Highly Resistant Gram-Negative Microorganisms Incidence Density and Occurrence of Nosocomial Transmission (TRIANGLe Study)

Willemsen, Ina; Elberts, S.; Verhulst, Carlo; Rijnsburger, Martine; Filius, Margreet; Savelkoul, Paul H. M.; Kluytmans, Jan; Lommerse, E. J. M.; Spanjaard, Lodewijk; Vlaminckx, Bart J. M.; Vos, Anneke S. de; Wulf, M.W.H.; Vos, MC; Wintermans, R.; Andriesse, Gunnar I.; Zeijl, Jan van; Vorm, Eric van der; Buiting, A. G. M.; Sturm, Patrick; Blok, Hetty E. M.; Troelstra, Annet; Kaiser, Anna; Vandenbroucke-Grauls, Christina M. J. E.

doi:10.1086/658941

Cited by 22 publications

(29 citation statements)

References 15 publications

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“…Of a total of 892 HR-GNR included in the initial study (9), 653 isolates (559 Enterobacteriaceae and 94 nonfermentative Gram-negative rods) were available for further typing. As shown in Table 2, E. coli was the most prevalent species included in this study (296 isolates [53.0%]).…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, they cannot be used in most clinical laboratories. We tested a commercially available typing method, DiversiLab, on a well-defined collection of HR-GNR from a recent study in Dutch hospitals (9). The objective of this study was to determine the reliability of DiversiLab in comparison with the AFLP typing method for the typing of HR-GNR in a hospital setting.…”

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Evaluation of the DiversiLab Typing Method in a Multicenter Study Assessing Horizontal Spread of Highly Resistant Gram-Negative Rods

et al. 2011

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The worldwide prevalence of highly resistant Gram-negative rods (HR-GNR) is increasing rapidly. Reliable typing methods are needed to detect and control outbreaks and to monitor the effectiveness of infection control programs in endemic situations. In this study, we investigated the performance of the DiversiLab typing method in comparison with the amplified fragment length polymorphism (AFLP) typing method. Six hundred fifty-three HR-GNR isolates, which were obtained during a 6-month prospective survey in 18 Dutch hospitals, were typed by AFLP and DiversiLab. Subsequently, the sensitivity and specificity of DiversiLab were calculated, using AFLP as the reference method. In addition, results were compared by means of epidemiological linkage, and Cohen's kappa for agreement was calculated. DiversiLab considered significantly more isolates (275) to belong to a cluster than AFLP (198) (P < 0.001). In direct comparison, the sensitivity was 83.8%, and the specificity was 78.6%. When epidemiological linkage was included in the analysis, DiversiLab considered eight isolates as secondary cases, which were considered unique in AFLP. Only two secondary cases, according to AFLP, were missed by DiversiLab. This results in a kappa for agreement of 0.985. In daily practice, a typing method has to be used in combination with epidemiological information. When this was done, DiversiLab was shown to be a reliable method for the typing of HR-GNR. This, in combination with the ease of use and the speed, makes DiversiLab an appropriate method for screening in routine clinical practice. When a cluster is suspected and the consequences of these findings are substantial, a confirmatory analysis should be performed.

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confidence: 99%

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Evaluation of the DiversiLab Typing Method in a Multicenter Study Assessing Horizontal Spread of Highly Resistant Gram-Negative Rods

et al. 2011

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“…La gran mayoría de los estudios reportan porcentaje de resistencia frente a distintos antimicrobianos en los aislados de los laboratorios. Estudios de incidencia con metodología similar al nuestro se han realizado, pero en general enfocados en una bacteria multi-resistente en particular o una patología puntual y además, considerando a todos los pacientes hospitalizados, sin separar los datos de pacientes críticos, lo que baja considerablemente la incidencia y lo hace poco comparable a nuestros resultados [8][9][10] . Por otra parte, la mayoría son realizados en un solo centro y existen pocos estudios multicéntricos con una red de colaboración que entregue datos a nivel nacional como éste.…”

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Incidencia de bacterias multi-resistentes en unidades de cuidados intensivos de hospitales chilenos

Acuña

Cifuentes

Silva

et al. 2017

Rev. chil. infectol.

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Introduction: Incidence of multi-resistant bacteria is an indicator that permits better estimation of the magnitude of bacterial resistance in hospitals. Aim: To evaluate the incidence of relevant multi-drug resistant bacteria in intensive care units (ICUs) of Chile. Methods: Participating hospitals submitted information about the number of isolates from infected or colonized patients with 7 epidemiologically relevant multi-resistant bacteria in adult and pediatric ICUs between January 1, 2014 and October 31, 2015 and the number of bed days occupied in these units in the same period was requested. With these data incidence was calculated per 1,000 patient days for each unit. Results: Information from 20 adults and 9 pediatric ICUs was reviewed. In adult ICUs the bacteria with the highest incidence were K. pneumoniae ESBL [4.72 x 1,000 patient day (1.21-13.89)] and oxacillin -resistant S. aureus [3.85 (0.71-12.66)]. In the pediatric units the incidence was lower, highlighting K. pneumoniae ESBL [2.71 (0-7.11)] and carbapenem -resistant P. aeruginosa [1.61 (0.31-9.25)]. Conclusion: Important differences between hospitals in the incidence of these bacteria were observed. Incidence of multi-resistant bacteria in adult ICU was significantly higher than in pediatric ICU for most of the studied bacterias.

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“…It was observed that the Gram-negative bacilli carriers had a high length of stay (mean: 37.2 days). The prolonged length of stay in health institutions and the antimicrobials used may increase the risk of multidrug-resistant microorganisms acquisition [23] [24].…”

Section: Discussionmentioning

confidence: 99%

Epidemiological Characteristics, Resistance Patterns and Spread of Gram-Negative Bacteria Related to Colonization of Patients in Intensive Care Units

Damaceno¹,

Nicoli²,

Oliveira³

2015

AID

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Our aim was to determine the epidemiological characteristics, the resistance patterns and the spread of Gram negative bacteria related to colonization of patients in adult Intensive Care Units. Methods: A prospective cohort of patients colonized and/or infected with Gram negative bacteria was conducted at two adult ICUs from hospitals in Brazil (April 2012 to February 2013). Nasal, groin and perineum swabs were performed. Samples were incubated on MacConkey and cetrimide agar (48 h at 37˚C) and identification tests (Vitek-BioMérieux), antibiogram (Bauer-Kirby method), Carba NP test, Polymerase Chain Reaction (PCR) and sequencing were performed. The patterns of resistant microorganisms were compared by rep-PCR (Diversilab). Results: There were 53 cases of colonization. In these cases, we identified imipenem-resistant Acinetobacter baumannii (51%), Pseudomonas aeruginosa (32%), Klebsiella pneumoniae ESBL (38%) or imipenem resistant (5.6%). The use of antimicrobials and medical devices were related to colonization (p < 0.05). The resistance patterns expressed by Klebsiella pneumoniae were ESBL (CTX-M, SHV e TEM) and KPC2. A verified profile of Acinetobacter baumannii was related to OXA-23 and OXA-253 (OXA-143 variant). The profiles ESBL and KPC2 expressed by Klebsiella pneumoniae were distributed between the both ICUs. The distribution of OXA-23 and OXA-253 was verified only in one ICU. The similarity of strains ranged from 80% to 95%, highlighting the horizontal transference of these microorganisms.

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Highly Resistant Gram-Negative Microorganisms Incidence Density and Occurrence of Nosocomial Transmission (TRIANGLe Study)

Cited by 22 publications

References 15 publications

Evaluation of the DiversiLab Typing Method in a Multicenter Study Assessing Horizontal Spread of Highly Resistant Gram-Negative Rods

Evaluation of the DiversiLab Typing Method in a Multicenter Study Assessing Horizontal Spread of Highly Resistant Gram-Negative Rods

Incidencia de bacterias multi-resistentes en unidades de cuidados intensivos de hospitales chilenos

Epidemiological Characteristics, Resistance Patterns and Spread of Gram-Negative Bacteria Related to Colonization of Patients in Intensive Care Units

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