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Bolzano, Italy

Carattoli A.,Parasitic and Immune mediated Diseases | Aschbacher R.,Laboratorio Aziendale Of Microbiologia E Virologia | March A.,Reparto di Geriatria | Larcher C.,Laboratorio Aziendale Of Microbiologia E Virologia | And 2 more authors.
Journal of Antimicrobial Chemotherapy | Year: 2010

Objectives: We determined the complete nucleotide sequence of pKOX105, a 54641 bp plasmid from a Klebsiella oxytoca strain that was isolated from a resident of a long-term-care facility in Bolzano, Italy. Methods: The plasmid was sequenced using a shotgun approach. Combinatorial PCRs, directed PCRs and walking reads were used to assemble the contigs and to fill in gaps. Gene sequences were compared with reference plasmids and aligned with GenBank data using BLAST and CLUSTAL W software. Results: pKOX105 belonged to incompatibility group IncN, harboured bla VIM-1, bla SHV-12, qnrS1, aacA4 and dfrA14 and conferred resistance to carbapenems, oxyimino-cephalosporins, quinolones, aminoglycosides and trimethoprim. It was highly related to the p9 and p12 plasmids from Klebsiella pneumoniae and K. oxytoca strains isolated at a New York City hospital in 2005 carrying bla KPC-2 and bla KPC-3, respectively. Conclusions: IncN plasmids are broad host-range plasmids that have contributed significantly to the worldwide dissemination of many different resistance genes in Enterobacteriaceae from animal and human sources. This plasmid family is now playing a crucial role in the global spread of diverse carbapenemase genes in Klebsiella spp. © The Author 2010. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. Source


March A.,Reparto di Geriatria | Aschbacher R.,Reparto di Geriatria | Dhanji H.,Public Health England | Livermore D.M.,Public Health England | And 6 more authors.
Clinical Microbiology and Infection | Year: 2010

Long-term-care facilities (LTCFs) are reservoirs of resistant bacteria. We undertook a point-prevalence survey and risk factor analysis for specific resistance types among residents and staff of a Bolzano LTCF and among geriatric unit patients in the associated acute-care hospital. Urine samples and rectal, inguinal, oropharyngeal and nasal swabs were plated on chromogenic agar; isolates were typed by pulsed-field gel electrophoresis; resistance genes and links to insertion sequences were sought by PCR; plasmids were analysed by PCR, restriction fragment length polymorphism and incompatibility grouping. Demographic data were collected. Of the LTCF residents, 74.8% were colonized with ≥1 resistant organism, 64% with extended-spectrum β-lactamase (ESBL) producers, 38.7% with methicillin-resistant Staphylococcus aureus (MRSA), 6.3% with metallo-β-lactamase (MBL) producers, and 2.7% with vancomycin-resistant enterococci. Corresponding rates for LTCF staff were 27.5%, 14.5%, 14.5%, 1.5% and 0%, respectively. Colonization frequencies for geriatric unit patients were lower than for those in the LTCF. Both clonal spread and plasmid transfer were implicated in the dissemination of MBL producers that harboured IncN plasmids bearing blaVIM-1, qnrS, and blaSHV-12. Most (44/45) ESBL-producing Escherichia coli isolates had blaCTX-M genes of group 1; a few had blaCTX-M genes of group 9 or blaSHV-5; those with blaCTX-M-15 or blaSHV-5 were clonal. Risk factors for colonization of LTCF residents with resistant bacteria included age ≥86 years, antibiotic treatment in the previous 3 months, indwelling devices, chronic obstructive pulmonary disease, physical disability, and the particular LTCF unit; those for geriatric unit patients were age and dementia. In conclusion, ESBL-producing and MBL-producing Enterobacteriaceae and MRSA were prevalent among the LTCF residents and staff, but less so in the hospital geriatric unit. Education of LTCF employees and better infection control are proposed to minimize the spread of resistant bacteria in the facility. © 2009 The Authors. Journal Compilation © 2009 European Society of Clinical Microbiology and Infectious Diseases. Source


Sleghel F.,Reparto di Geriatria | Aschbacher R.,Laboratorio Aziendale Of Microbiologia E Virologia | Boettcher A.,Reparto di Geriatria | Knottner M.,Reparto di Geriatria | And 3 more authors.
Giornale di Gerontologia | Year: 2013

Introduction. Long-term-care facilities (LTCFs) are reservoirs of resistant bacteria. We undertook a point-prevalence survey and risk factor analysis for specific resistance types among residents and staff of a Bolzano LTCF and among geriatric unit patients in the associated acute-care hospital. Methods. Urine samples and rectal, inguinal, oropharyngeal and nasal swabs were plated on chromogenic agar. Demographic data were collected. Results. Of the 111 LTCF residents, 74.8% were colonized with ≥ 1 resistant organism, 64% with extended-spectrum beta-lactamase (ESBL) producers, 38.7% with methicillin-resistant Staphylococcus aureus (MRSA), 6.3% with metallo-beta-lactamase (MBL) producers, and 2.7% with vancomycin-resistant enterococci. Corresponding rates for LTCF staff were 27.5%, 14.5%, 14.5%, 1.5% and 0%, respectively. Colonization frequencies for geriatric unit patients were lower than for those in the LTCF. Risk factors for colonization of LTCF residents with resistant bacteria included age ≥ 86 years, antibiotic treatment in the previous 3 months, indwelling devices, chronic obstructive pulmonary disease, physical disability, but also LTCF unit. Risk factors for geriatric unit patients were age and dementia. Discussion. In conclusion, ESBL-producing and MBL-producing Enterobacteriaceae and MRSA were prevalent among the LTCF residents and staff, but less so in the hospital geriatric unit. Education of LTCF employees and better infection control are proposed to minimize the spread of resistant bacteria in the facility. Source


March A.,Reparto di Geriatria | Aschbacher R.,Laboratorio Aziendale Of Microbiologia E Virologia | Pagani E.,Laboratorio Aziendale Of Microbiologia E Virologia | Sleghel F.,Reparto di Geriatria | And 7 more authors.
Scandinavian Journal of Infectious Diseases | Year: 2014

Background: In 2012 we undertook a screening study for Enterobacteriaceae with extended-spectrum β-lactamases (ESBLs), derepressed or acquired high-level AmpC cephalosporinases, and metallo-β-lactamases (MBLs), and also methicillin-resistant Staphylococcus aureus (MRSA), in a long-term care facility (LTCF1) and the associated acute care hospital geriatric ward in Bolzano, northern Italy. The study followed up an initial survey carried out in LTCF1 in 2008. For comparison, screening in 2012 was extended to a second LTCF. Methods: Urine samples and rectal, inguinal, oropharyngeal, and nasal swabs were plated on selective agars. Isolates were typed by pulsed-field gel electrophoresis. Resistance genes and Escherichia coli belonging to ST131 were sought by PCR. Demographic data were collected. Results: Fewer residents of LTCF1 were colonized with multidrug-resistant (MDR) bacteria in 2012: all MDR organisms, 53.8% vs 74.8% in 2008; ESBL producers, 49.0% vs 64.0% in 2008; MRSA, 13.2% vs 38.7% in 2008; only 2 MBL-producers were isolated in 2012 vs 8 in 2008. Colonization of staff in LTCF1 by MDR bacteria had also decreased (overall 10.5% in 2012 vs 27.5% in 2008). Changed case mixes and risk factors, together with strengthened hygiene measures probably underlie the changes. Colonization proportions in 2012 in LTCF2 were similar to those in LTCF1. By contrast there was no significant change in the proportion of patients colonized by MDR bacteria in the geriatric ward (22.2% in 2008 vs 22.7% in 2012). Conclusions: A significant decrease in the proportions of staff and residents of an LTCF colonized by MDR bacteria was observed over a 4-y interval. © 2014 Informa Healthcare. Source

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