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Epidemic Infections in the ICU: Multiresistant Microorganisms

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Abstract

Nosocomial problems with antibiotic resistant microorganisms have occurred in several stages over the last 40 years. After the first recognition of antibiotic resistance of S. aureus to penicillin in the 1950s, emergence of Gram-negative bacteria resistant to multiple antibiotics became prominent in the 1970s and 1980s. Concerns about (multi-)resistance among nosocomial Gram-positive bacteria re-emerged in the late 1980s. Currently, the most important nosocomial resistance problems on a global scale are caused by methicillin-resistant S. aureus (MRSA), vancomycin-resistant enterococci (VRE), Enterobacteriaceae with plasmid-encoded extended-spectrum beta-lactamases (ESBL), and Pseudomonas aeruginosa.

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References

  1. Bonten MJM, Bergmans DCJJ, Speijer H, Stobberingh EE. Characteristics of polyclonal endemicity of Pseudomonas aeruginosa colonization in intensive care units: Implications for infection control. Am J Respir Crit Care Med 160:1212, 1999.

    Article  PubMed  CAS  Google Scholar 

  2. Olson B, Weinstein RA, Nathan C, Chamberlin W, Kabins SA. Epidemiology of endemic Pseudomonas aeruginosa: why infection control efforts have failed. J Infect Dis 150:808, 1984.

    Article  PubMed  CAS  Google Scholar 

  3. Murray BE. The life and times of the Enterococcus. Clin Microbiol Rev 3:46, 1990.

    PubMed  CAS  Google Scholar 

  4. Emori TG, Gaynes RP. An overview of nosocomial infections, including the role of the microbiology laboratory. Clin Microbiol Rev 6:428, 1993.

    PubMed  CAS  Google Scholar 

  5. Edmond MB, Ober JF, Dawson JD, Weinbaum DL, Wenzel RP. Vancomycin-resistant enterococcal bacteremia: Natural history and attributable mortality. Clin Infect Dis 23:1234, 1996.

    Article  PubMed  CAS  Google Scholar 

  6. Maki DG, Agger WA. Enterococcal bacteremia: Clinical features, the risk of endocarditis, and managment. Medicine 67:248, 1988.

    Article  PubMed  CAS  Google Scholar 

  7. Moellering RC. Emergence of Enterococcus as a significant pathogen. Clin Infect Dis 14:1173, 1992.

    Article  PubMed  Google Scholar 

  8. Uttley AHC, Collins CH, Naidoo J, George RC. Vancomycin-resistant enterococci. Lancet i:57, 1988.

    Google Scholar 

  9. Uttley AH, George RC, Naidoo J, et al. Highlevel vancomycin-resistant enterococci causing hospital infections. Epidemiol Infect 103:173, 1989.

    Article  PubMed  CAS  Google Scholar 

  10. Leclercq R, Derlot E, Duval J, Courvalin P. Plasmid-mediated resistance to vancomycin and teicoplanin in Enterococcus faecium. New Engl J Med 319:157, 1988.

    Article  PubMed  CAS  Google Scholar 

  11. Noble WC, Virani A, Cree R. Cotransfer of vancomycin and other resistance genes from Enterococcus faecalis NCTC 12201 to Staphylococcus aureus. FEMS Microbiol Lett 93:195, 1992.

    Article  CAS  Google Scholar 

  12. Leclercq R, Courvalin P. Resistance to glycopeptides in enterococci. Clin Infect Dis 24: 545, 1997.

    Article  PubMed  CAS  Google Scholar 

  13. Centers for Disease Control. Nosocomial enterococci resistant to vancomycin — United States, 1989–1993. MMWR 42:597, 1993.

    Google Scholar 

  14. Montecalvo MA, Horowitz H, Gedris C, et al. Outbreak of vancomycin-, ampicillin-, and aminoglycoside-resistant Enterococcus faecium bacteremia in an adult oncology unit. Antimicrob Agents Chemother 38:1363, 1994.

    Article  PubMed  CAS  Google Scholar 

  15. Boyce JM, Opal SM, Chow JW, et al. Outbreak of multi-drug-resistant Enterococcus faecium with transferable vanB class vancomycin resistance. J Clin Microbiol 32:1148, 1994.

    PubMed  CAS  Google Scholar 

  16. Edmond MB, Ober JF, Weinbaum DL, et al. Vancomycin-resistant Enterococcus faecium bacteremia: risk factors for infection. Clin Infect Dis 20:1126, 1995.

    Article  PubMed  CAS  Google Scholar 

  17. Jordens JZ, Bates J, Griffiths DT. Faecal carriage and nosocomial spread of vancomycin-resistant Enterococcus faecium. J Antimicrob Chemother 34:515, 1994.

    Article  PubMed  CAS  Google Scholar 

  18. Moreno F, Grota P, Crisp C, et al. Clinical and molecular epidemiology of vancomycin-resistant enterococcus faecium during its emergence in a city in southern Texas. Clin Infect Dis 21: 1234, 1995.

    Article  PubMed  CAS  Google Scholar 

  19. Biavasco F, Miele A, Vignaroli C, Manso E, Lupidi R, Varaldo PE. Genotypic characterization of a nosocomial outbreak of Van A Enterococcus faecalis. Microbial Drug Res 2:231, 1996.

    Article  CAS  Google Scholar 

  20. Brown AR, Amyes SGB, Paton R, et al. Epidemiology and control of vancomycin-resistant enterococci in a renal unit. J Hosp Infection 40: 115, 1998.

    Article  CAS  Google Scholar 

  21. Slaughter S, Hayden MK, Nathan C, et al. A comparison of the effect of universal use of gloves and gowns with that of glove use alone on acquisition of vancomycin-resistant enterococci in a medical intensive care unit. Ann Intern Med 125:448, 1996.

    Article  PubMed  CAS  Google Scholar 

  22. Morris JG, Jr, Shay DK, Hebden JN, et al. Enterococci resistant to multiple antimicrobial agents, including vancomycin. Establishment of endemicity in a University Medical Center. Ann Intern Med 123:250, 1995.

    Article  PubMed  CAS  Google Scholar 

  23. Bonten M, Hayden MK, Nathan C, et al. Epidemiology of colonisation of patients and environment with vancomycin-resistant enterococci. Lancet 348:1615, 1996.

    Article  PubMed  CAS  Google Scholar 

  24. Manso E, de Sio G, Biavasco F, Varaldo PE, Sambo G, Maffei C. Vancomycin-resistant enterococci. Lancet 342:616, 1993.

    PubMed  CAS  Google Scholar 

  25. Trick WE, Kuehnert MJ, Quirk SB, et al. Regional dissemination of vancomycin-resistant enterococci resulting from interfacility transfer of colonized patients. J Infectious Diseases 180:391, 1999.

    Article  CAS  Google Scholar 

  26. Livornese LL, Jr, Dias S, Samel C, et al. Hospital-acquired infection with vancomycin-resistant Enterococcus faecium transmitted by electronic thermometers. Ann Intern Med 117:112, 1992.

    Article  PubMed  Google Scholar 

  27. Bonten MJM, Hayden MK, Nathan C, Rice TW, Weinstein RA. Stability of vancomycin-resistant enterococcal genotypes isolated from long-term-colonized patients. J Infect Dis 177:378, 1998.

    Article  PubMed  CAS  Google Scholar 

  28. Montecalvo MA, de Lencastre H, Carraher M, et al. Natural history of colonization with vancomycin-resistant Enterococcus faecium. Infect Control Hosp Epidemiol 16:680, 1995.

    Article  PubMed  CAS  Google Scholar 

  29. Bonten MJM, Slaughter S, Ambergen AW, et al. The role of “colonization pressure” in the spread of vancomycin-resistant enterococci. An important infection control variable. Arch Intern Med 158:1127, 1998.

    Article  PubMed  CAS  Google Scholar 

  30. Rhinehart E, Smith NE, Wennerstein C, et al. Rapid dissemination of beta-lactamase-producing, aminoglycoside-resistant Enterococcus faecalis among patients and staff on an infant-toddler surgical ward. New Engl J Med 323:1814, 1990.

    Article  PubMed  CAS  Google Scholar 

  31. Elizaga ML, Beezhold D, Hayden MK, et al. The prevalence of colonization with vancomycin-resistant enterococci among hospitalized residents of long-term care facilities. Abstracts of the IDSA 34th annual meeting 101 abstract no 352, 1996.

    Google Scholar 

  32. Carmeli Y, Samore MH, Huskins C. The association between antecedent vancomycin treatment and hospital-acquired vancomycin-resistant enterococci. A meta-analysis. Archives Internal Medicine 159:2461, 1999.

    Article  Google Scholar 

  33. Centers for Disease Control. Preventing the spread of vancomycin resistance. Report from the Hospital Infection Control Practices Advisory Committee. Federal Register 59:25758, 1994.

    Google Scholar 

  34. Torres A, Gatell JP, Aznar E, et al. Re-intubation increases the risk of nosocomial pneumonia in patients needing mechanical ventilation. Am J Respir Crit Care Med 152:137, 1995.

    Article  PubMed  CAS  Google Scholar 

  35. Handwerger S, Raucher B, Altarac D, et al. Nosocomial outbreak due to Enterococcus faecium highly resistant to vancomycin, penicillin, and gentamicin. Clin Infect Dis 16:750, 1993.

    Article  PubMed  CAS  Google Scholar 

  36. Donskey CJ, Hanrahan JA, Hutton RA, Rice LB. Effect of parenteral antibiotic administration on persistence of vancomycin-resistant Enterococcus faecium in the mouse gastrointestinal tract. J Infect Dis 180:384, 1999.

    Article  PubMed  CAS  Google Scholar 

  37. Quale J, Landman D, Saurina G, Atwood E, Ditore V, Patel K. Manipulation of a hospital antimicrobial formulary to control an outbreak of vancomycin-resistant enterococci. Clin Infect Dis 23:1020, 1996.

    Article  PubMed  CAS  Google Scholar 

  38. Montecalvo MA, Jarvis WR, Uman J, et al. Infection-control measures reduce transmission of vancomycin-resistant enterococci in an endemic setting. Ann Intern Med 131:269, 1999.

    Article  PubMed  CAS  Google Scholar 

  39. Vincent JL, Bihari DJ, Suter PM, et al. The prevalence of nosocomial infection in intensive care units in Europe. Results of the european prevalence of infection in intensive care (EPIC) study. J Am Med Assoc 274:639, 1995.

    Article  CAS  Google Scholar 

  40. Talon D, Mulin B, Rouget C, Bailly P, Thouverez M, Viel J-F. Risks and routes for ventilator-associated pneumonia with Pseudomonas aeruginosa. Am J Respir Crit Care Med 157: 978, 1998.

    Article  PubMed  CAS  Google Scholar 

  41. Bonten MJM, Bergmans DCJJ, Ambergen AW, et al. Risk factors for pneumonia, and colonization of respiratory tract and stomach in mechanically ventilated ICU patients. Am J Respir Crit Care Med 154:1339, 1996.

    Article  PubMed  CAS  Google Scholar 

  42. Heyland D, Mandell LA. Gastric colonization by Gram-negative bacilli and nosocomial pneumonia in the intensive care unit patient: evidence for causation. Chest 101:187, 1992.

    Article  PubMed  CAS  Google Scholar 

  43. Inglis TJJ, Sherratt MJ, Sproat LJ, Gibson JS, Hawkey PM. Gastroduodenal dysfunction and bacterial colonization of the ventilated lung. Lancet 341:911, 1993.

    Article  PubMed  CAS  Google Scholar 

  44. Widmer AF, Wenzel RP, Trilla A, Bale MJ, Jones RN, Doebbeling BN. Outbreak of Pseudomonas aeruginosa infections in a surgical intensive care unit: probable transmission via hands of a health care worker. Clin Infect Dis 16:372, 1993.

    Article  PubMed  CAS  Google Scholar 

  45. Boyce JM, Opal SM, Potter-Bynoe G, et al. Spread of methicillin-resistant Staphylococcus aureus in a hospital after exposure to a health care worker with chronic sinusitis. Clin Infect Dis 17:496, 1993.

    Article  PubMed  CAS  Google Scholar 

  46. Noone MR, Pitt TL, Bedder M, Hewlett AM, Rogers KB. Pseudomonas aeruginosa colonisation in an intensive therapy unit: role of cross infection and host factors. Brit Med J 286:341, 1983.

    Article  CAS  Google Scholar 

  47. Craven DE, Goularte TA, Make BJ. Contaminated condensate in mechanical ventilator circuits: a risk factor for nosocomial pneumonia? Am Rev Respir Dis 129:625, 1984.

    PubMed  CAS  Google Scholar 

  48. Grundmann H, Kropec A, Hartung D, Berner R, Daschner F. Pseudomonas aeruginosa in a neonatal intensive care unit: reservoirs and ecology of the nosocomial pathogen. J Infect Dis 168:943, 1993.

    Article  PubMed  CAS  Google Scholar 

  49. File TM, Tan JS, Thomson RB, Stephens C, Thompson P. An outbreak of Pseudomonas aeruginosa ventilator-associated respiratory infections due to contaminated food coloring dye — further evidence of the significance of gastric colonization preceding nosocomial pneumonia. Infect Control Hosp Epidemiol 16:417, 1995.

    Article  PubMed  Google Scholar 

  50. Whitby JL, Rampling A. Pseudomonas aeruginosa contamination in domestic and hospital environment. Lancet i:15, 1972.

    Google Scholar 

  51. Favero MS, Carson LA, Bond WW, Petersen NJ. Pseudomonas aeruginosa: growth in distilled water from hospitals. Science 173:836, 1971.

    Article  PubMed  CAS  Google Scholar 

  52. Tredget EE, Shankowsky HA, Joffe MA, et al. Epidemiology of infections with Pseudomonas aeruginosa in burn patients: The role of hydrotherapy. J Infect Dis 15:941, 1992.

    CAS  Google Scholar 

  53. Maki DG. Control of colonization and transmission of pathogenic bacteria in the hospital. Ann Intern Med 89:777, 1978.

    Article  PubMed  CAS  Google Scholar 

  54. Olson B, Weinstein RA, Nathan C, Chamberlin W, Kabins S. Occult aminoglycoside resistance in Pseudomonas aeruginosa: epidemiology and implications for therapy and control. J Infect Dis 152:769, 1985.

    Article  PubMed  CAS  Google Scholar 

  55. Brun-Buisson C, Legrand P, Rauss A, et al. Intestinal decontamination for control of nosocomial multiresistant Gram-negative bacilli: study of an outbreak in an intensive care unit. Ann Intern Med 110:873, 1989.

    Article  PubMed  CAS  Google Scholar 

  56. Godard J, Guillaume C, Reverdy ME, et al. Intestinal decontamination in a polyvalent ICU: a double-blind study. Intens Care Med 16:307, 1990.

    Article  CAS  Google Scholar 

  57. Bonten MJM, Gaillard CA, de Leeuw PW, Stobberingh EE. Role of colonization of the upper intestinal tract in the pathogenesis of ventilator-associated pneumonia. Clin Infect Dis 24:309, 1997.

    Article  PubMed  CAS  Google Scholar 

  58. Pugin J, Auckenthaler R, Lew DP, Suter PM. Oropharyngeal decontamination decreases incidence of ventilator-associated pneumonia: a randomized, placebo-controlled, double-blind clinical trial. J Am Med Assoc 265:2704, 1991.

    Article  CAS  Google Scholar 

  59. Rodriguez-Roldan JM, Altuna-Cuesta A, Lopez A, et al. Prevention of nosocomial lung infection in ventilated patients: use of an antimicrobial pharyngeal nonabsorbable paste. Crit Care Med 18:1239, 1990.

    Article  PubMed  CAS  Google Scholar 

  60. Vollaard EJ, Clasener HAL. Colonization resistance. Antimicrob Agents Chemother 38:409, 1994.

    Article  PubMed  CAS  Google Scholar 

  61. Barber M. Methicillin-resistant staphylococci. J Clin Pathol 14:385, 1961.

    Article  PubMed  CAS  Google Scholar 

  62. Jacoby GA, Archer GL. New mechanisms of bacterial resistance to antimicrobial agents. New Engl J Med 324:601, 1991.

    Article  PubMed  CAS  Google Scholar 

  63. Hiramatsu K, Aritaka N, Hanaki H, et al. Dissemination in Japanese hospitals of strains of Staphylococcus aureus heterogeneously resistant to vancomycin. Lancet 350:1670, 1997.

    Article  PubMed  CAS  Google Scholar 

  64. Smith TL, Pearson ML, Wilcox KR, et al. Emergence of vancomycin resistance in Staphylococcus aureus. New Engl J Med 340: 493, 1999.

    Article  PubMed  CAS  Google Scholar 

  65. Sieradzki K, Roberts RB, Haber SW, Tomasz A. The development of vancomycin resistance in a patients with methicillin-resistant Staphylococcus aureus infection. New Engl J Med 340:517, 1999.

    Article  PubMed  Google Scholar 

  66. Waldvogel FA. New resistance in Staphylococcus aureus. New Engl J Med 340:556, 1999.

    Article  PubMed  CAS  Google Scholar 

  67. Haley RW, Hightower AW, Khabbaz RF, et al. The emergence of methicillin-resistant Staphylococcus aureus infections in United States hospitals. Possible role of the house staff-patient transfer circuit. Ann Intern Med 97:297, 1982.

    Article  PubMed  CAS  Google Scholar 

  68. Thompson RL, Cabezudo I, Wenzel RP. Epidemiology of nosocomial infections caused by methicillin-resistant Staphylococcus aureus. Ann Intern Med 97:309, 1982.

    Article  PubMed  CAS  Google Scholar 

  69. Centers for Disease Control. Methicillin-resistant Staphylococcus aureus. MMWR 30: 140, 1981.

    Google Scholar 

  70. Saravolatz LD, Pohlod DJ, Arking LM. Community-acquired methicillin-resistant Staphylococcus aureus infections: a new source for nosocomial outbreaks. Ann Intern Med 97:325, 1982.

    Article  PubMed  CAS  Google Scholar 

  71. Speller DCE, Johnson AP, James D, Marples RR, Charlett A, George RC. Resistance to methicillin and other antibiotics in isolates of Staphylococcus aureus from blood and cerebrospinal fluid, England and Wales, 1989–95. Lancet 350:323, 1997.

    Article  PubMed  CAS  Google Scholar 

  72. Voss A, Milatovic D, Wallrauch-Schwarz C, Rosdahl VT, Braveny I. Methicillin-resistant Staphylococcus aureus in Europe. Eur J Clin Microbiol Infect Dis 13:50, 1994.

    Article  PubMed  CAS  Google Scholar 

  73. Mulligan ME, Murray-Leisure K, Ribner BS, et al. Methicillin-resistant Staphylococcus aureus: A consensus review of the microbiology, pathogenesis, and epidemiology with implications for prevention and management. Am J Med 94:313, 1993.

    Article  PubMed  CAS  Google Scholar 

  74. Frenay HM, Vandenbroucke-Grauls CMJE, Molkenboer MJ, et al. Long-term carriage, and transmission of methicillin-resistant Staphylococcus aureus after discharge from hospital. Infect Control 22:207, 1992.

    CAS  Google Scholar 

  75. Crossley K, Landesman B, Zaske D. An outbreak of infections caused by strains of Staphylococcus aureus resistant to methicillin and aminoglycosides. II Epidemiologic studies. J Infect Dis 139:280, 1979.

    Article  PubMed  CAS  Google Scholar 

  76. Peacock JE, Marsik FJ, Wenzel RP. Methicillin-resistant Staphylococcus aureus: introduction and spread within a hospital. Ann Intern Med 93:526, 1980.

    Article  PubMed  Google Scholar 

  77. Boyce JM, White RL, Causey WA, Lockwood WR. Burn units as a source of methicillin resistant Staphylococcus aureus infections. J Am Med Assoc 249:2803, 1983.

    Article  CAS  Google Scholar 

  78. Rutala WA, Katz EBS, Sheretz RJ, Sarubbi FA. Environmental study of a methicillin-resistant Staphylococcus aureus epidemic in a burn unit. J Clin Microbiol 18:683, 1983.

    PubMed  CAS  Google Scholar 

  79. Farrington M, Ling J, Ling T, French GL. Outbreaks of infection with methicillin-resistant Staphylococcus aureus on neonatal and burns units of a new hospital. Epidemiol Infect 105:215, 1990.

    Article  PubMed  CAS  Google Scholar 

  80. Jernigan JA, Titus MG, Groschel DHM, Getchell-White SI, Farr BM. Effectiveness of contact isolation during a hospital outbreak of methicillin-resistant Staphylococcus aureus. Am J Epidemiol 143:496, 1996.

    Article  PubMed  CAS  Google Scholar 

  81. Haley RW, Cushion NB, Tenover FC, et al. Eradication of endemic methicillin-resistant Staphylococcus aureus infections from a neonatal intensive care unit. J Infect Dis 171:614, 1995.

    Article  PubMed  CAS  Google Scholar 

  82. Chaix C, Durand-Zaleski I, Alberti C, Brun-Buisson C. Control of endemic methicillin-resistant Staphylococcus aureus. A cost-benefit analysis in an Intensive Care Unit. JAMA 282: 1745, 1999.

    Article  PubMed  CAS  Google Scholar 

  83. Doebbeling BN, Breneman DL, Neu HC, et al. Elimination of Staphylococcus aureus nasal carriage in health care workers: Analysis of six clinical trials with calcium mupirocin ointment. Clin Infect Dis 17:466, 1993.

    Article  PubMed  CAS  Google Scholar 

  84. Dawson SJ, Finn LF, McCulloch JE, et al. Mupirocin-resistant MRSA. J Hosp Infect 28: 75, 1994.

    Article  PubMed  CAS  Google Scholar 

  85. Marples RR, Speller DCE, Cookson. Prevalence of mupirocin resistance in Staphylococcus aureus. J Hosp Infect 29:153, 1995.

    Article  PubMed  CAS  Google Scholar 

  86. Knothe H, Shah P, Krcmery V, Antal M, Mitsuhashi S. Transferable resistance to cefotaxime, cefoxitin, cefamandole and cefuroxime in clinical isolates of Klebsiella pneumoniae and Serratia marcescens. Infection 11:315, 1983.

    Article  PubMed  CAS  Google Scholar 

  87. Payne DJ, Marriott MS, Amyes SGB. Mutants of the TEM-1 beta-lactamase conferring resistance to ceftazidime. J Antimicrob Chemother 24:103, 1989.

    Article  PubMed  CAS  Google Scholar 

  88. Bush K, Jacoby G. Nomenclature of TEM beta-lactamases. J Antimicrob Chemother 39:1, 1997.

    Article  PubMed  CAS  Google Scholar 

  89. Medeiros AA. Evolution and dissemination of ß-lactamases accelerated by generations of ß-lactam antibiotics. Clin Infect Dis 24 (Suppl 1):S19, 1997.

    Article  PubMed  CAS  Google Scholar 

  90. Paterson DL, Ko WC, Mohapatra S, et al. Klebsiella pneumoniae bacteremia: Impact of extended spectrum beta-lactamases production in a global study of 216 patients. Proceedings of the 37th Interscience Conference on Antimicrobial Agents and Chem 328-J-210, 1997.

    Google Scholar 

  91. Itokazu GS, Quinn JP, Bell-Dixon C, Kahan FM, Weinstein RA. Antimicrobial resistance rates among aerobic gram-negative bacilli recovered from patients in intensive care units: evaluation of a national postmarketing surveillance program. Clin Infect Dis 23:779, 1996.

    Article  PubMed  CAS  Google Scholar 

  92. Brun-Buisson C, Legrand P, Philippon A, Montravers F, Ansquer M, Duval J. Transferable enzymatic resistance to third-generation cephalosporins during nosocomial outbreak of multiresistant Klebsiella pneumoniae. Lancet aug 8:302, 1987.

    Article  Google Scholar 

  93. Jarlier V, Nicolas MH, Fournier G, Philippon A. Extended broad-spectrum ß-lactamases conferring transferable resistance to newer ß-lactam agents in Enterobacteriaceae: hospital prevalence and susceptibility patterns. Rev Infect Dis 10:867, 1988.

    Article  PubMed  CAS  Google Scholar 

  94. Sirot J, Chanal C, Petit A, Sirot D, Labia R, Gerbaud G. Klebsiella pneumoniae and other Enterobacteriaceae producing novel plasmid-mediated ß-lactamases markedly active against third-generation cephalosporins: Epidemiologic studies. Rev Infect Dis 10:850, 1988.

    Article  PubMed  CAS  Google Scholar 

  95. Arlet G, Sanson-le Pors MJ, Rouveau M, et al. Outbreak of nosocomial infections due to Klebsiella pneumoniae producing SHV-4 beta-lactamase. Eur J Clin Microbiol Infect Dis 9: 797, 1990.

    Article  PubMed  CAS  Google Scholar 

  96. Papanicolaou GA, Medeiros AA, Jacoby GA. Novel plasmid-mediated beta-lactamase (MIR-1) conferring resistance to oxyimino- and ß-methoxy ß-lactams in clinical isolates of Klebsiella pneumoniae. Antimicrob Agents Chemother 34:2200, 1990.

    Article  PubMed  CAS  Google Scholar 

  97. Rice LB, Willey SH, Papanicolaou GA, et al. Outbreak of ceftazidime resistance caused by extended-spectrum ß-lactamases at a Massachusetts chronic-care facility. Antimicrob Agents Chemother 34:2193, 1990.

    Article  PubMed  CAS  Google Scholar 

  98. de Champs C, Rouby D, Guelon D, et al. A case-control study of an outbreak of infections caused by Klebstella pneumoniae strains producing CTX-1 (TEM-3) beta-lactamase. J Hosp Infect 18:5, 1991.

    Article  PubMed  Google Scholar 

  99. Naumovski L, Quinn JP, Miyashiro D, et al. Outbreak of ceftazidime resistance due to a novel extended-spectrum ß-lactamase in isolates from cancer patients. Antimicrob Agents Chemother 36:1991, 1992.

    Article  PubMed  CAS  Google Scholar 

  100. Coovadia YM, Johnson AP, Bhana RH, Hutchinson GR, George RC, Hafferjee IE. Multiresitant Klebsiella pneumoniae in a neonatal nursery: the importance of maintainance of infection control policies and procedures in the prevention of outbreaks. J Hosp Infect 22:197, 1992.

    Article  PubMed  CAS  Google Scholar 

  101. Bauernfeind A, Rosenthal E, Eberlein E, Holley M, Schweighart S. Spread of Klebsiella pneumoniae producing SHV-5 beta-lactamase among hospitalized patients. Infection 21:18, 1993.

    Article  PubMed  CAS  Google Scholar 

  102. Meyer KS, Urban C, Eagan JA, Berger BJ, Rahal JJ. Nosocomial outbreak of Klebsiella infection resistant to late-generation cephalosporins. Ann Intern Med 199:353, 1993.

    Article  Google Scholar 

  103. Prodinger WM, Fille M, Bauernfeind A, et al. Molecular epidemiology of Klebsiella pneumoniae producing SHV-5 β-lactamase: parallel outbreaks due to multiple plasm id transfer. J Clin Microbiol 34:564, 1996.

    PubMed  CAS  Google Scholar 

  104. Hobson RP, MacKenzie FM, Gould IM. An outbreak of multiply-resistant Klebsiella pneumoniae in the Grampian region of Scotland. J Hosp Infect 33:249, 1996.

    Article  PubMed  CAS  Google Scholar 

  105. Pegues DA, Pegues CF, Hibberd PL, Ford DS, Hooper DC. Emergence and dissemination of a highly vancomycin-resistant vanA strain of Enterococcus faecium at a large teaching hospital. J Clin Microbiol 35:1565, 1997.

    PubMed  CAS  Google Scholar 

  106. Dunne WM, Wang W. Clonal dissemination and colony morphotype variation of vancomycin-resistant Enterococcus faecium isolates in metropolitan Detroit, Michigan. J Clin Microbiol 35:388, 1997.

    PubMed  Google Scholar 

  107. Schiappa DA, Hay den MK, Matushek MG, et al. Ceftazidime-resistant Klebsiella pneumoniae and Escherichia coli bloodstream infection: A case-control and molecular epidemiologic investigation. J Infect Dis 174:529, 1996.

    Article  PubMed  CAS  Google Scholar 

  108. Lucet J-C, Chevret S, Decré D, et al. Outbreak of multiply resistant Enterobacteriaceae in an Intensive Care Unit: Epidemiology and risk factors for acquisition. Clin Infect Dis 22:430, 1996.

    Article  PubMed  CAS  Google Scholar 

  109. Coudron PE, Moland ES, Sanders C. Occurrence and detection of extended-spectrum beta-latamases in members of the family Enterobacteriaceae at a veterans medical center: Seek and you may find. J Clin Microbiol 35: 2593, 1997.

    PubMed  Google Scholar 

  110. D’Agata E, Venkataraman L, DeGirolami P, Samore M. Molecular epidemiology of acquisition of ceftazidime-resistant Gram-negative bacilli in a nonoutbreak setting. J Clin Microbiol 35:2602, 1997.

    PubMed  Google Scholar 

  111. French GL, Shannon KP, Simmons N. Hospital outbreak of Klebsiella pneumoniae resistant to broad-spectrum cephalosporins and beta-lactam-beta-lactamase inhibitor combinations by hyperproduction of SHV-5 beta-lactamase. J Clin Microbiol 34:358, 1996.

    PubMed  CAS  Google Scholar 

  112. Rahal JJ, Urban C, Horn D, et al. Class restriction of cephalosporin use to control total cephalosporin resistance in nosocomial Klebsiella. JAMA 280:1233, 1998.

    Article  PubMed  Google Scholar 

  113. Austin DA, Bonten MJM, Slaughter S, Weinstein RA, Anderson RM. Vancomycin-resistant enterococci in Intensive Care hospital settings: Transmission dynamics, persistence and the impact of infection control programs. Proc National Academy of Sciences USA 96:6908, 1999.

    Article  CAS  Google Scholar 

  114. Pittet D, Mourouga P, Perneger TV. Compliance with handwashing in a teaching hospital. Ann Inter Med 130: 126, 1999.

    Article  CAS  Google Scholar 

  115. Albert RK, Condie F. Hand-washing patterns in medical intensive-care units. New Engl J Med 304:1465, 1981.

    Article  PubMed  CAS  Google Scholar 

  116. Bonten MJM, Austin DJ, Weinstein RA, Anderson RM. Quantifying changes in infection control programs in intensive care hospital settings: Number of health care workers affects patient outcome, (submitted).

    Google Scholar 

  117. Spencer RC. The emergence of epidemic, multiple-antibiotic-resistant Stenotropho-monas (Xanthomonas) maltophilia and Burkholderia (Pseudomonas) cepacia. J Hosp Infect 30 (Suppl):453, 1995.

    Article  PubMed  Google Scholar 

  118. Bergogne-Bérézin E, Joly-Guillou ML. Hospital infection with Acinetobacter spp.: an increasing problem. J Hosp Infect 18:250, 1991.

    Article  PubMed  Google Scholar 

  119. Bergogne-Bérézin E. The increasing significance of outbreaks of Acinetobacter spp.: The needs for control and new agents. J Hosp Infect 30(Suppl):44l, 1995.

    Article  Google Scholar 

  120. Martinez-Martinez L, Pascual A, Tran J, Jacoby GA. Plasmid-mediated resistance to quinolones. Proc 37th Interscience Conference on Antimicrobial Agents and Chem Addendum: 6-LB-20, 1997.

    Google Scholar 

  121. Rasmussen BA, Bush K, Tally FP. Antimicrobial resistance in anaerobes. Clin Infect Dis 24 (Suppl 1):S110, 1997.

    Article  PubMed  CAS  Google Scholar 

  122. Sandven P, Bjorneklett A, Maeland A. Susceptibilities of Norwegian Candida albicans strains to fluconazole: Emergence of resistance. Antimicrob Agents Chemother 37:2443, 1993.

    Article  PubMed  CAS  Google Scholar 

  123. Novak R, Henriques B, Charpentier E, Normark S, Tuomanen E. Emergence of vancomycin tolerance in Streptococcus pneumoniae. Nature 399:590, 1999.

    Article  PubMed  CAS  Google Scholar 

  124. Seppala H, Klaukka T, Vuopio-Varkila J, et al. The effect of changes in the consumption of macrolide antibiotics on erythromycin resistance in group A streptococci in Finland. New Engl J Med 337:441, 1997.

    Article  PubMed  CAS  Google Scholar 

  125. Kollef MH, Vlasnik J, Sharpless L, Pasque C, Murphy D, Fraser V. Scheduled change of antibiotic classes. A strategy to decrease the incidence of Ventilator-Associated Pneumonia. Am J Respir Crit Care Med 156:1040, 1997.

    Article  PubMed  CAS  Google Scholar 

  126. Gould D. Nurses’ hand decontamination practice: results of a local study. J Hosp Infect 28:15, 1994.

    Article  PubMed  CAS  Google Scholar 

  127. Doebbeling BN, Stanley GL, Sheetz CT, et al. Comparative efficacy of alternative handwashing agents in reducing nosocomial infections in intensive care units. New Engl J Med 327:88, 1992.

    Article  PubMed  CAS  Google Scholar 

  128. Simmons B, Bryant J, Neiman K, Spencer L, Arheart K. The role of handwashing in prevention of endemic intensive care unit infections. Infect Control Hosp Epidemiol 11:589, 1990.

    Article  PubMed  CAS  Google Scholar 

  129. Jarvis WR. Handwashing — the Semmelweis lesson forgotten? Lancet 344:1311, 1994.

    Article  PubMed  CAS  Google Scholar 

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Bonten, M.J.M. (2001). Epidemic Infections in the ICU: Multiresistant Microorganisms. In: Rello, J., Valles, J., Kollef, M.H. (eds) Critical Care Infectious Diseases Textbook. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-1679-8_21

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