2475. Incidence of Multidrug-Resistant, Extensively Drug-Resistant and Pandrug-Resistant Gram-Negative Bacteria in Brazilian Intensive Care Units

Souza, Gregory Lauar e; Rocha, Rhayssa Fernanda de Andrade; Silveira, Andressa Do nascimento; Carvalho, Handerson Dias Duarte de; Oliveira, Cristóvão D M; Leite, Edna Marilea Meireles; Silva, Estevão Urbano; Giarola, Lucca Gontijo; Couto, Bráulio Roberto Gonçalves Marinho; Starling, Carlos Ernesto Ferreira

doi:10.1093/ofid/ofz360.2153

Cited by 5 publications

(6 citation statements)

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“…The prevalence of XDR, MDR, Carbapenemase-producing, and Carbapenem-resistant GNB is increasing [5,6,19]. In our study, the prevalence of MDR, XDR, Carbapenemase-producing, and carbapenem non-susceptible GNB is high.…”

Section: Discussionmentioning

confidence: 45%

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Detection and phenotypic characterization of carbapenem non susceptible gram-negative bacilli isolated from clinical specimens

Abdeta

Bitew

Fentaw

et al. 2021

Preprint

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Background Multi-drug resistant, extremely drug-resistant, pan-drug resistant, carbapenem-resistant, and carbapenemase-producing gram-negative bacteria are becoming more common in health care settings and are posing a growing threat to public health. Objective The study was aimed to determine the magnitude of multi-drug resistant, extremely drug-resistant, carbapenem non-susceptible, and carbapenemase-producing gram-negative bacilli at Ethiopian Public Health Institute. Materials and methods Prospective cross-sectional study was conducted from June 30, 2019, to May 30, 2020, at the national reference laboratory of the Ethiopian Public Health Institute. Clinical samples were collected, inoculated, and incubated in accordance to standard protocol for each sample. Antimicrobial susceptibility testing was done using Kirby Bauer disk diffusion. Identification was done using the traditional biochemical method. Multidrug-resistant and extensively drug-resistant were classified using a standardized definition established by European Centers for Disease prevention and control and the United States Centers for Disease prevention and control experts. Carbapenemase production was confirmed by modified carbapenem inactivation and a simplified carbapenem inactivation method. Meropenem with EDTA was used to differentiate serine carbapenemase and Metallo β-lactamase. Results A total of 1337 clinical specimens were analyzed, of which 429-gram negative bacilli isolates were recovered. Out of 429 isolates 319, 74, and 36 were Enterobacterales, Acinetobacter species, and P. aeruginosa respectively. In our study, the prevalence of Multidrug-resistant, extensively drug-resistant, Carbapenemase-producing, and carbapenem non-susceptible Gram-negative bacilli were, 45.2%, 7.7%, 5.4%, and 15.4% respectively. Out of 66 isolates screened for Carbapenemase, 34.8% (23/66) were Carbapenemase enzyme producers. Ten out of twenty-three Carbapenemase-positive organisms were Metallo-beta-lactamase producers. Thirteen out of twenty-three isolates were serine carbapenemase producers. Three out of 13 serine Carbapenemase positive organisms were Klebsiella pneumoniae Carbapenemase. Conclusion The finding from this study revealed a high prevalence of Multidrug-resistant, extremely drug-resistant, carbapenemase-producing gram-negative bacteria, particularly among Intensive care unit patients at the health facility level, this necessitates a robust laboratory-based antimicrobial resistance monitoring and infection prevention and control program.

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Section: Discussionmentioning

confidence: 45%

“…Particularly, increasing incidence of healthcare-associated infections due to multi-drug resistant (MDR), extremely drug-resistant (XDR), carbapenem-resistant, and Carbapenemase-producing Gram-negative bacilli (GNB) has been widely reported [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Detection and phenotypic characterization of carbapenem non susceptible gram-negative bacilli isolated from clinical specimens

Abdeta

Bitew

Fentaw

et al. 2021

Preprint

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“…Particularly, presence of XDR and PDR clinical isolates are not new and such isolates of Acinetobacter sp. have been reported in many countries across the globe (Chmielarczyk et al, 2018;Dimopoulos et al, 2015;Magiorakos et al, 2012;Souza et al, 2019 andWong et al, 2017). Here, we report the clinical evidence of XDR and PDR isolates of Acinetobacter sp.…”

Section: Clinical Isolates Of Acinetobacter Sp Exhibited Extended And...supporting

confidence: 64%

Clinical Evidence of Multi-drug Resistant, Extensively Drug Resistant and Pan-drug Resistant Acinetobacter sp. in Bangladesh

Asaduzzaman,

Nasrin,

Yeasmin

et al. 2024

Bangla Pharma J

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Blood borne infections are one of the major health problems in Bangladesh, which requires frequent use of antimicrobials. In most of the cases, diagnosis and treatment with such antimicrobials are done empirically. Therefore, updated information on etiological data for major pathogens and their pattern of antibiotic resistance is required for formulating strategy and guideline for the prescribers. This study was carried out to assess the pattern of antibiotic resistance and to determine the prevalence of resistance phenotypes of different bacterial pathogens, including Acinetobacter sp. previously collected from patients from a hospital in Dhaka, Bangladesh. Retrospective analysis of 573 clinical records was performed, and the antimicrobial susceptibility pattern of those records was used to determine the prevalence of the isolates that were multi-drug resistant. Our finding indicates that Acinetobacter sp. (12%), followed by Salmonella typhi (58%) were the second most often found pathogen in the blood samples. In addition, we identified that these organisms exhibited a multi-drug resistance (MDR) pattern toward the most frequently used antibiotic classes, including cephalosporin, fluoroquinolones, aminoglycosides and carbapenems. We found moderate to high levels of resistance against aminoglycosides (45-53%), cephalosporins (28-45%), fluoroquinolones (28-39%) and carbapenem (17- 19%) in Acinetobacter sp. (11.7%, n = 67), as well as multi-drug resistant (66.7%, n = 38), and extensively drug-resistant or XDR (13.64%, n = 9), isolates. We also found pan-drug resistant (PDR) isolates (2.3%) of Acinetobacter sp. showing resistance against all antibiotics that are used clinically. In order to launch effective treatment strategies and prevent the further emergence of MDR, it can be suggested that extensive national antimicrobial surveillance be conducted against these pathogens. There is also a need for further characterization of such superbugs to address the issue of antimicrobial resistance. Bangladesh Pharmaceutical Journal 27(1): 67-72, 2024 (January)

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“…The prevalence of XDR, MDR, carbapenemase-producing, and carbapenem-resistant GNB is increasing [ 5 , 6 , 37 ]. In our study, the prevalence of MDR, XDR, carbapenemase-producing, and carbapenem non-susceptible GNB is high.…”

Section: Discussionmentioning

confidence: 99%

Phenotypic characterization of carbapenem non-susceptible gram-negative bacilli isolated from clinical specimens

et al. 2021

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Background Multidrug resistant, extremely drug-resistant, pan-drug resistant, carbapenem-resistant, and carbapenemase-producing gram-negative bacteria are becoming more common in health care settings and are posing a growing threat to public health. Objective The study was aimed to detect and phenotypically characterize carbapenem no- susceptible gram-negative bacilli at the Ethiopian Public Health Institute. Materials and methods A prospective cross-sectional study was conducted from June 30, 2019, to May 30, 2020, at the national reference laboratory of the Ethiopian Public Health Institute. Clinical samples were collected, inoculated, and incubated for each sample in accordance with standard protocol. Antimicrobial susceptibility testing was conducted using Kirby-Bauer disk diffusion method. Identification was done using the traditional biochemical method. Multidrug-resistant and extensively drug-resistant isolates were classified using a standardized definition established by the European Centre for Disease Prevention and Control and the United States Centers for Disease Prevention and Control. Gram-negative organisms with reduced susceptibility to carbapenem antibiotics were considered candidate carbapenemase producers and subjected to modified carbapenem inactivation and simplified carbapenem inactivation methods. Meropenem with EDTA was used to differentiate metallo-β-lactamase (MBL) from serine carbapenemase. Meropenem (MRP)/meropenem + phenylboronic acid (MBO) were used to differentiate Klebsiella pneumoniae carbapenemase (KPC) from other serine carbapenemase producing gram-negative organisms. Results A total of 1,337 clinical specimens were analyzed, of which 429 gram-negative bacterial isolates were recovered. Out of 429 isolates, 319, 74, and 36 were Enterobacterales, Acinetobacter species, and Pseudomonas aeruginosa respectively. In our study, the prevalence of multidrug-resistant, extensively drug-resistant, carbapenemase-producing, and carbapenem nonsusceptible gram-negative bacilli were 45.2%, 7.7%, 5.4%, and 15.4% respectively. Out of 429 isolates, 66 demonstrated reduced susceptibility to the antibiotics meropenem and imipenem. These isolates were tested for carbapenemase production of which 34.8% (23/66) were carbapenemase producers. Out of 23 carbapenemase positive gram-negative bacteria, ten (10) and thirteen (13) were metallo-beta-lactamase and serine carbapenemase respectively. Three of 13 serine carbapenemase positive organisms were Klebsiella pneumoniae carbapenemase. Conclusion This study revealed an alarming level of antimicrobial resistance (AMR), with a high prevalence of multidrug-resistant (MDR) and extremely drug-resistant, carbapenemase-producing gram-negative bacteria, particularly among intensive care unit patients at the health facility level. These findings point to a scenario in which clinical management of infected patients becomes increasingly difficult and necessitates the use of “last-resort” antimicrobials likely exacerbating the magnitude of the global AMR crisis. This mandates robust AMR monitoring and an infection prevention and control program.

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2475. Incidence of Multidrug-Resistant, Extensively Drug-Resistant and Pandrug-Resistant Gram-Negative Bacteria in Brazilian Intensive Care Units

Cited by 5 publications

References 0 publications

Detection and phenotypic characterization of carbapenem non susceptible gram-negative bacilli isolated from clinical specimens

Detection and phenotypic characterization of carbapenem non susceptible gram-negative bacilli isolated from clinical specimens

Clinical Evidence of Multi-drug Resistant, Extensively Drug Resistant and Pan-drug Resistant Acinetobacter sp. in Bangladesh

Phenotypic characterization of carbapenem non-susceptible gram-negative bacilli isolated from clinical specimens

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