Antimicrobial Drug–Resistant Bacteria Isolated from Syrian War–Injured Patients, August 2011–March 2013

Teicher, Carrie; Ronat, Jean Baptiste; Fakhri, Rasheed M.; Basel, Mohamed; Labar, Amy S.; Hérard, Patrick; Murphy, Richard A.

doi:10.3201/eid2011.140835

Cited by 86 publications

(42 citation statements)

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“…Despite the hospital and community acquired A. baumannii infections, its occurrence appeared to be also related to injuries in war conflicts in e.g. Afghanistan, Iraq and Syria [17,18] as well as natural disasters, such as earthquakes and tsunami [19,20]. Epidemic spread of A. baumannii in above-mentioned extreme situations is attributed by some authors to substantial pressure on hospital emergency wards, which may result in failure in infection control precautions [7].…”

Section: Introductionmentioning

confidence: 99%

Acinetobacter baumannii: biology and drug resistance — role of carbapenemases

Nowak

Paluchowska

2015

Folia Histochem Cytobiol.

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Acinetobacter baumannii is a Gram-negative, glucose-non-fermenting, oxidase-negative coccobacillus, most commonly associated with the hospital settings. The ability to survive in adverse environmental conditions as well as high level of natural and acquired antimicrobial resistance make A. baumannii one of the most important nosocomial pathogens. While carbapenems have long been considered as antimicrobials of last-resort, the rates of clinical A. baumannii strains resistant to these antibiotics are increasing worldwide. Carbapenem resistance among A. baumannii is conferred by coexisting mechanisms including: decrease in permeability of the outer membrane, efflux pumps, production of beta-lactamases, and modification of penicillin-binding proteins. The most prevalent mechanism of carbapenem resistance among A. baumannii is associated with carbapenem-hydrolysing enzymes that belong to Ambler class D and B beta-lactamases. In addition, there have also been reports of resistance mediated by selected Ambler class A carbapenemases among A. baumannii strains. Resistance determinants in A. baumannii are located on chromosome and plasmids, while acquisition of new mechanisms can be mediated by insertion sequences, integrons, transposons, and plasmids. Clinical relevance of carbapenem resistance among strains isolated from infected patients, carriers and hospital environment underlines the need for carbapenemase screening. Currently available methods vary in principle, accuracy and efficiency. The techniques that deserve particular attention belong to both easily accessible unsophisticated methods as well as advanced techniques based on mass spectrometry or molecular biology. While carbapenemases limit the therapeutic options in A. baumannii infections, studies concerning novel beta-lactamase inhibitors offer a new insight into effective therapy.

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Section: Introductionmentioning

confidence: 99%

Acinetobacter baumannii: biology and drug resistance — role of carbapenemases

Nowak

Paluchowska

2015

Folia Histochem Cytobiol.

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“…These countries are known as countries with high prevalence for multidrug-resistant Gram-negative bacteria (MDR GNB) (Enterobacteriaceae, Acinetobacter baumannii) and for meticillin-resistant Staphylococcus aureus (MRSA) [2][3][4][5]. People from these countries are thus at higher risk of being colonised with such pathogens and adequate infection prevention measures need to be taken to prevent spread in healthcare settings in the countries where they seek refuge.…”

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confidence: 99%

Multidrug-resistant organisms detected in refugee patients admitted to a University Hospital, Germany June‒December 2015

et al. 2016

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Multidrug-resistant Gram-negative bacteria (MDR GNB) were found to colonise 60.8% (95% confidence interval: 52.3–68.9) of 143 refugee patients mainly from Syria (47), Afghanistan (29), and Somalia (14) admitted to the University Hospital Frankfurt, Germany, between June and December 2015. This percentage exceeds the prevalence of MDR GNB in resident patients four–fold. Healthcare personnel should be aware of this and the need to implement or adapt adequate infection control measures.

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“…3,4 In Syrian war-injured patients, MDROs have also been isolated frequently. 5 Therefore, prevention strategies to avoid colonization and subsequent infection are warranted.…”

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Prevalence of Multidrug-Resistant Organisms in Hospitalized Pediatric Refugees in an University Children’s Hospital in Germany 2015–2016

Tenenbaum

Becker

Lange

et al. 2016

Infect. Control Hosp. Epidemiol.

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objective. To determine the prevalence of multidrug-resistant organisms (MDROs) colonizing in pediatric refugees admitted to a University Children Hospital in Germany.design. Retrospective observational study.setting. General pediatric and pediatric surgery units.patients. In Germany, recommendations for MDRO screening of pediatric refugees were recently published. According to these and institutional recommendations, all hospitalized pediatric refugees were screened for MDROs between October 2015 and March 2016.methods. Using electronic surveillance data, we performed a chart review to identify the prevalence of MDROs among and the clinical diagnoses of pediatric refugees.results. Among 325 patients hospitalized for various causes, most frequently gastroenteritis (30.9%), MDROs were detected in 33.8%. Most of these patients were colonized with multidrug-resistant Gram-negative (MRGN) bacteria (113 isolates), mostly 2MRGN/ESBL (87 isolates); some patients were colonized with methicillin-resistant Staphylococcus aureus (MRSA, 22 isolates); and 1 patient was colonized with vancomycinresistant enterococci (VRE). Among 110 refugee patients, we detected single colonization with an MDRO in 84 patients (76.4%), co-colonization with 2 pathogens in 23 patients (20.9%), and triple colonization in 3 patients (2.7%). However, infections with MDROs occurred in only 3.6% of pediatric refugees. The peak of positive MDRO screening results in 2015 correlated with an increased hospitalization rate.conclusion. Implementation of infection control measures among pediatric refugees is challenging. Due to the high frequency of MDROs in these patients, current screening, isolation, and treatment strategies may have to be adapted.

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Antimicrobial Drug–Resistant Bacteria Isolated from Syrian War–Injured Patients, August 2011–March 2013

Cited by 86 publications

References 10 publications

Acinetobacter baumannii: biology and drug resistance — role of carbapenemases

Acinetobacter baumannii: biology and drug resistance — role of carbapenemases

Multidrug-resistant organisms detected in refugee patients admitted to a University Hospital, Germany June‒December 2015

Prevalence of Multidrug-Resistant Organisms in Hospitalized Pediatric Refugees in an University Children’s Hospital in Germany 2015–2016

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