scholarly journals Antimicrobial Resistance in Nosocomial Isolates of Gram-Negative Bacteria: Public Health Implications in the Latvian Context

Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 791
Author(s):  
Nityanand Jain ◽  
Inese Jansone ◽  
Tatjana Obidenova ◽  
Raimonds Simanis ◽  
Jānis Meisters ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Modern Medicine ◽  
Resistance Rate ◽  
Control Measures ◽  
Gram Negative ◽  
Extended Spectrum Beta Lactamase ◽  
Infection Control Measures ◽  
Emerging Trends ◽  
Resistance Rates ◽  
Klebsiella Spp

Antimicrobial Resistance (AMR) is one of the most serious threats in modern medicine which requires the constant monitoring of emerging trends amongst clinical isolates. However, very limited surveillance data is available in the Latvian context. In the present study, we conducted a retrospective analysis of microbiological data from one of the largest public multispecialty hospitals in Latvia from 2017 to 2020. AMR trends for 19 Gram-negative bacterial (GNB) genera were investigated. During the study period, 11,437 isolates were analyzed with Escherichia spp. (34.71%), Klebsiella spp. (19.22%) and Acinetobacter spp. (10.05%) being the most isolated. Carbapenems like Meropenem and Ertapenem were the most effective against GNBs (3% and 5.4% resistance rates, respectively) while high resistance rates (>50%) were noted against both Ampicillin and Amoxicillin/Clavulanic acid. Enterobacter spp. and Klebsiella spp. showed a significant increase in resistance rate against Ertapenem (p = 0.000) and Trimethoprim-Sulfamethoxazole (p = 0.000), respectively. A decrease in the prevalence of Extended-Spectrum Beta-Lactamase positive (ESBL+) Enterobacterales was noted. Despite the lower prescription levels of the penicillin group antimicrobials than the European average (as reported in ESAC-Net Surveillance reports), GNBs showed high average resistant rates, indicating the role of ESBL+ isolates in driving the resistance rates. Constant and careful vigilance along with proper infection control measures are required to track the emerging trends in AMR in GNBs.

scholarly journals Canadian Patterns of Antimicrobial Resistance: Overview of Current Trends Related to Hospital Pathogens

2006 ◽  
Vol 17 (suppl b) ◽  
pp. 3B-5B
Author(s):  
Tony Mazzulli
Keyword(s):  
Antimicrobial Resistance ◽  
Methicillin Resistance ◽  
Geographical Location ◽  
Current Data ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Gram Negative ◽  
Canadian Data ◽  
Gram Negative Organisms ◽  
Resistance Rates

Selection of appropriate empirical antibiotic therapy is dependent on many factors, not the least of which is an understanding of antimicrobial resistance rates in the patient population that is undergoing treatment. Resistance rates may vary by geographical location, institution, hospital ward or unit, and even body site of infection. The present paper reviews the currently available Canadian data regarding resistance rates for some of the most common hospital-acquired pathogens, includingEscherichia coli,Klebsiellaspecies,Pseudomonas aeruginosa,Enterobacterspecies,Staphylococcus aureusandEnterococcusspecies. Current data suggest that the rates of extended-spectrum beta-lactamases amongE coliandKlebsiellaspecies remain relatively low across Canada. There are very little data on the epidemiology of ampC cephalosporinases among Gram-negative organisms, although combined American and Canadian data suggest that ceftazidime resistance rates forEnterobacterspecies range from 17.1% to 24.8%. The increased use of fluoroquinolones has led to an increase in resistance rates among most Gram-negative organisms. In the late 1990s, ciprofloxacin resistance rates forP aeruginosawere reported to be approximately 20%. For the Gram-positive organisms, methicillin resistance rates forS aureushave been reported to be as high as 10% and vancomycin resistance rates forEnterococcusspecies have been reported to be less than 1%. Additional data that are representative of all regions of Canada are needed. Continued surveillance, antibiotic stewardship, and adherence to good infection prevention and control measures will lead to a better understanding of the epidemiology of antimicrobial resistance in Canadian hospitals, as well as help to control its spread.

scholarly journals High Prevalence of Antimicrobial Resistance Among Gram-Negative Isolated Bacilli in Intensive Care Units at a Tertiary-Care Hospital in Yucatán Mexico

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 588 ◽  
Author(s):  
Andrés H. Uc-Cachón ◽  
Carlos Gracida-Osorno ◽  
Iván G. Luna-Chi ◽  
Jonathan G. Jiménez-Guillermo ◽  
Gloria M. Molina-Salinas
Keyword(s):  
Escherichia Coli ◽  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Intensive Care Units ◽  
High Resistance ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Gram Negative ◽  
Resistance Rates

Background and Objectives: Antimicrobial resistance (AMR) is increasing worldwide and imposes significant life-threatening risks to several different populations, especially to those in intensive care units (ICU). The most commonly isolated organisms in ICU comprise gram-negative bacilli (GNB), and these represent a leading cause of serious infections. This study was conducted to describe the prevalence of resistance in GNB isolated from patients in adults, pediatric, and neonatal ICU in a tertiary-care hospital in Mérida, Mexico. Materials and Methods: A retrospective study was done on samples collected in Neonatal (NICU), Pediatric (PICU) and Adult (AICU) ICU of Unidad Médica de Alta Especialidad, Instituto Mexicano del Seguro Social in Mérida, México. The identification of isolates and antimicrobial susceptibility testing were performed using an automated system. Results: A total of 517 GNB strains were isolated. The most common positive culture was bronchial secretions. Pseudomonas aeruginosa was the prevalent pathogen in NICU and PICU, whereas Escherichia coli was common in the AICU. Overall, GNB exhibited a high resistance rates for Ampicillin (95.85%), Cefuroxime (84.17%), Piperacillin (82.93%), Cefotaxime (78.07%), Ceftriaxone (77.41%), Aztreonam (75.23%), Cefazolin (75.00%), and Ceftazidime (73.19%). There are significant differences in the resistance rates of GNB from different ICUs for penicillins, cephalosporins, carbapenems and fluoroquinolones drugs. Escherichia coli (multidrug-resistant [MDR] = 91.57%, highly resistant microorganisms [HRMO] = 90.36%) and Acinetobacter baumannii (MDR = 86.79%, HRMO = 83.02%) exhibited the highest percentage of MDR and HRMO profiles. The prevalence of the extended-spectrum beta-lactamases (ESBL)-producing isolates was 83.13% in E. coli, 78.84% in Klebsiella pneumoniae, and 66.67% in Proteus mirabilis, respectively. Conclusions: The high resistance rates to drugs were exhibited by our GNB isolates. Continuous surveillance and control of the use of antimicrobials are urgently needed to reduce the emergence and spreading of MDR, HRMO, and/or ESBL-producing bacilli.

scholarly journals Rapid identification of capsulated Acinetobacter baumannii using a density-dependent gradient test

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hadas Kon ◽  
David Schwartz ◽  
Elizabeth Temkin ◽  
Yehuda Carmeli ◽  
Jonathan Lellouche
Keyword(s):  
Rapid Identification ◽  
Control Measures ◽  
Clinical Severity ◽  
Bottom Phase ◽  
Gram Negative ◽  
Density Dependent ◽  
Infection Control Measures ◽  
Transmission Electron ◽  
Total Carbohydrates ◽  
Two Phases

Abstract Background Gram-negative bacterial capsules are associated with production of carbohydrates, frequently resulting in a mucoid phenotype. Infections caused by capsulated or mucoid A. baumannii are associated with increased clinical severity. Therefore, it is clinically and epidemiologically important to identify capsulated A. baumannii. Here, we describe a density-dependent gradient test to distinguish between capsulated and thin/non-capsulated A. baumannii. Results Thirty-one of 57 A. baumannii isolates displayed a mucoid phenotype. The density-dependent gradient test was comprised of two phases, with silica concentrations of 30% (top phase) and 50% (bottom phase). Twenty-three isolates migrated to the bottom phase, indicating thin or non-capsulated strains, and 34 migrated to the top phase, suggesting strains suspected to be capsulated. There was agreement between the mucoid and the non-mucoid phenotypes and the density-dependent gradient test for all but three isolates. Total carbohydrates extracted from strains suspected to be capsulated were significantly higher. Transmission electron microscopy confirmed the presence of a capsule in the six representative strains suspected to be capsulated. Conclusions The density-dependent gradient test can be used to verify capsule presence in mucoid-appearing A. baumannii strains. Identifying capsulated strains can be useful for directing infection control measures to reduce the spread of hypervirulent strains.

89 Antimicrobial Resistance Pattern and Prevalence of Extended Spectrum Beta-lactamase in Non-fermenting Gram Negative Bacteria, Isolated from Burn Wounds: A Prospective Study from a Tertiary Burn Center

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S59-S60 ◽  
Author(s):  
Niyousha Naderi ◽  
Armin Safdarpour ◽  
Mojdeh Hakemi-Vala ◽  
Hossein Masoomi
Keyword(s):  
Antimicrobial Resistance ◽  
Resistance Pattern ◽  
Gram Negative Bacteria ◽  
Beta Lactamase ◽  
Gram Negative ◽  
Burn Wounds ◽  
Extended Spectrum Beta Lactamase ◽  
Burn Center ◽  
Thermal Injuries ◽  
New Strategies

Abstract Introduction Burn wound infections are one of the major causes for long-term hospitalization and mortality among patients with thermal injuries. Identifying the bacterial cause of infection and determining the appropriate antibiotic to treat these infections is an important stage in treatment. The aim of this study was to investigate antimicrobial drug resistance in non-fermenting gram-negative bacteria isolated from burn wounds in patients who were admitted to a tertiary burn center. Methods In this prospective study during a six-month period in 2018,100 isolates of non-fermenting gram-negative bacteria were collected from 100 patients with thermal injuries. Antibiotic susceptibility test was performed using the Kirby-Bauer method based on the clinical and laboratory standards institute guidelines. Double-disc synergy test, a phenotypic method, was used to identify strains producing extended-spectrum beta-lactamase (ESBL). Data analyses were performed using SPSS. Results A total of 100 wound samples were examined from 100 patients, 76% were male and 24% were female with a mean age of 33 years (range 1–89 years old). Mean total body surface area burned was 35% (range 1–95%) and mean length of hospital stay was 24 days (range 3–69 days). Eighty five percent of cases were under 50 years old. Overall mortality rate in this study was 17%. The major causes of burn were liquefied natural gas tank explosion (35%) and scalds (19%). Acinetobacter baumannii (A.baumannii) was the most common pathogen followed by Pseudomonas aeruginosa (P.aeruginosa) (60% and 40%, respectively). ESBL producing rate was significantly higher in P.aeruginosa isolates (27.5%) than A.baumannii isolates (3.3%) (P-value < 0.001). Antibiotic resistance pattern of P.aeruginosa showed the highest resistance to ciprofloxacin, amikacin and imipenem (95%), followed by gentamicin (92.9%),ceftazidime(87.50) and piperacillin-tazobactam(85%). Antibiotic resistance pattern of A.baumannii showed the highest resistance to ceftazidime(100%) followed by ciprofloxacin, amikacin, imipenem(98.3%), gentamicin and piperacillin-tazobactam (93.3%). Multiple drug resistance (MDR) rate among A.baumannii and P.aeruginosa was 98.3% and 92.5% respectively, which is higher than previous reports. Conclusions A.baumannii and P.aeruginosa were the most common pathogens identified in this cohort with a significant MDR rate (over 95%). New strategies to control expansion of antimicrobial resistance in burn centers are necessary. Applicability of Research to Practice This study shows the antimicrobial resistance pattern and prevalence of ESBL in burn wounds indicating that further studies requires to identify new strategies to control emerging antimicrobial resistance in burn centers.

Distinct groups and antimicrobial resistance of clinical Stenotrophomonas maltophilia complex isolates from Korea

2013 ◽  
Vol 62 (5) ◽  
pp. 748-753 ◽  
Author(s):  
Ji-Young Rhee ◽  
Ji Young Choi ◽  
Myung-Jin Choi ◽  
Jae-Hoon Song ◽  
Kyong Ran Peck ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Stenotrophomonas Maltophilia ◽  
Multidrug Resistant ◽  
Resistance Rate ◽  
Gene Sequences ◽  
Accurate Identification ◽  
Group I ◽  
Clade B ◽  
Broth Microdilution Method ◽  
Resistance Rates

One hundred and twenty-one isolates of Stenotrophomonas maltophilia complex were collected from seven Korean hospitals. Species and groups were identified using partial gyrB gene sequences and antimicrobial susceptibility testing was performed using a broth microdilution method. Based on partial gyrB gene sequences, 118 isolates were identified as belonging to S. maltophilia complex, including S. maltophilia, S. pavanii, Pseudomonas beteli, P. geniculata and P. hibisciola. The S. maltophilia isolates were further divided into three groups, I to III. S. maltophilia groups II and III were clustered into clade A with S. pavanii and P. beteli; S. maltophilia group I was clustered into clade B with P. geniculata and P. hibisciola. For all S. maltophilia complex isolates, the resistance rate to trimethoprim/sulfamethoxazole (TMP/SMX) was very high (30.5 %). Antimicrobial resistance rates varied among species or groups of S. maltophilia complex. Isolates of clade A showed significantly lower antimicrobial resistance rates than those of clade B; while 25 % of clade A isolates were multidrug resistant, 46 % of clade B isolates were multidrug resistant (P = 0.001). The finding of high antimicrobial resistance rates, particularly to TMP/SMX, among S. maltophilia complex isolates from Korea, and the existence of distinct groups among the isolates, with differences in antimicrobial resistance rates, suggests consideration of alternative agents to TMP/SMX to treat S. maltophilia infections and indicates the importance of accurate identification for appropriate selection of treatment options.

Wide dissemination of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella spp. in acute care and rehabilitation hospitals

2011 ◽  
Vol 140 (3) ◽  
pp. 528-534 ◽  
Author(s):  
A. KOHLENBERG ◽  
F. SCHWAB ◽  
H. RÜDEN
Keyword(s):  
Escherichia Coli ◽  
Control Measures ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
The Mean ◽  
Rehabilitation Hospitals ◽  
Klebsiella Spp ◽  
Wide Dissemination ◽  
Community Onset

SUMMARYA prospective surveillance system for extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-E) and ESBL-producing Klebsiella spp. (ESBL-K) was implemented in 39 German hospitals with the aim of determining the incidence densities (IDs) of community-onset and hospital-onset cases and of identifying risk factors for high IDs of hospital-onset cases. During 2008, 2081 ESBL-E/K cases were documented. ESBL-E cases (n=1330, 63·9%) were more common than ESBL-K cases (n=751, 36·1%), but a higher proportion of ESBL-K cases (59%) than of ESBL-E cases (39·5%) were hospital-onset cases. The mean IDs were 0·54 (range 0–2·53) per 1000 patient-days for all ESBL-EK cases, 0·29 (range 0–1·81) per 1000 patient-days for community-onset ESBL-EK cases and 0·25 (range 0–1·82) per 1000 patient-days for hospital-onset ESBL-EK cases. Regression analysis showed a linear association between the IDs of community-onset and hospital-onset cases. The wide dissemination of ESBL-E and ESBL-K emphasizes the need for hospital-wide surveillance to guide control measures.

scholarly journals Genes de resistencia en bacilos Gram negativos: Impacto en la salud pública en Colombia

2016 ◽  
Vol 18 (1) ◽  
pp. 190 ◽  
Author(s):  
Diana Paola López Velandia ◽  
María Inés Torres Caycedo ◽  
Carlos Fernando Prada Quiroga
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Resistance Genes ◽  
Public Health Problem ◽  
Control Measures ◽  
World Health ◽  
Cochrane Library ◽  
Resistant Bacteria ◽  
Gram Negative ◽  
The Cochrane Library

ResumenIntroducción: La resistencia antimicrobiana es un grave problema de salud pública que se encuentra en aumento. Entre los factores más importantes relacionados con la diseminación de bacterias multirresistentes está el uso inapropiado de antibióticos y la aplicación insuficiente de las medidas de prevención y control. Adicionalmente, las bacterias tienen la capacidad de mutar o generar mecanismos de transferencia de genes de resistencia mediante plásmidos, transposones e integrones. Materiales y métodos: Se hizo una revisión crítica de la literatura sobre los principales genes de resistencia Gram negativos y su impacto en la salud pública. Fueron utilizadas las bases de datos de Medline, Embase, Lilacs, ScienceDirect, Scopus, SciELO, the Cochrane Library y Lilacs. Resultados: Se presenta una revisión de literatura que describe y analiza los principales genes de resistencia a antibióticos presentes en bacilos gram negativos, su origen, evolución y diseminación a microorganismos mediante la transferencia horizontal de genes; justificando la importancia de realizar una vigilancia epidemiológica del tránsito de clones con diferentes perfiles de resistencia y principales enzimas. Conclusiones: El seguimiento de la resistencia antimicrobiana desde el punto de vista de la epidemiología molecular forma parte transcendental de la vigilancia antibiótica como lo recomienda la Organización Mundial de la Salud; pues representa el futuro del monitoreo de la resistencia.AbstractIntroduction: Antimicrobial resistance is a serious public health problem that is increasing. Among the most important factors related to the spread of multi-resistant bacteria are the inappropriate use of antibiotics and the insufficient  implementation of prevention and control measures. Additionally, bacteria have the ability to mutate or create mechanisms for transfer of resistance genes via plasmids, transposons and integrons. Materials and methods: A critical review of the literature on major resistance genes in Gram negative bacteria and its impact on public health was conducted. Data have been collected from Medline, Embase, Lilacs, ScienceDirect, Scopus, SciELO, the Cochrane Library and Lilacs. Results: A review of literature that describes and analyzes the main antibiotic resistance genes present in gram-negative bacilli is presented, as well as their origin, evolution, and subsequent spread to hundreds of species of microorganisms by Horizontal gene transfer which justifies the importance of conducting an epidemiological surveillance on transit of clones with different resistance profiles and major enzymes. Conclusions: The control of antimicrobial resistance from the point of view of molecular epidemiology is part of the antibiotic surveillance control as recommended by the World Health Organization; as it represents the future of the surveillance of resistance.

scholarly journals In-vitro activity of levofloxacin against bacterial pathogens collected in China：A ten-year（2009-2018） retrospective study

2020 ◽  
Author(s):  
LU GAN ◽  
Yun Li ◽  
Yuan Lv ◽  
Bo Zheng
Keyword(s):  
Streptococcus Pneumoniae ◽  
Klebsiella Pneumoniae ◽  
Haemophilus Influenzae ◽  
Community Acquired Pneumonia ◽  
Resistance Rate ◽  
Gram Negative Bacteria ◽  
Icu Patients ◽  
Gram Negative ◽  
Resistance Rates

Abstract Background： This study was designed to evaluate the in-vitro activity of levofloxacin against bacterial pathogens collected from Chinese hospitalized patients between 2009 and 2018, and analysis the trends of levofloxacin resistance in China.Methods In this analysis, antimicrobial minimum inhibitory concentrations (MICs) experiments with levofloxacin and controls against a range of Gram-positive and Gram-negative bacteria collected from 2009 to 2018. MICs were determined using the agar dilution method according to the guidelines of Clinical and Laboratory Standards Institute (CLSI)，2019. Antimicrobial susceptibility was determined using CLSI breakpoints. Statistical tests were analysed by Statistical Package for the Social Sciences software (SPSS, Inc., Chicago, IL, USA), calculating the MIC90.Results In the past decade，the antibacterial activities of levofloxacin against Escherichia coli, Enterobacter cloacae, Pseudomonas aeruginosa and Stenotrophomonas maltophilia, which were common gram-negative bacteria, were stable; the resistance rates of these bacteria had no significant changes or decreased slightly. The levofloxacin resistance rates of Staphylococcus aureus and Enterococcus faecalis, which were gram positive bacteria, decreased from 48.4% and 36.9% in 2009-2010 to 22.8% and 25.7% in 2017-2018, respectively, respectively. The levofloxacin resistance rate among Haemophilus influenzae, Streptococcus pneumoniae and Streptococcus pneumoniae, the common pathogens of community acquired pneumonia (CAP), were less than 3%. The levofloxacin resistance rates for Klebsiella pneumoniae and Acinetobacter baumannii increased. No difference in the levofloxacin resistance rates by age group (18-64, 65-74, ≥75 years old age groups) was observed. The resistance rate of strains isolated from ICU patients was usually 10-20% higher than that of non-ICU patients.Conclusion In recent ten years, levofloxacin has continued to be active in-vitro against the strains in its antibacterial spectrum. No significant change of resistance rates was observed and it still has a good antibacterial effect on the main pathogenic bacteria of community-acquired pneumonia, such as Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella pneumoniae and MSSA.

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