Research Article
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Year 2020, , 1 - 9, 15.03.2020
https://doi.org/10.5799/jmid.700466

Abstract

References

  • 1. Asti A, Marmondi E, Tinelli C, et al. Microbiological sentinel events at a neurological hospital: a retrospective cohort study. J Med Microbiol 2016; 65, 1512–1520. 2. Guidance for control of Carbapenem-resistant Enterobacteriaceae (CRE) Facility Guidance for Control of Carbapenem-resistant Enterobacteriaceae (CRE). November 2015 Update - CRE Toolkit. National Center for Emerging and Zoonotic Infectious Diseases; Division of Healthcare Quality Promotion CDC. 3. Zhang Y, Wang Q, Yin Y, et al. Epidemiology of Carbapenem-Resistant Enterobacteriaceae Infections: Report from the China CRE Network. Antimicrob Agents Chemother 2018; 62 e01882-1817. 4. Meletis G. Carbapenem resistance: overview of the problem and future perspectives. Ther Adv Infect Dis 2016; 3(1), 1521. 5. van Duin D, Doi Y. The global epidemiology of carbapenemase producing Enterobacteriaceae. Virulence 2017; 8(4), 460-469. 6. Global priority list of antibiotic-resistant bacteria to guide research, discovery, and development of new antibiotics.http://www.who.int/medicines/publications/globalpriority-list-antibiotic-resistant-bacteria/en/ 7. Papp-Wallance KM, Endimiani A, Taracila MA, et al. Carbapenems: past, present and future. Antimicrob Agent Chemother 2011; 4943-4960 8. Hauck, K. & Zhao, X. How dangerous is a day in hospital? A model of adverse events and length of stay for medical inpatients. Med Care 2011; 49, 1068–1075. 9. World Health Organization Prevention of Hospital-Acquired Infections. a Practical Guide, 2nd edn. Geneva: 2002 WHO/CDS/CSR/EPH. 10. Fritzenwanker M, Imirzalioglu C, Herold S, et al. Treatment Options for Carbapenem- Resistant Gram-Negative Infections. Dtsch Arztebl Int 2018; 115, 345–52. 11. Puzniak L, DePestel DD, Srinivasan A, et al. A Combination Antibiogram Evaluation for Pseudomonas aeruginosa in Respiratory and Blood Sources from ICU and Non-ICU Settings in US. Hospitals. Antimicrob. Agents Chemother 2019; 63, 4 e02564-18. 12. A European One Health Action Plan against Antimicrobial Resistance (AMR). 2017 European Commission). https://eur-lex.europa.eu/legal-content/IT/TXT/PDF/?uri=CELEX:52017DC0339&from=EN 13. Nagy E, Becker S, Kostrzewa M, et al.. The value of MALDI-TOF MS for the identification of clinically relevant anaerobic bacteria in routine laboratories. J Med Microbiol 2012; 61, 1393-1400. 14. European Committee on Antimicrobial Susceptibility Testing (EUCAST). EUCAST guidelines for detection of resistance mechanisms and specific resistances of clinical and/or epidemiological importance, December 2013. http://www.eucast.org/fi leadmin/src/media/PDFs/EUCAST_files/ Resistance_mechanisms/EUCAST_detection_of_resistance_mechanisms_v1.0_20131211.pdf 15. Iacchini S, Sabbatucci M, Gagliotti C, et al. A. Bloodstream infections due to carbapenemase-producing Enterobacteriaceae in Italy: results from nationwide surveillance, 2014 to 2017. Eurosurveill 2019; 24, 5. 16. Uslan DZ, Crane SJ, Steckelberg JM, et al. Age-and sex-associated trends in bloodstream infection: a population-based study in Olmsted County, Minnesota. Arch Intern Med 2007; 167(8), 834-839. 17. Kousouli E, Zarkotou O, Politi L, et al. Infection control interventions affected by resource shortages: impact on the incidence of bacteremias caused by carbapenem-resistant pathogens. Eur J Clin Microbiol Infect Dis 2018; 37(1), 43-50. 18. Hubacek JA, Stüber F, Fröhlich D, et al. Gene variants of the bactericidal/permeability increasing protein and lipopolysaccharide binding protein in sepsis patients: gender-specific genetic predisposition to sepsis. Crit Care Med 2001; 29(3), 557-561. 19. Albiger B,. Glasner C, MJ Struelens MJ, et al. The European Survey of Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) working group. Carbapenemase-producing Enterobacteriaceae in Europe: assessment by national experts from 38 countries, May 2015. Euro Surveill 2015; 20(45). 20. Weng NP. Aging of the immune system: how much can the adaptive immune system adapt? Immunity 2006; 24(5),495-499. 21. Codjoe FS and Donkor ES. Carbapenem Resistance: A Review. Med Sci 2018; 6, 1 22. Ministero della Salute (Italian Ministry of Health). Piano Nazionale di Contrasto dell’Antimicrobico-Resistenza (PNCAR) 2017-2020. [National Action Plan on Antimicrobial Resistance 2017-2020] Rome: Ministry of Health; 24 Oct 2017. Italian. http://www.salute.gov.it/imgs/C_17_http://www.salute.gov.it/imgs/C. 23. Goldman DA, Weinstein RA, Wenzel RP, et al. Strategies to Prevent and Control the Emergence and Spread of Antimicrobial-Resistant Microorganisms in Hospitals. A Challenge to Hospital Leadership. JAMA 1996; 275, 234-240 24. Grundmann H, Glasner C, Albiger B, et al.and the European Survey of Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) Working Group. Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE): a prospective, multinational study. Lancet Infect Dis 2017; 17, 153-163. 25. Mandell GL, Bennett JE, Dolin R, Douglas M. Bennett’s Principles and Practice of Infectious Diseases, 7th edn. Oxford, 2010, Elsevier/Churchill Livingstone, United Kingdom. 26. Christoff J, Tolentino J, Mawdsley E, et al. Optimizing empirical antimicrobial therapy for infection due to Gram-negative pathogens in the intensive care unit: utility of a combination antibiogram. Infect Control Hosp Epidemiol 2010; 31, 256–261. 27. Davey P, Marwick CA, Scott CL et al. Interventions to improve antibiotic prescribing practices for hospital inpatients Cochrane Database of Systematic Reviews 2017; 9,2. 28. Hojgard S. Antibiotic resistance-why is the problem so difficult to solve? Infect Ecol Epidemiol 2012; 2,18165 29. Abulhasan YB, Rachel SP, Chatillon-Angle MO, et al. Healthcare associated infections in the neurological intensive care-unit: Results of 6 years surveillance study at a major tertiary care center. Am J Infect Control 2018; 46, 656-662.

Implementation of Preventive Actions to Control Carbapenem-Resistant Enterobacteriaceae and MDR Gram Negatives at a Neurological Hospital

Year 2020, , 1 - 9, 15.03.2020
https://doi.org/10.5799/jmid.700466

Abstract

Objectives: Objective: The aim of this study is to describe the epidemiological surveillance of Carbapenem-Resistant Enterobacteriaceae (CRE) effected at the Neurological Hospital Carlo Besta, Milano, Italy. The primary causes in our division of multidrug-resistant (MDRs) infections in 2016 were K. pneumoniae and A. baumannii; the preventive actions have ensured the reduction of their incidence in 2017 and allowed us to discover the microbiological sentinel events (SE) and start appropriate precautionary behavior and isolation.
Methods: The setting is inpatient care with MDR infections and the aim of the procedure is to formalize the management mode, reporting and transmission of SE, collected at the end of study period for previous years from January 1st, 2015 to December 31st, 2017.
Results: It should be noted that of a total of 5772 hospitalizations detected in 2016 there was an increase in rate of A. baumannii compared to the rate found in 2015 for 5679 hospitalizations and in 2017 for 5682 hospitalizations; the same trend was observed for K. pneumoniae. For as regards P. aeruginosa carbapenemase producing or MDR, the rates were lower in 2016 and in 2017.
Conclusions: The main goals that we achieved in the three years considered are the decreased incidence of healthcare-associated infections (HAIs) and the decreased incidence of multidrug-resistant (MDR) microorganisms. These actions were of course associated with the control of antibiotic pressure and a careful stewardship. The strict surveillance of HAIs is fundamental to control the growing reservoir within hospital communities. J Microbiol Infect Dis 2020; 10(1):1-9.

References

  • 1. Asti A, Marmondi E, Tinelli C, et al. Microbiological sentinel events at a neurological hospital: a retrospective cohort study. J Med Microbiol 2016; 65, 1512–1520. 2. Guidance for control of Carbapenem-resistant Enterobacteriaceae (CRE) Facility Guidance for Control of Carbapenem-resistant Enterobacteriaceae (CRE). November 2015 Update - CRE Toolkit. National Center for Emerging and Zoonotic Infectious Diseases; Division of Healthcare Quality Promotion CDC. 3. Zhang Y, Wang Q, Yin Y, et al. Epidemiology of Carbapenem-Resistant Enterobacteriaceae Infections: Report from the China CRE Network. Antimicrob Agents Chemother 2018; 62 e01882-1817. 4. Meletis G. Carbapenem resistance: overview of the problem and future perspectives. Ther Adv Infect Dis 2016; 3(1), 1521. 5. van Duin D, Doi Y. The global epidemiology of carbapenemase producing Enterobacteriaceae. Virulence 2017; 8(4), 460-469. 6. Global priority list of antibiotic-resistant bacteria to guide research, discovery, and development of new antibiotics.http://www.who.int/medicines/publications/globalpriority-list-antibiotic-resistant-bacteria/en/ 7. Papp-Wallance KM, Endimiani A, Taracila MA, et al. Carbapenems: past, present and future. Antimicrob Agent Chemother 2011; 4943-4960 8. Hauck, K. & Zhao, X. How dangerous is a day in hospital? A model of adverse events and length of stay for medical inpatients. Med Care 2011; 49, 1068–1075. 9. World Health Organization Prevention of Hospital-Acquired Infections. a Practical Guide, 2nd edn. Geneva: 2002 WHO/CDS/CSR/EPH. 10. Fritzenwanker M, Imirzalioglu C, Herold S, et al. Treatment Options for Carbapenem- Resistant Gram-Negative Infections. Dtsch Arztebl Int 2018; 115, 345–52. 11. Puzniak L, DePestel DD, Srinivasan A, et al. A Combination Antibiogram Evaluation for Pseudomonas aeruginosa in Respiratory and Blood Sources from ICU and Non-ICU Settings in US. Hospitals. Antimicrob. Agents Chemother 2019; 63, 4 e02564-18. 12. A European One Health Action Plan against Antimicrobial Resistance (AMR). 2017 European Commission). https://eur-lex.europa.eu/legal-content/IT/TXT/PDF/?uri=CELEX:52017DC0339&from=EN 13. Nagy E, Becker S, Kostrzewa M, et al.. The value of MALDI-TOF MS for the identification of clinically relevant anaerobic bacteria in routine laboratories. J Med Microbiol 2012; 61, 1393-1400. 14. European Committee on Antimicrobial Susceptibility Testing (EUCAST). EUCAST guidelines for detection of resistance mechanisms and specific resistances of clinical and/or epidemiological importance, December 2013. http://www.eucast.org/fi leadmin/src/media/PDFs/EUCAST_files/ Resistance_mechanisms/EUCAST_detection_of_resistance_mechanisms_v1.0_20131211.pdf 15. Iacchini S, Sabbatucci M, Gagliotti C, et al. A. Bloodstream infections due to carbapenemase-producing Enterobacteriaceae in Italy: results from nationwide surveillance, 2014 to 2017. Eurosurveill 2019; 24, 5. 16. Uslan DZ, Crane SJ, Steckelberg JM, et al. Age-and sex-associated trends in bloodstream infection: a population-based study in Olmsted County, Minnesota. Arch Intern Med 2007; 167(8), 834-839. 17. Kousouli E, Zarkotou O, Politi L, et al. Infection control interventions affected by resource shortages: impact on the incidence of bacteremias caused by carbapenem-resistant pathogens. Eur J Clin Microbiol Infect Dis 2018; 37(1), 43-50. 18. Hubacek JA, Stüber F, Fröhlich D, et al. Gene variants of the bactericidal/permeability increasing protein and lipopolysaccharide binding protein in sepsis patients: gender-specific genetic predisposition to sepsis. Crit Care Med 2001; 29(3), 557-561. 19. Albiger B,. Glasner C, MJ Struelens MJ, et al. The European Survey of Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) working group. Carbapenemase-producing Enterobacteriaceae in Europe: assessment by national experts from 38 countries, May 2015. Euro Surveill 2015; 20(45). 20. Weng NP. Aging of the immune system: how much can the adaptive immune system adapt? Immunity 2006; 24(5),495-499. 21. Codjoe FS and Donkor ES. Carbapenem Resistance: A Review. Med Sci 2018; 6, 1 22. Ministero della Salute (Italian Ministry of Health). Piano Nazionale di Contrasto dell’Antimicrobico-Resistenza (PNCAR) 2017-2020. [National Action Plan on Antimicrobial Resistance 2017-2020] Rome: Ministry of Health; 24 Oct 2017. Italian. http://www.salute.gov.it/imgs/C_17_http://www.salute.gov.it/imgs/C. 23. Goldman DA, Weinstein RA, Wenzel RP, et al. Strategies to Prevent and Control the Emergence and Spread of Antimicrobial-Resistant Microorganisms in Hospitals. A Challenge to Hospital Leadership. JAMA 1996; 275, 234-240 24. Grundmann H, Glasner C, Albiger B, et al.and the European Survey of Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) Working Group. Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE): a prospective, multinational study. Lancet Infect Dis 2017; 17, 153-163. 25. Mandell GL, Bennett JE, Dolin R, Douglas M. Bennett’s Principles and Practice of Infectious Diseases, 7th edn. Oxford, 2010, Elsevier/Churchill Livingstone, United Kingdom. 26. Christoff J, Tolentino J, Mawdsley E, et al. Optimizing empirical antimicrobial therapy for infection due to Gram-negative pathogens in the intensive care unit: utility of a combination antibiogram. Infect Control Hosp Epidemiol 2010; 31, 256–261. 27. Davey P, Marwick CA, Scott CL et al. Interventions to improve antibiotic prescribing practices for hospital inpatients Cochrane Database of Systematic Reviews 2017; 9,2. 28. Hojgard S. Antibiotic resistance-why is the problem so difficult to solve? Infect Ecol Epidemiol 2012; 2,18165 29. Abulhasan YB, Rachel SP, Chatillon-Angle MO, et al. Healthcare associated infections in the neurological intensive care-unit: Results of 6 years surveillance study at a major tertiary care center. Am J Infect Control 2018; 46, 656-662.
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Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Article
Authors

Monica Bricchi This is me

Annalia Asti This is me

Alessia Pascale This is me

Franco Andreini This is me

Milena Arghittu This is me

Dario Caldiroli This is me

Carla Carozzi This is me

Anna Pavan This is me

Publication Date March 15, 2020
Published in Issue Year 2020

Cite

APA Bricchi, M., Asti, A., Pascale, A., Andreini, F., et al. (2020). Implementation of Preventive Actions to Control Carbapenem-Resistant Enterobacteriaceae and MDR Gram Negatives at a Neurological Hospital. Journal of Microbiology and Infectious Diseases, 10(01), 1-9. https://doi.org/10.5799/jmid.700466
AMA Bricchi M, Asti A, Pascale A, Andreini F, Arghittu M, Caldiroli D, Carozzi C, Pavan A. Implementation of Preventive Actions to Control Carbapenem-Resistant Enterobacteriaceae and MDR Gram Negatives at a Neurological Hospital. J Microbil Infect Dis. March 2020;10(01):1-9. doi:10.5799/jmid.700466
Chicago Bricchi, Monica, Annalia Asti, Alessia Pascale, Franco Andreini, Milena Arghittu, Dario Caldiroli, Carla Carozzi, and Anna Pavan. “Implementation of Preventive Actions to Control Carbapenem-Resistant Enterobacteriaceae and MDR Gram Negatives at a Neurological Hospital”. Journal of Microbiology and Infectious Diseases 10, no. 01 (March 2020): 1-9. https://doi.org/10.5799/jmid.700466.
EndNote Bricchi M, Asti A, Pascale A, Andreini F, Arghittu M, Caldiroli D, Carozzi C, Pavan A (March 1, 2020) Implementation of Preventive Actions to Control Carbapenem-Resistant Enterobacteriaceae and MDR Gram Negatives at a Neurological Hospital. Journal of Microbiology and Infectious Diseases 10 01 1–9.
IEEE M. Bricchi, A. Asti, A. Pascale, F. Andreini, M. Arghittu, D. Caldiroli, C. Carozzi, and A. Pavan, “Implementation of Preventive Actions to Control Carbapenem-Resistant Enterobacteriaceae and MDR Gram Negatives at a Neurological Hospital”, J Microbil Infect Dis, vol. 10, no. 01, pp. 1–9, 2020, doi: 10.5799/jmid.700466.
ISNAD Bricchi, Monica et al. “Implementation of Preventive Actions to Control Carbapenem-Resistant Enterobacteriaceae and MDR Gram Negatives at a Neurological Hospital”. Journal of Microbiology and Infectious Diseases 10/01 (March 2020), 1-9. https://doi.org/10.5799/jmid.700466.
JAMA Bricchi M, Asti A, Pascale A, Andreini F, Arghittu M, Caldiroli D, Carozzi C, Pavan A. Implementation of Preventive Actions to Control Carbapenem-Resistant Enterobacteriaceae and MDR Gram Negatives at a Neurological Hospital. J Microbil Infect Dis. 2020;10:1–9.
MLA Bricchi, Monica et al. “Implementation of Preventive Actions to Control Carbapenem-Resistant Enterobacteriaceae and MDR Gram Negatives at a Neurological Hospital”. Journal of Microbiology and Infectious Diseases, vol. 10, no. 01, 2020, pp. 1-9, doi:10.5799/jmid.700466.
Vancouver Bricchi M, Asti A, Pascale A, Andreini F, Arghittu M, Caldiroli D, Carozzi C, Pavan A. Implementation of Preventive Actions to Control Carbapenem-Resistant Enterobacteriaceae and MDR Gram Negatives at a Neurological Hospital. J Microbil Infect Dis. 2020;10(01):1-9.