The opportunistic infections with Gram-negative bacilli are frequently reported. The clinical studies are focused on the course of human infectious and very often the source of infection remain unclear. We aim to see if the Gram-negative bacilli isolated from a non-contaminated environment—the caves—are reported in human infections. Eleven samples were collected from six Romanian caves. We used the standard procedure used in our clinical laboratory for bacterial identification and for antibiotic susceptibility testing of the cave isolates. Out of the 14 bacterial strains, three isolates are Gram-negative bacilli—one isolate belong to Hafnia alvei and two strains belong to Sphingomonas paucimobilis. We screened for the published studies—full-text original articles or review articles—that reported human infections with S. paucimobilis and H. alvei. Data sources—PubMed and Cochrane library. We retrieved 447 cases from 49 references—262 cases (58.61%) are S. paucimobilis infections and 185 cases (41.39%) are H. alvei infections. The types of infections are diverse but there are some infections more frequent; there are 116 cases (44.27%) and many infections of the bloodstream with S. paucimobilius (116 cases) and 121 cases (65.41%) are urinary tract infections with H. alvei. The acquired source of the bloodstream infections is reported for 93 of S. paucimobilis bloodstream infections—50 cases (43%) are hospital-acquired, and 40 cases (37%) are community-acquired. Most of the infections are reported in patients with different underlying conditions. There are 80 cases (17.9%) are reported of previously healthy persons. Out of the 72 cases of pediatric infections, 62 cases (86.11%) are caused by S. paucimobilis. There are ten death casualties—three are H. alvei infections, and seven are S. paucimobilis infections.
COVID-19 offers ideal premises for bacteria to develop antimicrobial resistance. In this study, we evaluated the presence of several antimicrobial resistance genes (ARG) in vancomycin-resistant Enterococcus (VRE) isolated from rectal swabs from patients at a hospital in Cluj-Napoca, Romania. Rectal swabs were cultivated on CHROMID® VRE (bioMérieux, Marcy—l’ Étoile, France) and positive isolates were identified using MALDI-TOF Mass Spectrometry (Bruker Daltonics, Bremen, Germany) and further analyzed using the PCR technique for the presence of the following ARGs: van A, van B, tet(M), tet(L), ermB, msrA, mefA, aac(6′)-Im, aph(2)-Ib, ant(4′)-Ia, sul1, sul2, sul3, and NDM1. We isolated and identified 68 isolates of Enterococcus faecium and 11 isolates of Enterococcus faecalis. The molecular analysis showed 66 isolates positive for the vanA gene and eight positive for vanB. The most frequent association of ARG in VRE was vanA-tet(M)-ermB. There was no statistically significant difference between Enterococcus faecium and Enterococcus faecalis regarding ARGs. Our work proves that during the COVID-19 pandemic, highly resistant isolates of Enterococcus were present in patients in the intensive care unit; thus, better healthcare policies should be implemented for the management and control of these highly resistant isolates in the future.
Aim.Carbapenem-resistant strains have been increasingly reported over the last few years. In this study we used laboratory records to determine the occurrence of carbapenem-resistant strains from hospitalized patients with emphasis on the comparative analysis of the incidence in various health-care settings.Materials and methods.From January 2012 to November 2012 and from May 2013 to November 2013, we evaluated 566 strains (Acinetobacter spp., Pseudomonas aeruginosa, Escherichia coli, and Klebsiella spp.). All isolates were tested and analyzed according to their antibiotic resistance phenotypic pattern. Laboratory results were correlated with data regarding admission in different clinical wards.Results.Among 566 isolates, 191 carbapenem-resistant or carbapenem-intermediate strains (33.74%) were detected. Non-fermentative species were the most prevalent carbapenem-resistant organisms, 80.62% of 191 carbapenem-resistant or carbapenem-intermediate strains isolated were Acinetobacter spp., and 17.27% of 191 were Pseudomonas aeruginosa. Apart from that, only 4 (2.09%) carbapenem-resistant Enterobacteriaceae (CRE) strains were identified. We identified 59.30% of 172 strains isolated from patients hospitalized in anesthesia and intensive care units non-susceptible to carbapenems. The main mechanism associated with carbapenem resistance could be the production of carbapenemase in combination with impermeability.Conclusions.Our study demonstrates that infections with carbapenem-resistant strains are correlated with hospitalization in intensive care units. Our data showed a predominant carbapenem-resistant Acinetobacter spp. strain in intensive care units.
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