Kooperativer Bibliotheksverbund

In: Clinical Infectious Diseases, Oxford University Press (OUP), Vol. 77, No. 4 ( 2023-08-22), p. 499-509

Abstract: Carbapenemase-producing (CP) Escherichia coli (CP-Ec) are a global public health threat. We aimed to describe the clinical and molecular epidemiology and outcomes of patients from several countries with CP-Ec isolates obtained from a prospective cohort. Methods Patients with CP-Ec were enrolled from 26 hospitals in 6 countries. Clinical data were collected, and isolates underwent whole-genome sequencing. Clinical and molecular features and outcomes associated with isolates with or without metallo-β-lactamases (MBLs) were compared. The primary outcome was desirability of outcome ranking (DOOR) at 30 days after the index culture. Results Of the 114 CP-Ec isolates in Consortium on resistance against carbapenems in Klebsiella and other Enterobacterales-2 (CRACKLE-2), 49 harbored an MBL, most commonly blaNDM-5 (38/49, 78%). Strong regional variations were noted with MBL-Ec predominantly found among patients in China (23/49). Clinically, MBL-Ec were more often from urine sources (49% vs 29%), less often met criteria for infection (39% vs 58%, P = .04), and had lower acuity of illness when compared with non–MBL-Ec. Among patients with infection, the probability of a better DOOR outcome for a randomly selected patient with MBL-Ec as compared with non–MBL-Ec was 62% (95% CI: 48.2–74.3%). Among infected patients, non–MBL-Ec had increased 30-day (26% vs 0%; P = .02) and 90-day (39% vs 0%; P = .001) mortality compared with MBL-Ec. Conclusions Emergence of CP-Ec was observed with important geographic variations. Bacterial characteristics, clinical presentations, and outcomes differed between MBL-Ec and non–MBL-Ec. Mortality was higher among non-MBL isolates, which were more frequently isolated from blood, but these findings may be confounded by regional variations.

Type of Medium: Online Resource

ISSN: 1058-4838 , 1537-6591

URL: Article

DOI: 10.1093/cid/ciad288

Language: English

Publisher: Oxford University Press (OUP)

Publication Date: 2023

detail.hit.zdb_id: 2002229-3

In: Revista de Salud Pública, Universidad Nacional de Colombia, Vol. 17, No. 5 ( 2016-02-02), p. 738-748

Abstract: 〈 p 〉 Identificar los conocimientos, actitudes y prácticas sobre dengue en propietarios y trabajadores de llantería, así como los niveles de infestación del vector en llanterías del departamento del Atlántico. 〈 /p 〉 〈 p 〉 〈 strong 〉 Métodos 〈 /strong 〉 Se realizó un estudio tipo descriptivo. Las variables se describieron a partir de porcentajes y medidas de tendencia central y dispersión. 〈 /p 〉 〈 p 〉 Se calculó el índice de infestación larvario para llanterías y el índice de depósitos en cada uno de los municipios muestreados. 〈 /p 〉 〈 p 〉 Se visitaron e inspeccionaron 111 llanterías; el 26,1 % (29/111) de estas se encontraron positivas para formas larvarias del vector 〈 em 〉 Ae. aegypti. 〈 /em 〉 Los municipios de Piojó, Santo Tomas, Santa Lucia, Sabanagrande y Luruaco presentaron los índices de infestación larvaria en llanterías más altos (IIL: 50-100 %). 〈 /p 〉 〈 p 〉 〈 strong 〉 Resultados 〈 /strong 〉 Con respecto al dengue, el 90,9 % de los entrevistados lo consideró un problema para ellos y sus familias. El 94,6 % conoce que es transmitido por mosquitos; el 91,1 % conoce a la larva del vector como “sarapico”, el 3,6 % como “gusarapo”. El 98,2 % consideró que existe una relación entre la larva y el mosquito 〈 em 〉 Ae. aegypti. 〈 /em 〉 El 100 % reconoce las llantas como un criadero para el mosquito. El 85,7 % consideró la fiebre como el síntoma más frecuente, el 83% manifestó asistir al puesto de salud para curar la enfermedad. El 90,8 % arroja las llantas no utilizables como basura. 〈 /p 〉 〈 p 〉 〈 strong 〉 Conclusión 〈 /strong 〉 En la población estudiada existen buenos conocimientos acerca del dengue y su vector; sin embargo, existen problemas de actitudes y prácticas para su prevención. 〈 /p 〉

Type of Medium: Online Resource

ISSN: 0124-0064

URL: Article

DOI: 10.15446/rsap.v17n5.35345

Language: Unknown

Publisher: Universidad Nacional de Colombia

Publication Date: 2016

detail.hit.zdb_id: 2060572-9

SSG: 7,36

In: Revista de Investigaciones Veterinarias del Perú, Universidad Nacional Mayor de San Marcos, Vicerectorado de Investigacion, Vol. 32, No. 3 ( 2021-06-23), p. e18476-

Abstract: La contaminación de la canal con E. coli O157:H7, agente etiológico de la Enfermedad Diarreica Aguda (EDA), durante el sacrificio es la ruta primaria para la contaminación de la carne picada de vacuno. El objetivo del presente estudio fue determinar la prevalencia de E. coli biotipo 1 genérico y E. coli O157:H7 en bovinos sacrificados en plantas de beneficio del departamento del Atlántico. Se analizaron 224 canales de bovino provenientes de plantas de beneficio de cuatro municipios. Las muestras fueron procesadas en el Laboratorio de Salud Pública del departamento del Atlántico. Se determinó E. coli O157:H7 por el método VIDAS UP E. coli O157 (incluyendo H7) (ECPT) y E. coli biotipo 1, usando agar TBX (Oxoid), método ISO 16649-2:2000. La prevalencia de E. coli O157:H7 fue de 0.45% y de E. coli biotipo 1 genérico fue de 0.89% en muestras con recuentos de E. coli biotipo 1 〉 100 UFC/cm2. En 54% de las canales con presencia de E. coli, las concentraciones oscilaron entre 1 y 758 UFC/cm2. Se concluye que la prevalencia de E. coli O157:H7 encontrada fue baja (0.45%); sin embargo, indica presencia de esta cepa patógena en la zona, por lo que se requiere fortalecer la vigilancia para expendios y distribuidores.

Type of Medium: Online Resource

ISSN: 1682-3419 , 1609-9117

URL: Article

DOI: 10.15381/rivep.v32i3.18476

Language: Unknown

Publisher: Universidad Nacional Mayor de San Marcos, Vicerectorado de Investigacion

Publication Date: 2021

detail.hit.zdb_id: 2114686-X

SSG: 7,36

In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 9, No. Supplement_2 ( 2022-12-15)

Abstract: Carbapenemase-producing (CP) Escherichia coli (CPEc) are a global public health threat. We describe the epidemiology and outcomes of patients with CPEc isolates obtained in CRACKLE 2, a prospective cohort study of hospitalized patients with positive cultures for CP Enterobacteriaceae. Methods In CRACKLE-2, patients with CPEc were enrolled from 26 hospitals in 6 countries (ClinicalTrials.gov NCT03646227). Clinical data were collected, and bacterial isolates underwent whole genome sequencing (WGS). Here, we included unique patients with CPEc by WGS (n=114). The primary outcome was desirability of outcome ranking (DOOR) at 30 days after index culture. Chi squared tests with alpha = 0.05 were used to evaluate differences in culture source and outcomes between metallo-beta-lactamase (MBL) and non-MBL isolates. Results Of 114 CPEc isolates, 57 (50%) represented infection (Table 1). Isolates primarily arose from urine (34%) and blood (21%). Compared to non-MBL isolates, isolates containing MBL were more often from urine (41% vs 29%) and less frequently from blood (6% vs 32%); p=0.02. We observed strong regional variations in CP (Figure 1) and MBL (p & lt; 0.0001). Sequence type (ST) 167 was more common among MBL than non-MBL isolates (31% vs 2%, p & lt; 0.0001); non-MBL isolates were more often ST410 and ST131 (17% and 20%). Extended-spectrum beta-lactamases (ESBL) were present in 52% of isolates; most commonly, CTX-M-15 in both MBL (33%) and non-MBL isolates (34%). Phylogenetic analysis of the isolates and corresponding region, bacterial characteristics, and DOOR outcomes are in Figure 1. Death at 30 days occurred in 18 (16%) of patients, more commonly among non-MBL than MBL CPEc (23% vs 6%; p=0.01). The probability of a better DOOR outcome for a randomly selected MBL was 58% [95% CI: 48.2, 67.4], indicating no significant difference between the groups. Figure 1:Phylogenetic population structures of Carbapenemase-producing Escherichia coli (CPEc) isolates Legend: Infection = categorization as infection or colonization. ST = sequence type. BlaCarb = Carbapenemase gene. BlaESBL = acquired ESBL enzymes. DOOR = desirability of outcome ranking. DOOR rankings: 1 = Alive without events; DOOR 2 = Alive with 1 event; DOOR 3 = Alive with 2 or 3 events; DOOR 4 = dead. Conclusion Emergence of carbapenem resistance with important geographic variations was observed in E coli including among high-risk clones such as ST131. Mortality was higher among non-MBL isolates, which were more frequently from blood, but these findings may be confounded by region. Disclosures Vance G. Fowler, Jr, MD, MHS, Affinergy: Grant/Research Support|Affinergy: Honoraria|Affinium: Honoraria|Amphliphi Biosciences: Honoraria|ArcBio: Stocks/Bonds|Basilea: Grant/Research Support|Basilea: Honoraria|Bayer: Honoraria|C3J: Honoraria|Cerexa/Forest/Actavis/Allergan: Grant/Research Support|Contrafect: Grant/Research Support|Contrafect: Honoraria|Cubist/Merck: Grant/Research Support|Debiopharm: Grant/Research Support|Deep Blue: Grant/Research Support|Destiny: Honoraria|Genentech: Grant/Research Support|Genentech: Honoraria|Integrated Biotherapeutics: Honoraria|Janssen: Grant/Research Support|Janssen: Honoraria|Karius: Grant/Research Support|Medicines Co.: Honoraria|MedImmune: Grant/Research Support|MedImmune: Honoraria|NIH: Grant/Research Support|Novartis: Grant/Research Support|Novartis: Honoraria|Pfizer: Grant/Research Support|Regeneron: Grant/Research Support|Regeneron: Honoraria|Sepsis diagnostics: Sepsis diagnostics patent pending|UpToDate: Royalties|Valanbio: Stocks/Bonds Cesar A. Arias, MD, PhD, Entasis Phramceuticals: Grant/Research Support|MeMed Diagnostics: Grant/Research Support|Merck: Grant/Research Support David Paterson, MBBS, Accelerate: Honoraria|bioMerieux: Honoraria|Entasis: Advisor/Consultant|Janssen-Cilag: Grant/Research Support|MSD: Advisor/Consultant|MSD: Grant/Research Support|MSD: Honoraria|Pfizer: Grant/Research Support|Pfizer: Honoraria|PPD: Grant/Research Support|Shionogi: Grant/Research Support|VenatoRx: Advisor/Consultant Karen M. Ordonez, MD, AstraZeneca: Expert Testimony|Biomerieux: Expert Testimony|Farma de Colombia: Expert Testimony|MSD: Expert Testimony|Pfizer: Expert Testimony Souha S. Kanj, Pr, MSD, Pfizer, Gilead, Menarini, Astellas: Advisor/Consultant|MSD, Pfizer, Gilead, Menarini, Astellas: Honoraria Robert Bonomo, MD, Cystic Fibrosis Foundation: Grant/Research Support|Merck: Grant/Research Support|NIH: Grant/Research Support|VA: Grant/Research Support|VenatoRx: Grant/Research Support|Wockhardt: Grant/Research Support David van Duin, MD, PhD, Achaogen: Advisor/Consultant|Allergan: Advisor/Consultant|Astellas: Advisor/Consultant|MedImmune: Advisor/Consultant|Melinta: Advisor/Consultant|Merck: Advisor/Consultant|Merck: Grant/Research Support|NeuMedicine: Advisor/Consultant|Pfizer: Advisor/Consultant|Qpex: Advisor/Consultant|Roche: Advisor/Consultant|Sanofi-Pasteur: Advisor/Consultant|Shionogi: Advisor/Consultant|Shionogi: Grant/Research Support|T2 Biosystems: Advisor/Consultant|Tetraphase: Advisor/Consultant.

Type of Medium: Online Resource

ISSN: 2328-8957

URL: Article

DOI: 10.1093/ofid/ofac492.307

Language: English

Publisher: Oxford University Press (OUP)

Publication Date: 2022

detail.hit.zdb_id: 2757767-3