• 1.

    Cohen CC, Cohen B, Shang J, 2015. Effectiveness of contact precautions against multidrug-resistant organism transmission in acute care: a systematic review of the literature. J Hosp Infect 90: 275284.

    • Search Google Scholar
    • Export Citation
  • 2.

    Lipke V, Emerson C, McCarthy C, Briggs-Hagen M, Farley J, Verani AR, Riley PL, 2016. Highlighting the need for more infection control practitioners in low- and middle-income countries. Public Health Action 6: 160163.

    • Search Google Scholar
    • Export Citation
  • 3.

    Del Rosario-Quintana C, Tosco-Núñez T, Lorenzo L, Martín-Sánchez AM, Molina-Cabrillana J, 2015. Prevalencia y factores asociados a la colonización de microorganismos multirresistentes en centros de larga estancia de Gran Canaria. Rev Esp Geriatr Gerontol 50: 232236.

    • Search Google Scholar
    • Export Citation
  • 4.

    Agarwala S, Lad D, Agashe V, Sobti A, 2016. Prevalence of MRSA colonization in an adult urban Indian population undergoing orthopaedic surgery. J Clin Orthop Trauma 7: 1216.

    • Search Google Scholar
    • Export Citation
  • 5.

    Hernandez DR, Newton DW, Ledeboer NA, Buchan B, Young C, Clark AE, Connoly J, Wolk DM, 2016. Multicenter evaluation of MRSASelect II chromogenic agar for identification of methicillin-resistant Staphylococcus aureus from wound and nasal specimens. J Clin Microbiol 54: 305311.

    • Search Google Scholar
    • Export Citation
  • 6.

    Beezhold DW, Slaughter S, Hayden MK, Matushek M, Nathan C, Trenholme GM, Weinstein RA, 1996. Skin colonization with vancomycin-resistant enterococci among hospitalized patients with bacteremia. Clin Infect Dis 1997: 704706.

    • Search Google Scholar
    • Export Citation
  • 7.

    Talavera G, Rodríguez M, Castro H, Melgarejo N, Noguera J, Portillo S, Basualdo W, 2013. Colonización intestinal por enterococo resistente a la vancomicina en pacientes oncológicos con factores de riesgo. Pediatría (Asunción) 38: 123125.

    • Search Google Scholar
    • Export Citation
  • 8.

    Ponessa A, Gambandé T, All L, Fernández de Arroyabe G, Ferrari M, Dlugovitzky D, Notario R, 2006. Enterococos vancomicina resistentes: colonización en pacientes hospitalizados, en Rosario, Argentina. Acta Bioquim Clin Latinoam 40: 499502.

    • Search Google Scholar
    • Export Citation
  • 9.

    Flores-Paredes W, 2010. Epidemiología de la colonización intestinal con enterococo resistente a vancomicina en pacientes de alto riesgo del Hospital Nacional Edgardo Rebagliati Martins. Lima, Perú. Rev Medica Hered 21: 128139.

    • Search Google Scholar
    • Export Citation
  • 10.

    Harris AD, McGregor JC, Johnson JA, Strauss SM, Moore AC, Standiford HC, Hebden JN, Morris JG, 2007. Risk factors for colonization with extended-spectrum beta-lactamase-producing bacteria and intensive care unit admission. Emerg Infect Dis 13: 11441149.

    • Search Google Scholar
    • Export Citation
  • 11.

    Azim A, Dwivedi M, Rao PB, Baronia AK, Singh RK, Prasad KN, Poddar B, Mishra A, Gurjar M, Dhole TN, 2010. Epidemiology of bacterial colonization at intensive care unit admission with emphasis on extended-spectrum beta-lactamase- and metallo-beta-lactamase-producing Gram-negative bacteria–an Indian experience. J Med Microbiol 59: 955960.

    • Search Google Scholar
    • Export Citation
  • 12.

    García C, Astocondor L, Rojo-Bezares B, Jacobs J, Sáenz Y, 2016. Molecular characterization of extended-spectrum β-lactamase-producer Klebsiella pneumoniae isolates causing neonatal sepsis in Peru. Am J Trop Med Hyg 94: 285288.

    • Search Google Scholar
    • Export Citation
  • 13.

    Clinical and Laboratory Standards Institute, 2016. Performance Standards for Antimicrobial Susceptibility Testing, 26th edition. Wayne, PA: CLSI Supplement.

  • 14.

    Guzmán-Blanco M, Labarca JA, Villegas MV, Gotuzzo E, 2014. Extended spectrum β-lactamase producers among nosocomial enterobacteriaceae in Latin America. Braz J Infect Dis 18: 421433.

    • Search Google Scholar
    • Export Citation
  • 15.

    Reyes J et al.., 2009. Dissemination of methicillin-resistant Staphylococcus aureus (MRSA), USA300 sequence type 8 lineage in Latin-America. Clin Infect Dis 49: 18611867.

    • Search Google Scholar
    • Export Citation
  • 16.

    March A, Aschbacher R, Dhanji H, Livermore DM, Böttcher A, Sleghel F, Maggi S, Noale M, Larcher C, Woodford N, 2010. Colonization of residents and staff of a long-term-care facility and adjacent acute-care hospital geriatric unit by multiresistant bacteria. Clin Microbiol Infect 16: 934944.

    • Search Google Scholar
    • Export Citation
  • 17.

    Ruscher C, Pfeifer Y, Layer F, Schaumann R, Levin K, Mielke M, 2014. Inguinal skin colonization with multidrug-resistant bacteria among residents of elderly care facilities: frequency, persistence, molecular analysis and clinical impact. Int J Med Microbiol 304: 11231134.

    • Search Google Scholar
    • Export Citation
  • 18.

    Low DE, Keller N, Barth A, Jones RN, 2001. Clinical prevalence, antimicrobial susceptibility, and geographic resistance patterns of enterococci: results from the SENTRY antimicrobial surveillance program, 1997–1999. Clin Infect Dis 32: S133S145.

    • Search Google Scholar
    • Export Citation
 
 
 

 

 
 
 

 

 

 

 

 

 

Multidrug-Resistant Microorganisms Colonizing Lower Extremity Wounds in Patients in a Tertiary Care Hospital, Lima, Peru

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  • 1 Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru;
  • | 2 Hospital Cayetano Heredia, Lima, Peru;
  • | 3 Infectious Disease Division, Henry Ford Health System, Detroit, Michigan;
  • | 4 Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium;
  • | 5 Department of Microbiology and Immunology, University of Leuven, Leuven, Belgium

Multidrug-resistant organism (MDRO) infections cause high morbidity and mortality, and high costs to patients and hospitals. The study aims were to determine the frequency of MDRO colonization and associated factors in patients with lower-extremity wounds with colonization. A cross-sectional study was designed during November 2015 to July 2016 in a tertiary care hospital in Lima, Peru. A wound swab was obtained for culture and susceptibility testing. MDRO colonization was defined if the culture grew with methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and/or extended spectrum beta-lactamase (ESBL) microorganisms. The frequency of MDRO wound colonization was 26.8% among the 97 patients enrolled. The most frequent MDRO obtained was ESBL-producing Escherichia coli, which was significantly more frequent in chronic wounds versus acute wounds (17.2% versus 0%, P < 0.05). Infection control measures should be implemented when patients with chronic lower-extremity wounds are admitted.

Author Notes

Address correspondence to Coralith García, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Lima, Peru. E-mail: coralith.garcia@upch.pe

Financial support: This study was sponsored by the Directorate General for Development Cooperation (DGCD) of the Belgian Government (framework agreement 3, project 95502) and Henry Ford Health System.

Authors’ addresses: Rafael Mendo-Lopez, Aurora Lizeth Astocondor, and Saul Alejos, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru, E-mails: rafael.mendo@upch.pe, lizeth1226@hotmail.com, and savaf@hotmail.com. Luis Jasso and Ximena Guevara, Department of Endocrinology, Hospital Nacional Cayetano Heredia, Lima, Peru, E-mails: ljasso18@yahoo.es and ximenaguevara@yahoo.com. Ana C. Bardossy and Marcus J. Zervos, Infectious Disease Division, Henry Ford Health System, Detroit, MI, E-mails: cbardos1@hfhs.org and mzervos1@hfhs.org. Tyler Prentiss, Global Health Initiative, Henry Ford Health Services, Detroit, MI, E-mail: tprenti1@hfhs.org. Jan Jacobs, Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium, E-mail: jjacobs@itg.be. Coralith García, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru, and Infectious Disease Division, Hospital Nacional Cayetano Heredia, Lima, Peru, E-mail: coralith.garcia@upch.pe.

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