Posts filed under ‘Resistencia bacteriana’

High Rate of MCR-1–Producing Escherichia coli and Klebsiella pneumoniae among Pigs, Portugal

Emerging Infectious Diseases December 2017 V.23 N.12 P.2023-2029

Research

Nicolas Kieffer, Marta Aires-de-Sousa, Patrice Nordmann, and Laurent Poirel

Author affiliations: Université de Fribourg, Fribourg, Switzerland (N. Kieffer, P. Nordmann, L. Poirel); Escola Superior de Saúde da Cruz Vermelha Portuguesa, Lisbon, Portugal (M. Aires-de-Sousa); University of Lausanne and University Hospital Centre, Lausanne, Switzerland (P. Nordmann)

The mcr-1 (mobile colistin resistance 1) gene, which encodes phosphoethanolamine transferase, has been recently identified as a source of acquired resistance to polymyxins in Escherichia coli.

Using the SuperPolymyxin selective medium, we prospectively screened 100 pigs at 2 farms in Portugal for polymyxin-resistant Enterobacteriaceae and recovered 98 plasmid-mediated MCR-1–producing isolates.

Most isolates corresponded to nonclonally related E. coli belonging to many sequence types; we also found 2 Klebsiella pneumoniae sequence types. The mcr-1 gene was carried on IncHI2 or IncP plasmid backbones.

Our finding of a high rate of MCR-1 producers on 2 pig farms in Portugal highlights the diffusion of that colistin-resistance determinant at the farm level.

The fact that the pigs received colistin as metaphylaxis in their feed during the 6 weeks before sampling suggests selective pressure.

PDF

https://wwwnc.cdc.gov/eid/article/23/12/pdfs/17-0883.pdf

Advertisements

November 19, 2017 at 1:02 pm

Characterization of Streptococcus pyogenes from Animal Clinical Specimens, Spain

Emerging Infectious Diseases December 2017 V.23 N.12 P.2011-2016

Research

Streptococcus pyogenes appears to be almost exclusively restricted to humans, with few reports on isolation from animals.

We provide a detailed characterization (emm typing, pulsed-field gel electrophoresis [PFGE], and multilocus sequence typing [MLST]) of 15 S. pyogenes isolates from animals associated with different clinical backgrounds.

We also investigated erythromycin resistance mechanisms and phenotypes and virulence genes.

We observed 2 emm types: emm12 (11 isolates) and emm77 (4 isolates).

Similarly, we observed 2 genetic linages, sequence type (ST) 26 and ST63. Most isolates exhibited the M macrolide resistance phenotype and the mefA/ermB genotype.

Isolates were grouped into 2 clones on the basis of emm-MLST-PFGE-virulence gene profile combinations: clone 1, characterized by the combined genotype emm12-ST36-pulsotype A-speG; and clone 2, characterized by the genotype emm77-ST63-pulsotype B-speC.

Our results do not show conclusively that animals may represent a new reservoir of S. pyogenes but indicate the ability of human-derived S. pyogenes isolates to colonize and infect animals.

PDF

https://wwwnc.cdc.gov/eid/article/23/12/pdfs/15-1146.pdf

November 19, 2017 at 1:00 pm

Randomized Comparison of 3 High-Level Disinfection and Sterilization Procedures for Duodenoscopes

Gastroenterology October 2017 V.153 N.4 P.1018-1025

Graham M. Snyder, Sharon B. Wright, Anne Smithey, Meir Mizrahi, Michelle Sheppard, Elizabeth B. Hirsch, Ram Chuttani, Riley Heroux, David S. Yassa, Lovisa B. Olafsdottir, Roger B. Davis, Jiannis Anastasiou, Vijay Bapat, Kiran Bidari, Douglas K. Pleskow, Daniel Leffler, Benjamin Lane, Alice Chen, Howard S. Gold, Anthony Bartley, Aleah D. King

Background and Aims

Duodenoscopes have been implicated in the transmission of multidrug-resistant organisms (MDRO). We compared the frequency of duodenoscope contamination with MDRO or any other bacteria after disinfection or sterilization by 3 different methods.

Methods

We performed a single-center prospective randomized study in which duodenoscopes were randomly reprocessed by standard high-level disinfection (sHLD), double high-level disinfection (dHLD), or standard high-level disinfection followed by ethylene oxide gas sterilization (HLD/ETO). Samples were collected from the elevator mechanism and working channel of each duodenoscope and cultured before use. The primary outcome was the proportion of duodenoscopes with an elevator mechanism or working channel culture showing 1 or more MDRO; secondary outcomes included the frequency of duodenoscope contamination with more than 0 and 10 or more colony-forming units (CFU) of aerobic bacterial growth on either sampling location.

Results

After 3 months of enrollment, the study was closed because of the futility; we did not observe sufficient

events to evaluate the primary outcome. Among 541 duodenoscope culture events, 516 were included in the final analysis. No duodenoscope culture in any group was positive for MDRO. Bacterial growth of more than 0 CFU was noted in 16.1% duodenoscopes in the sHLD group, 16.0% in the dHLD group, and 22.5% in the HLD/ETO group (P = .21). Bacterial growth or 10 or more CFU was noted in 2.3% of duodenoscopes in the sHLD group, 4.1% in the dHLD group, and 4.2% in the HLD/ETO group (P = .36). MRDOs were cultured from 3.2% of pre-procedure rectal swabs and 2.5% of duodenal aspirates.

Conclusions

In a comparison of duodenoscopes reprocessed by sHLD, dHLD, or HLD/ETO, we found no significant differences between groups for MDRO or bacteria contamination. Enhanced disinfection methods (dHLD or HLD/ETO) did not provide additional protection against contamination. However, insufficient events occurred to assess our  primary study end-point. ClinicalTrials.gov no: NCT02611648 .

FULL TEXT

http://www.gastrojournal.org/article/S0016-5085(17)35869-9/fulltext

PDF

http://www.gastrojournal.org/article/S0016-5085(17)35869-9/pdf

November 12, 2017 at 8:13 pm

Beyond Vasoprotection: Statins and Risk Reduction for Community-Acquired Staphylococcus aureus Bacteremia.

Mayo Clin Proc. October 2017 V.92 N.10 P.1463-1465.

Editorial

DeSimone DC1, DeSimone CV2.

Author information

1 Division of Infectious Diseases, Mayo Clinic, Rochester, MN. Electronic address: desimone.daniel@mayo.edu

2 Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.

FULL TEXT

http://www.mayoclinicproceedings.org/article/S0025-6196(17)30618-3/fulltext

PDF

http://www.mayoclinicproceedings.org/article/S0025-6196(17)30618-3/pdf

November 2, 2017 at 12:28 pm

Closing the Brief Case: Bacteremia and Vertebral Osteomyelitis Due to Staphylococcus schleiferi

Journal of Clinical Microbiology November 2017 V.55 N.11 P.3309-3310

Melanie L. Yarbrough, Yasir Hamad, Carey-Ann D. Burnham and Ige A. George

aDepartment of Pathology & Immunology, Division of Laboratory and Genomic Medicine, Washington University School of Medicine, St. Louis, Missouri, USA

bDepartment of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri, USA

ANSWERS TO SELF-ASSESSMENT QUESTIONS

PDF

http://jcm.asm.org/content/55/11/3309.full.pdf+html

October 26, 2017 at 3:29 pm

The Brief Case: Bacteremia and Vertebral Osteomyelitis Due to Staphylococcus schleiferi

Journal of Clinical Microbiology November 2017 V.55 N.11 P.3157-3161

Melanie L. Yarbrough, Yasir Hamad, Carey-Ann D. Burnham and Ige A. George

aDepartment of Pathology & Immunology, Division of Laboratory and Genomic Medicine, Washington University School of Medicine, St. Louis, Missouri, USA

bDepartment of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri, USA

A 60-year-old female was admitted to a hospital in Missouri with back pain and pathological fractures of multiple thoracic vertebrae. Four months prior to presentation, the patient began experiencing low back pain without inciting trauma. Over the next 2 months, the pain continued to worsen and she experienced a 20-lb weight loss and drenching night sweats, prompting her to seek care. During the initial encounter, the patient denied experiencing fevers. She was not immunocompromised and had no risk factors for tuberculosis and no history of recent travel, hospitalization, or invasive procedures. Magnetic resonance imaging (MRI) revealed abnormal enhancement and edema involving the T6, T7, and T8 vertebral bodies with associated prevertebral and postvertebral soft tissue enhancement and edema. A fluoroscopy-guided T7 vertebral body biopsy revealed acute and chronic osteomyelitis with no evidence of malignancy, prompting an infectious disease consult…

PDF

http://jcm.asm.org/content/55/11/3157.full.pdf+html

October 26, 2017 at 3:28 pm

Factors associated with acquisition of carbapenem-resistant Enterobacteriaceae.

Rev Lat Am Enfermagem. Oct.5, 2017  V.25:e2935.

[Article in English, Portuguese, Spanish]

Lavagnoli LS1, Bassetti BR2, Kaiser TDL1, Kutz KM3, Cerutti C Junior4.

Author information

1 MSc, Microbiologist, Laboratório de Microbiologia Médica, Secretaria de Saúde, Vitória, ES, Brazil.

2 Physician, Hospital Estadual Central, Vitória, ES, Brazil. Physician, Hospital Santa Casa de Misericóridia de Vitória, Vitória, ES, Brazil.

3 Specialist in Applied Microbiology, Microbiologist, Hospital Santa Casa de Misericóridia de Vitória, Vitória, ES, Brazil.

4 PhD, Associate Professor, Universidade Federal do Espírito Santo, Vitória, ES, Brazil.

Abstract

OBJECTIVE:

to identify possible risk factors for acquisition of Enterobacterial strains with a marker for resistance to carbapenems.

METHODS:

exploratory case-control study performed in hospital settings. The study sample consisted of patients with biological specimens that tested positive for carbapenem-resistant Enterobacteriaceae (cases), with the disk diffusion test and Etest, and controls with biological samples testing negative for carbapenem-resistant Enterobacteriaceae. In all, 65 patients were included: 13 (20%) cases and 52 (80%) controls.

RESULTS:

the microorganisms isolated were Serratia marcescens (6), Klebsiella pneumoniae (4), and Enterobacter cloacae (3). Univariate analysis revealed that length of hospitalization prior to sample collection (p=0.002) and having a surgical procedure (p=0.006) were statistically significant. In the multivariable logistic regression model, both were still significant, with odds ratios of 0.93 (p = 0.009; 95% CI: 0.89 to 0.98) for length of hospitalization prior to sample collection, and 9.28 (p = 0.05; 95% CI: 1.01 to 85.14) for having a surgical procedure.

CONCLUSION:

shorter hospitalization times and increased surveillance of patients undergoing surgery could play a decisive role in reducing the spread of carbapenem-resistant microorganisms in hospital settings.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5635698/pdf/0104-1169-rlae-25-e2935.pdf

October 23, 2017 at 3:46 pm

Older Posts


Calendar

November 2017
M T W T F S S
« Oct    
 12345
6789101112
13141516171819
20212223242526
27282930  

Posts by Month

Posts by Category