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VRE in ICU patients

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https://www.readbyqxmd.com/read/29611491/defining-the-role-of-the-environment-in-the-emergence-and-persistence-of-vana-vancomycin-resistant-enterococcus-vre-in-an-intensive-care-unit-a-molecular-epidemiological-study
#1
Andie S Lee, Elizabeth White, Leigh G Monahan, Slade O Jensen, Raymond Chan, Sebastiaan J van Hal
OBJECTIVETo describe the transmission dynamics of the emergence and persistence of vanA vancomycin-resistant enterococcus (VRE) in an intensive care unit (ICU) using whole-genome sequencing of patient and environmental isolates.DESIGNRetrospective cohort study.SETTINGICU in a tertiary referral center.PARTICIPANTSPatients admitted to the ICU over an 11-month period.METHODS VanA VRE isolated from patients (n=31) were sequenced using the Illumina MiSeq platform. Environmental samples from bed spaces, equipment, and waste rooms were collected...
April 3, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29501730/mobile-phones-and-computer-keyboards-unlikely-reservoirs-of-multidrug-resistant-organisms-in-the-tertiary-intensive-care-unit
#2
O C Smibert, A K Aung, E Woolnough, G P Carter, M B Schultz, B P Howden, T Seemann, D Spelman, S McGloughlin, A Y Peleg
Few studies have used molecular epidemiological methods to study transmission links to clinical isolates in intensive care units. Ninety-four multidrug-resistant organisms (MDROs) cultured from routine specimens from intensive care unit (ICU) patients over 13 weeks were stored (11 meticillin-resistant Staphylococcus aureus (MRSA), two vancomycin-resistant enterococci and 81 Gram-negative bacteria). Medical staff personal mobile phones, departmental phones, and ICU keyboards were swabbed and cultured for MDROs; MRSA was isolated from two phones...
March 2, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29449171/changes-in-antimicrobial-susceptibility-of-commonly-clinically-significant-isolates-before-and-after-the-interventions-on-surgical-prophylactic-antibiotics-spas-in-shanghai
#3
Su Wang, Li-Zhong Han, Yu-Xing Ni, Yi-Bo Zhang, Qun Wang, Da-Ke Shi, Wen-Hui Li, Yi-Chen Wang, Chen-Rong Mi
Surveillances and interventions on antibiotics use have been suggested to improve serious drug-resistance worldwide. Since 2007, our hospital have proposed many measures for regulating surgical prophylactic antibiotics (carbapenems, third gen. cephalosporins, vancomycin, etc.) prescribing practices, like formulary restriction or replacement for surgical prophylactic antibiotics and timely feedback. To assess the impacts on drug-resistance after interventions, we enrolled infected patients in 2006 (pre-intervention period) and 2014 (post-intervention period) in a tertiary hospital in Shanghai...
February 12, 2018: Brazilian Journal of Microbiology: [publication of the Brazilian Society for Microbiology]
https://www.readbyqxmd.com/read/29427322/comparison-of-risk-factors-and-outcomes-of-daptomycin-susceptible-and-nonsusceptible-vancomycin-resistant-enterococcus-faecium-infections-in-liver-transplant-recipients
#4
J D Lewis, A J Barros, C D Sifri
BACKGROUND: Vancomycin-resistant Enterococcus faecium (VRE) infections are common in liver transplant recipients (LTRs). Daptomycin (DAP) is an important treatment for such infections; however, DAP-nonsusceptible VRE (DNS-VRE) are increasingly frequent. The purpose of this study was to compare clinical characteristics and outcomes of LTRs with infections due to DNS-VRE and DAP-susceptible VRE (DS-VRE). METHODS: A single center, retrospective review of patients who underwent liver transplantation between January 1, 2010 and December 31, 2015 and developed infections due to DS-VRE or DNS-VRE post transplant was performed...
February 10, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29403213/risk-factors-for-intestinal-colonization-with-vancomycin-resistant-enterococci-a-prospective-study-in-a-level-iii-pediatric-intensive-care-unit
#5
Rajesh Amberpet, Sujatha Sistla, Subhash Chandra Parija, Ramachandran Rameshkumar
PURPOSE: Vancomycin-resistant enterococci (VRE) emerged as one of the major nosocomial pathogens across the globe. Gut colonization rate with VRE is higher in patients admitted to intensive care units (ICUs) due to the higher antibiotic pressure. VRE colonization increases the risk of developing infection up to 5-10 folds. The aim of this study was to determine the rates of VRE colonization among the patients admitted to pediatric ICU (PICU) and risk factors associated with it. MATERIALS AND METHODS: Rectal swabs were collected after 48 h of admission to PICU from 198 patients...
January 2018: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/29237512/vancomycin-resistant-enterococci-vre-in-the-intensive-care-unit-in-a-nonoutbreak-setting-identification-of-potential-reservoirs-and-epidemiological-associations-between-patient-and-environmental-vre
#6
Hélène McDermott, Mairead Skally, James O'Rourke, Hilary Humphreys, Deirdre Fitzgerald-Hughes
OBJECTIVE Among nosocomial bloodstream infections caused by enterococcal species, Ireland has the highest proportion caused by vancomycin-resistant enterococci (VRE) in Europe at 45.8%. The contribution of the near-patient environment to VRE transmission outside of outbreaks was investigated. DESIGN A prospective observational study was conducted during 7 sampling periods. METHODS Recovery of VRE isolates by swabbing the near-patient environment and patients in the intensive care unit (ICU) was conducted to identify reservoirs, clinical and molecular epidemiological associations, and the success of active surveillance cultures (ASCs)...
January 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29225976/intensive-care-in-a-patient-with-toxic-epidermal-necrolysis
#7
J Wallenborn, M Fischer
Toxic epidermal necrolysis (TEN) is a serious adverse drug reaction with high lethality, which usually requires intensive-medical care. A 44-year-old man developed generalized exanthema with increasing exfoliation and mucosal involvement after taking allopurinol, ibuprofen, and etoricoxib. The clinical diagnosis of TEN was histologically confirmed. Prednisolone therapy with 3 mg/kg body weight (BW) was not able to prevent further progress to finally 80% of the body surface, and infliximab 5 mg/kg BW was given as a single dose...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29046248/clinical-characteristics-and-treatment-outcomes-of-vancomycin-resistant-enterococcus-faecium-bacteremia
#8
Jung-Jr Ye, Shian-Sen Shie, Chun-Wen Cheng, Jeng-How Yang, Po-Yen Huang, Ting-Shu Wu, Ming-Hsun Lee, Ching-Tai Huang
BACKGROUND: Vancomycin-resistant Enterococcus faecium (VRE-fm) bacteremia causes significant mortality in hospitalized patients. We sought to investigate clinical characteristics, treatment outcomes, and microbiological eradication associated with VRE-fm bacteremia. METHODS: A retrospective cohort study was conducted and included 210 adult patients admitted between January 1, 2011 and December 31, 2015. RESULTS: The mean Pitt bacteremia score was 4...
October 5, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28961986/novel-multiresistance-cfr-plasmids-in-linezolid-resistant-methicillin-resistant-staphylococcus-epidermidis-and-vancomycin-resistant-enterococcus-faecium-vre-from-a-hospital-outbreak-co-location-of-cfr-and-optra-in-vre
#9
Alexandros Lazaris, David C Coleman, Angela M Kearns, Bruno Pichon, Peter M Kinnevey, Megan R Earls, Breida Boyle, Brian O'Connell, Gráinne I Brennan, Anna C Shore
Background: Linezolid is often the drug of last resort to treat infections caused by Gram-positive cocci. Linezolid resistance can be mutational (23S rRNA or L-protein) or, less commonly, acquired [predominantly cfr, conferring resistance to phenicols, lincosamides, oxazolidinones, pleuromutilins and streptogramin A compounds (PhLOPSA) or optrA, encoding oxazolidinone and phenicol resistance]. Objectives: To investigate the clonality and genetic basis of linezolid resistance in 13 linezolid-resistant (LZDR) methicillin-resistant Staphylococcus epidermidis (MRSE) isolates recovered during a 2013/14 outbreak in an ICU in an Irish hospital and an LZDR vancomycin-resistant Enterococcus faecium (VRE) isolate from an LZDR-MRSE-positive patient...
December 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28774865/shifts-in-antimicrobial-consumption-and-infection-rates-before-and-during-a-piperacillin-tazobactam-shortage
#10
S Travis King, Katie E Barber, Jason J Parham, Kayla R Stover
OBJECTIVES: Anti-infective shortages represent a growing threat to optimum management of infected patients and alter the institutional selective pressure against hospital-acquired infections (HAIs). The objective of this analysis was to assess the impact of a shortage of piperacillin/tazobactam (TZP) on overall antibacterial use and HAI rates at an academic institution. METHODS: Antimicrobial use and infection data were extracted from TheraDoc Clinical Surveillance Software (Premier, Inc...
December 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28702465/a-dynamic-transmission-model-to-evaluate-the-effectiveness-of-infection-control-strategies
#11
Karim Khader, Alun Thomas, W Charles Huskins, Molly Leecaster, Yue Zhang, Tom Greene, Andrew Redd, Matthew H Samore
BACKGROUND: The advancement of knowledge about control of antibiotic resistance depends on the rigorous evaluation of alternative intervention strategies. The STAR*ICU trial examined the effects of active surveillance and expanded barrier precautions on acquisition of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) in intensive care units. We report a reanalyses of the STAR*ICU trial using a Bayesian transmission modeling framework. METHODS: The data included admission and discharge times and surveillance test times and results...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28558010/effect-of-meteorological-factors-and-geographic-location-on-methicillin-resistant-staphylococcus-aureus-and-vancomycin-resistant-enterococci-colonization-in-the-us
#12
Natalia Blanco, Eli Perencevich, Shan Shan Li, Daniel J Morgan, Lisa Pineles, J Kristie Johnson, Gwen Robinson, Deverick J Anderson, Jesse T Jacob, Lisa L Maragakis, Anthony D Harris
BACKGROUND: Little is known about the effect of meteorological conditions and geographical location on bacterial colonization rates particularly of antibiotic-resistant Gram-positive bacteria. We aimed to evaluate the effect of season, meteorological factors, and geographic location on methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) colonization. METHODS: The prospective cohort included all adults admitted to 20 geographically-dispersed ICUs across the US from September 1, 2011 to October 4, 2012...
2017: PloS One
https://www.readbyqxmd.com/read/28431846/implementation-of-daily-chlorhexidine-bathing-to-reduce-colonization-by-multidrug-resistant-organisms-in-a-critical-care-unit
#13
Jackson S Musuuza, Ajay K Sethi, Tonya J Roberts, Nasia Safdar
BACKGROUND: Colonized patients are a reservoir for transmission of multidrug-resistant organisms (MDROs). Not many studies have examined the effectiveness of daily chlorhexidine gluconate (CHG) bathing under routine care conditions. We present a descriptive analysis of the trends of MDRO colonization following implementation of daily CHG bathing under routine clinical conditions in an intensive care unit (ICU). METHODS: From May 2010-January 2011, we screened patients admitted to a 24-bed ICU for and methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and fluoroquinolone-resistant gram-negative bacilli (FQRGNB)...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28384858/antimicrobial-resistance-surveillance-among-intensive-care-units-of-a-tertiary-care-hospital-in-southern-india
#14
Kailash Moolchandani, Apurba Sankar Sastry, R Deepashree, Sujatha Sistla, B N Harish, Jharna Mandal
INTRODUCTION: Hospital Acquired Infections (HAIs) are the rising threat in the health care facilities across the globe. As most Intesive Care Unit (ICU) patients are frequently on broad spectrum antimicrobials, this induces selective antibiotic pressure which leads to development of Antimicrobial Resistance (AMR) among the microorganisms of ICUs. AIM: To study the occurrence of different types of HAIs in patients admitted to various ICUs of JIPMER and the AMR pattern of the bacterial pathogens isolated from them...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27915096/universal-contact-precautions-do-not-change-the-prevalence-of-antibiotic-resistant-organisms-in-a-tertiary-burn-unit
#15
Adelyn L Ho, Reid Chambers, Claudia Malic, Anthony Papp
OBJECTIVE: The prevalence of antibiotic-resistant organisms (ARO) in burn units is increasing worldwide and contributes significantly to morbidity and mortality. Study aims are to describe the burden of AROs in burn patients admitted to a tertiary burn unit, to evaluate the impact of contact precautions implemented after an outbreak of antibiotic-resistant Acinetobacter baumannii, and to identify possible predictors of ARO acquisition. METHODS: Data of burn inpatients between 2006 and 2010 were retrospectively reviewed...
March 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/27905623/-mortality-analysis-of-enterococcus-faecium-bloodstream-infection-in-central-taiwan
#16
Chen Chang-Hua, Lin Li-Chen, Chang Yu-Jun, Chang Chih-Yen
BACKGROUND: Bloodstream infections (BSIs) due to Enterococcus faecium (E. faecium), particularly those due to vancomycin-resistant enterococcus (VRE), are still a therapeutic challenge. AIM: To evaluate mortality from BSI due to E. faecium and VRE in central Taiwan. MATERIALS AND METHODS: We retrospectively analyzed cases of significant E. faecium BSI in the Changhua Christian Hospital System between January 1, 2010 and December 31, 2013. RESULTS: Of the 76 cases, 28 patients (36...
August 2016: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/27895354/nosocomial-infections-in-the-icu-pens-and-spectacles-as-fomites
#17
Haris Farooq Murad, Khowaja Mohammad Inam Pal
Nosocomial infections are a major cause of morbidity and mortality. Non-medical objects known as fomites may have a role in their genesis. We investigated the significance of writing pens and spectacles as fomites. The study was conducted at Aga Khan University Hospital, Karachi, from July 2013 to September 2013. Cultures were taken from pens and/or spectacles of resident nurses, doctors and nursing assistants in intensive care unit (ICU). Organisms important in ICU nosocomial infections were targeted. Seven rounds of sampling over 3 weeks led to 55 pen and 5 spectacle samples...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27790430/screening-for-intestinal-colonization-with-vancomycin-resistant-enterococci-and-associated-risk-factors-among-patients-admitted-to-an-adult-intensive-care-unit-of-a-large-teaching-hospital
#18
Rajesh Amberpet, Sujatha Sistla, Subhash Chandra Parija, Molly Mary Thabah
INTRODUCTION: Gut colonization with Vancomycin Resistant Enterococci (VRE) increases the risk of acquiring infection during hospital stay. Patients admitted in the ICU's are the major reservoirs for VRE colonization due to higher antibiotic pressure. AIM: To determine the rate of VRE colonization among patients admitted in the Medical Intensive Care Unit (MICU) and to assess the various risk factors which are associated with VRE colonization. MATERIALS AND METHODS: This was a prospective study carried out over a period of 18 months from September 2013 to February 2015 in the Jawaharlal Institute of Post graduate Medical Education and Research (JIPMER), Pondicherry, South India...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27234462/an-observational-study-of-the-universal-use-of-octenidine-to-decrease-nosocomial-bloodstream-infections-and-mdr-organisms
#19
Petra Gastmeier, Klaus-Peter Kämpf, Michael Behnke, Christine Geffers, Frank Schwab
OBJECTIVES: To investigate the effect of universal decolonization with octenidine on the incidence of ICU-acquired bloodstream infections (BSI) and MDR organisms (MDRO). METHODS: A system-wide change in practice was performed in the ICUs of a university hospital with three campuses (eight medical ICUs and nine surgical ICUs). All ICUs had a general admission screening strategy for MRSA with subsequent isolation in the 12 month baseline period, which was stopped...
September 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27185645/real-time-application-of-whole-genome-sequencing-for-outbreak-investigation-what-is-an-achievable-turnaround-time
#20
Patrick McGann, Jessica L Bunin, Erik Snesrud, Seema Singh, Rosslyn Maybank, Ana C Ong, Yoon I Kwak, Scott Seronello, Robert J Clifford, Mary Hinkle, Stephen Yamada, Jason Barnhill, Emil Lesho
Whole genome sequencing (WGS) is increasingly employed in clinical settings, though few assessments of turnaround times (TAT) have been performed in real-time. In this study, WGS was used to investigate an unfolding outbreak of vancomycin resistant Enterococcus faecium (VRE) among 3 patients in the ICU of a tertiary care hospital. Including overnight culturing, a TAT of just 48.5 h for a comprehensive report was achievable using an Illumina Miseq benchtop sequencer. WGS revealed that isolates from patient 2 and 3 differed from that of patient 1 by a single nucleotide polymorphism (SNP), indicating nosocomial transmission...
July 2016: Diagnostic Microbiology and Infectious Disease
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