Journal article

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

  • Girlich, Delphine Faculty of Medicine, South-Paris University, Le Kremlin-Bicêtre, France
  • Nordmann, Patrice INSERM U914 «Emerging Resistance to Antibiotic», Le Kremlin-Bicêtre, France - Associated National Reference Center to Antibiotic Resistance, Le Kremlin-Bicêtre, France - Microbiology Unit, Department of Medicine, University of Fribourg, Fribourg, Switzerland - Hôpital Cantonal, Fribourg, Switzerland
  • Lécuyer, Hervé Bacteriology-Virology-Hygiene unit, Necker-Enfants Malades Hospital, Assistance Publique/Hôpitaux de Paris, France
  • Berche, Patrick Bacteriology-Virology-Hygiene unit, Necker-Enfants Malades Hospital, Assistance Publique/Hôpitaux de Paris, France
  • Marmorat-Khuong, Anne Centre Hospitalier de Saint-Denis, Saint-Denis, France
  • Gros, Isabelle Centre Hospitalier de Saint-Denis, Saint-Denis, France
  • Cuzon, Gaëlle INSERM U914 «Emerging Resistance to Antibiotic», Le Kremlin-Bicêtre, France - Associated National Reference Center to Antibiotic Resistance, Le Kremlin-Bicêtre, France - Bacteriology-Hygiene unit, Bicêtre Hospital, Assistance Publique/Hôpitaux de Paris, Le Kremlin-Bicêtre, France
  • Dortet, Laurent INSERM U914 «Emerging Resistance to Antibiotic», Le Kremlin-Bicêtre, France - Associated National Reference Center to Antibiotic Resistance, Le Kremlin-Bicêtre, France - Bacteriology-Hygiene unit, Bicêtre Hospital, Assistance Publique/Hôpitaux de Paris, Le Kremlin-Bicêtre, France - Faculty of Medicine, South-Paris University, Le Kremlin-Bicêtre, France
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    15.12.2014
Published in:
  • Diagnostic Microbiology and Infectious Disease. - 2015
English 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).
Faculty
Faculté des sciences et de médecine
Department
Médecine 3ème année
Language
  • English
Classification
Clinical medicine
License
License undefined
Identifiers
Persistent URL
https://folia.unifr.ch/unifr/documents/304210
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