Identification and detection of pathogenic bacteria from patients with hospital-acquired pneumonia in southwestern Iran; evaluation of biofilm production and molecular typing of bacterial isolates

Mazloomirad, Farzad; Hasanzadeh, Sajad; Sharifi, Asghar; Nikbakht, Gordafarin; Roustaei, Narges; Khoramrooz, Seyed Sajjad

doi:10.1186/s12890-021-01773-3

Cited by 9 publications

(10 citation statements)

References 51 publications

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“…A study conducted on Egyptian children revealed that GNB was more prevalent in HAP and VAP (91.67 and 87.8%, respectively) [ 49 ]. In Iran, GNB was obtained in 72.2 and 84.6% of HAP and VAP, respectively [ 50 ]. Feng et al [ 51 ] reported a 14.5% mortality rate of HAP related to GNB in a retrospective, single-center analysis study in China.…”

Section: Introductionmentioning

confidence: 99%

Multi-drug resistant gram-negative bacterial pneumonia: etiology, risk factors, and drug resistance patterns

Assefa

2022

Pneumonia

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Bacterial pneumonia is one of the most serious public health issues owing to its medical and economic costs, which result in increased morbidity and mortality in people of all ages around the world. Furthermore, antimicrobial resistance has risen over time, and the advent of multi-drug resistance in GNB complicates therapy and has a detrimental impact on patient outcomes. The current review aimed to summarize bacterial pneumonia with an emphasis on gram-negative etiology, pathogenesis, risk factors, resistance mechanisms, treatment updates, and vaccine concerns to tackle the problem before it causes a serious consequence. In conclusion, the global prevalence of GNB in CAP was reported 49.7% to 83.1%, whereas in VAP patients ranged between 76.13% to 95.3%. The most commonly reported MDR-GNB causes of pneumonia were A. baumannii, K. pneumoniae, and P. aeruginosa, with A. baumannii isolated particularly in VAP patients and the elderly. In most studies, ampicillin, tetracyclines, amoxicillin-clavulanic acid, cephalosporins, and carbapenems were shown to be highly resistant. Prior MDR-GNB infection, older age, previous use of broad-spectrum antibiotics, high frequency of local antibiotic resistance, prolonged hospital stays, ICU admission, mechanical ventilation, and immunosuppression are associated with the MDR-GNB colonization. S. maltophilia was reported as a severe cause of HAP/VAP in patients with mechanically ventilated and having hematologic malignancy due to its ability of biofilm formation, site adhesion in respiratory devices, and its intrinsic and acquired drug resistance mechanisms. Effective combination therapies targeting PDR strains and drug-resistant genes, antibiofilm agents, gene-based vaccinations, and pathogen-specific lymphocytes should be developed in the future.

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Section: Introductionmentioning

confidence: 99%

Multi-drug resistant gram-negative bacterial pneumonia: etiology, risk factors, and drug resistance patterns

Assefa

2022

Pneumonia

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“…A. baumannii is one of the most common bacteria detected in sputum culture and endotracheal aspirate from long-term hospitalized patients, including those with HAP. 3 A. baumannii is an opportunistic infectious agent that can cause lung infection and nosocomial infection transmission. 12 It usually causes bacterial colonization, defined as the presence of bacteria on the body surface, including the airway, without causing clinical evidence of infection in the individual.…”

Section: Discussionmentioning

confidence: 99%

“…Acinetobacter baumannii (A. baumannii) was the most prevalent organism, followed by Staphylococcus aureus (S. aureus), Pseudomonas aeruginosa (P. aeruginosa), and Escherichia coli (E. coli) from the sputum and endotracheal aspirates collected from each patient for bacterial isolation and detection. 3 A. baumannii infection often results in poor prognosis and high mortality. 4 In a multicenter retrospective cohort study, Ko RE found that A. baumannii was the most common multidrug-resistant (MDR) pathogen, leading to 28.2% of patients being admitted to the ICU for additional care and 28.1% dying.…”

Section: Introductionmentioning

confidence: 99%

Differentiation Between Acinetobacter Baumannii Colonization and Infection and the Clinical Outcome Prediction by Infection in Lower Respiratory Tract

Feng¹,

Zhou²,

Li³

et al. 2022

IDR

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Acinetobacter baumannii is the most common microorganism in sputum cultures from long-term hospitalized patients and is often the cause of hospital-acquired pneumonia (HAP), which is usually associated with poor prognosis and high mortality. It is sometimes difficult to distinguish between A. baumannii infection and colonization. This study aimed to evaluate factors that differentiate infection from colonization and predict mortality in patients with nosocomial pneumonia caused by A. baumannii. Patients and Methods:The data used in this study were collected in our hospital between January 2018 and December 2020 from patients whose sputum cultures were positive for A. baumannii. Results: A total of 714 patients were included, with 571 in the infection group and 143 in the colonization group. The in-hospital mortality rate in the infection group was 20.5%. Univariate and multivariate logistic regression analyses showed that age, total number of inpatient departments, absolute neutrophil count, and C-reactive protein (CRP) level helped distinguish between infection and colonization. The area under the receiver operating characteristic curve (ROC) of the identification model was 0.694. In the infection group, age, Charlson comorbidity score, neutrophil-to-lymphocyte ratio, blood urea nitrogen/albumin ratio, CRP level, presence of multidrug resistance, and clinical pulmonary infection score (≥6) ratio were associated with in-hospital mortality. The area under the ROC curve for the prediction model was 0.828. The top three drug resistance rates in the infection group were 100% (cefazolin), 98.77% (ceftriaxone), and 71.8% (cefuroxime). Conclusion:The combination of common parameters helps identify A. baumannii respiratory tract infection or colonization. Several novel predictors can be used to predict the risk of death from A. baumannii pneumonia to reduce mortality. The drug resistance of A. baumannii remains high.

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“…The incidence of MRSA pneumonia is different, depending on the classification of pneumonia. For CAP, the prevalence of S. aureus is 1.8%, whereas in HAP or VAP, S. aureus is isolated in 15%–18% of the cases 2 3. The prevalence of S. aureus being methicillin-resistant ranges from 37% to 54.4%.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic de-escalation in pneumonia with pharmacist education and ordering of methicillin-resistantStaphylococcus aureusnasal swabs

Doan

Smoke

2023

Eur J Hosp Pharm

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IntroductionWhen methicillin-resistant Staphylococcus aureus (MRSA) is the causative pathogen in pneumonia, in-hospital mortality rate is approximately 31.2%. However, the occurrence of MRSA pneumonia is uncommon, with a reported incidence of approximately 4.2%. Vancomycin is often empirically used for MRSA pneumonia coverage, but can lead to serious harm. The purpose of this study was to measure the impact of a pharmacy-driven MRSA nares testing protocol on vancomycin and linezolid prescribing patterns and clinical outcomes in patients diagnosed with pneumonia after removal of immediate educational intervention.MethodsThis single-centre, quasi-experimental study evaluated the use of a MRSA nasal swab on patients diagnosed with community-acquired pneumonia, hospital-acquired pneumonia and ventilator-associated pneumonia. This study consisted of three phases, the preimplementation phase, the active/educational phase and the postimplementation phase. The primary outcome was intravenous anti-MRSA antibiotic duration of therapy. Secondary outcomes included the occurrence of acute kidney injury, duration of hospital stay, number of vancomycin levels obtained, the number of MRSA nares swabs ordered and time points in the MRSA nares collection process.ResultsThe preimplementation phase (n=39), the active phase (n=45) and the postimplementation phase (n=26) demonstrated similar baseline characteristics. The primary outcome for duration of anti-MRSA therapy 0–72 hours was 61.5% vs 77.8% vs 76.9% (p=0.19). Acute kidney injury was decreased throughout the study at 25.6%, 24.4% and 16.7% (p=0.32). The number of MRSA nares swabs ordered were 23.1%, 60% and 30.8% in each of the phases, respectively (p=0.49).DiscussionOur novel approach to measuring the impact of pharmacist education and ordering of MRSA nasal swabs has demonstrated benefits that were sustained for a short period after the intervention was removed. Additional study is required to determine the long-term impact.ConclusionThe implementation of a hospital-wide anti-MRSA protocol in patients with confirmed or suspected pneumonia indicated sustained changes for at least 3 months after direct intervention.

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Identification and detection of pathogenic bacteria from patients with hospital-acquired pneumonia in southwestern Iran; evaluation of biofilm production and molecular typing of bacterial isolates

Cited by 9 publications

References 51 publications

Multi-drug resistant gram-negative bacterial pneumonia: etiology, risk factors, and drug resistance patterns

Multi-drug resistant gram-negative bacterial pneumonia: etiology, risk factors, and drug resistance patterns

Differentiation Between Acinetobacter Baumannii Colonization and Infection and the Clinical Outcome Prediction by Infection in Lower Respiratory Tract

Antibiotic de-escalation in pneumonia with pharmacist education and ordering of methicillin-resistantStaphylococcus aureusnasal swabs

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