Outbreak of carbapenem-resistant Providencia rettgeri in a tertiary hospital

Abstract

The emergence of resistance to multiple antimicrobial agents in pathogenic bacteria is a significant public health threat, as there are limited effective antimicrobial agents for infections caused by multidrug-resistant (MDR) bacteria. Several MDR bacteria are now frequently detected. Carbapenem resistance in Enterobacteriaceae is often plasmid mediated, necessitating stringent infection control practices. Wedescribe an outbreak of carbapenem-resistant Providencia rettgeri involving 4 patients admitted to intensive care and high-care units at a tertiary hospital. Clinical and demographic characteristics of 4 patients with carbapenem-resistant P. rettgeri were documented. All P. rettgeri isolated in these cases had a carbapenem-resistant antibiogram, with resistance to imipenem, ertapenem and meropenem. These cases could be epidemiologically linked. A multiprong approach, simultaneously targeting antibiotic stewardship, universal precautions and appropriate transmission-based precaution practices, is integral to prevention and control of nosocomial infections.

<i>Providencia</i> in retail meats from Guangzhou, China and Osaka, Japan: prevalence, antimicrobial resistance and characterization of classes 1, 2 and 3 integrons

“…Since isolation of Providencia and its association with diarrhea and UTI have been increasingly reported in developing and developed countries [ 2 , 6 , 7 , 9 , 10 , 11 , 19 , 20 , 23 , 27 , 29 , 35 , 37 , 38 , 42 , 47 , 48 ], in this study we therefore examined the prevalence of Providencia in retail meats purchased from markets in Guangzhou, China and Osaka, Japan. Our results indicate that retail meats in both China and Japan were substantially contaminated with Providencia spp., especially P. alcalifaciens , and Providencia contamination rate of retail meats purchased in China (45%) was higher than that in Japan (38%).…”

First literature review of carbapenem-resistant Providencia

“…The site of isolation of carbapenem-resistant Providencia was not mentioned in nine instances. Four outbreaks of carbapenem-resistant Providencia were reported in the literature [5] , [11] , [16] , [17] ; three were caused by carbapenem-resistant P. stuartii (CRPS) and one was linked to carbapenem-resistant P. rettgeri (CRPR). All the outbreaks occurred in intensive care units (ICUs).…”

“…Common equipment such as dialysis machines might facilitate the spread of carbapenem-resistant Providencia. In one outbreak of CRPR in South Africa [16] , all patients with CRPR were on dialysis; dialysis machines could be the source of CRPR in this outbreak. Three patients were HIV positive, which indicates that immunocompromised patients are more susceptible to CRPR infections.…”

“…Three patients were HIV positive, which indicates that immunocompromised patients are more susceptible to CRPR infections. It is worth mentioning that many patients with carbapenem-resistant Providencia had urinary catheters [13] , [15] , [16] , [17] , [24] .…”

First case report of Providencia Rettgeri neonatal sepsis

“…There is emergence of isolates that are carbapenemase producers carrying the New Delhi metallo-β-lactamase (NDM) gene bla NDM-1 [ 17 ]. Tshisevhe et al reported outbreak of carbapenem-resistant Providencia rettgeri involving four patients in South Africa with isolates being resistant to Meropenem, Imipenem and Ertapenem [ 18 ].…”