Multidrug resistant organisms: What are we up against? Hans Jørn Kolmos MD DMSc Professor, consultant Department of Clinical Microbiology Odense University.

Slides:

Advertisements

Similar presentations

NOSOCOMIAL ANTIBIOTIC RESISTANT ORGANISMS

Advertisements

DAVID R. WOODARD MSC, CIC, CPHQ, CLS Hospital Ecology.

East Texas Medical Center – Tyler Annual Physician Education MDRO -Multidrug-Resistant Organisms- Revised: April 2013.

Antimicrobial Resistance in Hospitals: Lack of Effective Treatment for Gram Negative Bacilli and the Rise of Resistant Clostridium difficile Infections.

The Resistance Problem PRSP = Penicillin Resistant Strep. pneumoniae QRSP = Quinolone Resistant Strep. pneumoniae MRSA = Methicillin Resistant Staph.

Preventing Multi-Drug Resistant Organism (MDRO) Infections For National Patient Safety Goal

The Increasing Public Health Exigency of Antimicrobial Resistance Alfred DeMaria, Jr., M.D. Massachusetts Department of Public Health.

MRSA Methicillin Resistant Staphylococcus Aureus

Today’s talk Dimensions of AB resistance History of AB resistance Biology of AB resistance –Biology of antibiotic action and measurement –Genetics –Biochemistry.

Antibiotic Overuse – how much does it matter? Thursday 1/17/08.

MRSA and VRE. MRSA  1974 – MRSA accounted for only 2% of total staph infections  1995 – MRSA accounted for 22% of total staph infections  2004 – MRSA.

MRSA and VRE. MRSA  1974 – MRSA accounted for only ____of total staph infections  1995 – MRSA accounted for _____ of total staph infections  2004 –

Monitoring antimicrobial resistance in the veterinary field: Norway -Special reference to MRSA, ESBLs and antimicrobial use to farmed fish Marianne Sunde.

Prevention, Surveillance and Statistics of Resistance to Antibiotics

Preventing Multidrug-Resistant Organisms (MDROs) What the Direct Caregiver Should Know Prepared by: Ann Bailey, RNC, BSN, CIC Joanne Dixon, RN, MN, CIC.

CHAPTER 20 ANTIBIOTIC RESISTANCE

Big Bad Bugs in the Dialysis Unit Douglas Shemin, MD Kidney Diseases and Hypertension Division, Rhode Island Hospital.

Hans Wolf-Watz, professor, UCMR, MIMS, Department of Microbiology, Umeå University, Sweden, Antibiotic resistance a new.

NOSOCOMIAL INFECTIONS Phase 1: Testing the efficacy of Nano-Mg (OH) 2 Dorothea A. Dillman PhD, RN, CCRN, LNC.

Physicians: Infection Prevention is in YOUR Hands

. Nosocomial Antibiotic Resistant Organisms Copyright © Texas Education Agency, All rights reserved.

Train-the-Trainer Understanding multidrug-resistance: Focus on Carbapenems Customize this presentation with your organization’s logo, etc. 13/17/2014.

Methicillin-resistant Staphylococcus Aureus - MRSA - Sharon Walker, RN, BPS Ingham County Health Department.

Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. Chapter 83 Basic Principles of Antimicrobial Therapy.

World Health Day 2011: Antimicrobial Resistance 1 |1 | Prevention and Containment of Antimicrobial Resistance USE ANTIBIOTICS RATIONALLY.

National and International Spread of Antimicrobial Resistance: Clones and Genes Professor Alan Johnson, Health Protection Services - HPA.

Microbiology- a clinical approach by Anthony Strelkauskas et al Chapter 20: Antibiotic resistance.

SPM 100 Clinical Skills Lab 1 Standard Precautions Sterile Technique Daryl P. Lofaso, M.Ed, RRT.

© Aurora Health Care, Inc. Carbapenem Resistant Enterobacteriaceae The Alphabet Soup of Infection Prevention Aurora Health Care System Infection Prevention.

Moving forward together infection prevention and control and AMR Rose Gallagher Nurse Advisor Infection Prevention and Control Royal College of Nursing.

ECDC-EMEA Joint Technical Report Part I: Trends and burden of antimicrobial resistance in the European Union Zsuzsanna Jakab, Director European Centre.

SPM 100 Skills Lab 1 Standard Precautions Sterile Technique Daryl P. Lofaso, M.Ed, RRT Clinical Skills Lab Coordinator.

CARBAPENEM RESISTANT ENTEROBACTERIACEAE: RISK FACTORS AND ROLE OF EXTENDED CARE FACILITIES A. Makarem, MD; P. Alvarez, MD; T. Chou, MPH, CIC; M. Kulkarni,

Microbiology Nuts & Bolts Antibiotics Part 1 Dr David Garner Consultant Microbiologist Frimley Park Hospital NHS Foundation.

How Hands Transmit Infection. How do our hands transmit infection? ■Hands are the most common vehicle to transmit health care-associated pathogens (e.g.,

INTRODUCTION TO INFECTION CONTROL ICNO Infection Control Unit, Teaching Hospital, Jaffna.

European Centre for Disease Prevention and Control

MICROBIOLOGICAL EPIDEMIOLOGY OF RESPIRATORY SPECIMENS IN ICU PATIENTS Dr Farooq Cheema, Dr Waseem Tariq, Dr Raja Ishtiaq, Dr Tabassum Qureshi, Dr Vincent.

KJO Hospital Infection Control Local 2176/2097 Ross Ibabao/ICCo.

Multi Drug- Resistant Organisms (MDRO’s) in the ICU A Guide for RT’s

Part II High Priority Resistant Organisms. Healthcare Associated Infections NHSN Staphylococcus aureus (16%) 2.Enterococcus spp (14%) 3.Escherichia.

Materials & Methods Objective Extraintestinal pathogenic Escherichia coli in healthy broiler chicken in Italy: a combination of virulence with antibiotic.

IMPORTANT ANTIBIOTICS AND ANTIMICROBIAL RESISTANCE A Presentation By Ms R.Venkatajothi, MSc., MPhil, PhD Senior Lecturer Department of Microbiology Faculty.

AMR containment in Thailand

Antibiotic-resistant Bacteria

Antibiotics: handle with care!

Antibiotics – Friend and enemy (or revenge of the microbes).

Tackling antimicrobial resistance – what is the current situation in Europe? Dr Andrea Ammon, ECDC Director, 27 June 2017, European Parliament.

Introduction to Antimicrobial Resistance

Dr.Mowna Karthick M.D MICROBIOLOGY

Antibiotic Stewardship in Pennsylvania

Antibiotics: handle with care!

ECDC-EMEA Joint Technical Report Part I: Trends and burden of antimicrobial resistance in the European Union Zsuzsanna Jakab, Director European Centre.

Prevention: The Answer for Bacterial Resistance

Antimicrobial Resistance in Hospitals: Lack of Effective Treatment for Gram Negative Bacilli and the Rise of Resistant Clostridium difficile Infections.

Before an outbreak - what to do after first MDR Gram-negatives enter your hospital? Jon Otter, PhD FRCPath Imperial College London

Nine decades of antibiotics: how many years of antibiotic resistance?

Some bacteria cause disease.

Question & Answer Session

Using the Toolkit to build a CPE policy

E. Monee’ Carter-Griffin DNP, RN, ACNP-BC

Summary of WHO PPL, CDC, and ESKAPE pathogen lists

AMR: a clinical perspective

CPE: coming to a hospital near you!

Empirical antibiotic treatment algorithm for hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP). Empirical antibiotic treatment algorithm.

Summary of WHO PPL, CDC, and ESKAPE pathogen lists

Removal of sinks from ICU Patient rooms

TRAINING PRESENTATION

Before an outbreak - what to do after first MDR Gram-negatives enter your hospital? Jon Otter, PhD FRCPath Imperial College London

Antibiotics: handle with care!

Presentation transcript:

Multidrug resistant organisms: What are we up against? Hans Jørn Kolmos MD DMSc Professor, consultant Department of Clinical Microbiology Odense University Hopsital Progress in Studies in the Reversal of Drug Resistance SDU 4 June 2012

Antibiotics: Miracle drugs, it started out so well, but ….

The antibiotic crisis: accelerating resistance & little new drug development Clatworthy. Nature Biochem Biol 2007; 3: 541-8

Staph aureus (MRSA) Pneumococci Enterococci Gonococci Clostridium difficile Corynebactera E. Coli (ESBL) Klebsiella (ESBL+CPE) Salmonella Pseudomonas Acinetobacter Stenotrophomonas Helicobacter …plus many others Multi-drug resistant bacteria: a rough overview MDR- & XDR-TB

MRSA in Europe 2009

ESBL producing E. coli & Klebsiella pneumoniae

Beyond ESBL: carbapenem resistance - the ultimate horror scenario Resistance to ESBL producing Enterobacteriaceae Penicillins Cephalosporins Carbapenem resistant Enterobacteriaceae (VIM,NDM-1, KPC-2,oxa-48) Penicillins Cephalosporins Carbapenems + others

The ecology of resistance: Selection and transmission Selection with antibiotics

ESBL: The steps from contamination to infection Healthy individual Intestinal colonization (low conc) Acquisition of ESBL by human contact & food Selection of ESBL (high conc) Destruction of normal intestinal flora by antibiotics Breach of natural barriers (surgery, catheters, chemotherapy etc) Patient with invasive infection ManySomeFew

Bugs fighting back: Antibiotic resistance mechanisms

A direct relationship between antibiotic consumption and antibiotic resistance Bronzwaer et al. Emerg Infect Dis 2002; 8:

Coupling of resistance on plasmids or gene cassettes: the genetic background for co-selection R tetra R ampi R ceph R genta R copper R zinc Virulence factors factors

Co-selection with tetracyclines: a driving force behind MRSA & ESBL in food animals DANMAP 2010 ESBL E. coli (broilers & pigs) % MRSA CC398 (pigs) 95 % Costa et al. Vet Microbiol 2009; 138: Ho et al. JAC 2011; 66: DANMAP 2008 Tetracycline resistance MRSA, ESBL

Why worry? n MDRO are dangerous n More difficult to treat n May be more virulent n Increase mortality n Increase morbidity n Resource-intensive n More expensive antibiotics n Increase length of hospitalization n Increase demand for isolation-facilities n Derived problems n Drug toxicity n Poorer quality of care due to single room isolation

End of antibiotics - the ultimate consequence

Measures against multidrug resistance 1.Stop selection n Antibiotic restriction 2.Stop transmission n Hygiene n Food animal management 3. Develop new drugs n antibiotics n helper compounds to antibiotics