Antibacterial resistance associated with long-term care facilities

Urban, Carl; Wehbeh, Wehbeh; Rahal, James J.

doi:10.1097/mrm.0b013e32831a4125

Cited by 5 publications

(4 citation statements)

References 73 publications

(102 reference statements)

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“…Obtaining information about resistant bacteria from these facilities has been problematic for various reasons (14)(15)26). There is no consistent support for active surveillance in nonoutbreak situations, and LTCFs are grossly underfunded and understaffed for these types of undertakings.…”

Section: Discussionmentioning

confidence: 99%

“…Long-term-care facilities have become a major focus of investigations because the patients harbor resistant organisms (14,15). Obtaining information about resistant bacteria from these facilities has been problematic for various reasons (14)(15)26).…”

Section: Discussionmentioning

confidence: 99%

“…Surveillance for CRE is especially useful among immunocompromised patients, including those in intensive care and transplant units (11,12). Screening residents of long-term-care facilities (LTCF) prior to admission and/or transfer to a hospital may be of increasing importance, as they may harbor antibiotic-resistant isolates (13)(14)(15). Although they are rapid, PCR-based technologies can be expensive and limited, as they only interrogate specific genes that are being screened and a positive result does not always predict the expression of resistance.…”

mentioning

confidence: 99%

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Evaluation of Remel Spectra CRE Agar for Detection of Carbapenem-Resistant Bacteria from Rectal Swabs Obtained from Residents of a Long-Term-Care Facility

LaBombardi

Urban²,

Kreiswirth

et al. 2015

J Clin Microbiol

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We compared the Remel Spectra CRE agar plate to CDC standard methodology for the isolation of carbapenem-resistant Enterobacteriaceae (CRE) from 300 rectal swab specimens obtained from patients residing in a long-term-care facility (LTCF). Multiplex PCR experiments were performed on isolates to identify specific Klebsiella pneumoniae carbapenemases (KPC) and additional ␤-lactamases. Of the 300 patients, 72 (24%) harbored CRE and were PCR positive for KPC enzymes. The Remel Spectra CRE plates detected KPC-type CRE in isolates from 70 of 72 patients (97.2%), while the CDC method detected CRE in 56 of 72 (77.8%). CRE identification results were available in 18 h compared to 36 h for the CDC method. Remel Spectra CRE agar plates can provide useful means for a fast and reliable method for detecting KPC-type CRE and for accelerated institution of appropriate infection control precautions. K lebsiella pneumoniae carbapenemases (KPC) are predominantly found in Klebsiella pneumoniae worldwide and have become endemic in major cities of the United States (1-4). They have also been characterized in Klebsiella oxytoca, Escherichia coli, Enterobacter spp., Citrobacter spp., Serratia spp., Acinetobacter baumannii, Salmonella spp., and Pseudomonas spp (1-3). Although KPC-type carbapenemases are the leading cause of carbapenem resistance among Enterobacteriaceae (CRE) in the United States, carbapenem resistance can be mediated by many other enzymes alone or in combination with other resistance mechanisms, including efflux and porin mutations (3, 5). Infections with these organisms are associated with higher mortality rates than those infections with more susceptible strains (6, 7). Patients who are asymptomatic carriers can serve as a source for nosocomial spread of these carbapenem-resistant organisms, necessitating the prompt detection of carriers and institution of appropriate infection control measures (8-11). Surveillance for CRE is especially useful among immunocompromised patients, including those in intensive care and transplant units (11,12). Screening residents of long-term-care facilities (LTCF) prior to admission and/or transfer to a hospital may be of increasing importance, as they may harbor antibiotic-resistant isolates (13-15). Although they are rapid, PCR-based technologies can be expensive and limited, as they only interrogate specific genes that are being screened and a positive result does not always predict the expression of resistance. While traditional culture methods are slow and may lack sensitivity, the use of chromogenic media to culture CRE and other multidrug-resistant microorganisms (MDRO) may facilitate the detection of these organisms in a timelier manner (16-18). The purpose of this investigation was to compare Remel Spectra CRE agar plates to the standard CDC method for the isolation of CRE from rectal swab specimens obtained from patients residing in an LTCF. Remel Spectra CRE agar is a selective and differential agar intended for use in the qualitative and presumptive identification of carbape...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Evaluation of Remel Spectra CRE Agar for Detection of Carbapenem-Resistant Bacteria from Rectal Swabs Obtained from Residents of a Long-Term-Care Facility

LaBombardi

Urban²,

Kreiswirth

et al. 2015

J Clin Microbiol

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“…Any microbial group, bacteria, viruses, fungi, or parasites can cause a nosocomial infection, but bacteria are the most prevalent organisms. The natural bacterial world has always coexisted with humans and their extended environments [3].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Oxacillin Disc Diffusion Test with mecA Polymerase Chain Reaction and Cefoxitin Disc Diffusion Test for the Detection of Oxacillinresistant Staphylococcus aureus Collected from Baghdad Hospitals

Al-Ugaili¹,

Fadhil²,

Wohaieb³

2014

JNUS

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This study was carried out to evaluate the accuracy of oxacillin and cefoxitin disc diffusion testcompared with mecA gene-positive PCR isolates. Two hundred and six clinical swabs fromnose, hand and ear were collected from four different hospitals in Baghdad. The diagnostic results showed that (154) out of (206) samples gave positive bacterial culture, (61) of them were confirmed as Staphylococcusaureus; of which 47 (77%) were oxacillin-resistant Staphylococcus aureus and exhibited multiple resistances to other tested antibiotics. Depending on the MICs values;23 isolates was chosen. Plasmid profiles revealed that (11) out of (23) had a plasmid with different molecular weight. Using polymerase chain reaction assay, 19 isolates were found to havemecA geneand results of agarose gel revealed the presence of DNA band at (200 bp.); the results detect a correlation between the positivity of the isolates for cefoxitin resistant test and the molecular study for the presence of (mecA).

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Evolution of β-Lactamases: Past, Present, and Future

Bush

2011

Antibiotic Discovery and Development

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Antibacterial resistance associated with long-term care facilities

Cited by 5 publications

References 73 publications

Evaluation of Remel Spectra CRE Agar for Detection of Carbapenem-Resistant Bacteria from Rectal Swabs Obtained from Residents of a Long-Term-Care Facility

Evaluation of Remel Spectra CRE Agar for Detection of Carbapenem-Resistant Bacteria from Rectal Swabs Obtained from Residents of a Long-Term-Care Facility

Comparison of Oxacillin Disc Diffusion Test with mecA Polymerase Chain Reaction and Cefoxitin Disc Diffusion Test for the Detection of Oxacillinresistant Staphylococcus aureus Collected from Baghdad Hospitals

Evolution of β-Lactamases: Past, Present, and Future

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