P. aeruginosa colonization at ICU admission as a risk factor for developing P. aeruginosa ICU pneumonia

Paling, F.; Wolkewitz, Martin; Depuydt, Pieter; Bus, Liesbet De; Sifakis, Frangiscos; Bonten, Marc J. M.; Kluytmans, Jan

doi:10.1186/s13756-017-0197-9

Cited by 16 publications

(11 citation statements)

References 9 publications

(12 reference statements)

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“…In our sample, 6.4% was found to be positive to PSAER on the admission, a rate that is lower than that reported in the US (11.6%) [ 24 ], France (17%) [ 25 ], and the Netherlands (9.2%) [ 26 ]. Despite our low infection rates compared with other studies, one of our patients acquired PSAER during the ICU stay, resulting in an ICU acquisition proportion of 1.26 (1.28 per 1000PD).…”

Section: Discussioncontrasting

confidence: 81%

“…When it comes to the comparison of the aggregated HAI acquisition rates during ICU hospitalization, our overall rates (2.56 per 1000 PD), were much lower than those in other published studies. The acquisition rate in the Greek study was 15.7 [ 23 ], in the Netherlands, it was 14 [ 26 ], and in a Chinese study, it was 35 per 1000 PD [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

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When Multidrug-Resistant Organism (MDRO)-Positive ICU Patient Isolation and Cohorting Is Not Feasible, What Comes Next?

Iordanou

Palazis

Timiliotou-Matsentidou

et al. 2021

Cureus

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Background The need for the implementation of an infection prevention strategy that included patient isolation and a cohorting procedure emerged in our ICU. Yet, isolation, as well as cohorting, were not feasible due to certain barriers associated with a high colonization pressure, open-plan ICU, inadequate bed separation, a limited number of isolation rooms, and nursing shortage. Despite these limitations, we tried to upgrade our ICU’s infection prevention efforts by developing the "universal use of contact precautions approach" for infection prevention and control for all the patients with and without multidrug-resistant organisms (MDROs), cohorting, and single room isolation. The study aimed to evaluate the effectiveness of our approach. Methods A prospective cohort study using surveillance screening cultures for Methicillin-resistant Staphylococcus aureus ( MRSA ) and MDROs for a period of 18 weeks from October 1, 2018, to January 31, 2019. The main purpose of the approach was to isolate all patients (regardless of their MDRO/MRSA status) in their own bed space as if they were in an isolation room for the entire duration of their ICU hospitalization, in such a way as to prevent horizontal transmission of infection (infection acquisition) in our open-plan ICU. Results Seventy-eight patients were admitted to our ICU for a total of 942 patient-days; a total of 432 swabs were collected during the study period. A total of 17 (21.8%) patients were admitted with a pre-existing infection while two (2.5%) patients acquired an infection during their ICU stay (one with Acinetobacter baumannii andone with Pseudomonas aeruginosa ; 1.28 acquisition per 1000 patient-days). No transmission was documented for Klebsiella pneumoniae , Enterococcus faecalis, and Staphylococcus aureus. Conclusions Our MDRO acquisition rates suggested that the implementation of our infection control strategy potentially prevents the horizontal transmission of pathogens in an open-plan ICU, despite the high colonization pressure and the lack of isolation and cohorting procedures.

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Section: Discussioncontrasting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

When Multidrug-Resistant Organism (MDRO)-Positive ICU Patient Isolation and Cohorting Is Not Feasible, What Comes Next?

Iordanou

Palazis

Timiliotou-Matsentidou

et al. 2021

Cureus

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“…A. baumannii is an opportunistic Gram-negative bacillus that is responsible for a variety of nosocomial infections with high morbidity and mortality rates, these include, pneumonia, wound infections, bloodstream infections, urinary tract infections, and secondary meningitis (Howard et al, 2012; Liu et al, 2016). Furthermore, in intensive care neonatal and burns units, A. baumannii is one of the most commonly encountered pathogens (Seifert et al, 1994) (a claim shared with Pseudomonas aeruginosa and Staphylococcus aureus ) (Paling et al, 2017a, b). Drug-resistant biofilm formation appears to play a vital role in the pathogenicity of A .…”

Section: Introductionmentioning

confidence: 99%

Antibiofilm and Antivirulence Efficacies of Flavonoids and Curcumin Against Acinetobacter baumannii

et al. 2019

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Acinetobacter baumannii is well adapted to hospital environments, and the persistence of its chronic infections is mainly due to its ability to form biofilms resistant to conventional antibiotics and host immune systems. Hence, the inhibitions of biofilm formation and virulence characteristics provide other means of addressing infections. In this study, the antibiofilm activities of twelve flavonoids were initially investigated. Three most active flavonoids, namely, fisetin, phloretin, and curcumin, dose-dependently inhibited biofilm formation by a reference A. baumannii strain and by several clinical isolates, including four multidrug-resistant isolates. Furthermore, the antibiofilm activity of curcumin (the most active flavonoid) was greater than that of the well-known biofilm inhibitor gallium nitrate. Curcumin inhibited pellicle formation and the surface motility of A. baumannii . Interestingly, curcumin also showed antibiofilm activity against Candida albicans and mixed cultures of C. albicans and A. baumannii . In silico molecular docking of the biofilm response regulator BfmR showed that the binding efficacy of flavonoids with BfmR was correlated with antibiofilm efficacy. In addition, curcumin treatment diminished A. baumannii virulence in an in vivo Caenorhabditis elegans model without cytotoxicity. The study shows curcumin and other flavonoids have potential for controlling biofilm formation by and the virulence of A. baumannii .

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“…Pseudomonas aeruginosa is an opportunistic pathogen. The organism is frequently causes nosocomial infection, wound sepsis, pneumonia and urinary tract infections (UTIs) in hospitalized patients, especially in intensive care units (ICUs) [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Molecular characterization of Pseudomonas aeruginosa isolates from various clinical specimens in Khartoum/Sudan: Antimicrobial resistance and virulence genes

Babour

Mohamed

Shehabi

2020

int. arab. j antimicrob. agents

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Background: Pseudomonas aeruginosa is a pathogenic organism responsible for frequent wound and nosocomial infections worldwide. Its infections are difficult to control since the organism is known to rapidly develop antibiotic resistance and becomes multidrug-resistant (MDR) during treatment of patients. Aim of the study: This study was intended to investigate the occurrence of certain important types of (ESBL) and (MBL) enzymes in association with important specific virulence factors associated with P. aeruginosa clinical isolates from Khartoum, Sudan. Methods: This study investigated 70 P. aeruginosa isolates which were collected from patients admitted to four major hospitals in Khartoum (Fedail, Ribat, Ibn Sina and Soba hospitals). These isolates were recovered from 40 wound swabs (57.1%), 27 urine samples (38.6%), and 3 pleural fluid samples (4.3%) of patients. Higher numbers of isolates were recovered from males 42 (60%) than in females 28 (40%). All P. aeruginosa isolates were first confirmed by conventional biochemical and second using molecular PCR tests. PCR methods were also used for detecting the presence of the virulence genes ToxA, AlgD, LasB, exoS, exoU, CTX, GES-1, and genes of VIM, IMP, KPC, CTX, VEB-1 and SHV-1. Results: Antimicrobial susceptibility testing of P. aeruginosa isolates showed a high resistance to azetronam 49 (70%), followed by ceftazidime 32 (45.7%), 16 ciprofloxacin (22.9%), gentamicin 13 (18.6 %), piperacillin-tazobactam 11 (15.7%), amikacin 9 (12.9 %), and imipenem 6 (8.6%) showed the least resistance. All isolates were positive for algD and lasB (100%), followed by toxA (90%), exoS (34.3), exoU (24.3%), respectively. The rates of detected ESBL genes blaTEM, blaCTX-m, blaSHV-1,GES-1, were 3.3%, 6.6%, 10%, 3.3%,10%, respectively, but all isolates were negative for bla-KPC and bla- VIM and IMP . The percentages of pigment production were 61.4% for pyocyanin, 37.1% for pyoverdin and 1.4% for pyorubin. Conclusion: The study demonstrated high rates of antimicrobial resistance markers to most commonly used antibiotics in treatment of P. aeruginosa infections. The majority of the isolates from urine and wound samples carried at least three potential virulence factor genes of algD, lasB and toxA and without any significant relation to their antimicrobial resistance markers.

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P. aeruginosa colonization at ICU admission as a risk factor for developing P. aeruginosa ICU pneumonia

Cited by 16 publications

References 9 publications

When Multidrug-Resistant Organism (MDRO)-Positive ICU Patient Isolation and Cohorting Is Not Feasible, What Comes Next?

When Multidrug-Resistant Organism (MDRO)-Positive ICU Patient Isolation and Cohorting Is Not Feasible, What Comes Next?

Antibiofilm and Antivirulence Efficacies of Flavonoids and Curcumin Against Acinetobacter baumannii

Molecular characterization of Pseudomonas aeruginosa isolates from various clinical specimens in Khartoum/Sudan: Antimicrobial resistance and virulence genes

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