scholarly journals KPC-2 producing Pseudomonas putida as an unexpected pathogen of catheter-associated bloodstream infection

2020 ◽  
Vol 14 (04) ◽  
pp. 411-414 ◽  
Author(s):  
Raiane Cardoso Chamon ◽  
Jaqueline Abel da Rocha ◽  
Isabella Araujo Martins ◽  
Laís Lopes Pires ◽  
Breno Macêdo de Almeida ◽  
...  
Keyword(s):  
Pseudomonas Putida ◽  
Fatal Case ◽  
Bloodstream Infections ◽  
Immunocompromised Host ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Becton Dickinson ◽  
Mortality And Morbidity ◽  
Flight Mass Spectrometry ◽  
Klebsiella Pneumoniae Carbapenemases

Infections due to multidrug resistant Gram-negative pathogens are of great concern worldwide, as they are frequently associated with high mortality and morbidity rates. The occurrence of Pseudomonas spp. producing Klebsiella pneumoniae carbapenemases (KPCs) imposes a great challenge through treatment course of bloodstream infections (BSIs). Pseudomonas putida has been recognized as an emerging pathogen of healthcare associated infections (HAIs). Therefore, we aimed to report a case of a non-fatal case of peripheral line associated BSI (PLA-BSI) in an immunocompromised host due to P. putida harboring blaKPC-2 gene in Brazil. A P. putida isolate was recovered from a blood culture of a 72-year-old man admitted at a University Hospital, identified by BD Phoenix™ 100 (Becton, Dickinson and Company), causing PLA-BSI. The species identification was confirmed by Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) and resistance to carbapenems were confirmed by Epsilometer test (E-test®). Additionally, the presence of important carbapenemases genes (blaKPC, blaNDM, blaOXA-48-like, blaSPM, blaIMP, blaVIM) was investigated by Polymerase Chain Reaction. The bacterial isolate was confirmed as meropenem resistant P. putida harboring blaKPC-2 gene.Thereofre, these fidings suggest that P. putida can work as a reservoir for resistance genes as this bacterium has the ability to disseminate through water-fluids inside hospital and community settings. Moreover, this paper highlights that a frequent and worldwide disseminated mechanism of resistance (blaKPC-2) is currently occurring among uncommon agents of BSI.

scholarly journals Evaluation of Antibiotic Resistance and Biofilm Production among Clinical Strain Isolated from Medical Devices

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Veronica Folliero ◽  
Gianluigi Franci ◽  
Federica Dell’Annunziata ◽  
Rosa Giugliano ◽  
Francesco Foglia ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Medical Devices ◽  
University Hospital ◽  
Clinical Strain ◽  
Bacterial Strains ◽  
Becton Dickinson ◽  
Gram Positive ◽  
Gram Negative ◽  
Antibiotic Resistance Profile ◽  
Flight Mass Spectrometry

Microbial biofilms pose a serious threat to patients requiring medical devices (MDs). Prolonged periods of implantation carry a high risk of device-related infections (DRIs). Patients with DRIs often have negative outcomes following the failure of antibiotic treatment. Resistant DRIs are mainly due to the MDs contamination by bacteria producing biofilm. The present study aimed to detect biofilm formation among MD bacterial isolates and to explore their antibiotic resistance profile. The study was conducted on 76 MDs, collected at University Hospital of Campania “Luigi Vanvitelli,” between October 2019 and September 2020. Identification of isolates and antibiotic susceptibility testing were performed using Matrix Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) and Phoenix Becton Dickinson, respectively. Biofilm-forming abilities were assessed using the tissue culture plate (TCP) method. Among the 94 MDs isolated strains, 42.7% were Gram-positive, 40.3% Gram-negative, and 17% Candida species. Among 78 bacterial strains, 43.6% were non-biofilm producers while 56.4% produced biofilms. All biofilm producing isolates were sensitive to a limited spectrum of antibiotic classes. All moderate and strong biofilm producers and 81% of weak biofilm producers were Multidrug Resistance (MDR) strains. In contrast, among non-biofilm producers, only 11.8% were classified as MDR strains. Our results highlighted that Sulfamides and Glycopeptides for the major Gram-positive strains and Fluoroquinolones, Carbapenems, and Aminoglycosides for the most represented Gram-negative isolates could be the most suitable therapeutic choice for most biofilm-DRIs.

scholarly journals Analysis of survival for patients in relation to central venous catheter and nosocomial blood stream infections: A case study of Aga Khan University Hospital, Nairobi

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1770
Author(s):  
Francis Maina Kiroro ◽  
Majid Twahir
Keyword(s):  
Clinical Care ◽  
Survival Rates ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
University Hospital ◽  
P Value ◽  
Infection Status ◽  
Central Venous ◽  
Mortality And Morbidity ◽  
Significant Difference

Background: This study was focussed on survival rates of patients admitted to acute care units who utilized medical devices known as central venous catheters (CVC). CVCs are useful devices in clinical care; however some infections such as central line associated bloodstream infections (CLABSI) may occur, which are associated with increased lengths of stay and costs as well as higher morbidity and mortality rates. The overall objective of the present study was to determine survival probabilities and hazard rates for patients who used CVC devices and compare the subgroups by infection status. Methods: The study was focused on all patients who were admitted to Critical Care Units between 8th December 2012 and 31st March 2016 and utilized CVC devices. It was a retrospective study. Survival analysis techniques, test of equality of proportions, Man-Whitney test and Chi–square test of independence were used. Results: A total of 363 out of 1089 patients included in the study died during hospitalization. 47 patients developed nosocomial CLABSI. The average duration was 18.19 days and median of 12 days for hospitalized patients who did not develop a nosocomial CLABSI compared to an average of 56.79 days and a median of 51 days for those who did. There was a significantly higher proportion of mortality of those who developed nosocomial CLABSI compared to those that didn’t (p-value=0.01379). The results indicate that there was a significant association between infection status and discharge status, and significant difference to the survival rates of the patients based on infection status. Conclusions: There is a significant impact on mortality and morbidity of patients who develop nosocomial CLABSI. The duration of hospitalization by patients who developed CLABSI was significantly higher compared to patients who did not. Increased length of stay leads to higher cost of hospitalization.

Early- and Late-Onset Bloodstream Infections in the Intensive Care Unit: A Retrospective 5-Year Study of Patients at a University Hospital in China

2020 ◽  
Vol 221 (Supplement_2) ◽  
pp. S184-S192
Author(s):  
Jianfeng Xie ◽  
Shuzi Li ◽  
Ming Xue ◽  
Congshan Yang ◽  
Yingzi Huang ◽  
...  
Keyword(s):  
Intensive Care ◽  
Early Onset ◽  
Late Onset ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Antimicrobial Treatment ◽  
University Hospital ◽  
Limited Data ◽  
Microbiological Characteristics ◽  
Improve Clinical Outcome

Abstract Background Limited data are available regarding the current microbiological characteristics of bloodstream infections (BSIs) in intensive care units (ICUs) in China. This retrospective study aimed to determine the epidemiology of early- and late-onset BSIs in our ICU. Methods We retrospectively collected data about ICU patients with BSI from 2013 to 2017. The patients were divided into the early- and late-onset BSI groups according to if BSI occurred within or beyond 48 hours after ICU admission. Univariate and multivariate logistic regression analyses were used to assess the risk factors for infection with multidrug resistant organisms (MDROs). Results Of 5474 ICU admissions, 486 (8.9%) patients with BSIs and with 500 microorganisms were included in this study, 246 (50.6%) of whom had early-onset BSIs. Two hundred and seventy patients were infected with MDROs. The proportion of MDRO infections was significantly higher among patients with late-onset BSIs than among those with early-onset BSIs (57.9% vs. 41.5%, P = .017). The ICU mortality rate was significantly higher in the late-onset BSI group (44.6% vs. 33.8%, P = .014) and early and appropriate antimicrobial treatment significantly improved the survival rate among patients with BSI (P < .001). Conclusions MDROs affected more than half of patients with BSI in the ICU. Early appropriate empirical antimicrobial therapy could improve clinical outcome of patients with BSIs.

scholarly journals Pan-Echinocandin-Resistant Candida glabrata Bloodstream Infection Complicating COVID-19: A Fatal Case Report

2020 ◽  
Vol 6 (3) ◽  
pp. 163 ◽  
Author(s):  
Brunella Posteraro ◽  
Riccardo Torelli ◽  
Antonietta Vella ◽  
Paolo Maria Leone ◽  
Giulia De Angelis ◽  
...  
Keyword(s):  
Candida Glabrata ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Clinical Course ◽  
Fatal Case ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Diabetes Patient ◽  
Gram Negative Bacteria ◽  
Echinocandin Resistance

Coinfections with bacteria or fungi may be a frequent complication of COVID-19, but coinfections with Candida species in COVID-19 patients remain rare. We report the 53-day clinical course of a complicated type-2 diabetes patient diagnosed with COVID-19, who developed bloodstream infections initially due to methicillin-resistant Staphylococcus aureus, secondly due to multidrug-resistant Gram-negative bacteria, and lastly due to a possibly fatal Candida glabrata. The development of FKS-associated pan-echinocandin resistance in the C. glabrata isolated from the patient after 13 days of caspofungin treatment aggravated the situation. The patient died of septic shock shortly before the prospect of receiving potentially effective antifungal therapy. This case emphasizes the importance of early diagnosis and monitoring for antimicrobial drug-resistant coinfections to reduce their unfavorable outcomes in COVID-19 patients.

scholarly journals Rapid increase of carbapenemase-producing Klebsiella pneumoniae strains in a large Italian hospital: surveillance period 1 March – 30 September 2010

2011 ◽  
Vol 16 (8) ◽  
Author(s):  
P Gaibani ◽  
S Ambretti ◽  
A Berlingeri ◽  
F Gelsomino ◽  
A Bielli ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Infection Control ◽  
Multidrug Resistant ◽  
Northern Italy ◽  
University Hospital ◽  
Resistant Bacteria ◽  
Surveillance Period ◽  
Multidrug Resistant Bacteria ◽  
First Case ◽  
Klebsiella Pneumoniae Carbapenemases

The first case of carbapenemase-producing Enterobacteriaceae in Italy was reported in 2009. We performed a study over a period of seven months in 2010 to survey the circulation of Klebsiella pneumoniae carbapenemases (KPC) in a 1,500-bed university hospital in northern Italy and report the presence and rapid increase of these multidrug-resistant bacteria. The results raise a major concern about these pathogens and demonstrate the urgent need for infection control and antibiotic stewardship programmes.

Nosocomial infection by VIM-2 metallo-β-lactamase-producing Pseudomonas putida

2010 ◽  
Vol 59 (7) ◽  
pp. 853-855 ◽  
Author(s):  
M. Treviño ◽  
L. Moldes ◽  
M. Hernández ◽  
L. Martínez-Lamas ◽  
C. García-Riestra ◽  
...  
Keyword(s):  
Pseudomonas Putida ◽  
Nosocomial Infections ◽  
Hospital Setting ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Santiago De Compostela ◽  
Carbapenem Resistant ◽  
Microbiological Characteristics ◽  
Different Strains ◽  
The University

Nosocomial infections caused by multidrug-resistant and carbapenem-resistant Pseudomonas putida isolates have been reported occasionally in severely ill or immunocompromised patients. Here we report the microbiological characteristics of what are believed to be the two first carbapenem-resistant VIM metallo-β-lactamase (MBL)-producing P. putida strains in Spain, which were isolated from patients at the University Hospital Complex of Santiago de Compostela. Both patients were immunocompromised with severe underlying diseases and had been hospitalized for more than 15 days. One of them had previously been treated with a broad-spectrum therapy. Antimicrobial susceptibility testing showed that both strains were resistant to piperacillin/tazobactam, ceftazidime, cefepime, imipenem, meropenem, gentamicin, tobramycin, aztreonam, trimethoprim/sulfamethoxazole and ciprofloxacin, but sensitive to amikacin and colistin. For both isolates PCR and sequencing was positive for the bla VIM-2 gene. Fingerprinting analysis revealed these were two different strains. One patient recovered clinically and one died; no direct link could be established between the isolation of P. putida and death. Our data expose the emergence of multidrug-resistant P. putida VIM-2 MBL, probably arising by independent horizontal transfer of resistance genes. So, although P. putida is not frequently isolated, it may survive easily in the hospital setting and occasionally cause difficult-to-treat nosocomial infections in severely ill patients.

scholarly journals Pan-Echinocandin-Resistant Candida glabrata Bloodstream Infection Complicating COVID-19: A Fatal Case Report

2020 ◽  
Author(s):  
Brunella Posteraro ◽  
Riccardo Torelli ◽  
Antonietta Vella ◽  
Paolo Maria Leone ◽  
Giulia De Angelis ◽  
...  
Keyword(s):  
Candida Glabrata ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Clinical Course ◽  
Fatal Case ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Diabetes Patient ◽  
Gram Negative Bacteria ◽  
Echinocandin Resistance

Coinfections with bacteria or fungi may be a frequent complication of COVID-19, although coinfections with Candida species in COVID-19 patients remain rare. We report the 53-day clinical course of a complicated type-2 diabetes patient diagnosed with COVID-19, who developed bloodstream infections initially due to methicillin-resistant Staphylococcus aureus, secondly to multidrug-resistant Gram-negative bacteria, and lastly to a possibly fatal Candida glabrata. Development of FKS-associated pan-echinocandin resistance in the C. glabrata isolated from the patient after 13 days of caspofungin treatment aggravated the situation. The patient died of septic shock shortly before the prospect of receiving potentially effective antifungal therapy. This case emphasizes the importance of early diagnosis and monitoring for antimicrobial drug-resistant coinfections to reduce their unfavorable outcomes in COVID-19 patients.

scholarly journals Emerging Multidrug-Resistant Candida duobushaemulonii Infections in Panama Hospitals: Importance of Laboratory Surveillance and Accurate Identification

2018 ◽  
Vol 56 (7) ◽  
Author(s):  
Ruben Ramos ◽  
Diego H. Caceres ◽  
Marilyn Perez ◽  
Nicole Garcia ◽  
Wendy Castillo ◽  
...  
Keyword(s):  
Antifungal Susceptibility ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Reference Laboratory ◽  
Emerging Pathogens ◽  
Candida Auris ◽  
Accurate Identification ◽  
Content Type ◽  
Flight Mass Spectrometry ◽  
Laboratory Surveillance

ABSTRACT Candida duobushaemulonii , a yeast closely related to Candida auris , is thought to cause infections in rare cases and is often misidentified. In October 2016, the Panamanian Ministry of Health implemented laboratory surveillance for C. auris . Suspected C. auris isolates were forwarded to the national reference laboratory for identification by matrix-assisted laser desorption ionization–time of flight mass spectrometry and antifungal susceptibility testing. Between November 2016 and May 2017, 17 of 36 (47%) isolates suspected to be C. auris were identified as C. duobushaemulonii. These 17 isolates were obtained from 14 patients at six hospitals. Ten patients, including three children, had bloodstream infections, and MICs for fluconazole, voriconazole, and amphotericin B were elevated. No resistance to echinocandins was observed. C. duobushaemulonii causes more invasive infections than previously appreciated and poses a substantial problem, given its resistance to multiple antifungals. Expanded laboratory surveillance is an important step in the detection and control of such emerging pathogens.

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