Colonization with multidrug-resistant bacteria — on the efficiency of local decolonization procedures

Münch, Julia; Hagen, Ralf Matthias; Müller, Martin; Kellert, Viktor; Wiemer, Dorothea; Hinz, Rebecca; Schwarz, Norbert; Frickmann, Hagen

doi:10.1556/1886.2017.00008

Cited by 6 publications

(6 citation statements)

References 24 publications

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“…The hygiene management of injured patients is also complicated by colonization or infection with multidrug-resistant bacteria, although nosocomial transmission in military medical facilities can be widely prevented if strict hygiene precautions are enforced [ 54 , 55 ]. The effects of local skin or mucous membrane disinfection on decolonization of such sites are moderate in comparison to spontaneous decolonization rates and depend on the compliance of the patients [ 56 ].…”

Section: Discussionmentioning

confidence: 99%

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Resistant Gram-Negative Bacteria and Diagnostic Point-of-Care Options for the Field Setting during Military Operations

Frickmann

Podbielski²,

Kreikemeyer³

2018

BioMed Research International

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The spread of multidrug-resistant bacteria in resource-poor settings affects the military medical service in case of deployments of soldiers to war and crisis zones. Patients with war injuries are prone to colonization or infection with multidrug-resistant bacteria. Resistant Gram-negative bacteria play a dominant role in military wound infections. Problematic hygiene conditions on deployment facilitate exposition of soldiers with subsequent colonization. Although colonizing strains are frequently cleared from their hosts after returning from deployment, transmission to close contacts of the soldiers in the home country cannot be excluded and therapeutic options are reduced if colonization progresses to invasive infection. Since sophisticated culture-based diagnostic approaches are typically not available in the field setting on deployment, molecular rapid diagnostic test systems are an option for transmission control if the locally prevalent molecular resistance mechanisms are known. Efforts for global resistance surveillance can contribute to better understanding of resistance distribution and spread at deployment sites. This review summarizes experience of the military medical services with multidrug resistance on deployment and with the influx of resistant strains to the home country and discusses potential use of available molecular rapid test systems as an option for the field setting.

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Section: Discussionmentioning

confidence: 99%

“…In spite of considerable efforts to achieve local decolonization by disinfectant washing, the results were only moderately better than the spontaneous decolonization rates. In addition, the effects depended on the compliance of the patients [ 56 ].…”

Section: Experience From Military Medical Healthcare Facilities Inmentioning

confidence: 99%

Resistant Gram-Negative Bacteria and Diagnostic Point-of-Care Options for the Field Setting during Military Operations

Frickmann

Podbielski²,

Kreikemeyer³

2018

BioMed Research International

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“…A significant decrease in colonization rate has been reported in association with the nasal wash using water twice daily 15 . This has been confirmed by a more recent study which found that patients' compliance with decolonizing washing procedures was associated with successful decolonization of multidrugresistant bacteria 16 .…”

Section: Introductionmentioning

confidence: 59%

Nasal Staphylococcus aureus Carriage in Ablution Performers

Fawzi

Ibraheem²

2018

Egyptian Journal of Medical Microbiology

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Background: Nasal washing is a part of religious ablution (Wodou), which is practiced normally five times a day, as a prerequisite for the Muslims' prayer. However, studies addressing its effect on the nasal colonization state are scarce and conflicting. Objective: to investigate whether carriage rates of nasal Staphylococcus aureus (S. aureus) would differ between performers and non-performers of ablution. Methodology:A total of 600 first-year students from Zagazig University, Egypt, were randomly selected and classified by their performance of ablution into two groups, performers and non-performers of ablution. A nasal swab was obtained from each participant and investigated for S. aureus with the standard technique. The antibiotic susceptibility of the isolated organisms was determined with the Vitek-2 system. Results: The overall S. aureus carriage rate was 30.2%. The performers of ablution had significantly lower S. aureus and methicillin-resistant S. aureus (MRSA) carriage rates than the nonperformers (P<0.001 for both comparisons). In the logistic regression analysis, the most significant independent risk factor for S. aureus nasal carriage was the non-performance of regular ablution. We also found that the strains isolated from the performers, compared to non-performers, were more susceptible to antibiotics. Conclusions: Performers of ablution, compared to non-performers, have reduced carriage rates of nasal S. aureus and MRSA, and higher susceptibility profile to antibiotics. The study advocates regular ablution as an effective and inexpensive method that helps in checking the increasing problem of S. aureus antimicrobial resistance.

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“…Substance-specific genes and genes encoding efflux pumps mediating tolerance to disinfectants were observed in Enterobacterales. Therefore, further monitoring of the spread of disinfectant tolerance-associated genes and the effects of their abundance on disinfectant-based skin and wound decolonization strategies [ 36 ] seem advisable.…”

Section: Discussionmentioning

confidence: 99%

Clonal Clusters, Molecular Resistance Mechanisms and Virulence Factors of Gram-Negative Bacteria Isolated from Chronic Wounds in Ghana

et al. 2021

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Wound infections are common medical problems in sub-Saharan Africa but data on the molecular epidemiology are rare. Within this study we assessed the clonal lineages, resistance genes and virulence factors of Gram-negative bacteria isolated from Ghanaian patients with chronic wounds. From a previous study, 49 Pseudomonas aeruginosa, 21 Klebsiella pneumoniae complex members and 12 Escherichia coli were subjected to whole genome sequencing. Sequence analysis indicated high clonal diversity with only nine P. aeruginosa clusters comprising two strains each and one E. coli cluster comprising three strains with high phylogenetic relationship suggesting nosocomial transmission. Acquired beta-lactamase genes were observed in some isolates next to a broad spectrum of additional genetic resistance determinants. Phenotypical expression of extended-spectrum beta-lactamase activity in the Enterobacterales was associated with blaCTX-M-15 genes, which are frequent in Ghana. Frequently recorded virulence genes comprised genes related to invasion and iron-uptake in E. coli, genes related to adherence, iron-uptake, secretion systems and antiphagocytosis in P. aeruginosa and genes related to adherence, biofilm formation, immune evasion, iron-uptake and secretion systems in K. pneumonia complex. In summary, the study provides a piece in the puzzle of the molecular epidemiology of Gram-negative bacteria in chronic wounds in rural Ghana.

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Colonization with multidrug-resistant bacteria — on the efficiency of local decolonization procedures

Cited by 6 publications

References 24 publications

Resistant Gram-Negative Bacteria and Diagnostic Point-of-Care Options for the Field Setting during Military Operations

Resistant Gram-Negative Bacteria and Diagnostic Point-of-Care Options for the Field Setting during Military Operations

Nasal Staphylococcus aureus Carriage in Ablution Performers

Clonal Clusters, Molecular Resistance Mechanisms and Virulence Factors of Gram-Negative Bacteria Isolated from Chronic Wounds in Ghana

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