Laboratory investigation of a suspected outbreak caused by Providencia stuartii with intermediate resistance to imipenem at a long-term care facility

Mao, Yuan-Chih; Chang, Chin-Lu; Huang, Yhu-Chering; Su, Lin‐Hui; Lee, Chao-Tai

doi:10.1016/j.jmii.2016.07.004

Cited by 20 publications

(15 citation statements)

References 37 publications

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“…P. stuartii , another bacterium isolated from fish sample ( Table 1 ), usually causes opportunistic infections and is associated with nosocomial outbreaks 28 . Khunthongpan et al .…”

Section: Discussionmentioning

confidence: 99%

Drug resistance, AmpC-β-lactamase and extended-spectrum β-lactamase-producing Enterobacteriaceae isolated from fish and shrimp

Almeida

Cangussú

Carvalho³

et al. 2017

Rev. Inst. Med. trop. S. Paulo

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The present study aims to detect the production of extended-spectrum beta-lactamases (ESBL) by enterobacteria isolated from samples of fresh shrimp and fish obtained from the retail trade of the city of Sobral, Ceará State, Brazil. All bacterial isolates were submitted to identification and antimicrobial susceptibility testing using aminopenicillin, beta-lactamase inhibitors, carbapenem, 1st, 2nd, 3rd and 4th generation cephalosporins, and monobactam. Three types of beta-lactamases - ESBL, AmpC and KPC - were investigated. 103 strains were identified, and the most frequent species in shrimp and fish samples was Enterobacter cloacae (n = 54). All the strains were resistant to penicillin and more than 50% of the isolates were resistant to ampicillin and cephalothin. Resistance to three 3rd generation cephalosporins (cefotaxime, ceftriaxone and ceftazidime) and one fourth generation cephalosporin (cefepime) was detected in two isolates of E. cloacae from shrimp samples. Phenotypic detection of AmpC was confirmed in seven strains. The ESBL was detected in two strains of E. cloacae from shrimp samples. No strain showed KPC production. These data can be considered alarming, since food (shrimp and fish) may be carriers of enterobacteria resistant to drugs of clinical interest.

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“…P. stuartii , another bacterium isolated from fish sample ( Table 1 ), usually causes opportunistic infections and is associated with nosocomial outbreaks 28 . Khunthongpan et al .…”

Section: Discussionmentioning

confidence: 99%

Drug resistance, AmpC-β-lactamase and extended-spectrum β-lactamase-producing Enterobacteriaceae isolated from fish and shrimp

Almeida

Cangussú

Carvalho³

et al. 2017

Rev. Inst. Med. trop. S. Paulo

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“…As shown in Table 3, the prevalence rate of CRE colonization among LTCFs in the Asia region ranged from 13%-22.7% (Dandachi et al, 2016;Lee et al, 2017;Chen et al, 2018;Hagiya et al, 2018;Jean et al, 2018;Mao et al, 2018;Le et al, 2020).…”

Section: Prevalence and Incidence Of Cre Among Residents In Ltcfsmentioning

confidence: 99%

Carbapenem-Resistant Enterobacterales in Long-Term Care Facilities: A Global and Narrative Review

Chen

Jean

Lee

et al. 2021

Front. Cell. Infect. Microbiol.

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The emergence of carbapenem-resistant Enterobacterales (CRE) has become a major public health concern. Moreover, its colonization among residents of long-term care facilities (LTCFs) is associated with subsequent infections and mortality. To further explore the various aspects concerning CRE in LTCFs, we conducted a literature review on CRE colonization and/or infections in long-term care facilities. The prevalence and incidence of CRE acquisition among residents of LTCFs, especially in California, central Italy, Spain, Japan, and Taiwan, were determined. There was a significant predominance of CRE in LTCFs, especially in high-acuity LTCFs with mechanical ventilation, and thus may serve as outbreak centers. The prevalence rate of CRE in LTCFs was significantly higher than that in acute care settings and the community, which indicated that LTCFs are a vital reservoir for CRE. The detailed species and genomic analyses of CRE among LTCFs reported that Klebsiella pneumoniae is the primary species in the LTCFs in the United States, Spain, and Taiwan. KPC-2-containing K. pneumoniae strains with sequence type 258 is the most common sequence type of KPC-producing K. pneumoniae in the LTCFs in the United States. IMP-11- and IMP-6-producing CRE were commonly reported among LTCFs in Japan. OXA-48 was the predominant carbapenemase among LTCFs in Spain. Multiple risk factors associated with the increased risk for CRE acquisition in LTCFs were found, such as comorbidities, immunosuppressive status, dependent functional status, usage of gastrointestinal devices or indwelling catheters, mechanical ventilation, prior antibiotic exposures, and previous culture reports. A high CRE acquisition rate and prolonged CRE carriage duration after colonization were found among residents in LTCFs. Moreover, the patients from LTCFs who were colonized or infected with CRE had poor clinical outcomes, with a mortality rate of up to 75% in infected patients. Infection prevention and control measures to reduce CRE in LTCFs is important, and could possibly be controlled via active surveillance, contact precautions, cohort staffing, daily chlorhexidine bathing, healthcare-worker education, and hand-hygiene adherence.

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“…In the latter study, 91% of overall CRE isolates were K. pneumoniae , while 59% were cultured from urine between 2008 and 2012 ( P < 0.0001) ( Thaden et al, 2014 ). In addition, it was observed that many residents from the LTCF in Taiwan were also the carriers of CRE, most (24/27) were K. pneumoniae ( Chuang, 2015 ; Mao et al, 2018 ). This was similar to the study conducted by Lee C.M.…”

Section: Community and Long-term Care Facility (Ltcf)-acquired Crementioning

confidence: 99%

Carbapenem-Resistant Enterobacteriaceae Infections: Taiwan Aspects

et al. 2018

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Carbapenem-resistant Enterobacteriaceae (CRE), a major resistance concern emerging during the last decade because of significantly compromising the efficacy of carbapenem agents, has currently become an important focus of infection control. Many investigations have shown a high association of CRE infections with high case-fatality rates. In Taiwan, a few surveys observed that a significant proportion (29–47%) of the CR-Klebsiella pneumoniae isolates harbored a plasmidic allele encoding K. pneumoniae carbapenemases (KPC, especially KPC-2). A significant increase in the number of oxacillinase (OXA)-48-like carbapenemases among CR-K. pneumoniae isolates was observed between 2012 and 2015. By striking contrast, isolates of CR-Escherichia coli and CR-Enterobacter species in Taiwan had a much lower percentage of carbapenemase production than CR-K. pneumoniae isolates. This differs from isolates found in China as well as in the India subcontinent. Apart from the hospital setting, CRE was also cultured from the inpatients from communities or long-term care facilities (LTCF). Therefore, implementation of regular CRE screening of LTCF residents, strict disinfectant use in nursing homes and hospital settings, and appropriate control of antibiotic prescriptions is suggested to alleviate the spread of clinical CRE isolates in Taiwan. Although there are some promising new antibiotics against CRE, such as ceftazidime-avibactam, meropenem-vaborbactam, aztreonam-avibactam and cefiderocol, these agents are not available in Taiwan currently. Therefore, in order to effectively decrease case-fatality rates among patients with the infections owing to carbapenemase-producing CRE isolates, combination antibiotic schemes, including colistin (or amikacin) and/or tigecycline in combination with an anti-pseudomonal carbapenem agent, remain the mainstay for treating clinical CRE infections.

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Laboratory investigation of a suspected outbreak caused by Providencia stuartii with intermediate resistance to imipenem at a long-term care facility

Cited by 20 publications

References 37 publications

Drug resistance, AmpC-β-lactamase and extended-spectrum β-lactamase-producing Enterobacteriaceae isolated from fish and shrimp

Drug resistance, AmpC-β-lactamase and extended-spectrum β-lactamase-producing Enterobacteriaceae isolated from fish and shrimp

Carbapenem-Resistant Enterobacterales in Long-Term Care Facilities: A Global and Narrative Review

Carbapenem-Resistant Enterobacteriaceae Infections: Taiwan Aspects

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