Emergence of Multidrug Resistance in Bacteria and Impact on Antibiotic Expenditure at a Major Army Medical Center Caring for Soldiers Wounded in Iraq and Afghanistan

2008 ◽  
Vol 29 (7) ◽  
pp. 661-663 ◽  
Author(s):  
Michael J. Zapor ◽  
Daniel Erwin ◽  
Goldina Erowele ◽  
Glenn Wortmann
Keyword(s):  
Medical Center ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Walter Reed Army Medical ◽  
Gram Negative Bacteria ◽  
Drug Resistant ◽  
Gram Negative ◽  
Army Medical ◽  
Resistant Strains ◽  
Drug Resistant Strains

Since the invasions of Iraq and Afghanistan, the epidemiologic traits of clinical isolates at Walter Reed Army Medical Center have shifted toward drug-resistant strains of microorganisms, particularly among the gram-negative bacteria. Moreover, antibiotic prescribing patterns during this period have changed remarkably and mirror the emergence of these organisms at our institution.

scholarly journals Nosocomial klebsiellas: I. Colonization of hospitalized patients

1979 ◽  
Vol 82 (2) ◽  
pp. 177-193 ◽  
Author(s):  
Michael L. Haverkorn ◽  
M. F. Michel
Keyword(s):  
Gram Negative Bacteria ◽  
Drug Resistant ◽  
Biochemical Tests ◽  
Survey Period ◽  
Antibiotic Resistant ◽  
Gram Negative ◽  
Epidemiological Tool ◽  
Resistant Strains ◽  
Drug Resistant Strains ◽  
Systemic Antibiotics

SUMMARYThe colonization of patients byKlebsiellaand several other gram-negative bacteria was studied in a hospital urological ward over a period of six months. Before and during the survey there was no evidence of an outbreak of nosocomial infection and multi-drug resistant strains ofKlebsiellawere not isolated.Klebsiellawere biotyped by nine biochemical tests, which led to the detection of 66 biotypes spread uniformly throughout the survey period. This method of biotyping proved a useful epidemiological tool. The colonization rate of throats, hands, and faeces of patients increased after admission to the ward, especially when antibiotics were used. The effect of systemic antibiotics was greater than that of urinary antibiotics especially on throat and faeces carrier rates. Carrier rates forKlebsiellaincreased also after catheterization and operation – relationships which could well be multifactorial.During the first two weeks after admission the proportion of antibiotic resistant strains ofKlebsiellain carriers increased. The proportion of resistant strains amongst isolations from clinical infections was always greater than among strains isolated routinely from sites of carriage.

scholarly journals Multidrug resistant, extensively drug resistant and pan drug resistant gram negative bacteria at a tertiary care centre in Bhubaneswar

2019 ◽  
Vol 6 (2) ◽  
pp. 567 ◽  
Author(s):  
Dipti Pattnaik ◽  
Subhra Snigdha Panda ◽  
Nipa Singh ◽  
Smrutilata Sahoo ◽  
Ipsa Mohapatra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Drug Resistant ◽  
Gram Negative ◽  
Extensively Drug Resistant ◽  
Resistant Strains ◽  
Drug Resistant Strains ◽  
Esbl Producers

Background: Multidrug resistance has emerged as a challenge in health care settings. Again increasing prevalence of multidrug resistant (MDR), extensively drug resistant (XDR) and pan drug resistant (PDR) gram negative bacteria is making the condition more critical because of limited options of antibiotics, increasing morbidity, mortality and hospital stay of the patients. The present study is carried out with an aim to estimate the prevalence of MDR, XDR, PDR gram negative bacteria in a tertiary care hospital.Methods: Total of 912 gram negative bacterial isolates obtained from various samples of indoor patients in a tertiary care hospital, were studied over a period of six months. The bacteria were identified by conventional methods. Antibiotic sensitivity testing was done by Kirby Bauer disc diffusion method. Minimum inhibitory concentration (MIC) of antibiotics for the resistant isolates were detected by Vitek-2 automated method. MDR, XDR and PDR were determined according to the definitions suggested by European Centre for Disease Prevention and Control (ECDC), and Centers for Disease Control and Prevention (CDC). Prevalence of extended spectrum beta lactamase (ESBL) producers was estimated.Results: Out of 912 isolates, prevalence of MDR, XDR and PDR were 66.12%, 34.32% and 0.98% respectively. Prevalence of MDR and XDR were higher in ICUs than clinical wards (p<0.0001). Prevalence of ESBL producers was 48.4%.Conclusions: The study highlights increased prevalence of multidrug resistant and extensively drug resistant strains in our hospital. Stringent surveillance, proper implementation of hospital infection control practices and antimicrobial stewardship will help in limiting the emergence and spread of drug resistant strains.

scholarly journals The activity of a mammalian proline-rich peptide against Gram-negative bacteria, including drug-resistant strains, relies on a nonmembranolytic mode of action

2018 ◽  
Vol Volume 11 ◽  
pp. 969-979 ◽  
Author(s):  
Tecla Ciociola ◽  
Laura Giovati ◽  
Angela Giovannelli ◽  
Stefania Conti ◽  
Massimo Castagnola ◽  
...  
Keyword(s):  
Mode Of Action ◽  
Gram Negative Bacteria ◽  
Drug Resistant ◽  
Gram Negative ◽  
Resistant Strains ◽  
Proline Rich Peptide ◽  
Drug Resistant Strains

scholarly journals Cefiderocol Retains Anti-Biofilm Activity in Multi-Drug Resistant Gram-Negative Pathogens

2020 ◽  
Author(s):  
Christine A. Pybus ◽  
Christina Felder-Scott ◽  
Victor Obuekwe ◽  
David E. Greenberg
Keyword(s):  
Antimicrobial Activity ◽  
Ferric Iron ◽  
Potent Inhibitor ◽  
Antimicrobial Properties ◽  
Drug Resistant ◽  
Gram Negative ◽  
Resistant Strains ◽  
Drug Resistant Strains ◽  
Antibiotic Dose ◽  
Antibiotic Combination

Cefiderocol is a siderophore cephalosporin with potent antibacterial activity against a broad range of Gram-negative pathogens, including multi-drug resistant strains. Siderophore antibiotics bind ferric iron and utilize iron transporters to cross the cell membrane. In the biofilm setting, where antibiotic resistance is high but iron scavenging is important, cefiderocol may have advantageous antimicrobial properties. In this study, we compared the antimicrobial activity of cefiderocol to seven commonly used antibiotics in well-characterized multi-drug resistant pathogens, then determined their efficacy in the biofilm setting. MIC90 values were consistently lower for cefiderocol in all strains tested compared to other antibiotics (ceftolozane-tazobactam, ceftazidime-avibactam, ceftazidime, piperacillin-tazobactam, imipenem, tobramycin, clarithromycin). Cefiderocol treatment displayed a superior reduction in Pseudomonas aeruginosa biofilm (93%, p<0.0001) compared to other antibiotics (49-82%). Cefiderocol was generally as effective or superior in reducing biofilm in other pathogens depending on the pathogen-antibiotic combination. There was a trend towards greater biofilm reduction when the antibiotic dose was increased or with increased frequency of antibiotic treatment. We conclude that cefiderocol effectively reduces biofilm and is a potent inhibitor of planktonic growth across a range of Gram-negative medically important pathogens.

scholarly journals 352Clinical and molecular characteristics of NDM-1 harboring Multi-Drug Resistant Gram Negative Bacteria at Carilion Medical Center

2014 ◽  
Vol 1 (suppl_1) ◽  
pp. S139-S140
Author(s):  
Ekta Bansal ◽  
Thomas Kerkering ◽  
Charles Schleupner ◽  
Ritesh Kohli ◽  
Anthony Baffoe ◽  
...  
Keyword(s):  
Medical Center ◽  
Molecular Characteristics ◽  
Gram Negative Bacteria ◽  
Drug Resistant ◽  
Gram Negative

scholarly journals Gonorrhoea: past, present and future

2020 ◽  
Vol 41 (4) ◽  
pp. 205
Author(s):  
Evgeny A Semchenko ◽  
Xiaofan Chen ◽  
Caroline Thng ◽  
Maree O'Sullivan ◽  
Kate L Seib
Keyword(s):  
Bacterial Pathogen ◽  
Health Concern ◽  
Drug Resistant ◽  
Transmitted Infection ◽  
Gram Negative ◽  
Sexually Transmitted ◽  
High Prevalence ◽  
Public Health Threat ◽  
Resistant Strains ◽  
Drug Resistant Strains

The sexually transmitted infection (STI) gonorrhoea is an ancient human disease caused by the Gram-negative bacterial pathogen Neisseria gonorrhoeae. Despite decades of research focused on preventing, diagnosing, and treating gonorrhoea, it remains a major global health concern due to its high prevalence, high rates of asymptomatic cases, the severe sequelae that can result from untreated infections, and the increasing difficulty in treating infections caused by multi-drug resistant strains of N. gonorrhoeae. It is estimated that there are more than 87 million cases of gonorrhoea worldwide each year, and the WHO, CDC and Australian National Antimicrobial Resistance (AMR) Strategy have prioritised N. gonorrhoeae as an urgent public health threat for which new therapeutics and a vaccine are needed.

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