scholarly journals Evaluation of the HB&L carbapenemase and extended spectrum beta lactamase-AmpC automated screening kits for the rapid detection of resistant Enterobacteriaceae in rectal swabs

2017 ◽  
Vol 32 (1) ◽  
Author(s):  
Sara Marani ◽  
Maria Federica Pedna

<em>Background</em>. In the past two decades, a rapid increase of infections due to multidrug-resistant <em>Enterobacteriaceae</em> was reported worldwide, including in Italy. These bacteria express genes encoding for extended-spectrum β-lactamases (ESBL) or bear a plasmid-mediated AmpC that induce phenotypically a resistance to the last-generation cephalosporins; even more worrying is the rapid increase of <em>Enterobacteriaceae</em> carrying genes conferring resistance to carbapenems (CPE). <br /><em>Materials and methods.</em> The gut may serve as reservoir for these antibiotic drug-resistant bacteria: as a consequence, the rapid detection of drug resistant <em>Enterobacteriaceae</em> from rectal swabs is an important tool to identify rectal carriage of resistant bacteria. This procedure is the basic tool to successfully implement the infection control measures in the hospital wards. The study evaluated the capability of the HB&amp;L ESBL/AmpC and CARBAPENEMASE screening kit (Alifax, Padua, Italy) to rapidly identify the drug resistant enterobacteriaceae from rectal swabs: the performance was compared with the conventional method. <br /><em>Results and conclusions.</em> The overall agreement was very good (91% for the detection of ESBL-AmpC, and 96.2% for the identification of CPE); this method is thus an efficient tool to quickly report positive multidrug resistant bacteria in rectal swabs.

2015 ◽  
Vol 1 (1) ◽  
pp. 20-25
Author(s):  
Puja Amatya ◽  
Suchita Joshi ◽  
Shrijana Shrestha

Introductions: Klebsiella sepsis is the most important nosocomial infection in neonates. The objectives of this study were to review an outbreak in a neonatal unit caused by Klebsiella species, to identify the source of the infections, and to identify infection control measures for eradication and prevention of these infections. Methods: The case notes and investigation reports of all sepsis cases admitted in neonatal units of Patan hospital from July to December 2011 caused by Klebsiella species were retrospectively reviewed. The demographic profile, risk factors along with clinical features and management of sepsis were reviewed. Results: Twenty three out of 37 neonatal blood cultures grew Klebsiella species. Thirty one were K. pneumoniae and six K. oxytoca. Seventeen of the 31 (55%) K. pneumoniae isolates were multidrug resistant and extended spectrum beta lactamase producers. Eighteen of 23 (78%) neonates with Klebsiella sepsis died. After extensive cleaning methods and identifying an intermittently leaking roof in one of the nurseries below a vescicovaginal fistula room of gynecological ward above, the infection outbreak was finally controlled. Conclusions: Infections with extended spectrum beta lactamase producing Klebsiella spp. are a threat in neonatal units because of limited treatment options for these multidrug resistant organisms. Identification of the source and control of the outbreak can be a challenge. Plain Language Summary: The study was done to review an outbreak caused by Klebsiella species, to identify the source of the infections along with infection control measures for eradication and prevention of these infections in neonate unit. Identification of the source and eradication of the outbreak of Klebsiella species can be a challenge. Hand washing remains one of the most important methods to prevent cross infections and nosocomial infections. DOI: http://dx.doi.org/10.3126/jpahs.v1i1.13011 Journal of Patan Academy of Health Sciences. 2014 Jun;1(1):20-25 


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Richard Onanga ◽  
Pierre Philippe Mbehang Nguema ◽  
Guy Roger Ndong Atome ◽  
Arsène Mabika Mabika ◽  
Berthelemy Ngoubangoye ◽  
...  

Antibiotic resistance occurs in the environment by multiplication and the spread of multidrug-resistant bacteria that would be due to an improper and incorrect use of antibiotics in human and veterinary medicine. The aim of this study was to establish the prevalence of E.coli producing Extended-Spectrum beta-Lactamase (ESBL) antibiotics from rats and gregarious animals in a semirural area of Gabon and to evaluate the origin of a resistance distribution in the environment from animal feces. The bacterial culture was carried out, and the identification of E. coli strains on a specific medium and the antibiotic susceptibility tests allowed establishing the prevalence. Characterization of resistance genes was performed by gene amplification after DNA extraction. On 161 feces collected in rats, 32 strains were isolated, and 11 strains of E. coli produced ESBL with a prevalence of 34.37%. Molecular tests showed that CTX-M genes 214 bp were identified in rats. The presence of CTX-M genes could have a human origin. So, the rats can carry ESBL-producing Enterobacteriaceae which poses a risk to human health and pets in this region of Gabon.


2020 ◽  
Vol 13 (1) ◽  
pp. 23-31
Author(s):  
Binita Koirala Sharma

Background: Hands of healthcare workers (HCWs) could be colonized by potential drug resistant bacteria like Extended Spectrum Beta Lactamase producers (ESBLs) and Carbapenems-resistant (CR) isolates and could become vectors of nosocomial pathogens in healthcare facilities that are associated with an increase of morbidity, mortality and healthcare costs. This study aimed to investigate the prevalence of ESBLs and CR isolates from hands of HCWs with their antibiotic susceptibility pattern. Materials and methods: This was a cross-sectional study that included a total of 150 hand swabs collected from March, 2018 to September, 2018 in Gandaki Medical College and Teaching Hospital. Isolation, identification and antimicrobial susceptibility tests were done using standard microbiological procedures. Results: Among the total isolates of 219 obtained from growth positive samples 92/219(42.01%) were Gram negative bacteria (GNB) and the most common were Klebsiella spp 32(34.78%) followed by Escherichia coli 17(18.48%), Pseudomonas aeruginosa12 (13.04%), Acenetobacter spp 11(11.96%), Proteus spp 9(9.78%), Citrobacter spp 7(7.61%) and Enterobacter spp 4(4.35%). The prevalence of ESBLs, CR and ESBLs with Co-resistant to Carbapenems were 19.56%,14.13% and 9.78%, respectively. The most effective drugs for isolates were Nitrofurantoin followed by Amikacin, Tetracycline and Gentamycin. Distribution pattern of the ESBLs and CR isolates among doctors, nurses, laboratory technicians, helpers and basic science faculties were not significant (p>0.05). Conclusions: This report revealed the emerging and moderately high prevalence of ESBLs, CR and ESBLs with Co-resistant to Carbapenems GNB with their antibiotic susceptibility patterns found on hands of HCWs in Nepal. Thus, this study could be helpful in developing proper guidelines on hand hygiene and implementation of infection control measures including contact precautions against the spread of infections by such pathogens in healthcare settings.  


Author(s):  
Emanuela Roscetto ◽  
Chiara Varriale ◽  
Umberto Galdiero ◽  
Camilla Esposito ◽  
Maria Rosaria Catania

Animal-assisted interventions (AAIs) are being implemented in many countries for the beneficial effects they have on humans. Patients involved in AAI are often individuals at greater risk of acquiring infections, and these activities involve close contact between humans and animals, as is the case with humans living with a pet. The spread of multidrug-resistant Enterobacterales is a serious problem for human health; an integrated One Health strategy is imperative to combat this threat. Companion dogs can be a reservoir of multidrug-resistant pathogens, and animal-to-human transmission could occur during AAI sessions. The aim of this review was to collect the available data on the carriage of extended-spectrum beta-lactamase-producing and carbapenem-resistant Enterobacterales in companion dogs and in an AAI context. Several papers have generally addressed the issue of microbial transmission during AAIs. Studies on the intestinal carriage of extended-spectrum beta-lactamase and/or carbapenem-resistant Enterobacterales have mainly been conducted in companion animals while few data are available on the carriage in dogs participating in AAI sessions. This review aims to draw attention to the antibiotic resistance problem in a One Health context and to the importance of extending infection control measures to this human–animal interface, to keep the balance of benefits/risks for AAIs shifted towards the benefits of these activities.


2015 ◽  
Vol 20 (36) ◽  
Author(s):  
Isabelle Arnaud ◽  
Sylvie Maugat ◽  
Vincent Jarlier ◽  
Pascal Astagneau ◽  
◽  
...  

Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) are a major focus of multidrug-resistant organisms (MRO) surveillance programmes in France. To describe the temporal and geographical trends of these pathogens, we conducted an epidemiological study based on data extracted from the nationwide MRO surveillance network from 2009 to 2013. During this time, the incidence of ESBL-E infections in French hospitals increased by 73%, from 0.35 to 0.60 per 1,000 patient days (PD) (p < 0.001) and ESBL-E bacteraemia by 77%, from 0.03 to 0.05 per 1,000 PD (p < 0.001). The incidence of ESBL-E infections was higher in intensive-care units (1.62 to 2.44 per 1,000 PD (p < 0.001)) than in recovery and long-term care facilities (0.20 to 0.31 per 1,000 PD (p < 0.001)). Escherichia coli was the most frequent extended-spectrum beta-lactamase-producing (ESBL) pathogen, representing 59% (26,238/44,425) of all ESBL isolates, followed by Klebsiella pneumoniae (20%; 8,856/44,425) in 2013. The most frequent infection was urinary tract infection, for all species. The incidence of ESBL-E varied by region but showed an upward trend overall. Reinforcement of control measures for halting the spread of such MRO is crucial.


Author(s):  
Pascal Astagneau ◽  
Elise Seringe ◽  
François Bricaire

Healthcare-associated infections (HAI) in older people frequently occur in mid or long-term cares facilities. The most frequent infections are those of the urinary tract, respiratory tract, skin/soft tissue, and gastrointestinal tract. The spectrum of pathogens are different in epidemic and endemic situations. Outbreaks occurring in long-term care frequently involve seasonal viruses such influenza, scabies, and multidrug-resistant bacteria such as Clostridium difficile. Ageing is a risk factor for HAI, which impairs immunological, metabolical, and neurological functions. Indwelling devices, poor nutritional status, and lack of mobility also increase the infection risk in the cared-for elderly. Infection control measures have to be implemented according to standard recommendations, including the use of alcohol-based hand rubs. Control measures should be adapted to the organization of healthcare facilites for older people, in particular environment and poor staff ressources. Focus should be made on vaccination programme of healthcare staff, especially against influenza.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Adane Bitew ◽  
Estifanos Tsige

Background. Multidrug-resistant Enterobacteriaceae particularly extended-spectrum beta-lactamase producers have become a major public health threat. Despite efforts to limit their spread, rates of multidrug-resistance members of the Enterobacteriaceae continue to increase throughout the world causing increased morbidity and mortality and raised costs for medical care. Objective. The aim of this study was to determine the prevalence of multidrug resistance and extended-spectrum β-lactamase-producing Enterobacteriaceae. Methods. Four hundred forty Enterobacteriaceae isolates from outpatients referred to Arsho Advanced Medical Laboratory were identified and assessed for their antimicrobial resistance pattern by using the automated VITEK 2 compact system. Extended-spectrum β-lactamase production was determined by the VITEK 2 automated compact system using the extended-spectrum β-lactamase test panel as per the instruction of the manufacturer. Results. The overall resistance rates of Enterobacteriaceae against cephalosporins, aminoglycosides, and fluoroquinolones were high. Nitrofurantoin with a resistance rate of 14.3% and piperacillin/tazobactam combination with a resistance rate of 17.3% were better active against this group of Gram-negative bacteria. Out of 440 isolates of Enterobacteriaceae, 42.1% were multidrug-resistant of which 34.3% and 8.95% were extensively drug-resistant and pan-drug resistant, respectively. Among 185 multidrug-resistant Enterobacteriaceae, 63.9% of the isolates produced extended-spectrum β-lactamase of which 75.4%, 19.5%, 1.7%, 2.5%, and 0.8% were E. coli, K. pneumoniae, C. freundii, E. cloacae, and P. mirabilis, respectively. Conclusions. The present study demonstrated high prevalence rates of multidrug-resistant and extended-spectrum-beta-lactamase-producing Enterobacteriaceae. In order to combat these problems, infection control strategy and proper antibiotic policies should be formulated.


Antibiotics ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 796
Author(s):  
Razib Mazumder ◽  
Ahmed Abdullah ◽  
Dilruba Ahmed ◽  
Arif Hussain

The emergence of multidrug-resistant (MDR) Escherichia coli (E. coli) clonal lineages with high virulence potential is alarming. Lack of sufficient data on molecular epidemiology of such pathogens from countries with high infection burden, such as Bangladesh, hinders management and infection control measures. In this study, we assessed the population structure, virulence potential and antimicrobial susceptibility of clinical E. coli isolates from Dhaka, Bangladesh. A high prevalence of MDR (69%) and extended-spectrum β-lactamase production (ESBL) (51%) was found. Most E. coli isolates were susceptible to amikacin (95%), meropenem (94%) and nitrofurantoin (89%) antibiotics. A high prevalence of ST131 (22%) and ST95 (9%) followed by ST69 (4%) and ST73 (3%) was observed. Phylogroups B2 (46%), B1 (16%), D (10%) and F (9%) were prominent. blaCTX-M-15 (52%) and blaNDM-1 (5%) were the most prevalent ESBL and carbapenem resistance genes, respectively. Moreover, the predominant pathotype identified was extraintestinal pathogenic E. coli (ExPEC) (41%) followed by enteric pathogens (11%). In conclusion, our results suggest the transmission of clonal E. coli groups amidst diverse E. coli population that are associated with high virulence potential and MDR phenotype. This is of high concern and mandates more efforts towards molecular surveillance of antimicrobial resistance (AMR) in clinically significant pathogens.


Author(s):  
Guillaume Miltgen ◽  
Thomas Garrigos ◽  
Pascal Cholley ◽  
Marine Deleume ◽  
Nicolas Allou ◽  
...  

AbstractConcomitant prevention of SARS-CoV-2 and extensively drug-resistant bacteria transmission is a difficult challenge in intensive care units dedicated to COVID-19 patients. We report a nosocomial cluster of four patients carrying NDM-1 plasmid-encoded carbapenemase-producing Enterobacter cloacae. Two main factors may have contributed to cross-transmission: misuse of gloves and absence of change of personal protective equipment, in the context of COVID-19-associated shortage. This work highlights the importance of maintaining infection control measures to prevent CPE cross-transmission despite the difficult context and that this type of outbreak can potentially involve several species of Enterobacterales.


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