Characterization and sensitivity to antibiotics of bacteria isolated from the lower respiratory tract of ventilated patients hospitalized in intensive care units

Medell, Manuel; Medell, Mariana; Martínez, Alicia; Valdés, Rodolfo

doi:10.1590/s1413-86702012000100008

Cited by 10 publications

(12 citation statements)

References 22 publications

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“…These opportunistic pathogens can also cause superinfections, especially in combination with viral respiratory tract infections in hospitalized patients. However, even patients without underlying diseases and in all age groups may be at the risk of co-infections as well [6,7].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of bacterial co-infections of the respiratory tract in COVID-19 patients admitted to ICU

Sharifipour

Shams

Esmkhani³

et al. 2020

BMC Infect Dis

348

270

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Background: COVID-19 is known as a new viral infection. Viral-bacterial co-infections are one of the biggest medical concerns, resulting in increased mortality rates. To date, few studies have investigated bacterial superinfections in COVID-19 patients. Hence, we designed the current study on COVID-19 patients admitted to ICUs. Methods: Nineteen patients admitted to our ICUs were enrolled in this study. To detect COVID-19, reverse transcription real-time polymerase chain reaction was performed. Endotracheal aspirate samples were also collected and cultured on different media to support the growth of the bacteria. After incubation, formed colonies on the media were identified using Gram staining and other biochemical tests. Antimicrobial susceptibility testing was carried out based on the CLSI recommendations. Results: Of nineteen COVID-19 patients, 11 (58%) patients were male and 8 (42%) were female, with a mean age of 67 years old. The average ICU length of stay was~15 days and at the end of the study, 18 cases (95%) expired and only was 1 case (5%) discharged. In total, all patients were found positive for bacterial infections, including seventeen Acinetobacter baumannii (90%) and two Staphylococcus aureus (10%) strains. There was no difference in the bacteria species detected in any of the sampling points. Seventeen of 17 strains of Acinetobacter baumannii were resistant to the evaluated antibiotics. No metallo-beta-lactamases-producing Acinetobacter baumannii strain was found. One of the Staphylococcus aureus isolates was detected as methicillin-resistant Staphylococcus aureus and isolated from the patient who died, while another Staphylococcus aureus strain was susceptible to tested drugs and identified as methicillin-sensitive Staphylococcus aureus. Conclusions: Our findings emphasize the concern of superinfection in COVID-19 patients due to Acinetobacter baumannii and Staphylococcus aureus. Consequently, it is important to pay attention to bacterial co-infections in critical patients positive for COVID-19.

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Section: Introductionmentioning

confidence: 99%

Evaluation of bacterial co-infections of the respiratory tract in COVID-19 patients admitted to ICU

Sharifipour

Shams

Esmkhani³

et al. 2020

BMC Infect Dis

348

270

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“…Colistin initially binds to the lipid A moiety of lipopolysaccharide (LPS), resulting in destabilization of the Gram-negative outer membrane (4). Alarmingly, as the use of colistin has increased, so have reports of colistin-resistant A. baumannii strains (5)(6)(7)(8)(9)(10). Previously, we have shown that A. baumannii can become resistant to colistin via mutations in the lipid A biosynthesis genes lpxA, lpxC, and lpxD, leading to the complete absence of LPS from the outer membrane (11,12); significantly, LPS loss has been observed in clinical isolates (11).…”

mentioning

confidence: 99%

Lipopolysaccharide-Deficient Acinetobacter baumannii Shows Altered Signaling through Host Toll-Like Receptors and Increased Susceptibility to the Host Antimicrobial Peptide LL-37

et al. 2013

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Infections caused by multidrug-resistant Acinetobacter baumannii have emerged as a serious global health problem. We have shown previously that A. baumannii can become resistant to the last-line antibiotic colistin via the loss of lipopolysaccharide (LPS), including the lipid A anchor, from the outer membrane (J. H. Moffatt, M. Harper, P. Harrison, J. D. Hale, E. Vinogradov, T. Seemann, R. Henry, B. Crane, F. St. Michael, A. D. Cox, B. Adler, R. L. Nation, J. Li, and J. D. Boyce, Antimicrob. Agents Chemother. 54:4971-4977, 2010). Here, we show how these LPS-deficient bacteria interact with components of the host innate immune system. LPS-deficient A. baumannii stimulated 2- to 4-fold lower levels of NF-κB activation and tumor necrosis factor alpha (TNF-α) secretion from immortalized murine macrophages, but it still elicited low levels of TNF-α secretion via a Toll-like receptor 2-dependent mechanism. Furthermore, we show that while LPS-deficient A. baumannii was not altered in its resistance to human serum, it showed increased susceptibility to the human antimicrobial peptide LL-37. Thus, LPS-deficient, colistin-resistant A. baumannii shows significantly altered activation of the host innate immune inflammatory response.

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“…are the most frequently detected causative agents of NIs 9 . In hospitalized patients with viral pneumonias, these opportunistic pathogens can cause superinfections not only in patients with serious underlying disease but also in patients without underlying diseases and in all age group 10,11 .…”

Section: Discussionmentioning

confidence: 99%

“…In accordance with local multidrug resistance (MDR) surveillance policy, all of the MDR bacteria isolated from blood cultures are routinely collected and stored at -80°C. The genetic relationships of the vancomycin-resistant Enteroccoccus species strains isolated from COVID-19 patients were explored by means of automated repetitive extragenic palindromic polymerase chain reaction (DiversiLab Enterococcus kit, bioMérieux) 9,10 . The amplified fragments were separated by means of capillary electrophoresis and their band patterns were compared using an Agilent 2100 Bioanalyzer (Agilent Technologies, Palo Alto, CA).…”

Section: Participantsmentioning

confidence: 99%

Post Tocilizumab Secondary Infections in Covid-19 patients”- Are we doing enough?

Rana¹,

Chachar²,

Zartash³

et al. 2021

PJMHS

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Aim: To focus on the frequency of ICU-acquired infections in Sars Co-V2 Corona Virus disease (COVID 19) patients. Method: A retrospective observational study carried out in two tertiary care hospitals treating COVID 19 cases, Services Institute of Medical Sciences and Bahria International Hospital, Lahore. Data was collected from the medical records of the COVID 19 ICUs of both hospitals from May 1, 2020 to April30, 2021. All charts were reviewed for the evidence of positive cultures. The treatment given prior to positive cultures, after the availability of culture results and outcomes were also recorded. Results: A total of 432 records were reviewed and 400 cases were included while 32 cases were excluded because of incomplete data. The frequency of infections per 1,000 days of ICU stay was calculated in 90 (22.5%) patients. Gram-negative bacteria accounted for 68 cases (75.5%) with Pseudomonas in 44 cases (48.8%), Acinetobacter in 23/90 (25.5%) while 17 cases (18.8%) had gram positive infection with Enterococcus in 14/18 (77.77%) or 14/90 (15.55%), MRSA in 4/18 (22.22%) 4/90 (4.44%), while 5/90 (5.5%) had more than 2 isolates at same time. Among these 3 had both pseudomonas and Acinetobacter while 2 patients had Pseudomonas and Stenotrophomonas Maltophilia. Conclusion: There seems to be an increase in the infection rate among critically sick COVID 19 patients admitted in ICU. Use of steroids and Tocilizumab seems to play a role through their immunomodulatory effects. Keywords: Tocilizumab, Secondary infections

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Characterization and sensitivity to antibiotics of bacteria isolated from the lower respiratory tract of ventilated patients hospitalized in intensive care units

Cited by 10 publications

References 22 publications

Evaluation of bacterial co-infections of the respiratory tract in COVID-19 patients admitted to ICU

Evaluation of bacterial co-infections of the respiratory tract in COVID-19 patients admitted to ICU

Lipopolysaccharide-Deficient Acinetobacter baumannii Shows Altered Signaling through Host Toll-Like Receptors and Increased Susceptibility to the Host Antimicrobial Peptide LL-37

Post Tocilizumab Secondary Infections in Covid-19 patients”- Are we doing enough?

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