exposure [44.1 and 181.5 animal-treatment days per 1000 animal days at risk (ATD)] were compared with a control group with minimal antimicrobial exposure (2.1 ATD). Litter-matched pigs (n = 108) with no prior antimicrobial exposure were assigned randomly to the treatment groups. Pen fecal samples were collected nine times during the wean-to-finish period and cultured for Escherichia coli and Enterococcus spp. Antimicrobial susceptibility testing was conducted using NARMS gram-negative and gram-positive antibiotic panels. Despite up to 65-fold difference in ATD, few and modest differences were observed between groups and over time. Resistant patterns at marketing overall remained similar to those observed at weaning, prior to any antimicrobial exposures. Those differences observed could not readily be reconciled with the patterns of antimicrobial exposure. Resistance of E. coli to streptomycin was higher in the group exposed to 44.1 ATD, but no aminoglycosides were used. In all instances where resistance differed between time points, the higher resistance occurred early in the trial prior to any antimicrobial exposures. These minimal impacts on AMR despite substantially different antimicrobial exposures point to the lack of understanding of the drivers of AMR at the population level and the likely importance of factors other than antimicrobial exposure. IMPORTANCE Despite a recognized need for more longitudinal studies to assess the effects of antimicrobial use on resistance in food animals, they remain sparse in the literature, and most longitudinal studies of pigs have been observational. The current experimental study had the advantages of greater control of potential confounding, precise measurement of antimicrobial exposures which varied markedly between groups and tracking of pigs until market age. Overall, resistance patterns were remarkably stable between the treatment groups over time, and the differences observed could not be readily reconciled with the antimicrobial exposures, indicating the likely importance of other determinants of AMR at the population level.

scholarly journals Regional Dissemination of a Carbapenemase-encoding Plasmid: Plasmidome analysis Reveals Diverse Adaptations of Carbapenemase-Producing Enterobacteriaceae

2020 ◽  
Author(s):  
Ryuichiro Abe ◽  
Yukihiro Akeda ◽  
Yo Sugawara ◽  
Dan Takeuchi ◽  
Yuki Matsumoto ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Bacterial Infections ◽  
Single Point ◽  
Complete Sequence ◽  
Surveillance Study ◽  
Single Point Mutation ◽  
Chromosomal Integration ◽  
Carbapenemase Gene ◽  
Resistance Patterns ◽  
Horizontal Spread

Abstract Background. The global dissemination of carbapenem-resistant Enterobacteriaceae (CRE) threatens human health by limiting the range of usable antibiotics even against common bacterial infections. The spread of CRE is primarily due to the transmission of carbapenemase genes located on plasmids. However, few studies have comprehensively identified regionally spreading carbapenemase-encoding plasmids because of the difficulty to determine the complete sequence of a plasmid encoding carbapenemases. In a CRE surveillance study of 1,507 patients from 43 hospitals in northern Osaka, Japan, we previously found that 12% of the patients carried CRE and 95% of CRE isolates were IMP-6 producers. This result suggested a vast horizontal spread of a clonal plasmid carrying blaIMP-6 among Enterobacteriaceae in this region. In the current study, we aimed to describe the dynamics of this regional horizontal plasmid transmission.Results. We systematically analysed the plasmids of 230 CRE isolates carrying blaIMP obtained in our previous surveillance study by using whole genome sequencing and Southern blotting. We detected a major population (187 out of 230 blaIMP-positive CRE isolates, 85.6%) that carried blaIMP-6 on the IncN plasmid pKPI-6, along with diverse minor subpopulations. Among the subpopulations, we identified a novel cluster carrying an IncF plasmid that leads to heteroresistance due to amplification of blaIMP-6, resulting in covert transmission of blaIMP-6 or occasional chromosomal integration of blaIMP-6. In addition, we detected one isolate that harboured blaIMP-1, which is identical to blaIMP-6 except for a single point mutation, on pKPI-6 and thus had acquired a broader range of antimicrobial resistance. Conclusions. Carbapenemase-encoding plasmid tracking revealed the clonal dissemination of pKPI-6 among chromosomally distinct isolates. Focusing on the mode of carbapenemase gene carriage is helpful for monitoring of horizontal spread of CRE isolates that is difficult to trace only by the comparisons of the whole genomes. A seemingly clonal horizontal dissemination of the predominant plasmid had embraced heterogenous subpopulations that contribute to diverse adaptations including covert transmission, stable chromosomal integration of blaIMP-6, or broadened antimicrobial resistance patterns, ultimately leading to treatment failure.

scholarly journals Bacterial infections and emerging resistance in renal transplant recipients

2014 ◽  
Vol 14 (1) ◽  
pp. 14-21 ◽  
Author(s):  
Inam Danish Khan ◽  
Ajay Kumar Sahni
Keyword(s):  
Renal Transplant ◽  
Antimicrobial Resistance ◽  
Bacterial Infections ◽  
Tertiary Care ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Beta Lactamases ◽  
Post Transplant ◽  
Resistance Patterns ◽  
Altered Metabolism

Objective: Renal transplantation is frequently complicated by bacterial infections in the scenario of immunosuppression, altered metabolism and interventions resulting in prolonged morbidity. Subdued clinical presentation, antimicrobial resistance and toxicity question the outcome of transplantation. This retrospective study conducted at tertiary care apex transplant centre highlights colonization, clinical infection and antimicrobial resistance patterns in Renal Transplant Recipients (RTR). Materials and methods: Infection and antimicrobial resistance patterns in 130 RTR were studied. Clinico-demographic and transplant parameters were noted. Infection screening in the post transplant period along with antimicrobial susceptibility were used to analyze data in a post transplant time frame. Results and discussion: Culture positivity timeline was dominated by post surgical infections in the first week post transplant. Urinary infections followed by blood stream infections were noted. Infection profile included simultaneous polymicrobial, prolonged and widespread infections. Multi-resistant organisms producing beta lactamases and extended spectrum beta lactamases were isolated. Conclusion: Transplant recipients remain prone to bacterial infections with multi-resistant organisms which may persist due to immunosuppression, altered metabolism and toxicity, and contribute to nosocomial hazard. Infection control may be targeted at avoidance of donor derived infections, surgical complications, epidemiologic exposures, strengthening antimicrobial prophylaxis and anti-infection engineering. Antimicrobial stewardship, outbreak and epidemic preparedness should be ensured. DOI: http://dx.doi.org/10.3329/bjms.v14i1.16306 Bangladesh Journal of Medical Science Vol.14(1) 2015 p.14-21

The role of phage therapy in burn wound infection management: advantages and pitfalls

2021 ◽  
Author(s):  
M M Azevedo ◽  
C Pina-Vaz ◽  
A Rodrigues
Keyword(s):  
Wound Infection ◽  
Bacterial Infections ◽  
Phage Therapy ◽  
Rapid Change ◽  
Bloodstream Infections ◽  
Wound Management ◽  
Wound Infections ◽  
Burn Wound ◽  
Regulatory Policies ◽  
Conventional Antibiotics

Abstract Burn wound infections are often the source of bacteria responsible for systemic infections, including bloodstream infections and pneumonia that ultimately can result in multisystem organ failure and death. Any rapid change in the burn wound appearance or the clinical condition of the burn patient may herald burn wound infection or sepsis. The revival of phage therapy, either in single mode or in combination with conventional antibiotics may represent a valuable alternative, to treat specific bacterial infections such as burn wound infections, including those caused by multidrug resistant organisms. This systematic review addresses the: a) general characteristics of bacteriophages; b) activity of bacteriophages versus conventional antibiotics; c) activity of bacteriophages against biofilms; d) bacteriophage administration; and e) use of bacteriophages in burn wound infections. Although several scientific organizations/societies recognized that phage therapy could be of key value in modern wound care, specific aspects are critical for a burn surgeon and might represent pitfalls discouraging phage therapy adoption in burn wound management; in particular, the unavailability of consensual therapeutic guidelines/regulatory policies and the lack of laboratorial support that might be predictive of its efficacy. The availability of a product/formulation convenient to use, with adequate stability and shelf half-life is also a key condition.

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