Author: Saeed, Laila Yosef ; Abdel-Rahman, Soheir ; El-Mahallawy, Hadir ; El-Kholy, Amani ; Rashed, Hebatallah G ; Aboulela, Aliaa Gamaleldin ; van Belkum, Alex ; Abd-El-Reheem, Fadwa ; Abdel-Latif, Radwa Ahmad Rabea ; Elsayed, Eman ; Sherif, May ; Palmieri, Mattia ; Mirande, Caroline ; El-Manakhly, Arwa Ramadan

Multidrug-resistant (MDR) Klebsiella pneumoniae is a common infectious pathogen. We performed whole-genome sequencing (WGS) of 39 randomly selected, geographically diverse MDR K. pneumoniae from nine Egyptian hospitals. Clinical sources, phenotypic antibiotic resistance, and hyper-mucoviscosity were documented. WGS data were epidemiologically interpreted and tested for the presence of antibiotic resistance and virulence genes. Based on WGS data, we identified 18 classical multi-locus sequence types (MLST), the most common type being ST101 (23.1%) followed by ST147 (17.9%). Phylogenetic analyses identified small numbers of closely related isolates in a few of the centers, so we mostly documented independent nosocomial acquisition or import from public sources. The most common acquired resistance gene found was bla_CTX-M-15, detected in 27 isolates (69.2%). Carbapenemase genes encountered were bla_NDM-1 (n = 13), bla_NDM-5 (n = 1), bla_OXA-48 (n = 12), bla_OXA-181 (n = 2), and bla_KPC2 (n = 1). Seven strains (18%) contained more than a single carbapenemase gene. While searching for virulence-associated genes, sixteen wzi alleles were identified with wzi137, wzi64, and wzi50 most commonly found in ST101, ST147, and ST16, respectively. Yersiniabactin was the most common virulence factor (69.2%). Hyper-mucoviscosity was documented for 6 out of 39 isolates.This is the first genomic study of MDR K. pneumoniae from Egypt. The study revealed a clear spread of well-known international clones and their associated antimicrobial resistance and (hyper)virulence traits. The clinical situation in Egypt seems to reflect the scenario documented in many other countries and requires close attention.

01 Aug 2020·Journal of Infection and Public HealthQ3 · MEDICINE

Six-year multicenter study on short-term peripheral venous catheters-related bloodstream infection rates in 246 intensive units of 83 hospitals in 52 cities of 14 countries of Middle East: Bahrain, Egypt, Iran, Jordan, Kingdom of Saudi Arabia, Kuwait, Lebanon, Morocco, Pakistan, Palestine, Sudan, Tunisia, Turkey, and United Arab Emirates—International Nosocomial Infection Control Consortium (INICC) findings

Q3 · MEDICINE

ArticleOA

Author: Zand, Farid ; Abdelaziz-Yousef, Reham H ; Aziz AlKhawaja, Safa A ; Helali, Najla J ; Tanzi, Vito L ; Ahmed, Hala ; Rosenthal, Víctor D ; Abdelhady, Kareem M ; Asad, Tasmiya ; Molano, Apsia M ; Mahfouz, Tahsine ; Caminade, Yvonne ; Alazmi, Muneefah ; Altowerqi, Rami ; Elawady, Basma ; Afeef, Majeda ; Shyrine, Leide ; Al-Abdely, Hail M ; Alkamaly, Modhi A ; Ben-Jaballah, Najla ; Belkebir, Souad ; Bohlega, Eatedal ; Abidi, Khalid ; Aldossary, Hajer A ; Demaisip, Nadia L ; Salama, Mona F ; Gamar-Elanbya, May O ; Sayed, Amani F ; Madco, Marjory ; Ikram, Aamer ; Diab, Hanan H ; Ibrahim, Ahmed ; Kelany, Ashraf ; Demiroz, Ali P ; Leblebicioglu, Hakan ; Sawan, Fahad A ; El-Kholy, Amani ; Elahi, Naheed ; Rushdi, Hala ; Abdel-Halim, Mona M

BACKGROUNDShort-term peripheral venous catheters-related bloodstream infections (PVCR-BSIs) rates have not been systematically studied, and data on their incidence by number of device-days is not available.METHODSProspective, surveillance study on PVCR-BSI conducted from September 1st, 2013 to 31st Mays, 2019 in 246 intensive care units (ICUs), members of the International Nosocomial Infection Control Consortium (INICC), from 83 hospitals in 52 cities of 14 countries in the Middle East (Bahrain, Egypt, Iran, Jordan, Kingdom of Saudi Arabia, Kuwait, Lebanon, Morocco, Pakistan, Palestine, Sudan, Tunisia, Turkey, and United Arab Emirates). We applied U.S.RESULTSWe followed 31,083 ICU patients for 189,834 bed-days and 202,375 short term peripheral venous catheter (PVC)-days. We identified 470 PVCR-BSIs, amounting to a rate of 2.32/1000 PVC-days. Mortality in patients with PVC but without PVCR-BSI was 10.38%, and 29.36% in patients with PVC and PVCR-BSI. The mean length of stay in patients with PVC but without PVCR-BSI was 5.94 days, and 16.84 days in patients with PVC and PVCR-BSI. The microorganism profile showed 55.2 % of gram-positive bacteria, with Coagulase-negative Staphylococci (31%) and Staphylococcus aureus (14%) being the predominant ones. Gram-negative bacteria accounted for 39% of cases, and included: Escherichia coli (7%), Klebsiella pneumoniae (8%), Pseudomonas aeruginosa (5%), Enterobacter spp. (3%), and others (29.9%), such as Serratia marcescens.CONCLUSIONSPVCR-BSI rates found in our ICUs were much higher than rates published from USA, Australia, and Italy. Infection prevention programs must be implemented to reduce the incidence of PVCR-BSIs.

01 May 2020·Infection Control & Hospital EpidemiologyQ4 · MEDICINE

Six-year multicenter study on short-term peripheral venous catheters-related bloodstream infection rates in 727 intensive care units of 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific Regions: International Nosocomial Infection Control Consortium (INICC) findings

Q4 · MEDICINE

Article

Author: Mehta, Yatin ; Abidi, Khalid ; Di-Silvestre, Gabriela ; Jayatilleke, Kushlani ; Mioljevic, Vesna ; Velinova, Velmira Angelova ; Elahi, Naheed ; AlKhawaja, Safa A Aziz ; Horhat, Florin George ; Sandoval-Castillo, Harrison Ronald ; Furova, Katarina ; Leblebicioglu, Hakan ; Zand, Farid ; Valderrama-Beltrán, Sandra L ; Belskiy, Vladislav ; El-Kholy, Amani ; Salgado-Yepez, Estuardo ; Trotter, Andrew ; Bat-Erdene, Ider ; Anguseva, Tanja ; Muralidharan, S ; Ikram, Aamer ; Del Rayo Morfin-Otero, María ; Duszynska, Wieslawa ; Rai, Vineya ; Mejia, Nepomuceno ; Demiroz, Ali Pekcan ; Raka, Lul ; Quesada-Mora, Ana Marcela ; Sayed, Amani F ; Guo, Xiuqin ; Belkebir, Souad ; Al-Abdely, Hail M ; Gamar-Elanbya, May Osman ; Tanzi, Vito L ; Gupta, Umesh ; Ben-Jaballah, Najla ; Tapang, Audrey Rose D ; Hung, Nguyen Viet ; Rajhans, Prasad ; Rosenthal, Víctor Daniel ; Luxsuwong, Montri ; de Lourdes-Dueñas, Miriam ; De-Carvalho, Braulio Matias ; Myatra, Sheila Nainan ; Afeef, Majeda ; Gupta, Debkishore ; Aguilar-de-Moros, Daisy ; Guanche-Garcell, Humberto

AbstractBackground:Short-term peripheral venous catheter–related bloodstream infection (PVCR-BSI) rates have not been systematically studied in resource-limited countries, and data on their incidence by number of device days are not available.Methods:Prospective, surveillance study on PVCR-BSI conducted from September 1, 2013, to May 31, 2019, in 727 intensive care units (ICUs), by members of the International Nosocomial Infection Control Consortium (INICC), from 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific regions. For this research, we applied definition and criteria of the CDC NHSN, methodology of the INICC, and software named INICC Surveillance Online System.Results:We followed 149,609 ICU patients for 731,135 bed days and 743,508 short-term peripheral venous catheter (PVC) days. We identified 1,789 PVCR-BSIs for an overall rate of 2.41 per 1,000 PVC days. Mortality in patients with PVC but without PVCR-BSI was 6.67%, and mortality was 18% in patients with PVC and PVCR-BSI. The length of stay of patients with PVC but without PVCR-BSI was 4.83 days, and the length of stay was 9.85 days in patients with PVC and PVCR-BSI. Among these infections, the microorganism profile showed 58% gram-negative bacteria: Escherichia coli (16%), Klebsiella spp (11%), Pseudomonas aeruginosa (6%), Enterobacter spp (4%), and others (20%) including Serratia marcescens. Staphylococcus aureus were the predominant gram-positive bacteria (12%).Conclusions:PVCR-BSI rates in INICC ICUs were much higher than rates published from industrialized countries. Infection prevention programs must be implemented to reduce the incidence of PVCR-BSIs in resource-limited countries.

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