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Epidemiologie von und Präventionsmaßnahmen bei multiresistenten Erregern

Epidemiology of and preventive measures for multiresistant pathogens

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Zusammenfassung

Multiresistente Erreger (MRE) nehmen weltweit zu. Die häufigsten MRE sind methicillinresistente S. aureus, gefolgt von vancomycinresistenten Enterokokken und ESBL (Extended-Spectrum β-Lactamase)-bildenden Erregern. Letztere spielen in der Augenheilkunde bisher keine große Rolle. MRE können schwere Infektionen verursachen und sind bei der empirischen Therapie nosokomialer Infektionen zu bedenken. Um die weitere Ausbreitung zu vermeiden, müssen Standard- und spezielle Hygienemaßnahmen eingehalten und ein gezieltes Antibiotikamanagement durchgeführt werden.

Abstract

Multidrug-resistant organisms (MROs) are increasing all over the world. The most important MROs are methicillin-resistant S. aureus, followed by vancomycin-resistant enterococci and extended-spectrum β-lactamase (ESBL)-producing bacteria. The latter are not yet of much importance in ophthalmology. MROs can cause serious infections and must be considered in empiric therapy of nosocomial infections. To prevent further spread, standard and contact precautions have to be followed, and antibiotic stewardship needs to be introduced.

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Literatur

  1. Arpin C, Rogues AM, Kabouche S et al (2000) Prospective survey of colonization and infection caused by SHV-4 producing Klebsiella pneumoniae in a neurosurgical intensive care unit. Epidemiol Infect 124(3):401–408

    Article  CAS  PubMed  Google Scholar 

  2. Austin DJ, Bonten MJ, Weinstein RA et al (1999) Vancomycin-resistant enterococci in intensive-care hospital settings: transmission dynamics, persistence and the impact of infection control programs. Proc Natl Acad Sci U S A 96(12):6908–6913

    Article  CAS  PubMed  Google Scholar 

  3. Barber M (1961) Methicillin-resistant staphylococci. J Clin Pathol 14:385–393

    Article  CAS  PubMed  Google Scholar 

  4. Bialasiewics AA, Welt R (1991) Präoperative mikrobiologische Diagnostik vor elektiven intraokularen Eingriffen und Infektionsprophylaxe mit Tobramycin-Augentropfen. Ergebnis einer multizentrischen Studie. Klin Monatsbl Augenheilkd 198:87–93

    Article  Google Scholar 

  5. Blomquist PH (2006) Methicillin-resistant Staphylococcus aureus infections of the eye and orbit (an American Ophthalmological Society thesis). Trans Am Ophthalmol Soc 104:322–345

    PubMed  Google Scholar 

  6. Bonten MJ, Hayden MK, Nathan C et al (1996) Epidemiology of colonisation of patients and environment with vancomycin-resistant enterococci. Lancet 348(9042):1615–1619

    Article  CAS  PubMed  Google Scholar 

  7. Bonten MJ, Mascini EM, Willems R et al (2000) Wat te doen als men vancomycineresistente enterokokken aantreeft? Ned Tijdschr Geneeskd 144(53):2545–2549

    CAS  PubMed  Google Scholar 

  8. Boyce JM (2002) Understanding and controlling methicillin-resistant Staphylococcus aureus infections. Infect Control Hosp Epidemiol 23(9):491–494

    Article  Google Scholar 

  9. Boyce JM, Havill NL, Kohan C et al (2004) Do infection control measures work for methicillin-resistant Staphylococcus aureus? Infect Control Hosp Epidemiol 25(5):395–401

    Article  PubMed  Google Scholar 

  10. Chuang YY, Huang YC, Lin CH et al (2009) Epidemiological investigation after hospitalising a case with pandrug-resistant Acinetobacter baumannii infection. J Hosp Infect 72(1):30–35

    Article  PubMed  Google Scholar 

  11. Coello R, Glynn JR, Gaspar C et al (1997) Risk factors for developing clinical infection with methicillin-resistant Staphylococcus aureus (MRSA) amongst hospital patients initially only colonized with MRSA. J Hosp Infect 37(1):39–46

    Article  CAS  PubMed  Google Scholar 

  12. Dettenkofer M, Widmer AF, Kern WV (2008) MRSA und andere multiresistente Erreger: ein Problem zunehmend auch in der ambulanten Medizin. Dtsch Med Wochenschr 133(8):370–371

    Article  CAS  PubMed  Google Scholar 

  13. The EARSS Management Team (2008) EARSS Annual Report 2007. http://www.rivm.nl/earss/Images/EARSS%202007_FINAL_tcm61-55933.pdf

  14. Esmaeli B, Holz ER, Ahmadi MA et al (2003) Endogenous endophthalmitis secondary to vancomycin-resistant enterococci infection. Retina 23:118–119

    Article  PubMed  Google Scholar 

  15. Falagas ME, Karageorgopoulos DE (2009) Extended-spectrum beta-lactamase-producing organisms. J Hosp Infect 73(4):345–354

    Article  CAS  PubMed  Google Scholar 

  16. Freidlin J, Acharya N, Lietman TM et al (2007) Spectrum of eye disease caused by methicillin-resistant Staphylococcus aureus. Am J Ophthalmol 144(2):313–315

    Article  PubMed  Google Scholar 

  17. Grundmann H, Aires-de-Sousa M, Boyce J, Tiemersma E (2006) Emergence and resurgence of methicillin-resistant Staphylococcus aureus as a public-health threat. Lancet 368(9538):874–885

    Article  PubMed  Google Scholar 

  18. Haley RW, Hightower AW, Khabbaz RF et al (1982) The emergence of methicillin-resistant Staphylococcus aureus infection in United States hospitals. Possible role of the house staff-patient transfer circuit. Ann Intern Med 97:297–308

    CAS  PubMed  Google Scholar 

  19. Hanberger H, Arman D, Gill H et al (2009) Surveillance of microbial resistance in European Intensive Care Units: a first report from the Care-ICU programme for improved infection control. Intensive Care Med 35(1):91–100

    Article  PubMed  Google Scholar 

  20. Heeg P, Schröppel K (2009) Infektionen durch Methicillin-resistente Staphylococcus aureus (MRSA). Med Klin 104(6):464–473

    Article  CAS  Google Scholar 

  21. Horio N, Horiguchi M, Murakami K et al (2000) Stenotrophomonas maltophilia endophthalmitis after intraocular lens implantation. Graefes Arch Clin Exp Ophthalmol 238(4):299–301

    CAS  PubMed  Google Scholar 

  22. Huang SS, Platt R (2003) Risk of methicillin-resistant Staphylococcus aureus infection after previous infection or colonization. Clin Infect Dis 36(3):281–285

    Article  PubMed  Google Scholar 

  23. Huang SS, Yokoe DS, Hinrichsen VL et al (2006) Impact of routine intensive care unit surveillance cultures and resultant barrier precautions on hospital-wide methicillin-resistant Staphylococcus aureus bacteremia. Clin Infect Dis 43(8):971–978

    Article  PubMed  Google Scholar 

  24. Huycke MM, Sahm DF, Gilmore MS (1998) Multiple-drug resistant enterococci: the nature of the problem and an agenda for the future. Emerg Infect Dis 4:239–249

    Article  CAS  PubMed  Google Scholar 

  25. Jevons MP (1961) Celbenin-resistant staphylococci. BMJ 1:124–125

    Article  Google Scholar 

  26. Leclerq R (2009) Epidemiological and resistance issues in multidrug-resistant staphylococci and enterococci. Clin Microbiol Infect 15:224–231

    Article  Google Scholar 

  27. Lister PD, Wolter DJ, Hanson ND (2009) Antibacterial-resistant pseudomonas aeruginosa: Clinical impact and complex regulation of chromosomally encoded resistance mechanisms. Clin Microbiol Rev 22(4):582–610

    Article  CAS  PubMed  Google Scholar 

  28. Maguen E, Morgan MA (2007) A case of Vancomycin-resistant enterococcus conjunctivitis and its clinically successful topical treatment. Cornea 26:223–224

    Article  PubMed  Google Scholar 

  29. Mangini E, Segal-Maurer S, Burns J et al (2007) Impact of contact and droplet precautions on the incidence of hospital-acquired methicillin-resistant Staphylococcus aureus infection. Infect Control Hosp Epidemiol 28(11):1261–1266

    Article  PubMed  Google Scholar 

  30. Mascini EM, Bonten MJ (2005) Vancomycin-resistant enterococci: consequences for therapy and infection control. Clin Microbiol Infect 11(Suppl 4):43–56

    Article  CAS  PubMed  Google Scholar 

  31. Ofner-Agostini M, Varia M, Johnston L et al (2007) Infection control and antimicrobial restriction practices for antimicrobial-resistant organisms in Canadian tertiary care hospitals. Am J Infect Control 35(9):563–568

    Article  PubMed  Google Scholar 

  32. Patel JB, Gorwitz RJ, Jernigan JA (2009) Mupirocin resistance. Clin Infect Dis 49(6):935–941

    Article  CAS  PubMed  Google Scholar 

  33. Paterson DL, Mulazimoglu L, Casellas JM et al (2000) Epidemiology of ciprofloxacin resistance and its relationship to extended-spectrum beta-lactamase production in Klebsiella pneumoniae isolates causing bacteremia. Clin Infect Dis 30(3):473–478

    Article  CAS  PubMed  Google Scholar 

  34. Peña C, Pujol M, Ricart A et al (1997) Risk factors for faecal carriage of Klebsiella pneumoniae producing extended spectrum beta-lactamase (ESBL-KP) in the intensive care unit. J Hosp Infect 35(1):9–16

    Article  PubMed  Google Scholar 

  35. Perencevich EN, Fisman DN, Lipsitch M et al (2004) Projected benefits of active surveillance for vancomycin-resitant enterococci in intensive care units. Clin Infect Dis 38(8):1108–1115

    Article  PubMed  Google Scholar 

  36. Peters G, Becker K (1996) Epidemiology, control and treatment of methicillin-resistant Staphylococcus aureus. Drugs 52(Suppl 2):50–54

    Article  PubMed  Google Scholar 

  37. Rathod D, Lugmani N, Webber SK, Hosein IK (2009) Survey of Methicillin-resistant Staphylococcus aureus policies in UK eye departments. J Hosp Infect 72(4):314–318

    Article  CAS  PubMed  Google Scholar 

  38. Roghmann MC, McCarter RJ Jr, Brewrink J et al (1997) Clostridium difficile infection is a risk factor for bacteremia due to vancomycin-resistant enterococci (VRE) in VRE-colonized patients with acute leukemia. Clin Infect Dis 25(5):1056–1059

    Article  CAS  PubMed  Google Scholar 

  39. Schulze-Röbbecke R (2009) Standardmaßnahmen zur Prävention der Übertragung nosokomialer Infektionen – Standardhygiene, Basishygiene. Krankenhaushygiene up2date 4(3):193–207

    Article  Google Scholar 

  40. Shanmuganathan VA, Armstrong M, Buller A, Tullo AB (2005) External ocular infections due to Methicillin-resistant Staphylococcus aureus (MRSA). Eye 19(3):284–291

    Article  CAS  PubMed  Google Scholar 

  41. Sievert DM, Rudrik JT, Patel JB et al (2008) Vancomycin-resistant Staphylococcus aureus in the United States, 2002–2006. Clin Infect Dis 46(5):668–674

    Article  CAS  PubMed  Google Scholar 

  42. Solomon R, Donnenfeld ED, Perry HD et al (2007) Methicillin-resistant Staphylococcus aureus infectious keratitis following refractive surgery. Am J Ophthalmol 143(4):629–634

    Article  PubMed  Google Scholar 

  43. Sotozono C, Inagaki K, Fujita A et al (2002) Methicillin-resistant Staphylococcus aureus and methicillin-resistant Staphylococcus epidermidis infections in the cornea. Cornea 21(7Suppl):S94–S101

    Article  PubMed  Google Scholar 

  44. Tang CW, Cheng CK, Lee TS (2007) Community-acquired bleb-related endophthalmitis caused by vancomycin-resistant enterococci. Can J Ophthalmol 42:477–478

    Article  PubMed  Google Scholar 

  45. Tenover FC, Hughes JM (1996) The challenges of emerging infectious diseases: development and spread of multiply resistant bacterial pathogens. JAMA 275:300–304

    Article  CAS  PubMed  Google Scholar 

  46. Rijen M van, Bonten M, Wenzel R, Kluytmans J (2008) Mupirocin ointment for preventing Staphylococcus aureus infections in nasal carriers. Cochrane Database Syst Rev 4:CD006216

    PubMed  Google Scholar 

  47. Voss A, Loeffen F, Bakker J et al (2005) Methicillin-resitant Staphylococcus aureus in pig farming. Emerg Infect Dis 11:1965–1966

    PubMed  Google Scholar 

  48. Wisplinghoff H, Bischoff T, Talient SM et al (2004) Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis 39(3):309–317

    Article  PubMed  Google Scholar 

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Danksagung

Wir danken Herrn Jos Monen vom EARSS-Management-Team für die freundliche Bereitstellung der aktuellen Grafiken zur Antibiotikaresistenzentwicklung in Europa.

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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Authors and Affiliations

  1. Deutsches Beratungszentrum für Hygiene, Schnewlinstr. 10, 79098, Freiburg im Breisgau, Deutschland

    E.-B. Kruse

  2. Institut für Umweltmedizin und Krankenhaushygiene, Universitätsklinikum Freiburg, Freiburg, Deutschland

    M. Dettenkofer

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  2. M. Dettenkofer
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Correspondence to E.-B. Kruse.

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Kruse, EB., Dettenkofer, M. Epidemiologie von und Präventionsmaßnahmen bei multiresistenten Erregern. Ophthalmologe 107, 313–317 (2010). https://doi.org/10.1007/s00347-009-2074-2

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