Trends of Bloodstream Infections in a University Greek Hospital during a Three-Year Period: Incidence of Multidrug-Resistant Bacteria and Seasonality in Gram-negative Predominance

The aim of the study was to assess the epidemiology, the incidence of multidrug-resistant bacteria and bloodstream infections’ (BSIs) seasonality in a university hospital. This retrospective study was carried out in the University General Hospital of Patras, Greece, during 2011–13 y. Blood cultures from patients with clinical presentation suggestive of bloodstream infection were performed by the BacT/ALERT System. Isolates were identified by Vitek 2 Advanced Expert System. Antibiotic susceptibility testing was performed by the disk diffusion method and E-test. Resistance genes (mecA in staphylococci; vanA/vanB/vanC in enterococci; blaKPC/blaVIM/blaNDM in Klebsiella spp.) were detected by PCR. In total, 4607 (9.7%) blood cultures were positive from 47451 sets sent to Department of Microbiology, representing 1732 BSIs. Gram-negative bacteria (52.3%) were the most commonly isolated, followed by Gram-positive (39.5%), fungi (6.6%) and anaerobes bacteria (1.8%). The highest contamination rate was observed among Gram-positive bacteria (42.3%). Among 330 CNS and 150 Staphylococcus aureus, 281 (85.2%) and 60 (40.0%) were mecA-positive, respectively. From 113 enterococci, eight were vanA, two vanB and two vanC-positives. Of the total 207 carbapenem-resistant Klebsiella pneumoniae (73.4%), 202 carried blaKPC, four blaKPC and blaVIM and one blaVIM. A significant increase in monthly BSIs’ incidence was shown (R2: 0.449), which may be attributed to a rise of Gram-positive BSIs (R2: 0.337). Gram-positive BSIs were less frequent in spring (P < 0.001), summer (P < 0.001), and autumn (P < 0.001), as compared to winter months, while Gram-negative bacteria (P < 0.001) and fungi (P < 0.001) were more frequent in summer months. BSIs due to methicillin resistant S. aureus and carbapenem-resistant Gram-negative bacteria increased during the study period. The increasing incidence of BSIs can be attributed to an increase of Gram-positive BSI incidence, even though Gram-negative bacteria remained the predominant ones. Seasonality may play a role in the predominance of Gram-negative’s BSI.

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Inhibition of Multidrug-Resistant Gram-Positive and Gram-Negative Bacteria by a Photoactivated Porphyrin

Polish Journal of Microbiology ◽

10.5604/01.3001.0010.7092 ◽

2017 ◽

Vol 66 (4) ◽

pp. 533-536 ◽

Cited By ~ 2

Author(s):

Moreno Bondi ◽

Anna Mazzini ◽

Simona de Niederhäusern ◽

Ramona Iseppi ◽

Patrizia Messi

Keyword(s):

Multidrug Resistant ◽

Resistant Bacteria ◽

Gram Negative Bacteria ◽

Multidrug Resistant Bacteria ◽

Gram Positive ◽

Gram Negative ◽

E Coli ◽

In Vitro Antibacterial Activity

The authors studied the in vitro antibacterial activity of the photo-activated porphyrin meso-tri(N-methyl-pyridyl), mono(N-tetradecyl-pyridyl)porphine (C14) against four multidrug-resistant bacteria: Staphylococcus aureus, Enterococcus faecalis (Gram-positive), Escherichia coli, Pseudomonas aeruginosa (Gram-negative). Using 10 μg/ml of porphyrin and 60 sec irradiation we observed the remarkable susceptibility of S. aureus and E. faecalis to treatment while, under the same conditions, E. coli and P. aeruginosa showed very low susceptibility. In a later stage, suspensions of Gram-negative bacteria were processed with EDTA before photo-activation, obtaining a significant decrease in viable counts. In view of the results, if the combination of low porphyrin concentrations and short irradiation times will be effective in vivo also, this approach could be a possible alternative to antibiotics, in particular against localized infections due to multidrug-resistant microorganisms.

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Antimicrobial resistance in hospitalized surgical patients: a silently emerging public health concern in Benin

10.21203/rs.3.rs-65379/v2 ◽

2020 ◽

Author(s):

Carine Laurence Yehouenou ◽

Arsène A. Kpangon ◽

Dissou Affolabi ◽

Hector Rodriguez-Villalobos ◽

Françoise Van Bambeke ◽

...

Keyword(s):

Gastrointestinal Surgery ◽

Multidrug Resistant ◽

Public Hospitals ◽

Health Concern ◽

Diffusion Method ◽

Resistant Bacteria ◽

Gram Negative Bacteria ◽

Multidrug Resistant Bacteria ◽

Strict Adherence ◽

Gram Negative

Abstract Background: Surgical site infections are related to high morbidity, mortality and healthcare costs. Because the emergence of multidrug-resistant bacteria in hospitals is becoming a worldwide challenge for surgeons who treat healthcare-associated infections, we wished to identify the causative agents involved in these infections and the rate of multidrug-resistant bacteria in six public hospitals in Benin. Methods: Using standard microbiological procedures, we processed pus specimens collected from obstetrics and gastrointestinal surgery wards. Mass spectrometry (MALDI-TOF) was used for confirmation. For the antibiotic susceptibility test, we first used the Kirby-Bauer disk diffusion method. The secondary test (by microdilution) used the Beckton Dickinson Phoenix automated system (Becton Dickinson Diagnostic, USA). Results: We included 304 patients, whose median length of stay was 9 days. A total of 259 wound swabs (85.2%) had positive aerobic bacterial growth. In obstetrics, S. aureus (28.5%, n=42) was the most common isolate. In contrast, Gram-negative bacteria (GNB) were predominant in gastrointestinal surgery, the most dominant being E. coli (38.4%, n=31). Overall, 90.8% (n=208) of aerobic bacteria were multidrug resistant. Two-thirds of S. aureus (65.3%, n= 32) were methicillin-resistant Staphylococcus aureus (MRSA), three of which carried both MRSA and induced clindamycin resistance (ICR). GNB showed high resistance to ceftazidime, ceftriaxone and cefepime. Extended-spectrum beta-lactamases were presented by 69.4% of E.coli (n=43/62) and 83.3% of K. pneumoniae (n=25/30). Overall, twelve Gram-negative bacteria (5.24%) showed resistance to at least one carbapenem. No isolates showed a wild-type susceptible phenotype. Conclusion: This study shows the alarming prevalence of multidrug-resistant organisms from surgical site infections in Benin hospitals. To reduce the spread of such bacteria, periodic surveillance of surgical site infections and strict adherence to good hand-hygiene practice are essential.

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Bacteriological Profile of Tracheal Aspirates of the Patients Attending Neuro-hospital Nepal

International Journal of Life Sciences ◽

10.3126/ijls.v4i0.3496 ◽

2010 ◽

Vol 4 ◽

Cited By ~ 3

Author(s):

Pratirodh Koirala ◽

Dwij Raj Bhatta ◽

Prakash Ghimire ◽

Bharat Mani Pokhrel ◽

Upendra Devkota

Keyword(s):

Pseudomonas Aeruginosa ◽

Multidrug Resistant ◽

Resistant Bacteria ◽

Gram Negative Bacteria ◽

Viridans Streptococci ◽

Multidrug Resistant Bacteria ◽

Gram Positive ◽

Gram Negative ◽

Gram Positive Bacteria ◽

Tracheal Aspirates

The tracheostomized patients are colonized mostly by gram negative bacteria which lead to either tracheobronchitis or bronchopneumonia. This study was conducted to isolate and identify the potential pathogen causing post tracheostomy infection. A cross-sectional study was conducted during April 2008 to February 2009 based at Neuro Center, Kathmandu. Tracheal aspirates of 50 patients having fever more than 38°C were collected and analyzed for bacterial content. Out of the 50 cases, 45(90%) cases showed bacterial growth. Sixty-seven isolates were identified; with 20(44.4%) poly-microbial cases. Pseudomonas aeruginosa and enteric gram negative bacteria were predominant bacteria (n=27, 40.3%) followed by Staphylococcus aureus (n=7, 10.4%), other Gram negative bacteria (n=4, 5.9%) and Viridans Streptococci (n=2, 2.9%). Pseudomonas aeruginosa were most sensitive to the Amikacin (n=22, 81.4%) and Ciprofloxacin (n=19, 70.3%). All Pseudomonal isolates were resistant to the Cefotaxime. Enteric Gram Negative bacteria (EGNB) were most sensitive to Amikacin and Chloramphenicol (20, 74.0%) and all were resistant to Ampicillin and Cephalexin. All the gram positive bacteria isolated were sensitive to Vancomycin. Among the total isolates, 24 (88.8%) of Pseudomonas aeruginosa, 21 (66.6%) of enteric gram negative bacteria, and 5 (55.5%) of Gram positive bacteria were multidrug resistant (MDR). The study reported alarming condition of MDR in tracheal aspirates. So surveillance for source of multidrug resistant bacteria would be beneficial for intervention of infection related to it. Key words: Tracheal aspirates, polymicrobial growth, Multidrug resistant bacteria (MDR)10.3126/ijls.v4i0.3496International Journal of Life Sciences Vol.4 2010 pp.60-65

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Antimicrobial resistance in hospitalized surgical patients: a silently emerging public health concern in Benin

Annals of Clinical Microbiology and Antimicrobials ◽

10.1186/s12941-020-00398-4 ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Carine Laurence Yehouenou ◽

Arsène A. Kpangon ◽

Dissou Affolabi ◽

Hector Rodriguez-Villalobos ◽

Françoise Van Bambeke ◽

...

Keyword(s):

Gastrointestinal Surgery ◽

Surgical Site Infections ◽

Multidrug Resistant ◽

Public Hospitals ◽

Health Concern ◽

Diffusion Method ◽

Resistant Bacteria ◽

Gram Negative Bacteria ◽

Multidrug Resistant Bacteria ◽

Gram Negative

Abstract Background Surgical site infections are related to high morbidity, mortality and healthcare costs. Because the emergence of multidrug-resistant bacteria in hospitals is becoming a worldwide challenge for surgeons who treat healthcare-associated infections, we wished to identify the causative agents involved in these infections and the rate of multidrug-resistant bacteria in six public hospitals in Benin. Methods Using standard microbiological procedures, we processed pus specimens collected from obstetrics and gastrointestinal surgery wards. Mass spectrometry (MALDI-TOF) was used for confirmation. For the antibiotic susceptibility test, we first used the Kirby-Bauer disk diffusion method. The secondary test (by microdilution) used the Beckton Dickinson Phoenix automated system (Becton Dickinson Diagnostic, USA). Results We included 304 patients, whose median length of stay was 9 days. A total of 259 wound swabs (85.2%) had positive aerobic bacterial growth. In obstetrics, S. aureus (28.5%, n = 42) was the most common isolate. In contrast, Gram-negative bacteria (GNB) were predominant in gastrointestinal surgery, the most dominant being E.coli (38.4%, n = 31). Overall, 90.8% (n = 208) of aerobic bacteria were multidrug resistant. Two-thirds of S. aureus (65.3%, n = 32) were methicillin-resistant Staphylococcus aureus (MRSA), three of which carried both MRSA and induced clindamycin resistance (ICR). GNB showed high resistance to ceftazidime, ceftriaxone and cefepime. Extended-spectrum beta-lactamases were presented by 69.4% of E.coli (n = 43/62) and 83.3% of K. pneumoniae (n = 25/30). Overall, twelve Gram-negative bacteria (5.24%) showed resistance to at least one carbapenem. No isolates showed a wild-type susceptible phenotype. Conclusion This study shows the alarming prevalence of multidrug-resistant organisms from surgical site infections in Benin hospitals. To reduce the spread of such bacteria in Benin, periodic surveillance of surgical site infections and strict adherence to good hand-hygiene practice are essential.

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Species Diversity of Environmental GIM-1-Producing Bacteria Collected during a Long-Term Outbreak

Applied and Environmental Microbiology ◽

10.1128/aem.00424-16 ◽

2016 ◽

Vol 82 (12) ◽

pp. 3605-3610 ◽

Cited By ~ 13

Author(s):

Andreas F. Wendel ◽

Sofija Ressina ◽

Susanne Kolbe-Busch ◽

Klaus Pfeffer ◽

Colin R. MacKenzie

Keyword(s):

Resistance Genes ◽

Multidrug Resistant ◽

Hospital Environment ◽

Resistant Bacteria ◽

Environmental Sampling ◽

Gram Negative Bacteria ◽

Multidrug Resistant Bacteria ◽

Gram Negative ◽

Content Type

ABSTRACTReports of outbreaks concerning carbapenemase-producing Gram-negative bacteria in which the main source of transmission is the hospital environment are increasing. This study describes the results of environmental sampling in a protracted polyspecies metallo-beta-lactamase GIM-1 outbreak driven by plasmids and bacterial clones ofEnterobacter cloacaeandPseudomonas aeruginosain a tertiary care center. Environmental sampling targeting wet locations (especially sinks) was carried out on a surgical intensive care unit and on a medical ward on several occasions in 2012 and 2013. We were able to demonstrate 43blaGIM-1-carrying bacteria (mainly nonfermenters but alsoEnterobacteriaceae) that were either related or unrelated to clinical strains in 30 sinks and one hair washbasin. GIM-1 was found in 12 different species, some of which are described here as carriers of GIM-1. Forty out of 43 bacteria displayed resistance to carbapenems and, in addition, to various non-beta-lactam antibiotics. Colistin resistance was observed in twoE. cloacaeisolates with MICs above 256 mg/liter. TheblaGIM-1gene was harbored in 12 different class 1 integrons, some without the typical 3′ end. TheblaGIM-1gene was localized on plasmids in five isolates.In vitroplasmid transfer by conjugation was successful in one isolate. The environment, with putatively multispecies biofilms, seems to be an important biological niche for multidrug-resistant bacteria and resistance genes. Biofilms may serve as a “melting pot” for horizontal gene transfer, for dissemination into new species, and as a reservoir to propagate future hospital outbreaks.IMPORTANCEIn Gram-negative bacteria, resistance to the clinically relevant broad-spectrum carbapenem antibiotics is a major public health concern. Major reservoirs for these resistant organisms are not only the gastrointestinal tracts of animals and humans but also the (hospital) environment. Due to the difficulty in eradicating biofilm formation in the latter, a sustained dissemination of multidrug-resistant bacteria from the environment can occur. In addition, horizontal transfer of resistance genes on mobile genetic elements within biofilms adds to the total “resistance gene pool” in the environment. To gain insight into the transmission pathways of a rare and locally restricted carbapenemases resistance gene (blaGIM-1), we analyzed the genetic background of theblaGIM-1gene in environmental bacteria during a long-term polyspecies outbreak in a German hospital.

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Increasing frequency of gram-positive cocci and gram-negative multidrug-resistant bacteria in spontaneous bacterial peritonitis

Liver International ◽

10.1111/liv.12152 ◽

2013 ◽

Vol 33 (7) ◽

pp. 975-981 ◽

Cited By ~ 56

Author(s):

Alexandra Alexopoulou ◽

Nikolaos Papadopoulos ◽

Dimitrios G. Eliopoulos ◽

Apostolia Alexaki ◽

Athanasia Tsiriga ◽

...

Keyword(s):

Spontaneous Bacterial Peritonitis ◽

Multidrug Resistant ◽

Resistant Bacteria ◽

Multidrug Resistant Bacteria ◽

Gram Positive ◽

Gram Negative ◽

Bacterial Peritonitis ◽

Gram Positive Cocci

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Antimicrobial Resistance in Hospitalized Surgical Patients: a Silently Emerging Public Health Concern in Benin.

10.21203/rs.3.rs-65379/v1 ◽

2020 ◽

Author(s):

Carine Laurence YEHOUENOU ◽

Arsène A. KPANGON ◽

Dissou AFFOLABI ◽

Hector RODRIGUEZ-VILLALOBOS ◽

Françoise Van Bambeke ◽

...

Keyword(s):

Gastrointestinal Surgery ◽

Surgical Site Infections ◽

Multidrug Resistant ◽

Public Hospitals ◽

Health Concern ◽

Diffusion Method ◽

Resistant Bacteria ◽

Gram Negative Bacteria ◽

Strict Adherence ◽

Gram Negative

Abstract Background: Surgical site infections are related to high morbidity, mortality and healthcare costs. As the emergence of multidrug-resistant bacterial pathogens in hospitals is becoming a worldwide challenge for surgeons who treat healthcare-associated infections, we wished to identify the causative agents involved in surgical site infections and their susceptibility pattern in six public hospitals in Benin. Methods: Using standard microbiological procedures, we processed pus specimens collected from obstetrics and gastrointestinal surgery wards. Mass spectrometry (MALDI-TOF) was used for confirmation. The antibiotic susceptibility test firstly used the Kirby-Bauer disc diffusion method. The secondary test by microdilution used the Beckton Dickinson Phoenix automated system (Becton Dickinson Diagnostic, USA). Results: We included 304 patients (mean age 32 ± 11 years), whose median length of stay was 9 days. A total of 259 wound swabs (85.2%) had positive aerobic bacterial growth. In obstetrics S. aureus (28.5%, n=42) was the most common isolate. In contrast, Gram-negative bacteria (GNB) were predominant in gastrointestinal surgery. The most dominant being E.coli (38.4%, n=31). Overall, 90.8% (n=208) of aerobic bacteria were multidrug resistant. Two-third of S. aureus (65.3%, n= 32) were methicillin-resistant Staphylococcus aureus (MRSA), three of which carried both MRSA and induced clindamycin resistance (ICR). GNB showed high resistance to ceftazidime, ceftriaxone and cefepime. Extended-spectrum beta-lactamases were presented by 69.4% of E.coli (n=43/62) and 83.3% of K. pneumoniae (n=25/30). Overall, twelve Gram negative bacteria (5.24%) isolates showed resistance to at least one carbapenem. No isolates showed a wild-type susceptible phenotype.Conclusion: This study shows the alarming prevalence of multidrug resistant organisms from surgical site infections in Benin hospitals. To reduce the spread of these multidrug-resistant bacteria, periodic surveillance of surgical site infections and strict adherence to good hand-hygiene practice are essential.

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Detection of Multidrug Resistant Gram Negative Bacteria in Healthy Cattle from Maiduguri Metropolitan, Nigeria

Journal of Advances in Microbiology ◽

10.9734/jamb/2020/v20i630255 ◽

2020 ◽

pp. 68-76

Author(s):

Adam Mustapha ◽

Mustafa Alhaji Isa ◽

Ibrahim Yusuf Ngoshe ◽

Hashidu Bala

Keyword(s):

Antibiotic Resistance ◽

Clinical Laboratory ◽

Resistance Index ◽

Multidrug Resistant ◽

Diffusion Method ◽

Resistant Bacteria ◽

Gram Negative Bacteria ◽

Salmonella Spp ◽

Gram Negative ◽

Healthy Cattle

Aim: Prevalence of multidrug resistant bacteria on apparently health animals has turned antibiotic resistance to multifaceted process and threatens global food security and public health. The aim of the present study was to investigate the resistance profile of isolates from apparently healthy cattle in Maiduguri, Nigeria. Methodology: A total of 120 nasal swab samples were collected from cattle. Colony identification was according to the guidelines of Bergey’s Manual of Determinative Bacteriology. The susceptibility pattern of the isolates was conducted on the identified isolates according to the Modified Kirby-Baur disc diffusion method on Muller-Hilton agar and interpreted according to the procedures of Clinical Laboratory Standards Institute (CLSI, 2018) guidelines. Multiple Antibiotic Resistance Index (MARI) was calculated using the formula, MARI=a/b where “a” is the number of antibiotic resisted and “b” is the total number of antibiotic used in the study. Results: Of the total samples (120) from cattle 96 (80%) detected the following isolates; E. coli was the most commonly recovered isolates (33, 34.4%), followed by Klebsiella spp (28, 29.2%), Salmonella spp (21, 21.9%) and Pseudomonas aeruginosa (14, 14.5%). In this study, all the recovered isolates were found to be multidrug resistant gram negative bacteria, with highest resistance was shown by Salmonella spp. The high MARI observed in all the isolates in this study ranging from 0.7 to 0.9. MARI value of 0.2 > is suggests multiple antibiotic resistant bacteria and indicate presence of highly resistant bacteria. Conclusion: The study indicates highly resistant bacteria are carried by healthy food animals. Thus, there is need for continued monitoring of antibiotics use in animal husbandry to prevent further spread of resistance in Maiduguri, Nigeria.

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Oral, nasopharyngeal, and gut decontamination in the ICU

10.1093/med/9780199600830.003.0287 ◽

2016 ◽

Author(s):

Evelien Oostdijk ◽

Marc Bonten

Keyword(s):

Digestive Tract ◽

Antibiotic Use ◽

Multidrug Resistant ◽

Selective Decontamination ◽

Resistant Bacteria ◽

Gram Negative Bacteria ◽

Detailed Data ◽

Multidrug Resistant Bacteria ◽

Gram Negative ◽

Selective Oropharyngeal Decontamination

Many infections are caused by enteric bacilli, presumably from endogenous origin. Selective decontamination of the digestive tract (SDD) was developed to selectively eliminate the aerobic Gram-negative bacilli from the digestive tract, leaving the anaerobic flora unaffected. As an alternative to SDD, investigators have evaluated the effects of selective oropharyngeal decontamination (SOpD) alone. Most detailed data on the effects of SDD and SOpD in ICU-patients come from two studies performed in Dutch ICUs. The Dutch studies provide strong evidence that SDD and SOpD reduce ICUmortality, ICU-acquired bacteraemia with Gram-negative bacteria, and systemic antibiotic use. Although successful application has been reported from several solitary ICUs across Europe, it is currently unknown to what extent these effects can be achieved in settings with different bacterial ecology. More studies are needed on the use of SDD or SOpD as a measure to control outbreaks with multidrug resistant bacteria.

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Bacteriocins, Antimicrobial Peptides from Bacterial Origin: Overview of Their Biology and Their Impact against Multidrug-Resistant Bacteria

Microorganisms ◽

10.3390/microorganisms8050639 ◽

2020 ◽

Vol 8 (5) ◽

pp. 639 ◽

Cited By ~ 13

Author(s):

Alexis Simons ◽

Kamel Alhanout ◽

Raphaël E. Duval

Keyword(s):

Antimicrobial Resistance ◽

Bacterial Infections ◽

Antimicrobial Agents ◽

Multidrug Resistant ◽

Resistant Bacteria ◽

Gram Negative Bacteria ◽

Multidrug Resistant Bacteria ◽

Gram Negative ◽

Gram Positive Bacteria ◽

Further Development

Currently, the emergence and ongoing dissemination of antimicrobial resistance among bacteria are critical health and economic issue, leading to increased rates of morbidity and mortality related to bacterial infections. Research and development for new antimicrobial agents is currently needed to overcome this problem. Among the different approaches studied, bacteriocins seem to be a promising possibility. These molecules are peptides naturally synthesized by ribosomes, produced by both Gram-positive bacteria (GPB) and Gram-negative bacteria (GNB), which will allow these bacteriocin producers to survive in highly competitive polymicrobial environment. Bacteriocins exhibit antimicrobial activity with variable spectrum depending on the peptide, which may target several bacteria. Already used in some areas such as agro-food, bacteriocins may be considered as interesting candidates for further development as antimicrobial agents used in health contexts, particularly considering the issue of antimicrobial resistance. The aim of this review is to present an updated global report on the biology of bacteriocins produced by GPB and GNB, as well as their antibacterial activity against relevant bacterial pathogens, and especially against multidrug-resistant bacteria.

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