scholarly journals Resistance Pattern of Carbapenem on Enterobacteriaceae

2018 ◽  
Vol 56 (214) ◽  
pp. 931-935
Author(s):  
Khilasa Pokharel ◽  
Bishwa Raj Dawadi ◽  
Chandra Prakash Bhatta ◽  
Satish Gupte ◽  
Beena Jha
Keyword(s):  
Culture Media ◽  
Antibiotic Sensitivity ◽  
Polymyxin B ◽  
Control Measures ◽  
Resistance Pattern ◽  
Clinical Microbiology Laboratory ◽  
Cross Sectional ◽  
Carbapenem Resistant ◽  
The Family ◽  
Carbapenem Resistant Enterobacteriaceae

Introduction: Gram negative bacilli are the important causes of common clinical infections. Carbapenem resistant Enterobacteriaceae are considered as important public health threat and is classified as urgent by the Centers of Disease Control and Prevention because of their progressive geographic dissemination and limited therapeutic alternatives. This study was done to find out the resistance pattern of Carbapenem among Enterobacteriaceae.Methods: The descriptive cross-sectional study was carried out in Clinical Microbiology laboratory from February 2018 to May 2018 after ethical approval. Organism was identified on the basis of its microscopic observation by performing Gram’s stain and by identification of morphology after its growth in culture media followed by its biochemical reactions. Antibiotic sensitivity test of isolated pathogens was done using Muller Hinton Agar by the standard disk diffusion technique of Kirby-Bauer method.Results: In our study, total 1055 sample belongs to the family Enterobacteriaceae. From the family Enterobactericeae, 348 (27%) of the bacilli were found to be Carbapenem resistant. Among which most common bacteria was Klebsiella pneumoniae followed by Escherichia coli. All strains of Carbapenem resistant Enterobacteriaceae were sensitive to Colistin, Polymyxin B and Tigecycline. Conclusions: Among Enterobacteriaceae, around one-third of the bacterial isolates were Carbapenem resistant. However, to reduce drug resistance antimicrobial stewardship programme and proper infection control measures is required.

scholarly journals Neonates with Maternal Colonization of Carbapenemase-Producing, Carbapenem-Resistant Enterobacteriaceae: A Mini-Review and a Suggested Guide for Preventing Neonatal Infection

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 399
Author(s):  
Judy Seesahai ◽  
Paige Terrien Church ◽  
Elizabeth Asztalos ◽  
Melanee Eng-Chong ◽  
Jo Arbus ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Neonatal Infection ◽  
Control Measures ◽  
Resistant Bacteria ◽  
Negative Consequences ◽  
Duration Of Treatment ◽  
Contact Precautions ◽  
Carbapenem Resistant ◽  
Carbapenem Resistant Enterobacteriaceae

Carbapenemase-producing, carbapenem-resistant Enterobacteriaceae (CP-CRE) are highly drug-resistant Gram-negative bacteria. They include New Delhi metallo-ß-lactamase (NDM)-producing carbapenemase (50.4% of all species in Ontario). Antibiotic challenges for resistant bacteria in neonates pose challenges of unknown dosing and side effects. We report two antenatally diagnosed CP-CRE colonization scenarios with the NDM 1 gene. The case involves extreme preterm twins who had worsening respiratory distress at birth requiring ventilator support, with the first twin also having cardiovascular instability. They were screened for CP-CRE, and a polymyxin antibiotic commenced. In the delivery room, neonatal intensive care unit (NICU) and the follow-up clinic, in collaboration with the interdisciplinary group, contact precautions and isolation procedures were instituted. None of the infants exhibited infection with CP-CRE. Consolidating knowledge with regard to CP-CRE and modifying human behavior associated with its spread can mitigate potential negative consequences. This relates to now and later, when travel and prolific human to human contact resumes, from endemic countries, after the current COVID-19 pandemic. Standardized efforts to curb the acquisition of this infection would be judicious given the challenges of treatment and continued emerging antibiotic resistance. Simple infection control measures involving contact precautions, staff education and parental cohorting can be useful and cost-effective in preventing transmission. Attention to NICU specific measures, including screening of at-risk mothers (invitro fertilization conception) and their probands, careful handling of breastmilk, judicious antibiotic choice and duration of treatment, is warranted. What does this study add? CP-CRE is a nosocomial infection with increasing incidence globally, and a serious threat to public health, making it likely that these cases will present with greater frequency to the NICU team. Only a few similar cases have been reported in the neonatal literature. Current published guidelines provide a framework for general hospital management. Still, they are not specific to the NICU experience and the need to manage the parents’ exposure and the infants. This article provides a holistic framework for managing confirmed or suspected cases of CP-CRE from the antenatal care through the NICU and into the follow-up clinic targeted at preventing or containing the spread of CP-CRE.

A National Intervention to Prevent the Spread of Carbapenem-Resistant Enterobacteriaceae in Israeli Post-Acute Care Hospitals

2014 ◽  
Vol 35 (7) ◽  
pp. 802-809 ◽  
Author(s):  
Debby Ben-David ◽  
Samira Masarwa ◽  
Amos Adler ◽  
Hagit Mishali ◽  
Yehuda Carmeli ◽  
...  
Keyword(s):  
Infection Control ◽  
Acute Care ◽  
Acute Care Hospitals ◽  
Control Measures ◽  
Resistant Bacteria ◽  
Carbapenem Resistant ◽  
Control Intervention ◽  
The Impact ◽  
Carbapenem Resistant Enterobacteriaceae ◽  
Post Acute Care

ObjectivePatients hospitalized in post-acute care hospitals (PACHs) constitute an important reservoir of antimicrobial-resistant bacteria. High carriage prevalence of carbapenem-resistant Enterobacteriaceae (CRE) has been observed among patients hospitalized in PACHs. The objective of the study is to describe the impact of a national infection control intervention on the prevalence of CRE in PACHs.DesignA prospective cohort interventional study.SettingThirteen PACHs in Israel.InterventionA multifaceted intervention was initiated between 2008 and 2011 as part of a national program involving all Israeli healthcare facilities. The intervention has included (1) periodic on-site assessments of infection control policies and resources, using a score comprised of 16 elements; (2) assessment of risk factors for CRE colonization; (3) development of national guidelines for CRE control in PACHs involving active surveillance and contact isolation of carriers; and (4) 3 cross-sectional surveys of rectal carriage of CRE that were conducted in representative wards.ResultsThe infection control score increased from 6.8 to 14.0 (P < .001) over the course of the study period. A total of 3,516 patients were screened in the 3 surveys. Prevalence of carriage among those not known to be carriers decreased from 12.1% to 7.9% (P = .008). Overall carrier prevalence decreased from 16.8% to 12.5% (P = .013). Availability of alcohol-based hand rub, appropriate use of gloves, and a policy of CRE surveillance at admission to the hospital were independently associated with lower new carrier prevalence.ConclusionA nationwide infection control intervention was associated with enhanced infection control measures and a reduction in the prevalence of CRE in PACHs.

scholarly journals Epidemiology of carbapenem-resistant Enterobacteriaceae in a Tertiary Care Center in the Kingdom of Bahrain

2019 ◽  
Vol 11 (02) ◽  
pp. 111-117 ◽  
Author(s):  
Nermin Kamal Saeed ◽  
Safaa Alkhawaja ◽  
Nashawa Fawzy Abd El Moez Azam ◽  
Khalil Alaradi ◽  
Mohammed Al-Biltagi
Keyword(s):  
Control Measure ◽  
Care Center ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Control Measures ◽  
Clinical Samples ◽  
Common Source ◽  
Care Hospital ◽  
Carbapenem Resistant ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract PURPOSE: The purpose of the study is to estimate the rate of infection with carbapenem-resistant Enterobacteriaceae (CRE) in the main governmental tertiary care hospital in Bahrain. MATERIALS AND METHODS: All clinical samples with positive growth of CRE over 6-year period (January 2012–December 2017) were collected from the microbiology laboratory data. RESULTS: The CRE incidence was high in the first half of study period (2012–2014) and then decreased between 2015 and 2017, after implementation of intensified CRE control measure bundle. About 49.4% of CRE-positive samples were isolated from the elderly age group (above 65 years old), most of them were admitted in the intensive care unit (ICU). The most common isolated organisms were Klebsiella pneumoniae (87.0%), followed by Escherichia coli (7.9%). Isolates from deep tracheal aspirate and midstream urine specimens were the most common source of CRE isolates (27.3%) and (26.3%), respectively. Bacteremia was documented in 21.2% of cases. CRE isolates in the study showed high rates of resistance to aminoglycosides (72.2% resistant to amikacin and 67.3% to gentamicin). Alternatively, most isolates retained their susceptibility to colistin and tigecycline with sensitivity of 83.9% and 85.7%, respectively. Combined resistance to both colistin and tigecycline was observed in 0.06% of total isolates. CONCLUSION: Elderly population and ICU admission were important risk factors for CRE acquisition. Most of CRE isolates were sensitive to both colistin and tigecycline, which make them the best combination for empiric frontline therapy for suspected serious CRE infection in our facility. Implementing CRE-bundled infection control measures significantly reduced the incidence of CRE infection in our hospital.

scholarly journals 2145. Carbapenem-Resistant Enterobacteriaceae infections at the Maharaj Nakorn Chiang Mai Hospital

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S727-S727
Author(s):  
Romanee Chaiwarith ◽  
Wisarut Supparatpinyo
Keyword(s):  
Univariate Analysis ◽  
Tertiary Care ◽  
Control Measures ◽  
Fisher Exact Test ◽  
Care Hospital ◽  
Chiang Mai ◽  
Chi Square ◽  
Exact Test ◽  
Carbapenem Resistant ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract Background Nowadays, carbapenem-resistant enterobacteriaceae (CRE) infection has been spreading worldwide in a tertiary care hospital and causing globally health damage. In Thailand, the studies of the epidemiology of CRE are scarce. This study aimed to describe epidemiology, clinical characteristics and treatment outcome of CRE infection. Methods A retrospective cohort study was conducted among patients admitted to the Maharaj Nakorn Chiang Mai Hospital between January 2014 and December 2016 who had clinical diagnosis of CRE infection. Characteristics between groups were compared using Chi-square, Fisher exact test or Student t-test, Mann–Whitney U test. Factors associated with mortality in univariate analysis were analyzed in the logistic regression model. Results Among 241 patients who had clinical specimens grew CRE, 51 had infection. Twenty-five patients (49%) were previously hospitalized within 90 days and 42 patients (82.4%) had exposed to antibiotics before documented CRE infection. The most common sites of clinical isolates were urine (33.3%), sputum (29.4%), and blood (21.6%). The mortality rate was 47.1%, which 17 (33.3%) patients’ death was attributable to CRE infection. Factor associated with mortality was higher body temperature (OR 4.8, P = 0.005) and thrombocytopenia. Conclusion CRE infections cause high mortality. Strategies to prevent emergence through prudent uses of antibiotics and transmission through infection control measures should be implemented in order to reduce mortality. Disclosures All authors: No reported disclosures.

scholarly journals Comprehensive Arrayed Transposon Mutant Library of Klebsiella pneumoniae Outbreak Strain KPNIH1

2017 ◽  
Vol 199 (20) ◽  
Author(s):  
Beth Ramage ◽  
Roxanne Erolin ◽  
Kiara Held ◽  
Joe Gasper ◽  
Eli Weiss ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Complex Traits ◽  
Antibiotic Sensitivity ◽  
Genetic Dissection ◽  
Mutant Library ◽  
Nosocomial Pathogens ◽  
Content Type ◽  
Phenotypic Microarray ◽  
Carbapenem Resistant ◽  
The Family

ABSTRACT Klebsiella pneumoniae and other carbapenem-resistant members of the family Enterobacteriaceae are a major cause of hospital-acquired infections, yet the basis of their success as nosocomial pathogens is poorly understood. To help provide a foundation for genetic analysis of K. pneumoniae, we created an arrayed, sequence-defined transposon mutant library of an isolate from the 2011 outbreak of infections at the U.S. National Institutes of Health Clinical Center. The library is made up of 12,000 individually arrayed mutants of a carbapenemase deletion parent strain and provides coverage of 85% of the predicted genes. The library includes an average of 2.5 mutants per gene, with most insertion locations identified and confirmed in two independent rounds of Sanger sequencing. On the basis of an independent transposon sequencing assay, about half of the genes lacking representatives in this “two-allele” library are essential for growth on nutrient agar. To validate the use of the library for phenotyping, we screened candidate mutants for increased antibiotic sensitivity by using custom phenotypic microarray plates. This screening identified several mutations increasing sensitivity to β-lactams (in acrB1, mcrB, ompR, phoP1, and slt1) and found that two-component regulator cpxAR mutations increased multiple sensitivities (to an aminoglycoside, a fluoroquinolone, and several β-lactams). Strains making up the two-allele mutant library are available through a web-based request mechanism. IMPORTANCE K. pneumoniae and other carbapenem-resistant members of the family Enterobacteriaceae are recognized as a top public health threat by the Centers for Disease Control and Prevention. The analysis of these major nosocomial pathogens has been limited by the experimental resources available for studying them. The work presented here describes a sequence-defined mutant library of a K. pneumoniae strain (KPNIH1) that represents an attractive model for studies of this pathogen because it is a recent isolate of the major sequence type that causes infection, the epidemiology of the outbreak it caused is well characterized, and an annotated genome sequence is available. The ready availability of defined mutants deficient in nearly all of the nonessential genes of the model strain should facilitate the genetic dissection of complex traits like pathogenesis and antibiotic resistance.

scholarly journals FAKTOR – FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN SERANGAN JANTUNG KORONER DI POLIKLINIK KHUSUS JANTUNG RSUP DR. M. DJAMIL PADANG 2017

2018 ◽  
Vol 2 (1) ◽  
pp. 39-44
Author(s):  
Revi Neini Iqbal ◽  
Rebbi Permata Sari
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Significant Relationship ◽  
Random Sampling ◽  
Design Research ◽  
Simple Random Sampling ◽  
Control Measures ◽  
Cross Sectional ◽  
Analytical Technique ◽  
The Family

Abstract   Coronary heart diseaseis a diseaseof highcurrentand is theleading cause of death, especially inworld. Based on theinitialresearchstudyof10familiesincludinga family of 7peopledo notknowabout theearly symptoms, attitudesandefforts tocontrolandtreatmentofcoronaryheartdisease, resulting in the risk ofcoronary heartdisease. The purpose ofthe studyto determine thefactors-factors related tothe incidence ofcoronary heart disease. Design research is an analytical technique using cross sectional study, conducted in the department of cardiac clinic of Dr. M. Djamil Padang on 05 May s/d 04 September 2017. Respondent control of coronary heart disease as much as 1557 people. The sample was 94 people simple random sampling analysis data processing through univariate and bivariate. Get research results coronary heart disease events (68,1%), negative attitudes (57,4%) and family measures on the incidence of heart attacks that have a unfavorable action (59,6%). Found a significant relationship between the attitude of the family with the incidence of coronary heart disease (p = 0.003) and asignificant correlation between the actions of the family incidence of coronary heart disease (p = 0.004). The results of this study it can be concluded that there is a significant relationship attitudes and actions of family on the incidence of coronary heart Advice for nurses in the cardiac clinic to improve the delivery of information and services, especially in the provision attitudes and actions towards family understanding of coronary heart disease and control measures in the form of leaflets or counseling. Keywords : attitudes, family action, the incidence of heart attack, heart control, heart coroner.   Abstrak Penyakit jantung koroner merupakan penyakit penyebab kematian nomor satu di dunia. Bedasarkan studi awal penelitian dari 10 orang keluarga 7 orang keluarga diantaranya tidak mengetahui tentang gejala awal, sikap dan upaya pengendalian dan perawatan dari penyakit jantung koroner. Tujuan penelitian untuk mengetahui faktor–faktor yang  berhubungan dengan kejadian serangan jantung koroner. Desain penelitian adalah analitik dengan menggunakan tehnik penelitian cross sectional, yang dilakukan di poliklinik jantung RSUP Dr. M. Djamil Padang. Penelitian dilakukan pada tanggal 05 Mei s/d 04 September 2017. Populasi adalah keluarga yang mendampingi pasien dengan penyakit jantung koroner. Dengan jumlah populasi 1157 orang. Sampel berjumlah 94 orang simple random sampling pengolahan data melalui analisa data secara univariat dan bivariat.  Hasil penelitian menunjukkan kejadian serangan jantung (68,1%.), sikap negatif (57,4%) tindakan yang tidak baik (59,6%). Di temukan adanya hubungan yang bermakna sikap keluarga dengan kejadian serangan jantung koroner (p=0,003) dan ada hubungan yang bermakna tindakan keluarga terhadap kejadian serangan jantung koroner (p=0,004). Hasil penelitian dapat disimpulkan bahwa ada hubungan yang bermakna antara sikap dan tindakan keluarga terhadap kejadian serangan jantung koroner. Peneliti menyarankan kepada perawat di poliklinik jantung untuk dapat memberikan penyuluhan tentang pemahaman sikap, dan tindakan keluarga terhadap penyakit jantung koroner dan upaya pengendaliannya.. Kata Kunci: sikap, tindakan keluarga, kejadian serangan jantung, pengendalian, jantung korener

scholarly journals RECORRIDO HISTÓRICO CENTRO COMERCIAL PLAZA DE MERCADO DE UBATÉ

2021 ◽  
Vol 8 (16) ◽  
pp. 37-42
Author(s):  
NORMA NARVÁEZ ◽  
◽  
NUBIA GUERRERO ◽  
GINA FUENTES
Keyword(s):  
Health Status ◽  
San Diego ◽  
Health And Safety ◽  
Cross Sectional Study ◽  
Control Measures ◽  
Sectional Study ◽  
Cross Sectional ◽  
Informal Workers ◽  
The Family ◽  
Commercial Center

Some The Villa of San Diego de Ubaté has been the main municipal seat, thus being the commercial center with the greatest influx, bringing together peasants not only from the central savannah, but also from Bogotá, people who gather around traditions and sale of products. that are harvested by themselves and by their families, thus being the family sustenance. The objective of this study is to make a diagnosis of informal workers who work in the Plaza de Mercado Villa de San Diego de Ubaté. This research is an observational, cross-sectional study with a quantitative approach and descriptive scope. An instrument was designed that assesses sociodemographic and occupational variables, health status, and health and safety conditions at work, the sample was 183 jobs who participated voluntarily. The main findings are found in the number of people who work especially in the batán (43%), peasant (25%) and fruver (15%) sections, showing discomfort mainly at the musculoskeletal level. It is concluded that it is necessary to implement control measures in the person, at the source and in the middle, in order to improve the health and safety conditions at work of informal workers.

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