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intense cre unit

I Rossi Gonçalves, M L Ferreira, B F Araujo, P A Campos, S Royer, D W F Batistão, L P Souza, C S Brito, J E Urzedo, P P Gontijo-Filho, R M Ribas
BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE), especially those that produce Klebsiella pneumoniae carbapenemase (KPC) and are associated with colistin resistance, pose a severe health threat due to the limited treatment options. AIM: To describe two outbreaks of KPC-producing K. pneumoniae in an adult intensive care unit (AICU) in Brazil. In May 2015, 14 patients had colistin-susceptible KPC-producing strains (ColS-KPC), and in July 2015, nine patients had colistin-resistant KPC-producing strains (ColR-KPC)...
August 26, 2016: Journal of Hospital Infection
Mirian de Freitas DalBen, Elisa Teixeira Mendes, Maria Luisa Moura, Dania Abdel Rahman, Driele Peixoto, Sania Alves Dos Santos, Walquiria Barcelos de Figueiredo, Pedro Vitale Mendes, Leandro Utino Taniguchi, Francisco Antonio Bezerra Coutinho, Eduardo Massad, Anna Sara Levin
OBJECTIVE To reduce transmission of carbapenem-resistant Enterobacteriaceae (CRE) in an intensive care unit with interventions based on simulations by a developed mathematical model. DESIGN Before-after trial with a 44-week baseline period and 24-week intervention period. SETTING Medical intensive care unit of a tertiary care teaching hospital. PARTICIPANTS All patients admitted to the unit. METHODS We developed a model of transmission of CRE in an intensive care unit and measured all necessary parameters for the model input...
November 2016: Infection Control and Hospital Epidemiology
C S Abboud, E E de Souza, E C Zandonadi, L S Borges, L Miglioli, F C Monaco, V L Barbosa, D Cortez, A C Bianco, A Braz, J Monteiro
BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) cause surgical site infections (SSIs) in intensive care units (ICUs). This study aimed to evaluate the impact of intervention and control measures to reduce CRE colonization and infection rates among patients in the ICU of a cardiac surgery hospital following a CRE outbreak. METHODS: An observational study of the pre- and postintervention status of a cohort of colonized or infected patients in the postoperative adult cardiac surgery ICU was performed between April 2013 and December 2014...
September 2016: Journal of Hospital Infection
Y Dickstein, R Edelman, T Dror, K Hussein, Y Bar-Lavie, M Paul
OBJECTIVES: To examine whether carbapenem-resistant Enterobacteriaceae (CRE) carriage is associated with incidence of clinical infection as a means of assessing whether the morbidity and mortality associated with these bacteria are mediated by underlying conditions or intrinsic properties of CRE. METHODS: This retrospective matched cohort study compared the incidence of invasive infections in CRE-colonized patients and matched non-carriers in the intensive care unit (ICU)...
September 2016: Journal of Hospital Infection
B Abdalhamid, N Elhadi, N Alabdulqader, K Alsamman, R Aljindan
Carbapenem-resistant Enterobacteriaceae (CRE) and carbapenem-resistant Pseudomonas aeruginosa (CRPAE) are globally a major medical issue, especially in intensive care units. The digestive tract is the main reservoir for these isolates; therefore, rectal swab surveillance is highly recommended. The purpose of this study was to detect the prevalence of gastrointestinal tract colonization of CRE and CRPAE in patients admitted to intensive care units in Saudi Arabia. This project also aimed to characterize carbapenem-hydrolyzing enzyme production in these isolates...
March 2016: New Microbes and New Infections
Anna Q Yaffee, Lynn Roser, Kimberly Daniels, Kraig Humbaugh, Robert Brawley, Douglas Thoroughman, Andrea Flinchum
During August 4-September 1, 2015, eight cases of Verona integron-encoded metallo-beta-lactamase (VIM)-producing Carbapenem-resistant Enterobacteriaceae (CRE) colonization were identified in six patients, using weekly active surveillance perirectal cultures in a Kentucky tertiary care hospital. No cases of clinical infection or complications attributable to colonization were reported. Four of the eight isolates were identified as Enterobacter cloacae; other organisms included Raoultella species (one), Escherichia coli (one), and Klebsiella pneumoniae (two)...
February 26, 2016: MMWR. Morbidity and Mortality Weekly Report
N Thacker, N Pereira, S D Banavali, G Narula, T Vora, G Chinnaswamy, M Prasad, R Kelkar, S Biswas, B Arora
BACKGROUND: Infection or colonization with multidrug-resistant organisms (MDRO) is associated with high mortality and morbidity. Knowledge of MDRO colonization may help in planning empirical antibiotic approach in neutropenic patients, which is known to improve patient outcomes. While routine cultures are positive and may help direct antibiotic therapy in only up to 15% neutropenic patients, surveillance cultures are positive in more than 90% of cancer patients. AIMS: To assess the rate of MDRO carrier status at presentation and rate of conversion to MDRO during the treatment...
October 2014: Indian Journal of Cancer
Srinivasan Periasamy, Pei-Yi Chu, Ya-Hui Li, Dur-Zong Hsu, Ming-Yie Liu
Sepsis is one of the major causes of death reported in intensive care units. Acute kidney injury (AKI) and hypotension are important in the pathogenesis and mortality of systemic inflammatory response (SIR). Sesamol delays mortality in sepsis; however, its effects on AKI and hypotension and the role of peroxisome proliferator-activated receptor-ɣ (PPAR-γ) activation have not been established. We investigated the effect of sesamol on SIR in cecal ligation and puncture (CLP)-induced acute kidney injury and lipopolysaccharide (LPS)-induced hypotension in rats...
2015: EXCLI journal
Ka-wai Ho, Wai-tong Ng, Margaret Ip, Joyce H S You
OBJECTIVE: Carbapenem-resistant Enterobacteriaceae (CRE) cause significant morbidity and mortality in intensive care unit (ICU) settings. We examined potential cost-effectiveness of active CRE surveillance at ICUs in a nonendemic region from the perspective of a Hong Kong health care provider. METHODS: A decision analytic model was designed to simulate outcomes of active CRE surveillance in ICUs. Outcome measures included CRE-associated direct medical cost, infection rate, mortality rate, quality-adjusted life year (QALY) loss, and incremental cost per QALY saved by active surveillance...
April 1, 2016: American Journal of Infection Control
A Karaaslan, A Soysal, G Altinkanat Gelmez, E Kepenekli Kadayifci, G Söyletir, M Bakir
BACKGROUND: Multidrug-resistant Gram-negative bacilli are responsible for more than 50% of healthcare-associated infections. Colonization dynamics, characteristics, and risk factor data for CR-GNB are scarce in children. AIM: To examine the molecular characteristics of, and risk factors for nosocomial colonization with, carbapenem-resistant Gram-negative bacilli (CR-GNB) in hospitalized paediatric patients in a tertiary university hospital's paediatric units in Turkey...
January 2016: Journal of Hospital Infection
Mihaela Ileana Ionescu, Dan Stefan Neagoe, Claudia Chiorean, Loredana Dumitras, Aurelia Rus
AIM: Carbapenem-resistant strains have been increasingly reported over the last few years. In this study we used laboratory records to determine the occurrence of carbapenem-resistant strains from hospitalized patients with emphasis on the comparative analysis of the incidence in various health-care settings. MATERIALS AND METHODS: From January 2012 to November 2012 and from May 2013 to November 2013, we evaluated 566 strains (Acinetobacter spp., Pseudomonas aeruginosa, Escherichia coli, and Klebsiella spp...
2014: Clujul Medical (1957)
Latania K Logan, John P Renschler, Sumanth Gandra, Robert A Weinstein, Ramanan Laxminarayan
The prevalence of carbapenem-resistant Enterobacteriaceae (CRE) infections is increasing in the United States. However, few studies have addressed their epidemiology in children. To phenotypically identify CRE isolates cultured from patients 1-17 years of age, we used antimicrobial susceptibilities of Enterobacteriaceae reported to 300 laboratories participating in The Surveillance Network-USA database during January 1999-July 2012. Of 316,253 isolates analyzed, 266 (0.08%) were identified as CRE. CRE infection rate increases were highest for Enterobacter species, blood culture isolates, and isolates from intensive care units, increasing from 0...
November 2015: Emerging Infectious Diseases
Pedro Torres-Gonzalez, Miguel Enrique Cervera-Hernandez, María Dolores Niembro-Ortega, Francisco Leal-Vega, Luis Pablo Cruz-Hervert, Lourdes García-García, Arturo Galindo-Fraga, Areli Martinez-Gamboa, Miriam Bobadilla-Del Valle, Jose Sifuentes-Osornio, Alfredo Ponce-de-Leon
BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) infections have emerged as a serious threat to health worldwide. They are associated with increased morbidity and mortality and are capable of silently colonizing the gastrointestinal tract. Because of this, there is great interest to characterize the epidemiology of CRE carriage and acquisition in healthcare facilities. The aim of this study was to determine the prevalence and factors associated with CRE fecal carriage (CRE-fc), and risk factors for incident cases...
2015: PloS One
Haejun Yim, Dohern Kym, Dong Kook Seo, Jaechul Yoon, Hyeong-Tae Yang, Jeonghwan Lee, Yong-Suk Cho, Jun Hur, Wook Chun, Seong-Woo Han
BACKGROUND: This study was aimed at evaluating the effectiveness of serum cystatin C and microalbuminuria as diagnostic markers for acute kidney injury (AKI) in major burn patients. MATERIALS AND METHODS: Major burn adult patients admitted to the burn intensive care unit within 24 h from the onset of injury were enrolled. Serum cystatin C and microalbuminuria (albumin-creatinine ratio, ACR) were obtained at postburn days 1, 3, 7, 14, 21 and 28. The patients were divided into two groups of the AKI group and the nonacute kidney injury group...
June 2015: European Journal of Clinical Investigation
P Viale, F Tumietto, M Giannella, M Bartoletti, S Tedeschi, S Ambretti, F Cristini, C Gibertoni, S Venturi, M Cavalli, A De Palma, M C Puggioli, D Mosci, E Callea, R Masina, M L Moro, R E Lewis
We performed a quasi-experimental study of a multifaceted infection control programme for reducing carbapenem-resistant Enterobacteriaceae (CRE) transmission and bloodstream infections (BSIs) in a 1420-bed university-affiliated teaching hospital during 2010-2014, with 30 months of follow-up. The programme consisted of the following: (a) rectal swab cultures were performed in all patients admitted to high-risk units (intensive-care units, transplantation, and haematology) to screen for CRE carriage, or for any room-mates of CRE-positive patients in other units; (b) cohorting of carriers, managed with strict contact precautions; (c) intensification of education, cleaning and hand-washing programmes; and (d) promotion of an antibiotic stewardship programme carbapenem-sparing regimen...
March 2015: Clinical Microbiology and Infection
S Vergara-López, M C Domínguez, M C Conejo, Á Pascual, J Rodríguez-Baño
BACKGROUND: Outbreaks of nosocomial infection due to carbapenem-resistant Enterobacteriaceae (CRE), mostly Klebsiella spp., have become a worldwide phenomenon. AIM: To investigate the risk factors for the acquisition of clonal multidrug-resistant Klebsiella oxytoca (MDRKO) producing the metallo-β-lactamase IMP-8 and hyperproducing chromosomal OXY-2 β-lactamase during a well-characterized outbreak, and to describe the clinical features of infections due to MDRKO...
February 2015: Journal of Hospital Infection
X-Q Jia, F Pang, J-Z Chen, L-X Jiang
OBJECTIVE: Multidrug-resistant organisms (MDROs) have become a widespread serious problem in recent years. Our objective was to determine the prevalence and clinical distribution of MDROs in a tertiary care hospital in China from January 1, 2012 to December 31, 2013. METHODS: The strains were cultured according to standard methods; bacterial identification and susceptibility testing were detected by Vitek 2 system. The prevalence and clinical distribution of extended-spectrum β-lactamases (ESBLs)-producing enterobacteriaceae, carbapenem-resistant enterobacteriaceae (CRE), multiple-drug/pan-drug resistant P...
February 2015: Pathologie-biologie
F Maechler, L A Peña Diaz, C Schröder, C Geffers, M Behnke, P Gastmeier
PURPOSE: Standardized prevalence and incidence data on carbapenem-resistant organisms (CRO) and, as a relevant subgroup, carbapenem-resistant Enterobacteriaceae (CRE) are scarce. CRO-surveillance within the German nosocomial infection surveillance system (KISS) aims to provide epidemiological surveillance data on CRO colonizations and infections. METHODS: CRO-surveillance is part of a KISS-module for the surveillance of multidrug-resistant organisms (MDRO). MDRO-KISS methods require surveillance of all patients admitted to the ward and standardized documentation of imported and ICU-acquired cases...
April 2015: Infection
Marybeth A Pysz, Steven B Machtaler, E Scott Seeley, John J Lee, Teresa A Brentnall, Jarrett Rosenberg, François Tranquart, Jürgen K Willmann
PURPOSE: To test ultrasonographic (US) imaging with vascular endothelial growth factor receptor type 2 (VEGFR2)-targeted microbubble contrast material for the detection of pancreatic ductal adenocarcinoma (PDAC) in a transgenic mouse model of pancreatic cancer development. MATERIALS AND METHODS: Experiments involving animals were approved by the Institutional Administrative Panel on Laboratory Animal Care at Stanford University. Transgenic mice (n = 44; Pdx1-Cre, KRas(G12D), Ink4a(-/-)) that spontaneously develop PDAC starting at 4 weeks of age were imaged by using a dedicated small-animal US system after intravenous injection of 5 × 10(7) clinical-grade VEGFR2-targeted microbubble contrast material...
March 2015: Radiology
Kyle B Enfield, Nujhat N Huq, Megan F Gosseling, Darla J Low, Kevin C Hazen, Denise M Toney, Gavin Slitt, Heidi J Zapata, Heather L Cox, Jessica D Lewis, John R Kundzins, Amy J Mathers, Costi D Sifri
OBJECTIVE: We describe the efficacy of enhanced infection control measures, including those recommended in the Centers for Disease Control and Prevention's 2012 carbapenem-resistant Enterobacteriaceae (CRE) toolkit, to control concurrent outbreaks of carbapenemase-producing Enterobacteriaceae (CPE) and extensively drug-resistant Acinetobacter baumannii (XDR-AB). DESIGN: Before-after intervention study. SETTING: Fifteen-bed surgical trauma intensive care unit (ICU)...
July 2014: Infection Control and Hospital Epidemiology
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