Evaluation of Carbapenem Resistance Mechanisms and Its Association with<i>Pseudomonas aeruginosa</i>Infections in the Northwest of Iran

Akhi, Mohammad Taghi; Khalili, Younes; Ghotaslou, Reza; Yousefi, Saber; Kafil, Hossein Samadi; Naghili, Behrooz; Sheikhalizadeh, Vajihe

doi:10.1089/mdr.2016.0310

Cited by 19 publications

(12 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In accordance with previous prospective or retrospective studies, our results confirmed that prior exposure to carbapenems was an independent risk factor for CRPA infection or colonization [7][8][9]. However, in contrast with some other studies [13,16], we did not find that the use of fluoroquinolones, or aminoglycosides was associated with increased CRPA infection or colonization. These inconsistent findings might be due to differences in antibiotic prescribing practices in different countries [17].…”

Section: Discussionsupporting

confidence: 89%

Risk factors for carbapenem-resistant Pseudomonas aeruginosa infection or colonization in a Chinese teaching hospital

Zhang¹,

Cui

Wang

et al. 2018

J Infect Dev Ctries

View full text Add to dashboard Cite

Introduction: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) is rapidly emerging as a life-threatening nosocomial infection. In this study, we aimed to identify risk factors, especially antibiotic use and co-carriage with other bacteria for CRPA infection or colonization. Methodology: A retrospective study was conducted in the First Affiliated Hospital of Xi’an Jiaotong University, which involved a cohort of patients with Pseudomonas aeruginosa infection or colonization from January 2014 to June 2016. Univariate analysis and multivariate analysis were performed to estimate the risk factors of CRPA occurrence. Results: Eight hundred and eighty-eight patients were included in the study. More than 50% of the risk factors were associated with CRPA infection or colonization according to univariate analysis (P < 0.05), such as invasive procedures, co-carriage with Gram-negative pathogens, and prior treatment with some antibiotics. However, only prior exposure to carbapenems (OR: 8.005; CI:4.507-14.217, P<0.001), the days of carbapenems treatment (OR: 1.190; CI: 1.073-1.272; P < 0.001), and co-carriage with Escherichia coli (OR: 1.824; CI: 1.005-3.310, P = 0.048) were considered independent risk factors by multivariate analysis. A higher mortality was found among patients with CRPA infection or colonization (P < 0.05). Conclusions: Risk factors for CRPA infection or colonization were prior exposure to carbapenems, the days of carbapenems treatment, and co-carriage with Escherichia coli. The prevalence of CRPA could be influenced by Gram-negative pathogens, especially in Escherichia coli, and it need more researches. Moreover, restrictions in the clinical use of carbapenems should be taken into account.

show abstract

Section: Discussionsupporting

confidence: 89%

Risk factors for carbapenem-resistant Pseudomonas aeruginosa infection or colonization in a Chinese teaching hospital

Zhang¹,

Cui

Wang

et al. 2018

J Infect Dev Ctries

View full text Add to dashboard Cite

show abstract

“…Only two studies reported the detection of OXA-23 and SPM-1 in Iranian clinical isolates of P. aeruginosa (Ostad Asadolah-Malayeri et al, 2016; Azimi et al, 2018). Akhi et al (2018) found that the main risk factor for acquiring an MBL infection is non-intensive wards hospitalization. Whether the dissemination of carbapenem resistant P. aeruginosa in Iran is polyclonal or not, cannot be assumed.…”

Section: Distribution Of Multi-drug Resistant Organisms In Humansmentioning

confidence: 99%

Understanding the Epidemiology of Multi-Drug Resistant Gram-Negative Bacilli in the Middle East Using a One Health Approach

et al. 2019

View full text Add to dashboard Cite

In the last decade, extended-spectrum cephalosporin and carbapenem resistant Gram-negative bacilli (GNB) have been extensively reported in the literature as being disseminated in humans but also in animals and the environment. These resistant organisms often cause treatment challenges due to their wide spectrum of antibiotic resistance. With the emergence of colistin resistance in animals and its subsequent detection in humans, the situation has worsened. Several studies reported the transmission of resistant organisms from animals to humans. Studies from the middle east highlight the spread of resistant organisms in hospitals and to a lesser extent in livestock and the environment. In view of the recent socio-economical conflicts that these countries are facing in addition to the constant population mobilization; we attempt in this review to highlight the gaps of the prevalence of resistance, antibiotic consumption reports, infection control measures and other risk factors contributing in particular to the spread of resistance in these countries. In hospitals, carbapenemases producers appear to be dominant. In contrast, extended spectrum beta lactamases (ESBL) and colistin resistance are becoming a serious problem in animals. This is mainly due to the continuous use of colistin in veterinary medicine even though it is now abandoned in the human sphere. In the environment, despite the small number of reports, ESBL and carbapenemases producers were both detected. This highlights the importance of the latter as a bridge between humans and animals in the transmission chain. In this review, we note that in the majority of the Middle Eastern area, little is known about the level of antibiotic consumption especially in the community and animal farms. Furthermore, some countries are currently facing issues with immigrants, poverty and poor living conditions which has been imposed by the civil war crisis. This all greatly facilitates the dissemination of resistance in all environments. In the one health concept, this work re-emphasizes the need to have global intervention measures to avoid dissemination of antibiotic resistance in humans, animals and the environment in Middle Eastern countries.

show abstract

“…Overexpression of AmpC β-lactamase enzymes was detected by an agar plate method, where the agar base was supplemented with cloxacillin (250 µg/mL), as cloxacillin inhibits the effects of AmpC β-lactamases. A two-fold decrease in ceftazidime MICs in the presence of cloxacillin, compared to MICs without cloxacillin, was considered as positivity for AmpC overexpression [14,47]. Phenotypic screening for carbapenemase production was detected by the modified Hodge (cloverleaf) test, optimized for P. aerugniosa, as previously described [39,48].…”

Section: Phenotypic Detection Of Ampc Overexpression and Carbapenemasmentioning

confidence: 99%

“…The effect of phenylalanine-arginine β-naphthylamide (PAβN; a compound with well-known efflux pump inhibitory activity) on the MICs of imipenem and meropenem was detected using the agar dilution method described previously [14,47]. During the experiments, the concentration of PAβN was 40 µg/mL in the agar base.…”

Section: Phenotypic Detection Of Efflux Pumpsmentioning

confidence: 99%

Carbapenem-Resistant but Cephalosporin-Susceptible Pseudomonas aeruginosa in Urinary Tract Infections: Opportunity for Colistin Sparing

Gajdács

2020

Antibiotics

View full text Add to dashboard Cite

This paper briefly reports the occurrence and epidemiology of carbapenem-resistant but cephalosporin-susceptible (Car-R/Ceph-S) Pseudomonas aeruginosa isolates from urinary tract infections (UTIs) in a tertiary-care hospital in the Southern Region of Hungary, and the phenotypic characterization of the possible resistance mechanisms in these isolates. Isolates and data were collected regarding P. aeruginosa UTIs corresponding to the period between 2008 and 2017. Susceptibility testing was performed using the Kirby–Bauer disk diffusion method; minimum inhibitory concentrations (MICs) of the isolates were determined using E-tests. The phenotypic detection of ampicillin C-type (AmpC) β-lactamases, efflux pump overexpression and carbapenemase production was also performed. P. aeruginosa represented n = 575 (2.72% ± 0.64%) from outpatient, and n = 1045 (5.43% ± 0.81%) from inpatient urinary samples, respectively. Based on the disk diffusion test, n = 359 (22.16%) were carbapenem-resistant; in addition to carbapenems, n = (64.34%) were also resistant to ciprofloxacin; n = (60.17%) to gentamicin/tobramycin; n = (58.51%) to levofloxacin; and n = (27.57%) to amikacin. From among the carbapenem-resistant isolates, n = 56 (15.59%) isolates were multidrug-resistant, while n = 16 (4.46%) were extensively drug-resistant. From among the Car-R/Ceph-S isolates (n = 57), overexpression of AmpC was observed in n = 7 cases (12.28%); carbapenemase production in n = 4 (7.02%); while overexpression of efflux pumps was present in n = 31 (54.39%) isolates. To spare last-resort agents, e.g., colistin, the use of broad-spectrum cephalosporins or safe, alternative agents should be considered in these infections.

show abstract

Evaluation of Carbapenem Resistance Mechanisms and Its Association withPseudomonas aeruginosaInfections in the Northwest of Iran

Cited by 19 publications

References 38 publications

Risk factors for carbapenem-resistant Pseudomonas aeruginosa infection or colonization in a Chinese teaching hospital

Risk factors for carbapenem-resistant Pseudomonas aeruginosa infection or colonization in a Chinese teaching hospital

Understanding the Epidemiology of Multi-Drug Resistant Gram-Negative Bacilli in the Middle East Using a One Health Approach

Carbapenem-Resistant but Cephalosporin-Susceptible Pseudomonas aeruginosa in Urinary Tract Infections: Opportunity for Colistin Sparing

Contact Info

Product

Resources

About