scholarly journals The evaluation of vancomycin-resistant enterococci and carbapenamase producing Klebsiella colonization among ICU-Hospitalized Patients

2021 ◽  
Vol 21 (4) ◽  
pp. 1662-8
Author(s):  
Gökhan Karaşin ◽  
Yasemin Bayram ◽  
Mehmet Parlak ◽  
Cenk Aypak ◽  
Mustafa Akgül ◽  
...  
Keyword(s):  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Intensive Care Units ◽  
Rectal Swab ◽  
Tertiary Hospital ◽  
Resistant Bacteria ◽  
Drug Resistant ◽  
Vancomycin Resistant Enterococcus ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

Background: Multi-drug resistant organisms, especially Vancomycin-Resistant Enterococcus (VRE) and Carbapenam Resistant Klebsiella pneumoniae (KPC), are serious health threat. Early detection of resistant bacteria colonization amongpatients in intensive care units (ICUs) not only enables effective treatment but more importantly prevents disease and limits transmission. Therefore, we aimed to to assess the frequency of VRE and KPC colonization via rectal swab sampling. Methods: The study was carried out in ICUs of a tertiary hospital. Two rectal swab samples were collected within the first 24 hours of admission and another one was taken every subsequent 15 days to test for for VRE and KPC carriage. Results: A total 316 rectal swab samples taken from 230 patients. Forty-seven patients were screened at least 2 times. 183 patients were not further screened due to discharge, exitus or transfer to other wards. Thirty-six patients (16%) were determinedto be VRE (+). The most frequently isolated strain was E. faecium (80.5%) and its most common genotype was VanA (87.5%). Seven patients (3%) were identified as KPC (+). OXA-48 type crbapenamase was confirmed in all KPC isolates. Conclusion: This study shows that VRE and KPC colonization continues to be a serious threat in ICUs. Keywords: Carbapenam resistant klebsiella pneumoniae; vancomycin-resistant enterococci; intensive care units.

scholarly journals The emerging extensively drug resistant bacteria in a university hospital in Tunisia in 2019

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Tilouche ◽  
N Haddad ◽  
S Boujaafar ◽  
R Elaissi ◽  
S Kahloun ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
University Hospital ◽  
Resistant Bacteria ◽  
Drug Resistant ◽  
Extensively Drug Resistant ◽  
Vancomycin Resistant Enterococci ◽  
Drug Resistant Bacteria ◽  
Rectal Swabs ◽  
Vancomycin Resistant

Abstract Background The discovery of antibiotics revolutionized medicine in the 20th century, however the emergence of extensively drug-resistant bacteria constitute a growing problem in our hospitals in Tunisia and across the world. This study aims to evaluate a screening program for Carbapenemase Producing Enterobacteriaceae (CPE) and vancomycin-resistant enterococci (VRE) undertaken by the Microbiology Laboratory of Sahloul University Hospital. Methods A descrptive and retrospective study was carried out between 01st April 2018 and 31th December 2019 in the university hospital Sahloul, in East Coast of Tunisia. The screening was based on rectal swabs; it concerned Medical Intensive Care Units, the postoperative unit, the paediatric and the nephrology departments. The rectal swabs were seeded on the chromID CARBASMART and chromID VRE agars(biomerieux, France)in search of CPE and VRE respectively. The identification and the antibiotic susceptibilities testing were performed using the Vitek2 System (biomerieux,France) Results In total, 191 patients were screened. Among them, 56% were admitted in Intensive Care Units, 9.95% in postoperative unit, 30.9% in paediatric department and 3.14% in the nephrology department. A total of 38 extensively drug-resistant bacteria were isolated: 20 CPE and 18 VRE. Among isolated CPE, 17 were identified as Klebsiella pneumonia: The ConfirmationKPC/MBLkit (RoscoDiagnostica, Denmark) supplemented with a disc of Temocillin showed that 7 strains produced metallo-carbapenemase and 10 strains produced OXA 48 carbapenemase. The other isoloted CPE were OXA-48 producers. All VRE were identified as Enterococcus faecium, Their Vancomycin and Teicoplanine MICs were greater than 32 mg/L. Conclusions Mastering the spread of extensively drug-resistant bacteria involves a multidisciplinary preventive strategy. It must include strict application of hygiene measures, early detection and isolation of carriers and rationalization of antibiotic use. Key messages the emergence of extensively drug-resistant bacteria constitute a growing problem that`s why Carbapenemase Producing Enterobacteriaceae and vancomycin-resistant enterococci screening is crucial. Anti microbial agents use must be rationalized.

scholarly journals Rapid detection of Vancomycin-Resistant Enterococci (VRE) in rectal samples from patients admitted to intensive care units

2009 ◽  
Vol 13 (4) ◽  
pp. 289-293 ◽  
Author(s):  
Pedro Alves d'Azevedo ◽  
Kelly Aline de Souza Santiago ◽  
Guilherme Henrique Campos Furtado ◽  
Diego Batista Xavier ◽  
Antonio Carlos Campos Pignatari ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Rapid Detection ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

scholarly journals Evaluation of GeneXpert vanA/vanB assay for the detection of vancomycin-resistant enterococci in patients newly admitted to intensive care units

2013 ◽  
Vol 43 ◽  
pp. 1008-1012
Author(s):  
Server YAĞCI ◽  
Çiğdem ATAMAN HATİPOĞLU ◽  
Şerife ALTUN ◽  
Cemal BULUT ◽  
Zeliha KOÇAK TUFAN ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

scholarly journals Risk Factors for New Detection of Vancomycin-Resistant Enterococci in Acute-Care Hospitals That Employ Strict Infection Control Procedures

2003 ◽  
Vol 47 (8) ◽  
pp. 2492-2498 ◽  
Author(s):  
Alexander A. Padiglione ◽  
Rory Wolfe ◽  
Elizabeth A. Grabsch ◽  
Di Olden ◽  
Stephen Pearson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
High Risk ◽  
Infection Control ◽  
Broad Spectrum ◽  
Rectal Swab ◽  
High Risk Patients ◽  
Vancomycin Resistant Enterococci ◽  
Risk Patients ◽  
Vancomycin Resistant

ABSTRACT Accurate assessment of the risk factors for colonization with vancomycin-resistant enterococci (VRE) among high-risk patients is often confounded by nosocomial VRE transmission. We undertook a 15-month prospective cohort study of adults admitted to high-risk units (hematology, renal, transplant, and intensive care) in three teaching hospitals that used identical strict infection control and isolation procedures for VRE to minimize nosocomial spread. Rectal swab specimens for culture were regularly obtained, and the results were compared with patient demographic factors and antibiotic exposure data. Compliance with screening was defined as “optimal” (100% compliance) or “acceptable” (minor protocol violations were allowed, but a negative rectal swab specimen culture was required within 1 week of becoming colonized with VRE). Colonization with VRE was detected in 1.56% (66 of 4,215) of admissions (0.45% at admission and 0.83% after admission; the acquisition time was uncertain for 0.28%), representing 1.91% of patients. No patients developed infection with VRE. The subsequent rate of new acquisition of VRE was 1.4/1,000 patient days. Renal units had the highest rate (3.23/1,000 patient days; 95% confidence interval [CI], 1.54 to 6.77/1,000 patient days). vanB Enterococcus faecium was the most common species (71%), but other species included vanB Enterococcus faecalis (21%), vanA E. faecium (6%), and vanA E. faecalis (2%). The majority of isolates were nonclonal by pulsed-field gel electrophoresis analysis. Multivariate analysis of risk factors in patients with an acceptable screening suggested that being managed by a renal unit (hazard ratio [HR] compared to the results for patients managed in an intensive care unit, 4.6; 95% CI, 1.2 to 17.0 [P = 0.02]) and recent administration of either ticarcillin-clavulanic acid (HR, 3.6; 95% CI, 1.1 to 11.6 [P = 0.03]) or carbapenems (HR, 2.8; 95% CI, 1.0, 8.0 [P = 0.05]), but not vancomycin or broad-spectrum cephalosporins, were associated with acquisition of VRE. The relatively low rates of colonization with VRE, the polyclonal nature of most isolates, and the possible association with the use of broad-spectrum antibiotics are consistent with either the endogenous emergence of VRE or the amplification of previously undetectable colonization with VRE among high-risk patients managed under conditions in which the risk of nosocomial acquisition was minimized.

scholarly journals Evaluating hospital infection control measures for antimicrobial-resistant pathogens using stochastic transmission models: Application to vancomycin-resistant enterococci in intensive care units

2016 ◽  
Vol 27 (1) ◽  
pp. 269-285 ◽  
Author(s):  
Yinghui Wei ◽  
Theodore Kypraios ◽  
Philip D O’Neill ◽  
Susan S Huang ◽  
Sheryl L Rifas-Shiman ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Control Measures ◽  
Screening Tests ◽  
Patient Level ◽  
Infection Control Measures ◽  
Vancomycin Resistant Enterococci ◽  
Hospital Infection Control ◽  
Vancomycin Resistant ◽  
Precautionary Measures

Nosocomial pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) are the cause of significant morbidity and mortality among hospital patients. It is important to be able to assess the efficacy of control measures using data on patient outcomes. In this paper, we describe methods for analysing such data using patient-level stochastic models which seek to describe the underlying unobserved process of transmission. The methods are applied to detailed longitudinal patient-level data on vancomycin-resistant Enterococci from a study in a US hospital with eight intensive care units (ICUs). The data comprise admission and discharge dates, dates and results of screening tests, and dates during which precautionary measures were in place for each patient during the study period. Results include estimates of the efficacy of the control measures, the proportion of unobserved patients colonized with vancomycin-resistant Enterococci, and the proportion of patients colonized on admission.

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