TITLE

Multidrug-resistant Enterobacteriaceae including metallo-β-lactamase producers are predominant pathogens of healthcare-associated infections in an Indian teaching hospital

AUTHOR(S)
Sarma, J. B.; Bhattacharya, P. K.; Kalita, D.; Rajbangshi, M.
PUB. DATE
January 2011
SOURCE
Indian Journal of Medical Microbiology;Jan2011, Vol. 29 Issue 1, p22
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Purpose: A study was carried out in an Indian teaching hospital in 2009 to detect the rate of surgical site infections (SSI) and peripheral vascular access site infections. Materials and Methods: The study was a point-prevalence study involving over 300 patients. The presence of infection was determined according to the CDC criteria. Swabs were taken from the infected sites and identification and sensitivity were carried out using VITEK® 2 automated system. Characterisation of β-lactamase was carried out at ARRML, Colindale, London. Results: The rate of SSI was 15% for the clean and clean-contaminated categories while that for the dirty contaminated category was 85% (NNIS risk index 0). Cultures yielded definite or probable pathogens from 64% (9/14) of the patients with SSI. In 1/3rd of the cultures, Staphylococcus aureus was grown and the rest had Enterobacteriaceae, either extended-spectrum β-lactamase (ESBL) producers or Amp-C hyperproducers and, alarmingly, three isolates were positive for newly recognised New Delhi metallo-β-lactamase-1 (NDM-1). In medicine, 87% (n = 99) of the patients had a peripheral IV access device, 55% developed associated phlebitis/infection and, in seven, probable pathogens were isolated (Candida species and Escherichia coli producing ESBL and NDM-1, respectively, Staphylococcus aureus and Enterococcus faecium). All ESBL and metallo-β-lactamase producers were resistant to multiple classes of antimicrobials, the latter being sensitive only to colistin and tigecycline. The study also found that all post-operative patients were on antibiotics, 92% on IV [213 defined daily doses (DDD)/100 post-op patients] limited mainly to the third-generation cephalosporins (26%) and aminoglycosides (24%) and imidazole derivatives (30%). In medicine, 83% (n = 82) were on IV antibiotics (123 DDD/100 bed-days), limited mainly to the third-generation cephalosporins (74%). Conclusion: Indiscriminate use of antibiotics is a major problem predisposing patients to harm by multi-resistant pathogens. Carbapenems were in little use in this hospital, but the selection pressure exerted by cephalosporins and other unrelated classes was sufficient to select NDM-1-producing strains due to co-selection, suggesting a role of single plasmid carrying resistance genes to multiple classes.
ACCESSION #
58658770

 

Related Articles

  • OXA-48-like carbapenemases: the phantom menace. Poirel, Laurent; Potron, Anaïs; Nordmann, Patrice // Journal of Antimicrobial Chemotherapy (JAC);Jul2012, Vol. 67 Issue 7, p1597 

    OXA-48-type carbapenem-hydrolysing class D β-lactamases are increasingly reported in enterobacterial species. To date, six OXA-48-like variants have been identified, with OXA-48 being the most widespread. They differ by a few amino acid substitutions or deletions (one to five amino acids)....

  • Risk factors and clinical outcomes for carbapenem-resistant Enterobacteriaceae nosocomial infections. Wang, Q.; Zhang, Y.; Yao, X.; Xian, H.; Liu, Y.; Li, H.; Chen, H.; Wang, X.; Wang, R.; Zhao, C.; Cao, B.; Wang, H. // European Journal of Clinical Microbiology & Infectious Diseases;Oct2016, Vol. 35 Issue 10, p1679 

    This study was aimed to determine the risk factors of Carbapenem-resistant Enterobacteriaceae (CRE) nosocomial infections and assess the clinical outcomes. A case-case-control design was used to compare two groups of case patients with control patients from March 2010 to November 2014 in China....

  • The Use of Cefepime for Treating AmpC β-Lactamase–Producing Enterobacteriaceae. Tamma, Pranita D.; Girdwood, Sonya C. T.; Gopaul, Ravindra; Tekle, Tsigereda; Roberts, Ava A.; Harris, Anthony D.; Cosgrove, Sara E.; Carroll, Karen C. // Clinical Infectious Diseases;Sep2013, Vol. 57 Issue 6, p781 

    The role of cefepime for treating invasive infections caused by AmpC β-lactamase–producing organisms is unclear, and many experts recommend carbapenem therapy. We conducted a propensity score–matched cohort study evaluating clinical outcomes of patients receiving cefepime...

  • First identification of an IMI-1 carbapenemase-producing colistin-resistant Enterobacter cloacae in China. Liang Huang; Xiaohui Wang; Yu Feng; Yi Xie; Liping Xie; Zhiyong Zong // Annals of Clinical Microbiology & Antimicrobials;11/25/2015, Vol. 14, p1 

    Background: Carbapenem resistance among the Enterobacteriaceae is a serious healthcare challenge. blaIMI is a carbapenemase gene mediating resistance to carbapenems but has not been commonly found. A blaIMI-carrying Enterobacter cloacae, which was also resistant to colistin, is reported here....

  • OXA-181 Beta Lactamase is not a Major Mediator of Carbapenem Resistance in Enterobacteriaceae. SHANTHI, M.; SEKAR, UMA; ARUNAGIRI, K.; BRAMHNE, HEMANT GOVERDHANDAS // Journal of Clinical & Diagnostic Research;Sep2013, Vol. 7 Issue 9, p1986 

    Background: Detection of carbapenem hydrolyzing class D beta lactamase OXA-181, (a variant of OXA-48) in Enterobacteriaceae, is important, to institute appropriate therapy and to initiate preventive measures. This study was done to determine the presence of OXA 48 and its derivative OXA-181 in...

  • Antibiotic exposure, renal disease linked to MDR gram-negative bacteremia.  // Infectious Diseases in Children;Feb2014, Vol. 27 Issue 2, p9 

    The article states that antibiotic exposure to third-generation cephalosporins and carbapenems in neonates with renal disease increases the risk for multidrug-resistant gram-negative bacteremia.

  • Emergence of Carbapenem-Resistant Hafnia: The Fall of the Last Soldier. Skurnik, David; Nucci, Amandine; Ruimy, Raymond; Lasocki, Sigismond; Muller-Serieys, Claudette; Montravers, Philippe; Andremont, Antoine; Courvalin, Patrice // Clinical Infectious Diseases;5/15/2010, Vol. 50 Issue 10, p1429 

    A letter to the editor is presented offering information related to emergence of carbapenem resistant hafnia bacterium.

  • Rapid Screening for Carbapenem Resistant Organisms: Current Results and Future Approaches. ANANDAN, SHALINI; DAMODARAN, SUNGANYA; GOPI, RADHA; BAKTHAVATCHALAM, YAMUNA DEVI; VEERARAGHAVAN, BALAJI // Journal of Clinical & Diagnostic Research;Sep2015, Vol. 9 Issue 9, p1 

    Carbapenem producing Enterobacteriaceae (CPE) is a major public health threat. A total of 120 carbapenem resistant E.coli (n=32) and K.pneumoniae (n=88) from blood stream infections were screened for the presence of carbapenem resistant genes KPC, NDM, IMP, VIM, and OXA-48 like using both...

  • In Vitro Activities of Ertapenem and Imipenem against Clinical Extended Spectrum Beta-Lactamase-Producing Enterobacteriaceae Collected in Military Teaching Hospital Mohammed V of Rabat. Elouennass, M.; Zohoun, A.; El Ameri, A.; Alem, N.; Kasouati, J.; Benlahlou, Y.; El Yaagoubi, I.; Frikh, M.; Lemnouer, A.; Benouda, A. // Interdisciplinary Perspectives on Infectious Diseases;2012, p1 

    Objective. To study the sensitivity level of extended spectrum beta-lactamase-producing Enterobacteriaceae to Carbapenems (Imipenem, Ertapenem) marketed in Morocco and discusses the place of Ertapenem in the treatment of extended spectrumbeta- lactamase-producing. Materials and Methods. A...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics