PREVALENCE OF HIGH LEVEL AMINOGLYCOSIDE RESISTANCE AND VANCOMYCIN RESISTANT ENTEROCOCCI IN ENTEROCOCCAL ISOLATES IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 3-5
Author(s):  
Sunita Agarwal ◽  
Nazneen Pathan ◽  
Shivra Batra ◽  
Rajni Sharma
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tertiary Care ◽  
Automated System ◽  
Care Hospital ◽  
Enterococcus Species ◽  
Aminoglycoside Resistance ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
High Level

Introduction: The emergence of High Level Aminoglycoside Resistance (Resistant to Gentamycin and Streptomycin) and Vancomycin Resistant Enterococci among Indoor and Intensive Care Unit admitted patient presents a serious challenge for clinicians. Objective: To determine Enterococcal burden in blood and urine specimens and to detect the prevalence of High Level Aminoglycoside Resistance and Vancomycin Resistant Enterococci. Material & Methods: One hundred ten Enterococci were isolated from blood and urine samples and processed according to standard laboratory protocol. Species identication and sensitivity was done using the VITEK 2 automated system (Biomerieux France) with the cards GPID and AST 67 respectively. Results: Out of 110 Enterococci isolates, 36 were from blood and 74 from urine were detected. Different Species isolated were Enterococcal faecium (59%), Enterococcal faecalis (34%), Enterococcal rafnosus (2.7%), Enterococcal gallinarum (1.8%), Enterococcal casseliavus (0.9%) and Enterococcal duran (0.9%).Out of 36 blood isolates, 14 (38%) were found to be both High Level Gentamycin Resistant (HLGR) & High Level Streptomycin Resistant (HLSR), 10 (27%) were only HLGR and 8 (22%) were only HLSR. 20 strain (55%) of Enterococcus species isolated in blood were VRE. All VRE strains were found to be resistant to both aminoglycosides ( HLAR).Among the 74 urinary isolates, 24 (34%) were found to be both HLGR & HLSR, only HLGR was observed in 20 (27%) and HLSR was observed in 11 (14%) isolates. 24 strains (34%) of Enterococcus species were found to be vancomycin resistant in urine. 23 strains out of 24 were resistant to high level of aminoglycosides. Conclusion: The prevalence of HLAR and VRE is very high among Enterococcus specimens from indoor/ intensive care unit patients. Early species identication and antibiotic sensitivity result can help in better clinical outcome.

scholarly journals Susceptibility Rates and High Level Aminoglycoside Resistance of Enterococcus Species Isolated from Intensive Care Unit Clinical Specimens

2008 ◽  
Vol 12 ◽  
pp. S41
Author(s):  
Stvlianos Xvtsas ◽  
Panagiota Kasviki ◽  
Magdalini Alexandridou ◽  
Marios Karvouniaris ◽  
Agni Michailidou ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Enterococcus Species ◽  
Aminoglycoside Resistance ◽  
Clinical Specimens ◽  
High Level

Management of an Outbreak of Vancomycin-Resistant Enterococci in the Medical Intensive Care Unit of a Cancer Center

2001 ◽  
Vol 22 (4) ◽  
pp. 217-219 ◽  
Author(s):  
Hend Hanna ◽  
Jan Umphrey ◽  
Jeffrey Tarrand ◽  
Michelle Mendoza ◽  
Issam Raad
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Intensive Care Unit ◽  
Tertiary Care ◽  
Control Measures ◽  
Cancer Center ◽  
Infection Control Measures ◽  
Vancomycin Resistant Enterococci ◽  
Medical Intensive Care ◽  
Vancomycin Resistant

AbstractBetween November 1996 and February 1997, 17 episodes of vancomycin-resistant enterococci (VRE) infection or colonization (9 infections, 8 colonizations), all with the same or a similar genomic DNA pattern, were identified in the medical intensive care unit (MICU) of a tertiary-care cancer hospital. The cases were genotypically traced to a patient who was admitted to the hospital in September 1996 and who, by December 1996, had four different admissions to the MICU. Multifaceted infection control measures, including decontamination of the environment and of nondisposable equipment, halted the nosocomial transmission of VRE in the MICU.

Considerations for the Management of Gram-Positive Pathogens in the Intensive Care Unit

2005 ◽  
Vol 18 (2) ◽  
pp. 100-108
Author(s):  
Christopher Schriever ◽  
Laurie Zeitz-Colaizzi ◽  
Andrea Quinn ◽  
Allison E. Schriever ◽  
Joan P. Cannon
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Opportunistic Pathogens ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
High Level ◽  
Therapeutic Alternatives ◽  
Immunocompromised Hosts

Surveillance data demonstrate that the majority of gram-positive bacterial isolates obtained in the intensive care unit (ICU) setting are staphylococci and enterococci. Staphylococci, mainly Staphylococcus aureus and coagulase-negative staphylococci, compose the majority of clinical isolates. Data from 25 North American ICUs reported methicillin-resistant Saureus (MRSA) in more than 50% of the Saureus organisms isolated mainly from a respiratory source. In addition to MRSA, Saureus with reduced susceptibility to vancomycin has been reported. Enterococci are typically considered opportunistic pathogens, infecting immunocompromised hosts. Resistance of enterococci to vancomycin, along with the newer gram-positive antimicrobials, is an increasing problem. Investigators have demonstrated that nearly 30% of enterococci isolated in the ICU are resistant to vancomycin. The high level of resistance and limited therapeutic options make treating resistant gram-positive organisms such as MRSA and vancomycin-resistant enterococci particularly problematic. While vancomycin has long been considered the gold standard for the treatment of resistant gram-positive infections, newer agents (eg, quinupristin-dalfopristin, linezolid, and daptomycin) offer therapeutic alternatives.

scholarly journals Real-world experience of how chlorhexidine bathing affects the acquisition and incidence of vancomycin-resistant enterococci (VRE) in a medical intensive care unit with VRE endemicity: a prospective interrupted time-series study

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Jin Woong Suh ◽  
Nam Hee Kim ◽  
Min Jung Lee ◽  
Seoung Eun Lee ◽  
Byung Chul Chun ◽  
...  
Keyword(s):  
Time Series ◽  
Intensive Care ◽  
Real World ◽  
Compliance Rate ◽  
Tertiary Care ◽  
Interrupted Time Series ◽  
Care Hospital ◽  
Effective Measure ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

Abstract Background Critically ill patients in intensive care units (ICUs) often acquire opportunistic infections or are colonized by vancomycin-resistant enterococci (VRE), which limits therapeutic options and results in high case-fatality rates. In clinical practice, the beneficial effects of universal chlorhexidine gluconate (CHG) bathing on the control of VRE remain unclear. This study aimed to investigate whether 2% CHG daily bathing reduced the acquisition of VRE in the setting of a medical ICU (MICU) with VRE endemicity. Methods This quasi-experimental intervention study was conducted in a 23-bed MICU of a tertiary care hospital in Korea from September 2016 to December 2017. In a prospective, interrupted time-series analysis (ITS) with a 6-month CHG bathing intervention, we compared the acquisition and incidence of VRE and the incidence of methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Acinetobacter baumannii (CRAB) between the pre-intervention and intervention periods. The primary and secondary outcomes were a change in the acquisition of VRE and incidence of VRE, MRSA, or CRAB between the two periods, respectively. Results All the adult patients admitted to the MICU were enrolled in the pre-intervention (n = 259) and intervention (n = 242). The overall CHG daily bathing compliance rate was 72.5%. In the ITS, there was a significant intervention effect with a 58% decrease in VRE acquisition (95% CI 7.1–82.1%, p = 0.038) following the intervention. However, there was no significant intervention effects on the incidence trend of VRE, MRSA, and CRAB determined by clinical culture between the pre-intervention and intervention periods. Conclusion In this real-world study, we concluded that daily bathing with CHG may be an effective measure to reduce VRE cross-transmission among patients in MICU with a high VRE endemicity.

scholarly journals Comparison of Different Phenotypic Methods for Detection of Vancomycin Drug Resistance in Enterococcus Species

2021 ◽  
Vol 8 (9) ◽  
pp. 289-293
Author(s):  
Deepa Pramod Devhare ◽  
Sae Pol
Keyword(s):  
Drug Resistance ◽  
Tertiary Care ◽  
Vancomycin Resistance ◽  
Automated System ◽  
Disk Diffusion ◽  
Clinical Samples ◽  
Care Hospital ◽  
Enterococcus Species ◽  
Vancomycin Resistant ◽  
Phenotypic Methods

Introduction: Vancomycin resistant enterococci have emerged as an important cause of nosocomial infection worldwide. Vancomycin drug resistance needs to be detected accurately in all Enterococcus species in order to prevent its spread in health care setting. Present study was conducted to compare three different phenotypic methods for detection of vancomycin resistance in enterococci. Material and methods: Study was conducted in a tertiary care hospital over a period of one year. Enterococcus species isolated from clinical samples like urine, pus, blood and sterile body fluids were tested by three different methods namely disk diffusion, E-strip and Phoenix automated system for detection of vancomycin resistance. Results: 400 Enterococcus species were isolated from clinical samples. 19(4.8%) Enterococcus species were found to be vancomycin resistant and one (0.25%) strain was found to be intermediate resistant to vancomycin by all three methods resulting in 100% sensitivity and 100%specificity. Conclusion: Present study recommends vancomycin disk diffusion as screening and E-strip as good confirmatory tests in resource poor settings for detection of vancomycin drug resistance. Keywords: VRE, vancomycin, disk diffusion, E strip, Phoenix automated system..

scholarly journals Genetic relatedness of clinical and environmental Acinetobacter baumanii isolates from an intensive care unit outbreak

2015 ◽  
Vol 9 (06) ◽  
pp. 665-669 ◽  
Author(s):  
Abiola Senok ◽  
Ghada Garaween ◽  
Adeola Raji ◽  
Harish Khubnani ◽  
Garwin Kim Sing ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Saudi Arabia ◽  
Intensive Care ◽  
Genetic Relatedness ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Automated System ◽  
Clinical Strain ◽  
Care Hospital

Introduction: Determination of microbial genetic relatedness is important for improving efficiency of infection control measures during hospital outbreaks. This study aimed to analyze the clonal relationships of clinical and environmental Acinetobacter baumannii strains isolated during an outbreak in the intensive care unit (ICU) of a secondary care hospital in Saudi Arabia. Methodology: Twelve clinical and fourteen environmental A. baumannii isolates identified during an outbreak in February 2013 in the 14-bed adult  intensive care unit of a tertiary care hospital in Riyadh, Saudi Arabia, were studied. Bacterial identification and antimicrobial susceptibility testing were carried out using Microscan Walkaway 96 automated system. Determination of clonal diversity was investigated by repetitive-sequence-based polymerase chain reaction (rep-PCR) with the semi-automated DiversiLab system. Results: The majority of the clinical isolates were from endotracheal tube aspirates (n = 9), one from a wound swab and two were from urine and sputum, respectively. Environmental isolates were from bed railings (n = 10) and with one each from curtain, stethoscope, computer mouse and telephone. Isolates were categorized into 6 clusters (Groups 1-6). Most of the isolates were associated with two clusters namely Groups 2 (n = 11) and 3 (n = 9). All isolates were multidrug resistant showing resistance to three or more classes of antibiotics. One clinical strain from Cluster 3 was resistant to colistin (MIC > 4ug/ml). Conclusion: This outbreak was caused by two clonal groups of multidrug resistant A. baumannii. The presence of multiple environmental clones was suggestive of environmental source dissemination via healthcare workers within the ICU.

Prevalence of Vancomycin Resistant Enterococci in Various Clinical Specimens in Tertiary Care Hospital in North Delhi

2012 ◽  
Vol 3 (3) ◽  
pp. 141-144
Author(s):  
Swati Chaudhary ◽  
◽  
Swastika Aggarwal ◽  
Pawan Kumar ◽  
SK Aggarwal SK Aggarwal ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Clinical Specimens ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

scholarly journals A Japanese traditional medicine Hochuekkito promotes negative conversion of vancomycin-resistant Enterococci

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Junko Kohno ◽  
Tsuyoshi Kawamura ◽  
Akiko Kikuchi ◽  
Tetsuya Akaishi ◽  
Shin Takayama ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Tertiary Care ◽  
Albumin Level ◽  
Kampo Medicine ◽  
Care Hospital ◽  
Intestinal Immunity ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Japanese Traditional Medicine ◽  
Negative Conversion

AbstractVancomycin-resistant enterococci (VRE) are prominent causes of nosocomial infections. Japanese traditional (Kampo) medicine promotes intestinal immunity and protects against bacterial infections. We assessed potential differences in the clinical course of VRE-positive patients, based on their characteristics and treatment with Kampo medicines. This retrospective observational study collected data from VRE-positive patients from August 2018 to July 2019 at a tertiary-care hospital in Japan. The data of 122 consecutive VRE-positive inpatients were analyzed. Sixty-nine patients were treated with probiotics, among whom, 18 were further treated with Kampo medicines. Twenty-six of the 122 patients subsequently died. In univariate analyses, subsequent VRE negative conversion significantly reduced the mortality of VRE-detected patients (p = .0003). Administration of probiotics (p = .0065) and Kampo medicines with probiotics (p = .0002), especially of the Kampo medicine hochuekkito (p = .0014), and a higher serum albumin level positively contributed to the subsequent VRE negative conversion. Multivariate analyses demonstrated that Kampo medicines and body mass index contributed to VRE negative conversion. Hochuekkito shortened the time needed for VRE negative conversion (p = 0.0485). Administration of Kampo medicines, especially of hochuekkito, in addition to probiotics in VRE patients may promote VRE negative conversion.

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