scholarly journals Evaluation of a Biocide Used in the Biological Isolation and Containment Unit of a Veterinary Teaching Hospital

Antibiotics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 639
Author(s):  
Catarina Geraldes ◽  
Cláudia Verdial ◽  
Eva Cunha ◽  
Virgílio Almeida ◽  
Luís Tavares ◽  
...  
Keyword(s):  
Organic Matter ◽  
Teaching Hospital ◽  
Antimicrobial Susceptibility ◽  
Multidrug Resistant ◽  
Cross Resistance ◽  
Induced Response ◽  
Minimal Bactericidal Concentration ◽  
Surveillance Systems ◽  
Susceptibility Profiles ◽  
Hospital Acquired

Hospital-acquired infections (HAIs) are a rising problem worldwide, and the best way of coping with them is through infection tracking and surveillance systems, combined with prevention strategies, namely efficient disinfection protocols, that employ various biocides. However, increasing reports about reductions in biocide susceptibility and the development of cross-resistance to antimicrobials emphasize the need for identifying the factors influencing biocide efficiency. In this study, 29 bacterial isolates (n = 3 E. coli, n = 2 Pseudomonas spp., n = 23 Enterococcus spp., and n = 1 Staphylococcus pseudintermedius), obtained from environmental samples collected from the Biological Isolation and Containment Unit (BICU), of the Veterinary Teaching Hospital of the Faculty of Veterinary Medicine, University of Lisbon, were tested in order to determine their antimicrobial susceptibility to various antibiotics. Thirteen of these isolates were further selected in order to determine their antimicrobial susceptibility to Virkon™ S, with and without the presence of organic matter. Afterward, seven of these isolates were incubated in the presence of sub-lethal concentrations of this formulation and, subsequently, new susceptibility profiles were determined. Fourteen of the 29 isolates (48.3%) were classified as multidrug resistant, all previously identified as enterococci. Concerning Virkon™ S’s susceptibility, the Minimal Bactericidal Concentration (MBC) of this biocide regarding all isolates was at least eight times lower than the concentration regularly used, when no organic matter was present. However, when organic matter was added, MBC values rose up to 23 times. After exposure to sub-lethal concentrations of Virkon™ S, four enterococci presented a phenotypical change regarding antimicrobial susceptibility towards gentamicin. Virkon™ S also resulted in higher MBC values, up to 1.5 times, in the presence of low concentrations of organic matter, but no rise in these values was observed in assays without interfering substance. Virkon™ S seemed to be an efficient formulation in eliminating all bacteria isolates isolated from the BICU. However, organic matter could represent a hindrance to this ability, which emphasizes the importance of sanitization before disinfection procedures. The changes seen in antimicrobial susceptibility could be explained by a general stress-induced response promoted by the sub-lethal levels of Virkon™ S. Additionally, when no organic matter was present, a decrease in susceptibility to this biocide seemed to be non-existent.

scholarly journals Gram-Negative Taxa and Antimicrobial Susceptibility after Fecal Microbiota Transplantation for Recurrent Clostridioides difficile Infection

mSphere ◽  
2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Danielle Barrios Steed ◽  
Tiffany Wang ◽  
Divyanshu Raheja ◽  
Alex D. Waldman ◽  
Ahmed Babiker ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Susceptibility ◽  
Fecal Microbiota Transplantation ◽  
Antibiotic Prescription ◽  
Multidrug Resistant ◽  
Fecal Microbiota ◽  
Gram Negative ◽  
Content Type ◽  
Clostridioides Difficile ◽  
Susceptibility Profiles

ABSTRACT Fecal microbiota transplantation (FMT) has promising applications in reducing multidrug-resistant organism (MDRO) colonization and antibiotic resistance (AR) gene abundance. However, data on clinical microbiology results after FMT are limited. We examined the changes in antimicrobial susceptibility profiles in patients with Gram-negative infections in the year before and the year after treatment with FMT for recurrent Clostridioides difficile infection (RCDI). We also examined whether a history of FMT changed health care provider behavior with respect to culture ordering and antibiotic prescription. Medical records for RCDI patients who underwent FMT at Emory University between July 2012 and March 2017 were reviewed retrospectively. FMT-treated patients with Gram-negative culture data in the 1-year period preceding and the 1-year period following FMT were included. Demographic and clinical data were abstracted, including CDI history, frequency of Gram-negative cultures, microbiological results, and antibiotic prescription in response to positive cultures in the period following FMT. Twelve patients were included in this case series. We pooled data from infections at all body sites and found a decrease in the number of total and Gram-negative cultures post-FMT. We compared susceptibility profiles across taxa given the potential for horizontal transmission of AR elements and observed increased susceptibility to nitrofurantoin, trimethoprim-sulfamethoxazole, and the aminoglycosides. FMT did not drastically influence health care provider ordering of bacterial cultures or antibiotic prescribing practices. We observed a reduction in Gram-negative cultures and a trend toward increased antimicrobial susceptibility. This study supports further investigation of FMT as a means of improving antimicrobial susceptibility. IMPORTANCE Fecal microbiota transplantation (FMT), which is highly efficacious in treating recurrent C. difficile infection (RCDI), has a promising application in decolonization of multidrug-resistant organisms, reduction of antibiotic resistance gene abundance, and restoration of healthy intestinal microbiota. However, data representing clinical microbiology results after FMT are limited. We sought to characterize the differences in culture positivity and antimicrobial susceptibility profiles in patients with Gram-negative infections in the year before and the year after FMT for RCDI. Drawing on prior studies that had demonstrated the success of FMT in eradicating extraintestinal infections and the occurrence of patient-level interspecies transfer of resistance elements, we employed an agnostic analytic approach of reviewing the data irrespective of body site or species. In a small RCDI population, we observed an improvement in the antimicrobial susceptibility profile of Gram-negative bacteria following FMT, which supports further study of FMT as a strategy to combat antibiotic resistance.

scholarly journals Antimicrobial Susceptibilities of Clostridium difficile Isolates from 12 Asia-Pacific Countries in 2014 and 2015

2020 ◽  
Vol 64 (7) ◽  
Author(s):  
Tanya Lew ◽  
Papanin Putsathit ◽  
Kyung Mok Sohn ◽  
Yuan Wu ◽  
Kentaro Ouchi ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Asia Pacific ◽  
Fluoroquinolone Resistance ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Content Type ◽  
Amoxicillin Clavulanate ◽  
Ongoing Surveillance ◽  
Susceptibility Profiles ◽  
Hospital Acquired

ABSTRACT Clostridium (Clostridioides) difficile causes toxin-mediated diarrhea and pseudomembranous colitis, primarily among hospital inpatients. Outbreaks of C. difficile infection (CDI) have been caused by strains with acquired antimicrobial resistance, particularly fluoroquinolone resistance, including C. difficile ribotype (RT) 027 in North America and Europe and RT 017, the most common strain in Asia. Despite being the most common cause of hospital-acquired infection in high-income countries, and frequent misuse of antimicrobials in Asia, little is known about CDI in the Asia-Pacific region. We aimed to determine the antimicrobial susceptibility profiles of a collection of C. difficile isolates from the region. C. difficile isolates (n = 414) from a 2014 study of 13 Asia-Pacific countries were tested for susceptibility to moxifloxacin, amoxicillin-clavulanate, erythromycin, clindamycin, rifaximin, metronidazole, vancomycin, and fidaxomicin according to the Clinical and Laboratory Standards Institute’s agar dilution method. All isolates were susceptible to metronidazole, vancomycin, amoxicillin-clavulanate, and fidaxomicin. Moxifloxacin resistance was detected in all countries except Australia, all RT 369 and QX 239 strains, and 92.7% of RT 018 and 70.6% of RT 017 strains. All C. difficile RT 012, 369, and QX 239 strains were also resistant to erythromycin and clindamycin. Rifaximin resistance was common in RT 017 strains only (63.2%) and was not detected in Australian, Japanese, or Singaporean isolates. In conclusion, antimicrobial susceptibility of C. difficile varied by strain type and by country. Multiresistance was common in emerging RTs 369 and QX 239 and the most common strain in Asia, RT 017. Ongoing surveillance is clearly warranted.

scholarly journals Multimodal Surveillance of HAI in an Intensive Care Unit of a Large Teaching Hospital

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
G Migliara ◽  
C Di Paolo ◽  
D Barbato ◽  
V Baccolini ◽  
C Salerno ◽  
...  
Keyword(s):  
Intensive Care ◽  
Incidence Rate ◽  
Teaching Hospital ◽  
Surveillance System ◽  
Multidrug Resistant ◽  
Surveillance Systems ◽  
Bacterial Isolates ◽  
Environmental Isolates ◽  
Infectious Risk ◽  
Large Teaching Hospital

Abstract Background Healthcare associated Infections (HAIs) represent a significant burden in terms of mortality, morbidity, length of stay and costs for patients in intensive care units (ICU). Surveillance systems are recommended to gather data in order to elaborate and evaluate intervention to reduce HAIs risk. Here we describe results of the multimodal surveillance system implemented in the ICU of a large teaching hospital in Rome from April 2016 to October 2018. Methods The surveillance system integrated four different approaches: i) active surveillance focused on inpatients; ii) environmental microbiological surveillance; iii) surveillance focused on isolated microorganisms; iv) behavioral surveillance of the healthcare personnel. The system included the molecular genotyping of bacterial isolates through the pulsed field gel electrophoresis (PFGE). Moreover, an intervention to improve personnel adherence to hand hygiene (HH) guidelines was conducted. Results Overall, 773 patients were included in the surveillance. The global incidence rate of the device related HAIs was 14.1 (95%CI: 12.2-16.3) per 1000 patient day. Monthly device related HAIs incidence rate showed a decreasing, from 26.9 per 1000 patient day in October 2016, to 4.9 in September 2018. The most common bacterial isolate was K. pneumoniae (20.7%), the 94.0% of which were multidrug-resistant. A total of 305 environmental bacterial isolates were retrieved and the most frequent was A. baumannii (27.2%), that was always multidrug-resistant. Genotyping showed a limited number of major PFGE patters in clinical and environmental isolates. Behavioral compliance to HH guidelines improved after the educational intervention. Conclusions The data showed an overall slight decrease over time of the adjusted risk HAIs rates. Through the integration of information gathered from the four approaches, the application of this model returns a precise and detailed view of the infectious risk and of the microbial ecology of the ICU. Key messages Multimodal surveillance systems are effective to monitor HAI incidence and to determine the infectious risk. Genotyping techniques allows to characterize and link the clinical and environmental isolates.

scholarly journals Outbreak of multidrug resistant Salmonella Typhimurium in calves at a veterinary hospital in Brazil

2019 ◽  
Vol 49 (2) ◽  
Author(s):  
Carolina Pantuzza Ramos ◽  
Letícia Camêlo Vespasiano ◽  
Isabela Oliveira Melo ◽  
Rafael Gariglio Clark Xavier ◽  
Carlos Augusto Gomes Leal ◽  
...  
Keyword(s):  
Salmonella Typhimurium ◽  
Teaching Hospital ◽  
Antimicrobial Susceptibility ◽  
Antimicrobial Agents ◽  
Preventive Measures ◽  
Multidrug Resistant ◽  
Nosocomial Outbreak ◽  
Antimicrobial Susceptibility Test ◽  
Stool Samples ◽  
Veterinary Hospital

ABSTRACT: The present study aimed to describe and characterize a nosocomial outbreak caused by a multidrug resistant Salmonella Typhimurium in hospitalized calves at a veterinary medical teaching hospital from Brazil. Sixty-three (96.9%) calves showed lethargy, hyperthermia and profuse diarrhea and despite treatment, 26 (41.2%) animals died. Five animals were necropsied and stool samples of six calves were collected. The isolated strains were subjected to antimicrobial susceptibility test by disc-difusion method and were fingerprinted by ERIC-PCR. Macroscopic lesions suggestive of salmonellosis, such as fibrinonecrotic enteritis and hepatosplenomegaly were observed. Salmonellosis was confirmed by isolation of S. Typhimurium from stool samples and organs from seven affected animals. Six out of seven isolates of S. Typhimurium, exhibited 100% of similarity at ERIC-PCR, suggesting occurrence of nosocomial transmission of S. Typhimurium among the hospitalized calves. All but one S. Typhimurium isolated were resistant to marbofloxacin, enrofloxacin, florfenicol, oxytetracycline and trimethoprim/sulfamethoxazole, antimicrobial agents largely used for humans and animal treatment. This is the first study of a nosocomial outbreak of multidrug resistant S. Typhimurium in a veterinary hospital in Brazil and highlighted the need for preventive measures to reduce the risks for inpatients and humans in contact with animals.

scholarly journals Detection of carbapenemase production in Enterobacteriaceae and Pseudomonas species by carbapenemase Nordmann–Poirel test

2019 ◽  
Vol 11 (02) ◽  
pp. 107-110 ◽  
Author(s):  
Morubagal R. Rao ◽  
Pooja Chandrashaker ◽  
Rashmi P. Mahale ◽  
Sowmya G. Shivappa ◽  
Ranjitha S. Gowda ◽  
...  
Keyword(s):  
Cost Effective ◽  
Multidrug Resistant ◽  
Cross Resistance ◽  
Gram Negative Bacteria ◽  
Beta Lactam ◽  
Hospital Acquired Infections ◽  
Beta Lactam Antibiotics ◽  
Pseudomonas Species ◽  
Life Threatening ◽  
Hospital Acquired

Abstract PURPOSE: Multidrug-resistant organisms causing community-acquired and hospital-acquired infections are increasing at a dangerous rate. Carbapenemase-producing Enterobacteriaceae and Pseudomonas species are an important source of concern since these organisms are not only resistant to beta-lactam antibiotics but also show cross-resistance to other groups of antibiotics. In the present study, rapid detection of these carbapenemase-producing Enterobacteriaceae and Pseudomonas species by carbapenemase Nordmann–Poirel (Carba NP) test was evaluated by comparing with modified Hodge test (MHT). MATERIALS AND METHODS: Imipenem-resistant Enterobacteriaceae and Pseudomonas species isolated from various samples such as pus, blood, sputum, urine, and endotracheal aspirates were processed for carbapenemase detection by MHT and Carba NP test. Kappa analysis was done to evaluate the percentage agreement between the two tests. RESULTS: Seventy imipenem-resistant Enterobacteriaceae and Pseudomonas isolates were analyzed in the present study for carbapenemase production. 63.41% ofEnterobacteriaceae and 34.48% of Pseudomonas species were carbapenemase producers considering both the methods. By MHT, 36 (51.42%) isolates and, by Carba NP test, 35 (50%) isolates were positive for carbapenemase production out of the 70 isolates. CONCLUSION: Carba NP test when compared to MHT is a simple, rapid, cost-effective biochemical test which can be used in all laboratories in the identification of life-threatening carbapenemase-producing Gram-negative bacteria.

scholarly journals Measuring the in-hospital costs of Pseudomonas aeruginosa pneumonia: methodology and results from a German teaching hospital

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Klaus Kaier ◽  
Thomas Heister ◽  
Tim Götting ◽  
Martin Wolkewitz ◽  
Nico T. Mutters
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Teaching Hospital ◽  
Financial Burden ◽  
Hospital Costs ◽  
Multidrug Resistant ◽  
Time Dependent ◽  
Sensitivity Analyses ◽  
The Cost ◽  
Hospital Acquired ◽  
The Impact

Abstract Background Pseudomonas aeruginosa-related pneumonia is an ongoing healthcare challenge. Estimating its financial burden is complicated by the time-dependent nature of the disease. Methods Two hundred thirty-six cases of Pseudomonas aeruginosa-related pneumonia were recorded at a 2000 bed German teaching hospital between 2011 and 2014. Thirty-five cases (15%) were multidrug-resistant (MDR) Pseudomonas aeruginosa. Hospital- and community-acquired cases were distinguished by main diagnoses and exposure time. The impact of Pseudomonas aeruginosa-related pneumonia on the three endpoints cost, reimbursement, and length of stay was analyzed, taking into account (1) the time-dependent nature of exposure, (2) clustering of costs within diagnostic groups, and (3) additional confounders. Results Pseudomonas aeruginosa pneumonia is associated with substantial additional costs that are not fully reimbursed. Costs are highest for hospital-acquired cases (€19,000 increase over uninfected controls). However, community-acquired cases are also associated with a substantial burden (€8400 when Pseudomonas aeruginosa pneumonia is the main reason for hospitalization, and €6700 when not). Sensitivity analyses for hospital-acquired cases showed that ignoring or incorrectly adjusting for time-dependency substantially biases results. Furthermore, multidrug-resistance was rare and only showed a measurable impact on the cost of community-acquired cases. Conclusions Pseudomonas aeruginosa pneumonia creates a substantial financial burden for hospitals. This is particularly the case for nosocomial infections. Infection control interventions could yield significant cost reductions. However, to evaluate the potential effectiveness of different interventions, the time-dependent aspects of incremental costs must be considered to avoid introduction of bias.

scholarly journals Antimicrobial susceptibility profiles of Staphylococcus spp. from domestic and wild animals

2016 ◽  
Vol 46 (12) ◽  
pp. 2148-2151 ◽  
Author(s):  
Isabela de Godoy ◽  
Danny Franciele da Silva Dias Moraes ◽  
Letícia Camara Pitchenin ◽  
Janaina Marcela Assunção Rosa ◽  
Francielle Cristina Kagueyama ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Multidrug Resistant ◽  
Clinical Isolates ◽  
Rrna Gene ◽  
Wild Animals ◽  
Species Determination ◽  
Disk Diffusion Test ◽  
Susceptibility Profiles ◽  
Staphylococcus Spp ◽  
The 16S Rrna Gene

ABSTRACT: The aim of this study was to determine the prevalence and diversity of veterinary clinical isolates of Staphylococcus and analyze their antimicrobial susceptibility. One hundred Staphylococcus spp. clinical isolates from domestic and wild animals were subjected to partial sequencing of the 16S rRNA gene to species determination. Antimicrobial susceptibility was obtained by a disk diffusion test against six antibiotics: amoxicillin (AMX), cephalexin (LEX), ciprofloxacin (CIP), erythromycin (ERY), gentamicin (GEN) and trimethoprim-sulfamethoxazole (SXT). The most common specie was S. pseudintermedius (61%, 61/100) and resistance to ERY (57%, 57/100), SXT (50%, 50/100) and AMX (46%, 46/100) was detected most frequently. In total, 40% (40/100) of Staphylococcus spp. exhibited a multidrug-resistant (MDR) phenotype. Results of this study emphasize that animals are reservoir of MDR Staphylococcus spp.

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