Extensive colonization with carbapenemase-producing microorganisms in Romanian burn patients: infectious consequences from the Colectiv fire disaster

Abstract

Health care of severe burn patients is highly specialized and may require international patient transfer. Burn patients have an increased risk of developing infections. Patients that have been hospitalized in countries where carbapenemase-producing microorganisms (CPMO) are endemic may develop infections that are difficult to treat. In addition, there is a risk on outbreaks with CPMOs in burn centers. This study underlines that burn patients may extensively be colonized with CPMOs, and it provides best practice recommendations regarding clinical microbiology and infection control. We evaluated CPMO-carriage and wound colonization in a burn patient initially treated in Romania, and transported to the Netherlands. The sequence types and acquired beta-lactamase genes of highly-resistant microorganisms were derived from next generation sequencing data. Next, we searched literature for reports on CPMOs in burn patients. Five different carbapenemase-producing isolates were cultured: two unrelated OXA-48-producing Klebsiella pneumoniae isolates, OXA-23-producing Acinetobacter baumanii, OXA-48-producing Enterobacter cloacae, and NDM-1-producing Providencia stuartii. Also, multi-drug resistant Pseudomonas aeruginosa isolates were detected. Among the sampling sites, there was high variety in CPMOs. We found 46 reports on CPMOs in burn patients. We listed the epidemiology of CPMOs by country of initial treatment, and summarized recommendations for care of these patients based on these reports and our study.

Whole genome sequencing snapshot of multi-drug resistant Klebsiella pneumoniae strains from hospitals and receiving wastewater treatment plants in Southern Romania

“…bla OXA-48, bla KPC-2, bla NDM-1 and bla OXA-162 ) found in the majority of the influent, effluent and clinical isolates are those reported as prevalent both in Romania and in other geographical areas [29]. Previous studies performed in Romania on carbapenem-non-susceptible Klebsiella pneumoniae clinical isolates have shown that bla OXA-48 was by far the most predominant genotype, followed by bla NDM-1 and bla KPC-2 [30,31,32]. The corresponding STs for the carbapenemase-producing isolates are: ST101 and ST258 (the most prevalent, as also reported in other studies including those performed on Romanian clinical strains by the authors of the present paper [11,33], followed by ST11, ST17, ST219, ST307 and ST395).…”

The Impact of Composites with Silicate-Based Glasses and Gold Nanoparticles on Skin Wound Regeneration

“…In a previous study, we demonstrated the antibacterial effect of the BGAuIND against multi-drug resistant Pseudonomas aeruginosa and Staphyloccoccus aureus [ 12 ]. Considering that the burn patients have an increased risk of developing infections and the Pseudomonas aeruginosa is a type of germ present in hospitals [ 23 ], the viable strategy would be to use the ointments with BGAuIND to treat these patients. Thus, a study of this possible application is the subject of a future study.…”

Antibiogram of burn wound isolates at Masina hospital, Mumbai, India: A 12-year descriptive cross sectional study

“…Presently Imipenem ,Vancomycin ,Netilmicin and Linizolid are effective for drug resistant pathogen, however there must be controlled use of these resourceful antibiotics. [7][8][9] Potz etal study stated that, while resistance to multiple antibiotics limits the therapeutic options for infections with ESBL-producing organisms, none of the isolates in their study showed resistance to Imipenem or Meropenem. It is therefore comforting to observe the continuing efficacy of the carbapenems against problematic isolates.…”