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.

scholarly journals DEKONTAMINASI DAN PEMBERSIHAN AKHIR (TERMINAL CLEANING) DI LINGKUNGAN ICU (Intensive Care Unit)

Medicinus ◽  
2018 ◽  
Vol 4 (9) ◽  
Author(s):  
Cucunawangsih Cucunawangsih
Keyword(s):  
Intensive Care Unit ◽  
Beta Lactamase ◽  
Healthcare Associated Infection ◽  
Extended Spectrum Beta Lactamase ◽  
Vancomycin Resistant Enterococci ◽  
Acinetobacter Spp ◽  
Vancomycin Resistant ◽  
Healthcare Associated ◽  
Hospital Acquired ◽  
Hydrogen Peroxide Vapor

<p>Patogen MDRO, seperti vancomycin-resistant enterococci (VRE), methicillin-resistant <em>Staphylococcus aureus</em> (MRSA), <em>Acinetobacter spp.</em>, <em>extended spectrum beta-lactamase</em> (<em>ESBL</em>)-producing bacteria, dan <em>Clostridium defficile </em>seringkali menyebabkan kolonisasi/<em>healthcare-associated infection</em> (HAI) di lingkungan ICU. Sejumlah penelitian membuktikan bahwa petugas kesehatan menularkan pathogen ini melalui kontak langsung dengan tangan atau sarung tangan setelah menyentuh permukaan yang terkontaminasi atau pasien. Lingkungan berperan penting pada penyebaran <em>hospital-acquired pathogens</em> (HAP) dan terjadinya HAI. Metode pembersihan dan dekontaminasi rutin yang telah diterapkan dan dilakukan di lingkungan rumah sakit seringkali gagal ataupun tidak efektif dalam menggurangi penyebaran patogen MDRO. Kegagalan ini disebabkan tidak seluruh permukaan medis dan rumahtangga yang seringkali tersentuh tidak terdekontaminasi dengan sempurna. Untuk itu diperlukan tindakan lanjutan berupa pembersihan terminal menggunakan metode baru, seperti (1) hydrogen peroxide vapor (HPV) dan (2) sinar UV yang telah terbukti efektif secara mikrobiologi, aman dan mudah digunakan.</p>

scholarly journals PREVALENCE AND CHARACTERISTIC MULTIDRUG RESISTANT ORGANISMS (MDRO) in INTENSIVE CARE UNIT OF Dr. WAHIDIN SUDIROHUSODO HOSPITAL MAKASSAR

2019 ◽  
Vol 25 (3) ◽  
pp. 323
Author(s):  
Sitti Khadijah ◽  
Irda Handayani ◽  
Nurhayana Sennang
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Burn Injury ◽  
Medical Officer ◽  
Multidrug Resistant ◽  
Extended Spectrum Beta Lactamase ◽  
Multidrug Resistant Organisms ◽  
Vancomycin Resistant

INTRODUCTIONAntibiotic is antibacterial substance produced by microorganisms which is supress other organisms growth. First antibiotic (penicillin) was found in 1928 by Alexander Fleming,who is a microbiologist from England. In 1930, penicillin begins given to infected patient. However, there is a resistant to penicillin called penicillinase.Antibiotic resistant is an increase of bacteria ability to antibiotic which is given. This cause bacteria does not responsive to antibiotic. When this organisms spread in community will threaten people and emerge new infection,which is more difficult to cure and increase cost of treatment. It will prolong patient’s length of stay, and increase mortality rates.Multidrug resistant organisms is microorganisms, most of it is bacteria, resistant to one or more class of antibiotic. In spite of, term of certain MDRO describe to resistant of one agent. For example, methicillin resistant Staphylococcus aureus (MRSA), vancomycin resistant Enterococcus (VRE), Vancomycin resistant Staphylococcus aureus (VRSA) dan Multidrug resistant Acinetobacter baumannii (MDRAB). These patogens are resistant to antimicrobe agent often used. This high resistant organisms necesssary to be more noticed in healthcare facilities. Except MRSA and VRE, there is other kind of MDRO such as Enterobacteriaceae produces- Extended spectrum beta-lactamase (ESBL) dan Klabsiella penumoniae carbapenemase producer (KPC). Multidrug resistant organisms implicates significant to infection management which is not found yet whether only limited handle based on prior isolation manual.Statistical data showed that prevalence of MDRO in Indonesia increases every year. Prevalence of MRSA in 1986 is 2,5% dan increased to 23,5% in 2006. Prevalence of Enterobacteriaceaeproduces ESBL in Harapan Kita hospital gain 16% which main caused in pediatric intensive care unit (PICU) is Klebsiella pneumoniae (14%) and second most agent caused is E. Coli (19%) (Winarto,2009). There was a research study in 2010 about Staphylococcus aureus sensitivity to vancomycin in Margono Soekarjo Purwokerto Hospital, Jawa Tengah, and it was found VRSA in 10 from 60 samples (15,6%) by stetoscope membrane. In United States by year 2000, it was 25,9% Enterococcus isolated by blood samples proved that resistant to vancomycin.Hospitalcare facilities are very vary by physical and functional characteristics of intensive care unit, burn injury unit, neonatal intensive care unit (NICU). A patient maybe infected to MDRO. A patient who had been infected may contaminate the infection to others sick or healthy people. Medical officer maybe one of elemen risk spreading infection when they ignore the rules of infection precaution and five moments handwash. Five moments consist of before contact to patient, before doing a patient, after doing a patient, after contact to patient, and after contact to patient’s neighbourhood.

scholarly journals Multidrug-Resistant, Including Extended-Spectrum Beta Lactamase-Producing and Quinolone-Resistant, Escherichia coli Isolated from Poultry and Domestic Pigs in Dar es Salaam, Tanzania

Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 406
Author(s):  
Zuhura I. Kimera ◽  
Fauster X. Mgaya ◽  
Gerald Misinzo ◽  
Stephen E. Mshana ◽  
Nyambura Moremi ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Multidrug Resistant ◽  
Antibiotics Resistance ◽  
Beta Lactamase ◽  
Domestic Pigs ◽  
Extended Spectrum Beta Lactamase ◽  
Phenotypic Profile ◽  
E Coli ◽  
Extended Spectrum ◽  
Esbl Producers

We determined the phenotypic profile of multidrug-resistant (MDR) Escherichia coli isolated from 698 samples (390 and 308 from poultry and domestic pigs, respectively). In total, 562 Enterobacteria were isolated. About 80.5% of the isolates were E. coli. Occurrence of E. coli was significantly higher among domestic pigs (73.1%) than in poultry (60.5%) (p = 0.000). In both poultry and domestic pigs, E. coli isolates were highly resistant to tetracycline (63.5%), nalidixic acid (53.7%), ampicillin (52.3%), and trimethoprim/sulfamethoxazole (50.9%). About 51.6%, 65.3%, and 53.7% of E. coli were MDR, extended-spectrum beta lactamase-producing enterobacteriaceae (ESBL-PE), and quinolone-resistant, respectively. A total of 68% of the extended-spectrum beta lactamase (ESBL) producers were also resistant to quinolones. For all tested antibiotics, resistance was significantly higher in ESBL-producing and quinolone-resistant isolates than the non-ESBL producers and non-quinolone-resistant E. coli. Eight isolates were resistant to eight classes of antimicrobials. We compared phenotypic with genotypic results of 20 MDR E. coli isolates, ESBL producers, and quinolone-resistant strains and found 80% harbored blaCTX-M, 15% aac(6)-lb-cr, 10% qnrB, and 5% qepA. None harbored TEM, SHV, qnrA, qnrS, qnrC, or qnrD. The observed pattern and level of resistance render this portfolio of antibiotics ineffective for their intended use.

scholarly journals A nosocomial cluster of vancomycin resistant enterococci among COVID-19 patients in an intensive care unit

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Stefanie Kampmeier ◽  
Hauke Tönnies ◽  
Carlos L. Correa-Martinez ◽  
Alexander Mellmann ◽  
Vera Schwierzeck
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Prevention ◽  
Control Measures ◽  
Whole Genome Sequence ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Healthcare Associated

Abstract Background Currently, hospitals have been forced to divert substantial resources to cope with the ongoing coronavirus disease 2019 (COVID-19) pandemic. It is unclear if this situation will affect long-standing infection prevention practices and impact on healthcare associated infections. Here, we report a nosocomial cluster of vancomycin-resistant enterococci (VRE) that occurred on a COVID-19 dedicated intensive care unit (ICU) despite intensified contact precautions during the current pandemic. Whole genome sequence-based typing (WGS) was used to investigate genetic relatedness of VRE isolates collected from COVID-19 and non-COVID-19 patients during the outbreak and to compare them to environmental VRE samples. Methods Five VRE isolated from patients (three clinical and two screening samples) as well as 11 VRE and six vancomycin susceptible Enterococcus faecium (E. faecium) samples from environmental sites underwent WGS during the outbreak investigation. Isolate relatedness was determined using core genome multilocus sequence typing (cgMLST). Results WGS revealed two genotypic distinct VRE clusters with genetically closely related patient and environmental isolates. The cluster was terminated by enhanced infection control bundle strategies. Conclusions Our results illustrate the importance of continued adherence to infection prevention and control measures during the COVID-19 pandemic to prevent VRE transmission and healthcare associated infections.

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