A new screening method for carbapenem-resistant Acinetobacter baumanii and Pseudomonas aeruginosa

Parthasarathy, Prabha; Soothill, J. F.

doi:10.1016/j.jhin.2005.06.011

Cited by 7 publications

(3 citation statements)

References 3 publications

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“…Also, no prepared commercial medium exists that is suited for screening faecal samples for carbapenemresistant Gram-negative pathogens. While novel microbiological techniques have been identified for screening for these multidrugresistant pathogens, 17 standardized methods are lacking. Until solutions to the therapeutic and infection control hurdles are realized, our region will undoubtedly continue to struggle with these pathogens.…”

Section: Discussionmentioning

confidence: 99%

Evolution of antimicrobial resistance among Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae in Brooklyn, NY

Landman

Bratu

Kochar

et al. 2007

Journal of Antimicrobial Chemotherapy

151

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Objectives: To document resistance patterns of three important nosocomial pathogens, Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae, present in hospitals in Brooklyn, NY.Methods: Susceptibility profiles of pathogens gathered during a surveillance study in 2006 were analysed and compared with similar surveys performed in 1999 and 2001. MICs were determined according to CLSI standards, and selected isolates were screened by PCR for the presence of VIM, IMP and KPC b-lactamases.Results: For P. aeruginosa, susceptibility to most antimicrobials fell in 2001 and then reached a plateau. However, there was a progressive decrease in the number of patients with P. aeruginosa during the three surveys. While the total number of isolates of A. baumannii remained steady, there was a progressive decrease in susceptibility to most classes of antimicrobial agents, and approximately one-third had combined resistance to carbapenems, fluoroquinolones and aminoglycosides. There was a noticeable rise in the number of isolates of K. pneumoniae over the surveillance periods, suggesting that this has become the predominant pathogen in many medical centres. Over one-third of K. pneumoniae collected in 2006 carried the carbapenemase KPC, and 22% were resistant to all three classes of antimicrobial agents.Conclusions: Hospitals in our region have been beset with antimicrobial-resistant Gram-negative bacteria. K. pneumoniae has rapidly emerged as the most common multidrug-resistant pathogen. Improved therapeutic agents and methods of detection are needed to reduce transmission of these bacteria.

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Section: Discussionmentioning

confidence: 99%

Evolution of antimicrobial resistance among Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae in Brooklyn, NY

Landman

Bratu

Kochar

et al. 2007

Journal of Antimicrobial Chemotherapy

151

View full text Add to dashboard Cite

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“…Early detection of these isolates is of paramount by guest on April 11, 2015 http://cid.oxfordjournals.org/ Downloaded from importance for the institution of appropriate infection-control measures. Although a simplified method has been recommended for the screening of carbapenemase-producing Acinetobacter baumannii and P. aeruginosa [27,28], the variability in carbapenem MICs among Enterobacteriaceae with carbapenemases may make an antimicrobial-based screening method unreliable [29]. Rather, PCR-based methods may be necessary for accurate identification [29].…”

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confidence: 99%

Detection and Spread of Escherichia coli Possessing the Plasmid-Borne Carbapenemase KPC-2 in Brooklyn, New York

Bratu

Brooks

Burney

et al. 2007

Clinical Infectious Diseases

109

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A carbapenem-resistant isolate of Escherichia coli was identified that possessed a 23-kb plasmid encoding Klebsiella pneumoniae carbapenemase type 2 (KPC-2). A subsequent surveillance study involving hospitals in Brooklyn, New York, revealed that, among 1417 E. coli isolates, 7 isolates (from 3 hospitals) possessed bla(KPC-2). E. coli possessing KPC-2 is emerging in our region, and improved methods for detection are urgently needed.

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“…Depending on the test system used, between 1 and 13 of the 15 nonsusceptible strains were misidentified as susceptible. Although several methods for assessing carbapenemase production have been proposed [ 71 - 74 ], current guidelines do not include protocols for assaying carbapenemase production.…”

Section: Carbapenem Resistancementioning

confidence: 99%

Clinical review: Balancing the therapeutic, safety, and economic issues underlying effective antipseudomonal carbapenem use

Slama

2008

Critical Care

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Antipseudomonal carbapenems have played a useful role in our antimicrobial armamentarium for 20 years. However, a review of their use during that period creates concern that their clinical effectiveness is critically dependent on attainment of an appropriate dosing range. Unfortunately, adequate carbapenem dosing is missed for many reasons, including benefit/risk misconceptions, a narrow therapeutic window for imipenem and meropenem (due to an increased rate of seizures at higher doses), increasingly resistant pathogens requiring higher doses than are typically given, and cost containment issues that may limit their use. To improve the use of carbapenems, several initiatives should be considered: increase awareness about appropriate treatment with carbapenems across hospital departments; determine optimal dosing regimens for settings where multidrug resistant organisms are more likely encountered; use of, or combination with, an alternative antimicrobial agent having more favorable pharmacokinetic, pharmacodynamic, or adverse event profile; and administer a newer carbapenem with lower propensity for resistance development (for example, reduced expression of efflux pumps or greater stability against carbapenemases).

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A new screening method for carbapenem-resistant Acinetobacter baumanii and Pseudomonas aeruginosa

Cited by 7 publications

References 3 publications

Evolution of antimicrobial resistance among Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae in Brooklyn, NY

Evolution of antimicrobial resistance among Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae in Brooklyn, NY

Detection and Spread of Escherichia coli Possessing the Plasmid-Borne Carbapenemase KPC-2 in Brooklyn, New York

Clinical review: Balancing the therapeutic, safety, and economic issues underlying effective antipseudomonal carbapenem use

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