Detection and characterization of carbapenem resistant Gram‐negative bacilli isolates recovered from hospitalized patients at Soba University Hospital, Sudan

Elbadawi, Hana S.; Elhag, K. M.; Mahgoub, Elsheikh; Altayb, Hisham N.; Ntoumi, Francine; Elton, Linzy; McHugh, Timothy D.; Tembo, John; Ippolito, Giuseppe; Osman, Abdinasir Yusuf; Zumla, Alimuddin; Hamid, Muzamil Mahdi Abdel

doi:10.1186/s12866-021-02133-1

Cited by 31 publications

(26 citation statements)

References 49 publications

(70 reference statements)

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“…However, it is very likely that the existence of only one carbapenem-resistance gene is not necessary associated with carbapenem-resistance. Contrary to what was previously noted in a study performed in Sudan, which revealed that 83% of isolates were positive by phenotypic tests, while 58.7% had one or more carbapenem-resistance genes [ 27 ].…”

Section: Discussioncontrasting

confidence: 73%

Characteristics of Carbapenem-Resistant Gram-Negative Bacilli in Patients with Ventilator-Associated Pneumonia

et al. 2021

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Carbapenem-resistant Gram-negative bacilli (CR-GNB) has become a global threat. In hospital settings, the association of CR-GNB with ventilator-associated pneumonia (VAP) is a critical public health concern owing to their high resistance rate to most antibiotics. The present study aims to identify the frequency of carbapenem-resistance and to determine the rate of multidrug resistance (MDR), extensive drug resistance (XDR) and pan-drug resistance (PDR) among CR-GNB infections in VAP. Antimicrobial susceptibility testing was carried out using the disk diffusion method and the detection of carbapenemases was screened using the imipenem-E test and the modified carbapenem-inactivation method (mCIM). The isolates were verified by polymerase chain reaction (PCR) for the presence of blaNDM, blaSPM, blaVIM, blaIMP and blaGIM genes. 89.5%, 14%, 17.5%, 10.5%, 3.5% of isolates exhibited the presence of blaNDM, blaVIM, blaSPM, blaIMP and blaGIM, respectively. 76%, 17% and 7% of isolates were PDR, XDR, and MDR, respectively. Carbapenem-resistance genes were identified in a significant percentage and blaNDM was the most predominant gene. All isolates were highly resistant to most antibiotics. This health concern has proven to be a big challenge in developing countries such as Egypt, as it is associated with high morbidity, high mortality, and raised healthcare costs.

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Section: Discussioncontrasting

confidence: 73%

Characteristics of Carbapenem-Resistant Gram-Negative Bacilli in Patients with Ventilator-Associated Pneumonia

et al. 2021

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“…Regarding blaVIM-2, the frequency was only 10.8 % (12/111) of the CR GNB isolates. This low rate is consistent with the research of Elbadawi et al [36] but differs from previous studies that showed a higher prevalence of this gene (82 %) [37]. We reported a low prevalence of blaSPM-1 and blaSIM-1 in this study (3.6 % and 1.8 % respectively) which agreed generally with previous studies but with different percentages (1.75% [38] and 4% [39] respectively.…”

Section: Discussionsupporting

confidence: 90%

Performance of chromID® CARBA-SMART medium and carbapenemase inhibition method for the detection of carbapenemases among Gram negative bacilli

Ghandour

Mohamad

Bakry

et al. 2022

Microbes and Infectious Diseases

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Background: Early detection of carbapenemase enzymes among Gram negative bacilli (GNB) is mandatory to prevent their spread. Objective: The goal of this study was to evaluate the performance of chromID® CARBA-SMART medium and carbapenemase inhibition method (CIM) for detection of carbapenemases in GNB. Methodology: A total of 142 GNB isolates were collected and tested using Vitek-2 ® system for identification and antimicrobial susceptibility testing The carbapenem resistant (CR) GNB were tested for carbapenemase production by phenotypic methods; chromID ® CARBA-SMART medium and CIM. Carbapenemase genes (𝑏𝑙𝑎NDM-1, blaSIM-1, 𝑏𝑙𝑎VIM-2, 𝑏𝑙𝑎KPC-1, blaGIM-1, blaSPM-1 and 𝑏𝑙𝑎OXA-48) were detected by PCR. Results: By minimal inhibitory concentration (MIC), 111 (78.17 %) of the 142 isolates were shown to be carbapenem resistant. Sensitivity and specificity of CIM and ChromID® CARBA-SMART medium were (100% and 66.7% respectively) for CIM and (86.7% and 100% respectively) for the medium. Resistance to carbapenem was associated with high percentages of resistance to many antibiotic classes. Carbapenemase genes were detected in 82% (91/111) of CR GNB with 𝑏𝑙𝑎NDM-1 (58.6%) and 𝑏𝑙𝑎OXA-48 (55.9 %) having the highest prevalence, followed by 𝑏𝑙𝑎KPC-1 (36 %) then 𝑏𝑙𝑎VIM-2 (10.8%) and lastly blaSPM-1 (3.6 %) and blaSIM-1 (1.8 %). The blaGIM-1 gene was not detected in any isolate. Conclusion: Carbapenemase inhibition method was found to be a very sensitive, easy, and cheap test for carbapenemase detection but needs the addition of ChromID® CARBA-SMART medium to improve the specificity of the test. This study has a high prevalence of carbapenemases among isolates with potential of rapid spread necessitating need for phenotypic tests.

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“…MDR strains were defined based on the previous descriptions [ 13 , 14 ]. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion method under the requirement of the Clinical and Laboratory Standards Institute (CLSI) guidelines [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

Establishment and validation of a nomogram to predict the in-hospital death risk of nosocomial infections in cancer patients

Jiang

Shi

Zheng

et al. 2022

Antimicrob Resist Infect Control

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Background Attributed to the immunosuppression caused by malignancy itself and its treatments, cancer patients are vulnerable to developing nosocomial infections. This study aimed to develop a nomogram to predict the in-hospital death risk of these patients. Methods This retrospective study was conducted at a medical center in Northwestern China. The univariate and multivariate logistic regression analyses were adopted to identify predictive factors for in-hospital mortality of nosocomial infections in cancer patients. A nomogram was developed to predict the in-hospital mortality of each patient, with receiver operating characteristic curves and calibration curves being generated to assess its predictive ability. Furthermore, decision curve analysis (DCA) was also performed to estimate the clinical utility of the nomogram. Results A total of 1,008 nosocomial infection episodes were recognized from 14,695 cancer patients. Extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (15.5%) was the most predominant causative pathogen. Besides, multidrug-resistant strains were discovered in 25.5% of cases. The multivariate analysis indicated that Eastern Cooperative Oncology Group Performance Status 3–4, mechanical ventilation, septic shock, hypoproteinemia, and length of antimicrobial treatment < 7 days were correlated with higher in-hospital mortality. Patients who received curative surgery were correlated with favorable survival outcomes. Ultimately, a nomogram was constructed to predict the in-hospital mortality of nosocomial infections in cancer patients. The area under the curve values of the nomogram were 0.811 and 0.795 in the training and validation cohorts. The calibration curve showed high consistency between the actual and predicted in-hospital mortality. DCA indicated that the nomogram was of good clinical utility and more credible net clinical benefits in predicting in-hospital mortality. Conclusions Nosocomial infections stay conjoint in cancer patients, with gram-negative bacteria being the most frequent causative pathogens. We developed and verified a nomogram that could effectively predict the in-hospital death risk of nosocomial infections among these patients. Precise management of high-risk patients, early recognition of septic shock, rapid and adequate antimicrobial treatment, and dynamic monitoring of serum albumin levels may improve the prognosis of these individuals.

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Detection and characterization of carbapenem resistant Gram‐negative bacilli isolates recovered from hospitalized patients at Soba University Hospital, Sudan

Cited by 31 publications

References 49 publications

Characteristics of Carbapenem-Resistant Gram-Negative Bacilli in Patients with Ventilator-Associated Pneumonia

Characteristics of Carbapenem-Resistant Gram-Negative Bacilli in Patients with Ventilator-Associated Pneumonia

Performance of chromID® CARBA-SMART medium and carbapenemase inhibition method for the detection of carbapenemases among Gram negative bacilli

Establishment and validation of a nomogram to predict the in-hospital death risk of nosocomial infections in cancer patients

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