Publications by authors named "Vered Schechner"

Carbapenem-resistant (CRAB) is an important threat to hospitalized patients. The virulence of varies between strains and geographic locations, which is believed to be related to its genetic plasticity. A comprehensive evaluation of virulence factor (VF) content of CRAB across genetically related clones is lacking.

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Objectives: To compare the case-fatality rate (CFR) following bacteremia caused by Staphylococcus aureus or Escherichia coli between acute care hospitals in Israel, Israel and estimates from published meta-analyses, and Israel and England.

Methods: This epidemiologic assessment used nationwide data from Israel and England and meta-analyses. We included all patients with S.

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BackgroundPost-acute care hospitals (PACH) may act as regional reservoirs for multidrug-resistant organisms.AimWe aimed to investigate the prevalence of carbapenem-resistant (CRAB) carriers and identify risk factors for CRAB carriage in PACH.MethodsWe conducted a point prevalence survey in 18 PACH in Israel from June to December 2021.

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We evaluated whether skin sampling with E-swabs is an effective alternative to pre-moistened sponges for detecting carbapenem-resistant Acinetobacter baumannii (CRAB) carriage. Skin samples were collected by sponges with enrichment and E-swabs with and without enrichment. We collected 899 samples (from 250 patients); 191 samples were CRAB positive.

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Background: We examined temporal trends in carbapenem-resistant (CRAB) infections in a hospital with hyperendemic CRAB and assessed the efficacy of varied infection control strategies in different ward types.

Methods: We retrospectively analyzed all CRAB clinical samples from 2006 to 2019 and categorized infections as hospital-onset (HO) or community-onset. We used interrupted time series analysis to assess the impact of interventions on the incidence of all HO-CRAB infections and bloodstream infections (BSIs) at the hospital and ward group levels.

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Article Synopsis
  • Rapid and efficient infection control is essential during outbreaks of carbapenem-resistant Enterobacterales, with FTIR spectroscopy emerging as a promising alternative to the costly and complex WGS.
  • A study investigated an outbreak of OXA-48-producing E. coli by using FTIR to determine the relatedness of isolates in real-time and confirmed findings with WGS.
  • Results showed that FTIR successfully identified the outbreak cluster's genetic similarities and differences among isolates, suggesting its value as a quick, reliable tool for real-time outbreak investigations.
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Our study's results provide promising evidence for the incorporation of a high-sensitivity carbapenem-resistant (CRAB) screening method in healthcare settings. Such an approach could prove beneficial in enhancing infection prevention and control measures, leading to improved patient outcomes and potentially alleviating the burden of CRAB in healthcare systems.

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Beta-lactam resistance can lead to increased mortality, higher healthcare expenses, and limited therapeutic options. The primary mechanism of beta-lactam resistance is the production of extended-spectrum beta-lactamases (ESBL) and AmpC beta-lactamases. The spread of beta-lactamase-producing via the food chain may create a resistance reservoir.

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(Ab) bloodstream infections (BSIs) are a major public health concern and associated with high mortality. We describe the nationwide incidence, antimicrobial resistance, and mortality of Ab-BSI in Israel using laboratory-based BSI surveillance data from January 2018 to December 2019. During the study period, there were 971 Ab-BSI events (508 in 2018 and 463 in 2019), with an average annual incidence of 8.

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The environment surrounding 30 of 31 carriers of carbapenem-resistant (CRAB) was contaminated by CRAB. The environmental CRAB loads were similar whether carriers were identified only by surveillance cultures (nonclinical carriers) or also had positive clinical cultures. Screening to detect and isolate nonclinical CRAB carriers may be important to prevent CRAB transmission.

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We report 2 outbreaks of genetically unrelated carbapenem-resistant New Delhi metallo-β-lactamase-producing caused by contaminated duodenoscopes. Using endoscopes with disposable end caps, adherence to the manufacturer's reprocessing instructions, routine audits, and manufacturer evaluation are critical in preventing such outbreaks.

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Background: We sought to determine incidence of common hospital-acquired bacteria among coronavirus disease 2019 (COVID-19) patients in Israeli general hospitals during the first year of the pandemic.

Methods: We analyzed routinely collected incidence data to determine hospital acquisition of the following sentinel bacteria: e, , , , , , , and . We examined 3 acquisition measures: (1) sentinel bacteria, (2) sentinel bacteremia, and (3) antimicrobial-resistant sentinel bacteremia.

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Background: The incidence of Escherichia coli bloodstream infections (BSI) is high and increasing. We aimed to describe the effect of season and temperature on the incidence of E. coli BSI and antibiotic-resistant E.

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Background: Limited data exist on long-term consequences of bloodstream infections (BSIs). We aimed to examine incidence, 1-year mortality, and years of potential life lost (YPLL) following BSI. We estimated the relative contribution of hospital-onset BSI (HO-BSI) and antibiotic-resistant BSI to incidence, mortality and YPLL.

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Nationwide studies on hospital-onset bloodstream infections (HO-BSIs) are scarce. To describe incidence, mortality and antimicrobial resistance (AMR) of HO-BSI caused by eight sentinel bacteria in Israel, we used laboratory-based BSI surveillance data from 1 January 2018 to 31 December 2019. All hospitals reported positive blood cultures growing , , , , , , and .

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Among 46 infants colonized with vancomycin-resistant during an outbreak in a neonatal intensive care unit, the estimated time until half had achieved clearance was 217 days. All 40 infants who completed follow-up cleared carriage by 1 year. No predictors of prolonged carriage (> 6 months) were identified.

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Colistin dependent (CD) isolates are dependent on colistin for optimal growth. Here we aimed to systematically determine the emergence of CD among colistin-heteroresistant carbapenem-resistant (CRAB) isolates. We also examined the phenotypic characteristics of CD and the evolution of CD strains to overt resistance.

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Objectives: Escherichia coli is the leading cause of bloodstream infection (BSI). The incidence of E. coli BSI caused by antibiotic-resistant strains is increasing.

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Absract: BACKGROUND: To describe the course and intervention of an hospital-wide IMI-Producing Enterobacter ludwigii outbreak.

Methods: This was an outbreak interventional study, done at a tertiary care center in Tel-Aviv, Israel. Data was collected on the course of the outbreak and the demographic and clinical characteristics of all patients involved in the outbreak.

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Background: In June 2018, the Ministry of Health received notification from 2 hospitals about 2 patients who presented with overwhelming sepsis that developed within 24 hours after a dental procedure. We describe the investigation of this outbreak.

Methods: The epidemiologic investigation included site visits in 2 dental clinics and interviews with all involved healthcare workers.

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Background: Hospital-acquired diarrhoea (HAD) and Clostridioides difficile infection (CDI) may be triggered by antibiotic use.

Objectives: To determine the effect of specific antibiotic agents and duration of therapy on the risk of HAD and CDI.

Patients And Methods: A single-centre retrospective cohort study was conducted between May 2012 and December 2014 in the internal medicine division.

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Infections caused by extended-spectrum beta-lactamase-producing (ESBL-KP) are on a constant rise and are a noted cause of outbreaks in neonatal intensive care units (NICUs). We used whole genome sequencing (WGS) to investigate the epidemiology of consecutive and overlapping outbreaks caused by ESBL-KP in NICUs in three hospitals in close proximity. Clonality of 43 ESBL-KP isolates from 40 patients was determined by BOX-PCR.

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Objective: To describe the containment of a widespread silent outbreak of vancomycin-resistant Enterococcus faecium (VRE-fm) in the Tel-Aviv Medical Center (TASMC) neonatal intensive care unit (NICU).

Methods: Setting - an NICU, participants - 49 cases of VRE-fm-colonized neonatal inpatients.

Results: A newborn was transferred from the TASMC NICU to another hospital and screened positive for VRE-fm upon arrival.

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Objective: We evaluated environmental contamination by carbapenem-resistant Acinetobacter baumannii (CRAB), the effectiveness of cleaning practices, the performance of aerosolized hydrogen-peroxide (aHP) technology, and the correlation between measures of cleaning and environmental contamination.

Design: Serial testing of environmental contamination during a 7-month period.

Setting: Single-patient rooms in intensive care units (ICUs) and multipatient step-up and regular rooms in internal medicine wards in a tertiary-care hospital with endemic CRAB.

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Background: Management of partially-treated, community-acquired bacterial meningitis (PCBM) is commonly compromised by lack of microbiological diagnosis. We aimed to analyze the impact of FilmArray Meningitis-Encephalitis (FA-ME) PCR on the management of PCBM.

Methods: Comparison of treatment variables of PCBM cases between two periods, before (6.

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