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APMIS : Acta Pathologica,... Mar 2020Pseudomonas aeruginosa is generally described as ubiquitous in natural settings, such as soil and water. However, because anecdotal observations and published reports... (Meta-Analysis)
Meta-Analysis
Pseudomonas aeruginosa is generally described as ubiquitous in natural settings, such as soil and water. However, because anecdotal observations and published reports have questioned whether or not this description is true, we undertook a rigorous study using three methods to investigate the occurrence of P. aeruginosa: We investigated environmental samples, analyzed 16S rRNA data, and undertook a systematic review and meta-analysis of published data. The environmental sample screening identified P. aeruginosa as significantly associated with hydrocarbon and pesticide-contaminated environments and feces, as compared to uncontaminated environments in which its prevalence was relatively low. The 16S rRNA data analysis showed that P. aeruginosa sequences were present in all habitats but were most abundant in samples from human and animals. Similarly, the meta-analysis revealed that samples obtained from environments with intense human contact had a higher prevalence of P. aeruginosa compared to those with less human contact. Thus, we found a clear tendency of P. aeruginosa to be present in places closely linked with human activity. Although P. aeruginosa may be ubiquitous in nature, it is usually scarce in pristine environments. Thus, we suggest that P. aeruginosa should be described as a bacterium largely found in locations associated with human activity.
Topics: Animals; Environment; Environmental Microbiology; Humans; Pseudomonas Infections; Pseudomonas aeruginosa; RNA, Ribosomal, 16S
PubMed: 31709616
DOI: 10.1111/apm.13010 -
International Journal of Infectious... Nov 2018Carbapenem-resistant (CR), extremely drug-resistant (XDR), and pan-drug-resistant (PDR) Acinetobacter baumannii and Pseudomonas aeruginosa pose a huge clinical threat.... (Meta-Analysis)
Meta-Analysis
Importance of control groups when delineating antibiotic use as a risk factor for carbapenem resistance, extreme-drug resistance, and pan-drug resistance in Acinetobacter baumannii and Pseudomonas aeruginosa: A systematic review and meta-analysis.
BACKGROUND
Carbapenem-resistant (CR), extremely drug-resistant (XDR), and pan-drug-resistant (PDR) Acinetobacter baumannii and Pseudomonas aeruginosa pose a huge clinical threat. This study reviews the impact of control groups on the association of antecedent antibiotic use and the acquisition of CR/XDR/PDR A. baumannii and P. aeruginosa.
METHODS
Studies investigating the role of antibiotics as a risk factor for CR/XDR/PDR A. baumannii and P. aeruginosa acquisition in adult hospitalized patients from 1950 to 2016 were identified in the databases. These were divided into two groups: antibiotic-resistant versus antibiotic-sensitive pathogens (group I); antibiotic-resistant versus no infection (group II). A random-effects model was performed.
RESULTS
Eighty-five studies (46 A. baumannii, 38 P. aeruginosa, and one of both) involving 22 396 patients were included. CR was investigated in 60 studies, XDR in 20 studies, and PDR in two studies. Prior antibiotic exposure was associated with significant acquisition of CR/XDR/PDR A. baumannii and P. aeruginosa in both groups I and II (p<0.05). Antibiotic classes implicated in both groups included aminoglycosides, carbapenems, glycopeptides, and penicillins. Cephalosporin use was not associated with resistance in either group. Fluoroquinolone exposure was only associated with resistance in group I but not group II.
CONCLUSIONS
Control groups play an important role in determining the magnitudes of risk estimates for risk factor studies, hence careful selection is necessary. Antibiotic exposure increases the acquisition of highly resistant A. baumannii and P. aeruginosa, thus appropriate antibiotic use is imperative.
Topics: Acinetobacter baumannii; Aminoglycosides; Anti-Bacterial Agents; Carbapenems; Control Groups; Drug Resistance, Multiple, Bacterial; Fluoroquinolones; Hospitalization; Humans; Microbial Sensitivity Tests; Pseudomonas aeruginosa; Risk Factors
PubMed: 29870795
DOI: 10.1016/j.ijid.2018.05.017 -
Journal of Global Antimicrobial... Dec 2018In the field of antimicrobial resistance, the number of studies using time series data (TSD) has increased recently. The purpose of this study was to systematically... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
In the field of antimicrobial resistance, the number of studies using time series data (TSD) has increased recently. The purpose of this study was to systematically review all studies on antimicrobial consumption and Pseudomonas aeruginosa antimicrobial resistance in healthcare settings that have used TSD.
METHODS
A systematic review of the literature up to June 2017 was conducted. All studies that have used TSD and have examined in-hospital antimicrobial consumption and P. aeruginosa resistance rates or incidence were eligible for inclusion; no other exclusion criteria were applied. Data on the structure, terminology used, methods and results for each article were recorded and analysed where possible.
RESULTS
A total of 36 studies were retrieved from PubMed, of which 23 were in accordance with the inclusion criteria. Thirteen studies were quasi-experimental studies and ten were ecological observational studies. Twenty studies collected TSD for both parameters, and the statistical methodology time series analysis was applied in nine studies.
DISCUSSION
Most of the studies were published in the last 8 years. The interrupted time series design was the most widespread. As expected, there was high heterogeneity with regard to study design, terminology and statistical methods applied.
Topics: Anti-Bacterial Agents; Drug Resistance, Bacterial; Humans; Microbial Sensitivity Tests; Pseudomonas Infections; Pseudomonas aeruginosa
PubMed: 29906626
DOI: 10.1016/j.jgar.2018.06.001 -
Antibiotics (Basel, Switzerland) Mar 2023The dissemination of -harboring (KPC-) is considered a serious public health problem. This study provides an overview of the epidemiology of these isolates to try to... (Review)
Review
The dissemination of -harboring (KPC-) is considered a serious public health problem. This study provides an overview of the epidemiology of these isolates to try to elucidate novel mobilization platforms that could contribute to their worldwide spread. A systematic review in PubMed and EMBASE was performed to find articles published up to June 2022. In addition, a search algorithm using NCBI databases was developed to identify sequences that contain possible mobilization platforms. After that, the sequences were filtered and pair-aligned to describe the genetic environment. We found 691 KPC- isolates belonging to 41 different sequence types and recovered from 14 countries. Although the gene is still mobilized by the transposon Tn, the non-Tn elements (NTE) were the most frequent. Our analysis allowed us to identify 25 different NTE, mainly belonging to the NTE-I, and a new type (proposed as IVa) was also observed. This is the first systematic review that consolidates information about the behavior of the acquisition in and the genetic platforms implied in its successful worldwide spread. Our results show high NTE prevalence in and an accelerated dynamic of unrelated clones. All information collected in this review was used to build an interactive online map.
PubMed: 37107020
DOI: 10.3390/antibiotics12040658 -
IDCases 2021Testicular infarction is a known serious complication associated with epididymitis. It is known to be idiopathic in 70% of cases but the frequency, risk factors, and...
BACKGROUND
Testicular infarction is a known serious complication associated with epididymitis. It is known to be idiopathic in 70% of cases but the frequency, risk factors, and management are yet to be elucidated. This paper aims to report a case of testicular infarction secondary to pyogenic epididymoorchitis caused
CASE PRESENTATION
A 64-year-old male with a past medical history of benign prostate hypertrophy using intermittent self-catheterization and a recent history of culture-negative pyogenic epididymoorchitis treated with oral cefpodoxime was admitted to our hospital due to a 4-week history of fever, right scrotal pain, and swelling. Scrotal ultrasonography showed a hypoechoic testis without testicular torsion. He was diagnosed with testicular infarction and a scrotal abscess due to , and was treated with cefepime along with transcutaneous drainage. Despite the antimicrobial treatment, he experienced testicular loss with necrotic tissue. Because little is known about the risk factors, clinical characteristics, management, and prognosis of testicular infarction secondary to epididymitis, we performed a systematic review of the literature.
CONCLUSION
This is a case of testicular necrosis during the treatment of epididymitis with negative urine culture and detection of in tissue culture. Clinicians should perform frequent blood flow evaluation to the testis for early urologic intervention.
PubMed: 34504766
DOI: 10.1016/j.idcr.2021.e01258 -
Life (Basel, Switzerland) May 2021Ceftolozane/tazobactam (C/T) is a β-lactam/β-lactamase inhibitor combination that mainly targets Gram-negative bacteria. The current international guidelines recommend... (Review)
Review
BACKGROUND
Ceftolozane/tazobactam (C/T) is a β-lactam/β-lactamase inhibitor combination that mainly targets Gram-negative bacteria. The current international guidelines recommend including C/T treatment in the empirical therapy for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). (PA) is one of the most challenging Gram-negative bacteria. We conducted a systematic review of all cases reported in the literature to summarize the existing evidence.
METHODS
The main electronic databases were screened to identify case reports of patients with drug-resistant PA respiratory infections treated with C/T.
RESULTS
A total of 22 publications were included for a total of 84 infective episodes. The clinical success rate was 72.6% across a wide range of comorbidities. The 45.8% of patients treated with C/T presented colonization by PA. C/T was well tolerated. Only six patients presented adverse events, but none had to stop treatment. The most common therapeutic regimens were 1.5 g every 8 h and 3 g every 8 h.
CONCLUSION
C/T may be a valid therapeutic option to treat multidrug-resistant (MDR), extensively drug-resistant (XDR), pandrug-resistant (PDR), and carbapenem-resistant (CR) PA infections. However, further data are necessary to define the optimal treatment dosage and duration.
PubMed: 34073847
DOI: 10.3390/life11060474 -
Open Forum Infectious Diseases Feb 2024is one of the most common pathogens in surgical site infections (SSIs). However, comprehensive epidemiological and antibiotic resistance details for in Chinese SSIs...
BACKGROUND
is one of the most common pathogens in surgical site infections (SSIs). However, comprehensive epidemiological and antibiotic resistance details for in Chinese SSIs are lacking. We evaluated the proportions and antimicrobial resistance of among patients with SSIs in China.
METHODS
Relevant papers from January 2010 to August 2022 were searched in databases including PubMed, Embase, Web of Science, China Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang, and Weipu. A meta-analysis was performed to analyze the proportions and 95% confidence interval (CIs) of among patients with SSIs. Meta-regression analysis was used to investigate the proportion difference among different subgroups and antimicrobial resistance.
RESULTS
A total of 72 studies met inclusion criteria, involving 33 050 isolated strains. The overall proportion of among patients with SSIs was 16.0% (95% CI, 13.9%-18.2%). Subgroup analysis showed higher proportions in orthopedic (18.3% [95% CI, 15.6%-21.0%]) and abdominal surgery (17.3% [95% CI, 9.9%-26.2%]). The proportion in the central region (18.6% [95% CI, 15.3%-22.1%]) was slightly higher than that in other regions. Antibiotic resistance rates significantly increased after 2015: cefoperazone (36.2%), ceftriaxone (38.9%), levofloxacin (20.5%), and aztreonam (24.0%). Notably, resistance to ampicillin and cefazolin exceeded 90.0%.
CONCLUSIONS
The proportion of infection among patients with SSIs was higher than the data reported by the Chinese Antimicrobial Resistance Surveillance System, indicating rising antimicrobial resistance. The existing antimicrobial drug management plan should be strengthened to prevent a hospital epidemic of drug-resistant strains.
PubMed: 38328500
DOI: 10.1093/ofid/ofad647 -
Journal of Cystic Fibrosis : Official... Jan 2015Cystic Fibrosis (CF) is a severe genetic disorder that is common among the Caucasian population. Bacterial respiratory infections are the main cause of morbidity and... (Review)
Review
BACKGROUND
Cystic Fibrosis (CF) is a severe genetic disorder that is common among the Caucasian population. Bacterial respiratory infections are the main cause of morbidity and mortality in CF patients. Pseudomonas aeruginosa is the main pathogen of lower airways (LAW) decline.
METHOD
To understand chronic broncho-pulmonary colonization, a systematic review is conducted. The aim of our article is to identify the pathways of contamination in the upper aero-digestive tract.
RESULTS
A large number of articles report that P. aeruginosa is established first at nasopharyngeal sites. The vast majority of authors agree that the upper aero-digestive tract is the first location of colonization by P. aeruginosa and its presence appears to be predictive of subsequent broncho-pulmonary colonization.
CONCLUSION
This review supports the possible involvement of the nasal and paranasal sinuses and oral cavity as means of contamination.
Topics: Cystic Fibrosis; Female; Humans; Incidence; Male; Mouth; Paranasal Sinuses; Prognosis; Pseudomonas Infections; Pseudomonas aeruginosa; Respiratory Tract Infections; Risk Assessment; Survival Rate
PubMed: 24933711
DOI: 10.1016/j.jcf.2014.04.008 -
Antimicrobial Resistance and Infection... 2014Increasing rates of resistant and multidrug-resistant (MDR) P. aeruginosa in hospitalized patients constitute a major public health threat. We present a systematic...
BACKGROUND
Increasing rates of resistant and multidrug-resistant (MDR) P. aeruginosa in hospitalized patients constitute a major public health threat. We present a systematic review of the clinical and economic impact of this resistant pathogen.
METHODS
Studies indexed in MEDLINE and Cochrane databases between January 2000-February 2013, and reported all-cause mortality, length of stay, hospital costs, readmission, or recurrence in at least 20 hospitalized patients with laboratory confirmed resistant P. aeruginosa infection were included. We accepted individual study definitions of MDR, and assessed study methodological quality.
RESULTS
The most common definition of MDR was resistance to more than one agent in three or more categories of antibiotics. Twenty-three studies (7,881 patients with susceptible P. aeruginosa, 1,653 with resistant P. aeruginosa, 559 with MDR P. aeruginosa, 387 non-infected patients without P. aeruginosa) were analyzed. A random effects model meta-analysis was feasible for the endpoint of all-cause in-hospital mortality. All-cause mortality was 34% (95% confidence interval (CI) 27% - 41%) in patients with any resistant P. aeruginosa compared to 22% (95% CI 14% - 29%) with susceptible P. aeruginosa. The meta-analysis demonstrated a > 2-fold increased risk of mortality with MDR P. aeruginosa (relative risk (RR) 2.34, 95% CI 1.53 - 3.57) and a 24% increased risk with resistant P. aeruginosa (RR 1.24, 95% CI 1.11 - 1.38), compared to susceptible P. aeruginosa. An adjusted meta-analysis of data from seven studies demonstrated a statistically non-significant increased risk of mortality in patients with any resistant P. aeruginosa (adjusted RR 1.24, 95% CI 0.98 - 1.57). All three studies that reported infection-related mortality found a statistically significantly increased risk in patients with MDR P. aeruginosa compared to those with susceptible P. aeruginosa. Across studies, hospital length of stay (LOS) was higher in patients with resistant and MDR P. aeruginosa infections, compared to susceptible P. aeruginosa and control patients. Limitations included heterogeneity in MDR definition, restriction to nosocomial infections, and potential confounding in analyses.
CONCLUSIONS
Hospitalized patients with resistant and MDR P. aeruginosa infections appear to have increased all-cause mortality and LOS. The negative clinical and economic impact of these pathogens warrants in-depth evaluation of optimal infection prevention and stewardship strategies.
PubMed: 25371812
DOI: 10.1186/2047-2994-3-32 -
Tropical Medicine & International... Jun 2020Tropical pyomyositis (TP) is a life-threatening bacterial infection of the skeletal muscle that occurs particularly among children, young adults and those with...
Tropical pyomyositis (TP) is a life-threatening bacterial infection of the skeletal muscle that occurs particularly among children, young adults and those with immunocompromised conditions. The appropriate diagnosis and treatment are often delayed due to its non-specific signs, leading to fatal consequences. Staphylococcus aureus, especially methicillin-susceptible S. aureus, is responsible for most TP cases. However, other bacteria (i.e. streptococci, Pseudomonas aeruginosa, Escherichia coli, Klebsiella spp., Candida spp., Mycobacterium spp.) have been reported. This narrative review provides an update on the epidemiology and clinical course of TP. A special focus is laid on the role of toxins (i.e. Panton-Valentine Leucocidin and α-toxin) in the pathogenesis of TP and their implication for the clinical management of infection.
Topics: Anti-Bacterial Agents; Developing Countries; Exotoxins; Humans; Immunocompromised Host; Pyomyositis; Staphylococcus aureus
PubMed: 32219926
DOI: 10.1111/tmi.13395