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Search Results : acinetobacter

Activities of doripenem against nosocomial bacteremic drug-resistant Gram-negative bacteria in a medical center in Taiwan.

J Microbiol Immunol Infect Start a Discussion »

Jun 052013

Activities of doripenem against nosocomial bacteremic drug-resistant Gram-negative bacteria in a medical center in Taiwan.

J Microbiol Immunol Infect. 2012 Dec;45(6):459-64

Authors: Dong SX, Wang JT, Chang SC

Abstract
BACKGROUND: The majority of nosocomial infections in Taiwan hospitals are caused by drug-resistant Gram-negative bacteria (GNB), including Pseudomonas aeruginosa, Acinetobacter baumannii, and various species of Enterobacteriaceae. Carbapenems are important agents for treating infections caused by these GNB. Recently, doripenem was approved for use in Taiwan in August 2009. However, data on its in vitro activity against nosocomial GNB isolated from Taiwan remain limited. The study was designed to look into this clinical issue.
METHODS: A total of 400 nonduplicated nosocomial blood isolates isolated in 2009, inclusive of P. aeruginosa (n = 100), A. baumannii (n = 100), and Enterobacteriaceae (n = 200), were randomly selected from the bacterial bank preserved at National Taiwan University Hospital. Susceptibilities of these 400 isolates to various antibiotics, including doripenem, imipenem, meropenem, ceftazidime, amikacin, ciprofloxacin, colistin, and tigecycline were determined by using Etest.
RESULTS: Doripenem demonstrated similar in vitro activity to imipenem and meropenem against P. aeruginosa (87%, vs. 85% and 89%), A. baumannii (56%, vs. 60% and 60%), and Enterobacteriaceae (100%, vs. 98.5% and 99.5%). The prevalence of carbapenem-resistant (any one of three tested carbapenems) P. aeruginosa, A. baumannii, and Enterobacteriaceae isolates was 15%, 44%, and 0.5%, respectively.
CONCLUSIONS: Doripenem was as effective as imipenem and meropenem in our study. However, there was a significant proportion of carbapenem resistance among the tested isolates. Hence, longitudinal surveillance is necessary to monitor the resistance trend.

PMID: 23102796 [PubMed - indexed for MEDLINE]

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Nosocomial urinary tract infections caused by Pseudomonas aeruginosa and Acinetobacter species: Sensitivity to antibiotics and risk factors.

Am J Infect Control Start a Discussion »

Jun 042013

Nosocomial urinary tract infections caused by Pseudomonas aeruginosa and Acinetobacter species: Sensitivity to antibiotics and risk factors.

Am J Infect Control. 2013 May 28;

Authors: Djordjevic Z, Folic MM, Zivic Z, Markovic V, Jankovic SM

Abstract
BACKGROUND: Pseudomonas aeruginosa and Acinetobacter species frequently cause intrahospital urinary tract infections (IUTI), contributing to increased hospital morbidity and mortality. Our objective was further exploration of possible risk factors for development of IUTI caused by P aeruginosa and Acinetobacter spp, including their resistance to various antibiotics. METHODS: The prospective case control study was conducted in Clinical Center Kragujevac, Serbia, during the period January 2009 to December 2011 and covered all patients with IUTI according to the Centers for Disease Control and Prevention criteria. The patients classified as "cases" had an IUTI caused by P aeruginosa or Acinetobacter spp. The control patients were matched to the cases and selected randomly from the remaining patients. RESULTS: There were 79 cases (11.9%) and 586 (88.1%) controls in the study. According to the multivariate binary logistic regression, there were 3 significant predictors of P aeruginosa and Acinetobacter spp IUTI: male sex (odds ratio [OR], 0.423; 95% confidence interval [CI]: 0.251-0.711; P = .001), stay in another hospital ward before emergence of IUTI (OR, 1.704; 95% CI: 1.013-2.864; P = .044), and previous use of penicillins and their combinations with inhibitors of β-lactamases (OR, 2.643; 95% CI: 1.044-6.692; P = .040). CONCLUSION: Knowing that IUTI caused by above-mentioned bacteria are especially frequent among male patients, after previous use of penicillins, and in patients who spent some time previously at other wards, sound strategies for prevention of such infections in clinical practice should be developed.

PMID: 23726656 [PubMed - as supplied by publisher]

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Clinical and microbiological efficacy of tigecycline for complicated skin-soft-tissue and intra-abdominal infections in a Turkish university hospital.

Int J Clin Pract Start a Discussion »

May 182013

Clinical and microbiological efficacy of tigecycline for complicated skin-soft-tissue and intra-abdominal infections in a Turkish university hospital.

Int J Clin Pract. 2013 Jun;67(6):505-11

Authors: Avkan-Oguz V, Yapar N, Alp-Cavus S, Demir Onder K, Aktas E, Gulay Z, Cakır N

Abstract
Objective: Tigecycline, a new glycylcycline antimicrobial agent, is indicated for the treatment of complicated skin structure infection (cSSTI), intra-abdominal infection (cIAI) and community acquired pneumonia. We aimed to evaluate the clinical and microbiological data together about tigecycline therapy. Methods: Patients with cIAIs and cSSTIs were included in a prospective, observational follow-up. Patient follow-up forms were developed and clinical and microbiological data were recorded. Results: Of the 107 patients, 67 had cSSTIs, 40 had cIAIs. Tigecycline was used empirically in 37.5% of cIAIs and in 50.7% of cSSTIs. In 85.0% of the patients with cIAI and in 73.1% of the patients with cSSTI, clinical and/or microbiological response could be achieved. A drug change was made in 26.9% and 7.5% of the patients with cSSTI and cIAI respectively. Superinfection was detected in 14.9% of the cSSTI and 7.5% of the cIAI patients. Conclusion: As a result, tigecycline can be safely used in the treatment of different infections. Compared with cSSTIs, the treatment response is better and the duration of treatment is shorter in cIAIs. However, MIC value must be determined at any rate if tigecycline is to be used in the treatment of Acinetobacter (MDR Acinetobacter, in particular) infections. Clinical cure and microbiological eradication rate of tigecycline therapy changes according to different clinical diagnosis and microorganism.

PMID: 23679904 [PubMed - in process]

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Withdrawal of Staphylococcus aureus from intensive care units in Turkey.

Am J Infect Control Start a Discussion »

May 152013

Withdrawal of Staphylococcus aureus from intensive care units in Turkey.

Am J Infect Control. 2013 May 7;

Authors: Erdem H, Dizbay M, Karabey S, Kaya S, Demirdal T, Koksal I, Inan A, Erayman I, Ak O, Ulu-Kilic A, Karasahin O, Akbulut A, Elaldi N, Yilmaz G, Candevir A, Gul HC, Gonen I, Oncul O, Aslan T, Azak E, Tekin R, Kocak Tufan Z, Yenilmez E, Arda B, Gungor G, Cetin B, Kose S, Turan H, Akalin H, Karabay O, Dogan-Celik A, Albayrak A, Guven T, Celebi G, Ozgunes N, Ersoy Y, Sirmatel F, Oztoprak N, Balkan II, Bayazit FN, Ucmak H, Oncu S, Ozdemir D, Ozturk-Engin D, Bitirgen M, Tabak F, Akata F, Willke A, Gorenek L, Ahmed SS, Tasova Y, Ulcay A, Dayan S, Esen S, Leblebicioglu H, Altun B, Unal S

Abstract
BACKGROUND: In the past, Staphylococcus aureus infections have displayed various patterns of epidemiologic curves in hospitals, particularly in intensive care units (ICUs). This study aimed to characterize the current trend in a nationwide survey of ICUs in Turkey. METHODS: A total of 88 ICUs from 36 Turkish tertiary hospitals were included in this retrospective study, which was performed during the first 3 months of both 2008 (period [P] 1) and 2011 (P2). A P value ≤.01 was considered significant. RESULTS: Although overall rates of hospital-acquired infection (HAI) and device-associated infection densities were similar in P1 and P2, the densities of HAIs due to S aureus and methicillin-resistant S aureus (MRSA) were significantly lower in P2 (P < .0001). However, the proportion of HAIs due to Acinetobacter was significantly higher in P2 (P < .0001). CONCLUSIONS: The incidence of S aureus infections is declining rapidly in Turkish ICUs, with potential impacts on empirical treatment strategies in these ICUs.

PMID: 23663858 [PubMed - as supplied by publisher]

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Surveillance of Device-Associated Infection Rates and Mortality in 3 Greek Intensive Care Units.

Am J Crit Care Start a Discussion »

May 032013

Surveillance of Device-Associated Infection Rates and Mortality in 3 Greek Intensive Care Units.

Am J Crit Care. 2013 May;22(3):e12-e20

Authors: Apostolopoulou E, Raftopoulos V, Filntisis G, Kithreotis P, Stefanidis E, Galanis P, Veldekis D

Abstract
Background Several studies suggest that device-associated, health care-associated infections (DA-HAIs) affect the quality of care in intensive care units, increasing patients' morbidity and mortality and the costs of patient care. Objectives To assess the DA-HAIs rates, microbiological profile, antimicrobial resistance, and crude excess mortality in 3 intensive care units in Athens, Greece. Methods A prospective cohort, active DA-HAI surveillance study was conducted in 3 Greek intensive care units from July 2009 to June 2010. The rates of mechanical ventilator-associated pneumonia (VAP), central catheter-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI) were calculated along with microbiological profile, antimicrobial resistance, and crude excess mortality. Results During 6004 days in intensive care, 152 of 294 patients acquired 205 DA-HAIs, an overall rate of 51.7% of patients or 34.1 DA-HAIs per 1000 days (95% CI, 29.3-38.6). The VAP rate was 20 (95% CI, 16.3-23.7) per 1000 ventilator-days, the CLABSI rate was 11.8 (95% CI: 9.2-14.8) per 1000 catheter-days, and the CAUTI rate was 4.2 (95% CI, 2.5-5.9) per 1000 catheter-days. The most frequently isolated pathogen was Acinetobacter baumannii among patients with CLABSI (37.8%) and Candida species among patients with CAUTI (66.7%). Excess mortality was 20.3% for VAP and CLABSI and 32.2% for carbapenem-resistant A baumannii CLABSI. Conclusion High rates of DA-HAIs, device utilization, and antimicrobial resistance emphasize the need for antimicrobial stewardship, the establishment of an active surveillance program of DA-HAIs, and the implementation of evidence-based preventive strategies.

PMID: 23635940 [PubMed - as supplied by publisher]

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Gram-negative bacteria that produce carbapenemases causing death attributed to recent foreign hospitalization.

Antimicrob Agents Chemother Start a Discussion »

Apr 252013

Gram-negative bacteria that produce carbapenemases causing death attributed to recent foreign hospitalization.

Antimicrob Agents Chemother. 2013 Apr 22;

Authors: Ahmed-Bentley J, Chandran AU, Joffe AM, French D, Peirano G, Pitout JD

Abstract
Overseas travel, as a risk factor for the acquisition of infections due to antimicrobial resistant organisms, has recently been described for carbapenemase-producing Gram negative bacteria. Multi-resistant Klebsiella pneumoniae, Escherichia coli and Acinetobacter baumannii were isolated from a wound of a Canadian patient with recent history of hospitalization in India. This resulted in the initiation of outbreak management that included surveillance cultures. Epidemiological and molecular investigations showed that NDM-1 producing K. pneumoniae ST16 and OXA-23-producing A. baumannii ST10 were transmitted to 5 other patients resulting in the colonization of 4 patients and the death of one patient due to septic shock caused by the OXA-23-producing A. baumannii. The high rate of false positivity of the screening cultures resulted in additional workload and increased costs for infection control and the clinical laboratory. We believe this is the first report that described infection with carbapenemase-producing Gram negative bacteria resulting in death attributed to a patient with recent foreign hospitalization. We recommend routine rectal and wound screening for colonization of multi-resistant bacteria in patients that have recently been admitted to hospitals outside Canada.

PMID: 23612195 [PubMed - as supplied by publisher]

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