Sample records for cefuroxime

  1. Clinical and diagnostic features of perioperative hypersensitivity to cefuroxime

    Christiansen, I S; Krøigaard, M; Mosbech, H; Skov, P S; Poulsen, L K; Garvey, L H


    INTRODUCTION: The Danish Anaesthesia Allergy Centre (DAAC) investigated 89 adult patients with suspected perioperative cefuroxime-associated hypersensitivity reactions between 2004 and 2013. The goals were to determine if the time to index reaction after cefuroxime exposure could be used to...... implicate cefuroxime as the cause of the reactions and explore different test modalities in diagnosing cefuroxime hypersensitivity. METHOD: Skin tests, in vitro tests, and titrated provocations were used to determine cefuroxime hypersensitivity. Patients were deemed cefuroxime positive on the basis of at...... patients reacted in < 15 minutes versus only 38/58 (65.5%) of negative patients. CONCLUSION: All patients with confirmed hypersensitivity to cefuroxime reacted within 15 minutes of administration, but so did 65.5% of cefuroxime negative patients, making timing of administration an unreliable predictor of...

  2. Effects of Implant-Associated Osteomyelitis on Cefuroxime Bone Pharmacokinetics

    Tøttrup, Mikkel; Bue, Mats; Koch, Janne;


    Background: The prolonged antibiotic therapy that is often needed for successful management of osteomyelitis may be related to incomplete penetration of antibiotics into the target site. The objective of this study was to assess the effects of implant-associated osteomyelitis on cefuroxime...... penetration into bone. Methods: Implant-associated osteomyelitis using a Staphylococcus aureus strain was induced in the right tibia in ten pigs. After five days and following administration of 1500 mg of cefuroxime, measurements of cefuroxime were obtained using microdialysis for eight hours in the implant...... cavity up to MICs of 2 mg/L compared with the other tissues, but the time was shorter for higher MICs. Conclusions: Cefuroxime penetration into infected cancellous bone was incomplete but comparable with that in healthy bone. The destructive bone processes associated with acute osteomyelitis reduced...

  3. The half-life and exposure of Cefuroxime varied in newborn infants after a Caesarean section

    Zachariassen, G; Hyldig, N; Joergensen, J S;


    AIM: No information was available on how fast intravenous cefuroxime administered to pregnant women before a Caesarean section was cleared in newborn infants. This study investigated the drug's half-life and the exposure of healthy newborn infants after their mothers received the drug. METHODS......: Healthy mothers received a single dose of cefuroxime 15 to 60 minutes before skin incision. One blood sample was drawn from the umbilical cord and two blood samples were drawn from the infant after delivery. Total plasma cefuroxime (μg/ml) was measured using high-pressure liquid chromatography. RESULTS......: Cefuroxime was given to 22 mothers, including two who had twins. The concentration of cefuroxime varied significantly among infants (p<0.001), while the rate of decline did not (p=0.24). The median cefuroxime half-life was 3.5 hours (range 2.9-5.5), which was approximately three times longer than in normal...

  4. Uveitis attack and drug reaction due to cefuroxime axetil.

    Akman, Canan; Duran, Arif; Kalafat, Utku Murat; Ocak, Tarık


    Antibiotics are natural or synthetic substances that are used to control bacterial infections because antibiotics are by definition only effective against bacteria. A 30-year-old female came to our emergency clinic complaining rubor in both eyes, especially in the left eye, with swelling, rubor and pain in ears, and eruption in lips extremities. In her anamnesis, it has been determined that she did not have any medical disease that requires regular utilization of drugs. After the patient received cefuroxime axetil for acute tonsillitis, she observed eruptions in lip extremities on the 3rd day, but she did not care about it. On the 5th day, rubor in both eyes and, especially in the left eye, have been developed, and complaints such as unable to look toward light and pain have started together with swelling, rubor, and pain in both ears. She came to our clinic because she was very much worried about the situation. In this study, we aimed to discuss a drug reaction characterized by face and ear skin observations, due to uveitis after the use of antibiotics including cefuroxime axetil for acute tonsillitis. PMID:26203731

  5. Comparative clinical efficacy of single oral doses of cefuroxime axetil and amoxicillin in uncomplicated gonococcal infections.

    Fong, I W; Linton, W; Simbul, M; Hinton, N A


    Cefuroxime axetil (1.5 g) was compared with amoxicillin (3 g), both given as a single oral dose combined with probenecid (1 g) for the treatment of uncomplicated gonorrhea. Of 60 evaluable patients receiving amoxicillin, 55 (91.7%) were cured, whereas 55 (96.5%) of the 57 patients receiving cefuroxime axetil were cured (P greater than 0.1). Both drugs were well tolerated.


    F.M. Patel et al


    Full Text Available Cefuroxime is a 2nd-generation cephalosporin and Sulbactam is a β-Lactamase inhibitor. The combination formulation is used for the treatment of lower respiratory tract infection. Two new, simple, accurate and precise UV spectrophotometric methods have been developed and validated for the simultaneous determination of Cefuroxime Sodium (CEF and Sulbactam Sodium (SUL in their combined dosage forms. First method is based on simultaneous estimation of Cefuroxime at 279nm and Sulbactam at 259 nm, while other Q‐absorption Ratio method using two wavelengths, 259nm (λmax of SUL and 272nm (Isoabsorptive point. 0.01 N NaOH was the solvent used in all methods. Cefuroxime Sodium showed linearity in the range of 8-32μg/mL and Sulbactam sodium showed linearity in the range of 4-16μg/mL in all the methods. All methods were validated statistically and recovery studies were carried out. All methods were found to be accurate, precise and reproducible. These methods were applied to the assay of the drugs in marketed formulation, which were found in the range of 98.0% to 100.0% of the labelled value for both Cefuroxime and Sulbactam. Hence, the methods herein described can be successfully applied in quality control of combined pharmaceutical dosage forms.

  7. Determination and correlation of cefuroxime acid solubility in (acetonitrile + water) mixtures

    Highlights: • The solubility of cefuroxime acid in different solvents was experimentally determined. • The experimental solubility data were correlated by three models. • The AIC was used to select the best solubility model. • The thermodynamic properties of cefuroxime acid in solution were obtained. - Abstract: The solubility of cefuroxime acid in (acetonitrile + water) mixtures was experimentally determined at temperatures from (278.15 to 313.15) K by using a dynamic method at atmospheric pressure. The solubility increased with the increasing of temperature, and it reached the maximum at acetonitrile molar fraction of 0.713 at constant temperature. The experimental solubility data were correlated well by using the modified Apelblat equation, the λh equation and the van’t Hoff equation, respectively. The Akaike’s Information Criterion (AIC) was used to select the best model for correlating the solubility of cefuroxime acid. Furthermore, the dissolution enthalpy, entropy and Gibbs free energy change of cefuroxime acid were also calculated by using the van’t Hoff equation

  8. Ocular Toxicity after High-Dose Cefuroxime Injection into the Anterior Chamber

    Harun Çakmak


    Full Text Available Cephalosporins are beta-lactam antibiotics and, like penicillin derivatives, they show bacteriostatic effect by disrupting bacterial cell wall synthesis. Cefuroxime is a second generation cephalosporin and the use of intracameral cefuroxime after cataract surgery has been widely used in the endophthalmitis prophylaxis. A 78-year-old male patient was operated for cataracts in both eyes about 8 years ago. Ocular trauma has occurred in the left eye nine months ago. Vitrectomy surgery combined with intraocular lens extraction was performed and the patient was left aphakic. Secondary intraocular lens implantation was performed. In this paper, we present postoperative ocular findings in a patient who was given cefuroxime into the anterior chamber 2.5 times higher than the recommended dose (25 mg/ml after secondary intraocular lens implantation.

  9. Evaluation of restoration of sensitivities of resistant staphylococcus aureus isolates by using cefuroxime and clavulanic acid in combination

    The present study was planned to observe the activity of cefuroxime, a second generation cephalosporin after combining it with a beta-lactamase inhibitor calvulanic acid. The study was conducted to evaluate the restoration or increase in sensitivity of beta-lactamase producing isolates of Staphylococcus aureus. Staphylococcus aureus were identified by standard procedures. For beta-lactamase detection chromogenic Nitrocefin impregnated sticks were used. The sensitivity of the bacteria to the antibiotic disks was measured by disk diffusion method using standard zone diameter criteria given by National Committee of Clinical Laboratory Standards. The disks of cefuroxime with clavulanic acid had developed larger zones of inhibition. The activity of cefuroxime against Staphylococcus areus was significantly increased by clavulanic acid. Clavulanic acid if used in combination with cefuroxime, can improve the antimicrobial activity of cefuroxime against beta - lactamase producing Staphylococcus aureus. (author)

  10. Agar diffusion tests with cefuroxime disks for predicting ceftriaxone susceptibility among isolates of Streptococcus pneumoniae

    Dias Cícero A.G.


    Full Text Available The performance of agar diffusion tests using disks of cefuroxime (30µg for predicting ceftriaxone susceptibility in 33 isolates of Streptococcus pneumoniae was studied. All 7 resistant isolates to ceftriaxone (MIC ³1.0 µg/ml exhibited zones of inhibition <28mm. The procedure can be easily adapted to clinical laboratories.

  11. Comparative efficacy of amoxicillin, cefuroxime and clarithromycin in the treatment of community acquired pneumonia in children

    Objective: To compare the clinical response to amoxicillin, cefuroxime and clarithromycin in the treatment of community-acquired pneumonia in children and to see the cost effectiveness of each treatment. Subjects and Methods: Patients between 3 to 72 months of age, admitted in the hospital with community acquired pneumonia, were randomly divided into three groups 1,2,3. They were started on amoxicillin, cefuroxime and clarithromycin respectively. The patients were assessed daily. If there was no clinical improvements at 48 hours the antibiotic was changed. ANOVA statistical test was applied to see the clinical response to the treatment in the three groups. Cost effectiveness of the treatment was compared. Results: There was no statistical difference in the clinical response at 48 hours of initiating treatment and discharge (p>0.01 each). The mean hospital stay in group 1 and 2 was 3.3 days and group 3 was 3.2 days respectively (p>0.01). Ninety-seven percent patients in group 1 and 3, and 95% patients in group 2 showed clinical improvement. The cost of treatment of community acquired pneumonia for 8 days was Rs. 496/-, 730/-, 1018/- for amoxicillin, clarithromycin and cefuroxime respectively. Conclusion: Amoxicillin was found in the most cost effective followed by clarithromycin and cefuroxime respectively in the treatment of non-severe and severe community-acquired pneumonia. (author)

  12. Ampicillin/Sulbactam versus Cefuroxime as antimicrobial prophylaxis for cesarean delivery: a randomized study

    Giamarellou Helen


    Full Text Available Abstract Background The efficacy and safety of a single dose of ampicillin/sulbactam compared to a single dose of cefuroxime at cord clamp for prevention of post-cesarean infectious morbidity has not been assessed. Methods Women scheduled for cesarean delivery were randomized to receive a single dose of either 3 g of ampicillin-sulbactam or 1.5 g of cefuroxime intravenously, after umbilical cord clamping. An evaluation for development of postoperative infections and risk factor analysis was performed. Results One hundred and seventy-six patients (median age 28 yrs, IQR: 24-32 were enrolled in the study during the period July 2004 - July 2005. Eighty-five (48.3% received cefuroxime prophylaxis and 91 (51.7% ampicillin/sulbactam. Postoperative infection developed in 5 of 86 (5.9% patients that received cefuroxime compared to 8 of 91 (8.8% patients that received ampicillin/sulbactam (p = 0.6. In univariate analyses 6 or more vaginal examinations prior to the operation (p = 0.004, membrane rupture for more than 6 hours (p = 0.08 and blood loss greater than 500 ml (p = 0.018 were associated with developing a postoperative surgical site infection (SSI. In logistic regression having 6 or more vaginal examinations was the most significant risk factor for a postoperative SSI (OR 6.8, 95% CI: 1.4-33.4, p = 0.019. Regular prenatal follow-up was associated with a protective effect (OR 0.04, 95% CI: 0.005-0.36, p = 0.004. Conclusions Ampicillin/sulbactam was as safe and effective as cefuroxime when administered for the prevention of infections following cesarean delivery. Trial registration identifier: NCT01138852

  13. Perioperative cefuroxime pharmacokinetics in cardiac surgery Farmacocinética da cefuroxima na antibioticoprofilaxia de cirurgia cardíaca

    Jorge Willian Leandro Nascimento; Maria José Carvalho Carmona; Tânia Mara Varejão Strabelli; José Otávio Costa Auler Jr; Sílvia Regina Cavani Jorge Santos


    OBJECTIVE: The objective was to investigate the plasma levels and to compare the pharmacokinetics of cefuroxime during and after surgery in adult patients with elective indication for coronary artery bypass grafting. METHODS: Seventeen patients received three 1.5-g bolus IV doses of cefuroxime, one every 12 hrs. Serial blood samples (3 mL) were collected 1, 3, 6, 9, and 12 hrs after the first dose (given during the intervention) and after the second and third doses (postsurgery). Blood sample...

  14. [Cefuroxime axetil, a new oral cephalosporin for treating infections of the ORL field: clinical synthesis].

    Westphal, J F


    Cefuroxime axetil (C.A.E.) is a broad spectrum cephalosporin, suitable for oral route. Its antibacterial activity includes all the pathogens usually responsible for E.N.T. infection, with low M.I.C.'s: H. influenzae, S. pneumoniae, S. aureus, S. pyogene. The stability of the drug against betalactamases, especially those produced by H. influenzae, associated with good bio availability (50%) and tissue penetration (30%) account for the potent in vivo bactericidal activity and clinical efficacy of cefuroxime axetil. More than 1,000 patients had been enrolled in controlled clinical trials: the success rates yielded by C.A.E. were 98%, 96% and 91%, respectively for pharingitis/tonsilitis, otitis media and acute sinusitis. C.A.E. is at least as effective as amoxycillin/clavulanic acid and safety appears to be better. PMID:2087617

  15. Intragastric floating drug delivery system of cefuroxime axetil: In vitro evaluation

    Patel, Viral F.; Patel, Natavarlal M.


    This investigation describes the development of an intragastric drug-delivery system for cefuroxime axetil. The 32 full factorial design was employed to evaluate contribution of hydroxypropyl methyl cellulose (HPMC) K4M/HPMC K100 LV ratio (polymer blend) and sodium lauryl sulfate (SLS) on drug release from HPMC matrices. Tablets were prepared using direct compression technique. Formulations were evaluated for in vitro buoyancy and drug release study using United States Pharmacopeia (USP) 24 p...

  16. Toxic anterior segment syndrome after uncomplicated cataract surgery possibly associated with intracamaral use of cefuroxime

    Cakir, Burcin


    Burçin Çakir, Erkan Celik, Nilgün Özkan Aksoy, Özlem Bursali, Turgay Uçak, Erdinç Bozkurt, Gursoy AlagozSakarya University Education and Research Hospital, Sakarya, TurkeyPurpose: To report toxic anterior segment syndrome (TASS) after cataract surgery possibly associated with intracameral use of cefuroxime.Methods: We conducted a retrospective chart review and analysis on the pre- and postoperative conditions of the subjec...

  17. Studies on Novel Pantoprazole and Cefuroxime Axetil Tablets for Site Specific Delivery.

    Putta Rajesh Kumar


    In this study core in coat tablets containing enteric coated Pantaprazole (PP) core and Cefuroxime axetil (CA) floating type coat formulation as single unit prepared by compression coating method. The tablets were evaluated for their various pre-compression, compression characteristics, in vitro drug release kinetics and stability studies. The analytical estimation of drugs was found to be accurate and precise. The results of rheological characteristics indicated that, the powder beds of both...

  18. Pharmacokinetics and tolerance of cefuroxime axetil in volunteers during repeated dosing.

    Sommers, D K; van Wyk, M.; Williams, P. E.; Harding, S M


    A total of 158 volunteers each received 21 repeated oral doses of 500 mg of cefuroxime axetil (CAE) during four comparative cross-over trials. Pharmacokinetics were studied in 8 volunteers (CAE versus ampicillin), relative bioavailability and tolerance were studied in 100 volunteers (CAE versus pivmecillinam and CAE versus pivampicillin), and tolerance alone was studied in 50 volunteers (CAE versus ampicillin). Overall, urinary recoveries of the active antibiotics ranked absorption of the dru...

  19. [Treatment of bacterial pneumonias with cefuroxime-axetil. Predictive value of measurement of the in vitro susceptibility].

    Cluzel, R; Portier, H; Modaï, J


    Cefuroxime axetil is an oral cephalosporin with proven efficacy in adult lower respiratory tract infections. Indeed, it has a broad spectrum of activity in vitro, covering most pathogens isolated in this setting and showing good stability in the presence of betalactamases. In vitro susceptibility data are a major element in the choice of antimicrobial agent. The aim of this study was to determine the predictive value of the cefuroxime minimal inhibitory concentration (MIC) on the clinical outcome of infections treated with cefuroxime axetil. One hundred-and-seventeen (117) patients with radiologically confirmed community-acquired pneumonia of presumed bacterial origin were enrolled in a prospective multicenter trial of cefuroxime axetil therapy (500 mg twice daily). The pathogen was identified in 44 patients who were treated for a mean of 8.8 days. Most isolates were S. pneumoniae (65.9%) and H. influenzae (15.9%). The MIC was known for 35 isolates and was < or = 4 micrograms/ml in 30 cases (85.7%). The MIC value was a good predictor of clinical efficacy with a sensitivity of 100%, a specificity of 83% and a positive predictive value of 97%; the latter value indicates that therapeutic success is virtually certain when the bacterium causing pneumonia is susceptible to cefuroxime. PMID:8761613

  20. Toxic anterior segment syndrome after uncomplicated cataract surgery possibly associated with intracamaral use of cefuroxime

    Çakır B; Celik E; Aksoy NÖ; Bursalı Ö; Uçak T; Bozkurt E; Alagoz G


    Burçin Çakir, Erkan Celik, Nilgün Özkan Aksoy, Özlem Bursali, Turgay Uçak, Erdinç Bozkurt, Gursoy AlagozSakarya University Education and Research Hospital, Sakarya, TurkeyPurpose: To report toxic anterior segment syndrome (TASS) after cataract surgery possibly associated with intracameral use of cefuroxime.Methods: We conducted a retrospective chart review and analysis on the pre- and postoperative conditions of the subjects who had developed TASS.Re...

  1. Effectiveness of penicillin, dicloxacillin and cefuroxime for penicillin-susceptible Staphylococcus aureus bacteraemia

    Nissen, Jette Lindbjerg; Skov, Robert; Knudsen, Jenny Dahl;


    OBJECTIVES: Penicillin-susceptible Staphylococcus aureus isolates account for a fifth of cases of S. aureus bacteraemia (SAB) in Denmark, but little is known about treatment outcomes with penicillins or other antimicrobials. Here we compare penicillin, dicloxacillin and cefuroxime as definitive...... treatments in relation to 30 day mortality. METHODS: A retrospective chart review of 588 penicillin-susceptible S. aureus cases at five centres from January 1995 to December 2010. Data on demographics, antimicrobial treatment, clinical signs and symptoms, and mortality at day 30 were collected. Hazard ratios...

  2. Toxic anterior segment syndrome after uncomplicated cataract surgery possibly associated with intracamaral use of cefuroxime

    Çakır B


    Full Text Available Burçin Çakir, Erkan Celik, Nilgün Özkan Aksoy, Özlem Bursali, Turgay Uçak, Erdinç Bozkurt, Gursoy AlagozSakarya University Education and Research Hospital, Sakarya, TurkeyPurpose: To report toxic anterior segment syndrome (TASS after cataract surgery possibly associated with intracameral use of cefuroxime.Methods: We conducted a retrospective chart review and analysis on the pre- and postoperative conditions of the subjects who had developed TASS.Results: The patient group consisted of 17 patients. Tyndallization and fibrin fibers were positive in all eyes. In four eyes, hypopyon formation developed. These reactions diminished on the third day and fully resolved 1 week after the operations with the use of intensive topical steroid and mydriatic therapy. To determine the etiology of TASS, infusion fluid, viscoelastics, and intracameral antibiotic agent were changed respectively. After changing intracameral antibiotic agent from cefuroxime axetile to moxifloxacin no new cases of TASS were diagnosed.Conclusion: All agents injected into the anterior chamber can cause TASS. Ophthalmologists and operating room staff need to pay careful attention to all drugs and irrigating solutions.Keywords: phacoemulsification, fibrin reaction, drug toxicity

  3. Rising incidence of Enterococcus species in microbiological specimens from orthopedic patients correlates to increased use of cefuroxime

    Siesing, Peter Christian; Alva-Jørgensen, Jens Peter; Brodersen, Jakob; Arpi, Magnus; Jensen, Poul Einar


    Enterococci are emerging causes of severe infections, including wound and bone infections in orthopedic patients. The main purpose of this study was to determine whether there was a correlation between the incidence of enterococci in tissue samples (biopsies) from orthopedic patients and...... consumption of cefuroxime in the orthopedic department....

  4. Intracameral cefuroxime and moxifloxacin used as endophthalmitis prophylaxis after cataract surgery: systematic review of effectiveness and cost-effectiveness

    Linertová R


    Full Text Available Renata Linertová,1,2 Rodrigo Abreu-González,3 Lidia García-Pérez,1,2 Marta Alonso-Plasencia,3 Luis Mateo Cordovés-Dorta,4 José Augusto Abreu-Reyes,4 Pedro Serrano-Aguilar2,5 1Fundación Canaria de Investigación y Salud (FUNCIS, Santa Cruz de Tenerife, Spain; 2Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC, Madrid, Spain; 3Ophthalmology Service, University Hospital Ntra Sra de La Candelaria, Santa Cruz de Tenerife, Spain; 4Ophthalmology Service, University Hospital of Canary Islands, La Laguna, Spain; 5HTA Unit, Canary Health Service, Santa Cruz de Tenerife, Spain Abstract: Postoperative endophthalmitis is one of the most serious potential complications of ocular lens surgery. Its incidence can be reduced by means of antibiotic prophylaxis. Although the prophylactic use of intracameral cefuroxime has been extended, other drugs, such as moxifloxacin, have arisen as alternatives. We performed a systematic literature review on the effectiveness and efficiency of intracameral cefuroxime and moxifloxacin for the prophylaxis of postoperative endophthalmitis after cataract surgery. Several bibliographic databases were searched up to October 2010 and were updated up to January 2013. Outcomes were the onset of endophthalmitis after surgery and the cost-effectiveness ratio of using both antibiotic prophylaxis alternatives. The following were included: a clinical trial reported in two papers, six observational studies, and an economic evaluation. All studies assessed cefuroxime compared with another antibiotic prophylaxis or no prophylaxis. The only randomized controlled trial performed by the European Society of Cataract and Refractive Surgery found that intracameral cefuroxime is significantly more effective than not using prophylaxis or the use of a topical antibiotic. The observational studies support these results. The economic evaluation compared different prophylaxis regimens and concluded that intracameral

  5. Fabrication of cefuroxime-impregnated calcium sulfate: Polycaprolactone composite implant for osteomyelitis

    Gupta Himanshu


    Full Text Available Osteomyelitis is characterized as an inflammatory bone disease caused by pyrogenic bacteria. As oral bioavailabilities of antibiotics are low, a regimen of 6 weeks of intravenous antibiotic is necessary for adequate therapy. Although the dose of antibiotic administered systemically is high, therapeutically effective drug concentrations are not always achieved at the site of infection. This problem can be overcome by the use of local antibiotics from a biodegradable implant for chronic osteomyelitis that can deliver the drug at least for 6 weeks. The implant delivers high antibiotic concentration at tissue levels, obliterates dead space, aids bone repair and does not need to be removed. The aim of this study was to develop and evaluate a calcium sulfate and polycaprolactone (PCL-based composite biodegradable implantable delivery system of cefuroxime for the localized treatment of osteomyelitis that can deliver the drug for at least 6 weeks. The PCL and calcium sulfate composite system has not been studied yet. Interaction studies were carried out to check any incompatibility between the ingredients. Implants were prepared by a modified fabrication technique to avoid solvent use. The prepared implants were evaluated for various in vitro parameters like dimensions, hardness, tensile strength, drug release profile, sterility test and morphological changes in pellet before and after drug release. The pellets were also tested for microbiological efficacy and compared with a plain drug solution in different concentrations. Developed pellets are regular in shape and size with good tensile strength. The release profile displayed drug levels above the minimum inhibitory concentration continuously for up to 2 months. A wide zone of inhibition by the pellet against Staphylococcus aureus as compared with the drug solution proves its efficacy in the treatment of osteomyelitis. Results show that the developed calcium sulfate and PCL-based composite

  6. Antibacterial activity of Rosmarinus officinalis L. alone and in combination with cefuroxime against methicillin-resistant Staphylococcus aureus

    Naser Jarrar; Awni Abu-Hijleh; Kamel Adwan


    Objective: To determine the antimicrobial activity of rosemary (Rosmarinus officinalis L.) and to investigate the synergistic effects of this extract combined with ceforuxime against methicillin-resistantStaphylococcus aureus (MRSA).Methods: The inhibitory and bactericidal activities of rosemary ethanol extract, alone and in combination with cefuroxime, were studied.Results: The minimum inhibitory concentrations (MICs) of the ethanol extract of rosemary were in the range of 0.39-3.13 mg/mL. The minimum bactericidal concentrations (MBCs) were usually equal to or double that MICs. The antimicrobial activity of combinations of the ethanol extract of rosemary and cefuroxime indicated their synergistic effects against all MRSAs.Conclusions: The present work clearly demonstrates that rosemary has a key role in the elevation of susceptibility toβ-lactams.

  7. Studies on Novel Pantoprazole and Cefuroxime Axetil Tablets for Site Specific Delivery.

    Putta Rajesh Kumar


    Full Text Available In this study core in coat tablets containing enteric coated Pantaprazole (PP core and Cefuroxime axetil (CA floating type coat formulation as single unit prepared by compression coating method. The tablets were evaluated for their various pre-compression, compression characteristics, in vitro drug release kinetics and stability studies. The analytical estimation of drugs was found to be accurate and precise. The results of rheological characteristics indicated that, the powder beds of both core formulations of PP are freely flowable and easily compressible. Acryl EZE coating over the core tablets protects PP from GI fluids and helps in release of drug in intestinal pH. These studies on coat granules indicated that, the granule beds of all the coat formulations of CA are easily compressible and that flow increases with the addition of glidants. The release rate of CA from HPMC K4M formulations is majorly by burst effect, since HPMCK4M (p<0.05 is relatively more hydrophilic and when swells it forms weaker gel. Also, the release of CA from guar gum and xanthan gum formulations follows zero order release (p<0.05. The guar gum when it swells forms thicker gels hence the release rate ‘k’ is small of the three diluents. Stability studies at 40°C / 75% RH indicated that there is no significant change in CA content for a period of 3 months. Therefore it could be concluded that the combination of PP and CA would be useful for improved ulcer therapy associated with symptomatic relief to the patient.

  8. Progress in the clinical pharmacokinetics of cefuroxime%头孢呋辛临床药动学的研究进展

    赵龙山; 李清; 何博赛; 王洁; 陈晓辉; 毕开顺


    目的 综述头孢呋辛钠和头孢呋辛酯的临床药动学的研究进展.方法 查阅国内外文献并进行分析归纳和总结.结果 头孢呋辛在组织和体液中分布广泛,消除快,体内药动学行为符合二室开放模型,头孢呋辛酯水解后以头孢呋辛的形式起作用,饮食影响头孢呋辛酯的生物利用度,在特殊人群中用药量需酌情减量,未见性别差异.结论 作为二代头孢类药物代表的头孢呋辛,已入选国家基本药物目录,但仍然需要检测患者血药浓度,避免抗生素滥用,实现个体化给药,达到临床的安全、合理、有效用药.%Objective To summarize the progress in the clinical pharmacokinetics of cefuroxime sodium and cefuroxime axile.Methods The literatures at home and abroad were consulted,analyzed and concluded.Results Cefuroxime is widely distributed in tissues and body fluids,and eliminated rapidly,with the pharmacokinetic profile in body best fitted by two-compartment open model,while cefuroxime axile is hydrolysed into cefuroxime which is in action.Food can effect the bioavailability of cefuroxime axile,and more attention should be paid for the special population using lower dosage.No gender differences were found for both formulations.Conclusions As the representation of the second-generation cephalosporins,cefuroxime has been listed in the Catalogue of Basic Medicines of the State,however,therapeutical drug monitoring of patients for cefuroxime should still be taken into consideration,so as to avoid the abuse of antibiotics,achieve individualized drug administration,and finally to come to be safe,reasonable and effective drug use in clinic.

  9. Relative efficacy of cefuroxime versus dicloxacillin as definitive antimicrobial therapy in methicillin-susceptible Staphylococcus aureus bacteraemia

    Rasmussen, Jon Bjarke; Knudsen, Jenny Dahl; Arpi, Magnus;


    OBJECTIVES: The objective of the present study was to compare the efficacy of cefuroxime with that of dicloxacillin as definitive antimicrobial therapy in methicillin-susceptible Staphylococcus aureus bacteraemia (MS-SAB) using a Danish bacteraemia database, information on the indication for...... antimicrobial therapy, multivariate adjustment and propensity score (PS) matching. METHODS: This was a retrospective cohort study. MS-SAB cases from 1 January 2006 to 31 December 2008 were included from a total of seven hospitals in the greater Copenhagen area and seven hospitals in the North Denmark Region....... Information including demographics, antimicrobial therapy and clinical condition was obtained. The physician's note detailing the indication for starting empirical antimicrobial therapy was given special attention. Hazard ratios (HRs) and 95% CIs for 30 day and 90 day mortality were calculated using PS...

  10. A validated stability indicating high-performance liquid chromatographic method for simultaneous estimation of cefuroxime sodium and sulbactam sodium in injection dosage form

    Falguni M Patel


    Full Text Available Background: A fixed dose combination of cefuroxime sodium (β lactam antibiotic and sulbactam sodium (β Lactamase inhibitor is used in ratio of 2:1 as powder for injection for the treatment of resistant lower respiratory tract and other infections. Aims: A simple, precise, and accurate ion-pair reverse-phase high-performance liquid chromatography (RP-HPLC method was developed and validated for determination of cefuroxime Na(CEF and sulbactam Na(SUL in injection. Materials and Methods: Isocratic RP-HPLC separation was achieved on an ACE C 18 column (150×4.6 mm id, 5 μm particle size using the mobile phase 0.002 M tetrabutylammonium hydroxide sulfate (TBAH in 10 mm potassium di-hydrogen phosphate buffer-acetonitrile (86:14 v/v, pH 3.7 at a flow rate of 1.0 ml/min. Results and Conclusion: The retention time of sulbactam Na and cefuroxime Na were 3.2 min and 10.2 min, respectively. The ion-pairing reagent improved the retention of highly polar sulbactam Na on reverse-phase column. The detection was performed at 210 nm. The method was validated for linearity, precision, accuracy, robustness, solution stability, and specificity. The method was validated for linearity, precision, accuracy, robustness, solution stability, and specificity. The method was linear in the concentration range of 10-100 μg/ml for cefuroxime Na and 5-50 μg/ml for sulbactam Na, with a correlation coefficient of 0.9999 and 0.9998 for the respective drugs. The intraday precision was 0.13-0.21% and 0.48-0.65%, and the interday precision was 0.32-0.81% and 0.60-0.83% for cefuroxime Na and sulbactam Na, respectively. The accuracy (recovery was found to be in the range of 98.76-100.61% and 98.99-100.30% for cefuroxime Na and sulbactam Na, respectively. The drugs were found to degrade under hydrolytic and oxidative conditions. The drugs could be effectively separated from different degradation products, and hence the method can be used for stability analysis.

  11. Eradication of Biofilm-like Microcolony Structures of Borrelia burgdorferi by Daunomycin and Daptomycin but not Mitomycin C in Combination with Doxycycline and Cefuroxime

    Jie eFeng


    Full Text Available Lyme disease, caused by Borrelia burgdorferi, is the most common vector-borne disease in the United States and Europe. While the majority of Lyme disease patients can resolve their symptoms if treated promptly, 10-20% of patients suffer from prolonged symptoms called post-treatment Lyme disease syndrome (PTLDS. Although the cause for PTLDS is unclear, one possibility is the presence of bacterial persisters not effectively cleared by the current Lyme antibiotics. Recent studies identified several drug candidates including daptomycin, daunomycin, doxorubicin, and mitomycin C that had good activity against B. burgdorferi persisters. However, their relative activities against B. burgdorferi persisters have not been evaluated under the same conditions. In this study, we tested the anti-persister activities of these drugs against both 7-day and 15-day old stationary phase cultures of B. burgdorferi individually as well as in combination with Lyme antibiotics doxycycline and cefuroxime (Ceftin. Our findings demonstrate daunomycin and daptomycin were more active than mitomycin C in single drug comparison at 10 and 20 µM, as well as in drug combinations with doxycycline and cefuroxime. In addition, daunomycin was more active than doxorubicin which correlated with their ability to stain and accumulate in B. burgdorferi. The two drug combination of doxycycline and cefuroxime was unable to eradicate biofilm-like microcolonies of B. burgdorferi persisters. However, the addition of either daunomycin or daptomycin to the doxycycline + cefuroxime combination completely eradicated the biofilm-like structures and produced no visible bacterial regrowth after 7 days and 21 days, while the addition of doxorubicin was unable to prevent regrowth at either 7 day or 21 day subculture. Mitomycin C in combination with doxycycline and cefuroxime caused no regrowth at 7 days but visible spirochetal regrowth occurred after 21 day subculture. Furthermore, we found that

  12. Influence of four modes of administration on penetration of aztreonam, cefuroxime, and ampicillin into interstitial fluid and fibrin clots and on in vivo efficacy against Haemophilus influenzae.

    Lavoie, G Y; Bergeron, M G


    The extravascular penetration and bactericidal activity of aztreonam, cefuroxime, and ampicillin against beta-lactamase-positive and -negative Haemophilus influenzae strains were compared in a rabbit model. All groups of animals received an identical total dose of 100 mg of either antibiotic per kg given by four different intravenous modes of administration including a single large injection, four intermittent injections, a continuous infusion, and an injection followed by an infusion. Aztreo...

  13. Development and Validation of a Rapid Turbidimetric Assay to Determine the Potency of Cefuroxime Sodium in Powder for Dissolution for Injection

    Daniela C. M. Vieira


    Full Text Available The cefuroxime sodium is a second generation cephalosporin indicated for infections caused by Gram-positive and Gram-negative microorganisms. Although this drug is highly studied and researched regarding the antimicrobial activity, pharmacokinetics and pharmacodynamics, there are few studies regarding the development of analytical methodology for this cephalosporin. Thus, research involving analytical methods is essential and highly relevant to optimize its analysis in the pharmaceutical industry and guarantee the quality of the product already sold. This study describes the development and validation of a microbiological assay applying the turbidimetric method for the determination of cefuroxime, using Micrococcus luteus ATCC 9341 as micro-organism test and 3x3 parallel line assay design, with nine tubes for each assay, as recommended by the Brazilian Pharmacopoeia. The developed and validated method showed excellent results of linearity, seletivity, precision and robustness, in the concentration range from 30.0 to 120.0 mg/mL, with 100.21% accuracy and content 99.97% to cefuroxime sodium in injectable pharmaceutical form.

  14. The in vitro Antibacterial Activity of Florfenicol in Combination with Amoxicillin or Cefuroxime against Pathogenic Bacteria of Animal Origin

    Myung-Jin Choia, Eun-Mi Leea, Seung-Jin Lee, Md. Ahsanur Reza, Joong-Su Lee, Elias Gebru, Man-Hee Rhee and Seung-Chun Park*


    Full Text Available This study evaluated the in vitro activity of florfenicol (F in combination with amoxicillin (AM or cefuroxime (CRM against pathogenic bacteria of animal origin, including E. coli, S. aureus, S. cholerasuis and P. mirabilis. The MIC of AM ranged from 16 to 256 μg/ml. The MBC of AM (64 μg/ml was four-fold higher than its MIC value (16 μg/ml for E. coli, and similar to the MIC for the other three species. The MIC of F ranged from 8 to 16 μg/ml. The MBC values of F for E. coli, S. aureus, and S. cholerasuis were eight-fold higher than the respective MIC values, and 32-fold higher than the MIC of P. mirabilis. The MIC of CRM ranged from 8 to 128 μg/ml. The MBC of CRM was the highest ( 256 μg/ml, except for E. coli. The F/AM combination resulted in synergism (FIC index  0.5 for E. coli, S. aureus, and P. mirabilis and in-difference (FIC index >1 for S. cholerasuis. For F/CRM combination, synergism (E. coli and S. cholerasuis and in-difference (S. aureus and P. mirabilis were observed. Killing rate study showed a 1.5 - > 3 log 10 cfu/ml reduction of E. coli with F/AM compared to AM or F alone. The highest activity of the combinations was observed when F comprised at least 50% of the combination. Further studies using many bacterial isolates and various proportion of each drug would reveal the potential of a combination product containing F and AM/CRM for use in veterinary practice.

  15. Preparation and evaluation of 99mTc-cefuroxime, a potential infection specific imaging agent: A reliable thin layer chromatographic system to delineate impurities from the 99mTc-antibiotic

    Technetium-99m labelled cefuroxime, a second-generation cephalosporin antibiotic and potential bacteria specific infection imaging agent was evaluated. A good radiochemical purity (95%) of the labelled product was obtained after filtering the reaction mixture through a 0.22 μm filter. Scintigraphy study of the purified product showed uptake in infectious lesions 45 min after injection and abscess-to-muscle ratios were found to be 1.80, 1.85 and 1.88 at 45 min, 1.5 hr and 3 hr, respectively. A versatile and reliable chromatographic technique to assess the radiochemical purity of 99mTc-cefuroxime has also been described. - Highlights: ► Preparation of 99mTc-cefuroxime in presence of Sn-tartrate as reducing agent. ► Physiochemical and biological evaluation of 99mTc-cefuroxime. ► A versatile and reliable chromatographic technique to assess the radiochemical purity of 99mTc-cefuroxime.

  16. 注射用头孢呋辛钠和缩宫素注射液配伍的稳定性观察%The Study of Compatible Stability of Cefuroxime Sodium for Injection and Oxytocin Injection

    陈卫民; 冯燕


    目的考察注射用头孢呋辛钠和缩宫素注射液配伍的稳定性。方法在20℃下8 h内考察注射用头孢呋辛钠和缩宫素注射液配伍后,其混合溶液的外观、pH及不溶性微粒变化,并用高效液相色谱法测定药物的含量。结果注射用头孢呋辛钠和缩宫素注射液配伍后,8 h内药物的含量、混合溶液pH、外观及不溶性微粒均无明显变化。结论注射用头孢呋辛钠和缩宫素注射液不存在理化性的配伍禁忌。%Objective To study the compatible stability of Cefuroxime Sodium for injection with oxytocin injection. Methods The change of appearance,PH value and indissoluble particle in the mixture within 8 h at 20℃were observed after Cefuroxime Sodium for injection being combined with Oxytocin injection. The contents of drugs were determined by HPLC. Results No significant change was found in content,pH value,appearance and indissoluble particle in 8h after Cefuroxime Sodium injection being combined with Oxytocin injection. Conclusion There is no physical and chemical compatibility taboo when Cefuroxime Sodium for injection is combined with Oxytocin injection.

  17. Effects of combination of clarithromycin and cefuroxime sodium on mutant prevention concentration of Staphylococcus aureus%克拉霉素联用头孢呋辛对金黄色葡萄球菌预防耐药突变浓度的影响

    蒙小菲; 杨玉芳; 钟小斌; 邹小琴; 李萌; 覃巧; 张文宇


    OBJECTIVE To study the antibacterial effect and the mutant prevention ability of Clarithromycin (CLR) ,Cefuroxime sodium (CXM ) separately and jointly against Staphylococcus aureus in vitro .METHODS The minimal inhibitory concentrations(MIC) of CLR and CXM against Staphylococcus aureus were determined by agar plate dilution method when they were used separately and by chess board method when they were used in combina‐tion .The fractional inhibitory concentrations (FIC) were then calculated .The 1010 CFU/ml Staphylococcus aureus was enriched by meat infusion culture‐medium and the mutant prevention concentrations (MPC) were determined by agar plate dilution method and simple chess board method .The corresponding selection index SI(MPC/MIC) was then calculated .RESULTS The MIC ,MPC and SI of CLR were 4 .0 μg/ml ,25 .6 μg/ml ,and 6 .4 .The MIC , MPC and SI of CXM were 4 .0 μg/ml ,51 .2 μg/ml ,12 .8 .When used in combination ,the MIC of CLR and CXM was 4 .0 μg/ml and indifferent effect (FIC) was 2 .0 ,and had irrelevant effect .The MPC of CLR decreased from 25 .6 μg/ml when it was used alone to 8 .0 μg/ml when it was combined with CXM ,and the SI reduced from 6 .4 when it was used alone to 2 .0 after combination with CXM .The MPC of CXM decreased from 51 .2 μg/ml when it used alone to 8 .0 μg/ml when it was combined with CLR ,and the SI decreased from 12 .8 when it was used a‐lone to 1 .0 after combination with CLR .When CLR and CXM were combined and each of them reached the value of 8 .0 μg/ml ,it could inhibit the generation of resistant mutants .CONCLUSION The combination of CLR and CXM can reduce the MPC and SI of Staphylococcus aureus and enhance the ability of anti drug resistant mutants .%目的:在体外探讨克拉霉素(CLR)、头孢呋辛(CXM )单用及合用对金黄色葡萄球菌的抗菌作用和预防耐药突变的能力。方法采用琼脂平板倍比稀释法和棋盘法分别测定CLR、CXM 单用及联用时对金黄色

  18. No Resistance to Penicillin, Cefuroxime, Cefotaxime, or Vancomycin in Pneumococcal Pneumonia

    Yayan, Josef; Ghebremedhin, Beniam; Rasche, Kurt


    Objectives: Group B Streptococcus is a primary source of pneumonia, which is a leading cause of death worldwide. During the last few decades, there has been news of growing antibiotic resistance in group B streptococci to penicillin and different antibiotic agents. This clinical study retrospectively analyzes antimicrobial resistance in inpatients who were diagnosed with group B streptococcal pneumonia. Methods: All of the required information from inpatients who were identified to have group...

  19. Detection of resistance due to inducible beta-lactamase in Enterobacter aerogenes and Enterobacter cloacae.

    Huber, T W; Thomas, J. S


    Thirty-six of 36 strains of Enterobacter cloacae and E. aerogenes with inducible beta-lactamase developed resistance when cefoxitin (inducer) was added to cefuroxime disks. Constitutive beta-lactamase producers (n = 23) were all resistant to cefuroxime. Cefuroxime resistance correlated with the amount of induced or constitutive beta-lactamase. Cefuroxime was a better indicator of induced resistance than cefamandole, cefazolin, cephalothin, ceftriaxone, cefotaxime, ticarcillin with or without ...

  20. Control Effect of Different Doses of 20% Cefuroxime Insect Amine SG on Rice BPH (Brown Palnthopper)%不同剂量20%呋虫胺SG对水稻褐飞虱的防效



    [目的]验证20%呋虫胺SG防治水稻褐飞虱的效果.[方法]设7个处理,研究不同剂量20%呋虫胺SG对水稻褐飞虱的防效.[结果]20%呋虫胺SG对褐飞虱成虫和若虫均有较好的防治效果,且持效期达16 d以上并随着使用剂量的增加防效也增加.[结论]20%呋虫胺SG是水稻田防治褐飞虱较为安全的理想药剂.

  1. Inlfuence of cefuroxime sodium on synaptic plasticity of parallel ifber-Purkinje cells in young rats%头孢呋辛钠影响幼鼠平行纤维-浦肯野细胞的突触可塑性

    何海燕; 任颖鸽; 李凌; 晋芙莉; 杜永平; 张月萍


    目的探讨头孢呋辛钠(CS)对Sprague-Dawley(SD)大鼠小脑浦肯野细胞(PCs)电生理功能的影响。方法将7 d龄(P7)SD大鼠分为早期用药Ⅰ组、Ⅱ组(P7~P14给药)和晚期用药组(P14~P21给药),均腹腔注射CS;以及早期用药对照组和晚期用药对照组,腹腔注射等容积的生理盐水(NS)。每组均10只。早期用药Ⅰ组及早期对照组于P15处死,早期用药Ⅱ组、晚期用药及晚期对照组于P22处死。采用全细胞膜片钳记录法,在小脑脑片上记录PCs的内向电流和动作电位,以及低频刺激平行纤维(PF)诱发的PCs兴奋性突触后电流(EPSC)的长时程抑制(LTD)现象。结果早期用药组和晚期用药组PCs内向电流幅值和动作电位峰值均略大于相应对照组,差异无统计学意义(P>0.05);用药组的EPSC抑制程度均大于对照组(P0.05). All administration groups had a signiifcantly higher degree of EPSC inhibition than the control groups (P<0.01), and the early administration II group had a signiifcantly greater degree of EPSC inhibition than the late administration group (P<0.01).ConclusionsEarly CS exposure after birth affects the synaptic plasticity of PF-PCs in the cerebellum of young rats, which persists after drug withdrawal.

  2. Adoption of intracameral antibiotic prophylaxis of endophthalmitis following cataract surgery: update on the ESCRS Endophthalmitis Study.

    Barry, Peter


    To determine the use of intracameral cefuroxime at the end of cataract surgery since the beneficial results were first reported by the European Society of Cataract and Refractive Surgeons Endophthalmitis Study Group in 2006, 250 ophthalmic surgeons affiliated with both public and private hospitals and clinics across Europe were surveyed. The questions regarded their awareness of the results of the ESCRS endophthalmitis study and their current use or non-use of intracameral antibiotics in their cataract procedures. Seventy-four percent of respondents said they always or usually use intracameral antibiotics in their cataract surgery procedures. The most frequently cited reasons for not using cefuroxime or other intracameral antibiotics was the lack of an approved commercial preparation and related anxieties regarding the risk of dilution errors and contamination. More than 90% of respondents said they would use cefuroxime if an approved single-unit dose product were commercially available.

  3. In vitro susceptibilities of Borrelia burgdorferi to five oral cephalosporins and ceftriaxone.

    Agger, W A; Callister, S M; Jobe, D A


    We determined the in vitro susceptibilities of eight Borrelia burgdorferi isolates to five oral cephalosporins. MICs for B. burgdorferi 297 were 23 micrograms/ml (cephalexin), 45 micrograms/ml (cefadroxil), 91 micrograms/ml (cefaclor), 0.13 microgram/ml (cefuroxime), 0.8 microgram/ml (cefixime), and 0.02 microgram/ml (ceftriaxone). When B. burgdorferi isolates were exposed to concentrations twice the MIC of cefuroxime, cefixime, or ceftriaxone, at least 72 h of incubation was required to kill...

  4. Bacteriology in acute exacerbation of chronic obstructive pulmonary disease in patients admitted to hospital

    Larsen, Mette V; Janner, Julie H; Nielsen, Susanne D; Friis-Møller, Alice; Ringbaek, Thomas; Lange, Peter


    We investigated the bacterial flora and antimicrobial sensitivity in sputum from patients admitted to hospital with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in order to recommend the best empirical treatment for these patients. The survey was a retrospective study of a...... AECOPD we recommend either cefuroxime for intravenous treatment or amoxicillin-clavulanate for oral treatment....

  5. Bartholinitis caused by Streptococcus pneumoniae : Case report and review of literature

    Parvathi S


    Full Text Available Most of the Bartholin′s gland abscesses have been thought to be caused by colonizing micro-organisms of the perineal region. We encountered an interesting case of acute Bartholins abscess caused by Streptococcus pneumoniae in a primigravida. The abscess was incised and drained. The patient was treated with Cefuroxime. This case is presented for its rarity.

  6. Antimicrobial Susceptibility and Clinical Sources of Dolosigranulum pigrum Cultures

    LaClaire, L.; Facklam, R


    Antimicrobial susceptibilities of 27 clinical isolates of Dolosigranulum pigrum were determined. All were susceptible to amoxicillin, cefotaxime, cefuroxime, clindamycin, levofloxacin, meropenem, penicillin, quinupristin-dalfopristin, rifampin, tetracycline, and vancomycin. Fifteen of the isolates were intermediate to chloramphenicol. One isolate was resistant to trimethoprim-sulfamethoxazole. Two isolates were susceptible, 10 were intermediate, and 15 were resistant to erythromycin.

  7. Resistance to Mercury and Antimicrobial Agents in Streptococcus mutans Isolates from Human Subjects in Relation to Exposure to Dental Amalgam Fillings

    Leistevuo, Jorma; Järvinen, Helinä; Österblad, Monica; Leistevuo, Tiina; Huovinen, Pentti; Tenovuo, Jorma


    Resistance to cefuroxime, penicillin, tetracycline, and mercury is reported for 839 Streptococcus mutans isolates from 209 human study subjects. The MICs of these drugs did not differ for isolates from one dental amalgam group and two nonamalgam subsets: a group with no known exposure to amalgam and a group whose members had their amalgam fillings removed.

  8. Study of the Electrophoretic Behavior of Cephalosporins by Capillary Zone Electrophoresis

    Gabriel Hancu; Adina Sasebeşi; Aura Rusu; Hajnal Kelemen; Adriana Ciurba


    Purpose: The aim of the study was the characterization of the electrophoretic behavior of cephalosporins from different generation having different structural characteristics in order to develop a rapid, simple and efficient capillary electrophoretic method for their identification and simultaneous separation from complex mixtures. Methods: Ten cephalosporin derivatives (cefaclor, cefadroxil, cefalexin, cefazolin, cefoxitin, cefuroxime, cefoperazone, cefotaxime, ceftazidime, ce...

  9. Kinetic Spectrophotometric Determination of Certain Cephalosporins in Pharmaceutical Formulations

    Omar, Mahmoud A.; Osama H. Abdelmageed; Tamer Z. Attia


    A simple, reliable, and sensitive kinetic spectrophotometric method was developed for determination of eight cephalosporin antibiotics, namely, Cefotaxime sodium, Cephapirin sodium, Cephradine dihydrate, Cephalexin monohydrate, Ceftazidime pentahydrate, Cefazoline sodium, Ceftriaxone sodium, and Cefuroxime sodium. The method depends on oxidation of each of studied drugs with alkaline potassium permanganate. The reaction is followed spectrophotometrically by measuring the rate of change of abs...

  10. Antimicrobial-induced endotoxaemia in patients with sepsis in the field of acute pyelonephritis.

    Giamarellos-Bourboulis E


    Full Text Available BACKGROUND: In vitro results have shown that antimicrobial agents may induce the Gram-negative bacteria to release endotoxins (LPS, which in turn, could trigger the secretion of cytokines from monocytes. AIMS: To compare the effect of cefuroxime, netilmicin or ciprofloxacin on serum levels of LPS and tumour necrosis factor-alpha (TNFalpha. METHODS: Seventy-four patients with acute pyelonephritis caused by Gram-negative bacteria and signs of sepsis were randomly assigned to receive one of three intravenous regimens of cefuroxime, netilmicin or ciprofloxacin. Blood samples were collected before therapy and at specified time intervals for 96 hours after the initiation of treatment for the determination of serum levels of LPS and of TNFalpha. RESULTS: Patients treated with cefuroxime presented an early peak of LPS and of TNFalpha in serum two hours after the initiation of treatment compared to the other study groups. After that time interval, concentrations of LPS and TNFalpha were similar in all the study groups. Fever accompanied by endotoxaemia was still detected for 48 hours after the start of therapy in 36, 37.5 and 36% of patients treated with cefuroxime, netilmicin and ciprofloxacin respectively. The corresponding figures for these agents at 72 hours were 28, 12.5 and 24%, respective and 12, 4.2 and 4% at 96 hours (P value not significant. CONCLUSIONS: With the exception of an early peak in the serum levels of LPS and TNFalpha in patients treated with cefuroxime, no significant difference could be detected amongst the study groups as far as their effect on serum levels of LPS and TNFalpha were concerned. This suggests that these three antimicrobial agents may be administered safely at the early stages of sepsis.

  11. Investigating a new drug delivery nano composite membrane system based on PVA/PCL and PVA/HA(PEG) for the controlled release of biopharmaceuticals for bone infections.

    Wan, Taoyu; Stylios, George K; Giannoudi, Marilena; Giannoudis, Peter V


    The capability for sustained and gradual release of pharmaceuticals is a major requirement in the development of a guided antimicrobial bacterial control system for clinical applications. In this study, PVA gels with varying constituents that were manufactured via a refreeze/thawing route, were found to have excellent potential for antimicrobial delivery for bone infections. Cefuroxime Sodium with poly(ethylene glycol) was incorporated into 2 delivery systems poly(e-caprolactone) (PCL) and hydroxyapatite (HA), by a modified emulsion process. Our results indicate that the Cefuroxime Sodium released from poly(e-caprolactone) in PVA was tailored to a sustained release over more than 45 days, while the release from hydroxyapatite PVA reach burst maximum after 20 days. These PVA hydrogel-systems were also capable of controlled and sustained release of other biopharmaceuticals. PMID:26747917

  12. Antibiotic susceptibility profile of Aeromonas spp. isolates from food in Abu Dhabi, United Arab Emirates.

    Awan, Mohammad Bashir; Maqbool, Ahmed; Bari, Abdul; Krovacek, Karel


    A total of 57 Aeromonas isolates from food samples such as fresh and frozen chicken, game birds, pasteurized milk, baby food, bakery products, fruit and vegetables, fish, and water from Abu Dahbi, UAE were investigated for antibiotic susceptibility profile. Most strains were resistant to penicillins (ticarcillin, mezlocillin, oxacillin, piperacillin), sulfamethoxazole, trimethoprim and macrolides (erythromycin, vancomycin, clindamycin) but sensitive to tetracycline, chloramphenicol, nitrofurantoin, aminoglycosides (amikacin, gentamicin, tobramycin), cephalosporins (cefuroxime, ceftrioxone, cefazolin, cephalexin, cephalothin, cefoxitin, cefotaxime), quinolone (ciprofloxacin), colistin sulphate and SXT (trimethoprim-sulfamethoxazole). On the other hand, many antibiotics showed excellent inhibitory activity (>75% strains were sensitive to them) against all the strains tested. These include cefuroxime, ceftrioxone, ciprofloxacin, colistin, amikacin, gentamicin, tetracycline, chloramphenicol, nitrofurantoin, cefotaxime and tobramycin. In conclusion, the results show a detailed pattern of sensitivity of the various Aeromonas spp. isolates to a variety of antibiotics and provide useful information in the context of selective isolation and phenotypic identification of the aeromonads from food. PMID:19382665

  13. The effect of ranitidine on postoperative infectious complications following emergency colorectal surgery: a randomized, placebo-controlled, double-blind trial

    Moesgaard, F; Jensen, L S; Christiansen, P M;


    OBJECTIVE AND DESIGN: To study the potential effect of ranitidine on postoperative infectious complications following emergency colorectal surgery. A randomized, placebo-controlled, double-blind trial was carried out in three university clinics and two county hospitals in Denmark. PATIENTS AND...... i.v. placebo (group II). All patients were given 1.5 g metronidazole plus 3.0 g cefuroxime at the time of surgery. Patients with perforation of the colon or rectum were given metronidazole and cefuroxime for further 3 days. All patients were assessed daily until discharge from the hospital. Thirty...... < 0.05). Wound infection, intraabdominal abscess, septicemia, and pneumonia were 12.9%, 5.2%, 3.8% and 14%, respectively in group I. In group II, the infectious complications were 16.1%, 6.8%, 6.9% and 22%, respectively. Twelve patients (13.8%) in the placebo group developed more than one complication...

  14. Antimicrobial-induced endotoxaemia in patients with sepsis in the field of acute pyelonephritis.

    Giamarellos-Bourboulis E; Perdios J; Gargalianos P; Kosmidis J; Giamarellou H


    BACKGROUND: In vitro results have shown that antimicrobial agents may induce the Gram-negative bacteria to release endotoxins (LPS), which in turn, could trigger the secretion of cytokines from monocytes. AIMS: To compare the effect of cefuroxime, netilmicin or ciprofloxacin on serum levels of LPS and tumour necrosis factor-alpha (TNFalpha). METHODS: Seventy-four patients with acute pyelonephritis caused by Gram-negative bacteria and signs of sepsis were randomly assigned to receive one of th...

  15. Electron spin resonance studies of some irradiated pharmaceuticals

    Gibella, M.; Crucq, A-S.; Tilquin, B. E-mail:; Stocker, P.; Lesgards, G.; Raffi, J


    Five antibiotics belonging to the cephalosporins and penicillins groups have been irradiated: anhydrous ampicilline acid, amoxicilline acid trihydrate, cefuroxime sodium salt, cloxacilline sodium salt monohydrate and ceftazidime pentahydrate. ESR studies have been carried out, showing the influence of irradiation and storage parameters on the nature and concentration of the free radicals trapped. These results may be used to detect an irradiation treatment on such pharmaceuticals. (author)

  16. Pharmacokinetics and bacteriological efficacy of cefoperazone, ceftriaxone, and moxalactam in experimental Streptococcus pneumoniae and Haemophilus influenzae meningitis.

    McCracken, G H; Nelson, J.D.; Grimm, L


    The pharmacokinetics and bacteriological efficacy of cefoperazone, cefuroxime, ceftriaxone, and moxalactam were evaluated in the experimental rabbit meningitis model of Haemophilus influenzae type b or Streptococcus pneumoniae infection. The cerebrospinal fluid penetration of these beta-lactam antibiotics was from 3 to 14% and was greater in Haemophilus-infected that in pneumococcus-infected animals. With the exception of moxalactam, the antibacterial activity in cerebrospinal fluid and chang...

  17. Effect of hyperproduction of TEM-1 beta-lactamase on in vitro susceptibility of Escherichia coli to beta-lactam antibiotics.

    Wu, P J; Shannon, K; Phillips, I


    The susceptibility of 173 TEM-1-producing isolates of Escherichia coli was assessed by determination of MICs by the agar dilution method. MICs of amoxicillin, mezlocillin, cephaloridine, and, to a smaller extent, amoxicillin-clavulanic acid (but not cephalexin, cefuroxime, cefotaxime, ceftazidime, or imipenem) were higher for isolates that produced large amounts of beta-lactamase than for isolates that produced smaller amounts. The effect of fixed concentrations of clavulanic acid on resistan...

  18. In vitro activity of Ro 19-5247 (T-2525) and interpretive criteria for disk diffusion susceptibility testing.

    Beskid, G; Fallat, V; Siebelist, J; Durkin, J W; Lipschitz, E R; McGarry, D H


    The activity of Ro 19-5247 (the active metabolite of the oral cephalosporin Ro 19-5248 [T-2588]) was compared with that of five orally active agents against a total of 331 bacterial strains. Ro 19-5247 was more active in vitro than amoxicillin, amoxicillin-clavulanate, cefaclor, cefuroxime, and cephalexin against members of the family Enterobacteriaceae. Amoxicillin-clavulanate and amoxicillin overall were more active than the other four agents against staphylococci. Ro 19-5247, amoxicillin-c...

  19. In-vitro Wirksamkeit von Moxifloxacin und Linezolid gegen Staphylococcus aureus-, Streptococcus pneumoniae- und Enterococcus spp.-Isolate in Abhängigkeit vom Testmedium und der Keimlokalisation

    Wilhelm, Cornelia


    Ziel der vorliegenden Arbeit ist die Untersuchung der zuvor nicht bekannten Beeinflussung der Aktivität von bestimmten Antibiotika durch unterschiedliche Testnährmedien. Zu diesem Zweck wird die Aktivität von Moxifloxacin, Linezolid, Penicillin G, Oxacillin und Cefuroxim gegen Bakterienisolate der Spezies S. aureus, S. pneumoniae, E. faecalis und E. faecium in Bouillon und Blut getestet. Des Weiteren wird die Aktivität von Moxifloxacin und Linezolid gegen intrazellulär in humanen Granulozyten...

  20. Moxifloxacin Induced Seizures -A Case Report

    Jiana Shi; Huimin Xu


    Abstract A 73-year-old female patient developed a generalized tonic-clonic seizure on the 6th day after treatment with moxifloxacin 400 mg daily intravenously for appendicitis. This patient had atrial fibrillation and history of a surgery for intracerebral hemorrhage, with impaired renal function and liver function, but without history of seizures. Moxifloxacin was discontinued and switched to cefuroxime. The patient remained seizure-free at discharge four days later. The naranjo adverse drug...

  1. Pharmacokinetic/Pharmacodynamic (PK/PD) Indices of Antibiotics Predicted by a Semimechanistic PKPD Model: a Step toward Model-Based Dose Optimization▿

    Nielsen, Elisabet I.; Cars, Otto; Friberg, Lena E.


    A pharmacokinetic-pharmacodynamic (PKPD) model that characterizes the full time course of in vitro time-kill curve experiments of antibacterial drugs was here evaluated in its capacity to predict the previously determined PK/PD indices. Six drugs (benzylpenicillin, cefuroxime, erythromycin, gentamicin, moxifloxacin, and vancomycin), representing a broad selection of mechanisms of action and PK and PD characteristics, were investigated. For each drug, a dose fractionation study was simulated, ...

  2. Activities of oral and parenteral agents against penicillin-susceptible and -resistant pneumococci.

    Pankuch, G A; Visalli, M A; Jacobs, M. R.; Appelbaum, P C


    This study examined bacteriostatic and bactericidal activities of oral and parenteral antibiotics for penicillin-susceptible and intermediately and fully penicillin-resistant pneumococci. beta-Lactamase inhibitors did not affect beta-lactam results. The activities of ampicillin, amoxicillin +/- clavulanate, WY-49605, cefuroxime, cefpodoxime, cefdinir, cefixime, and cefaclor against two penicillin-susceptible, two intermediately penicillin-resistant, and two fully penicillin-resistant pneumoco...

  3. Novel plasmid-mediated beta-lactamase from Escherichia coli that inactivates oxyimino-cephalosporins.

    Matsumoto, Y; Ikeda, F; Kamimura, T.; Yokota, Y.; Mine, Y


    A highly cephem-resistant Escherichia coli strain, FP1546, isolated from the fecal flora of laboratory dogs previously administered beta-lactam antibiotics was found to produce a beta-lactamase, FEC-1, of 48-kilodalton size and pI 8.2. FEC-1 hydrolyzed cefuroxime, cefotaxime, cefmenoxime, and ceftriaxone, as well as the enzymatically less-stable antibiotics cephaloridine, cefotiam, and cefpiramide. Of the oxyimino-cephalosporins, ceftizoxime was fairly stable to FEC-1. FEC-1 differed notably ...

  4. In vitro selection of one-step mutants of Streptococcus pneumoniae resistant to different oral beta-lactam antibiotics is associated with alterations of PBP2x.

    Sifaoui, F; Kitzis, M D; Gutmann, L


    Many oral penicillins and cephalosporins are used to treat clinical infections caused by Streptococcus pneumoniae. Therefore, using different beta-lactams as selectors, we estimated the frequencies of one-step mutations leading to resistance. Resistant mutants were obtained from penicillin-susceptible, intermediately resistant, and penicillin resistant strains. For cefixime, cefuroxime, cefpodoxime, cefotaxime, and ceftriaxone, the frequencies of mutation ranged from 10(-6) to 10(-8) when res...

  5. In vitro activities of moxalactam and cefotaxime against aerobic gram-negative bacilli.

    Jorgensen, J H; Crawford, S. A.; Alexander, G A


    The in vitro activities of two new beta-lactam antibiotics, moxalactam disodium (LY 127935) and cefotaxime (HR-756), were compared with cefoxitin, cefamandole, cefuroxime, cephalothin, and, in some instances, carbenicillin, gentamicin, and amikacin against aerobic gram-negative bacilli. Test isolates included normally cephalosporin-resistant members of the Enterobacteriaceae and Pseudomonas spp. and a variety of nonfermentative or oxidase-positive bacteria. Both moxalactam and cefotaxime demo...

  6. GR-20263: a new aminothiazolyl cephalosporin with high activity against Pseudomonas and Enterobacteriaceae.

    Verbist, L.; Verhaegen, J


    The in vitro activity of GR-20263, a new aminothiazolyl cephalosporin, was compared with the activities of other beta-lactam antibiotics by using 800 clinical bacterial isolates. GR-20263 was highly active (inhibition of 90% of the isolates between 0.03 and 1 microgram/ml) against the common Enterobacteriaceae and 5 to 20 times more active than cefuroxime, cefoxitin, and cephalothin. GR-20263 was three to six times less active than cefotaxime against Escherichia coli, Klebsiella pneumoniae, S...

  7. Simultaneous determination of 14 β-lactam antibiotics in cosmetic products by liquid chromatography tandem mass spectrometry method

    Cai Sheng Wu; Jin Lan Zhang; Yan Ling Qiao; Yi Lin Wang; Zhi Rong Chen


    In this study, a simple and rapid high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method was established and validated to determine the 14 β-lactam antibiotics in cosmetic products, including 1 (ceftazidime), 2 (cefaclor), 3 (cefdinir), 4 (ampicillin), 5 (cefalexin), 6 (ceftezole), 7 (cefotaxim), 8 (cefradine), 9 (cefuroxime), 10 (cephazoline), 11 (cefathiamidine), 12 (cefoperazone), 13 (cafalotin), 14 (piperacillin).

  8. Development of a capillary electrophoresis method for the simultaneous determination of cephalosporins

    Hancu Gabriel; Kelemen Hajnal; Rusu Aura; Gyéresi Árpád


    A rapid and simple capillary electrophoresis method has been developed for the simultaneous determination of six extensively used cephalosporin antibiotics (cefaclor, cefadroxil, cefalexin, cefuroxim, ceftazidim, ceftriaxon). The determination of cephalosporins was performed at a pH 6.8, using a 25 mM phospate - 25 mM borate mixed buffer, + 25 kV voltage at a temperature of 25 °C. We achieved a baseline separation in approximately 10 minutes. The separation resolution was increased by a...

  9. Antibiotic Selection of Escherichia coli Sequence Type 131 in a Mouse Intestinal Colonization Model

    Boetius Hertz, Frederik; Løbner-Olesen, Anders; Frimodt-Møller, Niels


    The ability of different antibiotics to select for extended-spectrum β-lactamase (ESBL)-producing Escherichia coli remains a topic of discussion. In a mouse intestinal colonization model, we evaluated the selective abilities of nine common antimicrobials (cefotaxime, cefuroxime, dicloxacillin, clindamycin, penicillin, ampicillin, meropenem, ciprofloxacin, and amdinocillin) against a CTX-M-15-producing E. coli sequence type 131 (ST131) isolate with a fluoroquinolone resistance phenotype. Mice ...

  10. In vitro susceptibility of Streptococcus mutans to chlorhexidine and six other antimicrobial agents.

    Järvinen, H; Tenovuo, J; Huovinen, P


    The susceptibility of Streptococcus mutans to chlorhexidine and to six commonly used, systemic antibacterial agents (amoxicillin, cefuroxime, penicillin, sulfamethoxazole-trimethoprim, tetracycline, and erythromycin) was studied for 424 clinical isolates from 116 children and students. The MIC of chlorhexidine for all isolates was < or = 1 micrograms/ml. No resistance to the other antimicrobial agents was detected. Although widely exposed to various antimicrobial agents, S. mutans has remaine...

  11. Susceptibility of Nocardia asteroides to 46 antibiotics, including 22 beta-lactams.

    Gutmann, L; Goldstein, F W; Kitzis, M D; Hautefort, B; Darmon, C; Acar, J F


    Twelve Nocardia asteroides isolates were tested for their susceptibility to 46 antibiotics by the agar dilution method. N-Formimidoyl thienamycin was the most active of 22 beta-lactam antibiotics, inhibiting 11 of the 12 strains at 1 microgram/ml. Penicillins, including ureidopenicillins, showed poor activity. Cefotaxime, ceftriaxone, and especially cefuroxime had the best activities of the cephalosporins tested. Among the other antibiotics, amikacin and minocycline, respectively, inhibited a...

  12. Novel water soluble neutral vanadium(IV)-antibiotic complex: Antioxidant, immunomodulatory and molecular docking studies.

    Datta, Chitraniva; Das, Dharitri; Mondal, Paritosh; Chakraborty, Biswajit; Sengupta, Mahuya; Bhattacharjee, Chira R


    A novel water soluble five coordinate oxovanadium(IV) complex, [VO(C16H15N4O8S)HSO4] incorporating cefuroxime, a cephalosporin group of antibiotic have been prepared from an interaction of vanadyl sulfate and cefuroxime in aqueous solution. The compound was characterized by Fourier transform infrared spectroscopy (FTIR), CHN microanalyses, ultraviolet-visible spectroscopy (UV-Vis), fast atom bombardment (FAB) mass spectrometry and thermogravimetric analysis (TGA). Density Functional Theory (DFT) computation using Gaussian 09 program at B3LYP level revealed a distorted square pyramidal energy optimized geometry for the vanadyl(IV) complex. The molecular docking studies show that the interaction between the vanadium complex and protein receptor, clathrin is dominated by hydrophobic forces. The experimental (1)H nuclear magnetic resonance (NMR) features of the analogous Zn(II) complex matched well with the theoretically computed values further affirming the distorted square pyramidal geometry for the vanadyl(IV) complex. Cyclic voltammetry revealed a metal centered single-electron oxidation-reduction response for VO(IV)/VO(V) couple. The antioxidant activity of the vanadium(IV)-complex vis-à-vis the antibiotic has been assessed by 1,1-diphenyl-2-picrylhydrazyl (DPPH) method. The vanadium complex showed comparatively better radical scavenging ability compared to the antibiotic cefuroxime. The antimicrobial activity of the compound has been assayed for five different microbial strains using minimum inhibitory concentration (MIC) method. Immunomodulatory studies carried out using phagocytosis index, myeloperoxidase release and cytokine assay indicated the vanadium(IV)-complex to be immunosuppressant. The cytotoxicity of the compound was evaluated by MTT (3-(4, 5-dimethyl thiazol-2-yl)-2, 5-diphenyl tetrazolium bromide) reduction assay. PMID:25982330

  13. Ability of medical students to calculate drug doses in children after their paediatric attachment

    Oshikoya KA


    Full Text Available Dose calculation errors constitute a significant part of prescribing errors which might have resulted from informal teaching of the topic in medical schools. Objectives: To determine adequacy of knowledge and skills of drug dose calculations in children acquired by medical students during their clinical attachment in paediatrics.Methods: Fifty two 5th year medical students of the Lagos State University College of Medicine (LASUCOM, Ikeja were examined on drug dose calculations from a vial and ampoules of injections, syrup and suspension, and tablet formulation. The examination was with a structured questionnaire mostly in the form of multiple choice questions.Results: Thirty-six (69.2% and 30 (57.7% students were taught drug dose calculation in neonatal posting and during ward rounds/ bed-side teaching, respectively. Less than 50% of the students were able to calculate the correct doses of each of adrenaline, gentamicin, chloroquine and sodium bicarbonate injections required by the patient. Dose calculation was however relatively better with adrenalin when compared with the other injections. The proportion of female students that calculated the correct doses of quinine syrup and cefuroxime suspension were significantly higher than those of their male counterparts (p<0.05 and p<0.01, respectively; Chi-square test. When doses calculated in mg/dose and mL/dose was compared for adrenalin injection and each of quinine syrup and cefuroxime suspension, there were significant differences (adrenaline and quinine, p=0.005; adrenaline and cefuroxime, p=0.003: Fischer’s exact test. Dose calculation errors of similar magnitude to injections, syrup and suspension were also observed with tablet formulation.Conclusions: LASUCOM medical students lacked the basic knowledge of paediatric drug dose calculations but were willing to learn if the topic was formally taught. Drug dose calculations should be given a prominent consideration in the undergraduate medical

  14. The availability and cost of antibiotics for treating PID in the Central Region of Ghana and implications for compliance with national treatment guidelines.

    Bosu, W K; Mabey, D


    The availability and cost of antibiotics for treating pelvic inflammatory disease (PID) were assessed in 17 drug-dispensing outlets in 5 districts of the Central Region, Ghana. The outlets included the dispensaries of 2 regional and 4 district hospitals, 4 privately-owned pharmacies and 7 chemical seller shops. The most common antibiotics available, including co-trimoxazole, metronidazole, benzylpenicillin, amoxycillin, chloramphenicol and gentamicin, were also the lowest-priced drugs. Conversely, the most expensive antibiotics including ceftriaxone, ciprofloxacin, cefuroxime and spectinomycin, were also the least commonly available. Recommended anti-gonococcal antibiotics (ciprofloxacin, ceftriaxone) may not be prescribed if they are not available in the districts. PMID:9764942

  15. Sternal and costochondral infections with gentamicin and methicillin resistant Staphylococcus aureus following thoracic surgery.

    Cafferkey, M T; Luke, D A; Keane, C T


    Six patients in a thoracic unit developed sternal osteomyelitis and costochondritis following median sternotomy. Five of the patients were operated on in another hospital. Gentamicin and methicillin resistant Staphylococcus aureus was isolated in pure culture in each case. The S. aureus isolate from 2 patients was of the same phage type suggesting cross-infection. Antibiotic prophylaxis administered in the perioperative period was ineffective. One patient, treated with amikacin (to which all of the strains were sensitive in vitro) and cefuroxime, died from overwhelming infection in spite of débridement and resuturing of the wound. The remaining 5 patients were cured with vancomycin therapy usually coupled with surgical intervention. PMID:6557667

  16. Cloning of a Chryseobacterium (Flavobacterium) meningosepticum Chromosomal Gene (blaACME) Encoding an Extended-Spectrum Class A β-Lactamase Related to the Bacteroides Cephalosporinases and the VEB-1 and PER β-Lactamases

    Rossolini, Gian Maria; Franceschini, Nicola; Lauretti, Laura; Caravelli, Berardo; Riccio, Maria Letizia; Galleni, Moreno; Frère, Jean-Marie; Amicosante, Gianfranco


    In addition to the BlaB metallo-β-lactamase, Chryseobacterium (Flavobacterium) meningosepticum CCUG 4310 (NCTC 10585) constitutively produces a 31-kDa active-site serine β-lactamase, named CME-1, with an alkaline isoelectric pH. The blaACME gene that encodes the latter enzyme was isolated from a genomic library constructed in the Escherichia coli plasmid vector pACYC184 by screening for cefuroxime-resistant clones. Sequence analysis revealed that the CME-1 enzyme is a new class A β-lactamase ...

  17. Melkersson-Rosenthal syndrome associated with psoriasis vulgaris and orofacial impetiginization

    Ryszard Galus


    Full Text Available Melkersson-Rosenthal syndrome (MRS is a disease of unknown etiology, usually restricted to the orofacial region, characterized by reccurent orofacial swelling, relapsing facial palsy and plicated tongue. We report case of MRS associated with psoriasis in a 25-year-old woman. The patient has been treated with satisfying results with a combination of Cetirizine, Cefuroxime axetil and Mupirocin ointment; psoriatic eruptions were successfully treated with 10 % salicylic-sulphuric ointment twice a day. MRS syndrome is a rare disease and should be considered in the differential diagnosis of labial swelling and facial palsy.

  18. Fosfomycin trometamol: a review of its use as a single-dose oral treatment for patients with acute lower urinary tract infections and pregnant women with asymptomatic bacteriuria.

    Keating, Gillian M


    Fosfomycin trometamol (fosfomycin tromethamine) [Monuril(®), Monurol(®), Monural(®)] is approved in numerous countries worldwide, mainly for the treatment of uncomplicated urinary tract infections (UTIs). Fosfomycin has good in vitro activity against common uropathogens, such as Escherichia coli (including extended-spectrum β-lactamase-producing E. coli), Proteus mirabilis, Klebsiella pneumoniae and Staphylococcus saprophyticus, and the susceptibility of uropathogens to fosfomycin has remained relatively stable over time. A single oral dose of fosfomycin trometamol 3 g (the approved dosage) achieves high concentrations in urine. Results of recent randomized trials indicate that single-dose fosfomycin trometamol had similar clinical and/or bacteriological efficacy to 3- to 7-day regimens of ciprofloxacin, norfloxacin, cotrimoxazole or nitrofurantoin in women with uncomplicated lower UTIs. In addition, single-dose fosfomycin trometamol had similar bacteriological efficacy to a 5-day course of cefuroxime axetil or a 7-day course of amoxicillin/clavulanic acid in pregnant women with asymptomatic bacteriuria, and similar clinical and/or bacteriological efficacy to a 5-day course of cefuroxime axetil or amoxicillin/clavulanic acid or a 3-day course of ceftibuten in pregnant women with a lower UTI. Single-dose fosfomycin trometamol was generally well tolerated, with gastrointestinal adverse events (e.g. diarrhoea, nausea) reported most commonly. In conclusion, single-dose fosfomycin trometamol is an important option for the first-line empirical treatment of uncomplicated lower UTIs. PMID:24202878

  19. Clinical observations associated with proven and unproven cases in the ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery.

    Barry, Peter


    PURPOSE: To describe cases of postoperative endophthalmitis in the European Society of Cataract & Refractive Surgeons (ESCRS) study of the prophylaxis of endophthalmitis, compare characteristics of unproven cases and cases proven by culture or polymerase chain reaction, and compare the characteristics with those in other reported series. SETTING: Twenty-four ophthalmology units in Austria, Belgium, Germany, Italy, Poland, Portugal, Spain, Turkey, and the United Kingdom. METHODS: Univariable and multivariable logistic regression models were used to analyze data for statistical association of signs and symptoms in cases with proven or unproven endophthalmitis. Specific data describing characteristics of the cases were compared between the 2 types of cases. RESULTS: Data from 29 endophthalmitis cases were analyzed. Swollen lids and pain were statistically associated with proven cases of endophthalmitis on univariable regression analysis. Multivariable analysis indicated that swollen lids and an opaque vitreous were associated with proven cases. Five cases of endophthalmitis occurred in the cefuroxime-treated groups. No case of streptococcal infection occurred in the cefuroxime-treated groups. However, cases of infection due to streptococci showed striking differences in visual acuity and were associated with earlier onset. Characteristics in the 29 cases parallel results in previous studies, such as the Endophthalmitis Vitrectomy Study, although the addition of a control group in the ESCRS study elicited additional findings. CONCLUSION: Swollen lids, pain, and an opaque vitreous were statistically associated with proven endophthalmitis cases in the ESCRS study.

  20. Molecular epidemiology of serotype 19A Streptococcus pneumoniae isolated from children in Beijing, 1997-2006

    XUE Lian; YAO Kai-hu; YU Sang-jie; LIU Zun-jie; QIAN Jing; SHEN Xu-zhuang; YANG Yong-hong


    Background Despite the prevalence of Streptococcus pneumoniae serotype 19A, the molecular characteristics of this serotype are yet to be fully elucidated. The aim of this study was therefore to determine the homology of the serotype 19A in China.Methods Pulsed-field gel electrophoresis and multilocus sequence typing were done to these forty-nine serotype 19A isolates to investigate the relationship between the strains prevalent in Beijing and other regions. Results From 1997 to 2006, the percentage of serotype 19A isolates increased. The susceptibility rate to penicillin and amoxicillin decreased and the resistance rate to cefuroxime increased. ST320 was the most prevalent ST, followed by ST3546. There were six new STs identified in our study. The serotype 19A strains were classified into six different pulsed-field gel electrophoresis (PFGE) patterns. ST320, which was associated with two different PFGE patterns (A and D), accounted for 32 isolates, and ST3546, which was associated with two PFGE patterns (B and E), accounted for eightConclusions From 2003 onwards, ST320 was the most common ST and the rate of resistance to cefuroxime increased significantly. Further long-term surveys of Streptococcus pneumoniae serotype 19A are required to monitor ST prevalence and antimicrobial resistance in this important human pathogen.


    Kuvat, Nuray; Nazik, Hasan; Berkiten, Rahmiye; Öngen, Betigül


    Resistance of 235 Haemophilus influenzae clinical isolates from Istanbul Medical Faculty Hospital, Turkey were determined against 19 antibiotics by disc diffusion method, and minimum inhibitory concentrations (MICs) of those found resistant to ampicillin, cefuroxim, chloramphenicol and meropenem were measured using E-test. Ampicillin-resistant isolates producing beta-lactamase as demonstrated by a nitrocefin assay were analyzed for the presence of TEM-1 and ROB-1 genes by PCR. Eleven percent of the isolates were resistant to ampicillin (10 µg/ml), of which 73% were beta-lactamase positive and carried TEM-1 gene, but none were positive for ROB-1 gene. All isolates susceptible to amoxicillin-clavulanate (20/10 µg/ml), azithromycin (15 µg/ml), aztreonam (30 µg/ml), cefotaxime (30 µg/ml), ceftriaxone (30 µg/ml), ciprofloxacin (5 µg/ml), levofloxacin (5 µg/ml), and telithromycin (15 µg/ml) but 24%, 15%, 4%, 4%, 2%, 1%, 1%, 0.5%, 0.5% and 0.5% were resistant to trimethoprim-sulfamethoxazole (1.25/23.75 µg/ml), tetracycline (30 µg/ml), cefaclor (30 µg/ml), clarithromycin (15 µg/ml), cefuroxime (30 µg/ml), meropenem (10 µg/ml), chloramphenicol (30 µg/ml), ampicillin-sulbactam (10/10 µg/ml), nalidixic acid (30 µg/ml), and fosfomycin (30 µg/ml), respectively. MIC values of three cefuroxime-resistant isolates was 24, 48 and > 256 µg/ml, respectively; of two meropenem-resistant strains > 256 µg/ml; and of two chloramphenicol-susceptible isolates (by disc diffusion method) 6 µg/ml (considered as intermediate susceptible). Multiple- antibiotics resistance was detected in 15% of the strains, with resistance to 2, 3, 4, 5 and 6 antibiotics in 8.5%, 4%, 2%, 0.5% and 0.5% of the isolates, respectively. By identifying beta-lactamase-negative ampicillin-resistant H. influenzae, empirical therapy with beta-lactam/beta-lactamase inhibitor combinations and second generation cephalosporins would be inappropriate for such patients (approximately 3%). Our findings will

  2. Evaluation of the Oxoid Aura image system for measuring zones of inhibition with the disc diffusion technique.

    Andrews, J M; Boswell, F J; Wise, R


    In this study the Oxoid Aura image antibiotic sensitivity test system, used as a stand-alone device, was compared with manual zone measurement and use of a template, for the determination of sensitivities. An overall correlation coefficient of 0.99 was observed for zone diameters measured using the Aura image system and zones measured manually, when the differences between zones were within 3 mm; 5.4% of zones showed a difference in zone diameter between manual and automated measurement of >3 mm. The results obtained using the template method for interpretation were less reliable than zone measurement, with cefuroxime and ampicillin tested against Enterobacteriaceae and Acinetobacter spp. When linked to a laboratory patient database, the bar code and disc identification facilities avoided errors that were associated with manual data entry. PMID:11020249


    Babych E.M.


    Full Text Available The biological properties (growth characteristics, adhesive activity and sensitivity to antimicrobial of probiotic Lactobacillus strains were studied under different gas composition of incubation atmosphere. It was found that the number of viable lactobacilli cells in the one dose of investigated probiotic preparations was lower than it was claimed by the manufacturer. Gas composition of incubation atmosphere affects cell viability of probiotic strains. The number of colony forming units of lactobacilli under microaerophilic conditions increased in 1,19-1,33 times as compared with aerobic conditions. It was proved that adhesive activity of probiotic Lactobacillus strains and sensitivity to 2th, 3th, 4th generations of cephalosporins (cefuroxime, cefotaxime, cefepime and tetracyclines (doxycycline also increased under microaerophilic conditions. The changes of the biological properties of lactobacilli under different cultivation conditions require further study for optimization of correction of dysbiotic disorders.

  4. A case of Gaucher's disease progressing to liver cirrhosis.

    Debnath, C R; Debnath, M R; Nabi, N; Khan, N A; Chakraborty, S


    We are going to present a 17 year old female with Gaucher's disease. The patient presented with fever, cough, respiratory distress & abdominal heaviness. There was mild pallor, redness of palm of hands & raised temperature. Liver was hugely enlarged along with splenomegaly. X-ray chest showed non specific bronchiectatic change in both lungs. Ultrasonography of abdomen revealed marked hepatosplenomegaly with no ascites. Bone marrow examination showed cellular marrow with plenty of megakaryocytes. Most of the cells were smear cells & there was histiocytes proliferation & infiltration of bone marrow by small atypical cells. Histologically, lipid was found in hepatocytes in moderate amount. The portal areas showed high lipid contents in macrophages. Different clinical findings & incidental diagnosis of lipid storage disease submerged us in diagnostic dilemma. We give conservative treatment with antibiotic cefuroxime, syrup lactulose & vitamins and this patient was improved. PMID:23715368

  5. Antimicrobial susceptibility of clinical isolates of Haemophilus influenzae to ampicillin-sulbactam.

    Mortensen, J E; LaRocco, M; Himes, S L; Inderlied, C; Daly, J A; Campos, J M; Mendelman, P M


    A total of 1092 clinical isolates of Haemophilus influenzae (306 type b; 786 non-type-b), from five medical centers were obtained during 1987 and 1988. Disk diffusion antimicrobial susceptibilities were obtained for all isolates, and broth microdilution susceptibilities were obtained for 502 isolates. Beta-lactamase was produced by 34.3% of type-b and 22.1% of non-type-b isolates, with some geographic variations. Using disk diffusion antimicrobial susceptibility testing, all isolates were susceptible to ampicillin-sulbactam, ceftriaxone, cefuroxime, and rifampin; two isolates were resistant to chloramphenicol. Whether tested using a fixed ratio of ampicillin to sulbactam of 2:1 or a fixed concentration of sulbactam, the ampicillin-sulbactam combination demonstrated good activity against clinical isolates of H. influenzae. Only 8 of the 1092 isolates did not produce beta-lactamase but demonstrated MICs of greater than or equal to 2 micrograms/ml for ampicillin. PMID:2076596

  6. Antimicrobial susceptibility of clinical isolates of Acinetobacter baumannii.

    Shi, Z Y; Liu, P Y; Lau, Y; Lin, Y; Hu, B S; Shir J-M


    The in-vitro activity of 18 antimicrobial agents alone or in combination against 248 clinical isolates of Acinetobacter baumannii from Taiwan were tested by agar dilution. The MIC90S of ampicillin, amoxicillin, piperacillin, cefuroxime, cefotaxime, ceftriaxone, gentamicin, and amikacin were at least 128 mu g/ml. Ceftazidime, cefepime, sulbactam, clavulanic acid, and tazobactam presented moderate activity with MIC90S of 32, 16, 16, 32, and 32 mu g/ml, respectively. The increased activity of ampicillin/sulbactam, amoxicillin/clavulanic acid, and piperacillin/tazobactam was due to the intrinsic effect of sulbactam, clavulanic acid, and tazobactam, respectively. Imipenem, meropenem, and ciprofloxacin were the most active antimicrobial agents with MIC90S of 1, 1, and 0.5 mu g/ml, respectively. Nineteen isolates (7.7%) were resistant to all aminoglycosides and beta-lactam antibiotics, except carbapenems and ciprofloxacin. We are concerned about the multidrug resistance of A. baumannii in this study. PMID:9147913

  7. Antibiotic prevention of postcataract endophthalmitis

    Kessel, Line; Flesner, Per; Andresen, Jens;


    Endophthalmitis is one of the most feared complications after cataract surgery. The aim of this systematic review was to evaluate the effect of intracameral and topical antibiotics on the prevention of endophthalmitis after cataract surgery. A systematic literature review in the MEDLINE, CINAHL......, Cochrane Library and EMBASE databases revealed one randomized trial and 17 observational studies concerning the prophylactic effect of intracameral antibiotic administration on the rate of endophthalmitis after cataract surgery. The effect of topical antibiotics on endophthalmitis rate was reported by one...... with the use of intracameral antibiotic administration of cefazolin, cefuroxime and moxifloxacin, whereas no effect was found with the use of topical antibiotics or intracameral vancomycin. Endophthalmitis occurred on average in one of 2855 surgeries when intracameral antibiotics were used compared to...

  8. Multiple drug resistance of Aeromonas hydrophila isolates from Chicken samples collected from Mhow and Indore city of Madhyapradesh



    Full Text Available Fourteen antibacterial agents belonging to 9 different groups of antibiotics viz. aminoglycosides, cephalosporins, nitrofurantoin, fluroquinolones, chloramphenicol, sulphonamides, tetracyclines, penicillin and polymixin were used for in vitro sensitivity testing of Aeromonas hydrophila isolated from fifteen samples of chicken collected from retail shops in Mhow city. The sensitivity (100% was attributed to ciprofloxacin, cefuroxime, ceftriaxone, cephotaxime, chloramphenicol, gentamycin, kanamycin, nitrofurantoin, nalidixic acid and ofloxacin followed by oxytetracycline (50%. All the isolates were resistant to ampicillin and colistin antibiotics. That means, none of the isolates were found to be sensitive for penicillin and polymixin group of antibiotics. Multiple drug resistance was also observed in all A. hydrophila isolates. Out of total isolates, 100% were resistant to two antimicrobial drugs and 50% to three drugs. [Vet. World 2009; 2(1.000: 31-32

  9. Moxifloxacin Induced Seizures -A Case Report.

    Jiana Shi


    Full Text Available A 73-year-old female patient developed a generalized tonic-clonic seizure on the 6th day after treatment with moxifloxacin 400 mg daily intravenously for appendicitis. This patient had atrial fibrillation and history of a surgery for intracerebral hemorrhage, with impaired renal function and liver function, but without history of seizures. Moxifloxacin was discontinued and switched to cefuroxime. The patient remained seizure-free at discharge four days later. The naranjo adverse drug reaction probability scale score was 4, indicating a possible adverse reaction to moxifloxacin. The potential risk factors related to moxifloxacin-induced seizures are discussed. It highlights that preexisting central nervous system disease, elderly female with lower bodyweight and severe renal impairment may be the risk factors involved in moxifloxacin-induced seizures.

  10. Voltammetric and theoretical studies of electrochemical behavior of cephalosporins at the mercury electrode

    Nikolić Katarina


    Full Text Available Study of the adsorption and electroreduction behavior of cefpodoxime proxetil, cefotaxime, desacetylcefotaxime, cefetamet, ceftriaxone, ceftazidime, and cefuroxime axetile at the mercury electrode surface has been performed using Cyclic (CV, Differential Pulse (DPV, and Adsorptive Stripping Differential Pulse Voltammetry (AdSDPV. The Quantitative Structure Property Relationship (QSPR study of the seven cephalosporins adsorption at the mercury electrode has been based on the density functional theory DFT-B3LYP/6-31G (d,p calculations of molecular orbitals, partial charges and electron densities of analytes. The DFT-parameters and QSPR model explain well the process of adsorption of the examined cephalosporins. QSPR study defined that cefalosporins with lower charge of sulphur in the thiazine moiety, lower electron density on the nitrogen atom of the N-O bond, higher number of hydrogen bond accepting groups, and higher principal moment of inertia should express high adsorption on the mercury electrode. [Projekat Ministarstva nauke Republike Srbije, br. 172033

  11. Analysis of prescriptions dispensed at community pharmacies in Nablus, Palestine.

    Sawalha, A F; Sweileh, W M; Zyoud, S H; Al-Jabi, S W; Shamseh, F F Bni; Odah, A


    We investigated the prescription quality and prescribing trends of private clinicians in Nablus governorate, Palestine. A total of 363 prescriptions were collected from a random sample of 36 community pharmacies over a study period of 288 working hours. Data regarding elements in the prescription and the types of drugs prescribed were analysed. Physician-related variables were mostly noted, however, patient's address and weight were absent in all prescriptions and less than half included age and sex. Information regarding strength of the medications prescribed was missing in over 70% of prescriptions. Other drug-related variables like frequency and instruction of use were present in over 80% of prescriptions. Antimicrobial agents were the most commonly prescribed followed by NSAIDs/analgesics. Amoxicillin alone or in combination was the most commonly prescribed antimicrobial agents followed by cefuroxime. Prescription writing quality in Nablus is deficient in certain aspects and improvement is required. PMID:20799538

  12. Skin infections in pregnancy.

    Müllegger, Robert R; Häring, Nina S; Glatz, Martin


    A wide array of infectious diseases can occur in pregnancy. Their acquisition, clinical presentation, and course during gestation may be altered due to an impairment of the maternal cellular immunity. Some infectious diseases can lead to serious consequences for the mother or the offspring, including congenital malformations. This review describes in detail the clinical presentation, course, management, and associated maternal and fetal risks of selected viral (varicella-zoster virus infections, condylomata acuminata), fungal (candida vulvovaginitis), bacterial (Lyme borreliosis), and parasitic (scabies) infections. The treatment options are critically reviewed. First-line therapies include acyclovir and varicella-zoster virus immunoglobulin for varicella-zoster virus infections, surgical modalities for genital warts, topical clotrimazole and oral fluconazole for Candida vulvovaginitis, amoxicillin and cefuroxime for Lyme borreliosis, and permethrin for scabies. A synopsis of maternal and fetal risks of other important infections is also included. PMID:27265075

  13. [Pharmacokinetics of cefixime in volunteers and a literature comparison with the new ester prodrug cephalosporins].

    Kees, F; Naber, K G


    The pharmacokinetic parameters of cefixime were determined in healthy volunteers following oral administration of 200 mg cefixime as tablet, syrup and dry suspension, respectively. All three galenic formulations showed reliable absorption. Mean peak plasma concentrations amounted to 2.4-3.4 mg/l and were reached after 3.3-3.5 h. Mean terminal half-lives were 2.9-3.1 h. The mean areas under the plasma concentration-time curves ranged between 18 and 26 mg/l.h; 18-24% of the dose administered were recovered unchanged in the urine. The best bioavailability was obtained with the dry suspension followed by the tablet and the syrup. With respect to the ester pro-drug cephalosporins, cefuroxime axetil, cefetamet pivoxyl and cefotiam hexetil, cefixime exhibits higher plasma half-life and area under the curve as well as, comparable absolute bioavailability but consistently lower urinary recovery which indicates higher non-renal clearance. PMID:2079377

  14. Long-Term Evolution Studies of E. Coli under Combined Effects of Simulated Microgravity and Antibiotic.

    Karouia, Fathi; Tirumalai, Madhan R.; Ott, Mark C.; Pierson, Duane L.; Fox, George E.; Tran, Quyen


    Multiple spaceflight and simulated microgravity experiments have shown changes in phenotypic microbial characteristics such as microbial growth, morphology, metabolism, genetic transfer, antibiotic and stress susceptibility, and an increase in virulence factors. However, while these studies have contributed to expand our understanding of the short-term effects of spaceflight or simulated microgravity on biological systems, it remains unclear the type of responses subsequent to long-term exposure to space environment and microgravity in particular. As such, organisms exposed to the space environment for extended periods of time may evolve in unanticipated ways thereby negatively impacting long duration space missions. We report here for the first time, an experimental study of microbial evolution in which the effect of long-term exposure to Low Shear Modeled MicroGravity (LSMMG) on microbial gene expression and physiology in Escherichia coli (E. coli) MG1655 was examined using functional genomics, and molecular techniques with and without simultaneous exposure to broad spectrum antibiotic chloramphenicol. E. coli cells were grown under simulated microgravity for 1000 generations in High Aspect Ratio Vessels (HARVs) that were either heat-sterilized (115 deg C, 15 min) or by using/rinsing the HARVs with a saturated solution of the broad-spectrum antibiotic chloramphenicol. In the case of the cells evolved using the antibiotic sterilized HARVs, the expression levels of 357 genes were significantly changed. In particular, fimbriae encoding genes were significantly up-regulated whereas genes encoding the flagellar motor complex were down-regulated. Re-sequencing of the genome revealed that a number of the flagellar genes were actually deleted. The antibiotic resistance levels of the evolved strains were analyzed using VITEK analyzer. The evolved strain was consistently resistant to the antibiotics used (viz., Ampicillin, Cefalotin, Cefurox-ime, Cefuroxime Axetil

  15. Evaluation of Eight Different Cephalosporins for Detection of Cephalosporin Resistance in Salmonella enterica and Escherichia coli

    Aarestrup, Frank Møller; Hasman, Henrik; Veldman, K; Mevius, D


    This study evaluates the efficacy of eight different cephalosporins for detection of cephalosporin resistance mediated by extended spectrum beta-lactamases (ESBL) and plasmidic AmpC beta-lactamases in Salmonella and Escherichia coli. A total of 138 E. coli and 86 Salmonella isolates with known beta...... cephalosporin-susceptible, 56 ESBL isolates and 19 isolates with plasmidic AmpC, as well as 10 ampC hyper-producing E. coli. The minimum inhibitory concentration distributions and zone inhibitions varied with the tested compound. Ampicillin-resistant isolates showed reduced susceptibility to the cephalosporins...... compared to ampicillin-susceptible isolates. Cefoperazone, cefquinome, and cefuroxime were not useful in detecting isolates with ESBL or plasmidic AmpC. The best substances for detection were cefotaxime, cefpodoxime, and ceftriaxone, whereas ceftazidime and ceftiofur were not as efficient. Ceftriaxone may...

  16. Development of a capillary electrophoresis method for the simultaneous determination of cephalosporins

    Hancu Gabriel


    Full Text Available A rapid and simple capillary electrophoresis method has been developed for the simultaneous determination of six extensively used cephalosporin antibiotics (cefaclor, cefadroxil, cefalexin, cefuroxim, ceftazidim, ceftriaxon. The determination of cephalosporins was performed at a pH 6.8, using a 25 mM phospate - 25 mM borate mixed buffer, + 25 kV voltage at a temperature of 25 °C. We achieved a baseline separation in approximately 10 minutes. The separation resolution was increased by addition of an anionic surfactant, 50 mM sodium dodecyl sulfate, to the buffer solution. The proposed separation was evaluated on the basis of detection and quantification limits, effective electrophoretic mobility and relative standard deviation for migration times and peak areas.

  17. Six cases of Aerococcus sanguinicola infection: Clinical relevance and bacterial identification

    Ibler, K.; Jensen, K.T.; Ostergaard, C.;


    were associated with infective endocarditis. Most patients were elderly (median age 70 y) and had underlying neurological disorders including dementia, cerebral degeneration, and myelomeningocele. The primary focus of infection was the urinary tract in 3 cases and the gallbladder in 1; no focus was......Aerococcus sanguinicola is a Gram-positive coccus first described in 2001. Infections in humans are rare but the use of 16S rRNA gene sequencing and improved phenotypic methods has facilitated the identification of A. sanguinicola. We report here 6 cases of A. sanguinicola bacteraemia, 2 of which...... detected in 2 cases. Long-term prognosis was poor reflecting the frailty of the patients. All strains were susceptible to penicillin, ampicillin, cefuroxime, vancomycin, erythromycin, and rifampicin. The optimal treatment of infection with A. sanguinicola has yet to be determined Udgivelsesdato: 2008...

  18. The prevalence of ESBL-producing E-coli and Klebsiella strains in the Copenhagen area of Denmark

    Kjerulf, A.; Hansen, D.S.; Sandvang, D.;


    The main purpose of the study was to investigate the frequency of ESBL-producing E. coli and Klebsiella strains in the Greater Copenhagen area. Four collections of strains were investigated: A) 380 consecutive E. coli and Klebsiella isolates primarily from urine, B) 200 gentamicin-resistant E. coli...... and Klebsiella isolates primarily from urine, C) 210 consecutive E. coli isolates from blood cultures, and D) 68 cefuroxime-resistant E. coli and Klebsiella isolates primarily from urine. Only one strain per patient was included. Strains with a zone diameter for cefpodoxime <= 23 mm were tested by a...... and AmpC (n=1). In conclusion, the frequency of ESBL-producing E. coli and Klebsiella isolates was low in the Copenhagen area of Denmark (0.8 %). The most common ESBL genes found in our study were ctx-m and shv genes Udgivelsesdato: 2008/2...

  19. Impact of antibiotic restriction on resistance levels of Escherichia coli

    Boel, Jonas; Andreasen, Viggo; Jarløv, Jens Otto;


    OBJECTIVES: We evaluated the effect of an antibiotic stewardship programme (ASP) on the use of antibiotics and resistance levels of Escherichia coli using a method that allowed direct comparison between an intervention hospital and a control hospital. METHODS: The study was conducted as a...... of E. coli. Results were directly compared with data from the control hospital utilizing a subtracted time series (STS). RESULTS: Direct comparison with the control hospital showed that the ASP was associated with a significant change in the level of use of cephalosporins [-151 DDDs/1000 bed-days (95......% CI -177, -126)] and fluoroquinolones [-44.5 DDDs/1000 bed-days (95% CI -58.9, -30.1)]. Resistance of E. coli showed a significant change in slope for cefuroxime [-0.13 percentage points/month (95% CI -0.21, -0.057)] and ciprofloxacin [-0.15 percentage points/month (95% CI -0.26, -0.038)]. CONCLUSIONS...

  20. [Antimicrobial susceptibility of Neisseria gonorrhoeae strains determined by disk diffusion].

    Llanes Caballero, R; Acosta Giraldo, J C; Sosa Puente, J; Guzmán Hernández, D; Gutiérrez González, O; Llop Hernández, A


    The Gonoccocus Laboratory of "Pedro Kourí" Tropical Medicine Institute carried out a study of in vitro susceptibility of Neisseria gonorrhoeae to penicillin, tetracycline, cefuroxime ceftriaxone, cefotaxine and ciprofoxacin by means of a disk diffusion method with the culture medium agar base GC plus supplement. In the first phase, the method was standardized and the reference N. gonorrhoeae ATCC 49226 strain was used whereas in the second phase, 50 gonococcal strains isolated in 8 provinces during 1995 and 1996 were examined. The results of such standardization confirmed that the antimicrobial susceptibility values were within the allowable limits. 52 and 34% of strains were resistant to penicillin and tetracycline respectively and all of them showed susceptibility to the rest of evaluated antimicrobial drugs. We recommend the use of the disk diffusion method for surveillance of gonococci resistance to these drugs in our country. PMID:10887570

  1. [Properties of a cephalosporinase produced by Proteus penneri inhibited by clavulanic acid].

    Miro, E; Barthelemy, M; Peduzzi, J; Reynaud, A; Morand, A; Prats, G; Labia, R


    P. penneri produces an inducible cephalosporinase, as many Enterobacteriaceae. Nevertheless this betalactamase is susceptible to clavulanic acid which is an exception also encountered for P. vulgaris. The authors studied the enzyme produced by P. penneri 14HBC resistant to cefotaxime (MIC 16 mg/l) isolated in Spain in 1992. This betalactamase of isoelectric point 6.65 hydrolyzes first generation cephalosporins, amoxycillin and poorly ticarcillin as it occurs for all cephalosporinases. However, this enzyme hydrolyzes strongly oxyimino-cephalosporins: cefuroxime, cefotaxime, cefepime, cefpirome as it occurs with extended-spectrum betalactamases. Cephamycins and imipenem are not substrates. Clavulanic acid has a very good affinity for this betalactamase which is inactivated progressively. These properties are similar to those of the enzyme of P. vulgaris Ro104 of isoelectric point 8.3 which, contrarily to other cephalosporinases, belongs to the structural Ambler's class A. PMID:7824319

  2. [2d-generation cephalosporins in the treatment of gram-negative superinfections].

    Mouton, Y; Caillaux, M; Brion, M; Fourrier, A


    The second generation cephalosporins are those drugs that are totally or partially resistant to betalactamases (cefamandole, cefuroxime) or the cephamycins (cefoxitine). This property allows them to destroy the enterobacteria resistant to cefalotine and they may have a place in the treatment of certain post-operative infections (abdominal, gynaecological, urinary) on their own or in combination with an aminoglycoside. They also may be of use in combination with an aminoglycoside in the management of secondary septicaemia infections. Outside of these indications which are dependent on the bacteriological findings, their use should be limited even when there is an absence of organisms that are Cefalotine sensitive on the antibiogram. This careful approach (which applies particularly for cefotaxine) may be abandoned once a certain quantity of resistant strains have emerged. For the time being, the second generation cephalosporins ought to be used only for specific indications, and as a general rule should not be first line antibiotic treatment. PMID:44971

  3. Pattern of microbial isolates and microbial sensitivity among HIV positive pregnant women with asymptomatic bacteriuria in Zaria, Nigeria

    Pam S


    Full Text Available Background: Asymptomatic bacteruria in pregnancy is a common condition affecting pregnant women because of both anatomical and physiological changes in pregnancy. This condition appears to be commoner in people living with HIV because of the added immunosuppression caused by the virus. Aim: The study was to identify the pattern of microbial isolates and microbial sensitivity among HIV positive pregnant women with asymptomatic bacteriuria in Zaria, Nigeria. Methods: This was a prospective cross sectional study among symptom-free HIV positive pregnant women attending the prevention of mother to child transmission of HIV (PMTCT antenatal clinic in Zaria, Nigeria between 1st March and 31st August 2011. A structured, closeended questionnaire was administered and mid-stream urine samples were obtained and processed within 2 hours of collection in the laboratory. Results: A total of 220 consenting, asymptomatic, HIV positive pregnant women were screened for bacteriuria out of the 240 eligible women who were approached to participate in the study. Sixteen (16 women were positive for significant bacteriuria, giving a prevalence of 7.3%. A total of six (6 different isolates were isolated with Staphylococcus aureus (8 making 50%, E. Coli (4 18.8%, Klebsiella spp (2 12.5%, Streptococcus spp (2 12.5% and Proteus spp (1 6.2%. All the isolated organisms were sensitive to gentamycin, cefuroxime, ceftazidime, ciprofloxacin and nitrofurantoin. Conclusion: This study found Staphylococcus aureus as the most common organism isolated in the urine of asymptomatic patients with HIV infection in pregnancy. The isolated organisms were sensitive to gentamycin, cefuroxime, ceftazidime, ciprofloxaxin and nitrofurantoin.

  4. Synthesis and evaluation of antimicrobial and anticonvulsant activities of some new 3-[2- (5-aryl-1,3,4-oxadiazol-2-yl/4-carbethoxymethylthiazol-2-yl) imino-4-thiazolidinon-5-ylidene]-5-substituted/nonsubstituted 1H-indole-2-ones and investigation of their structure-activity relationships.

    Altintaş, Handan; Ateş, Oznur; Uyde-Doğan, B Sönmez; Alp, F Ilkay; Kaleli, Deniz; Ozdemir, Osman; Birteksöz, Seher; Otük, Gülten; Atana, Dilek; Uzun, Meltem


    In the present study, 20 new compounds having 3-[2-(5-aryl-1,3,4-oxadiazol-2-yl) imino-4-thiazolidinon-5-ylidene]-5-substituted/nonsubstituted 1H-indole-2-one (I-XII) and 3-[2-(4-carbethoxymethylthiazol-2-yl)imino-4-thiazoldinon-5-ylidenel-5-substituted/nonsubstituted IH-indole-2-one (XIII-XX) systems were synthesized. The structures were confirmed by spectral methods (UV, IR, 1H-NMR, 13C-NMR, 13C-DEPT (135), electron impact mass spectrometry) and elemental analysis. All compounds were tested for in vitro antimicrobial activity against Staphylococcus aureus ATCC 6538, Staphylococcus epidermidis ATCC 12228, Escherichia coli ATCC 8739, Klebsiella pneumoniae ATCC 4352, Pseudomonas aeruginosa ATCC 1539, Salmonella typhi, Shigella flexneri, Proteus mirabilis ATCC 14153, Candida albicans ATCC 10231, Microsporum gypseum (NCPF-580), Microsporum canis, Trichophyton mentagrophytes and Trichophyton rubrum and some of them were found to be active. Especially, compound I was more active than cefuroxime sodium (CAS 56238-63-2) which was used as a standard, and the activity of compound XII was close to that of cefuroxime sodium against Staphylococcus epidermidis ATCC 12228. Primary screening for antituberculous activity was conducted at 6.25 microg/ml against Mycobacterium tuberculosis H37Rv in BACTEC 12B medium using the BACTEC 460 radiometric system. The anticonvulsant activities of selected prototoype compounds (I, IV-VI, VIII, XI, XIII, XVI-XVIII) administered at doses of 50-200 mg/kg (i.p.) were evaluated using the pentetrazol test (PTZ) in mice. PMID:16618017

  5. Incidence and transferability of antibiotic resistance in the enteric bacteria isolated from hospital wastewater

    Mohammad Zubair Alam


    Full Text Available This study reports the occurrence of antibiotic resistance and production of β-lactamases including extended spectrum beta-lactamases (ESβL in enteric bacteria isolated from hospital wastewater. Among sixty-nine isolates, tested for antibiotic sensitivity, 73.9% strains were resistant to ampicillin followed by nalidixic acid (72.5%, penicillin (63.8%, co-trimoxazole (55.1%, norfloxacin (53.6%, methicillin (52.7%, cefuroxime (39.1%, cefotaxime (23.2% and cefixime (20.3%. Resistance to streptomycin, chloramphenicol, nitrofurantoin, tetracycline, and doxycycline was recorded in less than 13% of the strains. The minimum inhibitory concentration (MIC showed a high level of resistance (800-1600 µg/mL to one or more antibiotics. Sixty three (91% isolates produced β-lactamases as determined by rapid iodometric test. Multiple antibiotic resistances were noted in both among ESβL and non-ESβL producers. The β-lactamases hydrolyzed multiple substrates including penicillin (78.8% isolates, ampicillin (62.3%, cefodroxil (52.2%, cefotoxime (21.7% and cefuroxime (18.8%. Fifteen isolates producing ESβLs were found multidrug resistant. Four ESβL producing isolates could transfer their R-plasmid to the recipient strain E. coli K-12 with conjugation frequency ranging from 7.0 x 10-3 to 8.8 x 10-4. The findings indicated that ESβL producing enteric bacteria are common in the waste water. Such isolates may disseminate the multiple antibiotic resistance traits among bacterial community through genetic exchange mechanisms and thus requires immediate attention.


    A Moirangthem


    Full Text Available Objective: Infections of throat have a tremendous impact on public health. This present study aims to find out the bacterial load in throat infections as well as their susceptibility pattern in patients attending Central Referral Hospital, Tadong, Sikkim.Method: A total of 55 symptomatic patients having throat infections attended Central Referral Hospital Sikkim, among which 28 were males and 27 were females. A total of 55 throat swabs were collected from the patients with symptoms ofpharyngitis. Results: Out of 55 samples, culture was positive in 37 samples. Twenty one strains of Staphylococcus aureus, 13 strains of Streptococcus pyogenes, 1 strain of Pseudomonas aeruginosa and 2 strains of Proteus spp. were isolated. The isolation rate of Staph.aureus was found to be statistically significant when compared between the isolation rate of Ps.aeruginosa, Stp. pyogenes and Proteus spp. 3 isolates of Staph. aureus were sensitive to penicillin, 1 isolate was moderately sensitive and 17 isolates were resistant. 12 strains of Staph.aureus were sensitive to methicillin. Methicillinresistant was seen in 9 strains of Staph. aureus. The strains of Stp. pyogenes isolated were either moderately sensitive or resistant to the used antibiotics, it was not sensitive to any of the used antibiotics. It was moderately sensitive to amoxiclave, clarithromycin, erythromycin and resistant toclindamycin and cefuroxime. 100% strains of Ps. aeruginosa were resistant to ciprofloxacin, gentamicin, piperacillin, ticarcillin, tobramycin and the strains were sensitive only to imipenem (100%. Further 100% strains of Proteus spp.were sensitive to cefuroxime, azithromycin, amoxicillinand cephalexin.Conclusion: Our study showed a high rate of monomicrobial infection. The controlof throat infections demands the availability of primary care and appropriate treatment.

  7. The identification, typing, and antimicrobial susceptibility of Pseudomonas aeruginosa isolated from mink with hemorrhagic pneumonia.

    Qi, Jing; Li, Lulu; Du, Yijun; Wang, Shourong; Wang, Jinwen; Luo, Yanbo; Che, Jie; Lu, Jinxing; Liu, Hui; Hu, Guangchun; Li, Jixia; Gong, Yanwen; Wang, Guisheng; Hu, Ming; Shiganyan; Liu, Yuqing


    The biological characteristics and molecular epidemiology of Pseudomonas aeruginosa associated with mink hemorrhagic pneumonia from Shandong province of eastern China were determined in this study. From 2010 to 2011, 30 mink P. aeruginosa isolates were identified from lung, fecal and feed samples of clinical cases and subjected to serotyping, antimicrobial susceptibility testing and pulsed-field gel electrophoresis (PFGE) using SpeI. The P. aeruginosa isolates belonged to four serotypes-21 of type G, four of type I, three of type M, one of type B, and one non-typable strain. The strains were divided into four large groups as determined by PFGE. Isolates from the group 2 were highly homologous and were obtained from the same region as an epidemic. All of the isolates were sensitive to piperacillin, piperacillin/tazobactam, ceftazidime, cefepime, imipenem, amikacin, gentamicin and tobramycin and resistant to ampicillin, cefuroxime and cefuroxime axetil. A high frequency of resistance was found to ampicillin/sulbactam, cefazolin, cefotetan, ceftriaxone, nitrofurantoin, and trimethoprim/sulfamethoxazole (96.7%). Resistance to ticarcillin/clavulanic acid, ciprofloxacin and levofloxacin was less common (13.3%). There was no relationship between antibiotic resistance and serotype distribution of the isolates. The epidemic serotype of P. aeruginosa from the mink hemorrhagic pneumonia in Shandong province was type G, which was a clone of commonly found in this province. These findings reveal the genetic similarities and antimicrobial susceptibility profiles of P. aeruginosa from clinical cases of mink hemorrhagic pneumonia and will facilitate the prevention and control of the disease in Shandong province of China. PMID:24629901

  8. Effectiveness of Nalidixic Acid and Commonly Used Antibiotics Against Pathogens of Urinary System

    Keramettin Yanik


    Full Text Available Aim: Medicines for treatment Urinary tractinfections in common population are ineffective due to long usage and developing resistance. Nowadays quinolones are first choise for empiric treatment this infections. Nalidixic acid is first used quinolone type antimicrobial in this group. Because of developing resistance and side effects new quinolones have found treatment instead of nalidixic acid. For urinary system infections. In our study we aimed to compare resistance to nalidixic acid, fosfomycin and other frequently used oral antimicrobials. Material and Method: We studied 314 urine specimens from Medical Faculty Hospital%u2019s various clinic in microbiology laboratory. After 24 hours incubation the bacteria%u2019s media that cultured were examined. Bacteria were identified with conventional and automatic systems (Vitec® 2 Compact - bioMérieux, France. Antibiotic suseptibility tested were made with Cirby-Bauer method and evaluateda eccording to Clinical Laboratory Standards Institute standards. Results: 241 (79,8% E.coli, 53 (16,9% Klebsiella spp. 11 (3,5% Proteus spp. and 9 Enterobacter spp. bacteria were identified from urine samples.. All strains resistant rate belong to Enterobacteriaceae to nalidixic acid, trimethoprim-sulfamethoxazole, cefuroxime, ciprofloxacin, norfloxacin, nitrofurantoin and fosfomycin were given 42.3% 41.4 %, 32.8 %, 28.6%, 31.5 %, 14.6% 8.5 % respectively. Mostly isolated bacterial from urine was E.coli with high potency to fosfomycin with 2.9% resistance rate was followed by nitrofurantion (resistance rate 6,9%, Cefuroxime, ciprofloxacin, norfloxacin, trimethoprim-sulfamethoxazole, nalidixic acid resistance rate were 6.2%, 30.2%, %32.3, %35.3, %46.4, %46.8 in order. Discussion: As result resistance to nalidixic acide not decreased despite not being in use for a long time and were determined that fosfomycin more susceptible fortreatment urinary tract infections.

  9. Intracellular activity of antibiotics against Staphylococcus aureus in a mouse peritonitis model.

    Sandberg, Anne; Hessler, Jonas H R; Skov, Robert L; Blom, Jens; Frimodt-Møller, Niels


    Antibiotic treatment of Staphylococcus aureus infections is often problematic due to the slow response to therapy and the high frequency of infection recurrence. The intracellular persistence of staphylococci has been recognized and could offer a good explanation for these treatment difficulties. Knowledge of the interplay between intracellular antibiotic activity and the overall outcome of infection is therefore important. Several intracellular in vitro models have been developed, but few experimental animal models have been published. The mouse peritonitis/sepsis model was used as the basic in vivo model exploring a quantitative ex vivo extra- and intracellular differentiation assay. The intracellular presence of S. aureus was documented by electron microscopy. Five antibiotics, dicloxacillin, cefuroxime, gentamicin, azithromycin, and rifampin (rifampicin), were tested in the new in vivo model; and the model was able to distinguish between their extra- and intracellular effects. The intracellular effects of the five antibiotics could be ranked as follows as the mean change in the log(10) number of CFU/ml (Delta log(10) CFU/ml) between treated and untreated mice after 4 h of treatment: dicloxacillin (3.70 Delta log(10) CFU/ml) > cefuroxime (3.56 Delta log(10) CFU/ml) > rifampin (1.86 Delta log(10) CFU/ml) > gentamicin (0.61 Delta log(10) CFU/ml) > azithromycin (0.21 Delta log(10) CFU/ml). We could also show that the important factors during testing of intracellular activity in vivo are the size, number, and frequency of doses; the time of exposure; and the timing between the start of infection and treatment. A poor correlation between the intracellular accumulation of the antibiotics and the actual intracellular effect was found. This stresses the importance of performing experimental studies, like those with the new in vivo model described here, to measure actual intracellular activity instead of making predictions based on cellular pharmacokinetic and MICs. PMID

  10. 儿童鼻部携带肺炎链球菌的研究%Nasal carriage of Streptococcus pneumoniae among children in Beijing

    李洁; 袁林; 俞桑洁; 杨永弘


    Objective To investigate the antimicrobial susceptibility of Streptococcus pneumoniae carried in the nose among children in Beijing and the distribution of serotypes,and to analyze the risk factors for nasal carriage of penicillin non-susceptible S.pneumoniae.Methods A disk diffusion test was applied to detect the antimicrobial susceptibilities of S.pneumoniae to erythromycin,trimethoprim-sulfamethoxazole,chloramphenicol and tetracycline.The E test was applied to determine the minimal inhibitory concentrations of penicillin,cefuroxime,cefotaxime,augmentin and imipenem.S.pneumoniae isolates were serotyped by the Quellung reaction.Results S.pneumoniae that was resistant to penicillin or cefuroxime was not found,but S.pneumoniae intermediate resistant to penicillin and cefuroxime accounted for 8.2% and 2.1%,respectively.All of the isolates were susceptible to cefotaxime,augmentin and imipenem.S.pneumonia that was resistant to erythromycin,trimethoprim-sulfamethoxazole and tetracycline were extremely numerous,accounting for 72%,70% and 79%,respectively.Five serotypes(19,6,14,23,17)accounted for 54.7%,and nontypables accounted for 20.6% of all the S.pneumoniae.Previous history of otitis media was a risk factor we found for nasal carriage of penicillin non-susceptible S.pneumoniae.Conclusions Continued surveillance of the antimicrobial susceptibilities of S.pneumoniae is necessary.A larger scale investigation is needed to identify if the 7 or 9-valent conjugate pneumococcal vaccine is appropriate for Chinese children.%目的了解北京地区儿童鼻部携带的肺炎链球菌对抗生素的敏感性以及血清型分布,分析鼻部携带青霉素非敏感肺炎链球菌的危险因素.方法用纸片扩散法检测肺炎链球菌对红霉素,复方新诺明,氯霉素和四环素的敏感性;E-试验确定青霉素,头孢呋新,头孢噻肟,安灭菌和亚胺培南的最小抑菌浓度;Quellung反应确定肺炎链球菌的血清型.结果未发现对青霉素和头

  11. 淋菌对β-内酰胺类抗菌药物的药敏试验结果回顾性分析%Drug susceptibility tests of neisseria gonorrhoeae to β-lactams antibiotics:a retrospective analysis

    刘明章; 沈翠芬; 吴原; 张晓祥; 王翔


    目的 了解淋菌对β-内酰胺类抗菌药物的敏感性,为淋病的防治提供科学依据.方法 回顾性分析纸片扩散法检测86株淋菌对6种β-内酞胺类抗菌药物的药敏试验结果,产色头孢硝噻吩法检测β-内酰胺酶.结果 质粒介导的产青霉素酶淋菌阳性菌株30株,占34.88%;淋菌对青霉素、头孢呋辛、头孢噻肟、头孢他啶、头孢曲松、头孢吡肟的敏感率分别为8.14%,75.58%,90.70%,93.02%,86.05%,94.19%;青霉素的药物敏感性显著低于头孢呋辛,差异有统计学意义(X2=80.36,P<0.01);头孢呋辛的药物敏感性比头孢曲松的药物敏感性低,差异无统计学意义,但是头孢呋辛有5株耐药菌株;头孢噻肟、头孢他啶、头孢曲松、头孢吡肟的敏感率,差异无统计学意义.结论 第三、四代头孢菌素可作为治疗淋菌感染的一线药物.%OBJECTIVE To investigate the β-lactams susceptibility of Neisseria gonorrhoeae and provide scientific basis for the treatment and prevention of gonorrhea. METHODS A retrospective survey was conducted. β-lactams susceptibility tests were tested by Disk diffusion, and βlactamase was determined by nitrocefin. RESULTS Plasmid mediated penicillinase producing Neisseria gonorrhoeae(PPNG) were 30 straines(34. 88 %). Susceptive rates of penicillin, cefuroxime, cefotaxime, ceftazidime, ceftriaxone and cefepime were 8. 14%, 75. 58%, 90.70%, 93. 02%, 86. 05% and 94. 19%, respectively. The sensitivity of penicillin was lower than that of cefuroxime with significant difference(x2 =80.36, P<0. 001). The sensitivity of cefuroxime was lower than that of ceftriaxone without significant difference (x2 =3.04, P = 0. 08), while there were 5 resistant strains for cefuroxine. There was no significant difference (x2=4.08,P= 2. 53) among the sensitivities of cefotaxime, ceftazidime, ceftriaxone and cefepime. CONCLUSION The third generation of cephalosporins such as cefotaxime, ceftazidime, ceftriaxone and the

  12. [Urinary tract infection in pregnancy].

    Duarte, Geraldo; Marcolin, Alessandra Cristina; Quintana, Silvana Maria; Cavalli, Ricardo Carvalho


    Several factors cause urinary tract infection (UTI) to be a relevant complication of the gestational period, aggravating both the maternal and perinatal prognosis. For many years, pregnancy has been considered to be a factor predisposing to all forms of UTI. Today, it is known that pregnancy, as an isolated event, is not responsible for a higher incidence of UTI, but that the anatomical and physiological changes imposed on the urinary tract by pregnancy predispose women with asymptomatic bacteriuria (AB) to become pregnant women with symptomatic UTI. AB affects 2 to 10% of all pregnant women and approximately 30% of these will develop pyelonephritis if not properly treated. However, a difficult-to-understand resistance against the identification of AB during this period is observed among prenatalists. The diagnosis of UTI is microbiological and it is based on two urine cultures presenting more than 10(5) colonies/mL urine of the same germ. Treatment is facilitated by the fact that it is based on an antibiogram, with no scientific foundation for the notion that a pre-established therapeutic scheme is an adequate measure. For the treatment of pyelonephritis, it is not possible to wait for the result of culture and previous knowledge of the resistance profile of the antibacterial agents available for the treatment of pregnant women would be the best measure. Another important variable is the use of an intravenous bactericidal antibiotic during the acute phase, with the possibility of oral administration at home after clinical improvement of the patient. At our hospital, the drug that best satisfies all of these requirements is cefuroxime, administered for 10-14 days. Third-generation cephalosporins do not exist in the oral form, all of them involving the inconvenience of parenteral administration. In view of their side effects, aminoglycosides are considered to be inadequate for administration to pregnant women. The inconsistent insinuation of contraindication of

  13. StabiIity Study of 10% Fructose Injection Mixed with 10 Kinds of Drugs%10%果糖注射液与10种药物配伍稳定性研究

    黄攀豪; 赵翊畅; 裴奇; 刘世坤


    OBJECTIVE To investigate the compatibile stability of fructose injection mixed with 10 kinds of commonly used injectable drugs in clinical .METHODS Through numerous articles about fructose compatibility ex-periments and other drugs compatibility experiments ,a variety of physical and chemical properties:the appearance of the liquid in different times,pH,insoluble particles,UV absorption spectrum changes were observed ,to determine the stability of fructose injection mixed with 10 commonly used injectable drugs in clinical .RESULTS Vancomycin and levofloxacin when mixed with 10%fructose injection present significant change of the UV absorption curve ,content , and pH value compared to other drugs ,while the other 8 drugs as cefuroxime basically unchanged or did not change significantly after compatibility in stability .CONCLUSION Vancomycin,and levofloxacin are considered unfit to 10%fructose injection.The other 8 drugs as cefuroxime can mix with 10%fructose injection injections keep nice sta-bility.%目的:探究果糖注射液与10种抗菌药物配伍的稳定性。方法观察不同时刻的配伍液外观、pH、不溶性微粒、紫外吸收光谱变化,果糖含量变化来确定临床常用的一些注射液与果糖注射液配伍时的稳定性。结果万古霉素、左氧氟沙星与10%果糖配伍后紫外吸收曲线、含量、pH值较其他药物变化明显,头孢呋辛等8种药物与果糖注射液配伍后稳定性及含量基本不变或变化不明显。结论万古霉素、左氧氟沙星不适宜与10%果糖注射液配伍;头孢呋辛等8种药物在与10%果糖注射液配伍时,有良好的稳定性,适宜与10%果糖注射液配伍。

  14. Inhibition of methicillin-resistant Staphylococcus aureus by the compound Qingre granules

    YU Yi-yun; WANG Hong; ZHANG Shu-wen; WANG Bao-en


    Background The infection rate of methicillin-resistant Staphylococcus aureus (MRSA) is increasing yearly due to the overprescription of antibiotics. Traditional Chinese compound medicines are less inclined to induce bacterial resistance in the clinical setting because of their multi-acting mechanisms. However, most current research is limited to bacteriostasis in vitro using single extracts or formulations. Plasma pharmacology is an in vitro method, using what is called "medicine serum". The aim of this study was to investigate whether the medicine serum of compound Qingre granules (QRKL) alone or in combination with antibiotics may treat MRSA infection in the clinic.Methods An animal model of MRSA resistance was created by injecting rabbits with the standard strain of MRSA ATCC43300. Infected rabbits were treated with QRKL by intragastric administration. Sixty minutes after the last intragastric administration, serum was obtained from the rabbits by heart puncture to obtain what is termed "medicine serum". The minimum inhibitory concentration (MIC) of QRKL, medicine serum alone, or serum combined with antibiotics was assessed by agar dilution. Results were compared with the growth of sixteen isolates of MRSA. Results The MIC of QRKL to the standard strain ATCC43300 was 10.00 mg/ml. The MIC_(90)of vancomycin was 1.00 ug/ml, which, when combined with QRKL, dropped to 0.50 μg/ml. The MIC_(90) of cefuroxime alone was 512.00 μg/ml- This level also decreased to 256.00 μ g/ml when combined with QRKL. The addition of QRKL thus significantly reduced the MIC of both cefuroxime and vancomycin compared with antibiotics alone (P <0.01). The MIC90 of vancomycin with medicine serum decreased to 0.50 μ g/ml, and the MIC of vancomycin with medicine serum also descended compared with using vancomycin alone (P<0.01).Conclusions The growth of MRSA can be inhibited by QRKL or medicine serum of QRKL in vitro. The addition of QRKL results in increased sensitivity of MRSA to

  15. Prevalence of β-Lactamase Producing Escherichia coli from Retail Meat in Turkey.

    Pehlivanlar Önen, Sevda; Aslantaş, Özkan; Şebnem Yılmaz, Ebru; Kürekci, Cemil


    Extended spectrum β-lactamase (ESBL) and plasmid-mediated AmpC β-lactamase (pAmpC) producing Escherichia coli have been shown to be present in humans and animals representing a significant problem worldwide. This study aimed to search the presence of ESBL and/or AmpC-producing E. coli in retail meats (chicken and beef) in Turkey. A total of 88 β-lactamase-producing E. coli were isolated from chicken (n = 81/100) and beef meat (n = 7/100) samples and their susceptibility to several antimicrobials were tested using disc diffusion method. E. coli isolates were further characterized for their phylogenetic groups. β-Lactamase encoding (blaTEM , blaSHV , blaOXA , blaCTX-M , and blaAmpC ) and quinolone resistance genes (qnrA, qnrB, qnrS, qepA, and acc(6')-Ib-cr) were also secreened by polymerase chain reaction (PCR). However, in regard to β-lactamase genes, 84 of 88 isolates were positive for blaCTX-M-1 (n = 39), blaCTX-M-3 (n = 5), blaCTX-M-15 (n = 4), blaTEM-1b (n = 2), blaSHV-12 (n = 1), blaCTX-M-1 /blaTEM-1b (n = 10), blaCTX-M-1 /blaTEM-1b /blaSHV-5 (n = 1), blaCTX-M-1 /blaCMY-2 (n = 1) and blaTEM-1b /blaCMY-2 (n = 6), blaCTX-M-15 /blaSHV-12 (n = 1), blaCTX-M-15 /blaTEM-1b (n = 1), blaTEM-1b /blaSHV-12 (n = 1), and blaCMY-2 (n = 12) genes. Resistance to cefuroxime (75.6% and 85.7%), nalidixic acid (89% and 85.7%), tetracycline (91.4% and 100%), streptomycin (40.2% and 100%), and trimethoprim-sulfamethoxazole (36.6% and 85.7%) was observed among strains isolated from chicken and beef, respectively. However, all isolates were found to be susceptible to amikacin, imipenem, and cefepime. Resistance to ampicillin and cefoxitin was significantly linked to blaCMY-2 gene, while there was a significant correlation between CTX-M type ESBL and antimicrobial resistance to cefuroxime and streptomycin (P < 0.05). The results of this study suggest that raw chicken retail meats are highly contaminated with ESBL-producing E. coli implementing a great risk to human health in

  16. Etiología y sensibilidad bacteriana en infección urinaria en niños. Hospital Infantil Club Noel y Hospital Universitario del Valle, Cali, Colombia.

    Iris de Castaño


    Full Text Available Introduction: Urinary tract infection (UTI is the most common renal disease in childhood. To find the etiologic microorganism and an early adequate antibiotic therapy are essential to avoid permanent kidney injuries. Objectives: To know the etiologic bacteria and their antibiotic sensibility in urine cultures of children with UTI consulting University Hospital and Club Noel Hospital in Cali, Colombia. Methodology: A total of 123 children under 14 years of age that came into Emergency Service or outpatient clinics at University Hospital or Club Noel Hospital with clinical suspicion of UTI from August 2004 to February 2005 were included in a descriptive transversal study. Urine cultures were taken by supra-pubic aspiration, urine catheterization or mid strain urine. UTI definition was based on colony counts according to recollection method. Positive urine cultures, type of bacteria and antibiotic sensibility were considered for the analysis. Children having either urine cultures with colony counts inferior to recollection method, asymptomatic bacteriuria, occasional catheterization, immunosuppression, vesicostomy or previous admission to intensive care unit, were excluded. Results: Among 123 children entering to the study, 31 were eliminated for colony counts inferior to the recollection method. A total of 123 urine cultures were left for the analysis: 50% of urine cultures were obtained by catheterization, 33% via mid void stream and 17% by supra-pubic aspiration; 58% of patients were females. Escherichia coli was cultured in 72% of the cases, Klebsiella in 16.4%, Proteus 2.5% and other type of bacteria account for 9%. Antibiotics and antibacterials with sensibility over 80% were: cefixime, norfloxocin, cefuroxime, cefprozil, nalidixic acid, ceftriaxone, amikacin, and gentamicin. Intermediate sensibility from 61 to 70%: amoxicillin-clavulinic, cefaclor, ciprofloxacin, and nitrofurantoin. Sensibility under 60% was found for amoxicillin, ampicillin


    Iroha Ifeanyichukwu Romanus


    Full Text Available Streptococcus pneumoniae is a major cause of illness such as pneumonia, meningitis, bacteremia and otitis media in children and the elderly. The emergence of drug-resistant strains threatens to complicate the management of these diseases. We conducted a hospital-based surveillance for drug-resistant Strep. Pneumoniae in outpatients with pneumococcal infection in Abakaliki Ebonyi State Nigeria. Between 2003-2005 from January through December, a cross-sectional study was conducted in Ebonyi State University Teaching Hospital (EBSUTH Abakaliki to assess the prevalence of drug resistant strains of Streptococcus pneumoniae isolated from sputum samples of patients with pneumococcal infections attending the outpatient clinics. A total of 305 sputum samples of patients with clinically diagnosed pneumonia were collected and inoculated on 5% sheep-blood agar, incubated at 35°C for 24 h in 5-10% CO2. Colonies were Gram-stained; alpha-hemolysis colonies were tested with a 6mm optochin disk followed by bile solubility test. Susceptibility testing panels of the following antibiotics: penicillin, ciprofloxacin, clavulanic acid/amoxicillin, septrin, erythromycin, gentamycin, clarithromycin, cefotaxime and cefuroxime were tested against isolated strains of Streptococcus pneumoniae using disc diffusion method. Of the 305 sputum samples collected 30 (9.8% of S. pneumoniae was isolated from patients within the age range of 20-40 years, 140 (45.9% from patients within 41-60, 135(44.2% from patients within 60 years and above. Susceptibility studies showed that the highest resistance was 182 (59.6%, for penicillin followed by septrin 156 (51.2%, erythromycin 120(39.3%, clavulanic/amoxicillin 118(38.7% cefotaxime 114(37.4% clarithromycin 100(32.7%, ciprofloxacin 94(30.8%, gentamycin 75(24.6%, cefuroxime 70(22.9% and ceftriaxone 69(22.6%. The prevalence of S. pneumoniae resistance was relatively high and we suggest that proper antibiotics use should be adopted to avert

  18. Antibiotic prophylaxis: different practice patterns within and outside the United States

    Schwartz SG


    Full Text Available Stephen G Schwartz,1 Andrzej Grzybowski,2 Harry W Flynn Jr1 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA; 2Department of Ophthalmology, Poznan City Hospital, Poznan, Poland Abstract: Endophthalmitis remains a rare but important cause of visual loss. Prophylaxis strategies are important to reduce rates of endophthalmitis after cataract surgery, intravitreal injection, and other procedures. There is substantial variability between the US and the rest of the world. During cataract surgery, intracameral antibiotics are commonly used in many nations, especially in Europe, but are less commonly used in the US. A randomized clinical trial from the European Society of Cataract and Refractive Surgeons reported an approximately fivefold reduction in endophthalmitis rates associated with intracameral cefuroxime but these results are controversial. There are no randomized clinical trials regarding endophthalmitis associated with intravitreal injection. Topical antibiotics are commonly used in many nations, but are less commonly used in the US. At this time, there is no global consensus and it appears unlikely that additional major clinical trials will conclusively define the optimal endophthalmitis prophylaxis techniques. Keywords: cataract surgery, endophthalmitis, intracameral antibiotic, intravitreal injection, prophylaxis

  19. Primary swenson′s pull-through in children with chronic constipation: A preliminary report

    Bakare Tajudeen I


    Full Text Available Background: The discrepancy in diameters of the resected ends coupled with the heavy faecal loads in the colon of chronically constipated children with Hirschsprung′s disease makes definitive primary pull-through procedure quite difficulty in this group. Patients and Methods: Four consecutive patients (aged 5 months to 11 years who presented with chronic constipation were given warm saline enema along with Castor oil per oram twice daily for 1 week before and 2 weeks after full-thickness biopsies that confirmed Hirschsprung′s disease. All patients had intravenous Cefuroxime or Ceftriaxone plus Metronidazole at induction of anaesthesia. Intra-operatively, the levels of resections were 6-8 cm proximal to the most contractile part of the colon adjacent to the transition zone observed after complete division of mesenteric vessels. Results: There were three males and one female, aged 5 months to 11 years. The levels of aganglionosis were in the rectosigmoid region, except one in the descending colon. There was one case each of anastomotic stenoses, mild enterocolitis and deep peri-anal excoriation. The bowel motions were two to four times daily within 1 month post-operatively. Conclusion: It can be concluded from this preliminary study that with pre-operative saline enema and oral Castor oil for about 3 weeks in chronically constipated children with Hirschsprung′s disease primary pull-through procedures can be performed successfully. However, further prospective work is required with this method.

  20. Anti-inflammatory effects of antibacterials on human bronchial epithelial cells

    Hatz Rudolf


    Full Text Available Abstract Background Human Bronchial epithelial cells (hu-BEC have been claimed to play a significant role in the pathogenesis of chronic inflammatory airway diseases like COPD. In this context IL-8 and GM-CSF have been shown to be key cytokines. Some antibiotics which are routinely used to treat lower respiratory tract infections have been shown to exert additional immunomodulatory or anti-inflammatory effects. We investigated whether these effects can also be detected in hu-BEC. Methods Hu-BEC obtained from patients undergoing lung resections were transferred to air-liquid-interface (ALI culture. These cultures were incubated with cefuroxime (CXM, 10-62.5 mg/l, azithromycin (AZM, 0.1-1.5 mg/l, levofloxacin (LVX, 1-8 mg/l and moxifloxacin (MXF, 1-16 mg/l. The spontaneous and TNF-α (10 ng/ml induced expression and release of IL-8 and GM-CSF were measured using PCR and ELISA in the absence or presence of these antibiotics. Results The spontaneous IL-8 and GM-CSF release was significantly reduced with MXF (8 mg/l by 37 ± 20% and 45 ± 31%, respectively (both p Conclusion Using ALI cultures of hu-BEC we observed differential effects of antibiotics on spontaneous and TNF-α induced cytokine release. Our data suggest that MXF and AZM, beyond bactericidal effects, may attenuate the inflammatory process mediated by hu-BEC.

  1. [Lyme disease--clinical manifestations and treatment].

    Stock, Ingo


    Lyme disease (Lyme borreliosis) is a systemic infectious disease that can present in a variety of clinical manifestations. The disease is caused by a group of spirochaetes--Borrelia burgdorferi sensu lato or Lyme borrelia--that are transmitted to humans by the bite of Ixodes ticks. Lyme disease is the most common arthropode-borne infectious disease in many European countries including Germany. Early localized infection is typically manifested by an erythema migrans skin lesion, in rarer cases as a borrelial lymphocytoma. The most common early disseminated manifestation is (early) neuroborreliosis. In adults, neuroborreliosis appears typically as meningoradiculoneuritis. Neuroborreliosis in children, however, is typically manifested by meningitis. In addition, multiple erythema migrans lesions and Lyme carditis occur relatively frequently. The most common manifestation oflate Lyme disease is Lyme arthritis. Early manifestations (and usually also late manifestations) of Lyme disease can be treated successfully by application of suitable antibacterial agents. For the treatment of Lyme disease, doxycycline, certain penicillins such as amoxicillin and some cephalosporins (ceftriaxone, cefotaxime, cefuroxime axetil) are recommended in current guidelines. A major challenge is the treatment of chronic, non-specific disorders, i. e., posttreatment Lyme disease syndrome and "chronic Lyme disease". Prevention of Lyme disease is mainly accomplished by protecting against tick bites. Prophylactic administration of doxycycline after tick bites is generally not recommended in Germany. There is no vaccine available for human beings. PMID:27348896

  2. Role of anaerobes in acute pelvic inflammatory disease

    Saini S


    Full Text Available Pouch of Douglas aspirates were collected from 50 women with history and examination suggestive of acute pelvic inflammatory disease (PID and 20 healthy women admitted for tubal ligation served as control. A total of 57 microorganisms were isolated from 37 patients out of 50 in study group. Of 37 positive cultures 21(56.7% were monomicrobial and 16(43.2% were polymicrobial. Most common symptom in study group was lower abdominal pain (90%, vaginal discharge (70% and irregular bleeding (40% and 30% patients had history of intrauterine contraceptive device (IUCD implantation. The predominant aerobic isolates were Escherichia coli, Coagulase Negative Staphylococcus (CONS, Staphylococcus aureus, Klebsiella pneumoniae while common anaerobes were Bacteroides fragilis, Prevotella melaninogenica, Fusobacterium nucleatum and Peptostreptococcus spp. Our study shows that cefotaxime, cefuroxime and gentamicin may be used for gram negative aerobic bacilli; cloxacillin, cephaloridine and erythromycin for aerobic gram positive cocci and amikacin and ceftazidime for Pseudomonas aeruginosa. Thus for optimum therapy of acute PID it is beneficial to keep in mind major conceptual changes and therapeutic realities that have influenced current understanding of acute PID and have affected the choice of therapy.

  3. Role of anaerobes in acute pelvic inflammatory disease.

    Saini, S; Gupta, N; Batra, G; Arora, D R


    Pouch of Douglas aspirates were collected from 50 women with history and examination suggestive of acute pelvic inflammatory disease (PID) and 20 healthy women admitted for tubal ligation served as control. A total of 57 microorganisms were isolated from 37 patients out of 50 in study group. Of 37 positive cultures 21(56.7%) were monomicrobial and 16(43.2%) were polymicrobial. Most common symptom in study group was lower abdominal pain (90%), vaginal discharge (70%) and irregular bleeding (40%) and 30% patients had history of intrauterine contraceptive device (IUCD) implantation. The predominant aerobic isolates were Escherichia coli, Coagulase Negative Staphylococcus (CONS), Staphylococcus aureus, Klebsiella pneumoniae while common anaerobes were Bacteroides fragilis, Prevotella melaninogenica, Fusobacterium nucleatum and Peptostreptococcus spp. Our study shows that cefotaxime, cefuroxime and gentamicin may be used for gram negative aerobic bacilli; cloxacillin, cephaloridine and erythromycin for aerobic gram positive cocci and amikacin and ceftazidime for Pseudomonas aeruginosa. Thus for optimum therapy of acute PID it is beneficial to keep in mind major conceptual changes and therapeutic realities that have influenced current understanding of acute PID and have affected the choice of therapy. PMID:17643017

  4. ESBL-producing Enterobacteriaceae: occurrence, risk factors for fecal carriage and strain traits in the Swiss slaughter cattle population younger than 2 years sampled at abattoir level.

    Martin Reist

    Full Text Available During the past decade extended-spectrum beta-lactamase (ESBL producing Enterobacteriaceae have become a matter of great concern in human and veterinary medicine. In this cross-sectional study fecal swabs of a geographically representative number of Swiss cattle at slaughterhouse level were sampled i to determine the occurrence of ESBL producing Enterobacteriaceae in the Swiss slaughter cattle population younger than 2 years, and ii to assess risk factors for shedding ESBL producing Enterobacteriaceae. In total, 48 (8.4%; 95% C.I. 6.3-11.1% independent ESBL producing Enterobacteriaceae were detected among the 571 tested animals. Species identification revealed 46 E. coli strains, one Enterobacter cloacae and one Citrobacter youngae. In view of beta-lactam antibiotics, all 48 isolates were resistant to ampicillin, cephalothin and cefpodoxime. Forty-five (93.8% isolates were resistant cefuroxime; one (2.1% isolate to cefoxitin, 28 (58.3% isolates to cefotaxime, 2 (4.2% isolates to ceftazidime, and 2 (4.2% isolates to cefepime. Risk factors for shedding ESBL producing Enterobacteriaceae were (i age (OR 0.19 and 0.12 in age category 181 d to 1 y and 1 y to 2 y compared to ≤180 d, (ii primary production type, meaning dairy compared to beef on farm of origin (OR 5.95, and (iii more than 1 compared to less than 1 animal movement per d per 100 animals on farm of origin (OR 2.37.

  5. [Tinea capitis profunda due to Trichophyton verrucosum with cMRSA superinfection in an infant].

    Blömer, R-H; Keilani, N; Faber, A; Rodeck, B; Krüger, C; Uhrlaß, S; Gräser, Y; Nenoff, P


    A 28-month-old boy developed a cutaneous and subcutaneous lesion of the scalp together with alopecia. Treatment with sulfadiazine silver ointment and oral administration of cefaclor failed. The boy lived on a farm where cows and calves were present. He presented with a 5 cm erythematous, erosive, edematous, and sharply defined lesion with yellow crusts and circumscribed alopecia on the temporoparietal scalp. Peripheral hairs were easily epilated. Swabs from the wound revealed cMRSA (community acquired methicillin-resistant Staphylococcus aureus, Panton Valentine Leukocidin [PVL] toxin negative). There was no improvement after treatment with cefuroxime intravenously over 3 days. Therapy was changed to vancomycin and fosfomycin. Because of the purulent abscess, surgical incision was performed. PCR (polymerase chain reaction)-Elisa assay detected Trichophyton (T.) interdigitale-DNA from wound secretion and skin biopsy. Because of the clinical and molecular diagnosis of tinea capitis, oral antifungal therapy with fluconazole 5 mg kg(-1) body weight was started, along with cotrimoxazole and fosfomycin for the cMRSA. After 4 weeks incubation, the causative agent T. verrucosum was grown on culture and its identity confirmed by sequencing of the "internal transcribed spacer" (ITS) region of the ribosomal DNA. After 4 weeks of fluconazole, the lesion was nearly healed. PMID:22406762

  6. Novel Genes Related to Ceftriaxone Resistance Found among Ceftriaxone-Resistant Neisseria gonorrhoeae Strains Selected In Vitro.

    Gong, Zijian; Lai, Wei; Liu, Min; Hua, Zhengshuang; Sun, Yayin; Xu, Qingfang; Xia, Yue; Zhao, Yue; Xie, Xiaoyuan


    The emergence of ceftriaxone-resistantNeisseria gonorrhoeaeis currently a global public health concern. However, the mechanism of ceftriaxone resistance is not yet fully understood. To investigate the potential genes related to ceftriaxone resistance inNeisseria gonorrhoeae, we subcultured six gonococcal strains with increasing concentrations of ceftriaxone and isolated the strains that became resistant. After analyzing several frequently reported genes involved in ceftriaxone resistance, we found only a single mutation inpenA(A501V). However, differential analysis of the genomes and transcriptomes between pre- and postselection strains revealed many other mutated genes as well as up- and downregulated genes. Transformation of the mutatedpenAgene into nonresistant strains increased the MIC between 2.0- and 5.3-fold, and transformation of mutatedftsXincreased the MIC between 3.3- and 13.3-fold. Genes encoding the ABC transporters FarB, Tfq, Hfq, and ExbB were overexpressed, whilepilM,pilN, andpilQwere downregulated. Furthermore, the resistant strain developed cross-resistance to penicillin and cefuroxime, had an increased biochemical metabolic rate, and presented fitness defects such as prolonged growth time and downregulated PilMNQ. In conclusion, antimicrobial pressure could result in the emergence of ceftriaxone resistance, and the evolution of resistance ofNeisseria gonorrhoeaeto ceftriaxone is a complicated process at both the pretranscriptional and posttranscriptional levels, involving several resistance mechanisms of increased efflux and decreased entry. PMID:26787702


    Ashok Rangaiahagari


    Full Text Available Introduction: A great concern exists about the emergence of antibiotic resistant organisms. The goal of this study is to delineate antibiotic sensitivity patterns at King Faisal Hospital. Methods: A three years study, from Jan 2009 to Dec 2011 was conducted in the Microbiology unit, department of Laboratory, King Faisal hospital, Rwanda. All the specimens and antibiotic sensitivity were processed according to the standard guidelines. Microorganisms and their sensitivity data were reviewed and compiled by using hospital information system. Results: Over the 3-year period, several Enterobacteriaceae pathogens declined in susceptibility to various antimicrobial agents. A total of 2153 Enterobacteriaceae were isolated. Most common isolate was Escherichia coli (1413 followed by Klebsiella species (550, Enterobacter species (110, Proteus species (165, Citrobacter Species (79, Shigella species (110 and other species. Most notable were the decreased sensitivities to cefuroxime: E. coli (84% to 72%, Klebsiella (78% to 33%, Enterobacter (50% to 41% Proteus(67% to 59% and Shigella to ciprofloxacin (100% to 96%. And also decreased sensitivities to Imipenem: E. coli (100% to 98% and Klebsiella species (100% to 94%. Conclusion: These decreased antibiotic sensitivities reflect increased bacterial selection pressure as a result of widespread antibiotic use. A combined approach involving infection-control specialists, infectious disease physicians, and hospital administrators is necessary to address this increasingly difficult problem.

  8. Medication use and potential drug interactions in pediatric patients with infectious diseases.

    Lisby, S M; Nahata, M C


    Infectious diseases are the most common type of illness in pediatric patients. Limited data are available, however, about the most frequently prescribed drugs for children in pediatric infectious diseases units. The authors prospectively evaluated medication records of 493 children over a 5-month period to determine the pattern of drug prescribing and incidence of potential drug interactions in children admitted to the infectious diseases unit in a pediatric hospital. Antimicrobial agents were the most frequently prescribed class of drugs, comprising 60% of all drug orders. Of all antibiotics used during this period, ampicillin was the most common (24% of antibiotic orders). Ceftriaxone, cefuroxime, and gentamicin were also used frequently and consisted of 15%, 10%, and 14% of all orders for anti-infective agents, respectively. Other classes of drugs frequently given to patients on the infectious disease unit were antipyretics (14%), bronchodilators (10%), and anticonvulsants (7%). The incidence of potential drug interactions was 3.5%, the majority involving anticonvulsants. A clinically significant drug interaction was not documented in any of these cases. Observations made from this study may assist in developing clinical pharmacy services and educational programs for pharmacy students. In addition, knowledge of drug use patterns may aid in conducting antibiotic use reviews. PMID:10281735

  9. Antibiotic Therapy in Pyogenic Meningitis in Paediatric Patients

    Objective: To isolate and identify the causative pathogen, antibiotic sensitivity testing and success rate of empirical antibiotic therapy in pyogenic meningitis. Study Design: Analytical study. Place and Duration of Study: The Children's Hospital and Institute of Child Health, Lahore, Pakistan, from March to July 2012. Methodology: The study was performed on 72 culture positive meningitis cases in children less than 15 years of age. This therapy was evaluated by monitoring the patient's clinical picture for 14 - 21 days. The collected data was analyzed by Chi-square test. Results: Seventeen different bacteria were isolated. The most commonly occurring bacteria were coagulase negative Staphylococci (25%), E. coli (12.5%), Klebsiella pneumoniae (8.3%), Streptococcus pneumoniae (8.3%) and Pseudomonas aeruginosa (8.3%). All the bacteria were sensitive to vancomycin (96.7%), meropenem (76.7%), amikacin (75%), ciprofloxacin (65.3%), chloramphenicol (46.5%), ceftazidime (44.2%), cefepime (41.9%), co-amoxiclav (38.0%), oxacillin (34.8%), cefotaxime (21.4%), penicillin (20.7%), ceftriaxone (18.6%), cefuroxime (14%) and ampicillin (6.9%). The combination of sulbactam and cefoperazone showed antimicrobial sensitivity of 81.4%. The success rate of empirical antibiotic therapy was 91.7%. Conclusion: It was found that Gram negative bacteria were the major cause of pyogenic meningitis. Mostly there were resistant strains against all commonly used antibiotics except vancomycin. All empirical antibiotic therapies were found to be most successful. (author)

  10. A Simple Assay to Screen Antimicrobial Compounds Potentiating the Activity of Current Antibiotics

    Iqbal, Junaid; Kazmi, Shahana Urooj; Khan, Naveed Ahmed


    Antibiotic resistance continues to pose a significant problem in the management of bacterial infections, despite advances in antimicrobial chemotherapy and supportive care. Here, we suggest a simple, inexpensive, and easy-to-perform assay to screen antimicrobial compounds from natural products or synthetic chemical libraries for their potential to work in tandem with the available antibiotics against multiple drug-resistant bacteria. The aqueous extract of Juglans regia tree bark was tested against representative multiple drug-resistant bacteria in the aforementioned assay to determine whether it potentiates the activity of selected antibiotics. The aqueous extract of J. regia bark was added to Mueller-Hinton agar, followed by a lawn of multiple drug-resistant bacteria, Salmonella typhi or enteropathogenic E. coli. Next, filter paper discs impregnated with different classes of antibiotics were placed on the agar surface. Bacteria incubated with extract or antibiotics alone were used as controls. The results showed a significant increase (>30%) in the zone of inhibition around the aztreonam, cefuroxime, and ampicillin discs compared with bacteria incubated with the antibiotics/extract alone. In conclusion, our assay is able to detect either synergistic or additive action of J. regia extract against multiple drug-resistant bacteria when tested with a range of antibiotics. PMID:23865073

  11. A Simple Assay to Screen Antimicrobial Compounds Potentiating the Activity of Current Antibiotics

    Junaid Iqbal


    Full Text Available Antibiotic resistance continues to pose a significant problem in the management of bacterial infections, despite advances in antimicrobial chemotherapy and supportive care. Here, we suggest a simple, inexpensive, and easy-to-perform assay to screen antimicrobial compounds from natural products or synthetic chemical libraries for their potential to work in tandem with the available antibiotics against multiple drug-resistant bacteria. The aqueous extract of Juglans regia tree bark was tested against representative multiple drug-resistant bacteria in the aforementioned assay to determine whether it potentiates the activity of selected antibiotics. The aqueous extract of J. regia bark was added to Mueller-Hinton agar, followed by a lawn of multiple drug-resistant bacteria, Salmonella typhi or enteropathogenic E. coli. Next, filter paper discs impregnated with different classes of antibiotics were placed on the agar surface. Bacteria incubated with extract or antibiotics alone were used as controls. The results showed a significant increase (>30% in the zone of inhibition around the aztreonam, cefuroxime, and ampicillin discs compared with bacteria incubated with the antibiotics/extract alone. In conclusion, our assay is able to detect either synergistic or additive action of J. regia extract against multiple drug-resistant bacteria when tested with a range of antibiotics.

  12. Antibiotics Susceptibility of the Microorganisms which Reproducing the Culture of Patients with Chronic Otitis Media

    Omer Coskun


    Full Text Available AIM: Study; we aimed the isolation of bacteria and establishment of their susceptibility to antibiotics in patients diagnosed as Chronic Supurative Otitis Media. METHOD: Sixty-three patients were included in the study. The samples of suppurative material were cultured. Antibiotic susceptibility testing was performed as recommended by Clinical and Laboratory Standards Institute (CLSI and species was identified. RESULTS: S.aureus was isolated in 36,5 % of the 63 patients enrolled in the study. For this bacterium, increased rates of resistance to antibiotics penicillin G, ampicillin /sulbactam, gentamicin, amicacin ve TMP/SMX are detected. The other mostly isolated bacteria are P. aeruginosa (32.69% and E. coli (23.07% in turn. P. aeruginosa showed increased ratio of resistance to ceftriaxone, cefuroxime, amicacin, gentamicin, ampicillin, TMP/SMX and amoxicillin/clavulanate and also E. coli showed increased rates of resistance to gentamicin, ampicillin, ampicillin /sulbactam and amoxicillin/clavulanate. CONCLUSION: We consider Chronic Supurative Otitis Media therapy regarding antimicrobial susceptibility rates will be more rational and satisfying. [TAF Prev Med Bull 2010; 9(1.000: 51-54

  13. Current efficacy of antibiotics against Klebsiella isolates from urine samples - a multi-centric experience in Karachi.

    Abdullah, Farhan Essa; Mushtaq, Ammara; Irshad, Mubashira; Rauf, Hiba; Afzal, Noureen; Rasheed, Abdur


    Due to emergence of bacterial resistant strains, the effectiveness of current antibiotic treatment without culture/sensitivity testing is questionable. Our study aims to assess the present sensitivity profiles of Klebsiella isolates from urine samples and provide options for empiric prescription in critically ill patients. Klebsiella pneumoniae isolates collected over a period of 28 months till January 2011 from 1,617 urine samples of subjects presenting with Urinary Tract Infections were identified at a local diagnostic lab using standard protocol and subjected to Kirby-Bauer disk diffusion sensitivity testing. MICs were also estimated by E-nephelometry. Among 20 drugs used, low sensitivity was found to amoxicillin (0.1%), doxycycline (11.5%), nitrofurantoin (15.5%), amoxiclav (18.2%), gentamicin (35.4%), pipemidic acid, cephradine (40.3%) and cotrimoxazole (43.1%). The isolates were more sensitive to cefuroxime (55.9%), cefixime (57.7%), ciprofloxacin (62.5%), ofloxacin (63%), ceftriaxone (66.2%), ceftazidime (66.4%), cefotaxime (66.6%), fosfomycin (77.5%) and amikacin (89.4). Most effective were cefroperazone.sulbactam (95.8%), piperacillin.tazobactam (95.7%) and imipenem (97.7%). Self-medication, lack of awareness, and the misuse of antibiotics by doctors has exacerbated the menace of microbial resistance. The study warrants the prudent choice of drugs in adherence with prevailing sensitivity profiles. PMID:23261722

  14. Antimicrobial activity of antibiotics in combination with natural flavonoids against clinical extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae.

    Lin, Rong-Dih; Chin, Yi-Ping; Lee, Mei-Hsien


    Extended-spectrum beta-lactamases (ESBLs) are plasmid-mediated class A enzymes commonly found in the family Enterobacteriaceae, mainly in Klebsiella pneumoniae. Flavonoids have also been reported to possess antimicrobial activity. In this study, the in vitro activities of 18 antibiotics and 12 flavonoids against 20 ESBL-producing K. pneumoniae isolates were evaluated. All of these isolates were susceptible to imipenem and cefmetazole, but were resistant to ampicillin, ampicillin/sulbactam, aztreonam, cefazolin, cefoperazone, cefotaxime, ceftazidime, ceftriaxone, cefuroxime, piperacillin and ticarcillin. Susceptibilities to amikacin, amoxicillin/clavulanate, cefoxitin, ciprofloxacin and gentamicin were variable. Myricetin, a flavonol, inhibited ESBL-producing K. pneumoniae isolates at a high minimum inhibitory concentration (MIC) (MIC(90) value 256 mg/mL), but exhibited significant synergic activity against ESBL-producing K. pneumoniae in separate combination with amoxicillin/clavulanate, ampicillin/sulbactam and cefoxitin. Because of the low-toxic nature of flavonoids, the combination of antibiotics and flavonoids is a potential new strategy for developing therapies for infections caused by ESBL-producing bacteria in the future. PMID:16161024

  15. Prediction of piperacillin-tazobactam susceptibility among Enterobacteriaceae, Pseudomonas aeruginosa, and other bacteria using ticarcillin-clavulanic acid, ceftazidime, and other broad-spectrum antimicrobial in vitro test results.

    Jones, R N; Sutton, L D; Cantrell, H F; Lankford, R B


    The ability of various in vitro beta-lactam susceptibility test results to predict the susceptibility of piperacillin-tazobactam (a new beta-lactam-beta-lactamase inhibitor combination) was assessed using more than 46,000 recent clinical isolates. The organisms were tested by reference-quality National Committee for Clinical Laboratory Standards (NCCLS) broth microdilution procedures and interpreted by the currently published NCCLS criteria. The recommended antimicrobial tests that would accurately predict the piperacillin-tazobactam in vitro efficacy had an overall very major, false-susceptible rate of only 0.6% (sulbactam (1.8%) results; for Haemophilus influenzae and Moraxella catarrhalis use cefotaxime or cefuroxime or ceftriaxone (1.5%); and for staphylococci use oxacillin by NCCLS recommendations. When the piperacillin-tazobactam testing reagents become available, the direct testing of this combination should be applied to relevant clinical isolates. The piperacillin-tazobactam break points should be reassessed as indicated by the cited minimum inhibitory concentration population analysis to improve predictive accuracy; H. influenzae susceptibility modified to < or = 2/4 micrograms/ml and Enterococcus species susceptibility tested at < or = 16/4 micrograms. PMID:7874881

  16. Vaginal foreign body mimicking cervical cancer in postmenopausal woman – case study

    Michał Ciebiera


    Full Text Available We present a case report of a 73-year-old, postmenopausal woman with detailed history of breast cancer and oncology treatment including tamoxifen therapy. She presented at the clinic of gynecology and obstetrics with recurrent inflammation of the urinary and genital tract and suspicion of a cervical mass. She also presented occasional abdominal complaints and malodorous vaginal discharge. These symptoms were observed in the patient for several years. Before hospitalization she received many kinds of empirical, antimicrobial treatment such as chlorquinaldol, metronidazole, nifuratel, and nystatin. She did not receive further guidance from doctors about the causes of ailments and further diagnostic and treatment capabilities. In our clinic a detailed diagnostic process including ultrasound transvaginal examination and a minisurgical procedure revealed the presence of a vaginal foreign body (which turned out to be a plastic, shampoo bottle cap surrounded by a mass of inflamed tissue mimicking a cervical tumor. All symptoms and complaints subsided after surgical removal of the foreign body and antibacterial therapy with metronidazole and cefuroxime. Our study draws attention to the need of thorough gynecological care including prophylaxis, especially in the case of complaints of an intimate nature. Even trivial, frequently occurring disorders can be dangerous and require proper and responsible doctor’s supervision and management through the healing process.

  17. Vaginal foreign body mimicking cervical cancer in postmenopausal woman - case study.

    Ciebiera, Michał; Słabuszewska-Jóźwiak, Aneta; Ledowicz, Witold; Jakiel, Grzegorz


    We present a case report of a 73-year-old, postmenopausal woman with detailed history of breast cancer and oncology treatment including tamoxifen therapy. She presented at the clinic of gynecology and obstetrics with recurrent inflammation of the urinary and genital tract and suspicion of a cervical mass. She also presented occasional abdominal complaints and malodorous vaginal discharge. These symptoms were observed in the patient for several years. Before hospitalization she received many kinds of empirical, antimicrobial treatment such as chlorquinaldol, metronidazole, nifuratel, and nystatin. She did not receive further guidance from doctors about the causes of ailments and further diagnostic and treatment capabilities. In our clinic a detailed diagnostic process including ultrasound transvaginal examination and a minisurgical procedure revealed the presence of a vaginal foreign body (which turned out to be a plastic, shampoo bottle cap) surrounded by a mass of inflamed tissue mimicking a cervical tumor. All symptoms and complaints subsided after surgical removal of the foreign body and antibacterial therapy with metronidazole and cefuroxime. Our study draws attention to the need of thorough gynecological care including prophylaxis, especially in the case of complaints of an intimate nature. Even trivial, frequently occurring disorders can be dangerous and require proper and responsible doctor's supervision and management through the healing process. PMID:26528112

  18. Antibiotic sensitivity of Enterobacteriaceae at a tertiary care center in India

    Summaiya Mulla


    Full Text Available Aims and Objectives: It has been observed that various microorganisms are acquiring resistance to most of the available potent antibiotics; hence, there is a need for every hospital to follow the use of antibiotics according to antibiotic sensitivity pattern in that particular hospital or geographical area. It has been reported that Enterobacteriaceae group of microorganisms are increasingly acquiring resistance to many antibiotics and this resistance varies geographically. As there is a short of recent data with respect to Indian hospital, this particular study was designed with the aim of establishing sensitivity pattern of Enterobacteriaceae group of microorganisms to various antibiotics. Materials and Methods: Data of antibiotic sensitivity from December 2010 to April 2011 of different Enterobacteriaceae was taken from the Department of Microbiology, Govt. Medical College, Surat. Sensitivity of different Enterobacteriaceae was shown as using descriptive statistics. Results: E. coli (55.6% and Klebsiella (31.2% were the most frequent bacteria isolated. Enterobacteriaceae were very less sensitive to amoxicillin + clavulanic acid (13.7%, chloramphenicol (7.6%, cefoperazone (14.4%, cefixime (15.7%, and cefuroxime (17.6. Sensitivity to aztreonam was 32.7%. Sensitivity to carbapenem group of drugs included in this study, i.e., meropenem was 69.8%. Highest sensitivity was shown for ceftazidime (74.1%. E. coli is more sensitive to meropenem as compared with Klebsiella. Conclusion: Sensitivity of Enterobacteriaceae group of microorganisms to known antibiotics is decreasing. Decreased sensitivity to carbapenem group of antibiotics is a matter of concern.

  19. Prevalence and emerging resistance of Moraxella catarrhalis in lower respiratory tract infections in Karachi

    Objective: To determine the prevalence of Moraxella catarrhalis in sputum cultures from patients with lower respiratory tract infection and their antimicrobial sensitivity profiles. Methods: The study comprised sputum specimens of 776 patients at various branches of Dr Essa's Diagnostic Lab, Karachi. The specimens were cultured on blood, chocolate, and eosin methylene blue agars between October 2010 and October 2011. The isolates were identified by conventional methods and anti-biograms were determined by the Kirby-Bauer Agar Disc Diffusion Method. Results: Moraxella catarrhalis was isolated from 39 (5.02%) sputa of which 18 (46.15%) belonged to males. The bimodal age prevalence was 238 (30.7%) in age group 20-29 years, and 180 (23.1%) in 70 years and above. Amoxicillin/clavulanate, cefotaxime, and ceftriaxone were most effective (100%). Very high resistance was seen with amikacin (92.3%), cefixime (92.3%), fosfomycin (84.6%), cefuroxime (84.6%), erythromycin and amoxicillin (76.9%), cotrimoxazole (90%) and doxycycline (76.9%). Conclusions: The incidence of Moraxella catarrhalis in sputum encourages routine culture and sensitivity of sputa from patients suffering from lower respiratory tract infection, especially the elderly and immunocompromised, for tailored drug prescription. (author)

  20. Cefditoren: Comparative efficacy with other antimicrobials and risk factors for resistance in clinical isolates causing UTIs in outpatients

    Hatzaki Despina


    Full Text Available Abstract Background To investigate a possible role of Cefditoren, a recently marketed in Greece third-generation oral cephalosporin in urinary infections of outpatients. Methods During a multicenter survey of Enterobacteriaceae causing UTIs in outpatients during 2005–2007, Cefditoren MICs were determined by agar dilution method in a randomly selected sample of uropathogens. Susceptibility against 18 other oral/parenteral antimicrobials was determined according to Clinical and Laboratory Standards Institute methodology. Results A total of 563 isolates (330 Escherichia coli, 142 Proteus mirabilis and 91 Klebsiella spp was studied; MIC50/MIC90 of Cefditoren was 0.25/0.5 mg/L respectively, with 97.1% of the isolates being inhibited at 1 mg/L. All 12 strains producing ESBLs or AmpC enzymes were resistant to cefditoren. Susceptibility rates (% for amoxicillin/clavulanic acid, cefuroxime axetil, cefotaxime, ciprofloxacin, trimethoprim/sulfamethoxazole and fosfomycin were 93.1- 94.1- 96.8-93.1-71.9 and 92.8% respectively. Cefditoren MIC was significantly higher in nalidixic/ciprofloxacin non-susceptible strains; resistance to cefditoren was not associated with resistance to mecillinam, fosfomycin nitrofurantoin and aminoglycosides. Multivariate analysis demonstrated history of urinary infection in the last two weeks or three months as risk factors for cefditoren resistance. Conclusions Cefditoren exhibited enhanced in vitro activity against the most common uropathogens in the outpatient setting, representing an alternative oral treatment option in patients with risk factors for resistance to first-line antibiotics.

  1. Biocompatible cephalosporin-hydroxyapatite-poly(lactic-co-glycolic acid)-coatings fabricated by MAPLE technique for the prevention of bone implant associated infections

    Rădulescu, Dragoş; Grumezescu, Valentina; Andronescu, Ecaterina; Holban, Alina Maria; Grumezescu, Alexandru Mihai; Socol, Gabriel; Oprea, Alexandra Elena; Rădulescu, Marius; Surdu, Adrian; Trusca, Roxana; Rădulescu, Radu; Chifiriuc, Mariana Carmen; Stan, Miruna S.; Constanda, Sabrina; Dinischiotu, Anca


    In this study we aimed to obtain functionalized thin films based on hydroxyapatite/poly(lactic-co-glycolic acid) (HAp/PLGA) containing ceftriaxone/cefuroxime antibiotics (ATBs) deposited by Matrix Assisted Pulsed Laser Evaporation (MAPLE) technique. The prepared thin films were characterized by transmission electron microscopy (TEM), scanning electron microscopy (SEM), X-Ray diffraction (XRD), selected area electron diffraction (SAED), and infra red (IR) analysis. HAp/PLGA/ATBs thin films sustained the growth of human osteoblasts, proving their good biocompatibility. The microscopic evaluation and the culture-based quantitative assay of the E. coli biofilm development showed that the thin films inhibited the initial step of microbial attachment as well as the subsequent colonization and biofilm development on the respective surfaces. This study demonstrates that MAPLE technique could represent an appealing technique for the fabrication of antibiotics-containing polymeric implant coatings. The bioevaluation results recommend this type of surfaces for the prevention of bone implant microbial contamination and for the enhanced stimulation of the implant osseointegration process.

  2. Antimicrobial activity of cefmetazole (CS-1170) and recommendations for susceptibility testing by disk diffusion, dilution, and anaerobic methods.

    Jones, R N; Barry, A L; Fuchs, P C; Thornsberry, C


    Cefmetazole, formerly CS-1170, was found to have antimicrobial activity slightly superior to that of cefoxitin but a clinically usable antimicrobial spectrum that should be considered identical to that of cefoxitin. Disk diffusion and dilution test methods with cefmetazole correlated highly (r, greater than or equal to 0.95) with cefoxitin results. The recommended 30-micrograms cefmetazole disk interpretive breakpoints for susceptibility and resistance were greater than or equal to 18 mm (MIC, less than or equal to 8.0 micrograms/ml) and less than or equal to 14 mm (MIC, greater than or equal to 32 micrograms/ml), respectively. Cefmetazole and cefoxitin should be considered to be in the same antimicrobial spectrum class, requiring separate testing for other cephalosporins such as cephalothin, cefamandole, cefuroxime, and cefotetan. Recommended interpretive criteria performed well for fastidious organisms (Haemophilus influenzae, Neisseria meningitidis, and Branhamella catarrhalis) and for broth microdilution tests with anaerobes. Cefmetazole and cefoxitin broth disk elution tests for anaerobic bacteria produced higher rates of false susceptibility results. PMID:3097064


    Murugaiyah Marimuthu


    Full Text Available This study was conducted in order to determine the prevalence and bacteriological assessment of subclinical mastitis and antimicrobial resistance of bacterial isolates from dairy cows in different farms around Selangor, Malaysia. A total of 120 milk samples from 3 different farms were randomly collected and tested for subclinical mastitis using California Mastitis Test (CMT, as well as for bacterial culture for isolation, identification and antimicrobial resistance. The most prevalent bacteria was Staphylococcus sp. (55%, followed by Bacillus sp., (21% and Corynebacterium sp., (7%, Yersinia sp. and Neisseria sp. both showed 5% prevalence, other species with prevalence below 5% are Acinetobacter sp., Actinobacillus sp., Vibrio sp., Pseudomonas sp., E.coli, Klebsiella sp. and Chromobacter sp. Selected Staphylococcus sp. showed a mean antimicrobial resistance of 73.3% to Ampicillin, 26.7% to Penicillin, Methicillin and Compound Sulphonamide each, 20% to Oxacillin, Amoxycillin and Cefuroxime, 13.3% to Polymyxin B, Erythromycin, Ceftriaxone and Azithromycin and 6.7% to Streptomycin, Clindamycin, Lincomycin and Tetracycline each. This study indicates the need for urgent and effective control measures to tackle the increase in prevalence of subclinical mastitis and their antimicrobial resistance in the study area.

  4. Increase resistant rates and ESBL production between E. coli isolates causing urinary tract infection in young patients from Iran

    Babak Pourakbari


    Full Text Available Emerging antimicrobial resistance rates and Extended-spectrum beta-lactamase producing Escherichia coli recovered from urinary tract infections (UTI is an increasing problem in specific regions, limiting therapeutic options. One hundred E. coli isolates causing UTI in patients with age from 2 months to 12 years admitted at CMC in the period of April 2009 to March 2010 were tested for antibiotic susceptibility using the disk diffusion method. Surprisingly high resistance rates were recorded for E. coli against TMP/SMX (84%, cefalotin (66%, cefuroxime (50%, cefixime (50% and ceftriaxone (45%. Antimicrobial susceptibility of E. coli isolates was followed by meropenem (98%, amikacin (95%, nitrofurantoin (91% and gentamicin (68%. Extended spectrum beta-lactamase production, was observed in 32% of community and 42% of nosocomial isolates. The results of this study and numerous observations regarding the increasing resistance to these antibiotics, in several countries, emphasize the need for local population-specific surveillance for guiding empirical therapy for UTI in children.

  5. Antibiotic combinatorial approach utilized against extended spectrum beta-lactamase (ESBL bacteria isolates from Enugu, South Eastern Nigeria

    Ruth A. Afunwa


    Full Text Available Introduction: Antibiotic options in the treatment of extended spectrum beta-lactamase (ESBL producing bacteria are very limited. The purpose of this study was to analyze several commonly applied antibiotics in quite various novel combinations for use against ESBL-producing bacteria isolates.Methods: Total of 460 samples of urine, throat and anal swab were collected from volunteers and patients from nursery, primary and secondary schools and from other individuals in the community. Hospital and community isolates comprised of 65% and 35% respectively. The identification and characterization of the isolates were done by standard culturing and in vitro antibiotic sensitivity procedures.Results: The antibiotic combination studies showed that the combination of gentamicin with the other antibiotics had predominantly synergistic effects. The percentage synergistic effect for the combinations of gentamicin/pefloxacin was 69%, gentamicin/[Amoxicillin and clavulanic acid] 72%, gentamicin/ceftriaxone 68%, gentamicin/cefuroxime 81.9%, and gentamicin/ciprofloxacin 80.6%, against the community and hospital derived ESBL producing organisms of both Enterobacteriaceae and Pseudomonas species.Conclusion: Good antimicrobial monitoring exercise and corresponding antimicrobial screening activities should work towards a dynamic approach to generate effective treatment options using combination therapy.

  6. Antibiotic Prescription Practices Among Children with Influenza.

    Nitsch-Osuch, A; Gyrczuk, E; Wardyn, A; Życinska, K; Brydak, L


    The important factor in the development of resistance to antibiotics is their overuse, especially for viral respiratory infections. The aim of the study was to find out the frequency of the antibiotic therapy administrated to children with influenza. A total of 114 children younger than 59 months seeking care for the acute respiratory tract infection was enrolled into the study. The patients had influenza-like symptoms: fever > 38 °C, cough, and sore throat of less than 4 days duration. Nasal and pharyngeal swabs were tested for influenza A and B virus with a real-time PCR. Thirty six cases of influenza were diagnosed: 34 of influenza A (H3N2) and 2 of influenza B. The rate of influenza infection was 32 % in the study group. The antibiotic therapy was ordered for 58 % patients with influenza. Antibiotics were given less frequently in the outpatient setting (33 %) compared with the hospitalized patients (93 %) (p clavulanic acid, cefuroxime, and amoxicillin. None of the patients received oseltamivir. Antibiotics were overused, while antivirals were underused among children with influenza. To improve health care quality, more efforts in the diagnosis of influenza and the appropriate use of antimicrobials and antivirals are required. PMID:26801146

  7. Study of the Electrophoretic Behavior of Cephalosporins by Capillary Zone Electrophoresis

    Gabriel Hancu


    Full Text Available Purpose: The aim of the study was the characterization of the electrophoretic behavior of cephalosporins from different generation having different structural characteristics in order to develop a rapid, simple and efficient capillary electrophoretic method for their identification and simultaneous separation from complex mixtures. Methods: Ten cephalosporin derivatives (cefaclor, cefadroxil, cefalexin, cefazolin, cefoxitin, cefuroxime, cefoperazone, cefotaxime, ceftazidime, ceftriaxone were analyzed by capillary zone electrophoresis using different background electrolyte solutions at different pH values. Electrophoretic mobilities of the analytes were calculated, the influence of the electrophoretic parameteres on the separation was established and the analytical conditions were optimized. Results: Taking into consideration their structural and chemical properties cephalosporins can be detected over a pH range between 6 and 10. The best results were obtained using a buffer solution containing 25 mM disodium hydrogenophosphate - 25 mM sodium dihydrogenophosphate, at a pH – 7.00, + 25 kV voltage at a temperature of 25 C, UV detection at 210 nm. Using the optimized analytical conditions we achieved the simultaneous baseline separation for seven cephalosporins in less then 10 minutes. Conclusion: Using the described optimized electrophoretic procedures, capillary electrophoresis can be used for the identification and determination of cephalosporins in formulated pharmaceutical products and for their separation from complex mixtures.

  8. Distribution and persistence of cephalosporins in cephalosporin producing wastewater using SPE and UPLC-MS/MS method.

    Yu, Xin; Tang, Xinyao; Zuo, Jiane; Zhang, Mengyu; Chen, Lei; Li, Zaixing


    An investigation to study the distribution and persistence of cephalosporins in the cephalosporin producing wastewater was carried out in this paper. The target cephalosporins included ceftriaxone (CRO), cefalexin (CEF), cefotaxime (CTX), cefazolin (CZO), cefuroxime (CXM), cefoxitin (CFX) and cefradine (CF). A rapid and reliable detection method for cephalosporins was established based on solid phase extraction and ultra-performance liquid chromatography - tandem mass spectrometry. In the cephalosporin producing wastewater effluent (CPWWeff), the limit of quantification for the targets ranged from 27.5ng/L to 131.8ng/L, and the recoveries for all of the analytes ranged from 73% to 102%. The mean concentrations of the seven cephalosporins were 12.85-141.55μg/L and 0.05-24.38μg/L in cephalosporin producing wastewater influent and effluent, respectively. Although high removal efficiencies were achieved for the cephalosporins (78.8-99.7%), up to 1.9kg of cephalosporins was discharged per day from the investigated C-WWTP. The degradation processes of CRO, CEF, CZO and CXM followed first-order kinetics in CPWWeff under all of the testing conditions. The degradation rates of tested cephalosporins were accelerated by high temperature and light. Persistence of CXM was the highest among the four tested cephalosporins in CPWWeff. PMID:27328396

  9. The occurrence of antimicrobial resistance and class 1 integrons among commensal Escherichia coli isolates from infants and elderly persons

    Kõljalg Siiri


    Full Text Available Abstract Background The aim of our study was to compare the presence of the intI1 gene and its associations with the antibiotic resistance of commensal Escherichia coli strains in children with/without previous antibiotic treatments and elderly hospitalized/healthy individuals. Methods One-hundred-and-fifteen intestinal E. coli strains were analyzed: 30 strains from 10 antibiotic-naive infants; 27 from 9 antibiotic-treated outpatient infants; 30 from 9 healthy elderly volunteers; and 28 from 9 hospitalized elderly patients. The MIC values of ampicillin, cefuroxime, cefotaxime, gentamicin, ciprofloxacin, and sulfamethoxazole were measured by E-test and IntI1 was detected by PCR. Results Out of the 115 strains, 56 (49% carried class 1 integron genes. Comparing persons without medical interventions, we found in antibiotic-naive children a significantly higher frequency of integron-bearing strains and MIC values than in healthy elderly persons (53% versus 17%; p Conclusion The prevalence of integrons in commensal E. coli strains in persons without previous medical intervention depended on age. The resistance of integron-carrying and non-carrying strains is more dependent on influencing factors (hospitalization and antibiotic administration in particular groups than merely the presence or absence of integrons.

  10. Ultrasound-assisted matrix solid phase dispersive extraction for the simultaneous analysis of β-lactams (four penicillins and eight cephalosporins) in milk by high performance liquid chromatography with photodiode array detection.

    Karageorgou, Eftichia G; Samanidou, Victoria F; Papadoyannis, Ioannis N


    The application of ultrasound-assisted matrix solid phase dispersive extraction for the confirmatory analysis of 12 β-lactam antibiotics in milk by high performance liquid chromatography with photodiode array detection has been proposed herein. Four penicillins (cloxacillin, dicloxacillin, oxacillin, and amoxicillin) and eight cephalosporins (cefaclor, cefadroxil, ceftiofur, cefuroxime, cefoperazone, cefazolin, cephalexin, and cefotaxime) are effectively extracted using a mixed sorbent of Quick Easy Cheap Effective Rugged Safe technique and OASIS HLB providing a matrix free from any endogenous interference. Examined analytes were well resolved on an Inertsil ODS-3 analytical column with a mobile phase of CH(3)COONH(4) (0.05 M) and acetonitrile delivered under a gradient program. 1,7-Dimethyl-xanthine was used as internal standard. The method was validated meeting the European Legislation determining linearity, selectivity, stability, decision limit, detection capability, accuracy, precision, and ruggedness according to the Youden approach. Recoveries of all antibiotics rated from 85.0 to 115.7%, while RSD values were <12.7%. Finally, the method was successfully applied to milk samples purchased from local market. PMID:22941669

  11. Surgical infections: a microbiological study

    Santosh Saini


    Full Text Available Surgical infections are mostly polymicrobial, involving both aerobes and anaerobes. One hundred seventeen cases comprised of abscesses (n=51, secondary peritonitis (n=25, necrotizing fascitis (n=22 and wounds with devitalized tissues (n=19 were studied. The number of microorganisms isolated per lesion was highest in secondary peritonitis (2.32. The aerobe/ anaerobe ratio was 0.81 in secondary peritonitis and 1.8 in necrotizing fascitis. Most secondary peritonitis (80%, necrotizing fascitis (75% and wounds with devitalized tissues (66.7% were polymicrobial. Common microorganisms isolated in our study were E. coli, Staphylococcus aureus, Klebsiella spp., Pseudomonas aeruginosa, Bacteroides fragilis and Peptostreptococcus spp. The most effective antibiotics for S. aureus were clindamycin (79.1% and cefuroxime (70.8%. For Gram-negatives (Klebsiella spp., E. coli and Proteus spp., the most effective antibiotics were cefotaxime, ceftizoxime, amikacin and ciprofloxacin. Pseudomonas aeruginosa was maximally sensitive to amikacin (35.2% and ciprofloxacin (35.2%. The greatest degree of multidrug resistance to all the drugs was found in P. aeruginosa (52.9%, followed by Klebsiella spp. (33.3%, Proteus spp. (33.3%, E. coli (22.2%, and S. aureus (12.5%. All the anaerobes that we isolated were 100% sensitive to metronidazole and chloramphenicol, followed by clindamycin (95% to 100%. Apart from antibiotic therapy, non-antimicrobial methods, such as hyperbaric oxygen therapy and debridement also play an important role in the treatment of surgical infections.

  12. The Escherichia coli phylogenetic group B2 with integrons prevails in childhood recurrent urinary tract infections.

    Kõljalg, Siiri; Truusalu, Kai; Stsepetova, Jelena; Pai, Kristiine; Vainumäe, Inga; Sepp, Epp; Mikelsaar, Marika


    The aim of our study was to characterize the phylogenetic groups of Escherichia coli, antibiotic resistance, and containment of class 1 integrons in the first attack of pyelonephritis and in subsequent recurrences in young children. Altogether, 89 urine E. coli isolates from 41 children with urinary tract infection (UTI) were studied for prevalence and persistence of phylogenetic groups by pulsed-field gel electrophoresis (PFGE), antibacterial resistance by minimal inhibitory concentrations (MIC) and class 1 integrons by PCR. Phylogenetic group B2 was most common (57%), followed by D (20%), A (18%) and B1 (5%). Overall resistance to betalactams was 61%, trimethoprim-sulfamethoxazole 28%, and was not associated with phylogenetic groups. According to PFGE, the same clonal strain persisted in 77% of patients. The persistence was detected most often in phylogenetic group B2 (70%). Phylogenetic group B2 more often contained class 1 integrons than group A. Integron positive strains had higher MIC values of cefuroxime, cefotaxime, and gentamicin. In conclusion, phylogenetic group B2 was the most common cause of the first episode of pyelonephritis, as well as in case of the persistence of the same strain and contained frequently class 1 integrons in childhood recurrent UTI. An overall frequent betalactam resistance was equally distributed among phylogenetic groups. PMID:24033434

  13. Ecological antibiotic policy.

    Høiby, N


    Development of resistance to antibiotics is a major problem worldwide. The normal oropharyngeal flora, the intestinal flora and the skin flora play important roles in this development. Within a few days after the onset of antibiotic therapy, resistant Escherichia coli, Haemophilus influenzae and Staphylococcus epidermidis can be detected in the normal flora of volunteers or patients. Horizontal spread of the resistance genes to other species, e.g. Salmonella spp., Staphylococcus aureus and Streptococcus pneumoniae, occurs by conjugation or transformation. An ecologically sound antibiotic policy favours the use of antibiotics with little or no impact on the normal flora. Prodrug antibiotics which are not active against the bacteria in the mouth and the intestine (before absorption) and which are not excreted to a significant degree via the intestine, saliva or skin are therefore preferred. Prodrugs such as pivampicillin, bacampicillin, pivmecillinam and cefuroxime axetil are favourable from an ecological point of view. Experience from Scandinavia supports this, since resistance to mecillinam after 20 years of use is low (about 5%) and stable. PMID:11051626

  14. Hyperammonemic encephalopathy induced by a combination of valproate and pivmecillinam.

    Lokrantz, C-M; Eriksson, B; Rosén, I; Asztely, F


    We describe the clinical and neurophysiological findings in a case of hyperammonemic encephalopathy. A 72-year-old woman taking valproate (VPA), as monotherapy for her partial epilepsy developed urinary tract infection. She was treated with pivmecillinam 600 mg daily. The following days she deteriorated and became stuporous. At admission her serum ammonia level was increased (113 mmol/l) but the liver function appeared normal. EEG showed bilateral triphasic waves and continuous high-amplitude delta-theta wave. The patient recovered rapidly after discontinuation of VPA and i.v. treatment with cefuroxime for her urinary tract infection. VPA-induced hyperammonemic encephalopathy in adults is a rare phenomenon, especially when VPA is used as monotherapy. It has been suggested that the VPA-induced hyperammonemic encephalopathy is due to reduced serum carnitine concentration. Pivmecillinam, a widely used antibiotic for treatment of urinary tract infections, is also known to decrease the serum carnitine concentration. Our case shows that caution is required when treatment with VPA is combined with pivmecillinam due to the risk of developing hyperammonemic encephalopathy. PMID:15016014

  15. Antimicrobial Evaluation of Bacterial Isolates from Urine Specimen of Patients with Complaints of Urinary Tract Infections in Awka, Nigeria

    Ekwealor, Perpetua A.; Ugwu, Malachy C.; Ezeobi, Ifeanyi; Amalukwe, George; Ugwu, Belinda C.; Okezie, Ugochukwu; Stanley, Catherine; Esimone, Charles


    Urinary tract infections (UTIs) account for one of the major reasons for most hospital visits and the determination of the antimicrobial susceptibility patterns of uropathogens will help to guide physicians on the best choice of antibiotics to recommend to affected patients. This study is designed to isolate, characterize, and determine the antimicrobial susceptibility patterns of the pathogens associated with UTI in Anambra State Teaching Hospital, Amaku, Anambra State, Nigeria. Clean catch urine samples of inpatient and outpatient cases of UTI were collected and bacteriologically analyzed using standard microbiological procedures. Antibiogram was done by the Kirby-Bauer disc diffusion method. The most prevalent isolates were S. aureus (28%), E. coli (24.6%), and S. saprophyticus (20%). The antibacterial activities of the tested agents were in the order of Augmentin < Ceftazidime < Cefuroxime < Cefixime < Gentamicin < Ofloxacin < Ciprofloxacin < Nitrofurantoin. It was found that all the organisms were susceptible in varying degrees to Nitrofurantoin, Ciprofloxacin, and Ofloxacin. It was also observed that all the bacterial species except Streptococcus spp. have a Multiple Antibiotic Resistance Index (MARI) greater than 0.2. For empiric treatment of UTIs in Awka locality, Nitrofurantoin, Ciprofloxacin, and Ofloxacin are the first line of choice. PMID:27200093

  16. Increasing antimicrobial resistance in Escherichia coli isolates from community-acquired urinary tract infections during 1998-2003 in Manisa, Turkey.

    Kurutepe, Semra; Surucuoglu, Suheyla; Sezgin, Cenk; Gazi, Horu; Gulay, Mehmet; Ozbakkaloglu, Beril


    Urinary tract infections are among the most common infections with an increasing resistance to antimicrobials. The aim of this study was to determine the change in antimicrobial susceptibility of Escherichia coli isolates from patients with community-acquired urinary tract infection (UTI) for the years 1998 through 2003 and to suggest that the current empirical antibiotic therapy used for these patients is inappropriate. During the study period, 7,335 community urine samples of which 1,203 (16.4%) grew bacterial isolates were analyzed. Among the total of 1,203 isolates, 880 (73.2%) were E. coli. The range of resistance of E. coli to ampicillin was 47.8 to 64.6% and that to trimethoprim-sulfamethoxazole was 37.1 to 44.6% during the study period. The susceptibility pattern of E. coli to nitrofurantoin and cefuroxime did not vary significantly over the 6-year period. There was a significant increase in the susceptibility of E. coli to ciprofloxacin (11.3 - 26.7%), amoxicillin-clavulanate (18.4 - 29.2%) and gentamicin (7.0 - 25.6%) (P < 0.05). Empirical initial treatment with ampicillin and trimethoprim-sulfamethoxazole was thus inadequate in approximately half of UTI cases in our region. PMID:15973007

  17. Kinetic Spectrophotometric Determination of Certain Cephalosporins in Pharmaceutical Formulations

    Mahmoud A. Omar


    Full Text Available A simple, reliable, and sensitive kinetic spectrophotometric method was developed for determination of eight cephalosporin antibiotics, namely, Cefotaxime sodium, Cephapirin sodium, Cephradine dihydrate, Cephalexin monohydrate, Ceftazidime pentahydrate, Cefazoline sodium, Ceftriaxone sodium, and Cefuroxime sodium. The method depends on oxidation of each of studied drugs with alkaline potassium permanganate. The reaction is followed spectrophotometrically by measuring the rate of change of absorbance at 610 nm. The initial rate and fixed time (at 3 minutes methods are utilized for construction of calibration graphs to determine the concentration of the studied drugs. The calibration graphs are linear in the concentration ranges 5–15 g mL−1 and 5–25 g mL−1 using the initial rate and fixed time methods, respectively. The results are validated statistically and checked through recovery studies. The method has been successfully applied for the determination of the studied cephalosporins in commercial dosage forms. Statistical comparisons of the results with the reference methods show the excellent agreement and indicate no significant difference in accuracy and precision.

  18. Kinetic spectrophotometric determination of certain cephalosporins in pharmaceutical formulations.

    Omar, Mahmoud A; Abdelmageed, Osama H; Attia, Tamer Z


    A simple, reliable, and sensitive kinetic spectrophotometric method was developed for determination of eight cephalosporin antibiotics, namely, Cefotaxime sodium, Cephapirin sodium, Cephradine dihydrate, Cephalexin monohydrate, Ceftazidime pentahydrate, Cefazoline sodium, Ceftriaxone sodium, and Cefuroxime sodium. The method depends on oxidation of each of studied drugs with alkaline potassium permanganate. The reaction is followed spectrophotometrically by measuring the rate of change of absorbance at 610 nm. The initial rate and fixed time (at 3 minutes) methods are utilized for construction of calibration graphs to determine the concentration of the studied drugs. The calibration graphs are linear in the concentration ranges 5-15 mug mL(-1) and 5-25 mug mL(-1) using the initial rate and fixed time methods, respectively. The results are validated statistically and checked through recovery studies. The method has been successfully applied for the determination of the studied cephalosporins in commercial dosage forms. Statistical comparisons of the results with the reference methods show the excellent agreement and indicate no significant difference in accuracy and precision. PMID:20140078

  19. Synergistic activity of biocides and antibiotics on resistant bacteria from organically produced foods.

    Fernández Fuentes, Miguel Angel; Abriouel, Hikmate; Gadea, Rebeca; Pérez Pulido, Rubén; Gálvez, Antonio; Ortega, Elena


    Synergism between biocides and antibiotics was investigated in 20 biocide and antibiotic-resistant bacterial strains that were previously isolated from organically produced foods, according to their antimicrobial resistance profiles. Most of the antibiotic/biocide combinations yielded synergistic interactions, reducing the inhibitory concentrations of biocides and antibiotics by 4- to 16-fold. Among enterococci, synergism with biocides was detected for amoxicillin (AM), cefuroxime (CX), erythromycin (EM), ciprofloxacin (CP), and trimethoprim/sulphametoxazol (T/S). Among staphylococci, interactions were synergistic (AM) and either synergistic or indifferent (CX and EM, depending on biocide). Among the three methicillin-resistant Staphylococcus aureus clinical strains included in the study, the combinations of methicillin and triclosan or hexachlorophene acted synergistically in all strains, but interactions were either synergistic or indifferent for the other biocides, depending on the strain. All combinations tested were synergistic for Lactobacillus (AM, CX, EM, and CP) and Micrococcus (AM, EM). In Salmonella, interactions were indifferent (AM, CX, EM, and CP) or synergistic (T/S). Synergism with biocides was also detected in Klebsiella isolates (AM, CX, and T/S), Enterobacter sp. (AM, CX, EM, and T/S), Pantoea (AM, CX, EM, CP, and T/S), and Chryseobacterium sp. (EM). These results suggest that combinations of biocides and antibiotics may open new possibilities to combat antimicrobial resistance. PMID:24660956

  20. In vitro susceptibility of community-acquired urinary tract pathogens to commonly used antimicrobial agents in Spain: a comparative multicenter study (2002-2004).

    Garcia Garcia, M I; Munoz Bellido, J L; Garcia Rodriguez, J A


    The susceptibility patterns of 2724 uropathogens isolated in 9 Spanish regions during 2002, and 3013 obtained in 2004 were determined. The antibiotics tested were fosfomycin trometamol, amoxicillin, co-amoxiclav, cefixime, cefuroxime-axetil, pipemidic, ceprofloxacin, trimethoprim plus sulphamethoxazole and nitrofurantoin. Escherichia coli was the main pathogen in both studies (73% vs. 68.3%) followed by Proteus mirabilis 7.2% vs. 6.4%) and Klebsiella pneumoniae (5.4% vs. 5.2%). Enteroccocus spp. (4.7% vs. 6.8%), Streptoccocus agalactiae (1.7% vs. 3.1%) and Staphyloccocus saprophyticus (0.7% vs. 1.3%)were the most frequent Gram-positive pathogens. 31.3% of E. coli in 2002 and 32% in 2004 were susceptible to all antibiotics tested. Around 40% of E. coli were resistant to a single agent. 21.6-24.1% were resistant to two antibiotics. 35.4% of first period isolates, and 37.6% of second period ones were resistant to two or more classes of antibiotics. Fosfomycin (2.1- 2.8%) and nitrofurantoin (3.5-5.7%) had the lowest resistance rates for E. coli. Amoxicillin (58.2-58.7%), co-trimoxazole (30.8-33.8%) and ciprofloxacin (22.6-22.7%) showed the highest resistance rates, and their suitability as empiric treatments for UTI should probably be re-evaluated. PMID:17594920

  1. Comparison of the serum-supplemented Todd-Hewitt and the new Haemophilus test media for broth microdilution susceptibility testing of Streptococcus pneumoniae.

    Roger, M; Lapointe, J R


    Horse serum-supplemented Todd-Hewitt broth (STH) in use at Hôpital Ste-Justine for the last 12 years was compared to the recently proposed Haemophilus test medium (HTM), for broth microdilution susceptibility testing of Streptococcus pneumoniae. One hundred and twenty S. pneumoniae isolates from pediatric clinical specimens were used in this study. In general, the minimum inhibitory concentrations (MICs) in STH for 15 antimicrobial agents were quite comparable to those determined in HTM but tended to be higher. Drugs which generated MICs within +/- 1 log2 concentration differences in both media included penicillin, ampicillin, oxacillin, cefuroxime, cefotaxime, cefixime, clindamycin, chloramphenicol, trimethoprim-sulfamethoxazole, rifampin, ciprofloxacin and vancomycin. Cefaclor and tetracycline MICs tended to be > or = 2 log2 dilutions higher with STH for most of the isolates tested, while erythromycin MICs were often 2 log2 dilutions lower with STH than with HTM. Despite some differences in MICs noted above, few very major (0.4%), major (0.2%) and minor interpretive category errors (4.4%) were observed. The visual reading of the MICs for most of the 120 clinical isolates tested was generally easier in STH which was superior in supporting best the bacterial growth as detected by spectrophotometry. The risk of false susceptibility is thus decreased by using STH rather than HTM; furthermore, STH is free of the technical problems of the lysed horse blood Mueller-Hinton (LHB-MH) recommended by the NCCLS. PMID:8808713

  2. Design, synthesis and biological evaluation of 4-benzoyl-1-dichlorobenzoylthiosemicarbazides as potent Gram-positive antibacterial agents.

    Paneth, Agata; Plech, Tomasz; Kaproń, Barbara; Hagel, Dominika; Kosikowska, Urszula; Kuśmierz, Edyta; Dzitko, Katarzyna; Paneth, Piotr


    Twelve 4-benzoyl-1-dichlorobenzoylthiosemicarbazides have been tested as potential antibacterials. All the compounds had MICs between 0.49 and 15.63 µg/ml toward Micrococcus luteus, Bacillus cereus, Bacillus subtilis and Staphylococcus epidermidis indicating, in most cases, equipotent or even more effective action than cefuroxime. In order to clarify if the observed antibacterial effects are universal, further research were undertaken to test inhibitory potency of two most potent compounds 3 and 11 on clinical isolates of Staphylococcus aureus. Compound 11 inhibited the growth of methicillin-sensitive S. aureus (MSSA) at MICs of 1.95-7.81 µg/ml, methicillin-resistant S. aureus (MRSA) at MICs of 0.49-1.95 µg/ml and MDR-MRSA at MIC of 0.98 and 3.90 µg/ml, respectively. Finally, inhibitory efficacy of 3 and 11 on planktonic cells and biofilms formation in clinical isolates of S. aureus and Haemophilus parainfluenzae was tested. The majority of cells in biofilm populations of MSSA and MRSA were eradicated at low level of 3, with MBICs in the range of 7.82-15.63 µg/ml. PMID:25897586

  3. 常见养殖淡水鱼肠道细菌耐药性研究%Antibiotic resistance of the intestinal flora in the domestic species of cultured freshwater fish

    杨宇宸; 崔泽林; 郭晓奎; 刘畅


    Objective To study the different antibiotic resistance of the intestinal flora in domestic species of freshwater fish. Methods The fecal specimens were collected from two species of freshwater fish,and were cultured on agar-plate containing 7 kinds of antibiotics ( penicilin G, cefuroxime sodium, gentamicin,ciprofloxacin, tetracycline, erythromycin and SMZ) for the antibiotic susceptibility test. PCR was applied on the results to analyse the 16S rRNA gene sequences of resistant strains and identify their species. x2test was adopt in the comparison between the two fishes. Results 2956 drug-resistant isolates were screened from all of the samples. The rates of resistance to penicilin G, cefuroxime sodium, gentamicin, ciprofloxacin,tetracycline, erythromycin and SMZ were 8.89%, 1.57%, 0.08%, 0. 11%, 0. 28%, 0.07% and 0.06%,respectively. The results of identification showed that the main components of the 71 strains selected by simple random method were 31 strains of Aeromonas (43.66%), 8 strains of Acinetobacter (11.27%), 6 strains of Pseudomonas (8.45%) and 6 strains of Chryseobacterium (8.45%). There were statistically significant differences in the rates of resistance to penicilin G, cefuroxime sodium, SMZ, erythromycin and tetracycline between the two kinds of fish (x2 values were 129.06,212. 54,7. 76,8. 62 and 35.40, P<0. 05).Conclusions The rates of resistance to penicilin G, cefuroxime sodium, gentamicin, ciprofoxacin,tetracycline, erythromycin and SMZ of the intestinal flora in domestic species of freshwater fish we obtained can provide foundation for us to do some researches and pursue the changes of the antibiotic resistance rates of the intestinal flora in domestic species of freshwater fish in future.%目的 调查分析目前国内常见养殖淡水鱼类肠道菌群对不同抗生素的耐药性现状.方法 选取两种常见养殖淡水鱼类的粪便标本,分别在添加了7种抗生素[青霉素G、头孢呋辛钠、庆大霉素、环丙沙星、

  4. Spectrum and Sensitivity of Bacterial Keratitis Isolates in Auckland

    S. Marasini


    Full Text Available Background. The bacteria isolated from severe cases of keratitis and their antibiotic sensitivity are recognised to vary geographically and over time. Objectives. To identify the most commonly isolated bacteria in keratitis cases admitted over a 24-month period to a public hospital in Auckland, New Zealand, and to investigate in vitro sensitivity to antibiotics. Methods. Hospital admissions for culture-proven bacterial keratitis between January 2013 and December 2014 were identified. Laboratory records of 89 culture positive cases were retrospectively reviewed and antibiotic sensitivity patterns compared with previous studies from other NZ centres. Results. From 126 positive cultures, 35 species were identified. Staphylococcus was identified to be the most common isolate (38.2%, followed by Pseudomonas (21.3%. Over the last decade, infection due to Pseudomonas species, in the same setting, has increased (p≤0.05. Aminoglycosides, cefazolin, ceftazidime, erythromycin, tetracycline, and doxycycline were 100% effective against tested isolates in vitro. Amoxicillin (41.6%, cefuroxime (33.3%, and chloramphenicol (94.7% showed reduced efficacy against Gram-negative bacteria, whereas penicillin (51% and ciprofloxacin (98.8% showed reduced efficacy against Gram-positive bacteria. Conclusions. Despite a shift in the spectrum of bacterial keratitis isolates, antibiotic sensitivity patterns have generally remained stable and show comparability to results within the last decade from NZ centres.

  5. [Antibacterial activity and beta-lactamase stability of eleven oral cephalosporins].

    Bauernfeind, A; Jungwirth, R; Schweighart, S; Theopold, M


    Oral cephalosporins (cefixime, cefdinir, cefetamet, ceftibuten, cefpodoxime, loracarbef, cefprozil, cefuroxime, cefaclor, cefadroxil and BAY 3522) were compared by their antibacterial profile including stability against new beta-lactamases. Both activity and antibacterial spectrum of compounds structurally related to third generation parenteral cephalosporins (of the oximino class) were superior to established compounds. Activity against staphylococci was found to be highest for cefdinir, cefprozil and BAY 3522. Cefetamet, ceftibuten and cefixime demonstrate no clinically meaningful antistaphylococcal activity while the other compounds investigated demonstrate intermediate activity. The antibacterial spectrum was broadest for cefdinir and cefpodoxime. New oral cephalosporins are equally inactive as established compounds against Enterobacter spp., Morganella, Listeria, Pseudomonas and Acinetobacter spp., methicillin-resistant staphylococci, Enterococcus spp., penicillin-resistant pneumococci and anaerobes. New extended broad-spectrum betalactamases (TEM-3, TEM-5, TEM-6, TEM-7, SHV-2, SHV-3, SHV-4, SHV-5, CMY-1, CMY-2, and CTX-M) are active against the majority of oral cephalosporins. Ceftibuten, cefetamet, cefixime and cefdinir were stable against some of these enzymes even to a higher extent than parenteral cephalosporins. New oral cephalosporins should improve the therapeutic perspectives of oral cephalosporins due to their higher activity against pathogens marginally susceptible to established compounds (higher multiplicity of maximum plasma concentrations over MICs of the pathogens) and furthermore by including in their spectrum organisms resistant to established absorbable cephalosporins (e.g. Proteus spp., Providencia spp., Citrobacter spp., and Serratia spp.). PMID:2079378

  6. 上海崇明地区3家二级综合医院2011-2013年抗菌药物类国家基本药物使用情况分析%Utilization Analysis of National Essential Medicines in Antibiotics in 3 Second-level General Hospitals from Chongming Area of Shanghai from 2011 to 2013

    岳德永; 姜云达; 杨忠英


    目的:为促进抗菌药物类国家基本药物的合理使用提供参考。方法:对上海崇明地区3家二级综合医院2011-2013年抗菌药物类国家基本药物的使用情况进行统计、分析。结果:抗菌药物类国家基本药物销售金额呈增长趋势,年平均增长率为28.16%;而其销售金额占药品销售总金额比例仍较低,平均为2.16%。2011-2013年排序列前3位的3类抗菌药物销售金额之和分别占抗菌药物类国家基本药物销售总金额的87.92%、93.60%、95.54%,呈上升趋势;而抗菌药物类国家基本药物DDDs 2012、2013年较2011年有所下降。DDDs排序列前2位的是头孢呋辛酯片、阿莫西林胶囊,销售金额居首位的是注射用头孢呋辛钠;金额/DDDs排序比接近1的品种较少,说明用药金额与用药人次同步性较差。结论:抗菌药物类国家基本药物应用仍存在一些问题,在以后的相关工作中需持续改进,进一步提高用药合理性和经济性,逐步实现抗菌药物临床应用管理的制度化、常态化。%OBJECTIVE:To provide reference for promoting the rational use of national essential medicines in antibiotics. METHODS:The use of national essential drugs in antibiotics in 3 second-level general hospitals from Chongming area of Shanghai from 2011 to 2013 were statistically analyzed. RESULTS:The sales amount of antibiotics was in an increasing trend,with an aver-age growth rate of 28.16%;while the proportion of sales amount accounted for the total sales amount of drugs were still relatively low,with an average growth rate of 2.16%. The proportion of total sales amount of top 3 antibiotics from 2011 to 2013 accounted for the total sales amount of drugs were respectively 87.92%,93.60% and 95.54%,with an increasing trend;while compared with 2011,the DDDs of national essential medicines in antibiotics was decreased a little during 2012-2013;the top 2 DDDs were Cefuroxime axetil

  7. 249株流感嗜血杆菌的分离与耐药性分析%Analysis on Isolation and Antibiotic Resistance of 249 Strains of Haemophilus influenzae

    曹敏晖; 曹友德; 李浩; 蔡瑞云


    目的 了解流感嗜血杆菌(Hi)的检出状况与耐药情况,指导临床合理用药.方法 统计分析2007-2010年我院Hi的分离与耐药情况.结果 在1052份痰及咽拭子标本中分离出Hi 210株,在242份胆汁标本中分离出Hi 16株,在203份胸腹水标本中分离出Hi 12株,在163份眼、耳拭子标本中分离出Hi 11株.体外药敏结果显示Hi对复方磺胺甲恶哇耐药性最高为63.5%,氨苄西林次之为46.2%,而对阿莫西林/棒酸、利福平、头孢呋辛、头孢噻肟、亚氨培南敏感,耐药率≤2.0%.结论 Hi在呼吸道标本中的检出率最高,眼、耳拭子标本中次之,在胆汁、胸腹水中亦有检出.建议眼、耳拭子及胆汁、胸腹水标本作细菌培养时也应同时接种哥伦比亚血平板(COS)、淋球菌选择性平板(VCA)及嗜血杆菌选择性平板(HAE),Hi感染的治疗应首选复方阿莫西林、头孢二代或三代类抗生素.%Objective To investigate the isolation rate and antibiotic resistance rate of Haemophilus influenzae, and to guide the rational use of antibiotic therapy in clinical practice. Methods The data about the isolation rate and antibiotic resistance rate of Haemophilus influenzae from 2007 to 2010 were analyzed with SPSS11.0 statistical software. Results Totally 210 strains of Haemophilus influenzae were isolated from 1,052 specimens of sputum and pharyngeal secretion, 16 strains isolated from 242 bile specimens, 12 strains isolated from 203 hydrothoraxs specimens, and 11 strains isolated from 163 specimens of eye or ear secretion. In vitro drug- sensitivity test showed that the resistance rate of Haemophilus influenzae to trimethoprime sulfanomicles was the highest (63.5%), followed by ampicillin (46.2%). But the resistance rates to amoxicillin/clavalanic acid, rifampicine, cefuroxime, cefotaxime and imipenem were very low (≤2.0%). Conclusions Heamophilus influenzae could be isolated from the secretions of respiratory track, eye, ear, bile

  8. In vitro antibacterial activity of fosfomycin combined with nine antimicrobial agents against acinetobacter%磷霉素与9种抗菌药物分别联用对不动杆菌的体外抗菌活性研究

    杨莹莹; 王镇山; 薛欣; 聂大平; 李玉中


    [ Objective] To study the antibacterial activity of fosfomycin combined with other 9 antimicrobial agents against 47 strains of Acinetobacter in vitro, in order to provide laboratory data for clinical combination application. [ Methods] The 47 strains of acinetobacter isolated from sputum samples were treated by 10 antimicrobial agents alone and by fosfomycin combined with other 9 antimicrobial agents. Through the minimal inhibitory concentration (MIC) and fractional inhibitory concentration (FIC) index, using a two -fold agar dilution method, we could evaluate the antibacterial activity of fosfomycin combined with other 9 antimicrobial agents in vitro. [ Results] All the 47 strains of acinetobacter were resistant to fosfomycin, levofloxacin, ciprofloxacin, cefuroxime, ceftazidime, cefepime, cefoperazone/sulbactam, amikacin, and were intermedium to meropenem and imipenem/cilastatin. The ratio of antimicrobial agents was 1: 1. The MICs of fosfomycin combined with other 9 antimicrobial agents were lower than those of 10 antimicrobial agents alone and FIC index≤2. The primary action was synergistic/additional effect. There was no antagonistic effect observed. [ Conclusion] Synergistic/additional effect was observed in fosfomycin combined with levofloxacin, ciprofioxacin, cefuroxime, ceftazidime, cefepime, cefoperazone/sulbactam, amikacin, meropenem and imipenem/cilastatin against acinetobacter in vitro. The antimicrobial activities of combination were increased.%[目的]研究磷霉素与其它9种临床常用抗菌药物分别联合应用对47株不动杆菌的体外抗菌活性.[方法]收集痰标本中分离出的不动杆菌47株,将磷霉素与其它9种抗菌药物在体外单独以及联合应用,采用琼脂二倍稀释法,测定最低抑菌浓度(MIC)、计算部分抑菌浓度(FIC)指数,评价磷霉素与其它9种抗菌药物分别联合应用的体外抗菌活性.[结果]磷霉素、左氧氟沙星、环丙沙星、头孢呋辛、头孢他啶、头孢

  9. In vitro activity of Yinhua Miyan Ling%银花泌炎灵体外抗菌作用研究

    李耘; 吕媛; 刘健; 薛峰; 杨维维; 张佳


    Objective To evaluation in vitro activity and synergy of Yin-hua Miyan Ling against main clinical isolated strains.Methods All of 285 stains from 18 tertiary hospitals in recent three years were studied. Minimal inhibition concentrations ( MIC ) were tested by Agar dilution method and combination effects were measured by Checkerboard method. Results Yinhua Miyan Ling showed more in vitro activity against Sta-phylococcus and Proteus mirabilis, MIC values from 3.13~6.25 mg・ mL-1 . On the other hand, Yinhua Miyan Ling showed the same antibiotic activi-ty against extended-spectrumβlactamases ( ESBLs) positive and nega-tive strains or methecillin susceptible and resistant Staphylococcus.Syner-gy was detected with Yinhua Miyan Ling in combination with amoxillin/clavulanate, cefuroxime and levofloxacin against gram-positive strains, especially methicillin-resistant Staphylococcus aureus ( MRSA).Against E.faecalis, synergy was observed in Yinhua Miyan Ling and cefuroxime. Additive effect was found between Yinhua Miyan Ling and amoxillin/clavulanate against 100%E.coli.Conclusion Synergy was found with Yinhua Miyan Ling in combination withβlactams and quinolones against gram -positive strains and additive effect was found against gram-negative bacilli.%目的:评价银花泌炎灵体外抗菌活性及与临床常用抗菌药物的体外联合作用。方法对来自全国18家医院近3年临床分离的285株菌进行了最低抑菌浓度( MIC)测定, MIC测定用琼脂二倍稀释法,联合药敏测定采用棋盘法。结果银花泌炎灵对葡萄球菌和奇异变形杆菌具有较好的抗菌活性,MIC值在3.13~6.25 mg・ mL-1。不论细菌是否产超广谱β内酰胺酶( ESBLs)或是否为甲氧西林耐药株或是否为环丙沙星耐药株,银花泌炎灵均表现出同样的抗菌作用。联合药敏结果显示,银花泌炎灵与阿莫西林/克拉维酸、头孢呋辛以及左氧氟沙星联合对革兰阳性菌,特别是

  10. Presence Of Multi Drug Resistant Coliform Bacteria Isolated From Biofilm Of Sachet And Borehole Waters Sold In Abakaliki Metropolis Ebonyi State Nigeria.

    Okafor Collins Onyebuchi Okeke


    Full Text Available ABSTRACT This study investigated the presence of multi drug resistant coliform bacteria from biofilm of sachet and borehole waters sold in Abakaliki metropolis in Ebonyi State Nigeria. Five hundred 500 samples of water comprising 250 each from selected brand of sachet water retailers and borehole water dispensers from seven locations were sampled for the detection of coliform bacteria from biofilm and to determine their antimicrobial susceptibility using commercially prepared antibiotic discs. Results revealed a high faecal contamination level in sachet waters as Gospel 36 72 Aqua Rapha 30 60 and Bejoy 18 36 were the highest among the sachet water brands examined with Nene and Rock Tama sachet water brands having the lowest contamination level of 612 and 1326 respectively. Borehole samples results revealed that Aboffia had 27 76.93 samples contaminated with faecal bacteria while Azugwu 11 28.5 Azuiyiokwu 18 50 Azuiyiudene 2980 Kpirikpiri 24 66.63 PrescoNtezi 1646.15 and Udensi 22 61.54. Escherichia coli Enterobacter spp and Klebsiella spp were the major contaminants of both sachet and borehole water samples. The bacteria isolates from biofilm of sachet and borehole waters were susceptible to only three of the antibiotics used namely nitrofurantoin amoxycilin and ampicillin. The bacteria were completely resistant to ciprofloxacin tetracycline norbactinnorfloxacin ofloxacin cefuroxime and gentamicin. This showed that they exhibit multi-drug resistance pattern which is a common feature of medically important biofilm bacteria. We therefore report the presence of multi-drug resistant coliform bacteria from biofilm of sachet and borehole waters sold in Abakaliki metropolis Ebonyi State Nigeria.

  11. The status of drug resistance and ampC gene expression in Enterobacter cloacae

    周志慧; 李兰娟; 俞云松; 马亦林


    Objective To investigate the status of the drug resistance and the ampC gene expression of Enterobacter cloacae. Methods Disk diffusion tests were made for detecting the susceptibility of antimicrobial agents against Enterobacter cloacae. AmpC gene was amplified by polymerase chain reaction (PCR) and verified by DNA sequencing. AmpC gene expression was analyzed according to antimicrobial agent sensitive phenotype.Results The sensitivity rates of 144 strains to imipenam, cefepime and cefoperazone/sulbactam were 98.61%, 65.97% and 63.89%, respectively. The sensitivity rates of 144 strains to other antimicrobial agents were lower. Among the 144 strains 120 were found to be positive by PCR for ampC. The PCR product showed high homology to the GenBank ampC sequence. Stably derepressed strains, hyperinducible strains and unexpressing or lower level expressing strains accounted for 30.0% (36/120), 37.5% (45/120), and 32.5% (39/120), respectively. Fifty-six out of 120 strains (46.67%) also produced extended spectrum β-lactamases (ESBLs). The hyperinducible strains were highly sensitive to all the antimicrobial agents except amoxicillin/clavulanic acid and cefuroxime, while the stably derepressed strains were only sensitive to imipenam and cefepime. However, sensitivity to cefepime decreased if the strains also produced ESBLs. Conclusions The durg resistant status of Enterobacter cloacae is severe. Clearing out the expressive status of ampC gene will be helpful in selection of antimicrobial agents in the treatment of clinical infection.

  12. Our experience on developing urinary tract infections after transrectal prostate biopsy

    Gülay Dede


    Full Text Available Objective: Prostate cancer is a common disease in men proportionally with age. For the diagnosis of prostate cancer, prostate biopsy be performed routinely in all centers so it has become today. Complications after prostate biopsy is a surgical procedure can be seen. The most important complications are urinary tract infection and sepsis. The use of prophylactic antibiotics before the procedure reduces the risk of infectious complications. In this study, infectious complications after transrectal prostate needle biopsy were evaluated for risk reduction practices are discussed. Methods: We evaluated infective complications after transrectal prostate needle biopsy in 276 patients admitted to our hospital in October 2009- October 2011 with high level of prostate-specific antigen, abnormal signs in transrectal ultrasound, abnormal digital rectal examination due to done transrectal prostate needle biopsy. Results: Transrectal prostate needle biopsy was performed to 276 cases and 59 (21% cases with hematuria, 21 (7% cases with hematospermia, 23 (8% cases with rectal bleeding, 6 (2.1% cases with asymptomatic bacteriuria, 12 (5.3% cases with in complicated urinary tract infection was detected. Three patients (1% had sepsis. 21 (7.3% patients had positive urine culture. Of them there were 20 positive cultures of E. coli and one Klebsiella spp. respectively. All of the bacteria cultured in twenty-one patients resistant to ciprofloxacin, while 90% to amikacin, 10% to amoxicillin-clavulanate, 35% to cefuroxime sodium and 40% were susceptible to ceftriaxone. Conclusion: Transrectal prostate needle biopsies of 276 patients, 21 (7.3% patients had positive urine culture. The most frequent complication was hematuria. The most serious complication of sepsis detected in three (1% patients.

  13. [Intravenous antimicrobial use among different hospital in Chile during 2005].

    Fica C, Alberto; Cabello M, Angela; Juliet L, Chrystal; Prado D, Priscilla; Bavestrello F, Luis


    Intravenous antimicrobial consumption has not been evaluated previously in Chile. In order to know this consumption (in DDD per 100 bed days), associated factors and antimicrobial control systems across the country, a questionnaire was sent to evaluate these features during 2005. A total of 29 public hospitals and private clinics answered this poll, 20 belonging to the public health system (69%). Only 48.1% declared to have an independent antimicrobial committee and 17.2% allowed unrestricted antimicrobial use. Glycopeptides and carbapenems were the most regulated compounds (75.9 and 82.8%, respectively). Antimicrobial controls systems were more frequently declared among public hospitals and only non-public hospitals permitted free use of antimicrobials. Global consumption reached 59.98 DDD per 100 bed-days, with beta-lactams representing 74.3% of this consume (44.57 DDD per 100), and cephalosporins 43% (25.78 DDD per 100). Chloramphenicol, penicillin G and cloxacillin use was significantly higher among public hospitals. The opposite was observed for imipenem-cilastatin, linezolid, cefuroxime and caspofungin with higher consumes observed among non-public hospitals. In a multivariate analysis, increased cefazolin use was independently associated with sites allowing unrestricted use, and ciprofloxacin consumption with non-public hospitals. Institutions with decreased susceptibility to imipenem-cilastatin among non-fermentative gram negative bacilli showed a higher use of this compound and linezolid consumption paralleled vancomycin-resistant enterococci prevalence. It is necessary to reinforce governmental regulations about antimicrobial use issued during 1999. PMID:19194604

  14. Microbial colonization of biopolymeric thin films containing natural compounds and antibiotics fabricated by MAPLE

    Cristescu, R., E-mail: [National Institute for Lasers, Plasma and Radiation Physics, Lasers Department, PO Box MG-36, Bucharest-Magurele (Romania); Surdu, A.V.; Grumezescu, A.M.; Oprea, A.E.; Trusca, R.; Vasile, O. [Faculty of Applied Chemistry and Materials Science, Department of Science and Engineering of Oxide Materials and Nanomaterials, Politehnica University of Bucharest, Polizu Street No. 1–7, 011061 Bucharest (Romania); Dorcioman, G.; Visan, A.; Socol, G.; Mihailescu, I.N. [National Institute for Lasers, Plasma and Radiation Physics, Lasers Department, PO Box MG-36, Bucharest-Magurele (Romania); Mihaiescu, D. [Faculty of Applied Chemistry and Materials Science, Department of Organic Chemistry, Politehnica University of Bucharest, 1–7 Polizu Street, 011061 Bucharest (Romania); Enculescu, M. [National Institute of Materials Physics, PO Box MG-7, Bucharest-Magurele (Romania); Chifiriuc, M.C. [Microbiology Immunology Department, Faculty of Biology, Research Institute of the University of Bucharest—ICUB, Research Institute of the University of Bucharest, 77206 Bucharest (Romania); Boehm, R.D.; Narayan, R.J. [Biomedical Engineering, University of North Carolina, Chapel Hill, NC (United States); Chrisey, D.B. [Department of Physics and Engineering Physics, Tulane University, New Orleans, LA (United States)


    Highlights: • We deposited thin composite quercetin/polyvinylpyrrolidone/antibiotic films with close resemblance to the starting/drop-cast composition by MAPLE. • Quercetin flavonoid shows an anti-biofilm activity comparable to that of the tested large-spectrum antibiotics (norfloxacin or cefuroxime), especially in case of 72 h biofilms. • These results could account for the possible use of quercetin as an alternative to antibiotics to combat the mature biofilms developed on different substrates. • MAPLE may be used to produce implantable medical devices that provide a relatively long term in vitro stability and resistance to the growth of microorganisms. - Abstract: Although a great number of antibiotics are currently available, they are often rendered ineffective by the ability of microbial strains to develop genetic resistance and to grow in biofilms. Since many antimicrobial agents poorly penetrate biofilms, biofilm-associated infections often require high concentrations of antimicrobial agents for effective treatment. Among the various strategies that may be used to inhibit microbial biofilms, one strategy that has generated significant interest involves the use of bioactive surfaces that are resistant to microbial colonization. In this respect, we used matrix assisted pulsed laser evaporation (MAPLE) involving a pulsed KrF* excimer laser source (λ = 248 nm, τ = 25 ns, ν = 10 Hz) to obtain thin composite biopolymeric films containing natural (flavonoid) or synthetic (antibiotic) compounds as bioactive substances. Chemical composition and film structures were investigated by Fourier transform infrared spectroscopy and X-ray diffraction. Films morphology was studied by scanning electron microscopy and transmission electron microscopy. The antimicrobial assay of the microbial biofilms formed on these films was assessed by the viable cell counts method. The flavonoid-containing thin films showed increased resistance to microbial colonization

  15. The incidence of deep brain stimulator hardware infection: the effect of change in antibiotic prophylaxis regimen and review of the literature.

    Bhatia, Robin; Dalton, Arthur; Richards, Mike; Hopkins, Chris; Aziz, Tipu; Nandi, Dipankar


    The complication of hardware infection related to deep brain stimulator implantation (or revision) varies between 0 and 15.2% in the literature. However, no national guidelines exist at present to define an average or acceptable rate of infection associated with, nor the preferred antibiotic prophylaxis required for, this procedure. The aim of this study was to examine the effect of changing the antibiotic prophylaxis regimen used in a single neurosurgical centre on the incidence and outcome of hardware infection. A prospective cohort of 38 patients undergoing deep brain stimulation (DBS) implantation or internal pulse generator (IPG) replacement and receiving perioperative vancomycin (including intravenous gentamicin on induction) and pouch-installed gentamicin, was compared to a historical cohort of 35 patients receiving perioperative cefuroxime in the same unit. The infection rate over 2 years in the prospective group for DBS surgery was 0 compared to 1 (5.6%) in the historical cohort (p = 0.11, χ(2)); the infection rate for IPG replacements was 1(3.6%) in the prospective cohort, versus 3 (17.6%) in the historical (p = 0.44, χ(2)). In this article, we have also systematically reviewed the literature to date and derived an average infection rate of 4.7% (PI 0.9-22%, Random Effects Meta-analysis, Stata) for 35 studies comprising 3550 patients. There is no significant difference in infection rates between DBS procedures that are primarily internalised (n = 9) compared to those in which there is a period of electrode externalisation (n = 23) (p = 0.9, Meta-regression analysis, Stata). PMID:21501065

  16. Purification and biochemical characterization of the VIM-1 metallo-beta-lactamase.

    Franceschini, N; Caravelli, B; Docquier, J D; Galleni, M; Frère, J M; Amicosante, G; Rossolini, G M


    VIM-1 is a new group 3 metallo-beta-lactamase recently detected in carbapenem-resistant nosocomial isolates of Pseudomonas aeruginosa from the Mediterranean area. In this work, VIM-1 was purified from an Escherichia coli strain carrying the cloned bla(VIM-1) gene by means of an anion-exchange chromatography step followed by a gel permeation chromatography step. The purified enzyme exhibited a molecular mass of 26 kDa in sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and an acidic pI of 5.1 in analytical isoelectric focusing. Amino-terminal sequencing showed that mature VIM-1 results from the removal of a 26-amino-acid signal peptide from the precursor. VIM-1 hydrolyzes a broad array of beta-lactam compounds, including penicillins, narrow- to expanded-spectrum cephalosporins, carbapenems, and mechanism-based serine-beta-lactamase inactivators. Only monobactams escape hydrolysis. The highest catalytic constant/K(m) ratios (>10(6) M(-1). s(-1)) were observed with carbenicillin, azlocillin, some cephalosporins (cephaloridine, cephalothin, cefuroxime, cefepime, and cefpirome), imipenem, and biapenem. Kinetic parameters showed remarkable variability with different beta-lactams and also within the various penam, cephem, and carbapenem compounds, resulting in no clear preference of the enzyme for any of these beta-lactam subfamilies. Significant differences were observed with some substrates between the kinetic parameters of VIM-1 and those of other metallo-beta-lactamases. Inactivation assays carried out with various chelating agents (EDTA, 1,10-o-phenanthroline, and pyridine-2,6-dicarboxylic acid) indicated that formation of a ternary enzyme-metal-chelator complex precedes metal removal from the zinc center of the protein and revealed notable differences in the inactivation parameters of VIM-1 with different agents. PMID:11036013

  17. [A rare cause of pneumonia: Shewanella putrefaciens].

    Durdu, Bülent; Durdu, Yasemin; Güleç, Nuray; Islim, Filiz; Biçer, Mualla


    Shewanella putrefaciens is a gram-negative, non-fermentative, oxidase positive, motile bacillus that produces hydrogen sulphide. It is found widely in the nature especially in marine environments. Although it is accepted as saprophytic, different clinical syndromes, most commonly skin or soft tissue infections, have been associated with S.putrefaciens, mainly in immunocompromised cases and patients with underlying diseases. However, pneumonia cases due to S.putrefaciens are quite limited in the literature. In this report, a case of pneumonia caused by S.putrefaciens was presented. A 43-year-old female patient was admitted to our hospital with the complaints of fever, cough, sputum and weakness. The patient has had brochiectasis since childhood and has used periodical antibiotic therapies due to pneumoniae episodes. She was diagnosed to have pneumonia based on the clinical, radiological and laboratory findings, and empirical antibiotic treatment with ciprofloxacin and ceftazidime combination was initiated. Gram-stained smear of sputum yielded abundant leucocytes and gram-negative bacteria, and the isolate grown in the sputum culture was identified as S.putrefaciens by conventional methods and API 20 NE (BioMerieux, France) system. The isolate was found susceptible to ceftriaxone, ceftazidime, cefepime, ciprofloxacin, piperacillin-tazobactam, cephoperazon-sulbactam, imipenem, amikacin, gentamicin and trimethoprime-sulphametoxazole; whereas resistant to ampicillin, amoxycillin-clavulanate, cefazolin and cefuroxime, by Kirby-Bauer disk diffusion method. According to the antibiogram results, the therapy was changed to ceftriaxone (1 x 2 g, intravenous). The patient was discharged with complete cure after 14 days of therapy. In conclusion, S.putrefaciens should be considered in patients with predisposing factors as an unusual cause of pneumonia and the characteristics such as H2S production and sensitivity to third generation cephalosporins and penicillins should be used

  18. The erratic antibiotic susceptibility patterns of bacterial pathogens causing urinary tract infections.

    Ahmed, Iftkhar; Sajed, Muhammad; Sultan, Aneesa; Murtaza, Iram; Yousaf, Sohail; Maqsood, Bushra; Vanhara, Petr; Anees, Mariam


    Increasing trend of antibiotic resistance and expression of Extended Spectrum Beta Lactamases (ESBLs) are serious threats for public health as they render the treatment ineffective. Present study was designed to elucidate the antibiotic-susceptibility patterns of ESBL and non-ESBL producing E. coli and K. pneumoniae causing urinary tract infections so that the ineffective antibiotics could be removed from the line of treatment. The bacterial isolates obtained from the urine of patients visiting a tertiary health care facility were cultured for strain identification using API20E. Antimicrobial susceptibility and ESBL detection were done by Kirby-bauer diffusion technique. Almost 53.4 % isolates of E. coli and 24.5 % isolates of K. pneumoniae were found to be ESBL producers. The ESBL producing bacteria were found to be more resistant towards various antibiotics. The most effective drugs against E. coli ESBL isolates were imipenem (99.54 %), ampicillin-sulbactam (97.48 %), piperacillin-tazobactam (96.86 %), fosfomycin (94.51 %), amikacin (92.26 %) and nitrofurantoin (90.68 %). The most effective drugs against K. pneumoniae ESBL isolates were imipenem (97.62 %), piperacillin-tazobactam (95.35 %), ampicillin-sulbactam (90.48 %) and amikacin (88.37 %). The antibiotics having the highest resistance, particularly by the ESBL producers were amoxicillin clavulanic acid, sulphamethoxalzole/ trimethoprim, cefuroxime, cefpirome, ceftriaxone and ciprofloxacin. Most of the isolates showed multi drug resistance (MDR). High frequency of ESBL producing E. coli and K. pneumoniae were observed as compared to previous data. Penicillins, cephalosporins and some representatives of fluoroquinolones were least effective against the common UTIs and are recommended to be removed from the line of treatment. PMID:26648826

  19. Activities of beta-lactam antibiotics against Escherichia coli strains producing extended-spectrum beta-lactamases.

    Jacoby, G A; Carreras, I


    Seven extended-spectrum beta-lactamases related to TEM and four enzymes derived from SHV-1 were transferred to a common Escherichia coli host so that the activity of a variety of beta-lactams could be tested in a uniform genetic environment. For most derivatives, penicillinase activity was 10% or less than that of strains making TEM-1, TEM-2, or SHV-1 beta-lactamase, suggesting that reduced catalytic efficiency accompanied the broader substrate spectrum. Despite this deficit, resistance to aztreonam, carumonam, cefdinir, cefepime, cefixime, cefmenoxime, cefotaxime, cefotiam, cefpirome, cefpodoxime, ceftazidime, ceftibuten, ceftizoxime, ceftriaxone, cefuroxime, and E1040 was enhanced. For strains producing TEM-type enzymes, however, MICs of carumonam, cefepime, cefmenoxime, cefotiam, cefpirome, and ceftibuten were 8 micrograms/ml or less. Susceptibilities of cefmetazole, cefotetan, cefoxitin, flomoxef, imipenem, meropenem, moxalactam, temocillin, FCE 22101, and Sch 34343 were unaffected. FCE 22101, imipenem, meropenem, and Sch 34343 were inhibitory for all strains at 1 microgram/ml or less. In E. coli an OmpF- porin mutation in combination with an extended-spectrum beta-lactamase enhanced resistance to many of these agents, but generally by only fourfold. Hyperproduction of chromosomal AmpC beta-lactamase increased resistance to 7-alpha-methoxy beta-lactams but not that to temocillin. When tested at 8 micrograms/ml, clavulanate was more potent than sulbactam or tazobactam in overcoming resistance to ampicillin, while cefoperazone-sulbactam was more active than ticarcillin-clavulanate or piperacillin-tazobactam, especially against TEM-type extended-spectrum beta-lactamases. PMID:2193623

  20. Acinetobacter baumannii Infection in the Neonatal Intensive Care Unit

    AMK AL Jarousha


    Full Text Available Background: To perform a prospective case control study of blood stream infection to determine the infection rate of Acine­tobac­ter baumannii and the risk factors associated with mortality."nMethods:   From February 2004 to January 2005, 579 consecutive episodes of blood stream infection were obtained at two neo­na­tal intensive care units Al Nasser and Al Shifa hospitals in Gaza City. Forty (6.9% isolates of A. baumannii were ob­tained from the neonates under 28 d. Most of the isolates (92% were from hospitalized patients in the intensive care units."nResults: Community acquired infection was 8%.  Sixty three percent of the patients were males. The isolates of A. bauman­nii were resistant to commonly used antibiotics while being sensitive to meropenem (92.5%, imipenem (90%, chloram­pheni­col (80%, ciprofloxacin (75%, gentamicin (57.5%, ceftriaxone (50%, amikacin (37.5%, cefuroxime and ce­fo­taxime (35%. Over all crude mortality rate was 20% with much higher crude mortality among patients with noso­co­mial infec­tion.  Based on logistic regression, the following factors were statistically significant: weight < 1500g, age < 7 d, mean of hospitalization equal 20 days, antibiotic use, and mechanical ventilation, when compared to the control group (P< 0.05."nConclusion:  Infection rate of nosocomial blood stream infection was considerable and alarming in neonatal intensive care unit infants and associated with a significant excess length of NICU stay and a significant economic burden.  

  1. Diurnal variations in the occurrence and the fate of hormones and antibiotics in activated sludge wastewater treatment in Oslo, Norway

    We present an assessment of the dynamics in the influent concentration of hormones (estrone, estriol) and antibiotics (trimethoprim, sulfamethoxazole, tetracycline, ciprofloxacin) in the liquid phase including the efficiency of biological municipal wastewater treatment. The concentration of estradiol, 17-α-ethinylestradiol, doxycycline, oxytetracycline, demeclocycline, chlortetracycline, cefuroxime, cyclophosphamide, and ifosfamide were below the limit of detection in all of the sewage samples collected within this study. Two different types of diurnal variation pattern were identified in the influent mass loads of selected antibiotics and hormones that effectively correlate with daily drug administration patterns and with the expected maximum human hormone release, respectively. The occurrence of natural hormones and antimicrobials, administered every 12 hours, shows a daily trend of decreasing contaminant mass load, having the maximum values in the morning hours. The occurrence of antibiotics, typically administered every 8 hours, indicates a daily peak value in samples collected under the highest hydraulic loading. The efficiency of biological removal of both hormones and antibiotics is shown to be limited. Compared to the values obtained in the influent samples, increased concentrations are observed in the biologically treated effluent for trimethoprim, sulfamethoxazole and ciprofloxacin, mainly as a result of deconjugation processes. Ciprofloxacin is shown as the predominant antimicrobial compound in the effluent, and it is present at quantities approximately 10 fold greater than the total mass of the other of the compounds due to poor removal efficiency and alternating solid-liquid partitioning behaviour. Our results suggest that, to increase the micro-pollutant removal and the chemical dosing efficiency in enhanced tertiary treatment, significant benefits can be derived from the optimisation of reactor design and the development of control schemes that

  2. Antimicrobial Resistance Pattern and Their Beta-Lactamase Encoding Genes among Pseudomonas aeruginosa Strains Isolated from Cancer Patients

    Mai M. Zafer


    Full Text Available This study was designed to investigate the prevalence of metallo-β-lactamases (MBL and extended-spectrum β-lactamases (ESBL in P. aeruginosa isolates collected from two different hospitals in Cairo, Egypt. Antibiotic susceptibility testing and phenotypic screening for ESBLs and MBLs were performed on 122 P. aeruginosa isolates collected in the period from January 2011 to March 2012. MICs were determined. ESBLs and MBLs genes were sought by PCR. The resistant rate to imipenem was 39.34%. The resistance rates for P. aeruginosa to cefuroxime, cefoperazone, ceftazidime, aztreonam, and piperacillin/tazobactam were 87.7%, 80.3%, 60.6%, 45.1%, and 25.4%, respectively. Out of 122 P. aeruginosa, 27% and 7.4% were MBL and ESBL, respectively. The prevalence of blaVIM-2, blaOXA-10-, blaVEB-1, blaNDM-, and blaIMP-1-like genes were found in 58.3%, 41.7%, 10.4%, 4.2%, and 2.1%, respectively. GIM-, SPM-, SIM-, and OXA-2-like genes were not detected in this study. OXA-10-like gene was concomitant with VIM-2 and/or VEB. Twelve isolates harbored both OXA-10 and VIM-2; two isolates carried both OXA-10 and VEB. Only one strain contained OXA-10, VIM-2, and VEB. In conclusion, blaVIM-2- and blaOXA-10-like genes were the most prevalent genes in P. aeruginosa in Egypt. To our knowledge, this is the first report of blaVIM-2, blaIMP-1, blaNDM, and blaOXA-10 in P. aeruginosa in Egypt.

  3. Empiric antibiotic therapy in acute uncomplicated urinary tract infections and fluoroquinolone resistance: a prospective observational study

    Düzgün Nurşen


    Full Text Available Abstract Background The aims of this study were to determine the antimicrobial susceptibility patterns of urinary isolates from community acquired acute uncomplicated urinary tract infections (uUTI and to evaluate which antibiotics were empirically prescribed in the outpatient management of uUTI. Methods Among the patients which were admitted to outpatient clinics of Ankara University Medical Faculty, Ibni-Sina Hospital during 2005-2006, a total of 429 women between the age of 18 and 65 years old who were clinically diagnosed with uUTI and to whom prescribed empirical antibiotics were enrolled in this prospective observational study. Patients' demographical data, urine culture results, resistance rates to antimicrobial agents and prescribed empiric antimicrobial therapy were analyzed. Results Totally 390 (90.9% patients among all study population were requested for urine culture by their physicians. 150 (38.5% of these urine cultures were positive. The most common isolated uropathogen was Escherichia coli (E. coli (71.3%. The variations of uropathogens according to age and menopause status were not significantly different. The resistance rates of E. coli isolates for ampicillin, ampicillin-sulbactam, amoxicillin-clavulonate, cefuroxime, ceftriaxone, fluoroquinolones (FQ, co-trimoxazole (TMP-SMX and gentamicin were 55.1%, 32.7%, 32.7%, 23.4%, 15.9%, 25.2%, 41.1%, 6.1% respectively. FQ were the most common prescribed antibiotics (77.9% (P P Conclusion Empirical use of FQ in uUTI should be discouraged because of increased antimicrobial resistance rates.

  4. Phenotypic and molecular characterization of 5 novel CTX-M enzymes carried by Klebsiella pneumoniae and Escherichia coli

    Jun CHENG; Ying YE; Ying-ying WANG; Hui LI; Xu LI; Jia-bin LI


    Aim: The aim of the present study was to study the phenotypic and molecular characterization of 5 novel CTX-M-β-lactamases carried by 5 Klebsiella pneumoniae isolates and 3 Escherichia coli isolates collected from 4 hospitals in Hefei, China. Methods: The purified PCR products were ligated with pGEM-Teasy vectors, expressed, and sequenced. The complete genes of the CTX-M-β-lactamases were ligated with the pHSG398 vector to express prokaryotic recombi-nant proteins. Plasmids were extracted by rapid alkaline lysis protocol, and the PCR method was performed to determine whether the prokaryotic expression was successful or not. Antimicrobial susceptibility was tested and the phenotypes of transformants were determined according to criteria recommended by the Clinical and Laboratory Standards Institute. The kinetic parameters of enzymes were confirmed. The isoelectric points (pI) were determined by isoelectric focusing assay. Pulsed-field gel electrophoresis and plasmid profiling were performed. Results: The PCR products had 1101 nucleotides and were determined as CTX-M-46, CTX-M-47, CTX-M-48, CTX-M-49, and CTX-M-50. All strains were resistant to cefotaxime, but most of them were susceptible or intermediate to ceftazidime. The phenotypes of novel enzymes were determined as extended-spectrum β-lactamases (ESBL). Penicillin G, cephalothin, cefuroxime, and cefotaxime were determined to good substrates, whereas ceftazidime hydrolysis was not detected. The pI of the 5 novel CTX-M-βlactamases were 8.0. CTX-M-derivatives could be the multiplex genesis in our area. Conclusion: This is the first report of these 5 novel plasmid-mediated CTX-M ESBL produced from China in the world. Mo-lecular typing reveals notably different origin in genes encoding different CTX-M variants of 8 strains.

  5. Identification of specific mRNA signatures as fingerprints for carcinogenesis in mice induced by genotoxic and nongenotoxic hepatocarcinogens.

    Kossler, Nadine; Matheis, Katja A; Ostenfeldt, Nina; Bach Toft, Dorthe; Dhalluin, Stéphane; Deschl, Ulrich; Kalkuhl, Arno


    Long-term rodent carcinogenicity studies for evaluation of chemicals and pharmaceuticals concerning their carcinogenic potential to humans are currently receiving critical revision. Additional data from mechanistic studies can support cancer risk assessment by clarifying the underlying mode of action. In the course of the IMI MARCAR project, a European consortium of EFPIA partners and academics, which aims to identify biomarkers for nongenotoxic carcinogenesis, a toxicogenomic mouse liver database was generated. CD-1 mice were orally treated for 3 and 14 days with 3 known genotoxic hepatocarcinogens: C.I. Direct Black 38, Dimethylnitrosamine and 4,4'-Methylenedianiline; 3 nongenotoxic hepatocarcinogens: 1,4-Dichlorobenzene, Phenobarbital sodium and Piperonyl butoxide; 4 nonhepatocarcinogens: Cefuroxime sodium, Nifedipine, Prazosin hydrochloride and Propranolol hydrochloride; and 3 compounds that show ambiguous results in genotoxicity testing: Cyproterone acetate, Thioacetamide and Wy-14643. By liver mRNA expression analysis using individual animal data, we identified 64 specific biomarker candidates for genotoxic carcinogens and 69 for nongenotoxic carcinogens for male mice at day 15. The majority of genotoxic carcinogen biomarker candidates possess functions in DNA damage response (eg, apoptosis, cell cycle progression, DNA repair). Most of the identified nongenotoxic carcinogen biomarker candidates are involved in regulation of cell cycle progression and apoptosis. The derived biomarker lists were characterized with respect to their dependency on study duration and gender and were successfully used to characterize carcinogens with ambiguous genotoxicity test results, such as Wy-14643. The identified biomarker candidates improve the mechanistic understanding of drug-induced effects on the mouse liver that result in hepatocellular adenomas and/or carcinomas in 2-year mouse carcinogenicity studies. PMID:25410580

  6. The Resistance of E.coli in Child Patients in Bingöl Region

    İlhan Geçit


    Full Text Available Aim: In this study, it has been aimed to put forward the resistance of the antibiotic in urinary infections caused by E.coli. Material and Method: The samples of the urine culture sent from 1412 patients who referred to Bingol State Hospital with the suspicion of urinary tract infection between 2007-2011 were retrospectively analyzed. Those who have recently used the antibiotic were excluded from the study. Results: Of the urine cultures sent from 1412 patients with the suspicion of urinary tract infection, there was reproduction in 113 (8%. E.coli was proliferated in 78 patients (69% detected the reproduction in their urine culture. The gender distribution of the patients proliferated E.coli in their urine culture was respectively 13 male (17% and 65 girls (83%. The age range of the children detected the urinary tract infection acquired from the community was under 7 years 39%. The resistance rates of antibiotic for E.coli were found to be 71% for ampicillin, 53% for amoksilin-clavulanate, 51% for co-trimaksazol, 48% for cephalothin, 37% for cefuroxime, 30% for ciprofloxacin, 25% for cefepime, % 21 for norfloxacin, 21% for gentamicin, 6% for sulbactam-seforazom, 2% for amikacin, and 0% for imipenem and meropenem. Discussion: The resistance rates occurring against the antibiotics are getting more and more important because there has been a longer life expectancy in the age group of the children. For this reason, potential uropathogens and antibiotic sensitivities in children should be considered in the treatment by following closely.

  7. Antibacterial agents and heavy metal resistance in Gram-negative bacteria isolated from seawater, shrimp and sediment in Iskenderun Bay, Turkey

    Matyar, Fatih [Cukurova University, Faculty of Education, Department of Science and Technology Education, 01330 Balcali, Adana (Turkey)], E-mail:; Kaya, Aysenur; Dincer, Sadik [Cukurova University, Faculty of Science and Letters, Department of Biology, 01330 Balcali, Adana (Turkey)


    The aim of the present study was to determine the level of antibiotic resistance patterns and distribution of heavy metal resistance of bacterial isolates from seawater, sediment and shrimps, and to determine if there is a relationship between antibiotic and heavy metal resistance. We undertook studies in 2007 in the industrially polluted Iskenderun Bay, on the south coast of Turkey. The resistance of 236 Gram-negative bacterial isolates (49 from seawater, 90 from sediment and 97 from shrimp) to 16 different antibiotics, and to 5 heavy metals, was investigated by agar diffusion and agar dilution methods, respectively. A total of 31 species of bacteria were isolated: the most common strains isolated from all samples were Escherichia coli (11.4%), Aeromonas hydrophila (9.7%) and Stenotrophomonas maltophilia (9.3%). There was a high incidence of resistance to ampicillin (93.2%), streptomycin (90.2%) and cefazolin (81.3%), and a low incidence of resistance to imipenem (16.5%), meropenem (13.9%) and cefepime (8.0%). Some 56.8% of all bacteria isolated from seawater, sediment and shrimp were resistant to 7 or more antibiotics. Most isolates showed tolerance to different concentrations of heavy metals, and minimal inhibition concentrations ranged from 12.5 {mu}g/ml to > 3200 {mu}g/ml. The bacteria from seawater, sediment and shrimp showed high resistance to cadmium of 69.4%, 88.9%, and 81.1% respectively, and low resistance to manganese of 2%, 6.7% and 11.3% respectively. The seawater and sediment isolates which were metal resistant also showed a high resistance to three antibiotics: streptomycin, ampicillin and trimethoprim-sulphamethoxazole. In contrast, the shrimp isolates which were metal resistant were resistant to four antibiotics: cefazolin, nitrofurantoin, cefuroxime and ampicillin. Our results show that Iskenderun Bay has a significant proportion of antibiotic and heavy metal resistant Gram-negative bacteria, and these bacteria constitute a potential risk for

  8. Antibacterial agents and heavy metal resistance in Gram-negative bacteria isolated from seawater, shrimp and sediment in Iskenderun Bay, Turkey

    The aim of the present study was to determine the level of antibiotic resistance patterns and distribution of heavy metal resistance of bacterial isolates from seawater, sediment and shrimps, and to determine if there is a relationship between antibiotic and heavy metal resistance. We undertook studies in 2007 in the industrially polluted Iskenderun Bay, on the south coast of Turkey. The resistance of 236 Gram-negative bacterial isolates (49 from seawater, 90 from sediment and 97 from shrimp) to 16 different antibiotics, and to 5 heavy metals, was investigated by agar diffusion and agar dilution methods, respectively. A total of 31 species of bacteria were isolated: the most common strains isolated from all samples were Escherichia coli (11.4%), Aeromonas hydrophila (9.7%) and Stenotrophomonas maltophilia (9.3%). There was a high incidence of resistance to ampicillin (93.2%), streptomycin (90.2%) and cefazolin (81.3%), and a low incidence of resistance to imipenem (16.5%), meropenem (13.9%) and cefepime (8.0%). Some 56.8% of all bacteria isolated from seawater, sediment and shrimp were resistant to 7 or more antibiotics. Most isolates showed tolerance to different concentrations of heavy metals, and minimal inhibition concentrations ranged from 12.5 μg/ml to > 3200 μg/ml. The bacteria from seawater, sediment and shrimp showed high resistance to cadmium of 69.4%, 88.9%, and 81.1% respectively, and low resistance to manganese of 2%, 6.7% and 11.3% respectively. The seawater and sediment isolates which were metal resistant also showed a high resistance to three antibiotics: streptomycin, ampicillin and trimethoprim-sulphamethoxazole. In contrast, the shrimp isolates which were metal resistant were resistant to four antibiotics: cefazolin, nitrofurantoin, cefuroxime and ampicillin. Our results show that Iskenderun Bay has a significant proportion of antibiotic and heavy metal resistant Gram-negative bacteria, and these bacteria constitute a potential risk for public


    Yengkhom Rameshwor


    Full Text Available Urinary tract infection (UTI is a common infection in infants and children. The clinical manifestations of UTI are varied and the etiology of UTI and the antibiotic resistance of uropathogens have been changing over the past years, both in community and nosocomial infections. However, there are not much information on etiology and resistance pattern of community acquired UTIs in India. This study was designed and conducted in the department of Pediatrics, BVDU Medical college hospital, Pune during the per iod from July 2009 to August 2011 to study children from birth to 12 years of age presenting with their first UTI with respect to their age and sex distributions, clinical manifestations, laboratory parameters, uropathogens and their antibiotic sensitivity patterns of 52 patients who attended our tertiary care centre. This study showed highest incidence of first UTI among infants with male preponderance among 5WBCs/mm 3 . E. coli was the commonest organism found in urine culture in all the age groups followed by CONS, Klebsiella and Pseudomonas. Maximum Sensitivity of E. coli was to Imipenem, Meropenem, Amikacin, Gatifloxacin and Nitrofurantoin. E. coli was found resistant to commonly used oral antibiotics like cotrimoxazole, ampicil lin, cephalexin, cefuroxime, cefixime, cepodoxim. Most isolates of Klebsiella, Pseudomonas and Proteus were highly sensitive to Piperacillin - Tazobactum, Imipenem, Aminoglycosides, Fluroquinolones and Nitrofurantoin. Also, Klebsiella isolates were found se nsitive to third generation cephalosporins but Pseudomonas and Proteus isolates were resistant to it. CONS and Enterococci were highly sensitive to Co - amoxyclav, Ampicillin - sulbactum, Piperacillin - tazobactum, Imipenem, Amikacin and Gatifloxacin.

  10. Geographical Variation in Antibiotic-Resistant Escherichia coli Isolates from Stool, Cow-Dung and Drinking Water

    Cecilia Stålsby Lundborg


    Full Text Available Little information is available on relationships between the biophysical environment and antibiotic resistance. This study was conducted to investigate the antibiotic resistance pattern of Escherichia coli isolated from child stool samples, cow-dung and drinking water from the non-coastal (230 households and coastal (187 households regions of Odisha, India. Susceptibility testing of E. coli isolates (n = 696 to the following antibiotics: tetracycline, ampicillin/sulbactam, cefuroxime, cefotaxime, cefixime, cotrimoxazole, amikacin, ciprofloxacin, norfloxacin and nalidixic acid was performed by the disk diffusion method. Ciprofloxacin minimum inhibitory concentration (MIC values were determined for ciprofloxacin-resistant isolates (n = 83. Resistance to at least one antibiotic was detected in 90% or more of the E. coli isolates. Ciprofloxacin MIC values ranged from 8 to 32 µg/mL. The odds ratio (OR of resistance in E. coli isolates from children’s stool (OR = 3.1, 95% CI 1.18–8.01, cow-dung (OR = 3.6, 95% CI 1.59–8.03, P = 0.002 and drinking water (OR = 3.8, 95% CI 1.00–14.44, P = 0.049 were higher in non-coastal compared to coastal region. Similarly, the co-resistance in cow-dung (OR = 2.5, 95% CI 1.39–4.37, P = 0.002 and drinking water (OR = 3.2, 95% CI 1.36–7.41, P = 0.008 as well as the multi-resistance in cow-dung (OR = 2.2, 95% CI 1.12–4.34, P = 0.022 and drinking water (OR = 2.7, 95% CI 1.06–7.07, P = 0.036 were also higher in the non-coastal compared to the coastal region.

  11. Diversity of uropathogens and their resistogram in diabetic and non-diabetic patients in sub Himalayan region of Uttarakhand, India: A case control study

    Rajat Prakash


    Full Text Available Background: Both symptomatic and asymptomatic urinary tract infections (UTIs are thought to occur more frequently in diabetic patients. Local data about the antimicrobial resistance of Uropathogens should be available for proper therapeutic interventions of UTI. Objective: To evaluate the spectrum of the Uropathogens and their profiles of antimicrobial resistance on a series of diabetic and non-diabetic patients. Materials and Methods: A Case-Control study with 100 participants was conducted targeting the Diabetic and Non-diabetic population, symptomatic or asymptomatic for UTI. Antibiotic sensitivity test was done on each of the isolates and the results of the antibiogram were compared with that of control group (nondiabetic group. The statistical analysis was done by Chi-Square Test, Fisher exact test using statistical product and service solutions formerly known as Statistical Package for the Social Sciences (SPSS 16.0 Version. Results: Most common isolate responsible for UTI was Escherichia coli followed by Klebsiella, Enterobacter, Proteus, Citrobacter, Acinetobacter and Candida. 93.3% and 86.6% of the isolates were sensitive to Amikacin and Amoxycillin-clavulanic acid respectively for Non Diabetics. Whereas isolates from diabetic group were 77.7 and 50% sensitive to Amikacin and Amoxycillin-clavulanic acid respectively. Highest resistance was seen for Cefuroxime for the isolates from both diabetic and non-diabetic group with 53.3 and 72.2% respectively. Significant difference in resistance pattern was observed in Amoxycillin-clavulanic acid, cefazolin, piperacillin- tazobactam and ticarcillin-clavulanic acid. Conclusion: Culture of urine and susceptibility testing of isolated organisms is strongly advocated in the clinical management of impending complication in diabetic individuals.

  12. Pure drug nanoparticles in tablets: what are the dissolution limitations?

    There has been increasing interests for drug companies to incorporate drug nanoparticles into their existing formulations. However, technical knowledge in this area is still in its infancy and more study needs to be done to stimulate growth in this fledging field. There is a need to scrutinize the performance of pure drug nanoparticles in tablets, particularly relating formulation variables to their dissolution performance. Application of the pure form, synthesized without the use of surfactants or stabilizers, is often preferred to maximize drug loading and also to minimize toxicity. Cefuroxime axetil, a poorly water-soluble cephalosporin antibiotic, was used as the model drug in the formulation development. Drug release rate, tablet disintegration time, tensile strength and energy of failure were predominantly influenced by the amount of super-disintegrant, amount of surfactant, compression force and diluent species, respectively. The compression rate had minimal impact on the responses. The main hurdle confronting the effective use of pure drug nanoparticles in tablets is the difficulty in controlling aggregation in solution, which could potentially be aggravated by the tabletting process. Through the use of elevated levels of surfactants (8 w/w% sodium dodecyl sulphate), drug release from the nanoparticle preparation was enhanced from 58.0 ± 2.7% to 72.3 ± 0.7% in 10 min. Hence, it is recommended that physical formulations for pure drug nanoparticles be focused on the particle de-aggregation step in solution, if much higher rates are to be desired. In conclusion, even though pure drug nanoparticles could be easily synthesized, limitations from aggregation may need to be overcome, before successful application in tablets can be fully realized.

  13. Multidrug-Resistant Bacteria Isolated from Surface Water in Bassaseachic Falls National Park, Mexico

    Delgado-Gardea, Ma. Carmen E.; Tamez-Guerra, Patricia; Gomez-Flores, Ricardo; Zavala-Díaz de la Serna, Francisco Javier; Eroza-de la Vega, Gilberto; Nevárez-Moorillón, Guadalupe Virginia; Pérez-Recoder, María Concepción; Sánchez-Ramírez, Blanca; González-Horta, María del Carmen; Infante-Ramírez, Rocío


    Bacterial pathogens are a leading cause of waterborne disease, and may result in gastrointestinal outbreaks worldwide. Inhabitants of the Bassaseachic Falls National Park in Chihuahua, Mexico show seasonal gastroenteritis problems. This aim of this study was to detect enteropathogenic microorganisms responsible for diarrheal outbreaks in this area. In 2013, 49 surface water samples from 13 selected sampling sites along the Basaseachi waterfall and its main rivers, were collected during the spring, summer, autumn, and winter seasons. Fecal and total coliform counts were determined using standard methods; the AutoScan-4 system was used for identification of isolates and the antibiotic resistance profile by challenging each organism using 21 antibiotics. Significant differences among seasons were detected, where autumn samples resulted in the highest total (p < 0.05) and fecal (p < 0.001) coliform counts, whereas the lowest total coliform counts were recorded in spring. Significant differences between sampling sites were observed, where samples from sites 6, 8, and 11 had the highest total coliform counts (p < 0.009), whereas samples from site 9 exhibited the lowest one. From the microbiological analysis, 33 bacterial isolates from 13 different sites and four sampling seasons were selected; 53% of isolates were resistant to at least one antibiotic, and 15% exhibited a multidrug resistance (MDB) phenotype. MDB were identified as Klebsiella oxytoca (two out of four identified isolates), Escherichia coli (2/7), and Enterobacter cloacae (1/3). In addition, some water-borne microorganisms exhibited resistance to cefazoline, cefuroxime, ampicillin, and ampicillin-sulbactam. The presence of these microorganisms near rural settlements suggests that wastewater is the contamination source, providing one possible transmission mechanism for diarrheal outbreaks. PMID:27322297

  14. Multicentre survey of the comparative in-vitro activity of piperacillin/tazobactam against bacteria from hospitalized patients in the British Isles.

    Chen, H Y; Bonfiglio, G; Allen, M; Piper, D; Edwardson, T; McVey, D; Livermore, D M


    Twenty-nine British and Irish hospitals each collected up to 300 bacterial isolates from in-patients. The organisms were identified by an appropriate API system or, for staphylococci, by their Gram and coagulase reactions. Disc susceptibility tests were performed. Isolates that gave zones spp. streptococci, pneumococci and Enterococcus faecalis were susceptible to piperacillin/tazobactam (defined as giving a zone > or = 22 mm to a 75 micrograms + 10 micrograms disc), as were 86% of Acinetobacter spp. and 82% of the Citrobacter, Enterobacter, Morganella and Serratia group. Tazobactam particularly extended the activity of piperacillin against E. coli isolates (96% susceptible cf. 61% to piperacillin alone) klebsiellae (95% cf. 70%), P. mirabilis (99% cf. 86%), and Acinetobacter spp. (86% cf. 53%). Occasional (18%) resistance in Enterobacter, Serratia and Citrobacger spp. was probably caused by stable depression of Class I beta-lactamases, which are inhibited poorly by tazobactam. High resistance frequencies (> 25%) were found for Enterococcus faecium and Xanthomonas maltophilia. Tazobactam potentiated piperacillin against beta-lactamase-producing methicillin-susceptible Staphylococcus aureus, but the mode inhibition zone of piperacillin/tazobactam discs was only 26 mm, compared to 38 mm for beta-lactamase-negative isolates. Nevertheless, fewer than 5% of the enzyme producers appeared resistant to 8 + 4 mg/L piperacillin/tazobactam in MIC tests. Similar behaviour was noted for coagulase-negative staphylococci. Amongst the eleven comparator drugs, ceftazidime, gentamicin and ciprofloxacin were as active as piperacillin/tazobactam against most enterobacteria. However, Acinetobacter and Bacteroides spp. and enterococci were resistant to ceftazidime, and Bacteroides spp., enterococci, pneumococci and other streptococci were inherently resistant to ciprofloxacin and gentamicin. Cefuroxime, ampicillin and co-amoxiclav had narrower spectra. Only imipenem showed a

  15. Prevalence of Device-associated Nosocomial Infections Caused By Gram-negative Bacteria in a Trauma Intensive Care Unit in Libya

    Abdulaziz Zorgani


    Full Text Available Objectives: Device-associated nosocomial infections (DANIs have a major impact on patient morbidity and mortality. Our study aimed to determine the distribution rate of DANIs and causative agents and patterns of antibiotic resistance in the trauma-surgical intensive care unit (ICU. Methods: Our study was conducted at Abusalim Trauma Hospital in Tripoli, Libya. All devices associated with nosocomial infections, including central venous catheters (CVC, endotracheal tubes (ETT, Foley’s urinary catheters, chest tubes, nasogastric tubes (NGT, and tracheostomy tubes, were removed aseptically and examined for Gram-negative bacteria (GNB. Results: During a one-year study period, 363 patients were hospitalized; the overall mortality rate was 29%. A total of 79 DANIs were identified, the most common site of infection was ETT (39.2%, followed by urinary catheters (19%, NGTs (18%, tracheostomy tubes (11%, CVCs (10%, and chest tubes (3%. The most frequently isolated organisms were Klebsiella pneumonia, Acinetobacter baumannii, and Pseudomonas aeruginosa (30%, 20%, and 14%, respectively. Extremely high resistance rates were observed among GNB to ampicillin (99%, cefuroxime (95%, amoxicillin-clavulante (92%, and nitrofurantoin (91%. Lower levels of resistance were exhibited to amikacin (38%, imipenem (38%, and colistin (29%. About 39% of the isolates were defined as multi-drug resistant (MDR. Overall, extended spectrum β-lactmase producers were expressed in 39% of isolates mainly among K. pneumonia (88%. A. baumannii isolates exhibited extremely high levels of resistance to all antibiotics except colistin (100% sensitive. In addition, 56.3% of A. baumannii isolates were found to be MDR. P. aeruginosa isolates showed 46%–55% effectiveness to anti-pseudomonas antibiotics. Conclusion: High rates of DANI’s and the emergence of MDR organisms poses a serious threat to patients. There is a need to strengthen infection control within the ICU environment

  16. Encouraging good antimicrobial prescribing practice: A review of antibiotic prescribing policies used in the South East Region of England

    Mayon White Richard T


    Full Text Available Abstract Background Good prescribing practice has an important part to play in the fight against antimicrobial resistance. Whilst it was perceived that most hospitals and Health Authorities possessed an antibiotic policy, a review of antibiotic policies was conducted to gain an understanding of the extent, quality and usefulness of these policies. Methods Letters were sent to pharmacists in hospitals and health authorities in across the South East region of the National Health Service Executive (NHSE requesting antibiotic policies. data were extracted from the policies to assess four areas; antibiotic specific, condition specific, patient specific issues and underpinning evidence. Results Of a possible 41 hospital trusts and 14 health authorities, 33 trusts and 9 health authorities (HAs provided policies. Both trust and HA policies had a median publication date of 1998 (trust range 1993-99, HA 1994-99. Eleven policies were undated. The majority of policies had no supporting references for the statements made. All policies provided some details on specific antibiotics. Gentamicin and ciprofloxacin were the preferred aminoglycoside and quinolone respectively with cephalosporins being represented by cefuroxime or cefotaxime in trusts and cephradine or cephalexin in HAs. 26 trusts provided advice on surgical prophylaxis, 17 had meningococcal prophylaxis policies and 11 covered methicillin resistant Staphylococcus aureus (MRSA. There was little information for certain groups such as neonates or children, the pregnant or the elderly. Conclusion There was considerable variation in content and quality across policies, a clear lack of an evidence base and a need to revise policies in line with current recommendations.

  17. Solid-phase extraction in combination with dispersive liquid-liquid microextraction and ultra-high performance liquid chromatography-tandem mass spectrometry analysis: the ultra-trace determination of 10 antibiotics in water samples.

    Liang, Ning; Huang, Peiting; Hou, Xiaohong; Li, Zhen; Tao, Lei; Zhao, Longshan


    A novel method, solid-phase extraction combined with dispersive liquid-liquid microextraction (SPE-DLLME), was developed for ultra-preconcentration of 10 antibiotics in different environmental water samples prior to ultra-high performance liquid chromatography-tandem mass spectrometry detection. The optimized results were obtained as follows: after being adjusted to pH 4.0, the water sample was firstly passed through PEP-2 column at 10 mL min(-1), and then methanol was used to elute the target analytes for the following steps. Dichloromethane was selected as extraction solvent, and methanol/acetonitrile (1:1, v/v) as dispersive solvent. Under optimal conditions, the calibration curves were linear in the range of 1-1000 ng mL(-1) (sulfamethoxazole, cefuroxime axetil), 5-1000 ng mL(-1) (tinidazole), 10-1000 ng mL(-1) (chloramphenicol), 2-1000 ng mL(-1) (levofloxacin oxytetracycline, doxycycline, tetracycline, and ciprofloxacin) and 1-400 ng mL(-1) (sulfadiazine) with a good precision. The LOD and LOQ of the method were at very low levels, below 1.67 and 5.57 ng mL(-1), respectively. The relative recoveries of the target analytes were in the range from 64.16% to 99.80% with relative standard deviations between 0.7 and 8.4%. The matrix effect of this method showed a great decrease compared with solid-phase extraction and a significant value of enrichment factor (EF) compared with dispersive liquid-liquid microextraction. The developed method was successfully applied to the extraction and analysis of antibiotics in different water samples with satisfactory results. PMID:26780712

  18. Combination of essential oils and antibiotics reduce antibiotic resistance in plasmid-conferred multidrug resistant bacteria.

    Yap, Polly Soo Xi; Lim, Swee Hua Erin; Hu, Cai Ping; Yiap, Beow Chin


    In this study we investigated the relationship between several selected commercially available essential oils and beta-lactam antibiotics on their antibacterial effect against multidrug resistant bacteria. The antibacterial activity of essential oils and antibiotics was assessed using broth microdilution. The combined effects between essential oils of cinnamon bark, lavender, marjoram, tea tree, peppermint and ampicillin, piperacillin, cefazolin, cefuroxime, carbenicillin, ceftazidime, meropenem, were evaluated by means of the checkerboard method against beta-lactamase-producing Escherichia coli. In the latter assays, fractional inhibitory concentration (FIC) values were calculated to characterize interaction between the combinations. Substantial susceptibility of the bacteria toward natural antibiotics and a considerable reduction in the minimum inhibitory concentrations (MIC) of the antibiotics were noted in some paired combinations of antibiotics and essential oils. Out of 35 antibiotic-essential oil pairs tested, four of them showed synergistic effect (FIC≤0.5) and 31 pairs showed no interaction (FIC>0.5-4.0). The preliminary results obtained highlighted the occurrence of a pronounced synergistic relationship between piperacillin/cinnamon bark oil, piperacillin/lavender oil, piperacillin/peppermint oil as well as meropenem/peppermint oil against two of the three bacteria under study with a FIC index in the range 0.26-0.5. The finding highlighted the potential of peppermint, cinnamon bark and lavender essential oils being as antibiotic resistance modifying agent. Reduced usage of antibiotics could be employed as a treatment strategy to decrease the adverse effects and possibly to reverse the beta-lactam antibiotic resistance. PMID:23537749

  19. Antibiotic selection of Escherichia coli sequence type 131 in a mouse intestinal colonization model.

    Boetius Hertz, Frederik; Løbner-Olesen, Anders; Frimodt-Møller, Niels


    The ability of different antibiotics to select for extended-spectrum β-lactamase (ESBL)-producing Escherichia coli remains a topic of discussion. In a mouse intestinal colonization model, we evaluated the selective abilities of nine common antimicrobials (cefotaxime, cefuroxime, dicloxacillin, clindamycin, penicillin, ampicillin, meropenem, ciprofloxacin, and amdinocillin) against a CTX-M-15-producing E. coli sequence type 131 (ST131) isolate with a fluoroquinolone resistance phenotype. Mice (8 per group) were orogastrically administered 0.25 ml saline with 10(8) CFU/ml E. coli ST131. On that same day, antibiotic treatment was initiated and given subcutaneously once a day for three consecutive days. CFU of E. coli ST131, Bacteroides, and Gram-positive aerobic bacteria in fecal samples were studied, with intervals, until day 8. Bacteroides was used as an indicator organism for impact on the Gram-negative anaerobic population. For three antibiotics, prolonged colonization was investigated with additional fecal CFU counts determined on days 10 and 14 (cefotaxime, dicloxacillin, and clindamycin). Three antibiotics (cefotaxime, dicloxacillin, and clindamycin) promoted overgrowth of E. coli ST131 (P 0.95), nor did they suppress Bacteroides or Gram-positive organisms. The results showed that antimicrobials both with and without an impact on Gram-negative anaerobes can select for ESBL-producing E. coli, indicating that not only Gram-negative anaerobes have a role in upholding colonization resistance. Other, so-far-unknown bacterial populations must be of importance for preventing colonization by incoming E. coli. PMID:25092712

  20. 207株肺炎克雷伯菌临床分布及耐药性分析%Clinical distribution and drug resistance analysis of 207 Klebsiella pneumoniae strains

    龙绍芬; 黎铁斌


    目的 分析临床分离肺炎克雷伯菌对抗菌药物的耐药性.方法 对临床分离肺炎克雷伯菌用纸片扩散法(K-B)或微量稀释法对16种抗菌药物进行药物敏感试验.结果 产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌59株,对头孢曲松、头孢呋辛、头孢噻肟、头孢哌酮、头孢噻吩、复方新诺明、美洛西林有很高的耐药率,分别是91.53%、91.53%、100.00%、100.00%、93.22%、72.88%和91.53%,甚至出现多重耐药菌株.结论 产ESBLs肺炎克雷伯菌耐药情况非常严重,应加强医院感染监测和控制措施.%Objective To analyse the drug resistance of Klebsiella pneumoniae. Methods the disk diffusion method (KB) or mi cro dilution method (MIC) was used to detect the resistance rates of Klebsiella pneumoniae clinical isolates to 16 kinds of antibacte rial drugs. Results There were 59 strains of Klebsiella pneumoniae producing extended spectrum |3 lactamase (ESBLs) ,and they had high resistance rates to ceftriaxone(91. 53%) ,cefuroxime(91. 53%) , cefotaxime(100. 00%) ,cefoperazone(100. 00%) ,cepha lothin(93. 22%) ,co trimoxazole(72. 88%) ,mezlocillin(91. 53%) respectively. There are even multi drug resistant strains were de tected. Conclusion The drug resistance of ESBLs producing Klebsiella pneumoniae is very serious. The hospital infection surveil lance and control measures should be strengthen.

  1. Microbial colonization of biopolymeric thin films containing natural compounds and antibiotics fabricated by MAPLE

    Highlights: • We deposited thin composite quercetin/polyvinylpyrrolidone/antibiotic films with close resemblance to the starting/drop-cast composition by MAPLE. • Quercetin flavonoid shows an anti-biofilm activity comparable to that of the tested large-spectrum antibiotics (norfloxacin or cefuroxime), especially in case of 72 h biofilms. • These results could account for the possible use of quercetin as an alternative to antibiotics to combat the mature biofilms developed on different substrates. • MAPLE may be used to produce implantable medical devices that provide a relatively long term in vitro stability and resistance to the growth of microorganisms. - Abstract: Although a great number of antibiotics are currently available, they are often rendered ineffective by the ability of microbial strains to develop genetic resistance and to grow in biofilms. Since many antimicrobial agents poorly penetrate biofilms, biofilm-associated infections often require high concentrations of antimicrobial agents for effective treatment. Among the various strategies that may be used to inhibit microbial biofilms, one strategy that has generated significant interest involves the use of bioactive surfaces that are resistant to microbial colonization. In this respect, we used matrix assisted pulsed laser evaporation (MAPLE) involving a pulsed KrF* excimer laser source (λ = 248 nm, τ = 25 ns, ν = 10 Hz) to obtain thin composite biopolymeric films containing natural (flavonoid) or synthetic (antibiotic) compounds as bioactive substances. Chemical composition and film structures were investigated by Fourier transform infrared spectroscopy and X-ray diffraction. Films morphology was studied by scanning electron microscopy and transmission electron microscopy. The antimicrobial assay of the microbial biofilms formed on these films was assessed by the viable cell counts method. The flavonoid-containing thin films showed increased resistance to microbial colonization

  2. Poliartritis y tenosinovitis grave por Streptococcus agalactiae en un paciente con hipoesplenia funcional Severe polyarthritis and tenosynovitis caused by Streptococcus agalactiae in a patient with functional hyposplenia

    Domingo C. Balderramo


    Full Text Available La artritis por Streptococcus agalactiae es infrecuente. No conocemos publicaciones de casos sobre la afección tendinosa por este microorganismo. Se presenta una mujer de 46 años que consultó por fiebre, poliartralgias, mialgias, diarrea y vómitos. Como antecedentes presentaba carcinoma papilar de tiroides e hipoesplenia funcional. Al examen se encontraba hemodinámicamente inestable, febril, con artritis de mano izquierda, muñecas, codos, hombro derecho y tobillo izquierdo. Presentaba tenosinovitis en ambos pies y en la mano izquierda. Los hemocultivos y el cultivo de la bursa olecraniana derecha fueron positivos para S. agalactiae. La ecografía mostró signos de tenosinovitis del tibial anterior izquierdo. Completó 20 días de tratamiento endovenoso con cefazolina y 12 días de cefuroxima oral. El cuadro articular revirtió completamente en 60 días. El Streptococcus agalactiae puede causar, en forma infrecuente, un síndrome de poliartritis, tenosinovitis y fiebre similar al producido por la infección gonocócica.Cases of arthritis caused by Streptococcus agalactiae are infrequent and in our knowledge there are no case reports of tenosynovitis caused by S. agalactiae. A 46-year-old woman presented with fever, polyarthralgia, myalgia, diarrhea and vomiting. She had a history of papillary thyroid carcinoma and functional hyposplenia. She was febrile, with arthritis in hands, wrists, elbows, right shoulder and left ankle joints, and presented tenosynovitis in both feet and left hand. Blood and right olecranon bursa sample cultures were positive for S. agalactiae. An ultrasound scan made at the musculus tibialis anterior of left foot revealed signs of tenosynovitis. She was treated with intravenous cefazolin for 20 days and oral cefuroxime for 12 days. The joint involvement completely subsided in 60 days. Streptococcus agalactiae can cause, infrequently, a polyarthritis and tenosynovitis syndrome similar to disseminated gonococcal

  3. Antibiotic Sensitivity Pattern of Staphylococcus aureus and Escherichia coli Isolated from Bovine Fresh Milk (POLA SENSITIVITAS ANTIBIOTIK TERHADAP STAPHYLOCOCCUS AUREUS DAN ESCHERICHIA COLI YANG DIISOLASI DARI SUSU SAPI SEGAR

    Lucia Ratna Winata Muslimin


    Full Text Available The aims of this study were to determine the sensitivity of S.aureus and E. coli isolated fromfresh milk against against several antibiotics and to determine the safety of the milk for humancomsumsion. Milk was collected from milking diary cow and was used for the bacterial isolation. E.coli were were identified using Total Plate Count (TPC, Gram staining, their growth on Endo Agarand Eosin MethyleneBlue Agar, Biochemical analysis including glucose, lactose, sucrose,maltose, andsorbitol would be followed by Sorbitol Mac Conkey Agar Test for the identification of E.coliO157:H7.The isolation and identification of S.aureus were performed using Gram stain, TPC, growth on BairdParker Agar and Mannitol Salt Agar. S. aureus and S. epidermidis were differentiated by coagulaseand catalase tests. The antibiotic sensitivity tests for both S. aureus and E.coli were carried out usingthe following antibiotics: ampicillin, bacitracin, vancomycin, cefoperazone, ceftriaxone, cefotamine,cefuroxime, cefepime, cefazoline, ceftazidime, chloramphenicol, tetracycline, doxycycline, amikacin,kanamycin, neomycin, ertapenem, meropenem, imipenem, erythromycin, gentamycin, nalidixic acid,ciprofloxacin, levofloxacine, norfloxacine, ofloxacin, and novobiocin. Fresh milk obtained from thefarm was positive for S.aureus and E.coli and resistant to most antibiotics tested. The best antibioticsfor S. aureus were imipenem (54.1 mm, ampicillin (42.3 mm, cefazolin (41.6 mm, doxycycline (41.15mm, and for E.coli were Imipenem (30.1 mm, ertapenem (29.5 mm, and meropenem (25.35 mm. Thebovine fresh milk examined was contaminated by S.aureus and E.coli and to some extent, were alsoresistant to most antibiotics tested.

  4. Diurnal variations in the occurrence and the fate of hormones and antibiotics in activated sludge wastewater treatment in Oslo, Norway

    Plosz, Benedek Gy., E-mail: [Norwegian Institute for Water Research, NIVA, Gaustadalleen 21, NO-0349, Oslo (Norway); Leknes, Henriette [Norwegian Institute for Air Research NILU, 2027 Kjeller (Norway); Liltved, Helge; Thomas, Kevin V. [Norwegian Institute for Water Research, NIVA, Gaustadalleen 21, NO-0349, Oslo (Norway)


    We present an assessment of the dynamics in the influent concentration of hormones (estrone, estriol) and antibiotics (trimethoprim, sulfamethoxazole, tetracycline, ciprofloxacin) in the liquid phase including the efficiency of biological municipal wastewater treatment. The concentration of estradiol, 17-{alpha}-ethinylestradiol, doxycycline, oxytetracycline, demeclocycline, chlortetracycline, cefuroxime, cyclophosphamide, and ifosfamide were below the limit of detection in all of the sewage samples collected within this study. Two different types of diurnal variation pattern were identified in the influent mass loads of selected antibiotics and hormones that effectively correlate with daily drug administration patterns and with the expected maximum human hormone release, respectively. The occurrence of natural hormones and antimicrobials, administered every 12 hours, shows a daily trend of decreasing contaminant mass load, having the maximum values in the morning hours. The occurrence of antibiotics, typically administered every 8 hours, indicates a daily peak value in samples collected under the highest hydraulic loading. The efficiency of biological removal of both hormones and antibiotics is shown to be limited. Compared to the values obtained in the influent samples, increased concentrations are observed in the biologically treated effluent for trimethoprim, sulfamethoxazole and ciprofloxacin, mainly as a result of deconjugation processes. Ciprofloxacin is shown as the predominant antimicrobial compound in the effluent, and it is present at quantities approximately 10 fold greater than the total mass of the other of the compounds due to poor removal efficiency and alternating solid-liquid partitioning behaviour. Our results suggest that, to increase the micro-pollutant removal and the chemical dosing efficiency in enhanced tertiary treatment, significant benefits can be derived from the optimisation of reactor design and the development of control schemes that

  5. Antimicrobial prophylaxis in minor and major surgery.

    Bassetti, M; Righi, E; Astilean, A; Corcione, S; Petrolo, A; Farina, E C; De Rosa, F G


    Surgical site infections (SSIs) are a frequent cause of morbidity following surgical procedures. Gram-positive cocci, particularly staphylococci, cause many of these infections, although Gram-negative organisms are also frequently involved. The risk of developing a SSI is associated with a number of factors, including aspects of the operative procedure itself, such as wound classification, and patient-related variables, such as preexisting medical conditions. Antimicrobial prophylaxis (AP) plays an important role in reducing SSIs, especially if patient-related risk factors for SSIs are present. The main components of antimicrobial prophylaxis are: timing, selection of drugs and patients, duration and costs. Compliance with these generally accepted preventive principles may lead to overall decreases in the incidence of these infections. Ideally the administration of the prophylactic agent should start within 30 minutes from the surgical incision. The duration of the AP should not exceed 24 hours for the majority of surgical procedures. The shortest effective period of prophylactic antimicrobial administration is not known and studies have demonstrated that post-surgical antibiotic administration is unnecessary. Furthermore, there were no proven benefits in multiple dose regimens when compared to single-dose regimens. The choice of an appropriate prophylactic antimicrobial agent should be based primarily on efficacy and safety. Broad spectrum antibiotics should be avoided due to the risk of promoting bacterial resistance. Cephalosporins are the most commonly used antibiotics in surgical prophylaxis; specifically, cefazolin or cefuroxime are mainly used in the prophylaxis regimens for cardio-thoracic surgery, vascular surgery, hip or knee arthroplasty surgery, neurosurgical procedures and gynecologic and obstetric procedures. A review of the prophylactic regimens regarding the main surgical procedures is presented. PMID:24561611

  6. Prevalence of Antimicrobial Resistance Among Gram-Negative Isolates in and Adult Intensive care unit at a Tertiary care Center in Saudi Arabia

    Patients in the ICU have encountered an increasing emergence and spread of antibiotic-resistant pathogens. We examined patterns of antimicrobial susceptibility in gram-negative isolates to commonly used drugs in an adult ICU at a tertiary care hospital in Riyadh, Saudi Arabia.A retrospective study was carried out of gram-negative isolates from the adult ICU of King Fahad National Guard Hospital (KFNGH) between 2004 and 2009. Organisms were identified and tested by an automated identification and susceptibility system, and the antibiotic susceptibility testing was confirmed by the disk diffusion. The most frequently isolated organism was Acinetobacter baumannii, followed by Pseudomonas aeruginosa, Escherichia coli, Klebsiella pnemoniae, Stenotrophomonas maltophilia, and Enterobacter. Antibiotic susceptibility patterns significantly declined in many organisms, especially A baumannii, E coli, S marcescens, and Enterobacter. A baumannii susceptibility was significantly decreased to imipenem (55% to 10%), meropenem (33% to 10%), ciprofloxacin (22% to 10%), and amikacin (12% to 6%). E coli susceptibility was markedly decreased (from 75% to 50% or less) to cefuroxime, ceftazidime, cefotaxime, and cefepime. S marcescens susceptibility was markedly decreased to cefotaxime (100% to 32%), ceftazidime (100% to 35%), and cefepime (100% to 66%). Enterobacter susceptibility was markedly decreased to ceftazidime (34% to 5%), cefotaxime (34% to 6%), and pipracillin-tazobactam (51% to 35%). Respiratory samples were the most frequently indicative of multidrug-resistant pathogens (63%), followed by urinary samples (57%).Antimicrobial resistance is an emerging problem in the KFNGH ICU, justifying new more stringent antibiotic prescription guidelines. Continuous monitoring of antimicrobial susceptibility and strict adherence to infection prevention guidelines are essential to eliminate major outbreaks in the future (Author).

  7. Infecção urinária na gravidez: análise dos métodos para diagnóstico e do tratamento Urinary infection in pregnancy: analysis of diagnostic methods and treatment

    Geraldo Duarte


    aspects and the complications of symptomatic urinary tract infections (UTI during pregnancy of patients who were hospitalized. Methods: a total of 136 pregnant women with a clinical diagnosis of pyelonephritis were studied. The studied parameters were: age and parity of patients, gestational age of diagnosis, epidemiologic aspects, laboratory evaluation for UTI, treatment and clinic evolution, prophylaxis and complications. Results: pyelonephritis was diagnosed at the same proportions at all gestational ages. The incidence of UTI was higher among primigravidae. Only 29.3% of the pregnant women had a previous history of UTI; 57.0% were anemic and 93.0% had altered urinalysis. Escherichia coli was the most prevalent uropathogen (75.8% of cases, with low percentages of sensitivity to ampicillin (60.6% and high percentages of sensitivity to cefuroxime (95,5%. The highest rate of clinical improvement was obtained for the pregnant women treated with cefuroxime (95.7%. Prophylaxis was needed in 11.0% of the patients. Preterm labor occurred in 33.3% of the pregnant women who delivered in our service and preterm delivery occurred in 18.9%. Conclusions: the present results support the need for an early diagnosis and effective treatment of UTI in pregnant women in order to prevent the frequent occurrence of perinatal complications such as premature labor and delivery. We emphasize the need of a periodical evaluation of the pattern of sensitivity of the etiologic agents to the antimicrobials allowed for use during pregnancy, with cefuroxime being adopted as the antibiotic of choice for the treatment of UTI during pregnancy.

  8. Prevalence, pathogenesis, antibiotic susceptibility profiles, and in-vitro activity of selected medicinal plants against Aeromonas isolates from stool samples of patients in the Venda region of South Africa.

    Obi, C L; Ramalivhana, J; Samie, A; Igumbor, E O


    The prevalence, pathogenic indices, such as haemolytic and haemagglutinating activities, antibiograms, and in-vitro activities of local medicinal plants against Aeromonas isolates in Vhembe district of Limpopo province, South Africa, were studied using standard microbiological methods. In total, 309 diarrhoeic stool samples were collected from patients attending five health centres in the region during December 2004-May 2005. Aeromonas species were identified using the API 20E system. The haemagglutinating and haemolytic activities of isolates on human, sheep, pig and chicken red blood cells were investigated. Antibiotic susceptibility profiles of the isolates to several antibiotics and in-vitro activity of local medicinal plants were also ascertained using previously-reported schemes. Results showed that 104 (33.6%) of the 309 samples were positive for Aeromonas species, of which 89 (85.6%) were Aeromonas hydrophila, 12 (11.5%) A. sobria, and three (2.9%) A. caviae. All strains of A. hydrophila and A. caviae produced haemolysis on sheep blood, while eight of the 12 A. sobria strains were haemolytic on sheep blood. The haemolytic activities of the isolates were variable on other red blood cells tested. High level of resistance was observed to amoxicillin and ampicillin, followed by cefuroxime (79%), chloramphenicol (74%), and erythromycin (65%). The carbapenems were the most active drugs with only 7% resistance to meropenem and 11% to imipenem. About 12% of the isolates were resistant to ciprofloxacin. The extracts of three of seven medicinal plants tested showed inhibitory activity against all Aeromonas isolates; these included acetone and hexane extracts of Pterocarpus angolensis, Syzygium cordatum, and Zornia milneana. The results suggest a high prevalence of Aeromonas species in the region. The isolates demonstrated multiple resistant profiles to different antibiotics tested. Some local medicinal plants were inhibitory to Aeromonas isolates, indicating a

  9. Acute suppurative thyroiditis in pre-existing goiter in diabetic patients

    Biswaranjan Nayak


    Full Text Available Background: Thyroid abscess is a rare clinical entity and infrequently encountered. We hereby present a review of 11 adult age group patients who presented to our hospital, which is a tertiary care referral center with thyroid abscess and the management being incision and drainage of abscess. Aims and Objective: In this paper, we have studied the association of acute suppurative thyroiditis (AST with diabetes mellitus (DM, its early diagnosis and management. Materials and Methods: All the suspected AST cases were admitted to endocrine surgical unit of S.C.B Medical College and Hospital, Cuttack, India and studied prospectively. Thorough history taking and physical examination were done. All blood counts, serology and thyroid function were done. Plain radiograph, ultrasonography, computed tomography scan, magnetic resonance imaging of the neck were done as per the requirement. Indirect laryngoscopy was done as a routine procedure. Diagnostic aspiration was done in every case followed by incision and drainage. Results: We report our observations from the 11 cases of AST being managed in endocrine surgical unit. All the patients were of female sex and their age ranging from 27 to 65 years. Each of them had a pre-existing goiter of duration from 1 to 7 years. Staphylococcus aureus (nine cases was the most common pathogen followed by Escherichia coli (two cases. Proper antibiotics as per culture sensitivity (cefuroxime, amikacin, control of diabetes with insulin, daily copious irrigation of the wound with normal saline healed all these abscesses. They were discharged from the hospital after full resolution of the infection and underwent thyroidectomy at a later date. Conclusion: Type-2 DM is rapidly emerging as a public health problem in South East Asia particularly in India leading to a wide variety of infectious complications in different anatomic locations. It is the single most important cause of AST in our population. Early recognition and

  10. Trends in antibacterial resistance among Streptococcus pneumoniae isolated in the USA: update from PROTEKT US Years 1–4

    Brown Steven D


    Full Text Available Abstract Background The increasing prevalence of resistance to established antibiotics among key bacterial respiratory tract pathogens, such as Streptococcus pneumoniae, is a major healthcare problem in the USA. The PROTEKT US study is a longitudinal surveillance study designed to monitor the susceptibility of key respiratory tract pathogens in the USA to a range of commonly used antimicrobials. Here, we assess the geographic and temporal trends in antibacterial resistance of S. pneumoniae isolates from patients with community-acquired respiratory tract infections collected between Year 1 (2000–2001 and Year 4 (2003–2004 of PROTEKT US. Methods Antibacterial minimum inhibitory concentrations were determined centrally using the Clinical and Laboratory Standards Institute (CLSI broth microdilution method; susceptibility was defined according to CLSI interpretive criteria. Macrolide resistance genotypes were determined by polymerase chain reaction. Results A total of 39,495 S. pneumoniae isolates were collected during 2000–2004. The percentage of isolates resistant to erythromycin, penicillin, levofloxacin, and telithromycin were 29.3%, 21.2%, 0.9%, and 0.02%, respectively, over the 4 years, with marked regional variability. The proportion of isolates exhibiting multidrug resistance (includes isolates known as penicillin-resistant S. pneumoniae and isolates resistant to ≥ 2 of the following antibiotics: penicillin; second-generation cephalosporins, e.g. cefuroxime; macrolides; tetracyclines; and trimethoprim-sulfamethoxazole remained stable at ~30% over the study period. Overall mef(A was the most common macrolide resistance mechanism. The proportion of mef(A isolates decreased from 68.8% to 62.3% between Year 1 and Year 4, while the percentage of isolates carrying both erm(B and mef(A increased from 9.7% to 18.4%. Over 99% of the erm(B+mef(A-positive isolates collected over Years 1–4 exhibited multidrug resistance. Higher than previously

  11. Infective myositis A one-case report

    Daoyou Zhou; Jianwen Guo; Yan Huang


    BACKGROUND: Infective myositis is rare. The retrospective report of clinical data and symptoms from one patient with infective myositis will hopefully provide more information for clinicians in the diagnosis of this disease. METHODS: A male patient, 65 years old, was admitted with "fever and muscle pain since four days ago, accompanied by inertia of all limbs for one day", to the First Department of Neurology, Guangdong Provincial Hospital of Traditional Chinese Medicine on April 25th, 2005. Following admission, a history of diseases was record, and detailed physical and neurological examinations were performed. During the examination, symmetrical myasthenia appeared, tendon reflex disappeared, and creatine kinase levels were increased 500 times higher than normal. The patient was primarily diagnosed with hypokalemic periodic paralysis, myositis, Guillain-Barre syndrome, and upper respiratory infection. Subsequently, the patient was treated with the following: cefuroxime for infection, potassium supplements, breviscapin for promoting blood circulation through the removal of stasis, and ATP/CO-A for myocardial nutrition. Antiviral drugs were not administered. However, laboratory samples were continuously monitored. Creatine kinase levels decreased to normal, and muscle pain was obviously relieved following antibiotics treatment. The results led to a final diagnosis of infective myositis.RESULTS: Four days after treatment (April 29th), muscular tenderness and throat congestion were obviously improved (+/-). The neurological examination showed the patient was conscious, cooperated with treatment, and had normal intellect. No abnormalities of the cranial nerve were observed upon examination. Proximal and distal muscle strength and muscular tensions of the four limbs were all normal. Reflexes of the right biceps brachii muscle and its tendon were decreased, and knee tendon and Achilles tendon reflex were not induced. A Babinski reflex was not detected. The neurological

  12. 金鱼嗜水气单胞菌的分离鉴定及药敏试验%Identification and Drug Sensitivity Test of Pathogenic Aeromonas hydrophila from Goldfish Carassius auratus

    周毅; 张培培; 徐晔; 曹洁; 孟学平; 段宏安


    自病死金鱼肝脏中分离到一株优势菌,对其进行感染试验、培养特性观察、生化特性鉴定及16S rRNA序列分析。试验结果表明,该分离菌株为嗜水气单胞菌,与已报道的嗜水气单胞菌的16S rRNA序列同源性>99.3%。用纸片扩散法进行药敏试验,试验结果显示,该分离株对四环素类、喹诺酮类、磺胺类、头孢呋新、头孢他啶、头孢吡肟等21种药物敏感,对青霉素G、氨苄西林、阿莫西林、头孢氨苄、林可霉素、麦迪霉素耐药。本次金鱼发病是由嗜水气单胞菌感染引起,可选用强力霉素、麦迪霉素、复方新诺明、磺胺甲基异恶唑、阿奇霉素、恩诺沙星、诺氟沙星等多种药物进行防治。%Aeromonas hydrophila is one of the main pathogen of freshwater fish bacterial septicemia .The bacterium was isolated and identified from dead gold fish and drug sensitive tests were performed in order to provide references for the bacterial disease prevention and control in ornamental fish .A dominant bacteria strain was isolated from hepatopancreas of dead Carassius auratus and identified by artificial infection experiment ,cultural characteristics ,physical and chemical characters ,and 16S rRNA sequence analysis .The results showed that the strain was A .hydrophila .Homology of 16S rRNA of the isolated strain and other several A .hydrophila was more than 99 .3% .Drug sensitive test revealed that the isolated strain was highly sensitive to 21 kinds of drugs , including tetracyclines ,quinolones , sulfonamides , cefuroxime ,ceftazidimeand cefepime ,and resistant to penicillin G ,ampicillin ,amoxicillin ,cefalexin , lincomycin and medemycin . Results in this study showed that many antibiotics (such as doxycycline , midecamycin ,co‐trimoxazole ,sulfamethoxazole ,azithromycin ,enrofloxacin ,and norfloxaci) can be used to control and prevent bacterial disease caused by A .hydrophila in gold fish .

  13. No Outbreak of Vancomycin and Linezolid Resistance in Staphylococcal Pneumonia over a 10-Year Period.

    Josef Yayan

    Full Text Available Staphylococci can cause wound infections and community- and nosocomial-acquired pneumonia, among a range of illnesses. Staphylococcus aureus and methicillin-resistant S. aureus (MRSA have been rapidly increasing as a cause of infections worldwide in recent decades. Numerous reports indicate that S. aureus and MRSA are becoming resistant to many antibiotics, which makes them very dangerous. Therefore, this study retrospectively investigated the resistance to antimicrobial agents in all hospitalized patients suffering from community- or nosocomial-acquired pneumonia due to S. aureus and MRSA.Information from the study groups suffering from either community- or nosocomial-acquired pneumonia caused by S. aureus or MRSA was gathered by searching records from 2004 to 2014 at the HELIOS Clinic Wuppertal, Witten/Herdecke University, Germany. The findings of antibiotic resistance were analyzed after the evaluation of susceptibility testing for S. aureus and MRSA.Total of 147 patients (63.9%, 95% CI 57.5%-69.8%, mean age 67.9 ± 18.5 years, with pneumonia triggered by S. aureus, and 83 patients (36.1%, 95% CI 30.2%-42.5%, mean age 72.3 ± 13.8 years, with pneumonia due to MRSA. S. aureus and MRSA developed no resistance to vancomycin (P = 0.019 vs. < 0.0001, respectively or linezolid (P = 0.342 vs. < 0.0001, respectively. MRSA (95.3% and S. aureus (56.3% showed a high resistance to penicillin. MRSA (87.7% was also found to have a high antibiotic resistance against ß-lactam antibiotics, compared to S. aureus (9.6%. Furthermore, MRSA compared to S. aureus, respectively, had increased antibiotic resistance to ciprofloxacin (90.1% vs. 17.0%, cefazolin (89.7% vs. 10.2%, cefuroxime (89.0% vs. 9.1%, levofloxacin (88.2% vs. 18.4%, clindamycin (78.0% vs. 14.7%, and erythromycin (76.5% vs. 20.8%.No development of resistance was found to vancomycin and linezolid in patients with pneumonia caused by S. aureus and MRSA.

  14. Antimicrobial resistance patterns and prevalence of class 1 and 2 integrons in Shigella flexneri and Shigella sonnei isolated in Uzbekistan

    Madiyarov Ruslan S


    Full Text Available Abstract Background Shigella is a frequent cause of bacterial dysentery in the developing world. Treatment with effective antibiotics is recommended for shigellosis, but options become limited due to globally emerging resistance. One of the mechanisms for the development of resistance utilizes integrons. This study described the antibiotic susceptibility and the presence of class 1 and 2 integrons in S. flexneri and S. sonnei isolated in Uzbekistan. Results We studied 31 isolates of S. flexneri and 21 isolates of S. sonnei isolated in Uzbekistan between 1992 and 2007 for the susceptibility or resistance to ampicillin (Am, chloramphenicol (Cl, tetracycline (Te, co-trimoxazole (Sxt, kanamycin (Km, streptomycin (Str, gentamicin (Gm, cefazolin (Czn, cefoperazone (Cpr, cefuroxime (Cur, ceftazidime (Ctz, nalidixic acid (NA and ciprofloxacin (Cip. Am/Str/Cl/Te and Am/Str/Cl/Te/Sxt resistance patterns were found most frequently in S. flexneri. Single isolates were resistant to aminoglycoside, quinolones and cephalosporins. The resistance patterns were different in the two species. Integrons were detected in 93.5% of S. flexneri (29/31 and 81.0% of S. sonnei (17/21 isolates. In addition, 61.3% of S. flexneri (19/31 isolates and 19.0% of S. sonnei (4/21 isolates carried both classes of integrons. In 29.0% of S. flexneri (9/31 isolates, only class 1 integrons were identified. In S. flexneri isolates, the presence of class 1 integrons was associated with resistance to ampicillin and chloramphenicol. Only Class 2 integrons were present in 61.9% of S. sonnei (13/21 isolates. Conclusions Our study documents antibiotic resistance among Shigella spp. in Uzbekistan. Ninety percent of Shigella strains were resistant to previously used antibiotics. Differences among S. flexneri and S. sonnei isolates in patterns of antimicrobial resistance to routinely used shigellosis antibiotics were observed. The majority of S. flexneri were resistant to ampicillin

  15. Prevention and control of catheter-associated urinary tract infections – implementation of the recommendations of the Commission for Hospital Hygiene and Infection Prevention (KRINKO in nursing homes for the elderly in Frankfurt am Main, Germany

    Heudorf, Ursel


    Full Text Available Introduction: Urinary tract infections range among the most frequent infections not only in hospital patients but also in residents of long-term care facilities for the elderly. Urinary catheters are the greatest risk factor for urinary tract infections. In the guidance paper on the “prevention of infections in nursing homes” (2005 as well as in the updated recommendations for the “prevention and control of catheter-associated urinary tract infections” (2015, the Commission for Hospital Hygiene and Infection Prevention (KRINKO has recommended adequate preventive measures. In 2015, the implementation of these KRINKO recommendations was investigated.Method: All of Frankfurt’s 40 nursing homes were evaluated using a checklist based on the KRINKO recommendations. The evaluation included assessing the availability of operating instructions, appropriate indications for the placement of catheters etc. Age, sex and duration of catheterization, as well as current and previous infections within the past 6 months were documented for every resident with a catheter.Results: In 35 (87.5% of the nursing homes, operating instructions for the handling of urinary tract catheters were available. The decision as to whether a catheter is indicated is made by physicians, while its placement is often delegated to the nursing service. Typically, silicon catheters are used. In three-quarters of the nursing homes, regular intervals of 4–6 weeks for changing catheters were reported. On the respective survey day, 7.3% of the residents were catheterized. On the survey day, 3.6% (4.2% and in the previous 6 months a total of 28% (28.9% of the residents had a urinary tract infection (prevalence of antibiotic therapy in parentheses. Ciprofloxacin was used most often followed by cefuroxime and cotrimoxazole.Discussion: In the current evaluation, fewer nursing home residents were catheterized than in previous years and the rate of urinary tract infections was low

  16. Antibiotic Susceptibility of Bacterial Strains Isolated From Patients with Community Acquired Urinary Tract Infections in Mersin

    Ozlem Kandemir


    Full Text Available AIM: This study objected to determination of distribution of bacterial agents, resistance proportions in community-acquired urinary tract infection (UTI in center of Mersin province and objected to regional treatment guide towards to our evidence. MATERIAL AND METHOD: In this study, included patients of pre-diagnosed as UTI based on clinical and laboratory in 11 health care centers between 11/01/2008–07/01/2009. Health care centers were checked for as daily and delivered appropriate urine samples for this study which collected sterile urine collection bottles. Urine samples were cultured including ≥leukocyte/mm3 with thoma slides, as a result of culture, samples of being on one type bacterial growth and ≥105 cfu/mL have done statically analysis. RESULTS: Totally 480 samples were collected and 311 (64.8% of them evaluated to as statistic significant. In bacterial culture analysis, E. coli (80.7% was the most commonly identified and as descending order found to Klepsiella spp. (8.7%, CNS (7.8%, Proteus spp. (1.9%, Enterobacter spp. (0.6%, and Pseudomonas spp. (0.3%. ESBL was determined to 10.0% of E. coli isolates, 3.7% of Klepsiella spp. isolates and also IBL was determined in two Enterobacter spp. isolates. Oxacillin resistance in CNS isolates was found as 12.5%. Imipenem resistance in Gram negative uropatogens was not detected and resistant rates were detected; 0.3% in amikacin, 0.7% in cefoperazone/sulbactam, 2.8% in cefoxitin, 6.3% in nitrofurantoin, 10.8% in ceftriaxone, 16.7% in ciprofloxacin, 16.7% in cefuroxime, 42.2% in cotrimoxazole, 97.6 % in amoxicillin clavulanic acid, and 94.4% in ampicillin sulbactam. There were no detected to resistance to glycopeptides and linezolid in gram positive agents. CONCLUSION: Ampicillin, ampicillin sulbactam, amoxicillin clavulanic acid, and cotrimoxazole antibiotics were out of the being preference for reason of resistance rates in UTI empirical treatment in our region. [TAF Prev Med Bull 2012

  17. New developments in antibacterial choice for lower respiratory tract infections in elderly patients.

    Ferrara, Anna Maria; Fietta, Anna Maria


    Elderly patients are at increased risk of developing lower respiratory tract infections compared with younger patients. In this population, pneumonia is a serious illness with high rates of hospitalisation and mortality, especially in patients requiring admission to intensive care units (ICUs). A wide range of pathogens may be involved depending on different settings of acquisition and patient's health status. Streptococcus pneumoniae is the most common bacterial isolate in community-acquired pneumonia, followed by Haemophilus influenzae, Moraxella catarrhalis and atypical pathogens such as Chlamydia pneumoniae, Legionella pneumophila and Mycoplasma pneumoniae. However, elderly patients with comorbid illness, who have been recently hospitalised or are residing in a nursing home, may develop severe pneumonia caused by multidrug resistant staphylococci or pneumococci, and enteric Gram-negative bacilli, including Pseudomonas aeruginosa. Moreover, anaerobes may be involved in aspiration pneumonia. Timely and appropriate empiric treatment is required in order to enhance the likelihood of a good clinical outcome, prevent the spread of antibacterial resistance and reduce the economic impact of pneumonia. International guidelines recommend that elderly outpatients and inpatients (not in ICU) should be treated for the most common bacterial pathogens and the possibility of atypical pathogens. The algorithm for therapy is to use either a selected beta-lactam combined with a macrolide (azithromycin or clarithromycin), or to use monotherapy with a new anti-pneumococcal quinolone, such as levofloxacin, gatifloxacin or moxifloxacin. Oral (amoxicillin, amoxicillin/clavulanic acid, cefuroxime axetil) and intravenous (sulbactam/ampicillin, ceftriaxone, cefotaxime) beta-lactams are agents of choice in outpatients and inpatients, respectively. For patients with severe pneumonia or aspiration pneumonia, the specific algorithm is to use either a macrolide or a quinolone in combination

  18. Salvage procedures in lower-extremity trauma in a child with hereditary motor and sensory neuropathy type I: a case report

    Gothner Martin


    Full Text Available Abstract Introduction Fractures of the lower extremity are a common type of childhood injury and many can be treated without surgery. Dislocated and open fractures are an indication for fracture stabilization via either intramedullary nailing or, in the case of complicated fractures, external fixation. But if complications are likely because of diseases and disabilities (for example, a neuropathy that can complicate the post-operative procedure and rehabilitation, what options does one have? Case presentation We report a nine-year-old Caucasian girl who had hereditary motor and sensory neuropathy type I and who was admitted with a grade I open tibia fracture after a fall from a small height. Plain radiographs showed a dislocated tibia and fibula fracture. An open reduction with internal fixation with a compression plate osteosynthesis was performed, and soft tissue debridement combined with an external fixateur was undertaken. Three months later, she was re-admitted with localized swelling and signs of a local soft tissue infection in the middle of her tibia. Plain radiographs showed a non-union of the tibia fracture, and microbiological analysis confirmed a wound infection with cefuroxime-sensitive Staphylococcus aureus. Because of the non-union, the osteosynthesis was replaced with an Ilizarov external fixateur, and appropriate antibiotic therapy was initiated. Four months after the initial accident, the fracture was consolidated and we removed the external fixateur. Conclusions If there is a pre-existing neuropathy and if disease makes it difficult for a child to follow all post-operative instructions, salvage procedures should be kept in mind in case of complications. There are multiple therapeutic options, including osteosynthesis, intramedullary nailing systems, cast therapy, or an external fixateur like the Ilizarov or Taylor spatial frame system. The initial use of an external fixateur such as an Ilizarov or Taylor spatial frame in

  19. 湖北省基层医疗卫生机构基本药物销售现状调查%Investigation of the Sales of Essential Medicines in Primary Health Care Institution, Hubei

    杨春艳; 向小曦; 张新平


    目的:了解湖北省基层医疗卫生机构基本药物销售现状,监测和评价基本药物制度实施效果.方法:湖北省83家基层卫生服务机构2011年1-7月基本药物的销售情况进行描述性分析.结果:基本药物销售金额比例为89.14%.头孢呋辛、头孢曲松钠、血塞通、葡萄糖注射液、氯化钠注射液、克林霉素、左氧氟沙星、血栓通等125种药品居销售前10位,抗生素和注射剂分别占前十位药品销售总额的53.17%和87.41%.结论:基层医疗机构可能存在抗生素和注射剂的过度使用,应切断医生收入与药品销售量之间的联系,减少供方诱导需求.应加强基层业务培训、用药知识宣传教育和用药监管,防止过度用药.%Objective: To understand the sales of essential medicines in primary health care institutions, and monitor and evaluate of the effect of essential medicine system. Methods: The sales of essential medicines of 83 primary health care institutions in Hubei Province were surveyed. Results: The Proportion of sales value of essential medicines was 89.14%. The top 10 sales value were 125 kinds of medicines, such as cefuroxime, ceftriaxone, Xuesaitong glucose injection, and so on. The sales value of antibiotics and injections were 53.17% and 87.41% of the 125 medicines. Conclusion: The overuse of antibiotics and injections may exist in the investigated primary health care institutions. The connection between physicians' incomes and drug sales should be cut off to decrease Supply -induced Demand. Training, propagandas, educations and regulations in drug use should be strengthened in primary health care institutions to prevent drug abuse.

  20. Genotypes and phenotypes of Shiga toxin-producing Escherichia coli (STEC in Abeokuta, Southwestern Nigeria

    Olowe OA


    Full Text Available Olugbenga Adekunle Olowe,1 Bukola W Aboderin,1,2 Olayinka O Idris,3 Victor O Mabayoje,4 Oluyinka O Opaleye,1 O Catherine Adekunle,1 Rita Ayanbolade Olowe,1 Paul Akinniyi Akinduti,5 Olusola Ojurongbe1 1Department of Medical Microbiology and Parasitology, College of Health Sciences, Osogbo, Osun State, Nigeria; 2Medical Microbiology Unit, Pathology Department, Federal Medical Centre, Abeokuta, Nigeria; 3Department of Microbiology, College of Sciences, Afe Babalola University, Ado Ekiti, Nigeria; 4Department of Haematology, College of Health Sciences, Ladoke Akintola University, Osogbo, Osun State, Nigeria; 5Department of Medical Microbiology and Parasitology, Olabisi Onabanjo University, Ago-Iwoye, Ogun State, Nigeria Purpose: To characterize the prevalence of hemolytic Shiga toxin-producing Escherichia coli (STEC with a multidrug-resistant pattern in different age groups in Abeokuta, Nigeria. Methods: Nonrepetitive E. coli isolates were collected from 202 subjects with or without evidence of diarrhea. Each isolate was biochemically identified and antimicrobial susceptibility testing was performed using the disk diffusion method. A sorbitol fermentation test of all the E. coli isolates was done and the minimum inhibitory concentration of suspected STEC was measured by the standard broth microdilution method to determine antibiotic resistance. The genotypes of stx1, stx2, and hlyA were determined by polymerase chain reaction assay. Results: The majority of subjects were aged ≥40 years (41.6% and were female (61.9%. Of the 202 subjects, 86.1% had STEC isolates (P<0.05. A high rate of STEC isolates resistant to amoxicillin (90.6%, cefotaxime (77.7%, and cefuroxime (75.7% was observed. Resistance to amoxicillin, gentamicin, and cefotaxime was demonstrated with a minimum inhibitory concentration >16 µg/mL in 13.9%, 11.4%, and 10.4% of the isolates, respectively. The prevalence of stx1, stx2, and hlyA was 13.9%, 6.9%, and 2.0%, respectively; 5.5% of

  1. Etiology and antibiotic susceptibility of bacterial pathogens responsible for community-acquired urinary tract infections in Poland.

    Stefaniuk, E; Suchocka, U; Bosacka, K; Hryniewicz, W


    Urinary tract infections (UTIs) are some of the most common infections in both community and hospital settings infections. With their high rate of incidence, recurrence, complications, diverse etiologic agents, as well as growing antibiotic resistance, UTIs have proven to be a serious challenge for medical professionals. The aim of this study was to obtain data on the susceptibility patterns of pathogens responsible for UTIs in Poland to currently used antibiotics. A total of 396 bacterial isolates were collected between March and May 2013 from 41 centers in all regions of Poland. The majority of isolates were from adult patients (96.2 %); 144 (37.8 %) patients were diagnosed with uncomplicated UTI, while the remaining 237 (62.2 %) had a complicated infection. The most prevalent pathogen was Escherichia coli (71.4 %), followed by Klebsiella spp. (10.8 %) and the Proteae group (7.6 %). Escherichia coli was responsible for 80.6 % of cases of uncomplicated and 65.8 % of complicated infections. Only 65.8 % of E. coli isolates were susceptible to ciprofloxacin (uncomplicated 75.9 %, complicated 58.3 %), 64.0 % to nitrofurantoin (67.2 %, 62.8 %), 65.1 % to trimethoprim/sulfamethoxazole (68.1 %, 62.8 %), and 66.4 % to fosfomycin (77.6 %, 62.2 %). Among E. coli isolates from all UTIs, only 43.4 % were susceptible to ampicillin, with 47.4 % from uncomplicated compared with 40.4 % from complicated infections; 88.2 % to amoxicillin/clavulanic acid (91.4 % vs. 85.9 % complicated); 90.1 % to cefuroxime (93.1 %, 87.8 %); and 94.1 % to cefotaxime (98.2 %, 91.0 %). Thirty-five strains (10.4 %) were capable of producing extended-spectrum β-lactamases (ESBLs). This study demonstrates an increase in multidrug-resistant strains, especially among the leading pathogens associated with UTIs, including E. coli, Klebsiella spp., and Proteus spp. PMID:27189078

  2. Detection limits of four antimicrobial residue screening tests for beta-lactams in goat's milk.

    Sierra, D; Sánchez, A; Contreras, A; Luengo, C; Corrales, J C; Morales, C T; de la Fe, C; Guirao, I; Gonzalo, C


    This study was conducted to compare the detection limits (DL) of several antibiotic residue screening tests with the maximum residue limits (MRL) authorized by the EU according to the guidance for the standardized evaluation of microbial inhibitor tests of the International Dairy Federation. Composite antibiotic-free milk samples from 30 primiparous Murciano-Granadina goats in good health condition were used to prepare test samples spiked with different concentrations of each antimicrobial. In total, 5,760 analytical determinations of 10 beta-lactam antibiotics (penicillin-G, ampicillin, amoxicillin, cloxacillin, oxacillin, dicloxacillin, cefadroxyl, cefalexin, cefoperazone, and cefuroxime) were performed using 4 antibiotic residue screening tests: the brilliant black reduction test BRT AiM (AiM-Analytik in Milch Produktions-und Vertriebs GmbH, München, Germany), Delvotest MCS (DSM Food Specialties, Delft, the Netherlands), Eclipse 100 (ZEU-Inmunotec SL, Zaragoza, Spain), and the Copan Milk Test (CMT; Copan Italia SpA, Brescia, Italy). For each method, we estimated the detection limits of the antimicrobial agents using a logistic regression model. Using the CMT and Delvotest on samples spiked with the 8 antibiotics for which MRL were available, DL were at or below the MRL. The BRT test provided DL at or below the MRL for all of the agents except cefalexin, whereas the Eclipse 100 method failed to detect 4 antibiotics (ampicillin, amoxicillin, cloxacillin, and cefoperazone) at MRL or below. Logistic regression-determined levels of agreement were highest for the CMT method (98.6 to 100%) and lowest for Eclipse 100 (66.3 to 100%). In general, agreement levels indicated good correlation between observed results and those predicted by logistic regression. The lowest b values (closely related to test sensitivity) were recorded for the cephalosporins (0.074 to 0.430) and highest for penicillin G, ampicillin, and amoxicillin (11.270 to 11.504). Delvotest and CMT best

  3. Vigilants Factor of Childhood Urinary Tract Infections and Antibiotic Resistance in One Tourism Region

    Gokhan Aydemir


    Full Text Available AIM: Nowadays, it has become quite difficult to set on empiric treatment of the urinary tract infections (UTI due to the levels of antibiotic resistance showing local differences. In our study, we aimed to find out what the antibiotic resistance, the region factors of UTI and we also wanted to observe wheather this resistance shows differences betwen diffirent age groups. METHOD: In this study we made inquiry of six questions with patient parents about region factors effects of UTI. Two hundred children who applied to pediatrics policlinic of Ahu Hetman Hospital with urinary system complaints or diagnosed to have (UTI while hospitalizing and with positive urinary culture results were included in the study. There were no known chronic disorders or no frequent recurrence of UTI history in the patients. The subjects were divided into three groups as 1 under 1 year old; 2 between 1-6 years old; 3 over 6 years old. Then the frequency of the pathogens was examined in terms of the resistance levels occurring against the antibiotics. RESULTS: The range of age the patients was between 1 and 192 months. The reproducing pathogens were Escherichiacoli 86% (n=172, Klebsiella pneumoniae 8% (n=16, Proteus mirabilis 4% (n=8 and Enterococcus spp 2% (n=4 respectively. While there was high resistance to amoxycilline (75.8%, ureidopenicillines (%46.4, 1st generation cephalosporin, (48.4% and cotrimaksazole (43.1%; there was low resistance to imipenem (1.7%, amicasin (5.6% and 3rd generation cephalosporins (14.7%. According to thes age groups, in Group 1 (¡U12 months the most effective agents were netilmicine (13%, gentamicine (13% and ceftriakson (17%; in addition to these, we can add cefuroxim-axetil (22.7% in Group 2 (12-72 months and nitrofrantoin (11% in Group 3. Under 1 year old groups didn't include this inquiry about UTL in tourism region. We made this study with a hundred seventy pation's parents ( upper of one year children than we observed some of

  4. Infecção urinária na gravidez Urinary tract infection in pregnancy

    Geraldo Duarte


    these requirements is cefuroxime, administered for 10-14 days. Third-generation cephalosporins do not exist in the oral form, all of them involving the inconvenience of parenteral administration. In view of their side effects, aminoglycosides are considered to be inadequate for administration to pregnant women. The inconsistent insinuation of contraindication of monofluorinated quinolones, if there is an indication, norfloxacin is believed to be a good alternative to cefuroxime. In cases in which UTI prophylaxis is indicated, chemotherapeutic agents are preferred, among them nitrofurantoin, with care taken to avoid its use at the end of pregnancy due to the risk of kernicterus for the neonate.

  5. 呼吸道嗜血杆菌属的生物学分型及耐药性分析%Biological typing and drug resistance analysis of Haemophilus strains from respiratory tract

    江秀爱; 赵自云; 姜蓓; 乔显森


    strains of Haemophilus influenzae(1.6%)were isolated,10(10.4%)strains of Haemophilus influenzae were identified as type Ⅰ,31(32.3%)as type Ⅱ,40(41.7%)as typeⅢand 1 5(1 5.6%)as other types.A total of 125 strains Hae-mophitus parl influenzae(2.1%)were isolated,1 5 (12.0%)strains of Haemophilus parl influenzae were identified as type Ⅰ,23 (18.4%)as typeⅡ,69(55.2%)as type Ⅲ and 18(14.4%)as type Ⅳ,other types were not identified.The highest infected rate was in winter.Resistance rate of Haemophilus influenzae and Haemophitus parl influenzae to ampicillin were 40.6% and 44.8%,to tri-methoprim-sulfamethoxazole were 5 1.0% and 66.4%.The prevalence ofβ-lactamase of all strains were 40.6%and 44.8%.But sus-ceptible rates of Haemophilus to cefotaxime,cefuroxime,meropenem,chloramphenicol were over 90.0%.Conclusion The respira-tory tract infections to Haemophilus influenzae and Haemophitus parl influenzae is more frequently found in winter.Type Ⅱ and type Ⅲ are the most prevalent types.The resistance rates of Haemophilus to ampicillin and trimethoprim-sulfamethoxazole are in-creasing,should not be used as empirical treatment of Haemophilus infection.Antibiotics such as cefotaxime,cefuroxime,meropen-em could be chosen for the treatment of respiratory tract infection caused by Haemophilus.

  6. 呼吸道流感嗜血杆菌的生物学分型与耐药基因的相关性研究%The correlation study between biological typing and drug resistance gene of respiratory haemophilus influenza

    江秀爱; 王荣; 张秀云; 乔显森


    (PCR).Results:Seven biotypes (Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅵ、Ⅶ) were detected among 110 cases of clinical isolated haemophilus,The main types were type Ⅱ (38strains,34.5%)and type Ⅲ (46 strains, 41.8%),and typeⅧwas not detected.a total of 45 strains of TEM gene and ROB gene were detected, 93.3%as TEM gene, 6.7%as ROB gene. winter infection rate was the highest.Drug resistance of the strains agains ampicillin was 40.9%, The prevalence of beta lactamase of all strains was 40.9%. The drug resistance rate to cefotaxime,cefuroxime and chloramphenicol was over 90%.,the resistant strain was not detected to meropenem. Conclusions:The respiratory tract infections of Haemophilus influenzae were more prevalent in winter and TrpyⅡand typeⅢwere the most prevalent types.The drug resistance of Haemophilus influenzae to ampicillin and trimethoprim-sulfamethoxazole is increasing ,should not be used as an empirical treatment of Haemophilus infection. suggesting that the cefotaxime , cefuroxime and meropenem could serve as an ideal option for the treatment.

  7. 院内获得性肺炎老年患者产超广谱β-内酰胺酶病原菌的分布及耐药性分析%Distribution and antibiotic resistance analysis of extended spectrum β-lactamases in older patients with hospital-acquired pulmonary infection

    刘萍; 庄伟荣; 金小玲; 周瑛; 秦兴国; 李惠萍


    Objective To investigate the distribution and antibiotic resistance of the extended spectrum lactamases (ESBLs) in older patients with hospital-acquired pulmonary infection. Methods A total of 978 patients who were treated in Yangpu Geriatric Hospital and Shidong Hospital during Oct. 2006 to Oct. 2007 were studied, and 78 patients meeting the hospital acquired pneumonia (HAP) criterion were retrospectively analyzed. Results The incidence of HAP was 7.98% (78/978). The qualified sputum specimen bacterial positive rate was 61.9% (164/265). There were 39 strains of ESBLs bacteria, accounting for 31.7% (39/123)of the gram-negative bacteria. ESBLs-producing strains were positive in 51.5% (17/33) of Escherichia coli, 45.2% (14/31) of Klebsiella pneumoniae, and 17.6% (3/17) of Proteus mirabilis isolates. ESBLs-producing Escherichia coil strains had a >90% resistant rates to Ampicillin Sodium, Piperacillin Ciprofloxacin, Cefuroxime, Cefotaxime, and Cefazolin, and had a resistance rate of 54.7% to Aztreonam, but had a lower resistance rate to Cefoxitin, Cefoperazone/Sulbactam, Piperacillin Sodium and Tazobactam Sodium, Cefoxitine, and Ceftazidime. ESBLs-producing Klebsiella pneumoniae had a >90% resistance rate to Ampicillin Sodium, Cefuroxime, and Cefazolin, a>80% resistance rate to Cefotaxine and Piperacillin, a resistance rate of 71.7% to Aztreonam, and lower resistance rates to Piperacillin/Tazobactam and Cefoxitin. Conclusions The ESBLs producing stains of Escherichia coli and Klebsiella pneumoniae are high in our cohort, and most of them are multiple drugs resistant. ESBLs-producing strains should be suspected when the isolated Escherichia coli and Klebsiella pneumonioe are resistant to third generation cephalosporin, such as Cefotaxime and Ceftriaxone. ESBLs-producing strains should also be suspected when Gram negative strains are sensitive to third generation cephalosporin, but failure in treatment occurs.%目的 探讨院内获得性肺炎老年患者产超广谱

  8. 孝感地区儿童呼吸道流感嗜血杆菌感染流行病学特点及耐药性分析%Study on epidemiological features and drug-resistance of respiratory infection of Haemophilus influenzae in children in Xiaogan region

    刘东华; 李从荣


    Objective To study epidemiological features and drug -resistance of respiratory infection of Haemophilus influenzae (HI) in children in Xiaogan region. Methods Bacterial culture, isolation identification and drug sensitive test were performed in samples from respiratory tract secretions of 3 328 children with respiratory infections in local region from 2009-201L Epidemiological data were analyzed. Results A total of 433 strains of HI were isolated. Infection rate in group of 2-3 year-old was significantly higher than those of other age groups (P < 0,05). Type 5 HI was the most common biological form (39.7%), Most of the strains could be serotyped, of which type A was most common. Resistance rates of HI to ampicillin, cotrimoxazole and chloramphenicol were 21.4%-44,8%, 31.6%-59,3% and 10.2% -24.7%, Resistance rates to levofloxacin, ciprofloxacin, azithromycin, cefotaxime, cefuroxime and ampicillin/shubatan were all below 10%. Positive rate of β-lactamase was 24.0%. Conclusion Haemophilus influenzae is one of the most common causes of respiratory infections in children in the region, with higher in winter, common in 2 -3 year-old age. Positive rate of β-lactamase increases year by year. Cephalosporin and azithromycin are sensitive drugs suitable for children.%目的 探讨孝感地区儿童呼吸道流感嗜血杆菌感染流行病学特点及耐药性分析.方法 总结本地区2009-2011年3328例呼吸道感染患儿的流行病学资料,对其呼吸道分泌物标本进行细菌培养、分离、鉴定、药敏试验.结果 共分离出流感嗜血杆菌433株,2~3岁组感染率明显高于其他年龄组(P<0.05).流感嗜血杆菌的生物学分型以5型最多(39.7%);血清学分型以可分型株为主(67.2%),其中a型最多.流感嗜血杆菌对氨苄西林、磺胺甲(恶)唑、氯霉素的耐药率分别为21.4%~44.8%、31.6%~59.3%、10.2%~24.7%,对左氧氟沙星、环丙沙星、阿奇霉素、头孢噻肟、头孢呋辛、

  9. Study on Acinetobacter baumannii plasmid with 3 types of beta-lactamase genes in a burn ward%关于携带3种β内酰胺酶基因的鲍氏不动杆菌质粒的研究

    李蓉; 李文林; 石小玉; 曾元临; 徐小文; 赵林


    Objective To study the transferrable character of Aciuetobacter baumanni i(AB)plasraids with 3 types of beta-lactamase gene. Methods The plasmid of multi-drug resistant AB(donor)isolated from burn wound were transferred to E.coil ATCC25922 (receptor) through conjugation,and drug sensitivity was also observed.Drug-resistant gene and Stability of filial generation and zygote were analyzed by PCR. Results The dug-resistance of donor plasmids to Sulfamethoxazole, Ampicillin, Cefalotin, Cetpodoxime,Cefuroxime,Imipenem/Cilastatin and Ampicillin/SuIbactam,and three types of beta-lactamase gene were transferred to the receptor,and were also stably transmitted for passages. The minimum inhibitor concentration ot receptor to Sulfamethoxazole was>2 mg/L after conjugation with donor,and inhibitory character could be transferred to next generation. Conclusion blaTEM-1,blaPER-1 and blaOXA-23 genes carried in the ptasmid of AB can be transferred through conjugation and stably transmitted for passages,and it is one of the molecular mechanisms for AB with multi-drug resistance after burn infections.%目的 了解携带3种β内酰胺酶基因的鲍氏不动杆菌质粒的町传递性.方法 选取从烧伤创面分离出的多重耐药鲍氏不动杆菌(供体菌),将之与大肠埃希菌ATCC 25922(受体菌)进行耐药质粒接合、药物敏感试验,并采用PCR分析接合子及其子代的耐药基因型、传代稳定性. 结果鲍氏不动杆菌通过接合将其携带对磺胺甲恶唑、氨苄西林、头孢噻吩、头孢博肟、头孢呋辛、亚胺培南/两司他丁和氨苄西林/舒巴坦的耐药性质粒及3种耐药基因传递给受体菌(例如经接合,使受体菌对磺胺甲恶唑的最低抑菌浓度>2 mg/L),且可稳定传代. 结论鲍氏不动杆菌质粒上携带可接合传递并稳定传代的β内酰胺酶基冈(blaTEM-1、blaPER-1、blaOXAS-23),是烧伤感染后其具有多重耐药性的分子生物学机制之一.

  10. Antibiotic prophylaxis compliance for clean-contaminated wounds in a district hospital in Jakarta

    Syachroni Syachroni


    hospital in Jakarta during periodof January 1 to December 31, 2013. The data came from medical records of adult subjects who underwentsurgery with criteria clean-contaminated wound except caesareans. The standard for antibiotic based onIndonesian Ministry of Health Decree No. 2406/2011 for national antibiotics guidelines and internationalstandard guidelines for surgical prophylaxis.Results: A total of 626 subjects were included in the study. Gynecological (49.5% and genitourinary surgery(32.6% were the most frequent of surgeries performed. More than 80% of the surgery were elective. Mostcommonly administered antibiotic preoperatively as well as postoperatively was ceftriaxone (49.8%,ampicillin/sulbactam (11.7% and cefuroxime (8.3%. Overall antibiotics prophylaxis appropriatenessshowed 96.8% in surgery procedures, 21.5% in choice of antibiotic and only 2.3% in time administrationthat given 60 min before first skin incision.Conclusions: The compliance of antibiotics prophylactic for clean-contaminated wounds in a districthospital Jakarta has not been in conformity with the national guideline and international standards. (HealthScience Journal of Indonesia 2015;6:57-62Keywords: antibiotic, clean-contaminated, compliance, prophylaxis, surgery.

  11. 48株流感嗜血杆菌耐药性分析及β-内酰胺酶基因检测%Analysis on antimicrobial resistance and beta-lactamases gene detection of 48 haemophilus influenzae

    桂和翠; 王中新; 沈继录


    目的 了解本地区流感嗜血杆菌的分布及耐药性,为指导临床合理用药提供依据.方法 k-B法进行药敏试验,玻片法测定β-内酰胺酶.PCR扩增TEM及ROB型β-内酰胺酶基因.结果 48株流感嗜血杆菌主要分布于呼吸内科和门诊.对复方新诺明、四环素和氨苄西林耐药率分别为62.50%、35.42% 和22 92%;阿莫西林/克拉维酸钾、氨曲南耐药率为12.50%;氨苄西林/舒巴坦、头孢噻肟、头孢拉定、头孢曲松、阿奇霉素、氯霉素耐药率为8.33%;头孢吡肟、头孢呋辛、环丙沙星、左氧氟沙星耐药率为6.25%.哌拉西林/三唑巴坦、亚胺培南敏感率高为100%.10株氨苄西林耐药菌株均产β-内酰胺酶,产酶率为20.83%,且均检测到TEM基因.结论 复方新诺明和四环素已不再适于临床治疗流感嗜血杆菌引起的感染.氨苄西林仍可作为临床经验用药.哌拉西林/三唑巴坦和亚胺培南抗菌活性高,可望作为治疗耐氨苄西林流感嗜血杆菌感染的理想用药.喹诺酮类药物耐药率高,应引起重视.流感嗜血杆菌对氨苄西林耐药的主要机制为产TEM型β-内酰胺酶.%To investigate antimicrobial resistance and genotypes of β-lactamase of in this erea , and guide clinical rational drug use effectively. Methods Kirby-Bauer method was applied for the drug susceptibility test and nitrocefin slide test was used to detect β-lactamase. The genotypes of β-lactamase were detected by PCR. Results A total of 48 strains of haemophilus influenzae were mainly distributed in department of respiratory and outpatient service. The resistant straint to compound sulf-amethoxazole, ampicillin and tetrocycline were 62. 50% , 35. 42% ,22. 92% respectively, the resistant rate to amoxicillin-clavulanic acid, ceftriaxome, aztreonam, ciprofloxa-cin and levofloxacin was 12.50% ,the resistant rate to ampicillin-sulbactam, cefotaxime, ceftazidime, cefuroxime, azithromycin, chlorampheniol was 8. 33% ;the

  12. Antibiotic resistance of the germs which cause acute pyelonephritis in pregnancy

    Salcedo-Ramos Francisco


    Full Text Available Introduction: pyelonephritis is one of the most common infections during thepregnancy. Approximately it is presented approximately in 1 to 2 % of the pregnancyand it puts at risk both mother and fetus.Objective: to determine bacterial resistance to antibiotics in pregnant women withacute pyelonephritis.Methods: descriptive and prospective study in which was evaluated the resistance tothe antibiotics used in patients with diagnosis of acute pyelonephritis in the hospitalizedservice of the Clínica de Maternidad Rafael Calvo, Cartagena, Colombia, since July of2008 to July of 2009. The participants signed informed consent.Results: there were included 118 patients, age range: 14 – 33 years old, with anaverage of 21 years old. 12% of the patients had 16 years old or less. 90.5% of thepatients were in the second or third trimester of the pregnancy. The most common germsidentified were: E. coli 44%, Klebsiella oxítoca 22%, Klebsiella ozaenae y pneumoniae11% each one, Proteus mirabilis 6% and other diverse germs 4%. Ampicillin was theantimicrobial with major resistance: 73%, follow by cefradine: 47%. Pseudomonasaeruginosa was resistant for ampicillin and cefradine in all the cases. Germs resistant toCefuroxime and Cefoperazone/sulbactam were not found.Conclusion: it was found high bacterial resistance to the antibiotics that are usedtraditionally as first generation (ampicillin and cefradine for the treatment of acutepyelonephritis in pregnancy women. Rev.cienc.biomed. 2012;3(2:260-266RESUMEN:Introducción: la pielonefritis es una de las infecciones más comunes durante lagestación. Se presenta aproximadamente en 1 a 2% de los embarazos y pone en riesgotanto a la madre como al feto.Objetivo: determinar resistencia bacteriana a antibióticos en gestantes con pielonefritisaguda.Metodología: estudio descriptivo prospectivo donde se evaluó la resistencia a losantibióticos utilizados en pacientes con diagnóstico de pielonefritis aguda en el

  13. 2006-2011年浙江省杭州市萧山区流感嗜血杆菌耐药性监测%Surveillance of drug resistance of Haemophilus influenzae in Hangzhou.Zhejiang, 2006 -2011

    郭远瑜; 吴伟志; 沈丽芳; 董华丽


    目的 调查了解流感嗜血杆菌的临床分布及耐药情况,为临床用药提供依据.方法 对2006年1月至2011年12月浙江萧山医院临床分离的流感嗜血杆菌,用ATB嗜血杆菌药敏板条测定抗菌药物的敏感性,用头孢硝噻吩纸片法测定β-内酰胺酶,所有数据用WHONET 5.6软件进行回顾性分析.结果 共检出流感嗜血杆菌375株,对复方新诺明、氨苄西林耐药分别为248株(66.1%)和127株(33.8%),对氯霉素、头孢克洛和四环素耐药分别为38株(10.2%)、52株(13.8%)和55株(14.7%);其他几种常用药物阿莫西林/克拉维酸、头孢呋辛、头孢噻肟、利福平和氧氟沙星对流感嗜血杆菌保持较好的抗菌活性(耐药率≤5.0%);β-内酰胺酶阳性菌株对多种药物的耐药率显著高于阴性菌株(P<0.01).结论 复方新诺明耐药率高而不宜用于流感嗜血杆菌感染的治疗,氨苄西林应慎重用于经验治疗;流感嗜血杆菌对氨苄西林耐药率呈下降趋势,对二代头孢菌素耐药率呈上升趋势,临床应根据药敏结果合理使用抗菌药物.%Objective To understand the clinical distribution and drug resistance of Haemophilus influenzae in Xiaoshan district in Hangzhou and provide evidence for clinical antibiotic use. Methods The drug susceptibility of H. influenzae strains isolated in Zhejiang Xisoahn hospital from January 2006 to December 2011 was tested by using ATB HAEMO strip, β-lactamases was detected with Nitrocefin discs test, and the results were analyzed retrospectively by using WHONTET 5. 6 software. Results A total of 375 H. influenzae isolates were tested, the resistance rate was 66.1% to trimethoprim-sulfamethoxazole (TMP/SMZ), 33.8% to ampicillin, 10.2% to chloramphenicol, 13.8% to cefaclor and 14.7% to tetracycline. Amoxicillin/clavulanic acid, cefuroxime, cefotaxime, rifampicin and ofloxac in had good antibacterial activity on H. influenzae (the resistance rate ≤5.0% ). The

  14. 128株流感嗜血菌对抗菌药物耐药性分析%Drug resistance of 128 strains of haemophilus influenzae to antibiotics

    张有忠; 都青; 李娜


    目的 对襄樊市中医院2008-2009年临床微生物室分离出的流感嗜血菌耐药性及耐药趋势进行回顾性分析,为指导临床合理用药提供科学依据;同时优化检测方法,提高检出率.方法 对128株流感嗜血菌进行β-内酰胺酶测定,采用K-B法进行体外药敏试验.结果 128例流感嗜血菌中,产β-内酰胺酶率为28.69%,对氨苄西林、氨苄西林/舒巴坦、头孢噻肟、磺胺甲噁唑/甲氧苄啶、头孢呋辛、环丙沙星、阿奇霉素、左氧氟沙星、氯霉素、亚胺培南的耐药率分别为47.66%、15.63%、28.91%、56.25%、27.34%、19.53%、19.53%、29.69%、46.09%、0.结论 流感嗜血菌对亚胺培南、氨苄西林/舒巴坦、环丙沙星、阿奇霉素的敏感性较高,临床医师可选择这些药物进行治疗.%OBJECTIVE To retrospectively analyze the drug resistance trend and drug resistance of Haemophiius influenzae isolated from clinical microorganism room in the Xiangfan Traditional Chinese Medicine H ospital in the whole year of 2009, to provide scientific data for the clinical on rational drug use and optimize the detection method and improve the detection rate. METHODS The determination of β-lactamase was performed on 128 strains of HI and drug sensitivity was tested in vitro by using the method of Kirty-Bauer. RESULTS In 128 strains of H. influenzae, the β-lactamase producing rate was 28.69%, the drug resistant rates to ampicillin, ampicillin sulbactam,cefotaxime, cotrimoxazole, cefuroxime, ciprofloxacin, azithromycin, levofloxacin, chloramphenicol and imipenem were 47. 66%, 15. 63%, 28. 91%, 56. 25%, 27. 34%, 19. 53%, 19. 53%, 29.69%, 46. 09% and 0,respectively. CONCLUSION H. influenzae is sensitive to imipenem, ampicillin/sulbactam, ciprofloxacin and azithromycin, the clinicians can choose these drugs for the treatment.

  15. Distribution and drug resistance analysis of Streptococcus pneumonia and Haemophilus influenzae%肺炎链球菌和流感嗜血杆菌分布及耐药性分析

    宁静; 韦桂雪


    . The resistance rates of Haemophilus influenzae to ampicillin、cotrimoxazole and cefuroxime were high, and 64.17%Haemophilus influenzae producedβ-lactamase. The resistance rates of Streptococcus pneumoniae to erythromycin、chloramphenicol、tetracycline、clindamycin were serious, and there were 47 (56.63%) isolates of Streptococcus pneumoniae were penicillin non-susceptible (PNSP). Conclusions:The resistance of Haemophilus influenzae and Streptococcus pneumoniae were serious. Monitoring the resistance of Haemophilus influenzae and Streptococcus pneumoniae will help to reduce the generation of resistant strains.

  16. 根据我院第三季度致病菌流行情况及耐药性分析促进医院合理用药%According to my Courtyard third quarter of Pathogens of epidemic Situation and Analysis of resistance to Promote Rational drug use in hospital



    Objective Through comparative analysis of antimicrobial susceptibility and drug resistance of pathogenic bacteria in our hospital,and provide the basis for clinical rational use of antimicrobial drugs standard. Methods The epidemiology and drug resistance of pathogenic bacteria in microbial experimental data reports in our hospital from 2013 July to September were col ected from underlying infection rate statistics, analysis.Results The third quarter of 2013 specimens in 3 180 cases, bacterial culture and drug sensitive test training+were detected in 18 species of bacteria,a total of 277 cases,accounting for 8.7%,including Escherichia coli, Staphylococcus aureus, Staphylococcus aureus, Pseudomonas aeruginosa,Klebsiel a pneumoniae, Bauman Acinetobacter ranked in the top 6 position;antibacterial drugs in the hospital the amount of sales of the top 10 were Cefoperazone/sulbactam sodium, Alosi Lin,etimicin sulfate and sodium chloride injection,meropenem and ornidazole injection and clindamycin, cefuroxime sodium,ceftriaxone sodium,cefazolin and amoxicil in/clavulanate potassium.Conclusion The antimicrob ial drug use process exists unreasonable, should further strengthen the supervision of the antibacterial drugs, improve the level of clinical rational use of drugs.%目的:通过对比致病菌对我院抗菌药物敏感性及耐药性的分析,为规范临床合理使用抗菌药物提供依据。方法对我院2013年7月至9月感染患者送检标本的微生物实验数据报告的致病菌流行情况及耐药率进行统计并分析。结果2013年第三季度送检标本3180例,细菌培养及培养+药敏检测共检测出细菌18种,共计277例,占8.7%,其中大肠埃希菌、表皮葡萄球菌、金黄色葡萄球菌、铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌排在前6位;本院销售金额排名前10位的抗菌药物分别为头孢哌酮/舒巴坦钠、阿洛西林、依替米星氯化钠注射液、美罗培南、奥硝

  17. 132株奇异变形杆菌的临床分布及药敏分析%Clinical distribution and drug sensitivity analysis of 132 strains of Proteus mirabilis

    马巧红; 陈群英; 何娟妃


    Objective To study the clinical distribution and drug resistance of Proteus mirabilis isolated in Ningbo Women and Children's Hospital, and provide guidance for clinical medication. Method The authors collected 132 strains of Proteus mirabilis isolated from their hospital during June 1, 2009 to May 31 , 2011. The clinical isolates were identified by VITEK-60 of Bio-Merieux oi France. Antibiotic susceptivity test was done by Kirby-Bauer method. And quality control was done with reference strains. Result Most of the clinical specimens came from urine (51.50% ) , followed by wound secretion (21.21% ) , vaginal discharge ( 19. 70% ) , and others (7.59% ). Proteus mirabilis was more sentive to the following antibiotics; Amikacin, Aztreonam, Meropenem, Imipenem, Cefazolin, Cefuroxime axetil, Ceftriaxone, Ceftazidime, Cefotaxime, Maxipime, Cefoxitin, Roxithromycin, Ampicillin/sulbactam, Piperacillin/tazobactam, and Cefoperazone/sulbactam, respectively. Conclusion It is important to strengthen the separation, identification and resistance test of Proteus mirabilis to guide clinical selection of antihioties.%目的 了解宁波市妇女儿童医院奇异变形杆菌的临床分布和耐药情况,为临床合理用约提供依据.方法 对该院2009年6月1日至2011年5月31日期间分离的132株奇异变形杆菌进行分析,菌株鉴定采用法国生物梅里埃公司的VITEK 60分析仪,药敏试验采用K-B法,用参考菌株作质量控制.结果 该院分离的奇异变形杆菌主要来自尿液(51.50%),其次是创口分泌物(21.21%),再次是阴道分泌物(19.70%),其他(7.59%).对奇异变形杆菌敏感率较高的抗生素是:丁胺卡那霉素、氨曲南、美罗培南、亚胺培南、头孢唑林、头孢呋辛酯、头孢曲松、头孢他啶、头孢噻肟、马斯平、头孢西丁、罗红霉素、氨苄西林/舒巴坦、哌拉西林/他唑巴坦和头孢哌酮/舒巴坦.结论 加强奇异变形杆菌的分离鉴定及耐药性的测定,

  18. ICU患者感染病原菌分布与耐药性分析%Distribution and drug resistance of pathogens in ICU

    王毅; 徐恩洁; 季萍; 于湘友


    pneumoniae and Proteus mirabilis was 48 .9% ,36 .0% and 9 .1% among gram‐negative bacteria .Enterobacteriaceae had resistance >50 .0% to cefazo‐lin ,cefuroxime ,ceftriaxone ,and cefotaxime .CONCLUSION The problem of multidrug resistance in ICU is still serious .Actively early screening and obtaining the local bacterial epidemiology helps to guide clinical prevention and treatment .

  19. 头孢唑肟与其他5种抗生素体外抗菌活性比较%In vitro antibacterial activity of ceftizoxime in comparison with five other agents

    肖永红; 刘健; 钟巍; 郝风兰; 杨维维


    Objective To compare the in vitro antibacterial activity against clinical isolates of ceftizoxime and other 5 antibiotics. Method NCCLS agar dilution method was used for the determination of minimum inhibitory concentrations. Results Five hundred seventy bacterial strains including 367 Gram-negative and 203 Gram-positive isolates were examined. Ceftizoxime was a potent antibiotic against Enterobacteriacaea and Streptococcus, no resistant strain was found in E. coli, K. pneumoniae, E. aerogenes, Sh. sonnei,Sh. flexneri, P. mirabilis, M. morganii, H. influenza, S. pneumoniae, S. pyogenes, S. agalactiae and M. catarralis. The MICs of ceftizoxime against major Enterobacteriacaea were comparable to those of ceftriaxone, and superior to those of ceftazidime and cefuroxime. S. marcescens was most susceptible to ceftizoxime in the agents tested with MIC50 and MIC90 of 0. 5mg/L. Conclusion Ceftizoxime still kept highly antibacterial activity after 15 years clinical application in China, it can be used as empiric therapeutic agent in the treatment of moderate and severe bacterial infections.%目的比较头孢唑肟与其他5种抗生素对临床分离菌的体外抗菌活性.方法用NCCLS2002年发布的琼脂平板法测定抗生素的最低抑菌浓度.结果本研究共测定细菌570株,其中革兰氏阴性菌367株,革兰氏阳性菌203株.头孢唑肟对肠杆菌科细菌与链球菌具有强大抗菌活性,大肠埃希氏菌、肺炎克雷伯氏菌、产气肠杆菌、志贺氏菌、奇异变形菌、摩根摩氏菌、流感噬血杆菌、肺炎链球菌、化脓链球菌、无乳链球菌、粘膜炎莫拉氏菌对头孢唑肟100%敏感.头孢唑肟对大多数肠杆菌科细菌MIC值与头孢曲松相近,远低于头孢他啶和头孢呋辛.头孢唑肟对液化沙雷氏的菌抗菌活性为所有检测药物中最强的一个,MIC50与MIC90均为0.5mg/L.结论头孢唑肟应用于临床15年后仍保持强大抗菌活性,本品可用于中重度细菌感染的经验性治疗.

  20. Etiología y sensibilidad bacteriana en infección urinaria en niños. Hospital Infantil Club Noel y Hospital Universitario del Valle, Cali, Colombia

    Consuelo de Rovetto


    gentamicina. Mostraron sensibilidad intermedia entre 61% y 70%: amoxacilina-clavulanato, cefaclor, ciprofloxacina, nitrofurantoína y baja sensibilidad (<60%: amoxacilina, ampicilina, cefadroxilo, cefalexina, cefradina, trimetoprim-sulfa, ampicilina-sulbactan, cefalotina, cefazolina.Conclusiones: Escherichia coli fue la bacteria que más produjo infección urinaria en la población estudiada. Para el manejo ambulatorio se recomiendan como medicamentos empíricos de primera línea los antibióticos orales que mostraron mayor sensibilidad como cefuroxime, cefproxil, cefixime y ácido nalidíxico, mientras se procesa el urocultivo. A pesar de la buena sensibilidad que mostró la norfloxacina, se debe reservar su uso sólo en casos especiales donde haya resistencia a los antibióticos mencionados antes. Debe evitarse en primera instancia el uso de medicamentos como cefalexina, trimetoprim, ampicilina y amoxacilina. Si el estado clínico del paciente amerita hospitalización, los medicamentos parenterales recomendados serían: ceftriazone o amikacina.

  1. Antibiotic resistance of Helicobacter pylori in Guizhou Province%贵州省幽门螺杆菌临床菌株的抗生素耐药现状

    刘苓; 胡林; 刘娅琳; 周力; 车筑萍; 谭庆华


    Objective To determine the Helicobaeter pylori ( H. pylori) resistance to multiple antibiotics and the clinical features of antibiotic-resistance patients. Methods 30 H. pylori strains were successfully isolated. Resistance to different antibiotics, including clarithromycin (CLA), amoxieillin (AMO) and metronidazole (MTZ) were determined by Kirby-Bauer and E-test methods. Information of clinical features was gathered. Results Kirby-Bauer results showed 20.00% , 3.33% , 13.33% , 30.00% , 6.67% , 0, 0 of the strains were resistant to AMO, levofloxcin, gentamicin, CLA, tetracycline, cefuroxime or SMZ-TMP respectively. E-test results manifested that 63. 33% , 26.67% , 33.33% of the strains were resistant to MTZ, AMO or CLA respectively. The resistance rate of H. pylori to MTZ in male patients (77. 78% ) was higher than that in female patients (41. 67% ) ( P 0. 05 ). There was no significant difference in CLA and AMO resistance rate among sex ages or disease. Conclusion Resistance of H. pylori to antibodies should be pay more concern in Guizhou province. Resistant rate of H. pylori to MTZ is the highest compared with other antibodies, especially in male patients with peptic ulcer around 30 ~ 60 ages.%目的 检测贵州省幽门螺杆菌( Helicobacter pylori,H.pylori)临床菌株对多种抗生素的耐药率,并分析甲硝唑(MTZ)、克拉霉素(CLA)、阿莫西林(AMO)耐药菌株的临床特征.方法 以贵州地区30株培养成功的H.pylori临床菌株为研究对象,采用Kirby-Bauer及E-test法测定菌株对MTZ、CLA、AMO等多种抗生素的耐药性.分析MTZ、CLA、AMO耐药菌株与敏感菌株患者性别、年龄及疾病种类的差异.结果 Kirby-Bauer法显示H.pylori临床菌株对AMO、左氧氟沙星、庆大霉素、CLA、四环素、头孢呋肟、复方新诺明的耐药率分别为20.00%、3.33%、13.33%、30.00%、6.67%、0、0;E-test法显示H.pylori临床菌株对MTZ、AMO、CLA耐药率分别为63.33%、26.67% 、33.33

  2. 96株儿童肺炎链球菌耐药情况分析%Resistance of 96 strains of streptococcus pneumoniae in children

    樊有; 姜静; 蒋德升; 尚宁; 施毅


    Objective To investigate antibiotic resistance of streptococcus pneumoniae to children in Nanjing.Methods Totally 96 strains of streptococcus pneumoniae were collected to test the MICs of various antibiotics by agar dilution method according to the approved standard of CLIS.Results Among 96 strains of streptococcus pneumoniae ,63 (65.6%) strains were resistant to penicillin ( MIC≥2 mg/L).87.5% ,29.2%,8.3% and 4.2% of streptococcus pneumoniae were resistant against the cefuroxime,cefotaxim,amoxicillin ,and ceftriaxone ,retrospectively.The resistance rates to other antibiotic agents, such as erythromycin, azithromycin,tetracycline,and Chloram-phenicol were 96.9% ,95.8% ,95.8% ,94.8%, respectively.All 96 strains of streptococcus pneumoniae were sensitive to vancomycin, tigocycline and linezolid.Conclusion The antibiotic resistance to streptococcus pneumoniae is serious in Nanjing.Most of them are multi-resistant strains.Except for vancomycin,tigecycline,linezolid, and ceftriaxone, most antibiotic agents have lost the reactivities against streptococcus pneumoniae.%目的 了解南京地区儿童感染肺炎链球菌对常用抗菌药物的耐药性.方法 琼脂稀释法测定96株肺炎链球菌对14种抗菌药物最低抑菌浓度.结果 96株肺炎链球菌中,耐青霉素肺炎链球菌(penicillin resist streptococcus pneumoniae,PRSP)最小抑菌浓度(minimal inhibitory concentration,MIC)≥2mg/L的检出率为65.6%;头孢呋辛、头孢噻肟、阿莫西林、头孢曲松的耐药率依次为87.5%、29.2%、8.3%和4.2%;红霉素、四环素、阿奇霉素和克林霉素耐药率分别为96.9%、95.8%、95.8%、94.8%;万古霉素、替加环素、利奈唑胺均敏感.结论 南京地区儿童肺炎链球菌对青霉素、红霉素、阿奇霉素、克林霉素和四环素、头孢呋辛等抗生素耐药性高,应注意合理选择用药.

  3. 2012-2014年海军总医院分离自无菌体液细菌的分布及耐药性分析%Analysis of bacteria distribution and drug resistance separated from sterile bodyfluid in Navy General Hospital from 2012 to 2014

    丁毅伟; 郝秀红; 李艳君; 钱扬会; 赵强元


    /sulbactam, Cefotetan, Ceftriaxone, Cefazolin, Cefuroxime sodium, SMZ-TMP, Nitrofurantoin and Cefuroxime Axetil, with the average drug resistance rate of more than 90%.Conclusion The resistant strains of pathogenic bacteria in sterile bodyfluids show a rising trend. Klebsiella pneumoniae is found to be resistant to carbon penicillium enzyme. It is important for clinicians to monitor the changes of pathogenic bacterialflora and their drug resistance tendency promptly, so as to decrease the production of drug-resistant strains.

  4. Analysis of clinical distribution and drug-resistant trend of Escherichia coli from 2008 to 2012%2008-2012年大肠埃希菌临床分布及耐药趋势分析

    张翠英; 栗志平; 李菊平; 杨妮娜; 赵芳


    ,accounting for 16.79% ; 132 strains from pus or secretion,accounting for 16.42% ; and 39 strains from blood,accounting for 4.85%.E.coli demonstrated much higher resistant rate to levofloxacin,cefazolin,cefuroxime,gentamicin,tobramycin(> 50%),the resistant rate to levofloxacin had rising trend year by year,and E.coli had much lower resistant rate to cefoperazone/sulbactam,piperacillin/tazobactam,amikacin,nitrofurantoin.No strains were found to be resistant to imipenem.Conclusions Escherichia coli detection rate and the multiple antibiotic resistant rate of E.coli is maintained at a high level,it should be based on susceptibility results,rational use of antimicrobial drugs to prevent the generation of resistant bacteria.

  5. Serotype distribution and antimicrobial resistance of Streptococcus pneumoniae isolated from the children in Shanghai%儿童肺炎链球菌血清型分布及其对抗菌药物的耐药性

    张泓; 李万华; 孔菁; 王春; 陆敏; 陆权


    typing was performed by Quellung reaction. Antimicrobial susceptibility was determined by E-test method. Results The common serotypes of these S. pneumoniae strains were 19F (138, 41. 0 %), 19A (67, 19. 8%), 14 (30, 8.9 %), 23F (14, 4. 1%), 6B (13, 3.8%), 6A (12, 3.6%) and 15B (10, 3.0%). PCV7 vaccine was expected to cover 41.9% (26/62) of the penicillin non-susceptible S. pneumoniae (PNSP) and 59. 6% (198/332) of macrolide resistant S. pneumoniae (ERSP) strains. PCV13 vaccine could cover 72. 6% (45/62) of PNSP and 84. 9% (282/332) of ERSP strains. Antibiotic susceptibility testing showed that 81.7% (267/338) of these S. pneumoniae strains were susceptible to penicillin (PSSP), 10.9% (37/338) intermediate (PISP), and only 7.9% (25/338) resistant (PRSP). As for 19F and 19A groups, PNSP strains were more resistant to amoxicillin-clavulanic acid and eeftriaxone than PSSP strains (P<0. 01). In the nontypable group, PNSP strains were more resistant to amoxicillin-clavulanic acid, ceftfiaxone and cefuroxime sodium than PSSP strains (P<0. 01). Conclusions Serotypes 19F, 19A, 14, 23F, 6B and 6A were the common types of S. pneumoniae strains in Shanghai. PCV13 could cover most of the PNSP and ERSP strains, suggesting its preventive effect on pneumococcal infection and spread of antimicrobial resistance.

  6. Tratamiento de la neumonía del adulto adquirida en la comunidad TREATMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN ADULTS

    Alejandro Díaz F.


    so antibiotic treatment is empirically prescribed. In Chile, one third of Streptococcus pneumoniae strain isolates has diminished susceptibility to penicillin; in-vitro erythromycin resistance is about 10-15% and cefotaxime resistance 2-10%. It is recommended to classify patients with community acquired pneumonia in four risk categories: Group 1: patients under 65 years without co-morbidities, in ambulatory attendance. Treatment: oral amoxicillin 1 g TID, 7 days. Group 2: patients over 65 years and / or co-morbidities, in ambulatory attendance. Treatment: oral amoxicillin/clavulanate 500/125 mg TID or 875/125 mg BID, or cefuroxime 500 mg BID, 7 days. Group 3: patients admitted to general wards with criteria of moderate severity. Treatment: ceftriaxone 1-2 g once a day or cefotaxime 1 g TID, IV, 7-10 days. Group 4: patients with severe CAP that must be interned into ICU. Treatment: ceftriaxone 2 g once a day or cefotaxime 1 g TID, IV, associated to erythromycin 500 QID, levofloxacin 500-1.000 mg once a day, or moxifloxacin 400 mg/once a day, IV, 10-14 days. In the presence of allergy to or treatment failure with betalactam drugs and/or positive serology for Mycoplasma, Chlamydia or Legionella sp it is recommended to add: erythromycin 500 mg QID, IV or oral, oral clarithromycin 500 mg BID, or oral azythromycin 500 mg once a day

  7. Analysis on Application of Antimicrobial Drugs and Bacterial Resistance in Orthopedics Department of A TCM Hospital in 2013%2013年某中医院骨科病区抗菌药物使用与细菌耐药性分析

    孙毅东; 张美容; 张劲新; 叶凌云; 林爱华


    ABSTRACTObjective:To investigate the application of antimicrobial drugs and bacteriology in orthopedics de-partment of our hospital so as to provide a clinical reference for the rational use of antimicrobial agents.Methods:The application of antimicrobial drugs,the results of bacterial examination and bacterial resistance in orthopedics department of our hospital in 2013 were analyzed statistically by a retrospective investigation method.Results:The top three drug categories based on the DDDs sequence of the use of antibacterials were cephalosporins(9 536.4), penicillins(613.9)and quinolones(445.0),and the top three drugs were cefathiamidine(3 036.7),cefazolin (2 293.0)and cefuroxime(1 688.5). In l46 strains of detected bacteria,100 strains were Gram-negative bacteria (68.5%),includingEscherichiacoli,KlebsiellapneumoniaeandPseudomonasaeruginosa,31 strains were Gram-positive bacteria(21.2%)which was mainlyStaphylococcus,and 15 strains of fungi(10.3%),of which Candidaalbicanswas the main part. The drug sensitive rate of Gram-positive bacteria was higher,but Gram-nega-tive bacteria and fungi had a lower drug sensitivity rate of antimicrobial agents ranked at forefront of DDDs.Con-clusion:The application of antimicrobial drugs did not lead to an extensive bacterial resistance in orthopedics de-partment of our hospital in 2013. The strict grasp of drug use indications and reasonable administration of antimicro-bial drugs were critical points to obtain a low rate of bacterial resistance. Traditional Chinese medicine syndrome differentiation was one of the possible reasons.%目的:调查我院骨科病区抗菌药物的应用及细菌学情况,为提高抗菌药物合理应用水平提供依据。方法:采用回顾性调查方法,对骨科病区2013年1-12月抗菌药物的使用情况、细菌学检查结果及其耐药性进行统计、分析。结果:各类抗菌药物使用按用药频度(DDDs)排序,前3位分别为头孢菌素类(9536.4

  8. Tonsillitis and sore throat in children

    Stelter, Klaus


    , viruses and fungi belong to the healthy flora and do no harm. Ten percent of healthy children even bear all the time in the tonsils with no clinical signs. In these children decolonization is not necessary. Therefore, microbiological screening tests in children without symptoms are senseless and do not justify an antibiotic treatment (which is sometimes postulated by the kindergartens. The acute tonsillitis should be treated with steroids (e.g. dexamethasone, NSAIDs (e.g. ibuprofene and betalactam antibiotics (e.g. penicillin or cefuroxime. With respect to the symptom reduction and primary healing the short-term late-generation antibiotic therapy (azithromycin, clarithromycin or cephalosporine for three to five days is comparable to the long-term penicilline therapy. There is no difference in the course of healing, recurrence or microbiological resistance between the short-term penicilline therapy and the standard ten days therapy. On the other hand, only the ten days antibiotic therapy has proven to be effective in the prevention of rheumatic fever and glomerulonephritic diseases. The incidence of rheumatic heart disease is currently 0.5 per 100,000 children of school age. The main morbidity after tonsillectomy is pain and the late haemorrhage. Posttonsillectomy bleeding can occur till the whole wound is completely healed, which is normally after three weeks. Life-threatening haemorrhages occur often after smaller bleedings, which can spontaneously cease. That is why every haemorrhage, even the smallest, has to be treated properly and in ward. Patients and parents have to be informed about the correct behaviour in case of haemorrhage with a written consent before the surgery.The handout should contain important addresses, phone numbers and contact persons. Almost all cases of fatal outcome after tonsillectomy were due to false management of haemorrhage. Haemorrhage in small children can be especially life-threatening because of the lower blood volume and the danger of

  9. Discólisis percutánea con ozono: nuestra experiencia Percutaneous ozone discolysis: our experience

    M. Castro


    (85,4%, regular para 4 (9,8%, y solamente 2 (4,9% la calificaron de mala. Conclusiones: La discólisis percutánea con ozono se muestra como una técnica eficaz y segura en el tratamiento del dolor lumbar irradiado secundario a hernia de disco lumbar.Objective: To demonstrate the safety and effectiveness of percutaneous discolysis using ozone in the treatment of symptomatic lumbar hernia. Material and methods: We performed a prospective observational study in 41 patients diagnosed with symptomatic lumbar hernia, in whom we performed 49 percutaneous discolysis procedures introducing ozone in the lumbar region between February 2004 and February 2009. All the procedures were performed in the operating room under radiological guidance, with aseptic conditions, local anaesthesia and sedation. The ozone was introduced into the lumbar disc (5 to 7 ml, in the epidural (5 to 7 ml and periradicular spaces (5 to 7 ml at a concentration of 27 Ìg. In all patients, 1500 mg of cefuroxime was administrated intravenously as a prophylactic measure. The effectiveness of the treatment was based on pain control according to the visual analogue scale before the procedure (VAS 0, at 30 days (VAS 1, at 90 days (VAS 3 and at 6 months (VAS 6, and by means of Lattinen's test before treatment and at the end of the study. All the patients were asked about the possible adverse effects of the treatment and a survey was carried out on patient satisfaction with the technique. Results: We performed 49 percutaneous ozone discolysis procedures in 41 patients. The initial mean VAS was 7.37 ± 0.96 and subsequent values were 2.41 ± 2.17 at 1 month, 1.80 ± 2.31 at 3 months and 2.05 ± 2.45 at 6 months, with statically significant differences in the three measurements. The initial mean Lattingen index was 12.68 ± 2.32 and was 6.07 ± 2.91 at 6 months, representing a statically significant reduction. Adverse effects occurred in only five patients (12.2%: four mild transient headaches and one symptomatic

  10. 2010~2013年重庆医科大学附属永川医院抗菌药物调查分析%Analysis the use of antibiotic in the Yongchuan hospital Chongqing Medical University during 2010-2013

    徐中良; 金梅


    Objective To study the status quo and tendency of the utilization of antibiotics in our hospital in order to provide ref-erence for clinical rational drug use .Methods A retrospective analysis was performed on the consumption sum ,DDDs and defined daily cost(DDC) of antibiotics ,which taken from HIS system in drug storehouse from 2010 to 2013 .Results 2010~2013 ,the anti-microbial drug sales in proportion to the amount of drug sales were 35 .99% ,26 .47% ,14 .69% and 14 .52% respectively .Cephalo-sporins andβ-lactamase inhibitor have been in the forefront of the antimicrobial agents in the sales amount .The sales amount of Ce-foxitin sodium and Piperacillin/tazobactam has rapid grow th ,for three consecutive years of antimicrobial agents in the sales amount ordering frist and second .2010~2013 ,Cephalosporins and Macrolides antibiotics has been in the forefront on the sorting of DDDs . The DDDs of antifungal drugs increased year by year ,quinolones and nitroimidazoles was declining .The DDDs of Clarithromycin tablets ,Azithromycin enteric-coated capsules and Roxithromycin Capsules in the front row .2011-2013 ,the DDC of Cefuroxime in-creased the larger from 15 .37 to 68 .06 .Conclusion The antibacterial drug sales amount of drug sales amount is reduced year by year from 2010 to 2013 ,and the application of antimicrobial agents is given priority to Cephalosporins ,Antifungal drug sustained growth ,Macrolides antibiotics and Penicillins keep at a high level .%目的:评价抗菌药物应用现状和趋势,为临床合理用药提供参考。方法提取2010~2013年本院医院信息系统(HIS)的出库数据,对抗菌药物的销售金额、用药频度(DDDs)和限定日费用(DDC)进行回顾性分析。结果2010~2013年抗菌药物销售金额占药品销售金额的比例分别为35.99%、26.47%、14.69%和14.52%,各类抗菌药物销售金额中头孢菌素类和β-内酰胺酶抑制药一直居前列,头孢西丁钠