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Sample records for aztreonam

  1. 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 ...

  2. 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...

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

    Science.gov (United States)

    Parkins, Michael D; Elborn, J Stuart

    2010-08-01

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

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

    NARCIS (Netherlands)

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

    1996-01-01

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

  5. 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).

  6. 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...

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

    NARCIS (Netherlands)

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

    2001-01-01

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

  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. 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

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

  11. Aztreonam Injection

    Science.gov (United States)

    ... effects of your treatment using laboratory tests and physical examinations. It is important to keep all appointments ... health care provider as soon as possible: tenderness warmth irritation drainage redness swelling pain

  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. Sequential Treatment of Biofilms with Aztreonam and Tobramycin Is a Novel Strategy for Combating Pseudomonas aeruginosa Chronic Respiratory Infections.

    Science.gov (United States)

    Rojo-Molinero, Estrella; Macià, María D; Rubio, Rosa; Moyà, Bartolomé; Cabot, Gabriel; López-Causapé, Carla; Pérez, José L; Cantón, Rafael; Oliver, Antonio

    2016-05-01

    Traditional therapeutic strategies to control chronic colonization in cystic fibrosis (CF) patients are based on the use of a single nebulized antibiotic. In this study, we evaluated the therapeutic efficacy and dynamics of antibiotic resistance in Pseudomonas aeruginosa biofilms under sequential therapy with inhaled aztreonam (ATM) and tobramycin (TOB). Laboratory strains PAO1, PAOMS (hypermutable), PAOMA (mucoid), and PAOMSA (mucoid and hypermutable) and two hypermutable CF strains, 146-HSE (Liverpool epidemic strain [LES-1]) and 1089-HSE (ST1089), were used. Biofilms were developed using the flow cell system. Mature biofilms were challenged with peak and 1/10-peak concentrations of ATM (700 mg/liter and 70 mg/liter), TOB (1,000 mg/liter and 100 mg/liter), and their alternations (ATM/TOB/ATM and TOB/ATM/TOB) for 2 (t = 2), 4 (t = 4), and 6 days (t = 6). The numbers of viable cells (CFU) and resistant mutants were determined. Biofilm structural dynamics were monitored by confocal laser scanning microscopy and processed with COMSTAT and IMARIS software programs. TOB monotherapy produced an intense decrease in CFU that was not always correlated with a reduction in biomass and/or a bactericidal effect on biofilms, particularly for the CF strains. The ATM monotherapy bactericidal effect was lower, but effects on biofilm biomass and/or structure, including intense filamentation, were documented. The alternation of TOB and ATM led to an enhancement of the antibiofilm activity against laboratory and CF strains compared to that with the individual regimens, potentiating the bactericidal effect and/or the reduction in biomass, particularly at peak concentrations. Resistant mutants were not documented in any of the regimens at the peak concentrations and only anecdotally at the 1/10-peak concentrations. These results support the clinical evaluation of sequential regimens with inhaled antibiotics in CF, as opposed to the current maintenance treatments with just one

  18. [Aztreonam as monotherapy in urinary tract infections with a systemic repercussion in patients with a relative contraindication for the use of aminoglycosides].

    Science.gov (United States)

    Pedrajas, J M; Pieltain, R; Mesa, N; Ramón, P; García, C; Pontes, J C; Fernández-Cruz, A

    1993-04-01

    A comparative study has been performed to evaluate the clinical efficacy and safety of aztreonam in the treatment of urinary tract infections with systemic affectation, in a group of patients who showed a relative contraindication to be treated with aminoglycosides. The group studied was formed by 30 patients (21 females and 9 males). Mean age of said group was 78 years and percentage of patients over 65 years was 93%. Moreover, 53.3% of patients showed nephropathy, 30% diabetes mellitus and 16.6% hearing disorders. Responsible germ of the infection was identified through blood and urine culture in 24 patients (80%) being the most frequent isolated E. Coli (60%). The cure rate was of 76.6% and improvement rate was 13.3%. Three deaths happened on the studied group (10%). In a patient superinfection due to Enterococcus was detected. There were no significative adverse effects (hypersensibility reactions, hematological disorders, nephrotoxicity or hepatotoxicity). Aztreonam could be an efficacious alternative in the treatment of urinary infection with systemic affectation, caused by gram-negative germs, showing low toxicity. PMID:8497718

  19. 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。

  20. 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

  1. 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

  2. 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

  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. 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...

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  6. 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...

  7. Drug: D00240 [KEGG MEDICUS

    Lifescience Database Archive (English)

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

  8. Drug: D06558 [KEGG MEDICUS

    Lifescience Database Archive (English)

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

  9. Antibiotic therapy for stable non-CF bronchiectasis in adults - A systematic review

    DEFF Research Database (Denmark)

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

    2016-01-01

    , exacerbations and QoL, whereas studies on aztreonam revealed no significant clinical improvements in the outcomes of interest, including exacerbation rate. Adverse events, including bronchospasm, have been reported in association with tobramycin and aztreonam. Several antibiotic treatment regimens have been...... the inclusion criteria. Studies of inhaled tobramycin have revealed conflicting results regarding quality of life (QoL), exacerbations and admissions, but may result in sputum cultures negative for Pseudomonas aeruginosa, whereas studies investigating the effect of inhaled gentamycin have shown positive effects...... on sputum bacterial density, decrease in sputum cultures positive for P. aeruginosa, QoL and exacerbation rate, but no improvement in forced expiratory volume in first second (FEV1). Oral azithromycin can reduce exacerbations, together with minor improvements in QoL and FEV1 Furthermore, oral erythromycin...

  10. 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.

  11. 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...

  12. 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...

  13. 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...

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

    OpenAIRE

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

    1997-01-01

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

  15. 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

  16. 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

  17. 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.

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

    Science.gov (United States)

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

    1997-01-01

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

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

    Science.gov (United States)

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

    2000-09-01

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

  20. 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...

  1. 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

  2. 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...

  3. 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.

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

    OpenAIRE

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

    1994-01-01

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

  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. 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.

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

    Science.gov (United States)

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

    2015-01-01

    The aim of this study was to characterize the ultrastructural effects caused by β-lactam antibiotics in Klebsiella pneumoniae isolates. Three K. pneumoniae clinical isolates were selected for the study with resistance profiles for third-generation cephalosporins, aztreonam, and/or imipenem and with different resistance genes for extended-spectrum β-lactamases (ESBL) or Klebsiella pneumoniae carbapenemase (KPC). Two K. pneumoniae isolates obtained from the microbiota, which were both resistant to amoxicillin and ampicillin, were also analyzed. In accordance with the susceptibility profile, the clinical isolates were subjected to subminimum inhibitory concentrations (sub-MICs) of cefotaxime, ceftazidime, aztreonam, and imipenem and the isolates from the microbiota to ampicillin and amoxicillin, for analysis by means of scanning and transmission electron microscopy. The K. pneumoniae isolates showed different morphological and ultrastructural changes after subjection to β-lactams tested at different concentrations, such as cell filamentation, loss of cytoplasmic material, and deformation of dividing septa. Our results demonstrate that K. pneumoniae isolates harboring different genes that encode for β-lactamases show cell alterations when subjected to different β-lactam antibiotics, thus suggesting that they possess residual activity in vitro, despite the phenotypic resistance presented in the isolates analyzed. PMID:26491715

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

    Directory of Open Access Journals (Sweden)

    Vinod Singh et al

    2012-10-01

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

  9. 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. 

  10. Antibiotic-Resistant Vibrios in Farmed Shrimp

    Directory of Open Access Journals (Sweden)

    Renata Albuquerque Costa

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Elio Jesús Núñez Tamayo

    2003-12-01

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

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

    Science.gov (United States)

    Koc, Serkan; Kabatas, Burak; Icgen, Bulent

    2013-08-01

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

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

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    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.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2005-01-01

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

  16. 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.

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

    Science.gov (United States)

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

    2000-07-01

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

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

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    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%.

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

    Science.gov (United States)

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

    2016-03-01

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

  20. 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.

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    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.

  1. 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.

  2. 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.

  3. 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

  4. 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

  5. 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

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

    Science.gov (United States)

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

    2015-01-01

    Selective fluorescent β-lactam chemical probes enable the visualization of the transpeptidase activity of penicillin-binding proteins (PBPs) at different stages of bacterial cell division. To facilitate the development of new fluorescent probes for PBP imaging, we evaluated 20 commercially available β-lactams for selective PBP inhibition in an unencapsulated derivative of the D39 strain of Streptococcus pneumoniae. Live cells were treated with β-lactam antibiotics at different concentrations and subsequently incubated with Bocillin FL (Boc-FL; fluorescent penicillin) to saturate uninhibited PBPs. Fluorophore-labeled PBPs were visualized by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and fluorescence scanning. Among 20 compounds tested, carbapenems (doripenem and meropenem) were coselective for PBP1a, PBP2x, and PBP3, while six of the nine penicillin compounds were coselective for PBP2x and PBP3. In contrast, the seven cephalosporin compounds tested display variability in their PBP-binding profiles. Three cephalosporin compounds (cefoxitin, cephalexin, and cefsulodin) and the monobactam aztreonam exhibited selectivity for PBP3, while only cefuroxime (a cephalosporin) was selective for PBP2x. Treatment of S. pneumoniae cultures with a sublethal concentration of cefuroxime that inhibited 60% of PBP2x activity and less than 20% of the activity of other PBPs resulted in formation of elongated cells. In contrast, treatment of S. pneumoniae cultures with concentrations of aztreonam and cefoxitin that inhibited up to 70% of PBP3 activity and less than 30% of other PBPs resulted in no discernible morphological changes. Additionally, correlation of the MIC and IC50s for each PBP, with the exception of faropenem, amdinocillin (mecillinam), and 6-APA, suggests that pneumococcal growth inhibition is primarily due to the inhibition of PBP2x. PMID:25845878

  7. [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

  8. 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.

  9. 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

  10. 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

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

    Institute of Scientific and Technical Information of China (English)

    邱义城; 卢玉贞; 汤凤珍; 欧阳英娥

    2012-01-01

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

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

    Science.gov (United States)

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

    2014-06-01

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

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

    Science.gov (United States)

    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

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

    Institute of Scientific and Technical Information of China (English)

    马立艳; 苏建荣

    2011-01-01

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

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

    Science.gov (United States)

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

    2002-04-01

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

  16. 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

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

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    Weiner Marcin

    2015-06-01

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

  18. 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

  19. 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

  20. 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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

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

    2014-07-01

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

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

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    Kashina Allydice-Francis

    2012-01-01

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

  4. 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

  5. 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.

  6. Antibiotic Susceptibility of Potentially Probiotic Vaginal Lactobacilli

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    Virginia Ocaña

    2006-01-01

    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.

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

    Science.gov (United States)

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

    2015-10-01

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

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

    Science.gov (United States)

    Mardaneh, Jalal; Soltan Dallal, Mohammad Mehdi

    2016-01-01

    Enterobacter asburiae (E. asburiae) is a facultative anaerobic, non-spore-forming gram-negative rod-shaped bacterium belonging to the family of Enterobacteriaceae. It is an opportunistic pathogen that its strains are isolated from a variety of clinical and environmental specimens. Since powdered infant formula milk (PIF) is not a sterile product, it is an excellent medium for bacterial growth. The aim of this study was to isolate and identify E. asburiae from PIF in the neonatal intensive care unit (NICU) and determine antimicrobial susceptibility patterns of this bacterium. A total 125 PIF samples were purchased from drug stores between June 2011 to March 2012. E. asburiae was isolated according to FDA method. For final confirmation, biochemical tests embedded in the API-20E system were used. The drug susceptibility test was performed using the disc diffusion method according to CLSI recommendations. Out of the 125 PIF samples investigated, 2 (1.6%) samples were positive for E. asburiae. All isolated strains were uniformly susceptible to aztreonam, cefotaxim, amikacin, streptomycin, nalidixic acid, meropenem, tetracycline, ceftazidime, and colistin. Variable susceptibility was seen to the some antimicrobial agents tested. Each country should categorize its own designed guidelines for the preparation and handling of PIF adapted to the local environment. Moreover, the pathogenesis of the E. asburiae in infants hospitalized in NICU and other groups such as immunosuppressed patients and HIV infected individuals is uncertain and requires further study. PMID:26853289

  9. [CYSTIC FIBROSIS: CARE OF THE LUNG DISEASE].

    Science.gov (United States)

    Hubert, Dominique

    2015-10-01

    (Rh-DNase) and/or hydration (hypertonic saline) nebulisations, Moreover, treatment with inhaled antibiotics is indicated (tobramycin, colistine or aztreonam lysine) for chronic lung infection with Pseudomonas aeruginosa (PA). The treatment regimen also includes bronchodilators for bronchospasms and azithromycin. Regular physical activity is recommended. A treatment potentiating the CFTR protein, ivacaftor, is now indicated for patients with a class 3 mutation. Initial bronchial infection with PA must be treated as soon as possible in order to eradicate the pathogen. Pulmonary exacerbations require antibiotic courses, either orally or intravenously for PA infection. Complications require hospitalisation, with thoracic chest tube placement for a pneumothorax or bronchial artery embolisation for massive hemoptysis. Oxygen therapy and non-invasive ventilation with a nasal mask become necessary when respiratory insufficiency progresses, justifying the initiation of the lung transplant process. Lung disease affects the prognosis of cystic fibrosis, therefore its management in cystic fibrosis centres is of utmost importance. Maintenance treatment mainly relies on daily chest physiotherapy, which can be facilitated by mucolytic PMID:26749716

  10. 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

  11. 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

  12. 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.

  13. Profiling of β-lactam selectivity for penicillin-binding proteins in Escherichia coli strain DC2.

    Science.gov (United States)

    Kocaoglu, Ozden; Carlson, Erin E

    2015-05-01

    Penicillin-binding proteins (PBPs) are integral players in bacterial cell division, and their catalytic activities can be monitored with β-lactam-containing chemical probes. Compounds that target a single PBP could provide important information about the specific role(s) of each enzyme, making identification of such molecules important. We evaluated 22 commercially available β-lactams for inhibition of the PBPs in live Escherichia coli strain DC2. Whole cells were titrated with β-lactam antibiotics and subsequently incubated with a fluorescent penicillin derivative, Bocillin-FL (Boc-FL), to label uninhibited PBPs. Protein visualization was accomplished by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) separation and fluorescent scanning. The examined β-lactams exhibited diverse PBP selectivities, with amdinocillin (mecillinam) showing selectivity for PBP2, aztreonam, piperacillin, cefuroxime, cefotaxime, and ceftriaxone for PBP3, and amoxicillin and cephalexin for PBP4. The remaining β-lactams did not block any PBPs in the DC2 strain of E. coli or inhibited more than one PBP at all examined concentrations in this Gram-negative organism. PMID:25733506

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

    Directory of Open Access Journals (Sweden)

    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.

  15. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  17. 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.

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

    Science.gov (United States)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2008-01-01

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

  20. 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.

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

    Institute of Scientific and Technical Information of China (English)

    Narayan Sharma; Ripan Mujumdar; Rajeev Kumar Gautam

    2016-01-01

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

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

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    Tatsuya Tada

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

  3. 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)

  4. Clonal spread of both oxyimino-cephalosporin- and cefoxitin-resistant Klebsiella pneumoniae isolates co-producing SHV-2a and DHA-1 beta-lactamase at a burns intensive care unit.

    Science.gov (United States)

    Song, Wonkeun; Lee, Kyu Man; Kim, Han-Sung; Kim, Jae-Seok; Kim, Jonghyun; Jeong, Seok Hoon; Roh, Kyoung Ho

    2006-12-01

    Over a 1-month period, a total of 16 ceftriaxone- and cefoxitin-resistant Klebsiella pneumoniae isolates were isolated from 15 patients hospitalised at a burns intensive care unit (ICU). These isolates showed negative results for extended-spectrum beta-lactamase (ESBL) by the Vitek system and were highly resistant to ceftazidime, aztreonam and cefoxitin (minimum inhibitory concentrations > or =128 microg/mL). The bla(SHV-2a) and bla(DHA-1) genes were detected by polymerase chain reaction and sequence analysis. Pulsed-field gel electrophoresis profiles of the isolates were identical. AmpC disk tests for AmpC enzymes as well as double-disk tests and Clinical and Laboratory Standards Institute (CLSI) confirmatory disk tests for ESBLs yielded positive results for all the isolates. However, only three isolates (18.8%) were shown to produce ESBL by CLSI confirmatory tests using broth microdilution. We report the first outbreak of colonisations and infections due to K. pneumoniae isolates co-producing an SHV-2a ESBL and a DHA-1 AmpC beta-lactamase in a Korean hospital, which were suggested to represent a single clonal spread at a burns ICU. In addition, this report presents problems associated with ESBL detection using broth microdilution in isolates that co-produce an ESBL and an AmpC beta-lactamase. PMID:17095195

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

    Directory of Open Access Journals (Sweden)

    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.

  6. 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

  7. 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

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

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    Jonathan K. Lutz

    2011-02-01

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

  9. 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

  10. 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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Institute of Scientific and Technical Information of China (English)

    包东武; 刘荣志

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    周军; 王玉月; 张秋娣

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    糜祖煌; 翁幸鐾; 秦玲

    2010-01-01

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

  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. 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

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

    Science.gov (United States)

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

    2016-06-01

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

  18. 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.

  19. Antimicrobial resistance in Dschang, Cameroon

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    Fusi-Ngwa Catherine Kesah

    2013-01-01

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

  20. 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.

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

    Science.gov (United States)

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

    2006-03-01

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

  2. 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

  3. KPC with ESBL: A multistarrer tragedy

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    Dibyendu Banerjee

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-02-08

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

  5. 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.

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

    Institute of Scientific and Technical Information of China (English)

    李韦伟; 江红; 胡世君

    2014-01-01

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

  7. 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.

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

    Science.gov (United States)

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

    2016-09-01

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

  12. 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

  13. 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.

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

    Science.gov (United States)

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

    2004-01-01

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

  15. 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

  16. 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

  17. 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.

  18. 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.

  19. 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.

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

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

    2011-12-29

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

  1. 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.

  2. 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.

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

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

    2014-01-01

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

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

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    Masoumeh Navidinia

    2014-06-01

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

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

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    Samei, Ali; Haghi, Fakhri; Zeighami, Habib

    2016-05-01

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

  6. 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.

  7. Effects of phenotype and genotype on methods for detection of extended-spectrum-beta-lactamase-producing clinical isolates of Escherichia coli and Klebsiella pneumoniae in Norway.

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    Tofteland, Ståle; Haldorsen, Bjørg; Dahl, Kristin H; Simonsen, Gunnar S; Steinbakk, Martin; Walsh, Timothy R; Sundsfjord, Arnfinn

    2007-01-01

    Consecutive clinical isolates of Escherichia coli (n = 87) and Klebsiella pneumoniae (n = 25) with reduced susceptibilities to oxyimino-cephalosporins (MICs > 1 mg/liter) from 18 Norwegian laboratories during March through October 2003 were examined for bla(TEM/SHV/CTX-M) extended-spectrum-beta-lactamase (ESBL) genes, oxyimino-cephalosporin MIC profiles, ESBL phenotypes (determined by the ESBL Etest and the combined disk and double-disk synergy [DDS] methods), and susceptibility to non-beta-lactam antibiotics. Multidrug-resistant CTX-M-15-like (n = 23) and CTX-M-9-like (n = 15) ESBLs dominated among the 50 ESBL-positive E. coli isolates. SHV-5-like (n = 9) and SHV-2-like (n = 4) ESBLs were the most prevalent in 19 ESBL-positive K. pneumoniae isolates. Discrepant ESBL phenotype test results were observed for one major (CTX-M-9) and several minor (TEM-128 and SHV-2/-28) ESBL groups and in SHV-1/-11-hyperproducing isolates. Negative or borderline ESBL results were observed when low-MIC oxyimino-cephalosporin substrates were used to detect clavulanic acid (CLA) synergy. CLA synergy was detected by the ESBL Etest and the DDS method but not by the combined disk method in SHV-1/-11-hyperproducing strains. The DDS method revealed unexplained CLA synergy in combination with aztreonam and cefpirome in three E. coli strains. The relatively high proportion of ESBL-producing E. coli organisms with a low ceftazidime MIC in Norway emphasizes that cefpodoxime alone or both cefotaxime and ceftazidime should be used as substrates for ESBL detection. PMID:17079502

  8. 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.

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

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    Christopher J. Dunn

    2006-03-01

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

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

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

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

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

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

    2016-01-01

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

  13. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-06-01

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

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

    Science.gov (United States)

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

    2011-06-01

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

  16. 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.

  17. 某院1998-2010年两种非发酵菌耐药率情况及与抗生素使用相关性分析%Antimicrobial resistance of two non-fermenting bacteria and correlation with antibiotic consumption between 1998 and 2010 in a hospital

    Institute of Scientific and Technical Information of China (English)

    耿嘉阳; 段金菊

    2012-01-01

    -domunas aeruginosa and Acinelobacler baumannii, and the correlation between antibiotics consunipliun and antimicrobial resistance rales between 1998 and 2010. Methods A retrospective analysis was performed based on the isolation and resistance rales of two non-fermenting bacteria, Pseudomonas aeruginosa and Acinelobacter baumannii, between 1998 and 2010. Also surveyed was antibiotics consumption of the same period. The frequency of antibiotic consumption was assessed using defined daily dose (DDD) recommended by World Health Organization. The correlation between bacterial resistance and antibiotics consumption was analyzed using SPSS13.0 software package for statistics. Results Pseudomonas aeruginosa exhibited higher sensitivity to amikacin and ceftazidime (resistance rate: approximately 20%) as compared with other antibiotics (resistance rate: over 30%). The resistance rate of Acinetobac-ter baumannii to imipenem and meropenem climbed to nearly 40% by 2010, and the figure to cefoperazone sulbactam surpassed 30% despite the low ranking. The DDD of imipenem and aztreonam was shown to be positively correlated with Pseudomonas aeruginosa resistance (P<0.05). A positive correlation was found between DDDs of imipenem, meropenem, cefoperazone sulbactam, piperacillin tazobactam and Acinetobacter baumannii resistance (P<0.05). There was a. Positive correlation between cephalosponns consumption and resistance rates of cefoperazone, aztreonam and imipenem, between compound preparation consumption and resistance rates of ciprofloxacm and levoiloxacm, as well a.s between carbapenems consumption and resistance rates oi cefoperazone, aztreona.m and imipenem (all P<0.05), as revealed by the correlation sta.tistics oi Pseudomonas aemginosa-rela.t.ed antibiotic resistance and accumulated DDDs oi various antibiotics. Based on the correlation statistics oi Acinetobacter baumannii antibiotic resistance and accumulated DDDs oi various antibiotics, positive correlation was found between cephalosponns

  18. Inhaled antibiotics for the treatment of chronic Pseudomonas aeruginosa infection in cystic fibrosis patients: challenges to treatment adherence and strategies to improve outcomes

    Directory of Open Access Journals (Sweden)

    Bodnár R

    2016-02-01

    Full Text Available Réka Bodnár,1,2 Ágnes Mészáros,2 Máté Oláh,2 Tamás Ágh3 1Department of Pediatric Pulmonology, Heim Pál Children’s Hospital, Budapest, Hungary; 2University Pharmacy Department of Pharmacy Administration, Semmelweis University, Budapest, Hungary; 3Syreon Research Institute, Budapest, Hungary Background: Inhaled antibiotics (ABs are recommended for use in the therapy of chronic Pseudomonas aeruginosa infection in patients with cystic fibrosis (CF. The aim of this systematic literature review was to identify level of adherence to inhaled ABs and to determine predictors and consequences of nonadherence in CF. Methods: A systematic literature search of English-language articles was conducted in April 2015 using Medline and Embase. No publication date limit was applied. The literature screening was conducted by two independent reviewers. All of the included studies were assessed for quality. Results: The search yielded 193 publications, of which ten met the inclusion criteria and underwent data extraction. Seven studies focused on inhaled tobramycin, one on inhaled colistimethate, one on inhaled levofloxacin, and one on inhaled aztreonam lysine. Medication adherence to inhaled ABs was analyzed by pharmacy refill history, daily phone diary, parent and child self-reports, vials counting, or electronic monitoring. In randomized controlled trials (n=3, proportion of adherent patients (>75%–80% of required doses taken ranged from 86% to 97%; in prospective cohort studies (n=3, adherence rates ranged between 36% and 92%, and in retrospective studies (n=4 it ranged between 60% and 70%. The adherence to inhaled ABs in CF was found to be associated with the complexity of treatment, time of drug administration, age of patients, treatment burden (adverse events, taste, and patient satisfaction. Conclusion: The high diversity of adherence data was because of the different study designs (randomized controlled trials vs real-world studies and the lack

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

    Directory of Open Access Journals (Sweden)

    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

  20. 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

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

    Directory of Open Access Journals (Sweden)

    Elisabetta Pezzati

    2005-06-01

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

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

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

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

  3. 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

  4. 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

  5. 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。

  6. 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.

  7. 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

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

    Institute of Scientific and Technical Information of China (English)

    戴昆琦; 奕利娟; 陈群英

    2012-01-01

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

  9. 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.

  10. 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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  13. Copy Number Change of the NDM-1 sequence in a multidrug-resistant Klebsiella pneumoniae clinical isolate.

    Directory of Open Access Journals (Sweden)

    Tzu-Wen Huang

    Full Text Available The genetic features of the antimicrobial resistance of a multidrug resistant Klebsiella pneumoniae strain harboring bla NDM-1 were investigated to increase our understanding of the evolution of NDM-1. The strain, KPX, came from a Taiwanese patient with a hospitalization history in New Delhi. Complete DNA sequencing was performed; and the genes responsible for antimicrobial resistance were systematically examined and isolated by library screening. KPX harbored two resistance plasmids, pKPX-1 and pKPX-2, which are 250-kb and 141-kb in size, respectively, with bla NDM-1 present on pKPX-1. The plasmid pKPX-1 contained genes associated with the IncR and IncF groups, while pKPX-2 belonged to the IncF family. Each plasmid carried multiple antimicrobial resistance genetic determinants. The gene responsible for resistance to carbapenems was found on pKPX-1 and that for resistance to aztreonam was found on pKPX-2. To our surprise, we discovered that bla NDM-1 exists on pKPX-1 as multiple copies in the form of tandem repeats. Amplification of bla NDM-1 was found to occur by duplication of an 8.6-kb unit, with the copy number of the repeat varying from colony to colony. This repeat sequence is identical to that of the pNDM-MAR except for two base substitutions. The copy number of bla NDM-1 of colonies under different conditions was assessed by Southern blotting and quantitative PCR. The bla NDM-1 sequence was maintained in the presence of the antimicrobial selection; however, removal of antimicrobial selection led to the emergence of susceptible bacterial populations with a reduced copy number or even the complete loss of the bla NDM-1 sequence. The dynamic nature of the NDM-1 sequence provides a strong argument for judicious use of the broad-spectrum antimicrobials in order to reduce the development and spread of antimicrobial resistance among pathogens.

  14. 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

  15. 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

  16. 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

  17. The comparison of bacterial resistance surveillance between sterile body fluid and non-sterile body fluid%无菌体液与非无菌体液细菌耐药监测对比分析

    Institute of Scientific and Technical Information of China (English)

    温伟洪; 徐令清; 李介华; 钟国权

    2016-01-01

    目的:探讨该院2014年无菌体液与非无菌体液来源细菌的菌种分布及耐药性的差异。方法采用回顾性分析方法,应用BD PhoenixTM 100全自动细菌鉴定药敏系统进行细菌鉴定与药敏检测,应用Whonet5.6软件和SPSS19.0统计软件对细菌耐药率进行统计分析。结果无菌体液分离率最高的细菌为大肠埃希菌(43%),非无菌体液分离率最高的细菌为铜绿假单胞菌(21%)。无菌体液来源的大肠埃希菌对氨苄西林、氨曲南、环丙沙星、氯霉素等11种抗菌药物耐药率低于非无菌体液来源的菌株,无菌体液来源的金黄色葡萄球菌对阿米卡星、阿莫西林/克拉维酸、环丙沙星等6种抗菌药物耐药率低于非无菌体液来源的菌株,无菌体液来源的铜绿假单胞菌对氨曲南耐药率低于非无菌体液来源的菌株,无菌体液来源的肺炎克雷伯菌对氨苄西林/舒巴坦、复方新诺明、氯霉素等6种抗菌药物耐药率低于非无菌体液来源的菌株,差异均有统计学意义(P<0.05)。结论无菌体液与非无菌体液来源细菌的菌种分布及耐药性存在差异,加强无菌体液细菌耐药性监测尤为重要。%Objective To compare the distribution and drug resistance of isolates between sterile body fluid and non‐sterile body fluid in the hospital in 2014 .Methods By adopting the retrospective analysis method ,we used BD phoenixTM 100 to conduct bacteria identification and drug susceptibility testing ,the Whonet5 .6 software and SPSS19 .0 software to statistically analysize the drug re‐sistance of the bacteria .Results E .coli ranked the top in sterile body fluid isolates(43% ) while the highest rate in non‐sterile body fluid was P .aeruginosa .E .coli(21% ) .Isolates from sterile body fluid had lower drug resistance rate to 11 kinds of antibacterials such as ampicillin ,chloramphenicol ,ciprofloxacin and aztreonam than the strains

  18. 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

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

    Institute of Scientific and Technical Information of China (English)

    金益军; 陆建红; 陈国军; 董长林; 李光亮

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    梅海燕; 明德松; 朱焱; 谢尊金

    2012-01-01

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

  1. Surveillance of bacterial resistance and analysis of antibiotics application%细菌耐药性监测与抗菌药物应用分析

    Institute of Scientific and Technical Information of China (English)

    陈叶红; 丁洁卫

    2013-01-01

    OBJECTIVE To understand the drug resistance of the clinical pathogens and the use of common antibiotics so as to provide basis for the reasonable use of antibiotics. METHODS The application of antibacterial drugs was analyzed through disk diffusion method for antimicrobial susceptibility testing of the clinical pathogens isolated in 2011, the utilization of antibacterial drugs was analyzed with DDD and DDDs as the indexes. RESULTS A total of 5113 strains of pathogens were detected. The gram-positive bacteria accounted for 17. 7%, the gram-negative bacteria accounted for 82. 3%. Methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Acinetobacter baumannii,carbapenem-resistant Pseudomonas aeruginosa , and carbapenem-resistant Enterobacter accounted for 21. 3% . 33. 8% , 17. 7% , and 1. 0% respectively. Levofloxacin and cefepime remained as ranking the first two places of DDDs. The ranking of DDDs of meropenem and imipenem were gradually back away till the drugs being withdrawn. Aztreonam was going forward quarterly in the ranking of DDDs. In the ranking of DDDs, ampicillin/sulbactam went backward by 73. 6% in the last three quarters compared with that in the first quarter. The ranking of DDDs of cefotaxime in the fourth quarter decreased by 86. 4% compared with that in the first three quarters. The DDDs of minocycline hydrochloride tablets ranked the last throughout the year, which lasted only 28 treatment days. The daily expense of piperacillin/tazobactam was the highest, which reached 798 yuan per day. CONCLUSION The trend of drug resistance of A. baumannii and P. aeruginosa to meropenem and imipenem is consistent with the trend of DDDs. The trend of drug resistance of P. aeruginosa is opposite to the DDDs of aztreonam. As the use of antimicrobial agents has a great influence on the bacterial drug resistance, the management in hospital should be strengthened to make sure that the antimicrobial drugs are properly used to delay the bacterial

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

    Institute of Scientific and Technical Information of China (English)

    王旭明; 李天娇; 莫成锦

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    龚小明; 何娟妃

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    陈坚; 余方友

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    赵亚楠; 郭育奇; 黄红兰; 武晓琳; 韦珍; 孙超; 赵春燕

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    边锋芝; 苑广盈; 孙玉国; 张延芳; 李金文

    2009-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    刘静; 苗元; 王丽萍; 崔京辉; 王永全; 吉彦莉

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    王选; 吴晓燕; 李佳萍; 宋国蓉; 邱炳峰; 顾丹霞; 张嵘

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    孔蕾; 朱凝瑜; 贝亦江; 丁雪燕; 陈健舜

    2013-01-01

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

  11. 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

  12. 2011~2012年广州地区儿童腹泻病原菌分布及耐药性分析%Composition and drug resistance of pathogenic bacteria causing infantile diarrhea in Guangzhou from 2011 to 2012

    Institute of Scientific and Technical Information of China (English)

    黄莲芬; 刘海英; 谢永强; 钟华敏; 周珍文

    2015-01-01

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

  13. 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

  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. 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,

  16. Klebsiella pneumoniae KPC: first isolations in Italy

    Directory of Open Access Journals (Sweden)

    Carla Fontana

    2009-12-01

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

  17. 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

  18. 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.

  19. 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

  20. 口腔颌面部间隙感染患者常见菌群分布和药敏分析%The distribution of general p athogenic bacteria and drug susceptibility of patients with oral and maxillofacial infections

    Institute of Scientific and Technical Information of China (English)

    刘巧荣; 石磊; 路兴华; 雷玲利

    2015-01-01

    Objective:To investigate the distribution of general pathogenic bacteria and drug susceptibility of patient with oral and maxillofacial infections,which would provide evidence for clinical rational use of antibiotics. Methods:160 patients with oral and maxillofacial infections were chosen from Feb, 2014 to Feb,2015. The stains from each patient were cultured and identified respectively. The Bact-IST system was used to identify the bacterial flora, and KB method was used to test the drug susceptibility, as well as WHONET5.6 software was used to analyze the data. Results: 207 strains of pathogenic bacteria were isolated from 160 patients. which including 115 strains of gram-postive(55.56%), 84 of gram-negative(40.58%), as well as 8 strains of fungi(3.86%). The drug susceptibility test showed that the staphylococcus aureus was susceptible to ciprofloxacin, clindamycin, rifampicin and vancomycin. Staphylococcus epidermidis was susceptible to ciprofloxacin and vancomycin. Streptococcus pneumonia had a high susceptibility to vancomycin and imipenem. As well as the prevotella was susceptible to metronidazole, vancomycin, imipenem and aztreonam. Conclusion: Gram-positive bacteria are the most common infection pathogen in patients with oral and maxillofacial space infection. Meanwhile anaerobic bacteria are the main detected gram-negative strains. Most pathogenic bacteria are resistant to many antibiotics, which suggests should be used more reasonable to prevent drug resistance in clinical treatment antibiotics.%目的:了解口腔颌面部间隙感染患者常见病原菌分布及药物敏感性,为临床合理使用抗菌药物提供基础依据. 方法:收集2014年2月到2015年2月就诊于甘肃省人民医院的口腔颌面部间隙感染患者160例,取其感染部位脓液标本进行病原菌培养,采用微生物分析系统Bact-IST进行细菌菌群鉴定,K-B法进行药物敏感性测试,数据分析采用WHONET5.6统计软件进行.结果:160份送

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

    Institute of Scientific and Technical Information of China (English)

    杨超; 刘大钺; 张恒; 王凌雁; 廖康; 刘金龙

    2011-01-01

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

  2. 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.

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

    Institute of Scientific and Technical Information of China (English)

    吴斌

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    胡云海; 范忠祥; 杜成雪

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    倪笑媚; 黄金莲; 胡硕

    2013-01-01

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

  6. 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 .

  7. 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

  8. 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

  9. 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.

  10. 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

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

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

    2013-01-01

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

  12. 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.

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

    Institute of Scientific and Technical Information of China (English)

    牛文娟; 荆菁华; 朱建奎

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    王曦; 罗丽玲; 李晓莉

    2015-01-01

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

  15. 产超广谱β-内酰胺酶大肠埃希菌和肺炎克雷伯菌的耐药性及其所致血流感染的危险因素%Antibiotic resistance of ESBLs-producing Escherichia coli and Klebsiella pneumoniae isolates and risk factors for bloodstream infections

    Institute of Scientific and Technical Information of China (English)

    丁月平; 陆军; 俞云松; 周志慧

    2015-01-01

    Objective To investigate the antibiotic resistance of extended-spectrum-β-1actamases (ESBLs)-producing Escherichia coli (E.coli) and Klebsiella pneumoniae (K.pneumoniae) isolates and the risk factors of bloodstream infections caused by these strains.Methods Clinical data of 131 patients with E.coli or K.pneumoniae-induced bloodstream infections admitted in the Second Affiliated Hospital of Zhejiang Chinese Medical University during September 2009 and June 2014 were retrospectively analyzed.Species identification and antimicrobial susceptibility test were performed by Vitek 2 system,and ESBLs production was tested by standard disk diffusion method.Logistic regression analysis was performed to identify the risk factors of bloodstream infections induced by ESBLs-producing strains.Results Among 131 patients,65 were infected with ESBLs-producing strains,and 66 were infected with non-ESBLs-producing strains.The resistance rates of ESBLs-producing strains were above 50% for penicillin,aztreonam and third/fourth generation cephalosporins,which were significantly higher than those of non-ESBLs producing strains.The resistance rates of ESBLs-producing E.coli and K.pneumoniae to carbapenems and piperacillin/tazobactam were 0-2.0%,2.3% and 0-14.3%,26.7%,respectively.The univariate analysis revealed that patients with exposure to cephalosporins in recent 3 months (x2 =18.322,P < 0.01),prior infection with ESBLs-producing strains (x2=14.610,P<0.01),indwelling catheter in recent 3 months (x2 =13.016,P < 0.01),history of hospitalization in recent 3 months (x2 =11.269,P < 0.01),exposure to quinolones in recent 3 months (x2 =10.638,P < 0.01),nosocomial infection (x2 =8.205,P < 0.01),history of indwelling deep venous catheter or percutaneous central catheter in recent 3 months (x2 =4.817,P < 0.05) and exposure to glucocorticoid hormone in recent 3 months (x2 =4.265,P < 0.05) were associated with infection of ESBLs-producing strains.Multivariate Logistic

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

    Institute of Scientific and Technical Information of China (English)

    杨玮; 蔡加昌; 胡燕燕; 周宏伟; 张嵘; 陈功祥

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    刘志远; 马玉芝; 潘健; 张婷菊; 齐杰; 刘贵建

    2014-01-01

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

  18. 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

  19. 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

  20. 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 .

  1. 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

  2. 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

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

    Institute of Scientific and Technical Information of China (English)

    胡蓉蓉; 马小琴; 张能华; 王静

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    钱超

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    鲍群丽; 汪宏良; 柯俊

    2015-01-01

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

  6. 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

  7. 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.

  8. 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.

  9. 2012年北京市海淀医院肺炎克雷伯菌致血流感染14例患者的耐药分析%Analysis of drug resistance to Klebsiella pneumoniae in 14 cases of bloodstream infection in 2012 of Beijing Haidian Hospital

    Institute of Scientific and Technical Information of China (English)

    董建平; 田国保; 李明明; 李明慧; 张璐

    2014-01-01

    hospital (Haidian Section of Peking University Third Hospital) and provide a reference for the clinical treatment of Klebsiella pneumoniae. Methods Clinical data and antibiotic resistance of the patients infected with Klebsiella pneumoniae of bloodstream from January to December in 2012 were collected, retrospectively. Statistical analysis was done by SPSS 12.0. Results All the 14 clinical isolates of Klebsiella pneumoniae infection were widely distributed in various hospital departments. The infection were more common in the elderly, cancer, uremia, cerebrovascular diseases and other critical patients. All the 14 cases were secondary BSI and mostly secondary to pulmonary infection and hepatobiliary tract infection. The rate of bacterial resistance to ampicillin (85.7%), piperacillin (57.1%), cefazolin (42.9%), cephalexin and sulbactam (57.1%), cefuroxime (42.9%), gentamicin (42.9%) and cotrimoxazole (42.9%), were more than 40%; the rate to ceftriaxone (21.4%), ceftazidime (21.4%), piperacillin and tazobactam (28.6%), ciprofloxacin (28.6%) and aztreonam (21.4%) were 20%-30%;and the rate to cefepime (7.1%), cefotetan (7.1%), levolfoxacin (14.3%), amikacin (7.1%), tobramycin (15.6%) and nitrofurantoin (7.1%) were all less than 20%. No resistance to carbapenems and cefoperazone/sulbactam were found. Conclusions Klebsiella pneumoniae is one of the common pathogens of secondary BSI. The different degree of drug resistance was found to some commonly used antibiotics based on clinical experience. Bacterial resistance monitoring should be strengthened in the region or hospital and could guide anti-infection treatment in clinical experience.

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

    Institute of Scientific and Technical Information of China (English)

    谢在海; 朱元祺; 李莉; 邓乃梅; 苏维奇

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  12. Distribution of pathogens causing postoperative intracranial infections in neurosurgery department patients undergoing craniotomy and treatment measures%神经外科开颅手术患者术后颅内感染病原菌分布与治疗

    Institute of Scientific and Technical Information of China (English)

    郭孝龙; 周江朝; 乔鹏; 武宏杰; 宋来君

    2015-01-01

    OBJECTIVE To explore the distribution of pathogens causing postoperative intracranial infections in the neurosurgery department patients undergoing craniotomy and put forward the treatment measures so as to provide guidance for prevention and treatment of the intracranial infections .METHODS The clinical data of 1 500 patients who underwent the craniotomy in the department of neurosurgery from Jan 2008 to Jun 2015 were retrospectively analyzed ,and the incidence of intracranial infections and characteristics of pathogens were observed .The patients with intracranial infections were treated with intraventricular irrigation or intrathecal irrigation of antibiotics ,and the curative effect was compared between the two drug delivery methods .RESULTS Of 1 500 patients undergoing the craniotomy ,50 had postoperative intracranial infections with the infection rate of 3 .3% .A total of 73 strains of pathogens were isolated from the cerebrospinal fluid specimens of the patients with the infections ,including 45 (61 .6% ) strains of gram‐positive bacteria ,25 (34 .3% ) strains of gram‐negative bacteria ,and 3 (4 .1% ) strains of fungi .The drug resistance rate of the Staphylococcus aureus to erythromycin was 100 .0% ,the drug resistance rate to penicillin was 90 .5% ,and the drug resistance rates to linezolid ,piperacillin‐tazobactam ,and vancomycin were 0 .The drug resistance rates of the K lebsiella pneumoniae to aztreonam was 100 .0% ,the drug resistance rate to imipenem was 0 .The total effective rate of treatment of the intraventricular irrigation group was 96 .3% , significantly higher than 73 .9% of the intrathecal irrigation group (χ2 = 5 .168 ,P< 0 .05) .CONCLUSION The gram‐positive bacteria rank the first place of the pathogens isolated from the cerebrospinal fluid specimens of the pa‐tients with intracranial infections .The curative effect of the intraventricular irrigation is significantly better than that of the intrathecal irrigation on treatment of

  13. 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

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

    Institute of Scientific and Technical Information of China (English)

    张晓洁; 邱胜丰; 葛高霞; 黎青

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    王丽杰; 孙莹; 宋文良; 张智洁; 刘春峰

    2012-01-01

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

  18. 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

  19. 产NDM-1肠杆菌科细菌的耐药机制和临床特征%Mechanism of drug resistance of NDM-1 producing Enterobacteriaceae and the clinical feature of its infection

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    黄增光; 夏淑; 肖书念; 林倍州; 王爱华; 徐安; 卓超

    2014-01-01

    存活.结论 华南地区已出现产NDM-1的肠杆菌科细菌,主要通过IncX3型质粒在肠杆菌中传播.感染此类细菌的患者预后良好.%Objeetive To explore the mechanism of drug resistance of New Delhi metallo-β-lactamase-1 (NDM-1) producing Enterobacteriaceae,and to investigate the characteristics of blaNDM-1 carrying plasmid and its gene environment.Methods A total of 48 strains of carbapenem-resistant Enterobacteriaceae were successively collected from six general hospitals in south China during August 2011 and January 2013.Escherichia coli J53 was used for plasmid conjugation.Modified Hodge test was performed,and PCR method was used for the detection of carbarpenase-related genes.The relative molecular mass of the blaNDM-1 carrying plasmid was determined using pulsed field gel electrophoresis (PFGE)assay,and enzyme digestion was performed to investigate the homology and incompatibility group of the plasmid.Clinical feature of blaNDM-1 producing Enterobacteriaceae infection was also investigated.Results Among 48 strains of carbapenem-resistant Enterobacteriaceae,43 were positive in modified Hodge tests.blaVIM,blaGIM and blaSPM genes were negative in all strains,while blaNDM-1 was positive in 19 strains including 3 strains of Escherichia coli,5 strains of Klebsiella pneumoniae,6 strains of Enterobacter cloacae,3 strains of Citrobacterfreundii,1 strain of Klebsiella oxytoca and 1 strain of Providencia rettgeri.All the 19 strains were resistant to imipenem,cefotaxime,ceftazidime,cefepime,aztreonam and piperacillin/tazobactam,47.3% strains were resistant to ciprofloxacin and levofloxacin,but 68.4% strains were sensitive to amikacin.Conjugation experiment showed that,blaNDM-1 carrying plasmids in 13 strains were transmitted to the Escherichia coli J53.The conjugants were resistant to imipenem,ceftazidime,cefotaxime and piperacillin/tazobactam,but were sensitive to amikacin,ciprofloxacin and levofloxacin.All genes in conjugant J-FR90 (Providencia rettgeri

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    杨盛权; 周志文; 周立仁; 王玉成

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    韩欣欣; 李庆淑; 申丽婷; 胡丹; 曲彦

    2014-01-01

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