Epidemiology of Multidrug Resistant Non-Fermentative Gram Negative Bacilli in Patients with Hospital Acquired Pneumonia: An Alarming Report from Somalia

Adan, Faduma Nur; Jeele, Mohamed Osman Omar; Omar, Nasteho Mohamed Sheikh

doi:10.2147/idr.s387370

Cited by 6 publications

(4 citation statements)

References 19 publications

(19 reference statements)

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“…In our present study, 131 of the 782 hospitals (for which data were available) were dominated by non-fermentative bacteria, which is a group of Gram-negative bacteria does not ferment sugar. Non-fermentative Gram-negative bacilli are one of the leading causes of hospital-acquired infections [ 29 – 31 ]. There are four major bacteria belonging to this group: Acinetobacter baumannii , Pseudomonas aeruginosa , Stenotrophomonas maltophilia , and Burkholderia cepacia .…”

Section: Discussionmentioning

confidence: 99%

“…They exist widely in nature and are important pathogens causing hospital infections. With the development of treatment technology and the wide application of new antimicrobial agents, incidence and drug resistance of non-fermentative bacterial infections have increased significantly in recent years [ 29 , 30 , 32 ]. Due to the generally existing multi-drug and even pan-drug resistance of non-fermentative bacteria, their increasing incidence has become a serious problem in the field of anti-infective therapy [ 33 – 35 ].…”

Section: Discussionmentioning

confidence: 99%

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Carbapenem is not always the best choice in the treatment of septic shock

Wang,

Ma,

Chen

et al. 2023

Eur J Med Res

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Background Septic shock is a global public health burden. In addition to the improvement of the level of individual care, the improvement of the overall hospital quality control management is also an essential key aspect of the Surviving Sepsis Campaign (SSC). Using of antibiotics is a cornerstone in the treatment of septic shock, so we conducted this study to investigate the influence of antibiotics and pathogenic bacteria on the mortality of septic shock at the level of overall hospital in China. Methods This was an observational database study in 2021 enrolled the data of 787 hospitals from 31 provinces/municipalities/autonomous regions of Mainland China collected in a survey from January 1, 2021 to December 31, 2021. Results The proportion of ICU patients with septic shock was 3.55%, while the patient mortality of septic shock was 23.08%. While carbapenem was the most preferred antibiotic medication used in 459 of the 782 hospitals, the preference for carbapenem did not show significant effect on the patient mortality in the treatment of septic shock (p-value 0.59). Compared with patients with fermenting bacteria as the most common pathogenic bacteria causing septic shock, patients with non-fermenting bacteria had a higher mortality (p-value 0.01). Conclusions Whether using carbapenem as the preferred antibiotic or not, did not show effect on the patient mortality of septic shock. Compared with patients with fermenting bacteria as the most common pathogenic bacteria, patients of septic shock with non-fermenting bacteria had a higher mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Carbapenem is not always the best choice in the treatment of septic shock

Wang,

Ma,

Chen

et al. 2023

Eur J Med Res

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“…Burkholderia cepacia complex has been associated with colonization and infection in patients with cystic fibrosis, and importantly, with the development of the Cepacia syndrome in this patient population, an acute necrotizing pneumonia that bears high mortality [40 ▪ ]. In addition, reports for several other uncommon NFGNB as cause of HCAIs have emerged in the recent years, mostly as case reports or case series [15 ▪▪ ,41,42 ▪ ,43 ▪ ]. The apparent emergence is partly due to advanced microbiological identification systems, such as the Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) [44].…”

Section: Text Of Reviewmentioning

confidence: 99%

“…Infections by NFGNB occur in the presence of several risk factors and, predominantly, in hospitalized patients. The risk factors for infection by NFGNB, include, among other, malignancy, immunosuppression, presence of intravascular devices and drain tubes, prolonged antibiotic use, lengthy hospitalization, older age, and presence of chronic respiratory disease or of other comorbidities [41,47,48 ▪▪ ]. It is noteworthy that Elizabethkingia spp.…”

Section: Text Of Reviewmentioning

confidence: 99%

Current viewpoint on the epidemiology of nonfermenting Gram-negative bacterial strains

Koulenti,

Vandana,

Rello

2023

Current Opinion in Infectious Diseases

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Purpose of review This article aims to review the epidemiology of nonfermenting Gram-negative bacilli (NFGNB) based on recent literature reports, particularly, of the less common, but with emerging clinical significance species. Recent findings The reported frequency of multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa is increasing, with very significant variability, however, between different countries. Apart from the major NFGNB, that is, A. baumannii and P. aeruginosa, already recognized as of critical importance healthcare risks, several other NFGNB genera have been increasingly associated with diverse severe infections, such as Stenotrophomonas maltophilia, Burkholderia spp., Elizabethkingia spp., Chryseobacterium spp., Achromobacter spp., Alcaligenes spp., Sphingomonas spp., Shewanella spp. and Ralstonia spp., among others. Summary The exploration of the epidemiology, as well as the pathogenic potential of the of the less frequent, but emerging and increasingly reported NFGNB, is crucial, not only for immunocompromised patients, but also for critically ill patients without overt immunosuppression. As we are heading fast towards a postantibiotic era, such information would contribute to the optimal antimicrobial management, that is, providing prompt, appropriate antimicrobial coverage when needed and, at the same time, avoiding overuse and/or inappropriate use of antimicrobial therapy. Also, it would help to better understand their transmission dynamics and to develop effective prevention strategies.

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