Muhammad Saeed, Farhan Rasheed, Muhammad Hidayat Rasool, Sumreen Hayat, Mohsin Khurshid
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引用次数: 0
Abstract
Ventilator-associated pneumonia (VAP) represents an important nosocomial infection, frequently encountered in intensive care unit (ICU) settings which results in prolonged hospitals stays. The nosocomial infections caused by Burkholderia cepacia complex (BCC) bacteria pose a significant challenge in healthcare settings owing to their intrinsic resistance to many antibiotics. This study investigates the antimicrobial susceptibility patterns and mechanisms of carbapenem resistance among BCC bacteria from VAP patients and the ventilator tubing. The blood and respiratory specimens from patients diagnosed with VAP were collected. In addition, the ventilators were also screened for the presence of BCC bacteria. The susceptibility profiling of BCC isolates was performed against the various antimicrobial agents, and screening for acquired beta-lactamase enzymes was conducted by polymerase chain reaction. Out of the total 134 patients with BCC-associated VAP, B. cepacia, Burkholderia multivorans, and Burkholderia cenocepacia was 68.7% (n = 92), 18.7% (n = 25), and 12.7% (n = 17). Overall, the BCC isolates showed varying susceptibility to different antibiotics: 76.9% were susceptible to chloramphenicol, 76.1% to minocycline, 69.4% to meropenem, 60.4% to ceftazidime, 51.5% to trimethoprim-sulfamethoxazole, and 50% to levofloxacin. Resistance to ceftazidime (51/92, 55.4%) and meropenem (36/92, 39.1%) was exclusively observed in B. cepacia isolates, and all isolates of B. multivorans and B. cenocepacia were found to be susceptible to both beta-lactam drugs. Among the 134 clinical isolates, 15 were found to harbor the blaNDM variants, that is, blaNDM−1 and blaNDM−5. All carbapenem-resistant isolates from the ventilator tubing were identified as B. cepacia and were found to harbor either the blaNDM−1 or the blaNDM−5 variants. The observed increase in resistance and the emergence of acquired beta-lactamases among BCC isolates highlight a concerning trend that could potentially lead to serious outbreaks.
期刊介绍：
Transboundary and Emerging Diseases brings together in one place the latest research on infectious diseases considered to hold the greatest economic threat to animals and humans worldwide. The journal provides a venue for global research on their diagnosis, prevention and management, and for papers on public health, pathogenesis, epidemiology, statistical modeling, diagnostics, biosecurity issues, genomics, vaccine development and rapid communication of new outbreaks. Papers should include timely research approaches using state-of-the-art technologies. The editors encourage papers adopting a science-based approach on socio-economic and environmental factors influencing the management of the bio-security threat posed by these diseases, including risk analysis and disease spread modeling. Preference will be given to communications focusing on novel science-based approaches to controlling transboundary and emerging diseases. The following topics are generally considered out-of-scope, but decisions are made on a case-by-case basis (for example, studies on cryptic wildlife populations, and those on potential species extinctions):
Pathogen discovery: a common pathogen newly recognised in a specific country, or a new pathogen or genetic sequence for which there is little context about — or insights regarding — its emergence or spread.
Prevalence estimation surveys and risk factor studies based on survey (rather than longitudinal) methodology, except when such studies are unique. Surveys of knowledge, attitudes and practices are within scope.
Diagnostic test development if not accompanied by robust sensitivity and specificity estimation from field studies.
Studies focused only on laboratory methods in which relevance to disease emergence and spread is not obvious or can not be inferred (“pure research” type studies).
Narrative literature reviews which do not generate new knowledge. Systematic and scoping reviews, and meta-analyses are within scope.
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