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Multidrug-Resistant Gram-Negative Bacteria in Burn Patients.
Ruegsegger, Laura; Xiao, Jamie; Naziripour, Arash; Kanumuambidi, Trey; Brown, Dylan; Williams, Felicia; Marshall, Steven H; Rudin, Susan D; Yen, Kelly; Chu, Tingyu; Chen, Liang; Sozzi, Emanuele; Bartelt, Luther; Kreiswirth, Barry; Bonomo, Robert A; van Duin, David.
Afiliación
  • Ruegsegger L; Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA.
  • Xiao J; Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA.
  • Naziripour A; Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA.
  • Kanumuambidi T; Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA.
  • Brown D; Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA.
  • Williams F; Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
  • Marshall SH; Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio, USA.
  • Rudin SD; Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio, USA.
  • Yen K; Department of Medicine, Case Western Reserve Universitygrid.67105.35 School of Medicine, Cleveland, Ohio, USA.
  • Chu T; Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, New Jersey, USA.
  • Chen L; Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, New Jersey, USA.
  • Sozzi E; Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, New Jersey, USA.
  • Bartelt L; Department of Environmental Science and Engineering, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.
  • Kreiswirth B; Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA.
  • Bonomo RA; Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, New Jersey, USA.
  • van Duin D; Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio, USA.
Antimicrob Agents Chemother ; 66(9): e0068822, 2022 09 20.
Article en En | MEDLINE | ID: mdl-36066237
Patients with burn injuries are at high risk for infectious complications, and infections are the most common cause of death after the first 72 h of hospitalization. Hospital-acquired infections caused by multidrug resistant (MDR) Gram-negative bacteria (GNB) in this population are concerning. Here, we evaluated carriage with MDR GNB in patients in a large tertiary-care burn intensive care unit. Twenty-nine patients in the burn unit were screened for intestinal carriage. Samples were cultured on selective media. Median time from admission to the burn unit to first sample collection was 9 days (IQR 5 - 17 days). In 21 (72%) patients, MDR GNB were recovered; the most common bacterial species isolated was Pseudomonas aeruginosa, which was found in 11/29 (38%) of patients. Two of these patients later developed bloodstream infections with P. aeruginosa. Transmission of KPC-31-producing ST22 Citrobacter freundii was detected. Samples from two patients grew genetically similar C. freundii isolates that were resistant to ceftazidime-avibactam. On analysis of whole-genome sequencing, blaKPC-31 was part of a Tn4401b transposon that was present on two different plasmids in each C. freundii isolate. Plasmid curing experiments showed that removal of both copies of blaKPC-31 was required to restore susceptibility to ceftazidime-avibactam. In summary, MDR GNB colonization is common in burn patients and patient-to-patient transmission of highly resistant GNB occurs. These results emphasize the ongoing need for infection prevention and antimicrobial stewardship efforts in this highly vulnerable population.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por Bacterias Gramnegativas / Bacterias Gramnegativas Límite: Humans Idioma: En Revista: Antimicrob Agents Chemother Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por Bacterias Gramnegativas / Bacterias Gramnegativas Límite: Humans Idioma: En Revista: Antimicrob Agents Chemother Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos