The Rising Influx of Multidrug-Resistant Gram-Negative Bacilli into a Tertiary Care Hospital

Pop-Vicas, Aurora; D’Agata, Erika M. C.

doi:10.1086/430314

Cited by 119 publications

(116 citation statements)

References 33 publications

(27 reference statements)

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“…Gemeinsam ist den Definitionen, dass auf eine Eingruppierung auf Basis der Resistenzmechanismen verzichtet und stattdessen die Resistenz gegenüber verschiedenen Antibiotikagruppen zugrunde gelegt wird [2,3,5,17,18]. Dabei unterscheiden sich die Definitionen in der Anzahl der betrachteten Antibiotikagruppen und der Anzahl der nicht wirksamen Gruppen.…”

Section: Definitionen Und Hintergrundunclassified

Hygienemaßnahmen bei Infektionen oder Besiedlung mit multiresistenten gramnegativen Stäbchen

2012

Bundesgesundheitsbl.

287

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Section: Definitionen Und Hintergrundunclassified

Hygienemaßnahmen bei Infektionen oder Besiedlung mit multiresistenten gramnegativen Stäbchen

2012

Bundesgesundheitsbl.

287

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“…Residents of LTCFs may be at increased risk of infection as a result of sharing common living areas and participating in group activities. Additionally, due to the frequent hospitalization of LTCF residents, pathogens may be transmitted between LTCFs and hospitals [1][2][3][4][5][6]. Serious infections may increase medical costs and mortality rates.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies investigating the duration of MDRO colonization have been predominantly conducted in hospitals [2,3,6,8,[14][15][16]. No prior studies have investigated the factors that affect the duration of MDRO colonization in the LTCF setting.…”

Section: Introductionmentioning

confidence: 99%

Duration of colonization with and risk factors for prolonged carriage of multidrug resistant organisms among residents in long-term care facilities

Lin

Huang

Pan

et al. 2017

Antimicrob Resist Infect Control

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Background: Residents of long-term care facilities (LTCFs) colonized with multidrug resistant organisms (MDROs) are often placed under contact isolation to ensure appropriate infection control. This isolation may reduce opportunities for rehabilitation and social stimuli and may also increase medical costs. However, the number of previous studies investigating the duration of colonization in LTCFs is limited. This study was conducted to determine the duration of colonization and risk factors for prolonged carriage of MDROs among residents of a LTCF. Methods: This retrospective study was conducted in a hospital-affiliated nursing home with 59 beds. Fifty-four residents in the nursing home were isolated for MDROs between January 1, 2013 and December 31, 2015. Clinical data were collected from the charts of these 54 residents, including catheter use, colonizing MDRO species and site, underlying diseases, Charlson Comorbidity Index (CCI) scores, and Barthel index scores before and after isolation. Forty-seven residents were included into the statistic analysis. Multivariate Cox regression analyses were performed using duration of colonization as the dependent variable.

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“…In one healthcare institution, MDR-P aeruginosa recovered form clinical cultures increased from 1 % in 1994 to 16 % in 2002, with similar dramatic increases among other species of gram-negative bacteria [9]. Effective antimicrobial therapy for infections caused by MDRGN is severely limited with over 30 % of MDRGN resistant to 5 or more different antibiotic groups [28]. Understanding the interrelated and dynamic factors contributing to the emergence of MDRGN is crucial for the development of effective preventive strategies.…”

Section: Introductionmentioning

confidence: 99%

Quantifying the Impact of Bacterial Fitness and Repeated Antimicrobial Exposure on the Emergence of Multidrug-Resistant Gram-Negative Bacilli

D’Agata

Horn

Webb

2007

Math. Model. Nat. Phenom.

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Abstract. The emergence of multidrug resistance among gram-negative bacilli is complex. Numerous factors need to be considered, including the biological fitness cost of resistance, fitnesscompensatory mutations and frequency and type of antibiotic exposure. A mathematical model evaluating these complex relationships was developed in an individual colonized with strains of pan-susceptible, single-, two-and multidrug-resistant (MDR) gram-negative bacilli (GN). The effect of bacterial fitness, compensatory mutations and the frequency of three-antimicrobial regimen exposure to predominance of multidrug-resistant strains were quantified. The model predicts that initially, in the absence of antibiotic exposure, the biologically fitter pan-susceptible strain predominates over the resistant strains. Over time, the fitness of the MDR strains increases faster with repeated antimicrobial exposure, through compensatory-fitness mutations. Increasing the frequency of exposure to the three-antimicrobial regimen or, increasing the initial fitness of the resistant strains, substantially decreases the time to MDR-GN predominance. The model implies that when MDR-GN strains evolve into strains that are fitter than susceptible strains, a reduction in antimicrobial exposure may not result in a decrease of MDR-GN, since the absence of selective antimicrobial pressure would no longer favor susceptible strains. The model also implies that antimicrobial cycling may promote the emergence of MDR-GN.

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The Rising Influx of Multidrug-Resistant Gram-Negative Bacilli into a Tertiary Care Hospital

Abstract: A substantial number of patients harbor MDR-GNB at hospital admission. Identification of common coresistance patterns among MDR-GNB isolates may assist in the selection of empirical antimicrobial therapy for patients with a high risk of harboring MDR-GNB.

Cited by 119 publications

References 33 publications

Hygienemaßnahmen bei Infektionen oder Besiedlung mit multiresistenten gramnegativen Stäbchen

Hygienemaßnahmen bei Infektionen oder Besiedlung mit multiresistenten gramnegativen Stäbchen

Duration of colonization with and risk factors for prolonged carriage of multidrug resistant organisms among residents in long-term care facilities

Quantifying the Impact of Bacterial Fitness and Repeated Antimicrobial Exposure on the Emergence of Multidrug-Resistant Gram-Negative Bacilli

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