scholarly journals Multidrug-Resistant Organism Carriage in Wisconsin Children

2020 ◽  
Vol 41 (S1) ◽  
pp. s324-s325
Author(s):  
Ashley Kates ◽  
Nathan Putman-Buehler ◽  
Lauren Watson ◽  
Tamara LeCaire ◽  
Kristen Malecki ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Kindergarten Children ◽  
Resistant Organism ◽  
Small Pilot Study ◽  
Cross Sectional ◽  
Vancomycin Resistant Enterococci ◽  
Increased Risk ◽  
Stool Samples ◽  
Vancomycin Resistant

Background: Children attending daycare are at increased risk of carrying multidrug-resistant organisms (MDROs) compared to children not attending daycare. Carriage of MDROs greatly increases the risk of infection, not only in the child but also for others living in the household. Understanding the epidemiology of MDRO carriage in children is essential to devising effective containment strategies. Here, we present the findings from a cross-sectional study assessing MDRO carriage in daycare-attending and nonattending children in Wisconsin. Methods: We applied the following enrollment criteria: Children aged between 6 months and <6 years and not enrolled in kindergarten; children who did not have an MDRO infection in the previous 6 months and did not receive any antimicrobials in the previous month; and children who did not have a gluten allergy, asthma, eczema, allergic rhinitis, cystic fibrosis, or an immunodeficiency. Children were enrolled by a parent or guardian who filled out a questionnaire on MDRO risk factor history and diet. Samples were collected from the nares, axilla or groin (pooled swab), and stool. Nasal samples were cultured for H. influenzae, S. pneumoniae, M. catarrhalis, and methicillin-resistant S. aureus (MRSA). Skin samples were cultured for MRSA, and stool samples were cultured for MRSA, C. difficile, vancomycin-resistant enterococci (VRE), and extended-spectrum β-lactamase–producing Gram-negative bacilli (ie, ESBL GNR). Results: In total, 44 children were enrolled in this study. The average age was 2.6 years and 50% were girls. Furthermore, 30 (68.2%) were identified by their parents as white, 9 (20.5%) as black, and 5 (11.3%) as other or multiracial. Incidentally, 23 children (52.3%) were enrolled in daycare. Overall, 18 children were positive for at least 1 organism, 9 of which had daycare exposure, and 5 children (1 in daycare) were positive for >1 organism (11.4%). From stool samples, 6 children (13.6%, 2 in daycare) were C. difficile carriers, 3 were VRE carriers (6.8%, 1 in daycare), 8 carried an ESBL GNR (18.2%, 4 in daycare), and 3 carried MRSA (6.8%, 1 in daycare). One child was positive for H. influenzae (2.3%, not in daycare) and 2 were positive for S. pneumoniae (4.6%, 1 in daycare) from nares swabs. One child was positive for MRSA (2.3%, not in daycare) from a skin swab. We detected no significant differences between children with and without daycare exposure for any organism. Conclusions: Children in this population had higher than expected rates of ESBL GNRs and MRSA for a community population. Daycare exposure was not correlated with increased carriage in this small pilot study, though larger longitudinal studies are needed.Funding: NoneDisclosures: None

Fasciola hepatica Infection Risk for Adult Household Members with Children with Fascioliasis in Cusco, Peru

2021 ◽  
Author(s):  
Maria A. Caravedo ◽  
Walter Ramirez ◽  
Maria L. Morales ◽  
Martha Lopez ◽  
Claire E. Janes ◽  
...  
Keyword(s):  
Fasciola Hepatica ◽  
Child Poverty ◽  
Serum Antibody ◽  
Cross Sectional Study ◽  
School Age Children ◽  
Cross Sectional ◽  
Increased Risk ◽  
At Risk Populations ◽  
Stool Samples ◽  
Household Members

Fasciola hepatica is highly prevalent in the highlands of Peru. School-age children have the greatest risk of infection. Mass treatment of at-risk populations has been proposed to control the infection and prevent complications. However, the decreasing effectiveness of triclabendazole raises concerns regarding this strategy. Previous studies reported aggregation of Fasciola infection among family members. This study aimed to determine the risk of fascioliasis among household members living with Fasciola-infected children identified through school-based testing. We conducted a cross-sectional study including adult members of households where children with and without fascioliasis were identified. Demographic, epidemiological, and socioeconomic information was collected. One blood sample was drawn to test for Fasciola antibodies, and three stool samples were collected for microscopy for Fasciola ova. We tested 326 adults from 213 households. Of these adult subjects, chronic fascioliasis (24 of 326, 7.4%) was the most common helminth infection. Thirty-nine subjects (12.7%) tested positive for Fasciola antibodies. Combining microscopy and serum antibody tests, 13.2% (43 of 326) had evidence of Fasciola infection. One third (104 of 326, 31.9%) of the participants lived with at least one child infected with Fasciola hepatica. Adults with fascioliasis were four times more likely to live with an infected child. Poverty and diet were associated with increased risk of Fasciola infection. Adults with fascioliasis were significantly more likely to live with Fasciola-infected children.

Novel method of calculating adjusted antibiotic use by microbiological burden

2021 ◽  
pp. 1-6
Author(s):  
Hana R. Winders ◽  
Majdi N. Al-Hasan ◽  
Bruce M. Jones ◽  
Darrell T. Childress ◽  
Kayla R. Stover ◽  
...  
Keyword(s):  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Resistant Bacteria ◽  
Bacterial Isolates ◽  
Sectional Study ◽  
Cross Sectional ◽  
Vancomycin Resistant Enterococci ◽  
Days Of Therapy ◽  
Novel Method ◽  
Vancomycin Resistant

Abstract Objective: To determine the usefulness of adjusting antibiotic use (AU) by prevalence of bacterial isolates as an alternative method for risk adjustment beyond hospital characteristics. Design: Retrospective, observational, cross-sectional study. Setting: Hospitals in the southeastern United States. Methods: AU in days of therapy per 1,000 patient days and microbiologic data from 2015 and 2016 were collected from 26 hospitals. The prevalences of Pseudomonas aeruginosa, extended-spectrum β-lactamase (ESBL)–producing bacteria, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE) were calculated and compared to the average prevalence of all hospitals in the network. This proportion was used to calculate the adjusted AU (a-AU) for various categories of antimicrobials. For example, a-AU of antipseudomonal β-lactams (APBL) was the AU of APBL divided by (prevalence of P. aeruginosa at that hospital divided by the average prevalence of P. aeruginosa). Hospitals were categorized by bed size and ranked by AU and a-AU, and the rankings were compared. Results: Most hospitals in 2015 and 2016, respectively, moved ≥2 positions in the ranking using a-AU of APBL (15 of 24, 63%; 22 of 26, 85%), carbapenems (14 of 23, 61%; 22 of 25; 88%), anti-MRSA agents (13 of 23, 57%; 18 of 26, 69%), and anti-VRE agents (18 of 24, 75%; 15 of 26, 58%). Use of a-AU resulted in a shift in quartile of hospital ranking for 50% of APBL agents, 57% of carbapenems, 35% of anti-MRSA agents, and 75% of anti-VRE agents in 2015 and 50% of APBL agents, 28% of carbapenems, 50% of anti-MRSA agents, and 58% of anti-VRE agents in 2016. Conclusions: The a-AU considerably changes how hospitals compare among each other within a network. Adjusting AU by microbiological burden allows for a more balanced comparison among hospitals with variable baseline rates of resistant bacteria.

scholarly journals Contact with poultry and animals increases risk of Campylobacter infections in adults of Ardabil province, Iran

2017 ◽  
Vol 36 (1) ◽  
pp. 59
Author(s):  
Reza Ranjbar ◽  
Daryoush Babazadeh
Keyword(s):  
Prevalence Ratio ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Worldwide Distribution ◽  
Increased Risk ◽  
Chi Square Test ◽  
Stool Samples ◽  
East Azerbaijan ◽  
Campylobacter Infections

<p>Background<br />The acute gastroenteritis caused by campylobacteriosis is known as one of the common infectious diseases with worldwide distribution. The aim of this study was to detect Campylobacter species in stool samples by routine culturing and polymerase chain reaction (PCR) and explore the risk factors in adult subjects in East Azerbaijan province of Iran.</p><p>Methods<br />A cross sectional study involving 1010 adult subjects, from whom stool samples were collected. Samples with inflammatory criteria like fecal leukocytes (WBC ³5) were selected and isolated through fecal lactoferrin detection test. The WBC ³5 and lactoferrin positive samples were selected for Campylobacter detection by culture and PCR methods. The required information consisting of gender, age, place of habitation, and contact with poultry and animals were asked and recorded. Chi-square test and prevalence ratio (PR) was used to analyze the data.</p><p>Results<br />Of 1010 stool samples, 231 (22.9 %) had WBC ³5, and from these samples 58 (25.1%) were positive by culturing and 61 (26.4 %) by PCR. Subjects having habitual contact with animals and poultry had increased risk of Campylobacter infections by 1.65 times compared with subjects without contact with animals and poultry (PR=1.65; 95% CI:1.07-2.68).</p><p>Conclusions<br />Detection of Campylobacter infections by PCR was more sensitive in adults. Investigation of Campylobacter prevalence in Ardabil showed this bacterium should be viewed as one of the possible pathogens in inflammatory diarrheal cases. People having habitual contact with animals should check the health of the animals regularly and not consume food from suspected sources.</p><p> </p>

scholarly journals Hand hygiene compliance among caregivers of inpatients with multidrug-resistant organism infection in China: a cross-sectional study

2020 ◽  
Author(s):  
Wenyan Chang ◽  
Xiaobing Chen ◽  
Wenying He ◽  
Taoyu Lin
Keyword(s):  
Hand Hygiene ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Resistant Organism ◽  
Cross Sectional ◽  
The Public ◽  
Direct Observations ◽  
Medical Institutions ◽  
Hygiene Compliance ◽  
Elderly Caregivers

Abstract Background Caregivers are an important provider of daily living care for multidrug-resistant organism (MDRO) inpatients in China, they are at risk for contracting and spreading MDRO from frequent interactions with patients. Improving the hand hygiene (HH) compliance of caregivers has important significance in reducing the incidence of infection. However, we have little information about HH compliance among caregivers of MDRO inpatients in most medical institutions. Therefore, we decide to examine HH compliance among caregivers of MDRO inpatients in China. Methods Using direct observations, we investigated HH compliance among caregivers of MDRO inpatients between March and August 2019 in a large university-affiliated hospital in China. Using the WHO’s Hand Hygiene Observation Tool, we surveyed a total of 440 HH opportunities. Results Out of the total participants, 16.2% were elderly. Overall HH compliance was 46.8%. The most frequent moment for HH was “after a touching patient” (69.2%) and the lowest compliance was “before clean/aseptic procedures” (25.6%). Compliance during “visiting” was highest (66.7%), with hands being less frequently washed during “resting” (29.0%). Conclusions Overall compliance with HH when caring for MDRO inpatients is less than optimal. Elderly caregivers should be valued by society and the public. These results may be used to identify issues and interventions to address HH practices and achieve a reduction in MDRO infections.

Prevalence and resistance profiles of vancomycin-resistant enterococcal isolates in Iran; an eight-month report from nine major cities

2019 ◽  
Vol 19 ◽  
Author(s):  
Shahnaz Armin ◽  
Shahram Shahraki Zahedani ◽  
Mohammad Rahbar ◽  
Leila Azimi
Keyword(s):  
Cross Sectional Study ◽  
Resistant Organism ◽  
Cross Sectional ◽  
Vana Gene ◽  
Wide Range ◽  
Health Care Associated Infections ◽  
Adults And Children ◽  
Vancomycin Resistant ◽  
Few Data ◽  
Iranian Children

Background: Enterococcal infections comprise a wide range of diseases with increasing importance due to the growing frequency of health-care-associated infections and increasing incidence of antimicrobial resistance. Vancomycin-resistant Enterococcus (VRE) is an emerging drug-resistant organism responsible for increasing numbers of nosocomial infections in both adults and children. Few data are available on the epidemiology and impact of VRE infections among Iranian children. In the present study, attempts were made to evaluate the prevalence and molecular characterization of VRE isolates from patients referred to several hospitals in Iran. Material and methods: Eight hundred and fourteen enterococcal clinical isolates from different patients were included in this cross-sectional study during June 2018 and February 2019. Antimicrobial susceptibility testing was performed by standard methods according to the Clinical Laboratories Standards Institute (CLSI) guidelines. The vanA and vanB genes in VRE isolates were amplified by PCR. Results: A majority of the isolates (20.7%) were collected from hospitalized patients in ICU. Among all isolates, 254 (30%) were identified as VRE strains. All of VRE isolates were sensitive to linezolid. Moreover, only 39.9% of VRE isolates harbored vanA gene, while none of them carried the vanB gene. Conclusion: The present study reports the highest range of VRE infections in Iran. The constant surveillance and monitoring of VRE strains is recommended to limit the occurrence and spread of VRE clones within and between hospitals and community settings.

scholarly journals Genotypic and Phenotypic Markers of Livestock-Associated Methicillin-Resistant Staphylococcus aureus CC9 in Humans

2016 ◽  
Vol 82 (13) ◽  
pp. 3892-3899 ◽  
Author(s):  
Xiaohua Ye ◽  
Xiaolin Wang ◽  
Yanping Fan ◽  
Yang Peng ◽  
Ling Li ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Phenotypic Markers ◽  
Methicillin Resistant ◽  
Content Type ◽  
Gene Environment ◽  
Increased Risk ◽  
Study Participants

ABSTRACTUse of antimicrobials in industrial food animal production is associated with the presence of multidrug-resistantStaphylococcus aureusamong animals and humans. The livestock-associated (LA) methicillin-resistantS. aureus(MRSA) clonal complex 9 (CC9) is associated with animals and related workers in Asia. This study aimed to explore the genotypic and phenotypic markers of LA-MRSA CC9 in humans. We conducted a cross-sectional study of livestock workers and controls in Guangdong, China. The study participants responded to a questionnaire and provided a nasal swab forS. aureusanalysis. The resulting isolates were assessed for antibiotic susceptibility, multilocus sequence type, and immune evasion cluster (IEC) genes. Livestock workers had significantly higher rates ofS. aureusCC9 (odds ratio [OR] = 30.98; 95% confidence interval [CI], 4.06 to 236.39) and tetracycline-resistantS. aureus(OR = 3.26; 95% CI, 2.12 to 5.00) carriage than controls. All 19S. aureusCC9 isolates from livestock workers were MRSA isolates and also exhibited the characteristics of resistance to several classes of antibiotics and absence of the IEC genes. Notably, the interaction analyses indicated phenotype-phenotype (OR = 525.7; 95% CI, 60.0 to 4,602.1) and gene-environment (OR = 232.3; 95% CI, 28.7 to 1,876.7) interactions associated with increased risk for livestock-associatedS. aureusCC9 carriage. These findings suggest that livestock-associatedS. aureusand MRSA (CC9, IEC negative, and tetracycline resistant) in humans are associated with occupational livestock contact, raising questions about the potential for occupational exposure to opportunisticS. aureus.IMPORTANCEThis study adds to existing knowledge by giving insight into the genotypic and phenotypic markers of LA-MRSA. Our findings suggest that livestock-associatedS. aureusand MRSA (CC9, IEC negative, and tetracycline resistant) in humans are associated with occupational livestock contact. Future studies should direct more attention to exploring the exact transmission routes and establishing measures to prevent the spread of LA-MRSA.

scholarly journals Vancomycin resistant enterococci gut Colonization and its associated factors among HIV infected patients on anti-Retro viral therapy in Ethiopia

2020 ◽  
Author(s):  
Belayneh Regasa ◽  
Zerihun Solomon ◽  
Mheret Tesfaye
Keyword(s):  
Associated Factors ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
P Value ◽  
Cross Sectional ◽  
Gut Colonization ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Study Participants

Abstract BackgroundThe emergence of vancomycin resistant Enterococci (VRE) has alarmed the global infectious diseases community due to its tendency for colonization of the gastrointestinal tract. Human Immunodeficiency Virus (HIV) patients are colonized by vancomycin resistant Enterococci than other groups. The aim of this study was to determine the prevalence of vancomycin resistant Enterococci gut colonization and its associated factors among HIV infected patients on Anti-Retroviral Therapy (ART).MethodsInstitution based cross sectional study was conducted among HIV infected patients on ART at from June 1 to August 30, 2020. Socio-demographic and clinical data were collected by pre-tested structured questionnaire. Stool sample was collected and processed by standard microbiological techniques. Kirby Bauer Disc diffusion method was used to perform antimicrobial susceptibility testing. Data were entered by Epi data version 4.6.0.2 and analyzed by SPSS version 25. P-value <0.05 was considered as significant.ResultsAmong a total of 200 study participants, colonization of Enterococci spp was isolated on 123 (61.50%) respondents. Among these isolates, the prevalence of vancomycin resistant Enterococci colonization was 11.4% [95% CI: (6.0-17.0)]. Enterococci isolates tested against commonly prescribed antibiotics showed highest rate of resistance to ampicillin (69.9%). Multidrug resistances were observed in 49.59% of Enterococci isolates. Study participants who had prior antibiotic exposure for more than two weeks [AOR=7.35; 95% CI: (1.2144.64)] and hospitalization in the last six months [AOR=5.68; 95% CI: (1.09 29.74)] were significantly associated with vancomycin resistant Enterococci gut colonization.ConclusionHigh prevalence of vancomycin resistant Enterococci gut colonization was found. Previous exposure to antibiotics for more than two weeks and previous hospitalization for more than six months were significant factors for vancomycin resistant Enterococci colonization. The isolated Enterococci had variable degrees of resistance to commonly prescribed antibiotics. Therefore, periodic surveillance on antimicrobial resistance pattern, adhering to rational use of antibiotics and implementing infection prevention protocols may reduce colonization by VRE.

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