scholarly journals Molecular Analysis of VanA Outbreak ofEnterococcus faeciumin Two Warsaw Hospitals: The Importance of Mobile Genetic Elements

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Ewa Wardal ◽  
Katarzyna Markowska ◽  
Dorota Żabicka ◽  
Marta Wróblewska ◽  
Małgorzata Giemza ◽  
...  
Keyword(s):  
Insertion Sequence ◽  
Molecular Data ◽  
Multidrug Resistant ◽  
Common Source ◽  
Hospital Acquired Infections ◽  
Vancomycin Resistant ◽  
Clonal Variability ◽  
Almost All ◽  
Hospital Acquired ◽  
Vntr Analysis

Vancomycin-resistantEnterococcus faeciumrepresents a growing threat in hospital-acquired infections. Two outbreaks of this pathogen from neighboring Warsaw hospitals have been analyzed in this study. Pulsed-field gel electrophoresis (PFGE) ofSmaI-digested DNA, multilocus VNTR analysis (MLVA), and multilocus sequence typing (MLST) revealed a clonal variability of isolates which belonged to three main lineages (17, 18, and 78) of nosocomialE. faecium. All isolates were multidrug resistant and carried several resistance, virulence, and plasmid-specific genes. Almost all isolates shared the same variant of Tn1546transposon, characterized by the presence of insertion sequence ISEf1and a point mutation in thevanAgene. In the majority of cases, this transposon was located on 50 kb or 100 kb pRUM-related plasmids, which lacked, however, theaxe-txetoxin-antitoxin genes. 100 kb plasmid was easily transferred by conjugation and was found in various clonal backgrounds in both institutions, while 50 kb plasmid was not transferable and occurred solely in MT159/ST78 strains that disseminated clonally in one institution. Although molecular data indicated the spread of VRE between two institutions or a potential common source of this alert pathogen, epidemiological investigations did not reveal the possible route by which outbreak strains disseminated.

Infection Control in the Era of Antimicrobial Resistance in China: Progress, Challenges, and Opportunities

2020 ◽  
Vol 71 (Supplement_4) ◽  
pp. S372-S378
Author(s):  
Zhiyong Zong ◽  
Anhua Wu ◽  
Bijie Hu
Keyword(s):  
Infection Control ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Multidrug Resistant ◽  
Building Capacity ◽  
Carbapenem Resistant ◽  
Challenges And Opportunities ◽  
Vancomycin Resistant ◽  
Almost All ◽  
Hospital Acquired ◽  
Established Infection

Abstract More than 3 decades have passed since infection control was implemented nationwide in China in 1986. A comprehensive set of regulations and guidelines has been developed, and almost all hospitals have established infection control teams. However, compliance is variable and is usually suboptimal. The incidence of certain multidrug-resistant organisms (MDROs), including carbapenem-resistant Acinetobacter baumannii (CRAB) and carbapenem-resistant Klebsiella pneumoniae (CRKP), is increasing, and associated infections are mainly hospital-acquired in China. Carbapenem-resistant Pseudomonas aeruginosa has remained relatively stable, whereas methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterobacter faecium have been decreasing. The spread of CRAB and CRKP in China is largely mediated by dominant high-risk lineages, namely, clonal complex 92 for CRAB and sequence type 11 for CRKP. However, challenges owing to MDROs bring opportunities for rethinking, taking coordinated action, building capacity, changing behavior, and performing studies that reflect everyday situations in the Chinese healthcare system.

scholarly journals Complete Genome Sequence of Klebsiella pneumoniae Phage Sweeny

2019 ◽  
Vol 8 (39) ◽  
Author(s):  
Nicholas Martinez ◽  
Eric Williams ◽  
Heather Newkirk ◽  
Mei Liu ◽  
Jason J. Gill ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Complete Genome Sequence ◽  
Protein Level ◽  
Multidrug Resistant ◽  
Content Type ◽  
Hospital Acquired Infections ◽  
Multidrug Resistant Bacterium ◽  
Protein Encoding ◽  
Hospital Acquired ◽  
Encoding Genes

Klebsiella pneumoniae is a multidrug-resistant bacterium causing many severe hospital-acquired infections. Here, we describe siphophage Sweeny that infects K. pneumoniae. Of its 78 predicted protein-encoding genes, a functional assignment was given to 36 of them. Sweeny is most closely related to T1-like phages at the protein level.

scholarly journals Hospital-acquired infections due to multidrug-resistant organisms in Hungary, 2005-2010

2013 ◽  
Vol 18 (2) ◽  
Author(s):  
S Caini ◽  
A Hajdu ◽  
A Kurcz ◽  
K Böröcz
Keyword(s):  
Infection Control ◽  
Multidrug Resistant ◽  
Special Focus ◽  
Gram Negative ◽  
Hospital Acquired Infections ◽  
Health Authorities ◽  
Multidrug Resistant Organisms ◽  
Public Health Authorities ◽  
Gram Negative Organisms ◽  
Hospital Acquired

Healthcare-associated infections caused by multidrug-resistant organisms are associated with prolonged medical care, worse outcome and costly therapies. In Hungary, hospital-acquired infections (HAIs) due to epidemiologically important multidrug-resistant organisms are notifiable by law since 2004. Overall, 6,845 case-patients (59.8% men; median age: 65 years) were notified in Hungary from 2005 to 2010. One third of case-patients died in hospital. The overall incidence of infections increased from 5.4 in 2005 to 14.7 per 100,000 patient-days in 2010. Meticillin-resistant Staphylococcus aureus (MRSA) was the most frequently reported pathogen (52.2%), but while its incidence seemed to stabilise after 2007, notifications of multidrug-resistant Gram-negative organisms have significantly increased from 2005 to 2010. Surgical wound and bloodstream were the most frequently reported sites of infection. Although MRSA incidence has seemingly reached a plateau in recent years, actions aiming at reducing the burden of HAIs with special focus on Gram-negative multidrug-resistant organisms are needed in Hungary. Continuing promotion of antimicrobial stewardship, infection control methodologies, reinforced HAI surveillance among healthcare and infection control practitioners, and engagement of stakeholders, hospital managers and public health authorities to facilitate the implementation of existing guidelines and protocols are essential.

Electrical Impedance Spectroscopy as a Powerful Analytical Tool for Monitoring Microbiological Growth on Medical Implants

2008 ◽  
pp. 487-496
Author(s):  
Louise M. Oliver ◽  
E. T. McAdams ◽  
P. S.M. Dunlop ◽  
J. A. Byrne ◽  
I. S. Blair ◽  
...  
Keyword(s):  
Electrical Impedance Spectroscopy ◽  
Common Source ◽  
Hospital Acquired Infection ◽  
Hospital Acquired Infections ◽  
Source Of Infection ◽  
Powerful Analytical Tool ◽  
Catheter Surface ◽  
Intravascular Catheters ◽  
Micro Organisms ◽  
Hospital Acquired

Hospital-acquired infections (HAI) are defined as infections that are neither present nor incubating when a patient enters the hospital (Bourn, 2000). Their effects vary from discomfort to prolonged or permanent disability and they may contribute directly or substantially to a patient’s death. HAI’s are estimated to cost the National Health Service (NHS) in England £1 billion annually (Bourn, 2000) with as many as 5,000 patients dying as a result of acquiring such an infection (Anon, 2001). Not all hospital-acquired infections are preventable but Infection Control Teams believe that they could be reduced by at least 15%, with yearly savings of £150 million (Anon, 2001). Central intravascular catheters have been found to be a common source of infection. Catheters can become infected via a number of different routes with the infection proliferating in multiple areas along the catheter surface. It has been reported that over 40% of the identified micro-organisms causing hospital-acquired infection were Staphylococci, an organism that is typically found on the natural skin flora (Bourn, 2000).

scholarly journals In Vitro Antifungal Combination of Flucytosine with Amphotericin B, Voriconazole, or Micafungin against Candida auris Shows No Antagonism

2019 ◽  
Vol 63 (12) ◽  
Author(s):  
A. L. Bidaud ◽  
F. Botterel ◽  
A. Chowdhary ◽  
E. Dannaoui
Keyword(s):  
Amphotericin B ◽  
Inhibitory Concentration ◽  
Geometric Mean ◽  
Multidrug Resistant ◽  
Candida Auris ◽  
Content Type ◽  
Hospital Acquired Infections ◽  
Resistant Mutants ◽  
Hospital Acquired

ABSTRACT Candida auris is an emerging, multidrug-resistant pathogen responsible for invasive hospital-acquired infections. Flucytosine is an effective anti-Candida species drug, but which cannot be used as a monotherapy because of the risk of development of resistant mutants during treatment. It is, therefore, noteworthy to test possible combinations with flucytosine that may have a synergistic interaction. In this study, we determined the in vitro interaction between flucytosine and amphotericin B, micafungin, or voriconazole. These combinations have been tested against 15 C. auris isolates. The MIC ranges (geometric mean [Gmean]) of flucytosine, amphotericin B, micafungin, and voriconazole were 0.125 to 1 μg/ml (0.42 μg/ml), 0.25 to 1 μg/ml (0.66 μg/ml), 0.125 to 0.5 μg/ml (0.3 μg/ml), and 0.03 to 4 μg/ml (1.05 μg/ml), respectively. When tested in combination, indifferent interactions were mostly observed with fractional inhibitory concentration index values from 0.5 to 1, 0.31 to 1.01, and 0.5 to 1.06 for the combinations of flucytosine with amphotericin B, micafungin, and voriconazole, respectively. A synergy was observed for the strain CBS 10913 from Japan. No antagonism was observed for any combination. The combination of flucytosine with amphotericin B or micafungin may be relevant for the treatment of C. auris infections.

Plasmids and Bacterial Strains Mediating Multidrug-Resistant Hospital-Acquired Infections Are Coresidents of the Hospital Environment

2013 ◽  
Vol 19 (2) ◽  
pp. 104-109 ◽  
Author(s):  
Thu Betteridge ◽  
John Merlino ◽  
Jonathon Natoli ◽  
Elaine Y.-L. Cheong ◽  
Thomas Gottlieb ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
Hospital Environment ◽  
Bacterial Strains ◽  
Hospital Acquired Infections ◽  
Hospital Acquired

scholarly journals Avoiding ventilator-associated pneumonia: Curcumin-functionalized endotracheal tube and photodynamic action

2020 ◽  
Vol 117 (37) ◽  
pp. 22967-22973
Author(s):  
Amanda C. Zangirolami ◽  
Lucas D. Dias ◽  
Kate C. Blanco ◽  
Carolina S. Vinagreiro ◽  
Natalia M. Inada ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Bacterial Infections ◽  
Bacterial Resistance ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Ventilator Associated Pneumonia ◽  
Hospital Acquired Infection ◽  
Hospital Acquired Infections ◽  
Hospitalization Costs ◽  
Hospital Acquired

Hospital-acquired infections are a global health problem that threatens patients’ treatment in intensive care units, causing thousands of deaths and a considerable increase in hospitalization costs. The endotracheal tube (ETT) is a medical device placed in the patient’s trachea to assist breathing and delivering oxygen into the lungs. However, bacterial biofilms forming at the surface of the ETT and the development of multidrug-resistant bacteria are considered the primary causes of ventilator-associated pneumonia (VAP), a severe hospital-acquired infection for significant mortality. Under these circumstances, there has been a need to administrate antibiotics together. Although necessary, it has led to a rapid increase in bacterial resistance to antibiotics. Therefore, it becomes necessary to develop alternatives to prevent and combat these bacterial infections. One possibility is to turn the ETT itself into a bactericide. Some examples reported in the literature present drawbacks. To overcome those issues, we have designed a photosensitizer-containing ETT to be used in photodynamic inactivation (PDI) to avoid bacteria biofilm formation and prevent VAP occurrence during tracheal intubation. This work describes ETT’s functionalization with curcumin photosensitizer, as well as its evaluation in PDI against Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli. A significant photoinactivation (up to 95%) against Gram-negative and Gram-positive bacteria was observed when curcumin-functionalized endotracheal (ETT-curc) was used. These remarkable results demonstrate this strategy’s potential to combat hospital-acquired infections and contribute to fighting antimicrobial resistance.

scholarly journals Characterization of the Enterobacter Phage vB_EclM_CIP9

2020 ◽  
Vol 9 (13) ◽  
Author(s):  
Klara Wang ◽  
Marielou G. Tamayo ◽  
Tiffany V. Penner ◽  
Bradley W. M. Cook ◽  
Deborah A. Court ◽  
...  
Keyword(s):  
Enterobacter Cloacae ◽  
Opportunistic Pathogen ◽  
Multidrug Resistant ◽  
Open Reading Frames ◽  
Resistant Isolate ◽  
Content Type ◽  
Hospital Acquired Infections ◽  
Hospital Acquired ◽  
Reading Frames

Enterobacter cloacae is an opportunistic pathogen that causes hospital-acquired infections in immunocompromised patients. Here, we describe vB_EclM_CIP9, a novel Enterobacter phage that infects a multidrug-resistant isolate of E. cloacae. Phage vB_EclM_CIP9 is a myovirus that has a 174,924-bp genome, with 296 predicted open reading frames.

scholarly journals In Vitro Activity of Pentamidine Alone and in Combination with Antibiotics against Multidrug-Resistant Clinical Pseudomonas aeruginosa Strains

Antibiotics ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. 885
Author(s):  
Soraya Herrera-Espejo ◽  
Tania Cebrero-Cangueiro ◽  
Gema Labrador-Herrera ◽  
Jerónimo Pachón ◽  
María Eugenia Pachón-Ibáñez ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Public Health Problem ◽  
Multidrug Resistant ◽  
Vitro Activity ◽  
Synergistic Activity ◽  
In Vitro Activity ◽  
Hospital Acquired Infections ◽  
Time Kill ◽  
Hospital Acquired

Multidrug-resistant (MDR) Pseudomonas aeruginosa is a public health problem causing both community and hospital-acquired infections, and thus the development of new therapies for these infections is critical. The objective of this study was to analyze in vitro the activity of pentamidine as adjuvant in combinations to antibiotics against seven clinical P. aeruginosa strains. The Minimum Inhibitory Concentration (MIC) was determined following standard protocols, and the results were interpreted according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints; however, the gentamicin activity was interpreted according to the Clinical and Laboratory Standards Institute (CLSI) recommendations. The bactericidal in vitro activity was studied at 1×MIC concentrations by time–kill curves, and also performed in three selected strains at 1/2×MIC of pentamidine. All studies were performed in triplicate. The pentamidine MIC range was 400–1600 μg/mL. Four of the strains were MDR, and the other three were resistant to two antibiotic families. The combinations of pentamidine at 1×MIC showed synergistic activity against all the tested strains, except for pentamidine plus colistin. Pentamidine plus imipenem and meropenem were the combinations that showed synergistic activity against the most strains. At 1/2×MIC, pentamidine plus antibiotics were synergistic with all three analyzed strains. In summary, pentamidine in combination with antibiotics showed in vitro synergy against multidrug-resistant P. aeruginosa clinical strains, which suggests its possible use as adjuvant to antibiotics for the therapy of infections from MDR P. aeruginosa.

scholarly journals Enterococci as Fecal Indicator in a Tropical Beach: A Case Study

2020 ◽  
Vol 9 (1) ◽  
pp. 53-72
Author(s):  
Fernanda Silva dos Santos ◽  
Luiz Affonso de Paula Junior ◽  
Gabriel Farias Araujo ◽  
Wellington Thadeu de Alcantara Azevedo ◽  
Steven Dutt Ross ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Intertidal Sediment ◽  
Multidrug Resistant Bacteria ◽  
Fecal Indicator ◽  
Hospital Acquired Infections ◽  
Brazilian Legislation ◽  
Resistant Strains ◽  
Hospital Acquired

Fecal enterococci are generally not virulent; however, multidrug-resistant strains have emerged as leading causes of hospital-acquired infections. Thus, periodic enterococci monitoring should be included in highly populated cities to control the dissemination of multidrug-resistant strains to the marine environment. This study aimed to quantify enterococci bacteria from water and intertidal sediment samples in a beach located near Rio de Janeiro touristic spots. We also intended to accomplish if enterococci should be included in touristic beaches sanitary monitoring. Toward this approach, we monitored from August to December 2014 fecal indicator bacteria (FIB) at a beach close to some touristic spots through multiple tube method. Although FIB quantification was within sanitary standards of Brazilian legislation, high enterococci densities (=30 MNP.100 mL-1) were detected in the water collected in August. Thus, enterococci monitoring should be included in touristic beaches to avoid the risk of multidrug-resistant bacteria dissemination among swimmers and beachgoers.

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