Identification of nasal colonization with β-lactamase-producing enterobacteriaceae in patients, health care workers and students in Madagascar

Micheel, Volker; Hogan, Benedikt; Rakotoarivelo, R.; Rakotozandrindrainy, Raphäel; Razafimanatsoa, Fetra; Razafindrabe, Tsiriniaina Jean Luco; Crusius, Sabine; Poppert, Sven; Schwarz, Norbert; May, Jürgen; Frickmann, Hagen; Hagen, Ralf Matthias

doi:10.1556/eujmi-d-15-00001

Cited by 12 publications

(13 citation statements)

References 23 publications

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“…Considering the fact that colonization frequently precedes infection, the observation by Yun et al [ 25 ] that local forces in Iraq showed high colonization rates of skin and mucous membranes with Gram-negative bacteria is of particular importance. Similar data on Gram-negative colonization of skin and mucous membranes with Gram-negative Enterobacteriaceae were recently described for patients, students, and healthcare workers in the highlands of Madagascar [ 72 ]. The reasons are unclear, although high temperatures and humidity which are frequent in subtropical and tropical settings were described to facilitate Gram-negative bacterial growth on human skin [ 73 ].…”

Section: Discussionsupporting

confidence: 75%

Resistant Gram-Negative Bacteria and Diagnostic Point-of-Care Options for the Field Setting during Military Operations

Frickmann

Podbielski²,

Kreikemeyer³

2018

BioMed Research International

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The spread of multidrug-resistant bacteria in resource-poor settings affects the military medical service in case of deployments of soldiers to war and crisis zones. Patients with war injuries are prone to colonization or infection with multidrug-resistant bacteria. Resistant Gram-negative bacteria play a dominant role in military wound infections. Problematic hygiene conditions on deployment facilitate exposition of soldiers with subsequent colonization. Although colonizing strains are frequently cleared from their hosts after returning from deployment, transmission to close contacts of the soldiers in the home country cannot be excluded and therapeutic options are reduced if colonization progresses to invasive infection. Since sophisticated culture-based diagnostic approaches are typically not available in the field setting on deployment, molecular rapid diagnostic test systems are an option for transmission control if the locally prevalent molecular resistance mechanisms are known. Efforts for global resistance surveillance can contribute to better understanding of resistance distribution and spread at deployment sites. This review summarizes experience of the military medical services with multidrug resistance on deployment and with the influx of resistant strains to the home country and discusses potential use of available molecular rapid test systems as an option for the field setting.

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Section: Discussionsupporting

confidence: 75%

Resistant Gram-Negative Bacteria and Diagnostic Point-of-Care Options for the Field Setting during Military Operations

Frickmann

Podbielski²,

Kreikemeyer³

2018

BioMed Research International

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“…One reason is the fact that there are numerous different molecular mechanisms, exceeding the potentials even of multiplex PCR approaches. However, if only singular or few resistance determinants circulate within a local population as suggested for Mali, PCR-based screening might be successfully applied as recently demonstrated for a setting in Madagascar [ 13 ].…”

Section: Resultsmentioning

confidence: 99%

β-lactamases encoded by blaCTX-M group I genes as determinants of resistance of ESBL-positive enterobacteriaceae in European soldiers in tropical Mali

Hagen¹,

Hinz²,

Frickmann³

2015

EuJMI

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ESBL (extended-spectrum-β-lactamase)-positive Enterobacteriaceae, which colonized European soldiers in tropical Western African Mali, were subjected to a molecular assessment of their resistance determinants. By doing so, a better insight into the locally endemic pattern of ESBL-associated β-lactamase genes was aspired.From a previous study on diarrhea in European soldiers on deployment in tropical Mali, 15 ESBL-positive Escherichia coli with demonstrated high clonal diversity and one positive Klebsiella pneumoniae were assessed. Polymerase chain reactions (PCRs) for blaTEM and blaSHV β-lactamase genes with subsequent sequencing for the discrimination of ESBL- and non-ESBL variants were performed, followed by four group-specific PCRs for blaCTX-M genes.Non-ESBL-associated blaTEM-1 was identified in six out of 15 (40%) E. coli strains, while 100% of the assessed strains were positive for group I blaCTX-M.Considering the known clonal diversity of the assessed strains, the striking restriction to one group of blaCTX-M genes accounting for the ESBL phenotypes of the isolates suggests little genetic exchange in the local setting. Under such circumstances of restricted numbers of locally endemic target genes, PCR-based screening approaches for ESBL colonization might be promising.

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“…Inhabitants of tropical or subtropical climate zones were shown to have high colonization rates of skin and mucous membranes with Gram-negative rod-shaped bacteria [21]. High frequencies were also reported from patients, students, and health-care workers in Madagascar [22]. This makes the discrimination between wound colonization and wound infection challenging.…”

Section: Plos Onementioning

confidence: 99%

Spectrum of antibiotic resistant bacteria and fungi isolated from chronically infected wounds in a rural district hospital in Ghana

et al. 2020

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Background Chronic infected wounds are generally difficult to manage and treatment can be particularly challenging in resource-limited settings where diagnostic testing is not readily available. In this study, the epidemiology of microbial pathogens in chronically infected wounds in rural Ghana was assessed to support therapeutic choices for physicians. Methods Culture-based bacterial diagnostics including antimicrobial resistance testing were performed on samples collected from patients with chronic wounds at a hospital in Asante Akim North Municipality, Ghana. Fungal detection was performed by broad-range fungal PCR and sequencing of amplicons. Results In total, 105 patients were enrolled in the study, from which 207 potential bacterial pathogens were isolated. Enterobacteriaceae (n = 84, 41%) constituted the most frequently isolated group of pathogens. On species level, Pseudomonas aeruginosa (n = 50, 24%) and Staphylococcus aureus (n = 28, 14%) were predominant. High resistance rates were documented, comprising 29% methicillin resistance in S. aureus as well as resistance to 3 rd generation cephalosporins and fluoroquinolones in 33% and 58% of Enterobacteriaceae, respectively. One P. aeruginosa strain with carbapenem resistance was identified. The most frequently detected fungi were Candida tropicalis.

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Identification of nasal colonization with β-lactamase-producing enterobacteriaceae in patients, health care workers and students in Madagascar

Cited by 12 publications

References 23 publications

Resistant Gram-Negative Bacteria and Diagnostic Point-of-Care Options for the Field Setting during Military Operations

Resistant Gram-Negative Bacteria and Diagnostic Point-of-Care Options for the Field Setting during Military Operations

β-lactamases encoded by blaCTX-M group I genes as determinants of resistance of ESBL-positive enterobacteriaceae in European soldiers in tropical Mali

Spectrum of antibiotic resistant bacteria and fungi isolated from chronically infected wounds in a rural district hospital in Ghana

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