Increasing trend of healthcare-associated infections due to vancomycin-resistant Enterococcus faecium (VRE-fm) paralleling escalating community-acquired VRE-fm infections in a medical center implementing strict contact precautions: An epidemiologic and pathogenic genotype analysis and its implications.

Objective: To clarify whether there were clandestine intra-hospital spreads of vancomycin-resistant Enterococcus faecium (VRE-fm) isolates that led to specific strain of VRE lingering in the hospital and/or developing outbreaks that rendered a progressively increasing trend of healthcare-associated infections due to VRE-fm (VRE-fm-HAIs).

Setting: Despite implementing strict contact precautions for hospitalized patients with VRE-fm-infection/colonization, number of VRE-fm-HAIs in a medical centre in southern Taiwan were escalating in 2009-2019, paralleling an increasing trend of community-acquired VRE-fm- infections.

Methods: We analyzed epidemiologic data and genotypes of non-duplicate VRE-fm isolates each grown from a normally sterile site of 89 patients between December 2016 and October 2018; multilocus sequence typing (MLST) and pulse-field gel electrophoresis (PFGE) typing were performed.

Increased financial burdens and lengths of stay in patients with healthcare-associated infections due to multidrug-resistant bacteria in intensive care units: A propensity-matched case-control study.

Background And Objectives: Incidence rates of healthcare-associated infections (HAIs) depend upon infection control policy and practices, and the effectiveness of the implementation of antibiotic stewardship. Amongst intensive care unit (ICU) patients with HAIs, a substantial number of pathogens were reported to be multidrug-resistant bacteria (MDRB). However, impacts of ICU HAIs due to MDRB (MDRB-HAIs) remain understudied.

Antibacterial effects on dry-fast and traditional water-based surgical scrubbing methods: a two-time points experimental study.

This study determined the in-use effects of dry-fast and traditional hand-washing surgical scrubs among operating room staff members. This is a static group comparison study with purposive sampling. A total of 156 staff members were recruited in an operating room in a medical center located in southern Taiwan.

Correlation of anti-fungal susceptibility with clinical outcomes in patients with cryptococcal meningitis.

Background: This study aimed to investigate the correlation of minimum inhibiting concentrations (MICs), obtained by broth micro-dilution, and clinical response in patients with cryptococcal meningitis.

Methods: Using retrospective analyses covering the period 2001-2010, factors affecting clinical therapeutic cure in patients with cryptococcal meningitis 10 weeks after the start of anti-fungal therapy were identified. Specific emphasis was placed on the role of anti-fungal susceptibility.

Spread of ISCR1 elements containing blaDHA-₁ and multiple antimicrobial resistance genes leading to increase of flomoxef resistance in extended-spectrum-beta-lactamase-producing Klebsiella pneumoniae.

Increasing resistance to quinolones, aminoglycosides, and/or cephamycins in extended-spectrum-β-lactamase (ESBL)-producing Enterobacteriaceae exacerbates the already limited antibiotic treatment options for infections due to these microbes. In this study, the presence of resistance determinants for these antimicrobial agents was examined by PCR among ESBL-producing Klebsiella pneumoniae (ESBL-KP) isolates that caused bacteremia. Pulsed-field gel electrophoresis was used to differentiate the clonal relationship among the isolates studied.

Prosthetic joint infection caused by Mycobacterium alvei in an elderly patient.

We report the first case of prosthetic joint infection caused by Mycobacterium alvei, which was identified by PCR-restriction fragment length polymorphism and verified by analysis of nucleotide sequences of its amplified 16S ribosomal DNA. The pathogen was susceptible to linezolid, amikacin, ciprofloxacin, tigecycline, and trimethoprim-sulfamethoxazole. The clinical implications are discussed.

Microbiologic and clinical implications of bacteremia due to extended-spectrum-beta-lactamase-producing Klebsiella pneumoniae with or without plasmid-mediated AmpC beta-lactamase DHA-1.

Bacteremias caused by Klebsiella pneumoniae producing extended-spectrum beta-lactamase (ESBL-KP; n = 52) and producing both ESBL and AmpC-type DHA-1 beta-lactamase (ESBL-PMABL-KP; n = 20) were analyzed. Higher MIC(50)s and MIC(90)s for carbapenems, ciprofloxacin, and piperacillin-tazobactam were observed with ESBL-PMABL-KP than with ESBL-KP. Patients with oxyimino-β-lactam exposure and high modified Pitt bacteremia scores (HMPBSs) were at higher risk, while those with piperacillin-tazobactam and aminoglycoside exposure were at lower risk for ESBL-KP bacteremia.

Activity of ertapenem, ciprofloxacin, ceftriaxone, piperacillin-tazobactam, and ampicillin-sulbactam against 12 common clinical isolates of community-acquired bacteremia.

Background And Purpose: To compare the antimicrobial activities of ertapenem, ciprofloxacin, ceftriaxone, piperacillin-tazobactam, and ampicillin-sulbactam against 12 common organisms that cause community-acquired bacteremia and to identify the most active agents for the treatment of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae.

Methods: 1200 blood specimens from patients with community-acquired bacteremia were collected at Chang Gung Memorial Hospital, Kaohsiung, Taiwan. All isolates were identified by the API system, and each culture's antimicrobial susceptibility was determined by the standard disk-diffusion method.

Antimicrobial effects of varied combinations of meropenem, sulbactam, and colistin on a multidrug-resistant Acinetobacter baumannii isolate that caused meningitis and bacteremia.

Meropenem (MEM; 2 g/8 hr; minimum inhibitory concentration [MIC] = 256 mg/L) plus sulbactam (SUL; 1 g/8 hr; MIC = 128 mg/L) (two-drug-therapy period), and subsequent additional intravenous colistin (COL; 2.5 mg/kg/12 hr) and intraventricular (COL, 5 mg/day; MIC = 1 mg/L) (three-drug-therapy period) were sequentially used in a patient with postneurosurgery bacteremic meningitis due to a multidrug-resistant Acinetobacter baumannii (MDRAB) isolate (AB(1)). We detected 4- to 32-fold increases in peak or trough cerebrospinal fluid bactericidal titer and serum bactericidal titer in three-drug-therapy period when comparing to those in two-drug-therapy period.

In vitro activity of flomoxef against rapidly growing mycobacteria.

The aim of this study was to determine the in vitro sensitivity of rapidly growing mycobacteria (RGM) to flomoxef in respiratory secretions collected from 61 consecutive inpatients and outpatients at Chang Gung Memorial Hospital-Kaohsiung medical center between July and December, 2005. Minimal inhibitory concentrations (MIC) of flomoxef were determined by the broth dilution method for the 61 clinical isolates of RGMs. The MICs of flomoxef at which 90% of clinical isolates were inhibited was >128 microg/mL in 26 isolates of Mycobacterium abscessus and 4 microg/mL in 31 isolates of M.

Shewanella soft tissue infection: case report and literature review.

Objective: To better understand the clinical characteristics of soft tissue infections caused by Shewanella in humans.

Methods: We report a case of Shewanella soft tissue infection and review the English literature from a search of PubMed.

Results: A total of 27 adults (mean age 61.

Treatment of ESBL-producing Klebsiella pneumoniae bacteraemia with carbapenems or flomoxef: a retrospective study and laboratory analysis of the isolates.

Objectives: To better understand the clinical outcomes of patients with extended-spectrum beta-lactamase-producing Klebsiella pneumoniae (ESBL-KP) bacteraemia treated with either flomoxef or a carbapenem, and to evaluate the in vitro activities of these antibiotics against ESBL-KP.

Methods: Retrospective analyses to identify risk factors for mortality in patients with flomoxef-susceptible ESBL-KP, especially addressing the therapeutic roles of flomoxef and carbapenem. In vitro activities of flomoxef and carbapenem against flomoxef-susceptible ESBL-KP isolates were evaluated by susceptibility testing and time-kill study.

Underdiagnosis of urinary tract infection caused by Methylobacterium species with current standard processing of urine culture and its clinical implications.

Methylobacterium species are environmental opportunistic bacteria, and urinary tract infection (UTI) caused by these pathogens has not yet been documented. Four cases of UTI with Methylobacterium bacteraemia in immunocompetent female patients are reported. Their urine cultures, processed according to standard procedures (i.