A Systematic Review of the Burden of Multidrug-Resistant Healthcare-Associated Infections Among Intensive Care Unit Patients in Southeast Asia: The Rise of Multidrug-Resistant<i>Acinetobacter baumannii</i>

Teerawattanapong, Nattawat; Panich, Pornpansa; Kulpokin, Disorn; Ranong, Siriwat Na; Kongpakwattana, Khachen; Saksinanon, Atibodi; Goh, Bey Hing; Lee, Learn‐Han; Apisarnthanarak, Anucha; Chaiyakunapruk, Nathorn

doi:10.1017/ice.2018.58

Cited by 74 publications

(60 citation statements)

References 65 publications

(60 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…2d) in the genomes of shared multidrug resistant strains may enable them to successfully colonize both hospital environments and patients, and thus be readily transferred between them. This points to a vicious cycle where disinfectant resistance, antibiotic resistance and virulence may in turn be selected for, enriching for strains that are adept at colonizing both niches in the presence of depleted microbial competition, and offers an explanation for the high incidence of multidrug resistant HAIs worldwide despite increased surveillance and aggressive cleaning measures in hospitals [58][59][60][61] . Paired-end sequencing (2×101bp reads) was performed on the Illumina HiSeq2500 platform.…”

Section: Discussionmentioning

confidence: 99%

Cartography of opportunistic pathogens and antibiotic resistance genes in a tertiary hospital environment

Chng

Bertrand

et al. 2019

Preprint

View full text Add to dashboard Cite

There is growing attention surrounding hospital acquired infections (HAIs) due to high associated healthcare costs, compounded by the scourge of widespread multi-antibiotic resistance. Although hospital environment disinfection is well acknowledged to be key for infection control, an understanding of colonization patterns and resistome profiles of environment-dwelling microbes is currently lacking. We report the first extensive genomic characterization of microbiomes (355), common HAI-associated microbes (891) and transmissible drug resistance cassettes (1435) in a tertiary hospital environment based on a 2-timepoint sampling of 179 sites from 45 beds. Deep shotgun metagenomic sequencing unveiled two distinct ecological niches of microbes and antibiotic resistance genes characterized by biofilm-forming and human microbiome influenced environments that display corresponding patterns of divergence over space and time. To study common nosocomial pathogens that were typically present at low abundances, a combination of culture enrichment and long-read nanopore sequencing was used to obtain thousands of high contiguity genomes (2347) and closed plasmids (5910), a significant fraction of which (>58%) are not represented in current sequence databases. These high-quality assemblies and metadata enabled a rich characterization of resistance gene combinations, plasmid architectures, and the dynamic nature of hospital environment resistomes and their reservoirs. Phylogenetic analysis identified multidrug resistant clonal strains as being more widely disseminated and stably colonizing across hospital sites. Further genomic comparisons with clinical isolates across multiple species supports the hypothesis that multidrug resistant strains can persist in the hospital environment for extended periods (>8 years) to opportunistically infect patients. These findings highlight the importance of characterizing antibiotic resistance reservoirs in the hospital environment and establishes the feasibility of systematic genomic surveys to help target resources more efficiently for preventing HAIs.

show abstract

Section: Discussionmentioning

confidence: 99%

Cartography of opportunistic pathogens and antibiotic resistance genes in a tertiary hospital environment

Chng

Bertrand

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…Antibiotic stewardship programs can significantly reduce the incidence of MDR-GNB infections and colonization, especially in Southeast Asia. [11][12][13] Finally, local epidemiology is crucial to neonatal care. For example, Southeast Asia has the lowest incidence of Group B Strepto-coccus in the world, 14,15 and low Listeria infection 16 but high MDR-GNB sepsis.…”

Section: Discussionmentioning

confidence: 99%

“…For example, Southeast Asia has the lowest incidence of Group B Strepto-coccus in the world, 14,15 and low Listeria infection 16 but high MDR-GNB sepsis. 5,6,12,[17][18][19] The cost-effectiveness of an intrapartum antibiotic prophylaxis or choice of empirical antimicrobial treatments should be the concern and related to the most common local pathogen. The prevalence and incidence density of MDR-GNB colonization showed an upward trend.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for 30-Day Mortality in Neonatal Gram-Negative Bacilli Sepsis

et al. 2019

View full text Add to dashboard Cite

Objective Multidrug-resistant gram-negative bacilli (MDR-GNB) have emerged globally as a serious threat and with a high case fatality rate (CFR). Study Design We performed a case–control study in a Thai neonatal intensive care unit to identify the risk factors for 30-day CFR of GNB sepsis between 1991 and 2017. The CFR was analyzed by Cox's proportional hazards model. Results For 27 years, the percentage of MDR-GNB from GNB sepsis was 66% (169/257). The medians (interquartile ranges) of gestational age and birth weight of the neonates with GNB sepsis were 33 (29–38) weeks and 1,817 (1,100–2,800) grams, respectively. The 30-day CFRs of the neonates with MDR-GNB and non-MDR-GNB sepsis were 33% (56/169) and 20% (18/88), respectively, (hazard ratio [HR] = 1.74; 95% confidence interval [CI]: 1.03–2.97; p = 0.04). Using Cox's proportional hazards model, nonsurvivors in GNB sepsis were more likely to have septic shock (adjusted HR [aHR] = 6.67; 95% CI: 3.28–13.57; p < 0.001) or no microbiological cure (aHR = 10.65; 95% CI: 4.98–22.76; p < 0.001) than survivors. Conclusion Neonates suspected of sepsis with septic shock need broad-spectrum empirical antimicrobial therapy until the second successive negative culture, especially in high MDR areas.

show abstract

“…There are some reports regarding MDR evidence, indicating that the rate of bacteria experienced MDR to cephalosporin significantly increased from 9.6% to 12% between 2011 and 2014 in Europe (ECDC 2015). In Southeast Asia, the resistance rate of bacteria to carbapenem (64.91%) and multidrug (58.51%) showed high percentage (Teerawattanapong et al 2018). On the other hand, most E. coli (64.9%) from UTI patients in Nepal was reported to have resistance against antibiotics (Parajuli et al 2017).…”

Section: Introductionmentioning

confidence: 99%

Actinomycetes of rhizosphere soil producing antibacterial compounds against Urinary Tract Infection bacteria

2019

View full text Add to dashboard Cite

Abstract. Apsari PP, Budiarti S, Wahyudi AT. 2019. Actinomycetes of rhizosphere soil producing antibacterial compounds against Urinary Tract Infection bacteria. Biodiversitas 20: 1259-1265. Based on the ability of actinomycetes as an antibacterial compounds producer and the need of finding novel antibacterial compounds, this study aims to look for antibacterial compounds from rhizosphere actinomycetes against bacteria in urine of UTI patients (Escherichia coli, Citrobacter braakii, Acinetobacter calcoaceticus, and Klebsiella pneumoniae). The screening of 21 actinomycetes was conducted based on the paper disc method. Potential actinomycetes that inhibited test bacteria were, then cultured in liquid medium and the supernatant was tested to six test bacteria. Then, the supernatant was extracted using ethyl acetate and crude extract from extraction process was tested to test bacteria. Afterward, the crude extract was scanned for bioactive compounds by GC-MS. Potential actinomycetes were identified by 16S rRNA gene to reveal the species. The screening results showed that ARJ 16, 24, and 36 had a wider inhibition zone than others. All of them showed that the supernatant and the crude extract could inhibit UTI's bacteria. The highest abundance of bioactive compound of crude extract was found in Propane, 1,2-dichloro, n-Hexadecanoic acid, and Carbonochloridic acid, 2-chloroethyl ester, respectively. Identification of potential actinomycetes based on 16S rRNA gene showed that ARJ 16 and ARJ 24 were highly similar to Streptomyces sp. in 99% and ARJ 36 was similar to Streptomyces tendae in 98%.

show abstract

A Systematic Review of the Burden of Multidrug-Resistant Healthcare-Associated Infections Among Intensive Care Unit Patients in Southeast Asia: The Rise of Multidrug-ResistantAcinetobacter baumannii

Cited by 74 publications

References 65 publications

Cartography of opportunistic pathogens and antibiotic resistance genes in a tertiary hospital environment

Cartography of opportunistic pathogens and antibiotic resistance genes in a tertiary hospital environment

Risk Factors for 30-Day Mortality in Neonatal Gram-Negative Bacilli Sepsis

Actinomycetes of rhizosphere soil producing antibacterial compounds against Urinary Tract Infection bacteria

Contact Info

Product

Resources

About