Impact and cost of infection control measures to reduce nosocomial transmission of extended-spectrum β-lactamase-producing organisms in a non-outbreak setting

Conterno, Lucieni de Oliveira; Shymanski, J.; Ramotar, Karam; Toye, Baldwin; Zvonar, Rosemary; Roth, Virginia

doi:10.1016/j.jhin.2006.12.014

Cited by 72 publications

(40 citation statements)

References 18 publications

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“…Reporting consistently the presence of ESBLs detected in bacterial strains isolated from clinical samples is very important for several reasons: the relatively high number of strains falsely reported to be susceptible (without interpretation or therapeutic correction), the increased risk of therapeutic failure and the increased potential risk of cross-transmission. For this reason, in all at-risk units (intensive care, burn, oncology-haematology, haemodialysis and organ transplant units) it is recommended to screen patients on admission and regularly during the period of stay (4). Data obtained from our study are in line with the observations at the national level (9,10,11) and showed as the problem of multi-drug resistant bacteria represents an emerging issue in our reality.…”

Section: Articlesupporting

confidence: 84%

Epidemiology of extended spectrum β-lactamase, AmpC and class A carbapenemases-producing organisms isolated at San Camillo Hospital of Treviso (Italy) between April 2012 and March 2014

Scapaticci¹,

Fossen²,

Ius³

2016

Microbiol Med

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SummaryThe indiscriminate use of broad-spectrum cephalosporins of the last years has favoured the selection of extended spectrum β-lactamases (ESBLs), AmpC and class A carbapenemases (KPC)-producing Enterobacteriaceae strains, representing a real health emergency. At San Camillo Hospital of Treviso, Italy, between April 2012 and March 2014, we isolated 263 suspected ESBL-producing strains from various specimens, including urine (76.4%), wound swabs (9.9%), blood cultures (4.6%), vaginal swabs (2.7%), fragments of bone (1.5%) and other materials (4.9%). The majority of the isolated bacteria were represented by Escherichia coli (43.3%), followed by Klebsiella pneumoniae (34.2%), Proteus mirabilis (15.2%), Enterobacter spp. 4%) andPseudomonas aeruginosa (0.4%). Using confirmatory phenotypic tests, 89.4% of the isolated resulted ESBL producer, 15.3% of which were also AmpC-producers, 1.5% were ESBL negative and AmpC positive, 4.2% were ESBL negative and AmpC negative, and 4.9%, consisting solely of K.pneumoniae, were confirmed as KPC positive. ESBL-mediated resistance to cephalosporin is not always clearly evident using susceptibility testing performed by agar diffusion-disc or dilution methods, for this reason it is strictly recommended to use specific tests able to reveal important mechanisms of resistance. The optimal use of diagnostic tools in microbiology is necessary to fight the spreading of pathogens with multiple antibiotic resistance mechanisms and in order to avoid giving useless antibiotic therapies to the patients.

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Section: Articlesupporting

confidence: 84%

Epidemiology of extended spectrum β-lactamase, AmpC and class A carbapenemases-producing organisms isolated at San Camillo Hospital of Treviso (Italy) between April 2012 and March 2014

Scapaticci¹,

Fossen²,

Ius³

2016

Microbiol Med

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“…At this time, systematic screening for ESBL-E carriage upon admission to hospital is not recommended. Systematic screening is costly, and its effectiveness and that of associated policies of isolation have not been demonstrated (110). In addition, the spread of ESBL-producing strains seems to be species dependent.…”

Section: How To Deal With Carriers Upon Admission To Hospitalmentioning

confidence: 99%

Trends in Human Fecal Carriage of Extended-Spectrum β-Lactamases in the Community: Toward the Globalization of CTX-M

et al. 2013

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SUMMARY In the last 10 years, extended-spectrum β-lactamase-producing enterobacteria (ESBL-E) have become one of the main challenges for antibiotic treatment of enterobacterial infections, largely because of the current CTX-M enzyme pandemic. However, most studies have focused on hospitalized patients, though today it appears that the community is strongly affected as well. We therefore decided to devote our investigation to trends in ESBL-E fecal carriage rates and comprehensively reviewed data from studies conducted on healthy populations in various parts of the world. We show that (i) community ESBL-E fecal carriage, which was unknown before the turn of the millennium, has since increased significantly everywhere, with developing countries being the most affected; (ii) intercontinental travel may have emphasized and globalized the issue; and (iii) CTX-M enzymes, especially CTX-M-15, are the dominant type of ESBL. Altogether, these results suggest that CTX-M carriage is evolving toward a global pandemic but is still insufficiently described. Only a better knowledge of its dynamics and biology will lead to further development of appropriate control measures.

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“…NIs result in up to $4.5 billion additional healthcare costs per year, and it affects approximately two million persons each year (12)(13)(14)(15)(16)(17). Different studies showed that by spending much lower costs for hospital hygiene and microbiological diagnosis, NIs can be largely avoided (18)(19)(20)(21). The condition of patient and type of hospital and ward can be associated with NIs (9,11,22,23).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Nosocomial Infections in a Teaching Hospital

Salmanzadeh

Yousefi

Ahmadi³

et al. 2015

Avicenna J Clin Microbiol Infect

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Background: Nosocomial infections (NIs) have increasingly resulted in death and patients have to bear high treatment costs. Healthcare personnel could play a prominent role in prevention and control of NIs. Objectives: The aim of this study was to evaluate NIs in patients admitted to a teaching hospital in Ahvaz, southwest of Iran, during 2013. Patients and Methods:The present study was a cross-sectional study conducted in Razi Hospital, Ahvaz during 12 months from March 2013 to March 2014. All patients hospitalized with no signs and symptoms of infection within 48 hours of admission and presenting signs and symptoms of infection after 48 hours of hospitalization were included in the study. Data about patients' age, sex, site of infection, ward of hospitalization and type of NIs were collected. Bacterial strains were isolated from various clinical samples of patients and identified by conventional methods. Results: The incidence of NIs was low (i.e. < 2%). Among 16936 admitted patients in this hospital, 174 patients (79 males and 95 females) with a mean age of 51.7 ± 24.6 years (range, 5 to 90 years) were diagnosed with an NI. Incidence density of NIs were 3.18% in infectious diseases ward, 2.17% in intensive care unit (ICU), 2% in orthopedic ward, 0.68% in obstetrics and gynecology (OBGYN) ward and 0.278% in general surgery. Regarding the etiology of infection, coagulase-negative staphylococci in 23.69%, Bacillus in 21.05%, Escherichia coli was found in 18.42%, and coagulase-positive staphylococci in 13.16% of the cases. The results indicated that coagulase-negative staphylococci was the most frequent pathogen. Conclusions:The frequency of NIs in this hospital was lower in comparison with other worldwide studies. However, low incidence of health care-associated infections in our study may be due to under diagnosis and underreporting of such infections by health care staff.

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Impact and cost of infection control measures to reduce nosocomial transmission of extended-spectrum β-lactamase-producing organisms in a non-outbreak setting

Cited by 72 publications

References 18 publications

Epidemiology of extended spectrum β-lactamase, AmpC and class A carbapenemases-producing organisms isolated at San Camillo Hospital of Treviso (Italy) between April 2012 and March 2014

Epidemiology of extended spectrum β-lactamase, AmpC and class A carbapenemases-producing organisms isolated at San Camillo Hospital of Treviso (Italy) between April 2012 and March 2014

Trends in Human Fecal Carriage of Extended-Spectrum β-Lactamases in the Community: Toward the Globalization of CTX-M

Evaluation of Nosocomial Infections in a Teaching Hospital

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