Carbapenem-resistant bacilli in a hospital in southern Brazil: prevalence and therapeutic implications

Costa, Jéssica Endy Scariot; Nogueira, Keite da Silva; Cunha, Clóvis Arns da

doi:10.1016/j.bjid.2020.07.006

Cited by 3 publications

(2 citation statements)

References 22 publications

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“…Some of these agents are associated with concomitant side effects, including ototoxicity and nephrotoxicity. In addition, the emergence of pandrug-resistant organisms (PDR) has increased recently [ 4 ]. As an outcome measure, an annual death rate of more than 10 million as well as the probability of reaching costs of up to US$ 100 trillion by 2050 has been reported as a consequence of failing to control and prevent infections with multidrug-resistant organisms effectively [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology and clinical characteristics of patients with carbapenem-resistant enterobacterales infections: experience from a large tertiary care center in a developing country

Aiesh,

Maali,

Qandeel

et al. 2023

BMC Infect Dis

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Background Carbapenem-resistant Enterobacterales (CREs) are a significant source of healthcare-associated infections. These bacteria are difficult to treat and have a high mortality rate due to high rates of antibiotic resistance. These pathogens are also linked to major outbreaks in healthcare institutions especially those with limited resources in infection prevention and control (IPC). Therefore, our study aimed to describe the epidemiology and clinical characteristics of patients with carbapenem-resistant Enterobacteriaceae in a referral hospital in a developing country. Methods This was a retrospective cross-sectional study that included 218 patients admitted to An-Najah National University Hospital between January 1, 2021, and May 31, 2022. The target population was all patients with CRE infection or colonization in the hospital setting. Results Of the 218 patients, 135 had CR-Klebsiella pneumoniae (61.9%), and 83 had CR-Escherichia coli (38.1%). Of these, 135 were male (61.9%) and 83 were female (38.1%), with a median age of 51 years (interquartile range 24–64). Malignancy was a common comorbidity in 36.7% of the patients. Approximately 18.3% of CRE patients were obtained from patients upon admission to the emergency department, the largest percentage among departments. Most CRE pathogens were isolated from rectal swabs, accounting for 61.3%. Among the 218 patients, colistin was the most widely used antimicrobial agent (13.3%). CR- E. coli showed resistance to amikacin in 23.8% of the pathogens tested and 85.7% for trimethoprim/sulfamethoxazole compared to CR- K. pneumonia, for which the resistance to trimethoprim/sulfamethoxazole was 74.1%, while for amikacin it was 64.2%. Regarding meropenem minimum inhibitory concentration, 85.7% of CR- E. coli were greater than 16 µg/mL compared to 84% of CR- K. pneumonia isolates. Conclusion This study found that CRE is frequently reported in this tertiary care setting, implying the presence of selective pressure and transmission associated with healthcare setting. The antibiotics tested showed a variety of resistance rates, with CR-K. pneumoniae being more prevalent than CR-E. coli, and exhibiting an extremely high resistance pattern to the available therapeutic options.

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Section: Introductionmentioning

confidence: 99%

“…According to the World Health Organization (WHO) Global Action Plan, one of the approaches to contain the spread and cross-transmission of resistant pathogens is to quickly generate and share epidemiological information specifically for each region [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and clinical characteristics of patients with carbapenem-resistant enterobacterales infections: experience from a large tertiary care center in a developing country

Aiesh,

Maali,

Qandeel

et al. 2023

BMC Infect Dis

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Multidrug-resistant Acinetobacter spp. from hospital intensive care units in Brazilian Amazon

da Silva,

Gomes,

Rodrigues

et al. 2023

The Brazilian Journal of Infectious Diseases

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Comparative phenotypic and genotypic analysis of community-acquired and hospital-acquired intra-abdominal infections among liver transplanted patients

Elmanakhly,

Safwat,

Tohamy

et al. 2024

Journal of Applied Microbiology

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Aim During liver transplantation, both hospital-acquired (HA) and community-acquired (CA) intra-abdominal infections (IAIs) are involved causing life-threatening diseases. Therefore, comparative studies of aerobic and facultative anaerobic HA-IAIs and CA-IAIs after liver transplantation surgery are necessary. Methods and Results the species of detected isolates (310) from intra-abdominal fluid were identified and classified into HA-IAIs and CA-IAIs. Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii were the most commonly detected species. The resistant phenotypes were commonly detected among the HA-IAIs; however, the virulent phenotypes were the predominant strains of CA-IAIs. Regrettably, the resistance profiles were shocking, indicating the inefficacy of monotherapy in treating these isolates. Therefore, we confirmed the use of empirical combination therapies of amikacin and meropenem for treating all IAIs (FICI≤0.5). Unfortunately, the high diversity and low clonality of all identified HA and CA-IAIs were announced with D-value in the range of 0.992 and 1. Conclusion This diversity proves that there are infinite numbers of infection sources inside and outside healthcare centers.

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Carbapenem-resistant bacilli in a hospital in southern Brazil: prevalence and therapeutic implications

Cited by 3 publications

References 22 publications

Epidemiology and clinical characteristics of patients with carbapenem-resistant enterobacterales infections: experience from a large tertiary care center in a developing country

Epidemiology and clinical characteristics of patients with carbapenem-resistant enterobacterales infections: experience from a large tertiary care center in a developing country

Multidrug-resistant Acinetobacter spp. from hospital intensive care units in Brazilian Amazon

Comparative phenotypic and genotypic analysis of community-acquired and hospital-acquired intra-abdominal infections among liver transplanted patients

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