Multiple colonization with highly resistant bacteria: carbapenemase-producing Enterobacteriaceae, carbapenemase-producing Pseudomonas aeruginosa, carbapenemase-producing Acinetobacter baumannii, and glycopeptide-resistant Enterococcus faecium

Autor: Isabelle Gros, Patrick Berche, Hervé Lécuyer, Laurent Dortet, Patrice Nordmann, Delphine Girlich, Anne Marmorat-Khuong, Gaelle Cuzon
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Popis: The dissemination of carbapenemase-producing bacteria worldwide is an important source of concern because carbapenemase producers are multidrug resistant (Nordmann and Poirel, 2014). National guidelines increasingly recommend a systematic screening of at least carbapenemase-producing Enterobacteriaceae (CPE) and glycopeptide-resistant enterococci (GRE) in patients admitted to hospitals who have been hospitalized aboard during the preceding 12 months (Lepelletier et al., 2011). We have investigated the occurrence of colonization and infection with multiple highly resistant bacteria of more than 4 different genus in 2 patients directly transferred from a foreign country.In June 2014, a 33-year-old French man (patient A) was admitted for a suicide attempt in a Vietnamese hospital where he was treated during 10 days for pneumonia with piperacillin + tazobactam before his transfer to Necker-Enfants Malades University Hospital in Paris, France. At the day of his hospitalization in France, distal protected pulmonary samples were collected, and imipenem was administered subsequently to a persistent fever. In addition, systematic screening to detect carbapenemase producers and GRE was also performed. Screening of extended spectrum β-lactamase (ESBL) producing Enterobacteriaceae, carbapenemase producers, and GRE was done on selective media (bioMérieux, La Balme-les-Grottes, France) ChromID ESBL, ChromID Carba Smart, and VRE medium, respectively. Carbapenemase production was identified using the Carba NP test for Enterobacteriaceae (Dortet et al., 2014a) and Pseudomonas aeruginosa ( Dortet et al., 2012) and CarbAcineto NP test for Acinetobacter baumannii ( Dortet et al., 2014b). Definitive identifications of resistance determinant were done by PCR amplifications followed by sequencing. Pulmonary samples grew an OXA-23–producing A. baumannii isolate and an IMP-1–producing P. aeruginosa ( Table 1). Screening identified also that the patient was colonized with a KPC-2–producing Klebsiella pneumoniae, a CTX-M-15–producing K. pneumoniae, and a VanA-positive glycopeptide-resistant Enterococcus faecium ( Table 1).
Databáze: OpenAIRE