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Sample records for aztreonam

  1. Aztreonam concentrations in human prostatic tissue.

    OpenAIRE

    Madsen, P O; Dhruv, R; Friedhoff, L T

    1984-01-01

    The concentrations of aztreonam in human prostatic tissue specimens obtained by transurethral resection were measured in nine patients after the intramuscular administration of a single 1-g dose. The average concentration of aztreonam was 7.8 microgram/g of prostate between 50 and 180 min after dosage. The average ratio of the drug concentration in prostate to that in serum was 0.25. The concentrations of aztreonam achieved were significantly higher than the MICs for most members of the famil...

  2. Metabolism and pharmacokinetics of aztreonam in healthy subjects.

    OpenAIRE

    Swabb, E A; Singhvi, S M; Leitz, M A; Frantz, M; Sugerman, A

    1983-01-01

    The metabolism and pharmacokinetics of aztreonam (SQ 26,776) were studied in four healthy male volunteers, each of whom received single 500-mg intravenous and intramuscular doses of 14C-labeled drug according to a two-way crossover design. Serial samples of serum, urine, and feces were assayed for aztreonam and metabolites. Serum pharmacokinetics of aztreonam administered intravenously were described by an open, linear, two-compartment kinetic model. Kinetics of intramuscular aztreonam follow...

  3. Evaluation of aztreonam in experimental bacterial meningitis and cerebritis.

    OpenAIRE

    Scheld, W. M.; Brodeur, J P; Gratz, J C; Foresman, P; Rodeheaver, G

    1983-01-01

    Aztreonam (SQ 26,776), a new monocyclic beta-lactam agent, was compared with ampicillin, ampicillin plus chloramphenicol, and gentamicin in rabbits with experimental meningitis induced by, respectively, ampicillin-susceptible Haemophilus influenzae, ampicillin-resistant H. influenzae, and Escherichia coli. Aztreonam was also compared with gentamicin in experimentally induced E. coli cerebritis in rats. Doses of the various agents were delivered that produced near-peak concentrations in serum ...

  4. Human Simulated Studies of Aztreonam and Aztreonam-Avibactam To Evaluate Activity against Challenging Gram-Negative Organisms, Including Metallo-β-Lactamase Producers

    OpenAIRE

    Crandon, Jared L.; Nicolau, David P.

    2013-01-01

    Secondary to the stability of aztreonam against metallo-β-lactamases, coupled with avibatam's neutralizing activity against often coproduced extended-spectrum β-lactamases (ESBLs) or AmpC enzymes, the combination of aztreonam and avibactam has been proposed as a principal candidate for the treatment of infections with metallo-β-lactamase-producing Gram-negative organisms. Using the neutropenic-mouse thigh infection model, we evaluated the efficacy of human simulated doses of aztreonam-avibact...

  5. Prevention of radiation-induced bacteraemia by post-treatment with OK-432 and aztreonam

    International Nuclear Information System (INIS)

    The effects of combined treatment with OK-432, an immunomodulator prepared from Streptococcus haemolyticus, and aztreonam, a monobactum antibiotic, in the prevention of radiation-induced bacteraemia and mortality were examined in ICR-MCH mice irradiated with 9.5 Gy. The organisms recovered from the irradiated mice were Streptococcus faecalis and Proteus mirabilis. Treatment with aztreonam reduced the incidence of mice infected with Proteus mirabilis (p<0.01), but it showed no efficacy on Streptococcus faecalis. OK-432 could reduce the frequency of bacteraemia attributed to both organisms (p<0.05). Combined treatment with OK-432 and aztreonam further decreased the incidence of bacteraemia by both organisms; no organisms were recovered at 14 days following irradiation. The survival rate at 30 days following irradiation was 80% in mice treated with OK-432 plus aztreonam and 55% with OK-432 alone, while it was 0% in the groups treated with aztreonam or saline alone. These results indicated that combined treatment with OK-432 and a suitable antibiotic such as aztreonam is more effective than OK-432 or aztreonam alone. (Author)

  6. Prevention of radiation-induced bacteraemia by post-treatment with OK-432 and aztreonam

    Energy Technology Data Exchange (ETDEWEB)

    Kurishita, A.; Ono, T. (Tohoku Univ., Sendai (Japan). School of Medicine); Uchida, A. (Kyoto Univ. (Japan). Radiation Biology Center)

    1993-03-01

    The effects of combined treatment with OK-432, an immunomodulator prepared from Streptococcus haemolyticus, and aztreonam, a monobactum antibiotic, in the prevention of radiation-induced bacteraemia and mortality were examined in ICR-MCH mice irradiated with 9.5 Gy. The organisms recovered from the irradiated mice were Streptococcus faecalis and Proteus mirabilis. Treatment with aztreonam reduced the incidence of mice infected with Proteus mirabilis (p<0.01), but it showed no efficacy on Streptococcus faecalis. OK-432 could reduce the frequency of bacteraemia attributed to both organisms (p<0.05). Combined treatment with OK-432 and aztreonam further decreased the incidence of bacteraemia by both organisms; no organisms were recovered at 14 days following irradiation. The survival rate at 30 days following irradiation was 80% in mice treated with OK-432 plus aztreonam and 55% with OK-432 alone, while it was 0% in the groups treated with aztreonam or saline alone. These results indicated that combined treatment with OK-432 and a suitable antibiotic such as aztreonam is more effective than OK-432 or aztreonam alone. (Author).

  7. Effects of aztreonam on fecal flora and on vitamin K metabolism.

    OpenAIRE

    Sakata, H.; Kakehashi, H.; Fujita, K; Yoshioka, H.

    1990-01-01

    The effects of aztreonam on fecal flora and on descarboxy prothrombin (PIVKA-II) in plasma and gamma-carboxyglutamic acid (Gla) in urine as an index of vitamin K metabolism were studied in seven children (age range, 2 months to 2 years) with urinary tract infections. Daily doses of aztreonam were 60 to 80 mg/kg. Stool specimens were obtained before the treatment, on days 3 to 5 of aztreonam use, and from 3 to 5 days after the cessation of treatment. The counts of enterobacteria decreased (P l...

  8. Introducing Aztreonam The First Monobactam Antibiotic, A Suitable Substitution for the Aminoglycosides

    Directory of Open Access Journals (Sweden)

    A. Jahanshahi M.Khajeh - Karamadeni S. Fazli Bazaz

    1992-07-01

    Full Text Available Aztreonam (Azactam for injection, squibb is the first member of a new and unique class of beta - lactam antibiotics designated by researchers at the Squibb Institute for Medical Research as monobactams (monocyclic bacterially produced beta - lactam antibiotics."nIn this research, for the first time, antimicrobial spectrum of aztrenoam was determined by Disk - Agar Diffusion (250 spp. and Macrodilution Broth Methods (150 Spp."nWe also compared this antibiotic with two routine aminoglycoside antibiotics (Amikacin, Gentamicin in Iran. The most active antibiotic in our study was aztreonam which had MIC50 & MIC90 of 4 & 32 ^g/ml specifically against Pseudomonas aeruginosa."nThis rate for the other aerobic gram - negative bacteria (E. coli, Kleb. pneumoniae, Proteus mirabilis, enterobacter spp., Shigella Spp. and Salmonella Spp. was less than 0.5 & 4 g/ml respectively."nAztreonam's MIC90 for kleb pneumoniae was 8/jg/mI our results were Correlated to the other studies"nAll aerobic gram - negative bacteria has been obtained from the Qhaem's Medical Center in Mashhad - IRAN."nThe results of Disk - Agar Diffusion Method determines that all bacteria were 100% susceptible against aztreonam except Pseudomonas aeruginosa with 83% susceptibility.

  9. 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.

  10. Aztreonam Injection

    Science.gov (United States)

    ... is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.Your health care provider (doctor, nurse, or pharmacist) may measure the effectiveness and side effects of ...

  11. 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

    for 'inhaled aztreonam' and 'cystic fibrosis'. Inhaled aztreonam is an important new treatment option for chronic P. aeruginosa infection in CF. Long-term studies have shown that the drug is safe and superior to inhaled tobramycin in these specific infections.......Chronic airway infection in cystic fibrosis (CF) is a main cause of the increased morbidity and mortality found with this disease. The most common cause of Gram-negative infection is Pseudomonas aeruginosa. The introduction of inhaled antibiotics has changed the lives of affected patients and the...

  12. Structural characterization of low level degradants in aztreonam injection and an innovative approach to aid HPLC method validation.

    Science.gov (United States)

    Ye, Qingmei; Ding, Wei; Rinaldi, Frank; Huang, Yande; Miller, Scott A; Bolgar, Mark

    2016-05-30

    Three new degradants have been identified from drug product and active pharmaceutical ingredient stability samples of aztreonam, a marketed synthetic monocyclic beta-lactam antibiotic. The degradants were detected following the implementation of a new, more selective HPLC method for the determination of impurities and degradants. The new method was developed in response to changes in the regulatory requirement for mature products. Two of the new unknown Degradants (I and II) were observed in chromatograms from stability samples of aztreonam injection. The third new Degradant (III) was observed during a stability study of the aztreonam active pharmaceutical ingredient. These degradants were structurally characterized. A small amount (ca. 1-3mg) of each degradant was isolated via preparative HPLC for structure elucidation using accurate MS, one and two-dimensional NMR spectroscopy. The small amount of each NMR sample was then reused as a standard for HPLC purity/impurity method validation. Their exact concentrations were determined using quantitative NMR which enabled the execution of the quantitative elements of the HPLC method validation. This innovative approach eliminated the need to isolate or synthesize larger quantities of markers for HPLC/UV method validation, thus saving significant time and reducing costs. PMID:26991056

  13. Elevated muscle enzyme levels due to aztreonam%氨曲南致肌酶水平升高

    Institute of Scientific and Technical Information of China (English)

    段丹丹; 李建华

    2012-01-01

    1例47岁女性患者因盆腔炎给予氨曲南1.0 g入0.9%氯化钠注射液250 ml静脉滴注2次/d,替硝唑0.4 g静脉滴注2次/d,保妇康栓1粒/d(阴道给药).用药第4天患者出现乏力,实验室检查示肌酸激酶(CK) 764 U/L,乳酸脱氢酶(LDH)357 U/L,α-羟丁酸脱酸酶(α-HBDH) 293 U/L.次日停用氨曲南,其他药物未变.停用氨曲南第5天乏力缓解,CK 257 U/L,LDH 351 U/L,α-HBDH 162 U/L;第9天乏力消失,CK 166 U/L,LDH 331 U/L,α-HBDH 156 U/L,均在正常范围内.%A 47-year-old female received an IV infusion of aztreonam 1.0 g in 0. 9% sodium chloride 250 ml twice daily, an IV infusion of tinidazole 0. 4 g twice daily and vaginal administration of one Baofukang (保妇康 ) suppository once daily for pelvic inflammation. Four days after drug administration, the patient developed asthenia. Laboratory tests revealed the following levels; creatine kinase ( CK ) 764 U/L, lactate dehydrogenase ( LDH ) 357 U/L, a-hydroxybutyrate dehydroge nase( α-HBDH ) 293 U/L. Aztreonam was withdrawn and her other medications remained unchanged. On the fifth day after aztreonam withdrawal! her asthenia improved. She had a CK level of 257 U/L, a LDH level of 351 U/L and a a-HBDH level of 162 U/L. On the ninth day after aztreonam withdrawal, her asthenia disappeared. Her CK( 166 U/L ), LDH ( 331 U/L ) and a-HBDH ( 156 U/L ) levels were within normal range.

  14. In vitro activities of aztreonam, piperacillin, and ticarcillin combined with amikacin against amikacin-resistant Pseudomonas aeruginosa and P. cepacia isolates from children with cystic fibrosis.

    OpenAIRE

    Aronoff, S C; Klinger, J D

    1984-01-01

    Amikacin, combined with aztreonam, piperacillin, or ticarcillin, synergistically inhibited amikacin-resistant sputum isolates of Pseudomonas aeruginosa and P. cepacia from children with cystic fibrosis. Ticarcillin-amikacin was the least active combination. Aminoglycoside resistance should not preclude the use of beta-lactam-aminoglycoside combinations in the treatment of pulmonary infections in cystic fibrosis.

  15. A case report of allergic shock caused by aztreonam%氨曲南致过敏性休克1例

    Institute of Scientific and Technical Information of China (English)

    李士华; 赵建芹

    2013-01-01

    A twenty years old female patient came to emergency department because of cough and expectoration in the past five days. It was the examination results that T 38. 3℃ ,P 87 beats per minute,R 16 beats per minute,BP 120/80mmHg. Her throat was congested. The doctor could hear the moist rales over the lung. The chest radiograph showed double lung with enhanced texture disorders,especially in the right lower lung. She was diagnosed with acute bronchitis. She was given the aztreonam intravenous infusion. She suddenly felt difficulty breathing, chest tightness, labored breathing. The nurse couldn't measure her blood pressure. Doctors heard her double lung full of wet rales, wheezing sound. She was diagnosed with allergic shock caused by aztreonam. She was intramuscular injection of epinephrine hydrochloride and other treatment, and then fully restored.

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

    OpenAIRE

    Lavoie, G Y; Bergeron, M G

    1985-01-01

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

  17. 一种新的β晶型氨曲南无菌原料药的生产方法%A new production method of the β crystalline aztreonam sterile APIs

    Institute of Scientific and Technical Information of China (English)

    贾佩骞; 李峰; 苗嘉伟; 李晶晶

    2012-01-01

    Objective: To study a new production method of the β crystalline aztreonam sterile APIs (active pharmaceutical ingredient). Methanol: Aztreonam of a crystalline form dissolved in anhydrous methanol solution, sterile filtration, the organic carboxylic acid is then added to the solution, the β crystal form aztreonam sterile APIs was obtained. Results: The reaction of β crystalline aztreonam yield of 75% or more, the quality of products meets the standards of Chinese Pharmacopoeia (edition 2010). Conclusion: the present reaction invention is simple, low cost, high yield, good purity, a small amount of solvent, it is appropriate to the industrial production and have a greater value.%目的:研究一种新的β晶型氨曲南无菌原料药的生产方法。方法:将α晶型氨曲南溶解于无水甲醇溶液中,进行无菌过滤,然后在溶液中加入有机羧酸,生成β晶型氨曲南无菌原料药。结果:反应生成的β晶型氨曲南收率达到75%以上,质量符合中国药典2010版。结论:本发明方法反应简单、成本低、产率高、产物纯度好、溶剂量小,宜于工业化生产,有较大的应用价值。

  18. Global Dissemination of blaKPC into Bacterial Species beyond Klebsiella pneumoniae and In Vitro Susceptibility to Ceftazidime-Avibactam and Aztreonam-Avibactam.

    Science.gov (United States)

    Kazmierczak, Krystyna M; Biedenbach, Douglas J; Hackel, Meredith; Rabine, Sharon; de Jonge, Boudewijn L M; Bouchillon, Samuel K; Sahm, Daniel F; Bradford, Patricia A

    2016-08-01

    The Klebsiella pneumoniae carbapenemase (KPC), first described in the United States in 1996, is now a widespread global problem in several Gram-negative species. A worldwide surveillance study collected Gram-negative pathogens from 202 global sites in 40 countries during 2012 to 2014 and determined susceptibility to β-lactams and other class agents by broth microdilution testing. Molecular mechanisms of β-lactam resistance among carbapenem-nonsusceptible Enterobacteriaceae and Pseudomonas aeruginosa were determined using PCR and sequencing. Genes encoding KPC enzymes were found in 586 isolates from 22 countries (76 medical centers), including countries in the Asia-Pacific region (32 isolates), Europe (264 isolates), Latin America (210 isolates), and the Middle East (19 isolates, Israel only) and the United States (61 isolates). The majority of isolates were K. pneumoniae (83.4%); however, KPC was detected in 13 additional species. KPC-2 (69.6%) was more common than KPC-3 (29.5%), with regional variation observed. A novel KPC variant, KPC-18 (KPC-3[V8I]), was identified during the study. Few antimicrobial agents tested remained effective in vitro against KPC-producing isolates, with ceftazidime-avibactam (MIC90, 4 μg/ml), aztreonam-avibactam (MIC90, 0.5 μg/ml), and tigecycline (MIC90, 2 μg/ml) retaining the greatest activity against Enterobacteriaceae cocarrying KPC and other β-lactamases, whereas colistin (MIC90, 2 μg/ml) demonstrated the greatest in vitro activity against KPC-positive P. aeruginosa This analysis of surveillance data demonstrated that KPC is widely disseminated. KPC was found in multiple species of Enterobacteriaceae and P. aeruginosa and has now become a global problem. PMID:27161636

  19. 吸入氨曲南赖氨酸治疗囊性纤维化肺假单胞菌感染%Inhaled aztreonam iysine for airway pseudomonas in cystic fibrosis

    Institute of Scientific and Technical Information of China (English)

    任艳丽

    2012-01-01

    Objective To assess the short - tain efficacy and safety of inhaled aztreonam ly-sine (AZLI) in patients with cystic fibrosis (CF) and pseudomonas aeruginosa (PA) airway infection. Methods AZLI group received 75 mg of AZLI (three times daily for 28 days). The control group received 5 mg of lactose (three times daily) and was monitored for 14 days. The primary efficacy end point was the change in patient - reported respiratory symptoms. Secondary end points included changes in pulmonary function (FEV 1), sputum PA density, and non - respiratory CFQ-R scales. Adverse events were monitored as well. Results After 28 - day treatment, compared with the placebo group, AZLI improved significantly in terms of the mean CFQ - R respiratory score, FEV 1, and sputum PA density. Significant improvements in emotional functioning, health perceptions, physical functioning, and vitality CFQ- R scales were observed. Adverse events were consistent with symptoms of CF lung disease. Conclusion In patients with CF, PA airway infection, moderate - to - severe lung disease, and no recent use of antipseudomonal antibiotics or azithromycin, 28 - day treatment with AZLI can significantly improve respiratory symptoms and pulmonary function, which is also well tolerated.%目的 评价囊性纤维化(CF)和铜绿假单胞菌(PA)气道感染患者吸入氨曲南赖氨酸(AZLI)的有效性和安全性.方法 AZLI用药组给予75 mg AZLI(3次/d,连续28 d)对照组给予5mg乳糖(3次/d),给药完成后监测14 d.主要观测指标为患者呼吸系统症状改善,其他指标包括肺功能(FEV1)、痰PA密度、非呼吸系统CFQ-R量表改善.监测不良反应.结果 经过28 d的治疗,与安慰剂对照组比较,AZLI组平均CFQ-R呼吸评分、FEV1和痰PA密度显著改善.观测到的情绪、呼吸系统症状、体力等明显改善.不良事件伴随CF肺疾病症状.结论 合并PA气道感染、中重度肺疾病、近期未应用抗假单孢菌属抗生素或阿

  20. 多黏菌素B、氨曲南和万古霉素药敏纸片在细菌分离及鉴定中的应用%Application of Polymyxin B,Aztreonam and Vancomycin Medicine Sensitive Slipin Bacteria Separation and Identification

    Institute of Scientific and Technical Information of China (English)

    王华; 苍金荣; 张利侠; 苏宝凤; 归巧娣; 刘文康; 任健康

    2012-01-01

    目的 利用多黏菌素B、氨曲南和万古霉素特殊的抗菌机制,拓展其在细菌分离及鉴定中的应用.方法 将直接涂片或增菌后革兰染色疑似肠杆菌和肠球菌共存的标本,直接接种于哥伦比亚血琼脂平板上,粘贴多黏菌素B 药敏纸片;对变形杆菌与革兰阳性球菌共存的混合培养物则粘贴氨曲南药敏纸片;对于形态不典型、革兰染色性不定的难以鉴定的菌株,采用KB药敏实验方法,同时粘贴多黏菌素B、万古霉素药敏纸片.35℃培养18~24 h观察结果.结果 多黏菌素B抑菌环内肠球菌生长良好而肠杆菌不生长,氨曲南抑菌环内革兰阳性球菌生长良好而变形杆菌不生长.取多黏菌素B、氨曲南抑菌环内细菌转种于哥伦比亚血琼脂平板,从而达到快速分纯菌株的目的.13份肠杆菌和肠球菌共存的胆汁及脓液标本,采取该方法仅需一代就可以将肠杆菌与肠球菌分离;5份变形杆菌与革兰阳性球菌共存的培养物也仅需一代就可将革兰阳性球菌分纯,而采用传统的方法,6份胆汁标本需2~3代才能分纯,剩余7份均未分离出肠球菌;5份变形杆菌与革兰阳性球菌共存的培养物采用传统的分纯方法也均未分离出革兰阳性球菌;对于形态不典型,革兰染色性不定的难以鉴定的菌株,对万古霉素敏感而多黏菌素耐药的多为革兰阳性细菌,对万古霉素耐药、多黏菌素B敏感的多为革兰阴性细菌.结论 利用多黏菌素B、氨曲南药敏纸片可将难以分纯标本中的肠球菌、革兰阳性球菌快速分纯;另外,对于形态不典型、革兰染色染色性不定的难以鉴定菌株,利用其对多黏菌素B、万古霉素的敏感性,可为待鉴定细菌选定正确的鉴定方向.%Objective To expand the application of separation and identification in bacteria with special antibacterial mechanism of polymyxin B, aztreonam and vancomycin. Methods Suspected enterobacter and

  1. 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. PMID:26711252

  2. 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...

  3. 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

  4. TEM-4, a new plasmid-mediated beta-lactamase that hydrolyzes broad-spectrum cephalosporins in a clinical isolate of Escherichia coli.

    OpenAIRE

    Paul, G C; Gerbaud, G; Bure, A; Philippon, A M; B. Pangon; Courvalin, P.

    1989-01-01

    A clinical isolate of Escherichia coli, strain CB-134, recovered in 1986 from an abdominal abscess, exhibited resistance to penams, oxyimino-beta-lactams including broad-spectrum cephalosporins (cefotaxime, ceftriaxone, ceftazidime), and aztreonam but remained susceptible to cephamycins (cefoxitin, cefotetan) and to moxalactam and imipenem. Clavulanate (2 micrograms/ml) restored the susceptibility of the strain to broad-spectrum cephalosporins and aztreonam. A beta-lactamase with an isoelectr...

  5. Comparison of the inoculum effects of members of the family Enterobacteriaceae on cefoxitin and other cephalosporins, beta-lactamase inhibitor combinations, and the penicillin-derived components of these combinations.

    OpenAIRE

    Goldstein, E J; Citron, D M; Cherubin, C E

    1991-01-01

    We compared the inoculum effects of 105 recent clinical isolates of the family Enterobacteriaceae on cefoxitin, other cephalosporins, aztreonam, and three beta-lactamase inhibitors (clavulanic acid, sulbactam, and tazobactam) and their penicillin-derived components. Piperacillin and aztreonam showed the largest inoculum effect, and cefoxitin showed the smallest. The other cephalosporins tested (cefotetan, ceftizoxime, and ceftriaxone) showed an intermediate inoculum effect. In general, the in...

  6. Antibiotic resistance profiles of Pseudomonas aeruginosa isolated from various Greek aquatic environments.

    Science.gov (United States)

    Olga, Pappa; Apostolos, Vantarakis; Alexis, Galanis; George, Vantarakis; Athena, Mavridou

    2016-05-01

    A large number of antibiotic-resistantP. aeruginosaisolates are continuously discharged into natural water basins mainly through sewage. However, the environmental reservoirs of antibiotic resistance factors are poorly understood. In this study, the antibiotic resistance patterns of 245 isolates from various aquatic sites in Greece were analysed. Twenty-three isolates with resistance patterns cefotaxime-aztreonam-ceftazidime, cefotaxime-aztreonam-meropenem, cefotaxime-ceftazidime-meropenem, cefotaxime-ceftazidime-aztreonam-meropenem and cefotaxime-ceftazidime-cefepime-aztreonam-meropenem were screened phenotypically for the presence of extended spectrum β-lactamases (ESBLs), while 77 isolates with various resistant phenotypes were screened for the presence of class 1 and class 2 integrase genes. The aztreonam-resistant isolates and ESBL producers were the main resistant phenotypes in all habitats tested. In 13/77 isolates class 1 integron was detected, while all tested isolates were negative for the presence of the class 2 integrase gene. CTX-M group 9 β-lactamase was present in a small number of isolates (three isolates) highlighting the emergence of ESBL genes in aquatic environments. As a conclusion, it seems that Greek water bodies could serve as a potential reservoir of resistantP. aeruginosaisolates posing threats to human and animal health. PMID:26917780

  7. In Vitro Pharmacodynamics of Levofloxacin and Other Aerosolized Antibiotics under Multiple Conditions Relevant to Chronic Pulmonary Infection in Cystic Fibrosis ▿

    OpenAIRE

    King, Paula; Lomovskaya, Olga; Griffith, David C.; Burns, Jane L.; Dudley, Michael N.

    2009-01-01

    The inhalational administration of antibiotics can provide high concentrations locally in the lungs of cystic fibrosis patients and, thus, can be useful for the treatment of chronic bacterial infections. The present study evaluated the in vitro activities of levofloxacin, ciprofloxacin, tobramycin, amikacin, and aztreonam against clinical isolates of Pseudomonas aeruginosa, Burkholderia cepacia complex, Stenotrophomonas maltophilia, Alcaligenes xylosoxidans, and Staphylococcus aureus from cys...

  8. Resistance of Xanthomonas maltophilia to antibiotics and the effect of beta-lactamase inhibitors.

    Science.gov (United States)

    Neu, H C; Saha, G; Chin, N X

    1989-01-01

    We examined the susceptibility of 50 isolates of Xanthomonas maltophilia and the effect of beta-lactamase inhibitors upon the susceptibility. The majority of isolates were resistant to azlocillin, piperacillin, mezlocillin, ticarcillin, cefotaxime, ceftizoxime, ceftriaxone, cefoperazone, and ceftazidime. All isolates were resistant to imipenem, CGP 31608, aztreonam, and carumonam. Although disk susceptibility tests showed that the combination of clavulanate with ticarcillin inhibited many isolates, at a ratio of 1:20 few isolates were susceptible to the combination. Addition of clavulanate to aztreonam and to imipenem failed to make organisms susceptible. Sulbactam combined with cefoperazone made some organisms susceptible, but ampicillin-sulbactam was ineffective, whereas tazobactam combined with piperacillin at a ratio of 1:4 made half the isolates have MICs of 32 micrograms/ml or less. The beta-lactamases from the isolates hydrolyzed all of the beta-lactams. PMID:2791491

  9. Alleviation of acute radiation damages by post-irradiation treatments

    International Nuclear Information System (INIS)

    Radiation induced hematopoietic and gastro-intestinal damages in mice were tried to alleviate experimentally by post-treatment. Combined treatment of OK-432 and aztreonam clearly prevented the radiation induced sepsis and elevated the survival rate in mice; the survival was 80% in the OK-432 plus aztreonam group while it was 55% in the group treated with OK-432 alone and 0% with saline. Irsogladine maleate, an anti-ulcer drug, increased the survival rate of jejunal crypt stem cells with a clear dose-related trend. The D0 for irsogladine maleate was 2.8 Gy although it was 2.3 Gy for saline, These findings suggest that some conventional drugs are effective for radiation induced hematopoietic and gastro-intestinal damages and the possibility that they can be applied for people exposed to radiation accidentally. (author)

  10. 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.

  11. 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.

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

    DEFF Research Database (Denmark)

    Høiby, Niels

    2011-01-01

    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...... 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....

  13. Occurrence of Extended-Spectrum β-Lactamases in Members of the Family Enterobacteriaceae in Italy: Implications for Resistance to β-Lactams and Other Antimicrobial Drugs

    OpenAIRE

    Spanu, T; Luzzaro, F.; Perilli, M; Amicosante, G; Toniolo, A.; Fadda, G.

    2002-01-01

    An Italian nationwide survey was carried out to assess the prevalences and the antimicrobial susceptibilities of members of the family Enterobacteriaceae producing extended-spectrum β-lactamases (ESBLs). Over a 6-month period, 8,015 isolates were obtained from hospitalized patients and screened for resistance to extended-spectrum cephalosporins and monobactams. On the basis of a synergistic effect between clavulanate and selected β-lactams (ceftazidime, aztreonam, cefotaxime, cefepime, and ce...

  14. Nosocomial Outbreak of Infections by Proteus mirabilis That Produces Extended-Spectrum CTX-M-2 Type β-Lactamase

    OpenAIRE

    Nagano, Noriyuki; Shibata, Naohiro; Saitou, Yuko; Nagano, Yukiko; Arakawa, Yoshichika

    2003-01-01

    Nineteen multidrug-resistant Proteus mirabilis strains were isolated from 19 patients suffering from infections probably caused by P. mirabilis. These strains were recovered from urine or other urogenital specimens of 16 inpatients and three outpatients with a hospitalization history in a urology ward of Funabashi Medical Center, from July 2001 to August 2002. These strains demonstrated resistance to cefotaxime, ceftriaxone, cefpodoxime, and aztreonam, while they were highly susceptible to ce...

  15. Determination of Susceptibilities of 26 Leptospira sp. Serovars to 24 Antimicrobial Agents by a Broth Microdilution Technique

    OpenAIRE

    Murray, Clinton K.; Hospenthal, Duane R.

    2004-01-01

    The MICs of 24 antimicrobials for 26 Leptospira spp. serovars were determined using a broth microdilution technique. The MICs at which 90% of isolates tested were inhibited (MIC90s) of cefepime, imipenem-cilastatin, erythromycin, clarithromycin, and telithromycin were all ≤0.01 μg/ml. The MIC90s of amoxicillin, aztreonam, cefdinir, chloramphenicol, and penicillin G were ≥3.13 μg/ml. Many antimicrobials have excellent in vitro activity against Leptospira.

  16. Detection Of Extended-Spectrum Beta Lactamase in Klebsiella pneumoniae and Klebsiella oxytoca Bacteria with the Combined Disc Method

    OpenAIRE

    Ebru Yılmaz; Güven Uraz

    2011-01-01

    Extended-spectrum beta lactamases (ESBLs) are responsible for resistance to cephalosporins (ceftazidime, ceftriaxone, and cefotaxime) and aztreonam in gram-negative bacilli. ESBL producing Klebsiella bacteria are a major problem for clinicians, ESBLs increase are cause of failure in treatment particularly paediatric patients and also in medical and surgical units. In this research ESBL was investigated by combined disc method. In this research, 128 clinical isolates of Klebsiella ssp. were co...

  17. Detection Of Extended-Spectrum Beta Lactamase in Klebsiella pneumoniae and Klebsiella oxytoca Bacteria with the Combined Disc Method

    OpenAIRE

    Yılmaz, Ebru; Uraz, Güven

    2000-01-01

    Extended-spectrum beta lactamases (ESBLs) are responsible for resistance to cephalosporins (ceftazidime, ceftriaxone, and cefotaxime) and aztreonam in gram-negative bacilli. ESBL producing Klebsiella bacteria are a major problem for clinicians, ESBLs increase are cause of failure in treatment particularly paediatric patients and also in medical and surgical units. In this research ESBL was investigated by combined disc method. In this research, 128 clinical isolates of Klebsiella ssp. were co...

  18. Emergence of Extensively Drug-Resistant Proteus mirabilis Harboring a Conjugative NDM-1 Plasmid and a Novel Salmonella Genomic Island 1 Variant, SGI1-Z.

    Science.gov (United States)

    Qin, Shangshang; Qi, Hui; Zhang, Qijing; Zhao, Di; Liu, Zhen-Zhen; Tian, Hao; Xu, Lijuan; Xu, Hui; Zhou, Mengmeng; Feng, Xianju; Liu, Hong-Min

    2015-10-01

    Acquisition of blaNDM-1 in bacterial species, such as Proteus mirabilis that is intrinsically resistant to tetracycline, tigecycline and colistin, will make clinical treatment extremely difficult. Here, we characterized an NDM-1-producing clinical isolate of P. mirabilis (PM58) that displayed an extensively drug-resistant (XDR) phenotype, susceptible only to aztreonam. Molecular analysis revealed that PM58 harbored both a conjugative NDM-1 plasmid and a novel Salmonella genomic island 1 variant on chromosome. PMID:26195511

  19. Genetic and biochemical characterization of FRI-1, a carbapenem-hydrolyzing class A β-Lactamase from Enterobacter cloacae

    OpenAIRE

    Dortet, Laurent; Poirel , Laurent; Abbas, Samia; Oueslati, Saoussen; Nordmann, Patrice

    2016-01-01

    An Enterobacter cloacae isolate was recovered from a rectal swab from a patient hospitalized in France with previous travel to Switzerland. It was resistant to penicillins, narrow- and broad-spectrum cephalosporins, aztreonam, and carbapenems but remained susceptible to expanded-spectrum cephalosporins. Whereas PCR-based identification of the most common carbapenemase genes failed, the biochemical Carba NP test II identified an Ambler class A carbapenemase. Cloning experiments followed ...

  20. High-Level Resistance to Ceftazidime Conferred by a Novel Enzyme, CTX-M-32, Derived from CTX-M-1 through a Single Asp240-Gly Substitution

    OpenAIRE

    Cartelle, Monica; del Mar Tomas, Maria; Molina, Francisca; Moure, Rita; Villanueva, Rosa; Bou, German

    2004-01-01

    A clinical strain of Escherichia coli isolated from pleural liquid with high levels of resistance to cefotaxime, ceftazidime, and aztreonam harbors a novel CTX-M gene (blaCTX-M-32) whose amino acid sequence differs from that of CTX-M-1 by a single Asp240-Gly substitution. Moreover, by site-directed mutagenesis we demonstrated that this replacement is a key event in ceftazidime hydrolysis

  1. Dissemination of CTX-M-Type β-Lactamases among Clinical Isolates of Enterobacteriaceae in Paris, France

    OpenAIRE

    Eckert, C.; Gautier, V.; Saladin-Allard, M.; Hidri, N.; Verdet, C.; Ould-Hocine, Z.; Barnaud, G.; Delisle, F.; Rossier, A.; Lambert, T; Philippon, A; Arlet, G

    2004-01-01

    We analyzed 19 clinical isolates of the family Enterobacteriaceae (16 Escherichia coli isolates and 3 Klebsiella pneumoniae isolates) collected from four different hospitals in Paris, France, from 2000 to 2002. These strains had a particular extended-spectrum cephalosporin resistance profile characterized by a higher level of resistance to cefotaxime and aztreonam than to ceftazidime. The blaCTX-M genes encoding these β-lactamases were involved in this resistance, with a predominance of blaCT...

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

    OpenAIRE

    Smitha O. Bagali; B.V. Peerapur

    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...

  3. Prevalence of AmpC and other beta-lactamases in enterobacteria at a large urban university hospital in Brazil

    OpenAIRE

    Dias, Rubens Clayton da Silva; Borges-Neto, Armando Alves; Ferraiuoli, Giovanna Ianini D’Almeida; de-Oliveira, Márcia P.; Riley, Lee W.; Moreira, Beatriz Meurer

    2007-01-01

    Production of extended-spectrum β-lactamases (ESBL) has been reported in virtually all species of Enterobacteriaceae, which greatly complicates the therapy of infections caused by these organisms. However, the frequency of isolates producing AmpC β-lactamases, especially plasmid mediated AmpC (pAmpC), is largely unknown. These β-lactamases confer resistance to extended spectrum cephalosporins and aztreonam, a multidrug-resistant (MDR) profile. The aim of the present study was to determine the...

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

    OpenAIRE

    Wang, Peng; Hu, Fupin; Xiong, Zizhong; Ye, Xinyu; Zhu, Demei; Wang, Yun F. (Wayne); 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, ...

  5. Antibacterial activity of BMS-180680, a new catechol-containing monobactam.

    OpenAIRE

    Fung-Tomc, J; Bush, K; Minassian, B; Kolek, B; Flamm, R; Gradelski, E; Bonner, D

    1997-01-01

    The in vitro activities of a new catechol-containing monobactam, BMS-180680 (SQ 84,100), were compared to those of aztreonam, ceftazidime, imipenem, piperacillin-tazobactam, ciprofloxacin, amikacin, and trimethoprim-sulfamethoxazole. BMS-180680 was often the most active compound against many species of the family Enterobacteriaceae, with MICs at which 90% of the isolates were inhibited (MIC90s) of < or = 0.5 microg/ml for Escherichia coli, Klebsiella spp., Citrobacter diversus, Enterobacter a...

  6. 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

    OpenAIRE

    Vera Magalhães; Ana Kelly Lins; Marcelo Magalhães

    2005-01-01

    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...

  7. Dissemination of the novel plasmid-mediated beta-lactamase CTX-1, which confers resistance to broad-spectrum cephalosporins, and its inhibition by beta-lactamase inhibitors.

    OpenAIRE

    Kitzis, M D; Billot-Klein, D; Goldstein, F W; Williamson, R.; Tran Van Nhieu, G; Carlet, J; Acar, J F; Gutmann, L

    1988-01-01

    The novel beta-lactamase CTX-1 (pI 6.3) encoded on a transferable 84-kilobase plasmid was found in six different bacterial species. It was responsible for a significant decrease in susceptibility towards most penicillins and cephalosporins, except imipenem, temocillin, and cephalosporins which have a 7-alpha-methoxy substituent. Synergy between either ampicillin, piperacillin, cefotaxime, ceftazidime, or aztreonam and three beta-lactamase inhibitors (clavulanic acid, sulbactam, and YTR 830) w...

  8. Involvement of penicillin-binding protein 2 with other penicillin-binding proteins in lysis of Escherichia coli by some beta-lactam antibiotics alone and in synergistic lytic effect of amdinocillin (mecillinam).

    OpenAIRE

    Gutmann, L; Vincent, S; Billot-Klein, D; Acar, J F; Mrèna, E; Williamson, R.

    1986-01-01

    Compared with cefotaxime, ceftazidime, moxalactam, and aztreonam, ceftriaxone produced the best lytic and bactericidal effects when each was added at about 10 times the MIC to Escherichia coli W7. When each of these antibiotics was added at its MIC, only bacteriostasis occurred, but the simultaneous addition of amdinocillin (mecillinam) was synergistic in causing rapid lysis and bactericidal effects. Induction of lysis of two E. coli mutants containing either a thermosensitive penicillin-bind...

  9. Efficacy of methanolic extract of green and black teas against extended-spectrum β-Lactamase-producing Pseudomonas aeruginosa.

    Science.gov (United States)

    Taherpour, Arezou; Hashemi, Ali; Erfanimanesh, Soroor; Taki, Elahe

    2016-07-01

    Pseudomonas aeruginosa is one of the major bacteria causing acute infections. β-Lactamase production is the principal defense mechanism in gram-negative bacteria. The aim of our study was to evaluate the antibacterial activity of Methanolic Extracts of Green and Black Teas on P. aeruginosa Extended Spectrum-β-Lactamases (ESBLs) production. This research was carried out on burn wounds of 245 hospitalized patients in Kerman, Iran. P. aeruginosa ESBLs and MBL producing strains were detected by Combination Disk Diffusion Test (CDDT) and Epsilometer test (E-test) strips, respectively. Minimum inhibitory concentration (MIC) was measured for Ceftazidime, Meropenem, Imipenem, Aztreonam, Cefotaxime and methanollic extracts of Camellia Sinensis (Green Tea). From 245 patients in the burn ward, 120 cases were infected with P. aeruginosa. 41 isolates contained ESBL while MBL was not detected. P. aeruginosa were resistant to Cefotaxime, Aztreonam, Ceftazidime, Meropenem and Imipenem, 72 (60%), 50 (41.66%), 79 (65.83%), 33 (27.5%) and 24 (20%), respectively. Green tea extract had the highest anti-bacterial effect on standard and P. aeruginosa strains in 1.25mg/ml concentration. This study determined that the methanolic extract of green tea has a higher effect against ESBL producing P. aeruginosa than Cefotaxime, Aztreonam and Ceftazidime. PMID:27393439

  10. Development of a novel antimicrobial screening system targeting the pyoverdine-mediated iron acquisition system and xenobiotic efflux pumps.

    Science.gov (United States)

    Sato, Kazuki; Ushioda, Kenichi; Akiba, Keiji; Matsumoto, Yoshimi; Maseda, Hideaki; Ando, Tasuke; Isogai, Emiko; Nakae, Taiji; Yoneyama, Hiroshi

    2015-01-01

    The iron acquisition systems in Pseudomonas aeruginosa are inducible in response to low-iron conditions and important for growth of this organism under iron limitation. OprM is the essential outer membrane subunit of the MexAB-OprM xenobiotic efflux pump. We designed and constructed a new model antimicrobial screening system targeting both the iron-uptake system and xenobiotic efflux pumps. The oprM gene was placed immediately downstream of the ferri-pyoverdine receptor gene, fpvA, in the host lacking chromosomal oprM and the expression of oprM was monitored by an antibiotic susceptibility test under iron depleted and replete conditions. The recombinant cells showed wild-type susceptibility to pump substrate antibiotics, e.g., aztreonam, under iron limitation and became supersusceptible to them under iron repletion, suggesting that expression of oprM is under control of the iron acquisition system. Upon screening of a chemical library comprising 2952 compounds using this strain, a compound-ethyl 2-(1-acetylpiperidine-4-carboxamido)-4,5,6,7-tetrahydrobenzo[b]thiophene-3-carboxylate-was found to enhance the efficacy of aztreonam under iron limitation, suggesting that the compound inhibits either the iron acquisition system or the MexAB-OprM efflux pump. This compound was subsequently found to inhibit the growth of wild-type cells in the presence of sublethal amounts of aztreonam, regardless of the presence or absence of dipyridyl, an iron-chelator. The compound was eventually identified to block the function of the MexAB-OprM efflux pump, showing the validity of this new method. PMID:25939068

  11. Development of a Novel Antimicrobial Screening System Targeting the Pyoverdine-Mediated Iron Acquisition System and Xenobiotic Efflux Pumps

    Directory of Open Access Journals (Sweden)

    Kazuki Sato

    2015-04-01

    Full Text Available The iron acquisition systems in Pseudomonas aeruginosa are inducible in response to low-iron conditions and important for growth of this organism under iron limitation. OprM is the essential outer membrane subunit of the MexAB-OprM xenobiotic efflux pump. We designed and constructed a new model antimicrobial screening system targeting both the iron-uptake system and xenobiotic efflux pumps. The oprM gene was placed immediately downstream of the ferri-pyoverdine receptor gene, fpvA, in the host lacking chromosomal oprM and the expression of oprM was monitored by an antibiotic susceptibility test under iron depleted and replete conditions. The recombinant cells showed wild-type susceptibility to pump substrate antibiotics, e.g., aztreonam, under iron limitation and became supersusceptible to them under iron repletion, suggesting that expression of oprM is under control of the iron acquisition system. Upon screening of a chemical library comprising 2952 compounds using this strain, a compound—ethyl 2-(1-acetylpiperidine-4-carboxamido-4,5,6,7-tetrahydrobenzo[b]thiophene-3-carboxylate—was found to enhance the efficacy of aztreonam under iron limitation, suggesting that the compound inhibits either the iron acquisition system or the MexAB-OprM efflux pump. This compound was subsequently found to inhibit the growth of wild-type cells in the presence of sublethal amounts of aztreonam, regardless of the presence or absence of dipyridyl, an iron-chelator. The compound was eventually identified to block the function of the MexAB-OprM efflux pump, showing the validity of this new method.

  12. 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.

  13. Inhibitor Discovery of Full-Length New Delhi Metallo-β-Lactamase-1 (NDM-1)

    OpenAIRE

    Shen, Bingzheng; Yu, Yan; Chen, Hui; Cao, Xin; Lao, Xingzhen; Fang, Yongliang; Shi, Yun; Chen, Jiao; Zheng, Heng

    2013-01-01

    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 ...

  14. Ocorrência e perfil de sensibilidade a antimicrobianos em Pseudomonas aeruginosa e Acinetobacter sp. em um hospital terciário, no sul do Brasil Occurrence and the susceptibility to antimicrobial agents in Pseudomonas aeruginosa and Acinetobacter sp. at a tertiary hospital in southern Brazil

    OpenAIRE

    Gabriele Mariani Machado; Aldalise Lago; Sérgio Roberto Riccardi Fuentefria; Daiane Bopp Fuentefria

    2011-01-01

    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, desc...

  15. Ocorrência e perfil de sensibilidade a antimicrobianos em Pseudomonas aeruginosa e Acinetobacter sp. em um hospital terciário, no sul do Brasil Occurrence and the susceptibility to antimicrobial agents in Pseudomonas aeruginosa and Acinetobacter sp. at a tertiary hospital in southern Brazil

    Directory of Open Access Journals (Sweden)

    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.INTRODUCTION: The main mechanism of emerging resistance in Pseudomonas aeruginosa and Acinetobacter sp. isolates is the production of metallo-β-lactamases (MβLs. MβLs are enzymes capable of hydrolyzing cephalosporins, penicillins and carbapenems, but not monobactams (aztreonam, which are often used as antimicrobial therapy to treat nosocomial infections. METHODS: An observational descriptive and retrospective study was designed to assess the frequency of MβLs among strains of P. aeruginosa and Acinetobacter sp. obtained from a tertiary hospital in southern Brazil. RESULTS: MβL production was observed in 77.6% (n = 173/223 for P. aeruginosa isolates and 22.4% (n = 50/223 of

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

    OpenAIRE

    Gabriele Mariani Machado; Aldalise Lago; Sérgio Roberto Riccardi Fuentefria; Daiane Bopp Fuentefria

    2011-01-01

    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 retros...

  17. In vitro evaluation of A-56619 (difloxacin) and A-56620: new aryl-fluoroquinolones.

    OpenAIRE

    Stamm, J M; Hanson, C W; Chu, D T; Bailer, R; Vojtko, C; Fernandes, P B

    1986-01-01

    The in vitro antibacterial potencies of A-56619 and A-56620, two new aryl-fluoroquinolones, were compared with the potency of norfloxacin against a broad spectrum of organisms. Cefotaxime, aztreonam, piperacillin, imipenem, penicillin, and gentamicin were also tested for reference purposes. The MICs required to inhibit at least 90% of the strains tested ranged from 0.25 to 4 micrograms/ml for A-56619 and from 0.06 to 0.5 microgram/ml for A-56620 for members of the Enterobacteriaceae. A-56619 ...

  18. Antimicrobial susceptibility of Campylobacter jejuni subsp. jejuni assessed by E-test and double dilution agar method in Southern Chile

    Directory of Open Access Journals (Sweden)

    Fernández H

    2000-01-01

    Full Text Available The susceptibility patterns of 108 Campylobacter jejuni subsp. jejuni clinical strains, to six antimicrobial agents was determined by using the E-test and the double dilution agar methods. Using both metods, no strain was found to be resistant to ciprofloxacin, erythromycin and gentamicin, but two (1.8% were resistant to tetracycline and all to aztreonam. Seven (6.5% strains were resistant to ampicillin by the E-test and five (4.6% by the double dilution agar method and by both meyhods. No great discrepancies were observed between both methods.

  19. Prevalencia de metalo-β-lactamasas en Pseudomonas aeruginosa resistentes a carbapenemes en un Hospital Universitario de Buenos Aires

    OpenAIRE

    G. Pagniez; Radice, M.; A. Cuirolo; Rodríguez, O; Rodríguez, H; Vay, C.; A. Famiglietti; G. Gutkind

    2006-01-01

    Se estudiaron 91 aislamientos de Pseudomonas aeruginosa resistentes a carbapenemes con el objetivo de conocer la prevalencia de metalo-β-lactamasas y evaluar la habilidad del ensayo de inhibición empleando discos de EDTA (1 µmol) en su detección. Se determinó la presencia de carbapenemasas en 10 (11%) de los aislamientos recuperados. La sensibilidad a aztreonam en los aislamientos resistentes a ambos carbapenemes resultó un buen predictor de la presencia de estas enzimas. Dichas carbapenemasa...

  20. Prevalencia de metalo-β-lactamasas en Pseudomonas aeruginosa resistentes a carbapenemes en un Hospital Universitario de Buenos Aires Prevalence of metallo-β-lactamase in carbapenem resistant Pseudomonas aeruginosa at an University Hospital of Buenos Aires City

    OpenAIRE

    G. Pagniez; Radice, M.; A. Cuirolo; Rodríguez, O; Rodríguez, H; Vay, C.; A. Famiglietti; G. Gutkind

    2006-01-01

    Se estudiaron 91 aislamientos de Pseudomonas aeruginosa resistentes a carbapenemes con el objetivo de conocer la prevalencia de metalo-β-lactamasas y evaluar la habilidad del ensayo de inhibición empleando discos de EDTA (1 µmol) en su detección. Se determinó la presencia de carbapenemasas en 10 (11%) de los aislamientos recuperados. La sensibilidad a aztreonam en los aislamientos resistentes a ambos carbapenemes resultó un buen predictor de la presencia de estas enzimas. Dichas carbapen...

  1. Treatment of pseudomonas and Staphylococcus bronchopulmonary infection in patients with cystic fibrosis.

    Science.gov (United States)

    Das, Rashmi Ranjan; Kabra, Sushil Kumar; Singh, Meenu

    2013-01-01

    The optimal antibiotic regimen is unclear in management of pulmonary infections due to pseudomonas and staphylococcus in cystic fibrosis (CF). We systematically searched all the published literature that has considered the evidence for antimicrobial therapies in CF till June 2013. The key findings were as follows: inhaled antipseudomonal antibiotic improves lung function, and probably the safest/most effective therapy; antistaphylococcal antibiotic prophylaxis increases the risk of acquiring P. aeruginosa; azithromycin significantly improves respiratory function after 6 months of treatment; a 28-day treatment with aztreonam or tobramycin significantly improves respiratory symptoms and pulmonary function; aztreonam lysine might be superior to tobramycin inhaled solution in chronic P. aeruginosa infection; oral ciprofloxacin does not produce additional benefit in those with chronic persistent pseudomonas infection but may have a role in early or first infection. As it is difficult to establish a firm recommendation based on the available evidence, the following factors must be considered for the choice of treatment for each patient: antibiotic related (e.g., safety and efficacy and ease of administration/delivery) and patient related (e.g., age, clinical status, prior use of antibiotics, coinfection by other organisms, and associated comorbidities ones). PMID:24489509

  2. Elazığ Belediyesi Atıksu Arıtma Tesisi Giriş Sularında Antibiyotik Kalıntılarının Varlığının Araştırılması

    Directory of Open Access Journals (Sweden)

    Murat TOPAL

    2012-12-01

    Full Text Available ÖzetBu çalışmada, Elazığ Belediyesi Atıksu Arıtma Tesisi giriş sularında antibiyotik kalıntılarının varlığının belirlenmesi amaçlanmıştır. Bu amaç için, arıtma tesisi giriş suyundan kompozit numune alınmış ve analizler yapılmıştır. Analiz sonuçlarına göre Elazığ Belediyesi Atıksu Arıtma Tesisi giriş sularında makrolidler (azitromisin, klaritromisin, eritromisin, beta laktamlar (aztreonam, sefalosporinler (sefamandol, sefepim, sefiksim, rifampisin (rifamisin ve sülfonamid (tetroksoprim antibiyotikleri bulunmuştur. AbstractIn this study, it was aimed to determine the presence of antibiotic residues in influents of Elazığ Municipal Wastewater Treatment Plant. For this aim, composite sample was taken from the influents of the treatment plant and analyses were done. According to the results of the analyses, macrolides (azitromycin, clarithromycin, erithromycin, beta lactams (aztreonam, cefalosporines (cefamondole, cefepime, cefixime, rifampicine (rifamycin and sulfonamide (tetroxoprim antibiotics were obtained in influents of Elazig Municipal Wastewater Treatment Plant.

  3. 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.

  4. Elazığ Belediyesi Atıksu Arıtma Tesisi Giriş Sularında Antibiyotik Kalıntılarının Varlığının Araştırılması / Investigation Of The Presence Of Antibiotic Residues Influent Of Elazig Municipal Wastewater Treatment Plant

    Directory of Open Access Journals (Sweden)

    Murat Topal

    2012-12-01

    Full Text Available Bu çalışmada, Elazığ Belediyesi Atıksu Arıtma Tesisi giriş sularında antibiyotik kalıntılarının varlığının belirlenmesi amaçlanmıştır. Bu amaç için, arıtma tesisi giriş suyundan kompozit numune alınmış ve analizler yapılmıştır. Analiz sonuçlarına göre Elazığ Belediyesi Atıksu Arıtma Tesisi giriş sularında makrolidler (azitromisin, klaritromisin, eritromisin, beta laktamlar (aztreonam, sefalosporinler (sefamandol, sefepim, sefiksim, rifampisin (rifamisin ve sülfonamid (tetroksoprim antibiyotikleri bulunmuştur. Investigation Of The Presence Of Antibiotic Residues Influent Of Elazig Municipal Wastewater Treatment Plant In this study, it was aimed to determine the presence of antibiotic residues in influents of Elazığ Municipal Wastewater Treatment Plant. For this aim, composite sample was taken from the influents of the treatment plant and analyses were done. According to the results of the analyses, macrolides (azitromycin, clarithromycin, erithromycin, beta lactams (aztreonam, cefalosporines (cefamondole, cefepime, cefixime, rifampicine (rifamycin and sulfonamide (tetroxoprim antibiotics were obtained in influents of Elazig Municipal Wastewater Treatment Plant.

  5. 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.

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

    Directory of Open Access Journals (Sweden)

    Keite da Silva Nogueira

    2006-12-01

    Full Text Available 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 combination disk method. We found a high frequency of ESBL (24% among Enterobacteriaceae, with a frequency of 57.4% for Klebsiella pneumoniae, 21.4% for Klebsiella oxytoca, and 7.2% for E. coli. In other members of Enterobacteriaceae, non-Klebsiella and non-E. coli, the prevalence was 21.6%. Ceftriaxone and cefotaxime showed a higher sensitivity in the screening test (99.2% when compared to ceftazidime, aztreonam and cefpodoxime. However, cefotaxime/cefotaxime plus clavulanic acid showed a higher sensitivity in the confirmatory test (96.7%.

  7. 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. 

  8. Detection Of Extended-Spectrum Beta Lactamase in Klebsiella pneumoniae and Klebsiella oxytoca Bacteria with the Combined Disc Method

    Directory of Open Access Journals (Sweden)

    Ebru Yılmaz

    2011-06-01

    Full Text Available Extended-spectrum beta lactamases (ESBLs are responsible for resistance to cephalosporins (ceftazidime, ceftriaxone, and cefotaxime and aztreonam in gram-negative bacilli. ESBL producing Klebsiella bacteria are a major problem for clinicians, ESBLs increase are cause of failure in treatment particularly paediatric patients and also in medical and surgical units. In this research ESBL was investigated by combined disc method. In this research, 128 clinical isolates of Klebsiella ssp. were collected from different microbiology laboratories in Ankara. All isolates were identified with classical methods and API 20E. According to the results of identification, 103 K. pneumoniae, 25 K. oxytoca were obtained. ESBL has been detected 59,37% in Klebsiella bacteria by the combined disk method.

  9. Worldwide Dissemination of the NDM-Type Carbapenemases in Gram-Negative Bacteria

    Directory of Open Access Journals (Sweden)

    Laurent Dortet

    2014-01-01

    Full Text Available The emergence of one of the most recently described carbapenemases, namely, the New Delhi metallo-lactamase (NDM-1, constitutes a critical and growingly important medical issue. This resistance trait compromises the efficacy of almost all lactams (except aztreonam, including the last resort carbapenems. Therapeutical options may remain limited mostly to colistin, tigecycline, and fosfomycin. The main known reservoir of NDM producers is the Indian subcontinent whereas a secondary reservoir seems to have established the Balkans regions and the Middle East. Although the spread of blaNDM-like genes (several variants is derived mostly by conjugative plasmids in Enterobacteriaceae, this carbapenemase has also been identified in P. aeruginosa and Acinetobacter spp. Acinetobacter sp. may play a pivotal role for spreading blaNDM genes for its natural reservoir to Enterobacteriaceae. Rapid diagnostic techniques (Carba NP test and screening of carriers are the cornerstone to try to contain this outbreak which threatens the efficacy of the modern medicine.

  10. 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.

  11. Identification, Characterization and Antibiotic Resistance of Bacterial Isolates Obtained from Waterpipe Device Hoses

    Directory of Open Access Journals (Sweden)

    Majed M. Masadeh

    2015-05-01

    Full Text Available The general lack of knowledge about the health effects of waterpipe smoking is among the reasons for its global spread. In this study, bacterial contamination of waterpipe hoses was investigated. Twenty hoses were collected from waterpipe cafés and screened for bacterial pathogens using standard culture and isolation techniques. Additionally, resistance of isolated bacteria to common antibiotics was determined by identifying the minimum inhibitory concentration (MIC of each isolate. Forty eight bacterial isolates were detected. Isolates included both Gram-positive and Gram-negative pathogens from species that included Micrococcus (12, Corynebacterium (13 and Bacillus (9. In addition, some of the detected pathogens were found to be resistant to aztreonam (79%, cefixime (79%, norfloxacin, amoxicillin (47%, clarithromycin (46% and enrofloxacin (38%. In conclusion, the hose of the waterpipe device is a good environment for the growth of bacterial pathogens, which can then be transmitted to users.

  12. Identification, characterization and antibiotic resistance of bacterial isolates obtained from waterpipe device hoses.

    Science.gov (United States)

    Masadeh, Majed M; Hussein, Emad I; Alzoubi, Karem H; Khabour, Omar; Shakhatreh, Muhamad Ali K; Gharaibeh, Mahmoud

    2015-05-01

    The general lack of knowledge about the health effects of waterpipe smoking is among the reasons for its global spread. In this study, bacterial contamination of waterpipe hoses was investigated. Twenty hoses were collected from waterpipe cafés and screened for bacterial pathogens using standard culture and isolation techniques. Additionally, resistance of isolated bacteria to common antibiotics was determined by identifying the minimum inhibitory concentration (MIC) of each isolate. Forty eight bacterial isolates were detected. Isolates included both Gram-positive and Gram-negative pathogens from species that included Micrococcus (12), Corynebacterium (13) and Bacillus (9). In addition, some of the detected pathogens were found to be resistant to aztreonam (79%), cefixime (79%), norfloxacin, amoxicillin (47%), clarithromycin (46%) and enrofloxacin (38%). In conclusion, the hose of the waterpipe device is a good environment for the growth of bacterial pathogens, which can then be transmitted to users. PMID:25985311

  13. 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.

  14. DETECTION & PREVALENCE OF EXTENDED SPECTRUM ΒETA - LACTAMASES AMONG ENTEROBACTERIACEAE SPECIES FROM VARIOUS CLINICAL SAMPLES AT KIMS, AMALAPURAM.

    Directory of Open Access Journals (Sweden)

    Padmaja

    2012-10-01

    Full Text Available ABSTRACT: The present study was conducted in the Department of Microbiology, KIMS, Amalapuram, East Godavari from January 2012 to July 2012. Out of 100 different clinical samples, 50 were culture positive. Of the 100 samples collected, more were from post operative wound sepsis - 44 (44%, followed by cellulites - 20 (20%, Ulcers - 17 (17%, Injuries 15 (15%. Least number of cases are from burns - 4 (4% . Among 50 culture positive cases, 38 (76% isolates belonged to Enterobacteriaceae famil y, followed by Pseudomonas aeruginosa - 8 (16%, followed by Staphylococcus aureus - 4 (8%. Among 38 of Enterobacteriaceae family isolates, 15 were ESBL producers. Among ESBL positiv e strains, more drug resistance was seen to Ceftazidime and Ampicillin (93.33%, followed by Ceftriaxone (86.66%, Aztreonam & Cefotaxime (80%.

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

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    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 .

  16. Characterization of Pseudomonas aeruginosa isolates from dogs and cats in Japan: current status of antimicrobial resistance and prevailing resistance mechanisms.

    Science.gov (United States)

    Harada, Kazuki; Arima, Sayuri; Niina, Ayaka; Kataoka, Yasushi; Takahashi, Toshio

    2012-02-01

    Seventy-three Pseudomonas aeruginosa isolates were collected from dogs and cats in Japan to investigate antimicrobial susceptibility and resistance mechanisms to anti-pseudomonal agents. Resistance rates against orbifloxacin, enrofloxacin, ciprofloxacin, cefotaxime, aztreonam and gentamicin were 34.2, 31.5, 20.5, 17.8, 12.3 and 4.1%, respectively. The degree of resistance to cefotaxime, orbifloxacin, and enrofloxacin was greatly affected by efflux pump inhibitors, indicating overexpression of efflux pump contributes to these resistances. Notably, orbifloxacin and enrofloxacin resistance was observed even in isolates without mutations in the target sites. This is the first report on cephalosporin- and fluoroquinolone-resistant isolates of P. aeruginosa from Japanese companion animals. PMID:22188523

  17. 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

    Methicillin-resistant Staphylococcus aureus (MRSA), especially CC398, have emerged in livestock worldwide. We investigated the occurrence of MRSA in pigs at slaughter and in retail meat. During 2009, nasal swabs (n=789) were taken from pigs at slaughter. Moreover, 866 meat samples [Danish: pork...... (153), broiler meat (121), beef (142) and; imported: pork (173), broiler meat (193), and beef (84)] were randomly collected in retail stores and outlets. MRSA was isolated from nasal swabs or from meat samples after preenrichment (Mueller Hinton broth with 6.5% NaCl), selective enrichment (tryptone...... 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 (101/789) of the...

  18. ANTIBIOTIC RESISTANCE PATTERN IN PSEUDOMONAS AERUGINOSA SPECIES ISOLATED AT INDORE (M.P.

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    Prafulla

    2014-01-01

    Full Text Available INTRODUCTION : Pseudomonas aeruginosa is an aerobic , motile , gram negative rod that belongs to the family , pseudomonadaceae 2 . Its general resistance is due to a combination of factors 3 .Regional variations in the antibiotic resistance exist for different organisms , including P. aeruginosa and this may be related to the difference in the antibiotic prescribing habits. So , we a imed in the present study , to determine the status of antimicrobial resistance to anti - pseudomonadal agents and the magnitude of the multidrug r esistance in these organisms. MATERIALS AND METHODS : This study was conducted during 1 st January 2013 to 30 th September 2013. During this period total of 5877 samples were tested , out of 5877 samples , 1693 samples showed growth on culture and out of 1693 sa mples , 152 Pseudomonas aeruginosa were isolated. Identification & sensitivity of all isolates were done by BD Phoenix TM Automated Microbiological System. The antibiotics which were include d in the panel were ciprofloxacin , levofloxacin , gentamicin , amikaci n , tobramycin , aztreonam , ceftazidime , cefepime , piperacillin , piperacillin/tazobactam , ticarcillin/tazobactam , imipenem , meropenem and colistin according to CLSIs guidelines. RESULT : In the present study , the highest number s of Pseudomonas infections was found in pus followed by urine and Endotracheal secretion. Pseudomonas aeruginosa isolated from various samples were resistant to aztreonam , ciprofloxacin followed by levofloxacin , ceftazidime , cefepime , amikacin , imipenem & colistin. CONCLUSION : To preven t the spread of the resistant bacteria , it is critically important to have strict antibiotic policies wherein surveillance programmes for multidrug resistant organisms and infection control procedures need to be implemented

  19. [The annual changes in antimicrobial susceptibility test results of Pseudomonas aeruginosa isolates from the Kinki district].

    Science.gov (United States)

    Fukuda, Saori; Komatsu, Masaru; Nakamura, Tatuya; Jikimoto, Takumi; Nishio, Hisaaki; Yamasaki, Katsutoshi; Satoh, Kaori; Toda, Hirofumi; Orita, Tamaki; Sueyoshi, Noriyuki; Kita, Machiko; Nishi, Isao; Akagi, Masahiro; Higuchi, Takeshi; Kofuku, Tomomi; Nakai, Isako; Ono, Tamotsu; Kida, Kaneyuki; Ohama, Masanobu; Watari, Hideo; Shimura, Satoshi; Niki, Makoto; Kuchibiro, Tomokazu; Wada, Yasunao

    2016-04-01

    A study was conducted of the 1,225 Pseudomonas aeruginosa strains that were isolated at 20 medical institutions in the Kinki district between 2011 and 2013 to determine their antimicrobial susceptibility and to characterize the strains of multidrug-resistant Pseudomonas aeruginosa (MDRP) and the metallo-β-lactamase (MBL) -producing strains. The MIC50/MIC90 values (μg/mL) of the various antimicrobial agents were as follows: imipenem, 2/>8; meropenem, 1/>8; doripenem, 0.5/8; biapenem, 1/>8; tazobactam/piperacillin, 8/>64; piperacillin, 8/>64; sulbactam/cefoperazone, 8/64; cefepime, 4/16; cefozopran, 2/>16; aztreonam, 8/>16; amikacin, 4/16; levofloxacin, 1/>4; and ciprofloxacin, 0.25/>2. From the viewpoint of the annual changes in the susceptibility rates (according to the CLSI guidelines [M100-S22]), the susceptibility to tazobactam/piperacillin, piperacillin, cefepime, cefozopran and aztreonam decreased in 2013. On the other hand, two antimicrobial agents showed high susceptibility rates each year; amikacin (94.0-95.6%) showed the highest rate, followed by doripenem (80.3-82.6%). With the exception of amikacin, there were substantial inter-institutional differences in antimicrobial susceptibility. In comparison to the previous CLSI guidelines (M100-S21), the new CLSI guidelines (M100-S22) on the use of carbapenems and penicillins show that the MIC80 has been affected. The MDRP detection rates in 2011, 2012 and 2013 were 1.8% (8 strains), 1.8% (8 strains), and 2.8% (10 strains), respectively. The MBL detection rates were as follows: bla(VIM-2), 0.2% (1 strain) in 2011; bla(IMP-1), 0.9% (4 strains) in 2012, and 1.7% (6 strains, including bla(IMP-1) [3 strains], bla(IMP-2) [2 strains] and bla(VIM-2) [1 strain]) in 2013. PMID:27544978

  20. OXA-46, a new class D beta-lactamase of narrow substrate specificity encoded by a blaVIM-1-containing integron from a Pseudomonas aeruginosa clinical isolate.

    Science.gov (United States)

    Giuliani, Francesco; Docquier, Jean-Denis; Riccio, Maria Letizia; Pagani, Laura; Rossolini, Gian Maria

    2005-05-01

    A novel OXA-type enzyme, named OXA-46, was found to be encoded by a gene cassette inserted into a class 1 integron from a multidrug-resistant Pseudomonas aeruginosa clinical isolate. The variable region of the integron also contained a bla(VIM-1) metallo-beta-lactamase cassette and a duplicated aacA4 aminoglycoside acetyltransferase cassette. OXA-46 belongs to the OXA-2 lineage of class D beta-lactamases. It exhibits 78% sequence identity with OXA-2 and the highest similarity (around 92% identity) with another OXA-type enzyme detected in clinical isolates of Burkholderia cepacia and in unidentified bacteria from a wastewater plant. Expression of bla(OXA-46) in Escherichia coli decreased susceptibility to penicillins and narrow-spectrum cephalosporins but not to extended-spectrum cephalosporins, cefsulodin, aztreonam, or carbapenems. The enzyme was overproduced in E. coli and purified by two anion-exchange chromatography steps (approximate yield, 6 mg/liter). OXA-46 was made of a 28.5-kDa polypeptide and exhibited an alkaline pI (7.8). In its native form OXA-46 appeared to be dimeric, and the oligomerization state was not affected by EDTA. Kinetic analysis of OXA-46 revealed a specificity for narrow-spectrum substrates, including oxacillin, other penicillins (but not temocillin), and narrow-spectrum cephalosporins. The enzyme apparently did not interact with temocillin, oxyimino-cephalosporins, or aztreonam. OXA-46 was inactivated by tazobactam and carbapenems and, although less efficiently, also by clavulanic acid. Enzyme activity was not affected either by EDTA or by divalent cations and exhibited low susceptibility to NaCl. These findings underscore the functional and structural diversity that can be encountered among class D beta-lactamases. PMID:15855521

  1. 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.

  2. Increased GVHD-related mortality with broad-spectrum antibiotic use after allogeneic hematopoietic stem cell transplantation in human patients and mice.

    Science.gov (United States)

    Shono, Yusuke; Docampo, Melissa D; Peled, Jonathan U; Perobelli, Suelen M; Velardi, Enrico; Tsai, Jennifer J; Slingerland, Ann E; Smith, Odette M; Young, Lauren F; Gupta, Jyotsna; Lieberman, Sophia R; Jay, Hillary V; Ahr, Katya F; Porosnicu Rodriguez, Kori A; Xu, Ke; Calarfiore, Marco; Poeck, Hendrik; Caballero, Silvia; Devlin, Sean M; Rapaport, Franck; Dudakov, Jarrod A; Hanash, Alan M; Gyurkocza, Boglarka; Murphy, George F; Gomes, Camilla; Liu, Chen; Moss, Eli L; Falconer, Shannon B; Bhatt, Ami S; Taur, Ying; Pamer, Eric G; van den Brink, Marcel R M; Jenq, Robert R

    2016-05-18

    Intestinal bacteria may modulate the risk of infection and graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Allo-HSCT recipients often develop neutropenic fever, which is treated with antibiotics that may target anaerobic bacteria in the gut. We retrospectively examined 857 allo-HSCT recipients and found that treatment of neutropenic fever with imipenem-cilastatin and piperacillin-tazobactam antibiotics was associated with increased GVHD-related mortality at 5 years (21.5% for imipenem-cilastatin-treated patients versus 13.1% for untreated patients, P = 0.025; 19.8% for piperacillin-tazobactam-treated patients versus 11.9% for untreated patients, P = 0.007). However, two other antibiotics also used to treat neutropenic fever, aztreonam and cefepime, were not associated with GVHD-related mortality (P = 0.78 and P = 0.98, respectively). Analysis of stool specimens from allo-HSCT recipients showed that piperacillin-tazobactam administration was associated with perturbation of gut microbial composition. Studies in mice demonstrated aggravated GVHD mortality with imipenem-cilastatin or piperacillin-tazobactam compared to aztreonam (P short-chain fatty acids or numbers of regulatory T cells. Notably, imipenem-cilastatin treatment of mice with GVHD led to loss of the protective mucus lining of the colon (P intestinal barrier function (P < 0.05). Sequencing of mouse stool specimens showed an increase in Akkermansia muciniphila (P < 0.001), a commensal bacterium with mucus-degrading capabilities, raising the possibility that mucus degradation may contribute to murine GVHD. We demonstrate an underappreciated risk for the treatment of allo-HSCT recipients with antibiotics that may exacerbate GVHD in the colon. PMID:27194729

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

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    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.

  4. Sepsis due to Weeksella virosa in wounds made by animal bite. A case report. Sepsis por weeksella virosa en herida por mordedura animal. Reporte de un caso.

    Directory of Open Access Journals (Sweden)

    Nancy Ramírez Martínez

    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.
    Se reporta un caso de sepsis aguda por Weeksella virosa, un microorganismo gramnegativo, no fermentador de carbohidratos oxidasa positiva, en una paciente sana, de 31 años, atendida en el servicio de Microbiología del Hospital Universitario ¨Dr. Gustavo Aldereguía Lima¨, en marzo del 2003. Los síntomas clínicos fueron: fiebre, dolor, limitación de movimientos, eritema y calor, a la cual se le diagnosticó linfangitis reticular. Se aisló Weeksella virosa por diagnóstico convencional. En las pruebas de susceptibilidad antimicrobiana resultó sensible a tetraciclina, aztreonam, ceftriazona y resistente a imipenem. Recibió tratamiento con tetraciclina 1 gr diario por siete días.

    El cuadro clínico mejoró con regresión total de los síntomas.

  5. Salmonella em carcaças de frango congeladas Salmonella in broiler frozen carcasses

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    Débora Martins Silva Santos

    2000-03-01

    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.Hundred and fifty frozen broiler carcasses of four commercial brands, purchased at retail stores for Salmonella research, were examined: 43 of the carcasses referred to each of the brands A, B, D and 21 of brand C. Thirty-two percent of the samples were found positive; 11 serotypes were identified as S. Agona, S. Anatum, S. Enteritidis, S. Hadar, S. Havana, S. Mbandaka, S. Montevideo, S. Ouakam, S. Poona, S. Schwarzengrund and S.I4, 5, 12:-. Antibiogram testing of the isolated strains showed 100% resistance to ampicilin, 75.0% to cefhalotin, 52.1% to cephoxitin, 22.9% to tobramicin, 6.2% to polimixin B and to tetracyclines, 4.2% to gentamicin, and 2.1% to netilmicin, to aztreonam and to amicacin. All strains showed total sensibility to chloramphenicol and to sulfazotrim.

  6. 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.

  7. Analysis of Drug Use in Children Hospitalized in Primary Hospital%基层医院儿科住院患儿药物利用分析

    Institute of Scientific and Technical Information of China (English)

    周代志

    2011-01-01

    Objective: To evaluate the drug use on children in our hospital and to provide the basis for the clinical use of drugs.Methods: The drug sales, drug use frequency (DDDs) of the pediatric department in 2009 were analyzed. Results: In 2009, totally 189 drugs were used and the top two categories were anti-lnicrobial drugs and respiratoly drugs. The sales of anti-lnicrobial drugs, water and electrolyte drugs ranked to the first two positions. Among 16 drugs that ranked to the first in DDDs, 7 drugs belonged to the antibiotics and water-soluble vitalnin injection, penicillin and cefoperazone-sulbactaln held the top three positions. The top three drugs in average daily costs were latamoxef, aztreonam and ambroxol hydrochloride. The top three drugs in the ratio of serial numbers were vitamin B6 injection, vitamin C injection and penicillin. While latamoxef, aztreonam and ambroxol hydrochloride held the last three position. Conclusions: Pediatric patients hospitalized in our hospital are reasonably treated, but the application of hormone drugs should be strictly weighed; latamoxef and aztreonam should be controlled because of their high prices.%目的:评价我院儿科住院患儿药物利用现状,为临床合理用药提供依据.方法:对我院2009年度儿科住院部的药品销售金额、用药频度(DDDs)等进行统计分析.结果:2009年度共使用药物189个,品种数居前两位的是抗微生物药物、呼吸系统药物;销售金额居前的是抗微生物药物、水电解质药物;用药频度位于前16位的治疗药品中,抗微生物药物有7种,居第一.DDDs排前三位的分别是水溶性维生素粉针、青霉素钠和头孢哌酮/舒巴坦钠;日均费用前三位分别是拉氧头孢、氨曲南和盐酸氨溴索;序号比最大的前三位分别是维生素B6注射液、维生素C注射液和青霉素钠,最小的分别是拉氧头孢、氨曲南和盐酸氨溴索.结论:我院儿科住院患儿用药较合理,但对激素类药物的

  8. 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

  9. Extended-spectrum plasmid-mediated beta-lactamases.

    Science.gov (United States)

    Sirot, D

    1995-07-01

    Extended-spectrum beta-lactamases (ESBLs) are mutant enzymes which derive from TEM or SHV (class A) enzymes. They confer variable levels of resistance to cefotaxime, ceftazidime and other broad-spectrum cephalosporins and to monobactams such as aztreonam but have no detectable activity against cephamycins and carbapenems. Recently, new plasmid-mediated ESBLs, not derived from TEM or SHV enzymes but related to cephalosporinases of Enterobacteriaceae (class C enzymes), that confer resistance to all cephalosporins including cephamycins, have been reported. However, to date there have been no reported outbreaks due to strains producing transferable cephalosporinases. Klebsiella pneumoniae is the species in which the ESBL enzymes have been most commonly reported around the world. Most of the clinical isolates that produce TEM- or SHV-derived ESBL, come from hospitalised patients and have frequently caused nosocomial outbreaks. Care should be taken in the selection of a beta-lactam for the treatment of infections because the presence of an ESBL does not prevent other mechanisms of resistance, such as decreased permeability, from emerging. Broad-spectrum cephalosporins including cefepime and cefpirome are hydrolysed by ESBL. However, low level resistance to cefotaxime, ceftriaxone, cefepime and aztreonam does occur in some strains producing certain TEM-derived ESBL. It remains to be seen, therefore, whether such isolates are clinically susceptible to these drugs. The combination of a third-generation cephalosporin and a beta-lactamase inhibitor such as sulbactam could be of interest against some strains producing certain ESBLs. Among the 7-alpha-methoxy cephalosporins, cefotetan and latamoxef are the most active. However, cephamycins should be used with caution to treat infections caused by ESBL-producing K. pneumoniae because of the relative ease with which clinical strains decrease the expression of outer membrane proteins. The most active beta-lactams are the

  10. 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. PMID:26853289

  11. 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

  12. 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.

  13. TO CORRELATE DOUBLE DISC SYNERGY TEST (DDST AND ETEST RESULTS FOR ESBL DETECTION IN ECOLI & KLEBSIELLA PNEUMONIAE ISOLATES

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    Rashmi

    2015-08-01

    Full Text Available Resistant to antimicrobial agents in microbes is a growing phenomenon worldwide. 1 β lactamase production is the most common mechanism of bacterial resistance to β lactam antibiotics. 2 Extended spectrum beta lactamases (ESBL that mediate resistance to oxyimino cephalosporins such as cefotaxime, ceftazidime and aztreonam are now observed in all species of Enterobacteriaceae. ESBL are capable of efficiently hydrolyzing penicillins, narro w spectrum cephalosporins, many extended spectrum cephalosporins, the oxyimino group containing cephalosporins ( C efotaxime, ceftazidime and monobactams ( A ztreonam, but not carbapenems and cephamycins. 3 ESBL producing Ecoli and Klebsiella pneumoniae are important pathogen in nosocomial infections and multidrug resistant out breaks. This study was conducted to correlate results of Double Disc Synergy Test (DDST and E test for ESBL detection in E coli and Klebsiella pneumoniae isolate by doing the double d isc synergy test (DDST by using cefotaxime and augmemtin discs. E test was used to determine the MIC for cefotaxime and ceftazidime of these isolates. Out of 98 ESBL isolates detected by DDST, 96 isolates were positive by E test. 02 isolates were indeterminable by E test. About 95% ESBL producing E coli and Klebsiella pneumoniae had MIC >1ug/ml for cefotaxime. The MIC of about 85% ESBL producing E coli and Klebsiella pneumonia was >4ug/ml for ceftazidime.

  14. 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.

  15. Drug resistance patterns of acinetobacter baumannii in makkah, saudi arabia

    International Nuclear Information System (INIS)

    Background: Acinetobacter baumannii causes infections of respiratory, urinary tract, blood stream and surgical sites. Its clinical significance has increased due to its rapidly developing resistance to major groups of antibiotics used for its treatment. There is limited data available on antimicrobial susceptibility of A. baumannii from Saudi Arabia. Objectives: To determine the patterns of drug resistance of Acinetobacter baumannii and predisposing factors for its acquisition.Subjects and Methods: In this descriptive study, 72 hospitalized patients infected with A baumannii were studied. The clinical and demographic data of the patients were collected using a predesigned questionnaire. Isolation and identification of A.baumannii from all clinical specimens were done using standard microbiological methods. Antibiotic susce ptibility testing was performed by disk diffusion method recommended by Clinical Laboratory Standards Institute. Results: Majority of the isolates (61.1%) were from respiratory tract infections. A.baumannii isolates showed high drug resistance to piperacil lin (93.1%), aztreonam (80.5%), ticarcillin, ampicillin, and tetracycline (76.4%, each) and cefotaxime (75%). Only amikacin showed low rate of resistance compared to other antibiotics (40.3%). About 36% patients had some underlying diseases with diabetes mellitus (11%) being the predominant underlying disease. Conclusions: High antimicrobial resistance to commonly used antibiotics was seen against A.baumannii isolates. Only amikacin was most effective against it. (author)

  16. Tigecycline: a critical update.

    Science.gov (United States)

    Shakil, S; Akram, M; Khan, A U

    2008-08-01

    Tigecycline is the first Food and Drug Administration (FDA) approved glycylcycline antibiotic. It has shown remarkable in vitro activity against a wide variety of gram-positive, gram-negative and anaerobic bacteria including many multidrug resistant (MDR) strains. However, it has minimal activity against Pseudomonas aeruginosa and Proteus spp. To date, little resistance to tigecycline has been reported. Clinical trials studying complicated skin and skin-structure infections (cSSSIs) demonstrated that tigecycline has equivalent efficacy and safety compared with the combination of vancomycin and aztreonam. For complicated intra-abdominal infections (cIAIs), tigecycline was found to be as effective as imipenem/cilastatin. Adverse events related to tigecycline therapy, i.e. nausea and vomiting, were tolerable. Currently available data suggest that tigecycline may play an important role in the future as a monotherapy alternative to older broad-spectrum antibiotics, such as advanced generation cephalosporins, carbapenems, fluoroquinolones, piperacillin/tazobactam, and gram-positive directed agents (e.g. daptomycin, linezolid and quinupristin/dalfopristin) for which resistance is being increasingly reported from all parts of the world. PMID:18676218

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

    Science.gov (United States)

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

    2013-01-01

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

  18. 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.

  19. Antibiotic susceptibility and imaging findings of the causative microorganisms responsible for acute urinary tract infection in children: a five-year single center study

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    Ji Eun Yoon

    2011-02-01

    Full Text Available Purpose : We studied the differences in the antibiotic susceptibilities of the microorganisms that causeing urinary tract infections (UTI in children to obtain useful information on appropriate drug selection for childhood UTI. Methods : We retrospectively analyzed the antibiotic susceptibilities of 429 microorganisms isolated from 900 patients diagnosed with UTI in the Department of Pediatrics, Chungbuk National University Hospital, from 2003 to 2008. Results : The most common causative microorganisms for UTI were Escherichia coli (81.4%, Klebsiella pneumoniae (8.4%, Enterobacter spp. (1.7%, and Proteus spp. (0.4%. E. coli showed relatively high susceptibility as compared to imipenem (100%, amikacin (97.7%, aztreonam (97.9%, cefepime (97.7%, and ceftriaxone (97.1%, while it showed relatively low susceptibility to gentamicin (GM (79.0%, trimethoprim/sulfamethoxazole (TMP/SMX (68.7%, ampicillin/sulbactam (33.0%, and ampicillin (AMP (28.6%. There were no significant differences in the image findings for causative microorganisms. Conclusion : Gram-negative organisms showed high susceptibility to amikacin and third-generation cephalosporins, and low susceptibility to AMP, GM, and TMP/SMX. Therefore, the use of AMP or TMP/SMX as the first choice in empirical and prophylactic treatment of childhood UTI in Korea should be reconsidered and investigated further.

  20. Retrospective analysis of antibiotic susceptibility patterns of respiratory isolates of Pseudomonas aeruginosa in a Turkish University Hospital

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    Akkurt Ibrahim

    2003-03-01

    Full Text Available Abstract Background Lower respiratory tract infections due to Pseudomonas aeruginosa have a high mortality rate. Antibacterial activity of various antibiotics against P. aeruginosa isolated from each hospital depends on the variety or amount of antibiotics used in each hospital. Method A total of 249 respiratory isolates of Pseudomonas aeruginosa in Sivas (Turkey were included between January-1999 and January-2002. Isolates were tested against 14 different antibiotics by a disc diffusion method or standardized microdilution technique. Results Organisms were cultured from the following specimens: sputum (31.3%, transtracheal/endotracheal aspirates (37.8%, and bronchial lavage (30.9%. Isolates in bronchial lavage were highly susceptible to cefoperazone and aminoglycosides. Resistance to ampicillin/sulbactam was 98.8%, ticarcillin 40.1%, ticarcillin/clavulanic acid 11.2%, piperacillin 21.8%, aztreonam 66.6%, cefotaxim 75.4%, ceftriaxone 84.2%, cefoperazone 39.0%, ceftazidime 50.8%, gentamicin 57.5%, tobramycin 58.4%, amikacin 25.4%, ciprofloxacin 16.1%, and imipenem/cilastatin 21.6%. The term multidrug-resistant P. aeruginosa covered resistance to imipenem, ciprofloxacin, ceftazidime, gentamicin, and piperacillin. 1.2% of isolates were multidrug-resistant. Conclusions These findings suggest that amikacin resistance increases progressively in Turkey. Piperacillin and ticarcillin/clavulanate were the most active agents against both imipenem- and ciprofloxacin-resistant isolates in our region.

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

    Science.gov (United States)

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

    2005-07-01

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

  2. Identification of an integron containing the quinolone resistance gene qnrA1 in Shewanella xiamenensis.

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    Zhao, Jing-yi; Mu, Xiao-dong; Zhu, Yuan-qi; Xi, Lijun; Xiao, Zijun

    2015-09-01

    This study investigated multidrug resistance in Shewanella xiamenensis isolated from an estuarine water sample in China during 2014. This strain displayed resistance or decreased susceptibility to ampicillin, aztreonam, cefepime, cefotaxime, chloramphenicol, ciprofloxacin, erythromycin, kanamycin and trimethoprim-sulfamethoxazole. The antimicrobial resistance genes aacA3, blaOXA-199, qnrA1 and sul1 were identified by PCR amplification and by sequencing. Pulsed-field gel electrophoresis and DNA hybridization experiments showed that the quinolone resistance gene qnrA1 was chromosomally located. qnrA1 was located in a complex class 1 integron, downstream from an ISCR1, and bracketed by two copies of qacEΔ1-sul1 genes. This integron is similar to In825 with four gene cassettes aacA3, catB11c, dfrA1z and aadA2az. An IS26-mel-mph2-IS26 structure was also detected in the flanking sequences, conferring resistance to macrolides. This is the first identification of the class 1 integron in S. xiamenensis. This is also the first identification of the qnrA1 gene and IS26-mediated macrolide resistance genes in S. xiamenensis. Presence of a variety of resistance genetic determinants in environmental S. xiamenensis suggests the possibility that this species may serve as a potential vehicle of antimicrobial resistance genes in aquatic environments. PMID:26316545

  3. 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.

  4. Detection and reporting beta-lactam resistance phenotypes in Escherichia coli and Klebsiella pneumoniae: a multicenter proficiency study in Spain.

    Science.gov (United States)

    Conejo, M Carmen; Mata, C; Navarro, F; Pascual, A

    2008-11-01

    The ability of 57 Spanish microbiology laboratories in detecting and reporting beta-lactam resistance phenotypes in Escherichia coli and Klebsiella pneumoniae was evaluated. Laboratories received 6 well-characterized isolates expressing the most widespread extended-spectrum beta-lactamases (ESBLs) in Spain (4 CTX-M type, 1 TEM type, and 1 SHV type), 3 isolates producing AmpC-type enzymes (2 plasmid mediated and 1 E. coli hyperproducing its chromosomal AmpC), and 3 quality control strains. Ninety-one percent of laboratories recognized all ESBL producers correctly, and therefore, low error rates were observed when testing cephalosporins and aztreonam. The highest error rates were observed with combinations of penicillin plus beta-lactamase inhibitor, although more than 60% of cases were due to the interpretation made by the microbiologists. Correct recognition of all AmpC beta-lactamase-producing strains occurred in only 47.4% of laboratories. These isolates were wrongly reported as ESBL producers and penicillinase hyperproducers in 7.6 % and 5.8% of cases, respectively. Detection of the AmpC-type phenotype by Spanish laboratories needs to be improved. PMID:18692340

  5. Prevalence of antimicrobial resistance in Escherichia coli and Klebsiella spp. in rural South India.

    Science.gov (United States)

    Sekar, Ramalingam; Mythreyee, Manoharan; Srivani, Seetharaman; Amudhan, Murugesan

    2016-06-01

    The emergence and dissemination of antimicrobial resistance (AMR) is an important public health problem as resistant organisms cause difficult-to-treat infections. In this study, the prevalence of AMR in Escherichia coli and Klebsiella spp. in rural South India was examined in order to aid empirical therapy. A cross-sectional prospective study was conducted during the period from January 2012 to December 2014. Routine clinical isolates of E. coli and Klebsiella spp. were tested for antimicrobial susceptibility to β-lactams, aminoglycosides, fluoroquinolones, tetracyclines, colistin and nitrofurantoin by the Kirby-Bauer disk diffusion method and the data were documented and analyzed with one per patient analysis using WHONET software. A total of 2292 non-duplicate clinical isolates were recovered during the study period, including 1338 E. coli and 954 Klebsiella spp. The prevalence of AMR in the total isolates was as follows: amikacin, 17.3%; ertapenem, 14.4%; doripenem, 4.5%; colistin, 13.2%; and tigecycline, 4.1%. The study results indicate a high prevalence of carbapenem resistance in Klebsiella spp. especially from pus and urinary isolates, whilst the prevalence of aztreonam and fluoroquinolone resistance was very high in E. coli. PMID:27436473

  6. 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.

  7. Identification of an NDM-5-producing Escherichia coli Sequence Type 167 in a Neonatal Patient in China.

    Science.gov (United States)

    Zhu, Yuan-Qi; Zhao, Jing-Yi; Xu, Cha; Zhao, Hui; Jia, Nan; Li, Yan-Nian

    2016-01-01

    Emergence of New Delhi metallo-β-lactamase-producing Enterobacteriaceae has become a challenging threat to public health. Two carbapenem-resistant Escherichia coli, strain QD28 and QD29, were recovered from the aspirating sputum of a neonate and the urine of an adult in a Chinese hospital in 2013. Molecular typing revealed that both isolates belonged to the sequence type 167, but they were clonally diverse. Both isolates exhibited resistance to carbapenems, cephalosporins, ciprofloxacin, gentamicin, piperacillin-tazobactam and trimethoprim-sulfamethoxazole. In addition, strain QD28 was also resistant to aztreonam, and strain QD29 was resistant to amikacin, fosfomycin and minocycline. Antimicrobial resistance gene screening revealed that strain QD28 harbored aac(6')-Ib, blaCTX-M-14, blaNDM-5, blaTEM-1 and sul1 genes, and strain QD29 harbored aac(6')-Ib, blaCTX-M-3, blaNDM-5, blaTEM-1, rmtB, sul1 and sul2 genes. The blaNDM-5 gene was found to be located on a 46-kb plasmid in two isolates, and further sequence analysis showed that this plasmid was highly similar to the previously reported IncX3 plasmid pNDM-MGR194 in India. This is the first identification of blaNDM-5-carrying E. coli in the neonatal infection. PMID:27406405

  8. Antibiotic resistance in children with complicated urinary tract infection

    International Nuclear Information System (INIS)

    Objective was to determine the resistance of antibiotics for complicated urinary tract infection (UTI), including urinary tract anomaly (UTA), for empirical antibiotic therapy of complicated UTI. Four hundred and twenty two urine isolates were obtained from 113 patients with recurrent UTI, who used prophylactic antibiotics between February 1999 and November 2004 in the Eskisehir Osmangazi University, Eskisehir, Turkey. Reflux was found to be most important predisposing factor for recurrent UTI (31.9%). Renal scar was detected more in patients with UTA than without UTA (59.2% versus 12.4%, p<0.05). Gram-negative organisms were dominant in patients with and without UTA (91.5% and 79.2%). Enterococci and Candida spp. were more prevalent in children with UTA than without UTA (p<0.001). Isolates were significantly more resistant to ampicillin, trimethoprim-sulfamethoxazole, amikacin, co-amoxiclav, ticarcillin-clvalanate and piperacillin-tazobactam in patients with UTA than without UTA. We found low resistance to ciprofloxacin and nitrofurantoin in UTI with and without UTA. Enterococci spp. was highly resistance to ampicillin and amikacin in patients with UTA. Aztreonam, meropenem and ciprofloxacin seemed to be the best choice for treatment of UTI with UTA due to Escherichia coli and Klebsiella spp. Nitrofurantoin and nalidixic acid may be first choice antibiotics for prophylaxis in UTI with and without UTA. The UTI with UTA caused by Enterococci spp. might not benefit from a combination of amikacin and ampicillin, it could be treated with glycopeptides. (author)

  9. Detection and characterization of class 1 integrons in Aeromonas spp. isolated from human diarrheic stool in Mexico.

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    Pérez-Valdespino, Abigail; Fernández-Rendón, Elizabeth; Curiel-Quesada, Everardo

    2009-12-01

    We determined the presence of class 1 integrons related to the acquisition of resistance to antimicrobials in Aeromonas spp. isolated from individuals with diarrhea. Species were identified as A. caviae, A. hydrophila, A. veronii and A. media using PCR-RFLP of the 16S rDNA. Selected isolates were further characterized by ERIC-PCR. Resistance to chloramphenicol, aztreonam, tetracycline, trimethoprim/sulfamethoxazole, nalidixic acid and streptomycin, among others, was determined using the Kirby-Bauer method. Integrons were detected by PCR amplification of the 5' conserved, variable, and 3' conserved regions. Sequencing of the variable regions revealed class 1 integrons with cassettes encoding resistance to trimethoprim (dfrA12, dfrA15, dfrB4), streptomycin/spectinomycin (aadA2, aadA1), oxacillin (oxa2) and chloramphenicol (catB3, cmlA4). Others had an open reading frame (orfD) or no insert at all. To our knowledge, this is the first description of the occurrence of genes cmlA4 and dfrA15 in Aeromonas class 1 integrons. Not all the integron-linked cassettes conferred their associated resistances, which suggests the inactivity of some cassettes. Most integrons were chromosomally located. The presence of class 1 integrons similar to those found in a wide variety of bacterial genera from different origins, including environmental and fish-borne Aeromonas, confirms the stability and horizontal transfer of these genetic elements. PMID:19810047

  10. Resistance pattern of clinical isolates of staphylococcus aureus against five groups of antibiotics

    International Nuclear Information System (INIS)

    Among the samples received in pathology laboratory, Pakistan institute of Medical Science, Islamabad, 5069 samples had bacterial growth, among these 2580 (51%) samples were Gram-positive cocci and 1688 were Staphylococcus aureus during a period of two years. Out of these Gram-positive cocci 56% were resistant to penicillin group, 27% were resistant to cephalosporin group, 22% were resistant to aminoglycoside group 15% were resistant to quinolone group and 31% were resistant to other antibiotics (cotrimaxazole, erythromycin, aztreonam, vancomycin, nitrofurantion and meropenam). Antibio-grams of Gram-positive cocci were determined against various antibiotics by disc diffusion method. The rate of resistance to most of the antibiotics such as ampicillin, piperacillin, carbenicillin, penicillin, cephradine, cefotaxime, erythromycin, ceclor, ofloxacin, pefloxacin, ciprofloxacin, cotrimexazole (septran), gentamicin, meropenem, ceftazidime, erythromycin, tobramycin, enoxacin was higher when tested against the isolates collected from pus as compared to those from blood and urine. Antibiotic resistant strains were more prevalent in pus samples than other clinical isolates (blood and urine). The randomly selected 155 strains of Staphylococcus aureus when tested against five groups of antibiotics showed resistance rate against ampicillin (92%), cephradine (92%), cephradine (60%), and gentamicin (58%). However intermediate resistance was found in case of vancomicin (38%), in hospitalized and non-hospitalized patients. (author)

  11. 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

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

    International Nuclear Information System (INIS)

    The SFC-1 gene from S. fonticola was cloned and SFC-1 was expressed, purified and crystallized. X-ray diffraction data were collected from an SFC-1 crystal to 1.6 Å resolution. 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 P212121, 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 VM of 1.99 Å3 Da−1 and a solvent content of 38.1%

  13. Design, synthesis and biological evaluation of monobactams as antibacterial agents against gram-negative bacteria.

    Science.gov (United States)

    Fu, Hai-Gen; Hu, Xin-Xin; Li, Cong-Ran; Li, Ying-Hong; Wang, Yan-Xiang; Jiang, Jian-Dong; Bi, Chong-Wen; Tang, Sheng; You, Xue-Fu; Song, Dan-Qing

    2016-03-01

    A series of monobactam derivatives were prepared and evaluated for their antibacterial activities against susceptible and resistant Gram-negative strains, taking Aztreonam and BAL30072 as the leads. Six conjugates (12a-f) bearing PIH-like siderophore moieties were created to enhance the bactericidal activities against Gram-negative bacteria based on Trojan Horse strategy, and all of them displayed potencies against susceptible Gram-negative strains with MIC ≤ 8 μg/mL. SAR revealed that the polar substituents on the oxime side chain were beneficial for activities against resistant Gram-negative bacteria. Compounds 19c and 33a-b exhibited the promising potencies against ESBLs-producing E. coli and Klebsiella pneumoniae with MICs ranging from 2 μg/mL to 8 μg/mL. These results offered powerful information for further strategic optimization in search of the antibacterial candidates against MDR Gram-negative bacteria. PMID:26827160

  14. The characteristics of genetically related Pseudomonas aeruginosa from diverse sources and their interaction with human cell lines.

    Science.gov (United States)

    Streeter, Klrissa; Neuman, Christina; Thompson, Jasmin; Hatje, Eva; Katouli, Mohammad

    2016-03-01

    We investigated a collection of Pseudomonas aeruginosa strains from hospitalised patients (n = 20) and various environmental sources (n = 214) for their genetic relatedness; virulence properties; antibiotic resistance; and interaction with intestinal (Caco-2), renal (A-498), and lung (Calu-3) cell lines. Using RAPD-PCR, we found high diversity among the strains irrespective of their sources, with only 6 common (C) types containing strains from both a clinical and environmental source. Environmental strains belonging to these C-types showed greater adhesion to A-498 cells than did clinical strains (17 ± 13 bacteria/cell versus 13 ± 11 bacteria/cell; p clavulanic acid, resistance against aztreonam, gentamicin, amikacin, piperacillin, and ceftazidime varied among environmental and clinical strains. These results suggest that environmental strains of P. aeruginosa carry virulence properties similar to clinical strains, including adhesion to various human cell lines, with some strains showing a higher adhesion to specific cell lines, indicating they may have a better ability to cause infection in those sites under predisposing conditions of the host. PMID:26854365

  15. 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.

  16. Antimicrobial resistance of Pseudomonas spp. isolated from wastewater and wastewater-impacted marine coastal zone.

    Science.gov (United States)

    Luczkiewicz, Aneta; Kotlarska, Ewa; Artichowicz, Wojciech; Tarasewicz, Katarzyna; Fudala-Ksiazek, Sylwia

    2015-12-01

    In this study, species distribution and antimicrobial susceptibility of cultivated Pseudomonas spp. were studied in influent (INF), effluent (EFF), and marine outfall (MOut) of wastewater treatment plant (WWTP). The susceptibility was tested against 8 antimicrobial classes, active against Pseudomonas spp.: aminoglycosides, carbapenems, broad-spectrum cephalosporins from the 3rd and 4th generation, extended-spectrum penicillins, as well as their combination with the β-lactamase inhibitors, monobactams, fluoroquinolones, and polymyxins. Among identified species, resistance to all antimicrobials but colistin was shown by Pseudomonas putida, the predominant species in all sampling points. In other species, resistance was observed mainly against ceftazidime, ticarcillin, ticarcillin-clavulanate, and aztreonam, although some isolates of Pseudomonas aeruginosa, Pseudomonas fluorescens, Pseudomonas pseudoalcaligenes, and Pseudomonas protegens showed multidrug-resistance (MDR) phenotype. Among P. putida, resistance to β-lactams and to fluoroquinolones as well as multidrug resistance become more prevalent after wastewater treatment, but the resistance rate decreased in marine water samples. Obtained data, however, suggests that Pseudomonas spp. are equipped or are able to acquire a wide range of antibiotic resistance mechanisms, and thus should be monitored as possible source of resistance genes. PMID:26286796

  17. 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.

  18. Prevalence and antimicrobial susceptibility patterns of uropathogenic E. coli among people in Zakho, Iraq

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    Reem Fouad Polse

    2016-04-01

    Full Text Available Background: Antimicrobial resistance in uropathogenic E. coli is of major concern worldwide due to its increasing resistance to several commonly prescribed antibiotics. The aims of this study were to determine the prevalence and to evaluate the presence and antibiogram pattern of uropathogenic E. coli among people in Zakho city, Iraq. Methods: 1120 urine samples were collected from people. Samples were screened for E. coli isolates and their susceptibility to different antibiotics was analyzed. Results: Diagnoses tests showed that only 106 (9.4% isolates were E. coli. Females (90, 85% were more susceptible to urinary tract infections (UTIs than males (16, 15% (p <0.05. The age 11-21 years old (23, 21.7% was the most affected group (p <0.05. All isolates were resistant to penicillin, ampicillin and aztreonam. While, all these isolates were sensitive to imipenem and meropenem. Conclusions: The incidence of uropathogenic E. coli among people is comparable with reports from elsewhere. E. coli isolates are highly susceptible towards imipenem, and meropenem antibiotics, and highly resistant towards beta-lactam and cephalosporins antibiotics. Education programs and improving the hygienic measures are necessary to prevent contaminations with E. coli and minimize the use of beta-lactam and cephalosporin antibiotics. [Int J Res Med Sci 2016; 4(4.000: 1219-1223

  19. New and Emerging Treatments for Cystic Fibrosis.

    Science.gov (United States)

    Barry, Peter J; Jones, Andrew M

    2015-07-01

    Recently, a significant number of additional key medications have become licensed in Europe for the treatment of patients with cystic fibrosis (CF), including a number of inhaled antibiotics, such as nebulised aztreonam and dry powder versions of colistin and tobramycin for inhalation; dry powder inhaled mannitol, an agent to improve airway hydration and aid airway clearance; and ivacaftor, an oral therapy that directly acts on dysfunctional CFTR to correct the basic defect encountered in CF patients with the G551D CF gene mutation. The marked success of ivacaftor both in clinical trials and in post-licensing evaluation studies in treating patients with G551D and other gating mutations has greatly encouraged the ongoing development of similar therapies that can directly target the underlying cause of CF. Other therapies, including a number of anti-infectives, anti-inflammatories and replacement pancreatic enzymes, are currently undergoing clinical studies. This article reviews those treatments that have been recently licensed for CF and highlights some of the exciting emerging therapies presently under evaluation in clinical trials. In addition, it discusses some of the potential challenges being encountered by research and clinical teams in developing and delivering treatments for this condition. PMID:26091951

  20. Antibiotic allergy in cystic fibrosis.

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    Parmar, J S; Nasser, S

    2005-06-01

    Allergic reactions to antibiotics are more common in cystic fibrosis (CF) than in the general population. This in part is due to the improving survival in adults with CF and the increased use of high dose intravenous antibiotics. While some are immediate anaphylaxis type (IgE mediated) reactions, the majority are late onset and may have non-specific features such as rash and fever. Piperacillin has consistently been found to have the highest rate of reported reactions (30-50%). There is a low risk of cross reactions between penicillins and other non-beta-lactam classes of antibiotics in penicillin skin prick positive patients. Carbapenems should only be used with extreme caution in patients with positive skin prick tests to penicillin. However, aztreonam can be used safely in patients who are penicillin allergic with positive skin prick reactions. The aminoglycosides are a relatively uncommon cause of allergic reactions, but patients who react to one member of the family may cross react with other aminoglycosides. Desensitisation relies on the incremental introduction of small quantities of the allergen and has been used for penicillins, ceftazidime, tobramycin and ciprofloxacin and must be repeated before each course. Personalized cards should be regularly updated for patients who develop allergic reactions. Written instructions on the emergency treatment of allergic reactions should be provided to patients self-administering intravenous antibiotics at home. Further research is required to identify risk factors and predictors for antibiotic allergy. PMID:15923254

  1. 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.

  2. Antibiotic Susceptibility of Potentially Probiotic Vaginal Lactobacilli

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    María Elena Nader-Macías

    2006-09-01

    Full Text Available Objective. To study the antimicrobial susceptibility of six vaginal probiotic lactobacilli. Methods. The disc diffusion method in Müeller Hinton, LAPTg and MRS agars by the NCCLS (National Committee for Clinical Laboratory Standards procedure was performed. Due to the absence of a Lactobacillus reference strains, the results were compared to those of Staphylococcus aureus ATCC29213. Minimal Inhibitory Concentration (MIC with 21 different antibiotics in LAPTg agar and broth was also determined. Results. LAPTg and MRS agars are suitable media to study antimicrobial susceptibility of lactobacilli. However, the NCCLS procedure needs to be standardized for this genus. The MICs have shown that all Lactobacillus strains grew at concentrations above 10 μg/mL of chloramphenicol, aztreonam, norfloxacin, ciprofloxacin, ceftazidime, ceftriaxone, streptomycin and kanamycin. Four lactobacilli were sensitive to 1 μg/mL vancomycin and all of them were resistant to 1000 μg/mL of metronidazole. Sensitivity to other antibiotics depended on each particular strain. Conclusions. The NCCLS method needs to be standardized in an appropriate medium to determine the antimicrobial susceptibility of Lactobacillus. Vaginal probiotic lactobacilli do not display uniform susceptibility to antibiotics. Resistance to high concentrations of metronidazole suggests that lactobacilli could be simultaneously used with a bacterial vaginosis treatment to restore the vaginal normal flora.

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

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    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.

     

     

  4. Antibiotic Resistance Pattern and the Prevalence of Extended Spectrum Beta-Lactamases (ESBLs in Urinary Isolates of Klebsiella Pneumoniae

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    Shahraki, SH. (PhD

    2014-11-01

    Full Text Available Background and Objective: Klebsiella pneumoniae is an opportunistic nosocomial pathogen causing a variety of infections including urinary tract infections, pneumonia, septicemia, wound infections and infections in the intensive care units. Since the ESBL producing Klebsiella pneumoniae strains are increasingly causing urinary tract infections, we aim to assess antibiotic resistance pattern and evaluate the prevalence of ESBL in Klebsiella pneumoniae isolated from urinary tract infections. Material and Methods: this cross-sectional study was conducted on 122 Klebsiella pneumoniae strains collected from Zahedan hospitals. After final identification of isolates, antibiotic susceptibility tests were carried out by using disk diffusion in agar method for 16 antibiotics and ESBL production was determined by the combined disk method. Results: The Klebsiella pneumoniae strains showed susceptibility to imipenem and amikacin ( 94.3% ,chloramphenicol (88.5% , gentamicin (81.1% , ciprofloxacin (80.3% , cefepime (73% ,streptomycin (72.1%, nalidixic acid (68% , tetracycline (65.6%, and cefotaxime, ceftazidime, cefpodoxime (62.3% . The resistance of strains was seen to nitrofurantoin (53.3%, cotrimoxazole (39.3%, Cefpodoxime (37.7%, cefotaxime (36.9%, ceftriaxone (36.1%, aztreonam (34.4%, ceftazidime (32.8%. Thirty-eight isolates (31.1% were shown to produce ESBLs. Conclusion: A high rate of resistance was observed to most of the antibiotics among ESBL producing strains; therefore, it is important to be careful about the use of antibiotics and identification of ESBL using phenotypic methods.

  5. [Survey of the antibiotic sensitivity of Pseudomonas aeruginosa in France and the distribution of beta-lactam resistance mechanisms: the GERPB 1999 study].

    Science.gov (United States)

    Cavallo, J D; Leblanc, F; Fabre, R; Fourticq-Esqueöute, A

    2001-09-01

    A prospective survey was carried out in october 1999 in 15 french teaching hospitals. Average susceptibility rates, determined by minimal inhibitory concentrations, for the 738 non-repetitive strains of P. aeruginosa isolated were: ticarcillin, 58%, ticarcillin + clavulanic acid, 56%, piperacillin, 73%, piperacillin + tazobactam, 82%, ceftazidime, 76%, cefepime, 53%, cefpirome, 36%, aztreonam, 58%, imipenem, 81%, amikacin, 62%, tobramycine, 71% and, ciprofloxacin, 60%. Among the 75% serotypable strains, the most frequent serotypes were: O:6 (15.3%), O:11 (14.5%), O:1 (10.4%), O:3 (7.9%), O:4 (6.1%) and O:12 (6.1%). The serotype O:12 was the most resistant to antibiotics. Forty-two percent of the strains were resistant or presented an intermediate susceptibility to ticarcillin. Mechanisms were as follow: 14.5% non enzymatic mechanism, 12.5% overproduction of the constitutive cephalosporinase, 7.1% transferable betalactamase and, 6.9% combination of these mechanisms. Among the 67 transferable betalactamases: 48 (71.6%) were PSE-1, 12 (19.4%) TEM-2 and 6 (7.5%) oxacillinases. One extended spectrum betalactamase was characterized. Among the cephalosporines tested, cefepime was less affected by the overproduction of constitutive cephalosporinase. Ceftazidime, remained the best cephalosporin except against the strains overexpressing the chromosomal type 1 beta-lactamase. Resistance to tobramycin was mainly due to enzymatic mechanisms with a high level of resistance. Decreased susceptibility was more frequent for amikacin than for tobramycin. This was probably related with non enzymatic mechanisms. PMID:11642015

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

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    Smitha O. Bagali

    2013-01-01

    Full Text Available 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 the clinical isolates of Escherichia coli. Methods: A total of 100 non-repeat clinical isolates obtained from urine, pus, sputum, blood and body fluids were taken. All the isolates were screened for AmpC β-lactamases by standard disc diffusion breakpoint for cefoxitin (30µg. Isolates with zone diameter less than 18 mm were tested for AmpC activity by AmpC disc test. Results: Of the 100 isolates that were tested, 30 yielded cefoxitin zone diameters less than 18 mm (screen positive. Production of AmpC β-lactamase was detected in 24 isolates by AmpC disc test. Conclusion: AmpC disc test can be used as a simple, convenient and rapid screening test for detection of AmpC β lactamase in clinical laboratories.

  7. Nationwide Survey of Klebsiella Pneumoniae Strains Producing CTX-M Extended-spectrum β-lactamases in Croatia.

    Science.gov (United States)

    Fiolić, Zlatko; Bosnjak, Zrinka; Bedenić, Branka; Budimir, Ana; Mareković, Ivana; Cetkovic, Helena; Kalenić, Smilja

    2015-12-01

    Extended-spectrum β-lactamases (ESBL) producing bacteria have been increasingly reported in both hospital and community patients. Production of ESBLs is the major mechanism of resistance to oxymino-cephalosporins and aztreonam in Gram-negative bacteria. Recently a new family of ESBLs with predominant activity against cefotaxime (CTX-M β-lactamases) has been reported. Over 80 CTX-M enzymes have been described so far, which can be grouped into five main subgroups according to amino acid sequence identity (CTX-M-1, CTX-M-2, CTX-M-8, CTX-M-9 and CTX-M-25). In some countries, CTX-M β-lactamases are the most prevalent types of ESBLs, for instance in Russia, Greece, Spain, Switzerland, Japan, Taiwan, China and Argentina. These enzymes have been identified in countries near Croatia such is Italy, Hungary and Austria. The aim of this study was to determine the prevalence and the types of CTX-M β lactamases produced by Klebsiella pneumoniae clinical isolates collected from October 2006 to January 2007 from both community- and hospital-based isolates were included (Figure 1.). 128 ESBL isolates were subjected to further analysis: screening with double disc diffusion test and confirmed by ESBL E test. PMID:26987165

  8. 老年晚期肺癌化疗前后肺部感染细菌培养及药敏试验变化研究%Research on change of spectrum distribution and drug susceptibility of bacterial culture for pulmonary infections in elderly patients with advanced cancer before and after chemotherapy

    Institute of Scientific and Technical Information of China (English)

    竺顺斌; 杜开齐

    2013-01-01

    目的 研究老年晚期肺癌患者化疗前、后肺部感染菌谱分布及耐药性变化,为临床预防治疗肺部感染提供参考.方法 收集76例晚期肺癌患者化疗前、后的痰标本进行细菌培养及药敏试验,比较化疗前后菌谱分布及耐药性变化.结果 化疗前检出病原菌62株,化疗后检出72株,化疗前、后细菌所占比例差异无统计学意义;化疗前、后检出白色假丝酵母菌分别占27.42%、44.44%,化疗后白色假丝酵母菌所占比例高于化疗前,差异有统计学意义(P<0.05);病原菌耐药率化疗前对氨曲南、氨苄西林、头孢克洛、亚胺培南耐药率分别为6.45%、19.35%、6.45%、8.06%,化疗后分别为33.33%、61.11%、37.50%、33.33%,化疗后氨曲南、氨苄西林、头孢克洛、亚胺培南等抗菌药物耐药性较化疗前高,差异有统计学意义(P<0.05).结论 老年晚期肺癌患者化疗后肺部感染细菌分离率增高,化疗对于主要抗菌药物敏感性影响不大,但对部分抗菌药物耐药性增加.%OBJECTIVE To study the change of spectrum distribution and drug resistance of the pathogens causing pulmonary infections in the elderly patients with late lung cancer before and after the chemotherapy so as to provide basis for clinical prevention and treatment of the pulmonary infections. METHODS The sputum samples were collected from 76 patients with advanced lung cancer so as to analyze the spectrum distribution and drug resistance, the changes of the bacterial spectrum and the drug resistance were compared between before and after the chemotherapy. RESULTS A total of 62 strains of pathogens were isolated before the chemotherapy, and 72 strains were detected after the chemotherapy; the proportion of the Candida albicans was 27. 42% before the chemotherapy, 44.44% after the chemotherapy, the difference was statistically significant (P<0. 05); the drug resistance rates of the pathogens to aztreonam

  9. Prevalence and Characterization of Integrons in Multidrug Resistant Acinetobacter baumannii in Eastern China: A Multiple-Hospital Study

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    Jing Chen

    2015-08-01

    Full Text Available Objective: The aim of this multiple-hospital study was to investigate the prevalence of integrons in multidrug-resistant Acinetobacter baumannii (MDRAB in Eastern China, and characterize the integron-integrase genes, so as to provide evidence for the management and appropriate antibiotic use of MDRAB infections. Methods: A total of 425 clinical isolates of A. baumannii were collected from 16 tertiary hospitals in 11 cities of four provinces (Fujian, Jiangsu, Zhejiang and Shandong from January 2009 to June 2012. The susceptibility of A. baumannii isolates to ampicillin/sulbactam, piperacillin/tazobactam, ceftazidime, ceftriaxone, cefepime, aztreonam, meropenem, amikacin, gentamicin, tobramycin, ciprofloxacin, levofloxacin, sulfamethoxazole/trimenthoprim, minocycline and imipenem was tested, and integrons and their gene cassettes were characterized in these isolates using PCR assay. In addition, integron-positive A. baumannii isolates were genotyped using pulsed-field gel electrophoresis (PFGE assay, and intI1 gene cassette was sequenced. Results: intI1 gene was carried in 69.6% of total A. baumannii isolates, while intI2 and intI3 genes were not detected. The prevalence of resistance to ampicillin/sulbactam, piperacillin/tazobactam, ceftazidime, ceftriaxone, cefepime, aztreonam, imipenem, meropenem, amikacin, gentamicin, tobramycin, ciprofloxacin, levofloxacin and sulfamethoxazole/trimenthoprim was significantly higher in integron-positive A. baumannii isolates than in negative isolates (all p values <0.05, while no significant difference was observed in the prevalence of minocycline resistance (p > 0.05. PFGE assay revealed 27 PFGE genotypes and 4 predominant genotypes, P1, P4, P7 and P19. The PFGE genotype P1 contained 13 extensive-drug resistant and 89 non-extensive-drug resistant A. baumannii isolates, while the genotype P4 contained 34 extensive-drug resistant and 67 non-extensive-drug resistant isolates, appearing a significant

  10. 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

  11. Metalo-beta-lactamases Metallo-beta-lactamases

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    Rodrigo Elisandro Mendes

    2006-04-01

    Full Text Available Nos últimos anos tem sido observada maior incidência de bacilos Gram-negativos resistentes a cefalosporinas de espectro ampliado no ambiente hospitalar, ocasionando, assim, maior uso de betalactâmicos mais potentes, como os carbapenens. A utilização de carbapenens exerce maior pressão seletiva sobre a microbiota hospitalar, o que pode ocasionar aumento da resistência a esses agentes. Entre os mecanismos de resistência a carbapenens mais comumente identificados estão a produção de betalactamases, como, por exemplo, as pertencentes à classe D de Ambler e as que pertencem à classe B de Ambler, ou metalo-beta-lactamases (MbetaL. Essas últimas hidrolisam todos betalactâmicos comercialmente disponíveis, sendo a única exceção o monobactam aztreonam. Desde o início da década de 1990, novos genes que codificam MbetaLs têm sido descritos em microrganismos clinicamente importantes, como Pseudomonas spp., Acinetobacter spp. e membros da família Enterobacteriaceae. O encontro desses microrganismos não-sensíveis a carbapenens pode ser submetido a metodologias fenotípicas para detecção da produção de MbetaL com o intuito de auxiliar a Comissão de Controle de Infecção Hospitalar (CCIH e prevenir a disseminação desses determinantes de resistência, uma vez que genes que codificam MbetaLs estão contidos em estruturas genéticas que propiciam sua mobilidade de forma muito efetiva, sendo então facilmente disseminados.Increase isolation of Gram-negative bacilli resistant to broad-spectrum cephalosporin has been observed during the last few years, thus determining the use of more potent beta-lactams, such as carbapenems. The use of these antimicrobial agents may lead to the emergence of carbapenem resistant Gram-negative bacilli in the nosocomial environment. Carbapenem resistance may be due to the production of Ambler class D beta-lactamase or Ambler class B beta-lactamase, also called metallo-beta-lactamase (MbetaL. Apart from

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

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    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.

  13. Prevalence of extended spectrum beta lactamases among strains of Pseudomonas aeruginosa isolated from burn patients

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    Mirsalehian

    2008-08-01

    Full Text Available Background: The resistance of Pseudomonas aeruginosa strains to broad spectrum cephalosporins may be mediated by extended spectrum b-lactamases (ESBLs. These enzymes are encoded by different genes located either on chromosome or plasmids. In this study, we determined the antimicrobial resistance patterns of P. aeruginosa isolates and screened for ESBL production. Methods: After isolation from burn patients in Tehran Hospital, identification of P. aeruginosa isolates were assessed using biochemical tests. We then performed disk agar diffusion (DAD according to CLSI guidelines to determine the pattern of antimicrobial resistance. The frequency of ESBLs and prevalence of the OXA-10 and PER-1 genes were determined with combined disk and polymerase chain reaction (PCR methods, respectively. Results: One hundred strains of P. aeruginosa were isolated. The resistance of these strains to cephpodoxime, aztreonam, ciprofloxacin, ofloxacin, ceftazidime, cefepime, imipenem, meropenem, cefotaxime, levofloxacin, piperacilin- tazobactam and ceftriaxon was 100%, 90%, 83%, 92%, 85%, 88%, 63%, 66%, 98%, 89%, 70% and 91%, respectively. Of these, 40 strains (40% were ESBL positive, 29 strains (29% were OXA-10 positive and 18 strains (18% were PER-1 positive. Conclusion: Our results confirm the need for proper antimicrobial therapy in burn hospitals, considering the resistance pattern and frequency of strains producing ESBLs and the presence of the OXA-10 and PER-1 genes. Since an increase in the prevalence of ESBL in P. aeruginosa strains might lead to the transfer of these ESBL genes to other gram-negative bacteria, we recommend the use of appropriate drugs, especially cephalosporins, in burn hospitals.

  14. Association of bacteria in diabetic and non-diabetic foot infection - An investigation in patients from Bangladesh.

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    Karmaker, Mousumi; Sanyal, Santonu K; Sultana, Munawar; Hossain, M A

    2016-01-01

    The microbial community on a host relies on its immune status and pathophysiological condition. Diabetes mellitus is a metabolic disorder associated with a 25% increased risk of developing foot infection. The pathophysiological differences between diabetic foot infection (DFI) and non-DFI patients may alter the microbial composition in infections. The present study aims to comparatively analyze the microbes colonized in DFI and non-DFI patients in Bangladesh. Pus specimens were collected from 67 DFI and 12 non-DFI patients to investigate the bacteria associated with foot infection. For this investigation, an array of microbiological, molecular biological and immunological approaches were performed. Common bacteria detected in both DFI/non-DFI samples were Pseudomonas spp. (22/29%), Bacillus spp. (12/3%), Enterobacter spp. (22/7%), Staphylococcus spp. (13/13%) and Acinetobacter spp. (10/10%). Enterococcus spp. (9%) and Klebsiella spp. (8%) occurred only in DFI patients, whereas Citrobacter spp. (29%) was only detected in non-DFI samples. The rate of occurrence of three organisms, namely, Enterococcus spp. |Z|=2.2125, Klebsiella spp. |Z|=1.732, Bacillus spp. |Z|=1.9034, were also statistically significant. Most of the isolates from DFI patients were commonly resistant to the cephalosporin (Ceftazidime, Ceftriazone, Cefurozime) and monobactam (Aztreonam) groups of antibiotics. DFI patients had comparatively higher C-reactive protein (CRP) levels than non-DFI patients, and a positive correlation was observed between multi-antibiotic resistance and CRP levels (one of the markers of chronic subclinical inflammation). The present investigation implicated a complex association of the bacterial population in DFI compared with non-DFI with different antimicrobial resistance properties, which was linked with CRP levels. PMID:26617249

  15. 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

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    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.

  16. 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.

  17. 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.

  18. 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.

  19. Multiyear, Multinational Survey of the Incidence and Global Distribution of Metallo-β-Lactamase-Producing Enterobacteriaceae and Pseudomonas aeruginosa.

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    Kazmierczak, Krystyna M; Rabine, Sharon; Hackel, Meredith; McLaughlin, Robert E; Biedenbach, Douglas J; Bouchillon, Samuel K; Sahm, Daniel F; Bradford, Patricia A

    2016-02-01

    Metallo-β-lactamases (MBLs) hydrolyze all classes of β-lactams except monobactams and are not inhibited by classic serine β-lactamase inhibitors. Gram-negative pathogens isolated from patient infections were collected from 202 medical centers in 40 countries as part of a global surveillance study from 2012 to 2014. Carbapenem-nonsusceptible Enterobacteriaceae and Pseudomonas aeruginosa were characterized for bla genes encoding VIM, IMP, NDM, SPM, and GIM variants using PCR and sequencing. A total of 471 MBL-positive isolates included the following species (numbers of isolates are in parentheses): P. aeruginosa (308), Klebsiella spp. (85), Enterobacter spp. (39), Proteeae (16), Citrobacter freundii (12), Escherichia coli (6), and Serratia marcescens (5) and were submitted by sites from 34 countries. Of these, 69.6% were collected in 9 countries (numbers of isolates are in parentheses): Russia (72), Greece (61), Philippines (54), Venezuela (29), and Kuwait, Nigeria, Romania, South Africa, and Thailand (20 to 25 isolates each). Thirty-two different MBL variants were detected (14 VIM, 14 IMP, and 4 NDM enzymes). Seven novel MBL variants were encountered in the study, each differing from a previously reported variant by one amino acid substitution: VIM-42 (VIM-1 [V223I]), VIM-43 (VIM-4 [A24V]), VIM-44 (VIM-2 [K257N]), VIM-45 (VIM-2 [T35I]), IMP-48 (IMP-14 [I69T]), IMP-49 (IMP-18 [V49F]), and NDM-16 (NDM-1 [R264H]). The in vitro activities of all tested antibiotics against MBL-positive Enterobacteriaceae were significantly reduced with the exception of that of aztreonam-avibactam (MIC90, 0.5 to 1 μg/ml), whereas colistin was the most effective agent against MBL-positive P. aeruginosa isolates (>97% susceptible). Although the global percentage of isolates encoding MBLs remains relatively low, their detection in 12 species, 34 countries, and all regions participating in this surveillance study is concerning. PMID:26643349

  20. Characterization of the new metallo-beta-lactamase VIM-13 and its integron-borne gene from a Pseudomonas aeruginosa clinical isolate in Spain.

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    Juan, Carlos; Beceiro, Alejandro; Gutiérrez, Olivia; Albertí, Sebastián; Garau, Margalida; Pérez, José L; Bou, Germán; Oliver, Antonio

    2008-10-01

    During a survey conducted to evaluate the incidence of class B carbapenemase (metallo-beta-lactamase [MBL])-producing Pseudomonas aeruginosa strains from hospitals in Majorca, Spain, five clinical isolates showed a positive Etest MBL screening test result. In one of them, strain PA-SL2, the presence of a new bla(VIM) derivative (bla(VIM-13)) was detected by PCR amplification with bla(VIM-1)-specific primers followed by sequencing. The bla(VIM-13)-producing isolate showed resistance to all beta-lactams (except aztreonam), gentamicin, tobramycin, and ciprofloxacin. VIM-13 exhibited 93% and 88% amino acid sequence identities with VIM-1 and VIM-2, respectively. bla(VIM-13) was cloned in parallel with bla(VIM-1), and the resistance profile conferred was analyzed both in Escherichia coli and in P. aeruginosa backgrounds. Compared to VIM-1, VIM-13 conferred slightly higher levels of resistance to piperacillin and lower levels of resistance to ceftazidime and cefepime. VIM-13 and VIM-1 were purified in parallel as well, and their kinetic parameters were compared. The k(cat)/K(m) ratios for the antibiotics mentioned above were in good agreement with the MIC data. Furthermore, EDTA inhibited the activity of VIM-13 approximately 25 times less than it inhibited the activity of VIM-1. VIM-13 was harbored in a class 1 integron, along with a new variant (Ala108Thr) of the aminoglycoside-modifying enzyme encoding gene aacA4, which confers resistance to gentamicin and tobramycin. Finally, the VIM-13 integron was apparently located in the chromosome, since transformation and conjugation experiments consistently yielded negative results and the bla(VIM-13) probe hybridized only with the genomic DNA. PMID:18644957

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

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    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

  2. Large Porous Particles for Sustained Release of a Decoy Oligonucelotide and Poly(ethylenimine): Potential for Combined Therapy of Chronic Pseudomonas aeruginosa Lung Infections.

    Science.gov (United States)

    d'Angelo, Ivana; Perfetto, Brunella; Costabile, Gabriella; Ambrosini, Veronica; Caputo, Pina; Miro, Agnese; d'Emmanuele di Villa Bianca, Roberta; Sorrentino, Raffaella; Donnarumma, Giovanna; Quaglia, Fabiana; Ungaro, Francesca

    2016-05-01

    We have recently demonstrated that the specific inhibition of nuclear factor-κB by a decoy oligonucleotide (dec-ODN) delivered through inhalable large porous particles (LPP) made of poly(lactic-co-glycolic acid) (PLGA) may be highly beneficial for long-term treatment of lung inflammation. Nevertheless, besides chronic inflammation, multifunctional systems aimed to control also infection are required in chronic lung diseases, such as cystic fibrosis (CF). In this work, we tested the hypothesis that engineering PLGA-based LPP with branched poly(ethylenimine) (PEI) may improve LPP properties for pulmonary delivery of dec-ODN, with particular regard to the treatment of Pseudomonas aeruginosa lung infections. After getting insight into the role of PEI on the technological properties of PLGA-based LPP for delivery of dec-ODN, the putative synergistic effect of PEI free or PEI released from LPP on in vitro antimicrobial activity of tobramycin (Tb) and aztreonam (AZT) against P. aeruginosa was elucidated. Meanwhile, cytotoxicity studies on A549 cells were carried out. Results clearly demonstrate that the dry powders have promising aerosolization properties and afford a prolonged in vitro release of both dec-ODN and PEI. The encapsulation of PEI into LPP results in a 2-fold reduction of the minimum inhibitory concentration of AZT, while reducing the cytotoxic effect of PEI. Of note, the developed ODN/PLGA/PEI LPP persisted at lung at least for 14 days after intratracheal administration in rats where they can provide sustained and combined release of dec-ODN and PEI. dec-ODN will likely act as an anti-inflammatory drug, while PEI may enhance the therapeutic activity of inhaled antibiotics, which are commonly employed for the treatment of concomitant lung infections. PMID:27002689

  3. 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. PMID:21783330

  4. CTX-M-producing Escherichia coli in Lithuania: associations between sites of infection, coresistance, and phylogenetic groups.

    Science.gov (United States)

    Giedraitienė, Agnė; Vitkauskienė, Astra; Ašmonienė, Virginija; Plančiūnienė, Rita; Simonytė, Sandrita; Pavilonis, Alvydas; Arlet, Guillaume

    2013-01-01

    Increasing resistance of Escherichia coli (E. coli) to antibiotics, especially to the third-generation cephalosporins, has prompted studies on widespread resistance genes such as blaCTX-M and differentiation of E. coli to phylogenetic groups. The aim of this study was to determine the associations between the CTX-M type and the phylogenetic group, the site of infection, and coresistance in Lithuanian E. coli isolates producing β-lactamases. MATERIAL AND METHODS. A total of 90 E. coli ESBL strains were recovered from the lower respiratory tract, the urinary tract, sterile body sites, wounds, and other body sites between 2008 and 2012. The E. coli isolates resistant to at least 2 antibiotics with different modes of action along with resistance to cefotaxime were considered as multiresistant. The blaCTX-M, blaTEM, blaOXA-1, and blaSHV genes, the phylogenetic groups, and the resistance profiles were analyzed. RESULTS. Of the 90 isolates, 84 (93.3%) were classified as multiresistant and 6 (6.6%) as resistant. The blaCTX-M-15 gene was the most prevalent gene followed by the blaCTX-M-14 and blaCTX-M-92 genes. The logistic regression analysis revealed the associations between CTX-M-15 and resistance to ceftriaxone, between CTX-M-14 and resistance to cefoxitin, aztreonam, ampicillin/sulbactam, ticarcillin/clavulanic acid, and tobramycin, and between CTX-M-92 and resistance to cefepime, piperacillin/tazobactam, gentamicin, and tobramycin. CONCLUSIONS. The results of this study showed a significant association between CTX-M-15, CTX-M-14, and CTX-M-92 β-lactamases and resistance to some antibiotics as well as CTX‑M-14 β-lactamase and phylogenetic group A in the Lithuanian population. The associations between the CTX-M type and the site of infection were not determined. PMID:24589574

  5. Molecular Identification and Antimicrobial Resistance Profile of Acinetobacter baumannii Isolated From Nosocomial Infections of a Teaching Hospital in Isfahan, Iran

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    Fazeli

    2014-10-01

    Full Text Available Background Multidrug resistant (MDR and extensively drug resistant (XDR Acinetobacter baumannii are among important causes of nosocomial infections and cause therapeutic problems worldwide. The emergence of extensively drug-resistant A. baumannii (XDRAB cause serious threats to hospital acquired infections (HAI worldwide and further limit the treatment options. Objectives The current study aimed to identify and isolate the MDR and XDR Acinetobacter baumannii from different wards of a teaching hospital in Isfahan, Iran, and determine the susceptibility pattern of these bacteria. Materials and Methods One hundred and twenty one (121 isolates of A. baumannii collected from a teaching hospital in Isfahan, Iran, within eight months (between September 2013 and April 2014 were included in the current study. The samples were isolated from different wards and different specimens. To confirm the species of A. baumannii, Polymerase chain reaction (PCRwas conducted to identify blaoxa-51 gene. Disk diffusion method was employed to evaluate antimicrobial susceptibility against cefotaxime, ceftriaxone, ampicillin-sulbactam, cefepime, meropenem, tobramycin, amikacin, tetracycline, ciprofloxacin, trimethoprim- sulfamethoxazole, and aztreonam. Results Among the 121 isolated A. baumannii, 44% and 56% were isolated from female and male, respectively. Samples cultured from the trachea (36%, urine (15%, blood (10%, wound (10%, cerebrospinal fluid (7%, bronchial (4% and the others (18%. Most of the isolates (50% were obtained from intensive care unit (ICU. Isolated A. baumannii showed high resistance to the evaluated antibiotics except ampicillin-sulbactam, which showed only 33.9% resistance. Also, 62.8% and 100% of the isolates were identified as XDR and MDR. Conclusions The result of the current study showed the growing number of nosocomial infections associated with XDR A. baumannii causing difficulties in antibiotic therapy. Resistant strains increasingly cause

  6. In vitro antimicrobial activity of piperacillin/tazobactam in comparison with other broad-spectrum beta-lactams.

    Science.gov (United States)

    Roland, R K; Mendes, R E; Silbert, S; Bolsoni, A P; Sader, H S

    2000-10-01

    Combining tazobactam, a beta-lactamase inhibitor, with the ureidopenicillin, piperacillin, successfully restores the activity of piperacillin against beta-lactamase producing bacteria. Thus, piperacillin/tazobactam is highly active against most clinically important species of Gram-negative and Gram-positive bacteria, including anaerobes. We evaluated the in vitro activity of piperacillin/tazobactam against clinical isolates from a tertiary university hospital located in Sao Paulo, Brazil. Its activity was compared to that of ticarcillin/clavulanic acid, ampicillin/sulbactam, ceftazidime, ceftriaxone, cefotaxime, cefoxitin, aztreonam, and imipenem against 820 isolates (608 Gram-negative and 212 Gram-positive) collected from hospitalized patients in 1999. The most frequent species tested were Pseudomonas aeruginosa (168/20%), Escherichia coli (139/17%), Acinetobacter spp. (131/16%), and Staphylococcus aureus (76/9%). Of the isolates studied, 30% were from the bloodstream, 16% from the lower respiratory tract, and 11% from surgical wounds or soft tissue. The isolates were susceptibility tested by the broth microdilution method according to NCCLS procedures. The isolates tested were highly resistant to most antimicrobial agents evaluated. Imipenem resistance was not verified among Enterobacteriaceae, and piperacillin/tazobactam was the second most active beta-lactams against this group of bacteria (80.0% susceptibility). Extended-spectrum beta-lactamase production was very high among E. coli (approximately 20%) and Klebsiella pneumoniae (approximately 40%). Imipenem was uniformly active against these species (100% susceptibility) and piperacillin/tazobactam was the second most active compound inhibiting 84.4% of isolates. Pseudomonas aeruginosa was highly resistant to all beta-lactams evaluated and piperacillin/tazobactam was the most active compound against this species. Our results demonstrate an extremely high level of antimicrobial resistance in the hospital

  7. In vitro activity of LK-157, a novel tricyclic carbapenem as broad-spectrum {beta}-lactamase inhibitor.

    Science.gov (United States)

    Paukner, Susanne; Hesse, Lars; Prezelj, Andrej; Solmajer, Tomaz; Urleb, Uros

    2009-02-01

    LK-157 is a novel tricyclic carbapenem with potent activity against class A and class C beta-lactamases. When tested against the purified TEM-1 and SHV-1 enzymes, LK-157 exhibited 50% inhibitory concentrations (IC(50)s) in the ranges of the clavulanic acid and tazobactam IC(50)s (55 nM and 151 nM, respectively). Moreover, LK-157 significantly inhibited AmpC beta-lactamase (IC(50), 62 nM), as LK-157 was >2,000-fold more potent than clavulanic acid and approximately 28-fold more active than tazobactam. The in vitro activities of LK-157 in combination with amoxicillin, piperacillin, ceftazidime, cefotaxime, ceftriaxone, cefepime, cefpirome, and aztreonam against an array of Ambler class A (TEM-, SHV-, CTX-M-, KPC-, PER-, BRO-, and PC-type)- and class C-producing bacterial strains derived from clinical settings were evaluated in synergism experiments and compared with those of clavulanic acid, tazobactam, and sulbactam. In vitro MICs against ESBL-producing strains (except CTX-M-containing strains) were reduced 2- to >256-fold, and those against AmpC-producing strains were reduced even up to >32-fold. The lowest MICs (combination of cefepime and cefpirome with a constant LK-157 concentration of 4 microg/ml, thus raising an interest for further development. LK-157 proved to be a potent beta-lactamase inhibitor, combining activity against class A and class C beta-lactamases, which is an absolute necessity for use in the clinical setting due to the worldwide increasing prevalence of bacterial strains resistant to beta-lactam antibiotics. PMID:19075067

  8. Use of microdilution panels with and without beta-lactamase inhibitors as a phenotypic test for beta-lactamase production among Escherichia coli, Klebsiella spp., Enterobacter spp., Citrobacter freundii, and Serratia marcescens.

    Science.gov (United States)

    Thomson, K S; Sanders, C C; Moland, E S

    1999-06-01

    Over the past decade, a number of new beta-lactamases have appeared in clinical isolates of Enterobacteriaceae that, unlike their predecessors, do not confer beta-lactam resistance that is readily detected in routine antibiotic susceptibility tests. Because optimal methodologies are needed to detect these important new beta-lactamases, a study was designed to evaluate the ability of a panel of various beta-lactam antibiotics tested alone and in combination with beta-lactamase inhibitors to discriminate between the production of extended-spectrum beta-lactamases, AmpC beta-lactamases, high levels of K1 beta-lactamase, and other beta-lactamases in 141 isolates of Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter cloacae, Enterobacter aerogenes, Citrobacter freundii, and Serratia marcescens possessing well-characterized beta-lactamases. The microdilution panels studied contained aztreonam, cefpodoxime, ceftazidime, cefotaxime, and ceftriaxone, with and without 1, 2, and 4 microg of clavulanate per ml or 8 microg of sulbactam per ml and cefoxitin and cefotetan with and without 8 microg of sulbactam per ml. The results indicated that a minimum panel of five tests would provide maximum separation of extended-spectrum beta-lactamase high AmpC, high K1, and other beta-lactamase production in Enterobacteriaceae. These included cefpodoxime, cefpodoxime plus 4 microg of clavulanate per ml, ceftazidime, ceftriaxone, and ceftriaxone plus 8 microg of sulbactam per ml. Ceftriaxone plus 2 microg of clavulanate per ml could be substituted for cefpodoxime plus 4 microg of clavulanate per ml without altering the accuracy of the tests. This study indicated that tests with key beta-lactam drugs, alone and in combination with beta-lactamase inhibitors, could provide a convenient approach to the detection of a variety of beta-lactamases in members of the family Enterobacteriaceae. PMID:10348759

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

    Science.gov (United States)

    Jacoby, G A; Carreras, I

    1990-05-01

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

  10. Regulatory aspects of Phase 3 endpoints for new inhaled antibiotics for cystic fibrosis patients with chronic Pseudomonas aeruginosa infections.

    Science.gov (United States)

    Montgomery, Alan Bruce; Abuan, Tammy; Yeager, Melissa A

    2012-08-01

    Available regulatory guidelines for developing inhaled anti-infective therapies offer general advice, but specific guidance often provides conflicting and outdated advice in regard to clinical trial design. For instance, the availability of two approved drugs makes the conduct of placebo-controlled trials longer than 28 days problematic. Comparator drugs require use per the product label, making comparator trials difficult to blind as taste, foaming, regimen, device, and delivery time differences are present. Currently, there is no consensus on the most appropriate endpoints for evaluation of aerosolized antimicrobials. FEV(1) is a surrogate endpoint that it is a predictor of mortality--it is standardized, reproducible, noninvasive, simple, and inexpensive to perform but small statistically significant changes may not be clinically important. FEV(1) improvement also has a ceiling effect in patients with mild lung function impairment and spirometry cannot be reliably done in patients under the age of 6 years. A patient-reported outcome is a promising clinical endpoint. However, there is not currently an accepted tool that can be used as a primary endpoint for the FDA or the EMA, although the latter recognizes the CFQ-R as a validated secondary endpoint and the FDA grandfathered acceptance of the CFQ-R respiratory domain in the pivotal aztreonam for inhalation study. Exacerbations are an important clinical endpoint that reflects morbidity and are a major driver of cost of care, but they occur infrequently and a standardized definition has not been reached. Furthermore, an exacerbation endpoint may fail even with an otherwise effective antibiotic therapy. Regulatory authorities will have a difficult time approving any new inhaled antibiotic based on one clinical endpoint alone. PMID:22857271

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

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    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.

  12. 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.

  13. 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.

  14. 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.

  15. 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

  16. Prospective study of urinary tract infection surveillance after kidney transplantation

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    Rivera-Sanchez Roberto

    2010-08-01

    Full Text Available Abstract Background Urinary tract infection (UTI remains one of the main complications after kidney transplantation and it has serious consequences. Methods Fifty-two patients with kidney transplantation were evaluated for UTI at 3-145 days (mean 40.0 days after surgery.. Forty-two received a graft from a live donor and 10 from a deceased donor. There were 22 female and 30 male patients, aged 11-47 years. Microscopic examinations, leukocyte esterase stick, and urinary culture were performed every third day and weekly after hospitalization. A positive culture was consider when patients presented bacterial counts up to 105 counts. Results UTI developed in 19/52 (37% patients at 3-75 days (mean 19.5 days after transplantation. Recurrent infection was observed in 7/52 (13.4% patients at days 17-65. UTI was more frequent in patients who received deceased grafts compared with live grafts (7/10, 70% vs. 12/42, 28%; p vs. 8/22, 36.35%; p Escherichia coli (31.5%, Candida albicans (21.0% and Enterococcus spp. (10.5%, followed by Pseudomonas aeruginosa, Klebsiella pneumoniae, Morganella morganii, Enterobacter cloacae and Micrococcus spp. Secondary infections were produced by (7/19, 36.8%. Enterococcus spp. (57%, E. coli (28% and Micrococcus spp. (14.2%. Antibiotic resistance was 22% for ciprofloxacin and 33% for ampicillin. Therapeutic alternatives were aztreonam, trimethoprim-sulfamethoxazole, netilmicin and fosfomycin. Conclusions Surveillance of UTI for the first 3 months is a good option for improving quality of life of kidney transplantation patients and the exit of graft function especially for female patients and those receiving deceased grafts. Antibiograms provided a good therapeutic alternative to patients who presented with UTIs after receiving a kidney allograft.

  17. Analysis of drug resistance of Escherichia coli and Proteus mirabilis in iatrogenic urinary tract infections%医源性尿路感染大肠埃希菌与奇异变形菌的耐药性分析

    Institute of Scientific and Technical Information of China (English)

    刘广义; 曹永献; 张娜娜; 任立晟; 孙美娟; 曲海军; 刘双

    2015-01-01

    OBJECTIVE To investigate the correlation and drug resistance mechanism of Escherichia coli and Pro-teus mirabilis causing iatrogenic urinary tract infections and the produution of extended-spectrum β-lactamases (ESBLs) in E .coli and P .mirabilis so as to provide evidence to guide the clinical reasonable use of antibiotics . METHODS A total of 197 strains of E .coli and P .mirabilis isolated from the urine specimens of hospitalized pa-tients from Jan .2012 and Dec .2013 were retrospectively analyzed as well as drug susceptibility ,and screening and confirmatory tests were done to identify ESBLs-producing strains .The software WHONET 5 .6 was used for statistical analysis .RESULTS Totally 1181 strains of pathogens were isolated ,including 893 strains of E .coli ac-counting for 75 .61% and 288 strains of P .mirabilis accounting for 24 .39% .The drug resistance rate of E .coli was over 85 .38% to ceftazidime ,cefazolin ,cefotaxime ,ceftriaxone and aztreonam ,and the drug resistance rate of it was lower than 85 .00% ,而对亚胺培南、美罗培南的耐药率较低 ,均66 .00% .结论 大肠埃希菌及奇异变形菌是引起医源性尿路感染的主要病原菌 ;大肠埃希菌及奇异变形菌产ESBLs菌株检出率较高 ,产ESBLs菌对头孢菌素类、喹诺酮类、磺胺类和氨基糖苷类等抗菌药物呈多药耐药性.

  18. 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.

  19. Detection of the frequency, antimicrobial susceptibility, and genotypic discrimination of Aeromonas strains isolated from municipally treated tap water samples by cultivation and AP-PCR.

    Science.gov (United States)

    Emekdas, Gurol; Aslan, Gonul; Tezcan, Seda; Serin, Mehmet Sami; Yildiz, Cilem; Ozturhan, Hakan; Durmaz, Riza

    2006-04-01

    The frequency, antibiotic susceptibility, and genotypic discrimination of Aeromonas strains isolated from municipally treated drinking tap water distribution systems were investigated in this study. We have analyzed 148 tap water samples collected from 8 different locations by bacterial cultivation and arbitrarily primed polymerase chain reaction (AP-PCR). Gram negative, hemolytic, oxidase (+) and catalase (+) bacterial colonies were applied to the study. Identification of bacterial colonies was done by conventional biochemical method and API ID 20E panel (BioMerieux-France). Molecular epidemiological discrimination of the isolates was done by AP-PCR. Aeromonas spp. was detected in 6 of 148 (4%) tap water samples from 8 different locations. Five isolates were identified as Aeromonas hydrophila and one isolate was identified as Vibrio fluvialis by conventional biochemical method. These data were also confirmed by API 20E panel. One of 6 isolates was resistant to gentamicin, 2 of 6 isolates were resistant to trimethoprim/sulfamethoxazole, 4 of 6 isolates were resistant to ampicillin and ampicillin-sulbactam and all of 6 isolates were resistant to cephalothin. All isolates were found to be susceptible to amikacin, aztreonam, ceftazidime, ceftriaxone, ciprofloxacin. All 6 strains of Aeromonas were discriminated by AP-PCR and were determined that all isolates were from different genotypic sources. Although the frequency of the isolates was under the standard limits, the results indicate that hemolytic A. hydrophila are present in municipally treated tap water samples in Mersin City. While all strains were genotypically distinct, all of them were resistant to first generation beta lactam antibiotics tested in this study. PMID:16427154

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

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    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.

  1. Phenotypic Tests for the Detection of β-Lactamase-Producing Enterobacteriaceae Isolated from Different Environments.

    Science.gov (United States)

    de Oliveira, Daniele V; Van Der Sand, Sueli T

    2016-07-01

    Some bacteria from the Enterobacteriaceae family are showing a significant capability to disseminate β-lactams resistance mechanisms among them, and these same mechanisms can be carried out from the hospital environment to superficial water. The aim of this study was to evaluate different phenotypic methods for the detection β-lactamases production by enterobacteria isolated from the anthropogenic environment: hospital wastewater and from a stream that cross the city of Porto Alegre. The applied tests were the modified Hodge test (MHT) and phenotypic tests with the following inhibitors: carbapenemase-phenylboronic acid (APB), metallo-β-lactamase-EDTA, AmpC β-lactamase-cloxacillin, and the confirmatory test for extended-spectrum β-lactamase (ESBL)-clavulanic acid. For this evaluation, 131 isolates were initially subjected to antibiogram using the following antimicrobials: cefotaxime (30 µg), cefpodoxime (10 μg), ceftazidime (30 µg), ertapenem (10 μg), meropenem (10 μg), and aztreonam (30 μg). After this first screening, 62 isolates showed a profile resistance for at least one antimicrobial. These isolates were subjected to all phenotypic tests. Of those, 40 isolates were positive for at least one phenotypic test. In MHT test, one isolate was positive and five were with inconclusive results. The results achieved with the inhibitors are as follows: APB 25/40 positive strains; EDTA 8/40 positive strains; and with CLOXA 2/40 positive strains. ESBL production was observed for 34/40 strains. This assessment shows a high level of bacteria which can produce enzymes that inactivate β-lactams present in the different environment like the stream waters and from the hospital settings. PMID:27071981

  2. 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

  3. 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 < 0.05). The most frequent combinations of PAI markers in 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. PMID:26563230

  4. 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

    2016-03-01

    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. PMID:26824956

  5. Efflux pumps expression and its association with porin down-regulation and β-lactamase production among Pseudomonas aeruginosa causing bloodstream infections in Brazil

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    Xavier Danilo E

    2010-08-01

    Full Text Available Abstract Background Multi-drug efflux pumps have been increasingly recognized as a major component of resistance in P. aeruginosa. We have investigated the expression level of efflux systems among clinical isolates of P. aeruginosa, regardless of their antimicrobial susceptibility profile. Results Aztreonam exhibited the highest in vitro activity against the P. aeruginosa isolates studied (64.4% susceptibility, whereas susceptibility rates of imipenem and meropenem were both 47.5%. The MexXY-OprM and MexAB-OprM efflux systems were overexpressed in 50.8% and 27.1% of isolates studied, respectively. Overexpression of the MexEF-OprN and MexCD-OprJ systems was not observed. AmpC β-lactamase was overexpressed in 11.9% of P. aeruginosa isolates. In addition, decreased oprD expression was also observed in 69.5% of the whole collection, and in 87.1% of the imipenem non-susceptible P. aeruginosa clinical isolates. The MBL-encoding genes blaSPM-1 and blaIMP-1 were detected in 23.7% and 1.7% P. aeruginosa isolates, respectively. The blaGES-1 was detected in 5.1% of the isolates, while blaGES-5 and blaCTX-M-2 were observed in 1.7% of the isolates evaluated. In the present study, we have observed that efflux systems represent an adjuvant mechanism for antimicrobial resistance. Conclusions Efflux systems in association of distinct mechanisms such as the porin down-regulation, AmpC overproduction and secondary β-lactamases play also an important role in the multi-drug resistance phenotype among P. aeruginosa clinical isolates.

  6. Comparison of double disk synergy test, VITEK 2 and Check-MDR CT102 for detection of ESBL producing isolates

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    Fatima Numanovic

    2013-05-01

    Full Text Available Objective. This study is to define the statistical significance for detection of ESBL producers by the double disk synergy test and molecular test (Check-MDR CT102, microdilution test (VITEK 2 with AES and double disk synergy test (DDST, as well as the microdilution test and molecular test. Materials and methods. Phenotypic testing of 55 isolates Enterobacteriaceae (Escherichia coli (14/55, Klebsiella pneumonia (34/55, Klebsiella oxytoca (3/55 and Proteus mirabilis (4/55 was performed by VITEK 2 Compact/AES. When this test showed positive results for the ESBL phenotype, then DDST with amoxicillin/clavulanate, ceftazidime, cefpodoxime, aztreonam, ceftriaxone and cefoxitin disks was performed along with Check-MDR CT102 which identified CTX-M, TEM and SHV β-lactamases. Results. Applying the McNemar test, we determined that there was a statistically significant difference in the results of detection of ESBLs bacteria using DDST compared to molecular methods (95% CI=41.92 to 54.55; p<0.0001, as well as a DDST and VITEK 2/AES (95% CI=40.13 to 52.73; p<0.0001. We did not find any statistically significant difference in the results of detection of ESBL producers using molecular techniques and VITEK 2/AES (CI=-4,43 to 5,36; p=1. Also we did not find any statistical difference between the resistance to cefpodoxime and ceftriaxone (50/50 compared to the results of molecular tests. Conclusion. In routine daily testing, good detection of ESBLs bacteria, especially CTX-M can be obtained with phenotypic methods with VITEK 2/AES and by DDST with cefpodoxime, and ceftriaksone disks.

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

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    Feng, Jie; Weitner, Megan; Shi, Wanliang; Zhang, Shuo; Sullivan, David; Zhang, Ying

    2015-01-01

    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 production, and reactive

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

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    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. PMID:27530851

  9. 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

  10. 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.

  11. 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.

  12. Phenotypic and molecular characterization of antimicrobial resistance in Proteus mirabilis isolates from dogs.

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    Harada, Kazuki; Niina, Ayaka; Shimizu, Takae; Mukai, Yujiro; Kuwajima, Ken; Miyamoto, Tadashi; Kataoka, Yasushi

    2014-11-01

    Large-scale monitoring of resistance to 14 antimicrobial agents was performed using 103 Proteus mirabilis strains isolated from dogs in Japan. Resistant strains were analysed to identify their resistance mechanisms. Rates of resistance to chloramphenicol, streptomycin, enrofloxacin, trimethoprim/sulfamethoxazole, kanamycin, ampicillin, ciprofloxacin, cephalothin, gentamicin, cefoxitin and cefotaxime were 20.4, 15.5, 12.6, 10.7, 9.7, 8.7, 5.8, 2.9, 2.9, 1.9 and 1.9%, respectively. No resistance to ceftazidime, aztreonam or imipenem was found. Class 1 and 2 integrases were detected in 2.9 and 11.7% of isolates, respectively. Class 1 integrons contained aadB or aadB-catB-like-blaOXA10-aadA1, whereas those of class 2 contained sat-aadA1, dhfr1-sat-aadA1 or none of the anticipated resistance genes. Of five distinct plasmid-mediated quinolone-resistance (PMQR) genes, only qnrD gene was detected in 1.9% of isolates. Quinolone-resistance determining regions (QRDRs) of gyrA and parC from 13 enrofloxacin-intermediate and -resistant isolates were sequenced. Seven strains had double mutations and three had single mutations. Three of nine ampicillin-resistant isolates harboured AmpC-type β-lactamases (i.e. blaCMY-2, blaCMY-4 and blaDHA-1). These results suggest that canine Proteus mirabilis deserves continued surveillance as an important reservoir of antimicrobial resistance determinants. This is the first report, to our knowledge, describing integrons, PMQRs and QRDR mutations in Proteus mirabilis isolates from companion animals. PMID:25187600

  13. 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.

  14. Meropenem in cystic fibrosis patients infected with resistant Pseudomonas aeruginosa or Burkholderia cepacia and with hypersensitivity to beta-lactam antibiotics.

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    Ciofu, Oana; Jensen, Tim; Pressler, Tacjana; Johansen, Helle Krogh; Koch, Christian; Høiby, Niels

    1996-01-01

    OBJECTIVE: To assess the efficacy and safety of meropenem, administered on a compassionate basis to 62 cystic fibrosis (CF) patients (age: 24plus minus6 years) with hypersensitivity reactions to beta-lactam antibiotics and/or infection by bacteria resistant to other antibiotics. METHODS: Fifty-seven patients were chronically infected with Pseudomonas aeruginosa and 5 with Burkholderia cepacia. In total, 124 courses (1 to 6/patient) of meropenem, 2 g three times a day by intravenous infusion (10 to 15 min) for 14 days, were administered. RESULTS: During treatment for P. aeruginosa the mean increase in pulmonary function (as a percentage of the predictive values) was 5.6% for FEV1 (forced expiratory volume in the first second) and 8.6% for FVC (forced vital capacity). C-reactive protein and erythrocyte sedimentation rate (ESR) and leukocyte count decreased significantly. In courses administered for chronic infection with B. cepacia the post treatment FEV1 and FVC values were higher than the pre-treatment values, and all the inflammatory parameters decreased. The geometric means of minimal inhibitory concentration (MICs) (microg/mL) for P. aeruginosa (B. cepacia) were: tobramycin 6 (59), ciprofloxacin 1.2 (9.7), piperacillin 49 (16.3), ceftazidime 26 (23), aztreonam 26 (35), imipenem 6.4 (not determined) and meropenem 5.1 (4.8). No statistically significant increase in the MICs of meropenem for either pathogen occurred during therapy. Of the 124 courses, 115 were tolerated without any clinical complaint. The following side effects were observed: nausea (0.8%), itching (4%), rash (3.2%), drug fever (1.6%). CONCLUSIONS: Meropenem proved to be a valuable drug in the treatment of CF patients with chronic pulmonary infection with multiresistant P. aeruginosa and B. cepacia and with hypersensitivity reactions to other beta-lactam drugs. PMID:11866824

  15. 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

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

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    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. PMID:25165124

  17. First detection of metallo-β-lactamases in nosocomial isolates of Pseudomonas aeruginosa in Alagoas, Brazil

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    Emmily M. L. R. Barros

    2015-10-01

    Full Text Available ABSTRACTIntroduction:Pseudomonas aeruginosa is a leading cause of opportunistic infections in humans, and the choice of effective antimicrobial agents to control this bacterium has been limited, mainly due to its ability to produce metallo-β-lactamases (MβL, enzymes capable of inactivating many antimicrobials through hydrolysis.Objective:This study aimed to detect the presence of multidrug-resistant (MDR P. aeruginosa strains and the MβL-encoding genes (blaSPM, blaIMP and blaVIM in nosocomial isolates in Maceió (AL.Methods:The isolates were collected from four public institutions/hospitals in Maceió, and cultures were identified by conventional methods. Antibiotic susceptibility was determined by the disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI, and polymerase chain reaction (PCR was used to identify the presence of the MβL-encoding genes blaSPM, blaIMP and blaVIM.RESULTS:Forty-three strains of P. aeruginosa were MDR among 85 identified nosocomial isolates (50.6%, 79.1% and 20% of which were resistant to carbapenem (imipenem and meropenem and aztreonam, respectively. PCR was performed in susceptible or resistant isolates and we identified nine (20.9% MDR strains with blaSPM gene, whereas only one strain had blaIMP and none blaVIM positive was found.Conclusion:Production of MβL is an important mechanism of resistance to carbapenems and other β-lactams among P. aeruginosa strains in the evaluated samples. We reported the first identification of MβL-encoding genes in P. aeruginosa from nosocomial environments in Maceió, a new insight for the epidemiology of MβL in the Northeastern region of Brazil.

  18. Molecular Study of Extended-Spectrum Beta-Lactamases among Enterobacter spp. Isolated from Teaching Hospitals in Tehran and Qazvin, Iran

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    Amir Peymani

    2013-10-01

    Full Text Available Abstract Background and objective: Enterobacter spp. are members of the family Enterobacteriaceae. In recent years, there are several reports showing the high prevalence of beta-lactam resistant among these organisms. Different types of beta-lactamase enzymes have been identified in Enterobacter spp., which Extended-Spectrum Beta-Lactamases (ESBLs are very important among them. The ESBL-producing isolates capable to hydrolyze extended spectrum penicillin's and cephalosporins. The aims of this study were to determine the prevalence of ESBLs and to detect of blaTEM and blaSHV genes among ESBL-producing Enterobacter spp. isolates. Materials and methods: A total of 107 Enterobacter isolates were collected from Tehran and Qazvin hospitals. Isolates were identified by standard microbiology and biochemical methods. All isolates were screened for ESBLs production by agar disk diffusion method using ceftazidime, cefotaxime, aztreonam, cefpodoxime and ceftriaxone discs and then were confirmed by combined disk method. ESBLs-positive isolates were tested for blaTEM and blaSHV-ESBLs genes. Results: Of the 107 isolates, 58 isolates (54.2% showed the reduced susceptibility to the screening antibiotics. 51 isolates (47.6% were ESBLs positive by combined disks method. Twenty eight isolates (54.9% contained blaTEM genes and 2 isolates (3.9% harbored the blaSHV genes. Conclusions: This study showed the high prevalence of ESBLs in Enterobacter spp. isolated from the clinical specimens in studied hospitals. The initial identification of ESBL-producing isolates and use of appropriate infection strategy is essential to control the more spread of these organisms in selected hospitals.

  19. Phenotypic and molecular characterization of extended-spectrum beta-lactamase-producing Escherichia coli in Bangladesh.

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    Taslima T Lina

    Full Text Available BACKGROUND: Resistance to cephalosporins in Enterobacteriaceae is mainly due to the production of extended-spectrum beta-lactamase (ESBL. Little is known about ESBL-producing bacteria in Bangladesh. Therefore, the study presents results of phenotypic and molecular characterization of ESBL-producing Escherichia coli from hospitals in Bangladesh. METHODS: A total of 339 E. coli isolated from patients with urinary tract and wound infections attending three different medical hospitals in urban and rural areas of Bangladesh between 2003-2007 were screened for ESBL-production by the double disk diffusion test. Isolates with ESBL-phenotype were further characterized by antibiotic susceptibility testing, PCR and sequencing of different β-lactamase and virulence genes, serotyping, and XbaI-macrorestriction followed by pulsed-field gel electrophoresis (PFGE. RESULTS: We identified 40 E. coli with ESBL phenotype. These isolates were resistant to ceftriaxone, ceftazidime, cefotaxime, aztreonam, cefepime, and nalidixic acid but remained susceptible to imipenem. All but one isolate were additionally resistant to ciprofloxacin, and 3 isolates were resistant to cefoxitin. ESBL genes of blaCTX-M-1-group were detected in all isolates; blaTEM-type and blaOXA-1-type genes were detected in 33 (82.5% and 19 (47.5% isolates, respectively. Virulence genes that are present in diarrhoeagenic E. coli were not found. Class-1 integron was present in 20 (50% isolates. All the ESBL-producing E. coli isolates harbored plasmids ranging between 1.1 and 120 MDa. PFGE-typing revealed 26 different pulsotypes, but identical pulsotype showed 6 isolates of serotype O25:H4. CONCLUSION: The prevalence of multidrug-resistant ESBL-producing E. coli isolates appears to be high and the majority of the isolates were positive for blaCTX-M. Although there was genetic heterogeneity among isolates, presence of a cluster of isolates belonging to serotype O25:H4 indicates dissemination of the

  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. 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

  2. A retrospective observational study on the efficacy of colistin by inhalation as compared to parenteral administration for the treatment of nosocomial pneumonia associated with multidrug-resistant Pseudomonas aeruginosa

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    Naesens Reinout

    2011-11-01

    Full Text Available Abstract Background Colistin is used as last treatment option for pneumonia associated with multidrug-resistant (MDR Pseudomonas spp.. Literature about the best administration mode (inhalation versus parenteral treatment is lacking. Methods A retrospective study of 20 intensive care patients with a pneumonia associated with MDR P. aeruginosa receiving colistin sulphomethate sodium (Colistineb® between 2007 and 2009 was performed. A strain was considered multidrug-resistant if it was resistant to at least 6 of the following antibiotics: piperacillin-tazobactam, ceftazidime, cefepime, meropenem, aztreonam, ciprofloxacin, and amikacin. The administration mode, predicted mortality based on the SAPS3 score, SOFA score at onset of the colistin treatment, clinical and microbiological response, and mortality during the episode of the infection were analysed. The non parametric Kruskal-Wallis and Fisher's Exact test were used for statistical analysis of respectively the predicted mortality/SOFA score and mortality rate. Results Six patients received colistin by inhalation only, 5 were treated only parenterally, and 9 by a combination of both administration modes. All patients received concomitant beta-lactam therapy. The mean predicted mortalities were respectively 72%, 68%, and 69% (p = 0.91. SOFA scores at the onset of the treatment were also comparable (p = 0.87. Clinical response was favorable in all patients receiving colistin by inhalation (6/6 and in 40% (2/5 of the patients receiving colistin parenterally (p = 0.06. In the patients with colistin administered both via inhalation and parenterally, clinical response was favorable in 78% of the patients (7/9 (p = 0.27 as compared to the treatment group receiving colistin only parenterally. When all patients with inhalation therapy were compared to the group without inhalation therapy, a favorable clinical response was present in respectively 87% and 40% (p = 0.06. In none of the patients, the

  3. Characterization of VIM-2, a carbapenem-hydrolyzing metallo-beta-lactamase and its plasmid- and integron-borne gene from a Pseudomonas aeruginosa clinical isolate in France.

    Science.gov (United States)

    Poirel, L; Naas, T; Nicolas, D; Collet, L; Bellais, S; Cavallo, J D; Nordmann, P

    2000-04-01

    Pseudomonas aeruginosa COL-1 was identified in a blood culture of a 39-year-old-woman treated with imipenem in Marseilles, France, in 1996. This strain was resistant to beta-lactams, including ureidopenicillins, ticarcillin-clavulanic acid, cefepime, ceftazidime, imipenem, and meropenem, but remained susceptible to the monobactam aztreonam. The carbapenem-hydrolyzing beta-lactamase gene of P. aeruginosa COL-1 was cloned, sequenced, and expressed in Escherichia coli DH10B. The deduced 266-amino-acid protein was an Ambler class B beta-lactamase, with amino acid identities of 32% with B-II from Bacillus cereus; 31% with IMP-1 from several gram-negative rods in Japan, including P. aeruginosa; 27% with CcrA from Bacteroides fragilis; 24% with BlaB from Chryseobacterium meningosepticum; 24% with IND-1 from Chryseobacterium indologenes; 21% with CphA-1 from Aeromonas hydrophila; and 11% with L-1 from Stenotrophomonas maltophilia. It was most closely related to VIM-1 beta-lactamase recently reported from Italian P. aeruginosa clinical isolates (90% amino acid identity). Purified VIM-2 beta-lactamase had a pI of 5.6, a relative molecular mass of 29.7 kDa, and a broad substrate hydrolysis range, including penicillins, cephalosporins, cephamycins, oxacephamycins, and carbapenems, but not monobactams. As a metallo-beta-lactamase, its activity was zinc dependent and inhibited by EDTA (50% inhibitory concentration, 50 microM). VIM-2 conferred a resistance pattern to beta-lactams in E. coli DH10B that paralleled its in vitro hydrolytic properties, except for susceptibility to ureidopenicillins, carbapenems, and cefepime. bla(VIM-2) was located on a ca. 45-kb plasmid that in addition conferred resistance to sulfamides and that was not self-transmissible either from P. aeruginosa to E. coli or from E. coli to E. coli. bla(VIM-2) was the only gene cassette located within the variable region of a novel class 1 integron, In56, that was weakly related to the bla(VIM-1)-containing

  4. Clinical distribution and drug resistance of pseudomonas aeruginosa isolated from intensive care unit%重症监护病房铜绿假单胞菌的分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    吕卫东; 游勇

    2011-01-01

    目的 探讨重症监护病房(ICU)铜绿假单胞菌(PAE)医院感染的标本分布及耐药性,为临床控制PAE医院感染提供依据.方法 回顾性调查医院ICU 2008年1月-2009年12月PAE感染的临床现状,对140株PAE的药敏试验结果进行统计分析.结果 医院ICU PAE主要来源于呼吸道标本,占总数的55.8%;PAE对头孢噻肟、庆大霉素、氨曲南、左氧氟沙星、磺胺甲噁唑/甲氧苄啶等耐药率均>68.0%,对其他抗菌药物也产生了不同的耐药性;而对亚胺培南、美罗培南、阿米卡星、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦敏感率均>74.0%.结论 临床医师应根据病原学检查的结果,合理使用抗菌药物,提高抗感染治疗水平.%OBJECTIVE To investigate the specimen distribution and drug-resistance in nosocomial infections with Pseudomonas aeruginosa (PAE) in intensive care unit (ICU) to provide the scientific evidence for clinical controlling of them. METHODS The clinical status of nosocomial infections with PAE from Jan. 2008 to Dec. 2009 was investigated retrospectively. The susceptibility testing results were analyzed statistically. RESULTS The specimen were mostly from respiratory tract (55. 8%). The drug-resistance rates of PAE to cefotaxime, gentamycin, aztreonam, levofloxacin and trimethoprim-sulfamethoxazole were all above 68. 0%, also to other antibiotics. The rates of susceptibility to imipenem, meropenem, amikacin, cefoperazone/sulbactam, piperacillin/ tazobactam were all above 74. 0%. CONCLUSION The clinician should prescribe the antibiotics reasonably according to etiology to raise the level of anit-infection and chemical therapy.

  5. 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

  6. Amikacin-fosfomycin at a five-to-two ratio: characterization of mutation rates in microbial strains causing ventilator-associated pneumonia and interactions with commonly used antibiotics.

    Science.gov (United States)

    Montgomery, A Bruce; Rhomberg, Paul R; Abuan, Tammy; Walters, Kathie-Anne; Flamm, Robert K

    2014-07-01

    The amikacin-fosfomycin inhalation system (AFIS), a combination of antibiotics administered with an in-line nebulizer delivery system, is being developed for adjunctive treatment of ventilator-associated pneumonia (VAP). The in vitro characterization of amikacin-fosfomycin (at a 5:2 ratio) described here included determining resistance selection rates for pathogens that are representative of those commonly associated with VAP (including multidrug-resistant strains) and evaluating interactions with antibiotics commonly used intravenously to treat VAP. Spontaneous resistance to amikacin-fosfomycin (5:2) was not observed for most strains tested (n, 10/14). Four strains had spontaneously resistant colonies (frequencies, 4.25 × 10(-8) to 3.47 × 10(-10)), for which amikacin-fosfomycin (5:2) MICs were 2- to 8-fold higher than those for the original strains. After 7 days of serial passage, resistance (>4-fold increase over the baseline MIC) occurred in fewer strains (n, 4/14) passaged in the presence of amikacin-fosfomycin (5:2) than with either amikacin (n, 7/14) or fosfomycin (n, 12/14) alone. Interactions between amikacin-fosfomycin (5:2) and 10 comparator antibiotics in checkerboard testing against 30 different Gram-positive or Gram-negative bacterial strains were synergistic (fractional inhibitory concentration [FIC] index, ≤ 0.5) for 6.7% (n, 10/150) of combinations tested. No antagonism was observed. Synergy was confirmed by time-kill methodology for amikacin-fosfomycin (5:2) plus cefepime (against Escherichia coli), aztreonam (against Pseudomonas aeruginosa), daptomycin (against Enterococcus faecalis), and azithromycin (against Staphylococcus aureus). Amikacin-fosfomycin (5:2) was bactericidal at 4-fold the MIC for 7 strains tested. The reduced incidence of development of resistance to amikacin-fosfomycin (5:2) compared with that for amikacin or fosfomycin alone, and the lack of negative interactions with commonly used intravenous antibiotics, further supports

  7. Drug Susceptibility and Molecular Epidemiology of Pseudomonas aeruginosa Isolated in a Burn Unit

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    Hassan Salimi

    2009-01-01

    Full Text Available Problem statement: Pseudomonas aeruginosa is an opportunistic pathogen that still develops life-threatening infections in patients with immunological system defects, like burn patients, especially in developing countries. Since this bacterium is naturally resistant to many drugs and is able to get resistance to all effective antibiotics, the infection with this organism is particularly problematic condition for patients. This study was design to evaluated drug susceptibility for determination of multidrug-resistant isolates and molecular epidemiology of P. aeruginosa colonization for investigation of the isolates routes in the burn unit of Shahid Motahhari Hospital in Tehran. Approach: About 127 clinical and 2 environmental P. aeruginosa isolates were collected during 6 months. All P. aeruginosa isolates were analyzed for drug susceptibility by disk diffusion method and molecular epidemiology assessment were done by RAPD-PCR analysis. Results: Drug susceptibility tests were shown high resistance for ceftizoxime (86.8%, aztreonam (80.6%, kanamycin (79.8% and tetracycline (78.3%; furthermore, low resistance for some antibiotics like imipenem (30.2%, piperacillin/tazobactam (34.1% and amikacin (41.1% was showed. In addition, 42 multidrug-resistant P. aeruginosa isolates were recovered from clinical specimens and one isolate from environmental samples. Molecular typing revealed eight different profiles that include two profiles, RAPD1 and RAPD4, with environmental resource. The major RAPD profile was RAPD1 profile (n = 64, 50.4%, which includes 31 (72.1% multidrug-resistant isolates with an environmental reservoir. Conclusion: In summery, we were found three different profiles for multidrug-resistant strains. Different RAPD profiles suggested the different resources of infection, two environmental resources were found, that one of them was multidrug-resistant strain. These findings highlighted the need for further attention to

  8. Antibiotic susceptibility pattern and identification of extended spectrum β-lactamases (ESBLs in clinical isolates of Klebsiella pneumoniae from Shiraz, Iran

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    Davood mansury

    2016-03-01

    Full Text Available Background and Objectives: Klebsiella pneumoniae, one of the important causes of nosocomial infections, is the most common extended spectrum β-lactamases (ESBLs producing organism. ESBLs are defined as the enzymes capable of hydrolyzing oxyimino-cephalosporins, monobactams and carbapenems. The aims of this study were to identify ESBL-producing K. pneumoniae isolates and detect their antibiotic susceptibility pattern.Materials and Methods: This cross-sectional study was conducted from December 2012 to May 2013 in teaching hospitals in Shiraz. Clinical specimens from the urine, sputum, wound, blood, throat, and body fluids were isolated and identified as K. pneumoniae. Antibacterial susceptibility testing was performed for 14 antibiotics using disk diffusion method according to CLSI guidelines. Isolates showing resistant to at least one of the β-lactam antibiotics were then evaluated for production of β-lactamase enzymes using E-test ESBL and combined disk Method. Also, MICs for ceftazidime and imipenem were determined using E-test. The presence of the blaSHV, blaTEM٫ blaPER and blaCTX-M genes was assessed by PCR.Results: Of 144 K. pneumoniae isolates from different specimens, 38 (26.3 % was identified as ESBL producer by phenotypic confirmatory test. All ESBL producing isolates were susceptible to imipenem and meropenem and resistant to aztreonam. The highest rate of resistance belonged to amoxicillin (100%, cefotaxime (50% and gentamicin (42.3% and the lowest rates were seen for meropenem (11.8%, imipenem and amikacin (both 15.9%. Sixty-two isolates had MICs≥ 4 μg/ mL for ceftazidime, of which 38 were positive for ESBLs in phenotypic confirmatory tests (PCT. The prevalence of blaSHV, blaCTX-M, and blaTEM genes among these isolates were 22.2%, 19% and 16%. blaPER was not detected in the studied isolates.Conclusions: Due to the relatively high prevalence of ESBLs-producing K. pneumoniae isolates in the studied population, it seems that

  9. 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.

  10. Rgional Difference of Drug Resistance of Acinetobacter Baumanii in Guangxi%广西鲍曼不动杆菌耐药性的地区差异

    Institute of Scientific and Technical Information of China (English)

    于虹

    2016-01-01

    Objective To study the reginal difference of drug resistance situation of acinetobacter baumanii in Guangxi. Methods The drug resistance rate of 1243 strains of acinetobacter baumanii isolated from clinical specimens in some grade AAA hospital in Guangxi to common antibiotics was counted and analyzed. Results In addition to cefoperazone/sulbactam in 2014, the drug resistance rates of acinetobacter baumanii to the other antimicrobial drugs were obviously at a high level, a-mong them, the resistance rate to aztreonam, piperacillin and ciprofloxacin and carbapenem (imipenem, meropenem) were respectively 100%, nearly 90% and more than 80%, which was higher than the drug resistance monitoring data of China CHINET. Conclusion The drug situation of acinetobacter baumanii in Guangxi was obviously higher than the national level with regional difference, which should be paid great attention.%目的:探讨广西地区鲍曼不动杆菌耐药形势的地区差异性。方法对广西某大型三甲医院2014年临床标本分离出的1243株鲍曼不动杆菌对常用抗菌素的耐药率进行统计和分析。结果2014年除头胞哌酮/舒巴坦外,鲍曼不动杆菌对其他监测的抗菌药物耐药率均明显处于高水平,其中对氨曲南耐药率为100%,对哌拉西林及环丙沙星耐药率已接近90%,对碳青霉烯类药物(亚胺培南、美罗培南)耐药率已大于80%,并高于中国CHINET耐药监测数据。结论广西地区鲍曼不动杆菌耐药形势明显高于全国水平,具有地方差异性,应引起高度重视。

  11. Clinical distribution and resistance analyses of acinetobacter baumanii%267株鲍曼不动杆菌感染临床分布与耐药性分析

    Institute of Scientific and Technical Information of China (English)

    曾雪峰; 陈锋; 王晓霞; 李凯; 李群

    2011-01-01

    Objective To investigate the clinical distribution and the drug resistance of acinetobacter baumanii in order to offer reference for the clinical therapeutics. Methods The distribution and the susceptibility results of Baumanii in our hospital from Jan. 2009to. Dec. 2009 were analyzed retrospectively. Results The majority of these resistant strains were isolated from sputum,and distributed in ICUs. The resistant rates of 267 strains to Cefoxitin, Aztreonam, Piperacillin, Piperacillin/tazobactam, Ticarcillin/Clavulanic Acid, Cefotaxime and Cefepime is 100%, 85.0%, 76.8%, 71.5%, 70.8%, 67.8%, 65.2% respectively. Conclusion The drug-resistance of Acinetobacter baumannii is severe in our hospital. and Imipenem or Cefeperazone/sulbactam was recommended.%目的 了解鲍曼不动杆菌的临床分布及其对常用抗生素的耐药状况,为临床使用抗生素治疗提供依据.方法 对我院2009年1月~2009年12月住院患者送检标本分离的287株鲍曼不动杆菌的分布及药敏结果进行回顾性分析.结果 267株鲍曼不动杆菌大多分离自痰液,主要来自于ICU病房;鲍曼不动杆菌对头孢西丁耐药率最高,为100 %,依次是氨曲南(85.0%)、哌拉西林(76.8%)、哌拉西林/三唑巴坦(71.5%)、替卡西林/克拉维酸(70.8%)、头孢噻肟(67.8 %)、头孢吡肟(65.2%)等.结论 我院鲍曼不动杆菌耐药情况严重,治疗首选碳青霉烯类抗生素,其次可选用头孢哌酮/舒巴坦.

  12. 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

  13. Prevalence of antimicrobial resistance in enteric Escherichia coli from domestic pets and assessment of associated risk markers using a generalized linear mixed model.

    Science.gov (United States)

    Leite-Martins, Liliana R; Mahú, Maria I M; Costa, Ana L; Mendes, Angelo; Lopes, Elisabete; Mendonça, Denisa M V; Niza-Ribeiro, João J R; de Matos, Augusto J F; da Costa, Paulo Martins

    2014-11-01

    Antimicrobial resistance (AMR) is a growing global public health problem, which is caused by the use of antimicrobials in both human and animal medical practice. The objectives of the present cross-sectional study were as follows: (1) to determine the prevalence of resistance in Escherichia coli isolated from the feces of pets from the Porto region of Portugal against 19 antimicrobial agents and (2) to assess the individual, clinical and environmental characteristics associated with each pet as risk markers for the AMR of the E. coli isolates. From September 2009 to May 2012, rectal swabs were collected from pets selected using a systematic random procedure from the ordinary population of animals attending the Veterinary Hospital of Porto University. A total of 78 dogs and 22 cats were sampled with the objective of isolating E. coli. The animals' owners, who allowed the collection of fecal samples from their pets, answered a questionnaire to collect information about the markers that could influence the AMR of the enteric E. coli. Chromocult tryptone bile X-glucuronide agar was used for E. coli isolation, and the disk diffusion method was used to determine the antimicrobial susceptibility. The data were analyzed using a multilevel, univariable and multivariable generalized linear mixed model (GLMM). Several (49.7%) of the 396 isolates obtained in this study were multidrug-resistant. The E. coli isolates exhibited resistance to the antimicrobial agent's ampicillin (51.3%), cephalothin (46.7%), tetracycline (45.2%) and streptomycin (43.4%). Previous quinolone treatment was the main risk marker for the presence of AMR for 12 (ampicillin, cephalothin, ceftazidime, cefotaxime, nalidixic acid, ciprofloxacin, gentamicin, tetracycline, streptomycin, chloramphenicol, trimethoprim-sulfamethoxazole and aztreonam) of the 15 antimicrobials assessed. Coprophagic habits were also positively associated with an increased risk of AMR for six drugs, ampicillin, amoxicillin

  14. Evaluation of multidrug efflux pump inhibitors by a new method using microfluidic channels.

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    Yoshimi Matsumoto

    Full Text Available Fluorescein-di-β-D-galactopyranoside (FDG, a fluorogenic compound, is hydrolyzed by β-galactosidase in the cytoplasm of Escherichia coli to produce a fluorescent dye, fluorescein. We found that both FDG and fluorescein were substrates of efflux pumps, and have developed a new method to evaluate efflux-inhibitory activities in E. coli using FDG and a microfluidic channel device. We used E. coli MG1655 wild-type, ΔacrB (ΔB, ΔtolC (ΔC and ΔacrBΔtolC (ΔBC harboring plasmids carrying the mexAB-oprM (pABM or mexXY-oprM (pXYM genes of Pseudomonas aeruginosa. Two inhibitors, MexB-specific pyridopyrimidine (D13-9001 and non-specific Phe-Arg-β-naphthylamide (PAβN were evaluated. The effects of inhibitors on pumps were observed using the microfluidic channel device under a fluorescence microscope. AcrAB-TolC and analogous pumps effectively prevented FDG influx in wild-type cells, resulting in no fluorescence. In contrast, ΔB or ΔC easily imported and hydrolyzed FDG to fluorescein, which was exported by residual pumps in ΔB. Consequently, fluorescent medium in ΔB and fluorescent cells of ΔC and ΔBC were observed in the microfluidic channels. D13-9001 substantially increased fluorescent cell number in ΔBC/pABM but not in ΔBC/pXYM. PAβN increased medium fluorescence in all strains, especially in the pump deletion mutants, and caused fluorescein accumulation to disappear in ΔC. The checkerboard method revealed that D13-9001 acts synergistically with aztreonam, ciprofloxacin, and erythromycin only against the MexAB-OprM producer (ΔBC/pABM, and PAβN acts synergistically, especially with erythromycin, in all strains including the pump deletion mutants. The results obtained from PAβN were similar to the results from membrane permeabilizer, polymyxin B or polymyxin B nonapeptide by concentration. The new method clarified that D13-9001 specifically inhibited MexAB-OprM in contrast to PAβN, which appeared to be a substrate of the pumps and

  15. 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

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

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    Estrella Álvarez-Varela

    2010-01-01

    Full Text Available 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 concentración mínima inhibitoria, que permanece en el intervalo de sensibilidad. Puede pasar inadvertido en el laboratorio, pero se manifiesta en el paciente, en el que no hay actividad de la droga y por lo tanto, se presenta una falla terapéutica. De ahí, la gran importancia de perfeccionar su detección a nivel del laboratorio de microbiología. En este trabajo, se comparó el sistema DIRAMIC con el método de sinergia de doble disco modificado (DDD para la detección fenotípica de BLEE. Se estudiaron 175 aislados clínicos, 132 Escherichia coli y 43 Klebsiella spp., provenientes de tres hospitales de Ciudad de La Habana, recolectados de junio de 2008 a junio de 2009. De un total de 42 (24 % aislados que presentaron fenotipo de BLEE por el método de DDD, el sistema DIRAMIC fue capaz de detectar 39 (22,3 %. En tres aislados, el fenotipo de BLEE solo fue detectado por DDD, los cuales resultaron falsos negativos por DIRAMIC. El 72,6 % de los aislados (127 fueron negativos por ambos métodos. Los métodos empleados tuvieron un desempeño similar, para un 92,85 % de correspondencia. El DIRAMIC mostró una sensibilidad del 92,85 % y una especificidad del 95,48 % con respecto al método de DDD.

  17. 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

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    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

  18. 20株奇异变形杆菌耐药基因和整合子分布及亲缘关系分析%Study on distribution of drug resistance gene and integron and analysis of genetic relationship of 20 isolates of Proteus mirabilis

    Institute of Scientific and Technical Information of China (English)

    冯福英; 杨湘越; 洪宇; 郑宗富; 张薇; 蒋际城; 曾琦

    2015-01-01

    Objective To investigate the prevalence and resistance mechanisms of Proteus mirabilis in the ward of neurology de‐partment of our hospital .Methods For a total of 20 clinic isolates of Proteus mirabilis ,PCR were used for the detection of AmpC , ESBLs ,KPC and MBLs and then DNA sequencing was performed .The integrons were also detected by using PCR and then sequen‐cing was carried out .The genetic relationship between isolates were detected and analysed by pulsed‐field gel electrophoresis(PF‐GE) .The results of drug sensitivity tests were analysed .Results TEM‐1 and CTX‐M‐14 gene were found in all the 20 isolates ,the 10 isolates of Proteus mirabilis were also found carrying CMY‐2 gene .Class Ⅰ integrons were amplified from 19 strains carrying gene cassettes "aacA4+cmlA1","dfrA12+orfF+aadA2"and "dfrA32+ereA+aadA2" respectively .PFGE analysis revealed that the 20 isolates were grouped into 11 PFGE types P1-P11 ,the 12 isolates of P1-P3 were same clones .The sensitive rates of the i‐solates to Meropenem ,Amikacin ,Aztreonam ,Ceftazidime and Tazocin were high .Conclusion Nosocomial transmission of the same clone of Proteus mirabilis was appeared in the ward of neurology department of our hospital .The predominance drug‐resistance genes were CTX‐M‐14 andCMY‐2 .The incidence of carrying class Ⅰ integrons was high ,and the major gene cassettes were"aacA4+cmlA1"and "dfrA12+orfF+aadA2".The 20 isolates were all sensitive to Meropenem ,Amikacin and Aztreonam .Other Clinical departments should also pay attention to the nosocomial infection caused by Proteus mirabilis and strengthen the infection control measures .%目的:了解该院神经内科病区奇异变形杆菌院内感染状况与耐药机制。方法对20株不重复奇异变形杆菌采用PCR法检测超广谱β内酰胺酶(ESBLs)、头孢菌素(AmpC)酶、碳青霉烯酶(KPC)和金属β内酰胺酶(MBLs)耐药基因并测序;PCR法检测整合子并测序;脉

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

    Institute of Scientific and Technical Information of China (English)

    刘萍; 庄伟荣; 金小玲; 周瑛; 秦兴国; 李惠萍

    2009-01-01

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

  20. Klebsiella pneumoniae KPC: first isolations in Italy

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    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

  1. 心脏手术患者围术期感染病原菌与耐药性研究%Pathogens causing infections in patients with cardiac surgeries during perioperative period and the drug resistance

    Institute of Scientific and Technical Information of China (English)

    张荣泽; 李晓峰; 张玉芬; 付立萍; 朱希燕

    2015-01-01

    aeruginosa were highly resistant to sulfamethoxazole and trime-thoprim with the rate of 88 .2% .Acinetobacter baumannii were resistant to aztreonam with the rate up to 78 .7% . Staphylococcus aureus , Staphylococcus epidermidis and Staphylococcus haemolyticus were 100% resistant to penicillin .CONCLUSION Pathogens causing infections in patients with cardiac surgeries during perioperative peri-od are proved to be highly drug resistant .Antibiotics should be used rationally to prevent infections .

  2. [Investigation of beta-lactamase genes and clonal relationship among the extended-spectrum beta-lactamase producing nosocomial Escherichia coli isolates].

    Science.gov (United States)

    Görgeç, Sündüz; Kuzucu, Çiğdem; Otlu, Barış; Yetkin, Funda; Ersoy, Yasemin

    2015-01-01

    Extended-spectrum beta-lactamase (ESBL) producing microorganisms currently cause a major problem. Among theseCTX-M beta-lactamase producing Escherichia coli has also disseminated worldwide as an important cause of both nosocomial and community-acquired infections. The aims of this study were to determine the prevalence of the beta-lactamase genes, antibiotic susceptibilities and clonal relationships of ESBL-producing nosocomial E.coli isolates. A total of 76 ESBL-producing E.coli strains isolated from urine (n= 26), blood (n= 25) and wound (n= 25) specimens of hospitalized patients identified as nosocomial infection agents according to the CDC criteria between June 2010-June 2011 were included in the study. Antibiotic susceptibilities of the isolates were detected by Kirby-Bauer disc diffusion method according to CLSI recommendations. ESBL production was tested by double disc diffusion method, and cefotaxime/cefotaxime-clavulanic acid E-test strips (AB Biodisk, Sweden) were used for indeterminate results. Presence of TEM, SHV, CTX-M, OXA-2 group, 0XA-10 group, PER, VEB and GES beta-lactamase genes were investigated by polymerase chain reaction (PCR) using specific primers. Pulsed-field gel electrophoresis (PFGE) method was used for the detection of clonal relationships among the strains. Most of the ESBL-producing E.coli strains were isolated from samples of inpatients in intensive care (35%), internal medicine (16%) and general surgery (13%) units. All of the 76 strains were found susceptible to imipenem, meropenem and amikacin; however all were resistant to cefotaxime and ceftriaxone. The susceptibility rates of the isolates to cefoxitin, ertapenem, cefoperazone/sulbactam, piperacillin-tazobactam, gentamicin, ciprofloxacin, cefepime, amoxicillin-clavulanic acid, aztreonam and ceftazidime were 96%, 83%, 63%, 61%, 50%, 41%, 25%, 21%, 20% and 18%, respectively. Among E.coli isolates, the frequency of CTX-M, TEM, OXA-2 group, PER, SHV and OXA-10 group beta

  3. Epidemiologic surveillance and analysis of Pseudomonas aeruginosa isolated from burn wards%烧伤病房铜绿假单胞菌的流行性分析

    Institute of Scientific and Technical Information of China (English)

    孙珍; 向军; 宋菲; 郇京宁

    2011-01-01

    (PDR), among which the resistance rate to gentamicin, piperacillin, piperacillin /tazobactam, aztreonam, cefoperazone, cefoperazone-sulbactam, cefepime and meropenem was respectively higher than 90. 0%. The resistance rate to ceftazidime and ciprofloxacin was the lowest (25. 0%). CONCLUSION P. Aeruginosa isolated from the burn wards do exist the prevalence strains in the recent years, which is developing to multidrug resistant or pan-drug resistant to commonly used antibiotics, and ceftazidime and ciprofloxacin would be the first choice for P. Aeruginosa infection treatment of burn patients.

  4. 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

  5. 132株奇异变形杆菌的临床分布及药敏分析%Clinical distribution and drug sensitivity analysis of 132 strains of Proteus mirabilis

    Institute of Scientific and Technical Information of China (English)

    马巧红; 陈群英; 何娟妃

    2012-01-01

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

  6. Change of drug resistance of Proteus mirabilis causing nosocomial infections and clinical strategies%奇异变形菌医院感染的耐药性变迁及临床对策

    Institute of Scientific and Technical Information of China (English)

    王晓慧; 王银存

    2012-01-01

    OBJECTIVE To analyze the change in antibiotic resistance of clinical isolates of Proteus mirabilis 30 as to provide basis for clinical reasonable use of antibiotics. METHODS A total of 385 P. mirabilis strains isolated from various clinical specimens from Jan 2008 to Dec 2010 were collected. Drug susceptibility testing was performed for 17 antimicrobial agents; the changes of the drug resistance during the 3 years were compared. RESULTS Of the P. mirabilis isolated, the susceptibility rate to imipenem/cilastatin was the highest (100. 0%) , the drug susceptibility rates to meropenem, piperacillin / methimazole, aztreonam, ceftriaxone, cephaiosporin, ceftazidime, and tobramycin were above 90. 0% ; the drug resistance rates to nitrofurantoin and sulfamethoxazole / trimethoprim were above 50. 0%, and the resistance rate to cefoperazone /sulbactam was 0. 2% , the resistance rates to ampicillin/sulhactam, eiprofloxacin, and levofloxacin kept an increasing upward tendency. CONCLUSION The isolation rate of P. mirabilis is high, the susceptibility is high ta many antimicrobial agents, but the drug resistance rates to some antibacterial agents are on the rise ;it is necessary to strengthen the monitoring and reasonably use of antibiotics on the basis of drug susceptibility testing.%目的 分析临床分离的奇异变形菌的耐药性及其变迁,为临床合理用药提供依据.方法 对医院2008年1月-2010年12月住院患者各种标本中分离到的奇异变形菌385株,采用17种抗菌药物进行药敏试验;并比较3年的变迁情况.结果 分离到的奇异变形菌对亚胺培南/西司他丁的敏感率最高为100.0%,对美罗培南、哌拉西林/他巴唑、氨曲南、头孢曲松、头孢匹美、头孢他啶、妥布霉素的敏感率均>90.0%;对呋喃妥因、磺胺甲噁唑/甲氧苄啶的耐药率均>50.0%,头孢哌酮/舒巴坦为0.3%,对氨苄西林/舒巴坦、环丙沙星、左氧氟沙星耐药率呈升高趋势.结论 医

  7. 435株铜绿假单胞菌的临床分布与耐药性分析%Analysis on Clinical Distribution and Drug Resistance in 435 Strains of Pseudomonas Aeruginosa

    Institute of Scientific and Technical Information of China (English)

    孙鑫晔; 王栋; 袁耀辉; 王丽华

    2012-01-01

    目的 了解医院铜绿假单胞菌(PAE)在临床的分布状况和耐药情况,为临床合理选择抗菌药物提供依据.方法 对医院2011年1月至2011年12月各种标本分离的PAE用纸片扩散法(K-B)法进行药物敏感性试验,对结果进行统计分析.结果 共分离到435株PAE,其中从痰标本中分离出370株,占85.06%;高发病区是神经外科、ICU、呼吸科;其对头孢他啶的耐药性最低,为15.64%,对头孢吡肟、阿米卡星、氨曲南、美罗培南、头孢哌酮舒巴坦的耐药率相对较低,分别为36.25%,36.96%,45.54%,47.89%,48.94%.结论 该院PAE的耐药率处于高位,必须加强耐药性监测,为临床提供最新的耐药性资料,医生应合理选用抗菌药物,减少耐药菌株的产生.%Objective To investigate the clinical distribution and drug resistance of Pseudomonas aeruginosa(PAE) in hospitals, and to provide the evidence for rational use of antibacterial drugs in clinic. Methods The drug sensitivity test on PAE isolated from various samples collected in our hospital from January to December 2011 was carried out by use of K - B method. Then the results were performed the statistical analysis. Results Four hundred thirty - five strains of PAE were isolated. Of which, 370 strains were isolated from sputum samples, accounting for 85. 06% . The high incidence inpatients areas were the departments of neurosurgery, ICU and respiration. The resistance to ceftazime was lowest(15. 64% ), the resistances to cefepime, amikacin, aztreonam, meropenem, cefoperazone and sulbactam were relatively lower, which were 36. 25% , 36. 96% , 45. 54% , 47. 89% and 48.94% respectively. Conclusion The PAE's drug resistance rate in our hospital is on a high position. Therefore, the drug - resistance surveillance and monitoring must be enhanced to provide the updated information for clinical medication. Doctors should choose antibacterial drugs reasonably to reduce the generation of drug - resistant

  8. 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

  9. Distribution of acinetobacter baumanii causing nosocomial infections in 743 patients and drug resistance%743例患者医院感染鲍氏不动杆菌的分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    周宁莉; 沈黎

    2011-01-01

    OBJECTIVE To investigate the distribution of nosocomial Acinetobacter baumanii (ABA) infection and its drug resistance. METHODS A retrospective analysis for nosocomial A. baumanii infection was made from Jan 1998 to Dec 2007. RESULTS A total of 743 strains were isolated from various specimens during the ten years specimens. The most ABA strains were cultured from the infection of sputum and wounds. Nosocomial infection caused by ABA happened mainly in intensive care units (ICU) (24.9 %) and department of cadre (11.8%). The resistant rates of ABA to cefoperazone/sulbacta, amikacin, imipenem, ciprofloxacin, ceftazidime, cefepime,piperacillin,tazobactam, ticacillin/clavulanic acid, piperacillin and aztreonam were 20. 6%, 7. 9%, 53. 0%,59.2%, 59.8%, 65. 1% and 65. 1% , respectively. CONCLUSION Nosocomial infections caused by ABA is serious. It is important to monitor drug resistance of nosocomial ABA infection and to use Antimicrobial agents rationally.%目的 了解医院感染鲍氏不动杆菌分布及对多种抗菌药物的耐药性,为临床治疗医院获得性鲍氏不动杆菌感染提供参考.方法 对1998年1月-2007年12月由鲍氏不动杆菌引起的医院感染进行回顾性统计分析.结果 共分离出鲍氏不动杆菌743株,标本来源以痰、创口分泌物和血液为主,分别占68.5%、15.3%及4.7%;医院感染主要发生在ICU、神经外科,各占24.9%及11.8%;鲍氏不动杆菌对头孢哌酮/舒巴坦、亚胺培南的总耐药率为20.6%和7.9%,阿米卡星、环丙沙星、哌拉西林/他唑巴坦、替卡西林/克拉维酸、哌拉西林的总耐药率分别为53.0%、59.2%、59.8%、65.1%、65.1%.结论 鲍氏不动杆菌引起的医院感染非常严重,应加强对鲍氏不动杆菌引起的医院感染耐药性监测,合理应用抗菌药物.

  10. 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

  11. 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.

  12. Pathogenic bacteria distribution and drug resistance observation of early wound infection in burn patients%烧伤患者早期创面感染病原菌分布与耐药性观察

    Institute of Scientific and Technical Information of China (English)

    吕敏

    2015-01-01

    Objective:To explore the pathogenic bacteria distribution and drug resistance of early wound infection in burn patients. Methods:300 patients with burn wound infection were selected from July 2009 to July 2014.The infection test results of the patients were analyzed.The athogenic bacteria drug resistance was analyzed.Results:There detected 171 strains of gram negative bacteria,141 strains of gram positive bacteria,6 strains of fungi.The antibacterial drug resistance situation of pseudomonas aeruginosa:the drug resistance rates of imipenem,amikacin,ceftazidime and aztreonam were lower,the drug resistance rates were 10%,27.7%,33.7%,35.4%;the drug resistance rates of ampicillin,ceftriaxone,gentamicin,cefoperazone were higher,the drug resistance rates were 100%,79.2%,69.3%,65.3%.The drug resistance rate for majority antibacterial agents of acinetobacter were high,the drug resistance rates of imipenem,amikacin,netilmicin were lower,they were 0,46.9%,50%.Conclusion:Early burn wound infection gives priority to with pseudomonas aeruginosa,acinetobacter,staphylococcus aureus and staphylococcus epidermidis. Through drug sensitivity test to select the appropriate effective antimicrobial contribute to the prevention and treatment of early burn wound infection.%目的:探讨烧伤患者早期创面感染病原菌分布情况与耐药性情况。方法:2009年7月-2014年7月收治烧伤创面感染患者300例,分析患者的感染检测结果;对病原菌耐药性进行分析。结果:检测到革兰阴性菌171株,革兰阳性菌141株,真菌6株。铜绿假单胞菌对抗菌药耐药情况:对亚胺培南、阿米卡星、头孢他啶和氨曲南耐药率较低,耐药率分别为10.0%、27.7%、33.7%、35.4%;对氨苄西林、头孢曲松、庆大霉素、头孢哌酮耐药率较高,分别为100%、79.2%、69.3%、65.3%。不动杆菌属对多数抗菌药物耐药率均高,对亚胺培南、阿米卡星、奈替米星耐药率较低,分别为0、46

  13. 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

  14. Microbiological and biochemical studies on certain antibiotic-resistant bacteria isolated from certain clinical specimens

    International Nuclear Information System (INIS)

    . Determination of B-lactamase and AmpC-B-lactamase enzyme production were carried out by two methods. Cefotaxime, ceftazidime, cefoperazone, cefoxitin and aztreonam were used with and without amoxycillin clavulanic acid to detect the presence of extended-spectrum B-lactamase (ESBL) harbouring isolates by using double-disk diffusion synergy test (DDST). Combined disk method was used also to detect the presence of ESBL harbouring isolates by using cefoperazone (CFP) and cefoperazone sulbactam (SCF) among the tested strains. Agar dilution method was used to determine minimum inhibitory concentration (MIC) of ampicillin sulbactam, cefoperazone, gentamycin and levofloxacin alone and in combination (Ampicillin sulbactam with both of gentamycin and levofloxacin) and (cefoperazone with both of gentamycin and levofloxacin). Fractional inhibitory concentration (FIC) for the combined antibiotics were calculated according to checkerboard method and synergistic effect were determined. Some resistant isolates were subjected to molecular studies including plasmid profile (Kleb.52 Morg.60 and Ps.72 ) by using a high pure plasmid isolation kit and protein pattern of Ps.72 before and after irradiation in the presence of different antibiotics alone (cefoperazone, gentamycin and ampicillin sulbactam) or in combined (cefoperazone with gentamycin and ampicillin sulbactam with gentamycin)The result of the present investigation showed that, 9 multi-drug resistant isolates were identified as; 2 isolates Escherichia coli, 2 isolates Pseudomonas aeruginosa, 1 isolate Citrobacter freundii, 1 isolate Morganella morganii all were isolated from urine samples

  15. Surveillance of the distribution and drug-resistance of the bacteria in the water of Yalujiang River of Sino-korean border%中朝边境鸭绿江江水细菌分布及耐药性监测

    Institute of Scientific and Technical Information of China (English)

    邱广斌; 徐宏亮; 翟如波; 胡伟华; 杨军; 杨慎江; 谢文全; 孔祥利

    2012-01-01

    Objective To reduce non-battle casualties of soldiers due to environmental pollution,it might be necessary to understand the bacterial species,its distribution and bacterial sensitivity to antibiotics near the Yalujiang River barracks. Methods Collect samples of water from 15 different water areas of the Yalujiang River,each location with three copies. The bacterial species in the 45 water samples were cultured and isolated for bacteriological identification and antibiotic sensitivity tests by automatic micro-bial analyzer. Results 218 strains of 45 kinds of species of bacteria were isolated, including 88 strains of Enterobacteriaceae(44. 89%) ,52 strains of non-fermenting bacteria(26. 53%) ,50 strains of the Vibrionaceae bacteria(25. 51%) , and 22 strains of Gram-positive coccidO. 09%). Susceptibility testing results show that sensitivity rate of the 88 strains of Enterobacteriaceae to imipenem, meropenem,piperacillin/tazobactam,cefoperazone/sulbactam,cefepime,amikacin was 100%,while sensitivity rate of which to third generation cephalosporins,Quinolone,aztreonam Nanmin was 85. 95%. The sensitivity rate of non-fermenting bacteria to all those antibiotics was 95% -100%. As for Vibrionaceae, the sensitivity rate was 95% -100%(with the exception of ticarcillin/clavulanic acid ,piperacillin,co-trimoxazole). Conclusion There could be a wide range of bacterial species in the Yalujiang River near the garrison, widely distributed , with a high sensitivity to antibiotics. Carrying out the river bacterial investigation and surveillance of antimicrobial resistance might be of great significance for the prevention and treatment of river bacterial infection and the spread of resistant bacteria.%目的 了解军营附近鸭绿江水域的细菌种类、分布情况及细菌对抗菌药物的敏感性.防止部队因环境污染造成战士非战斗减员.方法 采用采样器采集鸭绿江江水15个不同水域,每个位置采集3份,45份水样经增菌培养和细菌分

  16. 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 .

  17. 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 .

  18. 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.

  19. Sputum culture and antibiotic susceptibility for senile dementia patients with pneumonia%老年痴呆合并肺炎患者痰培养及药敏分析

    Institute of Scientific and Technical Information of China (English)

    徐英; 薛坚; 李伟峰; 宰淑培

    2015-01-01

    hospital from July 2012 to December 2013 were enrolled in this study. Fifty-three of them suffered from CAP and the rest 79 from HAP. After their sputa were collected, the specimens were immediately inspected and cultured for microbial strains detection. The distribution of the obtained bacterial strains and sensitivity to antimicrobial agents were analyzed. The differences in pathogens, treatment and prognosis were compared between the 2 groups. Results The percentage of the patients suffering from CAP was 40.2%while that of those from HAP was 59.8%. The top 3 strains were Streptococcus pneumoniae (SPN), Staphylococcus aureus (SAU) and Haemophilus influenzae (HIN) for the dementia patients with CAP, and SAU, Pseudomonas aeruginosa (PAE) and Klebsiella pneumoniae (KPN) for those with HAP. In terms of antibiotic sensitivity, the most effective antibiotics against PAE were amikacin and aztreonam, those against KPN were piperacillin/tazobactam and imipenem, and those against SAU and SPN were vancomycin and linezolide. The condition was severer in the patients with HAP than those with CAP, and the incidences of complications and mortality were also higher in the former than the latter. Conclusion The patients of CAP group have no typical clinical manifestations, and most of them are hospitalized due to senile dementia’s symptoms, while those of HAP group are manifested with fever, attack of body function or consciousness. We should strengthen the clinical observation, improve the inspection rate of microbial cultures, and adjust the antimicrobials according to the results of susceptibility test to offer appropriate antibacterial treatment.

  20. 2004-2006年瑞金医院烧伤病房病原菌分布及分子流行病学分析%Analysis of the molecular epidemiology and distribution of pathogenic bacteria in burn wards of Ruijin Hospital from 2004 to 2006

    Institute of Scientific and Technical Information of China (English)

    王文奎; 韩立中; 杨莉; 倪语星

    2009-01-01

    Objective To analyse the distribution, drug resistance and epidemiology of pathogenic bacteria in the burn wards of Ruijin Hospital. Methods Seventeen strains of Methicillin resistant staphy-loeoeuss aureus (MRSA) , 52 strains of Pseudomonas aeruginosa(PA) , and 11 strains of Acinetobacter bau-mannii (AB) isolated from the wound secretion, venous catheters, blood, urine and stool etc. Were collect-ed from burn patients hospitalized in our department from January 2004 to December 2006. The distribution and the drug resistance profile of bacteria were analyzed, and the homology analysis was performed by ran-domly amplified polymorphic DNA (RAPD). Results M RSA, PA and AB were the major strains in our burn wards in recent years, of which Staphylococuss aureus (SA) was the most dominant. During these 3 years, MRSA accounted for 77% (63/82), 85% (63/74), and 75% (74/99), respectively, for SA isola-ted in this period. MRSA was resistant to Amikacin, Gentamicin, Erythromycin, Clindamycin and Levoflox-acin; PA was resistant to Amikacin, Gentamicin, Piperacillin, Ceftazidime, Cefoperazone, Aztreonam and lmipenem; AB was resistant to Amikacin, Gentamicin, Piperacillin, Ceftazidime, Imipenem and Ciprofloxa-tin. Three bacteria were found to belong to the same type in the RAPD homology analysis. Conclusions There are many kind of multi-drug resistant pathogenic bacteria for nosocomial infection in our burn wards. To control the spread of infection due to above-mentioned 3 bacteria is the focus of nosocomial infection control.%目的 了解瑞金医院烧伤病房院内感染病原菌的分布、耐药性和流行情况.方法 2004年1月-2006年12月,从瑞金医院烧伤住院患者创面分泌物、静脉导管、血液、尿液、大便等标本中分离获得甲氧西林耐药金黄色葡萄球菌(MRSA)17株,铜绿假单胞菌52株,鲍氏不动杆菌11株.分析3年间该烧伤病房病原菌的分布和药物敏感试验情况;采用随机扩增多态DNA(RAPD)对院内感

  1. 复杂尿路感染常见致病菌的分布及抗菌药物的应用%The distribution of pathogens and antimicrobial drugs application in complex urinary tract infection

    Institute of Scientific and Technical Information of China (English)

    祝丹

    2016-01-01

    Objective To investigate the distribution of pathogens and antimicrobial drugs application in complex urinary tract infection. Methods The clinical data of 1 215 cases with complicated urinary tract infection in our hospital from June 2014 to June 2015 were analyzed, retrospectively, while the application status of antimicrobial drugs were analyzed. Results There were 840 Gram-negative bacteria, 260 Gram-positive bacteria and 115 fungi in pathogenic bacteria, accounted for 69.14%, 21.40% and 9.47%, respectively. The percentage of Gram-negative bacteria was significantly higher than that of the other two bacteria groups, with significant differences (χ2 = 16.32, P = 0.0000). Total of 840 strains of Gram-negative bacteria were collected, including E. coli, Klebsiella pneumoniae, Proteus mirabilis as main flora, a total of 675 (80.36%) strains. The drug resistance rate of 3 strains to gentamicin, ciprofloxacin and penicillin and 3 generation cephalosporins except for ceftazidime were higher than 50%, which were less than 10% to the imipenem, amikacin, cefperazone-sulbactam. There were 260 strains of Gram-positive bacteria, including Fecal enterococcus, Urine enterococcus as main flora, both for a total of 204 strains, accounting for 78.46%. Vancomycin, teicoplanin, linezolid had no drug resistance to Enterococcus. The high concentration of gentamicin, ciprofloxacin had high resistance to Enterococcus. Conclusions The main pathogenic bacteria of complex urinary tract infection are Gram-negative bacteria, while ampicillin/clavulanic acid, cefoperazone and ceftriaxone, amikacin, aztreonam and imipenem and meropenem were all effective.%目的:探讨导致复杂尿路感染的常见致病菌的分布并分析抗菌药物的应用现状。方法对2014年6月~2015年6月于某院接受治疗的1215例复杂尿路感染病例进行回顾性分析,并探究抗菌药物的应用状况。结果病原菌分类中革兰阴性菌、革兰阳性菌及真菌分别为840、260

  2. 肛周脓肿细菌谱及药敏变化特点%Bacterial spectrum of pathogens causing perianal abscesses and characteristics of drug susceptibility

    Institute of Scientific and Technical Information of China (English)

    谢杰斌; 陈荣; 郑晨果; 陈玉燕; 金莹; 蔡景理

    2013-01-01

    OBJECTIVE To investigate the distribution of the pathogens causing perianal abscesses as well as the characteristics of drug susceptibility in the recent three years so sa to provide basis for the wse of antibiotics cluriny the perioperative period.METHODS A total of 61 patients with perianal abscesses who enrolled hospital from Jun 2008 to Jun 2011 were included.The clinical data and the results of drug sensitivity testing were recorded,the bacterial spectrum and the drug resistance in different years were compared; By means of SPSS 17.0,the Kruskal-Wallish test was employed to analyze the differenles.RESULTS There was no statistical difference in the constituent ratio of the bacteria spectrum and the drug susceptibility rate in the recent three years; Escherichia coli took the proportion of 60.0%,66.7%,and 50.0% respectively from 2008 to 2010,among which ESBLsproducing E.coli kept an upward tendency,accounting for 33.33%,50.00%,and 52.38%,respectively,the difference was not statistically significant; the top three species of gram-negative bacteria were E.coli (59.68%),Proteus mirabilis (11.29%) and Klebsiella (6.45%),respectively; E.coli was found to be highly resistant to ampicillin,gentamycin,aztreonam,quinolinones,the first,second and third generation cephalosporin,while which was highly susceptible to imipenem,amikacin,and inhibitor-containing antibiotics.CONCLUSION E.coli remains as the predominant species of pathogens causing perianal abscesses,but bacterial spectrum does not change significantly; the drug resistance rate of the pathogens to the main antibiotics does not change significantly in the recent three years.%目的 研究医院近3年肛周脓肿致病菌的分布、变迁及药敏变化特点,为其围球期抗菌药物的应用提供依据.方法 回顾性分析医院2008年6月-2011年6月收治肛周脓肿行脓液培养的患者61例,分类整理其临床资料及药敏试验结果,比较不同年份

  3. Distribution and drug resistance of Acinetobacter baumannii infection in patients with lung diseases%肺部疾病患者鲍氏不动杆菌感染的分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    杜友谊; 吕祝庆; 孙德彬; 周家峰; 熊雪芳

    2012-01-01

    OBJECTIVE To explore the distribution and drug susceptibility of Acinetobacter baumaanii in patients with lung diseases, so as to prevent the correlated infections. METHODS Routine bacterial identification for the submitted specimens in respiratory department from 2009 to 2010 was performed with ATB, the specimens infected with A. baumaanii were screened out, statistical analysis of A. baumaanii infections and the distribution of diseases was performed; the drug susceptibility testing for the isolates was carried out according to CLSI standards, the drug resistance was analyzed. RESULTS Totally 165 strains of A. baumaanii were isolated from 1020 specimens with the detection rate of 16. 2% ; the specimens mainly obtained from sputum, blood, secretions, urine and others ,accounting for 57. 6% , 21.8%, 11.5%, 4. 9%,and 4. 2%, respectively, as compared with the sputum specimens, there were statistical significance (P<0. 01); A. baumaanii commonly distributed in the patients with ventilator-associated pneumonia, lung cancer, or tuberculosis, the difference between VAP and other diseases was statistically significant (P<0. 05); the result of drug susceptibility testing showed that A. baumaanii was susceptible to imipenem, cefoperazone/sulbactam, piperacillin/tazobactam,ofloxacin, cefepime, aztreonam , and piperacillin, and was resistant to the rest of antibiotics; the susceptibility rates to imipenem and cefoperazone/sulbactam were 52. 7% and 38. 8%, respectively,the difference in susceptibility rate was statistically significant as compared with other antibiotics (P<0. 05). CONCLUSION A. baumaanii isolates are with the highest detection rate from sputum specimens and are most common in the patients with VAP, the drug resistance rate is high, A. baumaanii isolates are relatively susceptible to imipenem and cefoperazone/sulbactam, according to drug susceptibility testing to enhance the therapeutic effect, so it is necessary to take a comprehensive consideration to improve

  4. 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

  5. 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

  6. 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.

  7. 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