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mdr infection

Raquel Girardello, Marina Visconde, Rodrigo Cayô, Regina Célia Bressan Queiroz de Figueiredo, Marcelo Alves da Silva Mori, Nilton Lincopan, Ana Cristina Gales
Polymyxins have become drugs of last resort for treatment of multi-drug resistant (MDR) Gram-negative infections. However, the mechanisms of resistance to this compound have not been completely elucidated. In this study, we evaluated the mechanisms of resistance to this antimicrobial in two A. baumannii clinical isolates, respectively, susceptible (A027) and resistant (A009) to polymyxin B before and after polymyxin B exposure (A027(ind) and A009(ind)). The pmrAB and lpxACD were sequenced and their transcriptional levels were analyzed by qRT-PCR...
October 8, 2016: Diagnostic Microbiology and Infectious Disease
A Daftary, N Padayatchi
OBJECTIVE: To examine influences on health care workers' (HCWs') capacity to deliver health care for multi- and/or extensively drug-resistant tuberculosis (MDR/XDR-TB) and human immunodeficiency virus (HIV) infection in South Africa. DESIGN: Qualitative data were collected via group and individual interviews with a purposive sample of 17 HCWs at a centralised, tertiary TB facility and analysed using grounded theory. RESULTS: Four themes were identified: 1) personal infection control practices among HCWs may be weakened by a workplace culture comprising low motivation, disparate risk perceptions and practices across workforce hierarchies, physical discomfort, and problems managing patients with treatment-induced hearing loss...
November 2016: International Journal of Tuberculosis and Lung Disease
Matteo Bassetti, Alessia Carnelutti, Maddalena Peghin
The isolation of multi-drug-resistant gram-negative (MDRGN) pathogens has progressively increased worldwide and has been associated with important delays in the prescription of an adequate antibiotic treatment, resulting in increased mortality rates. Patient's stratification for MDRGN infections to optimize the prescription of an adequate empiric antimicrobial regimen is crucial. Areas covered: This article covers MDRGN epidemiology, with a specific focus on risk factors for harbouring infections sustained by extended-spectrum-Beta-lactamase (ESBL), carbapenem resistant Enterobacteriacae (CRE), MDR Pseudomonas aeruginosa and MDR Acinetobacter baumanii...
October 21, 2016: Expert Review of Anti-infective Therapy
R Fussen, S Lemmen
Multidrug resistant (MDR) bacteria present an increasing threat for intensive care patients. Whereas colonization of intensive care patients with methicillin-resistant staphylococcus aureus (MRSA) in German ICUs has remained at a constant level in recent years and therapeutic options have improved, colonization and infections with MDR gram-negative bacteria and vancomycin-resistant enterococci are increasing year by year. Only a few or even no therapeutic options remain for the treatment of these bacteria...
October 20, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Richard Aschbacher, Elisabetta Pagani, Massimo Confalonieri, Claudio Farina, Paolo Fazii, Francesco Luzzaro, Pier Giorgio Montanera, Aurora Piazza, Laura Pagani
BACKGROUND: Rates of colonization and infection with multidrug-resistant (MDR) bacteria are increasing worldwide, in both acute care hospitals and long-term care facilities (LTCFs). Italy has one of the highest prevalence of MDR bacteria in European countries, especially with regard to methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum β-lactamase (ESBL) or carbapenemase producing Enterobacteriaceae (CPE). METHOD: Review of studies on colonization by MDR bacteria from Italian LTCFs, risk factors for colonization and molecular characteristics of surveillance and clinical isolates, compared with other European countries...
2016: Antimicrobial Resistance and Infection Control
Weiwei Wang, Ting Jiang, Weihong Zhang, Chunyu Li, Jun Chen, Dandan Xiang, Kejiang Cao, Lian-Wen Qi, Ping Li, Wei Zhu, Wensen Chen, Yan Chen
The study was undertaken to describe the profile of patients and the characteristics of all multidrug-resistant gram-negative bacteria (MDR-GNB) and to assess mortality. We examined 138 patients with bloodstream infections (BSIs) caused by MDR-GNB. Clinical characteristics, antibiotic therapy, and in-hospital mortality were analyzed. Survivor and nonsurvivor subgroups were compared to identify predictors of mortality. The in-hospital mortality rate was 25.4%. Univariate analysis revealed that comorbidities and inadequate initial antimicrobial treatment could increase risk of death...
October 17, 2016: American Journal of Infection Control
Ahmed Abdel Megeed, M Ali Hayssam, Mohamed Z M Salem, Mohamed S El-Shikh, Ibrahim Ahmed Talea, Yahya A Alogaibi
Multidrug-resistant (MDR) Acinetobacter baumannii infections are a great public health concern and demand continuous surveillance and antibiotic stewardship. Virulence traits and the pathogenicity of Acinetobacter are less studied compared with the molecular epidemiological and antibiotic resistance profile of this organism. In our present study, we investigated the primary characteristics contributing to the virulence of MDR A. baumannii isolates and compared them with avirulent isolates. A total of 32 well-characterized MDR A...
October 19, 2016: Journal of AOAC International
Ia Kusradze, Natia Karumidze, Sophio Rigvava, Teona Dvalidze, Malkhaz Katsitadze, Irakli Amiranashvili, Marina Goderdzishvili
Acinetobacter baumannii is a gram-negative, non-motile bacterium that, due to its multidrug resistance, has become a major nosocomial pathogen. The increasing number of multidrug resistant (MDR) strains has renewed interest in phage therapy. The aim of our study was to assess the effectiveness of phage administration in Acinetobacter baumannii wound infections in an animal model to demonstrate phage therapy as non-toxic, safe and alternative antibacterial remedy. Using classical methods for the study of bacteriophage properties, we characterized phage vB-GEC_Ab-M-G7 as a dsDNA myovirus with a 90 kb genome size...
2016: Frontiers in Microbiology
Keertan Dheda, Kwok Chiu Chang, Lorenzo Guglielmetti, Jennifer Furin, H Simon Schaaf, Dumitru Chesov, Aliasgar Esmail, Christoph Lange
Globally there is a burgeoning epidemic of drug mono-resistant tuberculosis (TB), multi-drug-resistant TB (MDR-TB), and extensively drug-resistant TB (XDR-TB). Almost 20% of all TB strains worldwide are resistant to at least 1 major TB drug including isoniazid. In several parts of the world there is an increasing incidence of MDR-TB, and alarmingly almost a third of MDR-TB cases globally are resistant to either a fluoroquinolone or aminoglycocide. This trend cannot be ignored because DR-TB is associated with greater morbidity compared to drug-sensitive TB, it accounts for almost 25% of global TB mortality, is extremely costly to treat, consuming substantial portions of budgets allocated to national TB programmes in TB endemic countries, and is a major threat to healthcare workers who are already in short supply in resource-poor settings...
October 15, 2016: Clinical Microbiology and Infection
Silvia Gómez-Zorrilla, Francisco Morandeira, María José Castro, Fe Tubau, Elisabet Periche, Rosario Cañizares, María Angeles Dominguez, Javier Ariza, Carmen Peña
The severity of Pseudomonas aeruginosa (PA) infection may be determined by the interaction with the host immune system. We designed a prospective study to assess the relationship between the inflammatory response and the clinical presentation and outcome of PA infection. We also investigated whether there are differences in the inflammatory response depending on the resistance profile of PA. Interleukin-6 (IL-6), IL-10, procalcitonin (PCT), and C-reactive protein (CRP) were measured. Sixty-nine infection episodes were recorded; 40 caused by non-multidrug-resistant (non-MDR) strains [29 (73%) respiratory; 8 (20%) bacteremia], 12 by MDR non-extensively drug-resistant (MDR-non-XDR) [9 (75%) respiratory; 3 (25%) bacteremia], and 17 by XDR strains [9 (53%) respiratory; 7 (41%) bacteremia]...
October 18, 2016: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
Yancheng Yang, Zhen Hu, Weilong Shang, Qiwen Hu, Junmin Zhu, Jie Yang, Huagang Peng, Xiaopeng Zhang, Hui Liu, Yanguang Cong, Shu Li, Xiaomei Hu, Renjie Zhou, Xiancai Rao
Methicillin-susceptible Staphylococcus aureus (MSSA) accounts for ∼40% of staphylococcal infections in China. However, the molecular characterization of MSSA is not well described. In this study, 124 MSSA strains collected in 2013 from a comprehensive teaching hospital in Chongqing, Southwestern China, were subjected to antibiotics susceptibility testing and molecular typing, including multilocus sequence typing, staphylococcal protein A (spa) gene typing, accessory gene regulator (agr) typing, pulsed-field gel electrophoresis (PFGE) typing, Panton-Valentine leukocidin (pvl) gene detection, and antibiotic-resistant gene detection...
October 18, 2016: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
Laura Pérez-Lago, Santiago Izco, Marta Herranz, Griselda Tudó, María Carcelén, Iñaki Comas, Olalla Sierra, Juliá González, María Jesús Ruiz-Serrano, Juan Eyene, Emilio Bouza, Darío García-de-Viedma
OBJECTIVE: Molecular epidemiology techniques in tuberculosis (TB) can identify high-risk strains that are actively transmitted. We aimed to implement a novel strategy to optimize the identification and control of MDR-TB in a specific population. METHODS: We developed a strain-specific-PCR tailored from whole-genome-sequencing (WGS) data to track a specific multidrug-resistant prevalent strain in Equatorial Guinea (EG-MDR). RESULTS: The PCR was applied prospectively on remnants of GeneXpert reaction mixtures owing to the lack of culture facilities in EG...
October 13, 2016: Clinical Microbiology and Infection
L Illesy, M Szabo-Pap, F Toth, G Zadori, L Zsom, L Asztalos, R P Szabo, R Fedor, B Nemes
BACKGROUND: Bacterial infections significantly affect graft loss and mortality after kidney transplantation (KT). We reviewed the frequencies, risk factors, and sources of bacterial infections after KT and their impact on graft and patient survivals. METHODS: The data of 154 kidney recipients who underwent transplantation from 2010 to 2015 were explored. Donor, recipient, and surgical parameters were collected, and source, type, and frequency of infectious complications, number of infective episodes, multidrug-resistant (MDR) bacteria, and the bacterial spectrum were established...
September 2016: Transplantation Proceedings
A K Gupta, V Kumar, J Mankotia
No abstract text is available yet for this article.
May 2016: Journal of the Association of Physicians of India
S J Kaiser, N T Mutters, A DeRosa, C Ewers, U Frank, F Günther
Pseudomonas aeruginosa (Pa) is one of the major bacterial pathogens causing nosocomial infections. During the past few decades, multidrug-resistant (MDR) and extensively drug-resistant (XDR) lineages of Pa have emerged in hospital settings with increasing numbers. However, it remains unclear which determinants of Pa facilitated this spread. A total of 211 clinical XDR and 38 susceptible clinical Pa isolates (nonXDR), as well as 47 environmental isolates (EI), were collected at the Heidelberg University Hospital...
October 12, 2016: European Journal of Clinical Microbiology & Infectious Diseases
Philippa C Matthews, Lucinda K Barrett, Stephanie Warren, Nicole Stoesser, Mel Snelling, Matthew Scarborough, Nicola Jones
BACKGROUND: Fosfomycin is increasingly called upon for the treatment of multi drug-resistant (MDR) organisms causing urinary tract infection (UTI). We reviewed oral fosfomycin use for UTI treatment in a large UK hospital. The primary goal was to audit our clinical practice against current national guidelines. Secondary aims were to identify factors associated with treatment failure, and to investigate the potential for using fosfomycin in patients with co-morbidities. METHODS: We retrospectively studied 75 adult patients with UTI who received 151 episodes of treatment with fosfomycin from March 2013 to June 2015...
October 11, 2016: BMC Infectious Diseases
Amber Kunkel, Frank G Cobelens, Ted Cohen
BACKGROUND: New drugs for the treatment of tuberculosis (TB) are becoming available for the first time in over 40 y. Optimal strategies for introducing these drugs have not yet been established. The objective of this study was to compare different strategies for introducing the new TB drug bedaquiline based on patients' resistance patterns. METHODS AND FINDINGS: We created a Markov decision model to follow a hypothetical cohort of multidrug-resistant (MDR) TB patients under different bedaquiline use strategies...
October 2016: PLoS Medicine
Kristen V Dicks, Deverick J Anderson, Arthur W Baker, Daniel J Sexton, Sarah S Lewis
OBJECTIVE To evaluate the impact of multidrug-resistant gram-negative rod (MDR-GNR) infections on mortality and healthcare resource utilization in community hospitals. DESIGN Two matched case-control analyses. SETTING Six community hospitals participating in the Duke Infection Control Outreach Network from January 1, 2010, through December 31, 2012. PARTICIPANTS Adult patients admitted to study hospitals during the study period. METHODS Patients with MDR-GNR bloodstream and urinary tract infections were compared with 2 groups: (1) patients with infections due to nonMDR-GNR and (2) control patients representative of the nonpsychiatric, non-obstetric hospitalized population...
October 11, 2016: Infection Control and Hospital Epidemiology
Igor K Voukeng, Veronique P Beng, Victor Kuete
BACKGROUND: Infectious diseases due to multidrug-resistant bacteria are one of the causes of treatment failures contributing to an increase in mortality and/or morbidity. In this study, we evaluated the antibacterial potential of different parts of six medicinal plants namely Alstonia boonei, Ageratum conyzoides, Croton macrostachys, Cassia obtusifolia, Catharanthus roseus and Paullinia pinnata against a panel of 36 multi-drug resistant (MDR) Gram-negative and Gram-positive bacteria. METHODS: Minimum Inhibitory Concentration (MIC) and Minimal Bactericidal Concentration (MBC) of the methanol extracts from different parts of the plants were determined using broth microdilution method; standard phytochemical methods were used for phytochemical screening...
October 10, 2016: BMC Complementary and Alternative Medicine
Jyoti Singh Tomar, Manju Narwal, Pravindra Kumar, Rama Krishna Peddinti
The rise of multiple-drug resistance in bacterial pathogens imposes a serious public health concern and has led to increased interest in studying various pathways as well as enzymes. Different DNA glycosylases collaborate during bacterial infection and disease by overcoming the effects of ROS- and RNS-mediated host innate immunity response. 3-Methyladenine DNA glycosylase I, an essential DNA repair enzyme, was chosen for the present study from the MDR species of A. baumannii. The enzyme was especially chosen because of its functional significance in A...
September 26, 2016: Molecular BioSystems
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