scholarly journals Risk factors for carbapenem-resistant Pseudomonas aeruginosa infection or colonization in a Chinese teaching hospital

2018 ◽  
Vol 12 (08) ◽  
pp. 642-648 ◽  
Author(s):  
Di Zhang ◽  
Kai Cui ◽  
Taotao Wang ◽  
Yuanyuan Shan ◽  
Haiyan Dong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Multivariate Analysis ◽  
Univariate Analysis ◽  
Antibiotic Use ◽  
Prior Exposure ◽  
Gram Negative ◽  
Carbapenem Resistant ◽  
Pseudomonas Aeruginosa Infection

Introduction: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) is rapidly emerging as a life-threatening nosocomial infection. In this study, we aimed to identify risk factors, especially antibiotic use and co-carriage with other bacteria for CRPA infection or colonization. Methodology: A retrospective study was conducted in the First Affiliated Hospital of Xi’an Jiaotong University, which involved a cohort of patients with Pseudomonas aeruginosa infection or colonization from January 2014 to June 2016. Univariate analysis and multivariate analysis were performed to estimate the risk factors of CRPA occurrence. Results: Eight hundred and eighty-eight patients were included in the study. More than 50% of the risk factors were associated with CRPA infection or colonization according to univariate analysis (P < 0.05), such as invasive procedures, co-carriage with Gram-negative pathogens, and prior treatment with some antibiotics. However, only prior exposure to carbapenems (OR: 8.005; CI:4.507-14.217, P<0.001), the days of carbapenems treatment (OR: 1.190; CI: 1.073-1.272; P < 0.001), and co-carriage with Escherichia coli (OR: 1.824; CI: 1.005-3.310, P = 0.048) were considered independent risk factors by multivariate analysis. A higher mortality was found among patients with CRPA infection or colonization (P < 0.05). Conclusions: Risk factors for CRPA infection or colonization were prior exposure to carbapenems, the days of carbapenems treatment, and co-carriage with Escherichia coli. The prevalence of CRPA could be influenced by Gram-negative pathogens, especially in Escherichia coli, and it need more researches. Moreover, restrictions in the clinical use of carbapenems should be taken into account.

scholarly journals National Surveillance of Antimicrobial Susceptibility of Bacteremic Gram-Negative Bacteria with Emphasis on Community-Acquired Resistant Isolates: Report from the 2019 Surveillance of Multicenter Antimicrobial Resistance in Taiwan (SMART)

2020 ◽  
Vol 64 (10) ◽  
Author(s):  
Po-Yu Liu ◽  
Yu-Lin Lee ◽  
Min-Chi Lu ◽  
Pei-Lan Shao ◽  
Po-Liang Lu ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Antimicrobial Resistance ◽  
Klebsiella Pneumoniae ◽  
Gram Negative Bacteria ◽  
National Surveillance ◽  
Gram Negative ◽  
Content Type ◽  
E Coli ◽  
Carbapenem Resistant

ABSTRACT A multicenter collection of bacteremic isolates of Escherichia coli (n = 423), Klebsiella pneumoniae (n = 372), Pseudomonas aeruginosa (n = 300), and Acinetobacter baumannii complex (n = 199) was analyzed for susceptibility. Xpert Carba-R assay and sequencing for mcr genes were performed for carbapenem- or colistin-resistant isolates. Nineteen (67.8%) carbapenem-resistant K. pneumoniae (n = 28) and one (20%) carbapenem-resistant E. coli (n = 5) isolate harbored blaKPC (n = 17), blaOXA-48 (n = 2), and blaVIM (n = 1) genes.

scholarly journals Prevalence and Risk Factors of Metallo β-lactamase Producing Pseudomonas aeruginosa and Acinetobacter species in Burns and Surgical Wards in a Tertiary Care Hospital

2012 ◽  
Vol 4 (01) ◽  
pp. 039-042 ◽  
Author(s):  
Simit H Kumar ◽  
Anuradha S De ◽  
Sujata M Baveja ◽  
Madhuri A Gore
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Tertiary Care ◽  
Significant Risk ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Resistance Mechanisms ◽  
Care Hospital ◽  
Acinetobacter Species ◽  
Carbapenem Resistant

ABSTRACT Introduction: The production of Metallo-β-lactamases (MBLs) is one of the resistance mechanisms of Pseudomonas aeruginosa and Acinetobacter species. There is not much Indian data on the prevalence of MBLs in burns and surgical wards. Materials and Methods: A total of 145 non-duplicate isolates of carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter species, isolated from pus/wound swabs and endotracheal secretions from burns and surgical wards, were tested for MBL production by modified ethylene diamine tetra acetic acid (EDTA) disc synergy and double disc synergy tests. Results: Prevalence of MBLs was 26.9% by both the above tests. All MBL-positive isolates were multidrug resistant. Only 6.06% (2/33) P.aeruginosa and 16.67% (1/06) Acinetobacter species were susceptible to piperacillin-tazobactam and netilmycin, respectively. These patients had multiple risk factors like >8 days hospital stay, catheterization, IV lines, previous antibiotic use, mechanical ventilation, etc. Graft application and surgical intervention were significant risk factors in MBL-positive patients. Overall mortality in MBL-positive patients was 34.21%. Conclusion: Emergence of MBL-producing Pseudomonas aeruginosa and Acinetobacter species in this hospital is alarming, which reflect excessive use of carbapenems and at the same time, pose a therapeutic challenge to clinicians as well as to microbiologists. Therefore, a strict antibiotic policy and implementation of proper infection control practices will go a long way to prevent further spread of MBLs. Detection of MBLs should also become mandatory in all hospitals.

scholarly journals Comparison of therapy with β-lactam/β-lactamase inhibitor combinations or carbapenems for bacteraemia of nonurinary source caused by ESBL-producing Escherichia coli or Klebsiella pneumoniae

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Hong Luo ◽  
Yanping Xiao ◽  
Yaping Hang ◽  
Yanhui Chen ◽  
Hongying Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Multivariate Analysis ◽  
Propensity Score ◽  
Klebsiella Pneumoniae ◽  
Treatment Failure ◽  
Day Treatment ◽  
Univariate Analysis ◽  
Treatment Failure Rate ◽  
Lactamase Inhibitor

Abstract Background Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae has become a public health concern. This study aimed to compare the clinical outcomes of patients with nonurinary source bacteraemia caused by ESBL-producing Escherichia coli (E. coli) or Klebsiella pneumoniae (ESBL-producing EK) receiving β-lactam/β-lactamase inhibitor combinations (BLICs) versus carbapenem treatment and assess the risk factors of mortality with these two drugs. Methods We conducted a retrospective single-centre study of adult hospitalised patients with ESBL-producing EK bloodstream infection (BSI) from nonurinary source at our centre over a 4-year period. One hundred and eighty patients who received BLICs or carbapenems were included in the analysis. The outcome variables were 14-day treatment failure and 30-day mortality. For more reliable results, propensity score analysis was performed to compare the efficacy of the two drugs and analyse their risk factors for 30-day mortality. Results Out of 180 patients, 114 received BLICs, and 66 received carbapenem therapy. Compared to carbapenem-treated patients, those treated with BLICs were older and had higher age-adjusted Charlson comorbidity index, but they had shorter stay in the hospital. Additionally, their Pitt bacteraemia score, SOFA score, rate of leukaemia, and immune compromise were lower. After propensity score matching (PSM), the baseline characteristics of patients in the two treatment groups were balanced. BLICs were associated with a higher 14-day treatment failure rate (20.6%, 13/63) than carbapenems (16.3%, 7/43), although the difference was not significant in either univariate analysis (P = 0.429) or multivariate analysis (P = 0.122). And the 30-day mortality rate in BTG (11.1%, 7/63) and CTG (11.6%, 5/43) did not significantly differ (univariate analysis, P = 0.926; multivariate analysis, P = 0.420). In the multivariate analysis, after PSM, leukaemia was the only independent predictor of mortality in both BTG and CTG. Conclusions Our study showed that BLICs had higher 14-day treatment failure rate compared with carbapenems, although there were no statistically significant differences because of the small number of patients, therefore, further evaluation of the efficacy of BLICs is needed.

scholarly journals Activity of β-lactam/taniborbactam (VNRX-5133) combinations against carbapenem-resistant Gram-negative bacteria

2020 ◽  
Vol 76 (1) ◽  
pp. 160-170
Author(s):  
Shazad Mushtaq ◽  
Anna Vickers ◽  
Michel Doumith ◽  
Matthew J Ellington ◽  
Neil Woodford ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Stenotrophomonas Maltophilia ◽  
Clinical Development ◽  
Published Data ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Class A ◽  
Carbapenem Resistant ◽  
Elizabethkingia Meningoseptica

Abstract Background Boronates are of growing interest as β-lactamase inhibitors. The only marketed analogue, vaborbactam, principally targets KPC carbapenemases, but taniborbactam (VNRX-5133, Venatorx) has a broader spectrum. Methods MICs of cefepime and meropenem were determined combined with taniborbactam or avibactam for carbapenem-resistant UK isolates. β-Lactamase genes and porin alterations were sought by PCR or sequencing. Results Taniborbactam potentiated partner β-lactams against: (i) Enterobacterales with KPC, other class A, OXA-48-like, VIM and NDM (not IMP) carbapenemases; and (ii) Enterobacterales inferred to have combinations of ESBL or AmpC activity and impermeability. Potentiation of cefepime (the partner for clinical development) by taniborbactam was slightly weaker than by avibactam for Enterobacterales with KPC or OXA-48-like carbapenemases, but MICs of cefepime/taniborbactam were similar to those of ceftazidime/avibactam, and the spectrum was wider. MICs of cefepime/taniborbactam nonetheless remained &gt;8 + 4 mg/L for 22%–32% of NDM-producing Enterobacterales. Correlates of raised cefepime/taniborbactam MICs among these NDM Enterobacterales were a cefepime MIC &gt;128 mg/L, particular STs and, for Escherichia coli only: (i) the particular blaNDM variant (even though published data suggest all variants are inhibited similarly); (ii) inserts in PBP3; and (iii) raised aztreonam/avibactam MICs. Little or no potentiation of cefepime or meropenem was seen for Pseudomonas aeruginosa and Acinetobacter baumannii with MBLs, probably reflecting slower uptake or stronger efflux. Potentiation of cefepime was seen for Stenotrophomonas maltophilia and Elizabethkingia meningoseptica, which have both chromosomal ESBLs and MBLs. Conclusions Taniborbactam broadly reversed cefepime or meropenem non-susceptibility in Enterobacterales and, less reliably, in non-fermenters.

scholarly journals Community-acquired spontaneous acute meningitis by Pseudomonas in adult without risk factors

2021 ◽  
Vol 0 ◽  
pp. 1-3
Author(s):  
Sanjeev Kumar Singla ◽  
Rakendra Singh
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Organ Dysfunction ◽  
Case Reports ◽  
Rare Entity ◽  
Gram Negative ◽  
Source Of Infection ◽  
Acute Meningitis ◽  
Immunocompromised State

Community-acquired meningitis by Gram-negative bacilli (GNB) occurs commonly with preexisting conditions such as neurosurgery, neurosurgical devices, trauma, remote source of infection, organ dysfunction, and nosocomial and immunocompromised state, but rarely occurs without these risk factors. Few case reports with Escherichia coli and Pseudomonas aeruginosa that too have some risk factors have been described in literature till now. GNB meningitis is associated with high mortality. There is very little literature available for community-acquired P. aeruginosa meningitis to date in patient without risk factors. Community-acquired spontaneous P. aeruginosa meningitis with pyogenic ventriculitis in a patient without any risk factors in adults is a rare entity and is likely to under-recognized.

scholarly journals Risk Factors Associated with Infection Recurrence of Posttraumatic Osteomyelitis Treated with Ilizarov Bone Transport Technique—A Retrospective Study of 149 Cases

2020 ◽  
Author(s):  
Yalikun Ainizier ◽  
Yushan Maimaiaili ◽  
WenQiang Li ◽  
Abulaiti Alimujiang ◽  
Yusufu Ahemaitijiang
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Univariate Analysis ◽  
Bone Transport ◽  
Post Traumatic ◽  
Ilizarov Bone Transport ◽  
Pseudomonas Aeruginosa Infection ◽  
Bone Exposure ◽  
Transport Technique ◽  
Infection Recurrence

Abstract Background: Post-traumatic tibial osteomyelitis is considered as complex clinical problem due to its unique characteristics such as prolonged course, multi-staged treatment and high recurrence rate. The purpose of this study is to identify and analyze the causes and risk factors associated with infection recurrence of tibial osteomyelitis treated with Ilizarov technique. Methods: From January 2011 to January 2019, a total of 149 patients with post-traumatic tibial osteomyelitis treated with Ilizarov bone transport technique were included in this study. Demographic and clinical data were collected and analyzed. Univariate analysis and logistic regression analysis were used to analyze the factors that may affect the recurrence or reinfection of post-traumatic tibial osteomyelitis after treated with Ilizarov bone transport technique.Results: All included patients were successfully followed up with an average of 37.5 month (18-78 month), among them, 17 patients (11.41%) occurred with recurrence or reinfection of tibial osteomyelitis in which 2 cases were in distraction area and 15 cases in docking site. Among them, 5 patients were treated successfully with sensitive intravenous antibiotic, the remaining 12 patients were intervened by surgical debridement or bone grafting after debridement. Univariate analysis showed that pseudomonas aeruginosa infection, bone exposure, number of previous operations (>3 times), blood transfusion during bone transport surgery, course of osteomyelitis >3 months, diabetes was associated with recurrence or reinfection of postoperative tibial osteomyelitis. According to the results of logistic regression analysis, pseudomonas aeruginosa infection, bone exposure, and the number of previous operations (>3 times) are risk factors for recurrence or reinfection of posttraumatic tibial osteomyelitis treated with Ilizarove bone transport technique, with odds ratios (OR) of 6.055, 7.413, and 1.753, respectively. Conclusion: The number of previous operations (>3 times), bone exposure, and pseudomonas aeruginosa infection are risk factors for infection recurrence of posttraumatic tibial osteomyelitis treated with Ilizarove bone transport technique.

scholarly journals Characteristics of and risk factors for biliary pathogen infection in patients with acute pancreatitis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shayan Chen ◽  
Jiyu Shi ◽  
Minghui Chen ◽  
Jun Ma ◽  
Zhaowei Zeng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Drug Resistance ◽  
Acute Pancreatitis ◽  
Klebsiella Pneumoniae ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Multidrug Resistant Bacteria ◽  
Gram Negative

Abstract Background Infection in patients with acute pancreatitis, especially severe acute pancreatitis patients, is a common and important phenomenon, and the distributions and drug resistance profiles of bacteria causing biliary infection and related risk factors are dynamic. We conducted this study to explore the characteristics of and risk factors for bacterial infection in the biliary tract to understand antimicrobial susceptibility, promote the rational use of antibiotics, control multidrug-resistant bacterial infections and provide guidance for the treatment of acute pancreatitis caused by drug-resistant bacteria. Methods The distribution of 132 strains of biliary pathogenic bacteria in patients with acute pancreatitis from January 2016 to December 2020 were analyzed. We assessed drug resistance in the dominant Gram-negative bacteria and studied the drug resistance profiles of multidrug-resistant bacteria by classifying Enterobacteriaceae and nonfermentative bacteria. We then retrospectively analyzed the clinical data and risk factors associated with 72 strains of Gram-negative bacilli, which were divided into multidrug-resistant bacteria (50 cases) and non-multidrug-resistant bacteria (22 cases). Results The main bacteria were Escherichia coli, Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa. Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli had a 66.67% detection rate. Acinetobacter baumannii had more than 50.00% drug resistance to carbapenems, ESBL-producing Klebsiella pneumoniae had 100.00% drug resistance, and Pseudomonas aeruginosa had 66.67% resistance to carbapenems. Multivariate logistic regression analysis suggested that the administration of third- or fourth-generation cephalosporins was an independent risk factor for Gram-negative multidrug-resistant biliary bacterial infection in acute pancreatitis patients. Conclusion Drug resistance among biliary pathogens in acute pancreatitis patients remains high; therefore, rational antimicrobial drug use and control measures should be carried out considering associated risk factors to improve diagnosis and treatment quality in acute pancreatitis patients.

scholarly journals Risk factors for carbapenem-resistant Pseudomonas aeruginosa infection in a tertiary care hospital in Serbia

2013 ◽  
Vol 7 (09) ◽  
pp. 686-690 ◽  
Author(s):  
Zorana Djordjevic ◽  
Marko Folic ◽  
Dejana Ruzic Zecevic ◽  
Goran Ilic ◽  
Slobodan Jankovic
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Full Text ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Carbapenem Resistant ◽  
Pseudomonas Aeruginosa Infection

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scholarly journals Characterization of Neonatal Infections by Gram-Negative Bacilli and Associated Risk Factors, Havana, Cuba

2021 ◽  
Vol 13 (1) ◽  
pp. 219-229
Author(s):  
Arlenis Oliva ◽  
Yenisel Carmona ◽  
Elizabeth de La C. López ◽  
Roberto Álvarez ◽  
Meiji Soe Aung ◽  
...  
Keyword(s):  
Risk Factors ◽  
Late Onset ◽  
Empirical Therapy ◽  
Antibiotic Use ◽  
Neonatal Infections ◽  
Cross Sectional ◽  
Prolonged Stay ◽  
Gram Negative ◽  
Associated Risk Factors ◽  
Resistance Rates

Infections represent an important problem in neonates because of the high mortality. An increase in neonatal infections has been found in Cuban hospitals in recent years. The aim of this study was to provide evidence on the clinical and microbiological behavior of Gram-negative bacilli that cause neonatal infections in hospitals of Havana, Cuba. It was carried out as a descriptive cross-sectional investigation from September 2017 to July 2018 in The Tropical Medicine Institute “Pedro Kouri” (IPK). Sixty-one Gram-negative bacilli isolated from neonates with infections in six Gyneco-Obstetric and Pediatric Hospitals of Havana were analyzed for their species and antimicrobial susceptibility. Late-onset infections were more common than early-onset ones and included urinary tract infection in the community (87%) and sepsis in hospitals (63.3%). Catheter use (47%) and prolonged stay (38%) were the most frequent risk factors. Species of major pathogens were Escherichia coli (47%) and Klebsiella spp. (26%). The isolated Gram-negative bacilli showed high resistance rates to third-generation cephalosporins, ciprofloxacin and gentamicin, while being more susceptible to carbapenems, fosfomycin, colistin and amikacin. The present study revealed the clinical impact of Gram-negative bacilli in neonatology units in hospitals of Havana. Evaluation of antimicrobial susceptibilities to the isolates from neonates is necessary for selection of appropriate empirical therapy and promotion of the rational antibiotic use.

scholarly journals MexAB-OprM Efflux Pump Interaction with the Peptidoglycan of Escherichia coli and Pseudomonas aeruginosa

2021 ◽  
Vol 22 (10) ◽  
pp. 5328
Author(s):  
Miao Ma ◽  
Margaux Lustig ◽  
Michèle Salem ◽  
Dominique Mengin-Lecreulx ◽  
Gilles Phan ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Cell Division ◽  
Membrane Proteins ◽  
Outer Membrane ◽  
Efflux Pump ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Active Efflux

One of the major families of membrane proteins found in prokaryote genome corresponds to the transporters. Among them, the resistance-nodulation-cell division (RND) transporters are highly studied, as being responsible for one of the most problematic mechanisms used by bacteria to resist to antibiotics, i.e., the active efflux of drugs. In Gram-negative bacteria, these proteins are inserted in the inner membrane and form a tripartite assembly with an outer membrane factor and a periplasmic linker in order to cross the two membranes to expulse molecules outside of the cell. A lot of information has been collected to understand the functional mechanism of these pumps, especially with AcrAB-TolC from Escherichia coli, but one missing piece from all the suggested models is the role of peptidoglycan in the assembly. Here, by pull-down experiments with purified peptidoglycans, we precise the MexAB-OprM interaction with the peptidoglycan from Escherichia coli and Pseudomonas aeruginosa, highlighting a role of the peptidoglycan in stabilizing the MexA-OprM complex and also differences between the two Gram-negative bacteria peptidoglycans.

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