ABSTRACT
The emergence of resistance to multiple antimicrobial agents in pathogenic bacteria is a significant public health threat, as there are limited effective antimicrobial agents for infections caused by multidrug-resistant (MDR) bacteria. Several MDR bacteria are now frequently detected. Carbapenem resistance in Enterobacteriaceae is often plasmid mediated, necessitating stringent infection control practices. Wedescribe an outbreak of carbapenem-resistant Providencia rettgeri involving 4 patients admitted to intensive care and high-care units at a tertiary hospital. Clinical and demographic characteristics of 4 patients with carbapenem-resistant P. rettgeri were documented. All P. rettgeri isolated in these cases had a carbapenem-resistant antibiogram, with resistance to imipenem, ertapenem and meropenem. These cases could be epidemiologically linked. A multiprong approach, simultaneously targeting antibiotic stewardship, universal precautions and appropriate transmission-based precaution practices, is integral to prevention and control of nosocomial infections.
Subject(s)
Carbapenems/therapeutic use , Cross Infection/epidemiology , Disease Outbreaks , Drug Resistance, Bacterial , Enterobacteriaceae Infections/epidemiology , Providencia/physiology , Urinary Tract Infections/epidemiology , Wound Infection/epidemiology , Adult , Coinfection/epidemiology , Cross Infection/drug therapy , Cross Infection/microbiology , Enterobacteriaceae Infections/drug therapy , Enterobacteriaceae Infections/microbiology , Female , HIV Infections/epidemiology , Humans , Male , Microbial Sensitivity Tests , Pressure Ulcer/epidemiology , Pressure Ulcer/microbiology , South Africa , Tertiary Care Centers , Urinary Tract Infections/drug therapy , Urinary Tract Infections/microbiology , Wound Infection/drug therapy , Wound Infection/microbiologyABSTRACT
Morphofunctional equivalents of the process of long-term intracellular prokaryotes--eukaryotes interaction were studied by light and electron microscopy. The mechanisms for adaptation, elaborated in the course of evolution of bacteria-host interaction, were analysed on the ultrastructural level. A concept on the role of hypothalamic nonapeptides, as factors of regulation of intracellular persistence and symbiosis of prokaryotes, is discussed.