scholarly journals Molecular epidemiology of vancomycin-resistant Enterococcus faecium clinical isolates in a tertiary care hospital in southern Thailand: a retrospective study

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11478
Author(s):  
Phanvasri Saengsuwan ◽  
Kamonnut Singkhamanan ◽  
Siribhorn Madla ◽  
Natnicha Ingviya ◽  
Chonticha Romyasamit
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Molecular Techniques ◽  
Diffusion Method ◽  
Care Hospital ◽  
Drug Resistant ◽  
Vancomycin Resistant Enterococci ◽  
Peritoneal Dialysis Fluid ◽  
Southern Thailand ◽  
Vancomycin Resistant

Objective Vancomycin-resistant enterococci are nosocomial pathogens that are responsible for commonly causing healthcare-associated infections, and they exhibit increased resistance to many antimicrobials, particularly to vancomycin. The epidemiological data available on vancomycin-resistant enterococci (VRE) in Thailand are inadequate. Methods Using enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR), this study investigated genes that encode antimicrobial resistance and genetic relatedness to further understand VRE prevalence. Ninety VRE isolates were collected between 2011 and 2019 from a tertiary care hospital in southern Thailand. Antimicrobial susceptibility was determined using the disk diffusion method and E-test methods. Multiplex PCR was performed to detect the van gene and virulence genes. Results The study showed a high prevalence of diverse multidrug-resistant VRE strains. The prevalence of VRE infection was the highest in 2014 (28 isolates, 39.4%). VRE were mostly found in the urogenital tract (26 isolates, 28.9%), followed by the digestive tract (20%), body fluid, i.e., pancreatic cyst fluid, peritoneal dialysis fluid, Jackson–Pratt (JP) drain (20%), and blood specimens (10%). Patients in medical and surgical wards had 71.1% multi-drug-resistant and 28.9% extensively drug-resistant (XDR) VRE strains, respectively. The most prevalent antibiotic resistance was to ampicillin (74.4%). Susceptibility to gentamicin and meropenem were similar (7% and 10%, respectively). Four isolates (4.4%) were resistant to colistin. Only vanA was detected among the strains. The virulence gene test showed that the detection rates of enterococcal surface protein (esp) and hyaluronidase (hyl) genes were 91.1% and 5.6%, respectively. According to ERIC-PCR analysis, 51 of 90 strains had clonality, with a similarity rate of 95%. Conclusions We conclude that there is a need to implement infection control practices and active surveillance. Molecular techniques can effectively detect antibiotic-resistant genes, which would allow monitoring to control VRE infection in hospitals.

scholarly journals Multi Drug Resistant Nosocomial Pathogens in Intensive Care Units of a Tertiary Care Hospital in Karachi

2017 ◽  
Vol 23 (2) ◽  
Author(s):  
Ishrat Irfan Ali ◽  
Irfan Ali Khan ◽  
Muhammad Kashif Munir
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Drug Resistant ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Klebsiella Spp ◽  
Susceptibility Patterns

Objective:  To evaluate occurrence of nosocomial infections and antibiotic susceptibility patterns of bacterial pathogens isolated from Intensive Care Units (IC-Us) in a tertiary care hospital of Karachi-Pakistan.Methods and Results:  One thousand and fifty clinical isolates were identified following standard proto-cols. Their antibiograms were evaluated and a clinical correlation was made to measure their pathogenic status and method of acquisition of infection. Fifty-six percent isolates were identified as Acinetobacter baumannii, 13.2% as Pseudomonas aeruginosa, 11.2% as Staphylococcus aureus (MRSA), 8.8% as Klebsiella pneumoniae, 4.1% as Vancomycin resistant Enterococci (VRE), 2.7% as Escherichia coli (ESBL), 1.2% as Klebsiella spp, 1.1% as coagulase negative staphylococcus, 0.7% as Salmonella typhi and 0.2% as salmonella spp. All the isolates exhibited different resistance patterns against conventional antibiotics. Majority of them were Multi Drug Resistant (MDR).Conclusions:  In this study, Acinetobacter baumannii isolates revealed a pathogenic potential of around 56% were identified by antimicrobial susceptibility patterns. In our study, majority of Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae, Vancomycin resistant Enterococci, E.coli, and Klebsiella spp were found to be multi drug resistant. High antimicrobial resistance in the ICU is an alarming situation, and calls for imperative measures leading to careful selection/use of antimicrobials while treating different infections. This study is expected to help infection control agencies to take robust steps to control nosocomial infections in developing countries.

Prevalence of Vancomycin Resistant Enterococci in Various Clinical Specimens in Tertiary Care Hospital in North Delhi

2012 ◽  
Vol 3 (3) ◽  
pp. 141-144
Author(s):  
Swati Chaudhary ◽  
◽  
Swastika Aggarwal ◽  
Pawan Kumar ◽  
SK Aggarwal SK Aggarwal ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Clinical Specimens ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

scholarly journals Prevalence of carbapenemase-producing Klebsiella pneumoniae at a tertiary care hospital in Kathmandu, Nepal

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Susil Pyakurel ◽  
Mehraj Ansari ◽  
Smriti Kattel ◽  
Ganesh Rai ◽  
Prasha Shrestha ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistant Bacteria ◽  
Growth Media ◽  
Care Hospital ◽  
Drug Resistant ◽  
Biochemical Tests

Abstract Aim Although carbapenem is the last-resort drug for treating drug-resistant Gram-negative bacterial infections, prevalence of carbapenem-resistant bacteria has substantially increased worldwide owing to irrational use of antibiotics particularly in developing countries like Nepal.  Therefore, this study was aimed to determine the prevalence of carbapenemase-producing K. pneumoniae and to detect the carbapenemase genes (blaNDM-2 and blaOXA-48) in at a tertiary care hospital in Nepal. Materials and methods A hospital-based cross-sectional study was carried out from June 2018 to January 2019 at the Microbiology Laboratory of Annapurna Neurological Institute and Allied Sciences, Kathmandu, Nepal. Different clinical samples were collected and cultured in appropriate growth media. Biochemical tests were performed for the identification of K. pneumoniae. Antibiotic susceptibility testing (AST) was performed by the Kirby–Bauer disc diffusion method. The modified Hodge test (MHT) was performed to detect carbapenemase producers. The plasmid was extracted by the modified alkaline hydrolysis method. Carbapenemase-producing K. pneumoniae were further confirmed by detecting blaNDM-2 and blaOXA-48 genes by PCR using specific forward and reverse primers followed by gel electrophoresis. Results Out of the total 720 samples, 38.9% (280/720) were culture positive. K. pneumoniae was the most predominant isolate 31.4% (88/280). Of 88 K. pneumoniae isolates, 56.8% (50/88) were multi-drug resistant (MDR), and 51.1% (45/88) were MHT positive. Colistin showed the highest sensitivity (100%; 88/88), followed by tigecycline (86.4%; 76/88). blaNDM-2 and blaOXA-48 genes were detected in 24.4% (11/45) and 15.5% (7/45) of carbapenemase-producing K. pneumoniae isolates, respectively. Conclusion The rate of MDR and carbapenemase production was high in the K. pneumoniae isolates. Colistin and tigecycline could be the drug of choice for the empirical treatments of MDR and carbapenemase-producing K. pneumoniae. Our study provides a better understanding of antibiotic resistance threat and enables physicians to select the most appropriate antibiotics.

scholarly journals Assessing the intestinal carriage rates of vancomycin-resistant enterococci (VRE) at a tertiary care hospital in Hungary

2019 ◽  
Vol 65 (3) ◽  
pp. 483-490
Author(s):  
Dorottya Franyó ◽  
Balázs Kocsi ◽  
Evelin Erzsébet Bukta ◽  
Judit Szabó ◽  
Zsuzsanna Dombrádi
Keyword(s):  
Risk Factors ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Resistant Bacteria ◽  
Care Hospital ◽  
Multiresistant Pathogens ◽  
Carriage Rate ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Broth Enrichment

Abstract Excessive use of antibiotics contributes to the selection of resistant bacteria and intestinal colonization with multiresistant pathogens poses a risk factor for subsequent infections. The present study assessed vancomycin-resistant enterococci (VRE) carriage rates in patients admitted to our tertiary care hospital. Stool samples sent for routine culturing were screened with vancomycin containing solid or broth enrichment media. VRE isolates were identified with matrix-assisted laser desorption/ionization-time of flight mass spectrometry and antibiotic susceptibilities were tested by E-test. Vancomycin resistance genes were detected by polymerase chain reaction. Medical records of carriers were examined for suspected risk factors for colonization. Altogether 3025 stool specimens were analyzed. Solid media identified a VRE carriage rate of 2.2% while broth enrichment detected 5.8%. Seventy percent of the isolates were Enterococcus faecium. VanB genotype was detected in 38.2%, VanA in 37.3%, VanC1 in 22.6%, and VanC2 in 1.9%. All VRE were sensitive to linezolid, daptomycin, and tigecycline. Collective risk factors for carriage were diabetes, normal flora absence, Clostridioides difficile positivity, longer hospital stay, and advanced age. 78.5% of the carriers received antibiotic therapy which was metronidazole in most cases (47.3%). We recommend regular screening of risk groups such as patients with diabetes, history of recent hospitalization, or former C. difficile infection as an imperative step for preventing VRE dissemination.

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