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Sample records for aztreonam

  1. Aztreonam Injection

    Science.gov (United States)

    ... Aztreonam is in a class of medications called carbapenem antibiotics. It works by killing bacteria.Antibiotics such ... such as penicillin or amoxicillin (Amoxil, Trimox, Wymox), carbapenem antibiotics such as doripenem (Doribax), ertapenem (Invanz), or ...

  2. Aztreonam lysine: a novel inhalational antibiotic for cystic fibrosis.

    Science.gov (United States)

    Parkins, Michael D; Elborn, J Stuart

    2010-08-01

    Acquisition of Pseudomonas aeruginosa, the most prevalent organism isolated from cystic fibrosis (CF) airways, is associated with an accelerated clinical deterioration and reduced survival. Strategies to chronically suppress P. aeruginosa infections in individuals with CF have evolved over the last four decades and now largely focus on regular administration of aerosolized antibiotics. Aztreonam lysine (AZLI; Cayston, Gilead Pharmaceuticals [Foster City, CA, USA]), a novel formulation of the monobactam aztreonam suitable for aerosol delivery has recently been developed. AZLI is administered as 75 mg three-times daily for 28 days in 'on/off' cycles using the Altera/eFlow electronic nebulizer (PARI Innovative Manufacturers [Midlothian, VA, USA]). In individuals with CF chronically infected with P. aeruginosa, AZLI improved healthcare-associated quality-of-life scores, pulmonary function and weight, prolonged time to requirement of antibacterial therapy for symptoms of pulmonary exacerbation and reduced P. aeruginosa sputum burdens. These outcomes were durable over 18 months of cycled use. AZLI has been demonstrated to be safe and effective, and expands available chronic maintenance therapies in CF.

  3. Stability of aztreonam in a portable pump reservoir used for home intravenous antibiotic treatment (HIVAT)

    NARCIS (Netherlands)

    Vinks, A A; Touw, D J; van Rossen, R C; Heijerman, H G; Bakker, W

    1996-01-01

    The stability of the monocyclic beta-lactam antibiotic aztreonam in portable pump reservoirs was studied during storage at temperatures of -20 degrees C and +5 degrees C and during drug delivery at 37 degrees C. Three 100-ml drug reservoirs and three glass containers containing 60 mg/ml aztreonam we

  4. Improved detection of methicillin-resistant Staphylococcus aureus using phenyl mannitol broth containing aztreonam and ceftizoxime.

    NARCIS (Netherlands)

    H.F.L. Wertheim (Heiman); H.A. Verbrugh (Henri); C. van Pelt (Cindy); P. de Man (Peter); A.F. van Belkum (Alex); M.C. Vos (Margreet)

    2001-01-01

    textabstractWe tested a phenyl mannitol broth containing ceftizoxime and aztreonam (PHMB(+)) for detection of methicillin-resistant Staphylococcus aureus (MRSA) with reference MRSA strains and, subsequently, with clinical samples (n = 1,098). All reference MRSA strains

  5. Conformational Change Observed in the Active Site of Class C β-Lactamase MOX-1 upon Binding to Aztreonam.

    Science.gov (United States)

    Oguri, Takuma; Ishii, Yoshikazu; Shimizu-Ibuka, Akiko

    2015-08-01

    We solved the crystal structure of the class C β-lactamase MOX-1 complexed with the inhibitor aztreonam at 1.9Å resolution. The main-chain oxygen of Ser315 interacts with the amide nitrogen of aztreonam. Surprisingly, compared to that in the structure of free MOX-1, this main-chain carboxyl changes its position significantly upon binding to aztreonam. This result indicates that the interaction between MOX-1 and β-lactams can be accompanied by conformational changes in the B3 β-strand main chain.

  6. Eradication of Burkholderia cepacia Using Inhaled Aztreonam Lysine in Two Patients with Bronchiectasis

    Directory of Open Access Journals (Sweden)

    A. Iglesias

    2014-01-01

    Full Text Available There are not many articles about the chronic bronchial infection/colonization in patients with underlying lung disease other than cystic fibrosis (CF, especially with non-CF bronchiectasis (NCFBQ. The prevalence of B. cepacia complex is not well known in NCFBQ. The vast majority of published clinical data on Burkholderia infection in individuals with CF is comprised of uncontrolled, anecdotal, and/or single center experiences, and no consensus has emerged regarding treatment. We present two cases diagnosed with bronchiectasis (BQ of different etiology, with early pulmonary infection by B. cepacia complex, which was eradicated with inhaled aztreonam lysine.

  7. Intraphagocytic bactericidal activity of ofloxacin compared with that of aztreonam and ceftriaxone against Serratia marcescens.

    Science.gov (United States)

    Traub, W H; Spohr, M; Bauer, D

    1986-02-01

    Addition of phenylbutazone (2 mg/ml) to 55 vol % of fresh defibrinated human blood permitted leukocytic ingestion of serum-resistant Serratia marcescens bacteria, but blocked phagocytic killing activity. The group A (phage tail) bacteriocin bA+ 16 served to kill extraphagocytic test bacteria. At greater than or equal to 2 X MBC, the DNA gyrase inhibitor ofloxacin revealed potent intraphagocytic bactericidal activity against S. marcescens test bacteria (99% kill; 3 h observation period) which corresponded to that of the control drug rifampin (97% kill). The monobactam aztreonam (11% kill) and the third generation cephalosporin ceftriaxone (14% kill) corresponded to cefotaxime (26% kill) in terms of suboptimal intraphagocytic activity. Ofloxacin and aztreonam yielded additive effects following combination of supra-(2 X MIC) and inhibitory (MIC), but not sub-inhibitory (0.5 X MIC) concentrations with 55 vol % of defibrinated human blood against S. marcescens and Escherichia coli control strain ATCC 25922; sub- and inhibitory concentrations of ceftriaxone yielded indifferent effects.

  8. Evidence for the efficacy of aztreonam for inhalation solution in the management of Pseudomonas aeruginosa in patients with cystic fibrosis

    DEFF Research Database (Denmark)

    Hansen, Christine; Skov, Marianne

    2015-01-01

    and the clinical outcome of this infection; this article focuses on the use of inhaled antibiotics in chronic P. aeruginosa infection in CF, and specifically on studies including the use of inhaled aztreonam lysine in P. aeruginosa infection. Studies were identified using PubMed and ClinicalTrials.gov, searching...

  9. High level of resistance to aztreonam and ticarcillin in Pseudomonas aeruginosa isolated from soil of different crops in Brazil.

    Science.gov (United States)

    Pitondo-Silva, André; Martins, Vinicius Vicente; Fernandes, Ana Flavia Tonelli; Stehling, Eliana Guedes

    2014-03-01

    Pseudomonas aeruginosa can be found in water, soil, plants and, human and animal fecal samples. It is an important nosocomial pathogenic agent characterized by an intrinsic resistance to multiple antimicrobial agents and the ability to develop high-level (acquired) multidrug resistance through some mechanisms, among them, by the acquisition of plasmids and integrons, which are mobile genetic elements. In this study, 40 isolates from Brazilian soil were analyzed for antibiotic resistance, presence of integrons and plasmidial profile. The results demonstrated that the vast majority of the isolates have shown resistance for aztreonam (92.5%, n=37) and ticarcillin (85%, n=34), four isolates presented plasmids and eight isolates possess the class 1 integron. These results demonstrated that environmental isolates of P. aeruginosa possess surprising antibiotic resistance profile to aztreonam and ticarcillin, two antimicrobial agents for clinical treatment of cystic fibrosis patients and other infections occurred by P. aeruginosa.

  10. Comparative antimicrobial efficacy of Metapex, Metronidazole, BioPure MTAD, Aztreonam on Bacteroides fragilis and Propionibacterium acne

    Directory of Open Access Journals (Sweden)

    Rajkumar Balakrishnan

    2013-01-01

    Full Text Available Aim: The purpose of this study was to evaluate the comparative antibacterial efficacy of Biopure MTAD, Metapex, Metronidazole, and Aztreonam against two obligate anerobic bacteria. Materials and Methods: Antimicrobial efficacy of selected medicaments against two obligate anaerobic bacteria Bacteroides fragilis and Propionibacterium acnes was done by Agar disc-diffusion method. Pre-sterilized Whatman paper discs, 6 mm in diameter and soaked with the test solution, were prepared and placed onto the previously seeded agar Petri plates. Each plate was incubated in anaerobic jar for anerobic environment at 37°C for 48 hours. A zone of inhibition was recorded for each plate and the results were analysed statistically. Saline and ethanol used as control group in this study. Results: Biopure MTAD, Metapex and Metronidazole were effective against all the selected microorganisms. Aztreonam was effective against Bacteroides fragilis. Saline and ethanol used as control were ineffective. Conclusions: Metronidazole showed the superior antibacterial property amongst the tested medicaments.

  11. Incidence of extended-spectrum-β-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates that test susceptible to cephalosporins and aztreonam by the revised CLSI breakpoints.

    Science.gov (United States)

    McWilliams, Carla S; Condon, Susan; Schwartz, Rebecca M; Ginocchio, Christine C

    2014-07-01

    The incidence of aztreonam and cephalosporin susceptibility, determined using the revised CLSI breakpoints, for extended-spectrum-β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae isolates was evaluated. Our analysis showed that results for aztreonam and/or ≥1 cephalosporin were reported as susceptible or intermediate for 89.2% of ESBL-producing E coli isolates (569/638 isolates) and 67.7% of ESBL-producing K. pneumoniae isolates (155/229 isolates).

  12. In vitro susceptibility of characterized β-lactamase-producing Gram-negative bacteria isolated in Japan to ceftazidime-, ceftaroline-, and aztreonam-avibactam combinations.

    Science.gov (United States)

    Yoshizumi, Ayumi; Ishii, Yoshikazu; Aoki, Kotaro; Testa, Raymond; Nichols, Wright W; Tateda, Kazuhiro

    2015-02-01

    Avibactam displays potent inhibition of extended-spectrum, AmpC, KPC and some OXA β-lactamases. We examined the combinations of avibactam with ceftazidime, ceftaroline and aztreonam by the broth microdilution method against Gram-negative bacteria harboring molecularly-characterized β-lactamase genes collected in Toho University, Japan. Bacterial isolates included: Ambler class A β-lactamase-producing Enterobacteriaceae (n = 26); class C β-lactamase-producing Enterobacteriaceae (n = 9) and class D β-lactamase-producing Acinetobacter baumannii (n = 9) and Enterobacteriaceae (n = 3). Ceftazidime-avibactam, ceftaroline-avibactam ands aztreonam-avibactam were active against the strains with an extended-spectrum β-lactamase (ESBL) or AmpC enzymes, but combination with avibactam did not reduce β-lactam MICs against A. baumannii with OXA β-lactamases including carbapenemases, such as OXA-40 and -69.

  13. Activities of ceftazidime, ceftaroline and aztreonam alone and combined with avibactam against isogenic Escherichia coli strains expressing selected single β-lactamases

    Science.gov (United States)

    Papp-Wallace, Krisztina M.; Bajaksouzian, Saralee; Abdelhamed, Ayman M.; Foster, Altreisha N.; Winkler, Marisa L.; Gatta, Julian A.; Nichols, Wright W.; Testa, Raymond; Bonomo, Robert A.; Jacobs, Michael R.

    2015-01-01

    Avibactam is a novel β-lactamase inhibitor that restores the activity of otherwise hydrolyzed β-lactams against Gram-negative bacteria expressing different classes of serine β-lactamases. In the last decade, β-lactam-avibactam combinations were tested against a variety of clinical isolates expressing multiple commonly encountered β-lactamases. Here, we analyzed isogenic Escherichia coli strains expressing selected single β-lactamase genes that were not previously tested or were not characterized in an isogenic background. The activities of ceftazidime, ceftaroline and aztreonam alone and in combination with 4 mg/L of avibactam, as well as comparator agents, were assessed against an unique collection of isogenic strains of E. coli carrying selected extended-spectrum, inhibitor-resistant, and/or carbapenem-hydrolyzing bla genes. When combined with avibactam, ceftazidime, ceftaroline or aztreonam MICs were reduced for 91.4%, 80.0% and 80.0% of isolates, respectively. The data presented adds to our understanding of the microbiologic spectrum of these β-lactams with avibactam and serve as a reference for further studies. PMID:25737290

  14. A Phase III, randomized, controlled, non-inferiority trial of ceftaroline fosamil 600 mg every 8 h versus vancomycin plus aztreonam in patients with complicated skin and soft tissue infection with systemic inflammatory response or underlying comorbidities

    Science.gov (United States)

    Dryden, Matthew; Zhang, Yingyuan; Wilson, David; Iaconis, Joseph P.; Gonzalez, Jesus

    2016-01-01

    Objectives Increasing the ceftaroline fosamil dose beyond 600 mg every 12 h may provide additional benefit for patients with complicated skin and soft tissue infections (cSSTIs) with severe inflammation and/or reduced pathogen susceptibility. A Phase III multicentre, randomized trial evaluated the safety and efficacy of ceftaroline fosamil 600 mg every 8 h in this setting. Methods Adult patients with cSSTI and systemic inflammation or comorbidities were randomized 2:1 to intravenous ceftaroline fosamil (600 mg every 8 h) or vancomycin (15 mg/kg every 12 h) plus aztreonam (1 g every 8 h) for 5–14 days. Clinical cure was assessed at the test of cure (TOC) visit (8–15 days after the final dose) in the modified ITT (MITT) and clinically evaluable (CE) populations. Non-inferiority was defined as a lower limit of the 95% CI around the treatment difference greater than –10%. An MRSA-focused expansion period was initiated after completion of the main study. Clinicaltrials.gov registration numbers NCT01499277 and NCT02202135. Results Clinical cure rates at TOC demonstrated non-inferiority of ceftaroline fosamil 600 mg every 8 h versus vancomycin plus aztreonam in the MITT and CE populations: 396/506 (78.3%) versus 202/255 (79.2%) patients (difference −1.0%, 95% CI −6.9, 5.4) and 342/395 (86.6%) versus 180/211 (85.3%) patients (difference 1.3%, 95% CI −4.3, 7.5), respectively. In the expansion period, 3/4 (75%) patients treated with ceftaroline fosamil were cured at TOC. The frequency of adverse events was similar between groups. Conclusions Ceftaroline fosamil 600 mg every 8 h was effective for cSSTI patients with evidence of systemic inflammation and/or comorbidities. No new safety signals were identified. PMID:27585969

  15. COMPARISON OF IMIPENEM VERSUS CEFUROXIM PLUS TOBRAMYCIN AS EMPIRICAL THERAPY FOR FEBRILE GRANULOCYTOPENIC PATIENTS AND EFFICACY OF VANCOMYCIN AND AZTREONAM IN CASE OF FAILURE

    NARCIS (Netherlands)

    ERJAVEC, Z; DEVRIESHOSPERS, HG; VANKAMP, H; VANDERWAAIJ, D; HALIE, MR; DAENEN, SMGJ

    1994-01-01

    143 aplastic episodes with fever in 91 haematological patients with granulocytopenia were treated empirically in a randomized prospective study using either imipenem (Imi) or a combination of tobramycin and cefuroxim (T/C). Response after 72 h was significantly better in patients receiving Imi (44/7

  16. Interspecies scaling of excretory amounts using allometry - retrospective analysis with rifapentine, aztreonam, carumonam, pefloxacin, miloxacin, trovafloxacin, doripenem, imipenem, cefozopran, ceftazidime, linezolid for urinary excretion and rifapentine, cabotegravir, and dolutegravir for fecal excretion.

    Science.gov (United States)

    Srinivas, Nuggehally R

    2016-09-01

    1. Interspecies allometry scaling for prediction of human excretory amounts in urine or feces was performed for numerous antibacterials. Antibacterials used for urinary scaling were: rifapentine, pefloxacin, trovafloxacin (Gr1/low; 50%). Rifapentine, cabotegravir, and dolutegravir was used for fecal scaling (high; >50%). 2. The employment of allometry equation: Y = aW(b) enabled scaling of urine/fecal amounts from animal species. Corresponding predicted amounts were converted into % recovery by considering the respective human dose. Comparison of predicted/observed values enabled fold difference and error calculations (mean absolute error [MAE] and root mean square error [RMSE]). Comparisons were made for urinary/fecal data; and qualitative assessment was made amongst Gr1/Gr2/Gr3 for urine. 3. Average correlation coefficient for the allometry scaling was >0.995. Excretory amount predictions were largely within 0.75- to 1.5-fold differences. Average MAE and RMSE were within ±22% and 23%, respectively. Although robust predictions were achieved for higher urinary/fecal excretion (>50%), interspecies scaling was applicable for low/medium excretory drugs. 4. Based on the data, interspecies scaling of urine or fecal excretory amounts may be potentially used as a tool to understand the significance of either urinary or fecal routes of elimination in humans in early development.

  17. An analysis of ear discharge and antimicrobial sensitivity used in its treatment

    Directory of Open Access Journals (Sweden)

    Mukund M. Vaghela

    2016-07-01

    Conclusions: Overall bacterial isolates were higher than fungal and pseudomonas appeared to be most common. It was found sensitive to ceftazidime, amikacin, imipenem, colistin and aztreonam. [Int J Res Med Sci 2016; 4(7.000: 2656-2660

  18. Beta-lactam antibiotic-mediated changes in platelet reactivity and vascular endothelial functions.

    Science.gov (United States)

    Togna, G I; Togna, A R; Caprino, L

    2001-05-01

    To evaluate vascular and platelet compatibility of intravenous administration of beta-lactam antibiotics, we assessed the effects of therapeutic concentrations of ceftriaxone, aztreonam, and ceftazidime on platelet reactivity to different agonists (sodium arachidonate, collagen and adenosine diphosphate) and on selected vascular endothelial functions (adenosine diphosphatase activity, prostacyclin production and t-PA release). Ceftriaxone and, to a lesser degree, aztreonam, enhanced platelet reactivity, evaluated as onset of platelet aggregating response, and increased thromboxane production to subthreshold concentrations of arachidonate. There was no modification in platelet reactivity after ceftazidime treatment. Ceftriaxone and ceftazidime, but not aztreonam, inhibited endothelial adenosine diphosphatase activity. Prostacyclin production and t-PA release were inhibited only by ceftriaxone at high concentrations. While it is difficult to establish which marker (platelet or endothelial functions) has more clinical reference in human vascular compatibility, it seems feasible to consider aztreonam the most compatible of the beta-lactams studied.

  19. Study of methicillin resistant Staphylococcus aureus (MRSA) in Danish pigs at slaughter and in imported retail meat reveals a novel MRSA type in slaughter pigs

    DEFF Research Database (Denmark)

    Agersø, Yvonne; Hasman, Henrik; Cavaco, Lina M.

    2012-01-01

    soya broth with 4mg/L cefoxitine and 75mg/L aztreonam) and selective plating on Brilliance Chromogenic MRSA agar. The presence of mecA was confirmed by PCR and the MRSA isolates were spa typed. Novel MRSA spa types were characterized by MLST, PFGE and SCCmec typing. Thirteen percent (101...

  20. Biochemical Characterization of SFC-1, a class A carbapenem-hydrolyzing beta-lactamase.

    Science.gov (United States)

    Fonseca, Fátima; Sarmento, Ana Cristina; Henriques, Isabel; Samyn, Bart; van Beeumen, Jozef; Domingues, Pedro; Domingues, Maria Rosário; Saavedra, Maria José; Correia, António

    2007-12-01

    The carbapenem-hydrolyzing beta-lactamase SFC-1 from Serratia fonticola UTAD54 was overexpressed in Escherichia coli, purified, and characterized. The enzyme exhibited an apparent molecular mass of 30.5 kDa, determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. SFC-1 hydrolyzes penicillins, cephalosporins, aztreonam, and carbapenems and is inhibited by clavulanic acid, sulbactam, and tazobactam.

  1. Biochemical Characterization of SFC-1, a Class A Carbapenem-Hydrolyzing β-Lactamase▿

    Science.gov (United States)

    Fonseca, Fátima; Sarmento, Ana Cristina; Henriques, Isabel; Samyn, Bart; van Beeumen, Jozef; Domingues, Pedro; Domingues, Maria Rosário; Saavedra, Maria José; Correia, António

    2007-01-01

    The carbapenem-hydrolyzing β-lactamase SFC-1 from Serratia fonticola UTAD54 was overexpressed in Escherichia coli, purified, and characterized. The enzyme exhibited an apparent molecular mass of 30.5 kDa, determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. SFC-1 hydrolyzes penicillins, cephalosporins, aztreonam, and carbapenems and is inhibited by clavulanic acid, sulbactam, and tazobactam. PMID:17875998

  2. Drug: D00240 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D00240 Drug Aztreonam (JP16/USP/INN); AZT; Azactam (TN) C13H17N5O8S2 435.0519 435.4328 D00240.gif Antimicrob...ial Same as: C06840 Therapeutic category: 6122 ATC code: J01DF01 penicillin binding

  3. Drug: D06558 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available icrobial ATC code: J01DF01 penicillin binding proteins inhibitor ko00550 Peptidogly...D06558 Drug Aztreonam lysine (USAN); Cayston (TN) C13H17N5O8S2. C6H14N2O2 581.1574 581.6203 D06558.gif Antim

  4. Antibiotic therapy for stable non-CF bronchiectasis in adults

    DEFF Research Database (Denmark)

    Fjaellegaard, Katrine; Sin, Melda Dönmez; Browatzki, Andrea

    2016-01-01

    shown to improve QoL and exacerbation rate, whereas findings regarding sputum production, lung function and admissions have been conflicting. Evidence-based treatment algorithms for antibiotic treatment of stable non-CF BE will have to await large-scale, long-term controlled studies.......To provide an update on efficacy and safety of antibiotic treatments for stable non-cystic fibrosis (CF) bronchiectasis (BE). Systematic review based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines was done. Twenty-six studies (1.898 patients) fulfilled......, exacerbations and QoL, whereas studies on aztreonam revealed no significant clinical improvements in the outcomes of interest, including exacerbation rate. Adverse events, including bronchospasm, have been reported in association with tobramycin and aztreonam. Several antibiotic treatment regimens have been...

  5. Metallo-beta-lactamase producing Pseudomonas aeruginosa strains isolated in hospitals in Recife, PE, Brazil Produção de metalo-beta-lactase de linhagens de Pseudomonas aeruginosa isoladas em hospitais do Recife, PE, Brasil

    Directory of Open Access Journals (Sweden)

    Vera Magalhães

    2005-06-01

    Full Text Available Out of 24 nosocomial strains of Pseudomonas aeruginosa from Recife, Brazil, 15 (62% were metallo-beta-lactamase producers. Such isolates were resistant to main antipseudomonas drugs, except polymixyn B and aztreonam. The enzyme responsible for the carbapenem-resistance belongs to SPM-1 class, and the gene involved, blaspm-1, is likely plasmid located.De 24 linhagens hospitalares de Pseudomonas aeruginosa provenientes de Recife, Brasil, 15 (62% produziram metalo-beta-lactamase. Tais isolados foram resistentes às principais drogas antipseudomonas, exceto polimixina B e aztreonam. A enzima responsável pela resistência aos carbapanêmicos pertence à classe SPM-1 e o gene envolvido, blaspm-1, provavelmente é plasmidial.

  6. Monitoring and Analysis on Multi Drug Resistance of Escherichia coli from Captive Population Amur Tiger

    Institute of Scientific and Technical Information of China (English)

    Xue; Yuan; Li; Fengyong; Sun; Jing; Cai; Longhui; Wu; Qingming; Zhou; Ming; Huang; Xianguang; Hua; Yuping

    2014-01-01

    In order to investigate the multi drug resistance to Escherichia coli from captive population Amur tiger,E. coli strains were isolated from the fecal samples of tiger in Heilongjiang Amur Tiger Park in Harbin. The sensitivity of E. coli isolates to 14 antibiotics was determined by scrip diffusion method. The results indicated that all the isolates varied in drug resistance to different antibiotics; the isolates gave high resistance to ampicillin,with a drug fast rate of 100%; over80% of the isolates were resistant to tetracycline and Paediatric Compound Sulfamethoxazole Tablets(SMZ- TMP),and over 70% of the isolates were sensitive to aztreonam,amoxicillin /potassium clavulanate. Most of the isolates had high sensitive to aztreonam and amoxicillin / clavulanate acid.

  7. Evaluation of Four Commercially Available Extended-Spectrum Beta-Lactamase Phenotypic Confirmation Tests

    OpenAIRE

    2005-01-01

    Extended-spectrum beta-lactamase (ESBL) production in members of the Enterobacteriaceae can confer resistance to extended-spectrum cephalosporins, aztreonam, and penicillin. As such, the accurate detection of ESBL producers is essential for the appropriate selection of antibiotic therapy. Twenty previously characterized isolates and 49 clinical isolates suspected of ESBL production were tested by four ESBL phenotypic confirmatory methods for accuracy and ease of use. The four ESBL phenotypic ...

  8. Occurrence of extended-spectrum beta-lactamases in Enterobacteriaceae isolated from hospitalized patients in Curitiba, southern Brazil

    OpenAIRE

    Keite da Silva Nogueira; Ilma Hiroko Higuti; Agnaldo José do Nascimento; Larissa Bail Terasawa; Simone Oliveira; Adriana Pereira Matos; Helena Aguilar Peres Homem de Mello de Souza; Laura Lúcia Cogo; Libera Maria Dalla Costa

    2006-01-01

    Production of extended-spectrum beta-lactamases (ESBL) by enterobacteria is an important resistance mechanism against antimicrobial beta-lactamics. We tested 498 bacterial strains isolated from two tertiary-care teaching hospitals for ESBL production, using screening breakpoints for aztreonam and third generation cephalosporins, according to CLSI recommendations. Among these isolates, 155 were positive for the ESBL screening test, and 121 (78%) were confirmed by the clavulanic acid combinatio...

  9. Mecanismes de resistència als [beta]-lactàmics en enterobacteris, 1994-1996

    OpenAIRE

    Sabaté i Pina, Montse

    2002-01-01

    Consultable des del TDX Títol obtingut de la portada digitalitzada All clinically relevant Enterobacteriaceae strains isolated between 1994 and 1996 without inducible chromosomal b-lactamase, that showed decreased susceptibility to broad-spectrum cephalosporins and/or aztreonam, were selected. The mechanism implicated in the decreased susceptibility was determined by analytical isoelectric focusing, PCR and/or sequenciation. The results obtained showed that the most frequent mechanism i...

  10. Detection of AmpC Beta-lactamases among Escherichia coli isolates at a tertiary care hospital in Karnataka

    OpenAIRE

    Smitha O. Bagali; Peerapur, B V

    2013-01-01

    Background & objective: AmpC β-lactamases are clinically significant because they may confer resistance to a wide variety of β-lactam drugs, including α-methoxy-β-lactams, such as cefoxitin, narrow-, expanded- and broad-spectrum cephalosporins, β-lactam-β-lactamase inhibitor combinations and aztreonam. Although reported with increasing frequency the true occurrence in different organisms remains unknown. The present study was conducted to determine the occurrence of AmpC β-lactamases among th...

  11. Characterization of a new TEM-derived beta-lactamase produced in a Serratia marcescens strain.

    OpenAIRE

    Perilli, M.; Felici, A.; Franceschini, N; De Santis, A; Pagani, L.(Physics Department, Università degli Studi and INFN, 16146 Genova, Italy); Luzzaro, F.; Oratore, A; Rossolini, G. M.; Knox, J R; Amicosante, G

    1997-01-01

    A natural TEM variant beta-lactamase was isolated from an epidemic strain of Serratia marcescens. Nucleotide gene sequencing revealed multiple point mutations located in the 42-to-44 tripeptide and positions 145 to 146, 178, and 238. In addition, a glutamic acid 212 deletion was also found. The purified enzyme was studied from a kinetic point of view, revealing the highest catalytic efficiency (k[cat]/Km) values for ceftazidime and aztreonam compared with the TEM-1 prototype enzyme. The in vi...

  12. OXA-18, a class D clavulanic acid-inhibited extended-spectrum beta-lactamase from Pseudomonas aeruginosa.

    Science.gov (United States)

    Philippon, L N; Naas, T; Bouthors, A T; Barakett, V; Nordmann, P

    1997-01-01

    Clinical isolate Pseudomonas aeruginosa Mus showed resistance both to extended-spectrum cephalosporins and to aztreonam. We detected a typical double-disk synergy image when ceftazidime or aztreonam was placed next to a clavulanic acid disk on an agar plate. This resistance phenotype suggested the presence of an extended-spectrum beta-lactamase. Isoelectric focusing revealed that this strain produced three beta-lactamases, of pI 5.5, 7.4, and 8.2. A 2.6-kb Sau3A fragment encoding the extended-spectrum beta-lactamase of pI 5.5 was cloned from P. aeruginosa Mus genomic DNA. This enzyme, named OXA-18, had a relative molecular mass of 30.6 kDa. OXA-18 has a broad substrate profile, hydrolyzing amoxicillin, ticarcillin, cephalothin, ceftazidime, cefotaxime, and aztreonam, but not imipenem or cephamycins. Its activity was totally inhibited by clavulanic acid at 2 microg/ml. Hydrolysis constants of OXA-18 (Vmax, Km) confirmed the MIC results. Cloxacillin and oxacillin hydrolysis was noticeable with the partially purified OXA-18. The blaOXA-18 gene encodes a 275-amino-acid protein which has weak identity with all class D beta-lactamases except OXA-9 and OXA-12 (45 and 42% amino acid identity, respectively). OXA-18 is likely to be chromosomally encoded since no plasmid was found in the strain and because attempts to transfer the resistance marker failed. OXA-18 is peculiar since it is a class D beta-lactamase which confers high resistance to extended-spectrum cephalosporins and seems to have unique hydrolytic properties among non-class A enzymes. PMID:9333046

  13. Susceptibility of Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae According to the New CLSI Breakpoints ▿

    Science.gov (United States)

    Wang, Peng; Hu, Fupin; Xiong, Zizhong; Ye, Xinyu; Zhu, Demei; Wang, Yun F.; Wang, Minggui

    2011-01-01

    In 2010 the Clinical and Laboratory Standards Institute (CLSI) lowered the susceptibility breakpoints of some cephalosporins and aztreonam for Enterobacteriaceae and eliminated the need to perform screening for extended-spectrum β-lactamases (ESBLs) and confirmatory tests. The aim of this study was to determine how many ESBL-producing strains of three common species of Enterobacteriaceae test susceptible using the new breakpoints. As determined with the CLSI screening and confirmatory tests, 382 consecutive ESBL-producing strains were collected at Huashan Hospital between 2007 and 2008, including 158 strains of Escherichia coli, 164 of Klebsiella pneumoniae, and 60 of Proteus mirabilis. Susceptibility was determined by the CLSI agar dilution method. CTX-M-, TEM-, and SHV-specific genes were determined by PCR amplification and sequencing. blaCTX-M genes alone or in combination with blaSHV were present in 92.7% (354/382) of these ESBL-producing strains. Forty-two (25.6%) strains of K. pneumoniae harbored SHV-type ESBLs alone or in combination. No TEM ESBLs were found. Utilizing the new breakpoints, all 382 strains were resistant to cefazolin, cefotaxime, and ceftriaxone, while 85.0 to 96.7% of P. mirabilis strains tested susceptible to ceftazidime, cefepime, and aztreonam, 41.8 to 45.6% of E. coli strains appeared to be susceptible to ceftazidime and cefepime, and 20.1% of K. pneumoniae were susceptible to cefepime. In conclusion, all ESBL-producing strains of Enterobacteriaceae would be reported to be resistant to cefazolin, cefotaxime, and ceftriaxone by using the new CLSI breakpoints, but a substantial number of ESBL-containing P. mirabilis and E. coli strains would be reported to be susceptible to ceftazidime, cefepime, and aztreonam, which is likely due to the high prevalence of CTX-M type ESBLs. PMID:21752977

  14. Killing curve activity of ciprofloxacin is comparable to synergistic effect of beta-lactam-tobramycin combinations against Haemophilus species endocarditis strains

    DEFF Research Database (Denmark)

    Westh, H; Frimodt-Møller, N; Gutschik, E

    1992-01-01

    Nine Haemophilus species strains, all beta-lactamase negative, isolated from patients with endocarditis were tested in killing curve experiments. Antibiotics used were penicillin, amoxicillin, aztreonam alone and in combination with tobramycin, as well as ciprofloxacin alone. Synergism between beta......-lactams and tobramycin with reduction of colony counts to zero was seen after 24 h for H. influenzae, H. parainfluenzae and H. segnis strains. Ciprofloxacin was as effective as beta-lactam-tobramycin combinations. The H. aphrophilus strain was not killed as effectively as other strains by any of the antibiotics....

  15. Detección de aislados clínicos de Escherichia coli y Klebsiella spp. productoras de B-lactamasas de espectro extendido mediante el sistema DIRAMIC

    OpenAIRE

    Estrella Álvarez-Varela; Angela Zayas-Tamayo; Idania Castillo-Castillo; Leonora González-Mesa; Rolando Contreras-Alarcón

    2010-01-01

    En los últimos años, se ha incrementado el interés por las enterobacterias productoras de B-lactamasas de espectro extendido (BLEE). Las cepas que expresan este fenotipo son capaces de hidrolizar un amplio grupo de antibióticos, incluidas las cefalosporinas de tercera generación y aztreonam, por lo que constituyen un reto terapéutico de difícil abordaje. Este mecanismo les confiere a las bacterias un grado de resistencia variable a los oximino-betalactámicos, se manifiesta en un aumento de la...

  16. Drug-resistance mechanisms and prevalence of Enterobacter cloacae resistant to multi-antibiotics

    Institute of Scientific and Technical Information of China (English)

    张杰; 顾怡明; 俞云松; 周志慧; 杜小玲

    2004-01-01

    @@The main drug-resistance mechanism of gram-negative bacteria is producing β-lactamases. Two kinds of enzymes cause drug resistance by hydrolyzing oxyimino-cephalosporins and aztreonam: one is chromosomally encoded AmpC β-lactamases, the other is plasmid-mediated extended-spectrum β-lactamases (ESBLs). Enterobacter cloacae can produce both of them, so that these strains are seriously resistance to many antibiotics. In order to study the main drug-resistant mechanism in Enterobacter cloacae, PCR and nucleotide sequencing were performed on 58 multidrug resistant strains.

  17. TEM-72, a new extended-spectrum beta-lactamase detected in Proteus mirabilis and Morganella morganii in Italy.

    Science.gov (United States)

    Perilli, M; Segatore, B; de Massis, M R; Riccio, M L; Bianchi, C; Zollo, A; Rossolini, G M; Amicosante, G

    2000-09-01

    A new natural TEM-2 derivative, named TEM-72, was identified in a Proteus mirabilis strain and in a Morganella morganii strain isolated in Italy in 1999. Compared to TEM-1, TEM-72 contains the following amino acid substitutions: Q39K, M182T, G238S, and E240K. Kinetic analysis showed that TEM-72 exhibits an extended-spectrum activity, including activity against oxyimino-cephalosporins and aztreonam. Expression of bla(TEM-72) in Escherichia coli was capable of decreasing the host susceptibility to the above drugs.

  18. TEM-72, a New Extended-Spectrum β-Lactamase Detected in Proteus mirabilis and Morganella morganii in Italy

    Science.gov (United States)

    Perilli, Mariagrazia; Segatore, Bernardetta; Rosaria De Massis, Maria; Riccio, Maria Letizia; Bianchi, Ciro; Zollo, Alessandro; Rossolini, Gian Maria; Amicosante, Gianfranco

    2000-01-01

    A new natural TEM-2 derivative, named TEM-72, was identified in a Proteus mirabilis strain and in a Morganella morganii strain isolated in Italy in 1999. Compared to TEM-1, TEM-72 contains the following amino acid substitutions: Q39K, M182T, G238S, and E240K. Kinetic analysis showed that TEM-72 exhibits an extended-spectrum activity, including activity against oxyimino-cephalosporins and aztreonam. Expression of blaTEM-72 in Escherichia coli was capable of decreasing the host susceptibility to the above drugs. PMID:10952610

  19. Interaction of oxyimino beta-lactams with a class C beta-lactamase and a mutant with a spectrum extended to beta-lactams.

    OpenAIRE

    Nukaga, M; Tsukamoto, K; Yamaguchi, H; Sawai, T.

    1994-01-01

    The class C beta-lactamase of Citrobacter freundii GN346 is a typical cephalosporinase comprising 361 amino acids, and substitution of the glutamic acid at position 219 in the enzyme by lysine was previously shown to broaden its substrate spectrum to oxyimino beta-lactams (K. Tsukamoto, R. Ohno, and T. Sawai, J. Bacteriol. 172:4348-4351, 1990). To clarify this spectrum extension from the kinetic point of view, the interactions of cefuroxime, ceftazidime, and aztreonam with the wild-type and m...

  20. A 5 year (2005-2009 review of antimicrobial susceptibility of clinical Klebsiella pneumoniae isolates from pediatric patients in Jordan

    Directory of Open Access Journals (Sweden)

    Mohammad Al-Shara

    2013-10-01

    Full Text Available Aim of the Study: The present study was conducted to investigate antimicrobial susceptibility pattern of Klebsiella pneumoniae strains isolated from clinical specimens of Jordanian pediatric patients during a five year period from 2005-2009. A total of 1023 Klebsiella pneumoniae strains were isolated from clinical specimens and tested for their susceptibility to different antimicrobial drugs. Main findings: Overall, high susceptibility rate was recorded for ciprofloxacin (90.5%, followed by norfloxacin (84.8%, imipenem (69.9%, nalidixic acid (66.6%, and cefixime (63.9%. Low susceptibility rate was recorded for ampicillin (16.6%, followed by amoxicillin-clavulanic acid (22.5%, tobramycin (28.6%, amikacin (31.4%, cotrimoxazole (37.3%, and aztreonam (39.3%, Conclusion: most of β-lactam antibiotics as well as tobramycin, amikacin, cotrimoxazole, and aztreonam, should not be used in treating infections caused by pathogenic K. pneumoniae and other related bacteria in Jordan. However, quinolone compounds and imipenem seem to be effective in treatment of infections caused by pathogenic K. pneumoniae in children.

  1. Effectiveness of antibiotic combination therapy as evaluated by the Break-point Checkerboard Plate method for multidrug-resistant Pseudomonas aeruginosa in clinical use.

    Science.gov (United States)

    Nakamura, Itaru; Yamaguchi, Tetsuo; Tsukimori, Ayaka; Sato, Akihiro; Fukushima, Shinji; Mizuno, Yasutaka; Matsumoto, Tetsuya

    2014-04-01

    Multidrug-resistant Pseudomonas aeruginosa (MDRP) strains are defined as having resistance to the following 3 groups of antibiotics: carbapenems, aminoglycosides, and fluoroquinolones. Antibiotic combinations have demonstrated increased activity in vitro compared with a single agent. As an in vitro method of determining the combination activity of antibiotics, the Break-point Checkerboard Plate (BC-plate) can be used routinely in clinical microbiology laboratories. We evaluated the effectiveness of the BC-plate for MDRP infections in clinical settings. We retrospectively selected cases of MDRP infection treated with combination therapy of antibiotics in Tokyo Medical University Hospital (1015 beds), Tokyo, Japan, from November 2010 to October 2012. A total of 28 MDRP strains were clinically isolated from 28 patients during the study period. This study design is a case series of MDRP infection. Six infections among the 28 patients were treated based on the results of the BC-plate assay, and the 6 strains tested positive for MBL. One patient had pneumonia, 3 had urinary tract infections, 1 had vertebral osteomyelitis, and 1 had nasal abscess. The combination of aztreonam with amikacin demonstrated the most frequently recognized in vitro effect (5 patients). Next, aztreonam with ciprofloxacin and piperacillin with amikacin revealed equivalent in vitro effects (3 patients, respectively). The clinical cure rate was 83.3% (5/6 patients). Antibiotic combination therapy based on the results of the BC-plate assay might indicate the effective therapy against MDRP infection in clinical settings.

  2. Bacteremia among Jordanian children at Princess Rahmah Hospital: Pathogens and antimicrobial susceptibility patterns

    Directory of Open Access Journals (Sweden)

    A Mohammad

    2010-06-01

    Full Text Available Objective: To investigate microorganisms causing bacteremia in Jordanian children and to assess their sensitivity to various groups of antimicrobials."nMethods: A retrospective study was conducted on positive blood cultures taken from 378 children aged below 15 year, who sought medical attention at Princess Rahmah Hospital between January and December/2008."nResults: Out of 4475 tested blood samples, 378 isolates were recovered from blood cultures. The male to female isolate ratio was (1.26:1.0. The most frequent pathogen found was Staphylococcus aureus (86.2%, followed by Klebsiella spp. (9%, Escherichia coli (1.9%, Streptococcus spp. (1.9%, Pseudomonas spp. (0.8%, and Acinetobacter sp. was found in only one culture (0.3%. The susceptibility rate of S. aureus was recorded the highest (99.6% for vancomycin, and the lowest susceptibility rate (3.2% was recorded for aztreonam."nConclusions: Staphylococcus aureus was the main isolate in bacteremic children, with all isolates demonstrating susceptibility to vancomycin. Overall, aztreonam resistance was near 97%, and this rate was not affected by sex and blood isolate type. This information should be considered when empirical therapy is recommended or prescribed for children with bacteremia.

  3. Utilizing Monte Carlo Simulations to Optimize Institutional Empiric Antipseudomonal Therapy

    Directory of Open Access Journals (Sweden)

    Sarah J. Tennant

    2015-12-01

    Full Text Available Pseudomonas aeruginosa is a common pathogen implicated in nosocomial infections with increasing resistance to a limited arsenal of antibiotics. Monte Carlo simulation provides antimicrobial stewardship teams with an additional tool to guide empiric therapy. We modeled empiric therapies with antipseudomonal β-lactam antibiotic regimens to determine which were most likely to achieve probability of target attainment (PTA of ≥90%. Microbiological data for P. aeruginosa was reviewed for 2012. Antibiotics modeled for intermittent and prolonged infusion were aztreonam, cefepime, meropenem, and piperacillin/tazobactam. Using minimum inhibitory concentrations (MICs from institution-specific isolates, and pharmacokinetic and pharmacodynamic parameters from previously published studies, a 10,000-subject Monte Carlo simulation was performed for each regimen to determine PTA. MICs from 272 isolates were included in this analysis. No intermittent infusion regimens achieved PTA ≥90%. Prolonged infusions of cefepime 2000 mg Q8 h, meropenem 1000 mg Q8 h, and meropenem 2000 mg Q8 h demonstrated PTA of 93%, 92%, and 100%, respectively. Prolonged infusions of piperacillin/tazobactam 4.5 g Q6 h and aztreonam 2 g Q8 h failed to achieved PTA ≥90% but demonstrated PTA of 81% and 73%, respectively. Standard doses of β-lactam antibiotics as intermittent infusion did not achieve 90% PTA against P. aeruginosa isolated at our institution; however, some prolonged infusions were able to achieve these targets.

  4. PME-1, an extended-spectrum β-lactamase identified in Pseudomonas aeruginosa.

    Science.gov (United States)

    Tian, Guo-Bao; Adams-Haduch, Jennifer M; Bogdanovich, Tatiana; Wang, Hong-Ning; Doi, Yohei

    2011-06-01

    A novel extended-spectrum β-lactamase (ESBL) was identified in a Pseudomonas aeruginosa clinical isolate obtained from a patient admitted to a hospital in Pennsylvania in 2008. The patient had a prolonged hospitalization in a hospital in Dubai, United Arab Emirates, before being transferred to the United States. The novel ESBL, designated PME-1 (Pseudomonas aeruginosa ESBL 1), is a molecular class A, Bush-Jacoby-Medeiros group 2be enzyme and shared 50, 43, and 41% amino acid identity with the L2 β-lactamase of Stenotrophomonas maltophilia, CTX-M-9, and KPC-2, respectively. PME-1 conferred clinically relevant resistance to ceftazidime, cefotaxime, cefepime, and aztreonam in P. aeruginosa PAO1 but not to carbapenems. Purified PME-1 showed good hydrolytic activity against ceftazidime, cefotaxime, and aztreonam, while activity against carbapenems and cefepime could not be measured. PME-1 was inhibited well by β-lactamase inhibitors, including clavulanic acid, sulbactam, and tazobactam. The bla(PME-1) gene was carried by an approximately 9-kb plasmid and flanked by tandem ISCR24 elements.

  5. Ultrastructural Changes in Clinical and Microbiota Isolates of Klebsiella pneumoniae Carriers of Genes bla SHV, bla TEM, bla CTX-M, or bla KPC When Subject to β-Lactam Antibiotics.

    Science.gov (United States)

    Veras, Dyana Leal; Lopes, Ana Catarina de Souza; da Silva, Grasielle Vaz; Gonçalves, Gabriel Gazzoni Araújo; de Freitas, Catarina Fernandes; de Lima, Fernanda Cristina Gomes; Maciel, Maria Amélia Vieira; Feitosa, Ana Paula Sampaio; Alves, Luiz Carlos; Brayner, Fábio André

    2015-01-01

    The aim of this study was to characterize the ultrastructural effects caused by β-lactam antibiotics in Klebsiella pneumoniae isolates. Three K. pneumoniae clinical isolates were selected for the study with resistance profiles for third-generation cephalosporins, aztreonam, and/or imipenem and with different resistance genes for extended-spectrum β-lactamases (ESBL) or Klebsiella pneumoniae carbapenemase (KPC). Two K. pneumoniae isolates obtained from the microbiota, which were both resistant to amoxicillin and ampicillin, were also analyzed. In accordance with the susceptibility profile, the clinical isolates were subjected to subminimum inhibitory concentrations (sub-MICs) of cefotaxime, ceftazidime, aztreonam, and imipenem and the isolates from the microbiota to ampicillin and amoxicillin, for analysis by means of scanning and transmission electron microscopy. The K. pneumoniae isolates showed different morphological and ultrastructural changes after subjection to β-lactams tested at different concentrations, such as cell filamentation, loss of cytoplasmic material, and deformation of dividing septa. Our results demonstrate that K. pneumoniae isolates harboring different genes that encode for β-lactamases show cell alterations when subjected to different β-lactam antibiotics, thus suggesting that they possess residual activity in vitro, despite the phenotypic resistance presented in the isolates analyzed.

  6. STUDY OF ANTIBIOTIC SUSCEPTIBILITY TEST OF MODERN GENERATION OF DRUGS AGAINST UPPER RESPIRATORY TRACT PATHOGENS

    Directory of Open Access Journals (Sweden)

    Vinod Singh et al

    2012-10-01

    Full Text Available Nasal infection or sinusitis is an inflammation of nasal passages caused by both viral and bacteriological pathogens. Antimicrobial resistance has universally recognized as growing problem concern about suitable therapy for nasal infection. The study was aimed at determining the prevalence and antimicrobial susceptibility against nasal infecting microorganisms. 50 clinical samples were taken from OPD of GMC Hospital, Bhopal (MP, India. Of the samples analyzed, 47 bacterial strains were isolated out of which 29 strains were of Gram positive bacteria (8 strains were of Staphylococcus aureus, 6 of Staphylococcus epidermidis, 7 of Streptococcus pneumoniae and 8 of Corynebacterium diptheriae and 18 strains were of Gram negative bacteria (8 of Escherichia coli, 6 of Pseudomonas aeruginosa and 4 of Neisseria meningitidis. Antimicrobial susceptibility assay was performed by disc diffusion method according to the reference criteria of clinical and laboratory standard institute guidelines. In the present study antibiotic susceptibility pattern results showed maximum level of resistance in gram positive strains S. aureus 8 (100%, S. epidermidis 6 (100% and C. diptheriae (8 (100% against penicillin, S. aureus 8 (100%, S. epidermidis 6 (100% and S. pneumoniae 7 (100% were resistant to Cefuroxime, S. aureus 7 (87.5%, S. epidermidis 6 (100%, S. pneumoniae 7 (100% and C. diptheriae (8 (100% were resistant to erythromycin and azithromycin whereas, rest of gram positive strains showed satisfactory antibiotic susceptibility against chloramphenical, cefazolin, cephalexin, ciprofloxacin, ofloxacin and tetracyclin. Similarly for gram negative strains multi-drug resistance was observed in 8 (100% isolates of E. coli against aztreonam, cefdinir, cefixime, cefotaxime, ceftriaxone, ceftazidime, cefuroxime, ciprofloxacin, nalidixic acid and ofloxacin, P. aeruginosa 6 (100% were resistant to aztreonam, cefdinir, cefixime, cefotaxime, ceftazidime, ceftriaxone, cefuroxime

  7. Role of ser-237 in the substrate specificity of the carbapenem-hydrolyzing class A beta-lactamase Sme-1.

    Science.gov (United States)

    Sougakoff, W; Naas, T; Nordmann, P; Collatz, E; Jarlier, V

    1999-08-17

    The role of the serine residue found at position 237 in the carbapenemase Sme-1 has been investigated by constructing a mutant in which Ser-237 was replaced by an alanine. The S237A mutant showed a catalytic behavior against penicillins and aztreonam very similar to that of Sme-1. By contrast, S237A was characterized by a reduced catalytic efficiency against cephems, such as cephalothin and cephaloridine. In addition, the weak activity of Sme-1 against the cephamycin cefoxitin was hardly detectable with the mutant enzyme. Finally, the Ser-237-->Ala mutation resulted in a marked decrease in catalytic activity against imipenem, showing that Ser-237 contributes to the carbapenemase activity of the class A beta-lactamase Sme-1.

  8. Carbapenem-resistant Serratia marcescens isolates producing Bush group 2f beta-lactamase (SME-1) in the United States: results from the MYSTIC Programme.

    Science.gov (United States)

    Gales, A C; Biedenbach, D J; Winokur, P; Hacek, D M; Pfaller, M A; Jones, R N

    2001-02-01

    Two carbapenem (imipenem, meropenem)-resistant Serratia marcescens strains were isolated in the United States (Chicago, IL) through the 1999 MYSTIC (Meropenem Yearly Susceptibility Test Information Collection) Programme. The S. marcescens antimicrobial susceptible patterns were: susceptible to ceftriaxone, ceftazidime, and cefepime (MICs, 32 microg/ml) and aztreonam (MIC, > = 16 microg/ml). Each S. marcescens isolate shared an identical epidemiologic type (ribotype and PFGE) and the outer membrane protein profile was also identical to those of the wild type susceptible strains from the same medical center. The PCR utilizing bla(sme-1) primers amplified a gene product that was identified as consistent with SME-1 after DNA sequencing. Imipenem and meropenem resistance due to production of carbapenem-hydrolyzing enzymes among clinical isolates is still very rare, but microbiology laboratories should be aware of these chromosomally encoded enzymes among class C beta-lactamases producing enteric bacilli such as S. marcescens and Enterobacter cloacae.

  9. Crystallization and preliminary diffraction studies of SFC-1, a carbapenemase conferring antibiotic resistance.

    Science.gov (United States)

    Hong, Myoung-Ki; Lee, Jae Jin; Wu, Xing; Kim, Jin-Kwang; Jeong, Byeong Chul; Pham, Tan-Viet; Kim, Seung-Hwan; Lee, Sang Hee; Kang, Lin-Woo

    2012-09-01

    SFC-1, a class A carbapenemase that confers antibiotic resistance, hydrolyzes the β-lactam rings of β-lactam antibiotics (carbapenems, cephalosporins, penicillins and aztreonam). SFC-1 presents an enormous challenge to infection control, particularly in the eradication of Gram-negative pathogens. As SFC-1 exhibits a remarkably broad substrate range, including β-lactams of all classes, the enzyme is a potential target for the development of antimicrobial agents against pathogens producing carbapenemases. In this study, SFC-1 was cloned, overexpressed, purified and crystallized. The SFC-1 crystal diffracted to 1.6 Å resolution and belonged to the orthorhombic space group P2(1)2(1)2(1), with unit-cell parameters a = 65.8, b = 68.3, c = 88.8 Å. Two molecules are present in the asymmetric unit, with a corresponding V(M) of 1.99 Å(3) Da(-1) and a solvent content of 38.1%.

  10. Bacteremia and conventional diagnosis of Sphingobacterium spiritivorum. A case report

    Directory of Open Access Journals (Sweden)

    Elio Jesús Núñez Tamayo

    2003-12-01

    Full Text Available This is a case report of septicaemia due to Sphingobacterium Spiritovirum that caused acute symmetric acronecrosis in a previously healthy man who received medical assistance at the University Hospital ¨Dr. Gustavo Aldereguía Lima¨ from Cienfuegos province in November 2002. The clinical symptoms were: fever, lumbar pain and chills which evolved to shock with general malaise, accompanied with paresthesia, symptoms of distal necrosis in the four members, nose and ear. Sphingobacterium Spiritovirum was diagnosed by the conventional diagnosis of growing in the marrow tests and serial blood cultures. Susceptibility antimicrobial tests were sensible to sulphametoxazole – trimetropin and resistant to tetracycline, aztreonam, ceftriaxone and imipenem. The bibliography consulted did not evidence any previous isolation in Cuba .

  11. In vitro potency and combination testing of antimicrobial agents against Neisseria gonorrhoeae.

    Science.gov (United States)

    Bharat, Amrita; Martin, Irene; Zhanel, George G; Mulvey, Michael R

    2016-03-01

    Antimicrobial resistant Neisseria gonorrhoeae is a major concern to public health due to decreased susceptibility to frontline antimicrobials. To find agents that are active against N. gonorrhoeae, we tested antimicrobials alone or in combination by Etest gradient strips. The potencies (as assessed by minimum inhibitory concentrations) of twenty-five antimicrobials were evaluated against nine reference strains of N. gonorrhoeae (WHO F, G, K, L, M, N, O, P and ATCC 49226). Potency was greatest for netilmicin, quinupristin-dalfopristin, ceftriaxone, ertapenem and piperacillin-tazobactam. Combinations of azithromycin, moxifloxacin, or gentamicin with ceftriaxone, doripenem, or aztreonam were tested against reference isolates and the fractional inhibitory concentration index (FICI) was calculated. All nine combinations resulted in indifference (>0.5 FICI ≤ 4). Combinations with FICI gonorrhoeae. These data on antimicrobials with higher potency and combinations that did not show antagonism can help to guide larger scale susceptibility studies for antimicrobial resistant N. gonorrhoeae.

  12. THE STUDY OF ANTIBIOTIC- AND FAGOSENSITIVITY OF NOSOCOMIAL STRAINS BACTERIA ISOLATED FROM TRANSPLANTED PATIENTS

    Directory of Open Access Journals (Sweden)

    N. I. Gabrielan

    2011-01-01

    Full Text Available Antibiotic and fagosensitivity most etiologically important nosocomial strains of bacteria – Pseudomonas aeru- ginosa, Klebsiella pneumoniae, E. coli, Proteus spp., Staphylococcus spp. were studied. Multiple drug-resistant bacteria as gram-positive and gram-negative, isolated from 8 substrates, had been demonstrated. With regard to the sensitivity of Pseudomonas aeruginosa >40% was observed in 40–50% of the strains to aminoglycosides – aztreonam, amikacin, netilmicin, and only 23–25% of the strains – to gentamicin and levofloxacin (an average of antibiotic susceptibility was 27%. All strains of ESBL Klebsiella drew up and were sensitive only to imipenem, meropenem and aminoglycosides. Specific phages lysed 43–48% of the strains Pseudomonas aeruginosa and Klebsiella pneumoniae, E. coli, Pro- teus spp., multidrug resistant strains of Staphylococcus spp. It is proposed to introduce the use of phages in clinical practice. 

  13. Antibiotic Resistance Pattern of Extended-Spectrum Beta-Lactamases-Producing Klebsiella pneumoniae Clinical Isolates from Zahedan, Southeast Iran

    Directory of Open Access Journals (Sweden)

    Shahram Shahraki-Zahedani

    2016-10-01

    Full Text Available Background Resistance to various classes of antibiotics is common among extended-spectrum beta-lactamases (ESBLs-producing bacteria. Objectives To determine the antibiotic resistance pattern of ESBLs-producing K. pneumoniae clinical isolates from Zahedan. Methods In this sectional-descriptive study, susceptibility of 51 ESBLs-producing K. pneumoniae isolates to 18 antimicrobial agents was determined. Results All isolates were resistant to cefotaxime, cefpodoxime and amoxicillin as well as susceptible to colistin sulfate. Also, most isolates were resistant to trimethoprim/sulfamethoxazole and aztreonam. Conclusions Our findings demonstrated that the rate of resistance to beta-lactams, sulfonamides, tetracyclines, aminoglycosides and fluoroquinolones in ESBLs-producing K. pneumoniae isolates is high in Zahedan.

  14. KPC-PRODUCING Serratia marcescens IN A HOME-CARE PATIENT FROM RECIFE, BRAZIL

    Science.gov (United States)

    MARGATE, Emmily; MAGALHÃES, Vera; FEHLBERG, Lorena Cristina Corrêa; GALES, Ana Cristina; LOPES, Ana Catarina Souza

    2015-01-01

    SUMMARY In this brief communication we describe the occurrence of a KPC-producing Serratia marcescensisolate in a home-care patient from Recife, Brazil. The bla KPC, bla SPM, bla IMP, bla VIM bla OXA, bla CTX-M, bla SHV, bla TEM and bla GES genes were investigated by Polymerase Chain Reaction (PCR) and DNA sequencing. The isolate was positive for bla KPC-2 and bla TEM-1 and was resistant to aztreonam, cefepime, cefotaxime, imipenem, meropenem, gentamicin, ciprofloxacin and cefazidime, and susceptible only to amikacin, tigecycline and gatifloxacin. This is the first report in Brazil of KPC-producing S. marcescens clinical isolate outside of a hospital environment. Caregivers should be alert for the presence of this isolate in the community setting. PMID:26422164

  15. KPC-PRODUCING Serratia marcescens IN A HOME-CARE PATIENT FROM RECIFE, BRAZIL

    Directory of Open Access Journals (Sweden)

    Emmily MARGATE

    2015-08-01

    Full Text Available SUMMARY In this brief communication we describe the occurrence of a KPC-producing Serratia marcescensisolate in a home-care patient from Recife, Brazil. The blaKPC, blaSPM, blaIMP, blaVIMblaOXA, blaCTX-M, blaSHV, blaTEM and blaGES genes were investigated by Polymerase Chain Reaction (PCR and DNA sequencing. The isolate was positive for blaKPC-2 and blaTEM-1 and was resistant to aztreonam, cefepime, cefotaxime, imipenem, meropenem, gentamicin, ciprofloxacin and cefazidime, and susceptible only to amikacin, tigecycline and gatifloxacin. This is the first report in Brazil of KPC-producing S. marcescens clinical isolate outside of a hospital environment. Caregivers should be alert for the presence of this isolate in the community setting.

  16. Salmonella em carcaças de frango congeladas

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    Santos Débora Martins Silva

    2000-01-01

    Full Text Available Um total de 150 carcaças de frango congeladas, de quatro marcas comerciais, foram analisadas para pesquisa de Salmonella. Foram examinadas 43 carcaças de cada uma das marcas A, B, D e 21 da marca C. Observou-se um percentual de 32,0% de contaminação. Foram identificados 11 sorotipos: S. Agona, S. Anatum, S. Enteritidis, S. Hadar, S. Havana, S. Mbandaka, S. Montevideo, S. Ouakam, S. Poona, S. Schwarzengrund e S. I 4, 5, 12: -. O antibiograma das cepas mostrou 100% de resistência à ampicilina, 75,0% à cefalotina, 52,1% à cefoxitina, 22,9% à tobramicina, 6,2% à polimixina B e à tetraciclina, 4,2% à gentamicina e 2,1% à netilmicina, ao aztreonam e à amicacina. Todas as cepas apresentaram sensibilidade total ao cloranfenicol e ao sulfazotrim.

  17. New drugs for the treatment of complicated intra-abdominal infections in the era of increasing antimicrobial resistance.

    Science.gov (United States)

    Syue, Ling-Shan; Chen, Yen-Hsu; Ko, Wen-Chien; Hsueh, Po-Ren

    2016-04-01

    The continuing increase in multidrug-resistant organisms (MDROs) worldwide has created new challenges in treating complicated intra-abdominal infections (cIAIs). A number of novel antimicrobial agents have been developed against resistant pathogens. To target extended-spectrum β-lactamase (ESBL)-producing pathogens, novel β-lactam antibiotics, such as ceftolozane/tazobactam, ceftazidime/avibactam, aztreonam/avibactam, imipenem/relebactam and S-649266, are antimicrobial alternatives for cIAIs. Two new drugs, eravacycline and plazomicin, have activity against Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae, carbapenem-resistant Acinetobacter baumannii and ESBL-producers. New lipoglycopeptides and oxazolidinones provide feasible options against resistant Gram-positive pathogens. These novel antimicrobials may play a role in improving the clinical outcomes of cIAIs caused by MDROs.

  18. Bacteremia caused by Pseudomonas luteola in pediatric patients.

    Science.gov (United States)

    Bayhan, Gulsum Iclal; Senel, Saliha; Tanir, Gonul; Ozkan, Sengul

    2015-01-01

    Pseudomonas luteola has rarely been reported as a human pathogen. The clinical manifestations of P. luteola bacteremia and its susceptibility to antibiotics have not been characterized. This retrospective study was conducted at a 382-bed tertiary care center in Turkey. During the 9-year study period, 7 patients (5 females and 2 males) were diagnosed with P. luteola bacteremia. Six of these patients had hospital-acquired bacteremia, whereas 1 patient had community-acquired P. luteola infection. All patients had monomicrobial bacteremia. Antimicrobial susceptibility testing revealed that all strains of P. luteola were sensitive to amikacin, gentamicin, trimethoprim-sulfamethoxazole, and meropenem, and that all strains were resistant to piperacillin-tazobactam, aztreonam, and colistin. In conclusion, we believe that P. luteola can cause both community- and hospital-acquired bacteremia. Amikacin, gentamicin, trimethoprim-sulfamethoxazole, and meropenem were effective against P. luteola in the present study.

  19. Multidrug and heavy metal-resistant Raoultella planticola isolated from surface water.

    Science.gov (United States)

    Koc, Serkan; Kabatas, Burak; Icgen, Bulent

    2013-08-01

    A surface water isolate of Raoultella sp. having both multidrug- and multimetal-resistant ability was isolated and identified as Raoultella planticola. R. planticola displayed resistance to 15 drugs like ampicillin, amoxicillin/clavulanic acid, aztreonam, erythromycin, imipenem, oxacillin, pefloxacin, penicillin, piperacillin, piperacillin/tazobactam, rifampin, sulbactam/cefoperazone, ticarsillin, ticarsillin/clavulanic acid, vancomycin, and to 11 heavy metals like aluminum, barium, copper, iron, lead, lithium, manganese, nickel, silver, strontium, and tin. The multidrug and multi-metal-resistant R. planticola may remain present in the environment for a long time. Due to a possible health risk of these pathogenic bacteria, a need exists for an accurate assessment of their acquired resistance to multiple drugs and metals.

  20. Surveillance of antimicrobial resistance in Escherichia coli strains isolated from pigs at Spanish slaughterhouses.

    Science.gov (United States)

    Teshager, T; Herrero, I A; Porrero, M C; Garde, J; Moreno, M A; Domínguez, L

    2000-07-01

    Antimicrobial resistance can make the efficient treatment of bacterial infections in humans and animals more difficult. Antimicrobial use in food animals may be one of the factors contributing to resistance. The Spanish surveillance network VAV has established a baseline of antimicrobial resistance in Escherichia coli strains from healthy pigs. Minimum inhibitory concentration and patterns of resistance to antimicrobials used in animals and humans were determined for 205 faecal strains isolated in a sampling frame of four slaughterhouses in Spain from 220 pigs in 1998. Higher levels of resistance were seen against antimicrobial agents authorised for use in food animals especially tetracycline, sulphonamides, trimethoprim and amoxycillin. All isolates were susceptible to antimicrobials employed mainly in humans such as ceftazidime, cefotaxime, imipenem, aztreonam and amikacin.

  1. [Comparative susceptibility of Ochrobactrum anthropi, Agrobacterium tumefaciens, Alcaligenes faecalis, Alcaligenes denitrificans subsp. denitrificans, Alcaligenes denitrificans subsp. xylosidans and Bordetella bronchiseptica against 35 antibiotics including 17 beta-lactams].

    Science.gov (United States)

    Bizet, C; Bizet, J

    1995-04-01

    Ochrobactrum anthropi, formerly known as "Achromobacter sp." or CDC group Vd has been isolated from water, hospital environment (antiseptic solutions, dialysis fluids ... ). O. anthropi is a Gram negative, motile, strictly aerobic, oxydase positive and non-fermentative bacteria with a strong urease activity. The susceptibility of 13 strains of O. anthropi was determined by agar diffusion method and compared to those of type strains of Agrobacterium tumefaciens, Alcaligenes faecalis, Alcaligenes denitrificans subsp. denitrificans, Alcaligenes denitrificans subsp. xylosoxydans and Bordetella bronchiseptica. The MICs of 20 antimicrobial agents confirmed the distinct phenotype susceptibility of O. anthropi. All the strains of O. anthropi are sensitive to imipenem, amikacin, gentamicin, netilmicin, nalidixic acid, pefloxacin, ciprofloxacin, tetracyclin, colistin, sulphonamides and rifampicin and resistant to ampicillin, amoxycillin + clavulanic acid, ticarcillin, mezlocillin, cefuroxime, cefamandol, cefoxitin, cefotaxime, cefoperazon, ceftazidime, cefsulodin, aztreonam, streptomycin, kanamycin, pipemidic acid, chloramphenicol, erythromicin, pristinamycin, trimethoprim and fosfomycin. O. anthropi is implicated in nosocomial infections. O. anthropi was the species with the greatest resistance to beta-lactamins.

  2. Sepsis due to Weeksella virosa in wounds made by animal bite. A case report.

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    Elio Jesús Núñez Tamayo

    2003-07-01

    Full Text Available This paper contains a case report of acute sepsis due to Weeksella virosa, a Gram negative micro-organism non fermentative of positive oxidase carbohidrates in a healthy patient aged 31 who was assisted at the service of microbiology of the ¨Dr. Gustavo Aldereguía Lima¨ Hospital in March 2003. The clinical symptoms were fever, pain, limited movements, erythema and sensation of warm. A diagnosis of reticular lymphangitis was done and Weeksella virosa was isolated by a conventional diagnosis. Tests for antimicrobial susceptibility showed sensitivity to tetracycline, aztreonam, ceftriazone and resistance to imipenem. Treatment was applied with tetracycline 1 gr. Daily for 7 days. The clinical picture improved with total regression of symptom.

  3. KPC-PRODUCING Serratia marcescens IN A HOME-CARE PATIENT FROM RECIFE, BRAZIL.

    Science.gov (United States)

    Margate, Emmily; Magalhães, Vera; Fehlberg, Lorena Cristina Corrêa; Gales, Ana Cristina; Lopes, Ana Catarina Souza

    2015-01-01

    In this brief communication we describe the occurrence of a KPC-producing Serratia marcescens isolate in a home-care patient from Recife, Brazil. The blaKPC, blaSPM, blaIMP, blaVIM, blaOXA, blaCTX-M, blaSHV, blaTEM and blaGES genes were investigated by Polymerase Chain Reaction (PCR) and DNA sequencing. The isolate was positive for blaKPC-2 and blaTEM-1 and was resistant to aztreonam, cefepime, cefotaxime, imipenem, meropenem, gentamicin, ciprofloxacin and cefazidime, and susceptible only to amikacin, tigecycline and gatifloxacin. This is the first report in Brazil of KPC-producing S. marcescens clinical isolate outside of a hospital environment. Caregivers should be alert for the presence of this isolate in the community setting.

  4. BEL-1, a Novel Clavulanic Acid-Inhibited Extended-Spectrum β-Lactamase, and the Class 1 Integron In120 in Pseudomonas aeruginosa

    Science.gov (United States)

    Poirel, Laurent; Brinas, Laura; Verlinde, Annemie; Ide, Louis; Nordmann, Patrice

    2005-01-01

    Screening by a double-disk synergy test identified a Pseudomonas aeruginosa isolate that produced a clavulanic acid-inhibited expanded-spectrum β-lactamase (ESBL). Cloning and sequencing identified a novel ESBL, BEL-1, weakly related to other Ambler class A ESBLs. β-Lactamase BEL-1 hydrolyzed significantly most expanded-spectrum cephalosporins and aztreonam, and its activity was inhibited by clavulanic acid, tazobactam, cefoxitin, moxalactam, and imipenem. This chromosome-encoded ESBL gene was embedded in a class 1 integron containing three other gene cassettes. In addition, this integron was bracketed by Tn1404 transposon sequences at its right end and by P. aeruginosa-specific sequences at its left end. PMID:16127048

  5. blaGES carrying Pseudomonas aeruginosa isolates from a public hospital in Rio de Janeiro, Brazil

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    Flávia L. P. C. Pellegrino

    2006-08-01

    Full Text Available Previous analysis of Pseudomonas aeruginosa class-1 integrons from Rio de Janeiro, Brazil, revealed the blaGES gene in one isolate. We screened isolates of two widespread PFGE genotypes, A and B, at a public hospital in Rio, for the presence of blaGES. The gene was detected in all seven P. aeruginosa isolates belonging to genotype B. Three of the seven genotype-B isolates were resistant to amikacin, aztreonam, ceftazidime, cefepime, ciprofloxacin, gentamicin, imipenem, meropenem, piperacillin-tazobactam and ticarcillin-clavulanic acid. The other four isolates were resistant to all these agents, except gentamicin, imipenem, meropenem and piperacillin-tazobactam. A synergistic effect between ceftazidime and imipenem or clavulanic acid suggested the production of GES-type ESBL.

  6. Antibiotic-Resistant Vibrios in Farmed Shrimp

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    Renata Albuquerque Costa

    2015-01-01

    Full Text Available Antimicrobial susceptibility pattern was determined in 100 strains of Vibrio isolated from the Litopenaeus vannamei shrimp and identified phenotypically. A high antibiotic-resistance index (75% was observed, with the following phenotypic profiles: monoresistance (n=42, cross-resistance to β-lactams (n=20 and multiple resistance (n=13. Plasmid resistance was characterized for penicillin (n=11, penicillin + ampicillin (n = 1, penicillin + aztreonam (n = 1, and ampicillin (n = 1. Resistance to antimicrobial drugs by the other strains (n=86 was possibly mediated by chromosomal genes. The findings of this study support the conclusion that the cultured shrimps can be vehicles of vibrios resistant to β-lactam and tetracycline.

  7. Vibrio vulnificus specie isolation in series blood culture. A case report. Aislamiento de especie de Vibrio vulnificus en hemocultivos seriados. Reporte de un caso.

    Directory of Open Access Journals (Sweden)

    Annia Alvarado Borges

    2004-08-01

    Full Text Available This papers contains a report of a case with Vibrio vulnificuls, gram negative micro organism that ferments carbohydrates and that is positive to the oxidase test and halophile in a patient with history of heart and liver disease who was assisted at the Intensive Care Emergency Unit ( ICU of the ¨Dr. Gustavo Aldereguía Lima¨ University Hospital in July 2003. Thy symptoms were: oedema in lower limbs, orthopnea, chest pain that was interpreted as a case of pneumonia and a Myocardial Infarction. This patient progresses rapidly to cardiac arrest, is reanimated , and is admitted at the ICU with control pressuremetric ventilation. Vibrio Vulnificuls was isolated with a conventional diagnosis from hemo cultures. Anti microbial Susceptibility tests , the micro organism was susceptible to tetracycline, sulphaprim, aztreonam, ampicillin and was resistant to chloranphenicol.

    Se reporta un caso de sepsis por Vibrio vulnificus en un paciente con antecedentes de insuficiencia cardiaca y hepatopatía, atendido en el servicio de Cuidados Intensivos de Emergencia del Hospital Universitario ¨Dr. Gustavo Aldereguía Lima¨, en julio de 2003. Los síntomas fueron: edema en miembros inferiores, ortopnea y dolor precordial que se interpretaron como bronconeumonía extrahospitalaria e infarto agudo del miocardio. Evoluciona rápidamente al paro cardiorrespiratorio, se reanima e ingresa en Cuidados Intensivos con ventilación presiométrica controlada. Se aisló Vibrio vulnificus por diagnóstico convencional desde hemocultivos. En las pruebas de susceptibilidad antimicrobiana resultó sensible a tetraciclina, sulfaprim, aztreonam, ampicillin y resistente a cloranfenicol.

  8. TLA-1: a new plasmid-mediated extended-spectrum beta-lactamase from Escherichia coli.

    Science.gov (United States)

    Silva, J; Aguilar, C; Ayala, G; Estrada, M A; Garza-Ramos, U; Lara-Lemus, R; Ledezma, L

    2000-04-01

    Escherichia coli R170, isolated from the urine of an infected patient, was resistant to expanded-spectrum cephalosporins, aztreonam, ciprofloxacin, and ofloxacin but was susceptible to amikacin, cefotetan, and imipenem. This particular strain contained three different plasmids that encoded two beta-lactamases with pIs of 7.0 and 9.0. Resistance to cefotaxime, ceftazidime, aztreonam, trimethoprim, and sulfamethoxazole was transferred by conjugation from E. coli R170 to E. coli J53-2. The transferred plasmid, RZA92, which encoded a single beta-lactamase, was 150 kb in length. The cefotaxime resistance gene that encodes the TLA-1 beta-lactamase (pI 9.0) was cloned from the transconjugant by transformation to E. coli DH5alpha. Sequencing of the bla(TLA-1) gene revealed an open reading frame of 906 bp, which corresponded to 301 amino acid residues, including motifs common to class A beta-lactamases: (70)SXXK, (130)SDN, and (234)KTG. The amino acid sequence of TLA-1 shared 50% identity with the CME-1 chromosomal class A beta-lactamase from Chryseobacterium (Flavobacterium) meningosepticum; 48.8% identity with the VEB-1 class A beta-lactamase from E. coli; 40 to 42% identity with CblA of Bacteroides uniformis, PER-1 of Pseudomonas aeruginosa, and PER-2 of Salmonella typhimurium; and 39% identity with CepA of Bacteroides fragilis. The partially purified TLA-1 beta-lactamase had a molecular mass of 31.4 kDa and a pI of 9.0 and preferentially hydrolyzed cephaloridine, cefotaxime, cephalothin, benzylpenicillin, and ceftazidime. The enzyme was markedly inhibited by sulbactam, tazobactam, and clavulanic acid. TLA-1 is a new extended-spectrum beta-lactamase of Ambler class A.

  9. TLA-1: a New Plasmid-Mediated Extended-Spectrum β-Lactamase from Escherichia coli

    Science.gov (United States)

    Silva, J.; Aguilar, C.; Ayala, G.; Estrada, M. A.; Garza-Ramos, U.; Lara-Lemus, R.; Ledezma, L.

    2000-01-01

    Escherichia coli R170, isolated from the urine of an infected patient, was resistant to expanded-spectrum cephalosporins, aztreonam, ciprofloxacin, and ofloxacin but was susceptible to amikacin, cefotetan, and imipenem. This particular strain contained three different plasmids that encoded two β-lactamases with pIs of 7.0 and 9.0. Resistance to cefotaxime, ceftazidime, aztreonam, trimethoprim, and sulfamethoxazole was transferred by conjugation from E. coli R170 to E. coli J53-2. The transferred plasmid, RZA92, which encoded a single β-lactamase, was 150 kb in length. The cefotaxime resistance gene that encodes the TLA-1 β-lactamase (pI 9.0) was cloned from the transconjugant by transformation to E. coli DH5α. Sequencing of the blaTLA-1 gene revealed an open reading frame of 906 bp, which corresponded to 301 amino acid residues, including motifs common to class A β-lactamases: 70SXXK, 130SDN, and 234KTG. The amino acid sequence of TLA-1 shared 50% identity with the CME-1 chromosomal class A β-lactamase from Chryseobacterium (Flavobacterium) meningosepticum; 48.8% identity with the VEB-1 class A β-lactamase from E. coli; 40 to 42% identity with CblA of Bacteroides uniformis, PER-1 of Pseudomonas aeruginosa, and PER-2 of Salmonella typhimurium; and 39% identity with CepA of Bacteroides fragilis. The partially purified TLA-1 β-lactamase had a molecular mass of 31.4 kDa and a pI of 9.0 and preferentially hydrolyzed cephaloridine, cefotaxime, cephalothin, benzylpenicillin, and ceftazidime. The enzyme was markedly inhibited by sulbactam, tazobactam, and clavulanic acid. TLA-1 is a new extended-spectrum β-lactamase of Ambler class A. PMID:10722503

  10. Inhibition by Avibactam and Clavulanate of the β-Lactamases KPC-2 and CTX-M-15 Harboring the Substitution N(132)G in the Conserved SDN Motif.

    Science.gov (United States)

    Ourghanlian, Clément; Soroka, Daria; Arthur, Michel

    2017-03-01

    The substitution N(132)G in the SDN motif of class A β-lactamases from rapidly growing mycobacteria was previously shown to impair their inhibition by avibactam but to improve the stability of acyl-enzymes formed with clavulanate. The same substitution was introduced in KPC-2 and CTX-M-15 to assess its impact on β-lactamases from Enterobacteriaceae and evaluate whether it may lead to resistance to the ceftazidime-avibactam combination. Kinetic parameters for the inhibition of the β-lactamases by avibactam and clavulanate were determined by spectrophotometry using nitrocefin as the substrate. The substitution N(132)G impaired (>1,000-fold) the efficacy of carbamylation of KPC-2 and CTX-M-15 by avibactam. The substitution improved the inhibition of KPC-2 by clavulanate due to reduced deacylation, whereas the presence or absence of N(132)G resulted in the inhibition of CTX-M-15 by clavulanate. The hydrolysis of amoxicillin and nitrocefin by KPC-2 and CTX-M-15 was moderately affected by the substitution N(132)G, but that of ceftazidime, ceftaroline, and aztreonam was drastically reduced. Isogenic strains producing KPC-2 and CTX-M-15 were constructed to assess the impact of the substitution N(132)G on the antibacterial activities of β-lactam-inhibitor combinations. For amoxicillin, the substitution resulted in resistance and susceptibility for avibactam and clavulanate, respectively. For ceftazidime, ceftaroline, and aztreonam, the negative impact of the substitution on β-lactamase activity prevented resistance to the β-lactam-avibactam combinations. In conclusion, the N(132)G substitution has profound effects on the substrate and inhibition profiles of class A β-lactamases, which are largely conserved in distantly related enzymes. Fortunately, the substitution does not lead to resistance to the ceftazidime-avibactam combination.

  11. Promoter deletions of Klebsiella pneumoniae carbapenemase (KPC)-encoding genes (blaKPC -2) and efflux pump (AcrAB) on β-lactam susceptibility in KPC-producing Enterobacteriaceae.

    Science.gov (United States)

    Seecoomar, Gomattie D; Marmol, Brenda C; Kwon, Dong H

    2013-11-01

    Klebsiella pneumoniae carbapenemase (KPC)-encoding genes containing promoter-deletions (bla(KPC-2a), bla(KPC-2b), and bla(KPC-2c) have disseminated in Enterobacteriaceae. The minimal inhibitory concentrations (MICs) to β-lactams in clinical KPC-producing Enterobacteriaceae range from susceptible to high-level resistant, resulting in diagnostic problems. To better understand the variability in β-lactam MICs among KPC-producing Enterobacteriaceae, three isoforms of bla(KPC-2) gene were used to transform Escherichia coli W4573 and its deletion mutant of an efflux pump (AcrAB) to examine the effects on β-lactam susceptibility. MICs to β-lactams in E. coli W4573 and its acrAB mutant strain increased 1- to 500-fold (MIC from 0.125 to 64 μg mL(-1) of aztreonam) in the bla(KPC-2a), bla(KPC-2b), and bla(KPC-2c) transformants compared with the cloning vector alone. However, transformants of the acrAB mutant strain remained susceptible to all β-lactams tested except for aztreonam and carbenicillin. Levels of the three promoters' length and carbapenemase activities in the transformants harboring the bla(KPC-2a), bla(KPC-2b), and bla(KPC-2c) were correlated to the levels of β-lactam MICs in both E. coli W4573 and its mutant of an efflux pump (AcrAB). Overall, these results suggest that promoter-deletions of bla(KPC-2) gene and AcrAB may be associated with the variability in β-lactam MICs in KPC-producing Enterobacteriaceae.

  12. In vivo efficacy of human simulated regimens of carbapenems and comparator agents against NDM-1-producing Enterobacteriaceae.

    Science.gov (United States)

    Wiskirchen, Dora E; Nordmann, Patrice; Crandon, Jared L; Nicolau, David P

    2014-01-01

    Doripenem and ertapenem have demonstrated efficacy against several NDM-1-producing isolates in vivo, despite having high MICs. In this study, we sought to further characterize the efficacy profiles of humanized regimens of standard (500 mg given every 8 h) and high-dose, prolonged infusion of doripenem (2 g given every 8 h, 4-h infusion) and 1 g of ertapenem given intravenously every 24 h and the comparator regimens of ceftazidime at 2 g given every 8 h (2-h infusion), levofloxacin at 500 mg every 24 h, and aztreonam at 2 g every 6 h (1-h infusion) against a wider range of isolates in a murine thigh infection model. An isogenic wild-type strain and NDM-1-producing Klebsiella pneumoniae and eight clinical NDM-1-producing members of the family Enterobacteriaceae were tested in immunocompetent- and neutropenic-mouse models. The wild-type strain was susceptible to all of the agents, while the isogenic NDM-1-producing strain was resistant to ceftazidime, doripenem, and ertapenem. Clinical NDM-1-producing strains were resistant to nearly all five of the agents (two were susceptible to levofloxacin). In immunocompetent mice, all of the agents produced ≥1-log10 CFU reductions of the isogenic wild-type and NDM-1-producing strains after 24 h. Minimal efficacy of ceftazidime, aztreonam, and levofloxacin against the clinical NDM-1-producing strains was observed. However, despite in vitro resistance, ≥1-log10 CFU reductions of six of eight clinical strains were achieved with high-dose, prolonged infusion of doripenem and ertapenem. Slight enhancements of doripenem activity over the standard doses were obtained with high-dose, prolonged infusion for three of the four isolates tested. Similar efficacy observations were noted in neutropenic mice. These data suggest that carbapenems are a viable treatment option for infections caused by NDM-1-producing Enterobacteriaceae.

  13. Bacteremia and conventional diagnosis of Sphingobacterium spiritivorum. A case report Bacteriemia y diagnóstico convencional de Sphingobacterium spiritivorum. Reporte de un caso.

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    Susana Chamero Melgarejo

    2003-12-01

    Full Text Available This is a case report of septicaemia due to Sphingobacterium Spiritovirum that caused acute symmetric acronecrosis in a previously healthy man who received medical assistance at the University Hospital ¨Dr. Gustavo Aldereguía Lima¨ from Cienfuegos province in November 2002. The clinical symptoms were: fever, lumbar pain and chills which evolved to shock with general malaise, accompanied with paresthesia, symptoms of distal necrosis in the four members, nose and ear. Sphingobacterium Spiritovirum was diagnosed by the conventional diagnosis of growing in the marrow tests and serial blood cultures. Susceptibility antimicrobial tests were sensible to sulphametoxazole – trimetropin and resistant to tetracycline, aztreonam, ceftriaxone and imipenem. The bibliography consulted did not evidence any previous isolation in Cuba .
    Se reporta un caso de septicemia por Sphingobacterium spiritivorum, que provocó acronecrosis simétrica aguda en un paciente anteriormente sano, atendido en el servicio de Cuidados Intensivos del Hospital Universitario “Dr. Gustavo Aldereguía Lima” de Cienfuegos, en noviembre del 2002. Los síntomas clínicos fueron: fiebre, dolor lumbar y escalofríos, que evolucionaron en pocas horas a shock con toma del estado general, acompañados de parestesias y síntomas de necrosis distal en los cuatro miembros, nariz y oreja. Se aisló Sphingobacterium spiritivorum por diagnóstico convencional del crecimiento en el medulograma y hemocultivos seriados. En las pruebas de susceptibilidad antimicrobiana resultó sensible a sulfametoxazol-trimetropim y resistente a tetraciclina, aztreonam, ceftriaxona e imipenem. La bibliografía consultada no evidenció reportes anteriores de aislamientos en Cuba.

  14. In vitro activity of tigecycline and comparators against carbapenem-susceptible and resistant Acinetobacter baumannii clinical isolates in Italy

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    Carattoli Alessandra

    2008-02-01

    Full Text Available Abstract Background In a recent multi-centre Italian survey (2003–2004, conducted in 45 laboratories throughout Italy with the aim of monitoring microorganisms responsible for severe infections and their antibiotic resistance, Acinetobacter baumannii was isolated from various wards of 9 hospitals as one of the most frequent pathogens. One hundred and seven clinically significant strains of A. baumannii isolates were included in this study to determine the in vitro activity of tigecycline and comparator agents. Methods Tests for the susceptibility to antibiotics were performed by the broth microdilution method as recommended by CLSI guidelines. The following antibiotics were tested: aztreonam, piperacillin/tazobactam, ampicillin/sulbactam, ceftazidime, cefepime, imipenem, meropenem tetracycline, doxycycline, tigecycline, gentamicin, amikacin, ciprofloxacin, colistin, and trimethoprim/sulphametoxazole. The PCR assay was used to determine the presence of OXA, VIM, or IMP genes in the carbapenem resistant strains. Results A. baumannii showed widespread resistance to ceftazidime, ciprofloxacin and aztreonam in more than 90% of the strains; resistance to imipenem and meropenem was 50 and 59% respectively, amikacin and gentamicin were both active against about 30% of the strains and colistin about 99%, with only one strain resistant. By comparison with tetracyclines, tigecycline and doxycycline showed a higher activity. In particular, tigecycline showed a MIC90 value of 2 mg/L and our strains displayed a unimodal distribution of susceptibility being indistinctly active against carbapenem-susceptible and resistant strains, these latter possessed OXA-type variant enzymes. Conclusion In conclusion, tigecycline had a good activity against the MDR A. baumannii strains while maintaining the same MIC90 of 2 mg/L against the carbapenem-resistant strains.

  15. Profiling of β-lactam selectivity for penicillin-binding proteins in Streptococcus pneumoniae D39.

    Science.gov (United States)

    Kocaoglu, Ozden; Tsui, Ho-Ching T; Winkler, Malcolm E; Carlson, Erin E

    2015-01-01

    Selective fluorescent β-lactam chemical probes enable the visualization of the transpeptidase activity of penicillin-binding proteins (PBPs) at different stages of bacterial cell division. To facilitate the development of new fluorescent probes for PBP imaging, we evaluated 20 commercially available β-lactams for selective PBP inhibition in an unencapsulated derivative of the D39 strain of Streptococcus pneumoniae. Live cells were treated with β-lactam antibiotics at different concentrations and subsequently incubated with Bocillin FL (Boc-FL; fluorescent penicillin) to saturate uninhibited PBPs. Fluorophore-labeled PBPs were visualized by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and fluorescence scanning. Among 20 compounds tested, carbapenems (doripenem and meropenem) were coselective for PBP1a, PBP2x, and PBP3, while six of the nine penicillin compounds were coselective for PBP2x and PBP3. In contrast, the seven cephalosporin compounds tested display variability in their PBP-binding profiles. Three cephalosporin compounds (cefoxitin, cephalexin, and cefsulodin) and the monobactam aztreonam exhibited selectivity for PBP3, while only cefuroxime (a cephalosporin) was selective for PBP2x. Treatment of S. pneumoniae cultures with a sublethal concentration of cefuroxime that inhibited 60% of PBP2x activity and less than 20% of the activity of other PBPs resulted in formation of elongated cells. In contrast, treatment of S. pneumoniae cultures with concentrations of aztreonam and cefoxitin that inhibited up to 70% of PBP3 activity and less than 30% of other PBPs resulted in no discernible morphological changes. Additionally, correlation of the MIC and IC50s for each PBP, with the exception of faropenem, amdinocillin (mecillinam), and 6-APA, suggests that pneumococcal growth inhibition is primarily due to the inhibition of PBP2x.

  16. Ocorrência e perfil de sensibilidade a antimicrobianos em Pseudomonas aeruginosa e Acinetobacter sp. em um hospital terciário, no sul do Brasil

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    Gabriele Mariani Machado

    2011-04-01

    Full Text Available INTRODUÇÃO: O principal mecanismo de resistência entre isolados de Pseudomonas aeruginosa e Acinetobacter sp. é a produção de metalo-β-lactamases (MβLs. As MβLs são enzimas capazes de hidrolisar cefalosporinas, penicilinas e carbapenêmicos, mas não monobactâmicos (aztreonam antibióticos que se encontram entre as principais opções terapêuticas para o tratamento de infecções causadas por bactérias não fermentadoras de glicose. MÉTODOS: Um estudo observacional, transversal, descritivo e retrospectivo foi desenvolvido para avaliar a frequência e o perfil de susceptibilidade cepas de P. aeruginosa e Acinetobacter sp. produtoras de MβLs isoladas no Hospital São Vicente de Paulo, Passo Fundo, Brasil. RESULTADOS: A produção de MβLs foi observada em 77,6% (n = 173/223 dos isolados de P. aeruginosa e em 22,4% (n = 50/223 dos isolados de Acinetobacter sp. Dentre as cepas produtoras de MβL, a maioria apresentou mais de 90% de resistência a seis antimicrobianos dos 12 testados, enfatizando a resistência a ceftazidima, gentamicina, aztreonam, piperaciclina/tazobactam, cefepime, ciprofloxacina, meropenem e tobramicina. CONCLUSÕES: Os índices de MβL encontrados confirmam a preocupação mundial com a disseminação desse mecanismo de resistência.

  17. 武汉、泉州两地肺炎克雷伯菌产β-内酰胺酶类型的比较研究%Study on classification and distribution of lactamase produced by Klebsiella pneumonia in Wuhan and Quanzhou

    Institute of Scientific and Technical Information of China (English)

    明德松; 谢尊金; 朱焱; 吴一波

    2004-01-01

    Objective:To study the Classification and Distribution of the β-Lactamases Produced by Klebsiella pneumonia in Wuhan and Quanzhou.Methods:Objective:To detect the β-Lactamases produced by Klebsiella pneumonia in Wuhan and Quanzhou with a multi-disk synergy test.Results:20 of 70 strains produced the β-Lactamases in Wuhan,Objective:Total producing rate was 28.7%,each strains produced penicillinase or cephalosporinase,4 strains produced broad-spectrum β-Lactamase(BSBLs,5.7%); 14 strains produce extented-spectrum β-Lactamase(ESBLs,20.0%),the sensitivities of the ceftazidime,aztreonam and cefotaxime were different,cefotaxime was the highest.60 of 70 strains in Quanzhou produced the β-Lactamases,Objective:Total producing rate was 85.7%,4 strains produced penicillinase,3 strains produced cephalosporinase; 11 strains produced BSBLs(15.7%),42 strains produced ESBLs(60.00%),the sensitivities of the ceftazidime,aztreonam and cefotaxime were different,aztreonam was the highest.All did not produce carbapenem-hydrolyzing β-Lactamase(CHBLs).Conclusions: The types of β-Lactamase produced by Klebsiella pneumonia in Wuhan and Quanzhou are mainly BSBLS and ESBLS,the sensitivities of the ceftazidime,aztreonam and cefotaxime were different,in wuhan Cefotaxime was the highest,in Quanzhou aztreonam was the highest; all did not produce carbapenem-hydrolyzing β-Lactamases(CHBLs).The rate and types of β-Lactamases Produced by Klebsiella pneumoniae in Wuhan and Quanzhou were different,the Objective:Total producing rate and thd producing rate of each rype of β-Lactamases producecd by Klebsiella isolates from Quanzhou were higher than that from Wuhan.%目的比较研究武汉、泉州两地肺炎克雷伯菌(Kpn)所产各种β-内酰胺酶(β-lase)分布情况.方法采用改良多底物相邻纸片协同法检测武汉、泉州各70株Kpn所产各种β-lase.结果武汉70株Kpn总β-lase检出率为28.7%,其中产青霉素酶、头孢菌素酶各1株(1.4%),产广谱酶4株(5.7%),

  18. Change of drug resistance of Acinetobacter baumannii causing respiratory tract infection in ICU and effect of intervention%ICU呼吸道感染鲍氏不动杆菌耐药性变迁及干预效果

    Institute of Scientific and Technical Information of China (English)

    陈炜; 屠传建; 金玲玲; 罗佳

    2012-01-01

    目的 了解重症监护病房(ICU)呼吸道感染鲍氏不动杆菌耐药性变迁,为临床控制多药耐药菌感染提供依据.方法 对2008-2010年医院痰标本分离的908株鲍氏不动杆菌进行药敏测定,并针对多药耐药性进行干预.结果 2009年鲍氏不动杆菌的耐药性比2008年增加,氨曲南、头孢曲松、头孢噻肟、哌拉西林耐药率>90.0%,2010年通过干预措施后鲍氏不动杆菌的耐药性比2009年有延缓趋势,氨曲南、头孢曲松、哌拉西林耐药率<75.0%.结论 鲍氏不动杆菌呈多药耐药性,应重视医护人员手卫生,加强口腔护理和消毒隔离,合理使用抗菌药物.%OBJECTIVE To study the change of drug resistance of Acinetobacter baumannii in the intensive care unit of our hospital, and to provide the reference for controlling the infection of drug resistant bacteria. METHODS Antibiotics susceptibility test of 908 strains of A. Baumannii was performed from 2008 to 2010, and multidrug resistance was intervened. RESULTS Drug resistance of A. Baumannii was increased in 2009 compared to 2008. The resistance rates to aztreonam, ceftriaxone, cefotaxime, piperacillin were > 90. 0%. Through intervention measures, drug resistance was reduced in 2010, the resistance rates to aztreonam, ceftriaxone, piperacillin declined to <75. 0%. CONCLUSION A. Baumannii are multiple antimicrobial-resistant bacteria. To control the infection caused by A. Baumannii in ICU, medical staff hand hygiene, oral care, disinfection, isolation, rational use of antimicrobial agents should be highlighted.

  19. Antibiotic sensitivity of bacterial strains isolated from newborn infants Sensibilidad a los antibióticos de bacterias aisladas de neonatos hospitalizados

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    Alvaro Uribe

    1990-02-01

    Full Text Available

    Eighty nine bacterial strains isolated from newborn infants hospitalized at a Special Care Unit in Medellin, Colombia, were studied. The sensitivity of each one was determined by the Minimallnhibitory Concentration method against 21 antibiotics; a high frequency of resistance was found toward gentamycin, netilmycin, oxacillin, penicillin G and ampicillin, that are often employed as initial therapy in newborn infants; on the other hand both Gram positive and Gram negative bacteria exhibited high percentages of sensitivity against quinolones; aztreonam and third generation cephalosporins were also highly effective against Gram negative bacilli. On the basis of this new information the need to restate therapeutic conducts in the case of serious bacterial neonatal infections is emphasized.

    Se estudiaron 89 cepas bacterianas aisladas de neonatos hospitalizados en la sala de cuidados especiales de la Fundación Hospitalaria San Vicente de Paúl, de Medellín; a cada una se le determinó la sensibilidad frente a 21 antibióticos por el método de la concentración inhibitoria mínima (CIM; se halló una alta frecuencia de resistencia hacia la gentamicina, la netilmicina, la oxacilina y la ampicilina que se usan a menudo en esta institución como terapia inicial en las infecciones del recién nacido; por otra parte se demostraron altos porcentajes de sensibilidad hacia las quinolonas tanto de las bacterias gram positivas como de las gram negativas; contra estas últimas también fueron muy efectivos el aztreonam y las cefalosporinas de tercera generación. A la luz de esta nueva información se llama la atención hacia la necesidad de revaluar las normas de la antibioterapia en las infecciones graves del recién nacido.

  20. The distribution and the vicissitudes of antimicrobial resistance of Pseudomonas aeruginosa in hospital from 2009 to 2012.%2009~2012医院内感染铜绿假单胞菌的临床分布及耐药性变迁

    Institute of Scientific and Technical Information of China (English)

    邱义城; 卢玉贞; 汤凤珍; 欧阳英娥

    2012-01-01

      目的了解我院院内感染铜绿假单胞菌的临床分布和耐药情况,为临床预防和治疗铜绿假单胞菌院内感染提供依据.方法采用回顾性分析方法分析2009-2012年间院内住院患者分离铜绿假单胞菌病区分布、药敏结果、耐药性变化和耐药组合情况.结果4年间铜绿假单胞菌分离率较高的科室分别为神经外科、中心重症监护室和神经内科.痰标本检出铜绿假单胞菌最多,占74.4%.药敏结果显示哌拉西林,哌拉西林/他唑巴坦,庆大霉素,头孢吡肟(FEP)等20种抗菌药物耐药率呈下降的趋势.结论医院内获得铜绿假单胞菌感染以下呼吸道感染为主,且耐药性明显高于其他部位分离菌株.铜绿假单胞菌耐药机制复杂,临床应根据其分布特点和药敏结果合理用药.%  Objective To investigate antimicrobial resistance of clinical isolates of our hospital ,to offer information for preventing and curing Pseudomonas aeruginosa. Methods the retrospective analytical method test was employed to study the antimicrobial resistance. Results the top three the division of isolating rate of Pseudomonas aeruginosa is neurosurgery,ICU and neurology department. The strains were separated from sputum accounted for 74.4% ,which is the most. There is an obvious descending tendency of antimicrobial resistance of Pseudomonas aeruginosa for Amikacin, Aztreonam, Aztreonam, Piperacilin, Piperacilin/ Tazobactam, Gentamycin, Gentamycin/ Clavulanic Acid, Cefepime, Ceftazidime, Tobramycin, Imipenem, Levofloxacin, Cefotaxime, Ceftriaxone. Oppositey, there is not for Cefotaxime/ Clavulanic Acid, Ampicilin, Ampicilin/ Ampicilin, trimethoprim-sulfamethoxazole, Cefoxitin, Cephazolin. Conclusion the primary infection in Hospitals is lower respiratory tract infection, which is supper than other position infection. The antimicrobial resistance mechanism of Pseudomonas aeruginosa is multiplicity. So, we should take the rational

  1. K. pneumoniae: ¿The new “superbacteria”? Pathogenicity, epidemiology and resistance mechanisms K. pneumoniae: ¿la nueva

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    Lina María Echeverri Toro

    2010-05-01

    Full Text Available The antimicrobial resistance is an increasing problem of public health. Klebsiella pneumoniae has become one of the most important pathogens because it is a frequent cause of nosocomial and community acquired infections and it has pathogenicity mechanisms like capsules, adhesive properties mediated by specialized estructures (pillis and siderophores that are capable of taking up iron, an essential factor in bacterial growth. The increase in bacterial resistance to antibiotics has evolved with the use of these in patients treatments, being increasingly wide the spectrum that they include, happening from the resistance to ampicillin by the production of betalactamase SHV-1 to carbapenems resistance by diverse mechanisms, from the production of extendedspectrum betalactamases (ESBL that are associated with hydrolysis of extended-spectrum cephalosporins and aztreonam. Microbiology laboratory should follow international recommendations to detect and confirm the presence of this resistance mechanism in bacteria and the clinicians should make a suitable interpretation of the results to make the better choice of the antibiotic therapy. ----- La resistencia de los microorganismos a los antibióticos es un problema cada vez creciente en salud pública. Entre estos, Klebsiella pneumoniae es un representante importante no sólo por su frecuencia como causa de infecciones asociadas al cuidado de la salud y de la comunidad, sino por los mecanismos patogénicos que posee, como la capacidad de producir cápsula, la presencia de estructuras especializadas que le permiten adherirse a las células del hospedero (pilis, y de sideróforos que le permiten obtener el hierro necesario para su desarrollo. La resistencia de Klebsiella pneumoniae a los antimicrobianos ha evolucionado de acuerdo con la aparición y uso de estas moléculas en el tratamiento de los pacientes, siendo cada vez más amplio el espectro que abarcan, el cual va desde la resistencia a la ampicilina

  2. Beta-lactam hypersensitivity and cross-reactivity.

    Science.gov (United States)

    Terico, Adrienne T; Gallagher, Jason C

    2014-12-01

    Penicillin is the most frequently reported cause of drug allergy, and cross-reactivity of penicillins with other beta-lactam antibiotics is an area of debate. This review evaluates the available data on immunoglobulin E-mediated penicillin hypersensitivity and cross-reactivity with cephalosporin, carbapenem, and monobactam antibiotics. A MEDLINE search was conducted from 1950 to October 2013, and selected references from review articles were also evaluated. There is a wide variety in reported incidences of cross-reactivity between penicillins and cephalosporins or carbapenems, with early retrospective studies suggesting up to 41.7% and 47.4% cross-reactivity, respectively. Conversely, the use of monobactam antibiotics is frequently employed in the case of a penicillin allergy, as prescribers believe that there is no cross-reactivity between the 2 drug classes. More recent prospective studies suggest that the rates of cross-reactivity with cephalosporins and carbapenems are penicillin and cephalosporin side chains may play a role in cross-reactivity between these classes. Cross-reactivity with monobactams is essentially negligible; however, there are some clinical data to support an interaction between ceftazidime and aztreonam, due to the similarity of their side chains. The data reviewed suggest that avoidance of other beta-lactams in patients with type 1 hypersensitivity to penicillins should be reconsidered.

  3. Resistance to extended-spectrum β-lactamases in Salmonella from a broiler supply Chain.

    Science.gov (United States)

    Gelinski, Jane Mary Lafayette Neves; Bombassaro, Amanda; Baratto, César Milton; Vicente, Vânia Aparecida

    2014-11-13

    The prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae varies worldwide, however, the incidence of ESBL-producing environmental Salmonella isolates is increasing. Salmonella is still one of the most important pathogens that occur in the poultry supply chain. Therefore, this study analyzed the susceptibility of Salmonella isolates collected from a poultry supply chain to β-lactam antibiotics, and examined the phenotypes of the isolates based on enzyme-inducible AmpC β-lactamase analysis. All analysis of the putative positive isolates in the current study confirmed that 27.02% (77/285 analysis) of all ESBL tests realized with the isolates produced a profile of resistance consistent with β-lactamase production. All isolates of S. Minnesota serotype had ESBL phenotype. Aztreonam resistance was the least common amongst the Salmonella isolates, followed by ceftazidime. The presence of inducible chromosomal ESBL was detected in 14 different isolates of the 19 serotypes investigated. These results are very indicatives of the presence of ESBL genes in Salmonella isolates from a broiler supply chain, reaffirming the growing global problem of ESBL resistance.

  4. Molecular epidemiology of VIM-1 producing Escherichia coli from Germany referred to the National Reference Laboratory.

    Science.gov (United States)

    Kaase, Martin; Pfennigwerth, Niels; Lange, Felix; Anders, Agnes; Gatermann, Sören G

    2015-10-01

    The distribution of carbapenemase genes in Escherichia coli strains isolated between September 2009 and May 2013 in Germany was investigated. Out of 192 isolates with carbapenemase production OXA-48 was found in 44.8%, VIM-1 in 18.8%, NDM-1 in 11.5% and KPC-2 in 6.8%. Patients with VIM-1 producing E. coli (n=36) differed from patients with OXA-48 by an older age, less frequent mention of travel history and an increased proportion of clinical over screening specimens. These data might indicate that introduction from abroad is of minor importance for VIM-1 producing E. coli compared to other carbapenemases. Multilocus sequence typing revealed that E. coli with VIM-1 were mostly multiclonal, emphasizing the role of horizontal gene transfer in its spread. Susceptibility testing of VIM-1 producing E. coli demonstrated aztreonam susceptibility in 55.6%. Among non-β-lactams susceptibility rates of >90% were observed for amikacin, tigecycline, colistin, fosfomycin and nitrofurantoin.

  5. Antimicrobial resistance among Brazilian Corynebacterium diphtheriae strains

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    Gabriela Andrade Pereira

    2008-08-01

    Full Text Available The increasing problems with multidrug resistance in relation to Corynebacterium, including C. diphtheriae, are examples of challenges confronting many countries. For this reason, Brazilian C. diphtheriae strains were evaluated by the E-Test for their susceptibility to nine antibacterial drugs used in therapy. Resistance (MIC < 0.002; 0.38 µg/ml to penicillin G was found in 14.8% of the strains tested. Although erythromycin (MIC90 0.75 µg/ml and azithromycin (MIC90 0.064 µg/ml were active against C. diphtheriae in this study, 4.2% of the strains showed decreased susceptibility (MIC 1.0 µg/ml to erythromycin. Multiple resistance profiles were determined by the disk diffusion method using 31 antibiotics. Most C. diphtheriae strains (95.74% showed resistance to mupirocin, aztreonam, ceftazidime, and/or oxacillin, ampicillin, penicillin, tetracycline, clindamycin, lincomycin, and erythromycin. This study presents the antimicrobial susceptibility profiles of Brazilian C. diphtheriae isolates. The data are of value to practitioners, and suggest that some concern exists regarding the use of penicillin.

  6. Antimicrobial resistance and presence of the SXT mobile element in Vibrio spp. isolated from aquaculture facilities.

    Science.gov (United States)

    García-Aljaro, Cristina; Riera-Heredia, Jordi; Blanch, Anicet R

    2014-07-01

    The aim of this work was to assess the susceptibility of Vibrio spp. strains isolated from fish cultures against some usually applied antibiotics and the occurrence of the SXT mobile genetic element among them. Antimicrobial resistance was assessed by the standard disk diffusion technique while the presence of the SXT mobile genetic element was determined by conventional PCR. High levels of resistance to ampicillin (70%), cefoxitin (44%), streptomycin (31%), aztreonam (25%) and sulfamethoxazole (21%) were detected, and a high inter-and-intraspecies diversity in the resistance profile was observed for the majority of the analysed isolates. The SXT mobile genetic element was detected in only 4 isolates belonging to the species V. diazotrophicus (1), V. mediterranei (2) and V. vulnificus (1), which showed a variable antibiotic resistance profile. Horizontal antibiotic resistance gene transfer from the V. diazotrophicus SXT-positive strain to a laboratory E. coli strain was demonstrated under laboratory conditions. Our results suggest that the Vibrio spp. isolated from aquaculture facilities analysed in this study, although not being pathogenic, they constitute a source of antimicrobial resistance genes that could be mobilized to other bacterial populations through mobile genetic elements. However, the low occurrence of the SXT element in these isolates supports the hypothesis that this element is not involved in the development of resistance in the majority of Vibrio spp. in the examined aquaculture facilities.

  7. Detection of antibiotic resistance in probiotics of dietary supplements

    KAUST Repository

    Wong, Aloysius Tze

    2015-09-14

    Background Probiotics are live microorganisms that confer nutrition- and health-promoting benefits if consumed in adequate amounts. Concomitant with the demand for natural approaches to maintaining health is an increase in inclusion of probiotics in food and health products. Since probiotic bacteria act as reservoir for antibiotic resistant determinants, the transfer of these genes to pathogens sharing the same intestinal habitat is thus conceivable considering the fact that dietary supplements contain high amounts of often heterogeneous populations of probiotics. Such events can confer pathogens protection against commonly-used drugs. Despite numerous reports of antibiotic resistant probiotics in food and biological sources, the antibiogram of probiotics from dietary supplements remained elusive. Findings Here, we screened five commercially available dietary supplements for resistance towards antibiotics of different classes. Probiotics of all batches of products were resistant towards vancomycin while batch-dependent resistance towards streptomycin, aztreonam, gentamycin and/or ciprofloxacin antibiotics was detected for probiotics of brands Bi and Bn, Bg, and L. Isolates of brand Cn was also resistant towards gentamycin, streptomycin and ciprofloxacin antibiotics. Additionally, we also report a discrepancy between the enumerated viable bacteria amounts and the claims of the manufacturers. Conclusions This short report has highlighted the present of antibiotic resistance in probiotic bacteria from dietary supplements and therefore serves as a platform for further screenings and for in-depth characterization of the resistant determinants and the molecular machinery that confers the resistance.

  8. Isolation and Identification Enterobacter asburiae from Consumed Powdered Infant Formula Milk (PIF) in the Neonatal Intensive Care Unit (NICU).

    Science.gov (United States)

    Mardaneh, Jalal; Soltan Dallal, Mohammad Mehdi

    2016-01-01

    Enterobacter asburiae (E. asburiae) is a facultative anaerobic, non-spore-forming gram-negative rod-shaped bacterium belonging to the family of Enterobacteriaceae. It is an opportunistic pathogen that its strains are isolated from a variety of clinical and environmental specimens. Since powdered infant formula milk (PIF) is not a sterile product, it is an excellent medium for bacterial growth. The aim of this study was to isolate and identify E. asburiae from PIF in the neonatal intensive care unit (NICU) and determine antimicrobial susceptibility patterns of this bacterium. A total 125 PIF samples were purchased from drug stores between June 2011 to March 2012. E. asburiae was isolated according to FDA method. For final confirmation, biochemical tests embedded in the API-20E system were used. The drug susceptibility test was performed using the disc diffusion method according to CLSI recommendations. Out of the 125 PIF samples investigated, 2 (1.6%) samples were positive for E. asburiae. All isolated strains were uniformly susceptible to aztreonam, cefotaxim, amikacin, streptomycin, nalidixic acid, meropenem, tetracycline, ceftazidime, and colistin. Variable susceptibility was seen to the some antimicrobial agents tested. Each country should categorize its own designed guidelines for the preparation and handling of PIF adapted to the local environment. Moreover, the pathogenesis of the E. asburiae in infants hospitalized in NICU and other groups such as immunosuppressed patients and HIV infected individuals is uncertain and requires further study.

  9. Metallo-beta-lactamases of Pseudomonas aeruginosa--a novel mechanism resistance to beta-lactam antibiotics.

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    Dorota Olszańska

    2008-06-01

    Full Text Available Since about twenty years, following the introduction into therapeutic of news beta-lactam antibiotics (broad-spectrum cephalosporins, monobactams and carbapenems, a very significant number of new beta-lactamases appeared. These enzymes confer to the bacteria which put them, the means of resisting new molecules. The genetic events involved in this evolution are of two types: evolution of old enzymes by mutation and especially appearance of new genes coming for some, from bacteria of the environment. Numerous mechanisms of enzymatic resistance to the carbapenems have been described in Pseudomonas aeruginosa. The important mechanism of inactivation carbapenems is production variety of b-lactam hydrolysing enzymes associated to carbapenemases. The metallo-beta-enzymes (IMP, VIM, SPM, GIM types are the most clinically significant carbapenemases. P. aeruginosa posses MBLs and seem to have acquired them through transmissible genetic elements (plasmids or transposons associated with integron and can be transmission to other bacteria. They have reported worldwide but mostly from South East Asia and Europe. The enzymes, belonging to the molecular class B family, are the most worrisome of all beta-lactamases because they confer resistance to carbapenems and all the beta-lactams (with the exception of aztreonam and usually to aminoglycosides and quinolones. The dissemination of MBLs genes is thought to be driven by regional consumption of extended--spectrum antibiotics (e.g. cephalosporins and carbapenems, and therefore care must be taken that these drugs are not used unnecessarily.

  10. Caracterización bioquímica, patrón de sensibilidad y perfil plasmídico de cepas hospitalarias multirresistentes de Klebsiella pneumoniae

    Directory of Open Access Journals (Sweden)

    Laura Castañeda

    2001-04-01

    Full Text Available

    Klebsiella spp, particularmente K. pneumoniae son causa importante de infección nosocomial. Este microorganismo es frecuentemente resistente a numerosos antibióticos incluyendo las recientes oxy-imino-cefalosporinas y el aztreonam; la adquisición de plasmidos que codifican la producción de β-lactamasa de espectro extendido (BLEE es uno de los mecanismos de resistencia más importantes, lo que hace difícil la selección de antibióticos para el tratamiento. La colonización por estas cepas productoras de BLEE, es un fenómeno complejo que involucra diferentes mecanismos: diseminación de cepas epidémicas, de plasmidos o de genes de resistencia. En Colombia son pocos los trabajos realizados para estudiar el comportamiento del fenómeno de resistencia de este patógeno nosocomial.

     

     

  11. Effect of various antibiotics on modulation of intestinal microbiota and bile acid profile in mice.

    Science.gov (United States)

    Zhang, Youcai; Limaye, Pallavi B; Renaud, Helen J; Klaassen, Curtis D

    2014-06-01

    Antibiotic treatments have been used to modulate intestinal bacteria and investigate the role of intestinal bacteria on bile acid (BA) homeostasis. However, knowledge on which intestinal bacteria and bile acids are modified by antibiotics is limited. In the present study, mice were administered various antibiotics, 47 of the most abundant bacterial species in intestine, as well as individual BAs in plasma, liver, and intestine were quantified. Compared to the two antibiotic combinations (vancomycin+imipenem and cephalothin+neomycin), the three single antibiotics (metronidazole, ciprofloxacin and aztreonam) have less effect on intestinal bacterial profiles, and thus on host BA profiles and mRNA expression of genes that are important for BA homeostasis. The two antibiotic combinations decreased the ratio of Firmicutes to Bacteroidetes in intestine, as well as most secondary BAs in serum, liver and intestine. Additionally, the two antibiotic combinations significantly increased mRNA of the hepatic BA uptake transporters (Ntcp and Oatp1b2) and canalicular BA efflux transporters (Bsep and Mrp2), but decreased mRNA of the hepatic BA synthetic enzyme Cyp8b1, suggesting an elevated enterohepatic circulation of BAs. Interestingly, the two antibiotic combinations tended to have opposite effect on the mRNAs of most intestinal genes, which tended to be inhibited by vancomycin+imipenem but stimulated by cephalothin+neomycin. To conclude, the present study clearly shows that various antibiotics have distinct effects on modulating intestinal bacteria and host BA metabolism.

  12. Occurrence and characterisation of MRSA and extended-spectrum ß-lactamases producing Escherichia coli isolated from mastitic cows’ milk

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    Weiner Marcin

    2015-06-01

    Full Text Available The aim of study was the preliminary evaluation of the occurrence of methicillin-resistant Staphylococcus aureus (MRSA and extended spectrum ß-lactamases (ESBL - producing Escherichia coli in 650 milk and inflammatory secretions from cows with clinical or subclinical mastitis. One millilitre of the sample was added to Mueller-Hinton broth supplemented with 6.5% NaCl, Tryptone Soya Broth with cefoxitin and aztreonam, and then to MRSA ID agar. Presumptive MRSA colonies were analysed for the presence of mecA gene. Parallel to MRSA identification, the samples were incubated in buffered peptone water, lauryl tryptose broth and McConkey agar supplemented with cefotaxim for ESBL-producing E. coli isolation. These bacteria were identified using API Rapid 32 E and the ability of ESBL production was initially established using disc test D68C and confirmed by MIC technique using Sensititre ESBL plates. The primers (blaCTX, blaTEM, blaSHV, and blaCMY-2-group for the detection of some of the genes encoding ESBL production were used. The 45 strains of S. aureus with mecA gene and 41 strains of E. coli with blaTEM gene were detected.

  13. Recent advances in the treatment of Pseudomonas aeruginosa infections in cystic fibrosis

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    Høiby Niels

    2011-04-01

    Full Text Available Abstract Chronic Pseudomonas aeruginosa lung infection in cystic fibrosis (CF patients is caused by biofilm-growing mucoid strains. Biofilms can be prevented by early aggressive antibiotic prophylaxis or therapy, and they can be treated by chronic suppressive therapy. New results from one small trial suggest that addition of oral ciprofloxacin to inhaled tobramycin may reduce lung inflammation. Clinical trials with new formulations of old antibiotics for inhalation therapy (aztreonam lysine against chronic P. aeruginosa infection improved patient-reported outcome, lung function, time to acute exacerbations and sputum density of P. aeruginosa. Other drugs such as quinolones are currently under investigation for inhalation therapy. A trial of the use of anti-Pseudomonas antibiotics for long-term prophylaxis showed no effect in patients who were not already infected. Use of azithromycin to treat CF patients without P. aeruginosa infection did not improve lung function. Here I review the recent advances in the treatment of P. aeruginosa lung infections with a focus on inhalation treatments targeted at prophylaxis and chronic suppressive therapy.

  14. Determination of the prevalence of extended spectrumβ-lactamase in clinical samples collected from Dehradun City Hospital

    Institute of Scientific and Technical Information of China (English)

    Narayan Sharma; Ripan Mujumdar; Rajeev Kumar Gautam

    2016-01-01

    Objective:To detect extended spectrumβ-lactamase (ESBL) and determine its prevalence in various clinical samples collected from Dehradun City Hospital. Methods:The samples were first cultured in MacConkey’s agar plates by streak plate method, then identified by Gram staining and biochemical tests. The isolated bacterial strains were then tested for antibiotic susceptibility by Kirby-Bauer method. TheESBL detection is then carried out by double disc diffusion method. Results: Off the 56 samples cultured, 21 strains were identified which were sixEscherichia coli(E. coli), sixKlebsiella, fourProteus, fourPseudomonas aeruginosa (P. aeruginosa) and only oneAcinetobacter. Eight out of 21 (38.1%) strains including three ofE. coli, three ofKlebsiella and two ofP. aeruginosa, were found to be resistance to all five antibiotics (piperacillin, amikacin, ampicillin, gentamicin, and ciprofloxacin). Initial screening using four antibiotics (cefotaxime, ceftazidime, aztreonam and ceftriaxone) and the final confirmatory test using ceftazidime/clavulanic acid and ceftazidime alone showed that 19.05% of all strains isolated wereESBL producers. Individually, 16.67%E. coli, 16.67%Klebsiella pneumoniae, 25%P. aeruginosa and 100%Acinetobacter were found to beESBL producers. Conclusions:Antibiotic resistance byESBL has become a major risk factor worldwide, therefore routine checkup and accordingly prescription are suggested.

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

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    Summaiya Mulla

    2011-01-01

    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.

  16. Analysis of the drug-resistant characteristics of Klebsiella pneumoniae isolated from the respiratory tract and CTX-M ESBL genes.

    Science.gov (United States)

    Huang, S Y; Pan, K Y; Liu, X Q; Xie, X Y; Dai, X L; Chen, B J; Wu, X Q; Li, H Y

    2015-10-05

    The main aim of this study was to understand the relationship between the drug-resistant characteristics of Klebsiella pneumoniae and CTX-M-type extended spectrum β-lactamases (ESBLs), and to detect the distributions of CTX-M-type ESBLs in clinically isolated strains. CTX-M ESBL genes isolated from the clinical samples were amplified by polymerase chain reaction and identified by sequence analysis; the antibiotic susceptibility of the samples was determined using the Kirby-Bauer disc-diffusion method. One hundred and five strains among the 246 isolated strains of K. pneumoniae tested positive for ESBL production (42.68%); 92 of these produced CTX-M ESBLs. Of the 92 CTX-M ESBL strains, 81 produced CTX-M-1 ESBLs and 11 produced CTX-M-25 ESBLs. Fifty-seven of the CTX-M-1 ESBL- and six of the CTX-M-25 ESBL-producing bacteria had CTX-M ESBL genes that coexisted in the plasmid and chromosome. The Kirby-Bauer antibiotic susceptibility method revealed that CTX-M ESBL-positive strains showed a higher rate of resistance to cefazolin, cefoxitin, cefuroxime, ceftazidime, cefotaxime, aztreonam, levofloxacin, and cotrimoxazole, compared to the CTX-M ESBL-negative strains (P ESBL genes were commonly observed in the K. pneumoniae isolated from respiratory tract samples; these were significantly associated with the drug-resistant characteristics of K. pneumoniae to β-lactam antibiotics.

  17. Occurrence of PER-1 producing clinical isolates of Pseudomonas aeruginosa in Japan and their susceptibility to doripenem.

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    Yamano, Yoshinori; Nishikawa, Toru; Fujimura, Takaji; Yutsudou, Takashi; Tsuji, Masakatsu; Miwa, Hideaki

    2006-12-01

    The acquisition of resistance by extended-spectrum beta-lactamases (ESBL) has been reported primarily for Enterobacteriaceae, but there are few reports on the isolation of ESBL-producing Pseudomonas aeruginosa. PER-1-type ESBL producing P aeruginosa has been found in various regions around the world but there are no reports of clinical isolates in Japan. During our susceptibility surveillance studies over a 10 year period, we found four clinical isolates resistant to ceftazidime due to production of PER-1. They were resistant to ceftazidime but susceptible in the presence of clavulanic acid, a class A beta-lactamase inhibitor. The strains had the ability to hydrolyze ceftazidime. They also had the gene for PER-1-type ESBL. This is the first report of the isolation of PER-1 producing strains in Japan. These four strains were resistant to ceftazidime, cefepime and aztreonam with MICs of 64 microg/ml or more, but were more susceptible to carbapenem antibiotics. In particular, doripenem, which is a novel carbapenem antibiotic, showed good antibacterial activity with a MIC of 2 or 4 microg/ml, which was more potent than meropenem and imipenem. Doripenem also showed good therapeutic efficacy against a systemic infection of mice with a PER-1 producing strain, and was also more potent in vivo than imipenem or meropenem.

  18. E240V substitution increases catalytic efficiency toward ceftazidime in a new natural TEM-type extended-spectrum beta-lactamase, TEM-149, from Enterobacter aerogenes and Serratia marcescens clinical isolates.

    Science.gov (United States)

    Perilli, Mariagrazia; Celenza, Giuseppe; De Santis, Francesca; Pellegrini, Cristina; Forcella, Chiara; Rossolini, Gian Maria; Stefani, Stefania; Amicosante, Gianfranco

    2008-03-01

    The aim of this study was to characterize a novel extended-spectrum beta-lactamase that belongs to the TEM family, the TEM-149 enzyme, and that was isolated from the urine of two hospitalized patients from different hospitals in southern Italy. The peculiarity of this enzyme was the finding of a valine residue at position 240. The array of amino acid substitutions found in TEM-149 was as follows: E104K, R164S, M182T, and E240V. A reversion of a threonine residue at position 182 was also performed to create a new mutant, TEM-149 T182M, in order to assess the contribution of this substitution on the kinetic profile and the stability of TEM-149. The bla TEM-149 and bla TEM-149/T182M genes were cloned into pBC-SK, and the corresponding enzymes were purified from recombinant Escherichia coli HB101 by the same procedure. Both enzymes hydrolyzed all beta-lactams tested, with a preference for ceftazidime, which was found to be the best substrate. By comparison of the kinetic parameters of the TEM-149 and the TEM-149 T182M enzymes, a reduction of the catalytic efficiency for the TEM-149 T182M mutant was observed against all substrates tested except benzylpenicillin, cefotaxime, and aztreonam. Tazobactam, clavulanic acid, and sulbactam were good inhibitors of the TEM-149 beta-lactamase.

  19. New options of antibiotic combination therapy for multidrug-resistant Pseudomonas aeruginosa.

    Science.gov (United States)

    Nakamura, I; Yamaguchi, T; Tsukimori, A; Sato, A; Fukushima, S; Matsumoto, T

    2015-01-01

    Several antibiotic combinations have demonstrated increased activity against multidrug-resistant Pseudomonas aeruginosa (MDRP) in vitro compared with a single antibiotic. The aim of this study was to investigate the activity against MDRP of some aminoglycosides in combination with monobactam, piperacillin (PIPC), and carbapenem. Clinical isolates of MDRP were collected between November 2010 and October 2012 from patients in Tokyo Medical University Hospital, Tokyo (1,015 beds). Our new method was designed to evaluate three concentrations around the breakpoint of each drug using the Checkerboard method. The aminoglycosides tested were amikacin (AMK), tobramycin (TOB), and arbekacin (ABK). Ciprofloxacin, PIPC, and biapenem (BIPM), which have been reported to demonstrate combination effects, were also tested. Sixty-six MDRP strains were identified from the 2,417 P. aeruginosa strains. Of the 66, 27 tested positive for metallo-β-lactamase (MBL). Aztreonam (AZT) with AMK or ABK was the most effective against MDRP. PIPC with AMK or ABK were somewhat effective. AZT with AMK or ABK were more effective against MBL-positive strains than MBL-negative strains. However, PIPC with AMK or ABK were more effective against MBL-negative strains than MBL-positive strains. Combination activities showed differences between MBL-positive and MBL-negative strains.

  20. Genetic Lineages and Antimicrobial Resistance in Pseudomonas spp. Isolates Recovered from Food Samples.

    Science.gov (United States)

    Estepa, Vanesa; Rojo-Bezares, Beatriz; Torres, Carmen; Sáenz, Yolanda

    2015-06-01

    Raw food is a reservoir of Pseudomonas isolates that could be disseminated to consumers. The presence of Pseudomonas spp. was studied in food samples, and the phenotypic and genotypic characterizations of the recovered isolates were analyzed. Two samples of meat (3%, turkey and beef) and 13 of vegetables (22%, 7 green peppers and 6 tomatoes) contained Pseudomonas spp. A total of 20 isolates were identified, and were classified as follows (number of isolates): P. aeruginosa (5), P. putida (5), P. nitroreducens (4), P. fulva (2), P. mosselli (1), P. mendocina (1), P. monteilii (1), and Pseudomonas sp. (1). These 20 Pseudomonas isolates were clonally different by pulsed-field-gel-electrophoresis, and were resistant to the following antibiotics: ticarcillin (85%), aztreonam (30%), cefepime (10%), imipenem (10%), and meropenem (5%), but were susceptible to ceftazidime, piperacillin, piperacillin-tazobactam, doripenem, gentamicin, tobramycin, amikacin, ciprofloxacin, norfloxacin, and colistin. Only one strain (Ps158) presented a class 1 integron lacking the 3' conserved segment. The five P. aeruginosa strains were typed by multilocus sequence typing in five different sequence-types (ST17, ST270, ST800, ST1455, and ST1456), and different mutations were detected in protein OprD that were classified in three groups. One strain (Ps159) showed a new insertion sequence (ISPa47) truncating the oprD gene, and conferring resistance to imipenem.

  1. In vitro activities of antimicrobial agents, alone and in combination, against Acinetobacter baumannii isolated from blood.

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    Chang, S C; Chen, Y C; Luh, K T; Hsieh, W C

    1995-11-01

    In vitro activities of 15 antimicrobial agents against 90 strains of Acinetobacter baumannii isolated from blood cultures from hospitalized patients were determined using the agar dilution method. Imipenem, ofloxacin, and ciprofloxacin had the best antimicrobial activity with minimum inhibitory concentrations (MIC50s) of 0.25 mu g/ml and MIC90s of 0.5-1 mu g/ml. beta-lactam antibiotics other than imipenem had poor activity, with MIC50s ranging from 8 to 64 mu g/ml and MIC90s from 32 to > or = 256 mu g/ml. The checkerboard titration method was used to study the effects of combination of two antimicrobial agents. Combinations of ceftazidime, aztreonam, imipenem, or ciprofloxacin with amikacin showed either synergistic effects or partial synergistic effects for 40.9%-86.4% of 22 tested strains. The best in vitro activity was observed with the combination of imipenem and amikacin. No antagonistic effects were observed with the combination of imipenem and amikacin. Synergistic effects were confirmed by time-kill curve studies. In conclusion, imipenem, ofloxacin, and ciprofloxacin were the three most active agents against human blood isolates of A. baumannii. The combination of a beta-lactam or ciprofloxacin with amikacin was synergistic for some of the isolates.

  2. Chironomid egg masses harbour the clinical species Aeromonas taiwanensis and Aeromonas sanarellii.

    Science.gov (United States)

    Beaz-Hidalgo, Roxana; Shakèd, Tamar; Laviad, Sivan; Halpern, Malka; Figueras, María J

    2012-12-01

    Bacteria of the genus Aeromonas are found worldwide in aquatic environments and may produce human infections. In 2010, two new clinical species, Aeromonas sanarellii and Aeromonas taiwanensis, were described on the basis of one strain recovered from wounds of hospitalized patients in Taiwan. So far, only four environmental isolates of A. sanarellii and one of A. taiwanensis have been recorded from waste water in Portugal and an additional clinical strain of A. taiwanensis from the faeces of a patient with diarrhoea in Israel. In the present study, strains belonging to these two species were identified from chironomid egg masses from the same area in Israel by sequencing the rpoD gene. This represents a new environmental habitat for these novel species. The first data on the virulence genes and antibiotic susceptibility are provided. The isolates of these two new species possess multiple virulence genes and are sensitive to amikacin, aztreonam, cefepime, cefoxatime, ceftazidime, ciprofloxacin, gentamicin, piperacillin-tazobactam, tigecycline, tobramycin, trimethoprim-sulfamethoxazole and imipenem. The key phenotypic tests for the differentiation of these new species from their closest relative Aeromonas caviae included the utilization of citrate, growth at 45 °C in sheep blood agar and acid production of cellobiose.

  3. Diversity of Antimicrobial Resistance and Virulence Determinants in Pseudomonas aeruginosa Associated with Fresh Vegetables

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    Kashina Allydice-Francis

    2012-01-01

    Full Text Available With the increased focus on healthy eating and consuming raw vegetables, this study assessed the extent of contamination of fresh vegetables by Pseudomonas aeruginosa in Jamaica and examined the antibiotic susceptibility profiles and the presence of various virulence associated determinants of P. aeruginosa. Analyses indicated that vegetables from retail markets and supermarkets were widely contaminated by P. aeruginosa; produce from markets were more frequently contaminated, but the difference was not significant. Lettuce and carrots were the most frequently contaminated vegetables, while tomatoes were the least. Pigment production (Pyoverdine, pyocyanin, pyomelanin and pyorubin, fluorescein and alginate were common in these isolates. Imipenem, gentamicin and ciprofloxacin were the most inhibitory antimicrobial agents. However, isolates were resistant or showed reduced susceptibility to ampicillin, chloramphenicol, sulphamethoxazole/trimethoprim and aztreonam, and up to 35% of the isolates were resistant to four antimicrobial agents. As many as 30% of the isolates were positive for the fpv1 gene, and 13% had multiple genes. Sixty-four percent of the isolates harboured an exoenzyme gene (exoS, exoT, exoU or exoY, and multiple exo genes were common. We conclude that P. aeruginosa is a major contaminant of fresh vegetables, which might be a source of infection for susceptible persons within the community.

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

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    Junaid Iqbal

    2013-01-01

    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.

  5. Clinical implementation of 2010 reference standards of the U.S.Chinical and Laboratory Standards Institute in antimicrobial susceptibility for Enterobacteriaceae%2010年微生物药敏试验标准在肠杆菌科细菌药敏试验中的临床应用

    Institute of Scientific and Technical Information of China (English)

    马立艳; 苏建荣

    2011-01-01

    目的 比较美国临床和实验室标准化研究所(CLSI)制定的微生物药敏试验2009年和2010年判读标准在肠杆菌科细菌药敏试验中的临床应用.方法 分别应用CLSI M100-S19(2009)和M100-S20(2010)中头孢曲松、头孢他啶和氨曲南的判读标准对大肠埃希菌(308株)和肺炎克雷伯菌(194株)临床分离株的药敏试验结果进行比较分析.结果 在2009年和2010年判读标准中,ESBLs(+)大肠埃希菌对头孢他啶、头孢曲松、氨曲南的耐药率分别为84.2%和98.0%、84.2%和98.0%、84.9%和98.0%;ESBLs(-)大肠埃希菌对头孢他啶、头孢曲松、氨曲南的耐药率分别为4.2%和7.7%、4.2%和7.7%、5.6%和8.4%;ESBLs(+)肺炎克雷伯菌对头孢他啶、头孢曲松、氨曲南的耐药率分别为67.2%和90.2%、67.2%和90.2%、67.2%和90.2%;ESBLs(-)肺炎克雷伯菌对头孢他啶、头孢曲松、氨曲南的耐药率分别为9.8%和10.6%、9.8%和10.6%、10.6%和10.6%.结论 按照2010年CLSI新标准判读,头孢曲松、头孢他啶和氨曲南的耐药率较2009年旧版标准均有不同程度的升高;与ESBLs(-)菌株相比,ESBLs(+)菌株受到新旧判读折点变化的影响更大;ESBLs(+)菌株中,受头孢他啶和氨曲南折点变化影响的肺炎克雷伯菌的百分比要高于大肠埃希菌.%Objective To compare the performance of 2009 and 2010 reference standards of the United States Clinical and Laboratory Standards Institute(CLSI)in antimicrobial susceptibility for Enterobacteriaceae.Methods The breakpoints of susceptibility for ceftriaxone,ceftazidime and aztreonam in CLSI M100-S19(2009)were used to analyze results of antimicrobial susceptibility of Escherichia coli (308 isolates)and Klebsiella pneumoniae(194 isolates),as well as those revised in M100-S20(2010).Results With both the breakpoints in CLSI M100-S19(2009)and CLSI M100-S20(2010),proportions of antimicmbial resistance of ceftriaxone,ceftazidime and aztreonam for isolates of extended-spectrum

  6. A detailed kinetic study of Mox-1, a plasmid-encoded class C beta-lactamase.

    Science.gov (United States)

    Alba, Jimena; Bauvois, Cedric; Ishii, Yoshikazu; Galleni, Moreno; Masuda, Katsuyoshi; Ishiguro, Masaji; Ito, Masahiko; Frere, Jean-Marie; Yamaguchi, Keizo

    2003-08-29

    Surveys of beta-lactamases in different parts of the world show an important increase in class C beta-lactamases, thus the study of these enzymes is becoming an important issue. We created an overproduction system for Mox-1, a plasmid class C beta-lactamase, by cloning the gene encoding this enzyme, and placing it under the control of a T7 promoter, using vector pET 28a. The enzyme, purified by ion exchange chromatography, was used to obtain the molecular mass (38246), the N-terminal sequence (GEASPVDPLRPVV), and pI (8.9), and to perform a detailed kinetic study. Cephalotin was used as reporter substrate in the case of poor substrates. The kinetic study showed that benzylpenicillin, cephalotin, cefcapene and moxalactam were good substrates for Mox-1 (k(cat)/K(m) values >2.5 x 10(6) M(-1) s(-1)). On the other hand, ceftazidime and cefepime were poor substrates for this enzyme (K(m) values >200 microM). Clavulanic acid had no inhibitory effect on Mox-1 (K(m)=30.2 mM), however aztreonam behaved as an inhibitor of Mox-1 (K(i)=2.85 microM).

  7. Inhibitor discovery of full-length New Delhi metallo-β-lactamase-1 (NDM-1.

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    Bingzheng Shen

    Full Text Available New Delhi metallo-β-lactmase-1 (NDM-1 has recently attracted extensive attention for its biological activities to catalyze the hydrolysis of almost all of β-lactam antibiotics. To study the catalytic property of NDM-1, the steady-kinetic parameters of NDM-1 toward several kinds of β-lactam antibiotics have been detected. It could effectively hydrolyze most β-lactams (k cat/K m ratios between 0.03 to 1.28 µmol⁻¹.s⁻¹, except aztreonam. We also found that thiophene-carboxylic acid derivatives could inhibit NDM-1 and have shown synergistic antibacterial activity in combination with meropenem. Flexible docking and quantum mechanics (QM study revealed electrostatic interactions between the sulfur atom of thiophene-carboxylic acid derivatives and the zinc ion of NDM-1, along with hydrogen bond between inhibitor and His189 of NDM-1. The interaction models proposed here can be used in rational design of NDM-1 inhibitors.

  8. Profile of antimicrobial resistance of bacteria isolated from cockroaches (Periplaneta americana in a Brazilian health care institution

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    Marinésia Aparecida Prado

    2006-02-01

    Full Text Available Cockroaches carry microorganisms to sterilized materials, equipment and non-contaminated food in hospitals and in homes. Hence, they are regarded as major microbial vectors. We isolated and identified microorganisms from living cockroaches captured from a Brazilian health care institution and we determined the antimicrobial susceptibility profile of the isolates. Following collection, cockroaches were immobilized at 4ºC for 10 to 20 minutes, immersed in 0.8% saline solution and then homogenized. Next, the suspension was seeded in culture media: brain and heart agar infusion, MacConkey agar, Naito agar, and they were incubated for up to 48 hours at 37ºC. Sabouraud agar cultures were incubated at ambient temperature. The microbial colonies were analyzed with a stereomicroscope to count and phenotypically identify the colony-forming units (cfu. The discdiffusion method was used to determine the profile of susceptibility to antimicrobials. Among the 103 cockroaches analyzed, fungi were found in 97%, enterobacteria in 74.6% and coagulase-negative staphylococci (CNS in 25.40%. Among the enterobacteria, 96% were resistant to gentamicin, 84% to ampicillin, 75.3% to caphalothin, 66.7% to ampicillin-sulbactam, 50% to aztreonam and 30% to chloramphenicol. Among the CNS, 61% were resistant to oxacillin. We concluded that cockroaches carry organisms associated with nosocomial infections and that are resistant to antimicrobials. This fact contributes to the epidemiological chain, complicating therapeutics, and consequently, medical costs are increased.

  9. Broth Microdilution Method To Detect Extended-Spectrum β-Lactamases and AmpC β-Lactamases in Enterobacteriaceae Isolates by Use of Clavulanic Acid and Boronic Acid as Inhibitors ▿

    Science.gov (United States)

    Jeong, Seok Hoon; Song, Wonkeun; Kim, Jae-Seok; Kim, Han-Sung; Lee, Kyu Man

    2009-01-01

    This study was designed to evaluate the performance of the broth microdilution (BMD) method to detect production of extended-spectrum β-lactamases (ESBLs) and AmpC β-lactamases in Enterobacteriaceae by using clavulanic acid (CA) and boronic acid (BA) as ESBL and AmpC β-lactamase inhibitors, respectively. A total of 100 clinical isolates of Enterobacteriaceae were analyzed. Mueller-Hinton broth containing serial twofold dilutions of cefotaxime (CTX), ceftazidime (CAZ), aztreonam (ATM), or cefepime (FEP) with or without either or both CA and BA was prepared. An eightfold or greater decrease in the MIC of CTX, CAZ, ATM, or FEP in the presence of CA and BA was considered a positive result for ESBL and plasmid-mediated AmpC β-lactamase (PABL), respectively. In tests with CA, expanded-spectrum β-lactams containing BA (CTX-BA, CAZ-BA, ATM-BA, and FEP-BA) showed higher positive rates in detecting ESBL producers than those without BA. The combination of CTX- and CAZ-based BMD tests with CA and BA showed sensitivity and specificity of 100% for the detection of ESBLs and PABLs. The BMD testing could be applicable for routine use in commercially available semiautomated systems for the detection of ESBLs and PABLs in Enterobacteriaceae. PMID:19710269

  10. The Lys234Arg Substitution in the Enzyme SHV-72 Is a Determinant for Resistance to Clavulanic Acid Inhibition▿

    Science.gov (United States)

    Mendonça, Nuno; Manageiro, Vera; Robin, Frédéric; Salgado, M. José; Ferreira, Eugénia; Caniça, Manuela; Bonnet, Richard

    2008-01-01

    The new β-lactamase SHV-72 was isolated from clinical Klebsiella pneumoniae INSRA1229, which exhibited the unusual association of resistance to the amoxicillin-clavulanic acid combination (MIC, 64 μg/ml) and susceptibility to cephalosporins, aztreonam, and imipenem. SHV-72 (pI 7.6) harbored the three amino acid substitutions Ile8Phe, Ala146Val, and Lys234Arg. SHV-72 had high catalytic efficiency against penicillins (kcat/Km, 35 to 287 μM−1·s−1) and no activity against oxyimino β-lactams. The concentration of clavulanic acid necessary to inhibit the enzyme activity by 50% was 10-fold higher for SHV-72 than for SHV-1. Molecular-dynamics simulation suggested that the Lys234Arg substitution in SHV-72 stabilized an atypical conformation of the Ser130 side chain, which moved the Oγ atom of Ser130 around 3.5 Å away from the key Oγ atom of the reactive serine (Ser70). This movement may therefore decrease the susceptibility to clavulanic acid by preventing cross-linking between Ser130 and Ser70. PMID:18316518

  11. A Carbapenem-Resistant Pseudomonas aeruginosa Isolate Harboring Two Copies of blaIMP-34 Encoding a Metallo-β-Lactamase.

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    Tatsuya Tada

    Full Text Available A carbapenem-resistant strain of Pseudomonas aeruginosa, NCGM1984, was isolated in 2012 from a hospitalized patient in Japan. Immunochromatographic assay showed that the isolate was positive for IMP-type metallo-β-lactamase. Complete genome sequencing revealed that NCGM1984 harbored two copies of blaIMP-34, located at different sites on the chromosome. Each blaIMP-34 was present in the same structures of the class 1 integrons, tnpA(ISPa7-intI1-qacG-blaIMP-34-aac(6'-Ib-qacEdelta1-sul1-orf5-tniBdelta-tniA. The isolate belonged to multilocus sequence typing ST235, one of the international high-risk clones. IMP-34, with an amino acid substitution (Glu126Gly compared with IMP-1, hydrolyzed all β-lactamases tested except aztreonam, and its catalytic activities were similar to IMP-1. This is the first report of a clinical isolate of an IMP-34-producing P. aeruginosa harboring two copies of blaIMP-34 on its chromosome.

  12. Evaluation of phenotypic tests for the detection of AmpC beta-lactamase in clinical isolates of Escherichia coli

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    Deepika Handa

    2013-01-01

    Full Text Available Background: AmpC beta lactamases are cephalosporinases that confer resistance to a wide range of beta lactam drugs thereby causing serious therapeautic problem. As there are no CLSI guidelines for detection of AmpC mediated resistance in Gram negative clinical isolates and it may pose a problem due to misleading results, especially so in phenotypic tests. Although cefoxitin resistance is used as a screening test, it does not reliably indicate AmpC production. Materials and Methods: We planned a study to determine the occurrence of AmpC beta lactamase in hospital and community, clinical isolates of Escherichia coli and simultaneously evaluate different phenotypic methods for detection of AmpC beta lactamases. Results: It was observed that 82.76% isolates were ESBL positive and 59% were cefoxitin screen positive. Using phenotypic confirmatory tests the occurrence of Amp C beta lactamases was found to be 40% and 39% by inhibitor based method using boronic acid (IBM and modified three dimensional test (M3D respectively. Conclusion: Both the test showed concordant result. Co-production was observed in 84.62% isolates Screening of ESBL and Amp C can be done in routine clinical microbiology laboratory using aztreonam and IBM respectively as it is a simple, rapid and technically less demanding procedure which can be used in all clinical laboratories.

  13. Diversity of fecal coliforms and their antimicrobial resistance patterns in wastewater treatment model plant.

    Science.gov (United States)

    Luczkiewicz, A; Fudala-Ksiazek, S; Jankowska, K; Quant, B; Olańczuk-Neyman, K

    2010-01-01

    The occurrence of resistance patterns among wastewater fecal coliforms was determined in the study. Susceptibility of the isolates was tested against 19 antimicrobial agents: aminoglycosides, aztreonam, carbapenems, cephalosporines, beta-lactam/beta-lactamase inhibitors, penicillines, tetracycline, trimethoprim/sulfamethoxazole, and fluoroquinolones. Additionally the removal of resistant isolates was evaluated in the laboratory-scale wastewater treatment model plant (M-WWTP), continuously supplied with the wastewater obtained from the full-scale WWTP. Number of fecal coliforms in raw (after mechanical treatment) and treated wastewater, as well as in aerobic chamber effluent was determined using selective medium. The selected strains were identified and examined for antibiotic resistance using Phoenix Automated Microbiology System (BD Biosciences, USA). The strains were identified as Escherichia coli (n=222), Klebsiella pneumoniae ssp. ozaenae (n=9), and Pantoea agglomerans (n=1). The isolate of P. agglomerans as well as 48% of E. coli isolates were sensitive to all antimicrobials tested. The most frequent resistance patterns were found for ampicillin: 100% of K. pneumoniae ssp. ozaenae and 41% of E. coli isolates. Among E. coli isolates 12% was regarded as multiple antimicrobial resistant (MAR). In the studied M-WWTP, the applied activated sludge processes reduced considerably the number of fecal coliforms, but increased the ratio of antimicrobial-resistant E. coli isolates to sensitive ones, especially among strains with MAR patterns.

  14. [Occurrence and susceptibility to antibiotics of carbapenem-resistant Pseudomonas aeruginosa strains between 1998 and 2009].

    Science.gov (United States)

    Bogiel, Tomasz; Mikucka, Agnieszka; Skalski, Tomasz; Gospodarek, Eugenia

    2010-01-01

    P. aeruginosa rods are dangerous pathogens mainly responsible for nosocomial infections of different localization. Resistance to carbapenems, observed among them, is a serious threat due to ability to be transmitted between bacterial species. The aim of our study was to retrospectively evaluate the frequency of isolation and susceptibility to antibiotics of imipenem- and meropenem-resistant P. aeruginosa strains isolated between 1998 and 2009 from patients of University Hospital No 1 of dr A. Jurasz in Bydgoszcz. Study shows increasing number of isolation that type of strains from 19 in 1998 to 144 in 2009. Among all isolated P. aeruginosa strains majority was obtained from patients of the Intensive Care Units, Rehabilitation and Surgery Clinics. Examined strains of P. aeruginosa rods were mainly isolated from urine (20.5%), bronchoalveolar lavage (17.7%) and wound swabs (14.5%) samples. The isolates demonstrated frequently resistance to carbenicillin (> or 66.7%), ticarcillin (> or = 72.7%) and cefotaxime (> or = 75.6%). The lowest rate of resistant strains was observed in case of ceftazidime (< or = 68.8%), aztreonam (< or = 47.4%) and colistin (< or = 1.7%) suggesting the highest activity of that antimicrobials against infections caused by examined strains.

  15. Colistin- and Carbapenem-Resistant Escherichia coli Harboring mcr-1 and blaNDM-5, Causing a Complicated Urinary Tract Infection in a Patient from the United States

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    José R. Mediavilla

    2016-08-01

    Full Text Available Colistin is increasingly used as an antibiotic of last resort for the treatment of carbapenem-resistant Gram-negative infections. The plasmid-borne colistin resistance gene mcr-1 was initially identified in animal and clinical samples from China and subsequently reported worldwide, including in the United States. Of particular concern is the spread of mcr-1 into carbapenem-resistant bacteria, thereby creating strains that approach pan-resistance. While several reports of mcr-1 have involved carbapenem-resistant strains, no such isolates have been described in the United States. Here, we report the isolation and identification of an Escherichia coli strain harboring both mcr-1 and carbapenemase gene blaNDM-5 from a urine sample in a patient without recent travel outside the United States. The isolate exhibited resistance to both colistin and carbapenems, but was susceptible to amikacin, aztreonam, gentamicin, nitrofurantoin, tigecycline, and trimethoprim-sulfamethoxazole. The mcr-1- and blaNDM-5-harboring plasmids were completely sequenced and shown to be highly similar to plasmids previously reported from China. The strain in this report was first isolated in August 2014, highlighting an earlier presence of mcr-1 within the United States than previously recognized.

  16. A STUDY OF METALLO-BETA-LACTATAMASE PRODUCING PSEUDOMONAS AERUGINOSA IN CLINICAL SAMPLES OF S.S.G. HOSPITAL

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    Mehul S Chaudhari Tanuja B Javadekar Govind Ninama Neelam Pandya Jivraj Damor

    2011-04-01

    Full Text Available Introduction: Pseudomonas spp. is common pathogen causing nosocomial infection. Acquired drug resistance is frequent in nosocomial isolates of Pseudomonas spp. Acquired metallo-β-lactamases (MBL in pseudomonas spp. have recently emerged as one of the most worrisome resistance mechanism because of their capacity to hydrolyze all beta-lactam antibiotics including penicillins, cephalosporins and carbapenems, with the exception of aztreonam. Aim: To detect metallo-β-lactamase producing isolates of Pseudomonas aerugenosa from various clinical samples from patients admitted in our hospital. Material and methods : In this studyt we studied the prevalence, following standard methods of isolation and identification techniques of these bacteria from clinical materials Source : Samples of patients from different wards of S.S.G.Hosital are proceeded in Microbiology department , Medical College and S.S.G.Hospital Baroda. Results: Of total study of 150 isolates of Pseudomonas aeruginosa, 8 isolates are resistance to Imipenem . Of 8 samples , all are producing Metallo-Beta-Lactamase enzyme. Conclusion :Infection cause by MBL (metallo-β-lactamase positive isolates of Pseudomonas aerugenosa is important to identify because it poses not only therapeutic problem, but also a serious concern for infection control management. [National J of Med Res 2011; 1(2.000: 60-63

  17. Characterization of lead-resistant river isolate Enterococcus faecalis and assessment of its multiple metal and antibiotic resistance.

    Science.gov (United States)

    Aktan, Yasin; Tan, Sema; Icgen, Bulent

    2013-06-01

    Contamination of surface waters has a direct impact on the public health of entire communities. Microorganisms inhabiting contaminated surface waters have developed mechanisms of coping with a variety of toxic metals and drugs. Investigations were carried out to isolate and identify lead-resistant bacteria from the river Kızılırmak along the city of Kırıkkale, Turkey. Of the 33 lead-resistant isolates, one isolate with a minimal inhibitory concentration of 1,200 mg L(-1) was isolated and identified as Enterococcus faecalis by using biochemical tests and 16S rRNA sequencing. Lead-resistant E. faecalis isolate was found out to be resistant to other heavy metals like aluminum, lithium, barium, chromium, iron, silver, tin, nickel, zinc, and strontium and to drugs like amikacin, aztreonam, and gentamicin. E. faecalis harbored four plasmids with the molecular sizes of 1.58, 3.06, 22.76, and 28.95 kb. Plasmid profile analyses of cured derivatives revealed that the lead resistance ability of E. faecalis was still existing despite the elimination of all the plasmids. Moreover, the antibiotic resistance pattern of the cured derivatives did not demonstrate any change from the parental strain. Our findings indicated that the lead resistance genes of E. faecalis were located on the chromosomal DNA rather than the plasmid.

  18. Class Ⅰ integron with a novel cassette array in an ESBL-producing multidrug-resistant Klebsiella pneumoniae isolate

    Institute of Scientific and Technical Information of China (English)

    Bing Gu; Mingqing Tong; Wangsheng Zhao; Shiyang Pan; Yuanhua Wei; Peijun Huang

    2006-01-01

    Objective: To analyze the molecular mechanism of integron mediated multi-resistance in an ESBL-producingK. Pneumoniae NJ 12 isolate. Methods: Susceptibility test was carried out by Kirby-Bauer method. Class Ⅰ, Ⅱ and Ⅲ integrons were detected by integrase gene PCR with primers that annealed to conserved regions of integron-encoded integrase genes intIl, intI2 and intI3.The variable region of integron was amplified by integron PCR with primers that targeted the conserved flanking regions, and the PCR product was sequenced. Six aminoglycoside modifying-enzyme genes, including ant ( 2")- Ⅰ , ant ( 3")- Ⅰ , aac (3)- Ⅰ , aac ( 3 )- Ⅱ , aac (6')- Ⅰ , and aac (6')- Ⅱ, were detected. Results: K. Pneumoniae NJ 12 was resistant to nine antibiotics, including piperacillin,ampicillin, cefuroxime, ceftazidime, cefotaxime, aztreonam, streptomycin, gentamicin and amikacin. This isolate was shown that there was positive with class Ⅰ integron, ant(2")- Ⅰ , ant(3")- Ⅰ , aac(3)-Ⅱ and aac(6')- Ⅰ modifying-enzyme genes. Neither class Ⅱ nor Ⅲ integron was detected; DNA sequencing of the fragment amplified by integron PCR revealed a novel cassette array aadB-cat-blaoxa-10/aadA1. Conclusion: Class Ⅰ integron with a novel cassette array in an ESBL-producing multidrug-resistant K. Pneumoniae NJ 12 isolate was reported from Nanjing area of China, with the GenBank accession number DQ141319.

  19. Resistenza ai principali antibiotici dei microrganismi isolati presso l’ospedale “Luigi Sacco” di Milano nel periodo 1997-2001

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    Giampietro Nardi

    2003-03-01

    Full Text Available Antibiotic resistance of commonly isolated bacterial species at “L. Sacco” Hospital of Milan (Italy is evaluated in the period 1997-2001. Staphylococcus aureus and Staphylococcus epidermidis are quite completely resistant to penicillin, while the agents with β-lactamase inhibitors are more active against Staphylococcus aureus than against Staphylococcus epidermidis. Also cephalotin and eritromycine are more active against Staphylococcus aureus than against Staphylococcus epidermidis. Cephalosporins are active against beta-haemolytic streptococci, while Streptococcus pyogenes shows a resistance of 25-30% against erytromicin. For Streptococcus pneumoniae there is a sporadic, not increasing, resistance to penicillin. Enterococcus faecalis shows an increasing resistance for the year 2001 against cotrimoxazole, but ampicillin and imipenem are always active against this species. Aztreonam is always active against Escherichia coli, while there is resistance to piperacillin (20-25% and ampicillin (35-45%. Resistance to cephalotin is increasing in time, while cefotaxime is always active. For Haemophilus influenzae there is a certain resistance to ampicillin (10-20%. Pseudomonas aeruginosa is often resistant to widespectrum penicillins and to imipenem and ciprofloxacin (30%. With the only exclusion of a great increase of resistance of Enterococcus faecalis to cotrimoxazole in the year 2001, all the other patterns of resistance appear to be comparable in each of the five years considered. Substantially we do not observe an increase of antibiotic resistance.

  20. Transmission of a multiresistant Pseudomonas aeruginosa strain at a German University Hospital.

    Science.gov (United States)

    Pitten, F A; Panzig, B; Schröder, G; Tietze, K; Kramer, A

    2001-02-01

    Over 15 months, 60 patients at a German University Hospital became infected or colonized by a multiresistant Pseudomonas aeruginosa strain, which was isolated from tracheal secretions, blood, urine, venous catheters, ascites and several wounds. Most patients had undergone invasive treatment (surgery, cancer therapy). The genetic relationship of the isolates was investigated by pulsed field gel electrophoresis. The isolates were resistant to beta-lactam antibiotics, including carbapenems and aztreonam, to aminoglycosides and quinolones. The only in vitro susceptibility was to polymyxin B. Extensive sampling was carried out to identify contaminated medical devices, surfaces or media (water, food). Samples were taken from doctors and nursing staff and various treatment procedures were observed for several weeks. The handling of respirators, resuscitation tubes, urine bottles, and bedpans resulted in the contamination of the patients' environment, although most devices were cleaned and disinfected with automatic washer/disinfectors. Several wash basins on the intensive care unit were contaminated, but none of the drinking water samples showed any growth of P. aeruginosa. We recommend the strict use of gloves and strict application of alcoholic hand disinfectants immediately after discarding the gloves. The chain of infection ceased after strict cohort isolation and the subsequent introduction of the specific hygiene regime.

  1. ISPpu22, a novel insertion sequence in the oprD porin gene of a carbapen- em-resistant Pseudomonas aeruginosa isolate from a burn patient in Tehran, Iran

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    Davood Kalantar-Neyestanaki

    2015-12-01

    Full Text Available Background and Objectives: The oprD mutation and AmpC overproduction are the main mechanisms of intrinsic resistance to carbapenems such as imipenem and meropenem in Pseudomonas aeruginosa.Materials and Methods: In this study, we investigated intrinsic resistance to carbapenems including mutation of oprD and AmpC overproduction in a carbapenem-resistant P. aeruginosa isolated from a burn patient by phenotypic and molecular methods.Results: In our study, the carbapenem-resistant P. aeruginosa isolate was resistant to imipenem, meropenem, cefepime, gentamicin, ceftriaxone, carbenicillin, aztreonam and ciprofloxacin but was susceptible to ceftazidime and polymyxin B. The minimum inhibitory concentrations (MICs against imipenem, meropenem and ceftazidime were 64 μg/ml, 16 μg/ml and 2μg/ml, respectively. The isolate was ESBLs and AmpC overproducer. No carbapenemase activity was detected by Modified Hodge test (MHT. This isolate was carrying only blaOXA-10. PCR amplification and sequencing of oprD performed on isolate resulted in PCR product of 2647bp. Sequence analysis of the 2647bp product revealed insertion of a sequence of 1232 bp at position 8 in coding region of oprD.Conclusion: According to the results of this study, oprD mutation and AmpC overproduction can cause the main mechanism of resistance of P. aeruginosa to carbapenems.Keywords: ISPpu22, oprD, AmpC, Carbapenem-resistant P. aeruginosa

  2. Respiratory infections by Achromobacter xylosoxidans in a cohort of Cystic Fibrosis patients: identification, antimicrobial susceptibility and molecular epidemiology

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    Antonietta Lambiase

    2010-03-01

    Full Text Available Pulmonary infections by Gram-negative bacteria such as Achromobacter xylosoxidans are recovered frequently in patients with Cystic Fibrosis. Aims of this study were to value the isolation frequency of A.xylosoxidans strains in a cohort of Cystic Fibrosis patients, to investigate their antimicrobial sensitivity and to establish possible clonal likeness among strains.A retrospective study was undertaken between January 2004 and December 2008 on 300 patients receiving care at the Regional Cystic Fibrosis Centre of “Federico II” University, Naples. Sputum samples were collected and selective media as well as commercial systems for bacterial identification were used. The activity of antimicrobial agents was determined using diffusion and micro-dilution methods. For DNA-fingerprinting, a genomic DNA macrorestriction followed by pulsed-field gel electrophoresis was carried out. A total of 238 strains from 51 patients were isolated. Strains were resistant to aztreonam, about half of these were resistant to gentamicin and trimethoprim-sulphamethoxazole. They were sensitive to piperacillin, piperacillin/tazobactam, and also to carbapenems, quinolones, cephalosporines. Macrorestriction analysis applied on some isolates showed substantial heterogeneity among strains.Actually, the prognostic role of A. xylosoxidans in Cystic Fibrosis is unclear, but this finding must imply difficulties on therapeutic approach. So, it is need to be on the look out regard such microorganisms. Preliminary results of DNA-fingerprinting indicate no evidence of clonal likeness and then of patient-to-patient spread.

  3. Diversity of CTX-M beta-lactamases and their promoter regions from Enterobacteriaceae isolated in three Parisian hospitals.

    Science.gov (United States)

    Saladin, Michèle; Cao, Van Thi Bao; Lambert, Thierry; Donay, Jean-Luc; Herrmann, Jean-Louis; Ould-Hocine, Zahia; Verdet, Charlotte; Delisle, Françoise; Philippon, Alain; Arlet, Guillaume

    2002-04-01

    Nine clinical isolates of Enterobacteriaceae (six Escherichia coli and three Proteus mirabilis) isolated in three Parisian hospitals between 1989 and 2000 showed a particular extended-spectrum cephalosporin-resistance profile characterized by resistance to cefotaxime and aztreonam but not to ceftazidime. CTX-M-1, CTX-M-2, CTX-M-9, CTX-M-14 and two novel plasmid-mediated CTX-M beta-lactamases (CTX-M-20, and CTX-M-21) were identified by polymerase chain reaction and isoelectric focusing (pI>8) and were associated in eight cases with TEM-1 (pI=5.4) or TEM-2 (pI=5.6) beta-lactamases. We used internal ISEcp1 and IS26 forward primers and the CTX-M consensus reverse primer to characterize the CTX-M beta-lactamase promoter regions and showed their high degree of structure diversity. We found upstream of some bla(CTX-M) genes, a 266-bp sequence 100% identical to the sequence upstream of the Kluyvera ascorbata beta-lactamase gene, suggesting that this chromosomal enzyme is the progenitor of the CTX-M-2/5 cluster.

  4. Multi-drug-resistant enterotoxigenic and enterohemorrhagic Escherichia coli isolated from children with diarrhea.

    Science.gov (United States)

    Zeighami, Habib; Haghi, Fakhri; Hajiahmadi, Fahimeh; Kashefiyeh, Mehdi; Memariani, Mojtaba

    2015-06-01

    Multi-drug-resistant (MDR) diarrheagenic Escherichia coli (DEC) has rapidly spread worldwide and represents the most serious threat to the management of diarrhea in developing countries. During the period from March 2011 to January 2012, a total of 450 stool samples of diarrheal children aged 0-60 months were studied. In order to detect enterotoxigenic E. coli (ETEC) and enterohemorrhagic E. coli (EHEC) simultaneously, a mixture of four primer pairs specific for eltB, estA, vt1, and vt2 genes was used in a multiplex PCR. Antimicrobial susceptibility testing was performed as the Clinical and Laboratory Standards Institute (CLSI) guidelines. A total of 140 (31·1%) DEC were isolated from 450 stool samples. Diarrheagenic E. coli exhibited high-level resistance to aztreonam (80·7%), amoxicillin (74·4%), and tetracycline (69·3%). Also, 86·4% of E. coli isolates were resistant to at least three different classes of antimicrobial agents and considered as MDR. The frequency of ETEC and EHEC pathotypes was 46·4 and 12·1%, respectively and all of these isolates were MDR. In conclusion, MDR ETEC continues to be an important agent associated with diarrhea in children from Tabriz, Iran.

  5. Performance of Vitek 2 for antimicrobial susceptibility testing of Enterobacteriaceae with Vitek 2 (2009 FDA) and 2014 CLSI breakpoints.

    Science.gov (United States)

    Bobenchik, April M; Deak, Eszter; Hindler, Janet A; Charlton, Carmen L; Humphries, Romney M

    2015-03-01

    Vitek 2 (bioMérieux Inc., Durham, NC) is a widely used commercial antimicrobial susceptibility test system. We compared the MIC results obtained using the Vitek 2 AST-GN69 and AST-XN06 cards to those obtained by CLSI broth microdilution (BMD) for 255 isolates of Enterobacteriaceae, including 25 isolates of carbapenem-resistant Enterobacteriaceae. In total, 25 antimicrobial agents were examined. For 10 agents, the MIC data were evaluated using two sets of breakpoints: (i) the Vitek 2 breakpoints, which utilized the 2009 FDA breakpoints at the time of the study and are equivalent to the 2009 CLSI M100-S19 breakpoints, and (ii) the 2014 CLSI M100-S24 breakpoints. There was an overall 98.7% essential agreement (EA). The categorical agreement was 95.5% (CA) using the Vitek 2 breakpoints and 95.7% using the CLSI breakpoints. There was 1 very major error (VME) (0.05%) observed using the Vitek 2 breakpoints (cefazolin) and 8 VMEs (0.5%) using the CLSI breakpoints (2 each for aztreonam, cefepime, and ceftriaxone, and 1 for cefazolin and ceftazidime). Fifteen major errors (MEs) (0.4%) were noted using the Vitek 2 breakpoints and 8 (0.5%) using the CLSI breakpoints. Overall, the Vitek 2 performance was comparable to that of BMD for testing a limited number of Enterobacteriaceae commonly isolated by clinical laboratories. Ongoing studies are warranted to assess performance in isolates with emerging resistance.

  6. Prevalence and Antimicrobial-Resistance of Pseudomonas aeruginosa in Swimming Pools and Hot Tubs

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    Jonathan K. Lutz

    2011-02-01

    Full Text Available Pseudomonas aeruginosa is an important opportunistic pathogen in recreational waters and the primary cause of hot tub folliculitis and otitis externa. The aim of this surveillance study was to determine the background prevalence and antimicrobial resistance profile of P. aeruginosa in swimming pools and hot tubs. A convenience sample of 108 samples was obtained from three hot tubs and eight indoor swimming pools. Water and swab samples were processed using membrane filtration, followed by confirmation with polymerase chain reaction. Twenty-three samples (21% were positive for P. aeruginosa, and 23 isolates underwent susceptibility testing using the microdilution method. Resistance was noted to several antibiotic agents, including amikacin (intermediate, aztreonam, ceftriaxone, gentamicin, imipenem, meropenem (intermediate, ticarcillin/clavulanic acid, tobramycin (intermediate, and trimethoprim/sulfamethoxazole. The results of this surveillance study indicate that 96% of P. aeruginosa isolates tested from swimming pools and hot tubs were multidrug resistant. These results may have important implications for cystic fibrosis patients and other immune-suppressed individuals, for whom infection with multidrug-resistant P. aeruginosa would have greater impact. Our results underlie the importance of rigorous facility maintenance, and provide prevalence data on the occurrence of antimicrobial resistant strains of this important recreational water-associated and nosocomial pathogen.

  7. Integron mediated multidrug resistance in extended spectrum beta-lactamase producing clinical isolates of Klebsiella pneumoniae

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    Maryam Mobarak-Qamsari

    2013-09-01

    Full Text Available The present study describes integron mediated multiple antibiotic resistance in extended-spectrum β-lactamase producing clinical isolates of Klebsiella pneumoniae. One hundred and four clinical isolates of K. pneumoniae from two Iranian hospitals were screened for extended-spectrum β-lactamase production and susceptibility of the extended-spectrum β-lactamase producing isolates was determined to 17 antibiotics by disc diffusion. Presence of integron classes 1, 2 and 3 was detected by PCR and integrase specific primers. Isolates harboring class 1 integron were then screened for variable regions using PCR. Fifty isolates (48% produced extended-spectrum β-lactamases among which, 22 (44% harbored class 1, 3 (6% carried class 2 and none contained class 3 integons. Integron carriage was significantly associated with higher rates of multiple antibiotic resistance in extended-spectrum β-lactamase producing clinical isolates of K. pneumoniae. Integron harboring isolates were more resistant to aztreonam (51.3%, ceftazidime (42.6%, cefotaxime (43.3%, cefepime (24.6%, kanamycin (43.2%, tobramycin (30.7%, norfloxcacin (32% and spectinomycin (25.6% compared to the organisms without integrons. On the other hand, resistance to nitrofurantoin and streptomycin was significantly higher among the integron negative isolates. PCR amplification of class1 integron variable regions revealed 9 different sized DNA fragments and isolates with similar profiles for class 1 integron variable regions showed the same antibiotic resistance phenotypes.

  8. Integron mediated multidrug resistance in extended spectrum beta-lactamase producing clinical isolates of Klebsiella pneumoniae

    Science.gov (United States)

    Mobarak-Qamsari, Maryam; Ashayeri-Panah, Mitra; Eftekhar, Freshteh; Feizabadi, Mohammad Mehdi

    2013-01-01

    The present study describes integron mediated multiple antibiotic resistance in extended-spectrum β-lactamase producing clinical isolates of Klebsiella pneumoniae. One hundred and four clinical isolates of K. pneumoniae from two Iranian hospitals were screened for extended-spectrum β-lactamase production and susceptibility of the extended-spectrum β-lactamase producing isolates was determined to 17 antibiotics by disc diffusion. Presence of integron classes 1, 2 and 3 was detected by PCR and integrase specific primers. Isolates harboring class 1 integron were then screened for variable regions using PCR. Fifty isolates (48%) produced extended-spectrum β-lactamases among which, 22 (44%) harbored class 1, 3 (6%) carried class 2 and none contained class 3 integons. Integron carriage was significantly associated with higher rates of multiple antibiotic resistance in extended-spectrum β-lactamase producing clinical isolates of K. pneumoniae. Integron harboring isolates were more resistant to aztreonam (51.3%), ceftazidime (42.6%), cefotaxime (43.3%), cefepime (24.6%), kanamycin (43.2%), tobramycin (30.7%), norfloxcacin (32%) and spectinomycin (25.6%) compared to the organisms without integrons. On the other hand, resistance to nitrofurantoin and streptomycin was significantly higher among the integron negative isolates. PCR amplification of class1 integron variable regions revealed 9 different sized DNA fragments and isolates with similar profiles for class 1 integron variable regions showed the same antibiotic resistance phenotypes. PMID:24516451

  9. The analysis of the distribution of pathogen and their characteristics of drug susceptibility in the intensive care units%重症监护病房患者医院感染病原菌及药敏调查

    Institute of Scientific and Technical Information of China (English)

    侯有华; 蒋全

    2010-01-01

    Objective To analyze the distribution of pathogens and its characteristics of drug susceptibility originating from nosocomial infections in the intensive care units(ICU) ,and to provide evidence for clinical anti-infection treatments. Methods The data of the pathogens and their chug susceptibility characteristics were retrospectively analyzed. Many kinds of samples were collected in ICU from May 2008 to October 2009. Results There were 605 postive strains and the highest postive rate in sputum. The Gram-postive bacteria strains were 122 ,including 98 strains of staphylococcus where postive β-lactamases were 93. The drug susceptibility rate of linezolid, vancomycin and rifampin was 100% ,98. 2% and 86. 7% ,respectively. However,the drug resistant rate of oxacillin was 98.9%. Totallly 393 strains of the Gram-negative bacteria have been found, where pseudomonas aeruginosa, acinetobactor baumannii,enterobacter cloacae, stenotrophomonas maltophilia and klebsiella spp were 133,106,24,20 and 19 strains, respectively. The drug susceptibility rate of imipenem, aztreonam, levofloxacin and amikacin was 61. 6%, 42.0%, 38.8 % and 36. 1%, respectively. But the drug resistant rate of the third and fourth generation cephalosporin was over 70%. 90 strains of fungi were also found. The most common fungi infection was candida. Conclusion The nosocomial infections in ICU occurs mainly in respiratory tract,most infections are caused by gram negative bacilli. Imipenem and aztreonam have greater susceptibility to treat them. Gram positive coccus still plays an important role in nosocomial infections in the ICU and they high level of resist beta-lactamase-producing drugs. But they are susceptive to linezolid,vancomycin and rifampin.%目的 观察重症监护室中重危患者感染的病原菌及其对抗菌药物的敏感性.方法 对2008年5月至2009年10月所送检的各类标本培养及药敏结果进行回顾性分析.结果 阳性605株,痰中阳性率最高.G+菌122

  10. Molecular evolution and binding free energy analysis on substrates of KPC carbapenemases%KPC型碳青霉烯酶分子进化及与底物结合自由能分析

    Institute of Scientific and Technical Information of China (English)

    糜祖煌; 翁幸鐾; 秦玲

    2010-01-01

    目的 分析KPC-2、KPC-5和KPC-10型碳青霉烯酶的分子进化及与10种β-内酰胺类药物的结合自由能.方法 用MEGA 4.1软件中的Minimum Evolution法分析KPC-2、KPC-5和KPC-10型碳青霉烯酶的分子进化,用ArgusLab 4.1软件中的Dock模块作这3种酶与10种β-内酰胺类药物的分子对接,并计算酶与底物的结合自由能(△G).结果 有碳青霉烯酶活性的A类β-内酰胺酶在同一簇且保守性较好,无碳青霉烯酶活性的普通A类β-内酰胺酶则在另一簇.KPC-2、KPC-5和KPC-10型碳青霉烯酶与碳青霉烯类药物结合自由能均下降,且降幅居前,它们的结合自由能比第三代头孢类抗生素更低.结合自由能较高的为氨曲南和克拉维酸.结论 KPC型碳青霉烯酶对碳青霉烯类药物的催化能力高于对第三代头孢类抗生素的催化能力,对氨曲南和克拉维酸的催化活性最低.%Objective To analyze molecular evolution and binding free energies in substrates of KPC-2,KPC-5 and KPC-10 carbapenemases.Methods Minimum Evolution method in MEGA 4.1 was used to analyze molecular evolution of KPC-2,KPC-5 and KPC-10 carbapenemases,Dock module in ArgusLab 4.1 was used to perform molecular docking of these 3 carbapenemases to 10 kinds of β-lactams substrates,and calculate binding free energies(△G).Results Ambler Class A β-lactamases with carbapenemase activities were grouped in the same cluster and had good conservation,while ordinary Ambler Class A β-lactamases without carbapenemase activities were groupod in the other cluster.Binding free energies of KPC-2,KPC-5 and KPC-10 carbapenemases were lower to carbapenem antibiotics than the thirdgeneration cephalosporins,while binding free energies to aztreonam and clavulanic acid were of comparatively higher levels.Conclusion Catalytic activities of KPC to carbapenem antibiotics are higher than those to the third-generation cephalosporins,but the activities to aztreonam and clavulanic acid are low.

  11. 临床分离大肠埃希菌的耐药性分析%ANALYSIS OF THE DRUG RESISTANCE OF THE CLINICAL ISOLATED ESCHERICHI COLI

    Institute of Scientific and Technical Information of China (English)

    包东武; 刘荣志

    2011-01-01

    [目的]探讨临床分离大肠埃希菌对常用抗生素的耐药性和不同标本中大肠埃希菌的耐药性差异,为临床治疗提供依据.[方法]用VITEK32型全自动细菌分析系统对我院2007年元月~2009年7月临床分离的395株大肠埃希菌进行鉴定,药敏试验采用K-B法,判断标准按NCCLS2006年版进行.[结果]大肠埃希菌对亚胺培南和头孢哌酮/舒巴坦的耐药率分别为2.5%和0;对头孢3代和4代杭生素、头霉素类、氟曲南、阿米卡星、呋喃妥因、哌拉西林/三唑巴坦的耐药率为9.1%~21.5%;对青霉素类、喹诺酮类、磺胺类的耐药率为62.0%~83.5%;痰标本中大肠埃希菌的耐药率明显高于血液和尿液及其他标本的分离株.[结论]大肠埃希菌对青霉素类、喹诺酮类、磺胺类的耐药率较高;对头孢3代和4代抗生素、头霉素类、氨曲南、阿米卡星、呋喃妥因和哌拉西林/三唑巴坦的耐药率较低;目前对亚胺培南和头孢哌酮/舒巴坦敏感;不同标本中大肠埃希菌对同种抗生素的耐药性存在着差异.%[Objective] To understand drug tolerance of escherichina coli in common antibiotic and the difference of drug tolerance in different samples, and to select drugs for clinical reference. [Methods] 395 clinical separate strains escherichia coli and drug tolerance in our hospital from Jan2007 to July 2009 were identified and detected. Drug sensitive experiment was performed by (K- B) method, distinguished standard according to NCCLS 2006. [Results] Drug tolerant rate of escherichia coli in cefoperazone/sulbactam and imipenem were 2.5% and 0, respectively. The rates of cephaloglycin, cephalexin, Cephamycin, aztreonam, amikacin, nitrofurantoin and piperacillim were at the range of 9.1%-21.5%; The rates of penicillins, Quinovic - ketone sulfonamides were at the range of 62.0%-83.5%; Drug tolerant rate of escherichia coli in sputum was higher than that in blood, urine and other samples separate

  12. ADC-57型头孢菌素酶分子进化及与底物结合自由能分析%Molecular evolution and binding free energy analysis of substrates of cephalosporinase ADC-57

    Institute of Scientific and Technical Information of China (English)

    周军; 王玉月; 张秋娣

    2012-01-01

    Objective To analyze molecular evolution and binding free energies of cephalosporinase ADC-57.Methods Minimum Evolution method in MEGA 5.0 was used to analyze molecular evolution of cephalosporinase ADC-57 and other 19 kinds of beta-lactamases.Tertiary structure of ADC-57 was predicted by homology modeling referring to tertiary structure of CMY-2.The molecular docking of ADC-57 to 11kinds of beta-lactams substrates was performed using DOCK module in ArgusLab 4.1and the binding free energies (△G) was calculated.Results ADC-57,CMY-2,DHA-1,ADC-7,ADC-56 were all belong to class C beta-lactamase,and molecular evolution between ADC-57 and ADC-56 was closest.The top three antibiotics with declining binding free energy of beta-lactams were ertapenem,cefoxitin and ceftazidine,while the last two were clavulanic acid and aztreonam.Conclusions Catalytic activities of cephalosporinase ADC-57 to ertapenem,cefoxitin and ceftazidine are high,while to clavulanic acid and aztreonam are low. Hydrolytic activities of enzyme to beta-lactams (substrates) can be analyzed by molecular docking.%目的 分析ADC-57型头孢菌素酶分子进化及其对各种底物的结合自由能.方法 用MEGA 5.0软件中的最小进化法分析ADC-57和其他19种β-内酰胺酶的分子进化,参照同类酶CMY-2型酶作同源建模获得ADC67型头孢菌素酶分子的3D结构,并用ArgusLab 4.1软件中的DOCK模块作ADC-57型头孢菌素酶与11种β-内酰胺类药物底物的分子对接,最后计算酶与底物的结合自由能值(△G).结果 ADC-57与CMY-2、DHA-1、ADC-7、ADC-56归属为C类β-内酰胺酶,均为头孢菌素酶,且与ADC-56关系最为密切.ADC-57与β-内酰胺类药物结合自由能下降居前3位的为厄他培南、头孢西丁和头孢他啶,结合自由能下降排在后2位的为克拉维酸和氨曲南.结论 ADC-57型头孢菌素酶对厄他培南、头孢西丁和头孢他啶的催化能力高,而对克拉维酸和氨曲南的催化能力低.分子对接

  13. Análise epidemiológica de isolados clínicos de Pseudomonas aeruginosa provenientes de hospital universitário Epidemiologic analysis of clinical isolates of Pseudomonas aeruginosa from an university hospital

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    Eduardo José Valença Cordeiro Pires

    2009-12-01

    Full Text Available OBJETIVOS: A Pseudomonas aeruginosa é um patógeno oportunista que tem se destacado quanto à prevalência em casos de infecções hospitalares. Sua ampla resistência aos diversos grupos de antimicrobianos garante a este microrganismo um papel de destaque entre as bactérias mais prevalentes associadas à infecção nosocomial. O objetivo deste estudo foi realizar um levantamento epidemiológico da P. aeruginosa, bem como do seu perfil de susceptibilidade aos antimicrobianos no Hospital das Clínicas da Universidade Federal de Pernambuco. MÉTODOS: Foi realizado um estudo retrospectivo baseado no livro de registro de secreções diversas do laboratório de bacteriologia do Hospital das Clínicas no período compreendido entre janeiro a junho de 2008. Entre os registros, identificamos aqueles que foram positivos para a P. aeruginosa, analisando sua origem e perfil de susceptibilidade aos antimicrobianos utilizados na rotina daquele laboratório. RESULTADOS: As bactérias mais freqüentes, isoladas das secreções diversas, foram P. aeruginosa (26% e S. aureus (25%. Quanto à origem, a P. aeruginosa foi isolada principalmente de infecções respiratórias, pois 33% das amostras positivas para esta bactéria foram provinientes de secreções traqueais e 21% nasais. Os antimicrobianos mais eficazes contra a P. aeruginosa foram: amicacina, imipenem, meropenem e aztreonam. CONCLUSÕES: Estes resultados mostram uma alta prevalência de P. aeruginosa, no Hospital das Clínicas da Universidade Federal de Pernambuco. Apesar de apresentar grande resistência a antimicrobianos mais antigos como as cefalosporinas de primeira e segunda geração, assim como cloranfenicol, em geral, este patógeno demonstrou boa sensibilidade às drogas utilizadas na rotina deste hospital.OBJECTIVES: Pseudomonas aeruginosa is an increasingly prevalent opportunistic pathogen in hospital infection cases. Its high resistance rates to many antimicrobials has given this

  14. Count, identification and antimicrobial susceptibility of bacteria recovered from dental solid waste in Brazil.

    Science.gov (United States)

    Vieira, Cristina Dutra; de Carvalho, Maria Auxiliadora Roque; Cussiol, Noil Amorim de Menezes; Alvarez-Leite, Maria Eugênia; dos Santos, Simone Gonçalves; Gomes, Renata Maria da Fonseca; Silva, Marcos Xavier; Nicoli, Jacques Robert; Farias, Luiz de Macêdo

    2011-06-01

    In Brazil, few studies on microbial content of dental solid waste and its antibiotic susceptibility are available. An effort has been made through this study to evaluate the hazardous status of dental solid waste, keeping in mind its possible role in cross-infection chain. Six samples of solid waste were collected at different times and seasons from three dental health services. The microbial content was evaluated in different culture media and atmospheric conditions, and the isolates were submitted to antibiotic susceptibility testing. A total of 766 bacterial strains were isolated and identified during the study period. Gram-positive cocci were the most frequent morphotype isolated (48.0%), followed by Gram-negative rods (46.2%), Gram-positive rods (5.0%), Gram-negative-cocci (0.4%), and Gram-positive coccobacillus (0.1%). Only two anaerobic bacteria were isolated (0.3%). The most frequently isolated species was Staphylococcus epidermidis (29.9%), followed by Stenotrophomonas maltophilia (8.2%), and Enterococcus faecalis (6.7%). High resistance rate to ampicillin was observed among Gram-negative rods (59.4%) and Gram-positive cocci (44.4%). For Gram-negative rods, high resistance was also noted to aztreonam (47.7%), cefotaxime (47.4%), ceftriaxone and cefazolin (43.7%), and ticarcillin-clavulanic acid (38.2%). Against Gram-positive cocci penicillin exhibit a higher resistance rate (45.0%), followed by ampicillin, erythromycin (27.2%), and tetracycline (22.0%). The present study demonstrated that several pathogenic bacteria are present in dental solid waste and can survive after 48 h from the waste generation time and harbor resistance profiles against several clinical recommended antibiotics.

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

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    Mai M. Zafer

    2014-01-01

    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.

  16. 肉犊牛沙门氏菌肺炎的诊治%Diagnosis and Treatment of Salmonella Pneumonia in Calves

    Institute of Scientific and Technical Information of China (English)

    李韦伟; 江红; 胡世君

    2014-01-01

    Twenty‐nine strains of bacteria were isolated from the nasal secretions and lung tissues collected by the cattle farms of Fengdu of Chongqing and Zigong of Sichuan .They were identified as Salmonella through morphological observation and biochemical tests and based on clinical signs and pathological chan‐ges .Antibiotic sensitivity tests were made of the strains with 21 kinds of antibiotic disks which are .com‐monly used in the clinics .The isolated Salmonella strains were shown to be highly sensitive to the cepha‐losporin drugs such as ceftriaxone ,aztreonam and imipenem .Satisfactory effects were obtained when ceph‐alosporin and spectinomycin were used clinically to treat sick calves .%为找出重庆丰都县和四川自贡市肉牛场肉犊牛肺炎的病原,从肉犊牛的鼻分泌物和肺组织共分离到29株细菌,经形态特性及生化试验,结合临床症状及病理变化,鉴定为沙门氏菌。用临床上常用的21种抗菌素纸片对分离菌进行药敏试验,结果显示所分离的沙门氏菌对头孢曲松等大部分头孢类药物、氨曲南和亚胺培南敏感性极高。临床上采用头孢曲松及壮观霉素进行治疗,效果良好。

  17. Characterization of VCC-1, a Novel Ambler Class A Carbapenemase from Vibrio cholerae Isolated from Imported Retail Shrimp Sold in Canada.

    Science.gov (United States)

    Mangat, Chand S; Boyd, David; Janecko, Nicol; Martz, Sarah-Lynn; Desruisseau, Andrea; Carpenter, Michael; Reid-Smith, Richard J; Mulvey, Michael R

    2016-01-11

    One of the core goals of the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) is to monitor major meat commodities for antimicrobial resistance. Targeted studies with methodologies based on core surveillance protocols are used to examine other foods, e.g., seafood, for antimicrobial resistance to detect resistances of concern to public health. Here we report the discovery of a novel Ambler class A carbapenemase that was identified in a nontoxigenic strain of Vibrio cholerae (N14-02106) isolated from shrimp that was sold for human consumption in Canada. V. cholerae N14-02106 was resistant to penicillins, carbapenems, and monobactam antibiotics; however, PCR did not detect common β-lactamases. Bioinformatic analysis of the whole-genome sequence of V. cholerae N14-02106 revealed on the large chromosome a novel carbapenemase (referred to here as VCC-1, for Vibrio cholerae carbapenemase 1) with sequence similarity to class A enzymes. Two copies of blaVCC-1 separated and flanked by ISVch9 (i.e., 3 copies of ISVch9) were found in an acquired 8.5-kb region inserted into a VrgG family protein gene. Cloned blaVCC-1 conferred a β-lactam resistance profile similar to that in V. cholerae N14-02106 when it was transformed into a susceptible laboratory strain of Escherichia coli. Purified VCC-1 was found to hydrolyze penicillins, 1st-generation cephalosporins, aztreonam, and carbapenems, whereas 2nd- and 3rd-generation cephalosporins were poor substrates. Using nitrocefin as a reporter substrate, VCC-1 was moderately inhibited by clavulanic acid and tazobactam but not EDTA. In this report, we present the discovery of a novel class A carbapenemase from the food supply.

  18. Antimicrobial Susceptibility Pattern of Clinical Isolates of Pseudomonas aeruginosa in an Indian Cardiac Hospital.

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    S.Meenakumari

    2011-09-01

    Full Text Available Out of the 5933 samples collected a total of 51 isolates of pseudomonas aeruginosa were collected consecutively between 26-December-2010 to 28-February-2011 from different patients. The total of 51 positive isolates consists both of pediatric as well as adult patients. The study was therefore carried out using bothmanual (Kirby-Bauer method as well as automated (Vitek2 system method to determine the Antimicrobial susceptibility pattern of pseudomonas aeruginosa isolates from in-patients and out-patients attending the microbiology section of the hospitals. The isolation rate of Pseudomonas aeruginosa was found to be 8.5% out of the total positive samples which were analyzed. In my study, notable sensitivity (100% to P.aeruginosa was observed against Aztreonam while it was found to be different in case of a study carried out in India earlier which observed Carbepenems with 19.40% resistance. In the study colistin showed the highest (100% sensitivity followed by Amikacin against P. aeruginosa , which is in corroboration with an earlier report published from India. Amikacin seems to be a promising therapy for Pseudomonal infection. Hence, its use should be restricted to severe nosocomial infections, in order to avoid rapid emergence of resistant strains. The sensitivity of Pseudomonas aeruginosa towards Imipenem is found to be 35.294% and towards Meropenem is 41.176%, which is different in case of the earlier study from India. An effective national and state level antibiotic policy and draft guidelines should be introduced to preserve the effectiveness of antibiotics and for better patient management.

  19. Extended-spectrum beta-lactamase orthopedic wound infections in Nigeria

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    Olusolabomi J Idowu

    2011-01-01

    Full Text Available Background: Extended-spectrum beta-lactamase (ESBL-producing Gram-negative bacteria are emerging and impacting significantly on the management of patients and hospital costs. Besides, they are not being routinely sought after in diagnostic laboratories thus contributing to treatment failure. Materials and Methods: Bacterial isolates from wounds of 45 patients were identified using commercial identification kits and antibiotic susceptibility was evaluated by the Bauer-Kirby method. Screening and phenotypic confirmation of ESBL production were done as prescribed by the Clinical and Laboratory Standards Institute. The conjugation experiment was performed by the mating assay in broth between the ESBL producers and E. coli ATCC 25922 as the recipient. Results: Out of 102 Gram-negative bacteria isolated, 36 were positive for ESBL mainly of the Enterobacteriaceae family (33 and the rest were oxidase-positive bacilli (3. The predominant bacteria were Klebsiella spp. and E. coli. Others were Serratia rubidae, Citrobacter freundii, Morganella morgannii, Proteus spp., Providencia stuartii, and Enterobacter spp. There was a significant association between treatment with third-generation cephalosporins (3GCs and isolation of ESBLs ( p=0.0020 . The ESBL producers were multiply resistant and moderately sensitive to colistin. The conjugation experiment showed that the ESBL gene was transferred horizontally and tetracycline, cotrimoxazole, nitrofurantoin, gentamicin, and aztreonam resistance genes were co-transferred. No mortality was recorded but the mean length of stay in the hospital was 82 days. Conclusion: The development and spread of ESBL among Gram-negative bacteria and possible horizontal transfer calls for concern, especially in view of treatment failure, high treatment cost, and consequent discomfort to patients.

  20. Characterization and sensitivity to antibiotics of bacteria isolated from the lower respiratory tract of ventilated patients hospitalized in intensive care units

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    Manuel Medell

    2012-02-01

    Full Text Available OBJECTIVE: This observational study described the characterization of bacteria isolated from the lower respiratory tract of ventilated patients hospitalized in intensive care units. The demonstration of isolated microorganism resistance to antibiotics and a time-trend analysis of infection comparing a 48-month period were also other objectives. METHOD: Semi-quantitative assays of 1254 samples taken from 741 ventilated patients were performed, while pathogens were identified using the Enterotube II assay and VITEK 2 Compact equipment. Bacterial resistance to antibiotics was assessed by the Kirby-Bauer disc diffusion method and time-trend analysis of infection was based on data recorded by hospital microbiology laboratories. RESULTS: The most prevalent isolated bacteria from the patient's lower respiratory tract were with Gram-negative bacteria (67.8% mostly represented by: Acinetobacter spp. (25.2%, Pseudomonas spp. (18.3% and Klebsiellas spp. (9.4%. Acinetobacter spp. showed moderate high to very high resistance to ceftriaxone (CRO, gentamicin (CN, amikacin (AK, meropenem (MRP, aztreonam (ATM and piperacillin/tazobactam (TZP. Some isolates of Acinetobacter spp. resistant to colistin (CS were identified in this patient population. Pseudomonas spp. and Klebsiella spp. were very highly resistant to ampicillin/sublactam (AMS and with moderate or low resistance to CRO, ATM, MRP, AK, CN and TZP. A decrease in the Pseudomonas spp. prevalence rate was observed, whereas an increase in Acinetobacter spp. and Klebsiella spp. prevalence rates were observed in a 48-month period. CONCLUSION: This research corroborated that these nosocomial infections are a relevant medical problem in our context. The most prevalent bacterial infections in the lower respiratory tract of ventilated patients were by Acinetobacter spp., Pseudomonas spp. and Klebsiella spp. The panel of antibiotics used as preventive therapy was not the solution of infections and probably induced

  1. Carbapenem non-susceptible enterobacteriaceae in Quebec, Canada: results of a laboratory surveillance program (2010-2012.

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    Brigitte Lefebvre

    Full Text Available The emergence and spread of carbapenemase-producing Enterobacteriaceae (CPE represent a major public health concern because these bacteria are usually extensively resistant to most antibiotics. In order to evaluate their dissemination in Quebec, a surveillance program was introduced in 2010. We report the molecular and epidemiological profiles of CPE isolates collected. Between August 2010 and December 2012, a total of 742 non-duplicate isolates non-susceptible to carbapenems were analysed. AmpC β-lactamase and metallo-β-lactamase production were detected by Etest and carbapenemase production by the modified Hodge test (MHT. Antibiotic susceptibility profiles were determined using broth microdilution or Etest. Clonality of Klebsiella pneumoniae carbapenemase (KPC strains was analyzed by pulsed-field gel electrophoresis (PFGE. The presence of genes encoding carbapenemases as well as other β-lactamases was detected using PCR. Of the 742 isolates tested, 169 (22.8% were CPE. Of these 169 isolates, 151 (89.3% harboured a blaKPC gene while the remaining isolates carried blaSME (n = 9, blaOXA-48 (n = 5, blaNDM (n = 3, and blaNMC (n = 1 genes. Among the 93 KPC strains presenting with a unique pattern (unique PFGE pattern and/or unique antibiotics susceptibility profile, 99% were resistant to ertapenem, 95% to imipenem, 87% to meropenem, 97% to aztreonam, 31% to colistin and 2% to tigecycline. In 19 patients, 2 to 5 KPC strains from different species or with a different PFGE pattern were isolated. CPE strains were present in the province of Quebec with the majority of strains harbouring KPC. Alternately, SME, OXA-48 and NMC containing strains were rarely found.

  2. Occurrence and sensitivity profile of extended spectrum beta-lactamase-producing Enterobacteriaceae at a tertiary hospital in Southern Brazil

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    Cristina Letícia Rugini

    2015-12-01

    Full Text Available Abstract: INTRODUCTION: Nosocomial infections are closely associated with antimicrobial drug resistance. One of the most important mechanisms of resistance to β-lactam antibiotics is the production of extended spectrum β-lactamases (ESBLs. The objective of the present study was to evaluate the prevalence and antimicrobial susceptibility profile of ESBL-producing strains and to assess the evolution of antimicrobial drug resistance between 2007 and 2013 at the Hospital São Vicente de Paulo, Passo Fundo, State of Rio Grande do Sul, Brazil. METHODS: We conducted a descriptive, observational, cross-sectional study. Bacterial culture was performed from January to December 2013. The antimicrobial susceptibility profile of these cultures was determined using the disk diffusion method. Phenotypic screening for ESBL production was performed using the disk approximation method. RESULTS : We analyzed a total of 19,112 cultures, 11.5% of which were positive for Enterobacteriaceae. Of these, 30.3% of the isolates were positive for ESBL production, and the most prevalent species was Klebsiella sp. (37.5%. Over 95% of these isolates showed reduced susceptibility to all cephalosporins, aztreonam, and amoxicillin/clavulanic acid. The isolates also showed high sensitivity to the following antimicrobials: amikacin, meropenem, and piperacillin/tazobactam. Overall, the resistance rates among ESBL-producing Enterobacteriaceae decreased from 2007 to 2013. CONCLUSIONS : In our hospital, the increased sensitivity to certain antimicrobial agents seems to be directly related to the implementation of improvements in the methods to prevent and control nosocomial infections in addition to the natural development of other resistance mechanisms.

  3. DETECCIÓN DE Escherichia coli O157: H7 y Salmonella spp., EN CERDOS DEL DEPARTAMENTO DE CORDOBA

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    Jaime Vargas

    2004-07-01

    Full Text Available E. coli O157:H7 y Salmonella spp., son bacterias de distribución mundial causantes de enfermedades intestinales queafectan tanto al hombre como a LOS animales. ESTE estudio tuvo como objetivo determinar la presencia y frecuenciade aparición de E. coli O157:H7 y Salmonella spp., en los diferentes sistemas de producción porcina que se empleanen el departamento de Córdoba. Se realizó un estudio de corte descriptivo prospectivo, con un muestreo al azar enlos sistemas de explotación porcina intensiva y extensiva. Se procesaron 500 muestras de materia fecal de porcinos,250 provenientes del sistema extensivo y 250 del sistema intensivo. Para la detección E. coli y Salmonella spp., sellevaron a cabo procedimientos estándares microbiológicos. Los resultados mostraron una frecuencia de aparición deSalmonella spp., del 1%, el 0.2% en el sistema intensivo y el 0.8% en el sistema extensivo; no se aisló Escherichia coliO157:H7. Los resultados de resistencia y sensibilidad a los antibióticos en las cepas aisladas de Salmonella spp.,mostraron una sensibilidad del 100% al trimetoprim sulfametozasol, a la amikacina, al ceftriaxona, a la ciprofloxacina,a la gentamicina y al aztreonam y un 20% a la ampicilina y al sulbactam. Se concluye que la frecuencia de apariciónde Salmonella spp., en muestras coprológicas porcinas es baja, y nula para E. coli O157:H7, sin embargo, se debemantener la vigilancia sobre estos patógenos, por lo que se recomienda continuar los estudios epidemiológicos.

  4. Stenotrophomonas maltophilia in Mexico: antimicrobial resistance, biofilm formation and clonal diversity.

    Science.gov (United States)

    Flores-Treviño, Samantha; Gutiérrez-Ferman, Jessica Lizzeth; Morfín-Otero, Rayo; Rodríguez-Noriega, Eduardo; Estrada-Rivadeneyra, Diego; Rivas-Morales, Catalina; Llaca-Díaz, Jorge M; Camacho-Ortíz, Adrián; Mendoza-Olazarán, Soraya; Garza-González, Elvira

    2014-11-01

    Stenotrophomonas maltophilia is an important multidrug-resistant nosocomial pathogen associated with high mortality. Our aim was to examine antimicrobial susceptibility, biofilm production and clonal relatedness of clinical isolates of S. maltophilia. S. maltophilia isolates were collected between 2006 and 2013 from two tertiary care hospitals in Mexico. Antimicrobial susceptibility was evaluated by the broth microdilution method. PCR was used to determine the presence of β-lactamase genes L1 and L2. Biofilm formation was assessed with crystal violet staining. Clonal relatedness was determined by PFGE. Among the 119 collected S. maltophilia isolates, 73 (61.3%) were from the respiratory tract. Resistance levels exceeded 75% for imipenem, meropenem, ampicillin, aztreonam, gentamicin and tobramycin. Resistance to trimethoprim-sulfamethoxazole was 32.8%. L1 and L2 genes were detected in 77.1% (91/118) and 66.9% (79/118) of isolates, respectively. All S. maltophilia strains were able to produce biofilms. Strains were classified as weak (47.9%, 57/119), moderate (38.7%, 46/119), or strong (13.4%, 16/119) biofilm producers. A total of 89 distinct PFGE types were identified and 21.6% (22/102) of the isolates were distributed in nine clusters. This is the first study in Mexico to reveal characteristics of clinical isolates of S. maltophilia. Clonal diversity data indicate low cross-transmission of S. maltophilia in a hospital setting. The high antibiotic resistance underscores the need for continuous surveillance of S. maltophilia in hospital settings in Mexico.

  5. Ceftaroline fosamil for community-acquired pneumonia and skin and skin structure infections: a systematic review.

    Science.gov (United States)

    El Hajj, Maguy Saffouh; Turgeon, Ricky D; Wilby, Kyle John

    2017-02-01

    Background Ceftaroline is a parentally administered cephalosporin that has an in vitro expanded spectrum of activity compared with other cephalosporins yet data is conflicting regarding its place in therapy. Aim of the Review To compare the efficacy and safety of ceftaroline against standard antibiotic regimens for community-acquired pneumonia (CAP) and complicated skin and skin structure infections (cSSSIs). Method The databases of MEDLINE, EBSCO, and Embase were searched up to June 2016. Manual review of references was completed and experts in the field were contacted for unpublished data. Randomized controlled trials of ceftaroline in CAP or cSSSI populations were included. Outcomes included clinical cure, mortality, adverse events, serious adverse events, and discontinuation due to adverse events. Meta-analysis was used to pool results for these outcomes. We performed subgroup analyses for gram positive infections in CAP and infections caused by methicillin-resistant Staphylococcus aureus in cSSSIs. Risk of bias was assessed for all studies. Results Six trials (three for each indication) were included, each of which had an unclear or high risk of bias in at least one domain. For CAP, ceftaroline was significantly more efficacious in achieving clinical cure than ceftriaxone [risk ratio (RR) 1.11, 95% confidence interval (CI) 1.04-1.19; I(2) = 47%]. For cSSSIs, there was no significant difference in clinical cure between ceftaroline and vancomycin plus aztreonam (RR 1.01, 95% CI 0.97-1.05; I(2) = 0%). No differences were found for overall mortality, serious adverse events, discontinuation due to adverse events, and overall adverse events. Conclusion Ceftaroline is a viable therapeutic alternative for patients with CAP and cSSSIs, yet identified risks of bias and poor external validity preclude it from being recommended as a first-line agent.

  6. Changes of antimicrobial resistance among acinetobacter baumannii isolated from the patients in the year of 2008 to 2013%2008~2013年鲍曼不动杆菌的耐药性变迁

    Institute of Scientific and Technical Information of China (English)

    宋育明; 杨色娟; 吴秀益

    2015-01-01

    Objective:To analyze the trend of the antibiotic resistance of acinetobacter baumannii in my Hospital during 2007 to 2011. Methods:The identification of bacteria and susceptibility test were perfomed using automatic bicanalysis-Vitek-2. Results:Acinetobacter baumannii resistance increased year by year,acinetobacter baumannii have a higher resistance in addition to amikacin, Aztreonam up to 96. 8%. Conclusion:Acinetobacter baumannii resistance in severe and resistant rate to rise year by year,clinicians should take the necessary measures to slow down the deterioration,bacterial resistance.%目的:对某院2008年~2013年分离出的鲍曼不动杆菌的耐药性作回顾性分析,为临床合理选用抗菌药物提供依据。方法:应用VITEK2全自动微生物分析仪对菌株进行培养鉴定及药敏试验。结果:鲍曼不动杆菌的耐药率呈逐年上升趋势,除阿米卡星外均有较高的耐药性,氨曲南高达96.8%。结论:鲍曼不动杆菌的耐药性严重且耐药率逞逐年上升趋势,临床应采取必要措施,以减缓其耐药性的恶化。

  7. KPC with ESBL: A multistarrer tragedy

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    Dibyendu Banerjee

    2016-01-01

    Full Text Available Background: One of the most dangerous carbapenemase is Klebsiella pneumoniae Carbapenemase or KPC, possessing the ability to hydrolyze the Carbapenems, and other beta-lactams as well like Penecillins, Cephalosporins, and aztreonam. Many members of the family Enterobacteriaceae and few other non-fermenters contain the gene blaKPC, which codes for the enzyme KPC, and hence this is transferrable. Although the reports of KPC producers are scanty from India, it is still a dark cloud on the horizon, with the ability to overcast the sky. Our main aim was to identify KPC producing isolates of Klebsiella pneumoniae in our Tertiary care Medical Institution. Materials and Methods: Over a 3 months period, we collected 54 isolates of Klebsiella pneumoniae from different samples. We performed sensitivity against a variety of antibiotics including 3 Carbapenems , 3 extended spectrum Cephalosporins, and co-amoxyclav, both by disc diffusion and E-test against Ertapenem. Results: Out of 54 isolates of Klebsiella pneumoniae, 38 (70.37% showed resistance towards Ertapenem. Among these 38 isolates, 8 (14.81% were found to be KPC producers. They were ESBL producers also. Conclusions: Ertapenem resistance is the most sensitive phenotypic marker for detecting KPC. Also, KPC shows resistance to the extended spectrum Cephalosporins. We found 38 isolates showing reduced susceptibility to Ertapenem (by MIC - thus raising the chance of harbouring the enzyme. Truly, 8 among were confirmed as KPC and ESBL producers. All the microbiology laboratories should routinely search for KPC producers, using Ertapenem as a marker followed by confirmation with the three extended spectrum Cephalosporins.

  8. Modified Hodge test using Mueller-Hinton agar supplemented with cloxacillin improves screening for carbapenemase-producing clinical isolates of Enterobacteriaceae.

    Science.gov (United States)

    Takayama, Yoko; Adachi, Yuzuru; Nihonyanagi, Shin; Okamoto, Ryoichi

    2015-07-01

    Increasing numbers of clinical isolates of Enterobacteriaceae that produce carbapenemase are now being detected, with the most common carbapenemase found among Enterobacteriaceae in Japan being IMP-1-type metallo-β-lactamase. Clinical isolates of Enterobacteriaceae harbouring carbapenemases may be resistant to carbapenem antimicrobial agents, despite apparent in vitro susceptibility when tested according to Clinical and Laboratory Standards Institute criteria. We evaluated the prevalence of carbapenemase producers among isolates of Enterobacteriaceae at our hospital and assessed the performance of the modified Hodge test (MHT) for correctly identifying the phenotype. We studied 47 clinical isolates obtained between 2006 and 2010 for which the MIC of imipenem was 2 or 4 μg imipenem ml- 1. Antibacterial susceptibility testing was done for cephalosporins and carbapenems, the MHT was performed with meropenem and detection of the genes encoding IMP-1, VIM-2, KPC-2 and NDM-1-type metallo-β-lactamases was performed by PCR. Twelve isolates showed a positive result in the MHT with meropenem and were classified as carbapenemase producers. Of these 12 isolates, seven carried the gene for IMP-1 type, but not for VIM-2, KPC-2 or NDM-1 types. None of the carbapenemase genes tested were detected in the other five isolates. All five isolates were Enterobacter cloacae showing high resistance to ceftazidime and aztreonam. False-positive results were inhibited when Mueller-Hinton agar supplemented with 200 mg cloxacillin ml- 1 was used for the MHT. Five of 12 MHT-positive isolates were shown to have no carbapenemase genes and these isolates were high AmpC producers. Adding cloxacillin when performing the MHT prevented such false-positive results. The MHT with cloxacillin can overcome most problems related to detection of carbapenemases.

  9. Regional variation in the prevalence of extended-spectrum beta-lactamase-producing clinical isolates in the Asia-Pacific region (SENTRY 1998-2002).

    Science.gov (United States)

    Hirakata, Yoichi; Matsuda, Junichi; Miyazaki, Yoshitsugu; Kamihira, Shimeru; Kawakami, Sayoko; Miyazawa, Yukihisa; Ono, Yasuo; Nakazaki, Nobuhiko; Hirata, Yasuyoshi; Inoue, Matsuhisa; Turnidge, John D; Bell, Jan M; Jones, Ronald N; Kohno, Shigeru

    2005-08-01

    We examined the prevalence of extended-spectrum beta-lactamase (ESBL)-producing strains of Klebsiella pneumoniae, Klebsiella oxytoca, Escherichia coli, Proteus mirabilis, Citrobacter koseri, and Salmonella spp. that were isolated as part of the SENTRY Asia-Pacific Surveillance Program between 1998 and 2002. During the study period, a total of 6,388 strains were gathered from 17 medical centers in 7 countries and examined for ESBL production and hyperproduction of K. oxytoca chromosomal K1 beta-lactamase enzyme. High rates of confirmed ESBL-producing isolates were found in K. pneumoniae strains from Singapore (35.6%), followed by those from mainland China (30.7%), South Africa (28.1%), and the Philippines (21.9%), whereas the rates were less than 10% in Japan and Australia. ESBL-producing E. coli strains were also prominent in mainland China (24.5%), Hong Kong (14.3%), and Singapore (11.3%). ESBL-producing K. oxytoca were common in the Philippines (38.5%), Singapore (33.3%), and China (30.0%). Hyperproduction of K. oxytoca chromosomal K1 beta-lactamase enzyme was common in Australia and Japan. P. mirabilis strains from Singapore produced ESBL (17.9%) despite the low prevalence (0-8.1%) in other countries. Few ESBL-producing C. koseri and Salmonella spp. strains were found in Japan, Singapore, Taiwan, and South Africa. Although there was variation among countries in substrate preference, ceftazidime was more likely to detect presumptive ESBL phenotype in K. pneumoniae and aztreonam more likely in E. coli, whereas ceftriaxone was the best substrate for the confirmation of ESBL production. ESBL-producing strains showed high levels of co-resistance to aminoglycosides, tetracycline, trimethoprim-sulfamethoxazole, and ciprofloxacin. Imipenem retained activity against all ESBL-producing strains. Organisms expressing ESBLs are widely distributed in the Asia-Pacific region, although prevalence rates vary significantly.

  10. Triclosan can select for an AdeIJK-overexpressing mutant of Acinetobacter baumannii ATCC 17978 that displays reduced susceptibility to multiple antibiotics.

    Science.gov (United States)

    Fernando, Dinesh M; Xu, Wayne; Loewen, Peter C; Zhanel, George G; Kumar, Ayush

    2014-11-01

    In order to determine if triclosan can select for mutants of Acinetobacter baumannii ATCC 17978 that display reduced susceptibilities to antibiotics, we isolated a triclosan-resistant mutant, A. baumannii AB042, by serial passaging of A. baumannii ATCC 17978 in growth medium supplemented with triclosan. The antimicrobial susceptibility of AB042 was analyzed by the 2-fold serial dilution method. Expression of five different resistance-nodulation-division (RND) pump-encoding genes (adeB, adeG, adeJ, A1S_2818, and A1S_3217), two outer membrane porin-encoding genes (carO and oprD), and the MATE family pump-encoding gene abeM was analyzed using quantitative reverse transcriptase (qRT) PCR. A. baumannii AB042 exhibited elevated resistance to multiple antibiotics, including piperacillin-tazobactam, doxycycline, moxifloxacin, ceftriaxone, cefepime, meropenem, doripenem, ertapenem, ciprofloxacin, aztreonam, tigecycline, and trimethoprim-sulfamethoxazole, in addition to triclosan. Genome sequencing of A. baumannii AB042 revealed a (116)G→V mutation in fabI, the gene encoding the target enzyme for triclosan. Expression analysis of efflux pumps showed overexpression of the AdeIJK pump, and sequencing of adeN, the gene that encodes the repressor of the adeIJK operon, revealed a 73-bp deletion which would cause a premature termination of translation, resulting in an inactive truncated AdeN protein. This work shows that triclosan can select for mutants of A. baumannii that display reduced susceptibilities to multiple antibiotics from chemically distinct classes in addition to triclosan resistance. This multidrug resistance can be explained by the overexpression of the AdeIJK efflux pump.

  11. blaCTX-M,blaTEM, andblaSHV inEnterobacteriaceae from North-Indian tertiary hospital:high occurrence of combination genes

    Institute of Scientific and Technical Information of China (English)

    Mohammed Shahid; Anuradha Singh; Farrukh Sobia; Mohammad Rashid; Abida Malik; Indu Shukla; Haris Manzoor Khan

    2011-01-01

    Objective:To delineate the frequency of occurrence ofblaCTX-M,blaTEM, andblaSHV in Enterobacteriaceae from North-Indian tertiary hospital.Methods: A random collection of a subset of45Escherichia coli (E. coli) and28Klebsiella pneumoniae (K. pneumoniae) that was resistant to a third generation cephalosporin and obtained during2007-2008 was selected for detailed screening forblaCTX-M,blaTEM, andblaSHV by monoplexPCRs. The isolates demonstrating the presence of blaCTX-M alleles were characterized for the specificCTX-M-genogroup by using a multiplexPCR.Results:Resistance to cefoperazone, ceftazidime, ceftriaxone, cefotaxime, cefoxitin and piperacillin was 100% each inK. pneumoniae isolates, whereas these resistance-rates forE. coli isolates were93.1%, 83.8%, 91.9%, 93.6%, 97.3% and97.1%, respectively. Concomitant resistance to aminoglycosides, quinolones and aztreonam was also noticed. Presence of any of the bla genes (blaCTX-M,blaTEM, andblaSHV) was noticed in a total of28 (38.4%) isolates of the73isolates studied. Many isolates demonstrated occurrence of these genes in various combinations.blaCTX-M,blaTEM, andblaSHV were noticed in 28.8%,10.9% and13.7% isolates, respectively. MultiplexPCR inblaCTX-Mharboring isolates demonstrated the presence ofCTX-M-Genogroup-1 and sequencing for the specificCTX-M-type revealed presence ofCTX-M-15 type. RAPD typing showed wide diversity in isolates.Conclusions:This is amongst the premier report describing the simultaneous occurrence ofblaTEM,blaSHV, andblaampC in IndianEnterobacteriaceae and that wider dissemination of these genes, as demonstrated by diversity of isolates, raises concern and emphasizes a need for extensive search for the presence of these gene pools in Indian subcontinent.

  12. Genetic and biochemical characterization of the chromosomal class A beta-lactamases of Raoultella (formerly Klebsiella) planticola and Raoultella ornithinolytica.

    Science.gov (United States)

    Walckenaer, Estelle; Poirel, Laurent; Leflon-Guibout, Véronique; Nordmann, Patrice; Nicolas-Chanoine, Marie-Hélène

    2004-01-01

    Enterobacterial strains of Raoultella spp. display a penicillinase-related beta-lactam resistance pattern suggesting the presence of a chromosomal bla gene. From whole-cell DNA of Raoultella planticola strain ATCC 33531(T) and Raoultella ornithinolytica strain ATCC 31898(T), bla genes were cloned and expressed into Escherichia coli. Each gene encoded an Ambler class A beta-lactamase, named PLA-1 and ORN-1 for R. planticola and R. ornithinolytica, respectively. These beta-lactamases (291 amino acids), with the same pI value of 7.8, had a shared amino acid identity of 94%, 37 to 47% identity with the majority of the chromosome-encoded class A beta-lactamases previously described for Enterobacteriaceae, and 66 to 69% identity with the two beta-lactamases LEN-1 and SHV-1 from Klebsiella pneumoniae. However, the highest identity percentage (69 to 71%) was found with the plasmid-mediated beta-lactamase TEM-1. PLA-1, which displayed very strong hydrolytic activity against penicillins, also displayed significant hydrolytic activity against cefepime and, to a lesser extent, against cefotaxime and aztreonam, but there was no hydrolytic activity against ceftazidime. Such a substrate profile suggests that the Raoultella beta-lactamases PLA-1 and ORN-1 should be classified into the group 2be of the beta-lactamase classification of K. Bush, G. A. Jacoby, and A. A. Medeiros (Antimicrob. Agents Chemother. 39:1211-1233, 1995). The highly homologous regions upstream of the bla(PLA-1A) and bla(ORN-1A) genes comprised a nucleotide sequence identical to the -35 region and another one very close to the -10 region of the bla(LEN-1) gene. From now on, as the bla gene sequences of the most frequent Raoultella and Klebsiella species are available, the bla gene amplification method can be used to differentiate these species from each other, which the biochemical tests currently carried out in the clinical laboratory are unable to do.

  13. Multidrug-resistant (MDR) Aeromonas recovered from the metropolitan area of Valencia (Spain): diseases spectrum and prevalence in the environment.

    Science.gov (United States)

    Esteve, C; Alcaide, E; Giménez, M J

    2015-01-01

    Aeromonas infections are rare in Europe and often related to traveller's diarrhoea. A total of 185 Aeromonas isolates from river water, fish and clinical sources, recovered during a 1-year period, were used to investigate the disease spectrum and impact of multidrug-resistant (MDR) strains. They were all identified by biochemical tests and 25% of them were also identified by sequencing of the 16S rRNA gene. The minimum inhibitory concentrations (MICs) of 21 antimicrobials were determined for all isolates by broth microdilution/E-strips methods, and susceptibility was assessed according to the Clinical and Laboratory Standards Institute (CLSI). Strains pathogenicity was determined by using Swiss Webster mice as the animal model. Aeromonas diseases had an incidence of around 20 cases/million inhabitants in the metropolitan area of Valencia (Spain). Acute gastroenteritis in children with no history of travel abroad was the main pathology. These cases were related to A. caviae, A. veronii biovar sobria, A. hydrophila and A. dhakensis. A significant incidence of A. caviae in humans was found, while the other species were equally present in clinical and environmental origins. A. jandaei, A. bestiarum and A. media had mainly an environmental distribution. The prevalence of MDR Aeromonas was maximal in clinical samples, and resistance phenotypes were significantly related to this source. 7.2% of environmental Aeromonas was resistant to at least five drugs; most of them were moderately virulent for mice and, in addition, belonged to clinically significant species. The present study demonstrates a diseases spectrum similar to that reported in tropical countries, and also that pathogenic and heavily MDR Aeromonas are present in environmental reservoirs. MDR Aeromonas from any source analysed were susceptible to aztreonam, netilmicin, cefotaxime, ceftazidime, cefepime and fluoroquinolones.

  14. Profile of Virulence Factors in the Multi-Drug Resistant Pseudomonas aeruginosa Strains of Human Urinary Tract Infections (UTI)

    Science.gov (United States)

    Habibi, Asghar; Honarmand, Ramin

    2015-01-01

    Background: Putative virulence factors are responsible for the pathogenicity of UTIs caused by Pseudomonas aeruginosa (P. aeruginosa). Resistance of P. aeruginosa to commonly used antibiotics is caused by the extreme overprescription of those antibiotics. Objectives: The goal of the present study was to investigate the prevalence of virulence factors and the antibiotic resistance patterns of P. aeruginosa isolates in UTI cases in Iran. Patients and Methods: Two hundred and fifty urine samples were collected from patients who suffered from UTIs. Samples were cultured immediately, and those that were P. aeruginosa-positive were analyzed for the presence of virulence genes using polymerase chain reaction (PCR) testing. Antimicrobial susceptibility testing (AST) was performed using the disk diffusion method. Results: Of the 250 urine samples analyzed, 8 samples (3.2%) were positive for P. aeruginosa. The prevalence of P. aeruginosa in male and female patients was 2.7% and 3.5%, respectively, (P = 0.035). In patients less than 10 years old, it was 4.2%, and in patients more than 55 years old, it was 4.2%. These were the most commonly infected groups. The highest levels of resistance were seen against ampicillin (87.5%), norfloxacin (62.5%), gentamycin (62.5%), amikacin (62.5%), and aztreonam (62.5%), while the lowest were seen for meropenem (0%), imipenem (12.5%), and polymyxin B (12.5%). LasB (87.5%), pclH (75%), pilB (75%), and exoS (75%) were the most commonly detected virulence factors in the P. aeruginosa isolates. Conclusions: It is logical to first prescribe meropenem, imipenem, and polymyxin B in cases of UTIs caused by P. aeruginosa. Medical practitioners should be aware of the presence of levels of antibiotic resistance in hospitalized UTI patients in Iran. PMID:26756017

  15. Effect of various antibiotics on modulation of intestinal microbiota and bile acid profile in mice

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Youcai; Limaye, Pallavi B.; Renaud, Helen J.; Klaassen, Curtis D., E-mail: curtisklaassenphd@gmail.com

    2014-06-01

    Antibiotic treatments have been used to modulate intestinal bacteria and investigate the role of intestinal bacteria on bile acid (BA) homeostasis. However, knowledge on which intestinal bacteria and bile acids are modified by antibiotics is limited. In the present study, mice were administered various antibiotics, 47 of the most abundant bacterial species in intestine, as well as individual BAs in plasma, liver, and intestine were quantified. Compared to the two antibiotic combinations (vancomycin + imipenem and cephalothin + neomycin), the three single antibiotics (metronidazole, ciprofloxacin and aztreonam) have less effect on intestinal bacterial profiles, and thus on host BA profiles and mRNA expression of genes that are important for BA homeostasis. The two antibiotic combinations decreased the ratio of Firmicutes to Bacteroidetes in intestine, as well as most secondary BAs in serum, liver and intestine. Additionally, the two antibiotic combinations significantly increased mRNA of the hepatic BA uptake transporters (Ntcp and Oatp1b2) and canalicular BA efflux transporters (Bsep and Mrp2), but decreased mRNA of the hepatic BA synthetic enzyme Cyp8b1, suggesting an elevated enterohepatic circulation of BAs. Interestingly, the two antibiotic combinations tended to have opposite effect on the mRNAs of most intestinal genes, which tended to be inhibited by vancomycin + imipenem but stimulated by cephalothin + neomycin. To conclude, the present study clearly shows that various antibiotics have distinct effects on modulating intestinal bacteria and host BA metabolism. - Highlights: • Various antibiotics have different effects on intestinal bacteria. • Antibiotics alter bile acid composition in mouse liver and intestine. • Antibiotics influence genes involved in bile acid homeostasis. • Clostridia appear to be important for secondary bile acid formation.

  16. Identification of Additional Anti-Persister Activity against Borrelia burgdorferi from an FDA Drug Library

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    Jie Feng

    2015-09-01

    Full Text Available Lyme disease is a leading vector-borne disease in the United States. Although the majority of Lyme patients can be cured with standard 2–4 week antibiotic treatment, 10%–20% of patients continue to suffer from prolonged post-treatment Lyme disease syndrome (PTLDS. While the cause for this is unclear, persisting organisms not killed by current Lyme antibiotics may be involved. In our previous study, we screened an FDA drug library and reported 27 top hits that showed high activity against Borrelia persisters. In this study, we present the results of an additional 113 active hits that have higher activity against the stationary phase B. burgdorferi than the currently used Lyme antibiotics. Many antimicrobial agents (antibiotics, antivirals, antifungals, anthelmintics or antiparasitics used for treating other infections were found to have better activity than the current Lyme antibiotics. These include antibacterials such as rifamycins (3-formal-rifamycin, rifaximin, rifamycin SV, thiostrepton, quinolone drugs (sarafloxacin, clinafloxacin, tosufloxacin, and cell wall inhibitors carbenicillin, tazobactam, aztreonam; antifungal agents such as fluconazole, mepartricin, bifonazole, climbazole, oxiconazole, nystatin; antiviral agents zanamivir, nevirapine, tilorone; antimalarial agents artemisinin, methylene blue, and quidaldine blue; antihelmintic and antiparasitic agents toltrazuril, tartar emetic, potassium antimonyl tartrate trihydrate, oxantel, closantel, hycanthone, pyrimethamine, and tetramisole. Interestingly, drugs used for treating other non-infectious conditions including verteporfin, oltipraz, pyroglutamic acid, pidolic acid, and dextrorphan tartrate, that act on the glutathione/γ-glutamyl pathway involved in protection against free radical damage, and also the antidepressant drug indatraline, were found to have high activity against stationary phase B. burgdorferi. Among the active hits, agents that affect cell membranes, energy

  17. Emergence of ciprofloxacin-resistant extended-spectrum β-lactamase-producing enteric bacteria in hospital wastewater and clinical sources.

    Science.gov (United States)

    Maheshwari, Meenu; Yaser, Nawar Hadi; Naz, Suraiya; Fatima, Mansha; Ahmad, Iqbal

    2016-06-01

    This study aimed to evaluate the incidence of ciprofloxacin-resistant extended-spectrum β-lactamase (ESBL)-producing enteric bacteria in hospital wastewater and clinical sources. Enteric bacteria, mainly Escherichia coli, were isolated from clinical sources (urinary tract and gastrointestinal tract infections; 80 isolates) and hospital wastewater (103 isolates). The antibiotic resistance profile and ESBL production of the isolates were investigated by disc diffusion assay and combined disc diffusion test, respectively. Plasmid profiling was performed by agarose gel electrophoresis, and elimination of resistance markers was performed by a plasmid curing experiment. Antibiotic susceptibility testing revealed a high incidence of β-lactam resistance, being highest to ampicillin (88.0%) followed by amoxicillin, ceftriaxone, cefpodoxime, cefotaxime, aztreonam, cefepime and ceftazidime. Among the non-β-lactam antibiotics, the highest resistance was recorded to nalidixic acid (85.7%). Moreover, 50.8% of enteric bacteria showed resistance to ciprofloxacin. Among 183 total enteric bacteria, 150 (82.0%) exhibited multidrug resistance. ESBL production was detected in 78 isolates (42.6%). A significantly higher incidence of ciprofloxacin resistance was observed among ESBL-producing enteric bacteria both in clinical (P=0.0015) and environmental isolates (P=0.012), clearly demonstrating a close association between ESBL production and ciprofloxacin resistance. Plasmid profiling of selected ESBL-positive strains indicated the presence of one or more plasmids of varying sizes. Plasmid curing resulted in loss of ciprofloxacin and cefotaxime resistance markers simultaneously from selected ESBL-positive isolates, indicating the close relationship of these markers. This study revealed a common occurrence of ciprofloxacin-resistant ESBL-producing enteric bacteria both in hospital wastewater and clinical sources, indicating a potential public health threat.

  18. Antimicrobial resistance in Dschang, Cameroon

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    Fusi-Ngwa Catherine Kesah

    2013-01-01

    Full Text Available Background: Health-care-associated and community infections remain problematic in most of Africa where the increasing incidences of diseases, wars, poverty, malnutrition, and general environmental deterioration have led to the gradual collapse of the health-care system. Detection of antimicrobial resistance (AMR remains imperative for the surveillance purposes and optimal management of infectious diseases. This study reports the status of AMR in pathogens in Dschang. Materials and Methods: From May 2009 to March 2010, the clinical specimens collected at two hospitals were processed accorded to the standard procedures. Antibiotic testing was performed by E test, and antimycotics by disc-agar diffusion, as recommended by the Clinical and Laboratory Standards Institute on pathogens comprising Staphylococcus aureus (100 strains, Enterococcus faecalis (35, Klebsiella pneumoniae (75, Escherichia coli (50, Proteus mirabilis (30, Pseudomonas aruginosa (50, Acinetobacter species (20, and Candida albicans (150 against common antimicrobials. Results: There was no vancomycin resistance in the cocci, the minimum inhibitory concentration for 90% of these strains MIC 90 was 3 μg/ml, methicillin-resistant S. aureus (MRSA was 43%, benzyl penicillin 89% resistance in S. aureus as opposed to 5.7% in E. faecalis. Low resistance (<10% was recorded to cefoxitin, cefotaxime, and nalidixic acid (MIC 90 3-8 μg/ml against the coliforms, and to ticarcillin, aztreonam, imipenem, gentamicin, and ciprofloxacin among the non-enterobacteria; tetracycline, amoxicillin, piperacillin, and chloramphenicol were generally ineffective. Resistance rates to fluconazole, clotrimazole, econazole, and miconazole were <55% against C. albicans. The pathogens tested exhibited multidrug-resistance. Conclusion: The present findings were intended to support antimicrobial stewardship endeavors and empiric therapy. The past, present, and the future investigations in drug efficacy will continue

  19. Antimicrobial susceptibility and genetic characterization of Escherichia coli recovered from frozen game meat.

    Science.gov (United States)

    Mateus-Vargas, Rafael H; Atanassova, Viktoria; Reich, Felix; Klein, Günter

    2017-05-01

    The increasing number of antimicrobial resistant Enterobacteriaceae both in veterinary and human medicine, the dissemination of these bacteria in several environments and their possible repercussions on human health is causing concern. Game meat is usually seen as free of antimicrobial resistant bacteria. The objective of this study was to evaluate the current antimicrobial susceptibility status in generic Escherichia coli isolated from packed frozen game meat from a game handling establishment in Germany. A total of 229 E. coli isolates were obtained from cuts of red deer, roe deer and wild boar. The susceptibility to 12 antimicrobial agents was evaluated by a broth microdilution method according to ISO 20776-1:2006. Minimal Inhibitory Concentration (MIC) values were compared to breakpoints and cut-off values published by the EUCAST. Isolates showing MICs above the reference values were further studied for associated resistance determinants and phylogrouping by PCR. Overall, 16 E. coli isolates (7.0%) showed resistance (microbiological or clinical) to at least one antimicrobial agent tested. Clinical resistance was recorded to ampicillin (5/229) and chloramphenicol (4/229), whereas the MIC of 9 isolates exceeded the epidemiological cut-off value for doxycycline. One of the ampicillin-resistant isolates showed resistance to the β-lactam antibiotic derivatives tested, cephalosporines and aztreonam. Three of 9 non-wild-type isolates for doxycycline were positive for tet (B) genes. The ß-lactam-resistant isolate was found to harbour blaCTX-M-1 gene. These data show a low prevalence of resistant E. coli in packed game meat compared to studies on conventional meat. Although isolates obtained in this study may also be originating from the processing environment and not necessarily from animals, based on our results, it is important to monitor the development of antimicrobial resistance in game animals and products in order to identify future threats for the

  20. Antimicrobial susceptibilities and bacteriological characteristics of bovine Pseudomonas aeruginosa and Serratia marcescens isolates from mastitis.

    Science.gov (United States)

    Ohnishi, Mamoru; Sawada, Takuo; Hirose, Kazuhiko; Sato, Reiichiro; Hayashimoto, Mizuki; Hata, Eiji; Yonezawa, Chizuko; Kato, Hajime

    2011-12-29

    The presence of metallo-β-lactamase (MBL)-producing and multidrug-resistant Pseudomonas aeruginosa (MDRP) strains among bovine isolates of Gram-negative bacilli, and O-serotypes of bovine Serratia marcescens and P. aeruginosa isolates have been reported rarely. The aims of this study were to (1) elucidate antimicrobial susceptibilities and O-serotypes of P. aeruginosa and S. marcescens isolates from bovine mastitis and the presence of MBL-producers and MDRP strains among them and (2) evaluate their relationships to human isolates. We investigated the MICs of 24 antimicrobials and O-serotypes for 116 P. aeruginosa and 55 S. marcescens isolates in Japan, primarily in 2006. A total of 171 isolates exhibited high antimicrobial susceptibilities with the exception of a partial drug. P. aeruginosa isolates exhibited high susceptibilities of ≥ 95.7% to ciprofloxacin, imipenem, meropenem, piperacillin, ceftazidime, cefepime, cefoperazone/sulbactam, amikacin, tobramycin, and gentamicin; however, they exhibited a susceptibility of only 69.8% to aztreonam. They exhibited substantial resistances to ceftriaxone, enrofloxacin, cefotaxime, and moxalactam. S. marcescens isolates exhibited high susceptibilities of ≥ 90.9% to kanamycin, ceftiofur, sulfamethoxazole-trimethoprim, and the 15 aforementioned drugs, but exhibited resistance to minocycline. Neither MBL-producers nor MDRP strains were detected among the 171 strains. The dominant serotypes of P. aeruginosa isolates were OG, OA, OB, OI, OF, OE, and OK; those of S. marcescens isolates were O6 and O5. Every S. marcescens isolate was pigmented. These findings suggest that bovine P. aeruginosa and S. marcescens isolates differ from human isolates from both antibiogram and phenotypic perspectives, and could help to evaluate differences in bacteriological characteristics between bovine and human isolates.

  1. Prevalence and Antibiogram of Generic Extended-Spectrum β-Lactam-Resistant Enterobacteria in Healthy Pigs

    Directory of Open Access Journals (Sweden)

    Ifeoma Chinyere UGWU

    2015-09-01

    Full Text Available This study was conducted to isolate generic extended-spectrum β-lactam (ESBL-resistant enterobacteria from pigs reared in Enugu State Southeast, Nigeria and determine the antibacterial resistance profile of the isolates. Rectal swabs were collected from 190, randomly selected, apparently healthy pigs. Isolation of ESBL-resistant enterobacteria was done using Mac Conkey agar supplemented with 2 µg/ml of cefotaxime. Phenotypic characterization of the isolates to generic level was done following standard biochemical methods. Phenotypic resistance of the isolates to antibacterial agents was determined using the disc diffusion method. Out of 46 ESBL-resistant enterobacterial isolates, 4 (8.7% were Escherichia coli, 11 (23.9% were Salmonella species, while 31 (67.4% were Klebsiella species. Resistance of the Salmonella isolates was 45.5% to ciprofloxacin, 36.4% to ofloxacin and levofloxacin, 9.1% to norfloxacin, amikacin and gentamicin, 27.3% to streptomycin, 72.7% to chloramphenicol and 90.9% to tetracycline. Resistance of the Klebsiella isolates was 93.5% to ampicillin, 12.9% to ciprofloxacin, 19.4% to ofloxacin and levofloxacin, 9.7% to norfloxacin and streptomycin, 64.5% to chloramphenicol and 38.7% to tetracycline. Resistance of the E. coli isolates was 100% to gentamicin, 75% to ampicillin and streptomycin, 50% to ciprofloxacin, norfloxacin, chloramphenicol and tetracycline, and 25% to ofloxacin, levofloxacin and amikacin. All the isolates were resistant to ceftriaxone, cefotaxime, ceftazidime, cefepime, cefpodoxime, amoxicillin/clavulanic acid and aztreonam. Resistance of the isolates to more than 3 classes of antibacterial agents tested was 54.8% for Klebsiella, 90.9% for Salmonella and 100% for E. coli, respectively. This study has shown that pigs reared in Enugu State Southeast, Nigeria, are colonized by ESBL-resistant Enterobactericeae and are potential reservoirs and disseminators of these organisms.

  2. Hospital-acquired Pneumonia due to Achromobacter spp. in a Geriatric Ward in China: Clinical Characteristics, Biofilm Production, Antibiotic Resistance and Integrons of Isolated Strains.

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    Xiangqun eFang

    2016-05-01

    Full Text Available Background: Hospital-acquired pneumonia (HAP due to Achromobacter has become a substantial concern in recent years. However, HAP due to Achromobacter in the elderly is rare.Methods: A retrospective analysis was performed on 15 elderly patients with HAP due to Achromobacter spp., in which the sequence types (STs, integrons, biofilm production and antibiotic resistance of the Achromobacter spp. were examined. Results: The mean age of the 15 elderly patients was 88.8±5.4 years. All patients had at least 3 underlying diseases and catheters. Clinical outcomes improved in 10 of the 15 patients after antibiotic and/or mechanical ventilation treatment, but three patients had chronic infections lasting more than 1 year. The mortality rate was 33.3% (5/15. All strains were resistant to aminoglycosides, aztreonam, nitrofurantoin, and third- and fourth-generation cephalosporins (except ceftazidime and cefoperazone. Six new STs were detected. The most frequent ST was ST306. ST5 was identified in two separate buildings of the hospital. ST313 showed higher MIC in cephalosporins, quinolones and carbapenems, which should be more closely considered in clinical practice. All strains produced biofilm and had integron I and blaOXA-114-like. The main type was blaOXA-114q. The variable region of integron I was different among strains, and the resistance gene of the aminoglycosides was most commonly inserted in integron I. Additionally, blaPSE-1 was first reported in this isolate. Conclusion: Achromobacter spp. infection often occurs in severely ill elders with underlying diseases. The variable region of integrons differs, suggesting that Achromobacter spp. is a reservoir of various resistance genes.

  3. Phylogenetic grouping and pathotypic comparison of urine and fecal Escherichia coli isolates from children with urinary tract infection.

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    Navidinia, Masoumeh; Peerayeh, Shahin Najar; Fallah, Fatemeh; Bakhshi, Bita; Sajadinia, Raheleh Sadat

    2014-01-01

    The aim of this study was to investigate the phylogenetic background and to assess hlyD (involved in the secretion of haemolysin A) and intI1 (encoding a class 1 integrase) in Escherichia coli isolates derived from urinary and fecal specimens. A total of 200 E. coli isolates was collected from patients presenting with urinary tract infection (UTI) during September 2009 to September 2010 and screened for hlyD and intI1 genes by polymerase chain reaction (PCR). Phylogenetic analysis showed that E. coli is composed of four main phylogenetic groups (A, B1, B2 and D) and that uropathogenic E. coli (UPEC) isolates mainly belong to groups B2 (54%) and D (34%) whereas group A (44%) and D (26%) are predominant among commensal E. coli isolates. In this study, hlyD was present in 26% of UPEC and 2% of commensal E. coli isolates. However, hemolytic activity was detected for 42% of UPEC and 6% of commensal E. coli isolates (p UPEC (24%) in comparison with commensal E. coli isolates (12%). Resistance to aztreonam, co-trimoxazole and cefpodoxime were frequently found among UPEC isolates whereas commensal E. coli isolates were commonly resistant to co-trimoxazole, nalidixic acid and cefotaxime. Concluding, a considerable difference between UPEC and commensal E. coli isolates was observed regarding their phylogenetic groups, presence of class 1 integron and hlyD gene, hemolysin activity and resistance pattern. The detection of class 1 integrons and hlyD gene was higher among UPEC compared with commensal E. coli isolates. These findings may contribute for a better understanding of the factors involved in the pathogenesis of UPEC.

  4. Phylogenetic grouping and pathotypic comparison of urine and fecal Escherichia coli isolates from children with urinary tract infection

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    Masoumeh Navidinia

    2014-06-01

    Full Text Available The aim of this study was to investigate the phylogenetic background and to assess hlyD (involved in the secretion of haemolysin A and intll (encoding a class 1 integrase in Escherichia coli isolates derived from urinary and fecal specimens. A total of 200 E. coli isolates was collected from patients presenting with urinary tract infection (UTI during September 2009 to September 2010 and screened for hlyD and intll genes by polymerase chain reaction (PCR. Phylogenetic analysis showed that E. coli is composed of four main phylogenetic groups (A, B1, B2 and D and that uropathogenic E. coli (UPEC isolates mainly belong to groups B2 (54% and D (34% whereas group A (44% and D (26% are predominant among commensal E. coli isolates. In this study, hlyD was present in 26% of UPEC and 2% of commensal E. coli isolates. However, hemolytic activity was detected for 42% of UPEC and 6% of commensal E. coli isolates (p < 0.05. intll gene was more frequently expressed in UPEC (24% in comparison with commensal E. coli isolates (12%. Resistance to aztreonam, co-trimoxazole and cefpodoxime were frequently found among UPEC isolates whereas commensal E. coli isolates were commonly resistant to co-trimoxazole, nalidixic acid and cefotaxime. Concluding, a considerable difference between UPEC and commensal E. coli isolates was observed regarding their phylogenetic groups, presence of class 1 integron and hlyD gene, hemolysin activity and resistance pattern. The detection of class 1 integrons and hlyD gene was higher among UPEC compared with commensal E. coli isolates. These findings may contribute for a better understanding of the factors involved in the pathogenesis of UPEC.

  5. Distribution of pathogenicity island markers in commensal and uropathogenic Escherichia coli isolates.

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    Samei, Ali; Haghi, Fakhri; Zeighami, Habib

    2016-05-01

    Uropathogenic Escherichia coli (UPEC) isolates contain large genomic segments, termed pathogenicity islands (PAIs), that contribute to their virulence. A total of 150 UPEC and 50 commensal E. coli isolates from outpatients were investigated for antimicrobial susceptibility and the presence of eight PAI markers. One hundred ninety (95 %) isolates were resistant to one or more antimicrobial agents. The most frequent resistance found against amoxicillin (68 %), amoxicillin/clavulanic acid (55 %), aztreonam (50 %), trimethoprim/sulfamethoxazole (46 %) and tetracycline (43.5 %). Antimicrobial resistance among UPEC isolates was higher than that of commensals. PAI markers were detected in substantial percentage of commensal (88 %) and UPEC isolates (98.6 %) (P > 0.05). The most prevalent PAI marker among UPEC and commensal isolates was PAI IV536 (98.7 % UPEC vs. 84 % commensal). We found a high number of PAI markers such as PAI ICFT073, PAI IICFT073, PAI I536, PAI II536, PAI III536 and PAI IIJ96 significantly associated with UPEC. PAI III536 (21.3 %) and PAI IIJ96 (8 %) were detected only in the uropathogenic isolates. Several different combinations of PAIs were found among UPEC isolates. Comparison of PAIs among UPEC and commensal isolates showed that many UPEC isolates (79.3 %) carried two or more PAI markers, while 6 % of commensals had two PAI markers (P UPEC isolates were PAI IV536 + PAI IICFT073 (18 %) and PAI IV536 + PAI ICFT073 + PAI IICFT073 (18 %). These results indicate that PAI markers are widespread among commensal and UPEC isolates and these commensal isolates may be reservoirs for transmission of these markers.

  6. Antimicrobial Resistance of Shigella flexneri Serotype 1b Isolates in China.

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    Xianyan Cui

    Full Text Available Shigella flexneri serotype 1b is among the most prominent serotypes in developing countries, followed by serotype 2a. However, only limited data is available on the global phenotypic and genotypic characteristics of S. flexneri 1b. In the present study, 40 S. flexneri 1b isolates from different regions of China were confirmed by serotyping and biochemical characterization. Antimicrobial susceptibility testing showed that 85% of these isolates were multidrug-resistant strains and antibiotic susceptibility profiles varied between geographical locations. Strains from Yunnan were far more resistant than those from Xinjiang, while only one strain from Shanghai was resistant to ceftazidime and aztreonam. Fifteen cephalosporin resistant isolates were identified in this study. ESBL genes (blaSHV, blaTEM, blaOXA, and blaCTX-M and ampC genes (blaMOX, blaFOX, blaMIR(ACT-1, blaDHA, blaCIT and blaACC were subsequently detected among the 15 isolates. The results showed that these strains were positive only for blaTEM, blaOXA, blaCTX-M, intI1, and intI2. Furthermore, pulsed-field gel electrophoresis (PFGE analysis showed that the 40 isolates formed different profiles, and the PFGE patterns of Xinjiang isolates were distinct from Yunnan and Shanghai isolates by one obvious, large, missing band. In summary, similarities in resistance patterns were observed in strains with the same PFGE pattern. Overall, the results supported the need for more prudent selection and use of antibiotics in China. We suggest that antibiotic susceptibility testing should be performed at the start of an outbreak, and antibiotic use should be restricted to severe Shigella cases, based on resistance pattern variations observed in different regions. The data obtained in the current study might help to develop a strategy for the treatment of infections caused by S. flexneri 1b in China.

  7. Detection and Drug Resistance Analysis of ESBLs and AmpC in Intestinal Bacteria%肠杆菌科细菌ESBLs和AmpC酶检测及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    张丹丹; 陆阳; 马良

    2016-01-01

    目的:探讨肠杆菌科细菌ESBLs和AmpC酶检测及耐药性。方法选取300株肠杆菌,AmpC酶、ESBLs表型通过双纸片确诊试验、双纸片氯唑西林增效试验予以测定,观察300株菌种对10种抗菌药物的耐药性。结果300株肠杆菌中检测到ESBLs菌158株,AmpC酶菌130株;单产AmpC酶菌对头孢曲松、氨曲南、哌拉西林、头孢噻肟产生的耐药性明显低于非产酶菌,差异具有统计学意义(P<0.05)。结论 ESBLs和AmpC酶是造成肠杆菌细菌产生耐药的重要原因,可依照实际药敏结果采取合理治疗。%Objective To study the enterobacteriaceae bacteria ESBLs and AmpC enzyme detection and drug resistance.Methods Chose 300 strains of intestinal bacilli, AmpC enzyme, ESBLs phenotype by double disc conifrmatory test, observation of 300 strains bacteria resistance of 10 kinds of antimicrobial agents.Results 300 strains of intestinal bacilli detected in ESBLs 158 strains bacteria, AmpC enzyme 130 strains bacteria; The yield of AmpC enzyme bacteria resistance to ceftriaxone, aztreonam, cefotaxime and cefotaxime have signiifcantly lower than that of enzyme producing bacteria, the difference was statistically signiifcant (P<0.05).ConclusionESBLs and AmpC enzyme is the important cause of bacteria resistance, can be in accordance with the actual drug susceptibility results take reasonable treatment.

  8. Factors associated with the occurrence of MRSA CC398 in herds of fattening pigs in Germany

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    Alt Katja

    2011-11-01

    Full Text Available Abstract Background The purpose of this study was to investigate the prevalence of MRSA in herds of fattening pigs in different regions of Germany, and to determine factors associated with the occurrence of this pathogen. For this purpose pooled dust samples were collected, and a questionnaire covered information regarding herd characteristics and management practices. Samples were pre-enriched in high-salt medium followed by selective enrichment containing cefoxitin/aztreonam, and culturing. Presumptive colonies were confirmed by multiplex-PCR targeting nuc-, mecA- and 16S rRNA-genes. Isolates were spa- and SCCmec-, and in selected cases, multilocus sequence-typed. Susceptibilities to 13 antimicrobials were determined by broth microdilution. Statistical analysis was carried out using backward stepwise logistic regression to calculate odds ratios with the MRSA test result as the outcome and herd characteristics as categorical covariates. Results Overall, 152 of 290 (52% fattening pig farms tested positive for MRSA. The prevalence in the east, north- and south-west of Germany ranged from 39 to 59%. t011 (66% and t034 (23% were the most commonly identified spa-types, and 85% of isolates carried SCCmec Type V. Identified spa-types were all associated with clonal complex CC398. Susceptibility testing revealed that all isolates were resistant to tetracycline. High resistance rates were also found for sulfamethoxazole/trimethoprim (40%, and quinupristin/dalfopristin (32%. In addition, 83% of strains displayed multidrug resistant (> 3 substance classes phenotypes. Logistic regression revealed herd size (large farms OR: 5.4; CI: 2.7-11.2; p Conclusions MRSA CC398 is widely distributed among herds of fattening pigs in Germany. Farm management plays a crucial role in the dissemination of MRSA with herd size, and production type representing potential major indicators.

  9. Structural basis for effectiveness of siderophore-conjugated monocarbams against clinically relevant strains of Pseudomonas aeruginosa

    Energy Technology Data Exchange (ETDEWEB)

    Han, Seungil; Zaniewski, Richard P.; Marr, Eric S.; Lacey, Brian M.; Tomaras, Andrew P.; Evdokimov, Artem; Miller, J. Richard; Shanmugasundaram, Veerabahu (Pfizer)

    2012-02-08

    Pseudomonas aeruginosa is an opportunistic Gram-negative pathogen that causes nosocomial infections for which there are limited treatment options. Penicillin-binding protein PBP3, a key therapeutic target, is an essential enzyme responsible for the final steps of peptidoglycan synthesis and is covalently inactivated by {beta}-lactam antibiotics. Here we disclose the first high resolution cocrystal structures of the P. aeruginosa PBP3 with both novel and marketed {beta}-lactams. These structures reveal a conformational rearrangement of Tyr532 and Phe533 and a ligand-induced conformational change of Tyr409 and Arg489. The well-known affinity of the monobactam aztreonam for P. aeruginosa PBP3 is due to a distinct hydrophobic aromatic wall composed of Tyr503, Tyr532, and Phe533 interacting with the gem-dimethyl group. The structure of MC-1, a new siderophore-conjugated monocarbam complexed with PBP3 provides molecular insights for lead optimization. Importantly, we have identified a novel conformation that is distinct to the high-molecular-weight class B PBP subfamily, which is identifiable by common features such as a hydrophobic aromatic wall formed by Tyr503, Tyr532, and Phe533 and the structural flexibility of Tyr409 flanked by two glycine residues. This is also the first example of a siderophore-conjugated triazolone-linked monocarbam complexed with any PBP. Energetic analysis of tightly and loosely held computed hydration sites indicates protein desolvation effects contribute significantly to PBP3 binding, and analysis of hydration site energies allows rank ordering of the second-order acylation rate constants. Taken together, these structural, biochemical, and computational studies provide a molecular basis for recognition of P. aeruginosa PBP3 and open avenues for future design of inhibitors of this class of PBPs.

  10. Detection of extended spectrum β-lactamase in Pseudomonas spp. isolated from two tertiary care hospitals in Bangladesh

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    Begum Shahanara

    2013-01-01

    Full Text Available Abstract Background Extended spectrum ß-lactamases (ESBLs represent a major group of lactamases responsible for resistance, mostly produced by gram-negative bacteria, to newer generations of ß-lactam drugs currently being identified in large numbers worldwide. The present study was undertaken to see the frequency of ESBL producing Pseudomonas spp. isolated from six hundred clinical specimens (wound, pus, aural, urine, sputum, throat and other swabs collected over a period of three years from two tertiary care hospitals in Bangladesh. Findings Aerobic bacterial culture was performed on aseptically collected swabs and only growth of Pseudomonas was considered for further species identification and ESBL production along with serotyping of Pseudomonas aeruginosa. Antimicrobial susceptibility testing was carried out using the Kirby-Bauer agar diffusion method and ESBL production was detected on Mueller Hinton agar by double-disk synergy technique using Amoxicillin-Clavulanic acid with Ceftazidime, Cefotaxime, Ceftriaxone and Aztreonam. Culture yielded 120 Pseudomonas spp. and 82 of them were biochemically characterized for species. Pseudomonas aeruginosa was found to be the predominant (90.2% species. Of 82 isolates tested for ESBL, 31 (37.8% were ESBL positive with 29 (93.5% as Pseudomonas aeruginosa, the remaining 2 (6.5% were Stenotrophomonas maltophilia and Ralstonia pickettii. Antibiogram revealed Imipenem as the most effective drug (93.3% among all antimicrobials used against Pseudomonas spp. followed by Aminoglycosides (63.7%. Conclusion ESBL producing Pseudomonas spp. was found to be a frequent isolate from two tertiary care hospitals in Bangladesh, showing limited susceptibility to antimicrobials and decreased susceptibility to Imipenem in particular, which is a matter of great concern.

  11. Emergence of colistin resistant Pseudomonas aeruginosa at Tabriz hospitals, Iran

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    Hamid Reza Goli

    2016-03-01

    Full Text Available Background and Objectives: The prevalence of multidrug resistant Pseudomonas aeruginosa is the main reason of new drugs resurgence such as colistin. The main objectives of this study were to determine the antibiotic resistance pattern and the rate of colistin resistance along with its correlation with overexpression of MexAB-OprM and MexXY-OprM efflux pumps among P. aeruginosa isolates.Materials and Methods: Hundred clinical isolates were collected from 100 patients during 6 months in 2014. Susceptibility to the eight antibiotics was investigated using Kirby-Bauer and agar dilution methods. The Quantitative Real-time PCR was used to determine the expression levels of efflux genes.Results: Resistance rates to various antibiotics were as follows: ticarcillin (73%, ciprofloxacin (65%, aztreonam (60%, ceftazidime (55%, gentamicin (55%, imipenem (49%, piperacillin/tazobactam (34% and colistin (2%. In disk diffusion method, only two isolates were non susceptible to colistin, however in agar dilution method the two isolates were confirmed as resistant and two others were intermediate resistant. Sixty eight (68% isolates were multi-drug resistant and 10 isolates were susceptible to all tested antibiotics. Both colistin resistant isolates showed overexpression of both efflux pumps, but two intermediate resistant isolates exhibited reduction of efflux genes expression.Conclusions: Emergence of colistin resistance is increasing in P. aeruginosa indicating great challenge in the treatment of infections caused by MDR strains of this organism in Iran. ParRS may promote either induced or constitutive resistance to colistin through the activation of distinct mechanisms such as MDR efflux pumps, and LPS modification. Keywords: Pseudomonas aeruginosa, Multi drug resistant, Colistin, MexAB-OprM, MexXY-OprM

  12. Clonal dissemination, emergence of mutator lineages and antibiotic resistance evolution in Pseudomonas aeruginosa cystic fibrosis chronic lung infection.

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    Carla López-Causapé

    Full Text Available Chronic respiratory infection by Pseudomonas aeruginosa is a major cause of mortality in cystic fibrosis (CF. We investigated the interplay between three key microbiological aspects of these infections: the occurrence of transmissible and persistent strains, the emergence of variants with enhanced mutation rates (mutators and the evolution of antibiotic resistance. For this purpose, 10 sequential isolates, covering up to an 8-year period, from each of 10 CF patients were studied. As anticipated, resistance significantly accumulated overtime, and occurred more frequently among mutator variants detected in 6 of the patients. Nevertheless, highest resistance was documented for the nonmutator CF epidemic strain LES-1 (ST-146 detected for the first time in Spain. A correlation between resistance profiles and resistance mechanisms evaluated [efflux pump (mexB, mexD, mexF, and mexY and ampC overexpression and OprD production] was not always obvious and hypersusceptibility to certain antibiotics (such as aztreonam or meropenem was frequently observed. The analysis of whole genome macrorestriction fragments through Pulsed-Field Gel Electrophoresis (PFGE revealed that a single genotype (clone FQSE-A produced persistent infections in 4 of the patients. Multilocus Sequence typing (MLST identified clone FQSE-A as the CF epidemic clone ST-274, but striking discrepancies between PFGE and MLST profiles were evidenced. While PFGE macrorestriction patterns remained stable, a new sequence type (ST-1089 was detected in two of the patients, differing from ST-274 by only two point mutations in two of the genes, each leading to a nonpreviously described allele. Moreover, detailed genetic analyses revealed that the new ST-1089 is a mutS deficient mutator lineage that evolved from the epidemic strain ST-274, acquired specific resistance mechanisms, and underwent further interpatient spread. Thus, presented results provide the first evidence of interpatient dissemination

  13. Extended-spectrum ß-lactamases in gram negative bacteria

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    Deepti Rawat

    2010-01-01

    Full Text Available Extended-spectrum ß-lactamases (ESBLs are a group of plasmid-mediated, diverse, complex and rapidly evolving enzymes that are posing a major therapeutic challenge today in the treatment of hospitalized and community-based patients. Infections due to ESBL producers range from uncomplicated urinary tract infections to life-threatening sepsis. Derived from the older TEM is derived from Temoniera, a patient from whom the strain was first isolated in Greece. ß-lactamases, these enzymes share the ability to hydrolyze third-generation cephalosporins and aztreonam and yet are inhibited by clavulanic acid. In addition, ESBL-producing organisms exhibit co-resistance to many other classes of antibiotics, resulting in limitation of therapeutic option. Because of inoculum effect and substrate specificity, their detection is also a major challenge. At present, however, organizations such as the Clinical and Laboratory Standards Institute (formerly the National Committee for Clinical Laboratory Standards provide guidelines for the detection of ESBLs in Klebsiella pneumoniae, K. oxytoca, Escherichia coli and Proteus mirabilis. In common to all ESBL-detection methods is the general principle that the activity of extended-spectrum cephalosporins against ESBL-producing organisms will be enhanced by the presence of clavulanic acid. Carbapenems are the treatment of choice for serious infections due to ESBL-producing organisms, yet carbapenem-resistant isolates have recently been reported. ESBLs represent an impressive example of the ability of gram-negative bacteria to develop new antibiotic-resistance mechanisms in the face of the introduction of new antimicrobial agents. Thus there is need for efficient infection-control practices for containment of outbreaks; and intervention strategies, e.g., antibiotic rotation to reduce further selection and spread of these increasingly resistant pathogens.

  14. Antibiotic sensitivity pattern of causative organisms of neonatal septicemia in an urban hospital of Bangladesh

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    Forhad Monjur

    2010-01-01

    Full Text Available Background: The information of the sensitivity pattern of the causative organisms is very important for effective control of septicemia in neonates. OBJECTIVE: To determine the proportion and profile of pathogenic bacteria in the blood cultures of the neonates with clinically suspected septicemia and their susceptibility pattern to antimicrobial agents for developing a unified antibiotic treatment protocol. Materials and Methods: A cross-sectional retrospective study was conducted over a period of 3 year and 4 months (39 months. The study included 1000 patients admitted in the selected hospital in Bangladesh. Blood samples for culture were taken aseptically before starting antibiotic therapy. Microorganisms were isolated and identified by standard microbiological processes which include colony morphology, Gram stain, and biochemical profiles. Antimicrobial sensitivity patterns were performed by Kirby-Bauer′s disc diffusion method against imipenem, ciprofloxacin, ceftazidime, chloramphenicol, netilmicin, gentamicin, ceftriaxone, aztreonam, cefotaxime, cephalexin, and ampicillin. Results: Among the patients, 633 (63.3% were males and 367 (36.7% were females. Blood cultures were found positive in 194 (19.4% neonates. The organisms isolated were Pseudomonas spp. (31.4%, Klebsiella pneumoniae (23.2%, Staphylococcus aureus (12.4%, Escherichia coli (7.2%, Acinatobactor (5.7%, Gram-negative Bacilli (4.1%, Flavobacterium spp. (3.6%, Serratia spp. (5.7%, Citrobacter fruendi (3.1%, Streptococcus species (2.6%, and Enterobacter spp. (1.0%. A majority of the bacterial isolates in neonatal sepsis were found sensitive to imipenem (91.8% and ciprofloxacin (57.2% and resistant to commonly used antibiotics, eg. ampicillin (96.4% and cephalexin (89.2%. Conclusion : The problem can be mitigated by careful selection and prudent use of available antibiotics.

  15. Biochemical and molecular characterization of three new variants of AmpC beta-lactamases from Morganella morganii.

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    Power, Pablo; Galleni, Moreno; Ayala, Juan A; Gutkind, Gabriel

    2006-03-01

    Morganella morganii produces an inducible, chromosomally encoded AmpC beta-lactamase. We describe in this study three new variants of AmpC within this species with apparent pIs of 6.6 (M19 from M. morganii strain PP19), 7.4 (M29 from M. morganii strain PP29), and 7.8 (M37 from M. morganii strain PP37). After gene sequencing, deduced amino acid sequences displayed one to six substitutions when compared to the available Morganella AmpC sequences. An AmpR-encoding gene was also found upstream of ampC, including the LysR regulators' helix-turn-helix DNA-binding domain and the putative T-N11-A-protected region in the ampR-ampC intercistronic sequence. All three AmpC variants were purified from in vitro-generated derepressed mutants and showed overall similar kinetic parameters. None of the observed amino acid changes, occurring at the surface of the protein, appear to have a major influence in their catalytic properties. Morganella AmpCs exhibit the highest catalytic efficiencies (k(cat)/K(m)) on classical penicillins, cefoxitin, narrow-spectrum cephalosporins, and cefotaxime. Cefotaxime was more effectively hydrolyzed than other oxyimino-cephalosporins, whereas cefepime was 3 log-fold less efficiently hydrolyzed than other cephalosporins such as cephalothin. Several differences with other AmpC beta-lactamases were found. Ampicillin was more efficiently hydrolyzed than benzylpenicillin. High k(cat)/K(m) values were observed for oxacillin and piperacillin, which are usually poor substrates for AmpC. A fairly efficient hydrolysis of imipenem was detected as well. Aztreonam, carbenicillin, and tazobactam were effective transient inactivators of these variants.

  16. [Infectious diseases caused by carbapenemase-producing Enterobacteriaceae--a particular challenge for antibacterial therapy].

    Science.gov (United States)

    Stock, Ingo

    2014-05-01

    OXA-48 carbapenemases. It may be used successfully in combination with ceftazidime, ceftaroline or aztreonam.

  17. Molecular characterisation of extended-spectrum β-lactamase- and plasmid AmpC-producing Escherichia coli strains isolated from broilers in Béjaïa, Algeria.

    Science.gov (United States)

    Belmahdi, Mohamed; Bakour, Sofiane; Al Bayssari, Charbel; Touati, Abdelaziz; Rolain, Jean-Marc

    2016-09-01

    This study aimed to characterise the molecular support of antibiotic resistance in expanded-spectrum cephalosporin (ESC)-resistant Escherichia coli isolates recovered from healthy broilers in Béjaïa, northeast Algeria. A total of 61 intestinal swabs from slaughtered broilers from four regions in Béjaïa locality, Algeria, were collected between February and April 2014, from which 20 ESC-resistant E. coli strains were isolated. Escherichia coli isolates were identified by classical biochemical and MALDI-TOF methods. Antibiotic susceptibility testing was performed using disk diffusion and Etest methods. Screening for β-lactamases, aminoglycoside-modifying enzyme (AME)-encoding genes and qnr determinants was performed by PCR and sequencing. Clonal relatedness was determined using molecular typing by multilocus sequence typing (MLST). Antibiotic susceptibility testing revealed that the isolates showed high rates of resistance (>90%) to amoxicillin, amoxicillin/clavulanic acid, piperacillin/tazobactam, aztreonam, ceftazidime, streptomycin, tobramycin, nalidixic acid and ciprofloxacin. Low rates of resistance were observed for kanamycin (35%), amikacin (30%), cefoxitin (20%) and cefotaxime (15%). Molecular characterisation revealed that all of the isolates expressed the blaTEM-1 gene. Fourteen of them harboured the blaSHV-12 gene, two harboured the blaCTX-M-1 gene and four isolates harboured blaCMY-2. Screening for AME-encoding genes demonstrated that all isolates contained the aadA gene. In addition, qnrA was detected as the quinolone resistance determinant in 13 isolates. MLST revealed four known sequence types (STs), including ST744, ST38, ST1011 and ST2179, as well as one new sequence type (ST5086). Here we report the first study describing the clonal diversity of extended-spectrum β-lactamase (ESBL)- and plasmid AmpC-producing E. coli isolated from healthy broilers in Algeria.

  18. Emerging Carbapenem-Resistant Pseudomonas aeruginosa Isolates Carrying blaIMP Among Burn Patients in Isfahan, Iran

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    Radan, Mohsen; Moniri, Rezvan; Khorshidi, Ahmad; Gilasi, Hamidreza; Norouzi, Zohreh; Beigi, Fahimeh; Dasteh Goli, Yasaman

    2016-01-01

    Background Metallo-β-lactamase (MBL)-producing Pseudomonas aeruginosa is a significant pathogen in burn patients. Objectives The aim of this study was to determine the prevalence of carbapenem-resistant P. aeruginosa isolates, including those resistant to imipenemase (IMP), in a burn unit in Isfahan, Iran. Patients and Methods One hundred and fifty P. aeruginosa isolates from burn patients were tested for antibiotic susceptibility by the disc diffusion method in accordance with CLSI guidelines. Production of MBL was identified with the EDTA disk method. DNA was purified from the MBL-positive isolates, and detection of the blaIMP gene was performed with PCR. Results Fifty-seven out of 150 (38%) isolates were multi-drug resistant (MDR), and 93 (62%) were extensively-drug resistant (XDR). Among all isolates, the resistance rate to ciprofloxacin, tobramycin, imipenem, meropenem, amikacin, ceftazidime, and cefepime was higher than 90%, while the resistance rates to piperacillin/tazobactam and aztreonam were 70.7% and 86%, respectively. Colistin and polymyxin B remained the most effective studied antibiotics. All of the imipenem-resistant P. aeruginosa isolates were MBL-positive, and 107 out of 144 (74.3%) of the MBL isolates were positive for the blaIMP gene. Conclusions The results of this study show that the rate of P. aeruginosa-caused burn wound infections was very high, and many of the isolates were resistant to three or more classes of antimicrobials. Such extensive resistance to antimicrobial classes is important because few treatment options remain for patients with burn wound infections. blaIMP-producing P. aeruginosa isolates are a rising threat in burn-care units, and should be controlled by conducting infection-control assessments.

  19. Detection of Achromobacter xylosoxidans in hospital, domestic, and outdoor environmental samples and comparison with human clinical isolates.

    Science.gov (United States)

    Amoureux, Lucie; Bador, Julien; Fardeheb, Sakina; Mabille, Cédric; Couchot, Charlyne; Massip, Clémence; Salignon, Anne-Lise; Berlie, Guillaume; Varin, Véronique; Neuwirth, Catherine

    2013-12-01

    Achromobacter xylosoxidans is an aerobic nonfermentative Gram-negative rod considered an important emerging pathogen among cystic fibrosis (CF) patients worldwide and among immunocompromised patients. This increased prevalence remains unexplained, and to date no environmental reservoir has been identified. The aim of this study was to identify potential reservoirs of A. xylosoxidans in hospital, domestic, and outdoor environments and to compare the isolates with clinical ones. From 2011 to 2012, 339 samples were collected in Dijon's university hospital, in healthy volunteers' homes in the Dijon area, and in the outdoor environment in Burgundy (soil, water, mud, and plants). We designed a protocol to detect A. xylosoxidans in environmental samples based on a selective medium: MCXVAA (MacConkey agar supplemented with xylose, vancomycin, aztreonam, and amphotericin B). Susceptibility testing, genotypic analysis by pulsed-field gel electrophoresis, and blaOXA-114 sequencing were performed on the isolates. A total of 50 strains of A. xylosoxidans were detected in hospital (33 isolates), domestic (9 isolates), and outdoor (8 isolates) samples, mainly in hand washing sinks, showers, and water. Most of them were resistant to ciprofloxacin (49 strains). Genotypic analysis and blaOXA-114 sequencing revealed a wide diversity among the isolates, with 35 pulsotypes and 18 variants of oxacillinases. Interestingly, 10 isolates from hospital environment were clonally related to clinical isolates previously recovered from hospitalized patients, and one domestic isolate was identical to one recovered from a CF patient. These results indicate that A. xylosoxidans is commonly distributed in various environments and therefore that CF patients or immunocompromised patients are surrounded by these reservoirs.

  20. Tigecycline: an evidence-based review of its antibacterial activity and effectiveness in complicated skin and soft tissue and intraabdominal infections

    Directory of Open Access Journals (Sweden)

    Christopher J. Dunn

    2006-03-01

    Full Text Available Christopher J. DunnCatalyst Communications Ltd, Auckland, New ZealandIntroduction: There is an urgent need for novel agents to manage serious bacterial infections, particularly those contracted in healthcare facilities. Tigecycline is a novel broad-spectrum glycylcycline with good activity against Gram-positive, many Gram-negative, anaerobic, and some atypical pathogens that has been developed to address this need.Aims: To review the evidence for the use of tigecycline in serious and complicated skin and soft tissue and intraabdominal infections.Evidence review: There is substantial evidence that tigecycline is as effective as vancomycin plus aztreonam in complicated skin and skin structure infections (SSSIs and as effective as imipenem plus cilastatin in intraabdominal infections. Limited evidence shows effectiveness in patients with resistant Acinetobacter infection in an intensive care unit, and the possibility that the use of tigecycline may reduce length of hospital stay. The drug is well tolerated, with nausea and vomiting as the major adverse effects.Outcomes summary: The introduction of tigecycline should be beneficial at a time of increasing problems with bacterial resistance, and evidence to date has been sufficient for regulatory approval for complicated SSSIs and intraabdominal infections. Research into tigecycline’s efficacy in other infectious diseases (notably pneumonia and bacteremia is ongoing. Further good quality studies and ongoing surveillance for any emerging bacterial resistance will be needed to determine outcomes with tigecycline relative to other novel antibacterial agents, and to explore the economic implications of its adoption.Key words: antibiotic resistance, bacterial infections, glycylcycline, nosocomial infections, review, tigecycline

  1. [Antimicrobial resistance trends in pathogens isolated from nosocomial infections].

    Science.gov (United States)

    Rincón-León, Héctor A; Navarro-Fuentes, Karla R

    2016-01-01

    Introducción: el tratamiento de las infecciones nosocomiales se dificulta por la tendencia al incremento de la resistencia a antimicrobianos de los gérmenes que las causan. El objetivo fue evaluar las tendencias en la resistencia de las bacterias de aislados de infección nosocomial. Métodos: estudio retrospectivo de 2009 a 2012 en un hospital de tercer nivel en Chiapas. Resultados: fueron obtenidos 1300 gérmenes, 62.3 % bacterias Gram negativas, 22.8 % Gram positivas y 14.9 % levaduras; Pseudomonas aeruginosa pasó del 47.1 al 60.5 % de resistencia a imipenem; Escherichia coli mostró un aumento en la resistencia a aztreonam, cefepime y ceftazidima; Acitenobacter baumannii incrementó su resistencia a amikacina, cefepime, ceftazidima y ciprofloxacino; Klebsiella pneumoniae disminuyó su resistencia a amikacina y piperacilina/tazobactam; la resistencia a vancomicina fue del 3.6 al 25.5 %. Conclusiones: predominaron los gérmenes Gram negativos y mostraron tendencias al incremento en la resistencia antimicrobiana. Hubo un aumento proporcional de la incidencia de infección por E. coli, Candida tropicalis y Staphylococcus haemolyticus. Es indispensable contar con planes y programas para el uso racional y basado en evidencia de antimicrobianos, así como la difusión y el apego a las guías de práctica clínica y la implementación de programas novedosos para la vigilancia y el control de las infecciones hospitalarias, las técnicas de aislamiento y los cuidados generales.

  2. Investigations of multiresistance to antibiotics and chemotherapeutics and extended spectrum beta: Lactamase effect (ESBL test in strains E.coli and salmonella originating from domestic animals

    Directory of Open Access Journals (Sweden)

    Mišić Dušan

    2006-01-01

    Full Text Available The presence of multiresistance to the effects of antibiotics and chemotherapeutics and extended spectrum beta-lactamase were examined in 45 strains of E. coli and 35 strains of Salmonella. The strains of E. coli originated from several species of domestic animals: dogs, cats, poultry, and cattle, and 30 strains of Salmonella originated from poultry, 4 strains from cattle, and 1 strain from swine. The presence of the following serovarieties was established using serological examinations: Salmonella Enteritidis 17 strains, Salmonella Gallinarum 1 strain, Salmonella Hartford 5 strains, Salmonella Anatum 1 strain, Salmonella Typhimurium 4 strains, Salmonella Agona 1 strain, Salmonella Infantis 1 strain, Salmonella Thompson var. Berlin 1 strain, Salmonella Tennessee 1 strain, Salmonella Senftenberg 1 strain, Salmonella Glostrup 1 strain, and Salmonella Hadar 1 strain. In the examinations of the listed strains we used antibiogram discs of ampicillin, amoxicillin with clavulanic acid, cephalexin, cephtriaxon, cephotaxim, cephtazidime, aztreonam, gentamycin, chloramphenicol, tetracycline, cyprofloxacine, and a combination of sulphamethoxasole and trimethoprim. The lowest prevalence of multiresistance in E. Coli strains to 3 or more antibiotics was established in dogs 20%, and the highest in 60% strains originating from swine. In 62.88% strains of Salmonella we established sensitivity to all applied antibiotics. Resistance was also established in a small number of the examined strains to ampicillin (11 strains, to tetracycline (5 strains, to amoxicillin with clavulanic acid (5 strains, to sulphamethoxasole with trimethoprim (5 strains, to gentamycin (3 strains, and to cloramphenicol (1 strain. Of all the examined strains of Salmonella, 6 strains originating from poultry exhibited multiresistence. The presence of extended spectrum beta-lactamase effects examined using the ESBL test, was not established in strains of E. coli and Salmonella strains.

  3. Occurrence of multi-antibiotic resistant Pseudomonas spp. in drinking water produced from karstic hydrosystems.

    Science.gov (United States)

    Flores Ribeiro, Angela; Bodilis, Josselin; Alonso, Lise; Buquet, Sylvaine; Feuilloley, Marc; Dupont, Jean-Paul; Pawlak, Barbara

    2014-08-15

    Aquatic environments could play a role in the spread of antibiotic resistance genes by enabling antibiotic-resistant bacteria transferred through wastewater inputs to connect with autochthonous bacteria. Consequently, drinking water could be a potential pathway to humans and animals for antibiotic resistance genes. The aim of this study was to investigate occurrences of Escherichia coli and Pseudomonas spp. in drinking water produced from a karst, a vulnerable aquifer with frequent increases in water turbidity after rainfall events and run-offs. Water samples were collected throughout the system from the karstic springs to the drinking water tap during three non-turbid periods and two turbid events. E. coli densities in the springs were 10- to 1000-fold higher during the turbid events than during the non-turbid periods, indicating that, with increased turbidity, surface water had entered the karstic system and contaminated the spring water. However, no E. coli were isolated in the drinking water. In contrast, Pseudomonas spp. were isolated from the drinking water only during turbid events, while the densities in the springs were from 10- to 100-fold higher than in the non-turbid periods. All the 580 Pseudomonas spp. isolates obtained from the sampling periods were resistant (to between 1 and 10 antibiotics), with similar resistance patterns. Among all the Pseudomonas isolated throughout the drinking water production system, between 32% and 86% carried the major resistance pattern: ticarcillin, ticarcillin-clavulanic acid, cefsulodin, and/or aztreonam, and/or sulfamethoxazol-trimethoprim, and/or fosfomycin. Finally, 8 Pseudomonas spp. isolates, related to the Pseudomonas putida and Pseudomonas fluorescens species, were isolated from the drinking water. Thus, Pseudomonas could be involved in the dissemination of antibiotic resistance via drinking water during critical periods.

  4. In vitro susceptibility to antimicrobial agents and ultrastructural characteristics related to swimming motility and drug action in Campylobacter jejuni and C. coli.

    Science.gov (United States)

    Yabe, Shizuka; Higuchi, Wataru; Takano, Tomomi; Razvina, Olga; Iwao, Yasuhisa; Isobe, Hirokazu; Yamamoto, Tatsuo

    2010-06-01

    Campylobacter jejuni has recently been noted as the most common cause of bacterial food-borne diseases in Japan. In this study, we examined in vitro susceptibility to 36 antimicrobial agents of 109 strains of C. jejuni and C. coli isolated from chickens and patients with enteritis or Guillain-Barré syndrome from 1996 to 2009. Among these agents, carbapenems (imipenem, meropenem, panipenem, and biapenem) showed the greatest activity [minimal inhibitory concentration (MIC)(90), 0.03-0.125 microg/ml]. This was followed by sitafloxacin (MIC(90), 0.25 microg/ml), furazolidone and azithromycin (MIC(90), 0.5 microg/ml), gentamicin and clindamycin (MIC(90), 1 microg/ml), and clavulanic acid (beta-lactamase inhibitor; MIC(90), 2 microg/ml). All or most strains were resistant to aztreonam, sulfamethoxazole, and trimethoprim. Marked resistance was also observed for levofloxacin and tetracyclines. Resistance was not present for macrolides and rare for clindamycin. C. jejuni (and C. coli) exhibited high swimming motility and possessed a unique end-side (cup-like) structure at both ends, in contrast to Helicobacter pylori and Vibrio cholerae O1 and O139. The morphology of C. jejuni (and C. coli) changed drastically after exposure to imipenem (coccoid formation), meropenem (bulking and slight elongation), and sitafloxacin (marked elongation), and exhibited reduced motility. In the HEp-2 cell adherence model, unusually elongated bacteria were also observed for sitafloxacin. The data suggest that although resistance to antimicrobial agents (e.g., levofloxacin) has continuously been noted, carbapenems, sitafloxacin, and others such as beta-lactamase inhibitors alone showed good in vitro activity and that C. jejuni (and C. coli) demonstrated a unique ultrastructural nature related to high swimming motility and drug action.

  5. Electron microscopic structures, serum resistance, and plasmid restructuring of New Delhi metallo-β-lactamase-1 (NDM-1)-producing ST42 Klebsiella pneumoniae emerging in Japan.

    Science.gov (United States)

    Yamamoto, Tatsuo; Takano, Tomomi; Fusegawa, Takehito; Shibuya, Tetsuo; Hung, Wei-Chun; Higuchi, Wataru; Iwao, Yasuhisa; Khokhlova, Olga; Reva, Ivan

    2013-02-01

    Enterobacteriaceae, carrying the New Delhi metallo-β-lactamase-1 (NDM-1) gene (bla (NDM-1)), have emerged and posed a threat since 2006. In Japan, bla (NDM-1)-carrying Escherichia coli was first described in 2010. In this study, we characterized NDM-1-positive Klebsiella pneumoniae strain 419 in Japan, which was isolated from the urine of a 90-year-old Japanese patient who had never been to the Indian subcontinent. K. pneumoniae 419 belonged to ST42. It possessed a surface capsule (with untypeable capsular PCR types) and was resistant to serum killing. K. pneumoniae 419 cells were occasionally flagellated or piliated and autoaggregated. K. pneumoniae 419 was resistant to β-lactams (including carbapenems), aminoglycosides, and fluoroquinolones, and was susceptible to imipenem (or biapenem), aztreonam, polymixin B, and colistin. It possessed at least eight plasmids; of those, a 74-kb plasmid (pKPJ1) of the replicon FIIA carried bla (NDM-1) and was conjugally transferred to E. coli strains, with a 71-kb transferable azithromycin-resistant (mphA (+)) plasmid of the replicon F (pKPJ2), as a large (145-kb) plasmid (pKPJF100) through a transposition event. In addition to bla (NDM-1), pKPJ1 carried arr-2, pKPJ2 carried mphA, and pKPJF100 carried both. They were negative for the 16S rRNA methylase gene, e.g., which is frequently associated with bla (NDM-1). The data demonstrate that K. pneumoniae 419 possessed virulence- and fitness-associated surface structures, was resistant to serum killing, and possessed a unique (or rare) genetic background in terms of ST type and bla (NDM-1)-carrying plasmid.

  6. Evaluation and updating of the Osiris expert system for identification of Escherichia coli beta-lactam resistance phenotypes.

    Science.gov (United States)

    Bert, Frédéric; Juvin, Manette; Ould-Hocine, Zahia; Clarebout, Gervais; Keller, Emmanuelle; Lambert, Nicole; Arlet, Guillaume

    2005-04-01

    Osiris is a video zone size reader for disk diffusion tests that includes a built-in extended expert system (EES). We evaluated the efficacy of the Osiris EES for the identification of beta-lactam susceptibility phenotypes of Escherichia coli isolates. Fifteen beta-lactam agents and three beta-lactam-beta-lactamase inhibitor combinations were tested by the disk diffusion method against 50 E. coli strains with well-characterized resistance mechanisms. The strains were screened for the production of extended-spectrum beta-lactamase (ESBL) by the double-disk synergy test using a disk of amoxicillin-clavulanic acid with disks of the extended-spectrum cephalosporins and aztreonam. Overall, the EES accurately identified the phenotype for 78% of the strains, indicated an inexact phenotype for 17% of the strains, and could not find a matching phenotype for the remaining 5% of the strains. The percentage of correct identification for each resistance mechanism was 100% for inhibitor-resistant TEM and for TEM plus cephalosporinase, 88.9% for TEM and for ESBL, 70.8% for cephalosporinase overproduction, and 25% for oxacillinase. The main cause of discrepancy was the misidentification of oxacillinase as inhibitor-resistant TEM. The conventional double-disk synergy test failed to detect ESBL production in two strains (one producing VEB-1 and one producing CTX-M-14), but synergy between cefepime and amoxicillin-clavulanic acid was visible after the distance between the disks was reduced to 20 mm. After the interpretative guidelines of the EES were updated according to our results, the percentage of correct phenotype identification increased from 78 to 96%.

  7. Transconjugation and genotyping of the plasmid-mediated AmpC β-lactamase and extended-spectrum β-lactamase genes in Klebsiella pneumoniae

    Institute of Scientific and Technical Information of China (English)

    SHI Wei-feng; ZHOU Jun; QIN Jian-ping

    2009-01-01

    Backgroud AmpC β-lactamases and extended-spectrum β-lactamases (ESBLs) are becoming predominant causes of resistance to third and forth-generation cephalosporins in Klebsiella pneumoniae (K. Pneumoniae). It is very difficult to treat infectious diseases caused by multidrug-resistant K. Pneumoniae. The purpose of the present study was to investigate transconjugation and characteristics of β-lactamase genes in K. Pneumoniae producing AmpC β-lactamases and ESBLs.Methods AmpC β-lactamases were detected by three-dimension test and ESBLs by disc confirmatory test. Minimum inhibitory concentrations (MICs) were determined by agar dilution. Transfer of resistance to EC600 (Rif') was attempted by conjugation in broth and screened on agar containing cefotaxime (2 μg/ml) plus rifampin (1024 μg/ml). The genes encoding AmpC or ESBLs and their transconjugants were detected by PCR and verified by DNA sequencing. Results The resistant rates to ampicillin and piperacillin were 100% in 18 isolates of K. Pneumoniae. However, imipenem was still of great bactericidal activity on K. Pneumoniae, and its MIC50 was 0.5 μg/mL. Eleven β-lactamase genes, including TEM-1, TEM-11, SHV-13, SHV-28, CTX-M-9, CTX-M-22, CTX-M-55, OXA-1, LEN, OKP-6 and DHA-1, were found from 18 isolates. And at least one β-lactamase gene occurred in each isolate. To our surprise, there were six β-lactamase genes in the CZ04 strain. Among 18 isolates of K. Pneumoniae, the partial resistant genes in 8 isolates were conjugated successfully, which had 100% homological sequence with donors by sequence analysis. Compared with donors, 8 transconjugants had attained resistance to most β-lactams, including ampicillin, piperacillin, cefoxitin, cefotaxime and aztreonam, or even amikacin and gentamicin.Conclusions R plasmids can be easily transferred between the resistant and sensitive negative bacilli. It is very difficult to block and prevent the spread of antimicrobial resistance. So more attention should be paid

  8. Identification and molecular characterization of Escherichia coli blaSHV genes in a Chinese teaching hospital.

    Science.gov (United States)

    Zhu, Mei; Yang, Guangjian; Li, Ailing; Zong, Li; Dong, Zhaoguang; Lu, Junwan; Zhang, Kaibo; Cheng, Cong; Chang, Qingli; Wu, Xiuying; Ying, Jianchao; Li, Xianneng; Ding, Li; Zheng, Haixiao; Yu, Junping; Ying, Jun; Xu, Teng; Yi, Huiguang; Li, Peizhen; Li, Kewei; Wu, Songquan; Bao, Qiyu; Wang, Junrong

    2017-02-05

    Escherichia coli (E. coli) commonly reside in human intestine and most E. coli strains are harmless, but some serotypes cause serious food poisoning. This study identified and molecularly characterized blaSHV genes from 490 E. coli strains with multi-drug resistance in a hospital population. PCR and molecular cloning and southern blot were performed to assess functions and localizations of this resistant E. coli gene and the pulsed-field gel electrophoresis (PFGE) was utilized to demonstrate the clonal relatedness of the positive E. coli strains. The data showed that 4 of these 490 E. coli strains (4/499, 0.8%) carried blaSHV genes that included EC D2485 (blaSHV-5), EC D2487 (blaSHV-5), EC D2684 (blaSHV-11) and EC D2616 (blaSHV-195, a novel blaSHV). Analysis of blaSHV open-reading frame showed that blaSHV-5 had a high hydrolysis activity to the broad-spectrum penicillin (ampicillin or piperacillin), ceftazidime, ceftriaxone, cefotaxime and aztreonam. blaSHV-195 and blaSHV-11 had similar resistant characteristics with high hydrolysis activities to ampicillin and piperacillin, but low activities to cephalosporins. Moreover, the two blaSHV-5 genes were located on a transferable plasmid (23kb), whereas the other two blaSHV variants (blaSHV-11 and blaSHV-195) seemed to be located in the chromosomal material. Both EC D2485 and EC D2487 clones isolated in 2010 had the same DNA finger printing profile and they might be the siblings of clonal dissemination. The data from the current study suggest that the novel blaSHV and clonal dissemination may be developed, although blaSHV genes were infrequently identified in this hospital population. The results of the work demonstrate the necessity for molecular surveillance in tracking blaSHV-producing strains in large teaching hospital settings and emphasize the need for epidemiological monitoring.

  9. 儿童烧伤创面感染细菌种类分布及耐药情况%INVESTIGATION OF BACTERIAL SPECIES DISTRIBUTION AND DRUG RESISTANCE OF CHILDREN WITH BURN WOUND INFECTION

    Institute of Scientific and Technical Information of China (English)

    戴昆琦; 奕利娟; 陈群英

    2012-01-01

    目的 研究医院病房儿童烧(烫)伤患者创面感染细菌分布和耐药情况.方法 采用细菌分离培养和药敏试验方法,对住院儿童烧伤创面分泌物标本进行了检测.结果 从1 698份标本中检出致病菌379株,检出率为22.32%.烧伤感染致病菌中,革兰阳性球菌占65.17%,革兰阴性杆菌占32.98%,真菌占1.85%.检出的铜绿假单胞菌对氨苄西林、头孢曲松、复方新诺明耐药率均高达100%,鲍曼不动杆菌对氨曲南、环丙沙星和复方新诺明耐药率均高达80%以上.结论 该医院住院儿童烧伤感染致病菌以革兰阳性球菌为主,但革兰阴性杆菌耐药率高.%Objective To investigate the bacterial species distribution and drug resistance of children with bum wound infection. Methods The bacteria isolated culturing and the medicine sensitive test were used to detect secretion specimen from burn wound of children. Results From 1 698 specimen there were 379 strains pathogenic bacteria detected and the positive rate was 22. 32%. Of the burn infection pathogenic bacteria the gram positive coccus accounted for 63. 17% , the gram negative bacillus accounted for 32. 98% and the fungus accounted for 1.85%. The resistance rates of Pseudomonas aeruginosa detected to Amicillin, Ceftriaxone, Trimethoprim - sulfamethoxazole reached 100% , while the resistance rates of Acinetobacter buumannii detected to Aztreonam, Ciprofloxacin and Trimethoprim - sulfamethoxazole were above 80%. Conclusion The main infection pathogenic bacteria of children bum wound are the gram positive coccus and the drug resistance rate of negative bacillus is high.

  10. Distribution of CTX-M group I and group III β-lactamases produced by Escherichia coli and klebsiella pneumoniae in Lahore, Pakistan.

    Science.gov (United States)

    Abrar, Samyyia; Vajeeha, Ayesha; Ul-Ain, Noor; Riaz, Saba

    2017-02-01

    Extended-spectrum-lactamases (ESBLs) of the CTX-M type is worrisome issue in many countries of the world from past decade. But little is known about CTX-M beta-lactamase producing bacteria in Pakistan. Therefore, this study was carried out to investigate the distribution of CTX-M beta-lactamase producing E. coli and Klebsiella pneumoniae using phenotypic and molecular techniques. A total of 638 E. coli and 338 Klebsiella pneumoniae were isolated from patients attending two hospitals and one diagnostic Centre in Pakistan during 2013-2015. ESBL production was screened by double disc synergism, combination disc (cefotaxime and ceftazidime with clavulanic acid) and E-test. These strains were further characterized by PCR (CTX-M I, CTX-M III) and sequencing. After ribotyping of strains accession numbers were obtained. These isolates were highly resistant to cephalosporins, ceftazidime, cefotaxime, aztreonam, and cefuroxime but susceptible to carbapenems, sulfzone, amikacin and tazocin. Multiple antibiotic resistances index (MAR) revealed that 51% of E. coli strains fell in the range of 0.61-0.7 and 39% of Klebsiella pneumoniae strains fell in the range of 0.71-0.8. 64% Double disc synergism (DDS), 76.4% combination disc (CD), 74% E-test showed ESBL positivity in strains. In E. coli ESBL genes blaCTX-M-I and blaCTX-M-III were detected in 212 (72.1%) and 25 (8.5%) respectively. In Klebsiella pneumoniae ESBL genes blaCTX-M-I and blaCTX-M-III were detected in 89 (82.4%) and 10 (9.2%). Combination of both genes blaCTX-M-I and blaCTX-M-III were found in 16 (5.4%) of E. coli strains and 5 (4.6%) of Klebsiella pneumoniae strains. Sequencing revealed that CTXM-15 was predominately present in the CTX-M-I group. The prevalence of ESBL producing E. coli and Klebsiella pneumoniae isolates was high and the majority of them positive for blaCTX-M-I as compared to blaCTX-M-III. These findings highlight the need to further investigate the epidemiology of other CTX-M beta

  11. Occurrence and Multiple Antibiotic Resistance Profiles of Non-fermentative Gram-Negative Microflora in Five Brands of Non-carbonated French Bottled Spring Water.

    Science.gov (United States)

    Mary; Defives; Hornez

    2000-05-01

    Five brands of French bottled mineral water were analyzed by heterotrophic plate counts (HPC) and for the presence of multiple antibiotic resistant bacteria. HPC at 22 degrees C were around 10(4) colony forming units ml(-1) on R2A medium. Enumeration on PCA/10, MH, and especially PCA and King B media was less efficient. At 37 degrees C, HPC were two to three orders of magnitude less than at 22 degrees C. Moreover, phenotypic diversity (7 to 15 phenotypes) was optimal on R2A incubated at 22 degrees C. All isolates were identified as non-fermentative Gram-negative rods and 75% were non-identifiable with the API 20NE system. Stenotrophomonas maltophilia and fluorescent Pseudomonas were isolated on VIA and CFC selective agar media, respectively. Burkholderia cepacia strains were not isolated on BCSA medium. The species S. maltophilia was found in 33%, 28%, and 11% of sample from springs A, D, and E, respectively. Independent of brand, isolates from HPC media were less efficient to achieve confluent growth in 18 h on MH at 30 or 37 degrees C (0 to 40%) than isolates from selective media (28 to 63%). Seventy percent of the total isolates from dominant microflora (1-5 x 10(3) CFU ml(-1) on HPC media) were resistant against two or four antibiotics. The antibiotics concerned were principally aztreonam, ampicillin, and nalidixic acid. The remaining dominant bacteria showed a 6-9 multiple antibiotic resistant (MAR) pattern. All isolates were susceptible to newer antimicrobial agents. Owing to their low nutrient and temperature requirements, these isolates are unlikely to cause concern to public heath. Fifty percent of strains isolated from selective media (non-dominant microflora, 4-40 CFU l(-1)) showed a 10-18 MAR pattern and 33%, identified as S. maltophilia, a 20-27 MAR pattern. However, minocycline was effective against all isolates. Owing to its low concentration, colonization of human intestine by MAR S. maltophilia is unlikely.

  12. TEM-1 AND ROB-1 PRESENCE AND ANTIMICROBIAL RESISTANCE IN HAEMOPHILUS INFLUENZAE STRAINS, ISTANBUL, TURKEY.

    Science.gov (United States)

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

    2015-03-01

    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

  13. Indagine epidemiologica locale sulle infezioni sostenute da Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Burkholderia cepacia e sensibilità agli antibiotici di questi microrganismi.

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    Valeria Di Marcello

    2007-03-01

    Full Text Available Background: The aim of this local surveillance study was to determine the distribution of Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Burkholderia cepacia in our geographic area, their impact in the hospital and community acquired infections and their resistance to antimicrobial agents currently used in the treatment of infections due to these microrganisms. Materials and Methods: During the period January 2001 - June 2003, 14.200 clinical isolates were collected from urine,wounds, catheters, body fluids, blood, respiratory tract specimens. Bacterial identifications were performed according to the standard methods (Murray, 2003 and antibiotic susceptibility tests were carry out in microassay by the automated system MicroScan (Dade Behring, Milano, Italy.The following antimicrobial agents were tested: piperacillin (PIP, ticarcillin (TIC, piperacillin-tazobactam (TZP, ticarcillin-clavulanic acid (TTC, ceftazidime (CAZ, ceftriaxone (CRO, aztreonam (ATM, imipenem (IPM, trimethoprim-sulfamethoxazole (SXT, gentamicin (CN, amikacin (AK, tobramycin (TOB, ciprofloxacin (CIP. Results: A total of 994 Pseudomonadaceae were isolated from in- (67% and out-patients (33%.They were P.aeruginosa (81%, other Pseudomonas species as P.fluorescens and P.putida (8%, S.maltophilia (9% and B.cepacia (2%.The great majority of the strains were collected from respiratory tract specimens (70% and urine (15%.The divisions from which derived the greater quantity of isolates were pediatric (33.8%, intensive care (22.7% and pneumology (10% units.Antibiotics more active against P. aeruginosa were IPM, CAZ,AK and TZP. IPM was effective against B. cepacia also.The other drugs, except SXT, displayed against this microrganism high rates of resistance. Even S. maltophilia was not susceptible to much antimicrobial agents, whereas SXT was the drug more active against this germ. Conclusion: P. aeruginosa was the microrganism more frequently isolated among non-fermenting Gram

  14. Studio preliminare sul possibile utilizzo del sistema Uro-Quick per l’esecuzione rapida di antibiogrammi su ceppi provenienti da reparti di terapia intensiva

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    Elisabetta Pezzati

    2005-06-01

    Full Text Available L’Uro-Quick, un sistema automatizzato ampiamente utilizzato per lo screening delle batteriurie sui campioni d’urina, è stato precedentemente impiegato per la valutazione della sensibilità agli antibiotici negli uropatogeni e per l’identificazione di resistenze ben caratterizzate veicolate da diverse specie batteriche. In questo studio sono stati esaminati utilizzando la metodica classica Kirby-Bauer per la determinazione dell’antibiotico sensibilità patogeni isolati durante il periodo settembre 2003 - marzo 2004 in reparti di terapia intensiva di un grande ospedale italiano e i risultati sono stati confrontati con quelli ottenuti con il nuovo sistema rapido Uro-Quick. L’antibiotico (in concentrazione appropriata è stato introdotto in una cuvetta Uro-Quick contenente 2 ml di Mueller-Hinton brodo, successivamente sono stati addizionati 0.5 ml di sospensione del ceppo da saggiare (5x105 CFU/ml. Una cuvetta priva di farmaco è stata utilizzata come controllo. Dopo 3 o 5 ore di incubazione (per i ceppi Gram-negativi o Gram-positivi rispettivamente i risultati sono stati interpretati nel seguente modo: l’assenza di sviluppo indicava sensibilità, mentre una curva di crescita analoga a quella del controllo rappresentava un ceppo resistente. I microrganismi Gram-negativi sono stati saggiati con ciprofloxacina (CIP, ampicillina (AM, piperacillina (PIP, aztreonam (ATM, amoxicillina-clavulanato (AMC, piperacillina/tazobactam (TZP, imipenem (IPM, ceftazidime (CAZ, cefotaxime (CTX, cefepime (CFP, cefuroxime (CXM, ceftriaxone (CRO, amikacina (AN, gentamicina (GM e trimethoprim-sulfametossazolo (SXT. I Gram-positivi, invece, sono stati saggiati con ciprofloxacina (CIP, clindamicina (CM, eritromicina (E, rifampicina (RA, ampicillina (AM, penicillina (P, oxacillina (OXA, imipenem (IPM, gentamicina (GM, streptomicina (S, tetraciclina (TE, trimethoprim – sulfametazolo (SXT, vancomicina (VA e linezolid (LZD. Sono stati esaminati 197 ceppi Gram

  15. [Susceptibility of ESBL-producing Escherichia coli and Klebsiella pneumoniae to various antibacterial agents].

    Science.gov (United States)

    Nakamura, Tatsuya; Komatsu, Masaru

    2005-02-01

    With the increasing use of broad-spectrum antibacterial agents, the increase in various drug-resistant bacterial strains has become a concern in recent years. Especially, the development of drug-resistance by Enterobacteriaceae which significantly affects therapy and prognosis in sepsis and lower gastrointestinal post-operative infection. The extended spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae strains isolated in the Surveillance Program of Bacterial Resistance in Kinki region of Japan (SBRK) were supplied between November 2000 and March 2003. The susceptibilities of them to 16 kinds of antimicrobial agents were investigated. The number of them was 48 strains consisting of 36 Escherichia coli strains (75%) and 12 Klebsiella pneumoniae strains (25%). Our focus was on carbapenem and the new quinolone antibacterial agents. Among the 16 major antibacterial agents examined, carbapenem had low MIC50/90 values. Meropenem had a MIC50/90 of 0.03/0.06microg/ml, followed by biapenem (0.12/0.5), imipenem (0.25/0.5) and panipenem (0.25/0.5). Among cephem, ceftazidime had the lowest MIC50 at 4 microg/ml. All four of the cephem agents had a MIC90 of greater than 128microg/ml. Among beta-lactamase inhibitors, tazobactam/piperacillin had the lowest MIC50 at 4 microg/ml, and sulbactam/cefoperazone had a MIC50 of 32 microg/ml. Among the new quinolones, prulifloxacin had the lowest MIC50 at 1 microg/ml, and the other drugs had a MIC50 of 2 microg/ml. The resistance rate of ciprofloxacin was 61.1% in E. coli and 16.6% in K. pneumoniae. Comparison of drug-sensitivity to cephem by ESBL-gene type revealed that cefpirome, cefepime and cefozopran had higher MIC50/90 values against the CTX-M group with a MIC50 of greater than 128microg/ml. Ceftazidime and aztreonam had higher MIC50/90 values against the TEM/SHV group than those against the CTX-M group. In the CTX-M group, the MIC50 was 4 and 16microg/ml, respectively.

  16. Analysis on the use of antibiotics in treatment of 180 infantile patients with acute diarrhea in our hospital%180例小儿急性腹泻病住院患者抗菌药物应用分析

    Institute of Scientific and Technical Information of China (English)

    罗宏丽; 肖顺林; 王国俊

    2011-01-01

    Objective: To investigate the usage of antibiotics in treatment of infantile acute diarrhea in our hospital and provide reference for clinical rational administration. Methods: The application of antibiotics in the treatment of 180 infantile inpatients with acute diarrhea from October 2010 to March 2011 was investigated retrospectively, and the basic situation of the patient diagnosis, pathogeny examination,outcomes and the use of the antibiotics in infantile patients with acute diarrhea were statistically analysed. Results: Among 180 patients, 135 patients received antibiotics (75.0%). Aztreonam took the highest proportion (49.39%) in use frequency of antibiotics. In terms of drug combination (14.81%), the first place was piperacillin sodium and sulbactam sodium in combination with cefazolin sodium pentahydrate (4.44%). Conclusion: Clinical management of rational use of antibiotics must be enhanced because the application of antibiotics had unreasonable administration problems in terms of indications, drug selection, dosage, length of the treatment and combination therapy.%目的:了解我院小儿急性腹泻病住院患者应用抗菌药物的情况,为临床合理用药提供参考.方法:回顾性调查我院2010年10月-2011年3月180例小儿腹泻病住院患者抗菌药物的应用情况,从患者基本情况、诊断及病原学检查、患儿转归情况、抗菌药物应用基本情况等方面进行统计.结果:180例患儿中,有135例(75.0%)应用抗菌药物,应用频率最高的药物是氨曲南,占49.39%;联合用药率为14.81,以哌拉西林钠舒巴坦钠联用五水头孢唑啉钠最多,占4.44%.结论:我院治疗小儿腹泻病抗菌药物的应用在用药指征、品种选择、剂量、疗程及联合使用等方面存在不合理现象,需加强管理.

  17. An update on the management of urinary tract infections in the era of antimicrobial resistance.

    Science.gov (United States)

    Bader, Mazen S; Loeb, Mark; Brooks, Annie A

    2017-03-01

    , polymixin B, fosfomycin, aztreonam, aminoglycosides, and tigecycline are treatment options for UTIs caused by carbapenem-resistant Enterobacteriaceae (CRE). Treatment options for UTIs caused by multidrug resistant (MDR)-Pseudomonas spp. include fluoroquinolones, ceftazidime, cefepime, piperacillin-tazobactam, carbapenems, aminoglycosides, colistin, ceftazidime-avibactam, and ceftolozane-tazobactam. The use of fluoroquinolones for empiric treatment of UTIs should be restricted due to increased rates of resistance. Aminoglycosides, colistin, and tigecycline are considered alternatives in the setting of MDR Gram-negative infections in patients with limited therapeutic options.

  18. Community-acquired urinary tract infections by extended-spectrum beta-lactamase-producing Enterobacteriaceae in Zenica-Doboj Canton, Bosnia and Herzegovina

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    D. Saric

    2006-08-01

    Full Text Available The aim of this study was to determine the incidence and antimicrobial resistance of ESBL-producing strains in the community-acquired urinary tract infections (CAUTIs, which is necessary for antimicrobial therapy selection. From January 2003 to September 2004, 4,112 consecutive, non-duplicate coliform isolates from CAUTIs were analyzed. Antimicrobial susceptibility testing to fifteen antimicrobials was performed by disc-diffusion method. Double-disk synergy test (DDST with amoxicillin-clavulanat, cefotaxime, ceftazidime, ceftriaxone and aztreonam, and Etest strips with PM/PML (AB Biodisk was performed according to CLSI recommendation in order to detect the ESBL producers. The overall incidence of ESBL producing strains was 2.6% (108/4112, it was significantly higher in males, 8.4% (79/936 than in females, 0.9% (29/3176. The highest prevalence of ESBL producers was noted in the oldest and youngest age group: 4.8% (52/106 and 2.6% (27/1045, respectively. An increase from 2.2% (52/2402 to 3.3% (56/1710, and a shift of ESBL producers toward the age group 0-6 years (1.6% and 3.8%, respectively in this period was observed. The incidence of ESBL producing strains among isolated Klebsiella spp. were 7.8% (83/1060, E. coli 0.7% (18/2561, Citrobacter spp. 0.6% (1/156, Enterobacter spp. 7.7% (3/39 and Proteus spp. 1.0% ( 3/297. Among ESBL producing isolates Klebsiella spp. predominated, 76.9% (83/108, followed by E. coli 16.7% (18/108. ESBL producing strains showed significantly higher resistance rates to all tested antibiotics as compared to to non-ESBL-producers. The increase and shift toward the youngest age group of the ESBL producer incidences is of our concern. Further studies are required to detect ESBL types in terms of highly different geographical dissemination of these isolates.

  19. Antibiotic resistance in wastewater: occurrence and fate of Enterobacteriaceae producers of class A and class C β-lactamases.

    Science.gov (United States)

    Amador, Paula P; Fernandes, Ruben M; Prudêncio, Maria C; Barreto, Mário P; Duarte, Isabel M

    2015-01-01

    Antibiotics have been intensively used over the last decades in human and animal therapy and livestock, resulting in serious environmental and public health problems, namely due to the antibiotic residues concentration in wastewaters and to the development of antibiotic-resistant bacteria. This study aimed to access the contribution of some anthropological activities, namely urban household, hospital and a wastewater treatment plant, to the spread of antibiotic resistances in the treated wastewater released into the Mondego River, Coimbra, Portugal. Six sampling sites were selected in the wastewater network and in the river. The ampicillin-resistant Enterobacteriaceae of the water samples were enumerated, isolated and phenotypically characterized in relation to their resistance profile to 13 antibiotics. Some isolates were identified into species level and investigated for the presence of class A and class C -lactamases. Results revealed high frequency of resistance to the -lactam group, cefoxitin (53.5%), amoxicillin/clavulanic acid combination (43.5%), cefotaxime (22.7%), aztreonam (21.3) cefpirome (19.2%), ceftazidime (16.2%) and to the non--lactam group, trimethoprim/sulfamethoxazol (21.1%), tetracycline (18.2%), followed by ciprofloxacin (14.1%). The hospital effluent showed the higher rates of resistance to all antibiotic, except two (chloramphenicol and gentamicin). Similarly, higher resistance rates were detected in the wastewater treatment plant (WWTP) effluent compared with the untreated affluent. Regarding the multidrug resistance, the highest incidence was recorded in the hospital sewage and the lowest in the urban waste. The majority of the isolates altogether are potentially extended-spectrum -lactamases positive (ESBL(+)) (51.9%), followed by AmpC(+) (44.4%) and ESBL(+)/AmpC(+) (35.2%). The most prevalent genes among the potential ESBL producers were blaOXA (33.3%), blaTEM (24.1%) and blaCTX-M (5.6%) and among the AmpC producers were blaEBC (38

  20. PREVALENCE AND ANTIBIOGRAM OF EXTENDED SPECTRUM BET A- LACTAMASE PRODUCING ESCHERICHIA COLI

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    Mohd.

    2013-04-01

    .33%, followed by pus (62.62%, urine (61.80% a nd blood (60.61% samples. The antibiogram revealed no resistance to imipenem, whi le the highest resistance rate was detected against cefoperazone, amoxicillin/clavulanic acid, a mpicillin, cefotaxime, aztreonam, cefoxitin, piperacillin, ceftazidime, and ceftriaxone. CONCLUSIONS: ESBL producing strains of Escherichia coli show extremely wide spectrum of antibiotic resi stance including resistance to penicillins, cephalosporins, aminoglycosides, and fluoroquinolones . This leads to significant implications in the management of patients. Advanced drug resistanc e surveillance and determination of molecular characteristics of ESBL isolates are nece ssary to formulate antibiotic prescription policies, so as to ensure appropriate and judicious use of the available antimicrobial drugs.

  1. THE NEW METALL-BETA-LACTAMASE’S INHIBITOR EFFICACY IN A MODEL SYSTEM IN VITRO

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    A. G. Afinogenova

    2016-01-01

    Full Text Available The Enterobacteriaceae antibiotics resistance depends on a combination of several mechanisms, such as the beta-lactamases overproduction, the microbial cell reduction outer membrane permeability (usually associated with loss of protein porin, the presence of efflux systems. Particularly noteworthy are the metallo-beta-lactamases (MBL whose presence causes resistance of gram-negative microorganisms to all beta-lactam antibiotics (in some cases except aztreonam. Currently there are no MBL inhibitors permitted for use in the clinic. The effective inhibitors search for carbapenem-resistant bacteria’ MBL authorized for use in the clinic and reinforcing effects of carbapenems, served as the basis for the present study. The work was carried out in three stages: 1 creating a model system using a standard enzyme reagent metallo-beta-lactamase P. aeruginosa recombinant expressed in E. coli, to evaluate the increasing of minimal inhibitory concentrations (MIC of carbapenems against previously sensitive Gram-negative microorganisms strains in vitro; 2 evaluation of MBL promising inhibitors in the presence of the same standard enzyme reagent; 3 evaluation of the ability of the identified inhibitors increase the carbapenems effects against clinical isolates of Gram-negative microorganisms producing MBL, in terms of the their MIC and fractional inhibitory concentration index (FIC index. The checkerboard array was modified to evaluate the combined use of carbapenems and potential MBL inhibitor — a drug from the group of bisphosphonates — etidronic acid. Using a standard enzyme reagent metallo-beta-lactamase P. aeruginosa recombinant expressed in E. coli, we created a model system that allows to assess the prospects of new inhibitors MBL gram-negative microorganisms. A dose-dependent effect of increasing the meropenem level MIC from reagent MBL quantity in a model system against previously antibiotic sensitive reference strains of microorganisms was

  2. 337 株肠杆菌科细菌超广谱 β-内酰胺酶的检测及耐药分析%Detection of extended - spectrum β-Lactamasesin members of the family enterobacteriaceae

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective To detect the extended - spectrum β-lactamases(ESBLs) and resistance rate to usually used antibiotics in members of the family Enterobacteriaceae. Methods: Double disk test and K - B test was performed to detect ESBLs and antibiotic resistance rate. Results: 31 ESBL - producing isolates was assessed in 337 clinical isolates; ESBLs - producing isolates usually was mutiple antibiotic resistance, the resistance rate is obviously increasing than non - ESBLs - producing organisms to third - generation cephalosporins, aztreonam augmentin and timentin. Conclusions: It may be clinical necessary to institute additional testing on a routine basis to detect ESBLs production in all clinical isolates of the family Enterobacteriaceae, and the third - generation cephalosporins should be used cautiusly in clinic.%目的:测定 337 株肠杆菌科细菌产超广谱 β-内酰胺酶(ESBLs)情况,了解产酶株组与非产酶株组对临床常用抗生素的耐药情况。方法:用双纸片协同试验筛选产 ESBLs 株,采用 K-B 法测定产酶株与非产酶株对临床常用抗生素的敏感性。结果:31 株肠杆菌科细菌为产 ESBLs 株。1998~1999 年度产酶率(12.9%)显著高于 1996~1997 年度产酶率(4.2%)。产酶株组对 3 代头孢和氨曲南、安美汀、特美汀耐药率显著高于非产酶株组,经 x2 检验,P<0.05(0.01)。但对亚胺培南、环丙沙星、丁胺卡那耐药率较低。结论:对肠杆菌科细菌感染应注意 ESBLs 的检测。临床应慎用 3 代头孢菌素。对产 ESBLs 株可选用亚胺培南、环丙沙星、丁胺卡那霉素治疗。

  3. Relationship between antimicrobial resistance and aminoglycoside-modifying enzyme gene expressions in Acinetobacter baumannii

    Institute of Scientific and Technical Information of China (English)

    SHI Wei-feng; JIANG Jian-ping; MI Zu-huang

    2005-01-01

    Background Acinetobacter baumannii is one of the main gram-negative bacilli in clinical practice. Nosocomial infections caused by multi-drug resistance Acinetobacter baumannii is very difficult to treat. This study was designed to investigate the antimicrobial resistance characteristics and four resistant gene expressions of aminoglycoside-modifying enzymes including N-acetyltransferases and O-phosphotransferases in Acinetobacter baumannii. Methods Bacterial identification and antimicrobial susceptibility test were performed by PhoenixTM system in 247 strains of Acinetobacter baumannii. Minimal inhibitory concentrations (MICs) of seven aminoglycosides including gentamicin, amikacin, kanamycin, tobramycin, netilmicin, neomycin and streptomycin in 15 strains of multi-drug resistant Acinetobacter baumannii were detected by agar dilution. Four aminoglycoside-modifying enzyme genes were amplified by polymerase chain reaction (PCR) and verified by DNA sequencer.Results The resistance rates of 247 strains of Acinetobacter baumannii against cefotaxime, levofloxacin, piperacillin, aztreonam, tetracycline, ciprofloxacin and chloramphenicol were more than 50%. Imipenem and meropenem showed high antibacterial activities with resistance rates of 3.2% and 4.1%. MIC50 and MIC90 of gentamicin, amikacin, streptomycin and kanamycin in 15 strains of multi-drug resistant Acinetobacter baumanii were all more than 1024 mg/L, and the resistance rates were 100%, 100%, 100% and 93.3%, respectively. But their resistance rates to tobramycin, netilmicin and neomycin were 86.7%, 93.3% and 46.7%, respectively. Three modifying enzyme genes, including aacC1, aacC2 and aacA4 genes, were found in 15 strains, but aphA6 had not been detected. Their positive rates were 93.3%, 20.0% and 20.0%, respectively. These three genes existed simultaneously in No.19 strain. Nucleotide sequences of aacC1, aacC2 and aacA4 genes shared 100%, 97.9% and 99.7% identities with GenBank genes (AY307113, S68058 and AY

  4. [Sepsis caused by Chryseobacterium indologenes in a patient with hydrocephalus].

    Science.gov (United States)

    Ceylan, Abdullah; Güdücüoğlu, Hüseyin; Akbayram, Sinan; Bektaş, Abdullah; Berktaş, Mustafa

    2011-10-01

    , piperacillin, cefotaxime, ceftazidime, aztreonam, meropenem, imipenem, tetracycline, and chloramphenicol. The treatment continued with ampicillin/sulbactam and levofloxacin without removing the shunt. However, C.indologenes growth persisted in CSF and blood cultures of the patient. The general condition of the patient deteriorated on the 65. day of the hospitalization and the patient was lost due to cardiopulmonary arrest. Case reports related to isolation of C.indologenes from blood cultures are present in the literature, however, isolation of C.indologenes from central nervous system was reported previously in a single case. In conclusion, C.indologenes should be considered as opportunistic infectious agents especially in the infectious diseases that develop in immunocompromised patients with underlying disease and with foreign device implementation.

  5. Pseudomonas aeruginosa: freqüência de resistência a múltiplos fármacos e resistência cruzada entre antimicrobianos no Recife/PE Pseudomonas aeruginosa: frequency of resistance to multiple drugs and cross-resistance between antimicrobials in Recife/PE

    Directory of Open Access Journals (Sweden)

    Eduardo Andrada Pessoa de Figueiredo

    2007-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A multi-resistência bacteriana tem crescido significativamente nos últimos anos. Entre os gram-negativos a P. aeruginosa demonstra maior facilidade de desenvolvimento de resistência aos antibióticos. O objetivo deste estudo foi determinar os padrões de susceptibilidade antimicrobiana, freqüência de resistência a múltiplos fármacos e de resistência cruzada entre antimicrobianos das cepas de Pseudomonas aeruginosa. MÉTODO: O estudo foi realizado entre setembro de 2004 e janeiro de 2006. Os testes de susceptibilidade antimicrobiana foram realizados em 304 cepas de P. aeruginosa segundo os padrões do National Committee for Clinical and Laboratory Standards (NCCLS. RESULTADOS: Os materiais mais freqüentes foram urina com 26,7% e secreção traqueal com 26,1%. Os seguintes antibióticos, com respectivos percentuais de susceptibilidade, foram observados: piperacilina-tazobactam (66,2%; aztreonam (59,8%; amicacina (59,4%; meropenem (58,2%; imipenem (57,7%; ciprofloxacina (49,7%; gentamicina e cefepima (48,6%; ceftazidima (30% e cefotaxima (6,8%. Detectou-se elevada prevalência de multi-resistência, com 49,7% das cepas resistentes a três antibióticos ou mais e 28% resistentes a seis antibióticos ou mais. Adicionalmente se demonstraram taxas de resistência cruzada entre os beta-lactâmicos (carbapenêmicos e piperacilina/tazobactam e os aminoglicosídeos e quinolonas entre 22,9% e 38,1% (fármacos comumente utilizados como adjuvantes no tratamento das infecções graves por pseudomonas, refletindo dificuldade nas opções de associação de antimicrobianos para tratamentos combinados. CONCLUSÕES: A freqüência de cepas multi-resistentes de P. aeruginosa foi semelhante à descrita na literatura nacional e maior do que a mundial. Para reduzir a freqüência destes clones multi-resistentes, monitorização epidemiológica e racionalização de antimicrobianos devem ser implementadas urgentemente.BACKGROUND AND

  6. KPC-12型碳青霉烯酶分子进化及与β-内酰胺类药物分子对接分析%Molecular evolution of carbapenemases KPC-12 and molecular docking analysis of β-lactams

    Institute of Scientific and Technical Information of China (English)

    朱健铭; 姜如金; 肖丹宇; 吴康乐; 孔海深

    2013-01-01

    .Results Molecular evolution between KPC-12 and KPC-2 was the closest.The top three decline in binding free energies of β-lactams were penicillin G sodium salt (△G =-8.45149 kcal/mol),ertapenem (△G =-8.36383 kcal/mol) and ampicillin (△G =-8.19326 kcal/mol),while the last two decline in binding free energies of β-lactams were aztreonam (△G =-6.50614 kca]/mol) and clavulanic acid (△G =-6.88533 kcal/mol).Conclusion Carbapenemase KPC-12 has high catalytic activities to penicillin G sodium salt,ertapenem and ampicillin,while has low catalytic activities to aztreonam and clavulanic acid.

  7. 2012~2014年铜绿假单胞菌耐药性变迁及抗菌药物应用分析%The change of Pseudomonas aeruginosa resistance and the use of antibi-otics during 2012 to 2014

    Institute of Scientific and Technical Information of China (English)

    王立兰; 安儒峰

    2015-01-01

    .8%). The isolation rate of multi-drug resistant P. aeruginosa (MDRPA) was 19.0%and the isolation rate of pan-drug resistant P. aeruginosa (PDRPA) was 5.5%. According to the resistance monitoring results, the antimicrobial resistance rate of P. aeruginosa to amikacin, piperacillin-tazobactam and gentamicin were less than 10.0%, the antimicrobial resistance rate to meropenem, piperacillin, ciprofloxacin, cefepime, ceftazidime, imipenem, levofloxacin and aztreonam varied at 12.4%-23.9%. The DDDs showed that the use intensity of cefuroxime, cefoperazone-sulbactam and levofloxacin ranked in the top 4 for three consecutive years, while that of meropenem and imipenem stayed a relatively low level, the use intensity of aztre-onam reduced substantially. Conclusion P. aeruginosa was the main cause of respiratory tract and burn wound infec-tion, the detection rate of showed an upward trend from 2012 to 2014, while the detection rate of multi-drug resistant P. aeruginosa (MDRPA) and pan-drug resistant P. aeruginosa (PDRPA) has declined. The resistance rate of P. aerugi-nosa to commonly used antimicrobial agents was decreased. Therefore, the work of monitoring drug resistance and pro-moting rational application of antibiotics should be strengthened.

  8. CARACTERIZACIÓN MOLECULAR DE AISLAMIENTOS DE ENTEROBACTER CLOACAE MULTIRRESISTENTES, PRODUCTORES â-LACTAMASAS PROVENIENTES DE PACIENTES DE UN HOSPITAL DE TERCER NIVEL DE BOGOTÁ Molecular characterizacion of multi-cephalosporin resistan Enterobacter cloacae isolates from a third level hospital in Bogota-Colombia

    Directory of Open Access Journals (Sweden)

    Ibonne Aydee García Romero

    2005-07-01

    Full Text Available Antecedentes. Las enterobacterias, antaño flora normal del tracto gastrointestinal, han cambiado su biología y emergido como agentes patógenos nosocomiales que se tornan resistentes los antibióticos conocidos. Objetivo. Realizar la caracterización epidemiológico-molecular de 20 aislamientos de Enterobacter cloacae resistentes a cefalosporinas de tercera generación; provenientes de un hospital de tercer nivel de Bogotá-Colombia. Material y métodos. Los aislamientos fueron identificados mediante sistemas automatizados Microscan y VITEK, se utilizó el Enterobacter asbureae como control externo inter-especie. La confirmación de resistencia se hizo por técnica de difusión en agar, y una vez establecida se realizó BLEE para comprobación. La determinación de puntos isoeléctricos se hizo, mediante lisis por ultrasonido y la genotipificación mediante la metodología para bacterias Gramnegativas propuesta por Versalovic. Resultados: Los aislamientos colectados durante un año fueron causantes de 15 casos de infección Intrahospitalaria y dos colonizaciones. Todos los aislamientos presentaron resistencia a cefotaxima, ceftazidima, ceftriaxona, aztreonam y ciprofloxacina, 95% a amikacina, gentamicina y cloranfenicol, 75% a trimetoprim/sulfametoxazol, 20% a cefepime y todos fueron sensibles a imipenem. Dos aislamientos fueron confirmados como productores de â-lactamasas de espectro extendido (BLEE por la técnica microbiológica de disco combinado. Por isoelectroenfoque presentaron dos â-lactamasas con puntos isoeléctricos (pI de 5,4 y 8,2. En los 18 aislamientos no inhibidos por ácido clavulánico, se detectaron entre 2 y 4 â-lactamasas con pI de 5,4; 6,0; 7,0; 8,2 y mayor que 8,2; la resistencia a cefalosporinas de tercera generación podría ser atribuida a la hiperproducción de AmpC; los valores de pI sugieren la producción simultánea de â-lactamasas tipo SHV y TEM. La genotipificación mediante tres metodologías de rep

  9. 昆明医科大学第一附属医院铜绿假单胞菌感染的临床分布及耐药性分析%Analysis of Distribution and Drug Resistance of Pseudomonas Aeruginosa in Nosocomial Infection in the 1st Affiliated Hospital of Kunming Medical University

    Institute of Scientific and Technical Information of China (English)

    卯建; 赵滢; 邵天波; 张真铭

    2013-01-01

    Objective To investigate the clinical distribution and the drug resistances of Pseudomonas aeruginosa (PAE) during past 3 years in the 1st Affiliated Hospital of Kunming Medical University, and to provide evidence for clinical treatment of PAE infection.Methods The isolated PAE strains from 2010 to 2012 in the 1st Affiliated Hospital of Kunming Medical University were identified and antimicrobial susceptibility tests were performed using the MIC and the KB method,and thus, the ward distribution and the drug resistance rates and the changing trend were respectively analyzed by WHONET 5.5 software, and statistically analyzed with SPSS 17.0 SOFTWARE. Results Within the three years, a total of 208 strains, 260 strains and 280 strains of Pseudomonas aeruginosa were isolated separately in 2010,2011and 2012. A total of 746 PAE strains were isolated in 3 years,in which the most common specimens were sputum (79.8%), followed by the throat swab (7.6%) and the urine (6.2%) . When it came to the ward distribution , ICU was the primary, which accounted for (32.4%), followed by the department of cadre sanatorium (27.7%), the department of respiratory medicine (12.2%) and the department of neurosurgery (6.8%) . Besides imipenem, Cefoperazone-sulbactam and aztreonam, the others were obviously in a decreasing trend in drug resistances. In 2010, 2011 and 2012, the resistances rates of imipenem were ( 65.2%) , ( 74.2%) and ( 69.5%) , respectively, the resistances rates of Cefoperazone-sulbactam were (48.0%), (48.7%) and (55.8%), and the the resistances rates of aztreonam were (72.2%), (78.2%) and (72.4%) . Amikacin,piperacillin-tazobactam,Cefoperazone-sulbactam were the most active antimicrobial agents against P.aeruginosa. Conclusions The PAE is an important source of infection, ICUs are the focus of interest for resistance monitoring and control. Antimicrobial resistance of PAE is fairly serious. Clinicians should select appropriate antibiotic therapy based on sensitivity testing

  10. 下呼吸道感染患者痰培养结果及病原菌耐药性分析%Sputum culture of pathogens causing lower respiratory tract infections and analysis of drug resistance

    Institute of Scientific and Technical Information of China (English)

    金益军; 陆建红; 陈国军; 董长林; 李光亮

    2013-01-01

    OBJECTIVE To investigate the distribution and drug resistance of the common pathogens causing lower respiratory tract infections. METHODS The sputum culture result for 5917 hospitalized patients as well as the drug susceptibility of the main pathogens was retrospectively analyzed. RESULTS Gram-negative bacteria were the main pathogens causing lower respiratory tract infections,accounted for 65. 43% ; the top three species were Klebsiella pneumonia , Pseudomonas aeruginosa ,and Acinetobacter calcium acetate , respectively. The drug resistance rate of K. pneumonia to ampicillin was 100. 00% , 1. 58% to cefoperazone/sulbactam,and 6. 96% to imipenem. The drug resistance rates of P. aeruginosa to tetracycline, chloramphenicol, ampicillin, sulfamethoxazole/trimethoprim, amoxicillin/clavulanic acid, cefazolin, ampicillin/sulbactam, and cefotaxime were all 100. 00%, 1. 19% to cefoperazone/sulbactam, and 1. 98% to polymyxin. The drug resistance rates of A. calcium acetate to ampicillin, aztreonam, amoxicillin/clavulanic acid, cefazolin were all 100. 00%, 0 to cefoperazone/sulbactum,and 1. 37% to polymyxin. The drug resistance rates of A. baumannii to ampicillin, aztreonam, amoxicillin/clavulanic acid, cefazolin, and piperacillin were 100. 00%, with 0 to cefoperazone/sulbactam and polymyxin. CONCLUSION The lower respiratory tract infections are related to the bacterial drug resistance, it is of great significance in reducing the incidence of nosocomial infections to use antibiotics reasonably and delay the bacterial resistance.%目的 探讨下呼吸道感染患者常见病原菌分布特点及其耐药性分析的临床价值.方法 回顾性分析5917例住院患者的痰培养结果及主要病原菌的药敏资料.结果 下呼吸道感染病原菌以革兰阴性菌为主,占65.43%;前3位依次为肺炎克雷伯菌、铜绿假单胞菌、乙酸钙不动杆菌;肺炎克雷伯菌对氨苄西林耐药率为100.00%,对头孢哌酮/舒巴坦

  11. Drug resistance and resistant mechanisms of Pasteurella aerogenes from knee joint fluid%膝关节液中产气巴斯德菌的耐药性及耐药机制研究

    Institute of Scientific and Technical Information of China (English)

    梅海燕; 明德松; 朱焱; 谢尊金

    2012-01-01

    目的 探讨产气巴斯德菌耐药性及耐药机制.方法 用美国BD公司PhoenixTMl00全自动细菌鉴定/药敏仪,对膝关节炎患者膝关节液分离的1株病原菌进行鉴定,并对21种抗菌药物的敏感性进行检测,应用头孢硝噻吩(Ncf)试验检测其β-内酰胺酶(BLs),多底物纸片法分类检测β-内酰胺酶.结果 PhoenixTMl00细菌鉴定仪鉴定该菌为产气巴斯德菌,可信度(ID)为94.0%;对氨曲南、头孢他啶耐药,对氨苄西林、氨苄西林/舒巴坦、阿莫西林/克拉维酸、哌拉西林、哌拉西林/他唑巴坦、头孢唑林、头孢西丁、头孢噻肟、头孢吡肟、碳青霉烯类、氨基糖苷类、四环素类、氯霉素、多黏菌素、氟喹诺酮类、磺胺甲噁唑/甲氧苄啶敏感;BLs的分类检测中,氨曲南为6 mm,耐药,与头孢他啶/克拉维酸、氨苄西林/舒巴坦均无协同及拮抗,头孢他啶为10 mm,耐药,头孢他啶/克拉维酸及头孢噻肟均为14 mm,头孢噻肟/克拉维酸为16 mm,头孢西丁为28 mm,均敏感.结论 该产气巴斯德菌临床分离株仅对部分β-内酰胺类药物耐药(耐药性较低),其机制为产BLs,耐药表型及克拉维酸协同试验阳性,推测为产某种产超广谱β-内酰胺酶(ESBLs).%OBJECTIVE To investigate the drug resistance and resistant mechanisms of β-lactam of Pasteurella aerogenes(P. Aero)from the joint fluid of a patient with knee osteoarthritis. METHODS One pathogenic bacteria isolated from the knee joint fluid of the patient with knee osteoarthritis was identified by BD s phoenixTMlOO, and 21 antibacterial agents were detected for susceptibility with nitrocefin test(Ncf) for β-lactamase (BLs) and a multi-disk test for the variety of BLs. RESULTS The strain was identificated by phoenixTMlOO as P. Aerogenes with ID of 94%; the strain was resistant to ceftazidime and aztreonam, but susceptible to ampcillin, ampcillin/ sulbactam, piperacillin, piperacillin/tazobactam, penicillins, amocillin

  12. 2010-2012年我院2种非发酵菌耐药变迁及抗菌素应用相关性分析%Antimicrobial resistance of two non-fermenting bacteria and correlation with antibiotic consumption from 2010 to 2012 in our hospital

    Institute of Scientific and Technical Information of China (English)

    董凌云; 吴巧珍; 吴文英; 张利芳

    2014-01-01

    目的 研究我院2010-2012年铜绿假单胞菌和鲍曼不动杆菌2种非发酵菌耐药率变化以及耐药率与抗菌药物使用强度(AUD)之间的相关性.方法 回顾性调查2010-2012年本院2种非发酵菌的分离和耐药情况,同时调查同期的抗菌素AUD,进行相关性分析.结果 铜绿假单胞菌和鲍曼不动杆菌均位于年分离率的前5位,并且高耐药的菌株检出率有上升趋势.氨苄西林和头孢曲松耐药率高,头孢他啶和氨曲南的耐药率在2012年有明显上升,头孢哌酮舒巴坦耐药率最低.左氧氟沙星、头孢吡肟、哌拉西林他唑巴坦和亚胺培南/西司他丁的耐药率在近2年有下降趋势.相关性分析显示氨曲南、左氧氟沙星和亚胺培南/西司他丁的AUD与铜绿假单胞菌的耐药率呈正相关(r值分别为1.000、0.998、0.998,P值均<0.05);头孢他啶、哌拉西林他唑巴坦的AUD与鲍曼不动杆菌的耐药率呈正相关(r值分别为0.997、0.999,P值均<0.05).结论 2种非发酵菌的耐药率变化与抗菌素AUD具有相关性.医院加强抗菌药物临床应用的管理,对细菌的耐药性进行监控,采取干预措施,有助于下降细菌的耐药率.%Objective To investigate the changes in resistance rate of two non-fermenting bacteria,Pseudomonas aeruginosa and Acinetobacter banmannii,and the correlation between antibiotics use density (AUD) and antimicrobial resistance rate from 2010 to 2012.Methods A retrospective analysis was performed based on the isolation and resistance rates of two non-fermenting bacteria from 2010 to 2012.AUD during the same time was also surveyed.The correlation was analyzed.Results The separation rates of Pseudomonas aeruginosa and Acinetobacter banmannii were located ahead of the fifth in every year,and the detection rate of high resistant strains was on the rise.The resistance rates of ampicillin and ceftriaxone were high,and the resistance to ceftazidime and aztreonam in 2012 had an obvious

  13. Analysis of antibiotics susceptibility and isolation of Haemophilus unsusceptible to azithromycin%阿奇霉素非敏感嗜血杆菌的分离及其药敏试验观察

    Institute of Scientific and Technical Information of China (English)

    朱海平; 易思华; 张羿; 姚立琼; 陈保锦; 金凤玲

    2012-01-01

    azithromycin unsusceptible haemophilus, with isolation rate of 21. 48% , and isolation rate had the trend to ascend during the four years. In 389 azithromycin unsusceptible haemophilus, Haemophilus parahaemolyticus accounted for 308 (79. 18%), Haemophilus influenzae only accounted for 81 (20. 82%). The resistant rate of azithromycin unsusceptible Haemophilus influenzae to amoxicillin/Clavulanic acid, ampicillin/sul bactam, cefuroxime was higher than that of azithromycin unsusceptible Haemophilu parahaemolyticus, and both of them were with reduced susceptibility to ceftriaxone, cefpodoxime, aztreonam, meropenem, levofloxacin. The resistant rate of azithromycin unsus ceptible haemophilus to ampicillin increased year by year from 2008 to 2011. Compared with susceptible strains, azithromycin un susceptible Haemophilus influenzae had a significantly higher resistant rate or unsusceptible rate to ampicillin, ampicillin/sulbac tam, ceftriaxone, aztreonam, levofloxacin. But for Haemophilus parahaemolyticus, azithromycin unsusceptible strains had a nota ble higher resistant and unsusceptible rate to the test antimicrobials. Conclusion Azithromycin unsusceptible haemophilus might in crease year by year, with high resistant and unsusceptible rate to commonly used antibiotics.

  14. The distribution of bacteria infected by urinary tract in adolescent patients and the analysis of drug resistance ability%青少年尿路感染细菌分布以及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    吴斌

    2016-01-01

    to ofloxacin, E.faecalis was to clindamycin,E.coli was to ceftriaxone, pseudomonas aeruginosa was to aztreonam,klebsiella pneumoniae was to Ceftriaxone,citrobacter was to Ciprofloxacin. Conclusion As for the young bacterial urinary tract infection patients,Gram-negative bacteria was the main drug-resistant pathogens, especially Escherichia coli.

  15. In vitro drug sensitivity analysis of Legionella pneumophila isolated from cooling tower in Shijiazhuang%石家庄市冷却塔水中嗜肺军团菌体外药物敏感性分析

    Institute of Scientific and Technical Information of China (English)

    郭玉梅; 秦丽云; 张慧贤; 王苋; 周吉坤

    2012-01-01

    Objective To study the drug sensitivity and resistance of Legionella pneumophila isolated from six hospital cooling towers of Shijizhuang. Methods Eight major categories and 26 kinds of antibiotics drug test on 30 strains of Legionella pneumophila isolated from hospital cooling tower by using K-B disk diffusion method. The drug susceptibility testing results were reported refer to the national Health Industry Standard Paper film method (antimicrobial WS/T125 -1999). Results The sensitivity of 30 strains of Legionella pneumophila to Cefuroxime, doxycycline, tetracycline, streptomycin, ciprofloxacin, levofloxacin, moxifloxacin, erythromycin, azithromycin, clarithromycin, rifampicin and ofloxacin was 100%, and they presented different levels of resistance to cefazolin, aztreonam, ampicillin, cephalothin, ceftazidime, tobramycin and cefoxitin. Experimental strains produced eight kinds of resistance spectrum, they were multi-drug resistant strains. Conclusion Resistance is more common to penicillins, cephalosporins, aminoglycosides among 30 starins of Legionella pneumophila. Macrolides, quinolones, rifampicin is superior to the other kinds of antibiotics in vitro susceptibility test, respectively, and these antibiotics can be used as the first choice in clinical therapy of Legionella infections.%目的 了解分离自石家庄市6家医院冷却塔水的嗜肺军团菌的药物敏感性.方法 采用K-B纸片扩散法对30株分离自冷却塔水的嗜肺军团菌进行8大类26种抗生素的药敏实验,参照WS/T125-1999《中华人民共和国卫生行业标准纸片法抗菌药物敏感试验标准》读取结果.结果 30株嗜肺军团菌均对头孢呋辛、强力霉素、四环素、链霉素、环丙沙星、左旋氧氟沙星、莫西沙星、红霉素、阿奇霉素、克拉霉素、利福平、氧氟沙星共12种抗生素敏感,对头孢唑林、氨曲南、氨苄西林、头孢噻吩、头孢他啶、妥布霉素、头孢西丁共7种抗生素均产生

  16. Clinical analysis of postoperative infections in gastrointestinal cancer with diabetic patients%糖尿病患者胃肠道恶性肿瘤术后感染的临床分析

    Institute of Scientific and Technical Information of China (English)

    王战立; 李永茂; 王成虎; 陈小兵

    2015-01-01

    OBJECTIVE To observe and analyze the clinical features of postoperative infections in gastrointestinal cancer with diabetic patients ,so as to provide basis for preventing postoperative infections .METHODS The clinical characters ,pathogen distribution and drug sensitivity of 143 cases of gastrointestinal cancer with diabetic patients from Mar .2010 to Mar .2014 were analyzed retrospectively .The software SPSS13 .0 was used for statistical analysis of data .RESULTS Among 143 gastrointestinal cancer with diabetic patients ,35 cases were infected after operation ,the infection rate was 24 .5% .The single factor analysis showed postoperative infections in gastrointes‐tinal cancer with diabetic patients was significantly correlated with age ,operation time and bleeding amounts(χ2 =5 .873 ,4 .356 ,5 .394 ,P80% to ampicillin ,aztreonam , and ceftriaxone ,and relative sensitivity to cefoperazone/sulbactam ,norfloxacin ,levofloxacin ,ciprofloxacin ,pip‐eracillin/tazobactam and imipenem with resistance rates <40 .0% .CONCLUSION The postoperative infection rate in gastrointestinal cancer with diabetic patients is high .The clinical doctors should take early preventive measures based on pathogen features and use antimicrobial drugs rationally to reduce the incidence of postoperative infections and drug resistance .%目的:观察并分析胃肠道恶性肿瘤合并糖尿病患者术后感染的临床特点,为有效预防术后感染提供依据。方法回顾性分析2010年3月-2014年3月143例胃肠道肿瘤合并糖尿病患者的临床资料、病原菌分布和药敏试验结果,采用SPSS13.0软件对数据进行统计分析。结果143例胃肠道肿瘤合并糖尿病患者发生术后感染35例,感染率为24.5%;单因素分析,胃肠道肿瘤合并糖尿病患者发生术后感染与年龄、手术时间、出血量呈明显相关性(χ2=5.873,4.356,5.394,P<0.05);35例感染患者中共分离培养出病原菌46

  17. 2009年贵州省黔南地区革兰阴性杆菌耐药监测分析%Monitoring to drug resistance of Gram-negative bacillus from Qiannan Area, Guizhou in 2009

    Institute of Scientific and Technical Information of China (English)

    林开颜; 莫非; 黄志卓; 周勇; 肖兰

    2011-01-01

    目的 了解医院常见革兰阴性杆菌的分布和耐药性,为临床合理用药提供依据.方法 收集2009年1月-2009年12月从住院患者分离的562株革兰阴性杆菌,采用VITEK、Microscan等微生物分析鉴定系统进行菌种鉴定;采用K-B法对细菌作药敏试验.结果分离率居前5位的革兰阴性杆菌依次为:大肠埃希菌、其他肠杆菌科细菌、肺炎克雷伯菌、鲍氏不动杆菌、铜绿假单胞菌,分别占34.3%、18.9%、17.4%、12.1%、6.2%,产超广谱β-内酰胺酶( ESBLs)大肠埃希菌和肺炎克雷伯菌检出率分别为52.8%和34.2%,其余革兰阴性杆菌均显示了不同程度的耐药性,铜绿假单胞菌对头孢曲松和氨曲南的耐药率>60.0%,鲍氏不动杆菌对头孢曲松和哌拉西林的耐药率>60.0%.结论医院检验科务必做好感染病原菌的动态监测,为临床医师合理使用抗菌药物提供科学依据.%OBJECTIVE To analyze the distribution and the features of drug resistance of the commonly occurred Gram-negative bacillus in order to provide the methods for clinicians to use antibiotics on patients rationally. METHODS A total of 562 samples separated from patients in hospital who were affected by Gram-negative bacillus were collected from Jan to Dec 2009. Then, the pathogens were identified by adopting VITEK, Microscan and other microbiological analysis system. At the same time, K-B analysis was also applied to test the drug sensitivity. RESULTS The top 5 isolation rates of Gram-negative bacillus in turn were: Escherichia coli (34. 3%) , Enterobact-er(18. 9%), Klebsiella pneumoniae (17. 4%) , Acinetobactor baumannii (12. 1%) and Pseudomonas aeruginosa (6.2%). The detection rates of ESBIs-producing E. Coli and K. Pneumoniae were respectively 52. 8% and 34. 2%. And the rest of Gram-negative bacillus showed drug resistance at various degree. The resistance rates of the P. Aeruginosa to ceftriaxone sodium(Rocephin) and aztreonam was higher

  18. 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

    Institute of Scientific and Technical Information of China (English)

    桂和翠; 王中新; 沈继录

    2012-01-01

    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

  19. 鲍曼不动杆菌在胸外科重症监护室的分布及耐药情况%Distribution and drug resistance of Acinetobacter Baumannii in intensive care unit after thoracic surgery

    Institute of Scientific and Technical Information of China (English)

    李惠珍; 周妍; 娄加陶

    2014-01-01

    Objective To study the distribution and drug resistance of Acinetobacter Baumannii in intensive care unit (ICU) after thoracic surgery.Methods A retrospective study was performed according to American National Clinical Laboratory standards to examine the infection distribution and drug resistance of Acinetobacter Baumannii,in the ICU of thoracic surgery department.Results Totally 437 strains were isolated.Among which 77 strains were Acinetobacter Baumannii,accounting for 17.6% of the total strains isolated.60 (77.9%),16 (20.8%) and 1 (1.3%) ofAcinetobacter Baumannii strains were detected in sputum,thoracic fluid and urine respectively.Acinetobacter Baumannii was entirely sensitive to polymixin and completely resistant to Ampicillin,Aztreonam and Cefazolin.Meanwhile,it showed a comparatively low drug resistance rate to Ceforazone/sulbactam (57.5% in 2011 and 62.2% in 2012).Conclusions There is a high detection rate of the Acinetobacter Baumannii especially among sputum specimens of the ICU patients.The study suggests the drug resisitance of bacteriae should be monitored; antibiotics or anti-infection drugs should be rationally used and the disinfection and isolation measurements should be reinforced to prevent serious infection within the hospital.%目的 探讨胸外科重症监护室内鲍曼不动杆菌的分布情况及耐药状况.方法 采用回顾性研究方法,根据美国国家临床实验标准对上海交通大学附属胸科医院2011和2012年度胸外科重症监护室鲍曼不动杆菌的感染分布及耐药情况进行分析.结果 2011和2012年度胸外科重症监护室病房共分离出菌株437株,其中鲍曼不动杆菌77株(17.6%).痰液、胸腔积液和中段尿液中检出鲍曼不动杆菌分别为60株(77.9%)、16株(20.8%)和1株(1.3%).鲍曼不动杆菌对多黏菌素敏感,药物敏感率为100.0%;耐药率达100.0%的有氨苄西林、氨曲南、头孢唑林;耐药率较低的为头孢哌酮/舒巴坦(2011

  20. ICU患者血流感染鲍氏不动杆菌耐药性分析%Drug resistance of Acinetobacter baumannii causing bloodstream infections in ICU patients

    Institute of Scientific and Technical Information of China (English)

    杨莉; 李玉苹; 章红霞

    2015-01-01

    OBJECTIVE To understand the drug resistance of Acinetobacter baumannii causing bloodstream infec‐tions in intensive care units (ICUs) so as to provide guidance for clinical control of A .baumannii infection and for reasonable use of antibiotics .METHODS The positive blood culture specimens were submitted from the patients who were hospitalized the ICUs from Jan 2009 to Dec 2013 ,then the isolated A .baumannii strains were identified by using VITEK‐2 Compact automatic microorganism analyzer of BioMerieux ,France ,the drug susceptibility to the commonly used antibiotics was determined with the use of MIC method ,and all the data were statistically ana‐lyzed by using SPSS11 .0 software .RESULTS Of totally 35 829 blood culture specimens submitted from the ICUs from Jan 2009 to Dec 2013 ,the A .baumannii strains were cultured from 49 blood specimens ;with the positive rate of 0 .14% .The A .baumannii was most susceptible to polymyxin ,and the drug susceptibility rates to ampicil‐lin‐sulbactam ,aztreonam ,ciprofloxacin ,ceftriaxone ,and cefepime were very low .CONCLUSION The A .bauman‐nii strains tend to be multidrug‐resistant during the antibiotics therapy .As for the poor prognosis of the patients with A .baumannii bloodstream infections ,it is necessary for the hospital to reasonably use antibiotics ,strengthen the disinfection and isolation in the ICUs ,and cut the various possible transmission routes .%目的:了解重症监护病房(IC U )鲍氏不动杆菌血流感染的耐药性,指导临床控制鲍氏不动杆菌感染,合理使用抗菌药物。方法对2009年1月-2013年12月IC U住院患者送检血培养阳性标本,对检出的鲍氏不动杆菌采用法国生物梅里埃公司VITEK‐2 Compact全自动微生物分析仪进行鉴定,采用MIC法测定常用抗菌药物的敏感性,所有资料采用SPSS11.0软件进行统计分析。结果2009年1月-2013年12月ICU共送检血培养标本35829份,其中有49

  1. 医院感染鲍氏不动杆菌的临床特点及耐药分析%Clinical characteristics and drug resistance of Acinetobacter baumannii in hospital infection

    Institute of Scientific and Technical Information of China (English)

    张颖; 王仙园; 周娟; 于庆华

    2014-01-01

    OBJECTIVE To investigate clinical characteristics and drug resistance of Acinetobacter baumannii in our hospital and to provide the basis for controlling hospital infection .METHODS A retrospective analysis was applied to the clinical data of 229 patients with hospital infection from 2011 to 2012 .The clinical characteristics and drug resistance of Acinetobacter baumannii strains in hospital infection were analyzed .The software SPSS10 .0 was used for statistical analysis .RESULTS There were 3 strains in 2011 and 18 strains in 2012 ,the hospital infection rates were 1 .97% and 12 .24% respectively .The difference was significant(P<0 .01) .Totally 21 A .baumannii strains were all from sputum specimens and respiratory tract was the first infection site .The 21 A .baumannii strains in hospital infection were resistant to antibiotics such as cefazolin ,cefuroxime ,aztreonam ,cefoperazone , ceftriaxone ,ceftazidime ,piperacillin ,norfloxacin ,gentamicin ,amikacin ,tobramycin ,ampicillin ,chlorampheni‐col ,and ciprofloxacin but sensitive to imipenem .CONCLUSION A .baumannii is the major pathogenic bacteria in hospital infection and shows an increasing trend year by year .Clinical nursing staff should strengthen the preven‐tion and control measures according to bacteriological characteristics .%目的:了解医院鲍氏不动杆菌的临床特点及耐药性,为控制医院感染提供参考依据。方法回顾性分析医院2011-2012年299例医院感染患者临床资料,分析鲍氏不动杆菌的临床特点及耐药性,数据采用SPSS10.0进行统计处理。结果2011、2012年鲍氏不动杆菌感染分别为3、18例,感染率分别为1.97%、12.24%,差异有统计学意义( P<0.01);21株鲍氏不动杆菌均来自痰培养标本,呼吸道为首发感染部位;21株鲍氏不动杆菌对头孢唑林、头孢呋辛、氨曲南、头孢哌酮、头孢曲松、头孢他啶、哌拉西林、诺氟沙星、庆大霉素、阿

  2. 尿道感染大肠埃希菌对喹诺酮耐药性及相关因素分析%Drug Resistance and Risk Factors Analysis of Escherichia Coli Isolated from Urinary Tract Infection to Quinolone

    Institute of Scientific and Technical Information of China (English)

    张昭勇; 张吉才; 杜毅

    2013-01-01

    Objective To investigate the drug resistance and risk factors of Escherichia coli isolated from urinary tract infection (UTI) to quinolone. Methods Drug resistance of 705 strains of Escherichia coli isolated from 749 urine specimens of UTI from 2010 to 2011 in our hospital were detected and divided into the resistance group and the sensitive group according to sensitiveness to quinolone, and the risk factors of the quinolone resistance strains were analyzed. Results In 705 strains isolates E. coli, there were 474 strains (67. 2% ) of quinolone resistance in the resistance group, 231 strains (32. 8% ) of quinolone sensitiveness in the sensitive group and there was no carbapenem resistant strain. The differences in resistance rates of amoxicillin/clavulanic acid, cefotaxime, ceftazidime, aztreonam, piperacillin, amikacin, bactrim, gentamicin and cefepime of the two groups were statistically significant (P<0. 05) . Logistic regression analysis showed that the proportion of female patients, drug use of tert-cephalosporins and quinolones, urinary drainage and bacterium producing extended spectrum β lactamases (ESBLS) were independent risk factors of quinolone resistance E. coli. The differences in hospital stay and cost of the two groups were statistically significant (P<0. 05). Conclusion The detection rate of quinolone resistance escherichia coli isolated from UIT is high. The emergence of resistant strains is related to antibiotic application, invasive handling and bacterial variation. To strengthen the independent risk factors regulation can effectively prevent and control spread of infection.%目的 探讨尿道感染(urinary tract infection,UIT)大肠埃希菌对喹诺酮耐药性及其相关因素.方法 对我院2010-2011年749例UIT尿液标本中分离的705株大肠埃希菌的耐药性进行检测,以对喹诺酮敏感与否分为耐药株组和敏感株组,分析耐药株感染的相关因素.结果 705株大肠埃希菌中对喹诺酮耐药474株(67.2

  3. 铜绿假单胞菌致呼吸机相关性肺炎的临床分析%Clinical analysis of pseudomonas aeruginosa-induced ventilator-associated pneumonia

    Institute of Scientific and Technical Information of China (English)

    王昌明; 王晨; 何宗广; 肖爱兵; 俞莲花

    2011-01-01

    目的 为防治铜绿假单胞菌(PAE)致呼吸机相关性肺炎(VAP)提供科学依据.方法 回顾性分析医院ICU 2004年1月-2008年12月,86例铜绿假单胞菌致VAP的住院患者的临床资料及药敏情况.结果 铜绿假单胞菌所致VAP均有较严重的基础疾病,老年患者占79.1%,发病前均曾使用过≥1种抗菌药物,33.7%有混合感染;铜绿假单胞菌有多药耐药性,临床分离的铜绿假单胞菌共128株,耐药率依次为:阿米卡星23.4%,头孢哌酮/舒巴坦25.0%,亚胺培南34.4%,环丙沙星35.2%,哌拉西林/他唑巴坦37.5%,头孢噻肟40.6%,头孢他啶42.2%,氨曲南59.4%.结论 应根据该地区、医院铜绿假单胞菌致VAP的病原学分布特点及药敏情况,合理选择抗菌药物.%OBJECTIVE To explore the ventilator-associated pneumonia caused by Pseudomonas aeruginosa, and to provide the corresponding measures for clinical prevention. METHODS The clinical records and sputum cultivation bacterial susceptibility of 86 cases of VAP caused by P. aeruginosa between 2004 and 2008 in ICU of our hospital were reviewed. RESULTS All of the patients suffered from severe basic diseases, the aged accounted for 79.1 % ,at least one kind of antibiotic was used in all cases before occurrence of VAP. 33. 7% of the cases had mixed infections. The results of bacterial susceptibility tests showed that P. aeruginosa had multiple drug resistance, A total of 128 clinical isolates of P. aeruginosa were collected. The resistant rates of P. aeruginosa to antimicrobial agents from low to high were amikacin (23. 4%), cefoperazone/sulbactam (25. 0%), imipenem (34. 4%),ciprofloxacin (35. 2%), piperacillin/tazobactam (37. 5%), cefotaxime (40. 6%), ceftazidime (42. 2%) and aztreonam (59.4 % ). CONCLUSION The antibiotics to treat VAP caused by P. aeruginosa should be rationally selected based on the latest surveillance of etiology and drug sensitivity in this region.

  4. 2007-2010年革兰阴性菌对抗菌药物的敏感性分析%Drug susceptibility of gram-negative bacteria in 2007-2010

    Institute of Scientific and Technical Information of China (English)

    郭宏玥

    2013-01-01

    OBJECTIVE To understand the isolation of the common gram-negative bacilli and the drug susceptibility rates to commonly used antibiotics from Jan 2007 to Dec 2010 so as to provide the basis for the rational use of antimicrobial agents. METHODS The gram-negative bacilli isolated from the clinical specimens from Jan 2007 to Dec 2010 were retrospectively analyzed, the drug susceptibility testing was performed. RESULTS A total of 14 784 strains of gram-negative bacteria were isolated within four years, mainly consisting of 2260 strains of Pseudomonas aeruginosa (15. 29%), 2700 strains of Acinetobacter baumannii (18. 26%), 6241 strains of Escherichia colt (31. 87 % ) , and 2139 strains of Klebsiella pneumoniae (11. 80). The drug susceptibility rates of P. aeruginosa to aztreonam, amikacin, levofloxacin, ceftazidime, cefepime, piperacillin, cefoperazone-sulbactam, piperacillin-sul-bactam, imipenem, and meropenem were higher than 50. 00%. A. baumannii strains maintained high antibacterial activity against cefoperazone-sulbactam, imipenem, piperacillin-tazobactam, meropenem, and amkacin, with the drug susceptibility rates higher than 50. 00%. Only ESBLs-producing E. coli and K. pneumoniae strains showed high antibacterial activity against enzyme-containing inhibitors and the carbapenems. CONCLUSION The clinicians should focus on the drug susceptibility testing and use antibiotics reasonably on the basis of the result of drug susceptibility testing.%目的 了解医院2007年1月-2010年12月临床常见革兰阴性菌的分离情况及其对常用抗菌药物的敏感率,为临床合理使用抗菌药物提供依据.方法 回顾性分析2007年1月-2010年12月临床标本分离出的革兰阴性杆菌,并对其进行药敏试验.结果 4年共检出革兰阴性菌14784株,主要为铜绿假单胞菌2260株占15.29%,鲍氏不动杆菌2700株占18.26%,大肠埃希菌6241株占31.87%,肺炎克雷伯菌2139株占11.80;铜绿假单胞菌对氨曲南、阿米

  5. ICU与非ICU肠杆菌科细菌的耐药性分析%Drug resistance of ICU and non-ICU Enterobacteriaceae isolates

    Institute of Scientific and Technical Information of China (English)

    谢朝云; 熊芸; 孙静; 杨忠玲; 胡阳

    2015-01-01

    目的:了解临床肠杆菌科细菌感染的药敏变化,比较IC U与非IC U肠杆菌科细菌的耐药性,为临床合理应用抗菌药物提供科学依据。方法对2010年6月-2013年9月临床各类标本中分离出的产肠杆菌科细菌1661株,其中ICU 259株与非ICU1402株进行比较分析,采用VITEK‐32微生物分析系统进行病原菌鉴定,药敏试验采用K‐B纸片法,应用SPSS 19.0软件对临床分离细菌的药敏试验结果进行统计分析。结果 ICU、非IC U肠杆菌科细菌对头孢唑林、氨曲南、妥布霉素、奈替米星、氯霉素的耐药率分别为85.71%、67.4%,49.03%、32.67%,49.03%、41.08%,35.52%、23.75%,54.44%、34.74%,IC U耐药率明显高于非IC U ,差异有统计学意义(P<0.05)。结论 ICU肠杆菌科细菌耐药率远较非ICU严重,在临床选用抗菌药物治疗肠杆菌科细菌感染时要根据当地细菌的耐药特点,合理选用抗菌药物,防止肠杆菌科细菌尤其是多药耐药菌的传播与感染。%OBJECTIVE To investigate the change of drug susceptibility of the clinical Enterobacteriaceae isolates causing infections and compare the drug resistance between the ICU and non‐ICU Enterobacteriaceae isolates so as to provide scientific basis for reasonable clinical use of antibiotics .METHODS A total of 1 661 strains of Enterobac‐teriaceae were isolated from the clinical specimens from Jun 2010 to Sep 2013 ,including 259 ICU strains and 1402 non‐ICU strains ;the pathogens were identified by using VITEK‐32 microorganism analysis system ,the drug sus‐ceptibility testing was performed by means of K‐B disk method ,and the results of the drug susceptibility testing for the clinical isolates were statistically analyzed with the use of SPSS19 .0 software .RESULTS The drug resist‐ance rates of the ICU and non‐ICU Enterobacteriaceae strains to cefazolin ,aztreonam ,tobramycin

  6. 铜绿假单胞菌和鲍曼不动杆菌超广谱β-内酰胺酶的检测及耐药性分析%Detection and analysis of the resistance of extended-spectrum β-lactamase in Pseudomonas aeruginosa and in Acinetobacter baumannii

    Institute of Scientific and Technical Information of China (English)

    刘吉纯; 张艳菊; 郝英姿

    2011-01-01

    目的 了解产ESBLs铜绿假单胞菌(PA)和鲍曼不动杆菌(BA)的检出率并观察其耐药特性,为临床合理应用抗菌药物提供依据.方法 采用上海复星长征生物公司佰璐鉴定系统对临床分离株进行鉴定,药敏试验和ESBLs检测分别采用CLSI推荐的K-B纸片扩散法和表型确证试验进行,资料统计分析应用whonet5.3软件和SPSS-10.0软件.结果 产ESBLsPA检出率为19.25%,产ESBLsBA检出率为23.75%,产ESBLsPA的耐药率为对哌拉两林100%、阿莫两林100%、头孢他啶100%、阿米卡星35.48%、多黏菌素9.67%、亚胺培南12.90%,产ESBLsBA的耐药率为对哌拉西林100%、氨曲南100%、阿米卡星42.10%、多黏菌素0、亚胺培南15.78%,两组耐药率对比产ESBLs组高于非产酶组(P<0.05),但对阿米卡星、多黏菌素、亚胺培南均较敏感且无统计学差异P>0.05.结论 产ESBLsPA和AB在我院检出率较高,且具有多重耐药特点,阿米卡星、亚胺培南可以作为对抗产ESBLs检测阳性菌株的首选用药.%Objective To investigate the detectable rate of extended-spectrum p-lactamase(ESBLs) in Pseudomonas aeruginosa{PA) and in Acinetobacter baumannii(AB), Observe the characteristics of drug-resistance in ESBLs PA and ESBLs AB, and help us medicate reasonably in clinic. Methods Shanghai Fusun Bai Long biotechnology company the microbiological system was used to identify bacteria, antimicrobial susceptibility was tested by Kirby-bauer method and ESBLs were detected by the disk diffusion method described in CLSI. Whonet5.3 and SPSS-10.0 softwares were used to analyze the data. Results Producing ESBLs positive rate was 19.25% of PA and was 23.75% of AB, the resistance rates of producing ESBLs PA were: piperacillin 100%, amoxicillin 100%, ceftazidime 100%, amikacin 35.48%, polymyxin 9.67%, imipenem 12.90%, the resistance rates of producing ESBLs AB were: piperacillin 100%, aztreonam 100%, amikacin 42.10%, polymyxin 0, Imipenem 15.78%. Compared two

  7. Detection of a IMP-4 type metal beta lactamase-producing Klebsiella pneumonia highly resistant to carbapenem drugs%一株高度耐碳青霉烯类药物的肺炎克雷伯菌耐药性研究

    Institute of Scientific and Technical Information of China (English)

    王旭明; 李天娇; 莫成锦

    2011-01-01

    Objective To understand the resistant mechanism of a Klebsiella pneumonia strain highly resistant to to carbapenem drugs. Methods Both broth microdilution and Etest method were usef for antimicrobial susceptibility test of Klebsiella pneumonia to carbapenemases, modified Hodge test and double disk synergy method were uxed for phenotype detection and multiple groups of carbapenem resistance related gene primers PCR and sequencing was used for genotype determination with assistance of Beijing University Institute of Clinical Pharmacology. Results Klebsiella pneumonia resistant to on commonly used clinical imipenem (mic>32ug/ml),meropenem (mic>32ug/ml),the first to fourth generation of cephalosporins, quinolone and gentamicin, cefoxitin, aztreonam trimethoprim/sulphamethoxazole, telracycline minocycline, ampicillin, ampicillin/sulbactam, piperacillin, piperacillin/tazobactam, amoxicillin/clavulanic acid, cefoperazone/sulbactam, but sensitive to amikacin and polymyxin B. carbapenem resistance gene was blaIMP-4. Conclusion IMP-4 type metal lactamase Klebsiella pneumonia resistant to most common antibacterials has been detected in this hospital and attention be paid to monitoring and treatment.%目的 了解从临床患者病灶中分离到的一株高度耐碳青霉烯类药物的肺炎克雷伯菌的耐药机制.方法 药敏试验采用微量肉汤稀释法与etest法,碳青霉烯酶表型检测采用改良Hodge试验和双纸片增效法,其基因型测定采用多组碳青霉烯耐药相关基因引物PCR并测序,由北京大学临床药理研究所负责完成.结果 药敏测试结果除对阿米卡星和多粘菌素敏感外,对临床常用亚胺培南(mic>32ug/ml)、美罗培南(mic>32ug/ml)、一至四代的头孢菌素类、硅诺酮类以及庆大霉素、头孢西丁、氨曲南、复方新诺明、四环素、美满霉素、氨苄西林、氨苄西林/舒巴坦、哌拉西林、哌拉西林/他唑巴坦、阿莫西林/棒酸、头孢哌酮/舒巴坦,

  8. Klebsiella pneumoniae KPC: first isolations in Italy

    Directory of Open Access Journals (Sweden)

    Carla Fontana

    2009-12-01

    Full Text Available Klebsiella pneumoniae carbapenemase (KPC was detected in two isolates of carbapenem-resistant K. pneumoniae in an italian teaching hospital. This is the first report of a KPC-producing isolates in our country. The first strain was isolated from a urine sample collected from a indwelling urinary catheter in a ICU-patient with subdural haematoma, while the second was from the culture of the central venous catheter (CVC in a patient affected by Crohn’s disease admitted in gastroenterology ward. Both were resistant to all ß-lactams, susceptible to imipenem and meropenem and resistant to ertapenem.They were resistant to other classes of non-ß-lactams antibiotics such as quinolones, aminoglycosides (with the exception of amikacin, trimethoprim-sulfamethoxazole (TMP-SMX as well as to nitrofurantoin.The isolates were not associated with travel abroad.They were found to contain the plasmid encoded carbapenemase gene blaKPC and were also positive to the Hodge’s test.The detection of KPC-producing bacteria has important implications in infection control and public health. The K. pneumoniae carbapenemase (KPC belong to class A ß-lactamases of the functional group 2f. Reported for the first time in U.S. in 2001, these agents were subsequently identified in Europe. KPC strains are typically resistant to penicillins, extended-spectrum cephalosporin and aztreonam and present a peculiar behavior against carbapenems in that MIC is close to the susceptibility value or is borderline (except for ertapenem.This pattern is often associated with resistance to quinolones.The information is conveyed by the resistance plasmids, thus explaining their diffusion and implication in outbreaks of KPC. Despite this, to date there are few reports concerning the isolation of this phenotype in Italy.The purpose of this paper is to present two clinical cases related to the isolation of KPC in our hospital. The KPC-producing strains have been respectively isolated: the first

  9. 大肠埃希菌的耐药性及产超广谱β-内酰胺酶分析%Drug resistance of Escherichia coli and its production of extended spectrum β-lactamases

    Institute of Scientific and Technical Information of China (English)

    龚小明; 何娟妃

    2013-01-01

    OBJECTIVE To explore the drug resistance of Escherichia coli and the production of extended-spectrum fHactamases so as to provide basis for the clinical reasonable use of antibiotics. METHODS A retrospective study was carried out to investigate the relevant data of the isolated E. coli from Jan 2010 to Dec 2011. RESULTS Totally 1043 E. coli isolates were mainly isolated from urine. The detection rates of ESBLs-producing E. coli in 2010 and 2011 were respectively 52. 9% and 51. 18%, the difference between the ESBLs-producing strains and non-ESBLs-producing strains was not statistically significant. The drug resistance rate of E. coli was 0 to imipenem, the drug resistance rate to piperacillin/tazobactam varied between 7. 29% and 6. 69%, ampicillin/ sulbactam ranging from 38. 56% to 34. 84% , ampicillin and cefazolin higher than 87. 0%. The drug resistance rate to aztreonam, ceftriaxone, sulfamethoxazole/trimethoprim, cefotrximl, ciprofloxacin, and levofloxacin varied as high as from 60. 00% to 77. 00%. CONCLUSION E. coli is highly resistant to the most antibacterial agents. The rational use of antibacterial agents should be strengthened so as to achieve a good treatment effect.%目的 探讨大肠埃希菌的耐药性和产超广谱β-内酰胺酶(ESBLs)情况,为指导临床合理用药提供依据.方法 回顾性调查2010年1月—2011年12月临床分离的大肠埃希菌的有关数据.结果 1043株大肠埃希菌主要来源于尿液,2010年和2011年大肠埃希菌产ESBLs检出率分别为52.90%、51.18%,两年产与非产ESBLs菌株经检验差异无统计学意义;大肠埃希菌对亚胺培南的耐药率为0、对哌拉西林/他唑巴坦、氨苄西林/舒巴坦的耐药率分别为7.29%~6.69%、38.56%~34.84%,对氨苄西林、头孢唑林的耐药率>87.0%,对氨曲南、头孢曲松、磺胺甲噁唑/甲氧苄啶、头孢噻肟、环丙沙星、左氧氟沙星的耐药率达到60.00%~77.00%.结论 大肠埃希菌对多

  10. Effect of efflux pump inhibitor CCCP on antibiotic resistance of multidrug resistant Escherichia coli%外排泵抑制剂羰酰氰间氯苯腙对多重耐药大肠埃希菌的耐药性影响

    Institute of Scientific and Technical Information of China (English)

    邹永胜; 王旭; 黄永茂; 游春芳; 陈枫; 钟利; 向成玉; 陈庄

    2013-01-01

    Objective To investigate the effect of carbonyl cyanide m-chlorophenylhydrazone (CCCP) on drug resistance of multidrug resistant Escherichia coli. Methods Disk diffusion (Kirby-Bauer test method) was used to detect the susceptibility of 71 strains of E. coli to 6 kinds of antibiotics, PCR assay to detect the acrA and acrB genes in E. coli strains, and constant broth dilution method to determine minimum inhibitory concentrations (MICs) of 2 fluoroquinolones to E. coli. MICs detected before and after CCCP was added were compared. Results Totally 71 strains were found resistant to 6 kinds of antibiotics (3 categories). The resistant rate of E. coli to ciprofloxacin was the highest (73.24%), and that of E. coli to aztreonam was the lowest (30.99%). Multidrug resistance (52.11%) was the main resistance pattern. AcrA/acrB positive rates were high (91.89% and 81.03%, respectively) in multidrug resistant strains. Variations of MICs detected before and after CCCP was added in multidrug resistant and sensitive strains were significantly different. Conclusion Efflux pump inhibitor CCCP can reduce the MICs of fluoroquinolone antibiotics to multidrug resistant E. coli.%目的 探讨外排泵抑制剂羰酰氰间氯苯腙(carbonyl cyanide m-chlorophenylhydrazone,CCCP)对多重耐药大肠埃希菌的耐药性影响.方法 采用纸片扩散法(K-B法)进行71株大肠埃希菌对6种抗菌药物的药物敏感性检测,用PCR技术检测受试菌株携带的acrA和acrB基因,用常量肉汤稀释法测定2种氟喹诺酮类抗菌药物对大肠埃希菌的最低抑菌浓度(minimum inhibitory concentrations,MICs),并对比加入CCCP前后的MICs值.结果 71株大肠埃希菌对3类6种抗菌药物耐药,其中对环丙沙星耐药率最高(73.24%),对氨曲南耐药率最低(30.99%),耐药模式以多重耐药为主(52.11%);外排泵基因acrA和acrB在多重耐药菌株中阳性率高达91.89%和81.03%;加入CCCP前后多重耐药菌株和敏感菌株的MICs值

  11. Analysis on Change of Serum Types and Drug Resistance of Shigella in Xicheng District of Beijing from 2008 to 2010%2008-2010年北京市西城区志贺菌血清型变迁及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    刘静; 苗元; 王丽萍; 崔京辉; 王永全; 吉彦莉

    2011-01-01

    [Objective] To analyze the change of serum types and drug resistance of Shigella in Xicheng district of Beijing from 2008 to 2010. [Methods]The study was conducted according to the National protocol of shigellosis surveillance. [Results]In 2008, there were 7 strains of Shigella flexneri and 4 strains of Shigella sonnei in Xicheng district, which accounted for 63. 6% and 36.4% respectively. In 2009, there were 12 strains of Shigella flexneri, 19 strains of Shigella sonnei and 1 strain of Shigella boydii, which accounted for 37.5% , 59.4% and 3.1% respectively. In 2010, there were 6 strains of Shigella flexneri and 36 strains of Shigella sonnei, which accounted for 14.3% and 85.7% respectively. The results of drug sensitivity test showed that Shigella was sensitive to cefepime, cefoxitin, ceftazidime, ofloxacin, levofloxacin, norfloxacin and aztreonam, and it was resistant to ampicillin, sulfanila-mide and nalidixie acid. [ Conclusion] From 2008 to 2010, the main serum types of Shigella in Xicheng district of Beijing are Shigella flexneri and Shigella sonnei, while the former decreased and the latter increased year by year. Shigella is sensitive to cephalosporin and fluoroquinolones which are suggested for the clinical treatments.%目的 2008-2010年北京市西城区志贺菌血清型变迁及耐药性分析。方法 按《全国细菌性痢疾监测方案》的要求进行。结果 2008年西城区福氏志贺菌7株,占63.6%;宋内志贺菌4株,占36.4%。2009年西城区福氏志贺菌12株,占37.5%;宋内志贺菌19株,占59.4%;鲍氏志贺菌1株,占3.1%。2010年福氏志贺菌6株,占14.3%;宋内志贺菌36株,占85.7%。药敏试验结果:志贺菌对头孢吡肟、头孢西丁、头孢他啶、氧氟沙星、左氧氟沙星、诺氟沙星、氨曲南药物敏感。对氨苄西林、磺胺、奈啶酸耐药。结论 2008-2010年北京市西城区志贺菌血清型主要为福氏志贺菌和宋内志贺菌,但是福氏

  12. Detection and drug resistance of ESBLs-producing Shigella%志贺菌产ESBLs酶的检测及其耐药性分析

    Institute of Scientific and Technical Information of China (English)

    边锋芝; 苑广盈; 孙玉国; 张延芳; 李金文

    2009-01-01

    Objective To investigate the detection rate and drug resistance of extended-spectrum β-lactamases (ESBLs)-producing Shigella in the district, in order to provide a guidance to clinical ra-tional use of antibiotics. Methods ESBLs were detected by E-test, and AmpC was detected by the modified three-dimensional test; disc diffusion test (K-B method) was used to study the drug resist- ance of Shigella isolated from clinical specimens. The date analysis was performed with WHONET5.4 software. Results In 275 strains of Shigella,12 strains (4.4%) of ESBLs-producing Shigella were de-tected consider ESBLs, and no AmpC-producing strain was found in Shigella. The resistance rate of ESBLs-producing strains to first,second and third-generation cephalosporins as well as aztreonam was respectively significantly higher than that of ESBLs non-producing strains, but both of them were high sensitive to imipenem,cefoxitin,ciprofloxacin and gentamiein. Conclusion The positive rate of ESBLs-producing Shigella stains is lower in the district, but the trend of nosocomial infection to community in-fection should be paid more attention to. It is vital to use antibiotics rationally.%目的 了解本地区产超广谱β-内酰胺酶(ESBLs)志贺菌的检出率以及耐药情况,为临床治疗菌痢提供试验依据.方法 E-test试验进行ESBLs志贺菌的检测,改良三维试验检测AmpC酶,K-B纸片扩散法进行药敏试验,用WHONET5.4软件进行数据分析.结果 275株志贺菌中,产ESBLs志贺菌12株,检出率为4.4%,未检测出产AmpC酶菌株.产ESBLs组对第1代、第2代、第3代头孢菌素和氨曲南耐约性均明显高于非产ESBLs组,氨苄西林、氯霉素、四环素、复方新诺明耐药率在两组均有较高水平.对亚胺培南、头孢西丁、环丙沙星、庆大霉素较敏感.结论 本地区ESBLs志贺菌检出率虽然较低,但已经有院内感染向社区感染转化的趋势,应引起重视,合理使用抗菌药物至关重要.

  13. 广西猪源沙门菌的分离·鉴定和耐药性研究%Study on the Isolation, Identification and Drug Resistance of Swine Pathogenic Salmonella in Guangxi

    Institute of Scientific and Technical Information of China (English)

    蹇慧; 刘芳; 覃永长

    2013-01-01

    [目的]了解广西地区猪源沙门菌的流行情况、耐药现状及致病力情况.[方法]从广西不同地区11个规模猪场采集99份病料,进行细菌的分离、菌体形态特征观察以及生化鉴定,对分离菌进行常用抗生素药物敏感试验,最后对分离株进行小鼠致病性试验.[结果]从99份病料里分离到21株沙门菌,分离率21%.药敏试验表明,分离菌株对阿米卡星、头孢噻肟、氨曲南、左氟沙星具有较高的敏感性,对青霉素G、氨苄西林、阿莫西林、复方新诺明等产生较高的耐药性.致病性试验表明9株分离菌株可导致小白鼠死亡,致死率为43%.[结论]分离菌株存在较严重的耐药现象及较强的致病性.该研究为该地区有效控制沙门菌病的发生以及兽医临床上的合理用药提供可靠的理论依据.%[Objective] The research aimed to understand the prevalence, drug resistance and virulence of swine Salmonella in Guangxi. [Method] 99 samples were collected from eleven large-scale pig farms in different regions of Guangxi. Salmonella isolates were identified by staining,morphological features observation and bio-chemical test. All isolates were examined for susceptibility to common antimicrobial agents and virulence tests on mice wee made. [Result] 21 strains of Salmonella were isolated from 99 samples and the isolation rate was 21%. The drug sensitivity test showed that the isolated strains had higher sensitivity to amikacin, cefotaxime, aztreonam and levofloxacin, while they showed higher resistance to penicillin G, ampicillin, amoxicillin and cotrimoxazole. The virulence test showed that 9 strains of Salmonella could lead to the death of mice and the lethal rate was 43%. [Conclusion] The isolated strains had severe resistance to antimicrobials and stronger pathogenicity. The research provided theoretical basis for the effective control of salmonellosis and reasonable application of clinical medicines.

  14. Molecular characterization of encoding plasmid-mediated ESBLs and AmpC β-lactamases genes in Citrobacter freundii%质粒介导产ESBLs与AmpCβ-内酰胺酶基因弗氏柠檬酸杆菌的研究

    Institute of Scientific and Technical Information of China (English)

    陈坚; 余方友

    2011-01-01

    OBJECTIVE To investigate the resistant mechanism of Citrobacter freundii which coexisted with ESBLs and AmpC genes. METHODS A multi-resistant Citrobacter freundii was isolated from hospital by VITEK-60 system. The detection of ESBLs was performed by the CLSI-recommended confirmatory test, Cefoxitin three-dimentional test was presented to identify AmpC β-lactamases, the mimimal inhibitative concentration (MIC) was determined by E-test. Polymerase chain reaction(PCR) and sequencing were carried out for analyzing the encoding genes of β-lactamases. Conjugation study was performed to determine whether resistant genes were likely transferred by plasmid. RESULTS The isolate was highly resistant to ceftazidime (MICs,96 jug/ml), cefotaxime (MlCs,96 μg/ml), cefoxitin(MICs.256 μg/ml) , aztreonam(MICs, 192 fig/ml) , ampicillin(MICs,>256 μg/ml) and sinomin compositea(MICs,>32 fig/ml). The clinical isolate produced AmpCs and ESBLs. The presence of blacrx-M-3 and blaCMY-2 of clinical isolate were identified by PCR and sequenced. Those genes of clinical isolate could be transferred to Escherichia coli J53 through conjugation. CONCLUSION Citrobacter freundii carries ESBLs and AmpC β-lactamases genes synchronously, which were mediated by plasmid.%目的 研究一株同时产ESBLs和AmpC β-内酰胺酶弗氏柠檬酸杆菌(CFR)的耐药机制.方法 2008年1月从临床尿液标本中分离出多药耐药弗氏柠檬酸杆菌1株,采用双纸片扩散法检测产ESBLs,头孢西丁三维试验检测AmpC酶,E-test法测定抗菌药物最低抑菌浓度(MIC),聚合酶链反应(PCR)检测产ESBss和AmpC酶基因,DNA测序决定基因型;接合试验测定耐药基因的转移性.结果 临床分离出一株同时产ESBLs和AmpCβ-内酰胺酶的多药耐药弗氏柠檬酸杆菌,对头孢他啶、头孢噻肟、头孢西丁、氨曲南、氨苄西林、磺胺甲噁唑/甲氧苄啶的MIC分别为96、96、256、192、>256、>32 μg/ml,PCR扩增及测序

  15. Clinical features and antimicrobial resistance of community-acquired pneumonia caused by Klebsiella pneumoniae in infants%婴幼儿社区获得性肺炎克雷伯菌肺炎的临床特点及耐药分析

    Institute of Scientific and Technical Information of China (English)

    何丽芸; 王应建; 李季美

    2012-01-01

    penicillins, cephalosporins, amoxicillin/clavulanic acid, ampicillin/sulbactam, compound sulfamethoxazole, gentamycin, ciprofloxacin and aztreonam were significantly higher than for non-ESBLs-producing strains. ESBLs-producing strains also showed multiple-drug resistance. Conclusions Community-acquired pneumonia caused by Klebsiella pneumoniae is common in infants aged ≤ 3 months. ESBLs-producing strains are prevalent in community-acquired pneumonia caused by Klebsiella pneumoniae and demonstrate both high rates of drug resistance and multiple-drug resistance.

  16. 鲍曼不动杆菌107株感染的分布与耐药性%Acinetobacter baumannii infection in 107 tribution and drug resistance

    Institute of Scientific and Technical Information of China (English)

    马艳; 李俊伟; 翟金翎; 吴莉

    2009-01-01

    目的 分析鲍曼不动杆菌的标本来源、分布及耐药变迁趋势,为有效预防控制感染、指导临床合理用药提供依据.方法 采用VTTEK-32型自动微生物鉴定/药敏分析系统进行菌株鉴定及药物敏感性测试,耐药性数据分析采用WHONET5软件.结果 3年间分离出107株鲍曼不动杆菌,其对12种抗菌药物活性较好的是亚胺培南、阿米卡星、氨苄西林/舒巴坦,耐药率为0.9%、5.6%、6.5%;耐药率较高的是氨苄西林74.8%、头孢曲松钠63.6%、头孢噻肟钠38.3%,氨曲南25.2%.2008年与2006和2007年相比较,鲍曼不动杆菌的耐药率均有逐年上升的趋势.结论 本院监测结果显示鲍曼不动杆菌对碳青霉烯类、氨基糖苷类、β-内酰胺酶抑制剂复合药物保持较好的敏感性,但鲍曼不动杆菌临床分布逐年增加,耐药率逐渐上升.%Objective To investigate the variations of tendency of drug-resistance from Jan 2006 to Dec 2008. the origin and the distributing of Acinetobacter baumannii and provide basis for selection of clinical drugs.Methods The characteriztion and sensitivity to antibiotics of Acinetobacter baumannii were analysed using VTTEK-32 system.Results 107 strains of Acinetobacter baumannii were separated and characterized during the three years.The rates of resistance to antibiotics were Imipenem 0.9%,Amikacin 5.6%,Ampicillin/Sulbactam 6.5%,Ampicillin 74.8% Ceftriaone 63.6%,Cefotaxime 38.3%,Aztreonam 25.2%.The resistance rate of Acinetobacter baumanii increased from 2006 to 2008,showed increasing tendency.Conclusion Acinetobacter baumannii showed good sensitivity to Carbapenems,Aminoglycosides,β-lactam antibiotics,Acinetobacter baumanii are widely distributing in hospital and are widely resistant to many kinds of antibiotics,The results suggested that the resistance of Acinetobacter baumannii to antibiotics should be continuously monitored,it will be beneficial for infection-control to collect antibiotics basing on the

  17. 临床感染中病原菌的分布及耐药性分析%Pathogen distribution and drug resistance analysis in clinical infection

    Institute of Scientific and Technical Information of China (English)

    陈玮; 方进

    2012-01-01

    Objective: To comprehend the distribution of common pathogens and drug resistance in clinical infection, and provide the basis for rational use of antimicrobial drugs to clinicians. Methods: The statistical distribution of 602 strains of bacteria isolated from clinical samples in 2009 and the bacterial resistance rates of common infection were analyzed. Results: There were 134 strains of Gram-positive bacteria(22. 26% ) ,468 strains of Gram-negative bacteria (77. 74% ) in 602 strains of isolated bacteria. In Gram-positive bacteria infection, Staphylococcus epidermidis infection was more common ( 11. 79% ) , followed by other streptococci ( 5. 81% ) ; while E. coli infection ( 29. 57%) was at the top in Gram-negative bacteria infection, followed by Enterobacter ( 13. 29%) and Klebsiella ( 12. 46% ). Drug susceptibility analysis revealed that Staphylococcus epidermidis was sensitive to novobiocin and ampicillin 100. 00% and resistant to aztreonam, azithromycin and penicillin, the resistance rates were respectively 96. 00% ,96. 00% and 92. 42%. E. coli was sensitive to nitrofurantoin and 100. 00% resistant to penicillin, rifampin and lincomycin. Conclusions: The drug resistant rates of penicillin, lincomycin and azithromycin were very high, the drug resistant rates of Gram-positive bacteria to ampicillin, vancomycin, novobiocin are low;the Gram-negative bacteria is the most sensitive to cefoperazone/sulbactam,tazobactam,piperacillin/tazobactam.%目的:了解临床感染中常见病原菌分布及耐药情况,为临床医生合理选用抗菌药物提供依据.方法:对2009年临床标本中分离的602株病原菌的分布情况进行统计,并分析常见感染菌的耐药率.结果:分离的602株细菌中,G+菌134株(22.26%),G-菌468株(77.74%).G+菌中以表皮葡萄球菌感染为多见(71株),其次为其他链球菌(35株);而G-菌中大肠埃希菌(178株)居于首位,其次是肠杆菌属(80株)和克雷伯菌属(75株).表皮葡萄球菌

  18. 重症监护病房与非重症监护病房粘质沙雷菌耐药性比较%Comparison of drug-resistance of Serratia marcescens between ICU and non-ICU

    Institute of Scientific and Technical Information of China (English)

    倪笑媚; 黄金莲; 胡硕

    2013-01-01

    目的 了解重症监护病房(ICU)与非重症监护病房粘质沙雷菌耐药情况,指导抗生素的合理应用.方法 收集2009年至2010年永康市第一人民医院ICU病房送检标本中分离到的33株粘质沙雷菌与同期非ICU病房送检标本中分离到的26株粘质沙雷菌,对其耐药性进行回顾性分析.结果 ICU与非ICU分离的粘质沙雷菌,除均对头孢他啶、庆大霉素、亚胺培南、左氧氟沙星、哌拉西林/他唑巴坦、复方新诺明耐药外,ICU粘质沙雷菌对氨苄西林/舒巴坦、氨曲南、头孢曲松、头孢唑啉耐药率明显高于非ICU病房(P<0.05),差异有统计学意义.结论 ICU粘质沙雷菌耐药率明显高于非ICU.应及时对ICU患者进行抗生素耐药性检查,根据药敏试验结果选用抗生素,细菌耐药率少于30%的抗菌药物,首先选用,但要考虑感染程度及器官功能状态;耐药率大于75%的药物暂停使用.%Objective To investigate the drug resistance of Serratia marcescens isolated from ICU and non-ICUs, and provide evidences for the clinical reasonable application of antibiotics. Methods From January 2009 to December 2010, 33 strains of Serratia marcescens isolated from ICU and 26 strains from non-ICUs were evaluated by Microscan-Walkaway 40 (American Dade Behring) and their MICs were determined by combined bacterial identification/medicine sensitive analyzer. Statistical retrospective analysis of drug resistance results was conducted. Results Serratia marcescens isolated from both the ICU and non-ICUs were resistant to Ceftazidime, Gentamicin, Imipenem, Levofloxacin, Piperacillin/Tazobactam and Trimethoprim-Sulfamethoxazole. In addition, the pathogens from ICU were more resistant to Ampicillin/Sulbactam, Aztreonam, Ceftriaxone and Cefazolin than those from non-ICUs (P <0.05). Conclusion The rate of drug resistance of ICU Serratia marcescens is higher than that of the non-ICUs. Clinicians should select effective antibiotics

  19. MOLECULAR CHARACTERIZATION AND IMMUNOPROTECTIVE ACTIVITY OF CAPSULAR POLYSACCHARIDE OF KLEBSIELLA PNEUMONIAE ISOLATED FROM FARM ANIMALS AT TAIF GOVERNORATE

    Directory of Open Access Journals (Sweden)

    Ahmed M.A. Mansour

    2014-01-01

    Full Text Available Klebsiella pneumoniae is a Gram-negative enterobacterium that has historically been and currently remains, a significant cause of human disease and several kinds of infections in animals. In the present work, trials for the isolation of Klebsiella pneumoniae from diseased and apparently healthy farm animals (cows, sheep, goats and camels were done for recognition of Klebsiella pneumoniae subspecies. It was noticed that there was a marked variation between incidences of Klebsiella pneumoniae subspecies in examined animals as regards to health condition. The frequency was greater among samples collected from diseased animals 25.2% as compared with apparently healthy one 5.5%. It was found that there was great difference between the prevalence of Klebsiella isolated from various animal origins. On biochemical identification Klebsiella pneumoniae subsp. pneumoniae was the most prevalent followed by Klebsiella pneumoniae subsp. ozaenae and Klebsiella pneumoniae subsp. Rhinoscleromatis. Klebsiella pneumoniae subsp. rhinoscleromatis was not isolated from apparently healthy animals. The in vitro sensitivity of isolates of Klebsiella pneumoniae subspecies recovered from different animal species to 23 antimicrobial agents was tested. It was found that were resistance to cefoxitin, cefotaxime, cefoperazone, ceftazidime, ceftriaxone, aztreonam, amoxicillin and ampicillin. The most potent antibiotics showing 100% activity against Klebsiella pneumoniae subsp. isolated in this study were imipenem, ciprofloxacin, norfloxacin, gentamicin and kanamycin. While 96.2% of all examined isolates were sensitive to amoxicillin/clavulanic acid and ticarcillin/clavulanic acid. SDS-PAGE analysis showed that CPSs of Klebsiella pneumoniae subspecies contained wide variety of different molecular weights which ranged from 15.52 kDa to106.29 kDa and gave 10-13 bands. Evaluation of humoral immune response of mice immunized with CPSs was done using ELISA. It was found that the

  20. 老年VAP嗜麦芽寡养单胞菌感染及耐药性分析%Infection and drug-resistance of Stenotrophomonas maltophilia in geriatric patients with ventilator-associated pneumonia

    Institute of Scientific and Technical Information of China (English)

    吴丽丽; 沈世恩; 魏凌云; 叶友仙; 于小妹

    2011-01-01

    目的 研究老年VAP嗜麦芽寡养单胞菌(SMA)感染及耐药特征.方法 从161例老年患者分离的30株嗜麦芽寡养单胞菌采用纸片扩散法进行药敏试验,并对抗生素耐药结果进行回顾性分析.结果 30株嗜麦芽寡养单胞菌对氨节西林、亚胺培南、美罗培南、头抱哇琳、氨曲南、庆大霉素、阿米卡星高度耐药(100%,96.6700,96.67%,93.3300,80.00肠,73.3300);对头胞吡肟,头胞他啶,头胞噻肟耐药率较高(50.00%,50.00%and60.00%),对左氧氟沙星,环丙沙星耐药率接近50%(40.0000,46.67%);但对复方新诺明、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦耐药率较低(3.33%, 10.00 %,16.6700)0结论嗜麦芽寡养单胞菌对常用抗菌药物呈多重耐药,在老年VAP感染已十分严重,它的首选药物为复方新诺明、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦.%To investigate the infectious and resistant characteristics of Stenotrophomonas maltophilia (S. maltophilia)in geriatric patients with ventilator-associated pneumonia (VAP), and improve the level of clinical prevention and therapy of S.maltophilia infection, 161 geriatric patients with ventilator respiration treatment were monitored objectively. The microbial sensitivity of 30 isolates of S. maltophilia and antibiotic test results were retrospectively analyzed. Thirty isolates of S. naltophilia were highly resistant to ampicillin, imipenem, meropenem, cefazolin, aztreonam, gentamicin, and amikacin respectively (100%, 96.67%, 96.67%, 93.33%, 80.00% and 73.33%, respectively); higher resistant to cefepime,ceftazidime, and cefotaxime respectively(550.00% ,50.00% and 60.00%, respectively). The resistance rates to levofloxacin and ciprofloxacin were close to 50.00% (40.00% and 46.67%, respectively), but lower to trimethoprim-sulfamethoxazole, cefoperazone/sulbactam and piperacillin/ tazobactam (3.33%, 10.00 % and 16.67 %, respectively). It's suggested that S. maltophilia shows

  1. Identification of plasmid-mediated AmpC gene, blaDHA-1 from clinical isolates of Escherichia coli and Klebsiella pneumoniae%从大肠埃希菌和肺炎克雷伯菌中检出质粒介导的AmpC DHA-1型β内酰胺酶基因

    Institute of Scientific and Technical Information of China (English)

    王煜; 李振华

    2008-01-01

    目的 了解产质粒介导AmpC酶大肠埃希菌和肺炎克雷伯菌的耐药性和基因型.方法 收集2002年1月-2004年5月间我院呼吸科临床标本中分离的大肠埃希菌和肺炎克雷伯菌共110株,用酶提取物三维试验检测AmpC酶;用等电聚焦电泳、耐药质粒电转化试验、聚合酶链反应(PCR)及测序确定AmpC酶基因型.结果 大肠埃希菌和肺炎克雷伯菌中AmpC酶检出率分剐为9.30%和4.48%.药敏试验显示产酶株对头孢西丁全部耐药,对第三代头孢菌素、酶抑制剂、氨曲南、阿米卡星及环丙沙星均有不同程度耐药,对头孢吡肟及亚胺培南较敏感.7株产AmpC酶菌株中有5株通过电转化试验可将头孢西丁耐药性传递给受体菌,经PCR扩增和测序证实为质粒介导DHA-1型AmpC酶.结论 我院临床分离的大肠埃希菌和肺炎克雷伯菌中已经出现产质粒介导AmpC酶菌株,其耐药性能够水平传播,给临床抗感染治疗带来重大威胁.%[Objective]To investigate the susceptibility and genotype characteristics of Escherichia coli and Klebsiella pneumoniae producing plasmid-mediated AmpC β-lactamase. [Methods]A total of 110 strains of Escherichia coli and Klebsiella pneumoniae were collected from the patients hospitalized in our respiratory ward from January 2002 to May 2004. The isohtes harboring AmpC β-lactamase were detected by three-dimensional test, isoelectric focusing analysis, electroporation and PCR, the PCR products were sequenced subsequently. [Results]AmpC enzyme was detected in 9.30% of Escherichia coli and 4.48 % of Klebsiella pneumoniae. The susceptibility test showed 7 isolates producing plnsmid-mediated AmpC β-lactamase were all resistant to cefoxitin, part of these strains were resistant to the third-generation Cephalosparins, β-lactamase combined with the β-lactamase inhibitors, Aztreonam,Amikacin and Cipmfloxacin, most of them were susceptible to cefeime and imipenem. 3 strains of Klebsiella

  2. 医院内感染和社区感染儿童肺炎克雷伯杆菌临床特点及耐药性分析%The clinical characteristics and resistance analysis of children infected with Klebsiella pneumonia in community and nosocomial

    Institute of Scientific and Technical Information of China (English)

    何足元; 陈志敏

    2013-01-01

    Objective To investigate clinical characteristics of children infected with Klebsiella pneumonia (KP) in community and nosocomial ,and analysis briefly about their resistance .Methods 79 cases of children with pneumonia identified as KP infection by the method of sputum bacterial culture were collected and divided into nosocomial infection group (11 cases) and community in-fection group(68 cases) from January 2009 to December 2012 .The clinical information were recorded ,sputum bacterial susceptibili-ty and extended-spectrum β-lactamase enzyme were tested .Results 10 cases and 12 cases of extended-spectrumβ-lactamase enzyme strains were detected from nosocomial infection group and community infection group ,respectively .The children infected KP had a high degree of resistance to cefazolin ,ampicillin/sulbactam ,head penicillin ,ceftriaxone ,aztreonam ,cefepime and ceftazidime ,while sensitive to ciprofloxacin ,cefotetan and piperacillin/tazobactam in the nosocomial infection group .12 cases in community infection group produce highly resistant to penicillin-type drugs ,but were not obvious resistance to other types of antibiotics .Conclusion Multi-drug resistance problems are serious in the pneumonia children who infected KP and the extended-spectrum β-lactamase en-zyme is positive .Infected children should be treated differently in the selection of antibiotics in the treatment of infection in commu-nity and nosocomial .%目的:探讨医院内感染与社区感染儿童肺炎克雷伯杆菌(K P )的临床特点,并对其耐药性作简要分析。方法收集广西医科大学第四附属医院2009年1月至2012年12月收治的经痰液细菌培养确定为K P的肺炎患儿79例,分为院内感染组(11例)和社区感染组(68例),记录患儿临床信息,对痰液细菌作药敏试验并检测超广谱β-内酰胺酶。结果院内感染组检出超广谱β-内酰胺酶阳性菌株10例(90.9%,9/11),对头孢唑啉、氨苄

  3. Detection of highly producing AmpC enzymes, extended-spectrum β-lactamases and drug resistance in Acinetobacter baumannii%鲍曼不动杆菌的高产AmpC酶、ESBLs及其耐药性分析

    Institute of Scientific and Technical Information of China (English)

    谢海涛; 颜向军

    2008-01-01

    Objective To study the drug resistance and production status of highly producing AmpC enzymes, extended-spectrum β-lactamases (ESBLs) and drug resistance in Acinetobacter bau-mannii. Methods Drug sensitivity test was performed with Kirby-Bauer method. ESBLs were detected with phenotype confirmatory test (double-disk synergy test), and highly producing AmpC enzymes were measured with phenotype screening method. Results 93 strains of Acinetobacter baumannii were mainly obtained from respiratory department and neurosurgery, and isolated from sputum/pharyngeal stab, raw surface/wound secretion and urine samples. 15 strains (16.1%) of highly producing AmpCenzyme-producing Acinetobacter baumannii were detected, so were 10 strains (10. 8%) of ESBLs-pro-ducing isolates. All enzymes-producing strains displayed multi-resistant, and their resistant rates to the third cephalosporin, penicillins and aztreonam were much higher than enzymes non-producing ones. None was detected resistant to imipenem. Conclusion Occurrence of highly producing AmpC en-zymes and extended-spectrum β-lactamases (ESBLs) is one of causes for Acinetobacter baumannii multi-resistance. It suggests that detection of ESBLs-producing isolates should be strengthened so as to prevent their outbreak and spread.%目的 了解鲍曼不动杆菌高产AmpC酶、超广谱β-内酰胺酶(ESBLs)产生情况及其耐药谱.方法 用K-B法进行药物敏感性检测,按表型确证试验检测ESBLs,按表型筛选法检测高产AmpC酶.结果 93株鲍曼不动杆菌主要分离自呼吸内科、神经外科,以痰或咽拭子、创面或伤口分泌物、尿3类标本多见,检测到15株(16.1%)产高产AmpC酶菌株,10株(10.8%)产ESBLs菌株,产酶株均呈多重耐药,对第3代头孢菌素、青霉素类及氨曲南耐药率明显高于非产酶菌株,未发现亚胺培南耐药株.结论 产高产AmpC酶、产ESBLs酶是鲍曼不动杆菌多重耐药的原因之一,应加强对产酶株的检测,以指导临床

  4. 神经外科重症监护病房鲍氏不动杆菌感染与耐药性分析%Acinetobacter baumannii infections in NICU and drug resistance analysis

    Institute of Scientific and Technical Information of China (English)

    杨超; 刘大钺; 张恒; 王凌雁; 廖康; 刘金龙

    2011-01-01

    目的 分析神经外科重症监护病房(NICU)鲍氏不动杆菌(ABA)感染与耐药情况,为临床预防医院感染以及合理应用抗菌药物提供依据.方法 收集2006年1月-2009年12月NICU收治的患者痰标本分离出37株ABA,采用法国生物梅里埃公司VITEK-32全自动细菌分析系统及其配套的细菌鉴定卡和药敏卡进行检测.结果ABA所致的感染率0.99%,其对抗菌药物表现为多药耐药性;敏感率最高的抗菌药物是阿米卡星,为75.68%,其次为亚胺培南、头孢哌酮/舒巴坦、妥布霉素、美罗培南,分别为56.76%、45.95%、37.84%、32.43%,而耐药率最高的是头孢替坦,为97.30%,其次为氨曲南、头孢噻肟、庆大霉素、甲氧苄啶/磺胺甲噁唑,分别为91.89%、89.19%、86.49%、83.78%.结论 通过健全医院感染控制制度、培训医护人员、加强临床实验室监控的改进,对遏制ABA耐药率的增高和提高治疗效果有重要意义.%OBJECTIVE To study the Acinetobacterbaumannii (ABA)infection in neurosurgical ICU (NICU) of our hospital and analyze the drug resistance to provide evidences for rational use of antibiotics and rational measures for nosocomial infection prevention. METHODS Thirty seven ABA isolates from sputum were collected from Jan 2006 to Dec 2009 in NICU patients of our hospital. BioMerieux VITEK32 autonomic bacteria analysis system, attached species identification cards and drug sensitivity cards were used. RESULTS The ABA infection rate was 0. 99%, the isolates showed multi-drug-resistance) the top sensitive antibiotics were amikacin (75. 68%), followed by imipenem (56. 76%), cefoperazone/sulbactam (45. 95%), tobramycin (37. 84%) and meropenem (32. 43%); and the top resistant antibiotics were cefotetan (97. 30%), followed by aztreonam (91. 89%), cefotaxime (89.19%), gentamicin (86.49%), and trimethoprim/sulfamethoxazole (83. 78%). CONCLUSION By setting up strong hospital disinfection and isolation regulations

  5. Detection of plasmid-mediated Carbapenem-hydrolyzing β-lactamaseKPC-2 in a strain of Carbapenem-resistant C.freundii%碳青酶烯类抗生素耐药弗劳地枸橼JH酸杆菌KPC-2基因的检测

    Institute of Scientific and Technical Information of China (English)

    汪安勇; 王中新; 沈继录

    2012-01-01

    Objective To investigate the mechanism of Carbapenem resistance in C. Freudii. Methods Antibiotic susceptibilities were determined by agar dilution method. Conjugation experiments were carried out in mixed broth cultures. Plasmid DNA preparations were obtained by using an alkalinelysis technique and were digested by various endonucleases; The crude β-lactamase extracts of C. Freudii and E. Coli transconjugant were subjected to analytical isoelectric focusing( IEF )Specific PCR amplification and DNA sequence analysis were performed to confirm the β-lactamse type. Results The C. Freundii isolate showed resistance against Carbapenemes. The MICs of imipen-em and meropenem were both 64 mg · L-1 . The isolate was also resistant against penicillins, cephalosorins, cefoxitins, aztreonam, quinolo-nes,and aminoglycosides. The conjugant results showed the antibiotics can transfer by plasmid. Isoelectric focusing demonstrated two β-lactamases with the isoelectric points of 5. 0 and 7. 5 in conjugant. Specific PCR amplification and DNA sequence analysis show ed that the C. Freudii produce the gene of KPC-2. Coclusion the product of KPC-2 Carbapenem was the first and foremost dues of Carbapenem-risitance and it can transfer by plasmid.%目的 研究弗劳地枸橼酸杆菌对碳青霉烯类抗生素的耐药机制.方法 采用琼脂对倍稀释法检测弗劳地枸橼酸杆菌对亚胺培南和美罗培南以及其他常见药物的最低抑菌浓度(MIC).等电聚集电泳分析其β-内酰胺酶类型,聚合酶链反应(PCR)和DNA序列分析检测β-内酰胺酶基因型,接合试验分析其耐药质粒传递情况.结果 弗劳地枸橼酸杆菌对亚胺培南和美罗培南的MIC均为64 mg·L-1,对青霉素类、头孢菌素类、头孢西丁、氨曲南和氨基糖苷类均耐药.转移接合结果显示对亚胺培南和美罗培南的耐药性可以通过质粒转移.等电聚焦电泳结果显示转移接合子具有等电点(PI)约为5.0、7.5的2种β-内酰

  6. 产NDM-1型碳青霉烯酶摩根摩根菌的分离及分子背景研究%Isolation and molecular analysis of blaNDM-1-positive Morganella morganii

    Institute of Scientific and Technical Information of China (English)

    王选; 吴晓燕; 李佳萍; 宋国蓉; 邱炳峰; 顾丹霞; 张嵘

    2015-01-01

    Objective To investigate the molecular background of the New Delhi-metallo-1 (NDM-1)-producing Morganella morganii.Methods Two carbapenem-resistant M.morganii named 1 and 2 were isolated in the Second Hospital of Jiaxing,Zhejiang on October 4th and 29th,respectively.Antimicrobial susceptibility was determined by agar dilution method.Pulsed-field gel electrophoresis (PFGE) was performed to analyse the homololgy of isolates.Amplification with specific primers,DNA sequencing,conjugation experiments and genetic environment analysis were conducted to investigate the molecular mechanisms of resistance.Results The two M.morganii isolates were resistant to carbapenem and fluoroquinolones,while susceptible to aztreonam.PFGE analysis indicated that the two isolates were distinguishable.Amplification and DNA sequencing confirmed the coexistence of blaNDM-1,blasHv-12,qnrS1 and aac(6')-Ib-cr in both isolates.Transconjugants were detected with blaNDM.1 and qnrS1 simultaneously.Genetic environment analysis demonstrated that the blaNDM-1-bleMBL-trpF-dsbC-cutA1 structure was in consistence with those from known blaNDM-1-carrying Klebsiella pneumoniae.Conclusion The blaNDM-1 in M.morganii isolates possiblely obtained from K.pneumoniae through translatable plasmids.%目的 对发现的产新德里金属β内酰胺酶1(NDM-1)型碳青霉烯酶摩根摩根菌进行分子背景研究.方法 两株碳青霉烯类抗生素耐药摩根摩根菌1和2分别于2013年10月4日和10月29日分离自浙江省嘉兴市第二医院.琼脂稀释法测定抗生素敏感性;脉冲场凝胶电泳(PFGE)分析两菌株同源性;特异性PCR扩增和序列分析、接合试验和耐药基因周围序列分析进行菌株耐药机制分子水平研究.结果 2株菌对喹诺酮类和碳青霉烯类抗生素耐药,对氨曲南敏感;PFGE结果显示2株菌非同源;特异性PCR扩增和序列分析发现2株菌同时携带耐药基因blaNDM-1、blaSHV-12、qnrS1和aac(6')-Ib-cr;

  7. ISOLATION AND IDENTIFICATION OF PATHOGENIC MORGANELLA MORGANII ISOLATES FROM CHINESE SOFT-SHELLED TURTLE PELODISCUS SINENSIS%中华鳖(Pelodiscus sinensis)摩氏摩根菌(Morganella morganii)的鉴定及致病性研究

    Institute of Scientific and Technical Information of China (English)

    孔蕾; 朱凝瑜; 贝亦江; 丁雪燕; 陈健舜

    2013-01-01

    从3只患有头面部疖疮中华鳖(Pelodiscus sinensis)的肝脏、肾脏、头面部病灶干酪样组织,分离得到12株细菌.综合菌落形态观察、16S rRNA序列分析与生化特性分析方法,所有分离株均为摩氏摩根菌(Morganella morganii).稚鳖和小鼠感染试验提示该菌具有较强的致病力,其对小鼠的半数致死量(LD50)为107.24.同时采用常规琼脂扩散(K-B)法进行8类14种常用药物的抗菌敏感性测定,结果表明,分离株对氨基糖苷类、β-内酰胺类、四环素类、林可酰胺类、多肽类、喹诺酮类、磺胺类等中的8种药物耐药,对氨曲南、氟苯尼考、头孢哌酮则较为敏感.本研究为中华鳖以头面部疖疮为主要临床特征的摩氏摩根菌病的首例报道,旨在为该病的确诊与防治提供科学依据和参考.%An outbreak of Chinese soft-shelled turtle (Pelodiscus sinensis) disease with typical symptoms of head and facial furuncle sore happened in a large-scale breeding farm in Zhejiang Province,2012.A total of 12 isolates were collected from livers,kidneys and facial loci of these diseased turtles.Based on the colony morphology,biochemical reactions and the sequence analysis of 16S rRNA gene,these isolates were identified as Morganella morganii.These isolates demonstrated virulence potential both in Chinese soft-shelled turtle and mouse models,with the median lethal dose (LD50) in mice at 107.24.The susceptibity test to antibiotics using Kirby-Bauer Sagar diffusion method showed these M.morganii isolates were resistant to aminoglycosides,beta-lactams,tetracyclines,lincomycin amides,polypeptides,quinolones,sulfonamides,and sensitive to aztreonam,florfenicol,cefoperazone.This study represents the first report of M.morganii-mediated disease with the typical signs of head and facial furuncle sore in Chinese soft-shelled turtles,and paves the way for the prevention and treatment program of this disease.

  8. Distribution and Drug Resistance of Acinetobacter Baumannii%鲍曼不动杆菌的临床分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    刘丹

    2013-01-01

      目的了解医院感染鲍曼不动杆菌的临床分布及耐药性,为临床用药提供依据。方法收集医院2011年1月至2012年6月常规培养检出的258株鲍曼不动杆菌,分析其在临床标本和病房的分布、耐药状况。结果检出258株鲍曼不动杆菌中,标本主要分布以痰液为主,占85.3%;科室分布主要为重症监护病房(ICU)最高,占53.9%,其次为血液内科、神经外科、神经内科,呼吸内科分别占11.6%、10.5%、9.3%、9.3%;鲍曼不动杆菌对氨苄西林、哌拉西林、氨曲南、头孢唑啉、头孢噻肟、头孢他啶、头孢吡肟、庆大霉素、环丙沙星、左氧氟沙星的耐药率均>50.0%,而对多粘菌素耐药率为0.0%。结论鲍曼不动杆菌主要引起呼吸道感染,耐药性严重,应积极预防治疗医院感染,合理使用抗生素,以减少耐药株的上升。%Objective To investigate the distribution and drug resistance of Acinetobacter baumannii isolates and to provide basis for clinical applicationof antibiotics. Methods The data on 258 strains of Acinetobacter baumannii by cultured in normal methods from Jan 2011 to Jun 2012 were collected to analyze the changes in clinical specimens and ward distribution and drug resistance. Results Totally 258 strains of Acinetobacter baumannii isolated, the specimens were mainly obtained from sputum, accounting for 85.3%, Acinetobacter baumannii isolates were primarily from the Intensive care unit (ICU), accounting for 53.9%, the next:blood department of internal medicine, neurosurgery department, nerve department and respiratory medicine, accounting for 11.6%, 10.5%, 9.3%and 9.3%, Acinetobacter baumannii to ampicillin, piperacillin, aztreonam, cefazolin, cefotaxime, ceftazidime, cefepime, gentamicin, ciprofloxacin, levofloxacin resistance rate was>50.0%, to polymyxin resistance rate was 0.0%.Conclusion Acinetobacter baumannii cause respiratory tract infection, antibiotic resistance is

  9. 患病大鲵中弗氏柠檬酸杆菌的分离与鉴定%Isolation and identification of Citrobacter freundii from diseased giant salamander, Andrias davidianus

    Institute of Scientific and Technical Information of China (English)

    高正勇; 曾令兵; 孟彦; 刘小玲; 张波

    2012-01-01

    demonstrated that the bacterial strain JZO1 was susceptible to aztreonam, cefepime and cefotamine. [ Conclusion ] Citrobacter freundii is a pathogen for cultured Chinese giant salamander.

  10. 副猪嗜血杆菌江西分离株药物敏感性及四环素耐药基因tet(B)分析%Drug sensitive tests and analysis of tetracycline resistance gene tet(B ) of Haemophilus parasuis isolates

    Institute of Scientific and Technical Information of China (English)

    宋德平; 肖根辉; 王萍; 何后军; 邬向东; 黄冬艳; 邓舜洲; 张文波

    2011-01-01

    为了解副猪嗜血杆菌江西株的药物敏感性及其耐药基因,本实验采用K-B法测定分离株对57种药物的敏感性,结果显示20株副猪嗜血杆菌均对阿洛西林和万古霉素敏感,80%及以上的分离株对氨苄西林\\舒巴坦、阿莫西林\\棒酸等高度敏感.但分离株对恩诺沙星、氨曲南、四环素等的耐受性较强,某些菌株对多种药物具有抗性,其中6株菌能够耐受5种药物,5株菌能够耐受12种药物,3株菌能够耐受13种药物,甚至有2株菌能够耐受多达22种药物.将江西分离株的药物敏感性结果与其它国家或地区以及不同时间分离菌株的结果相比较表明,不同地区及不同时间段分离的菌株药物敏感性存在较大差异.为探索副猪嗜血杆菌耐药的分子机制,本研究设计引物并建立了检测四环素耐药基因tet(B)的PCR方法.运用所建立的方法检测江西株tet(B)基因,在15株四环素耐药菌株中检测出其中9株菌存在该基因,推测tet(B)可能是介导该菌对四环素耐药的主要分子机制之一.%To investigate the antibiotic sensitivity and genes mediated the insistence in Haemophilus parasuis, A total of 20 Jiangxi H. Parasuis isolates were tested with 57 antibiotics by a K-B method. The results showed that all the isolates were susceptible to azlocilin, enrofloxacin and vancomycin, while eighty percent of the isolates was susceptible to Ampicillin/ Sulbatam, Amoxicillin/Clavulanic acid, etc. Howerver, a high level of resistance was found for Enrofloxacin, Aztreonam, Tetracycline etc. Several multiresistance patterns were found among the isolates, of which resistant to 5 or even to 22 antibiotics. Furthermore, A PCR assay was established to detect the tetracycline drug resistance gene tet(B) for the H. Parasuis isolates and nine of the 15 Jiangxi isolates resistanted to tetracycline were positive, which indicated that tet(B) might be one of the main molecular mechanisms mediated the

  11. 2010~2014年医院铜绿假单胞菌的耐药性分析%Analysis of drug resistance of pseudomonas aeruginosa in 2010~2014

    Institute of Scientific and Technical Information of China (English)

    齐红双; 李英; 杨瀚; 卢瞧; 马敬花

    2016-01-01

    management for antibiotics in 2013~2013, drug resistance by pseudomonas aeruginosa was remarkably reduced for aztreonam, ceftazidime, cefoperazone/sulbactam, cefepime, imipenem, meropenem, piperacillin/tazobactam. Conclusion As one of the common pathogenic bacteria, pseudomonas aeruginosa is easily to show drug resistance. Understanding of changes in its clinical distribution and drug resistance can provide data to clinical treatment, and control infection by pseudomonas aeruginosa.

  12. 小儿心脏监护病房病原菌分布及超广谱β-内酰胺酶阳性菌的耐药性分析%Distribution of pathogenic bacteria and antibiotic resistance of ESBLs (+)bacteria in CICU

    Institute of Scientific and Technical Information of China (English)

    王保存; 丁力; 张峰

    2016-01-01

    目的:监测、分析小儿心脏监护病房(CICU)病原菌分布特点及超广谱β-内酰胺酶阳性菌[ESBLs(+)]的耐药状况,为指导临床合理用药提供理论依据。方法回顾性分析 CICU 分离的病原菌及耐药性。结果送检各类标本共计1192份,检测出病原菌124株(10.4%),主要来源于呼吸道(74株,59.7%),其中革兰阴性菌62株(50.0%)、革兰阳性菌50株(40.3%)、真菌12株(9.7%)。ESBLs(+)菌共24株(19.4%),均检自肺炎克雷伯菌及大肠埃希菌,对青霉素类、头孢菌素、氨曲南的耐药率高,对氨基糖苷类、喹诺酮类、碳氢霉烯类的耐药率低。结论CICU 病原菌多来源于呼吸道,ESBLs(+)菌的检出率高、耐药严重,应加强监测病原菌分布及耐药性,指导临床合理应用抗菌药物。%Objective To monitor and analyze the distribution of pathogenic bacteria and antibiotic resistance of ESBLs (+)bacteria in CICU of Anhui Provincial Children’s Hospital,in order to provide the theoretical basis for rational use of antibiotics in clinical prac-tice.Methods A retrospective analysis was made of pathogenic bacteria separated in CICU from January 2011 to December 2015 and of their antibiotic resistance.Results From a total of 1 192 samples,the detected pathogenic bacteria were 124 strains (10.4%), mainly derived from the respiratory tract (74 strains,59.7%).Among them,there were 62 strains (50.0%)of gram-negative bacteria, 50 strains (40.3%)of gram positive bacteria and 12 strains (9.7%)of fungus.ESBLs (+)bacteria,a total of 24 strains (19.4%), were both from pneumonia klebsiella bacteria and e.Coli,which were highly resistant to penicillin,cephalosporin and aztreonam,but were lowly resistant to aminoglycoside,quinolone and hydrocarbon alkene.Conclusions Pathogenic bacteria in CICU were mainly de-rived from respiratory tract.The detection rate of ESBLs (+)bacteria was

  13. Distribution and drug resistance of clinically isolated Alcaligenes xylosoxidans%木糖氧化产碱杆菌的临床分布与耐药性研究

    Institute of Scientific and Technical Information of China (English)

    王斌; 朴信爱; 蒋捍东

    2012-01-01

    OBJECTIVE To investigate the distribution and resistance of clinically isolated Alcaligenesxylosoxidans (AL xylosoxidans) strains. METHODS The distribution of 85 trains of Al. Xylosoxidans causing nosocomial infection was retrospectively analyzed. Antimicrobial susceptibility testing was performed by Kirby-Bauer method. RESULTS Of the specimens from which Al. Xylosoxidans strains were isolated, 95. 29% were from sputum, the minority were from wounds or keratitis secretions, which was mainly obtained from patients with low immunity. The infections distributed widely in respiratory department and ICU, accounting for 43. 53 % and 25. 88%, respectively, followed by cerebral surgery department (10. 59%) , neurology department (7. 06%) .endocrinology department (5. 88%), oncology department (3. 53%), orthopedics department (2. 35%) and ophthalmology department (1.18%). The drug resistance rates of the isolates to aztreonam and aminoglycoside antibiotics varied from 78. 82% to 87. 06%. The drug resistance rates to ceftriaxone, cefotaxim, cefepime, piperacillin, ciprofloxacin.and sulfamethoxazole/trimethoprim were 58. 82%, 63. 53%, 62. 35%, 52. 94%, 63. 53%, and 62.35%, respectively. The strains were susceptible to carbapenems,β-lactam/β-lactamase inhibitor combinations and ceftazidime with the drug resistance varying from 0 to 18. 82%. CONCLUSION Al. Xylosoxidans infections mainly occurs in respiratory tract. Disinfection of hospital environment with strict sterilization management system shall be strengthened and antibiotics should be used reasonably so as to reduce nosocomial infections.%目的 调查木糖氧化产碱杆菌在临床的分布及耐药性.方法 回顾性调查85株木糖氧化产碱杆菌的医院感染分布,采用K-B法分析细菌敏感性.结果 木糖氧化产碱杆菌多来自痰标本,占95.29%,少数来自于伤口及角膜炎分泌物标本中,后者均来自免疫力低下患者;感染主要分布于呼吸科和

  14. Detection and homology analysis on metallo-β-lactamases gene in clinically isolated gram-negative bacteria%临床分离革兰阴性菌金属β-内酰胺酶基因检测及其同源性分析

    Institute of Scientific and Technical Information of China (English)

    赵亚楠; 郭育奇; 黄红兰; 武晓琳; 韦珍; 孙超; 赵春燕

    2015-01-01

    Objective To investigate the detection of IMP andVIM metallo-β-lactamases (MβLs)genes in clinically iso-lated gram-negative bacteria as well as bacterial resistance toβ-lactam antimicrobial agents.Methods 113 clinically isolated bacteria were performed antimicrobial susceptibility testing by Kirby-Bauer method ,drug-resistant genes IMP and VIM were detected by polymerase chain reaction (PCR),PCR products were sequenced and aligned with BLAST software. Results VIM gene was detected in 1 Pseudomonas fluorescens strain ,IMP gene was detected in 15 strains ,they were Klebsiella pneumoniae (n=6),Acinetobacter baumannii (n=3),Escherichia coli (n=2),Ralstonia picket-tii (n=1),Pseudomonas aeruginosa (n=1 ),Citrobacter amalonaticua (n=1 ),and Enterobacter cloacae (n=1 ). BLAST results showed that VIM gene was VIM-2 subtype,similarity with gene bank was 99%;all IMP genes were IMP-1 subtype,which were highly homologous ,similarity was 98%-99%.Resistant rates of IMP positive strains to ceftriaxone,cefotaxime,cefoxitin,aztreonam and imipenem were all significantly higher than negative strains (all P <0.05).Conclusion IMP genes of different strains are highly homologous,all are IMP-1 type,indi-cating that IMP genes are highly transmissible and can spread among different species of bacteria.IMP genes are related with resistance ofβ-lactam antimicrobial agents.%目的:了解临床分离革兰阴性菌产 IMP 及VIM 金属β-内酰胺酶(MβLs)基因的检出情况,以及对β-内酰胺类抗生素的耐药状况。方法采用 K-B 法对临床分离的113株细菌进行药物敏感试验,采用聚合酶链反应(PCR)检测耐药基因 IMP 和 VIM ,测序并进行 BLAST 比对分析。结果1株荧光假单胞菌检出 VIM 基因;15株菌中检出 IMP 基因,其中肺炎克雷伯菌6株,鲍曼不动杆菌 3株,大肠埃希菌2株,罗尔斯顿菌、铜绿假单胞菌、无丙二酸柠檬酸杆菌、阴沟肠杆菌各1株。BLAST 结果显示,VIM

  15. 2011~2012年广州地区儿童腹泻病原菌分布及耐药性分析%Composition and drug resistance of pathogenic bacteria causing infantile diarrhea in Guangzhou from 2011 to 2012

    Institute of Scientific and Technical Information of China (English)

    黄莲芬; 刘海英; 谢永强; 钟华敏; 周珍文

    2015-01-01

    Objective To explore the main pathogenic bacteria and antibiotic resistance patterns in children with bacterial diar‐rhea from Guangzhou region .Methods Regular bacterial culture of stool samples from children with suspicious bacterial diarrhea was performed to isolate the pathogen during 2011 to 2012 ,followed by the analysis of its composition and serum type ,ward distri‐bution characteristics and drug resistance to 12 antimicrobacterial drugs .Results 416 strains of pathogenic bacteria were isolated from diarrhea children during 2011-2012 ,in which salmonella ,enteropathogenic E .coli ,Campylobacter jejuni and Candida albicans isolates accounted for 53 .61% ,37 .98% ,5 .29% and 1 .68% respectively .Drug resistance rate of the main strains to 12 antimicrobi‐al agents was 85 .25% to ampicillin ,54 .28% to compound sulfamethoxazole ,44 .70% to cefotaxime ,42 .53% to ceftriaxone , 40 .66% to chloramphenicol ,23 .55% to ceftazidime ,23 .36% to aztreonam ,14 .88% to ciprofloxacin ,8 .07% to cefepime ,7 .99% to cefperazone/sulbactam ,7 .42% to piperacillin/tazobactam respectively ,and no resistance to imipenem was detected .Conclusion The pathogenic bacteria causing diarrhea mainly includes salmonella ,pathogenic e .coli ,campylobacter jejuni in children from guang‐zhou region ,the top five sensitive antimicrobial reagents for the main strains includes imipenem ,piperacillin/tazobactam ,cefpera‐zone/sulbactam ,cefepime and ciprofloxacin .%目的:了解广州地区儿童细菌性腹泻主要病原菌分布及其耐药性。方法对2011~2012年疑似细菌性腹泻患儿大便标本进行细菌培养,分析病原菌分布特征及耐药性。结果2011~2012年共检出儿童腹泻病原菌416株,其中沙门菌属、致病性大肠埃希菌、空肠弯曲菌、白色念珠菌分别占53.61%、37.98%、5.29%、1.68%。主要病原菌对抗菌药物的耐药率分别为氨苄西林85.25%、复方磺胺甲噁唑54.28

  16. Analysis of pathogenic bacterium and antimicrobial susceptibility about child bacterial diarrhea in our hospital from 2010 to 2012%2010-2012年我院儿童细菌性腹泻病原菌及药敏分析

    Institute of Scientific and Technical Information of China (English)

    胡云海; 范忠祥; 杜成雪

    2013-01-01

    Objective To investigate the etiology, epidemiologic features, and antibiotic resistance of isolated pathogens from children with bacterial diarrhea, so as to provide important evidence for paediatrics clinical therapy. Methods The fecal samples of 246 children with infectious diarrhea between January 2010 and January 2012 were colected and cultured. The antimicrobial susceptibilties were tested by the micro-broth dilution method. Results A total of 39 isolates of pathogenic bacterium (15.9%) were obtained, including Citrobacter freundi (n=15), Salmonela typhimurium (n=10), Shigela (n=6), Escherichia coli (n=4), Klebsiela pneumoniae (n=2), and Proteus vulgaris (n=2). The detection rate of pathogenic bacteria presented highest in children under 3 years (89.7%). Ampicilin、amoxicilin/clavulanate potassium、sulfamethoxazole compound、cefamezin、gentamycin、ofloxacin、tobramycin in al showed great drug resistant rate, even 100%. Less than 20% of isolates were resistant to the third generation cephalosporins and aztreonam. There was no resistance to cefepime and tienam. Conclusion Opportunistic bacteria and Salmonela typhimurium were the major pathogen among children with bacterial diarrhea in our hospital, and concentrated on infants. The antimicrobial resistance of common pathogenic bacterial was serious, which should be noted.%  目的分析儿童细菌性腹泻病原菌、流行病学特征及其耐药性,指导临床合理用药。方法对我院2010年1月至2012年1月感染性腹泻患儿的新鲜标本进行细菌分离培养,采用微量肉汤稀释法进行药敏试验。结果从246份标本中检出39株病原菌,检出率为15.9%。其中氟劳地枸橼酸杆菌15株,鼠伤寒沙门氏菌10株,志贺菌属6株,大肠埃希氏菌4株,肺炎克雷伯杆菌2株,普通变形杆菌2株。病原菌的检出率以3岁以下婴幼儿最高,占89.7%。氨苄西林、阿莫西林/克拉维酸钾、复方新诺明、头孢唑啉、庆大

  17. Antibiotic Use and Pharmaceutical Care for a Patient with Chronic Nephritis Complicating with Urinary Tract Infection%1例慢性肾炎并发尿路感染患者的抗菌药物用药分析与药学监护

    Institute of Scientific and Technical Information of China (English)

    彭玲娜

    2014-01-01

    目的:为慢性肾炎并发尿路感染患者的抗菌药物合理应用提供参考。方法:分析1例慢性肾炎并发尿路感染患者的抗菌药物选择、用法用量、更换及降阶治疗情况,从患者肾功能状况、尿路感染的常见致病菌及耐药情况分析抗菌药物应用是否合理,并优化用药方案。结果:患者以氨曲南经验性治疗尿路感染存在一定的理论基础,但用药浓度偏大;后更换为抗菌药物哌拉西林/他唑巴坦,药师建议进一步优化,选择头孢哌酮/舒巴坦更佳;降阶治疗的时机把握欠合理。结论:肾功能低下的患者感染时要尽量选择肾毒性小的抗菌药物,药物剂量过大或浓度偏高可能会引发不良反应;经验性用药要结合感染类型和常见致病菌的耐药情况,尽量选择广谱抗菌药物;降阶治疗需及时,且要结合致病菌种类和药敏结果尽量选择相对窄谱、针对性强的抗菌药物。%OBJECTIVE:To provide references for rational use of antibiotics in patient with chronic nephritis complicating with urinary tract infection. METHODS:The rationality in drug selection,usage,dosage,replacement and reduced-order treatment in the antibiotic use in one patient with chronic nephritis complicating with urinary tract infection was analyzed based on patient’s re-nal function,the common pathogens causing urinary tract infection and drug resistance;meanwhile,the medication regimen was optimized. RESULTS:There is a certain theoretical basis for the empiric regimen of aztreonam for treatment of urinary tract infec-tion,but the drug concentration was too high,which was then replaced by piperacillin/tazobactam;however,pharmacists recom-mended further optimization using cefoperazone/sulbactam instead. The timing of reduced-order treatment was less than rational. CONCLUSIONS:It is advisable to choose antibiotics with mild renal toxicity for patients with renal dysfunction in that the over

  18. 新德里1型金属β内酰胺酶肺炎克雷伯菌的分子流行病学特征及耐药机制%Resistance mechanism and molecular epidemiology of the New Delhi metallo-β-lactamase-1 possessing Klebsiella pneumoniae

    Institute of Scientific and Technical Information of China (English)

    魏丹丹; 刘洋; 邓琼; 万腊根; 余阳; 徐群飞; 曹先伟

    2014-01-01

    pneumoniae ( K. pneumoniae ) . Methods Retrospective study was made on one hundred and ten non-repetitive carbepenem-resistant K. pneumoniae clinical isolated strains, which were collected from January 2011 to December 2012 in our hospital. The minimal inhibitory concentrations ( MICs ) of antibiotics were tested by the GN13 cards of BioMerieux Company. Modified Hodge test were used for the detection of carbapenemases. The blaNDM-1 encoding gene and linkage of ISAba125-NDM were detected by PCR method. The purified PCR products were cloned and sequenced. The homology of the K. pneumoniae were analyzed by the multilocus sequence typing ( MLST ) . Plasmid conjugation experiment and curing method were used to study the transfer of bacterial resistance. The Fisher′s exact probability test was used to compare the data. Results 13% NDM-1-producing K. pneumoniae were detected and confirmed as blaNDM-1 by sequencing (14/110). The resistance rates of the 14 NDM-1-producing K. pneumoniae strains to imipenem, meropenem, ertapenem, ciprofloxacin, levofloxacin, amikacin, and aztreonam were 14/14, 14/14, 13/14, 10/14, 9/14, 5/14, and 11/14. Meanwhile, the positive rate of ISAba125-NDM linkage of those 14 NDM-1-producing K. pneumoniae strains was 14/14. The E. coli J53 transconjugants, whose MICs of imipenem, meropenem, and ertapenem were increased by 4 to 64 times, were blaNDM-1 gene and ISAba125-NDM linkage positive. In addition, it was showed that the blaNDM-1 gene and ISAba125-NDM linkage were located on a plasmid with a size of approximately 65 000 bp. Conclusions The NDM-1 producing K. pneumoniae strains in this study were resistant to many commonly used antibiotics, however, the resistance rate to aminoglycoside and aztreonam were relatively low. The carbapenemase-resistant genotype spread by blaNDM-1 carried plasmid. Attention should be paid to its easily transmissible feature among the strains in clinic. The insertion sequence ISAba125 may be involved in the blaNDM-1 gene

  19. Studies on the clinical characteristics of intestinal infection caused by Aeromonas and drug susceptibility of the strains%气单胞菌肠道感染的临床特点和耐药特征分析

    Institute of Scientific and Technical Information of China (English)

    刘志远; 马玉芝; 潘健; 张婷菊; 齐杰; 刘贵建

    2014-01-01

    Objective To analyze the clinical characteristics of intestinal infection caused by Aeromonas and their drug suscepti-bility .Methods The data of 52 patients infected with Aeromonas were analyzed retrospectively .Aeromonas strains were identified with Vitek Ⅱ Compact .Drug susceptibility was determined by disk diffusion methods .Cefoxitin combined with ceftazidime ,aztreo-nam ,cefotaxime and ceftriaxone were used to detect inducible expression of AmpC β-lactamase .Results Abdominal pain ,watery di-arrhea ,tenesmus occurred in 75 .0% ,48 .1% ,and 38 .0% of the patients ,respectively .White blood cell tests were positive in 50 .0%patients′stools .52 strains of Aeromonas were isolated ,including 38 strains of Aeromonas hydrophila ,13 strains of Aeromonas so-bria ,and 1 strain of Aeromonas veronii .All strains were sensitive to carbapenems ,the second ,third generation of cephalosporins , monobactam ,fluoroquinolone ,aminoglycosides .The susceptibility rates to chloramphenicol ,trimethoprim-sulfamethoxazole ,cefox-itin ,cefazolin ,and amoxicillin/clavulanic acid were 94 .2% ,92 .3% ,76 .9% ,51 .9% and 23 .1% ,respectively .75 .0% isolates exhibi-ted inducible expression of AmpC β-lactamas .Conclusion Diarrhea caused by A eromonas has different clinical manifestations .Ceph-alosporins ,monobactam ,fluoroquinolone ,aminoglycosides are available for empirical therapy of diarrhea caused by A eromonas .But the third generation of cephalosporins should be cautiously used because of high prevalence of inducible AmpC β-lactamase in A ero-monas .%目的:了解气单胞菌所致腹泻的临床特点及气单胞菌的耐药情况。方法回顾性分析52例气单胞菌感染性腹泻患者的临床特点,采用Vitek Ⅱ Compact微生物分析仪鉴定气单胞菌,药敏试验采用纸片琼脂扩散法,头孢西丁纸片联合头孢他啶、头孢噻肟、头孢曲松和氨曲南纸片检测诱导型AmpC酶。结果75.0%气单胞菌感

  20. Detection and classification for extended-spectru m and Ⅰtype β-lactamases by varied antibiotics%联合应用抗生素测定并鉴别超广谱和Ⅰ型β-内酰胺酶

    Institute of Scientific and Technical Information of China (English)

    李向阳; 杨锦红; 叶映月; 陈圣高

    2001-01-01

    Objective:Detection for extended-spectrum β-lactamases(ESBLs) and Ⅰtype β-lactam ase s from Eschrichia coli Klebsiella pneumoniae Enterobacter cloacae using varie d antibiotics.Methods:ESBLs and Ⅰtype β-lactamases from E.coli,K.pneumonia e and E.cloacae was detected by double-disk(DD) potentiation procedure and rule v itro-sensitive test.Cefotaxime(CTX), ceftazidime(CTD),aztreonam(ATN),augmentin( AOA),cefoxitin(CXT) and imipenem were used in this test.Results:Imipenem is sensitive for all strain at this test.23.4% Eschrichia coli 36.8% Klebsiella pneumoniae,and 58.2% Enterobacter cloacae res isted 3rd cephalosporins, the resistance for cefoxitin is different. The β -lac tamases of hydrolyses extended-spectrum β-lactams is divided into two types.Th e rate of detection was higher by using CTX and CTD and ATN than using CTD or CT X or ATN only(χ2=5.14,P0.05).Conclusion:The ESBLs and Ⅰtype β-lactamases could be differe nt by using varied antibiotics,they have different resistance to antibiotics . U sing more than two β-lactams antibiotis, the positive rate of ESBLs isolate i s r aised The double-disk(DD) method is practical for clinical detection of ESBLs- produ cing isolates of Enterobateriaceae. The detection of ESBLs and Ⅰtype β-lactam ases should be conducted for clinical isolate%目的:联合应用抗生素测定并鉴别大肠埃希菌 、肺炎克雷伯菌、阴沟肠杆菌产生的超广谱和Ⅰ型β-内酰胺酶。方法:用头孢噻肟(CTX)、头孢他定(CTD)、氨曲南(ATN)、奥格门丁( AOA)、头孢西丁(CXT)和亚胺培能在MH琼脂上进行双纸片搭桥法检测和鉴别大肠埃希菌、 肺炎克雷伯菌、阴沟肠杆菌的超广谱β-内酰胺酶(ESBLs)及Ⅰ型β-内酰胺酶。结果:265株大肠埃希菌、95株肺炎克雷伯菌、67株阴沟肠杆菌均对亚胺培能 敏感;对三代头孢菌素的耐药率分别为23.4%、36.8%、58.2%,产生的能水解超广谱β-内酰

  1. Analysis on clinical distribution and antibacterial resistance of Acinetobacter Baumannii from 2010 to 2014%2010~2014年鲍曼不动杆菌临床分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    刘一力; 石毅

    2015-01-01

    Objective To investigate the clinical distribution characteristics and trend in antibacterial resistance of Acinetobacter baumannii in Pudong Hospital Affiliated to Fudan University,so as to provide the guidance for clinical rational use of antibacterial agents and infection control.Methods SPSS 1 9.0 statistical software was adopted to retrospectively analyze the specimen source, department distribution and antibacterial resistance change of the 1 678 strains of Acinetobacter baumannii in this hospital from Jan-uary 2010 to October 2014.Results Clinical isolates of Acinetobacter baumannii mainly came from respiratory tract specimens(ac-counted for 79.1%).The intensive care unit(21.1%),department of neurosurgery(1 7.7%)and department of cardiology(1 7.6%) were the top three departments from which the strains were isolated.The isolates of Acinetobacter baumannii were highly resistant to the first and second generation of cephalosporins,cephamycin,ampicillin and nitrofurantoin,and the resistance rates reached a-bove 90%.The resistance rates of these isolates against carbapenems,aztreonam,cefperazone-sulbactam and ampicillin-salbactam showed obviously uptrends,but the resistance rates of these isolates against amikacin and cotrimoxazole showed downtrends.And the resistance rates of these isolates against other antibacterial agents stayed between 30% and 50%.During the five years,the de-tection rates of multi-drug resistant strains steadied around 35.0%.Though the detection rates of pan-drug resistant strains de-clined year by year,the strains were isolated each year.Conclusion The antibacterial resistance of Acinetobacter baumannii is seri-ous in this hospital,with multi-drug and pan-drug resistance persisting.It is necessary to enhance monitoring antibacterial resist-ance,ensure rational use of antibacterial agents,and promote implementation of disinfection and isolation,so as to prevent the spread and popularity of Acinetobacter baumannii resistance in hospital.%

  2. Perfil de sensibilidade a antimicrobianos de bactérias isoladas do trato respiratório baixo de pacientes com pneumonia internados em hospitais brasileiros: resultados do Programa SENTRY, 1997 e 1998 Antimicrobial susceptibility of bacteria isolated from the lower respiratory tract of inpatients with pneumonia in Brazilian hospitals: results from the SENTRY surveillance program, 1997 and 1998

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    HÉLIO S. SADER

    2001-03-01

    mortality rates ranging from 30 to 60% and a rapid initiation of optimal antimicrobial therapy is important to obtain treatment success. SENTRY is a comprehensive antimicrobial surveillance study involving a great number of medical centers distributed worldwide. Objective: To evaluate the antimicrobial susceptibility of bacterial isolates collected from the lower respiratory tract of inpatients with pneumonia. Material & methods: The authors report the antimicrobial susceptibility of 525 isolates collected in 11 Brazilian hospitals, as part of the SENTRY program. The isolates were tested for susceptibility by broth micro-dilution against a large number of drugs. Results: The five most frequently isolated species were (n/%: Pseudomonas aeruginosa (158/30.1%, Staphylococcus aureus (103/19.6%, Acinetobacter spp. (68/13.0%, Klebsiella spp. (50/9.5%, and Enterobacter spp. (44/8.4%. These five species represented more than 80% of all isolates. P. aeruginosa demonstrated high rates of resistance to most antimicrobial agents tested. The highest susceptibility rates were shown by piperacillin/tazobactam (71.5% and meropenem (69.0%. Acinetobacter spp. also showed very high rates of resistance. The most active compounds against this species were imipenem and meropenem (80.9% susceptibility followed by tetracycline (63.2% susceptibility. Cephalosporin susceptibilities among Klebsiella spp were very low and 36.0% of isolates were considered ESBL producers based on increased MICs, > 2 mug/mL to ceftriaxone or ceftazidime or aztreonam. Ceftriaxone was active against only 56.8% of Enterobacter spp. isolates (MIC50 1 mug/mL, while cefepime was active against 88.6% of these isolates (MIC, < 0.12 mg/mL. Oxacillin-resistance was detected in 43.7% of S. aureus isolates. The most active drugs against this species were vancomycin, teicoplanin, quinupristin/dalfopristin, and linezolid. Conclusion: The results of this study demonstrated a higher prevalence of Acinetobacter spp. and higher

  3. 尿路分离大肠埃希菌耐药性及喹诺酮类药物耐药株危险因素病例对照研究%The drug resistance of Escherichia coli isolated from urinary tract infection and risk factors of quinolone resistance strains

    Institute of Scientific and Technical Information of China (English)

    张昭勇; 张吉才; 杜毅

    2013-01-01

    Objective To analyze the drug resistance of Escherichia coli isolated from urinary tract infection and risk factors of quinolone resistance strains.Methods A total of 705 cases (strains) with Escherichia coli drug resistance isolated from urine specimens were divided into quinolone sensitive group [474 cases(strains)] and quinolone resistance group [231 cases(strains)].The risk factors of the quinolone resistance strains were analyzed.Results The sensitivity rate of amoxicillin/clavulanic acid,cefalotin,ceftazidime,aztreonam,piperacillin,amikacin,compound sulfamethoxazole,ciprofloxacin,gentamicin,levofloxacin,cefepime in quinolone resistance group was higher than that in quinolone sensitive group [50.2%(238/474) vs.78.8%(182/231),11.6%(55/474) vs.48.5%(112/231),17.9%(85/474) vs.63.2%(146/231),15.0%(71/474) vs.57.6%(133/231),3.2%(15/474) vs.27.7%(64/231),80.8%(383/474)vs.93.1%(215/231),16.0%(76/474) vs.49.8%(115/231),0 vs.100.0%(231/231),32.5% (154/474)vs.70.6% (163/231),3.8% (18/474) vs.98.7% (228/231),18.6% (88/474) vs.63.2% (146/231),P <0.05].Logistic regression analysis showed history of using the third generation cephalosporins and quinolones,urinary drainage and bacterium producing extra-broad spectrum beta-lactamase was independent risk factor for quinolone resistance Escherichia coli (P < 0.05).Conclusions The epidemic of quinolone resistance Escherichia coli isolated from urine specimens is extremely serious.The quinolone resistance is strong,and infection patients have a high medical cost and average length of stay.The quinolone resistance Escherichia coli infection has multiple independent risk factors.To strengthen the control of the independent risk factors can effectively prevent quinolone resistance strains infection spread.%目的 分析尿路感染大肠埃希菌耐药性及喹诺酮类药物耐药株感染危险因素.方法 监测705例(株)尿路感染大肠埃希菌的耐

  4. 一株耐碳青霉烯类的阴沟肠杆菌的KPC酶检测%Detection of plasmid-mediated carbapenem-hydrolyzing β-lactamase KPC-2 in a strain of carbapenem-resistant Enterobacter cloacae

    Institute of Scientific and Technical Information of China (English)

    蔡加昌; 周宏伟; 陈功祥; 张嵘

    2008-01-01

    Objective To investigate the mechanism of carbapenem resistance in Enterobacter cloacae.Methods A carbapenem-resistant strain of E.cloacae (strain ZY1465)was isolated.Antibiotic susceptibilities were determined by agar dilution method.Conjugation experiments were carried out in mixed broth cultures.Plasmid DNA preparations were obtained by using an alkalinelysis technique and were digested by various endonucleases;The crude β-lactamase extracts of E.cloacae and E.coli transconjugant were subjected to analytical isoelectric focusing(IEF).Specific PCR amplification and DNA sequence analysis were preformed to confirm the β-lactamase type.Outer membrane proteins(OMPs)were isolated and examined by urea-sodium dodecyl sulfate-polyacrylamide gel electrophoresis.Results The E. cloacae isolate showed resistance against carbapenems.The MICs of imipenem and meropenem were both 32 μg/ml.The isolate was also resistant strongly against penicillins,cephalosporins,cefoxitin,aztreonam,quinolones,and aminoglycosides.Conjugation studies with E.coli resulted in the transfer of reduced carbapenem susceptibility from E.cloacae isolate.Plasmid restriction analysis showed identical restriction profiles between the transconjugants of E. cloacae ZY1465 and Serratia marcescens ZN008.Isoelectric focusing demonstrated six β-lactamases,with the isoelectrie points(pls)of5.4,6.7,7.3,7.8,7.9,and 8.6,in E.cloacae ZY1465.and only one β-lactamase with the pI of 6.7 in transconiugant.Specific PCR amplification and DNA sequence analysis confirmed that E.cloacae ZY1465 harbored TEM-1,KPC-2,DHA-1,CTX-M-14,CTX-M-3 and chromosomal AmpC(not detected in IEF)genes.Urea-SDS-PAGE analysis of OMPs showed that E. cloacae ZY1465 lacked an OMP of approximately 38 000 Da which was present in E. cloacae ATCC13047.Conclusion It is the first detection of plasmid-mediated carbapenemhydrolyzing β-lactamase KPC-2 in a clinical isolate of E.cloacae from China.Production of multiple β-lactamases,especially KPC-2 and

  5. 摩根摩根菌中质粒介导KPC-2型碳青霉烯酶的检测%Detection of plasmid-mediated carbapenem-hydrolyzing β-lactamase KPC-2 in Morganella morganii

    Institute of Scientific and Technical Information of China (English)

    杨玮; 蔡加昌; 胡燕燕; 周宏伟; 张嵘; 陈功祥

    2011-01-01

    Objective To investigate the molecular epidemiology and mechanisms of carbapenem resistance of Morganella morganii.Methods Seven carbapenem-non-susceptible M.morganii were isolated from Hangzhou Traditional Chinese Medicine Hospital from October 2010 to February 2011.Pulsed-field gel electrophoresis (PFGE) was performed to analysis the molecular epidemiology of isolates.Antibiotic susceptibilities were determined by agar dilution method.Conjugation experiments were carried out in mixed broth cultures.Plasmid DNA was obtained by an alkalinelysis technique and examined by electrophoresis.Specific PCRs and DNA sequencing were preformed to confirm the genotype of β-lactamases.Results PFGE indicated that 6 M.morganii isolates from emergency care unit were indistinguishable or closely related and 1 isolate from intensive care unit was distinguishable.Seven M.morganii showed similar antibiotic susceptibility patterns.M.morganii isolates were resistant to imipenem,were susceptible to meropenem,and were susceptible or intermediate resistant to ertapenem,with MICs of 8 μg/ml,1 μg/ml,and 0.25-0.50 μg/ml,respectively.M.morganii isolates were resistant to penicillins,aztreonam,and ciprofloxacin,were resistant or susceptible to cephalosporins,and were susceptible to amikacin.E.coli (EC600) acquired an approximately 60 kb plasmid from M.morganii by conjugation studies and resistant or intermediate resistant to carbapenems and other β-lactams.PCRs and DNA sequence analysis confirmed that all M.morganii isolates and their E. coli transconjugants produced the KPC-2 carbapenemase and carried the qnrS1 gene.Conclusion It is the first detection of KPC-2 in M.morganii isolates.Production of KPC-2 mainly contributed to the carbapenem resistance in M.morganii.%目的 研究碳青霉烯耐药摩根摩根菌的分子流行病学及其耐药机制.方法 2010年10月-2011年2月从杭州市中医院分离到7株碳青霉烯不敏感的摩根摩根菌.脉冲场凝胶电泳(PFGE)分析

  6. 革兰阴性杆菌10年耐药性变化分析%Resistance analysis of gram-negative bacilli in 10 years

    Institute of Scientific and Technical Information of China (English)

    黄长武; 丁小娟; 吴倩; 廖璞

    2013-01-01

    Objective To study the drug-resistance diversity of main Gram-negative bacilli isolated from inpatients from 2001. 1. 1 to 2009. 12. 31 and provide information for rational use of drugs. Methods The antimicrobial sensitivity test results of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter from 2001. 1. 1 to 2009. 12. 31 were analysed by WHONET 5. 4 software. Results The resistance rates of Escherichia coli and Klebsiella pneumoniae to Imipenem were less than 5%, to Amikacin, Pip-eracillin/Tazobactam and Cefepime less than 30%, to the third generation Cephalosporins, Cefoxitin and Aztreonam less than 40%, and to Penicillins, Quinolones and SMZ more than 50%. The resistance rates of Pseudomonas aeruginosa to Ceftazidime, Cefepime and Imipenem were less than 40%, while to the other monitored antibiotics more than 50%. The resistance rate of Acinetobacter to Imipenem was less than 25% (except in 2009), and to the other monitored antibiotics was 50% to 96%. The pan-resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii were 0 to 14% and 0 to 48% respectively. Conclusion Gram-negative bacilli are generally resistant to commonly used antimicrobial agents with an increasing trend; The resistance rates of Enterobacteriaceae to Carbapenem, Amikacin, Piperacillin/Tazobactam and Cefepime are relatively low. The resistance of nonfermenters has increased obviously, and the pan-resistance of Pseudomonas aeruginosa and Acinetobacter have significantly increased. Strict control on the use of antimicrobial drugs and the spread and breakout of resistant and pan-resistant strains becomes imminent.%目的 对重庆医科大学附属第二医院2001年1月1日至2009年12月31日10年临床标本中分离的主要革兰阴性杆菌耐药性变化进行分析,为临床合理用药提供依据.方法 采用回顾性方法对十年间大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和不动杆菌的药敏结果用WHONET 5.4

  7. Antimicrobial resistance surveillance of gram-negative bacteria from children in Chian, 2012%2012年全国儿童革兰阴性杆菌耐药状况

    Institute of Scientific and Technical Information of China (English)

    孟晋华; 朱镭; 李文玲; 李亮; 徐辉

    2015-01-01

    Objective To determine the bacterial distribution and drug resistance of the pathogens isolated from children in China so as to pro-vide a basis for guiding the clinical use of antibiotics, exploiting new drugs and controlling hospital infection.Methods The clinical isolates were collected from 557 tertiary hospitals and 232 second class hospitals, and antibiotic susceptibility test was carried out by means of K-B disk diffusion or automatic bacterial identifying system.The data was analyzed with WNONET 5.6 software by referring to CLSI 2012 breakpoints.Results A total of 117353 bacterial strains were isolated from children, which included 69710 (59.4%) strains of gram-negative bacteria.The top three of them were Escherichia coli ( 19204 strains, 27.5%) , Kleb-siella pneumonia (15051 strains, 21.6%) and non-fermenting bacteria (11254 strains, 16.1%).Escherichia coli were highly resistant to cepha-losporins and penicillin antibiotics, and remained at a high sensitivity to carbapenems antibiotics and amikacin.Quinolones antibiotics had a well sensitivity to Klebsiella pneumonia,the resistance rates of Klebsiella pneu-monia to imipenem, meropenem and amikacin were 7.4%, 3.1%and 3.6%.Amikacin and polymyxin B had favourable antimicrobial activity to non-fermenting bacteria.No strains of minocycline-resistant Pseudomonas aeruginosa and aztreonam – resistant Acinetobacter baumannii were detected.Conclusion The Escherichia coli, Klebsiella pneumonia and non -fermenting bacteria are still the predominant pathogens in children of China.Bacterial resistance situation is still serious, great attention should be paid to the carbapenem-resistant Enterbacteriaceae and multidrug -resistant non -fermenting bacteria, we must take more effective measures to control it.%目的:了解我国2012年医院临床从儿童患者分离的细菌构成及其对抗菌药的耐药性。方法收集来自全国557家三级医院和232家二级医院儿童患者分离的细菌,用纸片法

  8. 产ESBLs的大肠埃希菌和肺炎克雷伯菌的耐药性分析%Analysis of Antibitotic Resistance of ESBLs-product Escherichia Coli and Klebsiella Pneumoniae

    Institute of Scientific and Technical Information of China (English)

    钟皎; 胡锡池; 严子禾; 赵文艳

    2011-01-01

    OBJECTIVE To investigate the trend of antibiotic resistance of extend-spectrum β-lactamases(ESBLs)producing Escherichia coli and Klebsiella pneumoniae in our hospital, and to provide a guidance for clinical rational use of antibiotics. METHODS Escherichia coli and Klebsiella pneumoniae strains were collected, which were isolated from patients in clinical in 2008-2009. Bacterial susceptibility testing were detected by MIC methods and ESBLs-producing strains were detected by double-disc diffusion confirming test. RESULTS In 2008, 312 of 764 strains of Escherichia coli were considered ESBLs, the rate of ESBLs were 40.8%; 133 of 356 strains of Klebsiella pneumoniae were considered ESBLs, the rate of ESBLs were 37.4%. In 2009, 246 of 499 strains of Escherichia coli were considered ESBLs, the rate of ESBLs were 49.3%; 107 of 298 strains of Klebsiella pneumoniae were considered ESBLs, the rate of ESBLs were 35.9%. The resistance rate of ESBLsproducing strains were significantly higher than that of ESBLs non-producing strains(P<0.05). The resistance rate of ESBLs-producing strains to aztreonam and cephalosporin were higher in 2009 than in 2008(P<0.05). The resistance rate of ESBLs-producing strains to quinolones were lower in 2009 than in 2008(P<0.05). The resistance rate of ESBLs-producing strains of Klebsiella pneumoniae to imipenem was increased by 15.9% in 2009(P<0.05). CONCLUSION ESBLs producing Escherichia coli and Klebsiella pneumoniae have the multidrug-resistant phenomenon, surveillance should be intensified, so as to avoid the increasing, diffusive and popular of ESBLs-producing bacteria.%目的 探讨我院产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌和肺炎克雷伯菌的耐药性变化,为临床合理使用抗菌药物提供参考依据.方法 分析我院2008-2009年从临床送检的各类标本中分离得到的大肠埃希菌和肺炎克雷伯菌,采用MIC法进行药敏试验,双纸片确诊

  9. MICROORGANISMS ANTIBIOTIC SENSITIVITY DETERMINATION IN URINARY TRACT INFECTIONS

    Directory of Open Access Journals (Sweden)

    Shapovalova O.V.

    2016-06-01

    pneumoniae, Staphylococcus hominis, Candida spp. (5,4±3,0%. 2. The most effective antibacterial drug is meropenem. 78,7% of all isolates have sensitivity to it. The sensitivity to gatifloxacin have 73,7%; to tigecycline 71,1%; to amikacin – 67,3%, to moxifloxacin – 59,6% of cultures, to two agents (levofloxacin and pefloxacin – 55,8% of cultures respectively. 3. 100% of the family Micrococcaceae isolates were resistant to benzylpenicillin, 95,8% - to ampicillin, 87,5% - to amoxicillin and cefuroxime, 83,3% - to azithromycin, erythromycin and lincomycin. Members of the Streptococcaceae family were resistant to cefuroxime. 100% of the family Enterobacteriaceae isolates had no sensitivity to carbenicillin, 87,5% of isolates - to cefuroxim and gentamicin, 81,2% - to amoxicillin and ampicillin, 75,0% - to cefazolin, 50,0% - to ceftriaxonum and aztreonam. 4. Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus hominis Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter haemolyticus isolates were multi-drug resistant.

  10. Distribution and drug resistance of enteric pathogenic bacteria in Fengtai, Beijing,2010-2012%2010-2012年北京市丰台区感染性腹泻病原菌分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    封会茹; 曲梅; 耿荣; 秦萌; 余红; 尉秀霞; 赵伟; 邢洪光; 杨军勇

    2013-01-01

    coli. The time, population and serotype distributions of the pathogens were analyzed by statistical methods. The susceptibility of 140 strains of pathogens to antibiotics was tested by Kirby-Bauer method recommended by US Clinical and Laboratory Standards Institute. Results Totally 357 strains of pathogens were isolated from 1108 specimens (32. 22%). V. parahaemolyticus was predominant, accounting for 50. 98% , followed by Salmonella (18.49% ). The seasonality of the positive detection of pathogens was obvious, the detection rate was high during July-September. The differences in detection rate in different age groups were statistical significant ( P < 0. 05 ). The difference in positive rate of V. parahaemolyticus between males and females was statistical significant (P < 0. 01). The major serotype of V. parahaemolyticus was O3K6, the major serotype of Shigella was Shigella Sonnei and the major serotype of Salmonella were Salmonella Enteritidis and Salmonella senftenberg. The sensitivity of different pathogens to antibiotics varied. Most isolated strains were highly sensitive to cefoxitin, amoxicillin-clavulanic acid and aztreonam. Conclusion V. parahaemolyticus and Salmonella were the main pathogenic bacteria causing infectious diarrhea in Fengtai. The pathogen spectrum had changed. Different pathogenic bacterium had different resistance to antibiotics. The active surveillance of these pathogenic bacteria should be strengthened.

  11. Drug resistance mechanisms of imipenem-resistant K lebsiella p neumoniae%耐亚胺培南肺炎克雷伯菌的耐药机制研究

    Institute of Scientific and Technical Information of China (English)

    豆清娅; 邹明祥; 李春辉; 李军; 胡咏梅; 王海晨; 吴安华

    2016-01-01

    ,VIM ,NDM‐1 ,and OXA‐48 of β‐lactamase genes .The homology of the 25 strains was analyzed by mean of enterobacterial repetitive intergenic consensus‐PCR (ERIC‐PCR) .RESULTS Among the 18 antibiotics tested ,the drug resistance rates to piperacillin‐tazobactam ,ampicillin/sulbactam ,cefazolin ,ceftriaxone ,ampicillin ,ertapen‐em ,imipenem ,and aztreonam were 100 .0% ;the drug resistance rate to sulfamethoxazole‐trimethoprim was the lowest (32 .0% ) ,followed by amikacin and tobvamyin toth (68 .0% ) .The modified Hodge test showed that 20 strains(80 .0% ) were positive ;totally 25 strains were tested positive for SHV gene ,20 strains were tested posi‐tive for CTX‐M gene ,15 strains were tested positive for KPC‐2 gene ,1 strain was tested positive for IMP‐4 gene , 3 strains were tested positive for NDM‐1 gene ,and VIM and OXA‐48 genes were tested negative .The 25 strains were classified into 6 genotypes ,namely as the followsing :A (15 strains) ,B (5 strains) ,C (2 strains) ,D (1 strain) ,E(1 strain) ,and F (1 strain) .CONCLUSION The imipenem‐resistant K .pneumoniae strains are highly multidrug‐resistant ;the production of theβ‐lactamase is the leading mechanism for the resistance to multiple anti‐biotics ,and there is a clonal spread in the area ,and 3 strains carrying NDM‐1 gene ,to which great attention should be paid .

  12. 老年患者医院感染产超广谱β-内酰胺酶大肠埃希菌的检测与耐药性研究%The detection and antibiotic resistance of extend-spectrumβ-lactamases producing Escherichia coli in old patients with hospital infections

    Institute of Scientific and Technical Information of China (English)

    牛文娟; 荆菁华; 朱建奎

    2015-01-01

    OBJECTIVE To find out the detection and antibiotic resistance of extend‐spectrum β‐lactamases (ES‐BLs)‐producing Escherichia coli infected by old patients ,so as to provide basis for rational drug use .METHODS From Jul .2011 to Dec .2013 ,a total of 423 strains of E .coli were isolated and were detected by AST‐GN13 sus‐ceptibility cards .RESULTS The detection rate of ESBLs‐producing E .coli was 56 .3% .ESBLs‐producing E .coli were mainly isolated from urine ,accounting for 33 .2% ,followed by sputum ,accounting for 20 .6% ,blood ,ac‐counting for 13 .4% ,fluid drainage ,accounting for 8 .8% ,bile ,accounting for 7 .6% ,pleural effusion ,account‐ing for 6 .3% ,and secretions ,accounting for 4 .6% . E .coli were mainly isolated from ICU ,accounting for 25 .6% ,followed by emergency department ,accounting for 16 .4% ,oncology ,accounting for 13 .4% ,general surgery ,accounting for 11 .3% ,respiratory medicine ,accounting for 9 .2% ,neurosurgery ,accounting for 7 .6% , gastroenterology accounted for 3 .8% and neurology ,accounted for 2 .9% .The resistance rates of ESBLs‐produ‐cing E .coli to piperacillin ,cefazolin ,cefamandole ,cefoxitin ,ceftriaxone ,ceftazidime ,cefotaxime ,cefoperazone , aztreonam ,ciprofloxacin and ofloxacin were significantly higher than those non‐ESBLs‐producing E .coli(P0 .05) .ESBLs‐produ‐cing E .coli showed high resistance to piperacillin ,cefazolin ,cefamandole ,ceftriaxone ,cefotaxime ,cefoperazone , and the resistance rates were all above 80 .0% ,while sensitive to cefoxitin ,ceftazidime ,amikacin and imipenem , and the resistance rates were below 20% .CONCLUSION ESBLs‐producing E .coli are mainly isolated from urine and ICU and have serious drug resistance to antibiotics .Hence clinics should take effective measures based on riskfactors to use drug rationally so as to control emergence and dissemination of resistant strains .%目的:了解老年患者医院感染产超广谱β‐内酰胺酶(ESBLs)

  13. 深圳市儿童医院儿童粪便分离的459株沙门菌分布特征及耐药性%Distribution characteristics and antimicrobial resistance of 459 strains of Salmonella isolated from feces of children in Shenzhen Children’s Hospi-tal

    Institute of Scientific and Technical Information of China (English)

    王红梅; 王和平; 雷旻; 周高枫; 张交生; 彭宝玲; 张锐沐; 邓继岿

    2016-01-01

    Objective To understand the distribution characteristics and antimicrobial resistance of Salmonella isolated from feces of children.Methods Salmonella were isolated from fecal specimens of children in a hospital be-tween January 2012 and October 2015,serotypes and susceptibility of Salmonella to commonly used antimicrobial agents were analyzed.Results A total of 7 047 children’s fecal specimens were detected,459 (6.51%)children were isolated Salmonella,the ratio of male to female was 2.4 ∶1,352 (76.69%)children were less than 3 years old;374 strains (81.48%)were isolated from May to October,the numbers of stains isolated in July,August,and September were 72,84,and 78 respectively.Salmonella group B and group D were the most common serotypes,accounting for 69.06%and 19.39% respectively,most were serotypes of Salmonella typhimurium (S.typhimurium)and Salmonella enteritidis (S.enteritidis).No imipenem-or ertapenem-resistant strains were found,susceptibility of Salmonella to piperacillin/tazobactam,cefepime,ceftazidime,aztreonam,and ceftriaxone were all >70%,susceptibility rate of S.enteritidis to cephalosporins was lower than S.typhimurium,but to compound sulfamethoxazole was higher than S.typhimurium. Conclusion Salmonella are mainly isolated from children less than 3 years old in this hospital,summer and autumn are peak seasons,the main serotypes were S.typhimurium and S.enteritidis,antimicrobial therapy should be carefully select-ed in combination with serotypes and antimicrobial susceptibility testing result.%目的:了解儿童粪便分离沙门菌的分布特征及耐药情况。方法分析2012年1月—2015年10月某院患儿粪便标本分离的沙门菌检出情况,以及沙门菌血清型和对常用抗菌药物的敏感性。结果7047例患儿送检粪便标本,459例患儿检出沙门菌,总检出率为6.51%。沙门菌肠炎患儿男女比为2.4:1,其中3岁以下儿童352例(占76.69%);459株沙门菌中5—10

  14. Clinical characteristics of multidrug-resistant bacteria infections in neonates of plateau region and control measures%高原地区新生儿多药耐药菌感染的临床特点及控制研究

    Institute of Scientific and Technical Information of China (English)

    王曦; 罗丽玲; 李晓莉

    2015-01-01

    48 hours of admission ,of which 64 .15% were the gram‐negative bacteria and 35 .85% were the gram‐positive bacteria .Totally 26 strains of pathogens have been cultured at more than 48 hours of admission ,of which 65 .38% were the gram‐negative bacteria and 34 .62% were the gram‐positive bacteria .The drug resistance rate of the gram‐negative bacteria to imipenem was 0 ,and the drug re‐sistance rate to aztreonam ranged from 10 .00% to 26 .32% ;the drug resistance rates of the gram‐positive bacteria to teicoplanin and vancomycin were 0 .CONCLUSION The Escherichia coli is the predominant species of gram‐neg‐ative bacteria causing the multidrug‐resistant bacteria infections in the neonates of plateau region .It is an effective way to take the disinfection and isolation measures in early stage so as to reduce the incidence of nosocomial infections .

  15. Characteristics of Distribution of 215 Acinetobacter Pneumonia and Drug Susceptibility Analysis in Respiratory Ward%215株致肺炎不动杆菌的分布特点与药敏分析

    Institute of Scientific and Technical Information of China (English)

    周煦; 李文朴; 李榜龙

    2009-01-01

    [Objective] To investigate the distribution of Acinetobacter pneumonia,drug susceptibility and its relationship with diseases of pneumonia. [Methods] All the Acinetobacter isolated from sputum from January 2000 to December 2007 were analyzed retrospectively. [Results] All 215 Acinetobacter isolates were collected, which contained 132 baumanii(61.4%), accounting to 14.3% of the total of sputum culture positive and 16.4% of negative bacilli. The number of Acinetobacter isolated from patients with lung underlying diseases was 177(82.3%). The result of drug susceptibility suggested that sensitive antibacterials were Cefoperazone/ sulbactam ,Meropenem,Cefepime and Levofloxacin, and resistant antibacterials were Aztreonam, Mezlocillin and Amphemycin. The drug susceptibility between 132 baumanii and 83 other Acinetobacter had significant difference(P<0.05). The results of Acinetobacter strain sensitivity whether or not isolated from the patients using respirator had significant differences(P<0.05). [Conclusion] Acinetobacter is the fundamental composition of lower respiratory tract bacterial infection,and Acinetobacter baumanii is the main. The drug susceptibility is obviously different between baumanii and other Acinetobacter. Acinetobacter is resistant to antibiotics widely and also related to respirator and lung underlying diseases. The characteristics of Acinetobacter infection is prone to patients with lung underlying diseases and is not only the main pathogenic bacteria of hospital infection,but also can cause the patients with lung underlying diseases to suffer from the community acquired pneumonia.%[目的]了解本院住院患者肺炎不动杆菌的分布、与疾病的关系及药物敏感情况.[方法]对本院2000年1月至2007年12月本院肺炎住院患者痰或支气管分泌物标本不动杆菌培养阳性结果结合病历进行回顾性统计分析.[结果]共分离出不动杆菌215株,占总分离菌株的14.3%(215/1503),革兰阴性杆菌的16

  16. 安徽省104株黏质沙雷菌的分布及耐药性监测%Distribution and resistance surveillance of 104 clinical strains of Serratia marcescens in Anhui Province

    Institute of Scientific and Technical Information of China (English)

    程君; 杨海飞; 朱玉林; 胡立芬; 潘亚超; 刘艳艳; 叶英; 李家斌

    2012-01-01

    Objective To analyze the clinical distribution and antimicrobial resistance profile of Serratia marcescens (S. marcescens), and to provide the scientific evidence supporting clinical diagnosis and treatment.Methods The antimicrobial susceptibility test was performed in 104 strains of S. marcescens by agar dilution method. The results were judged according to the criteria recommended by Clinical and Laboratory Standards Institute (CLSI) 2010.The data were analyzed by chi square test. Results The majority of S. marcescens were isolated from sputum specimens,accounting for 59.6% (62/104). The bacteria were most frequently isolated from department of respiratory (33.7%,35/104),followed by intensive care unit (23.1%,24/104),department of gerontology (16.3%, 17/104). The results of antimicrobial susceptibility test showed that the resistance rates of S.marcescens against ampicillin,gentamicin and cephazolin were high,which were 90.4%,86.5% and 79.8%,respectively; those against the 3rd generation of cephalosporins were 24.0%-43.3%. No imipenem and meropenem resistant strains were identified. Compared with cefoxitin-resistant strains,the resistance rates of non-cefoxitin resistant strains against piperacillin (82.9% vs 28.6%),ceftazidime (63.4% vs 9.5%),aztreonam (68.3% vs 9.5%),amikacin (68.3% vs 20.6%),ciprofloxacin (48.8% vs 19.1%) and chloramphenicol (90.3% vs 58.7%) were all lower (all P < 0.05 ). Conclusions S. marcescens is one of the most common conditional pathogenic bacteria leading to nosocomial infections,which is resistant to many kinds of antimicrobial agents.The surveillance of antimicrobial resistance in S. marcescens should be strengthened for purpose of preventing the transmission of multidrug resistant strains.%目的 探讨黏质沙雷菌感染的临床分布及耐药特点,为临床诊断和治疗提供依据.方法 104株黏质沙雷菌药物敏感试验采用琼脂稀释法,结果依据临

  17. Drug resistance and detection of DHA-1 gene of Ochrobactrum anthropi from infected children%儿童感染人苍白杆菌的耐药性及DHA-1基因检出

    Institute of Scientific and Technical Information of China (English)

    李先斌; 刘健龙; 宋春荣; 郭宽鹏; 尤灿; 李胜涛

    2013-01-01

    isolates were amplified AcrA, Ram A, OprD, TEM and SHV gene. According to the resistance to piperacillin/tazobactam, 155 isolates were divided into drug-resistance group (126 isolates) and non-drug-resistance group (29 isolates), drug-resistance group were all resistant to ampicillin, first-third generation cephalosporins, aztreonam, but resistant rates to levofloxacin, imipenem, meropenem, ciprofloxacm, amikacin and gentamycin were low (0. 00% - 1. 59%). Conclusion Production of AmpC/R is the mechanism of multidrug resistance of O. anthropi, critically ill patients can choose imipenem. The detection of drug resistance of O. anthropi should be reinforced to prevent the prevalence of DHA gene among gram-negative bacteria.

  18. Study on isolated strains from the ascites specimens and the drug resistance%腹水分离菌株及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    吕东霞; 田霞; 鞠莹; 唐伯莹; 魏妮

    2009-01-01

    main bacteria was Staphylococcus epidermidis (10.60%), then were Micrococcus luteus (6.62 % ). Fungus accounted for 8.61%, among the fungus, Mycelial fungus accounted for 7.95 %. E. coli had high resistance rate to ampicillin(78..26%), piperacillin(55.56%), ampicillin/sulbactam(46.67%)and gentamycin (39.62%), but the resistance rate to amikacin, tazocin, cefopcrazone/sulbactam was low. Staphylococcus epidermidis had high resistance rate to aztreonam (100%), but had totally suaceptive to ampicillin, piperacillin/tazobactam, cefopcrazone/sulbactam and cefazolin. Conclusions All kinds of bacteria and fungus are isolated from ascites specimens. E. coli is the main pathogenic bacteria in the ascites specimens, and susceptive to amikacin or tazocin or cefopcrazone/ DOI: 10.3760/cma. j. issn. 1673-4149.2009.02.004sulbactam. Staphylococcus epidermidis is totally susceptive to ampicillin, piperacillin/tazobactam, cefopcrazone/sulbactam and cefazolin.

  19. 耐碳青霉烯类鲍曼不动杆菌临床分布及耐药谱动态观察%Distribution characteristics and dynamic observation of antimicrobial re-sistant spectrum of carbapenem-resistant Acinetobacter baumannii

    Institute of Scientific and Technical Information of China (English)

    鲍群丽; 汪宏良; 柯俊

    2015-01-01

    %),followed by neurosurgery department (12.4% ). CRAB presented highly antimicrobial resistance.Except cefotaxime and cefatriaxone,resistant rates of CRAB to the other detected antimicrobial agents(ceftazidime,cefepime,cefoperazone/sulbactam,aztreonam,imipenem,amika-cin,gentamycin,minocycline,chloramphenicol,levofloxacin,ciprofloxacin,and compound sulfamethoxazole)were all higher than non-CRAB isolates(all P ≤0.01),Compared with non-CRAB isolates,The resistant rate of CRAB to cefoperazone/sulbactam was the lowest(80.0%.Conclusion Surveillance of CRAB should be further strengthened.It is necessary to fo-cus on the control and prevention of healthcare-associated infection in ICU patients and respiratory system.

  20. Analysis on the drug-resistance and distribution of 223 strains ofEscherichia coli%223株大肠埃希菌的耐药性分析及分布

    Institute of Scientific and Technical Information of China (English)

    冯莉

    2014-01-01

    Objective To investigate the drug-resistance and distribution ofEscherichia coli(E. coli) isolated in clinic, so as to provide evidence for the clinicians to use antibiotics on the basis of experience. Methods Totla of 223 strains ofE. coli were isolated from January 2011 to October 2011 in our hospital. Drug resistance of strains to the antibacterial drug that commonly used in clinical and the distribution were analyzed, respectively. Results The drug-resistance rates of 223 strains ofE. coli to imipenem, piperacillin/tazobactam, amikacin, cefoxitin, amoxicillin/clavulanic acid, ceftazidime, tobramycin, levofloxacin, cefepime, cefotaxime, aztreonam, gentamicin, ciprolfoxacin, cefazolin, ampicillin and cotrimoxazole were 0.45% (1 strain), 4.04% (9 strains), 9.42% (21 strains), 13.00% (29 strains), 14.80% (33 strains), 39.46% (88 strains), 41.70% (93 strains), 48.43 % (123 strains), 51.12% (114 strains), 54.71% (122 strains), 55.16% (123 strains), 55.16% (123 strains), 57.40% (128 strains), 62.78% (140 strains), 71.75% (160 strains) and 86.10%(192 strains), respectively. There were 40.81% (91 strains) ofE. coli were collected from urine specimens, 30.94% (69 strains) from sputum specimens and 9.87% (22 strains) from blood specimens.ConclusionsE. coliseparated in our hospital mainly caused urinary tract infections and respiratory tract infections. The drug-resistance rates to the antimicrobial drugs that commonly used in clinical varied widely and clinicians should use antibiotics on the basis of the susceptibility results.%目的:了解临床分离的大肠埃希菌的耐药性及分布,为临床经验用药提供理论依据。方法对2011年1月至2012年10月本院临床分离的223株大肠埃希菌对临床常用抗菌药物的耐药性及分布进行分析。结果223株大肠埃希菌对亚胺培南、哌拉西林/他唑巴坦、阿米卡星、头孢西丁、阿莫西林/棒酸、头孢他啶、妥布霉素、左氧氟沙星、头孢吡肟、头孢噻

  1. Clinical distribution of multiple drug resistant pseudomonas aeruginosa and its drug resistance observation%多重耐药铜绿假单胞菌临床分布及耐药性观察

    Institute of Scientific and Technical Information of China (English)

    钱超

    2016-01-01

    .3%), Piperacillin (48.3%), Ticarcillin (58.3%), Piperacillin/Tazobactam (58.3%), Ticarcillin/Clavulanic Acid (58.3%), Ampicillin/Sulbactam (100.0%) were higher; the drug resistance rates of Aztreonam (33.3%), Imipenem (30.0%), Meropenem (30.0%), Gentamicin (40.0%), Amikacin (26.7%), Ciprofloxacin (33.3%), Levofloxacin (33.3%) were lower. There were 10 plants of generic drug resistant strains, the detection rate was 16.7%;through complementary medicine sensitive experiment, there were 6 plants (60.0%) had drug resistance to Cefoperazone/Sulbactam, there was no drug resistance to Polymyxin B. Conclusion The penicillium alkene, quinolones combination therapy can be used for multiple drug resistant pseudomonas aeruginosa treatment, generic drug resistant strains should be given Polymyxin B treatment.

  2. 耐碳青霉烯类肺炎克雷伯菌的耐药基因检测%Detection of genotypes of carbapenem-resistant Klebsiella pneumoniae isolates

    Institute of Scientific and Technical Information of China (English)

    张丽; 赵静宜; 朱元祺; 张小兵; 朱学海; 张丽华; 朱凯欣; 周静; 油丽萍; 徐茶

    2014-01-01

    目的:了解耐碳青霉烯类肺炎克雷伯菌的耐药基因携带,以减少耐药菌的产生。方法对2009年1月-2012年2月耐碳青霉烯类肺炎克雷伯菌分离株进行筛选,鉴定和药敏采用VITEK‐2 Compact系统进行,引物特异性PCR法分别检测分离株的碳青霉烯酶耐药基因、ESBLs基因和AmpC等相关耐药基因的存在。结果共分离出6株碳青霉烯耐药或中介的肺炎克雷伯菌,其对青霉素类、青霉素/青霉素酶抑制剂、氨曲南、头孢菌素类、氨基糖苷类、氟喹诺酮类和碳青霉烯等抗菌药物表现为较高程度的耐药,但对替加环素有较高的敏感性;每一株菌均携带超广谱β‐内酰胺酶基因,可检测到3~5个耐药基因;其中,1株菌经测序证实为携带 blaIM P‐4,并同时携带blaSHV、blaTEM和blaCTXG9基因;5株菌扩增到Ⅰ类整合子(intⅠ);blaNDM及其他碳青霉烯类耐药基因筛查均为阴性。结论临床分离的碳青霉烯耐药或中介肺炎克雷伯菌的耐药表型和基因型基本相符,因而推测广泛耐药的肺炎克雷伯菌的主要类耐药机制与菌株同时携带产ESBLs、AmpC酶、碳青霉烯酶和Ⅰ类整合子(intⅠ)有关。%OBJECTIVE To investigate the resistant genes carried in the clinical isolates of carbapenem‐resistant K lebsiella pneumoniae in our hospital so as to reduce occurrence of resistant strains .METHODS The strain identi‐fication and antibiotic susceptibility test were carried out with VITEK‐2 compact system for the carbapenem‐resist‐ant K . pneumoniae strains isolated during Jan .2009 and Feb .2012 .The genotypes of carbapenem‐resistant genes ,ESBLs genes ,and AmpC were screened by specific PCR .DNA sequencing was performed to confirm geno‐types .RESULTS Six carbapenem‐resistant or mediated K .pneumoniae isolates were screened to be highly resist‐ant to penicillin ,penicillin/penicillin enzyme inhibitor ,aztreonam

  3. 鲍曼不动杆菌临床分布及耐药表型检测分析%Clinical distribution of Acinetobacter baumannii and detection of enzyme-producting resistant phenotype

    Institute of Scientific and Technical Information of China (English)

    李文波; 贾晓冬; 张文杰; 钱兴玲; 王沛; 陈丹

    2009-01-01

    -,second-and third-generation cephalosporin as well as aztreonam (resistance rate 71.O%-100%).Its resistance rate was 12.6%to amikacin,25.4%to cefepime,40.8% to cefoperazone/sulbactam,43.6% to ciprofloxacin;its resistance rate was very low to imipenem/cilastatin,polymycin B and rifapin.Totally 38 strains were enzyme-producting ones,33 strains were enzyme non-producting ones,and enzyme-producting rate was 53.5%.In enzyme-producting strains,9 strains produced single ESBL(23.7%),26 strains produced AMPC enzyme(68.4%),11strains produced SSBL enzyme (28.9%),and 3 strains produced MBL enzyme(7.89%).Conclusion Acinetobacter baumannii shows multi-resistance,and enzyme-producing strains mainly produce AMPC enzyme and ESgLs.

  4. Analysis of Carbapenem-resistant Klebsiella pneumoniae molecular epidemiology and antibiotic resistance gene%碳青霉烯耐药肺炎克雷伯菌耐药机制及分子流行病学研究

    Institute of Scientific and Technical Information of China (English)

    储雯雯; 刘周; 杨凯; 管世鹤

    2016-01-01

    enterobacterial repetitive intergenic consensus sequence ( ERIC)-polymerase chain reaction ( PCR) .Re-sults A total of 44 strains of bacteria showed a high level resistance to routine antibiotics including carbapenems , penicillins , cephalosporin and aztreonam .A total of 41 strains were positive in modified Hodge test and all the 44 strains were negative to enzyme detection test .PCR result showed that 42 strains were of KPC-2 type, none of other gene types.ERIC-PCR result showed that 44 strains of Klebsiella pneumoniae were divided into 14 types, and the main type was type I .18 strains belonged to type I from ICU and neurosurgery .Conclusion Klebsiella pneumoniae that resists to carbapenem shows high levels of resistance to routine antibiotic in our hospital .Strains of carbapenem resistant Klebsiella pneumoniae appear , KPC-2 is the main reason to cause the bacterial resistance to carbapenems . Frequent transfer treatment of the patients among ICU and other clinical departments is the primary factor of carbap -enem-resistant Klebsiella pneumonia epidemic in the entire hospital .

  5. Analysis of carbapenemases genes andcolistin resistance gene mcr-1 in carbapenem-resistant Enterobacteriaceae%产碳青霉烯酶肠杆菌科细菌合并多黏菌素耐药基因 mcr-1的研究

    Institute of Scientific and Technical Information of China (English)

    张霞; 王莹超; 眭阳; 尹娟

    2016-01-01

    Objective To analyze carbapenemases genes and colistin-resistant gene mcr-1 in clinically isolated carbapenem-resistant Enterobacteriaceae(CRE).Methods Thirty four CRE isolates were collected from Suzhou Hospital Affiliated to Nanjing Medical University during January 201 4 and December 201 5.KPC,NDM,IMP,VIMand mcr-1 genes were screened by polymerase chain reaction (PCR);CRE carrying mcr-1 gene was examined with plasmid conjugation test;plasmid profiling was indentified by S1 -nuclease digestion followed by pulsed-field gel electrophoresis;and drug sensitive test was conducted to analyze the characteristics of recipient strain carrying mcr-1 or NDMgene.Results Amongthirty four strains of clinical isolates CRE,1 6 strains were KPC positive,6 strains were NDM positive,2 strains were IMP positive,and 1 strain was VIMpositive.Both positive NDMand mcr-1 genes were detected in one strain of Klebsiella pneumonia and one strain of Escherichia coli.Plasmid-mediated mcr-1 and NDM genes were successfully transferred to recipient E.coli J53 AZ-R strains by conjugation test;plasmids with mcr-1 and NDM were identified as the IncX4 type and IncX3 type,respectively.Drug sensitive test showed that strains carrying mcr-1 gene were only resistant to colistin,while those carrying NDM gene resistant to all β-lactam antibiotics except for aztreonam.Conclusion The detection of Enterobacteriaceae harbouring both NDM and the plasmid-mediated mcr-1 gene suggests that clinical monitoring of multiple drug-resistant bacteria need to be further strengthened.%目的:分析碳青霉烯类耐药肠杆菌科细菌(Carbapenem-resistant Enterobacteriaceae, CRE)碳青霉烯酶基因及黏菌素抗性基因 mcr-1,并分析 mcr-1的特性。方法连续收集2014年1月至2015年12月南京医科大学附属苏州医院分离的34株 CRE,采用聚合酶链反应(PCR)筛选 KPC、NDM、IMP、VIM和 mcr-1基因,对携带 mcr-1基因的 CRE 进行质粒接合转移试验、经 S1酶切

  6. Study on Serratia marcescensβ-lactam resistance gene%粘质沙雷菌β-内酰胺类耐药基因研究

    Institute of Scientific and Technical Information of China (English)

    谢在海; 朱元祺; 李莉; 邓乃梅; 苏维奇

    2014-01-01

    Objective Survey Serratia marcescens clinical isolatesβ-lactam resistance genes carry case,study its re-sistance mechanisms onβ-lactam antimicrobial.Methods Using Vitek 2 Compact automatic microbial analysis system identification of clinical isolates of Serratia marcescens,287 strains were detected,Susceptibility testing simultaneously selected 135 strains of multi-drug resistant Serratia marcescens.Using double disk confirmatory method for all 287 Ser-ratia marcescens for ESBLs detection,three-dimensional test AmpC enzyme assay,using the PCR method to 135 multi-drug resistant Serratia marcescens forβ-lactam antibiotics related gene SHV,TEM,OXA,PER,VEB,GES,IMP, VIM,FOX,CTX,KPC,DHA,MOX and oprD2 detection.Results Serratia marcescens to ampicillin,ceftriaxone, cefepime,cefotaxime,aztreonam,gentamicin,ciprofloxacin and piperacillin antimicrobial resistance rate is higher,the re-sistance rate of more than 60%,to imipenem,meropenem,sulperazone drug resistance rate is low,the resistance rate of less than 10%.In 287 Serratia marcescens,a total of 32 producing ESBLs,the detection rate of 11.1%,44 strains pro-ducing AmpC,the detection rate of 15.3%,while producing ESBLs and AmpC bacteria 16,accounting for 5.6%.PCR results showed that in 135 multi-drug resistant Serratia marcescens,the CTX-M genes detected with strains 91,TEM gene 25,SHV gene 19,DHA gene 48,KPC gene 10,MOX gene 3,OXA gene 1,oprD2 gene 7.Conclusion The region Serratia marcescens multidrug resistance phenomenon is more serious,the resistance genotype mainly CTX-M and DHA genotype.%目的:调查粘质沙雷菌临床分离株β-内酰胺类耐药基因的携带情况,研究其对β-内酰胺类抗菌药物的耐药机制。方法采用 Vitek2-Compact 全自动微生物系统对临床分离菌进行鉴定,检出粘质沙雷菌287株,同时进行药敏试验,选出多重耐药粘质沙雷菌135株;采用双纸片确证试验对所有287株粘质沙雷菌进行 ESBLs检测、三维试验法检测 Amp

  7. 汉中地区耐亚胺培南铜绿假单胞菌耐药机制及脉冲场凝胶电泳分型%Mechanisms of imipenem resistance and molecular epidemiology in Pseudomonas aeruginosa isolates in Hangzhong area and the PFGE genotyping

    Institute of Scientific and Technical Information of China (English)

    张樱; 蔺咏梅; 王克; 瞿婷婷; 柴阳; 李晓波; 辜依海

    2013-01-01

    OBJECTIVE To characterize the mechanism contributing to imipenem resistance mechanism in Pseudomonas aeruginosa clinical isolates in Hanzhong area in order to provide evidence for the effective control of the multidrug-resistant P. aeruginosa infections. METHODS A total of 70 imipenem-resistant P. aeruginosa isolates were identified in 3201 hospitals in Hangzhong area between Jan, 2006 and Mar, 2008. Antibiotics susceptibilities testing were determined on Mueller-Hinton agar by agar dilution or Etest methods. Double disk diffusion test and Etest were performed to detect the Metallo-β-lactamase (MBL). PCR was used to amplify the β-lactamase gene and oprD2 gene, and the qRT-PCR was employed to analyze oprD2 and ampC expression level. Colonial morpho-type was typed by pulsed field gel electrophoresis (PFGE). RESULTS The 70 strains of imipenem-resistant P. aeruginosa showed relatively higher susceptibility to polymyxin, aztreonam, and ceftazidime. Only 1 strain was detected for IMP-9. Of the 70 isolates, 65 isolates lost OprD2 expression. 4 isolates overproduced ampC. Sequencing analysis showed that the forward insertion sequence ISpal328 was inserted into at the same locus of oprD2 in the 62 isolates without OprD2 expression. PFGE indicated that most of isolates belonged to monoclone. CONCLUSION The epidemiology of 71 strains of imipenem-resistant P. aeruginosa is from monoclonal dissemination in the departments of the same hospital, which is the leading cause of the imipenem resistance in the Hanzhong area in the past two years, and the ISpal328 inserted into oprD2 gene leads to the imipenem resistance in these isolates.%目的 探讨汉中地区耐亚胺培南铜绿假单胞菌的耐药机制,为有效控制多药耐药铜绿假单胞菌感染提供依据.方法 采用琼脂稀释和Etest法对汉中地区3201医院2006年1月-2008年3月临床分离的70株耐亚胺培南铜绿假单胞菌进行耐药性分析;双纸片协同法和Etest法检测金属酶;聚

  8. Clinical distribution and drug resistance of Acinetobacter baumannii%鲍氏不动杆菌的临床分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    胡蓉蓉; 马小琴; 张能华; 王静

    2014-01-01

    OBJECTIVE To understand the separation rate and area distribution and drug resistance changing of A cinetobacter baumani in in clinics ,so as to provide the basis for clinical rational drug use .METHODS A total of 2412 strains of A .baumani from inpatients clinical samples during 2008 to 2012 were collected ,to understand the distribution and drug resistance of it .The susceptibility test was performed by K-B method .The interpretation of the results was based on the CLSI 2010 .WHONET 5 .4 and EXcellsoftware were used for bacterial distribution and drug resistance analysis .RESULTS Among 2412 strains of A .baumannii ,81 .50% were from sputum speci-mens ,77 .10% specimens from patients in ICU ward .Separation rate in 2008 was 5 .13% and increased by 9 .91%in 2012 ,which was on the rise .The resistance rate of A .baumani to aztreonam and ciprofloxacin was higher than 90% .The drug resistance respectively to imipenem , meropenem and cefoperazone/sulbactam was also from 13 .9% and 8 .6% in 2008 to 51 .6% ,55 .3% and 48 .3% .The drug resistance of A .baumannii to 16 kinds of an-timicrobial drugs was in a rising trend year by year ,and part shows the characteristics of multiple drug resistance . CONCLUSION The situation of drug resistance of Acinetobacter baumannii is becoming more and more serious , the monitoring and management of multi-drug resistant bacteria should be strengthened ,also rational use of antibi-otics ,stricting disinfection and quarantine system need to obey to prevent hospital infections ,avoid unnecessary invasive operation ,improve the immune system ,and prevent A cinetobacter baumannii nosocomial infection and outbreak .%目的:了解鲍氏不动杆菌在临床的分离率和病区分布及耐药性变迁,为临床合理用药提供参考依据。方法收集2008-2012年医院住院患者临床标本分离出的2412株鲍氏不动杆菌,了解其分布特点及耐药性,采用K-B法进行药敏试验,结果判定参照美国临

  9. Changes in the antibiotic resistance rates of Klebsiella pneumoniae before and after the implementation of special antibacterial drug management system%特殊抗菌药物管理制度实行前后肺炎克雷伯菌耐药率变化

    Institute of Scientific and Technical Information of China (English)

    裴丽淑; 祁伟; 魏殿军; 于树云; 杨夏

    2015-01-01

    目的:了解医院特殊抗菌药物管理制度实行前后,临床分离肺炎克雷伯菌的耐药性变化及常用抗菌药物用药频度变化。方法分析医院2011年1月-2012年12月临床分离1166株肺炎克雷伯菌,在特殊抗菌药物管理制度实行前、后,对常用抗菌药物的耐药率变化,并对医院常用抗菌药物的用药频度(DDD )变化进行统计分析。结果特殊抗菌药物管理制度实行前肺炎克雷伯菌对氨曲南、头孢吡肟、头孢呋辛、头孢曲松、头孢他啶的耐药率较高,分别为44.7%、44.5%、47.2%、44.4%、44.4%,实行后耐药率分别为38.1%、38.3%、41.3%、38.1%、38.1%,而对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星的耐药率较低,分别为11.9%、12.7%、5.0%,实行后耐药率分别为11.7%、11.2%、4.4%,差异有统计学意义(P<0.05),未发现耐美罗培南和亚胺培南菌株;常用抗菌药物的DDD值显示,特殊抗菌药物管理实施后特殊抗菌药物中的头孢吡肟、美罗培南、亚胺培南/西司他丁用量均有所下降。结论肺炎克雷伯菌对抗菌药物的耐药结果为临床抗感染经验用药提供参考,特殊抗菌药物管理制度实施后的细菌耐药性变化为临床抗菌药物管理提供借鉴。%OBJECTIVE To observe the changes in antibiotic resistance of clinical isolated K lebsiella pneumoniae and DDD before and after the implementation of special antibacterial drug management system .METHODS Totally 1 166 strains of clinical isolated K .pneumoniae in the hospital from Jan .2011 to Dec .2012 were analyzed for the changes in antibiotic resistance before and after the implementation of special antibacterial drug management system ,and the changes in commonly used antibiotic DDD were also statistically analyzed . RESULTS The resistance rates of K .pneumoniae to aztreonam ,cefepime

  10. 2011-2013年包头医学院第三附属医院木糖氧化产碱杆菌的分布与耐药性分析%Analysis on distribution and drug resistance ofAlcaligenes xylosoxidans in Third Affiliated Hospital of Baotou Medical College from 2011 to 2013

    Institute of Scientific and Technical Information of China (English)

    嵇晓霞; 任志明

    2014-01-01

    Objective To analyze the distribution and drug resistance ofAlcaligenes xylosoxidans in Third Affiliated Hospital of Baotou Medical College.Methods The distribution and drug resistance ofA. xylosoxidans in Third Affiliated Hospital of Baotou Medical College from 2011 to 2013 were reviewed, retrospectively.Results The specimens were mainly obtained from the sputum, accounting for 90.0%. The minority were from wounds secretions and enterocoelia fester, accounting for 10.0%. The infections distributed widely in ICU and respiratory department, accounting for 47.5% and 25.0%, followed by cerebral surgery department (17.5%) and other departments (10.0%). The drug resistance rates ofAlcaligenes xylosoxidans had increased in three years. The drug resistance rates of amoxicillin/clavulanic acid (100.0%) and aztreonam (90.0%) were higher than others. The drug resistance rates of aminoglycosides varied from 77.5% to 80.0%. Those of ceftriaxone, cefotaxime and cefepime were 57.5%, 82.5%, and 75.0%, respectively. The drug resistance rates of cefoperazone/sulbactam, piperacillin/tazobactam, ceftazidime, cefoperazone and imipenem were 2.5%, 12.5%, 12.5%, 5.0%, and 30%, respectively.ConclusionAlcaligenes xylosoxidans infection mainly occurs in respiratory system and its drug resistance is more and more serious. According to the results of drug resistance, the antibiotics are selected to reduce the occurrence of nosocomial infection and drug resistance strains.%目的:分析包头医学院第三附属医院木糖氧化产碱杆菌的分布与耐药性。方法对2011-2013年包头医学院第三附属医院木糖氧化产碱杆菌的分布及其耐药情况进行回顾性统计分析。结果木糖氧化产碱杆菌主要来自痰液标本,占90.0%,其余来自于伤口分泌物和腹腔脓液,占10.0%。感染区分布主要以重症监护病房和呼吸科为主,分别占47.5%、25.0%,脑外科及其他科室分别占17.5%、10.0%。菌株耐药率3年呈现逐年增

  11. Analysis of Distribution and Antibiotic Resistance of Pathogenic Bacteria of Blood Cultures in Newborns in Nanjing Area%南京地区新生儿血培养病原菌分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    张晓洁; 邱胜丰; 葛高霞; 黎青

    2012-01-01

    coagulase negative staphylococcus was dominant, accounting for 76.74% of positive bacteria, and accounting for 55.31% of the total separated strains. 50 strains were Gram-negative bacteria (27.93% ), and the Klebsiella pneumoniae was the most frequently isolated, accounting for 42.00% of negative bacteria, and ac-counting for 11.73% of the total separated strains. The resistance rate of Gram-positive bacteria to penicililn was the highest, fol-lowed by erythromycin. The resistance rate of them to vancomycin, piperacillin/tazobactam, amikacin and levofloxacin were rather lower. The resistance rate of Gram-negative bacteria to ampicillin was the highest, the next were followed by piperacillin, cefazolin and aztreonam. The resistance rate of them to imipenem, cefepime, amikacin, levofloxacin and enzyme inhibitor combinations were rather lower. CONCLUSIONS: Coagulase-negative staphylococcus is the primary pathogens causing neonatal septicemia in Nanjing area in recent 2 years, followed by Klebsiella pneunwniae. Drug resistance varies in different bacteria. It is important for reasonable use of antibiotics to know distribution and antibiotic resistance of pathogens.

  12. Analysis of 217 Strains Bacteria and their Drug Susceptibility from Hospitalized Children with Lower Respiratory Tract Infections%儿童下呼吸道感染217株细菌分析及药物敏感趋势监测

    Institute of Scientific and Technical Information of China (English)

    方敏; 何邱宁

    2012-01-01

    .45% ) and S. aureus (3.69% ). The sensitive drugs to Cram-negative bacilli were ceftazidime, cefepime, aztreonam, imipenem, piperacillin/tazobactam, cefoperazone/sulbactam and amikacin. Gram-positive cocci showed high resistance to benzylpenicillin, erythromycin, clindamycin and azithromycin, and showed sensitivity to other antibiotics. The incidence of ESBLs in 61 strains Escherichia coli was 55.74%, The incidences of MRSCN in 21 strains staphylococcus saprophyticus and 14 strains staphylococcus epidermidis were 9.52% and 7. 14% , respectively. The incidences of HLAR in 5 strains Enterococcus taecium and 4 strains E. faecalis were 40. 00% and 25. 00%, respectively. Conclusions; It is necessary for rational use of antibiotics by enhancing bacterial culture and drug resistance monitoring.

  13. Investigation of antimicrobial resistance of Klebsiella pneumoniae and Pseudomonas aeruginosa isolates from rat-like animals around a hospital in Guangzhou%广州市某医院周边鼠形动物肺炎克雷伯菌和铜绿假单胞菌的耐药性调查

    Institute of Scientific and Technical Information of China (English)

    钟雪珊; 葛婧; 陈少威; 熊益权; 郑雪燕; 邱旻; 霍舒婷; 陈清

    2016-01-01

    Rattus flavipectus and 8 Mus musculus. The positivity rates of K. pneumoniae and P. aeruginosa were 78.4%and 34.7%in the fecal samples from the captured animals, respectively. K. pneumoniae isolates from Suncus murinus showed a high resistance to ampicillin, cephazolin, nitrofurantoin, piperacillin and cefotaxime (with resistance rates of 100%, 51.2%, 44.2%, 37.2%, and 23.3%, respectively), and K. pneumoniae isolates from Rattus spp. showed a similar drug-resistance profile. The prevalence rates of multidrug resistance and ESBLs were 40.9%and 10.7%, respectively. P. aeruginosa from both Suncus murinus and Rattus spp. exhibited the highest resistance rates to aztreonam (12.4%and 16.0%, respectively), followed by penicillins and fluoroquinolones. P. aeruginosa isolates were susceptible to cephems, aminoglycosides and carbapenems (with resistance rates below 5%). Conclusion K. pneumoniae and P. aeruginosa isolated from rat-like animals showed drug-resistance profiles similar to those of the strains isolated from clinical patients, suggesting that the possible transmission of K. pneumoniae and P. aeruginosa between rat-like animals and human beings.

  14. Antimicrobial agent susceptibility of 163 strains of Yersinia enterocolitica%163株小肠结肠炎耶尔森菌的抗菌药物敏感性分析

    Institute of Scientific and Technical Information of China (English)

    孙文魁; 毕振旺; 寇增强; 侯配斌; 胡彬; 刘加力; 邹爱萍; 房明; 毕振强

    2013-01-01

    目的 了解高密市动物宿主中小肠结肠炎耶尔森菌分离株的抗菌药物敏感情况.方法采用VITEK 2 COMPACT 系统和AST-GN16药敏卡检测高密市2006-2011年分离到的163株小肠结肠炎耶尔森菌的抗菌药物敏感性.抗菌药物敏感率变化趋势采用直线回归法检验,不同宿主间抗菌药物敏感率检验采用非参数检验的Kruskal-Wallis法,两两比较采用Nemenyi法.结果 哌拉西林-他唑巴坦、头孢曲松、头孢吡肟、氨曲南、厄他培南、亚胺培南、阿米卡星、庆大霉素、妥布霉素、左氧氟沙星和替加环素的敏感率均达到或接近100%,氨苄西林和头孢唑林的耐药率超过90%;94.5%(154/163)的菌株对2种及2种以上的抗菌药物耐药,且对4种及4种以上的抗菌药物耐药的菌株达到71.2%(116/163);抗菌药物敏感率不存在线性变化趋势(P>0.05);不同宿主间菌株的抗菌药物敏感性仅环丙沙星和复方新诺明的差异有统计学意义,P值介于0.04-0.05之间,但经两两比较后差异亦无统计学意义.结论 高密市小肠结肠炎耶尔森菌在不同年份、不同宿主间的抗菌药物敏感性变化不大,但耐受多种抗菌药物的现象严重.%The purpose is to investigate the antimicrobial agent susceptibility of Yersinia enterocolitica isolated from animals in Gaomi City, Shandong Province. VITEK 2 COMPACT system and AST-GN16 card were used to test the antimicrobial agent susceptibility of 163 Yersinia enterocolitica strains isolated from Gaomi, 2006-2011. Linear regression was used to test the tendency of antimicrobial agent susceptibility. Kruskal-Wallis H rank sum test was used to test the difference of antimicrobial agent susceptibility among different hosts, and Nemenyi test was used to test the difference between each two kinds of hosts. Results showed that all or almost all of the isolates were sensitive to piperacillin/tazobactam, ceftriaxone, cefepime, az-treonam, ertapenem, imipenem

  15. Analysis on the pathogens, susceptibility and misapplication of antibiotics of community acquired pneumonia in the elderly community%老年社区获得性肺炎病原学、药敏及抗生素滥用状况分析

    Institute of Scientific and Technical Information of China (English)

    杨盛权; 周志文; 周立仁; 王玉成

    2014-01-01

    性进行动态监测。%Objective To analyze the distribution and drug resistance of the pathogens of community ac-quired pneumonia, and to discuss the effect of misapplication of antibiotics on the distribution of community acquired pneumonia in the elderly community. Methods A total of 218 elderly patients in the Second People's Hospital of Huangmei from June 2008 to May 2013 were selected and underwent aetiology test and susceptibility test. One hun-dred and forty-two patients who had the history of misapplication of antibiotic were selected as the antibiotics misap-plication group, and 76 patients who used antibiotic regularly were enrolled as the regular treatment group. The differ-ence of positive rate of bacterial culture and the positive rate of atypical pathogens were compared. Results 147 of the 218 cases were positive in aetiology test, including 115 bacteria (52.%) and 32 atypical pathogens (14.7%). Six cas-es were found with mixed infection of bacteria and atypical pathogens by Mycoplasma pneumonia mixed with bacteria. The top four bacteria found were Hemophilies influenzae (34 cases, 15.6%), Streptococcus pneumonia (31 cases, 14.2%), Klebsiella pneumonia (29 cases, 13.3%) and Escherichia coli (9 cases, 4.1%). Hemophilies were 64.7%resistant to Cotrimoxaxole, 44.1%resistant to Piperacilin, 38.2%resistant to Ampicil and Sulactam. Streptococcus pneumoniae were 67.7% resistant to Ampicil and Sulbactam, Klebsiella pneumoniae were 61.3% resistant to Ampicil and Sul-bactam, and Escherichia coli were 33.3%resistant to piperacillin. Pathogenic bacteria had higher resistant rates to Ampicil and Sulbactam, Aztreonam, Acm, Bactrim, Pieracillin and Ceftazidime than other antibacterial agents. 65.1%of the 218 patients had history of abused use of antibiotics. The positive rate of bacterial and atypical patho-gens showed significant differences between antibiotics misapplication group and regular treatment group, P<0.05. Conclusion The community acquired pneumonia for the elderly are caused mainly by

  16. Bacterial distribution and drug resistance change of nosocomial infection in intensive care unit%重症监护室院内感染细菌分布及其耐药性变迁

    Institute of Scientific and Technical Information of China (English)

    郑伟浩; 伍国达; 张丽珊; 赵英萍

    2012-01-01

    thehighest,more than 90%,and followed by resistances to other antimicrobial agents were lower than Pseudomonas aeruginosa.The resistance rate of stenotrophomonas maltophilia to minocycline was the lowest (< 10%),followed by was cotrimoxazole and levofloxacin,which were lower than 36.4%,and the resistance rates of other drugs were more higher.Conclusions The main bacteria of nosocomial infections in ICU was G- bacteria.Acinetobacter baumannii and stenotrophomonas maltophilia increased significantly; Drug-resistant rate was high,and most were multiple drug-resistance; the resistance rate of pseudomonas aeruginosa showed a declining tendency.aztreonam,more than 80% ; While the%目的 探讨重症监护室院内感染细菌的分布及其耐药情况的变化趋势.方法 对2008年1月至2010年12月广东省江门市中心医院重症医学科院内感染的细菌及其耐药情况进行统计分析.结果 37.1%的院内感染为革兰阳性(G+)菌,62.9%为革兰阴性(G-)菌,其中大约81.3%为下呼吸道感染.在G+菌中,金黄色葡萄球菌占38.9%,表皮葡萄球菌、溶血葡萄球菌各占19.5%;葡萄球菌属对糖肽类、利奈唑胺和奎奴普丁/达福普汀保持100%敏感率,除了氯霉素、复方新诺明对金葡菌的耐药率较低外,其他药物的耐药率均很高,超过60%;凝固酶阴性葡萄球菌的耐药率更高.在G-菌中,阴性杆菌占20%,非发酵菌占50%,并且,鲍曼不动杆菌和嗜麦芽窄食单胞菌逐年增多;肺炎克雷伯杆菌对碳青霉烯类和阿米卡星耐药率最低,低于8%,且呈显著下降趋势;对头孢西丁耐药率约20%,对其他抗菌药的耐药率则显著上升;大肠埃希菌对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、碳青霉烯类和阿米卡星的耐药率低于20%,对头孢菌素类(除头孢西丁外)和喹诺酮类的耐药率整体超过80%.对铜绿假单胞菌耐药率最低的是多粘菌素B,其次是阿米卡星、哌拉西林/

  17. 慢性阻塞性肺疾病急性加重期患者下呼吸道感染的革兰阴性菌分布及耐药性分析%Distribution and drug resistance of gram-negative bacteria causing lower respiratory tract infections ;in patients with acute exacerbation of chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    周炜; 王月平; 邵雪华; 齐激扬; 彭敏飞; 罗敏; 陈存国; 崔丹萍

    2016-01-01

    in carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa strains than those in non-carbapenem-resistant strains , and the differences were statistically significant (P <0.05 or <0.01).Stenotrophomonas maltophilia and Burkholderia cepacia strains were only sensitive to levofloxacin , compound sulfamethoxazole and minocycline . Klebsiella pneumonia (89 strains), Escherichia coli (80 strains) and Enterobacter cloacae (25 strains) were top 3 enterobacteriaceae , which were almost completely resistant to ampicillin , but were sensitive to piperacillin/tazobactam , cefoperazone/sulbactam , amikacin and carbapenems ( with resistant rates <15%) .More than 50%strains of extended spectrum β-lactamases ( ESBLs )-producing Klebsiella pneumonia and Escherichia coli were moderately or highly resistant to ampicillin/sulbactam , most cephalosporins ( except cefotetan and cefoperazone/sulbactam ), gentamycin, tobramycin, fluoroquinolones, aztreonam, compound sulfamethoxazole and minocycline , and the resistant rates were higher than those in non-ESBLs-producing strains (P <0.05 or <0.01).Conclusions Nonfermentative bacteria and enterobacteriaceae are the most prevalent gram-negative bacterial pathogens in lower respiratory tract infections in patients with AECOPD . Carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa strains, as well as ESBLs-producing Klebsiella pneumonia and Escherichia coli strains are highly resistant to most antibacterial agents .

  18. 尿路感染大肠埃希菌遗传种系分型及其耐药性的相关性探讨%Escherichia coli urinary tract infection germ line genetic typing and correlation of drug resistance

    Institute of Scientific and Technical Information of China (English)

    梅俪凡; 王荣聪; 焦石

    2015-01-01

    Objective To investigate different E.coli urinary tract infection germ line genetic typing and drug resistance of relevance.Methods Select our hospital between January 2013 and March 2014 separation of 122 strains within 48 h after admission e.coli urinary tract infection and 108 strains after 48 h after admission urinary tract infection e.coli as a clinical research objects,all samples are selected from mid-stream specimen of urine,urinary tract infection patients with isolated within 48 h after admission in patients with urinary tract infection e.coli as a community infected bacteria,isola-ted after 48 h after admission in patients with urinary tract infection e.coli bacteria for hospital infec-tion,mining API20E enterobacteriaceae bacteria identification kit with the French company ATB mi-crobial identification of strains,semi-automatic analyzer with producer diffusion method determination of urinary tract infection of e.coli drug sensitivity,contrast different genetic types of tie points urina-ry tract infections e.coli resistance,produce broad-spectrum beta lactamase(extended spectrum beta lactamases,ESBLs ) rate and the distribution of infection in hospital and community infection. Results Among the 230 strains of Escherichia coli,138 strains of producing strains were detected, and 34 strains of ESBLs and AmpC were detected by ESBLs76 and AmpC.230 strains of Escherichia coli to antibiotics resistance:resistance to commonly used antibiotics in clinic from top to bottom in turn:cotrimoxazole 81 .7%,piperacillin,pull Westwood 76.7%,74.2% of ampicillin,ampicillin sul-bactam 61 .7%,butylamine card that mildew element 61 .7%,cefuroxime 60.8%,cephalosporins cef-podoxime 59.2%,ammonia aztreonam 59.2%,pethidine pull Xin Lin He cling to Zun 32.5%,ce-fazolin 68.3%,gentamicin 57.5%,cephalosporins cefotaxime 43.3%,cefotaxime cefepime 38.3%, cefotaxime and 33.3% of cefoxitin,imipenem 0.8%.①According to the test results,and no bacterial infection in the community and

  19. Analysis of clinical distribution and drug resistance of bloodstream infections caused by Klebsiella pneumoniae%肺炎克雷伯菌血流感染的临床分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    查翔远; 宋有良; 林建; 崔小玲; 潘晓龙; 倪世峰

    2015-01-01

    Objective To study the clinical distribution and antimicrobial resistance of bloodstream infections caused by Klebsiella pneumoniae .Methods Patients with bloodstream infection caused by Klebsiella pneumoniae in Tongling People's Hospital in Anhui province from January 2008 to December 2013 were retrospectively reviewed.Results A total of 71 cases were found with bloodstream infection caused by Klebsiella pneumoniae, the top three clinical distribution departments were infectious diseases department, ICU and oncology de-partment, and the top three complications were pulmonary infection, malignant tumor, biliary tract infection as well as diabetes mellitus. There were 24 strains of ESBLs-producing Klebsiella pneumoniae, accounting for 33.8%among 71 strains of Klebsiella pneumoniae isolated from the blood samples, in which 18 (52.9%) strains of ESBLs-producing Klebsiella pneumoniae among 34 hospital acquired infection cases and 6 ( 1 6 .2%) strains of ESBLs-producing Klebsiella pneumoniae among 3 7 community acquired infection cases;the positive rate of ESBLs-producing Klebsiella pneumoniae strains among hospital acquired infection cases was significantly higher than that of community acquired in-fection cases(χ2 =10.680, P=0.05).Among 71 strains of Klebsiella pneumoniae, no imipenem or meropenem-resistant isolate was found, and the resistance rates to amikacin, levofloxacin, ciprofIoxacin, cefoxitin, cefepime, cefoperazone/sulbactam and piperacillin/tazobactam were low(<20%) .The resistance rates of stains isolated from hospital acquired infection cases to piperaeillin, amoxicillin/clavulanate, cef-operazone/sulbactam, ampicillin/sulbactam, ticareillin/clavulanate, piperacillin/tazobactam, cefazolin, cefoperazone, cefuroxime, ceftazi-dime, ceftriaxone, cefotaxime and aztreonam were significantly higher than those of stains isolated from community acquired infection cases. The resistance rates of ESBLs-producing Klebsiella pneumoniae strains to 20 antimicrobial

  20. Changes of drug-resistance of Pseudomonas aeruginosa in pediatric intensive care unit%儿科重症监护病房铜绿假单胞菌耐药性变迁

    Institute of Scientific and Technical Information of China (English)

    王丽杰; 孙莹; 宋文良; 张智洁; 刘春峰

    2012-01-01

    ,we analvzed the susceptibility patterns of Pseudomonas aeruginosa in pediatric intensive care unit (PICU). Method The age distribution,outcome of patients,sources of strains and susceptibility patterns of Pseudomonas aeruginosa in PICU from Jan 1,2007 to Dec 31,2011 were analyzed.Susceptibility to amikacin,piperacillin/tazobactam,aztreonam, ampicillin, ciprofloxacin, imipenem, meropenem, cefepime, cefoperazone, cefotaxime,ceftriaxone,ceftazidime,cefoperazone/sulbactam,cephazolin,cefuroxime,and polymyxin were determined by the disk-diffusion technique (K-B test method) and broth microdilution.P.aeruginosa ATCC 27853 was used as reference strain.Result Seventy-five patients were Pseudomonas aeruginosa positive.26(34.7% ) were < 6 m,49 ( 65.4% ) were < 2 y.The percentages of cases who were Pseudomonas aerugiosa positive in different age groups in the same time was basically similar; 18 (24.0%) cases died. Pseudomonas aeruginosa accounted for 10.9% of G- germs s,6.5% of all pathogens in 2010-2011.Of the 126 strains,83(65.9%) were from sputum sample,31 (24.6% ) were from catheter sample of tracheal eannula, 10 (7.9%) were from blood sample and 2( 1.6% )were from secretion sample.The sensitivity to antibiotics of Pseudomonas aeruginosa in pediatric common treatments was 72.4% to cefoperazone/sulbaetam,71.5% to meropenem,48.4% to imipenem,66.7% to ceftazidime,49.2% to piperacillin/tazobactam1. Absolute resistance to ampicillin,cephazolin,cefuroxime and cefotaxime. Multiple-drug resistance was still severe,but a decreasing tendency was observed,90.5% in 2007,81.3% in 2008,51.1% in 2009,53.8% in2010,33.3% in 2011.Pan-drug resistance in different years was similar,12.5% in 2008,2.2% in 2009,7.7% in 2010,6.7% in 2011. Conclusion The condition of drug resistance of Pseudomonas aeruginosa was still rigorous, we should conduct surveillance and prevent abusing antibiotics in order to avoid exacerbating drug resistance. We should improve

  1. 近两年医院感染常见病原菌分布及耐药性分析%Distribution and Drug Resistance of Common Pathogens of Hospital Infection in the Recent 2 Years

    Institute of Scientific and Technical Information of China (English)

    蒙光义; 潘鹏; 王冬晓; 彭评志; 庞家莲; 邹超世

    2016-01-01

    Objective To investigate the distribution and drug resistance of common pathogens, to provide guidance for reasonable clinical use of antibiotics and control nosocomial infections. Methods Specimens were collected and indentified from 2013 to 2014 in hospitali-zed patients with various clinical departments. The bacterial identification was indentified and performed by VITEK-2 Compact of Biomeriex, France, then the drug susceptibility testing was performed, and the data were analyzed by WHONET 5. 5 software. Results A total of 9 149 strains of pathogens were isolated from 2013-2014, among which the gram-negative bacteria were 6 647 strains, ac-counting for 72. 65%, of which, and the top 4 pathogens in order were escherichia coli, klebsiella pneumonia, pseudomonas aeruginosa and acinetobacter baumannii; gram-positive bacterium were 2 502 strains, accounting for 27. 35%, and the top 4 pathogens in order were staphylococcus aureus, streptococcus pneumoniae, enterococcus faecalis, staphylococcus haemolyticus. The drug resistance rate of escherichia coli and klebsiella pneumonia to cefazolin, ceftriaxone and trimethoprim/sulfamethoxazole were more than 50%;the drug re-sistance rate of hemophilus influenzae to ampicillin, levofloxacin and rimethoprim/sulfamethoxazole were 61. 45% , 60. 24% and 74. 70%, respectively; the drug resistance rate of enterobacter cloacae to ceftriaxone and aztreonam were 58. 90% and 50. 92%. The main gram-negative bacilli were especially sensitive to amikacin, imipenem, meropenem, cefotetan, cefoxitin, cefoperazone/sulbactam, and the drug resistance rate were more less 20%; the drug resistance rate of the main non-fermentataive bacterial to acinetobacter bau-mannii to common antibacterial drugs were high. The drug resistance rate of the main gram-positive bacteria in addition to vancomycin and linzolid were 0, and had different degrees of drug resistance rate to common antibacterial drugs, among which to penicillin was more than 45%, and to

  2. 2009-2013年我国16省市社区获得性细菌性腹泻病原菌分布及临床耐药分析%Distribution of the community-acquired bacterial diarrheal pathogens and drug resistance in 16 provinces or cities in China during 2009-2013

    Institute of Scientific and Technical Information of China (English)

    崔恩博; 曲芬; 毛远丽; 陈素明; 张成龙; 王勇; 贾天野; 鲍春梅; 张鞠玲; 王欢; 庞君丽

    2014-01-01

    Objective To analyze the characteristics of the community-acquired bacterial diarrheal pathogen spectrum and drug resistance in China during 5 years. Methods The strains isolated from the stool samples of patients with community-acquired bacterial diarrhea were collected from 16 provinces or cities in China during 2009-2013. The bacteria were incubated with Salmo-nella, Shigella agar, gentamicin agar and MacConkey agar plate and identification of pathogens suspected to be the cause of diarrhea was performed by VITEKⅡinstrument and biochemical reaction trace coding tube. Then, Salmonella, Shigella, Vibrio and diarrhea-genic Escherichia coli were serotyped by serum agglutination test. K-B method was used for antimicrobial susceptibility testing of bacterial pathogens. Results A total of 10 881 strains of diarrheal pathogens, including 7 genus, 22 species and 90 serotypes were isolated from diarrheal patients from 16 provinces or cities in China during 5 years. There were 7632 (70.14%) strains of Shigella, 1351 (12.42%) strains of Vibrio, 981 (9.02%) strains of Salmonella , 341 (3.13%) strains of diarrheagenic Escherichia coli, 302 (2.78%) strains of Aeromonas, 269 (2.47%) strains of Plesiomonas, and 5 (0.05%) strains of Yersinia enterocolitica. The major serotypes of Shigella were F2a, F4a and F1a belonging to group B and the major serotypes of Salmonella were Salmonella enteritidis and Salmonella typhimurium. Drug sensitivity monitoring showed that Shigella had better sensitivity to cefotaxime, cefepime, cefmetazole, imipenem and fosfomycin, with the sensitivity rates of 89.7%, 92.3%, 96.7%, 100%and 97.7%; the sensitive rates of Salmonella to cefotaxime, cefepime, aztreonam, imipenem and fosfomycin were 94.0%, 97.9%, 94.4%, 100% and 96.4%; the sensitive rates of Aeromonas to cefepime, levofloxacin, imipenem and fosfomycin were 80.9%, 80.0%, 92.6% and 84.0%; diarrheagenic Escherichia coli had poor sensitivity to antibiotics generally; Vibrio had good sensitivity to

  3. Analysis of the mechanism of drug resistance of VIM-2-type metallo-β-lactamase-producing Acinetobacter baumannii isolated from burn patients and its homology%烧伤患者中产VIM-2型金属β内酰胺酶鲍氏不动杆菌耐药机制及同源性分析

    Institute of Scientific and Technical Information of China (English)

    杨喜丽; 李悦; 詹剑华; 郭菲; 闵定宏; 王年云; 李国辉; 郭光华

    2015-01-01

    生素的耐药率均大于60.00%.(5)18株产VIM-2型MBL的AB经多次质粒接合试验均未见耐药基因阳性转移菌株.(6)18株产VIM-2型MBL的AB中9株携带CarO基因,携带CarO基因的产VIM-2型MBL的AB菌株外膜蛋白CarO缺失或表达量减少.(7)18株产VIM-2型MBL的AB ERIC-PCR指纹图谱共分6个谱型,A、B、C、F型菌株分别为6、4、3、l株,D、E型菌株各为2株. 结论 bla TEM-1、bla OXA-23和bla armA基因仍是引起AB耐药的主要原因之一;与此同时,产VIM-2型MBL联合外膜蛋白CarO缺失或改变也是导致烧伤患者AB对碳青霉烯类抗生素耐药的重要机制之一,其中Intl1基因也可能参与了bla VIM-2基因的传播.%Objective To study the drug resistance of Acinetobacter baumannii (AB) producing VIM-2-type metallo-β-lactamase (MBL) isolated from burn patients of our ward against carbapenem antibiotics and its homology.Methods A total of 400 strains of AB (identified) were isolated from sputum,urine,blood,pus,and wound drainage of burn patients hospitalized in our ward from September 2011 to March 2014.Drug resistance of the 400 strains of AB to 15 antibiotics,including compound sulfamothoxazole,aztreonam,etc.,was tested using the automatic microorganism identifying and drug sensitivity analyzer.Among the carbapenems-resistant AB isolates,modified Hodge test was applied to screen carbapenemase-producing strains.The carbapenemase genes of the carbapenemase-producing strains,and the mobile genetic elements class 1 integron (Intl1) gene and conserved sequence (CS) of carbapenemase-producing strains carrying bla VIM-2 gene were determined with PCR and DNA sequencing.For carbapenemase-producing strains carrying bla VIM-2 gene,synergism test with imipenem-ethylene diamine tetraacetic acid (EDTA) and enhancement test with imipenem-EDTA and ceftazidime-EDTA were used to verify the MBL-producing status.Drug resistance of the VIM-2-type MBL-producing AB strains was analyzed.For VIM-2-type MBL-producing AB strains

  4. Regional characteristics of postoperative bacterial infection and antibiotic resistance following traumatic limb fractures%四肢创伤性骨折术后细菌感染及耐药的地域性特征分析

    Institute of Scientific and Technical Information of China (English)

    任有亮; 彭笳宸; 李政道; 刘曦明; 杨晋; Stephen L.Kates; Edward M.Schwarz; Chao Xie

    2016-01-01

    .epidermidis,and 50% by Enterococcus avium),tetracycline (40.74% by S.aureus,and 50% by S.epidermidis & Enterococcus avium),cefoxitin (40.74% by S.aureus,and 50% by S.epidermidis) and oxacillin (40.74% by S.aureus,and 75% by S.epidermidis).The antibiotic resistance by the Gram-negative bacteria was observed in cefazolin (100%),ampicillin (88.89% by E.coli,and 100% by E.cloacae and Klebsiella pneumonia),aztreonam (44.44% by E.coli,25% by E.cloacae,and 100% by Klebsiella pneumonia),ceftriaxone (77.78% by E.coli,25% by E.cloacae,and 100% by Klebsiella pneumonia),cefotetan (75% by E.cloacae) and co-trimoxazole (66.67% by E.coli,25% by E.cloacae,and 50% by Klebsiella pneumonia).Fortunately,all the 25 cases of Gram-negative bacteria were sensitive to imipenem,and all the 11 cases of MRSA infection were sensitive to linezolid,ampieillin,quinupristin,tigecycline,pipracillin,furatoin,rifampicin,co-trimoxazole and vancomycin,respectively.Conclusions The most obvious regional characteristics are:the overall postoperative infection rate following surgery for limb fracture at Zunyi Medical University might be lower than the national average in China;the most common infections were monomicrobial in the lower extremities and forearm;S.aureus was the most common pathogen;MRSA was the most common.These findings support an empiric antibiotic therapy of carbapenum and vancomycin for postoperative infections in patients with traumatic limb fractures.

  5. 鲍曼不动杆菌生物膜形成能力与生物膜相关基因及耐药性之间的关系%Correlation between the biofilm-forming ability, biofilm-related genes and antimicrobial resistance of Acinetobacter baumannii

    Institute of Scientific and Technical Information of China (English)

    韩欣欣; 李庆淑; 申丽婷; 胡丹; 曲彦

    2014-01-01

    Objective To study the biofilm-forming ability and the distribution of biofilm-related genes in Acinetobacter baumannii clinical isolates as well as antimicrobial resistance,to analyze their relationships with the bacterial resistance phenotype.Methods A prospective study was conducted.Biofilm models of 70 strains Acinetobacter baumannii collected in Chengwu County People's Hospital from October 2012 to October 2013 were constructed using 96-well polystyrene plate.In order to analyze the biofilm-forming ability,a qualitative and quantitative analysis was conduct by crystal violet staining assay.And the antimicrobial resistance of different biofilm-forming ability strains was compared including imipenem,amikacin,meropenem,cefepime,sulbactam cefoperazone,trimethoprim,levofloxacin,gentamicin,ciprofloxacin,cefotaxime,ceftizoxime,aztreonam,piperacillin,ceftriaxone,cefuroxime.In addition,the expressions of biofilm-related gene Bap,bfs and intI1 were tested with polymerase chain reaction (PCR) assay.Results Among 70 strains Acinetobacter baumannii,40 strains were multi-drug resistant (57.14%) and 6 strains were pan-drug resistant (8.57%); 68 strains had biofilm-forming ability (97.14%),14 of which were weakly positive,20 were positive and 34 were strongly positive.The antimicrobial resistant rate of Acinetobacter baumannii to imipenem,amikacin,meropenem and cefepime was decreased,it was 30.00%,32.86%,38.57% and 41.43%,respectively.However,the antimicrobial resistant rates to other commonly used antibiotics were all higher than 50%.The drug resistance of Acinetobacter baumannii to levofloxacin (85.71%,45.00%,38.24%,x2=9.225,P=0.010),cefepime (71.43%,45.00%,29.41%,x2=7.222,P=0.027),gentamicin (78.57%,55.00%,38.24%,x2 =6.601,P=0.037) was significantly decreased when biofilm-forming ability reinforced (weakly positive,positive,hadro-positive).Bap gene positive rate of weakly positive,positive and strong positive biofilm-forming strains

  6. Evaluation of the susceptibility interpretation on Escherichia coli, Klebsiella pneumonia, Proteus mirabilis in China by agar dilution method according to the changes of cephalosporin breakpoints in CLSI 2010%2010年CLSI三代头孢菌素折点改变对我国大肠埃希菌和肺炎克雷伯菌及奇异变形杆菌药物敏感性结果解释的评估

    Institute of Scientific and Technical Information of China (English)

    刘文静; 季萍; 刘蓬蓬; 张利侠; 胡云建; 刘勇; 叶惠芬; 孙自镛; 段琼; 倪语星; 俞云松; 杨启文; 朱莲娜; 徐英春; 王辉; 谢秀丽; 王瑶; 赵旺盛; 何林; 王晶

    2010-01-01

    increased from 30. 3%,43. 2% under S19 (32 μg/ml) to42.0%, 56. 0% under S20 (16 μg/ml). The susceptibility rates slightly decreased from 58. 1%, 44. 1% under S19 (8 μg/ml) to 44. 7%, 28.0% under S20 (4 μg/ml). Second,as to the ESBL negative Escherichia coli, Klebsiella pneumonia and Proteus mirabilis, all the susceptibility rates of ceftazidime, cefotaxime and ceftriaxone were between 99. 2%-100. 0%, the resistant rate were between 0%-0. 4%. Third, the S20 MIC breakpoints had a good correspondence with the ESBL phenotype.Fourth, according to the recurrent analysis of MIC testing and disk dilution method, r value was 0. 67,0. 79, 0. 77 for ceftazidime, cefotaxime and ceftriaxone, respectively, and all P value were under 0. 01. The intermethod rates of S19 and S20 were both acceptable. Conclusions If the cefotaxime and ceftriaxone S20 new breakpoints were used, the concordance of antibacterial susceptibility results and ESBL phenotype would increase greatly. The clinician could select proper antibiotics according to the antibacterial susceptibility results and clinical symptoms. It is no longer necessary to edit results for cephalosporins, aztreonam, or penicillins from susceptible to resistant. However, until laboratories implement the new interpretive criteria,ESBL testing should be performed as described in Supplemental Table 2A-S1. The relationship between the new breakpoints of ceftazidime and clinical outcomes need to be further evaluated.