The Combinational Effect of Enhanced Infection Control Measures and Targeted Clinical Metagenomics Surveillance on the Burden of Endemic Carbapenem and Other β-Lactam Resistance Among Severely Ill Pediatric Patients
<b>Background:</b> Antimicrobial resistance (AMR) is recognized as one of the most important global public health threats. There is an urgent need to reduce the spread of these multidrug-resistant bacteria (MDR-B), particularly in extremely vulnerable patients. The aim of this study was...
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2024-12-01
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| author | Athina Giampani Maria Simitsopoulou Maria Sdougka Christos Paschaloudis Emmanuel Roilides Elias Iosifidis |
| author_facet | Athina Giampani Maria Simitsopoulou Maria Sdougka Christos Paschaloudis Emmanuel Roilides Elias Iosifidis |
| author_sort | Athina Giampani |
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| description | <b>Background:</b> Antimicrobial resistance (AMR) is recognized as one of the most important global public health threats. There is an urgent need to reduce the spread of these multidrug-resistant bacteria (MDR-B), particularly in extremely vulnerable patients. The aim of this study was to investigate whether targeted gene amplification performed directly on clinical samples can be used simultaneously with a bundle of enhanced infection control measures in a Pediatric Intensive Care Unit (PICU) endemic to MDR-B. <b>Methods</b>: This study had three phases: (1) the baseline phase was performed prior to intervention when first screening and sample collection were performed; (2) the intervention phase was performed when various enhanced infection control measures (EICM) were applied; and (3) the maintenance phase occurred when EICMs were combined with the implementation of targeted molecular surveillance. The presence of four carbapenemase genes, <i>bla</i><sub>KPC</sub>, <i>bla</i><sub>OXA-48-like</sub>, <i>bla</i><sub>VIM</sub>, and <i>bla</i><sub>NDM</sub>, as well as the β-lactamase genes <i>bla</i><sub>TEM</sub> and <i>bla</i><sub>SHV</sub>, was evaluated by PCR after DNA isolation directly from stool samples. The results were compared to culture-based phenotypic analysis. <b>Results and Conclusions</b>: The implementation of EICM appeared to reduce the resistance burden in this sample endemic to an MDR-B clinical setting. The direct implementation of a targeted and customized rapid molecular detection assay to clinical samples seems to be an effective clinical tool for the evaluation of EICM measures. |
| format | Article |
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| institution | Kabale University |
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| language | English |
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| spelling | doaj-art-e2bdf15c912a490e9ef37ab2e5053d022025-01-24T13:23:46ZengMDPI AGBiomedicines2227-90592024-12-011313110.3390/biomedicines13010031The Combinational Effect of Enhanced Infection Control Measures and Targeted Clinical Metagenomics Surveillance on the Burden of Endemic Carbapenem and Other β-Lactam Resistance Among Severely Ill Pediatric PatientsAthina Giampani0Maria Simitsopoulou1Maria Sdougka2Christos Paschaloudis3Emmanuel Roilides4Elias Iosifidis5Infectious Disease Unit, 3rd Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Hippokration General Hospital, 54642 Thessaloniki, GreeceInfectious Disease Unit, 3rd Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Hippokration General Hospital, 54642 Thessaloniki, GreecePediatric Intensive Care Unit, Hippokration General Hospital, 54942 Thessaloniki, GreeceIndependent Researcher, 54642 Thessaloniki, GreeceInfectious Disease Unit, 3rd Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Hippokration General Hospital, 54642 Thessaloniki, GreeceInfectious Disease Unit, 3rd Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Hippokration General Hospital, 54642 Thessaloniki, Greece<b>Background:</b> Antimicrobial resistance (AMR) is recognized as one of the most important global public health threats. There is an urgent need to reduce the spread of these multidrug-resistant bacteria (MDR-B), particularly in extremely vulnerable patients. The aim of this study was to investigate whether targeted gene amplification performed directly on clinical samples can be used simultaneously with a bundle of enhanced infection control measures in a Pediatric Intensive Care Unit (PICU) endemic to MDR-B. <b>Methods</b>: This study had three phases: (1) the baseline phase was performed prior to intervention when first screening and sample collection were performed; (2) the intervention phase was performed when various enhanced infection control measures (EICM) were applied; and (3) the maintenance phase occurred when EICMs were combined with the implementation of targeted molecular surveillance. The presence of four carbapenemase genes, <i>bla</i><sub>KPC</sub>, <i>bla</i><sub>OXA-48-like</sub>, <i>bla</i><sub>VIM</sub>, and <i>bla</i><sub>NDM</sub>, as well as the β-lactamase genes <i>bla</i><sub>TEM</sub> and <i>bla</i><sub>SHV</sub>, was evaluated by PCR after DNA isolation directly from stool samples. The results were compared to culture-based phenotypic analysis. <b>Results and Conclusions</b>: The implementation of EICM appeared to reduce the resistance burden in this sample endemic to an MDR-B clinical setting. The direct implementation of a targeted and customized rapid molecular detection assay to clinical samples seems to be an effective clinical tool for the evaluation of EICM measures.https://www.mdpi.com/2227-9059/13/1/31targeted resistomepediatric intensive care unitantimicrobial resistanceenhanced infection control measuresactive surveillance programgene amplification |
| spellingShingle | Athina Giampani Maria Simitsopoulou Maria Sdougka Christos Paschaloudis Emmanuel Roilides Elias Iosifidis The Combinational Effect of Enhanced Infection Control Measures and Targeted Clinical Metagenomics Surveillance on the Burden of Endemic Carbapenem and Other β-Lactam Resistance Among Severely Ill Pediatric Patients Biomedicines targeted resistome pediatric intensive care unit antimicrobial resistance enhanced infection control measures active surveillance program gene amplification |
| title | The Combinational Effect of Enhanced Infection Control Measures and Targeted Clinical Metagenomics Surveillance on the Burden of Endemic Carbapenem and Other β-Lactam Resistance Among Severely Ill Pediatric Patients |
| title_full | The Combinational Effect of Enhanced Infection Control Measures and Targeted Clinical Metagenomics Surveillance on the Burden of Endemic Carbapenem and Other β-Lactam Resistance Among Severely Ill Pediatric Patients |
| title_fullStr | The Combinational Effect of Enhanced Infection Control Measures and Targeted Clinical Metagenomics Surveillance on the Burden of Endemic Carbapenem and Other β-Lactam Resistance Among Severely Ill Pediatric Patients |
| title_full_unstemmed | The Combinational Effect of Enhanced Infection Control Measures and Targeted Clinical Metagenomics Surveillance on the Burden of Endemic Carbapenem and Other β-Lactam Resistance Among Severely Ill Pediatric Patients |
| title_short | The Combinational Effect of Enhanced Infection Control Measures and Targeted Clinical Metagenomics Surveillance on the Burden of Endemic Carbapenem and Other β-Lactam Resistance Among Severely Ill Pediatric Patients |
| title_sort | combinational effect of enhanced infection control measures and targeted clinical metagenomics surveillance on the burden of endemic carbapenem and other β lactam resistance among severely ill pediatric patients |
| topic | targeted resistome pediatric intensive care unit antimicrobial resistance enhanced infection control measures active surveillance program gene amplification |
| url | https://www.mdpi.com/2227-9059/13/1/31 |
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