[The microbiology laboratory's contribution to the surveillance and control of outbreaks caused by nonfermentative Gram-negative bacilli].
ABSTRACT Pseudomonas aeruginosa, Acinetobacter baumannii and Stenotrophomonas maltophilia are, among others, the most important nonfermentative Gram-negative bacilli within hospitals. These organisms are able to cause different types of nosocomial infections in predisposed patients, and P. aeruginosa and A. baumannii in particular may cause extensive clonal outbreaks and complex situations in which sporadic isolates may coexist with some epidemic strains. Some common features are their intrinsic resistance to many antimicrobials, their capacity to further develop antimicrobial resistance, and the possibility of environmental reservoirs as sources of these microorganisms in healthcare centers. The microbiology laboratory plays a key role in the detection of potential outbreaks, in the identification of new resistance mechanisms and in the characterization of local epidemiology, by detecting colonized patients and/or environmental reservoirs if needed, appropriately identifying the isolates, phenotypically or genotypically characterizing their mechanisms of resistance, if appropriate, and finally by using different molecular techniques for clonal typing, which are reviewed in this article. Such activities must be performed in the context of the surveillance and control programs of specific institutions and as part of the daily work of multidisciplinary infection control teams.
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ABSTRACT: Healthcare-associated infections due to multidrug-resistant Gram-negative bacteria (MDR-GNB) are a leading cause of morbidity and mortality worldwide. These evidence-based guidelines have been produced after a systematic review of published studies on infection prevention and control interventions aimed at reducing the transmission of MDR-GNB. The recommendations are stratified by type of infection prevention and control intervention and species of MDR-GNB and are presented in the form of 'basic' practices, recommended for all acute care facilities, and 'additional special approaches' to be considered when there is still clinical and/or epidemiological and/or molecular evidence of ongoing transmission, despite the application of the basic measures. The level of evidence for and strength of each recommendation, were defined according to the GRADE approach.Clinical Microbiology and Infection 01/2014; 20 Suppl 1:1-55. · 4.58 Impact Factor