A silent outbreak of vancomycin-resistant Enterococcus faecium in a neonatal intensive care unit

Marom, Ronella; Mandel, Dror; Haham, Alon; Berger, I; Ovental, Amit; Raskind, Craig; Grisaru‐Soen, Galia; Adler, Amos; Lellouche, Jonathan; Schwartz, David; Carmeli, Yehuda; Schechner, Vered

doi:10.1186/s13756-020-00755-0

Cited by 15 publications

(8 citation statements)

References 18 publications

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“…In regard to the virulence spectrum, Enterococcus species produces cytolysins, gelatinases, pore-forming toxins, and aggregation substances, which promote tissue invasion, immune evasion, or cellular damage [ 62 ]. Vancomycin-resistant enterococci (VRE) currently represent a fundamental healthcare concern due to an increased mortality rate among ICU patients [ 63 , 64 , 65 , 66 ]. Surveillance programs include VRE microbiological research on rectal swabs to prevent invasive diseases according to the ECDC protocols [ 10 ].…”

Section: Epidemiological Detailsmentioning

confidence: 99%

Bacterial Infections in Intensive Care Units: Epidemiological and Microbiological Aspects

Calvo,

Stefani,

Migliorisi

2024

Antibiotics

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Intensive care units constitute a critical setting for the management of infections. The patients’ fragilities and spread of multidrug-resistant microorganisms lead to relevant difficulties in the patients’ care. Recent epidemiological surveys documented the Gram-negative bacteria supremacy among intensive care unit (ICU) infection aetiologies, accounting for numerous multidrug-resistant isolates. Regarding this specific setting, clinical microbiology support holds a crucial role in the definition of diagnostic algorithms. Eventually, the complete patient evaluation requires integrating local epidemiological knowledge into the best practice and the standardization of antimicrobial stewardship programs. Clinical laboratories usually receive respiratory tract and blood samples from ICU patients, which express a significant predisposition to severe infections. Therefore, conventional or rapid diagnostic workflows should be modified depending on patients’ urgency and preliminary colonization data. Additionally, it is essential to complete each microbiological report with rapid phenotypic minimum inhibitory concentration (MIC) values and information about resistance markers. Microbiologists also help in the eventual integration of ultimate genome analysis techniques into complicated diagnostic workflows. Herein, we want to emphasize the role of the microbiologist in the decisional process of critical patient management.

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Section: Epidemiological Detailsmentioning

confidence: 99%

Bacterial Infections in Intensive Care Units: Epidemiological and Microbiological Aspects

Calvo,

Stefani,

Migliorisi

2024

Antibiotics

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“…Identification of methicillinresistant S. aureus strains that are also vancomycinintermediate or vancomycin-resistant is similarly concerning. Finally, vancomycin-resistant enterococci remain a rare but persistent threat in nurseries [24]. This trend has driven increased interest in the pharmacokinetics and pharmacodynamics of alternative antibiotics with activity against grampositives, including linezolid, daptomycin, and ceftaroline [21,[25][26][27].…”

Section: Gram-positivementioning

confidence: 99%

Neonatal bloodstream infections

Hadfield¹,

Cantey²

2021

Current Opinion in Infectious Diseases

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Purpose of review Neonatal bloodstream infections (BSI) are a major contributor to morbidity and mortality within neonatal intensive care units. BSI, including central line-associated BSI, have decreased over the past 15 years but remain common in extremely preterm infants. The purpose of this review is to highlight recent advances in the causes, diagnosis, management, and prevention of neonatal BSI. Recent findings Continued quality improvement efforts and bundles have reduced BSI incidence, and novel approaches are highlighted. An update of emerging pathogens as well as traditional pathogens with novel antimicrobial resistance, which are an increasingly common cause of neonatal BSI, is included. Finally, current and future investigations into serum or noninvasive biomarkers for neonatal BSI are reviewed. Summary Neonatal BSIs continue to decrease due to enhanced infection control and prevention techniques. However, many challenges remain, including emerging bacterial and fungal resistance and the continued need for novel diagnostics that hasten time to pathogen identification and effective treatment. This review of the past 18 months highlights the rapid changes in this area. Ongoing efforts to reduce the morbidity and mortality caused by neonatal BSI must remain a priority.

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“…Gram-positive strains, such as Coagulase-negative Staphylococcus (CONS) , S. aureus, and Enterococcus are at present the most frequent agents of nosocomial LOS in HICs [ 28 , 29 ] and vancomycin is among the most prescribed drugs in NICU [ 35 ]. Vancomycin-resistant Enterococci (VRE) are increasingly reported in neonatal sepsis worldwide [ 29 , 36 , 37 ] and accounted for 14% of all LOS in a network of Greek NICUs [ 29 ]. Resistance to glycopeptides of Gram-positive strains was reported in 13% of neonatal sepsis in India and 45% in Nigeria [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

New Antimicrobials for the Treatment of Neonatal Sepsis Caused by Multi-Drug-Resistant Bacteria: A Systematic Review

Poggi¹,

Dani

2023

Antibiotics

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Background: Infections by multi-drug-resistant (MDR) organisms are sharply increasing in newborns worldwide. In low and middle-income countries, a disproportionate amount of neonatal sepsis caused by MDR Gram negatives was recently reported. Newborns with infections by MDR organisms with limited treatment options may benefit from novel antimicrobials. Methods: We performed a literature search investigating the use in newborns, infants and children of novel antimicrobials for the treatment of MDR Gram negatives, namely ceftazidime/avibactam, ceftolozane/tazobactam, cefiderocol, meropenem/vaborbactam, imipenem/relebactam, and Gram positives with resistance of concern, namely ceftaroline and dalbavancin. PubMed, EMBASE, and Web of Science were searched. Results: A total of 50 records fulfilled the inclusion criteria. Most articles were case reports or case series, and ceftazidime/avibactam was the most studied agent. All studies showed favorable efficacy and safety profile in newborns and across different age cohorts. Conclusions: novel antibiotics may be considered in newborns for the treatment of MDR Gram negatives with limited treatment options and for Gram positives with resistance concerns. Further studies are needed to address their effectiveness and safety in newborns.

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A silent outbreak of vancomycin-resistant Enterococcus faecium in a neonatal intensive care unit

Cited by 15 publications

References 18 publications

Bacterial Infections in Intensive Care Units: Epidemiological and Microbiological Aspects

Bacterial Infections in Intensive Care Units: Epidemiological and Microbiological Aspects

Neonatal bloodstream infections

New Antimicrobials for the Treatment of Neonatal Sepsis Caused by Multi-Drug-Resistant Bacteria: A Systematic Review

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