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Journal of Medical Microbiology logo Journal of Medical Microbiology

Volume 55, Issue 10

Frequency and predictors of colonization of the respiratory tract by VIM-2-producing in patients of a newly established intensive care unit No Access

Abstract

The aim of this study was to examine the frequency and predictors of colonization of the respiratory tract by metallo--lactamase (MBL)-producing Gram-negative bacteria in patients admitted to a newly established intensive care unit (ICU) of a tertiary care hospital. Specimens of tracheobronchial aspirates for microbiological studies were obtained every day for the first 3 days of the ICU stay and subsequently every third day for the rest of the ICU stay. PCR analysis and nucleotide sequencing were performed to identify bacteria that had MBL genes. Thirty-five patients (20 male, 15 female) were hospitalized during the initial 3 month period of functioning of the ICU. Colonization of the lower respiratory tract by Gram-negative bacteria was found in 29 of 35 patients (83 %) during the first 6–20 days (median 13 days) following admission to the ICU (13 patients with , ten with , three with , two with and one with ). Six of 29 patients (21 %) colonized with Gram-negative bacteria had -positive isolates; one of these patients developed clinical infection due to this micro-organism. Previous use of carbapenems (=0.01) or other -lactams (=0.03), as well as a stay in the ICU of >20 days (<0.001), were associated with colonization with -producing . In conclusion, colonization by Gram-negative bacteria of the respiratory tract of patients in this newly established ICU was common (83 %). Use of -lactams, including carbapenems, was associated with subsequent colonization of the respiratory tract with MBL-positive .

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  • Accepted:
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Keyword(s): CLSI, Clinical and Laboratory Standards Institute , ICU, intensive care unit , MBL, metallo-β-lactamase and SAPS, simplified acute physiology score
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2006-10-01
2025-01-20
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References

  1. Andrade S. S., Jones R. N., Gales A. C., Sader H. S. 2003; Increasing prevalence of antimicrobial resistance among Pseudomonas aeruginosa isolates in Latin American medical centres: 5 year report of the SENTRY Antimicrobial Surveillance Program (1997–2001). J Antimicrob Chemother 52:140–141 [CrossRef]
     [Google Scholar]
  2. Bonten M. J., Weinstein R. A. 1996; The role of colonization in the pathogenesis of nosocomial infections. Infect Control Hosp Epidemiol 17:193–200 [CrossRef]
     [Google Scholar]
  3. Bonten M. J., Gaillard C. A., van Tiel F. H., Smeets H. G., van der Geest S., Stobberingh E. E. 1994; The stomach is not a source for colonization of the upper respiratory tract and pneumonia in ICU patients. Chest 105:878–884 [CrossRef]
     [Google Scholar]
  4. de Champs C., Poirel L., Bonnet R., Sirot D., Chanal C., Sirot J., Nordmann P. 2002; Prospective survey of β -lactamases produced by ceftazidime-resistant Pseudomonas aeruginosa isolated in a French hospital in 2000. Antimicrob Agents Chemother 46:3031–3034 [CrossRef]
     [Google Scholar]
  5. Flaherty J. P., Weinstein R. A. 1996; Nosocomial infection caused by antibiotic-resistant organisms in the intensive care unit. Infect Control Hosp Epidemiol 17:236–248 [CrossRef]
     [Google Scholar]
  6. Itokazu G. S., Quinn J. P., Bell-Dixon C., Kahan F. M., Weinstein R. A. 1996; Antimicrobial resistance rates among aerobic Gram-negative bacilli recovered from patients in intensive care units: evaluation of a national postmarketing surveillance program. Clin Infect Dis 23:779–784 [CrossRef]
     [Google Scholar]
  7. Jarvis W. R. 1996; The epidemiology of colonization. Infect Control Hosp Epidemiol 17:47–52 [CrossRef]
     [Google Scholar]
  8. Jarvis W. R., Edwards J. R., Culver D. H. 8 other authors 1991; Nosocomial infection rates in adult and pediatric intensive care units in the United States. National Nosocomial Infections Surveillance System. Am J Med 91 (Suppl. 2):S185–S191 [CrossRef]
     [Google Scholar]
  9. Johanson W. G. Jr, Pierce A. K., Sanford J. P., Thomas G. D. 1972; Nosocomial respiratory infections with Gram-negative bacilli. The significance of colonization of the respiratory tract. Ann Intern Med 77:701–706 [CrossRef]
     [Google Scholar]
  10. Kerver A. J., Rommes J. H., Mevissen-Verhage E. A., Hulstaert P. F., Vos A., Verhoef J., Wittebol P. 1988; Prevention of colonization and infection in critically ill patients: a prospective randomized study. Crit Care Med 16:1087–1093 [CrossRef]
     [Google Scholar]
  11. Lauretti L., Riccio M. L., Mazzariol A., Cornaglia G., Amicosante G., Fontana R., Rossolini G. M. 1999; Cloning and characterization of blaVIM, a new integron-borne metallo- β -lactamase gene from a Pseudomonas aeruginosa clinical isolate. Antimicrob Agents Chemother 43:1584–1590
     [Google Scholar]
  12. Le Gall J. R., Lemeshow S., Saulnier F. 1993; A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. JAMA ( J Am Med Assoc ) 270:2957–2963 [CrossRef]
     [Google Scholar]
  13. Mavroidi A., Tsakris A., Tzelepi E., Pournaras S., Loukova V., Tzouvelekis L. S. 2000; Carbapenem-hydrolysing VIM-2 metallo- β -lactamase in Pseudomonas aeruginosa from Greece. J Antimicrob Chemother 46:1041–1042 [CrossRef]
     [Google Scholar]
  14. Poirel L., Naas T., Nicolas D., Collet L., Bellais S., Cavallo J.-D., Nordmann P. 2000; Characterization of VIM-2, a carbapenem-hydrolyzing metallo- β -lactamase and its plasmid- and integron-borne gene from a Pseudomonas aeruginosa clinical isolate in France. Antimicrob Agents Chemother 44:891–897 [CrossRef]
     [Google Scholar]
  15. Pournaras S., Tsakris A., Maniati M., Tzouvelekis L. S., Maniatis A. N. 2002; Novel variant ( bla VIM-4) of the metallo- β -lactamase gene bla VIM-1 in a clinical strain of Pseudomonas aeruginosa . Antimicrob Agents Chemother 46:4026–4028 [CrossRef]
     [Google Scholar]
  16. Pournaras S., Maniati M., Petinaki E., Tzouvelekis L. S., Tsakris A., Legakis N., Maniatis A. N. 2003; Hospital outbreak of multiple clones of Pseudomonas aeruginosa carrying the unrelated metallo- β -lactamase gene variants bla VIM-2 and bla VIM-4 . J Antimicrob Chemother 51:1409–1414 [CrossRef]
     [Google Scholar]
  17. Senda K., Arakawa Y., Ichiyama S., Nakashima K., Ito H., Ohsuka S., Shimokata K., Kato N., Ohta M. 1996; PCR detection of metallo- β -lactamase gene ( bla IMP) in Gram-negative rods resistant to broad-spectrum β -lactams. J Clin Microbiol 34:2909–2913
     [Google Scholar]
  18. Trautmann M., Michalsky T., Wiedeck H., Radosavljevic V., Ruhnke M. 2001; Tap water colonization with Pseudomonas aeruginosa in a surgical intensive care unit (ICU) and relation to Pseudomonas infections of ICU patients. Infect Control Hosp Epidemiol 22:49–52 [CrossRef]
     [Google Scholar]
  19. Tsakris A., Pournaras S., Woodford N., Palepou M.-F. I., Babini G. S., Douboyas J., Livermore D. M. 2000; Outbreak of infections caused by Pseudomonas aeruginosa producing VIM-1 carbapenemase in Greece. J Clin Microbiol 38:1290–1292
     [Google Scholar]
  20. Walsh T. R., Toleman M. A., Poirel L., Nordmann P. 2005; Metallo- β -lactamases: the quiet before the storm?. Clin Microbiol Rev 18:306–325 [CrossRef]
     [Google Scholar]
  21. Woods D. E., Straus D. C., Johanson W. G. Jr, Bass J. A. 1981; Role of fibronectin in the prevention of adherence of Pseudomonas aeruginosa to buccal cells. J Infect Dis 143:784–790 [CrossRef]
     [Google Scholar]
  22. Yan J.-J., Hsueh P.-R., Ko W.-C., Luh K.-T., Tsai S.-H., Wu H.-M., Wu J. J. 2001; Metallo- β ±-lactamases in clinical Pseudomonas isolates in Taiwan and identification of VIM-3, a novel variant of the VIM-2 enzyme. Antimicrob Agents Chemother 45:2224–2228 [CrossRef]
     [Google Scholar]
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Frequency and predictors of colonization of the respiratory tract by VIM-2-producing Pseudomonas aeruginosa in patients of a newly established intensive care unit
J. Med. Microbiol. 55, 1435 (2006); https://doi.org/10.1099/jmm.0.46713-0
/content/journal/jmm/10.1099/jmm.0.46713-0
/content/journal/jmm/10.1099/jmm.0.46713-0
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