High mortality outbreak of carbapenem-resistant Pseudomonas aeruginosa infection in a Brazilian pediatric oncology hospital

Quiles, Marcos G.; Carlesse, Fabianne; Silva, Maria Aparecida Aguiar da; Mingrone, Roberta Cabral; Fonseca, Juliane Melo; Silva, Dafne Cardoso; Pignatari, Antônio Carlos Campos

doi:10.1016/j.bjid.2016.10.012

Cited by 4 publications

(4 citation statements)

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“…The resistance of P. aeruginosa to carbapenems has been reported as over 60 % in some Brazilian hospitals, and around 50 % in other developing countries, like Iran [9,10]. The production of metallo-β-lactamase (MBL) encoded by the bla SPM -1, bla VIM and bla IPM genes is considered the main antibiotic resistance mechanism [10][11][12]. However, poor outcomes concerning P. aeruginosa infections have also been associated to factors related to the host, the antibiotic treatment and the micro-organism itself [7,13].…”

Section: Introductionmentioning

confidence: 99%

“…aeruginosa to carbapenems has been reported as over 60 % in some Brazilian hospitals, and around 50 % in other developing countries, like Iran [9, 10]. The production of metallo-β-lactamase (MBL) encoded by the bla SPM -1, bla VIM and bla IPM genes is considered the main antibiotic resistance mechanism [10–12]. However, poor outcomes concerning P.…”

Section: Introductionmentioning

confidence: 99%

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High mortality by nosocomial infections caused by carbapenem-resistant P. aeruginosa in a referral hospital in Brazil: facing the perfect storm

Urzedo

Menezes

Porto

et al. 2020

Journal of Medical Microbiology

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Introduction. Carbapenem-resistant Pseudomonas aeruginosa is responsible for increased patient mortality. Gap Statement. Five and 30 day in-hospital all-cause mortality in patients with P. aeruginosa infections were assessed, followed by evaluations concerning potential correlations between the type III secretion system (TTSS) genotype and the production of metallo-β-lactamase (MBL). Methodology. This assessment comprised a retrospective cohort study including consecutive patients with carbapenem-resistant infections hospitalized in Brazil from January 2009 to June 2019. PCR analyses were performed to determine the presence of TTSS-encoding genes and MBL genes. Results. The 30-day and 5-day mortality rates for 262 patients were 36.6 and 17.9 %, respectively. The unadjusted survival probabilities for up to 5 days were 70.55 % for patients presenting exoU-positive isolates and 86 % for those presenting exo-negative isolates. The use of urinary catheters, as well as the presence of comorbidity conditions, secondary bacteremia related to the respiratory tract, were independently associated with death at 5 and 30 days. The exoS gene was detected in 64.8 % of the isolates, the presence of the exoT and exoY genes varied and exoU genes occurred in 19.3 % of the isolates. The exoU genotype was significantly more frequent among multiresistant strains. MBL genes were not detected in 92 % of the isolates. Conclusions. Inappropriate therapy is a crucial factor regarding the worse prognosis among patients with infections caused by multiresistant P. aeruginosa , especially those who died within 5 days of diagnosis, regardless of the genotype associated with TTSS virulence.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

High mortality by nosocomial infections caused by carbapenem-resistant P. aeruginosa in a referral hospital in Brazil: facing the perfect storm

Urzedo

Menezes

Porto

et al. 2020

Journal of Medical Microbiology

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“…In recent years, an increasing number of carbapenemase-producing P . aeruginosa outbreaks have been reported 5,6 . Worryingly, several of these have included metallo-β-lactamase (MBL) producing strains that are capable of rapidly hydrolysing carbapenems, a ‘last-resort’ treatment option for MDR Gram-negative infections 7–10 .…”

Section: Introductionmentioning

confidence: 99%

Dual β-lactam combination therapy for multi-drug resistant Pseudomonas aeruginosa infection: enhanced efficacy in vivo and comparison with monotherapies of penicillin-binding protein inhibition

Siriyong

Murray

Bidgood

et al. 2019

Sci Rep

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The aim of the study was to determine the efficacy of dual β-lactam combination treatments derived from eight approved drugs against Galleria mellonella larvae infected with MDR strains of P . aeruginosa . Carbapenem-resistant P . aeruginosa NCTC 13437 and an unrelated clinical isolate were used to infect G . mellonella larvae and the efficacy of twenty-eight dual β-lactam combination therapies were compared to their constituent monotherapies. For the most potent combinations identified, penicillin-binding protein (PBP) inhibition profiles were measured and compared with each constituent antibiotic. Five of the dual β-lactam combinations resulted in greater than 70% survival of infected G . mellonella . Two combinations showed potent, enhanced efficacy versus both strains − ceftazidime + meropenem and aztreonam + meropenem. Comparison of PBP inhibition profiles revealed that the enhanced efficacy of these two dual β-lactam combinations could not be explained by more potent inhibition of PBPs or inhibition of a broader range of PBPs. A possible contribution to the enhanced efficacy of the combinations could be stimulation of innate immunity via increased haemocyte numbers compared to their constituent monotherapies. Combinations of β-lactam antibiotics show promise in overcoming MDR P . aeruginosa and are worthy of additional study and development.

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“…These carbapenem-resistant P. aeruginosa (CRPa) could be the starting point for hospital colonization and the intra-and inter-specific transfer of carbapenem-resistant genetic determinants. If appropriate solutions are not taken, CRB epidemics could affect CHUSO as reported worldwide [44][45][46][47].…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Resistance Profiles of Bacteria Isolated from Patients Hospitalized at the Sylvanus Olympio University Teaching Hospital in Lomé, Togo

Dossim,

Bawe,

Dossouvi

et al. 2024

MRJI

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Aims: Bacteria isolated from hospitalized patients are often responsible for healthcare-associated infections (HAI), particularly in developing countries. Thus, this study aimed to determine the antibiotic resistance profiles of bacteria isolated from patients hospitalized at the Sylvanus Olympio University Teaching Hospital (CHUSO) in Lomé, Togo. Study Design: This was a descriptive cross-sectional study carried out on laboratory data collected from January 1, 2018, to December 31, 2019. Methodology: The Kirby-Bauer disc diffusion method was used for antibiotic susceptibility testing and the results were interpreted according to the guidelines of the Antibiogram Committee of the French Society of Microbiology (CA-SFM, 2018). Results: A total of 639 samples were collected, including mainly pus (n = 339; 53.1%) and urine (n = 260; 40.7%). The samples were mainly from pediatrics (n=107; 16.7%), intensive care units (n=73; 11.4%) and surgical emergencies (n=72; 11.3%). A total of 698 bacteria were isolated, including mainly Escherichia coli (n=247, 35.4%), Staphylococcus aureus (n=123, 17.6%), and Klebsiella pneumoniae (n=114, 16.3%). Enterobacteriaceae strains were resistant to almost all antibiotics tested, except amikacin and ertapenem, which had respective resistance rates of 2.8% and 8.4%. None of the P. aeruginosa strains were resistant to piperacillin-tazobactam. whereas 37.9% were resistant to imipenem. Among A. baumannii strains, 4.2% and 22.9% were respectively resistant to amikacin and imipenem, whereas 56.3% were resistant to levofloxacin. Almost all S. aureus strains (99.2%) were resistant to penicillin, whereas only 2.4% were resistant to rifampicin. Of the 698 bacteria isolated, the prevalence of multidrug-resistant bacteria (MDR) was 41.3% (n = 288), whereas the prevalence of ESBL-producing Enterobacteriaceae was 51.3% (201/392). Conclusion: We reported various resistance profiles of bacterial species isolated from hospitalized patients at the CHU Sylvanus Olympio, Lomé, Togo. The study of bacterial ecology and resistance in every prefectural, regional, and university teaching hospital would be of great importance to reduce mortality associated with hospital-acquired infections throughout the Togolese territory.

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High mortality outbreak of carbapenem-resistant Pseudomonas aeruginosa infection in a Brazilian pediatric oncology hospital

Cited by 4 publications

References 3 publications

High mortality by nosocomial infections caused by carbapenem-resistant P. aeruginosa in a referral hospital in Brazil: facing the perfect storm

High mortality by nosocomial infections caused by carbapenem-resistant P. aeruginosa in a referral hospital in Brazil: facing the perfect storm

Dual β-lactam combination therapy for multi-drug resistant Pseudomonas aeruginosa infection: enhanced efficacy in vivo and comparison with monotherapies of penicillin-binding protein inhibition

Antibiotic Resistance Profiles of Bacteria Isolated from Patients Hospitalized at the Sylvanus Olympio University Teaching Hospital in Lomé, Togo

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