Multidrug Resistance among Gram-Negative Pathogens That Caused Healthcare-Associated Infections Reported to the National Healthcare Safety Network, 2006–2008

2010 ◽  
Vol 31 (05) ◽  
pp. 528-531 ◽  
Author(s):  
Alexander J. Kallen ◽  
Alicia I. Hidron ◽  
Jean Patel ◽  
Arjun Srinivasan
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Multidrug Resistance ◽  
Klebsiella Pneumoniae ◽  
Acinetobacter Baumannii ◽  
Multidrug Resistant ◽  
Healthcare Associated Infections ◽  
Gram Negative ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Healthcare Associated

We evaluated isolates of Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii that were reported to the National Healthcare Safety Network from January 2006 through December 2008 to determine the proportion that represented multidrug-resistant phenotypes. The pooled mean percentage of resistance varied by the definition used; however, multidrug resistance was relatively common and widespread.

scholarly journals Antimicrobial-Resistant Pathogens Associated with Healthcare-Associated Infections Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2009–2010

2013 ◽  
Vol 34 (1) ◽  
pp. 1-14 ◽  
Author(s):  
Dawn M. Sievert ◽  
Philip Ricks ◽  
Jonathan R. Edwards ◽  
Amy Schneider ◽  
Jean Patel ◽  
...  
Keyword(s):  
Antimicrobial Agents ◽  
Klebsiella Oxytoca ◽  
Multidrug Resistant ◽  
Healthcare Associated Infections ◽  
Gram Negative ◽  
E Coli ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Tract Infections ◽  
Healthcare Associated

Objective.To describe antimicrobial resistance patterns for healthcare-associated infections (HAIs) reported to the National Healthcare Safety Network (NHSN) during 2009-2010.Methods.Central line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated pneumonia, and surgical site infections were included. Pooled mean proportions of isolates interpreted as resistant (or, in some cases, nonsusceptible) to selected antimicrobial agents were calculated by type of HAI and compared to historical data.Results.Overall, 2,039 hospitals reported 1 or more HAIs; 1,749 (86%) were general acute care hospitals, and 1,143 (56%) had fewer than 200 beds. There were 69,475 HAIs and 81,139 pathogens reported. Eight pathogen groups accounted for about 80% of reported pathogens: Staphylococcus aureus (16%), Enterococcus spp. (14%), Escherichia coli (12%), coagulase-negative staphylococci (11%), Candida spp. (9%), Klebsiella pneumoniae (and Klebsiella oxytoca; 8%), Pseudomonas aeruginosa (8%), and Enterobacter spp. (5%). The percentage of resistance was similar to that reported in the previous 2-year period, with a slight decrease in the percentage of S. aureus resistant to oxacillins (MRSA). Nearly 20% of pathogens reported from all HAIs were the following multidrug-resistant phenotypes: MRSA (8.5%); vancomycin-resistant Enterococcus (3%); extended-spectrum cephalosporin-resistant K. pneumoniae and K. oxytoca (2%), E. coli (2%), and Enterobacter spp. (2%); and carbapenem-resistant P. aeruginosa (2%), K. pneumoniae/oxytoca (<1%), E, coli (<1%), and Enterobacter spp. (<1%). Among facilities reporting HAIs with 1 of the above gram-negative bacteria, 20%-40% reported at least 1 with the resistant phenotype.Conclusion.While the proportion of resistant isolates did not substantially change from that in the previous 2 years, multidrug-resistant gram-negative phenotypes were reported from a moderate proportion of facilities.

scholarly journals Global Assessment of the Activity of Tigecycline against Multidrug-Resistant Gram-Negative Pathogens between 2004 and 2014 as Part of the Tigecycline Evaluation and Surveillance Trial

mSphere ◽  
2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Anna Giammanco ◽  
Cinzia Calà ◽  
Teresa Fasciana ◽  
Michael J. Dowzicky
Keyword(s):  
Health Care ◽  
Pseudomonas Aeruginosa ◽  
Multidrug Resistance ◽  
Acinetobacter Baumannii ◽  
Multidrug Resistant ◽  
Current Status ◽  
Gram Negative ◽  
Content Type ◽  
Trial Test

ABSTRACT Multidrug resistance among bacterial pathogens is an ongoing global problem and renders antimicrobial agents ineffective at treating bacterial infections. In the health care setting, infections caused by multidrug-resistant (MDR) Gram-negative bacteria can cause increased mortality, longer hospital stays, and higher treatments costs. The aim of the Tigecycline Evaluation and Surveillance Trial (TEST) is to assess the in vitro antimicrobial activities of tigecycline and other contemporary agents against clinically relevant pathogens. This paper presents antimicrobial activity data from the TEST study between 2004 and 2014 and examines global rates of MDR Gram-negative isolates, including Acinetobacter baumannii, Pseudomonas aeruginosa, and members of the Enterobacteriaceae, during this time. Our results show that tigecycline retained in vitro activity against many MDR Gram-negative pathogens over the study period, while rates of MDR A. baumannii increased globally. Using these findings, we hope to highlight the current status of multidrug resistance in medical facilities worldwide. Multidrug-resistant (MDR) Gram-negative organisms are a burden on the global health care system. The Tigecycline Evaluation and Surveillance Trial (TEST) is an ongoing global study designed to monitor the in vitro activities of tigecycline and a panel of marketed antimicrobials against a range of clinically significant pathogens. In this study, in vitro data are presented for MDR Acinetobacter baumannii, Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter aerogenes, and Enterobacter cloacae isolates collected from 2004 to 2014. In total, 13% (21,967/170,759) of isolates displayed multidrug resistance globally, with the highest rates recorded among A. baumannii (overall rate, 44% [8,294/18,741], increasing from 23% [309/1,323] in 2004 to 63% [447/712] in 2014). Other multidrug resistance rates ranged from 2.5% for K. oxytoca (203/8,000) to 12% for P. aeruginosa and K. pneumoniae (3,951/32,786 and 3,895/32,888, respectively), and rates among these pathogens remained stable during the study period. Against MDR E. coli, Klebsiella spp., and E. aerogenes, the lowest rates of resistance were to tigecycline (0.2%, 6%, and 12%, respectively), and the lowest MIC90 value against A. baumannii was observed for tigecycline (2 mg/liter; MIC range, ≤0.008 to ≥32 mg/liter). The only significant change in resistance to tigecycline during the study period was for MDR E. coli (P < 0.01), among which eight resistant isolates were identified globally from 2009 to 2013. In summary, these results show that tigecycline retained in vitro activity against the majority of MDR Gram-negative organisms presented here, but the rising rates of MDR A. baumannii highlight the need for the continued monitoring of global multidrug resistance. IMPORTANCE Multidrug resistance among bacterial pathogens is an ongoing global problem and renders antimicrobial agents ineffective at treating bacterial infections. In the health care setting, infections caused by multidrug-resistant (MDR) Gram-negative bacteria can cause increased mortality, longer hospital stays, and higher treatments costs. The aim of the Tigecycline Evaluation and Surveillance Trial (TEST) is to assess the in vitro antimicrobial activities of tigecycline and other contemporary agents against clinically relevant pathogens. This paper presents antimicrobial activity data from the TEST study between 2004 and 2014 and examines global rates of MDR Gram-negative isolates, including Acinetobacter baumannii, Pseudomonas aeruginosa, and members of the Enterobacteriaceae, during this time. Our results show that tigecycline retained in vitro activity against many MDR Gram-negative pathogens over the study period, while rates of MDR A. baumannii increased globally. Using these findings, we hope to highlight the current status of multidrug resistance in medical facilities worldwide.

scholarly journals Geraniol Restores Antibiotic Activities against Multidrug-Resistant Isolates from Gram-Negative Species

2009 ◽  
Vol 53 (5) ◽  
pp. 2209-2211 ◽  
Author(s):  
Vannina Lorenzi ◽  
Alain Muselli ◽  
Antoine François Bernardini ◽  
Liliane Berti ◽  
Jean-Marie Pagès ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Multidrug Resistance ◽  
Essential Oil ◽  
Acinetobacter Baumannii ◽  
Enterobacter Aerogenes ◽  
Multidrug Resistant ◽  
Synergistic Activity ◽  
Gram Negative

ABSTRACT The essential oil of Helichrysum italicum significantly reduces the multidrug resistance of Enterobacter aerogenes, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii. Combinations of the two most active fractions of the essential oil with each other or with phenylalanine arginine β-naphthylamide yield synergistic activity. Geraniol, a component of one fraction, significantly increased the efficacy of β-lactams, quinolones, and chloramphenicol.

scholarly journals Current Pattern and Clinico-Bacteriological Profile of Healthcare Associated Infections (HAI) in an ICU Setting: An Observational Study

2021 ◽  
Author(s):  
Mradul Kumar Daga ◽  
Govind Mawari ◽  
Saman Wasi ◽  
Naresh Kumar ◽  
Udbhav Sharma ◽  
...  
Keyword(s):  
Age Groups ◽  
Healthcare Facility ◽  
Central Line ◽  
Multidrug Resistant ◽  
Gram Negative Bacteria ◽  
Healthcare Associated Infections ◽  
Acinetobacter Species ◽  
Gram Negative ◽  
Causative Agents ◽  
Healthcare Associated

Abstract Objective To understand the pattern and types of healthcare associated infections (HAI) at our healthcare facility, and to determine the common causative agents and their antibiotic susceptibility profile. Methods One hundred consecutive patients diagnosed with HAI were enrolled and monitored; the causative organisms isolated on culture were recorded and their sensitivity profile was generated. Results Of the 100 patients diagnosed with HAI (mean age ± SD being 42 ± 17 years), there were a total of 110 hospital acquired infections with 10 patients having two infections each. Out of 100 patients with HAI, 69 patients had ventilator associated pneumonia (VAP), 21 patients had catheter associated urinary tract infection (CAUTI) patients, and 20 patients had central line associated bloodstream infection (CLABSI). There were 10 patients with both VAP and CAUTI. All of the HAIs were device associated. A total of 76 pathogens were isolated on culture. No organism was isolated in 40 HAI. Majority (94.7%) of the organisms isolated from HAIs were gram-negative bacteria and all were multidrug resistant. Seventy-seven of the enrolled patients expired while 23 were discharged from the hospital Conclusions Our study demonstrated that HAIs occur in patients of all age groups; younger patients are not spared. Majority of the HAIs were caused by multidrug resistant gram-negative bacteria and were associated with high patient mortality. Acinetobacter species was the most common organism associated with HAI.

scholarly journals In VitroActivity of RX-P873 against Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter baumannii

2015 ◽  
Vol 59 (4) ◽  
pp. 2280-2285 ◽  
Author(s):  
Robert K. Flamm ◽  
Paul R. Rhomberg ◽  
Ronald N. Jones ◽  
David J. Farrell
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Acinetobacter Baumannii ◽  
Active Agent ◽  
Multidrug Resistant ◽  
Surveillance Program ◽  
Gram Negative ◽  
Content Type ◽  
Highly Active ◽  
Bacterial Ribosome

ABSTRACTRX-P873 is a novel antibiotic from the pyrrolocytosine series which exhibits high binding affinity for the bacterial ribosome and broad-spectrum antibiotic properties. The pyrrolocytosines have shownin vitroactivity against multidrug-resistant Gram-negative and Gram-positive strains of bacteria known to cause complicated urinary tract, skin, and lung infections, as well as sepsis.Enterobacteriaceae(657),Pseudomonas aeruginosa(200), andAcinetobacter baumannii(202) isolates from North America and Europe collected in 2012 as part of a worldwide surveillance program were testedin vitroby broth microdilution using Clinical and Laboratory Standards Institute (CLSI) methodology. RX-P873 (MIC90, 0.5 μg/ml) was >32-fold more active than ceftazidime and inhibited 97.1% and 99.5% ofEnterobacteriaceaeisolates at MIC values of ≤1 and ≤4 μg/ml, respectively. There were only three isolates with an MIC value of >4 μg/ml (all were indole-positiveProtea). RX-P873 (MIC50/90, 2/4 μg/ml) was highly active againstPseudomonas aeruginosaisolates, including isolates which were nonsusceptible to ceftazidime or meropenem. RX-P873 was 2-fold less active againstP. aeruginosathan tobramycin (MIC90, 2 μg/ml; 91.0% susceptible) and colistin (MIC90, 2 μg/ml; 99.5% susceptible) and 2-fold more potent than amikacin (MIC90, 8 μg/ml; 93.5% susceptible) and meropenem (MIC90, 8 μg/ml; 76.0% susceptible). RX-P873, the most active agent againstAcinetobacter baumannii(MIC90, 1 μg/ml), was 2-fold more active than colistin (MIC90, 2 μg/ml; 97.0% susceptible) and 4-fold more active than tigecycline (MIC90, 4 μg/ml). This novel agent merits further exploration of its potential against multidrug-resistant Gram-negative bacteria.

Persisting intrahospital transmission of multidrug-resistant Klebsiella pneumoniae and challenges for infection control

2019 ◽  
Vol 40 (8) ◽  
pp. 904-909 ◽  
Author(s):  
Isabelle Vock ◽  
Sarah Tschudin-Sutter
Keyword(s):  
Klebsiella Pneumoniae ◽  
Infection Control ◽  
Multidrug Resistant ◽  
Global Scale ◽  
Resistance Mechanisms ◽  
Healthcare Associated Infections ◽  
The Past ◽  
Healthcare Settings ◽  
Healthcare Associated ◽  
Antibiotic Agents

AbstractIn the past several decades, the incidence of Klebsiella pneumoniae harboring resistance mechanisms against multiple antibiotic agents has increased on a global scale. We discuss reasons for ongoing transmission of multidrug-resistant K. pneumoniae in healthcare settings, which has resulted in the successful spread and establishment of this pathogen. It is now one of the most important causes of healthcare-associated infections worldwide.

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