Severe infections caused by multidrug-resistant non-fermentative bacilli in southern Poland

Chmielarczyk, Agnieszka; Pobiega, Monika; Ziółkowski, Grzegorz; Pomorska-Wesołowska, Monika; Romaniszyn, Dorota; Krawczyk, Lech; Wójkowska‐Mach, Jadwiga

doi:10.17219/acem/68545

Cited by 12 publications

(12 citation statements)

References 18 publications

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“…Emergence and dissemination of P. aeruginosa international high-risk clones are great challenge worldwide [54,81,98]. MDR and XDR strains of high-risk P. aeruginosa are frequently identified in nosocomial infections and these cause difficult to treat infections as limited treatment options are available [60].…”

Section: Discussionmentioning

confidence: 99%

Diversity and Distribution of Resistance Markers in Pseudomonas aeruginosa International High-Risk Clones

2021

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Pseudomonas aeruginosa high-risk clones are disseminated worldwide and they are common causative agents of hospital-acquired infections. In this review, we will summarize available data of high-risk P. aeruginosa clones from confirmed outbreaks and based on whole-genome sequence data. Common feature of high-risk clones is the production of beta-lactamases and among metallo-beta-lactamases NDM, VIM and IMP types are widely disseminated in different sequence types (STs), by contrast FIM type has been reported in ST235 in Italy, whereas GIM type in ST111 in Germany. In the case of ST277, it is most frequently detected in Brazil and it carries a resistome linked to blaSPM. Colistin resistance develops among P. aeruginosa clones in a lesser extent compared to other resistance mechanisms, as ST235 strains remain mainly susceptible to colistin however, some reports described mcr positive P. aeurigonsa ST235. Transferable quinolone resistance determinants are detected in P. aeruginosa high-risk clones and aac(6′)-Ib-cr variant is the most frequently reported as this determinant is incorporated in integrons. Additionally, qnrVC1 was recently detected in ST773 in Hungary and in ST175 in Spain. Continuous monitoring and surveillance programs are mandatory to track high-risk clones and to analyze emergence of novel clones as well as novel resistance determinants.

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Section: Discussionmentioning

confidence: 99%

Diversity and Distribution of Resistance Markers in Pseudomonas aeruginosa International High-Risk Clones

2021

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“…The extended spectrum betalactamases (ESBL) were detected by double disc synergy test (DDST) using 30 µg ceftazidime and 30 µg cefotaxime placed at a distance of 2 cm (between centers) from the disc with amoxicillin with clavulanic acid 20/10 µg. To increase the sensitivity of the test, discs with aztreonam 30 µg and cefepime 30 µg were added [3].…”

Section: Methodsmentioning

confidence: 99%

Multidrug-Resistant Microorganisms Associated with Urinary Tract Infections Following Orthopaedic Patients: A Laboratory-Based Analysis of 5239 Patients

Ziółkowski¹,

Pawłowska²,

Stasiowski

et al. 2020

Preprint

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Background: The risk of healthcare associated infections (HAI) in surgical wards remains closely related to the type of surgery and procedures performed on patients. They also condition the risk of various, apart from the most common, surgical site infections, forms of clinical infections, especially urinary tract infections (UTIs). Their occurrence in orthopedic patients is most often – in about 70%-80%, associated with the use of the bladder catheter in the perioperative period. The aim of this study was the epidemiological and microbiological analysis of UTIs following orthopedic patients, especially MDR in 2013-2015.Methods: The study was conducted in 38-bed Department of Orthopedic-Traumatic Surgery in Sosnowiec, Poland. 5 239 patients surgery included in the study, the urinary catheter utilization rate was 30.7 %. Laboratory based study using the UTI definition of the HAI-Net program, MDR was defined as resistant to at least one antibiotic from 2< antibiotics groups. The results were analyzed using the statistical package PQStat ver. 1.6.0.428 using the chi-square test (chi ^ 2) or Fisher's exact test.Results The UTI incidence was 3.2% (168 cases), CA-UTI incidence density was 9.6/1 000 catheter-days. The highest risk of UTI was found in patients aged 75 years and older. Gram-negative flora prevailed among microorganisms: 76.1%. Predominantly isolated Enterobacterales were: Escherichia coli, Klebsiella pneumoniae. Isolated microorganisms were fully sensitive to carbapenems. Gram-negative bacilli showed the lowest sensitivity to extended substrate spectrum penicillins and fluoroquinolones: 37-64%, trimethoprim-sulfamethoxazole: 50%; MDR prevalence: 24.4%.Conclusions The presented data indicate that UTI incidence is a significant problem in studied population, as well as antimicrobialresistance, especially to quinolones and extended spectrum cephalosporins, as first-line therapy remains a major challenge. To reduce the problem of high UTI incidence and MDR prevalence, the priority should be the reduction of UTI risk – which exceeded the expected values.

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“…Infections caused by these strains are a serious therapeutic issue and are particularly common among intensive care unit (ICU) patients, but also appear in people hospitalized in other departments [14][15][16][17][18][19]. It seems that A. baumannii is one of the main etiologic agents of hospital associated infections (HAIs) and epidemic outbreaks in Poland, compared to infections caused by other non-fermenting bacteria (Pseudomonas aeruginosa), which are less frequently reported in our country [9,20,21]. For two decades in Poland, A. baumannii infections have been a significant proportion of healthcare-associated infections (especially in ICUs) but there are only a few reports from Poland characterizing these pathogens and the conditions of epidemic outbreaks [20,22,23].…”

Section: Introductionmentioning

confidence: 95%

“…resistant to carbapenems, fluoroquinolones and aminoglycosides constitute 62.9%, which puts our country among several European countries with a high percentage of resistant strains (Latvia 56.8%, Bulgaria 66.4%, Italy 75.7%, Romania 77.6%, Cyprus 78.2%, Greece 81.3%, Lithuania 85.1%, Croatia 90.8%) [8]. Pandrug resistant bacteria (PDR) and XDR isolates of A. baumannii have been reported for many years, not only in Polish hospitals, but also globally [9][10][11][12][13]. Infections caused by these strains are a serious therapeutic issue and are particularly common among intensive care unit (ICU) patients, but also appear in people hospitalized in other departments [14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Investigation of Acinetobacter baumannii Activity in Vascular Surgery Units through Epidemiological Management Based on the Analysis of Antimicrobial Resistance, Biofilm Formation and Genotyping

Szczypta

Talaga-Ćwiertnia

Kielar

et al. 2021

IJERPH

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Background/Objectives: The genus Acinetobacter demonstrates resistance to antibiotics and has been shown to spread in the hospital environment causing epidemic outbreaks among hospitalized patients. The objectives of the present study was to investigate the antibiotic resistance, biofilm formation, and clonality among Acinetobacter baumannii strains. Materials and Methods: The study involved 6 (I Outbreak) and 3 (II Outbreak) A. baumannii strains isolated from patients hospitalized in vascular surgery unit. Results: All tested A. baumannii strains were extensively drug resistant (XDR) and all the isolates were carbapenem-resistant and among them, all carried the blaOXA-51 gene, the blaOXA-24 gene, as well as the blaOXA-23 gene. All of the investigated strains had the ability to form a biofilm, but all of them produced less biofilm than the reference strain. Multi-locus sequence typing (MLST) showed that all strains belonged to the ST2 clone. Pulsed-field gel electrophoresis (PFGE) divided the tested outbreak strains into two clones (A and B). Conclusion: This study shows a nosocomial spread of XDR A. baumannii ST2 having the blaOXA-51 gene, the blaOXA-24 gene, as well as the blaOXA-23 gene, low biofilm formers, that was prevalent in the vascular surgery unit. To identify the current situation of vascular surgery departments targeted epidemiological investigation was needed. Effective implementation of infection control prevented the spread of the epidemic outbreaks.

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Severe infections caused by multidrug-resistant non-fermentative bacilli in southern Poland

Cited by 12 publications

References 18 publications

Diversity and Distribution of Resistance Markers in Pseudomonas aeruginosa International High-Risk Clones

Diversity and Distribution of Resistance Markers in Pseudomonas aeruginosa International High-Risk Clones

Multidrug-Resistant Microorganisms Associated with Urinary Tract Infections Following Orthopaedic Patients: A Laboratory-Based Analysis of 5239 Patients

Investigation of Acinetobacter baumannii Activity in Vascular Surgery Units through Epidemiological Management Based on the Analysis of Antimicrobial Resistance, Biofilm Formation and Genotyping

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