Hospital infection due to Pseudomonas aeruginosa in resuscitation departments

The bacteriological survey of resuscitation and intensive care units has revealed the presence of P. aeruginosa strains in the microflora in 69.4% of cases. The circulation of 1-2 P. aeruginosa strains, identical in their serovar and pyocin type, is indicative of the presence of hospital infection and, therefore, the endogenous character of the contamination of patients. P. aeruginosa hospital strains are the main causative agents of infectious complications in the patients treated in resuscitation units.     

Role of Pseudomonas aeruginosa in the etiology of postoperative suppurative inflammatory complications in patients with chronic suppurative lung diseases

The study of P. aeruginosa strains isolated from patients and various objects of the environment in one of the clinics of Yerevan, carried out by the methods of serotyping, pyocin typing and phage typing, has allowed the authors to establish the circulation of hospital strains and their role in the appearance of post-operative suppurative inflammatory complications in patients with chronic suppurative diseases. The study has also allowed them to reveal the sources of infection which is spread by patients serving either as its reservoirs or as intermediate hosts.     

PCR-RAPD typing of carbapenem-resistant Pseudomonas aeruginosa strains

P. aeruginosa rods are opportunistic pathogens responsible generally for nosocomial infections. Resistance to carbapenems, observed among them, is a serious threat due to ability to be transmitted between bacterial species. The aim of our study was to evaluate the usefulness of PCR-RAPD technique in typing of 16 carbapenem-resistant P. aeruginosa strains isolated in 2007 from different patients of University HospitalNo. 1 of dr A. Jurasz Collegium Medicum of L. Rydygier in Bydgoszcz Nicolaus Copernicus University in Toruń. Study shows increasing frequency of isolation that type of strains when compared to 2006. Percentage of carbapenem-resistant isolates raised from 12,4% in 2006 to 22.9% in 2007. The majority of examined strains were obtained from patients of the Intensive Care Units (25.0%) and were isolated from bronchoalveolar lavage (25.0%), urine (25.0%) and wound swabs (18.8%) samples. Examined P. aeruginosa strains demonstrated resistance to doripenem (81.3%) and piperacillin (75.0%) and susceptibility to colistin (100.0%), amikacin (81.3%), netilmicin and norfloxacin (75.0% each). Using PCR-RAPD amplification with 208 and 272 primers, 14 and 16 DNA patterns were obtained, respectively. Usefulness of PCR-RAPD in carbapenem-resistant P. aeruginosa strains typing was proved in case of strains presenting similar and/or different antimicrobials susceptibility patterns.     

Hospital strains of Pseudomonas aeruginosa in the surgical clinic]

Circulation of different antigenic variants of P. aeruginosa in a surgical hospital was studied. In this study the process leading to the formation of pathogenic hospital strains, determined by time and location, from some serovars is demonstrated. The study also established that the department of the hospital where the selection of hospital strains mainly occurred was the resuscitation ward. Some pyoseptic infections of P. aeruginosa etiology with fetal outcome were found to be caused in most cases by hospital strains characteristic of the hospital in the period under study.     

Antibiotic sensitivity of different antigenic variants of Pseudomonas aeruginosa isolated in a hospital

The serological typing of 96% of P. aeruginosa strains isolated in hospitals has been carried out by means of agglutinating sera, and the tendency towards the prevalence of the strains of group V (25.3%) and serovar O11 (18.1%) has been revealed. The determination of the antibiotic sensitivity of different variants has shown that the strains of groups I, V and serovar O11 possess pronounced resistance to a wide spectrum of antibiotics, their resistance to gentamycin and polymixin being higher than in the strains of other serotypes. The determination of antibiotic resistance can serve only as an additional test in the serological typing of P. aeruginosa.     

Protective cross activity of the extracellular mucus of Pseudomonas aeruginosa

Extracellular slime was isolated from 15 P. aeruginosa typing strains of different O-serotypes (immunotypes). The isolated slime, partially purified by ethanol precipitation, was later referred to as crude slime. Glycolipoprotein was obtained from crude slime and lipopolysaccharide (LPS) was obtained from acetone-dried microbial cells by the method of aqueous-phenol extraction. All these antigenic preparations were studied in the active mouse cross-protection tests: immunized mice were challenged with 7 strains of different immunotypes, strain No. 170 019 or toxigenic strain PA-103. In experiments on mice the slime of different P. aeruginosa serotypes (immunotypes) was found to stimulate immunity to intraperitoneal infection with P. aeruginosa, both homologous or heterologous in respect to their immunotype, including toxigenic strains. Slime glycoprotein also stimulated active cross-immunity in mice, but the level of this immunity was higher than that of immunity stimulated by crude slime. LPS showed mostly weak protective activity in experiments on mice.     

Experience with epidemiologic studies of pyocyaneus infections. I. Feasibility of using serotypes and antibiotic resistance as a epidemiologic label for clinical strains]

The authors carried out serological typing of 98 Pseudomonas aeruginosa strains, isolated from patients of burn department of the Sklifosovsky First Aid Institute in January-July, 1974, and of 215 strains obtained from other sources; their sensitivity to 13 antibiotics was determined. Pseudomonas aeruginosa cultures isolated from the patients were typed with O-sera of 10 serological types. The presence of several hospital strains of Pseudomonas aeruginosa was found by means of serological typing; along with these there were revealed cultures of this causative agent sporadically appearing in the department. Sensitivity to some antibiotics could serve as an additional criterion for differentiation of Pseudomonas aeruginosa strains of the same serological type.     

Classification of 17 newly isolated virulent bacteriophages of Pseudomonas aeruginosa

Seventeen virulent bacteriophages specific to Pseudomonas aeruginosa strains were isolated by screening various environmental samples. These isolated bacteriophages were grouped based on results obtained from restriction fragment analysis of phage genomes, random amplification of polymorphic DNA (RAPD) typing, morphology observations under transmission electron microscope, and host range analysis. All 17 bacteriophages are double-stranded DNA viruses and can be divided into 5 groups based on DNA restriction profiles. A set of 10-mer primers was used in RAPD typing of phages, and similar conclusions were obtained as for restriction fragment analysis. One phage was randomly selected from each of the 5 groups for morphology observations. Four of them had an icosahedral head with a long contractile tail, belonging to the Myoviridae family, and one phage had an icosahedral head with a short tail, thereby belonging to the Podoviridae family. Host range experiments were conducted on 7 laboratory strains and 12 clinical strains of P.?aeruginosa. The results showed that 13 phages had the same infection profile, killing 8 out of 19 tested P.?aeruginosa strains, and the remaining 4 phages had different and unique infection profiles. This study highlights the diversity of bacteriophages specific to P.?aeruginosa in the environment.     

重症监护病房非发酵菌分布及耐药分析

目的分析医院重症监护病房非发酵菌感染的耐药情况,以指导临床合理使用抗菌药物。方法回顾性分析2008年至2009年医院自重症监护病房分离的非发酵菌,对其检出率及药敏结果进行统计分析。结果共检出4 273株非发酵菌,检出率为38%,分离率居前4位的依次是铜绿假单胞菌(44.09%)、鲍氏不动杆菌(27.64%)、嗜麦芽寡养单胞菌(10.58%)和洋葱伯克霍尔德菌(5.99%);4种常见的非发酵菌对常用抗菌药物耐药性均较高,头孢哌酮/舒巴坦等含酶抑制剂的复合型抗菌药物对非发酵菌有较高的敏感性。结论医院重症监护病房非发酵菌检出率高且耐药性强,应加强临床细菌学的检测,按照药敏试验结果合理用药。     

The rate of isolation of fungi in the genus Candida from the nasopharyngeal mucosa of the those in contact with the products from microbial protein manufacture]

In the mycological study of the air in working rooms at enterprises for the production of paprin and in the airspace of residential areas, as well as the study of the fungal contamination of the upper respiratory ways in workers and residents of the development zone, the isolation rate of the production fungal strains of the genus Candida from the nasopharynx was shown to depend on their content in the air. In the absence of producer microorganisms in the atmospheric air they were not detected among the population. The detection of yeast-like fungi of the genus Candida on the pharyngeal mucosa is of sanitary demonstrative importance for the evaluation of the specific microbial contamination of the air in working rooms and the air space of the development zone. When the stable work of gas purification systems was ensured at modern enterprises for the production of protein vitamin concentrate no production strains were detected in the atmospheric air of the development zone and on the nasopharyngeal mucosa of the residents, which was indicative of the absence of any influence of gas and air discharges from these enterprises on the microbial contamination of the airspace.     

The serological characteristics of the O antigens of Pseudomonas aeruginosa isolated from patients with a Pseudomonas infection during immunotherapy]

Serologic characteristics of P. aeruginosa O-antigens isolated from patients with P. aeruginosa infection were studied over the course of treatment with anti-P. aeruginosa sheep immunoglobulin. The preparation was used in 54 patients with nongeneralized forms of P. aeruginosa infection (infected wounds, pleural empyema) externally or intraperitoneally. From the clinical material collected from the patients a total of 54 P. aeruginosa strains were isolated. Serologic typing of the isolated strains with factor or group diagnostic agglutinating sera has revealed the O-group composition of the isolated strains; 66% of them were classified with O-groups 2,3, and 6. Serologic variants of the strains isolated from patients proved to be stable over the course of the disease immunotherapy. Analysis of the results of bacteriologic control of immunotherapy. efficacy and the clinical data has demonstrated the efficacy of immunotherapy in 61.1% of cases and its partial effect in 20.4% of cases of P. aeruginosa infection.     

Pyocine Typing of Clinical Strains of Pseudomonas aeruginosa

A total of 954 clinical isolates of Pseudomonas aeruginosa were typed by their ability to produce pyocines. The strains of Pseudomonas were isolated from urines, bloods, sputa, stools, and miscellaneous infectious exudates or tissue of patients of the Mayo Clinic and four associated hospitals. About 80% of the typable strains could be grouped into three major pyocine types: A (30.9%), B (34.8%), and D (14.1%). These large groups could be divided into subtypes by using additional indicator strains. There was no significant difference in the distribution of types by either institutional or specimen source, except that urine specimens yielded the highest percentage of one type. By this procedure, 93% of all isolates could be typed. Repeated typing of serially transferred strains indicated that the procedure has a high degree of reliability. Several strains exhibited extreme fluctuation in inhibition pattern. The procedure is a simple and reliable method to monitor the patterns of nosocomial infections due to P. aeruginosa.     

Imipenem resistance in Gram-negative rods and its consumption between 1999 and 2005

Multidrug resistant Gram-negative rods are increasingly isolated from clinical specimens, especially from hospitalized patients. The aim of this study was to evaluate the prevalence of imipenem resistant strains of Gram-negative rods isolated in dr. A. Jurasz University Hospital in Bydgoszcz between 1999 and 2005 and imipenem consumption in this period. Out of 109614 isolated microorganisms, Gram-negative rods were 28,5%, 637 (2,0%) of strains were resistant to imipenem. These strains were isolated mostly from patients hospitalized in intensive care and rehabilitation clinics. Among imipenem-resistant strains Pseudomonas aeruginosa prevailed (88,9%). P. aeruginosa strains were sensitive to colistin, 45,5% of them to aztreonam and 44,0% to ceftazidime. The imipenem consumption in the appropriate years included in this study was: 805,00; 1201,25; 940,00; 1390,00; 1660,00; 1341,25; 1841,25 DDD respectively, and was strictly connected with increasing imipenem-resistant Gram-negative rods isolation.     

Genetic similarity of vancomycin resistant strains of Enterococcus faecium isolated from clinical specimens

Twenty vancomycin resistant E. faecium strains (VRE) isolated from patients of three different hospital wards in 2005-2008 were examined. The strains originated from patients of intensive therapy, urological and internistic wards. The chosen wards differ significantly in their specificity. In all cases the presence of o vanA and lack of vanB, vanD, vanE and vanG genes and were found. Strains were compared by using RFLP-PFGE, the reference method for molecular typing of VRE. One group including fourteen strains showing similarity higher than 79.5% was distinguished. This group was divided into subgroups. The greatest similarity was found among strains from patients of intensive therapy ward. Two subgroups of strains showing similarity more than 93.3%, of four strains each were identified. The similarity between these two subgroups was 79.5%. Most strains from other two wards showed less than 79.5% similarity and they could be recognised as not related. Only one strain from internal ward and two strains from urologic ward were similar in 82.1 - 86.4% to one of subgroups of strains originated from intensive therapy.     

Contribution of Pseudomonas Aeruginosa strains to infections in patients of specialistic outpatients clinics of the SP ZOZ in Nidzica

The aim of this study was to examine a frequency of isolation and analysis of drug susceptibility o P. aeruginosa strains cultured from clinical specimens obtained from patients treated in specialistic outpatient clinics of the Samodzielny Publiczny Zespó? Opieki Zdrowotnej (SP ZOZ) in Nidzica durin 40 months (01. 09. 2000 - 31. 12. 2003). Ninety six P. aeruginosa strains were cultured out of 829 clinical samples collected from ambulatory patients and processed in the Bacteriological Laboratory of SP ZOZ in Nidzica during over three years. P. aeruginosa strains were isolated from 11.6% of examined specimens. The greatest number of strains (49.0%) were cultured from urine samples obtained from children. Identification of strains was performed using biochemical tests (Becton Dickinson, Emapol, bio-Merieux). Susceptibility of strains to antimicrobial agents was determined with disc diffusion method according to NCCLS recommendations. Special tests were applied to detect extended-spectrum beta-lactamases (ESBL). The most active in vitro against isolated P. aeruginosa strains was a carbapenem - imipenem. All strains were susceptible to this antibiotic. Ciprofloxacin (94.8% of susceptible strains), ceftazidime (89.6%), gentamicin (86.5%), piperacillin (84.4%) and aztreonam (76.0%) were active against the majority of P. aeruginosa strains isolated from ambulatory patients. Six strains (6.25% of all strains) producing extended--spectrum beta--lactamases (ESBL) were detected. It is alarming, that the majority of P. aeruginosa strains from outpatients were cultured out of pediatric samples (61.5%). Because of an increase in resistance and appearance of new mechanisms of resistance to antibiotics/chemotherapeutics in P. aeruginosa strains, it is necessary to monitor a drug susceptibility of these strains causing infections in ambulatory patients.     

The estimation of usefulness of Pseudomonas bacteriophages in epidemiological investigations of Pseudomonas aeruginosa clinical strains

Out of 20 Pseudomonas phages, 17 were most suitable for typing of Pseudomonas aeruginosa strains isolated from different sources of human infections. These phages have been classified into three taxons based on coefficient of correlation of their lytic activity. Out of these strains only one appeared nontypeable. 240 distinquished phagotypes were classified into three groups and seven subgroups. This schema of classification was used in the epidemiological investigations of the Pseudomonas strains in relation to the category of infection and the place of isolation. Some statisticaly significant differences were detected. Various possibilities of applications of typing set of Pseudomonas phages are discussed.     

Epidemiological study of the associations of Staphylococcus aureus and Pseudomonas aeruginosa in the pulmonology clinic

The results of the five-year study of S. aureus and P. aeruginosa associations isolated from the sputa of pulmonological patients are presented. The incidence rate of these bacteria in monocultures and associations is estimated. The results of the phage typing and serotyping of S. aureus and P. aeruginosa strains suggest that the formation of the associations of these organisms occurs mainly due to the tendency of P. aeruginosa hospital strains to associate with S. aureus cultures present in the patients.     

Nursery Outbreak of Pseudomonas aeruginosa: Epidemiological Conclusions from Five Different Typing Methods

In April 1971, nine cases of Pseudomonas aeruginosa septicemia occurred in a high-risk nursery. The epidemiology of the outbreak was studied by pyocin production, pyocin sensitivity, serological typing, antibiotic susceptibility, and phenotypic properties such as colonial morphology, pigment, and hemolysis. Ten isolates of P. aeruginosa were recovered from 9 newborn infants and from 13 environmental sources. Twenty-one of the 23 isolates had identical pyocin production patterns against 60 different indicator strains and were of the same serotype. These 21 isolates were designated as the "outbreak strain"; the other 2 isolates had no epidemiological significance. The results of pyocin sensitivity, antibiotic susceptibility tests, and phenotypic properties were dissimilar. They would yield incorrect epidemiological conclusions if used alone. The outbreak strain dissociated in vitro and these phenotypic changes accounted for the variable results by the latter three typing methods. Although the precise mode of introduction of the organism into the nursery could not be determined in retrospect, the epidemiological data strongly suggested that one infant contracted a P. aeruginosa infection, and this strain spread throughout the nursery by means of contaminated resuscitation equipment.     

Resistance epidemiology of gramnegative nonfermenting pathogens of nosocomial infections in intensive care units and surgical departments]

Etiological structure, patterns and antibiotic resistance mechanisms of gramnegative nonfermenting pathogens of nosocomial infections isolated from patients in intensive care units and surgical departments were investigated. One hundred thirty one clinical isolates, including 86 (65.6%) isolates of Pseudomonas aeruginosa and 45 (34.4%) isolates of Acinetobacter baumannii were tested. Carbapenems and cefoperazone/sulbactam showed the highest activity against the tested isolates. Eleven carbapenem resistant strains of P. aeruginosa were detected. The strains were found to possess genetic determinants of the VIM group encoding metal beta-lactamases.     

Evaluation of the biofilm-forming ability and genetic typing for clinical isolates of Pseudomonas aeruginosa by enterobacterial repetitive intergenic consensus-based PCR

Biofilm formation is an important phenotype associated with chronic Pseudomonas aeruginosa infections. In the present study, a total of 48 P. aeruginosa strains isolated from clinical specimens were examined for their biofilm-forming ability using a microtiter plate method. The different biofilm-forming abilities were demonstrated among the strains; however, most strains formed a larger biofilm than strain PAO1, a reference strain. The genetic typing was also carried out by enterobacterial repetitive intergenic consensus-based polymerase chain reaction. Although they were divided into five groups (A to E), most of the strains showing the higher biofilm-forming ability were found to be in groups D and E, suggesting a significant relationship between the biofilm-forming ability and the genetic group.