Risk factors for fecal carriage of IMP-6-producing Enterobacteriaceae at a long-term care hospital in Japan: A follow-up report from the northern Osaka multicentre study group

Hagiya, Hideharu; Yamamoto, Naoki; Kawahara, Ryuji; Akeda, Yukihiro; Shanmugakani, Rathina Kumar; Ueda, Akiko; Nishi, Isao; Asada, Rumiko; Yoshida, Hisao; Tomono, Kazunori

doi:10.1016/j.jiac.2018.03.009

Cited by 16 publications

(12 citation statements)

References 12 publications

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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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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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“…Using selective media and the new identification method discussed, it becomes possible to report on the presumed bacterial species and drug‐resistance factors within 24 hours of specimen submission. Considering that the detection rate of ESBL‐producing bacteria in Japan has risen compared to 20 years ago 9 and that of carbapenemase‐producing bacteria is also increasing, 10,11 there is a significant need for the implementation of this method as a screening test. Due to the importance of antimicrobial stewardship in recent years, 12 early presumptive reports on identification and resistance factors are extremely meaningful.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of presumptive identification of Enterobacterales using CHROMagar Orientation medium and rapid biochemical tests

Ohtaki

Takahashi

Niwa

et al. 2020

Clinical Laboratory Analysis

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Background The use of matrix‐assisted laser desorption/ionization time‐of‐flight mass spectrometry is gradually spreading among large‐scale laboratories; however, this method is impractical for small‐scale laboratories. In laboratories without access to these rapid identification methods, problems related to them remain unsolved. In this study, we aimed to develop a rapid and inexpensive method to presumptively identify Enterobacterales using CHROMagar Orientation medium. Methods The algorithm for presumptive identification of Enterobacteriaceae using CHROMagar Orientation medium was based on our previous studies. Modified property tests for indole, lysine decarboxylase, ornithine decarboxylase, and hydrogen sulfide were performed to evaluate the differentiation of the bacterial species. Results Using the type strains and clinical isolates, it was possible to conduct the property tests at a low cost, within 4 hours. The spot indole test was performed without any nonspecific reactions for the bacteria forming colored colonies. The presumptive identification of bacteria was thereby possible within 24 hours after specimen submission. Conclusion All these results suggest that the rapid presumptive identification of Enterobacterales is possible with this new identification method using CHROMagar Orientation medium. This is therefore a prompt and economical method that can be used in routine laboratory work.

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“…To date, IMP-type CPE strains are predominantly found in Japan [3,4]; however, the risk of importing other CPE strains also increases with globalization. In this context, the development of a multiplex assay for several CPE strains is required to prevent and control the spread of infection.…”

Section: Introductionmentioning

confidence: 99%

Multiplex Real-Time PCR Assay for Six Major Carbapenemase Genes

et al. 2021

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The global dissemination of carbapenemase-producing Enterobacteriaceae (CPE) is a major concern in public health. Due to the existence of the diversity of carbapenemases, development of an easily available, cost-effective multiplex detection assay for CPE is required worldwide. Using clinically available and reliable equipment, COBAS® z480 (Roche Diagnostics K.K., Tokyo, Japan), we developed a multiplex real-time PCR assay for the detection of two combinations of carbapenemases; first, blaNDM, blaKPC, and blaIMP (Set 1), and second, blaGES, blaOXA-48, and blaVIM (Set 2). We constructed standard curves for each carbapenemase gene using serial dilutions of DNA standards, then applied reference or clinical isolates with each carbapenemase gene to this assay. The multiplex assay showed satisfactory accuracy to detect CPE genes, with the correlation coefficients of greater than 0.99 for all genotypes. The assay appropriately differentiated the reference or clinical strains harboring each carbapenemase gene without cross reactivity. Lastly, the assay successfully detected multiple genes without false-positive reactions by applying six clinical isolates carrying both NDM and OXA-48-like carbapenemase genes. Major advantages of our assay include multiplicity, simple operation, robustness, and speed (1 h). We believe that the multiplex assay potentially contributes to early diagnosis of CPE with a diverse genetic background.

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Risk factors for fecal carriage of IMP-6-producing Enterobacteriaceae at a long-term care hospital in Japan: A follow-up report from the northern Osaka multicentre study group

Cited by 16 publications

References 12 publications

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

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

Evaluation of presumptive identification of Enterobacterales using CHROMagar Orientation medium and rapid biochemical tests

Multiplex Real-Time PCR Assay for Six Major Carbapenemase Genes

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