Near-patient environmental contamination of an intensive care unit with Vancomycin-resistant Enterococci (VRE) and Extended-Spectrum Beta-Lactamase–Producing Enterobacteriaceae (ESBL-E) before and after the introduction of chlorhexidine bathing for patients

2018 ◽  
Vol 39 (9) ◽  
pp. 1131-1132 ◽  
Author(s):  
Hélène McDermott ◽  
Mairead Skally ◽  
James O’Rourke ◽  
Hilary Humphreys ◽  
Deirdre Fitzgerald-Hughes
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Environmental Contamination ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Vancomycin Resistant Enterococci ◽  
Extended Spectrum ◽  
Chlorhexidine Bathing ◽  
Before And After ◽  
Vancomycin Resistant

scholarly journals Characterization of Methicillin-ResistantStaphylococcus aureus, Vancomycin-Resistant Enterococci and Extended-Spectrum Beta-Lactamase-ProducingEscherichia coliin Intensive Care Units in Canada: Results of the Canadian National Intensive Care Unit (Can-Icu) Study (2005–2006)

2008 ◽  
Vol 19 (3) ◽  
pp. 243-249 ◽  
Author(s):  
George G Zhanel ◽  
Mel DeCorby ◽  
Kim A Nichol ◽  
Patricia J Baudry ◽  
James A Karlowsky ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Multidrug Resistant ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Mrsa Strains

BACKGROUND: Methicillin-resistantStaphylococcus aureus(MRSA), extended-spectrum beta-lactamase (ESBL)-producingEscherichia coliand vancomycin-resistant enterococci (VRE) are important hospital pathogens in Canada and worldwide.OBJECTIVES: To genotypically and phenotypically characterize the isolates of MRSA, VRE and ESBL-producingE colicollected from patients in Canadian intensive care units (ICUs) in 2005 and 2006.METHODS: Between September 1, 2005, and June 30, 2006, 19 medical centres participating in the Canadian National Intensive Care Unit (CAN-ICU) study collected 4133 unique patient isolates associated with infections in ICUs. Isolates of MRSA underwentmecA polymerase chain reaction (PCR) and Panton-Valentine leukocidin analysis; they were typed using pulsed-field gel electrophoresis. All isolates ofE coliwith ceftriaxone minimum inhibitory concentrations greater than or equal to 1 μg/mL were tested for the presence of an ESBL using the Clinical Laboratory Standards Institute double-disk diffusion method. Subsequently, PCR and sequence analysis were used to identifyblaSHV,blaTEMandblaCTX-M. Isolates of VRE were tested for the presence ofvanA andvanB genes by PCR.RESULTS: Of the 4133 ICU isolates collected, MRSA accounted for 4.7% (193 of 4133) of all isolates. MRSA represented 21.9% (193 of 880) of allS aureuscollected during the study; 90.7% were health care-associated MRSA strains and 9.3% were community-associated MRSA strains. Resistance rates for the isolates of MRSA were 91.8% to levofloxacin, 89.9% to clarithromycin, 76.1% to clindamycin and 11.7% to trimethoprim-sulfamethoxazole; no isolates were resistant to vancomycin, linezolid, tigecycline or daptomycin. ESBL-producingE coliaccounted for 0.4% (18 of 4133) of all isolates and 3.7% (18 of 493) ofE coliisolates. All 18 ESBL-producingE coliwere PCR-positive for CTX-M, withblaCTX-M-15occurring in 72% (13 of 18) of isolates. All ESBL-producingE colidisplayed a multidrug-resistant phenotype (resistant to third-generation cephalosporins and one or more other classes of antimicrobials), with 77.8% of isolates resistant to ciprofloxacin, 55.6% resistant to trimethoprim-sulfamethoxazole, 27.8% resistant to gentamicin and 26.3% resistant to doxycycline; all isolates were susceptible to ertapenem, meropenem and tigecycline. VRE accounted for 0.4% (17 of 4133) of all isolates and 6.7% (17 of 255) of enterococci isolates; 88.2% of VRE had thevanA genotype. Isolated VRE that were tested were uniformly susceptible to linezolid, tigecycline and daptomycin.CONCLUSIONS: MRSA isolated in Canadian ICUs in 2005 and 2006 was predominately health care-associated (90.7%), ESBL-producingE coliwere all CTX-M producers (72%blaCTX-M-15) and VRE primarily harboured avanA genotype (88.2%). MRSA, ESBL-producingE coliand VRE were frequently multidrug resistant.

scholarly journals Molecular detection and antibiotic resistance pattern of extended-spectrum beta-lactamase producing Escherichia coli in a Tertiary Hospital in Enugu, Nigeria

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Ifeyinwa N. Nwafia ◽  
Martin E. Ohanu ◽  
Samuel O. Ebede ◽  
Uchenna C. Ozumba
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Associated Risk Factors

Abstract Background The use of antibiotic agents in the treatment of infectious diseases has greatly contributed to the decrease in morbidity and mortality, but these great advances in treatment are being undermined by the rapidly increasing antimicrobial resistant organisms. Extended-spectrum beta-lactamases are enzymes hydrolyzing the beta lactam antibiotics, including third generation cephalosporins and monobactams but not cephamycins and carbapenems. They pose a serious global health threat and have become a challenge for health care providers. The aim of this research was to assess the prevalence of extended-spectrum beta-lactamase producing Escherichia coli in University of Nigeria Teaching Hospital Ituku-Ozalla Enugu and to detect the risk factors for acquisition of the resistant organism. To proffer advice on antibiotic stewardship in clinical practice and public health interventions, to curb the spread of the resistant organisms in the hospital. Results Out of the 200 E. coli isolates, 70 (35.00%) were confirmed positive for extended-spectrum beta-lactamase production. Fifty-three (75.7%) were from hospital acquired infections. All the isolates were resistant to ampicillin, tetracycline and chloramphenicol while 68 (97.14%) of the 70 isolates were susceptible to imipenem. BlaTEM, blaSHV and blaTEM were detected in 66 (94%) of the 70 isolates. The ESBL bla genes detected were blaCTX-M (n = 26; 37.14%), blaTEM (n = 7; 10.00%), blaSHV (n = 2; 2.86%), blaCTX-M/TEM (n = 7; 10.0%), blaCTX-M/SHV (n = 14; 20.0%) and blaCTX-M/TEM/SHV (n = 10; 14.29%). The three bla genes were not detected in 4 (5.71%) of the isolates. Recent surgery, previous antibiotic and intensive care unit admission were the associated risk factors to infections caused by extended-spectrum beta-lactamase producing E. coli. Conclusion There is a high rate of infections caused by extended-spectrum beta-lactamase producing E. coli. Recent surgery, previous antibiotic and intensive care unit admission were associated risk factors.

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