Device-associated nosocomial infection rates in intensive care units at Cairo University hospitals: First step toward initiating surveillance programs in a resource-limited country

El-Kholy, Amani; Saied, Tamer; Gaber, Mervat; Younan, Maher Y. A.; Haleim, Mona M.A.; El-Sayed, Hanan M.; El-Karaksy, Hanaa’a; Bazaraa, Hafez; Talaat, Maha

doi:10.1016/j.ajic.2011.12.010

Cited by 56 publications

(69 citation statements)

References 30 publications

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“…The bacterium can colonize implanted devices, catheters, heart valves, ventilators or dental implants resulting in device-associated hospital acquired infections which are of major concern globally (El-Kholy et al, 2012). P. aeruginosa is associated with different types of infections which cause morbidity and mortality (Driscoll et al, 2007;Suárez et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Antipseudomonal Antibiotics and Mechanisms of Multidrug Resistance in Pseudomonas aeruginosa

Zowalaty

Gyetvai

2016

Polish Journal of Microbiology

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A b s t r a c tPseudomonas aeruginosa is a leading human pathogen that causes serious infections at various tissues and organs leading to life threatening health problems and possible deadly outcomes. Resistance patterns vary widely whether it is from hospitals or community acquired infections. Reporting resistance profiles to a certain antibiotics provide valuable information in a given setting, but may be extrapolated outside the sampling location. In the present study, P. aeruginosa isolates were screened to determine their susceptibilities against antipseudomonal antimicrobial agents and possible existing mechanisms of resistance were determined. Eighty-six isolates of P. aeruginosa were recovered. Isolates representing different resistance profiles were screened for the existence of three different resistance mechanisms including drug inactivation due to metallo-β-lactamases, drug impermeability by outer membrane proteins and drug efflux. All tested isolates showed uniform susceptibility (100%, n = 86/86) to piperacillin, meropenem, amikacin, and polymyxin B. A single isolate was found to be imipenem resistant (99%, n = 85/86). The possible mechanisms of resistance of P. aeruginosa to imipenem involve active drug efflux pumps, outer membrane impermeability as well as drug inactivating enzymes. These findings demonstrate the fundamental importance of the in vitro susceptibility testing of antibiotics prior to antipseudomonal therapy and highlight the need for a continuous antimicrobial resistance surveillance programs to monitor the changing resistance patterns so that clinicians and health care officials are updated as to the most effective therapeutic agents to combat the serious outcomes of P. aeruginosa infections. This copy is for personal use only -distribution prohibited.El Zowalaty M.E. and Gyetvai B.1 24 anti biotics (El Zowalaty et al., 2015). The literature is rich in surveillance studies from all over the world reporting varying resistance rates among P. aeruginosa against different antimicrobial agent. Recently, studies have focused on the decreased susceptibility of P. aeru ginosa to currently used antipseudomonal agents, including β-lactams, aminoglycosides, and fluoroquinolones (Al-Tawfiq, 2007) since resistance of P. aeru ginosa to carbapenems, piperacillin, and other highly active antibiotics has emerged and is increasing which makes treatment of P. aeruginosa infections troublesome (Strateva et al., 2007).Recently, resistance rates of P. aeruginosa clinical isolates recovered from patients admitted to Zagazig University hospitals in Egypt against different classes of antimicrobial agents were reported (El Zowalaty, 2012). The current study further examined the susceptibilities and possible resistance mechanisms of P. aeruginosa isolates collected from hospitalized patients against selected antipseudomonal agents that are available in the Egyptian pharmaceutical market and are frequently prescribed to patients. Experimental Materials and MethodsStudy site. The specimens were collected from ...

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Section: Introductionmentioning

confidence: 99%

Effectiveness of Antipseudomonal Antibiotics and Mechanisms of Multidrug Resistance in Pseudomonas aeruginosa

Zowalaty

Gyetvai

2016

Polish Journal of Microbiology

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“…7 The bacteria can colonize implanted devices, catheters, heart valves, ventilators or dental implants resulting in deviceassociated hospital acquired infections which are of major concern globally. 8 The resistance rates of P. aeruginosa are increasing globally creating a serious public health threat.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic resistance pattern in pseudomonas aeruginosa isolated from a private Medical College Hospital

Siddiqua¹,

Alam

Akter³

et al. 2018

KYAMC j.

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Background: Pseudomonas aeruginosa is an aerobic, motile, gram negative rod that belongs to the family, Pseudomonadaceae. They are often multidrug resistant due to intrinsic and acquired determinants. Continued emergence of resistance among P. aeruginosa to common antimicrobial drugs has been reported world-wide.Objectives: This study investigated the antimicrobial resistance as well as susceptibility patterns of isolates of P. aeruginosa in clinical specimens.Materials & Methods: One hundred and thirty-eight isolates of Pseudomonas aeruginosa were obtained from 4489 different clinical specimens. Antimicrobial susceptibility pattern of each isolate was carried out by the Kirby- Bauer disk diffusion method as per guidelines of Clinical Laboratory Standard Institute (CLSI).Results: Majority of isolates of P. aeruginosa were obtained from specimens of wound swab 89 (64.5%), pus 18 (13.05%), and urine 17 (13.1%). The isolated pathogens showed high resistance (91% to 96%) to cotrimoxazole and cefuroxime. Resistance rates to cefepime, ceftriaxone, cefotaxime, and gentamicin varied from 47% to 88%. All the isolates were comparatively better susceptible to meropenem, ciprofloxacin, amikacin and imipenem ranges from 76% to 87%.Conclusion: The results confirmed the occurrence of drug resistance of P. aeruginosa to anti-pseudomonal drugs. Imipenem, amikacin, ciprofloxacin and meropenem were found to be the most effective antimicrobial drugs. Therefore, judicious and rational treatment prescription is needed by the physicians to limit the further spread of antimicrobial resistance among the P. aeruginosa.KYAMC Journal Vol. 9, No.-1, April 2018, Page 16-19

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“…In Egypt, a surveillance project was developed by the Infection Control Unit at Naval Medical Research Unit-3 (NAMRU-3) in collaboration with the Cairo University hospital's [Promotion of Quality and Safety of Healthcare in Egypt], which focused on active prospective surveillance of HAIs in neonatal intensive care units (NICUs) [12]. All types of HAIs were subject to evaluation, and standardized CDC case definitions (defined as standardized criteria used to determine if a person has specific disease, condition or outcome, and usually incorporate clinical laboratory or other diagnostic criteria) were applied according to those published by the CDC's National Healthcare Safety Network [4].…”

Section: Introductionmentioning

confidence: 99%

Use of personal digital assistants to detect healthcare-associated infections in a neonatal intensive care unit in Egypt

Saleh

El-Kholy

Sayed

et al. 2016

J Infect Dev Ctries

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Introduction: Personal digital assistants (PDAs) used in electronic laboratory-based surveillance are a promising alternative to conventional surveillance to detect healthcare-associated infections (HAIs). The aim of the study was to monitor, detect, and analyze HAIs using PDAs in a neonatal intensive care unit (NICU). Methodology: In this descriptive study, 1,053 neonates admitted to the NICU in the obstetrics and gynecology ward at the Cairo University hospital were included and evaluated for HAIs by collecting data using PDAs programmed by Naval Medical Research Unit 3, Cairo, with the definitions for HAIs provided by the National Healthcare Safety Network of the Centers for Disease Control and Prevention. Case records were reviewed three times a week over 19 months, from March 2012 to September 2013. Results: Of 124 suspected episodes of infection recorded in PDAs, 89 confirmed episodes of infection were identified. HAI and NICU infection rates were 7.4 and 2.72/1,000 patient-days, respectively. Primary bloodstream infection was detected in 81 episodes and pneumonia in 8 episodes. The majority of infections (62%) were acquired in the ward before NICU admission. Klebsiella spp. was isolated most frequently (42%), followed by coagulase-negative Staphylococci (31%). Conclusions: This study is the first to report the use of PDAs in surveillance to detect HAIs in the NICU in our hospital. The majority of infections were acquired at the obstetric care department, indicating the importance of implementing rigorous prevention and control programs and a more detailed surveillance to identify other risk factors for infections.

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Device-associated nosocomial infection rates in intensive care units at Cairo University hospitals: First step toward initiating surveillance programs in a resource-limited country

Cited by 56 publications

References 30 publications

Effectiveness of Antipseudomonal Antibiotics and Mechanisms of Multidrug Resistance in Pseudomonas aeruginosa

Effectiveness of Antipseudomonal Antibiotics and Mechanisms of Multidrug Resistance in Pseudomonas aeruginosa

Antibiotic resistance pattern in pseudomonas aeruginosa isolated from a private Medical College Hospital

Use of personal digital assistants to detect healthcare-associated infections in a neonatal intensive care unit in Egypt

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