Retrospective Analysis of Multidrug-ResistantAcinetobacter baumanniiStrains Isolated During a 4-Year Period in a University Hospital

2006 ◽  
Vol 27 (7) ◽  
pp. 647-653 ◽  
Author(s):  
Judith Fillaux ◽  
Anne Dubouix ◽  
Jean-Marie Conil ◽  
Jacky Laguerre ◽  
Nicole Marty
Keyword(s):  
Gel Electrophoresis ◽  
Clinical Characteristics ◽  
Epidemiologic Study ◽  
Multidrug Resistant ◽  
Pulsed Field Gel Electrophoresis ◽  
University Hospital ◽  
Clinical Samples ◽  
Relative Hazard ◽  
Burn Unit ◽  
Resistant Strains

Objective.To describe the epidemiology ofAcinetobacter baumanniiinfection during 2000-2003 and to determine whether the multidrug-resistant strains were already present in our Toulouse hospital before the 2003 French national outbreak.Design.Descriptive molecular and clinical epidemiologic study ofA. baumanniiisolates using a combination of antibiotyping and pulsed-field gel electrophoresis (PFGE).Setting.A 1,000-bed university hospital in Toulouse, France.Methods.All clinical samples that had tested positive forA. baumanniibetween January 1, 2000, and December 31, 2003, were collected. Multidrug-resistant isolates ofA. baumanniiwere then submitted to PFGE, and clinical characteristics of the source patients were noted.Results.A total of 1,277A. baumanniisamples were identified, 791 of which had not been previously identified; 148 were positive for multidrug-resistant strains. These strains were more likely to have been isolated in the intensive care unit (ICU) than were susceptible strains (P<.001; relative hazard, 3.77). The positive clinical samples were of various types (eg, nonprotected respiratory samples [43%] and blood [5%]), but no difference in type of source was seen between resistant and susceptible strains. A simultaneous analysis of pulsotypes and antibiotypes proved that the outbreak in the ICU in 2003 could be linked to an initially endemic clone that had been isolated in 2001. Furthermore, a second clone responsible for an extended-spectrum β-lactamase phenotype was sporadically present in our institution. Although the strains isolated in the burn unit were also genetically related one to another, the specific responsible clone only appeared in 2003.Conclusion.Several multidrug-resistant clones can coexist endemically for several years and can be detected during an outbreak by close survey of epidemic sources.

Molecular and Epidemiologic Study of Polyclonal Outbreaks of Multidrug-ResistantAcinetobacter baumanniiInfection in an Israeli Hospital

2007 ◽  
Vol 28 (8) ◽  
pp. 945-950 ◽  
Author(s):  
Dror Marchaim ◽  
Shiri Navon-Venezia ◽  
Azita Leavitt ◽  
Irina Chmelnitsky ◽  
Mitchell J. Schwaber ◽  
...  
Keyword(s):  
Gel Electrophoresis ◽  
Care Center ◽  
Tertiary Care ◽  
Epidemiologic Study ◽  
Multidrug Resistant ◽  
Pulsed Field Gel Electrophoresis ◽  
Clinical Samples ◽  
Tertiary Care Center ◽  
Pulsed Field ◽  
Incident Cases

Objectives.To perform a molecular and epidemiologic investigation of multidrug-resistant (MDR)Acinetobacter baumanniiin an institution were polyclonal outbreaks have been observed and determine whether these polyclonal outbreaks had an endogenous origin or were caused by in-hospital patient-to-patient transmission.Design.Retrospective analysis of prospectively collected data.Setting.An epidemiologic and genotypic investigation of incident cases of MDRA. baumanniiinfection in an Israeli university tertiary care center.Patients.Hospitalized patients with MDRA. baumanniiisolated from clinical samples during a 13-week period, from April 15, 2003, through July 15, 2003.Intervention.All patients with new MDRA. baumanniiinfections were recruited, and isolates were typed using pulsed-field gel electrophoresis. Data on in-hospital movements and consultations were extracted from computerized databases. Quantification of transmission opportunities (TOPs), defined as encounters between an established carrier and a future carrier of MDRA. baumannii, and analysis of ward clusters were performed.Results.We studied 96 MDRA. baumanniiisolates, which belonged to 18 different pulsed-field gel electrophoresis clones. In 65% of cases, TOPs involving patients with the same clone were demonstrated, which is significantly greater than the number of TOPs involving patients with different clones (P= .01).Conclusion.Although outbreaks of MDRA. baumanniiinfection may be polyclonal, we believe that patient-to-patient transmission explains most cases of transmission. Polyclonal local outbreaks reflect several clonal outbreaks occurring simultaneously. The cause of polyclonal outbreaks ofA. baumanniiinfections clustered by ward and time remains to be explained.

Genetic relatedness of multidrug-resistantAcinetobacter baumanniiendemic to New York City

2008 ◽  
Vol 137 (2) ◽  
pp. 174-180 ◽  
Author(s):  
D. LANDMAN ◽  
M. BUTNARIU ◽  
S. BRATU ◽  
J. QUALE
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Gel Electrophoresis ◽  
Genetic Relatedness ◽  
Multidrug Resistant ◽  
Pulsed Field Gel Electrophoresis ◽  
Resistant Strains ◽  
Further Development ◽  
Multilocus Sequencing

SUMMARYMultidrug-resistant isolates ofAcinetobacter baumanniifrom New York City generally belong to one of three ribotypes. To assess the accuracy of ribotyping, the relatedness of representative isolates was further assessed by rep-PCR, pulsed-field gel electrophoresis (PFGE), and DNA sequencing of five genes potentially associated with antimicrobial resistance (ampC,ompA,adeB,adeR, andabeM). The isolates fell into several major groups. The first group shared the same ribotype and had common mutations affecting OmpA, AdeR, and AbeM, but consisted of two subtypes with distinctive rep-PCR and PFGE patterns andampCmutations. The second and third groups shared common alterations in OmpA, AdeR, and AbeM, but had distinct ribotype, rep-PCR, and PFGE patterns. The resistant isolates were unrelated to the β-lactam susceptible isolates. Many of the resistant strains shared OmpA and AdeB patterns observed in several European clonal groups. Further development of a multilocus sequencing typing scheme will help determine if multidrug-resistant isolates from diverse geographic areas are indeed ancestrally related.

Persistence of a Multidrug-ResistantPseudomonas aeruginosa Clone in an Intensive Care Burn Unit

1998 ◽  
Vol 36 (5) ◽  
pp. 1347-1351 ◽  
Author(s):  
Po-Ren Hsueh ◽  
Lee-Jene Teng ◽  
Pan-Chyr Yang ◽  
Yu-Chi Chen ◽  
Shen-Wu Ho ◽  
...  
Keyword(s):  
Intensive Care ◽  
Antimicrobial Agents ◽  
Present Report ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Clinical Samples ◽  
Burn Patients ◽  
Burn Unit ◽  
Severe Infections

Long-term colonization of various body sites with a multidrug-resistant Pseudomonas aeruginosa clone (resistant to piperacillin, cefoperazone, ceftazidime, aztreonam, imipenem, cefepime, cefpirome, ofloxacin, ciprofloxacin, minocycline, and aminoglycosides) with subsequent severe infections in burn patients has not been reported previously. Thirty-nine isolates of multidrug-resistant P. aeruginosa (resistant to ceftazidime and at least three of the agents listed above) recovered from various clinical samples from three patients in an intensive care burn unit from April 1997 to May 1997 and seven preserved isolates recovered from six patients in other medical wards at National Taiwan University Hospital from April 1996 to May 1997 were studied for their epidemiological relatedness. The epidemic could be attributed to a multidrug-resistant P. aeruginosa clone belonging to serogroup O:F (serogroup O:4) by means of antimicrobial susceptibility testing, O serogrouping, and analysis of the randomly amplified polymorphic DNA patterns generated by arbitrarily primed PCR of the isolates. The epidemic strain persisted in the three patients for weeks to months; in the meantime, these patients had received multiple antimicrobial agents for the management of intervening episodes of invasive infections (bacteremia, ventilator-associated pneumonia, and/or catheter-related sepsis) caused by this strain, as well as concomitant infections due to other organisms. The strain had been isolated only once previously, from a burn patient who was on the unit in December 1996. The present report, describing a small outbreak due to P. aeruginosa, documents the fact that a single clone of multidrug-resistant P. aeruginosa can cause long-term persistence in different body sites of burn patients and that the colonization can subsequently result in various severe infections.

scholarly journals Emergence of Multidrug-Resistant Klebsiella pneumoniae Isolates Producing VIM-4 Metallo-β-Lactamase, CTX-M-15 Extended-Spectrum β-Lactamase, and CMY-4 AmpC β-Lactamase in a Tunisian University Hospital

2006 ◽  
Vol 50 (12) ◽  
pp. 4198-4201 ◽  
Author(s):  
Sonia Ktari ◽  
Guillaume Arlet ◽  
Basma Mnif ◽  
Valérie Gautier ◽  
Fouzia Mahjoubi ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Gel Electrophoresis ◽  
Multidrug Resistant ◽  
Pulsed Field Gel Electrophoresis ◽  
Clinical Isolates ◽  
University Hospital ◽  
Class 1 Integron ◽  
Pulsed Field ◽  
Extended Spectrum ◽  
Class 1

ABSTRACT Klebsiella pneumoniae clinical isolates resistant to carbapenems were recovered from 11 patients in the hospital of Sfax, Tunisia. The isolates were closely related as shown by pulsed-field gel electrophoresis, and they produced VIM-4 metallo-enzyme, CTX-M-15 extended-spectrum β-lactamase, and CMY-4 AmpC enzyme. The bla VIM-4 gene is part of a class 1 integron.

scholarly journals 1280. In-Vitro Activity of Cefiderocol, Imipenem/Relebactam, & Ceftazidime/Avibactam in Ceftolozane/Tazobactam Resistant Strains of Multidrug Resistant Pseudomonas aeruginosa

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S655-S655
Author(s):  
Daniel Navas ◽  
Angela Charles ◽  
Amy Carr ◽  
Jose Alexander
Keyword(s):  
Multidrug Resistant ◽  
Resistance Mechanisms ◽  
Vitro Activity ◽  
Clinical Isolates ◽  
Resistance Testing ◽  
Clinical Samples ◽  
In Vitro Activity ◽  
Carbapenemase Gene ◽  
Resistant Strains

Abstract Background The activity of imipenem/relebactam (I/R), ceftazidime/avibactam (CZA) and cefiderocol (FDC) were evaluated against clinical isolates of multidrug resistant (MDR) strains of P. aeruginosa which was resistant to ceftolozane/tazobactam (C/T). The recent increase of MDR P. aeruginosa strains isolated from clinical samples has prompted research and development of new antimicrobials that can withstand its multiple resistance mechanisms. C/T is an effective option for treatment of MDR P. aeruginosa in our facility with only 10% of resistance in MDR strains, but the emergence of resistance may occur due to the presence of a carbapenemase gene or an ampC mutation. Methods Antimicrobial susceptibility testing for C/T Etest® (bioMérieux, Inc.) were performed on all MDR strains initially screened by the VITEK2® (bioMérieux, Inc.). 10% (n=20) of all MDR isolates were resistant to C/T by the CLSI 2019 breakpoints. These resistant isolates were tested for presence of a carbapenemase gene using the GeneXpert CARBA-R (Cepheid®) PCR and against CZA Etest® (bioMérieux, Inc.) I/R gradient strips (Liofilchem®) and FDC broth microdilution (Thermo Scientific™ Sensititre™). Results A total of 20 clinical isolates of MDR P. aeruginosa resistant to C/T were tested following standardized CLSI protocols and techniques. All 20 isolates were screened for the presence of a carbapenemase gene (blaVIM, blaNDM, blaKPC, blaOXA-48, blaIMP). A blaVIM gene was detected in 6 (30%) out of 20 isolates. FDC demonstrated the greatest activity with 85% (n=17) of susceptible isolates (CLSI MIC &lt;4µg/dL). CZA (CLSI MIC &lt;8µg/dL) and I/R (FDA MIC &lt;2µg/dL) showed 15% (n=3) and 10% (n=2) of susceptible isolates respectively. FDC was active against all 6 blaVIM isolates, where all 6 strains were resistant to CZA and I/R as expected. 3 isolates tested non-susceptible against FDC; additional characterization was not performed at this time. Conclusion Based on these results, FDC demonstrated the greatest in-vitro activity against C/T resistant strains of MDR P. aeruginosa. FDC also demonstrated activity against all 6 MDR P. aeruginosa carrying blaVIM gene. FDC is a strong option to consider on MDR P. aeruginosa strains based on a resistance testing algorithm and a cost/effective protocol. Disclosures All Authors: No reported disclosures

scholarly journals Heterogeneity of Salmonella isolates obtained from various sources in Russia 2010–2019

2020 ◽  
Vol 25 (1) ◽  
pp. 26-34
Author(s):  
Sofia Sh. Rozhnova ◽  
Konstantin V. Kuleshov ◽  
Anastasia S. Pavlova ◽  
Anna N. Guseva ◽  
Tatiana A. Kozhakhmetova ◽  
...  
Keyword(s):  
Gel Electrophoresis ◽  
Regional Differences ◽  
Significant Proportion ◽  
Pulsed Field Gel Electrophoresis ◽  
Clinical Samples ◽  
Pork Meat ◽  
Salmonella Spp ◽  
The Russian Federation ◽  
Meat Samples ◽  
Transmission Factors

Aim: the goal of the study was to evaluate the heterogeneity of the Salmonella enterica subsp. enterica strains isolated from clinical specimens and various environmental sources in the Russian Federation during the period 20112019. Materials and methods. The data of 3076 non-typhoid isolates of Salmonella obtained from sporadic and outbreak cases of salmonellosis (n = 2518), food and water samples (n = 558) were used. These isolates were serotyped according to the KaufmanWhite scheme and genotyped by Pulsed-Field Gel Electrophoresis (PFGE) using XbaI and BlnI restriction endonucleases according to a standard PFGE-protocol developed by PulseNet International Network. Results. The studied Salmonella isolates were differentiated into 73 serotypes and 601 PFGE types. A comparative analysis of isolates from various sources made it possible to identify subtypes that differed significantly in their prevalence in humans and potential transmission factors (sources). A significant proportion of chicken, turkey, and pork meat samples contained PFGE-subtypes which did not occur in clinical samples. Regional differences in the heterogeneity of the Salmonella spp. were also identified. Conclusions. Genetic heterogeneity of the Salmonella population from humans and other sources shows significant variability of virulent properties and indicates the necessity of differentiated assessment of their epidemiological potential.

scholarly journals Detection of the Philadelphia chromosome in acute lymphoblastic leukemia by pulsed-field gel electrophoresis

Blood ◽  
1989 ◽  
Vol 74 (3) ◽  
pp. 1101-1107 ◽  
Author(s):  
AL Hooberman ◽  
CM Rubin ◽  
KP Barton ◽  
CA Westbrook
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Gel Electrophoresis ◽  
Chromosomal Abnormalities ◽  
Lymphoblastic Leukemia ◽  
Philadelphia Chromosome ◽  
Pulsed Field Gel Electrophoresis ◽  
Myelogenous Leukemia ◽  
Clinical Samples ◽  
Pulsed Field ◽  
Translocation Breakpoints

Abstract The Philadelphia (Ph1) chromosome is an acquired abnormality in the malignant cells of 10% to 25% of patients with acute lymphoblastic leukemia (ALL). Unlike chronic myelogenous leukemia (CML), where the molecular detection of the Ph1 chromosome is relatively straightforward using conventional Southern hybridization analysis, the detection of the Ph1 chromosome in ALL is complicated by the existence of several molecular subtypes, and the fact that translocation breakpoints are dispersed over a large genomic area. To circumvent these difficulties, we investigated pulsed-field gel electrophoresis (PFGE) to determine if this method could be used directly on clinical samples to detect the Ph1 chromosome in ALL. We report that, in a study of seven patients with Ph1-positive ALL, we could easily detect the Ph1 using only a single PFGE analysis, regardless of the Ph1 subtype, and we could confirm that the translocations occur either within or very near the BCR gene in all seven. We conclude that PFGE is a useful technique for the detection of the Ph1 in ALL, which ultimately may find wide applicability in the detection of other chromosomal abnormalities in other malignancies.

An Outbreak of Mupirocin-ResistantStaphylococcus aureuson a Dermatology Ward Associated with an Environmental Reservoir

1993 ◽  
Vol 14 (7) ◽  
pp. 369-375 ◽  
Author(s):  
Marcelle C. Layton ◽  
Maritza Perez ◽  
Peter Heald ◽  
Jan Evans Patterson
Keyword(s):  
Blood Pressure ◽  
Dna Typing ◽  
Epidemiologic Study ◽  
Pulsed Field Gel Electrophoresis ◽  
University Hospital ◽  
Blood Pressure Cuff ◽  
Pressure Cuff ◽  
Environmental Reservoir ◽  
Communal Areas ◽  
Present On Admission

AbstractObjective:To investigate a cluster of mupirocin-resistantStaphylococcus aureuson a dermatology ward.Design:An outbreak of mupirocin-resistantSaureus was noted on the dermatology ward during a prospective epidemiologic study of methicillin-resistantS aureus(MRSA) and borderline methicillin-susceptibleS aureus(BMSSA). Pulsed-field gel electrophoresis (PFGE) of whole-cell DNA digested with Sma I was used as a marker of strain identity.Setting and Patients:An 850-bed university hospital with a 12-bed inpatient dermatology ward. Most patients have severe, exfoliating dermatologic disorders.Results:MRSA or BMSSA were isolated from 13 patients on the dermatology ward over a 14-month period. Eleven of these isolates (84.6%) were mupirocin-resistant. Nine isolates were present on admission (81.8%); 8 of these patients had been hospitalized on the same ward within the last two months. Nasal and hand cultures from 36 personnel were negative for mupirocin-resistant MRSA or BMSSA. Extensive environmental culturing revealed that a blood pressure cuff and the patients' communal shower were positive for mupirocin-resistant BMSSA. PFGE of all mupirocin-resistant isolates demonstrated that the nine patients and both environmental sources had identical DNA typing patterns.Interventions:Changing of blood pressure cuffs between patients and more stringent cleaning of communal areas was initiated. Repeat environmental cultures were negative.Conclusions:S aureusis not usually associated with an environmental reservoir; however, these patients all had severe desquamation, which may have prolonged environmental contamination.

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