Routine Nosocomial Infection Screening among Onco-Hematological Patients- Does It Change Management?

2021 ◽  
Vol 12 (4) ◽  
pp. 76-80
Author(s):  
Shadma Yaqoob ◽  
Areena Hoda Siddiqui ◽  
Sunil Sharad Dabadghao
Keyword(s):  
Nosocomial Infection ◽  
Empirical Therapy ◽  
Predictive Marker ◽  
Blood Cultures ◽  
Routine Screening ◽  
P Value ◽  
Beta Lactamases ◽  
Oncology Ward ◽  
Extended Spectrum Beta Lactamases ◽  
Time Of Admission

Background: Hospital acquired infection (HAI) or Nosocomial Infection (NI) is a well-known entity among patients. The onco-hemological patients are immune-compromised and are at high risk of acquiring these infections. Routine screening of these patients for the presence of micro-organisms, their identification and sensitivity at the time of admission, and during stay, can help us in identifying infections and guiding therapy. Aims and Objective: This study was undertaken to find out the role of routine screening of admitted patients in oncology ward with empirical therapy during neutropenic episodes. Nosocomial Infection Screening (NIS) test was performed for these patients. This test was done to detect Methicillin Resistant Staphylococcus Aureus (MRSA) and Extended Spectrum Beta Lactamases (ESBL) producing Gram Negatives. The NIS results obtained were correlated with organisms isolated from blood cultures. Material and Methods: This retrospective study was done from period of May, 2013 to February,2017 in patients of oncology ward. Only those patients whose NIS test and blood culture was sent to the lab were included in the study. Result: A Total number of 52 NIS tests and blood cultures were included in the study. Among 28 positive NIS samples, 19 samples correlated with blood cultures. Among 24 negative NIS sample 17 correlated with blood cultures. The p value was 0.017, PPV 73%, NPV 64%. SPSS software was used to calculated values. Conclusion: This study showed that NIS test can be used as a tool for predictive marker for septic episodes in these patients.There is a higher probability of developing septic episodes with positive NISsamples.At the same time negative NIS result does not rule out infection.

scholarly journals The frequency of resistance to antibiotics of most frequently isolated bacteria from blood cultures during the period 1997-2002

2004 ◽  
Vol 61 (4) ◽  
pp. 391-397
Author(s):  
Veljko Mirovic ◽  
Branka Tomanovic ◽  
Sonja Konstantinovic
Keyword(s):  
Clinical Laboratory ◽  
Blood Cultures ◽  
Diffusion Method ◽  
National Committee ◽  
Disk Diffusion Method ◽  
Beta Lactamases ◽  
Resistance To Antibiotics ◽  
Extended Spectrum Beta Lactamases ◽  
High Level

The aim of this study was to determine the frequency of resistance to antibiotics of the most frequently isolated bacteria from blood cultures of hospitalized patients during the period 1997-2002. The resistance to antibiotics was determined by disk diffusion method according to National Committee for Clinical Laboratory Standards procedures. The majority of staphylococci isolates were resistant to methicillin, and the proportion of methicillin-resistant Staphylococcus aureus was stable (76.8-81.6%), during the follow-up period. None of the staphylococci isolates were resistant to vancomycin, but there was a very high incidence of high-level resistance of enterococci to aminoglycosides (47.2-72.2%). In 1998, only one strain among enterococci was resistant to vancomycin (Enterococcus faecium, VanA fenotype). Enterococcus spp isolates expressed variable frequency of resistance to ampicillin (15-40.1%) during the follow-up period. Among Enterobacteriaceae there were no isolates resistant to imipenem, but dramatic increase of the resistance to ceftriaxone was found from 35.9% in 1997 to 95.9% in 2002 (p<0.001). Extended spectrum beta-lactamases production was found in all the species of enterobacteria isolates. Resistance to imipenem was observed in Acinetobacter spp isolates in 2002 for the first time. Pseudomonas spp isolates expressed high and very variable resistance to all antibiotics tested during the follow-up period.

scholarly journals Evaluation of Rapid Immunochromatographic Tests for the Direct Detection of Extended Spectrum Beta-Lactamases and Carbapenemases in Enterobacterales Isolated from Positive Blood Cultures

2021 ◽  
Author(s):  
Ahmed S. Keshta ◽  
Nazik Elamin ◽  
Mohammad Rubayet Hasan ◽  
Andrés Pérez-López ◽  
Diane Roscoe ◽  
...  
Keyword(s):  
Direct Detection ◽  
Bloodstream Infections ◽  
Resistance Mechanisms ◽  
Rapid Identification ◽  
Blood Cultures ◽  
Gram Negative Bacteria ◽  
Beta Lactamases ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases

The incidence of bloodstream infections (BSI) with extended spectrum beta-lactamase (ESBL) producing and carbapenemase producing Enterobacterales (CPE) is increasing at an alarming rate, for which only limited therapeutic options remain available. Rapid identification of these bacteria along with their antibiotic resistance mechanisms in positive blood cultures with Gram-negative bacteria will allow for early initiation of effective therapy and limit the overuse of broad-spectrum antibiotics in BSI (1).

scholarly journals Impact of SARS-COV-2 on the diagnosis of community bacteremia in a tertiary hospital

2022 ◽  
Author(s):  
Saray Mormeneo Bayo ◽  
Miguel Moreno Hijazo ◽  
María Pilar Palacián Ruíz, ◽  
María Cruz Villuendas Usón
Keyword(s):  
Escherichia Coli ◽  
Emergency Department ◽  
Staphylococcus Aureus ◽  
Tertiary Hospital ◽  
Blood Cultures ◽  
Contamination Rate ◽  
Beta Lactamases ◽  
E Coli ◽  
Number Of Patients ◽  
Extended Spectrum Beta Lactamases

Objective. We carry out an analysis of the bacteremia diagnosed in the Emergency Department during 2020, coinciding with the period of the pandemic. Method. We performed a retrospective analysis from March 4, 2020 to December 31, 2020. Results. The number of patients who went to the Emergency Department during the study period and the number of extracted blood cultures decreased by 46.79% and 35.7% compared to the same period in 2019 (p <0.05). 320 bacteremia occurred while 507 occurred in 2019, assuming a decrease of 36.8% (p <0.05). The positivity rate of blood cultures was 7.09% in 2020 and 7.23% in 2019 and the contamination rate was 7.07 % in 2020 and 5.67% in 2019. The most frequently isolated microorganism was Escherichia coli, followed by Staphylococcus aureus and Klebsiella pneumoniae. A 6.62% of the isolated E. coli were carriers of extended-spectrum beta-lactamases (ESBL). The percentage of methicillin-resistant S. aureus was 12.9 % and that of K. pneumoniae ESBL was 11.54%. Conclusion. During the SARS-CoV-2 pandemic there has been a decrease in the number of bacteremia diagnoses, it is possible that attention was focused especially on COVID, forgetting other diseases, such as bacteremia.

scholarly journals Genotypes and cephalosporin susceptibility in extended-spectrum beta-lactamase producing enterobacteriaceae in the community

2011 ◽  
Vol 6 (06) ◽  
pp. 470-477 ◽  
Author(s):  
Daniel Maina ◽  
Gunturu Revathi ◽  
Samuel Kariuki ◽  
Hastings Ozwara
Keyword(s):  
Local Community ◽  
Community Setting ◽  
Multidrug Resistant ◽  
P Value ◽  
Local Data ◽  
Beta Lactamases ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases ◽  
Susceptibility Profiles

Introduction:  Infections from extended spectrum beta lactamases (ESBLs) producing enterobacteriaceae are increasingly being reported in the community setting. These infections are often multidrug resistant, with clinical and epidemiological implications, and necessitate surveillance measures based on local data. In the present study ESBLs genotypes were correlated with susceptibility to cephalosporins among ESBL-producing Escherichia coli and Klebsiella pneumoniae isolates acquired in the community. Methodology:  We investigated 28 E. coli and 24 K. pneumoniae isolates by PCR for the presence of blaSHV, blaCTX-M, and blaTEM. Minimum inhibitory concentration (MIC) for cephalosporins was determined by use of E-tests. Results:  blaCTX-M was detected in 46 (88.5%), blaSHV in 13 (25%) and blaTEM in18 (34.6%) of the isolates. Nineteen (36.5%) isolates had more than one genotype detected. Urine specimens provided most of the ESBL-producing isolates (71%) followed by respiratory specimens (11%). MIC50 for cefotaxime, ceftazidime, and ceftriaxone were at 60μg/ml, 13μg/ml, and 139μg/ml, respectively. There was a statistically significant association (p-value = 0.017) between blaSHV and resistance to ceftazidime. Though other associations could be seen among the genotypes and susceptibility profiles of the three drugs, they were not statistically significant. Twenty-four (52.2%) of the blaCTX-M isolates were sensitive and nine (19.6%) resistant to ceftazidime. For cefotaxime, 29 (63%) of blaCTX-M isolates were resistant and two (4.3%) were sensitive. Conclusion:  The predominant ESBL genotype in the local community-acquired infections is blaCTX-M , most of which involved the urinary tract.  ESBL genes elevated MICs for the cephalosporins, but only blaSHV could predict resistance to ceftazidime.

scholarly journals Direct detection of extended-spectrum beta-lactamases (CTX-M) from blood cultures by LC-MS/MS bottom-up proteomics

2017 ◽  
Vol 36 (9) ◽  
pp. 1621-1628 ◽  
Author(s):  
F. Fleurbaaij ◽  
W. Goessens ◽  
H. C. van Leeuwen ◽  
M. E. M. Kraakman ◽  
S. T. Bernards ◽  
...  
Keyword(s):  
Direct Detection ◽  
Blood Cultures ◽  
Bottom Up ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases

scholarly journals The evaluation of eazyplexÒ SuperBug CRE test usefulness for the detection of ESBLs and carbapenemases genes directly from urine samples and positive blood cultures

2021 ◽  
Author(s):  
Alicja Sękowska ◽  
Tomasz Bogiel
Keyword(s):  
Genetic Material ◽  
Modern Medicine ◽  
Blood Cultures ◽  
Urine Samples ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Study Results ◽  
Genes Encoding ◽  
Extended Spectrum Beta Lactamases ◽  
Drug Resistant Strains

Abstract Background. An increasing antimicrobial resistance of Gram-negative rods is an important diagnostic, clinical and epidemiological problem of a modern medicine. Therefore, it is important to detect multi-drug resistant strains as quickly as possible. The aim of this study was to evaluate eazyplex® SuperBug CRE test for beta-lactamases genes detection among Gram-negative rods, directly from urine samples and positive blood cultures. Methods. Eazyplex® SuperBug CRE test is based on isothermal amplification of a genetic material and allows for the detection of a selection genes encoding carbapenemases, i.e. KPC, NDM, VIM, OXA-48, OXA-181 and extended-spectrum beta-lactamases from the CTX-M-1 and CTX-M-9 groups. A total of 120 clinical specimens were included in the study. Results. The test gave valid results for 58 (96.7%) urine samples and 57 (95.0%) positive blood cultures. ESBL and/or carbapenemase enzymes genes were detected in 56 urine and 55 blood samples, respectively. Conclusions. Eazyplex® SuperBug CRE test can be used for a rapid detection of the most important genes encoded for resistance to beta-lactams in Gram-negative rods also without the necessity of bacterial culture.

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