Significance of Screening Tests and the Incidence of New Delhi Metallo-beta-lactamase-Producing Gram-negative Bacilli in the Surgery and Transplantation Wards of a Warsaw Medical Center During the Period From April 2014 to May 2017

被引：1

作者：

Szymanek-Majchrzak, K. ^{[1
,2
]}

Mlynarczyk, A. ^{[2
]}

Kuthan, R. ^{[1
]}

Sawicka-Grzelak, A. ^{[1
,2
]}

Majchrzak, K. ^{[3
]}

Kawecki, D. ^{[1
]}

Kosieradzki, M. ^{[4
]}

Durlik, M. ^{[5
]}

Deborska-Materkowska, D. ^{[5
]}

Paczek, L. ^{[6
]}

Mlynarczyk, G. ^{[1
,2
]}

机构：

[1] Med Univ Warsaw, Dept Med Microbiol, T Chalubinskiego 5 Str, PL-02004 Warsaw, Poland

[2] Infant Jesus Teaching Hosp, Dept Med Microbiol, Warsaw, Poland

[3] Med Univ Warsaw, Dept Prosthet Dent, Warsaw, Poland

[4] Med Univ Warsaw, Inst Transplantat, Dept Gen & Transplantat Surg, Warsaw, Poland

[5] Med Univ Warsaw, Inst Transplantat, Dept Transplant Med & Nephrol, Warsaw, Poland

[6] Med Univ Warsaw, Inst Transplantat, Dept Immunol Transplantol & Internal Dis, Warsaw, Poland

来源：

TRANSPLANTATION PROCEEDINGS | 2018年 / 50卷 / 07期

关键词：

KLEBSIELLA-PNEUMONIAE; ESCHERICHIA-COLI; ENTEROBACTERIACEAE; BLA(NDM-1); CARRIAGE; OUTBREAK; POLAND;

D O I：

10.1016/j.transproceed.2018.04.002

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. The first New Delhi metallo-beta-lactamase (NDM)-producing bacteria were isolated in 2008 in the world, and in 2011 in Poland. Due to the high clonal diversity (17 types) of their blaNDM gene, encoded on (Tn125-like) mobile genetic elements, these strains usually exhibit resistance to nearly all available antibiotics, which is particularly dangerous for organ transplant recipients. Purpose. To assess of the prevalence of Gram-negative NDM-positive bacilli in surgery/transplantation wards of a teaching hospital in Warsaw and to ascertain the significance of screening tests on the rates and nature of colonization. Materials and Methods. The evaluated strains were isolated from 30 patients (between April 2014 and May 2017). The species were identified with VITEK-MS, antibiotic susceptibility was determined with VITEK 2, disk-diffusion, and/or E-test methods, according to EUCAST guidelines. The presence of the blaNDM-1 gene was confirmed using the polymerase chain reaction technique. Results and Conclusions. There were 77 blaNDM-1-positive Klebsiella pneumoniae strains isolated from 30 patients. Cultures from individual patients, mainly from rectal swabs (53.9%) and urine samples (39.8%), yielded 1-11 isolates. Fifteen patients were already colonized on admission, and the other 15 developed a symptomatic infection. In total, 24 (80%) patients were carriers, and their colonizations persisted for < 1-20 months. Most isolates were susceptible only to colistin, gentamicin, amikacin, tigecycline, and/or sulfamethoxazole/trimethoprim. Gastrointestinal-tract-colonizing K pneumoniae are the main reservoir of the blaNDM-1 gene. Following the introduction of on-admission mandatory screening for carbapenem-resistant strains, the rates of NDM-producing K pneumoniae isolation increased (7.5-fold), while the rates of isolation from patients with symptomatic infections considerably decreased (2.8-fold).

引用

页码：2159 / 2163

页数：5