An Important Public Health Problem "Carbapenem Resistant Enterobacteriaceae Frequency": An Example From A Training And Research Hospital

2021 ◽  
Vol 6 (14) ◽  
pp. 51-55
Author(s):  
Ülkü VERANYURT ◽  
Betül AKALIN
Keyword(s):  
Public Health ◽  
Klebsiella Pneumoniae ◽  
Klebsiella Oxytoca ◽  
Public Health Problem ◽  
Important Public Health Problem ◽  
Klebsiella Species ◽  
Research Hospital ◽  
Control Programs ◽  
Carbapenem Resistant ◽  
Training And Research

Background: Carbapenem-resistant Enterobacterales (CRE) infections are a significant threat to public health due to the limited availability of antibiotics and the effect on mortality. This study was conducted retrospectively to determine the prevalence of CRE in a teaching and research hospital in Istanbul. Materials and Methods: In 2016, 2017 and in the first half of 2018 Klebsiella species were evaluated retrospectively in culture samples that were sent to Microbiology Laboratory in an educational hospital. The typing of Klebsiella species were performed with MALDITOF-MS device (Biomerieux, France). Imipenem, merapenem, ertapenem susceptibilities of the strains were evaluated with VITEC2 Compact (Biomerieux, France) according to EUCAST (European Committee on Antimicrobial Susceptibility Testing). If the strains were found to be resistant, the results were confirmed by the antibiotic gradient test. Results: In our study, 257 samples; Klebsiella oxytoca 9 (3.49%) and Klebsiella pneumoniae 248 (96.51%) were detected. 130 endotracheal aspirates, 57 wounds, 34 blood, 15 urine, 9 sputum, 3 catheters, 4 tissue biopsies, 2 mediastinum, 2 peritoneal fluid and 1 pleural fluid strains were identified. While none of the Klebsiella oxytoca strains were resistant to carbapenems, the percentages of Klebsiella pneumoniae resistance against imipenem, merapenem and ertapenem were found to be 23.29%, 16.94% and 29.44% respectively. Conclusion: The increasing problem of carbapenem-resistant (CR) Klebsiella pneumoniae in the last decade has been observed in our hospital for the last 2 years. CR strains often show increased resistance to other antibiotics and their treatment possibilities are limited. It increases the importance of controlling this factor. The application of effective infection control programs and the use of rational antibiotics are of great importance.

scholarly journals Epidemic diffusion of KPC carbapenemase-producing Klebsiella pneumoniae in Italy: results of the first countrywide survey, 15 May to 30 June 2011

2013 ◽  
Vol 18 (22) ◽  
Author(s):  
T Giani ◽  
B Pini ◽  
F Arena ◽  
V Conte ◽  
S Bracco ◽  
...  
Keyword(s):  
Public Health ◽  
Klebsiella Pneumoniae ◽  
Clonal Complex ◽  
Public Health Problem ◽  
Resistance Mechanisms ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Carbapenem Resistant ◽  
Species Proportion ◽  
Carbapenem Resistant Enterobacteriaceae

Carbapenem-resistant Enterobacteriaceae (CRE) are emerging as a public health problem in various settings. In Italy, a rapid and remarkable increase of carbapenem-non-susceptible Klebsiella pneumoniae has been reported since 2010. Here we report on the results of a countrywide cross-sectional survey, carried out from 15 May to 30June 2011 to investigate the diffusion of CRE in Italy and to characterise the most prevalent resistance mechanisms and their dissemination patterns. CRE were reported from most (23 of 25) participating laboratories, with an overall proportion of 3.5% and 0.3% among consecutive non-duplicate clinical isolates of Enterobacteriaceae from inpatients (n=7,154) and outpatients (n=6,595), respectively. K. pneumoniae was the most frequent species (proportion of carbapenem-non-susceptible isolates: 11.9%), while a minority of CRE of other species were detected. Carbapenemase production was detected in the majority (85%) of CRE. KPC-type enzymes were by far the most common (89.5% of carbapenemase producers), followed by VIM-1 (9.2%) and OXA-48 (1.3%). KPC-producing K. pneumoniae (KPC-KP) were detected in most centres and contributed majorly to the epidemic dissemination of CRE recently observed in our country. Dissemination of KPC-KP was mostly sustained by strains of clonal complex 258 (ST-258 producing KPC-2 or KPC-3, and ST-512 producing KPC-3), while a minority belonged to ST-101.

scholarly journals Analisis faktor kejadian wasting pada anak balita 12-59 bulan di Puskesmas Bulili Kota Palu: Studi cross sectional

2021 ◽  
Vol 6 (2) ◽  
pp. 111
Author(s):  
Hepti Muliyati ◽  
Menis Mbali ◽  
Hadidja Bando ◽  
Riana Pangestu Utami ◽  
Opyn Mananta
Keyword(s):  
Public Health ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Public Health Problem ◽  
Sampling Technique ◽  
P Value ◽  
Fisher Exact Test ◽  
Important Public Health Problem ◽  
Cross Sectional ◽  
Exact Test

Wasting on children is an important public health problem because of its considerable impact on their health and growth. This problem could lead to iron deficiency which could induce infection disease and probably lower a child’s intelligence as a long-term effect. This study aimed to analyze factors related to wasting on 12-59 months children in Bulili Public Health Center (PHC), Palu City. The analytical descriptive study designed with a cross-sectional approach was applied in this study. One hundred and twenty-one subject was selected from 283 children with purposive sampling technique. Data were analyzed with chi-square and Fisher exact test with significant (p < 0,05). The result showed that most children with low birth weight experienced wasting with a p-value = 0,000. Most of the children from higher-income families did not experience wasting with a p-value = 0,004. Most children who didn’t receive breastfeeding milk did not experience wasting with a p-value = 0,958. This study concluded a correlation between low birth weight and income to wasting, but breastfeeding practice was not related.

scholarly journals Evaluation of molecular characterization and phylogeny for quantification of Acanthamoeba and Naegleria fowleri in various water sources, Turkey

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256659
Author(s):  
Mehmet Aykur ◽  
Hande Dagci
Keyword(s):  
Public Health ◽  
Public Awareness ◽  
Public Health Problem ◽  
Water Sources ◽  
Quantitative Detection ◽  
Human Populations ◽  
Rrna Gene ◽  
Natural Environments ◽  
Specific Primers ◽  
Important Public Health Problem

Free-living amoeba (FLA) is widely distributed in the natural environment. Since these amoebae are widely found in various waters, they pose an important public health problem. The aim of this study was to detect the presence of Acanthamoeba, B. mandrillaris, and N. fowleri in various water resources by qPCR in Izmir, Turkey. A total of (n = 27) 18.24% Acanthamoeba and (n = 4) 2.7% N. fowleri positives were detected in six different water sources using qPCR with ITS regions (ITS1) specific primers. The resulting concentrations varied in various water samples for Acanthamoeba in the range of 3.2x105-1.4x102 plasmid copies/l and for N. fowleri in the range of 8x103-11x102 plasmid copies/l. The highest concentration of Acanthamoeba and N. fowleri was found in seawater and damp samples respectively. All 27 Acanthamoeba isolates were identified in genotype level based on the 18S rRNA gene as T4 (51.85%), T5 (22.22%), T2 (14.81%) and T15 (11.11%). The four positive N. fowleri isolate was confirmed by sequencing the ITS1, ITS2 and 5.8S rRNA regions using specific primers. Four N. fowleri isolates were genotyped (three isolate as type 2 and one isolate as type 5) and detected for the first time from water sources in Turkey. Acanthamoeba and N. fowleri genotypes found in many natural environments are straightly related to human populations to have pathogenic potentials that may pose a risk to human health. Public health professionals should raise awareness on this issue, and public awareness education should be provided by the assistance of civil authorities. To the best of our knowledge, this is the first study on the quantitative detection and distribution of Acanthamoeba and N. fowleri genotypes in various water sources in Turkey.

TETANUS OF THE NEWBORN INFANT

PEDIATRICS ◽  
1964 ◽  
Vol 34 (1) ◽  
pp. 32-37
Author(s):  
Dacio Pinheiro
Keyword(s):  
Public Health ◽  
Newborn Infant ◽  
Public Health Problem ◽  
Clinical Severity ◽  
University Hospital ◽  
Important Public Health Problem ◽  
Important Public Health ◽  
Pediatric Service ◽  
The Central Nervous System ◽  
The University

Tetanus in the newborn infant is still a most important public health problem in Brazil. An analysis of 238 cases, admitted in a two-year period to the pediatric service of the University Hospital in Sao Paulo, is presented. It is suggested that prognosis is related more closely to amount of tetanospasmin produced and absorbed by the central nervous system than to some of the more traditional indices of clinical severity. The plan of treatment in use is presented, since the over-all recovery rate compares very favorably with other published reports.

E-Ophthalmology in the Diagnosis and Follow-Up of Chronic Glaucoma

2013 ◽  
pp. 88-108 ◽  
Author(s):  
Jose Andonegui ◽  
Aitor Eguzkiza ◽  
Mikel Auzmendi ◽  
Luis Serrano ◽  
Ane Zurutuza ◽  
...  
Keyword(s):  
Public Health ◽  
Intraocular Pressure ◽  
Visual Fields ◽  
Public Health Problem ◽  
Current Status ◽  
Future Trends ◽  
Important Public Health Problem ◽  
Important Public Health ◽  
Chronic Glaucoma

e-Ophthalmology is the use of information and telecommunications technologies to provide or support a group of activities related to ophthalmic care. Chronic glaucoma is an ocular disease characterized by optic neuropathy that leads to progressive loss of the visual fields and often is associated with elevated intraocular pressure levels. Glaucoma is an important public health problem because it is one of the main causes of blindness worldwide and generates an important demand for ophthalmologic consultations. The aim of this chapter is to discuss the application e-Ophthalmology-based models in the diagnosis and follow-up of chronic glaucoma. The authors describe the current status of the use of e-Ophthalmology-based models in the screening and follow-up of chronic glaucoma, the main advantages of these models, the technologic requirements for their implementation, and future trends in this field.

Leprosy (Hansen’s disease)

2010 ◽  
pp. 836-848
Author(s):  
Diana N.J. Lockwood
Keyword(s):  
Public Health ◽  
Chronic Granulomatous Disease ◽  
Health Problem ◽  
Disease Transmission ◽  
Public Health Problem ◽  
Mycobacterium Leprae ◽  
Granulomatous Disease ◽  
Important Public Health Problem ◽  
Important Public Health

Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae, an acid-fast intracellular organism not yet cultivated in vitro. It is an important public health problem worldwide, with an estimated 4 million people disabled by the disease. Transmission of M. leprae is only partially understood, but untreated lepromatous patients discharge abundant organisms from their nasal mucosa into the environment....

scholarly journals Dynamics of blaKPC-2 Dissemination from Non-CG258 Klebsiella pneumoniae to Other Enterobacterales via IncN Plasmids in an Area of High Endemicity

2020 ◽  
Vol 64 (12) ◽  
Author(s):  
Ana M. Rada ◽  
Elsa De La Cadena ◽  
Carlos Agudelo ◽  
Cesar Capataz ◽  
Nataly Orozco ◽  
...  
Keyword(s):  
Public Health ◽  
Klebsiella Pneumoniae ◽  
Neonatal Intensive Care ◽  
Carbapenem Resistance ◽  
Health Interventions ◽  
Global Public Health ◽  
Public Health Interventions ◽  
Content Type ◽  
Carbapenem Resistant ◽  
Long Read

ABSTRACT Carbapenem-resistant Enterobacterales (CRE) pose a significant threat to global public health. The most important mechanism for carbapenem resistance is the production of carbapenemases. Klebsiella pneumoniae carbapenemase (KPC) represents one of the main carbapenemases worldwide. Complex mechanisms of blaKPC dissemination have been reported in Colombia, a country with a high endemicity of carbapenem resistance. Here, we characterized the dynamics of dissemination of blaKPC gene among CRE infecting and colonizing patients in three hospitals localized in a highly endemic area of Colombia (2013 and 2015). We identified the genomic characteristics of KPC-producing Enterobacterales recovered from patients infected/colonized and reconstructed the dynamics of dissemination of blaKPC-2 using both short and long read sequencing. We found that spread of blaKPC-2 among Enterobacterales in the participating hospitals was due to intra- and interspecies horizontal gene transfer (HGT) mediated by promiscuous plasmids associated with transposable elements that was originated from a multispecies outbreak of KPC-producing Enterobacterales in a neonatal intensive care unit. The plasmids were detected in isolates recovered in other units within the same hospital and nearby hospitals. The gene “epidemic” was driven by IncN-pST15-type plasmids carrying a novel Tn4401b structure and non-Tn4401 elements (NTEKPC) in Klebsiella spp., Escherichia coli, Enterobacter spp., and Citrobacter spp. Of note, mcr-9 was found to coexist with blaKPC-2 in species of the Enterobacter cloacae complex. Our findings suggest that the main mechanism for dissemination of blaKPC-2 is HGT mediated by highly transferable plasmids among species of Enterobacterales in infected/colonized patients, presenting a major challenge for public health interventions in developing countries such as Colombia.

Statewide surveillance of carbapenemase-producing carbapenem-resistant Escherichia coli and Klebsiella species in Washington state, October 2012–December 2017

2020 ◽  
Vol 41 (6) ◽  
pp. 716-722
Author(s):  
Mimi R. Precit ◽  
Kelly Kauber ◽  
William A. Glover ◽  
Scott J. Weissman ◽  
Tashina Robinson ◽  
...  
Keyword(s):  
Public Health ◽  
Escherichia Coli ◽  
Health Care ◽  
The United States ◽  
Case Definition ◽  
Washington State ◽  
Public Health Department ◽  
Klebsiella Species ◽  
E Coli ◽  
Carbapenem Resistant

AbstractBackground:Carbapenem-resistant Enterobacterales (CRE) are common causes of healthcare-associated infections and are often multidrug resistant with limited therapeutic options. Additionally, CRE can spread within and between healthcare facilities, amplifying potential harms.Objective:To better understand the burden, risk factors, and source of acquisition of carbapenemase genes in clinical Escherichia coli and Klebsiella spp isolates from patients in Washington to guide prevention efforts.Design:Multicenter prospective surveillance study.Methods:Escherichia coli and Klebsiella spp isolates meeting the Washington state CRE surveillance case definition were solicited from clinical laboratories and tested at Washington Public Health Laboratories using polymerase chain reaction (PCR) for the 5 most common carbapenemase genes: blaKPC, blaNDM, blaIMP, blaVIM, and blaOXA-48. Case patients positive by PCR were investigated by the public health department.Results:From October 2012 through December 2017, 363 carbapenem-resistant E. coli and Klebsiella spp isolates were tested. Overall, 45 of 115 carbapenem-resistant K. pneumoniae (39%), 1 of 8 K. oxytoca (12.5%), and 28 of 239 carbapenem-resistant E. coli (11.7%) were carbapenemase positive. Of 74 carbapenemase-positive isolates, blaKPC was most common (47%), followed by blaNDM (30%), blaOXA-48 (22%), and blaIMP (1%). Although all cases had healthcare exposure, blaKPC acquisition was associated with US health care, whereas non-blaKPC acquisition was associated with international health care or travel.Conclusions:We report that blaKPC, the most prevalent carbapenemase in the United States, accounts for nearly half of carbapenemase cases in Washington state and that most KPC-cases are likely acquired through in-state health care.

scholarly journals Sickle Cell Anaemia Prevalence among Newborns in the Brazilian Amazon-Savanna Transition Region

2019 ◽  
Vol 16 (9) ◽  
pp. 1638
Author(s):  
Rayane Cristina Souza ◽  
Pedro Agnel Dias Miranda Neto ◽  
Jessflan Rafael Nascimento Santos ◽  
Sílvio Gomes Monteiro ◽  
Maria Cláudia Gonçalves ◽  
...  
Keyword(s):  
Public Health ◽  
Transition Region ◽  
Sickle Cell ◽  
Sickle Cell Anaemia ◽  
Sickle Cell Trait ◽  
Public Health Problem ◽  
The State ◽  
Screening Tests ◽  
Distribution Analysis ◽  
Important Public Health Problem

Sickle cell anaemia is one of the most common hemoglobinopathies worldwide and an important public health problem in Brazil. This study evaluated the prevalence of sickle cell anaemia and its traits in newborns from the Amazon-Savanna Transition Region in the state of Maranhão, Brazil. A cross-sectional study was carried out, based on data from neonatal screening tests performed in 2013–2015 in Maranhão. The Hardy-Weinberg theorem was applied to analyse the frequency of expected homozygotes based on HbSS phenotype. A spatial-temporal distribution analysis was performed to delimit the regions with the greatest number of newborn cases with sickle cell anaemia. Of 283,003 newborns, 162 were found to have sickle cell anaemia, while 10,794 had a sickle cell trait, with a prevalence of 0.05% and 3.8%, respectively. The prevalence of expected homozygotes was higher in the North Region and in the state capital of Maranhão. This study may contribute to existing social and public health actions or the creation of new strategies for sickle cell disease in endemic areas in Brazil to improve the quality of life.

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