Monica Licker - Academia.edu (original) (raw)
Papers by Monica Licker
BMC infectious diseases, May 22, 2017
Due to the vulnerable nature of its patients, the wide use of invasive devices and broad-spectrum... more Due to the vulnerable nature of its patients, the wide use of invasive devices and broad-spectrum antimicrobials used, the intensive care unit (ICU) is often called the epicentre of infections. In the present study, we quantified the burden of hospital acquired pathology in a Romanian university hospital ICU, represented by antimicrobial agents consumption, costs and local resistance patterns, in order to identify multimodal interventional strategies. Between 1(st) January 2012 and 31(st) December 2013, a prospective study was conducted in the largest ICU of Western Romania. The study group was divided into four sub-samples: patients who only received prophylactic antibiotherapy, those with community-acquired infections, patients who developed hospital acquired infections and patients with community acquired infections complicated by hospital-acquired infections. The statistical analysis was performed using the EpiInfo version 3.5.4 and SPSS version 20. A total of 1596 subjects were...
Journal of Chemistry, 2015
Background. Both 1,2,3- and 1,2,4-triazoles are nowadays incorporated in numerous antibacterial p... more Background. Both 1,2,3- and 1,2,4-triazoles are nowadays incorporated in numerous antibacterial pharmaceutical formulations.Aim. Our study aimed to prepare three substituted 1,2,4-triazoles and to evaluate their antibacterial properties.Materials and Methods. One disubstituted and two trisubstituted 1,2,4-triazoles were prepared and characterised by physical and spectroscopic properties (melting point, FTIR, NMR, and GC-MS). The antibacterial properties were studied against three bacterial strains:Staphylococcus aureus(ATCC 25923),Escherichia coli(ATCC 25922), andPseudomonas aeruginosa(ATCC 27853), by the agar disk diffusion method and the dilution method with MIC (minimal inhibitory concentration) determination.Results. The spectroscopic characterization of compounds and the working protocol for the synthesis of the triazolic derivatives are described. The compounds were obtained with 15–43% yields and with high purities, confirmed by the NMR analysis. The evaluation of biological ...
Annals of clinical microbiology and antimicrobials, Jan 13, 2017
Over recent decades, a dramatic increase in infections caused by multidrug-resistant pathogens ha... more Over recent decades, a dramatic increase in infections caused by multidrug-resistant pathogens has been observed worldwide. The aim of the present study was to investigate the relationship between local resistance bacterial patterns and antibiotic consumption in an intensive care unit in a Romanian university hospital. A prospective study was conducted between 1st January 2012 and 31st December 2013. Data covering the consumption of antibacterial drugs and the incidence density for the main resistance phenotypes was collected on a monthly basis, and this data was aggregated quarterly. The relationship between the antibiotic consumption and resistance was investigated using cross-correlation, and four regression models were constructed, using the SPSS version 20.0 (IBM, Chicago, IL) and the R version 3.2.3 packages. During the period studied, the incidence of combined-resistant and carbapenem-resistant P. aeruginosa strains increased significantly [(gradient = 0.78, R = 0.707, p = 0....
Bacteriologia, virusologia, parazitologia, epidemiologia (Bucharest, Romania : 1990)
The aim of this study was to determine the antibiotic resistance of Streptococcus agalactiae stra... more The aim of this study was to determine the antibiotic resistance of Streptococcus agalactiae strains isolated from urocultures in order to obtain new data regarding circulating phenotypes in Urology Department.
Bacteriologia, virusologia, parazitologia, epidemiologia (Bucharest, Romania : 1990)
This study analyzes the sensitivity to meropenem of 880 bacterial strains isolated from hospitali... more This study analyzes the sensitivity to meropenem of 880 bacterial strains isolated from hospitalized patients in various medical units of County Hospital No. 1 Timişoara. As a result, a high sensitivity of gram-negative pathogens to meropenem (82.01%) has been noticed. Among Enterobacteriaceae, 93.17% of Escherichia coli and 71% of Klebsiella sp. were susceptible to meropenem. For Pseudomonas aeruginosa strains, a high susceptibility was noticed to meropenem (91%), more than 70% to imipenem, but piperacillin + tazobactam had 42% resistance rates.
Bacteriologia, virusologia, parazitologia, epidemiologia, 2003
Bacteriologia, virusologia, parazitologia, epidemiologia, 2003
In order to analyse the evolution of the sensitivity to antibiotics of same strains with nosocomi... more In order to analyse the evolution of the sensitivity to antibiotics of same strains with nosocomial potential such as Klebsiella isolated in a hospital, we took into study a number of 976 samples, collected in a new-born care department of the "Dr. D. Popescu" hospital Timişoara. The study took place between November-December 2002. The collected samples were pharyngeal swabs, nasal swabs, gastric aspirates, ocular and umbilical secretions, vernix, urines, faeces and blood. From all these samples 803 strains with nosocomial potential were isolated, 84 strains being Klebsiella spp. Most of the isolated strains presented multiple phenotypes of resistance to antibiotics.
Bacteriologia, virusologia, parazitologia, epidemiologia, 2003
We collected 312 samples from hospitalized patients in two hospitals in Timişoara between Septemb... more We collected 312 samples from hospitalized patients in two hospitals in Timişoara between September-December 2003. We isolated 83 strains with nosocomial potential. Identification of the germs was performed using the automatic API system, and the susceptibility tests were performed using disc-diffusion and the agar dilution test. By analyzing the extended antibiograms we categorized the germs considering their phenotypes of resistance and we remarked a high percentage of E. coli, Klebsiella pneumoniae pneumoniae and S. aureus with multiple resistance to antibiotics.
Bacteriologia, virusologia, parazitologia, epidemiologia, 2002
OBJECTIVES Between November 2001-January 2002 we collected 406 samples from patients hospitalized... more OBJECTIVES Between November 2001-January 2002 we collected 406 samples from patients hospitalized in Intensive Care adults and new-borns Unit (ICU). The aim was to observe the colonization and infection status with bacteria that may have nosocomial potential and to establish circulating phenotypes in ICUs. METHODS The identification was performed by API (bioMerieux) method, and we have performed the antimicrobial susceptibility tests by both: API method and by Kirby-Bauer disc-diffusion test. RESULTS We isolated 295 strains with nosocomial potential: 34 MRSA strains, 23 MRCNS strains, 29 ESBL producing gram negative rods, etc. CONCLUSIONS We observed the presence of multiple drug resistant bacteria which play an important roll in both: massive colonization of patients and in the etiology of nosocomial infections. This leads us to the conclusion that antibiotic resistance pattern should be interpreted by the bacteriologist and a consistent policy concerning the use of antimicrobial d...
Infection and Drug Resistance, 2020
Background Carbapenem-resistant Proteeae (CRP) is a group of multidrug-resistant (MDR) microorgan... more Background Carbapenem-resistant Proteeae (CRP) is a group of multidrug-resistant (MDR) microorganisms that raise special treatment problems due to their intrinsic resistance to colistin. In this study, our aim is to provide a phenotypic and molecular characterization of the carbapenemases secreted by CRP strains isolated from inpatients from an intensive care unit (ICU) and surgical wards, as well as the identification of the risk factors involved in their acquisition. Methods An observational, cross-sectional study was performed which included all Proteeae strains isolated in samples from inpatients on high-risk wards of the largest university hospital in Western Romania, from July 2017 to April 2019. Meropenem-resistant strains (N=65) with MIC ≥16 µg/mL were subjected to a singleplex PCR assay for the detection of blaNDM, blaVIM and blaCTX-M genes. The analysis of risk factors was performed by logistic regression. Results Out of 8317 samples that were processed, 400 Proteeae strai...
Infection and Drug Resistance, 2020
Purpose Several mass spectrometry-based methods for antimicrobial sensitivity testing have been d... more Purpose Several mass spectrometry-based methods for antimicrobial sensitivity testing have been described in recent years. They offer an alternative to commercially available testing systems which were considered to have disadvantages in terms of cost- and time-efficiency. The aim of this study was to develop an LC-MS/MS-based antibiotic hydrolysis assay for evaluating antimicrobial resistance (AMR) of Gram-negative bacteria. Materials and Methods Four species of Gram-negative bacilli (Klebsiella pneumoniae, Escherichia coli, Providencia stuartii and Acinetobacter baumannii) were tested against six antibiotics from three different classes: ampicillin, meropenem, imipenem, ceftazidime, ceftriaxone and cefepime. Bacterial suspensions from each species were incubated with a mixture of the six antibiotics. Any remaining antibiotic following incubation was measured using LC-MS/MS. The results were interpreted using measurements obtained for an E. coli strain sensitive to all antibiotics ...
INTRODUCTION The Acinetobacter species are ubiquitary germs isolated more and more frequently, Ac... more INTRODUCTION The Acinetobacter species are ubiquitary germs isolated more and more frequently, Acinetobacter baumannii being currently considered the second strictly aerobic microorganism involved in the ethiology of severe nosocomial infections. Acinetobacter baumannii is usually encountered in surgery and intensive care units, especially in patients with depressed immunity, in which various locations are possible, the most frequvent being the respiratory tract infections, urinary tract infections and bacteriemia. MATERIAL AND METHOD The study used 52 strains of Acinetobacter spp. isolated from 1131 biological samples (bronchial aspirat, urine, wound secretion, blood, pus, CFS) obtained from the patients of the Timisoara Country Hospital. Identification of germs was performed using the API (BioMerieux) system, and the antibiotics sensitivity testing was made by disk diffusion testing (Kirby-Bauer), with automatic reading and phenotyping through the Osiris Evolution (BioRad) system....
PURPOSES The aim of our study was to determine the prevalence of multiresistant germs with nosoco... more PURPOSES The aim of our study was to determine the prevalence of multiresistant germs with nosocomial potential and their main resistance phenotype and genotype patterns in surgical departments. METHODS Identification of germs was performed by the API system (BioMerieux France) and susceptibility tests by disk-diffusion tests, (CLSI standards) with automatic reading methods (Osiris-Bio Rad Laboratories). ESBL producing E. coli and Klebsiella pneumoniae strains have been also genotyped. RESULTS From 190 samples (urines, wound secretions, blood, etc.); we isolated 106 microbial strains with nosocomial potential. 56 (52.83%) from these strains were represented by enterobacteria, 26 (24.52%) by Gram negative non-fermentative rods, and 24 (22.64%) by Gram positive cocci. CONCLUSIONS We noticed a high prevalence of multidrug resistant germs (ESBL, MRSA, etc). The majority of them were involved in nosocomial surgical site and urinary tract infections.
European Journal of Clinical Microbiology & Infectious Diseases
Evaluating trends in antibiotic resistance is a requisite. The study aimed to analyze the profile... more Evaluating trends in antibiotic resistance is a requisite. The study aimed to analyze the profile of multidrug-resistant organisms (MDROs) among hospitalized patients with bacteremia in intensive care units (ICUs) in a large geographical area. This is a 1-month cross-sectional survey for blood-borne pathogens in 57 ICUs from 24 countries with different income levels: lower-middle-income (LMI), upper-middle-income (UMI), and high-income (HI) countries. Multidrug-resistant (MDR), extensively drug-resistant (XDR), or pan-drug-resistant isolates were searched. Logistic regression analysis determined resistance predictors among MDROs. Community-acquired infections were comparable to hospital-acquired infections particularly in LMI (94/202; 46.5% vs 108/202; 53.5%). Although MDR (65.1%; 502/771) and XDR (4.9%; 38/771) were common, no pan-drug-resistant isolate was recovered. In total, 32.1% of MDR were Klebsiella pneumoniae, and 55.3% of XDR were Acinetobacter baumannii. The highest MDR and XDR rates were in UMI and LMI, respectively, with no XDR revealed from HI. Predictors of MDR acquisition were male gender (OR, 12.11; 95% CI, 3.025-15.585) and the hospital-acquired origin of bacteremia (OR, 2.643; 95%CI, 1.462-3.894), and XDR acquisition was due to bacteremia in UMI (OR, 3.344; 95%CI, 1.189-5.626) and admission to medical-surgical ICUs (OR, 1.481; 95% CI, 1.076-2.037). We confirm the urgent need to expand stewardship activities to community settings especially in LMI, with more paid attention to the drugs with a higher potential for resistance. Empowering microbiology laboratories and reports to direct prescribing decisions should be prioritized. Supporting stewardship in ICUs, the mixed medical-surgical ones in particular, is warranted.
Medicina
Background and Objectives: In Coronavirus Disease 2019 (COVID-19), which is caused by the infecti... more Background and Objectives: In Coronavirus Disease 2019 (COVID-19), which is caused by the infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the clinical manifestations are primarily related to the pulmonary system. Under 10% of cases also develop gastrointestinal events such as diarrhea, nausea, vomiting and abdominal pain. Materials and Methods: We conducted an observational, retrospective study in the Infectious Diseases Clinic of ‘’Victor Babes’’ Hospital, Timis County, in order to assess the incidence, outcome and risk factors for Clostridium Difficile infection (CDI) in COVID-19 patients. Results: Out of 2065 COVID-19 cases, hospitalized between 1st September 2020 and 30th April 2021, 40 cases of CDI were identified with 32 cases of hospital-onset of CDI and eight cases of community-onset and healthcare-associated CDI. By randomization, polymerase chain reaction ribotyping of Clostridium Difficile was performed in six cases. All the randomized cases t...
Infection and Drug Resistance
The purpose of this study was to identify risk factors for extensively drug-resistant (XDR) Acine... more The purpose of this study was to identify risk factors for extensively drug-resistant (XDR) Acinetobacter baumannii (AB) and XDR Proteeae association in the largest intensive care unit (ICU) in Western Romania. Materials and methods: This retrospective case-controlled study was conducted between January 2016 and December 2016 in the ICU of the "Pius Brînzeu" County Emergency Clinical Hospital of Timișoara. Data were collected, in strict confidentiality, from the electronic database of the Microbiology Laboratory and the hospital's electronic medical records. Risk factors were investigated by logistic regression. Independent variables with P≤0.05 and OR >1 (95% CI >1) in the univariate analysis were entered into multivariate sequenced analysis. Findings: The incidence density of coinfection with XDR AB and XDR Proteeae was 5.31 cases per 1,000 patient-days. Independent risk factors for the association of XDR AB and XDR Proteeae were represented by the presence of tracheostomy and naso-/orogastric nutrition ≥ 8 days. In addition, pressure ulcers were independent predictive factors for infections with all three infection types. Previous antibiotic therapy was an independent risk factor for the acquisition of XDR-AB strains, alone or in association, while the prolonged hospitalization in the ICU, blood transfusion, and hemodialysis appear as independent risk factors for single infections. Conclusion: This association of XDR AB and XDR Proteeae may well not be limited to our hospital or our geographical area.
At present, L. monocytogenes is considered as one of the most important food-borne pathogens. Hum... more At present, L. monocytogenes is considered as one of the most important food-borne pathogens. Human pathogenicity of L. monocytogenes includes a series of characters that aggravate the primary intestinal aggressivity through blood dissemination and passage of blood-brain barrier and placenta. Invasive listeriosis may occur as meningitis, encephalitis, sepsis or abortion, with high mortality rates. This paper presents a clinical case of sepsis with meningeal dissemination caused by L. monocytogenes in a food industry worker. The patient was admitted with the diagnosis of acute bacterial meningoencephalitis. 72 hours after hospital admission (9 days after symptom onset), the first suspicion of listeriosis was formulated. The bacteriological examination of the cerebrospinal fluid (CSF) confirmed the presumptive diagnosis by the isolation and identification of L. monocytogenes. The bacteriologic diagnosis was further confirmed by MALDITOF mass spectrometry (BruckerDaltomix-Germany).The ...
Revista Romana de Medicina de Laborator
Introduction: Resistance to first-line antibiotics of the Proteeae strains within the difficult-t... more Introduction: Resistance to first-line antibiotics of the Proteeae strains within the difficult-to-treat (DTR) phenotype is a cause of limitation of therapeutic options. The study aimed to characterize these strains, to identify the factors that influence their acquisition and the predictive factors for the patient’s evolution. Material and methods: Between July 2017 and January 2019, 400 of Proteeae strains were isolated from samples of patients admitted to intensive care units (ICUs) and surgical wards of a university hospital in Romania. The identification and testing of antibiotic sensitivity was performed using the Vitek 2 Compact system. The DTR phenotype was defined as the resistance (or intermediate resistance) to all categories of β-lactams, carbapenems and fluoroquinolones. Results: Out of 400 Proteeae strains, 21% were of the DTR type, most of them from the species Providencia stuartii and Proteus mirabilis, identified predominantly on the ICUs. The excess fatality in the...
Clinical Laboratory, 2016
The critically ill polytrauma patient, apart from the primary, traumatic injuries and the seconda... more The critically ill polytrauma patient, apart from the primary, traumatic injuries and the secondary, port-traumatic injuries, presents with a series of molecular disasters. Dysfunctions of the biochemical pathways and molecular damage add to the worsening of the clinical status of these patients, one of the most well-known molecular phenomena being oxidative stress (OS), responsible for an escalation of the inflammatory status, multiple infections, and multiple organ dysfunction syndrome (MODS). For this study was analysed the literature available on PubMed and Scopus. The key words used in the search were &amp;amp;amp;amp;amp;amp;amp;quot;oxidative stress&amp;amp;amp;amp;amp;amp;amp;quot;, &amp;amp;amp;amp;amp;amp;amp;quot;lipid peroxidation&amp;amp;amp;amp;amp;amp;amp;quot;, &amp;amp;amp;amp;amp;amp;amp;quot;critically ill&amp;amp;amp;amp;amp;amp;amp;quot;, &amp;amp;amp;amp;amp;amp;amp;quot;polytrauma patients&amp;amp;amp;amp;amp;amp;amp;quot;, and &amp;amp;amp;amp;amp;amp;amp;quot;biomarkers oxidative stress&amp;amp;amp;amp;amp;amp;amp;quot;. For the study we selected 47 science articles. The oxidative attack on lipids is responsible for the biosynthesis of an increased quantity of free radicals (FR), which further intensifies and aggravates the redox status in these patients. One of the most aggressive redox mechanisms related to lipid molecules is known as lipid peroxidation (LPOX).
BMC infectious diseases, May 22, 2017
Due to the vulnerable nature of its patients, the wide use of invasive devices and broad-spectrum... more Due to the vulnerable nature of its patients, the wide use of invasive devices and broad-spectrum antimicrobials used, the intensive care unit (ICU) is often called the epicentre of infections. In the present study, we quantified the burden of hospital acquired pathology in a Romanian university hospital ICU, represented by antimicrobial agents consumption, costs and local resistance patterns, in order to identify multimodal interventional strategies. Between 1(st) January 2012 and 31(st) December 2013, a prospective study was conducted in the largest ICU of Western Romania. The study group was divided into four sub-samples: patients who only received prophylactic antibiotherapy, those with community-acquired infections, patients who developed hospital acquired infections and patients with community acquired infections complicated by hospital-acquired infections. The statistical analysis was performed using the EpiInfo version 3.5.4 and SPSS version 20. A total of 1596 subjects were...
Journal of Chemistry, 2015
Background. Both 1,2,3- and 1,2,4-triazoles are nowadays incorporated in numerous antibacterial p... more Background. Both 1,2,3- and 1,2,4-triazoles are nowadays incorporated in numerous antibacterial pharmaceutical formulations.Aim. Our study aimed to prepare three substituted 1,2,4-triazoles and to evaluate their antibacterial properties.Materials and Methods. One disubstituted and two trisubstituted 1,2,4-triazoles were prepared and characterised by physical and spectroscopic properties (melting point, FTIR, NMR, and GC-MS). The antibacterial properties were studied against three bacterial strains:Staphylococcus aureus(ATCC 25923),Escherichia coli(ATCC 25922), andPseudomonas aeruginosa(ATCC 27853), by the agar disk diffusion method and the dilution method with MIC (minimal inhibitory concentration) determination.Results. The spectroscopic characterization of compounds and the working protocol for the synthesis of the triazolic derivatives are described. The compounds were obtained with 15–43% yields and with high purities, confirmed by the NMR analysis. The evaluation of biological ...
Annals of clinical microbiology and antimicrobials, Jan 13, 2017
Over recent decades, a dramatic increase in infections caused by multidrug-resistant pathogens ha... more Over recent decades, a dramatic increase in infections caused by multidrug-resistant pathogens has been observed worldwide. The aim of the present study was to investigate the relationship between local resistance bacterial patterns and antibiotic consumption in an intensive care unit in a Romanian university hospital. A prospective study was conducted between 1st January 2012 and 31st December 2013. Data covering the consumption of antibacterial drugs and the incidence density for the main resistance phenotypes was collected on a monthly basis, and this data was aggregated quarterly. The relationship between the antibiotic consumption and resistance was investigated using cross-correlation, and four regression models were constructed, using the SPSS version 20.0 (IBM, Chicago, IL) and the R version 3.2.3 packages. During the period studied, the incidence of combined-resistant and carbapenem-resistant P. aeruginosa strains increased significantly [(gradient = 0.78, R = 0.707, p = 0....
Bacteriologia, virusologia, parazitologia, epidemiologia (Bucharest, Romania : 1990)
The aim of this study was to determine the antibiotic resistance of Streptococcus agalactiae stra... more The aim of this study was to determine the antibiotic resistance of Streptococcus agalactiae strains isolated from urocultures in order to obtain new data regarding circulating phenotypes in Urology Department.
Bacteriologia, virusologia, parazitologia, epidemiologia (Bucharest, Romania : 1990)
This study analyzes the sensitivity to meropenem of 880 bacterial strains isolated from hospitali... more This study analyzes the sensitivity to meropenem of 880 bacterial strains isolated from hospitalized patients in various medical units of County Hospital No. 1 Timişoara. As a result, a high sensitivity of gram-negative pathogens to meropenem (82.01%) has been noticed. Among Enterobacteriaceae, 93.17% of Escherichia coli and 71% of Klebsiella sp. were susceptible to meropenem. For Pseudomonas aeruginosa strains, a high susceptibility was noticed to meropenem (91%), more than 70% to imipenem, but piperacillin + tazobactam had 42% resistance rates.
Bacteriologia, virusologia, parazitologia, epidemiologia, 2003
Bacteriologia, virusologia, parazitologia, epidemiologia, 2003
In order to analyse the evolution of the sensitivity to antibiotics of same strains with nosocomi... more In order to analyse the evolution of the sensitivity to antibiotics of same strains with nosocomial potential such as Klebsiella isolated in a hospital, we took into study a number of 976 samples, collected in a new-born care department of the "Dr. D. Popescu" hospital Timişoara. The study took place between November-December 2002. The collected samples were pharyngeal swabs, nasal swabs, gastric aspirates, ocular and umbilical secretions, vernix, urines, faeces and blood. From all these samples 803 strains with nosocomial potential were isolated, 84 strains being Klebsiella spp. Most of the isolated strains presented multiple phenotypes of resistance to antibiotics.
Bacteriologia, virusologia, parazitologia, epidemiologia, 2003
We collected 312 samples from hospitalized patients in two hospitals in Timişoara between Septemb... more We collected 312 samples from hospitalized patients in two hospitals in Timişoara between September-December 2003. We isolated 83 strains with nosocomial potential. Identification of the germs was performed using the automatic API system, and the susceptibility tests were performed using disc-diffusion and the agar dilution test. By analyzing the extended antibiograms we categorized the germs considering their phenotypes of resistance and we remarked a high percentage of E. coli, Klebsiella pneumoniae pneumoniae and S. aureus with multiple resistance to antibiotics.
Bacteriologia, virusologia, parazitologia, epidemiologia, 2002
OBJECTIVES Between November 2001-January 2002 we collected 406 samples from patients hospitalized... more OBJECTIVES Between November 2001-January 2002 we collected 406 samples from patients hospitalized in Intensive Care adults and new-borns Unit (ICU). The aim was to observe the colonization and infection status with bacteria that may have nosocomial potential and to establish circulating phenotypes in ICUs. METHODS The identification was performed by API (bioMerieux) method, and we have performed the antimicrobial susceptibility tests by both: API method and by Kirby-Bauer disc-diffusion test. RESULTS We isolated 295 strains with nosocomial potential: 34 MRSA strains, 23 MRCNS strains, 29 ESBL producing gram negative rods, etc. CONCLUSIONS We observed the presence of multiple drug resistant bacteria which play an important roll in both: massive colonization of patients and in the etiology of nosocomial infections. This leads us to the conclusion that antibiotic resistance pattern should be interpreted by the bacteriologist and a consistent policy concerning the use of antimicrobial d...
Infection and Drug Resistance, 2020
Background Carbapenem-resistant Proteeae (CRP) is a group of multidrug-resistant (MDR) microorgan... more Background Carbapenem-resistant Proteeae (CRP) is a group of multidrug-resistant (MDR) microorganisms that raise special treatment problems due to their intrinsic resistance to colistin. In this study, our aim is to provide a phenotypic and molecular characterization of the carbapenemases secreted by CRP strains isolated from inpatients from an intensive care unit (ICU) and surgical wards, as well as the identification of the risk factors involved in their acquisition. Methods An observational, cross-sectional study was performed which included all Proteeae strains isolated in samples from inpatients on high-risk wards of the largest university hospital in Western Romania, from July 2017 to April 2019. Meropenem-resistant strains (N=65) with MIC ≥16 µg/mL were subjected to a singleplex PCR assay for the detection of blaNDM, blaVIM and blaCTX-M genes. The analysis of risk factors was performed by logistic regression. Results Out of 8317 samples that were processed, 400 Proteeae strai...
Infection and Drug Resistance, 2020
Purpose Several mass spectrometry-based methods for antimicrobial sensitivity testing have been d... more Purpose Several mass spectrometry-based methods for antimicrobial sensitivity testing have been described in recent years. They offer an alternative to commercially available testing systems which were considered to have disadvantages in terms of cost- and time-efficiency. The aim of this study was to develop an LC-MS/MS-based antibiotic hydrolysis assay for evaluating antimicrobial resistance (AMR) of Gram-negative bacteria. Materials and Methods Four species of Gram-negative bacilli (Klebsiella pneumoniae, Escherichia coli, Providencia stuartii and Acinetobacter baumannii) were tested against six antibiotics from three different classes: ampicillin, meropenem, imipenem, ceftazidime, ceftriaxone and cefepime. Bacterial suspensions from each species were incubated with a mixture of the six antibiotics. Any remaining antibiotic following incubation was measured using LC-MS/MS. The results were interpreted using measurements obtained for an E. coli strain sensitive to all antibiotics ...
INTRODUCTION The Acinetobacter species are ubiquitary germs isolated more and more frequently, Ac... more INTRODUCTION The Acinetobacter species are ubiquitary germs isolated more and more frequently, Acinetobacter baumannii being currently considered the second strictly aerobic microorganism involved in the ethiology of severe nosocomial infections. Acinetobacter baumannii is usually encountered in surgery and intensive care units, especially in patients with depressed immunity, in which various locations are possible, the most frequvent being the respiratory tract infections, urinary tract infections and bacteriemia. MATERIAL AND METHOD The study used 52 strains of Acinetobacter spp. isolated from 1131 biological samples (bronchial aspirat, urine, wound secretion, blood, pus, CFS) obtained from the patients of the Timisoara Country Hospital. Identification of germs was performed using the API (BioMerieux) system, and the antibiotics sensitivity testing was made by disk diffusion testing (Kirby-Bauer), with automatic reading and phenotyping through the Osiris Evolution (BioRad) system....
PURPOSES The aim of our study was to determine the prevalence of multiresistant germs with nosoco... more PURPOSES The aim of our study was to determine the prevalence of multiresistant germs with nosocomial potential and their main resistance phenotype and genotype patterns in surgical departments. METHODS Identification of germs was performed by the API system (BioMerieux France) and susceptibility tests by disk-diffusion tests, (CLSI standards) with automatic reading methods (Osiris-Bio Rad Laboratories). ESBL producing E. coli and Klebsiella pneumoniae strains have been also genotyped. RESULTS From 190 samples (urines, wound secretions, blood, etc.); we isolated 106 microbial strains with nosocomial potential. 56 (52.83%) from these strains were represented by enterobacteria, 26 (24.52%) by Gram negative non-fermentative rods, and 24 (22.64%) by Gram positive cocci. CONCLUSIONS We noticed a high prevalence of multidrug resistant germs (ESBL, MRSA, etc). The majority of them were involved in nosocomial surgical site and urinary tract infections.
European Journal of Clinical Microbiology & Infectious Diseases
Evaluating trends in antibiotic resistance is a requisite. The study aimed to analyze the profile... more Evaluating trends in antibiotic resistance is a requisite. The study aimed to analyze the profile of multidrug-resistant organisms (MDROs) among hospitalized patients with bacteremia in intensive care units (ICUs) in a large geographical area. This is a 1-month cross-sectional survey for blood-borne pathogens in 57 ICUs from 24 countries with different income levels: lower-middle-income (LMI), upper-middle-income (UMI), and high-income (HI) countries. Multidrug-resistant (MDR), extensively drug-resistant (XDR), or pan-drug-resistant isolates were searched. Logistic regression analysis determined resistance predictors among MDROs. Community-acquired infections were comparable to hospital-acquired infections particularly in LMI (94/202; 46.5% vs 108/202; 53.5%). Although MDR (65.1%; 502/771) and XDR (4.9%; 38/771) were common, no pan-drug-resistant isolate was recovered. In total, 32.1% of MDR were Klebsiella pneumoniae, and 55.3% of XDR were Acinetobacter baumannii. The highest MDR and XDR rates were in UMI and LMI, respectively, with no XDR revealed from HI. Predictors of MDR acquisition were male gender (OR, 12.11; 95% CI, 3.025-15.585) and the hospital-acquired origin of bacteremia (OR, 2.643; 95%CI, 1.462-3.894), and XDR acquisition was due to bacteremia in UMI (OR, 3.344; 95%CI, 1.189-5.626) and admission to medical-surgical ICUs (OR, 1.481; 95% CI, 1.076-2.037). We confirm the urgent need to expand stewardship activities to community settings especially in LMI, with more paid attention to the drugs with a higher potential for resistance. Empowering microbiology laboratories and reports to direct prescribing decisions should be prioritized. Supporting stewardship in ICUs, the mixed medical-surgical ones in particular, is warranted.
Medicina
Background and Objectives: In Coronavirus Disease 2019 (COVID-19), which is caused by the infecti... more Background and Objectives: In Coronavirus Disease 2019 (COVID-19), which is caused by the infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the clinical manifestations are primarily related to the pulmonary system. Under 10% of cases also develop gastrointestinal events such as diarrhea, nausea, vomiting and abdominal pain. Materials and Methods: We conducted an observational, retrospective study in the Infectious Diseases Clinic of ‘’Victor Babes’’ Hospital, Timis County, in order to assess the incidence, outcome and risk factors for Clostridium Difficile infection (CDI) in COVID-19 patients. Results: Out of 2065 COVID-19 cases, hospitalized between 1st September 2020 and 30th April 2021, 40 cases of CDI were identified with 32 cases of hospital-onset of CDI and eight cases of community-onset and healthcare-associated CDI. By randomization, polymerase chain reaction ribotyping of Clostridium Difficile was performed in six cases. All the randomized cases t...
Infection and Drug Resistance
The purpose of this study was to identify risk factors for extensively drug-resistant (XDR) Acine... more The purpose of this study was to identify risk factors for extensively drug-resistant (XDR) Acinetobacter baumannii (AB) and XDR Proteeae association in the largest intensive care unit (ICU) in Western Romania. Materials and methods: This retrospective case-controlled study was conducted between January 2016 and December 2016 in the ICU of the "Pius Brînzeu" County Emergency Clinical Hospital of Timișoara. Data were collected, in strict confidentiality, from the electronic database of the Microbiology Laboratory and the hospital's electronic medical records. Risk factors were investigated by logistic regression. Independent variables with P≤0.05 and OR >1 (95% CI >1) in the univariate analysis were entered into multivariate sequenced analysis. Findings: The incidence density of coinfection with XDR AB and XDR Proteeae was 5.31 cases per 1,000 patient-days. Independent risk factors for the association of XDR AB and XDR Proteeae were represented by the presence of tracheostomy and naso-/orogastric nutrition ≥ 8 days. In addition, pressure ulcers were independent predictive factors for infections with all three infection types. Previous antibiotic therapy was an independent risk factor for the acquisition of XDR-AB strains, alone or in association, while the prolonged hospitalization in the ICU, blood transfusion, and hemodialysis appear as independent risk factors for single infections. Conclusion: This association of XDR AB and XDR Proteeae may well not be limited to our hospital or our geographical area.
At present, L. monocytogenes is considered as one of the most important food-borne pathogens. Hum... more At present, L. monocytogenes is considered as one of the most important food-borne pathogens. Human pathogenicity of L. monocytogenes includes a series of characters that aggravate the primary intestinal aggressivity through blood dissemination and passage of blood-brain barrier and placenta. Invasive listeriosis may occur as meningitis, encephalitis, sepsis or abortion, with high mortality rates. This paper presents a clinical case of sepsis with meningeal dissemination caused by L. monocytogenes in a food industry worker. The patient was admitted with the diagnosis of acute bacterial meningoencephalitis. 72 hours after hospital admission (9 days after symptom onset), the first suspicion of listeriosis was formulated. The bacteriological examination of the cerebrospinal fluid (CSF) confirmed the presumptive diagnosis by the isolation and identification of L. monocytogenes. The bacteriologic diagnosis was further confirmed by MALDITOF mass spectrometry (BruckerDaltomix-Germany).The ...
Revista Romana de Medicina de Laborator
Introduction: Resistance to first-line antibiotics of the Proteeae strains within the difficult-t... more Introduction: Resistance to first-line antibiotics of the Proteeae strains within the difficult-to-treat (DTR) phenotype is a cause of limitation of therapeutic options. The study aimed to characterize these strains, to identify the factors that influence their acquisition and the predictive factors for the patient’s evolution. Material and methods: Between July 2017 and January 2019, 400 of Proteeae strains were isolated from samples of patients admitted to intensive care units (ICUs) and surgical wards of a university hospital in Romania. The identification and testing of antibiotic sensitivity was performed using the Vitek 2 Compact system. The DTR phenotype was defined as the resistance (or intermediate resistance) to all categories of β-lactams, carbapenems and fluoroquinolones. Results: Out of 400 Proteeae strains, 21% were of the DTR type, most of them from the species Providencia stuartii and Proteus mirabilis, identified predominantly on the ICUs. The excess fatality in the...
Clinical Laboratory, 2016
The critically ill polytrauma patient, apart from the primary, traumatic injuries and the seconda... more The critically ill polytrauma patient, apart from the primary, traumatic injuries and the secondary, port-traumatic injuries, presents with a series of molecular disasters. Dysfunctions of the biochemical pathways and molecular damage add to the worsening of the clinical status of these patients, one of the most well-known molecular phenomena being oxidative stress (OS), responsible for an escalation of the inflammatory status, multiple infections, and multiple organ dysfunction syndrome (MODS). For this study was analysed the literature available on PubMed and Scopus. The key words used in the search were &amp;amp;amp;amp;amp;amp;amp;quot;oxidative stress&amp;amp;amp;amp;amp;amp;amp;quot;, &amp;amp;amp;amp;amp;amp;amp;quot;lipid peroxidation&amp;amp;amp;amp;amp;amp;amp;quot;, &amp;amp;amp;amp;amp;amp;amp;quot;critically ill&amp;amp;amp;amp;amp;amp;amp;quot;, &amp;amp;amp;amp;amp;amp;amp;quot;polytrauma patients&amp;amp;amp;amp;amp;amp;amp;quot;, and &amp;amp;amp;amp;amp;amp;amp;quot;biomarkers oxidative stress&amp;amp;amp;amp;amp;amp;amp;quot;. For the study we selected 47 science articles. The oxidative attack on lipids is responsible for the biosynthesis of an increased quantity of free radicals (FR), which further intensifies and aggravates the redox status in these patients. One of the most aggressive redox mechanisms related to lipid molecules is known as lipid peroxidation (LPOX).
Background: The recent emergence of Clostridium difficile infections has included this condition ... more Background: The recent emergence of Clostridium difficile infections has included this condition among top nosocomial infections, due to its incidence, complications and important fatality, as well as to significant economic costs. Methods: A prospective surveillance study of Clostridium difficile enterocolitis cases was performed in " Victor Babeş " Infectious Diseases Hospital in Timişoara (Romania) between 01.01.2013-30.06.2014, to estimate the incidence and to investigate the risk factors for unfavourable outcome and relapse. Dichotomous variables were compared by the chi-square test or Fisher exact test and the Mann–Whitney U test was used for continuous variables. Risk factors for unfavourable outcome/recurrence were investigated by logistic regression. Results: 210 patients who experienced 219 episodes of infection with Clostridium difficile were identified, which gives an incidence per hospital of 20.57/15.70 to 1,000 discharged patients in 2013/2014 or 17.73/14.04 to 10,000 patient-days. In 162 patients (77.14%) the evolution was favourable while in 48 (22.86%) the outcome was unfavourable. In 42 patients (20.00%) recurrence of symptoms was identified. The multivariate analysis by logistic regression identified the ATLAS score (OR = 4.97, 95% CI = 2.12 to 11.66, p <0.001), age (OR = 1.12, 95% CI = 1.00 to 1.25, p = 0.046), and the number of antibiotics after episode onset (OR = 2.692, 95% CI = 1.01 to 7.17, p = 0.047) as predictors of an unfavourable evolution, while the number of hospitalization days (OR = 1.10, 95% CI = 1.03 to 1.16, p = 0.0015) was associated with recurrence of symptoms.