scholarly journals Characteristics of Carbapenem-Resistant Pseudomonas aeruginosa Strains in Patients with Ventilator-Associated Pneumonia in Intensive Care Units

Medicina ◽  
2012 ◽  
Vol 47 (12) ◽  
pp. 95
Author(s):  
Astra Vitkauskienė ◽  
Erika Skrodenienė ◽  
Asta Dambrauskienė ◽  
Giedrė Bakšytė ◽  
Andrius Macas ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Intensive Care Units ◽  
University Hospital ◽  
Test Results ◽  
Disk Diffusion Test ◽  
Carbapenem Resistant ◽  
Resistant Strains ◽  
High Level ◽  
O 11

The aim of this study was to determine the characteristics of carbapenem-resistant Pseudomonas aeruginosa (P. aeruginosa) strains and 5-year changes in resistance in a tertiary university hospital. Material and Methods. The study included 90 and 101 randomly selected P. aeruginosa strains serotyped in 2003 and 2008, respectively. The standardized disk diffusion test and E-test were used to determine resistance to antibiotics. P. aeruginosa strains were considered to have high-level resistance if a minimum inhibitory concentration (MIC) for imipenem or meropenem was >32 μg/mL. To identify serogroups, sera containing specific antibodies against O group antigens of P. aeruginosa were used. P. aeruginosa isolates resistant to imipenem or/and meropenem were screened for metallo-β-lactamase (MBL) production by using the MBL E-test. Results. Comparison of the changes in resistance of P. aeruginosa strains to carbapenems within the 5-year period revealed that the level of resistance to imipenem increased. In 2003, 53.3% of P. aeruginosa strains were found to be highly resistant to imipenem, while in 2008, this percentage increased to 87.8% (P=0.01). The prevalence of MBL-producing strains increased from 15.8% in 2003 to 61.9% in 2008 (P<0.001). In 2003 and 2008, carbapenem-resistant P. aeruginosa strains were more often resistant to ciprofloxacin and gentamicin than carbapenem-sensitive strains. In 2008, carbapenem- resistant strains additionally were more often resistant to ceftazidime, cefepime, aztreonam, piperacillin, and amikacin than carbapenem-sensitive strains. MBL-producing P. aeruginosa strains belonged more often to the O:11 serogroup than MBL-non-producing strains (51.7% vs. 34.3%, P<0.05). A greater percentage of non-MBL-producing strains had low MICs against ciprofloxacin and amikacin as compared with MBL-producing strains. Conclusions. The results of our study emphasize the need to restrict the spread of O:11 serogroup P. aeruginosa strains and usage of carbapenems to treat infections with P. aeruginosa in the intensive care units of our hospital

scholarly journals Carbapenem resistance in non-fermentative bacterial species and in Enterobacteriaceae isolates from hospitalized patients in different health-care settings

2014 ◽  
Vol 87 (4) ◽  
pp. 235-241
Author(s):  
Mihaela Ileana Ionescu ◽  
Dan Stefan Neagoe ◽  
Claudia Chiorean ◽  
Loredana Dumitras ◽  
Aurelia Rus
Keyword(s):  
Health Care ◽  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Carbapenem Resistance ◽  
Hospitalized Patients ◽  
Health Care Settings ◽  
Carbapenem Resistant ◽  
Acinetobacter Spp ◽  
Resistant Strains

Aim. Carbapenem-resistant strains have been increasingly reported over the last few years. In this study  we used laboratory records to determine the occurrence of carbapenem-resistant strains from hospitalized patients with emphasis on the comparative analysis of the incidence in various health-care settings. Materials and methods. From January 2012 to November 2012 and from May 2013 to November 2013, we evaluated 566 strains (Acinetobacter spp., Pseudomonas aeruginosa, Escherichia coli, and Klebsiella spp.). All isolates were tested and analyzed according to their antibiotic resistance phenotypic pattern. Laboratory results were correlated with data regarding admission in different clinical wards.Results. Among 566 isolates, 191 carbapenem-resistant or carbapenem-intermediate strains (33.74%) were detected. Non-fermentative species were the most prevalent carbapenem-resistant organisms, 80.62% of 191 carbapenem-resistant or carbapenem-intermediate strains isolated were Acinetobacter spp., and 17.27% of 191 were Pseudomonas aeruginosa. Apart from that, only 4 (2.09%) carbapenem-resistant Enterobacteriaceae (CRE) strains were identified. We identified 59.30% of 172 strains isolated from patients hospitalized in anesthesia and intensive care units non-susceptible to carbapenems. The main mechanism associated with carbapenem resistance could be the production of carbapenemase in combination with impermeability.Conclusions. Our study demonstrates that infections with carbapenem-resistant strains are correlated with hospitalization in intensive care units. Our data showed a predominant carbapenem-resistant Acinetobacter spp. strain in intensive care units.

scholarly journals A 5- Year Surveillance of Nosocomial Infections in a University Hospital: A Retrospective Analysis

2021 ◽  
Author(s):  
Ilknur Erdem ◽  
Ilker Yildirim ◽  
Birol Safak ◽  
Ritvan Karaali ◽  
Berna Erdal ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Acinetobacter Baumannii ◽  
Intensive Care Units ◽  
Nosocomial Infections ◽  
Antimicrobial Agents ◽  
Public Health Problem ◽  
University Hospital ◽  
Esherichia Coli ◽  
Study Results

Abstract OBJECTIVE: ‘Nosocomial infections’ or ‘healthcare associated infections’ are a significant public health problem around the world. This study aimed to assess the rate of culture confirmed nosocomial infections (NIs), frequency of nosocomial pathogens and the antimicrobial resistance patterns of bacterial isolates in a University Hospital. METHODS: A retrospective evaluation of NIs in a tertiary hospital, between the years 2015 and 2019 in Tekirdag, Turkey. RESULTS : During the five years, the overall incidence rates (NI/100) and incidence densities (NI/1000 days of stay) of NIs were 2.04% (range 1.76-2.41/100) and 3.50/1000 patients-days (range 2.85-4.64/1000), respectively. 57.4 % of the infections were originated from the Intensive Care Units. The most common NIs according to the primary sites were bloodstream infections (55.3 %) and, pneumonia (20.4%). 67.5% of the isolated microorganisms as nosocomial agents were Gram negative bacteria, 24.9% of Gram positive bacteria and 7.6 % of candida. The most frequently isolated causative agents were Esherichia coli (16.7%) and Pseudomonas aeruginosa (15.7%). The rate of extended spectrum beta-lactamase production among E. coli isolates was 51.1%. Carbapenem resistance was 29.8% among isolates of Pseudomonas aeruginosa; 95.1% among isolates of Acinetobacter baumannii, 18.2% among isolates of Klebsiella pneumoniae. Colistin resistance was 2.4% among isolates of Acinetobacter baumannii. Vancomycin resistance was 5.3% among isolates of Enterococci.CONCLUSION: Our study results demonstrates the microorganisms of isolated from Intensive Care Units demonstrates high level resistance to many antimicrobial agents. The rising in incidence of multidrug-resistant microorganisms indicate that more interventions are urgently needed to reduce NIs in our ICUs.

scholarly journals Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units

2021 ◽  
Vol 63 ◽  
Author(s):  
Gleyce Hellen de Almeida de Souza ◽  
Luana Rossato ◽  
Gabriel Teixeira Brito ◽  
Graciela Mendonça dos Santos Bet ◽  
Simone Simionatto
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Health Problem ◽  
Carbapenem Resistant

scholarly journals Pseudomonas aeruginosa: Evaluation of Antimicrobial Resistance Patterns in Strains Isolated from Blood Culture in a University Hospital

2020 ◽  
Vol 25 (3) ◽  
pp. 308-315
Author(s):  
Ayşe Hümeyra Taşkın Kafa ◽  
Cem Çelik ◽  
Mürşit Hasbek ◽  
Mustafa Zahir Bakıcı
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Antibiotic Susceptibility ◽  
Empirical Treatment ◽  
University Hospital ◽  
High Rate ◽  
Automated System ◽  
Treatment Protocols ◽  
Susceptibility Profiles

Introduction: The aim of this study was to contribute to the establishment of appropriate empirical treatment protocols by determining antibiotic susceptibility profiles of Pseudomonas aeruginosa strains isolated from bacteremia patients in intensive care units and various clinics. Materials and Methods: Antibiotic susceptibility of a total of 111 P. aeruginosa isolates isolated from the blood of inpatients in intensive care units and other services between January 2014 and July 2018 in Cumhuriyet University, Faculty of Medicine were evaluated retrospectively. In the study, the susceptibility profiles of amikacin, piperacillin-tazobactam, ceftazidime, cefepim, gentamicin, ciprofloxacin, levofloxacin, imipenem and meropenem were investigated using the automated system of Phoenix 100 (Becton Dickinson Co., Sparks, MD, USA). The results were evaluated based on the criteria of the Clinical and Laboratory Standards Institute (CLSI) for 2014 and the European Committee on Antimicrobial Susceptibility Testing (EUCAST) from 2015 onwards. Results: One hundred and eleven P. aeruginosa were isolated from blood samples, 77 from intensive care units and 34 from various services of the hospital. P. aeruginosa strains isolated from cultures have a high rate of resistance against antimicrobial agents. The highest resistance was determined for imipenem with 20.7% and the lowest resistance was determined for amikacin with 1.8%. Piperacillintazobactam, ceftazidim, cefepim, ciprofloxacin, levofloxacin, and meropenem resistance rates were 18%, 17.1%, 17.8%, 18.9%, 13.9%, 19.8% respectively. Multidrug-resistant was found to be 10.8%. This ratio was determined as 13% in intensive care units. Conclusion: Considering the current antibiotic susceptibility profiles while determining empirical treatment protocols is rather important to prevent resistance. In addition, putting forward the bacterial resistance status periodically through this type of studies, to determine the strength of existing drugs and to guide therapy, presents valuable data. Within this context, we propose that the data of our study will contribute to the current literature

scholarly journals Plasmid curing pattern of nosocomial pathogens of intensive care units (ICU) in Zagazig University Hospital

2017 ◽  
Vol 2 (4) ◽  
pp. 703-711
Author(s):  
Soheir El Salam ◽  
Mohammed Farouk Ghaly ◽  
Ahmed Anwar Shahen ◽  
Mahmoud Mostafa Amer ◽  
Sanaa Atef Abdelkader
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Complete Removal ◽  
University Hospital ◽  
Resistant Bacteria ◽  
Klebsiella Pneumonia ◽  
Plasmid Curing

Nosocomial infections and antibiotic resistance are serious and growing phenomenon in contemporary medicine and has emerged as one of the public health concerns. A total of seventy isolates of bacteria were collected from patients. The selected isolates include 33 (56.9%) from males and 25 (43.1%) from females. All bacteria were susceptible to imipenem followed by amikacin, ceftazidime, ciprofloxacin and tobramycin, respectively. The multi-drug resistant (MDR) bacterial isolates (33 isolates) divided into four groups named Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus were selected to be identified according to the keys of different identification protocols. Escherichia coli found to be the most frequent pathogen within MDR isolates followed by Staphylococcus aureus, Pseudomonas aeruginosa and Klebsiella pneumonia, respectively. The MICs and MBCs of (Imipenem, Amikacin, Ceftazidime and ciprofloxacin) against the most resistant isolates were determined. Generally, P. aeruginosa (Strain No. 55) was found to be the highest resistant bacteria. Plasmid profile of Pseudomonas aeruginosa was carried out, after incubation at 37oc for 24hr recorded no changes in plasmid and compared with incubation at 43oc (plasmid curing) which showed complete removal of plasmid bands and the tested bacteria became more sensitive to antibiotics. This study therefore determined the prevalence, anti-biotic susceptibility and plasmid patterns of P. aeruginosa strains from clinical specimens obtained from the intensive care units of Zagazig University Hospital in Egypt.Asian J. Med. Biol. Res. December 2016, 2(4): 703-711

scholarly journals Activity of a New Cephalosporin, CXA-101 (FR264205), against β-Lactam-Resistant Pseudomonas aeruginosa Mutants Selected In Vitro and after Antipseudomonal Treatment of Intensive Care Unit Patients

2010 ◽  
Vol 54 (3) ◽  
pp. 1213-1217 ◽  
Author(s):  
Bartolome Moya ◽  
Laura Zamorano ◽  
Carlos Juan ◽  
José L. Pérez ◽  
Yigong Ge ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Efflux Pump ◽  
Multidrug Resistant ◽  
Icu Patients ◽  
Resistant Strains ◽  
High Level ◽  
Level Resistance

ABSTRACT CXA-101, previously designated FR264205, is a new antipseudomonal cephalosporin. We evaluated the activity of CXA-101 against a highly challenging collection of β-lactam-resistant Pseudomonas aeruginosa mutants selected in vitro and after antipseudomonal treatment of intensive care unit (ICU) patients. The in vitro mutants investigated included strains with multiple combinations of mutations leading to several degrees of AmpC overexpression (ampD, ampDh2, ampDh3, and dacB [PBP4]) and porin loss (oprD). CXA-101 remained active against even the AmpD-PBP4 double mutant (MIC = 2 μg/ml), which shows extremely high levels of AmpC expression. Indeed, this mutant showed high-level resistance to all tested β-lactams, except carbapenems, including piperacillin-tazobactam (PTZ), aztreonam (ATM), ceftazidime (CAZ), and cefepime (FEP), a cephalosporin considered to be relatively stable against hydrolysis by AmpC. Moreover, CXA-101 was the only β-lactam tested (including the carbapenems imipenem [IMP] and meropenem [MER]) that remained fully active against the OprD-AmpD and OprD-PBP4 double mutants (MIC = 0.5 μg/ml). Additionally, we tested a collection of 50 sequential isolates that were susceptible or resistant to penicillicins, cephalosporins, carbapenems, or fluoroquinolones that emerged during treatment of ICU patients. All of the mutants resistant to CAZ, FEP, PTZ, IMP, MER, or ciprofloxacin showed relatively low CXA-101 MICs (range, 0.12 to 4 μg/ml; mean, 1 to 2 μg/ml). CXA-101 MICs of pan-β-lactam-resistant strains ranged from 1 to 4 μg/ml (mean, 2.5 μg/ml). As described for the in vitro mutants, CXA-101 retained activity against the natural AmpD-PBP4 double mutants, even when these exhibited additional overexpression of the MexAB-OprM efflux pump. Therefore, clinical trials are needed to evaluate the usefulness of CXA-101 for the treatment of P. aeruginosa nosocomial infections, particularly those caused by multidrug-resistant isolates that emerge during antipseudomonal treatments.

scholarly journals Intrahospital spread of carbapenem-resistant Pseudomonas aeruginosa in a University Hospital in Florianópolis, Santa Catarina, Brazil

2010 ◽  
Vol 43 (4) ◽  
pp. 367-371 ◽  
Author(s):  
Mara Cristina Scheffer ◽  
Maria Luiza Bazzo ◽  
Mario Steindel ◽  
Ana Lucia Darini ◽  
Eduardo Clímaco ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Polymyxin B ◽  
University Hospital ◽  
Nucleotide Sequence Analysis ◽  
Epidemiological Typing ◽  
Carbapenem Resistant ◽  
Cross Transmission ◽  
Agar Dilution ◽  
High Level ◽  
The City

INTRODUCTION: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) has been isolated with increasing frequency in Brazilian hospitals. Since June 2003, its detection in a teaching hospital in the city of Florianópolis, Brazil, has increased. This study aimed to investigate the minimal inhibitory concentration (MIC), presence of Metallo-β-lactamase (MβL) and a possible clonal relationship among the isolates. METHODS: The study included 29 CRPA and seven isolates with reduced susceptibility. The MIC was determined by agar-dilution. Detection of MβL was performed by Double Disk Sinergism (DDS) and Combined Disk (CD). The MβL gene was verified by PCR and nucleotide sequence analysis. Epidemiological typing was performed by pulsed-field gel electrophoresis. RESULTS: Among the 29 carbapenem-resistant isolates, polymyxin B presented 100% susceptibility and piperacillin/tazobactam 96.7%. Seventeen (62%) strains were verified as clonal (A clone) and among these, six isolates indicated phenotypically positive tests for MβL and harbored the blaSPM-1 gene. The first CRPA isolates were unrelated to clone A, harbored blaIMP-16 and were phenotypically positive only by CD. CONCLUSIONS: The spread of a high-level of resistance clone suggests cross transmission as an important dissemination mechanism and has contributed to the increased rate of resistance to carbapenems. This study emphasizes the need for continuous surveillance and improved strategies.

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