Pyoverdine Inhibitors and Gallium Nitrate Synergistically Affect Pseudomonas aeruginosa

P. aeruginosa is one of the most common causative agents for ventilator-associated pneumonia and nosocomial bacteremia and is a leading cause of death in patients with cystic fibrosis. Pandrug-resistant strains of P. aeruginosa are increasingly identified in clinical samples and show resistance to virtually all major classes of antibiotics, including aminoglycosides, cephalosporins, and carbapenems.

Secondary infections in mechanically ventilated patients with COVID-19: An overlooked matter?

Introduction. The susceptibility to infection probably increases in COVID-19 patients due to a combination of virusand drug-induced immunosuppression. The reported rate of secondary infections was quite low in previous studies. The objectives of our study were to investigate the rate of secondary infections, risk factors for secondary infections and risk factors for mortality in COVID-19 critically ill patients. Material and methods. We performed a single-center retrospective study in mechanically ventilated critically ill COVID-19 patients admitted to our Critical Care Unit (CCU). We recorded the patients’ demographic data; clinical data; microbiology data and incidence of secondary infection during CCU stay, including ventilator-associated pneumonia (VAP) and nosocomial bacteremia (primary and secondary). Results. A total of 107 patients with a mean age 62.2 ± 10.6 years were included. Incidence of secondary infection during CCU stay was 43.0% (46 patients), including nosocomial bacteremia (34 patients) and VAP (35 patients). Age was related to development of secondary infection (65.2 ± 7.3 vs. 59.9 ± 12.2 years, p=0.007). Age ≥ 65 years and secondary infection were independent predictors of mortality (OR=2.692, 95% CI 1.068-6.782, p<0.036; and OR=3.658, 95% CI 1.385- 9.660, p=0.009, respectively). The hazard ratio for death within 90 days in the ≥ 65 years group and in patients infected by antimicrobial resistant pathogens was 1.901 (95% CI 1.198- 3.018; p= 0.005 by log-rank test) and 1.787 (95% CI 1.023-3.122; p= 0.036 by log-rank test), respectively. Conclusions. Our data suggest that the incidence of secondary infection and infection by antimicrobial resistant pathogens is very high in critically ill patients with COVID-19 with a significant impact on prognosis.

First Report on the Characteristics of Methicillin Resistant Staphylococcus Capitis Isolates and a NRCS-A-clone Related Isolate Obtained from Iranian Children.

Background: Methicillin-resistant Staphylococcus capitis (MRSC) NRCS-A clone (Multi-resistant and vancomycin-non susceptible) has been recently described as an emerging cause of nosocomial bacteremia especially in neonatal intensive-care units (NICUs). Objective: The objective of this study was to evaluate the antibiotic and antiseptic resistance patterns, biofilm producing ability and the prevalence of SCCmec and ACME types among MRSC isolates as well as to check the possible presence of NRCS-A clone at Tehran’s Children's Medical Center, Iran. Methods : A total of 256 coagulase negative Staphylococcal isolates were collected, of which 10 S. capitis isolates were obtained and tested for susceptibility against 13 antimicrobial and 3 antiseptic agents, as well as biofilm production. The presence of 15 distinct resistance genes, staphylococcal cassette chromosome mec (SCCmec), and arginine catabolic mobile elements (ACMEs) were tracked. Results: Seven out of 10 S. capitis isolates were MRSC (MIC90 van=8μg/mL) and resistant to trimethoprim/sulfamethoxazole, produced biofilm, (3 as strong biofilm producers) and carried ACME types I and II. Despite the identification of mec and ccr complexes in some isolates, all the SCCmec cassettes were untypeable (UT). Conclusion: According to the studied features, only one isolate belonged to the NRSC-A clone. The results indicate that MRSC with high antibiotic resistance and unknown SCCmec might become a serious problem in the future for the treatment of patients particularly children.

The Etiology of Nosocomial Infections in Pediatric Patients at the Department of Child Health, School of Medicine Padjadjaran University Hasan Sadikin General Hospital, Bandung

Tbe distribution of pathogens causing nosocomial gastroenteritis was E. coli (69.2%), Salmonella sp (23.1%), rotavirns (6.4%) and Shigella sp (1.3%) . Klebsiella pneumoniae seemed to be the pathogen most frequently associated with nosocomial skin infections (26. 7%), followed by Enterobacter aerogenes (20.0%), E. coli, Ps. Aeruginosa and S. aureus, each in 13.3% and others 03.4%). Salmonella sp was the pathogen most frequently associated with nosocomial bacteremia (20.2%), followed by Klebsiella sp 07.9%), S. a/bus 04.3%), Enterobacter sp 01.9%), Pseudomonas sp (9.5%), S. aureus (9.5%) and others (16. 7%). In nosocomial urinary tract infections, the result was E. coli (32.9%), Klebsiella pneumoniae (20.5%), Enterobacter sp 03. 7%), Citrobacter diversus (6.8%) and others (26.1%). In general, E. coli was the most frequently reported pathogens ( 42.0%), followed by Salmonella sp 07.1%), Klebsiella sp (10.2%), Citrobacter sp (7.2%), S. a/bus (4.5%), Pseudomonas sp (4.2%), S. aureus (3.6%) and others 01.2%), respectively.