scholarly journals Laboratory information system for reporting antimicrobial resistant isolates from academic hospitals, South Africa

2017 ◽  
Vol 11 (09) ◽  
pp. 705-718
Author(s):  
Peter Suwirakwenda Nyasulu ◽  
Jill Murray ◽  
Olga Perovic ◽  
Hendrik Koornhof

Introduction: We aimed to evaluate the appropriateness of Digital Innovation South Africa (DISA)-based laboratory information system (LIS) for assessing the prevalence, patterns and trends of antimicrobial resistance, and associated demographic factors. Methodology: A retrospective analysis was conducted on routine data of blood culture isolates of Staphylococcus aureus, Klebsiella pneumoniae, and Pseudomonas aeruginosa. These isolates were collected by the National Health Laboratory Services between July 1, 2005 and December 31, 2009 at seven tertiary public hospitals. Factors associated with antimicrobial resistance were analysed using multivariate logistic regression. Results: Information on 9969 isolates was available, of which 3942 (39.5%), 4466 (44.8%) and 1561 (15.7%) were Staphylococcus aureus, Klebsiella pneumoniae, and Pseudomonas aeruginosa, respectively. Reporting of resistance across antibiotics tested was highest in patient age group less than 5 years old. Methicillin resistant Staphylococcus aureus was 39% on average. There was a significant increasing trend of Klebsiella pneumoniae resistance to ciprofloxacin (32.6% to 64.9%, p < 0.001), cotrimoxazole (67.5% to 81.6%, p < 0.001) and cefotaxime-ceftriaxone (55.5% to 73.2%, p < 0.001) over the study period. Pseudomonas aeruginosa resistance to meropenem showed a significant increasing trend from 2006 (27.5%) to 2009 (53.9%) (p < 0.001). Age group < 5 years, female gender, hospital location, year of infection were significantly associated with antimicrobial resistance. Conclusions: The percentages of antimicrobial resistance were high and showed a significant increasing trend among individual agents over the duration of the study e.g. ciprofloxacin, cotrimoxazole among others. Continued surveillance of antimicrobial resistance among bloodstream hospital-acquired infections should be strengthened.

2020 ◽  
Vol 44 ◽  
pp. 1
Author(s):  
Kasim Allel ◽  
Patricia García ◽  
Jaime Labarca ◽  
José M. Munita ◽  
Magdalena Rendic ◽  
...  

Objective. To identify socioeconomic factors associated with antimicrobial resistance of Pseudomonas aeruginosa, Staphylococcus aureus, and Escherichia coli in Chilean hospitals (2008–2017). Methods. We reviewed the scientific literature on socioeconomic factors associated with the emergence and dissemination of antimicrobial resistance. Using multivariate regression, we tested findings from the literature drawing from a longitudinal dataset on antimicrobial resistance from 41 major private and public hospitals and a nationally representative household survey in Chile (2008–2017). We estimated resistance rates for three priority antibiotic–bacterium pairs, as defined by the Organisation for Economic Co-operation and Development; i.e., imipenem and meropenem resistant P. aeruginosa, cloxacillin resistant S. aureus, and cefotaxime and ciprofloxacin resistant E. coli. Results. Evidence from the literature review suggests poverty and material deprivation are important risk factors for the emergence and transmission of antimicrobial resistance. Most studies found that worse socioeconomic indicators were associated with higher rates of antimicrobial resistance. Our analysis showed an overall antimicrobial resistance rate of 32.5%, with the highest rates for S. aureus (40.6%) and the lowest for E. coli (25.7%). We found a small but consistent negative association between socioeconomic factors (income, education, and occupation) and overall antimicrobial resistance in univariate (p < 0.01) and multivariate analyses (p < 0.01), driven by resistant P. aeruginosa and S. aureus. Conclusion. Socioeconomic factors beyond health care and hospital settings may affect the emergence and dissemination of antimicrobial resistance. Preventing and controlling antimicrobial resistance requires efforts above and beyond reducing antibiotic consumption.


Author(s):  
Surbhi Mundra ◽  
Padam Singh

Infection is caused in the human body due to the invasion of pathogenic microbes, their multiplication, and production of toxins. The ESKAPE pathogen comprises a group of six bacterial pathogens, namely Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. These pathogens are associated with the emerging cases of antimicrobial resistance to commonly used antibiotics such as penicillin, vancomycin, etc. Most of these pathogens are multidrug resistant, which is among the major threats to human health at present. The developing resistance to existing antibiotics imposes a burden on modern science to exercise the mechanism behind this and also the identification of novel targets to combat antimicrobial resistance. This chapter describes briefly about the mechanism of development of antimicrobial resistance and some herbal medications that can be used to combat the same. It also describes some of the traditional preventives that can be practiced to deal with infections.


2019 ◽  
Vol 57 (6) ◽  
Author(s):  
Romney M. Humphries ◽  
April N. Abbott ◽  
Janet A. Hindler

ABSTRACT The Clinical and Laboratory Standards Institute (CLSI) has revised several breakpoints since 2010 for bacteria that grow aerobically. In 2019, these revisions include changes to the ciprofloxacin and levofloxacin breakpoints for the Enterobacteriaceae and Pseudomonas aeruginosa, daptomycin breakpoints for Enterococcus spp., and ceftaroline breakpoints for Staphylococcus aureus. Implementation of the revisions is a challenge for all laboratories, as not all systems have FDA clearance for the revised (current) breakpoints, compounded by the need for laboratories to perform validation studies and to make updates to laboratory information system/electronic medical record builds in the setting of limited information technology infrastructure. This minireview describes the breakpoint revisions in the M100 supplement since 2010 and strategies for the laboratory on how to best adopt these in clinical testing.


2019 ◽  
Vol 17 (3) ◽  
pp. 140-148 ◽  
Author(s):  
A. Ouelhadj ◽  
L. Ait Salem ◽  
D. Djenane

Ce travail vise l’étude de l’activité antibactérienne de l’huile essentielle (HE) de Pelargoniumx asperum et de la bactériocine, la nisine seul et en combinaison vis-à-vis de six bactéries dont quatre sont multirésistantes d’origine clinique. L’activité antibactérienne in vitro a été évaluée par la méthode de diffusion sur gélose. La concentration minimale inhibitrice (CMI) est aussi déterminée pour HE. Les résultats ont révélé une activité antibactérienne significative exercée par HE visà-vis de Staphylococcus aureus (ATCC 43300), Staphylococcus aureus et Escherichia coli avec des diamètres d’inhibition de 36,00 ; 22,50 et 40,00 mm, respectivement. Cependant, l’HE de Pelargonium asperum a montré une activité antibactérienne supérieure par rapport à la nisine. Les valeurs des CMI rapportées dans cette étude sont comprises entre 1,98–3,96 μl/ml. Les combinaisons réalisées entre HE et la nisine ont montré un effet additif vis-à-vis de Escherichia coli (ATCC 25922) avec (50 % HE Pelargonium asperum + 50 % nisine). Par contre, nous avons enregistré une synergie vis-à-vis de Klebsiella pneumoniae avec (75 % HE Pelargonium asperum + 25 % nisine) et contre Pseudomonas aeruginosa avec les trois combinaisons testées. Les résultats obtenus permettent de dire que l’HE de Pelargonium asperum possède une activité antibactérienne ainsi que sa combinaison avec la nisine pourrait représenter une bonne alternative pour la lutte contre l’antibiorésistance.


Author(s):  
Priscila Pinho da Silva ◽  
Fabiola A. da Silva ◽  
Caio Augusto Santos Rodrigues ◽  
Leonardo Passos Souza ◽  
Elisangela Martins de Lima ◽  
...  

Abstract Background The emergence and spread of antimicrobial resistance and infectious agents have challenged hospitals in recent decades. Our aim was to investigate the circulation of target infectious agents using Geographic Information System (GIS) and spatial–temporal statistics to improve surveillance and control of healthcare-associated infection and of antimicrobial resistance (AMR), using Klebsiella pneumoniae complex as a model. Methods A retrospective study carried out in a 450-bed federal, tertiary hospital, located in Rio de Janeiro. All isolates of K. pneumoniae complex from clinical and surveillance cultures of hospitalized patients between 2014 and 2016, identified by the use of Vitek-2 system (BioMérieux), were extracted from the hospital's microbiology laboratory database. A basic scaled map of the hospital’s physical structure was created in AutoCAD and converted to QGis software (version 2.18). Thereafter, bacteria according to resistance profiles and patients with carbapenem-resistant K. pneumoniae (CRKp) complex were georeferenced by intensive and nonintensive care wards. Space–time permutation probability scan tests were used for cluster signals detection. Results Of the total 759 studied isolates, a significant increase in the resistance profile of K. pneumoniae complex was detected during the studied years. We also identified two space–time clusters affecting adult and paediatric patients harbouring CRKp complex on different floors, unnoticed by regular antimicrobial resistance surveillance. Conclusions In-hospital GIS with space–time statistical analysis can be applied in hospitals. This spatial methodology has the potential to expand and facilitate early detection of hospital outbreaks and may become a new tool in combating AMR or hospital-acquired infection.


2015 ◽  
Vol 17 (4 suppl 3) ◽  
pp. 1142-1149 ◽  
Author(s):  
J.A.L MIRANDA ◽  
J.A. ROCHA ◽  
K.M. ARAÚJO ◽  
P.V. QUELEMES ◽  
S.J. MAYO ◽  
...  

RESUMO O uso de plantas medicinais no tratamento de doenças é uma estratégia antiga utilizada por praticamente todas as populações do mundo, e, embora novos antibióticos tenham sido desenvolvidos para o controle de micro-organismos infecciosos, às vezes são ineficazes. Diversos extratos de plantas medicinais têm efeitos antimicrobianos, principalmente quando associados à antibióticos de uso clínico, representando alternativa terapêutica para doenças infecciosas. Montrichardia linifera, conhecida popularmente como aninga, é espécie macrófita, aquática emergente de hábito herbáceo, pertencente a família Araceae e ocorre em áreas alagáveis. A utilidade farmacológica desta espécie é diversificada tendo sido relatada como cicatrizante, antirreumático, antidiurético e expectorante. Devido à relevância no campo etnofarmacológico, ampla utilização na medicina popular e escassez de trabalhos relacionados à atividade antibacteriana desta espécie, objetivou-se com este trabalho avaliar a atividade antibacteriana de extratos alcoólicos de folhas de Montrichardia linifera, coletadas na margem do rio Igaraçu, Parnaíba-PI. O extrato foi testado em oito cepas de bactérias: Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae e Pseudomonas aeruginosa. Foram utilizadas as técnicas de verificação da formação de halos de inibição e determinação das concentrações inibitórias e bactericidas mínimas. Os testes antibacterianos evidenciaram como principais resultados que o extrato metanólico seco (EMS), extrato metanólico fresco (EMF), e o extrato etanólico seco (EES), apresentaram ação antibacteriana, enquanto o extrato etanólico fresco (EEF) não apresentou atividade para as bactérias testadas. O EMS foi o mais eficiente, inibindo o crescimento bacteriano na concentração de 200 μg/mL para E. faecalis, 400 μg/mL para S. aureus, 400 μg/mL para S. epidermidis e 2.000 μg/mL para P. aeruginosa. O EMF obteve CIM de 2.000 μg/mL para E. faecalis e EES obteve CIM de 250 μg/mL para E. faecalis. Os resultados demonstraram que M. linifera constitui fonte eficiente de compostos bioativos antibacterianos. Os estudos sobre as propriedades farmacológicas de plantas da família Araceae são escassos, e os resultados deste trabalho são pioneiros em relação a atividade antibacteriana desta espécie.


2016 ◽  
Vol 27 (2) ◽  
pp. 83 ◽  
Author(s):  
José Enrique Oliva-Menacho ◽  
Marco Antonio García-Hjarles ◽  
José Arturo Oliva-Candela ◽  
Hugo Saturnino De la Cruz-Roca

Objetivos: Determinar el grado de contaminación bacteriana con bacterias patógenas de los estetoscopios del personal médico en un hospital general de Lima, Perú. Material y métodos: Estudio de tipo observacional, descriptivo y transversal, realizado en el Hospital Nacional Arzobispo Loayza, entre los meses de enero y juniodel 2013. Se estudiaron 124 muestras de estetoscopios del personal médico en las siguientes áreas: UCI 20; neonatología 13; quemados 3; medicina 52; emergencia 36. Se recolectaron las muestras con hisopos humedecidos, en condiciones estériles (En presencia de un mechero de vidrio para alcohol) y luego fueron introducidos en tuboscon preparado de caldo BHI (Infusión cerebro corazón) para ser incubados por 24 horas a 37°C; se cultivó en Agar sangre, Agar MacConkey, Agar manitol y Agar cetrimidepara su posterior determinación de bacterias patógenas por procedimientos bioquímicos ,luego se identificó la susceptibilidad bacteriana con la técnica de Kirby- Bauer. Resultados: De los 124 estetoscopios estudiados; 114 (91,9%) estuvieron contaminados; se aislaron 123 cepasbacterianas: Staphylococcus spp coagulasa negativa 106(86,1%), Staphylococcus aureus 5(4,0%), Enterobacter aerogenes 4 (3,2%), Acinetobacter spp 2(1,6%), Pseudomonas aeruginosa 4(3,2%), Klebsiella Pneumoniae 1(0,8%) y Escherichia coli 1(0,8%). Conclusiones: El aislamiento de bacterias patógenas sugiere que el estetoscopio debe ser considerado como un vector de la infección nosocomial.


Author(s):  
I. I. Myrko ◽  
T. I. Chaban ◽  
V. V. Ogurtsov ◽  
V. S. Matiychuk

Мета роботи. Здійснити синтез деяких нових піразолзаміщених 7H-[1,2,4]триазоло[3,4-b][1,3,4]тіадіазинів та провести дослідження антимікробних властивостей синтезованих сполук. Матеріали і методи. Органічний синтез, ЯМР-спектроскопія, елементний аналіз, фармакологічний скринінг. Результати й обговорення. У результаті взаємодії eтил (2Z)-хлоро(фенілгідразоно)ацетатів з ацетилацетоном було отримано етил 4-ацетил-5-метил-1-феніл-1H-піразол-3-карбоксилати. Зазначені сполуки піддали бромуванню, що дозволило одержати цільові бромкетони. Синтезовані на даній стадії етил 1-арил-4-(бромацетил)-5-метил-1Н-піразол-3-карбоксилати було введено у взаємодію з 4-аміно-5-арил(гетарил)-2,4-дигідро-3Н-1,2,4-триазол-3-тіонами з подальшим формуванням 1,3,4-тіадіазольного циклу та отриманням відповідних етил 1-арил-4-{3-арил(гетарил)-7H-[1,2,4]триазоло[3,4-b][1,3,4]тіадіазин-6-іл)}-5-метил-1H-піразол-3-карбоксилатів. Структура синтезованих сполук підтверджена даними елементного аналізу та ЯМР спектроскопією. В рамках міжнародного проекту "The Community for Antimicrobial Drug Discovery" (CO-ADD) за підтримки Wellcome Trust (Великобританія) і університету Квінсленда (Австралія) для синтезованих сполук здійснено скринінг антимікробної активності. Як тестові мікроорганізми використовували п'ять штамів бактерій: Escherichia coli ATCC 25922, Klebsiella pneumoniae ATCC 700603, Acinetobacter baumannii ATCC 19606, Pseudomonas aeruginosa ATCC 27853, Staphylococcus aureus ATCC 43300 та двох штамів грибків: Candida albicans ATCC 90028 і Cryptococcus neoformans ATCC 208821. Встановлено, що досліджувані сполуки виявляють різноманітну дію, від практично повної її відсутності до виразного антимікробного ефекту. Висновки. Здійснено синтез 12 нових етил 1-арил-4-{3-арил(гетарил)-7H-[1,2,4]триазоло[3,4-b][1,3,4]тіадіазин-6-іл)}-5-метил-1H-піразол-3-карбоксилатів. Зазначені речовини отримані шляхом взаємодії відповідних етил 1-арил-4-(бромацетил)-5-метил-1Н-піразол-3-карбоксилатів з 4-аміно-5-арил(гетарил)-2,4-дигідро-3Н-1,2,4-триазол-3-тіонами. Дослідження антимікробної активності синтезованих сполук демонструють потенціал пошуку антимікробних агентів серед зазначеного класу сполук.


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