Increased frequency of large R-plasmids in Klebsiella pneumoniae colonizing patients with spinal cord injury

Montgomerie, John Z.; John, Joseph F.; Atkins, Loretta M.; Gilmore, Donna S.; Ashley, Mary A.

doi:10.1016/0732-8893(93)90126-r

Cited by 7 publications

(11 citation statements)

References 22 publications

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“…Since surveillance cultures were not performed for all patients on admission to the rehabilitation unit, it was not possible to determine how often MRSA was acquired after admission. Similar to findings in other studies [16,18,[20][21][22], the most commonly isolated gram-negative organisms with associated antibiotic resistance were P. aeruginosa and K. pneumoniae. The findings regarding colonization must be viewed cautiously, since there was no systematic surveillance of patients, either as a routine of the unit or as part of the study protocol.…”

Section: Discussionsupporting

confidence: 87%

“…Other studies have focused on patients with SCI and specific infections (e.g., urinary tract infections [12]) or on specific organisms demonstrating antibiotic resistance (e.g., MRSA [13][14][15], P. aeruginosa [16][17][18][19][20], or K. pneumoniae [17,20,[21][22][23]). However, the patients evaluated in all of these studies varied from those who were just beginning acute rehabilitation to those who have had chronic disabilities for many years.…”

Section: Discussionmentioning

confidence: 99%

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Epidemiology of Nosocomial Infection and Resistant Organisms in Patients Admitted for the First Time to an Acute Rehabilitation Unit

Mylotte

Graham

Kahler

et al. 2000

Clinical Infectious Diseases

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The objectives of this study were to define the epidemiology of nosocomial bacterial colonization and infection and to define predictors of nosocomial infection among a cohort (n=423) of admissions to an acute rehabilitation unit. Overall, methicillin-resistant Staphylococcus aureus (MRSA) and enterococci were the most commonly identified colonizing organisms. Escherichia coli and Pseudomonas aeruginosa were the most commonly identified colonizing gram-negative bacilli. During 70 (16.5%) of the 423 hospitalizations in the unit, 94 nosocomial infections occurred. The most common infections were those of the urinary tract (30% of 94 infections) or a surgical site (17%), Clostridium difficile diarrhea (15%), and bloodstream infection (12.8%). Antibiotic-resistant bacteria most commonly caused bloodstream infection (41.7%) and surgical site infection (56.3%). Independent predictors of nosocomial infection at the time of admission were functional status (measured with the functional independence measure), APACHE III score, and spinal cord injury. In conclusion, gram-positive organisms were the predominant strains causing nosocomial colonization and infection. The logistic model, if verified, may be useful in defining patients who should be targeted for measures to prevent nosocomial infection.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Epidemiology of Nosocomial Infection and Resistant Organisms in Patients Admitted for the First Time to an Acute Rehabilitation Unit

Mylotte

Graham

Kahler

et al. 2000

Clinical Infectious Diseases

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“…Amikacin and gentamicin are not commonly used antibiotics because of their potential nephrotoxicity, which might be a cause for this result. Previous studies have focused on the antibiotic resistance of P. aeruginosa (15)(16)(17)(18)(19) or K. pneumoniae in patients with SCI (16,(19)(20)(21)(22). Although Klebsiella was the second most common uropathogen seen in our SCI patients, its distribution was not significantly different between acute and chronic patients.…”

Section: Discussionmentioning

confidence: 74%

Retrospective Analysis of Nosocomial Urinary Tract Infections with Spinal Cord Injury Patients in a Rehabilitation Setting

Yılmaz¹,

Yavuz²,

Adıgüzel³

2014

Turk J Phys Med Rehab

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Objective: To define the distribution and antibiotic susceptibility of nosocomial urinary tract infections (NAUTIs) in patients with spinal cord injury (SCI). Material and Methods: Records of the spinal cord injured patients were reviewed for NAUTIs between 2008 and 2010. Antibiotic resistance rates and factors that might affect urinary tract infection susceptibility were investigated retrospectively. Results: The data of 276 patients were included, of whom 159 were acute SCI patients and 117 were chronic SCI patients; 166 (61%) infections were asymptomatic bacteriuria (ASB), and 110 (39%) infections were symptomatic urinary tract infections (SUTIs). In patients with acute SCI, E. coli was the most frequently isolated pathogen of SUTIs, followed by Pseudomonas. In patients with chronic SCI, E. coli was the most frequently isolated pathogen in SUTIs and ASBs. There was no statistically significant difference in the rates of NAUTI (ASB and SUTI) between acute and chronic SCI patients in terms of bladder drainage method. The susceptibility ratios for E. coli were very low in both acute and chronic SCI patients using Foley catheters. Although the susceptibility ratios for E. coli were not that low in SCI patients using clean intermittent catheterization, the resistance ratios were higher than 50% for most of the uropathogens. Conclusion: These results reveal a blunt truth that the treatment of NAUTIs will be a great challenge in near future. Kronik SKY hastalarda SUTI ve ASB için en sık izole edilen patojen E. coli idi. Mesane boşaltım yöntemi dikkate alındığında, akut ve kronik SKY hastalar arasında NAUTI (ASB ve SUTI) dağılımı açısından anlamlı bir fark yoktu. Foley kateter kullanan akut ve kronik SKY hastalarda E. coli duyarlılık oranları çok düşüktü. Temiz aralıklı kateterizasyon uygulanan hastalarda duyarlılık oranları o kadar düşük olmasa da, direnç oranları üropatojenlerin çoğu için %50'nin üzerindeydi. Sonuç: Bu sonuçlar, nozokomiyal üriner sistem infeksiyonlarının tedavisinin yakın gelecekte ne kadar büyük bir sorun olacağı konusundaki gerçeği ortaya koymaktadır. Anahtar Kelimeler: Spinal kord yaralanması, nozokomiyal üriner sistem infeksiyonu, rehabilitasyon

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“…All these multiple resistance genes are usually carried on large transferable plasmids. Large plasmid profiles from K. pneumoniae associated with multiple resistances have been documented in Europe (Montgomerie et al, 1993;Reed et al, 1995;Marchese et al, 1996), United States (Wallace et al, 1995;Schiappa et al 1996) and Asia (Wang et al, 1995). Prodinger et al (1996) mentioned that there was R plasmid with 80 kbp responsible for conferring resistance to SHV-5 in K. pneumoniae isolates.…”

Section: Plasmidsmentioning

confidence: 99%

Detection of Conjugative Plasmid Encoded Ampicillin and Tetracycline Resistant in Klebsiella pneumonia

Ozdemir¹,

Hassan²,

Kala³

2013

IJB

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Klebsiella pneumonia were isolated and identified on the basis of morphology, growth, and biochemical characteristics. All the isolates offered different resistance patterns against antibiotics including Ampicillin, Cefotaxime, Erythromycin, tetracycline and Chloramphenicol. Transformation and conjugation techniques were used for plasmid transfer studies. The conjugation experiment showed that ≈ 51kbp conjugative plasmid conferring resistance to tetracycline and ampicillins were successfully transferred to the recipient cells E. coli MM294. The rest of the plasmid borne markers was non-conjugative/nontransferable. Conjugative plasmids carry a tremendous potential to disseminate resistance markers to distant recipient cells. The protocol is reliable enough to be used for large-scale visualization of native plasmids and we have used it to visualize and isolate DNA from hundreds of multidrug resistance plasmids.

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Increased frequency of large R-plasmids in Klebsiella pneumoniae colonizing patients with spinal cord injury

Cited by 7 publications

References 22 publications

Epidemiology of Nosocomial Infection and Resistant Organisms in Patients Admitted for the First Time to an Acute Rehabilitation Unit

Epidemiology of Nosocomial Infection and Resistant Organisms in Patients Admitted for the First Time to an Acute Rehabilitation Unit

Retrospective Analysis of Nosocomial Urinary Tract Infections with Spinal Cord Injury Patients in a Rehabilitation Setting

Detection of Conjugative Plasmid Encoded Ampicillin and Tetracycline Resistant in Klebsiella pneumonia

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