The spectrum of bacteria and mechanisms of resistance identified from the casualties treated in the Israeli field hospital after the earthquake in Nepal, 2015: A retrospective analysis.


Journal

Travel medicine and infectious disease
ISSN: 1873-0442
Titre abrégé: Travel Med Infect Dis
Pays: Netherlands
ID NLM: 101230758

Informations de publication

Date de publication:
Historique:
received: 15 11 2019
revised: 04 04 2020
accepted: 24 04 2020
pubmed: 1 5 2020
medline: 21 8 2021
entrez: 1 5 2020
Statut: ppublish

Résumé

On the April 25, 2015, a 7.8 magnitude earthquake struck Nepal. Soon-after, the Israel Defense Force (IDF) dispatched a tertiary field-hospital to Kathmandu. The field-hospital was equipped with a clinical laboratory with microbiology capabilities. Limited data exists regarding the spectrum of bacteria isolated from earthquake casualties. We aimed to identify the spectrum of bacteria and their mechanisms of resistance in-order to allow preparedness of antibiotic treatment protocols for future disaster scenarios. - The field-laboratory phenotypically processed cultures from sterile and non-sterile sites as needed clinically. Later-on, the isolates were brought to Israel for quality control, definite identification and molecular characterization including mechanisms of resistance. A total of 82 clinical pathogens were isolated from 56 patients; 68% of them were Gram negative bacilli. The most common isolates were Enterobacteriaceae (55%) -36% carried bla- - Gram negative bacteria were the predominant organism cultured from the casualties, of them 77% were MDR or XDR. NDM was the most common resistance mechanism. The Antibiotic inventory of a field-hospital should be set to cover a wide and unexpected spectrum of bacteria, including resistant organisms. This report adds important information to the scarce reports of bacterial resistance in Nepal.

Sections du résumé

BACKGROUND
On the April 25, 2015, a 7.8 magnitude earthquake struck Nepal. Soon-after, the Israel Defense Force (IDF) dispatched a tertiary field-hospital to Kathmandu. The field-hospital was equipped with a clinical laboratory with microbiology capabilities. Limited data exists regarding the spectrum of bacteria isolated from earthquake casualties. We aimed to identify the spectrum of bacteria and their mechanisms of resistance in-order to allow preparedness of antibiotic treatment protocols for future disaster scenarios.
METHODS
- The field-laboratory phenotypically processed cultures from sterile and non-sterile sites as needed clinically. Later-on, the isolates were brought to Israel for quality control, definite identification and molecular characterization including mechanisms of resistance.
RESULTS
A total of 82 clinical pathogens were isolated from 56 patients; 68% of them were Gram negative bacilli. The most common isolates were Enterobacteriaceae (55%) -36% carried bla-
CONCLUSIONS
- Gram negative bacteria were the predominant organism cultured from the casualties, of them 77% were MDR or XDR. NDM was the most common resistance mechanism. The Antibiotic inventory of a field-hospital should be set to cover a wide and unexpected spectrum of bacteria, including resistant organisms. This report adds important information to the scarce reports of bacterial resistance in Nepal.

Identifiants

pubmed: 32353631
pii: S1477-8939(20)30175-7
doi: 10.1016/j.tmaid.2020.101707
pii:
doi:

Substances chimiques

Anti-Bacterial Agents 0
beta-Lactamases EC 3.5.2.6

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

101707

Informations de copyright

Copyright © 2020 Elsevier Ltd. All rights reserved.

Auteurs

Tamar Lachish (T)

The Infectious Diseases Unit and the Internal Medicine Ward, Shaare-Zedek Medical Center, Jerusalem, Affiliated with the Hebrew University, Israel; Israel Defense Forces Medical Corps, Tel-Hashomer, Israel. Electronic address: lachisht@szmc.co.il.

Tami Halperin (T)

Israel Defense Forces Medical Corps, Tel-Hashomer, Israel.

Olga Snitser (O)

Israel Defense Forces Medical Corps, Tel-Hashomer, Israel.

Livnat Kashat (L)

Clinical Microbiology Laboratory, Shaare-Zedek Medical Center, Affiliated with the Hebrew University School of Medicine, Jerusalem, Israel.

Ofer Merin (O)

Israel Defense Forces Medical Corps, Tel-Hashomer, Israel; The Trauma Unit, Shaare-Zedek Medical Center, Affiliated with the Hebrew University, Jerusalem, Israel.

Tarif Bader (T)

Israel Defense Forces Medical Corps, Tel-Hashomer, Israel; Department of Military Medicine, Hebrew University, Jerusalem, Israel.

Assaf Rokney (A)

Government Central Laboratories, Ministry of Health, Jerusalem, Israel.

Eli Schwartz (E)

Israel Defense Forces Medical Corps, Tel-Hashomer, Israel; The Center for Geographic Medicine, The Chaim Sheba Medical Center, Tel-Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

Marc Victor Assous (MV)

Clinical Microbiology Laboratory, Shaare-Zedek Medical Center, Affiliated with the Hebrew University School of Medicine, Jerusalem, Israel.

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Classifications MeSH