Antibiotic resistance: a modern view of the problem by the example of a multi-profile hospital

2021 ◽  
pp. 19-25
Author(s):  
L. Yu. Kulagina ◽  
I. R. Valiullina ◽  
E. R. Kadyseva ◽  
M. L. Maksimov
Keyword(s):  
Mass Spectrometry ◽  
Antibiotic Resistance ◽  
Antibiotic Sensitivity ◽  
Hospital Infections ◽  
Strategic Decisions ◽  
Hospital Acquired Infections ◽  
Empirical Antibacterial Therapy ◽  
Inflammatory Processes ◽  
Hospital Acquired ◽  
Inpatient Department

Relevance. Conducting microbiological monitoring allows controlling hospital-acquired infections and making timely strategic decisions for epidemiologists and clinical pharmacologists. Objective of the work is to determine the tendency of prevailing problem microflora and to develop a strategy of empirical antibacterial therapy for severe nosocomial infections and inflammatory processes. Materials and methods. The article analyzes the main groups of pathogens of hospital infections in dynamics for the first quarter of 2018, 2019 and 2020. The relation of positive cultures to the total number of investigated samples was taken for the analysis. Antibiotic sensitivity was isolated, identified and determined using conventional mass spectrometry methods. The results. The stable sowing rate of Acinetobacter baumannii and Klebsiella pneumoniae in the intensive care and surgical departments was noted for the analyzed periods. To solve the issue of antibiotic resistance in the inpatient department, a strategy to contain it has been developed.

scholarly journals Antibiotic resistance in Acinetobacter baumannii as agent of surgery infection and approaches to its overcoming by means of deca-methoxinum antiseptic

2019 ◽  
Vol 1 (2) ◽  
pp. 18-22
Author(s):  
O A Nazarchuk ◽  
V I Nahaichuk
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Sensitivity ◽  
Antibiotic Resistant ◽  
Clinical Strains ◽  
Minimal Inhibitory Concentrations ◽  
Hospital Acquired Infections ◽  
Causative Agents ◽  
Resistant Strains ◽  
Burn Disease ◽  
Hospital Acquired

Introduction. Non-fermenting Gram-negative bacilli are known as one of the most frequent causative agents of hospital-acquired infections. Acinetobacter baumannii, as causative agent of infection complications of different localization, has obtained recently high resistance to anti-biotics and has belonged to ESKAPE group of pathogens. Antimicrobials, recommended for the prophylaxis and therapy of hospital-acquired infections, have been failing in their effectiveness and lead to selection of antibiotic resistant strains of A. baumannii. The aim of this research was to substantiate the way of overcoming of resistance in clinical strains of A. baumannii, by means of synergic antimicrobial activity of antibiotics and antiseptic decamethoxinum®. Material and methods. The research was carried out on 190 clinical strains of A. baumannii, isolated from patients with burn disease during the period 2011–2015. The sensitivity of clinical strains of A. baumannii was determined to such antibiotics as ampicillin/sulbactam, cefoperazone, cefoperazone/sulbactam, meropenem, imipenem, amikacin, ciprofloxacin, gatifloxacin and antiseptic decamethoxinum® (DCM; Registration certificate No UA/14444/01/01 since 24.06.2015. Order of the Ministry of Health of Ukraine No 373). The sensitivity of A. baumannii to antibiotics and DCM was determined by means of disk diffusion test and serial dilution (Order of the Ministry of Health of Ukraine No167 since 05.04.2007; EUCAST expert rules).The study of the influence of antiseptic DCM on the sensitivity of acinetobacteria to antibiotics was studied on 35 clinical strains of A. baumannii, drafted from the general number of isolates enrolled in the research. For this, the sensitivity of A. baumannii to antibiotics in the presence of sub-minimal inhibitory concentrations (subMIC) of DCM was identified. The received experimental data were analyzed by “Statistica 6.0”. Results and discussion. The changes of antibiotic sensitivity profile of A. baumannii for five years were shown. It was found that the sensitivity of A. baumannii to majority of antibiotics, selected for study, decreased significantly. But the only ampicillin/sulbactam was found to have vice versa tendency. We found the rising quantity of antibiotic resistant strains of A. baumannii. At the same time, high resistance of acinetobacteria to fluoroquinolones (ciprofloxacin– 96,1%; gatifloxacin– 95,8%) was found in 2015. The in vitro research of combined activity of DCM antiseptic remedy and early mentioned antibiotics against clinical strains of A. baumannii demonstrated the reveal antibiotic effectiveness. As follows, minimal inhibitory concentrations of antibiotics decreased in 1.5–4 times in the mediums which contained subMIC of DCM. Especially this tendency was found in resistant clinical strains. Conclusion. Under selective influence of antibiotics protected by β-lactamase inhibitors, carbapenems, fluoroquinolones aminoglycosides increase the antibiotic resistance in A. baumannii, causative agents of infectious complications in patients with burn disease. The antiseptic remedy decamethoxinum® helps to improve antibiotic sensitivity in resistant A. baumannii.

HOSPITAL INFECTION IN SURGICAL DEPARTMENTS AT HUE UNIVERSITY HOSPITAL IN 2015

2016 ◽  
pp. 39-43
Author(s):  
Dinh Binh Tran ◽  
Dinh Tan Tran
Keyword(s):  
Surgical Site Infection ◽  
Surgical Intervention ◽  
University Hospital ◽  
Hospital Infections ◽  
Site Infection ◽  
Cross Sectional ◽  
Surgical Interventions ◽  
Hospital Acquired Infections ◽  
Tract Infections ◽  
Hospital Acquired

Objective: To study nosocomial infections and identify the main agents causing hospital infections at Hue University Hospital. Subjects and Methods: A cross-sectional descriptive study of 385 patients with surgical interventions. Results: The prevalence of hospital infections was 5.2%, surgical site infection was the most common (60%), followed by skin and soft tissue infections (35%), urinary tract infections (5%). Surgical site infection (11.6%) in dirty surgery. There were 3 bacterial pathogens isolated, including Staphylococcus aureus (50%), Pseudomonas aeruginosa and Enterococcusspp (25%). Conclusion: Surgical site infection was high in hospital-acquired infections. Key words: hospital infections, surgical intervention, surgical site infection, bacteria

scholarly journals 819. Antibiotic Resistance in Pathogens Causing Hospital Acquired Infections in Brazil: A Multicenter Study

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S502-S503
Author(s):  
Carlos Starling ◽  
Bráulio R G M Couto ◽  
Estevão Urbano Silva ◽  
Virginia Andrade ◽  
Edna M M Leite ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Tertiary Care ◽  
Healthcare Associated Infections ◽  
Gram Positive ◽  
Resistance Profile ◽  
Hospital Acquired Infections ◽  
Microbiological Methods ◽  
Belo Horizonte ◽  
Healthcare Associated ◽  
Hospital Acquired

Abstract Background In the present study we determined the prevalence of antibiotic resistance in the most common organisms causing healthcare-associated infections in tertiary-care hospitals in Belo Horizonte, a 3,000,000 inhabitants city from Brazil. Methods Microbiology data of hospital acquired infections (HAI) defined by the National Healthcare Safety Network (NHSN)/CDC protocols of seven general hospitals were analyzed: three public institutions, two philanthropic, and two private hospitals. Samples from different topographies were plate in an ideal culture medium and after growth, the microorganisms were identified by standard biochemical and microbiological methods, using the VITEK 2 compact system (Biomerieux), which allows the simultaneous identification of Gram-positive and Gram bacteria -negative and combine the identification and TSA results in a single report. Six hospitals used automated methods and one institution used manual method for antimicrobial susceptibility testing. Results Samples of seven Gram-negative and two Gram-positive bacteria collected between Dec/2019-Nov/2020 from HAI isolates were analyzed: 565 Klebsiella, 293 Escherichia coli, 153 Proteus, 403 Pseudomonas, 275 Acinetobacter, 174 Serratia, 153, 361 Staphylococcus aureus, and 176 Enterococcus. Antibiotic resistance profile of each strain is summarized in Figures 1, 2, and 3. Resistance profile: Klebsiella, E. coli, Proteus. ATB profile: Pseudomonas, Acinetobacter, Serratia. ATB profile: Enterobacter, S. aureus, Enterococcus . Conclusion Benchmarks for antibiotic resistance in the most common organisms causing healthcare-associated infections were defined, and can be used as indicators for healthcare assessment, specially in developing countries institutions. Disclosures All Authors: No reported disclosures

scholarly journals Etiologic Agents and Antibiotic Resistance Pattern of Community- and Hospital-Acquired Infections

2018 ◽  
Vol 25 (1) ◽  
pp. 41-48
Author(s):  
Mohammad Mahdi Majzoobi ◽  
Azar Pirdehghan ◽  
Zahra Rashidian ◽  
Ali Saadatmand ◽  
◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Resistance Pattern ◽  
Hospital Acquired Infections ◽  
Antibiotic Resistance Pattern ◽  
Etiologic Agents ◽  
Hospital Acquired

scholarly journals Hospital infections in neonatal intensive care units

2005 ◽  
Vol 58 (9-10) ◽  
pp. 490-493
Author(s):  
Jasna Djurisic ◽  
Ljiljana Markovic-Denic ◽  
Slobodanka Ilic ◽  
Ruzdi Ramadani
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Hospital Infections ◽  
Hospital Acquired Infections ◽  
Number Of Patients ◽  
Increased Risk ◽  
Hospital Acquired ◽  
Epidemiological Characteristics

Introduction Sick newborn babies in the neonatal intensive care units (NICU) are al increased risk for hospital-acquired infections (HI). The aim of our study was to determine the incidence and localization of neonatal hospital infections in NICU. Material and methods A prospective, six-month study was carried out in a NICU. All patients hospitalized in NICU longer then 48 hours were examined according to their basic descriptive-epidemiological characteristics and the incidence of all hospital-acquired infections (diagnosed using CDC criteria) were accounted for. Results The incidence of patients with HI was 46.1% while the incidence of HI was 57.2%. On the basis of patients' records in the NICU, the incidence of HI was 43.9 per WOO patient- hospital days. Patients with HI were hospitalized significantly longer in NICU than patients without HI (t=9.2 DF=267 p<0.001). In terms of localization of HI, a large number of patients had pneumonia - 74.7% (115/154), followed by sepsis (37/154), while two had meningitis. Conclusion This study suggests that it is necessary to maintain continuous surveillance of HI in NICU, as well as infection control measures, which are also very beneficial.

scholarly journals Identification of Two Regulators of Virulence That Are Conserved inKlebsiella pneumoniaeClassical and Hypervirulent Strains

mBio ◽  
2018 ◽  
Vol 9 (4) ◽  
Author(s):  
Michelle Palacios ◽  
Taryn A. Miner ◽  
Daniel R. Frederick ◽  
Victoria E. Sepulveda ◽  
Joshua D. Quinn ◽  
...  
Keyword(s):  
Gene Expression ◽  
Antibiotic Resistance ◽  
Klebsiella Pneumoniae ◽  
Virulence Factors ◽  
Content Type ◽  
Hospital Acquired Infections ◽  
Capsule Type ◽  
Capsule Production ◽  
Invasive Infections ◽  
Hospital Acquired

ABSTRACTKlebsiella pneumoniaeis widely recognized as a pathogen with a propensity for acquiring antibiotic resistance. It is capable of causing a range of hospital-acquired infections (urinary tract infections [UTI], pneumonia, sepsis) and community-acquired invasive infections. The genetic heterogeneity ofK. pneumoniaeisolates complicates our ability to understand the virulence ofK. pneumoniae. Characterization of virulence factors conserved between strains as well as strain-specific factors will improve our understanding of this important pathogen. The MarR family of regulatory proteins is widely distributed in bacteria and regulates cellular processes such as antibiotic resistance and the expression of virulence factors.Klebsiellaencodes numerous MarR-like proteins, and they likely contribute to the ability ofK. pneumoniaeto respond to and survive under a wide variety of environmental conditions, including those present in the human body. We tested loss-of-function mutations in all themarRhomologues in a murine pneumonia model and found that two (kvrAandkvrB) significantly impacted the virulence of K1 and K2 capsule type hypervirulent (hv) strains and thatkvrAaffected the virulence of a sequence type 258 (ST258) classical strain. In thehvstrains,kvrAandkvrBmutants displayed phenotypes associated with reduced capsule production, mucoviscosity, and transcription fromgalFandmanCpromoters that drive expression of capsule synthesis genes. In contrast,kvrAandkvrBmutants in the ST258 strain had no effect on capsule gene expression or capsule-related phenotypes. Thus, KvrA and KvrB affect virulence in classical andhvstrains but the effect on virulence may not be exclusively due to effects on capsule production.IMPORTANCEIn addition to having a reputation as the causative agent for hospital-acquired infections as well as community-acquired invasive infections,Klebsiella pneumoniaehas gained widespread attention as a pathogen with a propensity for acquiring antibiotic resistance. Due to the rapid emergence of carbapenem resistance amongK. pneumoniaestrains, a better understanding of virulence mechanisms and identification of new potential drug targets are needed. This study identified two novel regulators (KvrA and KvrB) of virulence inK. pneumoniaeand demonstrated that their effect on virulence in invasive strains is likely due in part to effects on capsule production (a major virulence determinant) and hypermucoviscosity. KvrA also impacts the virulence of classical strains but does not appear to affect capsule gene expression in this strain. KvrA and KvrB are conserved amongK. pneumoniaestrains and thus could regulate capsule expression and virulence in diverse strains regardless of capsule type.

scholarly journals INVESTIGATION OF THE ANTIBIOTIC RESISTANCE: THE CASE OF BUU DIEN GENERAL HOSPITAL IN HO CHI MINH CITY

2019 ◽  
pp. 116-119
Author(s):  
Tran-Thi Ngoc-Van ◽  
Tran Quang-Thinh ◽  
Cu Thanh-Tuyen ◽  
Hoang-Thy Nhac-Vu
Keyword(s):  
Antibiotic Resistance ◽  
General Hospital ◽  
Susceptibility Testing ◽  
Antibiotic Use ◽  
Polymyxin B ◽  
Ho Chi Minh City ◽  
Cross Sectional ◽  
E Coli ◽  
Hospital Acquired Infections ◽  
Hospital Acquired

Objective: In Vietnam, antibiotic resistance has been gained the attention of medical professionals in antibiotic use management. This study aimed to investigate the antibiotic resistance among hospital-acquired infections at Buu Dien General Hospital in Ho Chi Minh City in the period of 01-12/2017. Methods: This cross-sectional descriptive study was conducted on the retrospective data of all antibiograms of bacteria isolated from hospital-acquired infections at Buu Dien General Hospital in Ho Chi Minh City in the period of 01-12/2017 to investigate the antibiotic resistance. Characteristics of antibiotic resistance were described by frequency and percentage of types of bacteria isolated and antibiotics being resistant. Results: A total of 179 isolates were collected during the period 01-12/2017, of which E. coli was the most commonly isolated pathogen (41.3%). The highest prevalent infections were in the skin and mucosa; respiratory tract; and urinary tract (34.6%; 32.4%; and 27.9%). The antibiotic susceptibility testing used 21 types of antibiotics. Among them, S. aureus was 82% resistant to clindamycin and 75% resistant to cefuroxime; the Proteus resistance percentages to amoxicillin/clavulanic, second-generation cephalosporins, ciprofloxacin and fosfomycin varied from 50 to 93%; Pseudomonas was 92% resistant to fosfomycin and 62% resistant to ceftazidime; A. baumannii was resistant to most classes of agents used (50-75%). Both E. coli and Klebsiella were highly resistant to gentamicin, amoxicillin, ciprofloxacin, 2nd and 3rd generation cephalosporin’s. Polymyxin B-resistant Proteus cultures were detected at 67%. Conclusion: The study described the antibiotic resistance situation of hospital-acquired bacteria at the Buu Dien General Hospital from 01-12/2017. This information will aid physicians to select proper antibiotics for their patients in the next period.

scholarly journals A Serendipitous Mutation Reveals the Severe Virulence Defect of a Klebsiella pneumoniae fepB Mutant

mSphere ◽  
2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Michelle Palacios ◽  
Christopher A. Broberg ◽  
Kimberly A. Walker ◽  
Virginia L. Miller
Keyword(s):  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Klebsiella Pneumoniae ◽  
Drug Targets ◽  
Carbapenem Resistance ◽  
Content Type ◽  
Hospital Acquired Infections ◽  
Tract Infections ◽  
Hospital Acquired ◽  
Rapid Emergence

ABSTRACT In addition to having a reputation as the causative agent of several types of hospital-acquired infections, Klebsiella pneumoniae has gained widespread attention as a pathogen with a propensity for acquiring antibiotic resistance. It is capable of causing a range of infections, including urinary tract infections, pneumonia, and sepsis. Because of the rapid emergence of carbapenem resistance among Klebsiella strains, there is a dire need for a better understanding of virulence mechanisms and identification of new drug targets. Here, we identify the periplasmic transporter FepB as one such potential target. Klebsiella pneumoniae is considered a significant public health threat because of the emergence of multidrug-resistant strains and the challenge associated with treating life-threatening infections. Capsule, siderophores, and adhesins have been implicated as virulence determinants of K. pneumoniae, yet we lack a clear understanding of how this pathogen causes disease. In a previous screen for virulence genes, we identified a potential new virulence locus and constructed a mutant (smr) with this locus deleted. In this study, we characterize the smr mutant and show that this mutation renders K. pneumoniae avirulent in a pneumonia model of infection. The smr mutant was expected to have a deletion of three genes, but subsequent genome sequencing indicated that a much larger deletion had occurred. Further analysis of the deleted region indicated that the virulence defect of the smr mutant could be attributed to the loss of FepB, a periplasmic protein required for import of the siderophore enterobactin. Interestingly, a ΔfepB mutant was more attenuated than a mutant unable to synthesize enterobactin, suggesting that additional processes are affected. As FepB is highly conserved among the members of the family Enterobacteriaceae, therapeutic targeting of FepB may be useful for the treatment of Klebsiella and other bacterial infections. IMPORTANCE In addition to having a reputation as the causative agent of several types of hospital-acquired infections, Klebsiella pneumoniae has gained widespread attention as a pathogen with a propensity for acquiring antibiotic resistance. It is capable of causing a range of infections, including urinary tract infections, pneumonia, and sepsis. Because of the rapid emergence of carbapenem resistance among Klebsiella strains, there is a dire need for a better understanding of virulence mechanisms and identification of new drug targets. Here, we identify the periplasmic transporter FepB as one such potential target.

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