National Nosocomial Infections Surveillance (NNIS) System Report, Data Summary from January 1992-June 2001, Issued August 2001

Solomon,; Horan,; Andrus,; Edwards,

doi:10.1067/mic.2001.119952

Cited by 400 publications

(32 citation statements)

References 15 publications

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“…Enterococcus , particularly some of the species isolated in this study including E. faecalis and E. faecium , has emerged as one of the leading causes of nosocomial bacteremias, urinary tract infections, and wound infections in the United States (NNIS 2001). Similarly, coagulase-negative staphylococci are the third most common causes of nosocomial infections and the most common causes of nosocomial bacteremias.…”

Section: Discussionmentioning

confidence: 99%

“…The goal of this study was to test air samples collected within a swine CAFO for the presence of antibiotic-resistant enterococci, gram-positive, catalase-negative cocci that are not only members of the normal intestinal flora of humans and animals but also capable of causing a variety of human and animal infections [National Nosocomial Infections Surveillance (NNIS) 2001]. Resistance to erythromycin, clindamycin, tetracycline, and virginiamycin [an analog to quinupristin/dalfopristin, which is used to treat vancomycin-resistant Enterococcus faecium infections in humans (Johnson and Livermore 1999)] was investigated.…”

mentioning

confidence: 99%

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Airborne Multidrug-Resistant Bacteria Isolated from a Concentrated Swine Feeding Operation

Chapin¹,

Rule²,

Gibson

et al. 2005

Environ Health Perspect

118

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The use of nontherapeutic levels of antibiotics in swine production can select for antibiotic resistance in commensal and pathogenic bacteria in swine. As a result, retail pork products, as well as surface and groundwaters contaminated with swine waste, have been shown to be sources of human exposure to antibiotic-resistant bacteria. However, it is unclear whether the air within swine operations also serves as a source of exposure to antibiotic-resistant bacterial pathogens. To investigate this issue, we sampled the air within a concentrated swine feeding operation with an all-glass impinger. Samples were analyzed using a method for the isolation of Enterococcus. A total of 137 presumptive Enterococcus isolates were identified to species level using standard biochemical tests and analyzed for resistance to erythromycin, clindamycin, virginiamycin, tetracycline, and vancomycin using the agar dilution method. Thirty-four percent of the isolates were confirmed as Enterococcus, 32% were identified as coagulase-negative staphylococci, and 33% were identified as viridans group streptococci. Regardless of bacterial species, 98% of the isolates expressed high-level resistance to at least two antibiotics commonly used in swine production. None of the isolates were resistant to vancomycin, an antibiotic that has never been approved for use in livestock in the United States. In conclusion, high-level multidrug-resistant Enterococcus, coagulase-negative staphylococci, and viridans group streptococci were detected in the air of a concentrated swine feeding operation. These findings suggest that the inhalation of air from these facilities may serve as an exposure pathway for the transfer of multidrug-resistant bacterial pathogens from swine to humans.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Airborne Multidrug-Resistant Bacteria Isolated from a Concentrated Swine Feeding Operation

Chapin¹,

Rule²,

Gibson

et al. 2005

Environ Health Perspect

118

View full text Add to dashboard Cite

show abstract

“…Staphylococci and enterococci are leading causes of antibiotic resistant, hospital-acquired infections (205). Although these organisms are major causes of nosocomial infection, numerically only a miniscule population of cells is involved in infection, with the vast majority of bacteria occurring in peaceful coexistence with the host as part of the commensal flora.…”

Section: Discussionmentioning

confidence: 99%

Virulence Plasmids of Nonsporulating Gram-Positive Pathogens

Tyne

Gilmore

2014

Microbiol Spectr

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SUMMARY Gram-positive bacteria are leading causes of many types of human infection, including pneumonia, skin and nasopharyngeal infections, as well as urinary tract and surgical wound infections among hospitalized patients. These infections have become particularly problematic because many of the species causing them have become highly resistant to antibiotics. The role of mobile genetic elements, such as plasmids, in the dissemination of antibiotic resistance among Gram-positive bacteria has been well studied; less well understood is the role of mobile elements in the evolution and spread of virulence traits among these pathogens. While these organisms are leading agents of infection, they are also prominent members of the human commensal ecology. It appears that these bacteria are able to take advantage of the intimate association between host and commensal, via virulence traits that exacerbate infection and cause disease. However, evolution into an obligate pathogen has not occurred, presumably because it would lead to rejection of pathogenic organisms from the host ecology. Instead, in organisms that exist as both commensal and pathogen, selection has favored the development of mechanisms for variability. As a result, many virulence traits are localized on mobile genetic elements, such as virulence plasmids and pathogenicity islands. Virulence traits may occur within a minority of isolates of a given species, but these minority populations have nonetheless emerged as a leading problem in infectious disease. This chapter reviews virulence plasmids in nonsporulating Gram-positive bacteria, and examines their contribution to disease pathogenesis.

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“…Antimicrobial resistance (AMR) is an increasing global healthcare phenomenon, with apocalyptic predictions of a post-antibiotic era where common infections and minor injuries may not be treatable by conventional antibiotics [8] . A WHO global report describes the majority of world regions with over 50% resistance of Escherichia coli (E. Coli) and Klebsiella Pneumoniae to 3 rd generation cephalosporins and fluoroquinolones.…”

Section: Antibiotic Resistance In Icu Its Contributors and Impactmentioning

confidence: 99%

Antibiotic stewardship programmes in intensive care units: Why, how, and where are they leading us

Zhang

Singh

2015

WJCCM

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Antibiotic usage and increasing antimicrobial resistance (AMR) mount significant challenges to patient safety and management of the critically ill on intensive care units (ICU). Antibiotic stewardship programmes (ASPs) aim to optimise appropriate antibiotic treatment whilst minimising antibiotic resistance. Different models of ASP in intensive care setting, include "standard" control of antibiotic prescribing such as "de-escalation strategies" through to interventional approaches utilising biomarkerguided antibiotic prescribing. A systematic review of outcomes related studies for ASPs in an ICU setting was conducted. Forty three studies were identified from MEDLINE between 1996 and 2014. Of 34 nonprotocolised studies, [1 randomised control trial (RCT), 22 observational and 11 case series], 29 (85%) were positive with respect to one or more outcome: These were the key outcome of reduced antibiotic use, or ICU length of stay, antibiotic resistance, or prescribing cost burden. Limitations of non-standard antibiotic initiation triggers, patient and antibiotic selection bias or baseline demographic variance were identified. All 9 protocolised studies were RCTs, of which 8 were procalcitonin (PCT) guided antibiotic stop/start interventions. Five studies addressed antibiotic escalation, 3 de-escalation and 1 addressed both. Six studies reported positive outcomes for reduced antibiotic use, ICU length of stay or antibiotic resistance. PCT based ASPs are effective as antibiotic-stop (de-escalation) triggers, but not as an escalation trigger alone. PCT has also been effective in reducing antibiotic usage without worsening morbidity or mortality in ventilator associated pulmonary infection. No study has demonstrated survival benefit of ASP. Ongoing challenges to infectious disease management, reported by the World Health Organisation global report 2014, are high AMR to newer antibiotics, and regional knowledge gaps in AMR surveillance. Improved AMR surveillance data, identifying core aspects of successful ASPs that are transferable, and further well-conducted trials will be necessary if ASPs are to be an effective platform for delivering desired patient outcomes and safety through best antibiotic policy.

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National Nosocomial Infections Surveillance (NNIS) System Report, Data Summary from January 1992-June 2001, Issued August 2001

Cited by 400 publications

References 15 publications

Airborne Multidrug-Resistant Bacteria Isolated from a Concentrated Swine Feeding Operation

Airborne Multidrug-Resistant Bacteria Isolated from a Concentrated Swine Feeding Operation

Virulence Plasmids of Nonsporulating Gram-Positive Pathogens

Antibiotic stewardship programmes in intensive care units: Why, how, and where are they leading us

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