scholarly journals A Proposed Evidence-Based Local Guideline for Definition of Multidrug-Resistant (MDR), Extensively Drug-Resistant (XDR) and Pan Drug-Resistant (PDR) Bacteria by the Microbiology Laboratory

2021 ◽  
Vol 04 (03) ◽  
Author(s):  
Arash Eatemadi ◽  
Keyword(s):  
Antimicrobial Agents ◽  
Medical Literature ◽  
Clinical Manifestations ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
Microbiology Laboratory ◽  
Healthcare Facilities ◽  
Extensively Drug Resistant ◽  
Definition Of ◽  
Local Guideline

Multi-drug resistant organisms (MDROs) are defined as microorganisms, predominantly bacteria, that are resistant to one or more classes of antimicrobial agents. These pathogens are frequently resistant to most available antimicrobial agents and deserve special attention in healthcare facilities. Generally, MDRO infections have clinical manifestations similar to infections caused by susceptible pathogens. Despite of two different classifications by WHO and CDC, still there are debates about update definition of MDROs in medical literature. Here we provide an updated local guideline for definitions of various MDROs by microbiology laboratory.

scholarly journals Carbapenemases: Transforming Acinetobacter baumannii into a Yet More Dangerous Menace

Biomolecules ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 720 ◽  
Author(s):  
Maria Soledad Ramirez ◽  
Robert A. Bonomo ◽  
Marcelo E. Tolmasky
Keyword(s):  
Acinetobacter Baumannii ◽  
Nosocomial Infections ◽  
Acquired Resistance ◽  
Clinical Manifestations ◽  
High Capacity ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
Wound Infections ◽  
Extensively Drug Resistant

Acinetobacter baumannii is a common cause of serious nosocomial infections. Although community-acquired infections are observed, the vast majority occur in people with preexisting comorbidities. A. baumannii emerged as a problematic pathogen in the 1980s when an increase in virulence, difficulty in treatment due to drug resistance, and opportunities for infection turned it into one of the most important threats to human health. Some of the clinical manifestations of A. baumannii nosocomial infection are pneumonia; bloodstream infections; lower respiratory tract, urinary tract, and wound infections; burn infections; skin and soft tissue infections (including necrotizing fasciitis); meningitis; osteomyelitis; and endocarditis. A. baumannii has an extraordinary genetic plasticity that results in a high capacity to acquire antimicrobial resistance traits. In particular, acquisition of resistance to carbapenems, which are among the antimicrobials of last resort for treatment of multidrug infections, is increasing among A. baumannii strains compounding the problem of nosocomial infections caused by this pathogen. It is not uncommon to find multidrug-resistant (MDR, resistance to at least three classes of antimicrobials), extensively drug-resistant (XDR, MDR plus resistance to carbapenems), and pan-drug-resistant (PDR, XDR plus resistance to polymyxins) nosocomial isolates that are hard to treat with the currently available drugs. In this article we review the acquired resistance to carbapenems by A. baumannii. We describe the enzymes within the OXA, NDM, VIM, IMP, and KPC groups of carbapenemases and the coding genes found in A. baumannii clinical isolates.

Retrospective analysis of the emergence of antibiotic-resistant Salmonella enterica infections in a level IV hospital from Lima, Peru

2021 ◽  
pp. 004947552110609
Author(s):  
Joaquim Ruiz ◽  
Wilfredo Flores-Paredes ◽  
Nestor Luque ◽  
Roger Albornoz ◽  
Nayade Rojas ◽  
...  
Keyword(s):  
Salmonella Enterica ◽  
Antimicrobial Agents ◽  
Multidrug Resistant ◽  
Hospitalized Patients ◽  
Drug Resistant ◽  
Antibiotic Resistant ◽  
Salmonella Infections ◽  
Extensively Drug Resistant ◽  
Period 2 ◽  
Automated Methods

This study retrospectively analysed the emergence of multidrug-resistant Salmonella enterica in a level IV hospital in Lima, Peru. A total of 64 S. enterica from January 2009 to June 2010 (Period 1, 24 isolates) and January 2012 to December 2014 (Period 2, 40 isolates) were included. Some 25 were from non-hospitalized and 39 from hospitalized patients. Antimicrobial susceptibility to 15 antimicrobial agents was established by automated methods. Most of the isolates were from blood (46.9%), urine (21.9%) and faeces (14.1%). There was a reduction in blood isolates in Period 2, while all the faecal isolates were from this period. In Period 1, only 3/24 (12.5%) isolates showed antibiotic resistance, whereas 25/39 isolates (64.1%) from Period 2 were antibiotic-resistant, with multidrug-resistant and extensively drug-resistant rates of 17.9% and 20.5%, respectively. Multidrug-resistant/extensively drug-resistant Salmonella isolates were introduced in the hospital in 2013, with Salmonella recovered from faeces from non-hospitalized patients suggested an increase in community-acquired multidrug-resistant/extensively drug-resistant Salmonella infections.

scholarly journals In Vitro Activities of Ceftaroline and Comparators against Streptococcus pneumoniae Isolates from U.S. Hospitals: Results from Seven Years of the AWARE Surveillance Program (2010 to 2016)

2017 ◽  
Vol 62 (2) ◽  
Author(s):  
Michael A. Pfaller ◽  
Rodrigo E. Mendes ◽  
Leonard R. Duncan ◽  
Robert K. Flamm ◽  
Helio S. Sader
Keyword(s):  
Streptococcus Pneumoniae ◽  
Antimicrobial Agents ◽  
Multidrug Resistant ◽  
Surveillance Program ◽  
Drug Resistant ◽  
Broth Microdilution ◽  
Content Type ◽  
Medical Centers ◽  
Extensively Drug Resistant

ABSTRACT We evaluated trends in Streptococcus pneumoniae antimicrobial susceptibility in United States hospitals in the 2010 to 2016 period. A total of 8,768 clinical isolates from 47 medical centers were tested for susceptibility by broth microdilution methods. Multidrug-resistant (MDR) and extensively drug-resistant (XDR) rates decreased from 25.7% and 12.4%, respectively, in 2010 to 17.7% and 3.6%, respectively, in 2016. The susceptibilities to most comparator antimicrobial agents increased, whereas the susceptibilities to ceftaroline, levofloxacin, linezolid, and tigecycline remained stable. Ceftaroline retained potent activity against S. pneumoniae (>99.9%) with no marked variations.

scholarly journals 1597. Ceftolozane-Tazobactam and Meropenem Synergy Testing Against Multi-Drug and Extensively-Drug Resistant Pseudomonas aeruginosa

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S794-S795
Author(s):  
Mary Francine P Chua ◽  
Syeda Sara Nida ◽  
Jerry Lawhorn ◽  
Janak Koirala
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Synergistic Effect ◽  
Inhibitory Concentration ◽  
Multidrug Resistant ◽  
Additive Effect ◽  
Teaching Hospitals ◽  
Drug Resistant ◽  
Extensively Drug Resistant ◽  
Synergy Testing ◽  
Concentration Indices

Abstract Background Multidrug-resistant (MDR) and extensively drug-resistant (XDR) Pseudomonas aeruginosa (PA) have limited therapeutic options for treatment. Ceftolozane/tazobactam is a newer anti-pseudomonal drug effective against resistant PA infections, however resistance against this drug has now also developed and is increasing. In this study, we explored the combination of ceftolozane/tazobactam (CT) and meropenem (MP) as a possible effective regimen against MDR and XDR PA. Methods We obtained 33 non-duplicate isolates of MDR and XDR PA grown from blood, urine and respiratory samples collected from patients admitted between 2015 and 2019 at our two affiliate teaching hospitals. MDR PA was defined as resistance to 3 or more classes of anti-pseudomonal antibiotics, and XDR PA as resistance to all but two or less classes of anti-pseudomonal antibiotics. Antimicrobial preparations of both MP and CT were made according to manufacturer instructions. Susceptibility testing was performed using the checkerboard method in accordance to CLSI guidelines (CLSI M100, 2017). The ATCC 27853 strain of PA used as control. Synergy, additive effect, indifference and antagonism were defined as FIC (fractional inhibitory concentration) indices of ≤0.5, >0.5 to <1, >1 to <4, and >4, respectively. Results Thirteen (39%) of 33 PA isolates were classified as XDR, while 20 (61%) PA isolates were MDR. All isolates were resistant to MP (MIC50 >32 ug/mL), while only 2 (6%) isolates were susceptible to CT (MIC50 64 ug/mL). A synergistic effect was seen in 9 (27.3%) of PA isolates (FIC index range 0.28 to 0.5)— 2 of which were XDR PA, and 7 were MDR PA. An additive effect was seen in 12 (36.4%), with indifference seen in 12 (36.4%) of isolates. In this study, no antagonism was seen when CT and MP were combined. Conclusion When used in combination, CT and MP can exert a synergistic effect against MDR and XDR PA. Additive effect and indifference can also be seen when both antibiotics were used. Moreover, there was no antagonism seen when both antibiotics were combined. This study shows that the use of CT and MP in combination may be an option against XDR and MDR PA infections. Disclosures All Authors: No reported disclosures

Metabolic profiles of multidrug resistant and extensively drug resistant Mycobacterium tuberculosis unveiled by metabolomics

Tuberculosis ◽  
2021 ◽  
Vol 126 ◽  
pp. 102043
Author(s):  
Amanda Mendes Rêgo ◽  
Duanne Alves da Silva ◽  
Nicole Victor Ferreira ◽  
Lucindo Cardoso de Pina ◽  
Joseph A.M. Evaristo ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Multidrug Resistant ◽  
Metabolic Profiles ◽  
Drug Resistant ◽  
Extensively Drug Resistant
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