Strategies for the eradication of extended-spectrum beta-lactamase or carbapenemase-producing Enterobacteriaceae intestinal carriage.

Strategies for the eradication of extended-spectrum beta-lactamase or carbapenemase-producing Enterobacteriaceae intestinal carriage. Expert Rev Anti Infect Ther. 2019 Jul 17;: Authors: Catho G, Huttner BD Abstract Introduction: Among the multidrug resistant pathogens, extended-spectrum beta-lactamase (ESBL-E) or carbapenemase-producing Enterobacteriaceae (CPE) are currently considered the main threat due to the scarcity of therapeutic options and their rapid spread around the globe. In addition to developing new antibiotics and stopping transmission, recent research has focused on "decolonization" strategies to eradicate the carriage of ESBL-E/CPE before infection occurs. Areas covered: In this narrative review, we aim to describe the current evidence of decolonization strategies for ESBL-E or CPE intestinal carriage. We first define decolonization and highlight the issues related to the lack of standardized definition, then we summarize the available data on the natural history of colonization. Finally, we review the strategies assessed over the past 10 years for ESBL and CPE decolonization: oral antibiotics, probiotics and more recently fecal microbiota transplantation. We conclude by presenting the risks and uncertainties associated with these strategies. Expert opinion: The evidence available today is too low to recommend decolonization strategies for ESBL-E or CPE in routine clinical practice. The potential increase of resistance and the i...
Source: Expert Review of Anti-Infective Therapy - Category: Infectious Diseases Tags: Expert Rev Anti Infect Ther Source Type: research

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Conclusion: These findings may have important clinical implications in prophylaxis and selection of antibiotic treatment. Continuous  surveillance is needed, especially for onco-hematological patients.Keywords: Infectious multi-drug resistant bacteria, immunocompromised patients, Tunisia.
Source: African Health Sciences - Category: African Health Source Type: research
In conclusion, 3.1-PP4 is a highly promising lead towards development of a topical treatment for severely infected skin injuries.
Source: Frontiers in Microbiology - Category: Microbiology Source Type: research
ConclusionThe ST307 type is becoming endemic in hospital environments and is frequently associated with carbapenem resistance. Treatment of infection caused by multidrug-resistant bacteria is a clinical challenge, and the use of old antibiotics associated with screening and decolonisation of the reservoirs can be an efficient therapeutic alternative.
Source: Journal of Global Antimicrobial Resistance - Category: Infectious Diseases Source Type: research
The emergence of antimicrobial resistance (AMR) is of great concern to global public health. Treatment of multi-drug resistant (MDR) infections is a major clinical challenge: the increase in antibiotic resistance leads to a greater risk of therapeutic failure, relapses, longer hospitalizations, and worse clinical outcomes. Currently, there are no validated treatments for many MDR or pandrug-resistant (PDR) infections, and preventing the spread of these pathogens through hospital infection control procedures and antimicrobial stewardship programs is often the only tool available to healthcare providers. Therefore, new solut...
Source: Frontiers in Microbiology - Category: Microbiology Source Type: research
In recent years we have witnessed an increase in infections due to multidrug-resistant organisms in kidney transplant recipients (KTR). In our setting, we have observed a dramatic increase in infections caused...
Source: BMC Nephrology - Category: Urology & Nephrology Authors: Tags: Research article Source Type: research
Publication date: Available online 18 June 2019Source: Journal of Hospital InfectionAuthor(s): P. Fehling, J. Hasenkamp, S. Unkel, I. Thalmann, S. Hornig, L. Trümper, S. ScheithauerSummaryBackgroundHand hygiene compliance even before infection-prone procedures (indication 2, ‘before aseptic tasks’, according to the World Health Organization (WHO)) remains disappointing.AimTo improve hand hygiene compliance by implementing gloved hand disinfection as a resource-neutral process optimization strategy.MethodsWe performed a three-phase intervention study on a stem cell transplant ward. After baseline evaluation...
Source: Journal of Hospital Infection - Category: Infectious Diseases Source Type: research
Purpose of review To provide an update on the current landscape of antimicrobial stewardship in solid organ transplant (SOT) recipients. Recent findings Constructing personalized antimicrobial prescribing approaches to avoid untoward consequences of antimicrobials while improving outcomes is an emerging and critical aspect of transplant medicine. Stewardship activities encompassing the specialized interests of transplant patients and programs are evolving. New literature evaluating strategies to optimize antimicrobial agent selection, dosing, and duration have been published. Additionally, consensus guidance for certa...
Source: Current Opinion in Organ Transplantation - Category: Surgery Tags: INFECTIOUS DISEASES: Edited by Emily Blodget Source Type: research
Abstract Over-expression of the human P-glycoprotein (P-gp) in tumor cells is a classic example of an ABC protein serving as a hindrance to effective chemotherapy. The existence of proteins homologous to P-gp in organisms encompassing the entire living kingdom highlights extrusion of drugs as a general mechanism of multidrug resistance. Infections caused by opportunistic human fungal pathogens such as Candida species are very common and has intensified in recent years. The typical hosts, who possess suppressed immune systems due to conditions such as HIV and transplantation surgery etc., are prone to fungal infect...
Source: Fungal Genetics and Biology - Category: Biology Authors: Tags: Fungal Genet Biol Source Type: research
ConclusionsAFI was found in 31% children with liver disease and almost half of them were nosocomial resulting in high mortality. ESBL producing Gram-negative bacteria were the most frequently isolated organisms. Cefoperazone –sulbactam or carbapenems may be useful empirical antibiotics in nosocomial setting. Children with AFI and CPT score ≥ 11 should be evaluated for liver transplantation.
Source: Hepatology International - Category: Infectious Diseases Source Type: research
Conclusions: We report that multidrug-resistant organisms are increasingly being identified as causative pathogens for sepsis in pediatric liver transplant recipients and are associated with significantly higher odds for mechanical ventilation and higher organ failure. The emergence of multidrug-resistant organism infections in pediatric liver transplant patients has implications for patient outcomes, antibiotic stewardship, and infection prevention strategies.
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Online Clinical Investigations Source Type: research
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