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Sample records for ceftazidime

  1. Effect of Ascorbic Acid on Lipid Peroxidation Induced by Ceftazidime

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    Devbhuti P*,1

    2011-01-01

    Full Text Available Lipid peroxidation is the oxidative deterioration of polyunsaturated lipids which is a free radical related process and responsible for thedevelopment of many diseases and disorders like diabetes mellitus, hypertension, cancer etc. End products of lipid peroxidation aremalondialdehyde (MDA, 4-hydroxy-2-nonenal (4-HNE, etc. which are the ultimate mediator of toxicity. Antioxidants have the capability toinhibit lipid peroxidation. Keeping in mind this fact, the present in vitro study was carried out to evaluate lipid peroxidation induction potential of ceftazidime, a cephalosporin antibiotic and its suppression with ascorbic acid considering some laboratory markers of lipid peroxidation like MDA, 4-HNE and reduced glutathione (GSH. Goat liver was used as the lipid source. After treatment of the liver homogenate with drug and/or antioxidant the levels of 4-HNE, MDA and GSH were estimated in different samples at different hours of incubation. The results showed that the drug ceftazidime could significantly induce lipid peroxidation and the antioxidant ascorbic acid has the capability to inhibit ceftazidime-inducedlipid peroxidation.

  2. First Report of Ceftazidime-Avibactam Resistance in a KPC-3-Expressing Klebsiella pneumoniae Isolate

    Science.gov (United States)

    Yang, Shangxin; Hemarajata, Peera; Ward, Kevin W.; Miller, Shelley A.; Gregson, Aric

    2015-01-01

    Ceftazidime-avibactam is the first antimicrobial approved by the U.S. FDA for the treatment of carbapenem-resistant Enterobacteriaceae. Avibactam, a non-β-lactam β-lactamase inhibitor, inactivates class A serine carbapenemases, including Klebsiella pneumoniae carbapenemase (KPC). We report a KPC-producing K. pneumoniae isolate resistant to ceftazidime-avibactam (MIC, 32/4 μg/ml) from a patient with no prior treatment with ceftazidime-avibactam. PMID:26195508

  3. CONTINUOUS-INFUSION OF CEFTAZIDIME IN FEBRILE NEUTROPENIC PATIENTS WITH ACUTE MYELOID-LEUKEMIA

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    DAENEN, S; ERJAVEC, Z; UGES, DRA; DEVRIESHOSPERS, HG; DEJONGE, P; HALIE, MR

    1995-01-01

    Twelve febrile patients with severe neutropenia, who had undergone aggressive chemotherapy for acute myeloid leukemia, were treated empirically with a continuous infusion of ceftazidime 100 mg/kg/day after a 500 mg loading dose, in order to study the pharmacokinetics of ceftazidime after continuous

  4. Development of ceftazidime resistance in an acute Burkholderia pseudomallei infection

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    Sarovich DS

    2012-08-01

    Full Text Available Derek S Sarovich,1,2,* Erin P Price,1,2,* Direk Limmathurotsakul,3 James M Cook,1 Alex T Von Schulze,1 Spenser R Wolken,1 Paul Keim,1 Sharon J Peacock,3,4 Talima Pearson1 1Center for Microbial Genetics and Genomics, Northern Arizona University, Flagstaff, AZ, USA; 2Tropical and Emerging Infectious Diseases Division, Menzies School of Health Research, Darwin, Australia; 3Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; 4Department of Medicine, University of Cambridge, Cambridge, United Kingdom*These authors contributed equally to this workAbstract: Burkholderia pseudomallei, a bacterium that causes the disease melioidosis, is intrinsically resistant to many antibiotics. First-line antibiotic therapy for treating melioidosis is usually the synthetic β-lactam, ceftazidime (CAZ, as almost all B. pseudomallei strains are susceptible to this drug. However, acquired CAZ resistance can develop in vivo during treatment with CAZ, which can lead to mortality if therapy is not switched to a different drug in a timely manner. Serial B. pseudomallei isolates obtained from an acute Thai melioidosis patient infected by a CAZ susceptible strain, who ultimately succumbed to infection despite being on CAZ therapy for the duration of their infection, were analyzed. Isolates that developed CAZ resistance due to a proline to serine change at position 167 in the β-lactamase PenA were identified. Importantly, these CAZ resistant isolates remained sensitive to the alternative melioidosis treatments; namely, amoxicillin-clavulanate, imipenem, and meropenem. Lastly, real-time polymerase chain reaction-based assays capable of rapidly identifying CAZ resistance in B. pseudomallei isolates at the position 167 mutation site were developed. The ability to rapidly identify the emergence of CAZ resistant B. pseudomallei populations in melioidosis patients will allow timely alterations in treatment strategies

  5. In Vitro Activity of Ceftazidime-Avibactam against Isolates in a Phase 3 Open-Label Clinical Trial for Complicated Intra-Abdominal and Urinary Tract Infections Caused by Ceftazidime-Nonsusceptible Gram-Negative Pathogens.

    Science.gov (United States)

    Stone, Gregory G; Bradford, Patricia A; Newell, Paul; Wardman, Angela

    2017-02-01

    The in vitro activity of ceftazidime-avibactam was evaluated against 341 Gram-negative isolates from 333 patients in a randomized, phase 3 clinical trial of patients with complicated urinary tract or intra-abdominal infections caused by ceftazidime-nonsusceptible pathogens (NCT01644643). Ceftazidime-avibactam MIC90 values against Enterobacteriaceae and Pseudomonas aeruginosa (including several class B or D enzyme producers that avibactam does not inhibit) were 1 and 64 μg/ml, respectively. Overall, the ceftazidime-avibactam activity against ceftazidime-nonsusceptible isolates was comparable to the activity of ceftazidime-avibactam previously reported against ceftazidime-susceptible isolates. (This study has been registered at ClinicalTrials.gov under identifier NCT01644643.).

  6. Ceftazidime-avibactam: a novel cephalosporin/β-lactamase inhibitor combination.

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    Zhanel, George G; Lawson, Christopher D; Adam, Heather; Schweizer, Frank; Zelenitsky, Sheryl; Lagacé-Wiens, Philippe R S; Denisuik, Andrew; Rubinstein, Ethan; Gin, Alfred S; Hoban, Daryl J; Lynch, Joseph P; Karlowsky, James A

    2013-02-01

    Avibactam (formerly NXL104, AVE1330A) is a synthetic non-β-lactam, β-lactamase inhibitor that inhibits the activities of Ambler class A and C β-lactamases and some Ambler class D enzymes. This review summarizes the existing data published for ceftazidime-avibactam, including relevant chemistry, mechanisms of action and resistance, microbiology, pharmacokinetics, pharmacodynamics, and efficacy and safety data from animal and human trials. Although not a β-lactam, the chemical structure of avibactam closely resembles portions of the cephem bicyclic ring system, and avibactam has been shown to bond covalently to β-lactamases. Very little is known about the potential for avibactam to select for resistance. The addition of avibactam greatly (4-1024-fold minimum inhibitory concentration [MIC] reduction) improves the activity of ceftazidime versus most species of Enterobacteriaceae depending on the presence or absence of β-lactamase enzyme(s). Against Pseudomonas aeruginosa, the addition of avibactam also improves the activity of ceftazidime (~fourfold MIC reduction). Limited data suggest that the addition of avibactam does not improve the activity of ceftazidime versus Acinetobacter species or most anaerobic bacteria (exceptions: Bacteroides fragilis, Clostridium perfringens, Prevotella spp. and Porphyromonas spp.). The pharmacokinetics of avibactam follow a two-compartment model and do not appear to be altered by the co-administration of ceftazidime. The maximum plasma drug concentration (C(max)) and area under the plasma concentration-time curve (AUC) of avibactam increase linearly with doses ranging from 50 mg to 2,000 mg. The mean volume of distribution and half-life of 22 L (~0.3 L/kg) and ~2 hours, respectively, are similar to ceftazidime. Like ceftazidime, avibactam is primarily renally excreted, and clearance correlates with creatinine clearance. Pharmacodynamic data suggest that ceftazidime-avibactam is rapidly bactericidal versus

  7. Assay of ceftazidime and cefepime based on fluorescence quenching of carbon quantum dots.

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    Huang, Yu; Zhang, Ying; Yan, Zhengyu; Liao, Shenghua

    2015-11-01

    A novel and sensitive method for the determination of ceftazidime and cefepime in an active pharmaceutical ingredient (API) has been developed based on the fluorescence quenching of poly(ethylene glycol) (PEG)2000-capped carbon quantum dots (CQDs) prepared using a chemical oxidation method. The quenching of fluorescence intensity is proportional to the concentration of ceftazidime and cefepime over the range of 0.33-3.30 and 0.24-2.40 µg/mL, respectively. The mode of interaction between PEG2000-capped CQDs and ceftazidime/cefepime in aqueous solutions was investigated using a fluorescence, UV/Vis and Fourier transform infrared spectrometry (FTIR) at physiological pH. UV/Vis and FTIR spectra demonstrated that ground state compounds were formed through hydrophobic interaction the fluorescence quenching of CQDs caused by ceftazidime and cefepime. The quenching constants decreased with increases in temperature, which was consistent with static quenching.

  8. [Clinical and pharmacokinetic evaluation of ceftazidime in children].

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    Fujita, K; Sakata, H; Murono, K; Yoshioka, H; Maruyama, S; Sanae, N; Takimoto, M

    1984-03-01

    Forty-two pediatric patients were treated with ceftazidime ( CAZ ) in the doses ranging from 45.6 to 120 mg/kg/day for 2 to 10 days, and the clinical efficacy and side effects were evaluated. Among the 37 children with bacterial infections including pneumonia, bronchitis, tonsillitis, croup, cervical lymphadenitis, abdominal abscess and urinary tract infections, the results were excellent in 22, good in 12, fair in 2, and poor in 1 patient with pneumonia. Out of the 42 patients, 5 cases showed eosinophilia, but no clinical sign such as rash, fever or diarrhea, attributable to CAZ was observed during the study. The serum concentrations of CAZ in 4 patients ranged from 60.8 to 71.0 micrograms/ml (mean 66.1 micrograms/ml) at 30 minutes and from 0.5 to 1.2 micrograms/ml (mean 0.8 micrograms/ml) at 8 hours after 20 mg/kg intravenous bolus injection of the antibiotic. The mean serum half-life was 1.42 hours (85 minutes). Patients with impairment of renal function were excluded from this study.

  9. Detection of extended spectrum beta lactamases, ampc beta lactamases and metallobetalactamases in clinical isolates of ceftazidime resistant Pseudomonas Aeruginosa

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    Sivaraman Umadevi

    2011-12-01

    Full Text Available We studied the prevalence of ceftazidime resistance in Pseudomonas aeruginosa and the rates of extended-spectrum β-lactamase (ESBL, AmpC β-lactamase (AmpC and metallo-β-lactamase (MBL production among the ceftazidime resistant Pseudomonas aeruginosa. A very high rate of MBL production was observed, which suggested it to be an important contributing factor for ceftazidime resistance among Pseudomonas aeruginosa.

  10. Effects of ceftazidime and ciprofloxacin on biofilm formation in Proteus mirabilis rods.

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    Kwiecińska-Piróg, Joanna; Bogiel, Tomasz; Gospodarek, Eugenia

    2013-10-01

    Proteus mirabilis rods are one of the most commonly isolated species of the Proteus genus from human infections, mainly those from the urinary tract and wounds. They are often related to biofilm structure formation. The bacterial cells of the biofilm are less susceptible to routinely used antimicrobials, making the treatment more difficult. The aim of this study was to evaluate quantitatively the influence of ceftazidime and ciprofloxacin on biofilm formation on the polyvinyl chloride surface by 42 P. mirabilis strains isolated from urine, purulence, wound swab and bedsore samples. It has been shown that ceftazidime and ciprofloxacin at concentrations equal to 1/4, 1/2 and 1 times their MIC values for particular Proteus spp. strains decrease their ability to form biofilms. Moreover, ciprofloxacin at concentrations equal to 1/4, 1/2 and 1 times their MIC values for particular P. mirabilis strains reduces biofilm formation more efficiently than ceftazidime at the corresponding concentration values.

  11. Cost Minimization Analysis of the Use of Meropenem and Ceftazidime in Febrile Neutropenia Therapy

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    Rizky Abdulah

    2016-06-01

    Full Text Available Use of antibiotics is required in febrile neutropenia therapy. The variety choice on the use of antibiotics has increased the role of pharmacoeconomics study to determine the most effective and efficient antibiotic in a specific area. The purpose of this study was to investigate the lowest cost antibiotic between meropenem and ceftazidime that were used as one of febrile neutropenia treatments at one of referral hospitals in West Java province during 2011–2013. This study was a retrospective, observational and analytical study that was performed on February 2014 by collecting medical record data related to febrile neutropenia inpatient who received meropenem or ceftazidime therapy. The result showed that although it was not statistically significant, the total cost for ceftazidime therapy was IDR7,082,523, which was lower than meropenem therapy (IDR11,094,147. Hopefully, this result can assist the health professionals in the management of febrile neutropenia therapy.

  12. In Vitro Selection of Ceftazidime-Avibactam Resistance in Enterobacteriaceae with KPC-3 Carbapenemase

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    Warner, Marina; Jamrozy, Dorota; Mushtaq, Shazad; Nichols, Wright W.; Mustafa, Nazim; Woodford, Neil

    2015-01-01

    Ceftazidime-avibactam is active against most Enterobacteriaceae isolates with KPC carbapenemases. We investigated whether this activity could be compromised by mutation. Single-step and multistep selections were attempted using ceftazidime-avibactam (avibactam fixed at 1 or 4 μg/ml) versus two strains each of Enterobacter cloacae and Klebsiella pneumoniae, all with the KPC-3 enzyme. Mutant blaKPC alleles were sequenced, and their parentage was confirmed by typing. Ceftazidime-avibactam selected mutants at up to 16× MIC, with frequencies of ca. 10−9. This contrasted with previous experience for ceftaroline-avibactam, where mutant frequencies under similar conditions were 256 μg/ml and those of ceftazidime with 4 μg/ml avibactam from 0.25 to 1 μg/ml to 4 to 128 μg/ml; ceftaroline-avibactam MICs rose less, typically from 0.5 to 1 μg/ml to 1 to 8 μg/ml. The MICs of carbapenems and cephalosporins except ceftazidime and piperacillin-tazobactam were reduced for many mutants. Sequencing of blaKPC revealed point and insertion changes in 12/13 mutants investigated, representing all four parents; one mutant lacked blaKPC changes and possibly had reduced permeability. Amino acid changes commonly involved Ω loop alterations or 1 to 6 amino acid insertions immediately C-terminal to this loop. The most frequent change, seen in four mutants from three strains, was Asp179Tyr, replacing a residue that ordinarily forms a salt bridge to stabilize the Ω loop. Since ceftaroline-avibactam was less affected than ceftazidime-avibactam, we postulate that these mutations increase ceftazidimase specificity rather than conferring avibactam resistance. The clinical relevance remains uncertain. PMID:26100712

  13. Synergy and Mode of Action of Ceftazidime plus Quercetin or Luteolin on Streptococcus pyogenes

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    Supatcharee Siriwong

    2015-01-01

    Full Text Available Streptococcus pyogenes causes streptococcal toxic shock syndrome. The recommended therapy has been often failure through the interfering of beta-lactamase-producing bacteria (BLPB. The present study was to investigate antibacterial activity, synergy, and modes of action of luteolin and quercetin using alone and plus ceftazidime against S. pyogenes. The MICs of ceftazidime, luteolin, and quercetin against all S. pyogenes were 0.50, 128, and 128 µg mL−1, respectively. A synergistic effect was exhibited on luteolin and quercetin plus ceftazidime against these strains at fractional inhibitory concentration indices 0.37 and 0.27, respectively, and was confirmed by the viable count. These combinations increased cytoplasmic membrane (CM permeability, caused irregular cell shape, peptidoglycan, and CM damage, and decreased nucleic acid but increased proteins in bacterial cells. Enzyme assay demonstrated that these flavonoids had an inhibitory activity against β-lactamase. In summary, this study provides evidence that the inhibitory mode of action of luteolin and quercetin may be mediated via three mechanisms: (1 inhibiting of peptidoglycan synthesis, (2 increasing CM permeability, and (3 decreasing nucleic acid but increasing the protein contents of bacterial cells. So, luteolin and quercetin propose the high potential to develop adjunct to ceftazidime for the treatment of coexistence of the BLPB and S. pyogenes infections.

  14. In vitro activity of ceftazidime-avibactam combination in in vitro checkerboard assays

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    Berkhout, J.; Melchers, M.J.B.; Mil, A.C. van; Nichols, W.W.; Mouton, J.W.

    2015-01-01

    To evaluate the in vitro effects of the combination of ceftazidime and avibactam on the MICs of both compounds, checkerboard assays were performed for 81 clinical strains, including 55 Enterobacteriaceae strains (32 Klebsiella pneumoniae, 19 Escherichia coli, 1 Citrobacter freundii, and 3 Enterobact

  15. Influence of the structure of ceftazidime on obtaining biologically active cellulosic bandage

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    Rodić-Grabovac Branka B.

    2017-01-01

    Full Text Available Biologically active fibers as drug carriers have improved characteristics in comparison with conventional medical therapies. Cellulosic fibers as hydrophilic and biocompatible, nontoxic and eco-friendly make a good polymer matrix for obtaining biologically active fibers. Current investigations in this area show that the features of these fibers depend on the type of carrier as well as the drug structure. Loading drugs on the fiber carrier is accomplished by ionic bonding between ionized drugs and the groups fixed on the fiber (by ion exchange or loosely adsorption on the fiber through hydrophobic interactions. These interactions can be achieved between hydrophobic parts of the drug and the fiber carrier or among the hydrophobic drugs bonded on the fiber. Prevailing mechanism of ionized drug bonding on the carrier is ionic, although different hydrophobic interactions can contribute the drug loading to varying degrees. In this paper oxidized cellulose (OC with different carboxylic group content is obtained by selective oxidation and used for chemical bonding of antibiotic ceftazidime. In its structure this antibiotic has aminothiazole ring and pyridine ring in the side chains of cephem nucleus. Ceftazidime has two carboxylic groups and also great number of electron donors and acceptors. Due to these groups and structures ceftazidime is able to form multiple chemical bonds i. e. interactions with oxidized cellulosic bandage. The bonding was performed in antibiotic water solution concentration of c=3,4∙10-3 mol/L at room temperature (22 ± 1°C, while desorption was performed in physiological solution. The amounts of bonded and released antibiotic were determined spectrophotometrically in UV range. Maximum amount of bound drug (0,0243 mg/g was obtained during the sorption on the oxidized bandage with 2,276 mmol/g COOH and the maximum amount of released drug was 0,0238 mmol/g. Antimicrobial activity of the samples with bonded ceftazidime was tested

  16. Ceftazidime resistance inBurkholderia pseudomallei:First report from India

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    Bijayini Behera; TLVD Prasad Babu; A Kamalesh; Gangadhar Reddy

    2012-01-01

    ABSTRACT Melioidosis, a disease of public health importance in Southeast Asia and Northern Australia, of late has shown an increasing trend in India, particularly Southern India. We describe a case of a39-year-old diabetic patient with left elbow septic arthritis, multiple liver, splenic abscesses, pneumonia, pleural effusion, followed by sepsis syndrome. Blood cultures and culture of the joint aspirate yielded pure growth ofBurkholderia pseudomallei (B. pesudomallei), sensitive to carbapenem, co-trimoxazole and resistant to ceftazidime. The patient was successfully treated with imipenem- cilastin.He was discharged on co-trimoxazole to complete the24 weeks course and follow-up has continued to date. The patient continues to remain asymptomatic. The case re-emphasizes the need to monitor the trend ofB. pseudomallei in India, particularly the development of ceftazidime resistance, which incidentally is the drug of choice.

  17. Activity of ceftazidime/avibactam against isogenic strains of Escherichia coli containing KPC and SHV β-lactamases with single amino acid substitutions in the Ω-loop

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    Winkler, Marisa L.; Papp-Wallace, Krisztina M.; Bonomo, Robert A.

    2015-01-01

    Objectives The objective of this study was to explore the activity of ceftazidime and ceftazidime/avibactam against a collection of isogenic strains of Escherichia coli DH10B possessing SHV and KPC β-lactamases containing single amino acid substitutions in the Ω-loop (residues 164–179). Methods Ceftazidime and ceftazidime/avibactam MICs were determined by the agar dilution method for a panel of isogenic E. coli strains expressing SHV-1 and KPC-2 with amino acid substitutions at positions 164, 167, 169 or 179. Two KPC-2 β-lactamase variants that possessed elevated MICs of ceftazidime/avibactam were selected for further biochemical analyses. Results Avibactam restored susceptibility to ceftazidime for all Ω-loop variants of SHV-1 with MICs 8 mg/L. β-Lactamase kinetics showed that the Asp179Asn variant of KPC-2 demonstrated enhanced kinetic properties against ceftazidime. The Ki app, k2/K and koff of the Arg164Ala and Asp179Asn variant KPC-2 β-lactamases indicated that avibactam effectively inhibited these enzymes. Conclusions Several KPC-2 variants demonstrating ceftazidime resistance as a result of single amino acid substitutions in the Ω-loop were not susceptible to ceftazidime/avibactam (MICs >8 mg/L). We hypothesize that this observation is due to the stabilizing interactions (e.g. hydrogen bonds) of ceftazidime within the active site of variant β-lactamases that prevent avibactam from binding to and inhibiting the β-lactamase. As ceftazidime/avibactam is introduced into the clinic, monitoring for new KPC-2 variants that may exhibit increased ceftazidime kinetics as well as resistance to this novel antibiotic combination will be important. PMID:25957381

  18. Comparison of the in vitro and in vivo susceptibilities of Burkholderia mallei to Ceftazidime and Levofloxacin

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    Torres Alfredo G

    2009-05-01

    Full Text Available Abstract Background Burkholderia mallei is a zoonotic Gram negative bacterium which primarily infects solipeds but can cause lethal disease in humans if left untreated. The effect of two antibiotics with different modes of action on Burkholderia mallei strain ATCC23344 was investigated by using in vitro and in vivo studies. Results Determination of minimal inhibitory concentrations (MICs in vitro was done by the agar diffusion method and the dilution method. The MICs of levofloxacin and ceftazidime were in the similar range, 2.5 and 5.0 μg/ml, respectively. Intracellular susceptibility of the bacterium to these two antibiotics in J774A.1 mouse macrophages in vitro was also investigated. Macrophages treated with antibiotics demonstrated uptake of the drugs and reduced bacterial loads in vitro. The efficacy of ceftazidime and levofloxacin were studied in BALB/c mice as post-exposure treatment following intranasal B. mallei infection. Intranasal infection with 5 × 105 CFUs of B. mallei resulted in 90% death in non-treated control mice. Antibiotic treatments 10 days post-infection proved to be effective in vivo with all antibiotic treated mice surviving to day 34 post-infection. The antibiotics did not result in complete clearance of the bacterial infection and presence of the bacteria was found in lungs and spleens of the survivors, although bacterial burden recovered from levofloxacin treated animals appeared reduced compared to ceftazidime. Conclusion Both antibiotics demonstrated utility for the treatment of glanders, including the ability for intracellular penetration and clearance of organisms in vitro.

  19. Hydrolysis of cefazolin by enzymes produced by Pseudomonas aeruginosa after exposure to ceftazidime in vitro

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    Papaioannidou Paraskevi

    2009-01-01

    Full Text Available Background/Aim. Sometimes resistance of Pseudomonas aeruginosa (Ps. aeruginosa is developed during antibiotic treatment, in spite of the initial susceptibility in vitro. The aim of this study was to use an in vitro model for the study of the development of resistant strains of Ps. aeruginosa after a short exposure to ceftazidime, and to study the hydrolysing capacity of β-lactamases produced by the resistant strains. Methods. Among 563 clinical strains of Ps. aeruginosa, 37 multisensitive strains were collected for the study. After being identified, strains with simultaneous sensitivity to 5 expanded spectrum cephalosporins were chosen. For each strain, the minimal inhibitory concentration (MIC of the 5 expanded spectrum cephalosporins was determined, and the production of extended spectrum β-lactamases (ESBL was excluded by the double-disc synergy diffusion test. Strains non producing ESBL were cultivated in concentrations of ceftazidime equal to MIC×2 and MIC×4. After 24 hours of culture, the development of resistant strains was estimated and the cephalosporinase activity of the produced β-lactamases was determined by their ability to hydrolyse cefazolin. Hydrolysis of cefazolin was studied by measuring the change of its absorbance on 272 nm using a Shimadzu 160A spectrophotometer. The hydrolyzing capacity of the enzymes was expressed as the percentage of the antibiotic, which was hydrolysed in 10 sec. Results. A total of 60% and 50% of strains developed resistant strains after exposure to ceftazidime in concentration MIC×2 and MIC×4, respectively. The hydrolyzing capacity of the original strains was 15-36% while the hydrolyzing capacity of the resistant strains was 10-73%. Totally 64% of the resistant strains expressed higher hydrolyzing capacity than the original strains. Conclusion. Regardless of the susceptibility test results, Ps. aeruginosa presented a high tendency to develop resistant strains after a short exposure to

  20. Amoxicillin and clavulanic acid vs ceftazidime in the surgical extraction of impacted third molar: a comparative study.

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    Sisalli, U; Lalli, C; Cerone, L; Maida, S; Manzoli, L; Serra, E; Dolci, M

    2012-01-01

    The objective of this work is to compare the effectiveness and the side effects of two different drugs, amoxicillin and clavulanic acid vs ceftazidime, used as antibiotic prophylaxis in the surgical extraction of third molars and to demonstrate that the use of second choice antibiotic has no significant advantages in comparison with a first choice antibiotic. One hundred and seven patients with impacted third molar were selected and divided into two groups: amoxicillin and clavulanic acid were administered to group 1 and ceftazidime to group 2 for five days after surgery and we observed the postoperative period. The statistical analysis showed no differences between the two groups which lead to the conclusion that there is no indication to routinely administrate intramuscular second-choice antibiotic prophylatic therapy (ceftazidime) in case of surgical extraction of the third molar.

  1. How to minimize toxic exposure to pyridine during continuous infusion of ceftazidime in patients with cystic fibrosis?

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    Bourget, P; Amin, A; Dupont, C; Abely, M; Desmazes-Dufeu, N; Dubus, J C; Jouani, B-L; Merlette, C; Nové-Josserand, R; Pages, J; Panzo, R; Vidal, F; Voge, F; Hubert, D

    2014-05-01

    Ceftazidime is particularly efficient against Pseudomonas aeruginosa in cystic fibrosis patients. Thus, the spontaneous production of pyridine, which is a toxic product, raises some concern. Our aim was to examine the kinetics of degradation of ceftazidime in portable infusion pumps either at 4°C, 22°C, or 33°C and to propose some recommendations in order to reduce the pyridine exposure. Two administration models were studied in vitro. In model 1, we administered 12 g of ceftazidime infused over 23 h (once-daily infusion) compared to 6 g infused over 11.5 h in model 2 (twice-daily regimen). Samples were collected at 0 h and then every 4 and 2 h after the shaping of portable infusion pumps in models 1 and 2, respectively. Both ceftazidime and pyridine were analyzed using an ultraviolet high-performance liquid chromatograph. Production of pyridine is highly depending on the temperature. The in situ production of pyridine per day of treatment decreases at a ratio close to 1/6 and 1/3 between 33°C and 4°C in models 1 and 2, respectively. Regardless of the conditions, the production of pyridine is significantly lower in model 2, whereas the total delivery amount of ceftazidime is significantly higher at 4°C and 33°C compared to that in model 1. According to a the precautionary principle, these findings lead to three major recommendations: (i) exposing a solution of ceftazidime to over 22°C should be strictly avoided, (ii) a divided dose of 6 g over 11.5 h instead of a once-daily administration is preferred, and (iii) infusion should be administered immediately after reconstitution.

  2. Antimicrobial Resistance to Ceftazidime and Ceftriaxone, and Detection of TEM Gene in Esherchia Coli

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    Jahani, S. (MSc

    2014-11-01

    Full Text Available Background and Objective: In the past, most strains of E. coli were susceptible to a wide range of antimicrobial agents, but this situation is now changed by indiscriminate use of antibiotics. Ceftriaxone and Ceftazidime are the most current antibiotics used for Enterobacteriaceae infections in hospitals. The aim of this study was to determine antimicrobial resistance of Escherichia coli strains isolated from patients. Material and Methods: During a 12-month period, 200 clinical samples taken from patients referred to Zahedan hospitals were assessed to isolate Escherichia coli. Antibiotic susceptibility was determined by disk diffusion method and micro-broth dilution; and Bla TEM resistance genes were detected by PCR. Results: Following phenotype verification testing, 112 isolates (56% were produced Extended Spectrum Beta Lactamase (ESBLs and 130 isolates were potential producers of beta-lactamase (ESBL. Using PCR, 72 isolates (38.55% have TEM gene. Conclusion: The rate of antibiotic resistance of Escherichia coli isolates to ceftriaxone and ceftazidime is high; therefore, it seems reasonable to do antibiogram before treatment.

  3. The prophylactic effect of ceftazidime on early bacterial infection after autologous peripheral blood stem cell transplantation: a prospective randomized controlled trial

    Institute of Scientific and Technical Information of China (English)

    段明辉

    2013-01-01

    Objective To evaluate the efficacy and safety of prophylactic ceftazidime on early bacterial infection in APBSCT recipients during neutropenia.Methods APBSCT recipients were prospectively randomly assigned to intravenous ceftazidime treatment group and control group (no prophylaxis of antibiotics) .The treatment started from the first day until resolution of neutropenia or the

  4. Ceftazidime/Avibactam and Ceftolozane/Tazobactam: Second-generation β-Lactam/β-Lactamase Inhibitor Combinations.

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    van Duin, David; Bonomo, Robert A

    2016-07-15

    Ceftolozane/tazobactam and ceftazidime/avibactam are 2 novel β-lactam/β-lactamase combination antibiotics. The antimicrobial spectrum of activity of these antibiotics includes multidrug-resistant (MDR) gram-negative bacteria (GNB), including Pseudomonas aeruginosa. Ceftazidime/avibactam is also active against carbapenem-resistant Enterobacteriaceae that produce Klebsiella pneumoniae carbapenemases. However, avibactam does not inactivate metallo-β-lactamases such as New Delhi metallo-β-lactamases. Both ceftolozane/tazobactam and ceftazidime/avibactam are only available as intravenous formulations and are dosed 3 times daily in patients with normal renal function. Clinical trials showed noninferiority to comparators of both agents when used in the treatment of complicated urinary tract infections and complicated intra-abdominal infections (when used with metronidazole). Results from pneumonia studies have not yet been reported. In summary, ceftolozane/tazobactam and ceftazidime/avibactam are 2 new second-generation cephalosporin/β-lactamase inhibitor combinations. After appropriate trials are conducted, they may prove useful in the treatment of MDR GNB infections. Antimicrobial stewardship will be essential to preserve the activity of these agents.

  5. Pharmacokinetics of Ceftazidime-Avibactam in Two Patients With KPC-Producing Klebsiella pneumoniae Bacteremia and Renal Impairment.

    Science.gov (United States)

    Veillette, John J; Truong, James; Forland, Steven C

    2016-11-01

    Limited data exist regarding optimal dosing of ceftazidime/avibactam (C/A) in patients with unique physiology, who were excluded from published clinical trials. Data are also lacking regarding clinical efficacy of C/A in patients with infections due to multidrug-resistant gram-negative pathogens. To expand knowledge in these areas, we present pharmacokinetic data from two patients with Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae bloodstream infections, both of whom had renal impairment, and one of whom was morbidly obese. C/A was initiated in both patients at higher doses than those recommended in the package insert. To assess adequacy of dosing at steady state, a trough was drawn before and consecutive levels were drawn after a C/A dose such that half-life and volume of distribution for ceftazidime and avibactam could be calculated using the Sawchuk-Zaske method. Both patients cleared their bloodstream infection without evidence of toxicity. Patient 1 and patient 2 had prolonged half-lives for ceftazidime (22.8 and 14.5 hours, respectively) and avibactam (19.6 and 11.3 hours, respectively). Both patients had volumes of distribution significantly larger than those listed in the package insert: ceftazidime 47.1 L and 24.7 L and avibactam 50.3 L and 38.7 L for patients 1 and 2, respectively. Considering the larger volumes of distribution and levels observed in our patients, recommended doses and intervals may not be sufficient for obese patients with renal failure, especially for those infected with KPC-producing organisms. Additional efficacy and pharmacokinetic data are still needed for this agent to define optimal dosing strategies in patients commonly encountered in clinical practice.

  6. Comparable effects of low-intensity electromagnetic irradiation at the frequency of 51.8 and 53 GHz and antibiotic ceftazidime on Lactobacillus acidophilus growth and survival.

    Science.gov (United States)

    Soghomonyan, Diana; Trchounian, Armen

    2013-01-01

    The effects of low-intensity electromagnetic irradiation (EMI) with the frequencies of 51.8 and 53 GHz on Lactobacillus acidophilus growth and survival were revealed. These effects were compared with antibacterial effects of antibiotic ceftazidime. Decrease in bacterial growth rate by EMI was comparable with the inhibitory effect of ceftazidime (minimal inhibitory concentration-16 μM) and no enhanced action was observed with combined effects of EMI and the antibiotic. However, EMI-enhanced antibiotic inhibitory effect on bacterial survival. The kinetics of the bacterial suspension oxidation-reduction potential up to 24 h of the growth was changed by EMI and ceftazidime. The changes were more strongly expressed by combined effects of EMI and antibiotic especially up to 12 h. Moreover, EMI did not change overall energy (glucose)-dependent H(+) efflux across the membrane but it increased N,N'-dicyclohexylcarbodiimide (DCCD)-inhibited H(+) efflux. In contrast, this EMI in combination with ceftazidime decreased DCCD-sensitive H(+) efflux. Low-intensity EMI had inhibitory effect on L. acidophilus bacterial growth and survival. The effect on bacterial survival was more significant in the combination with ceftazidime. The H(+)-translocating F 0 F 1-ATPase, for which DCCD is specific inhibitor, might be a target for EMI and ceftazidime. The revealed bactericide effects on L. acidophilus can be applied in biotechnology, food producing and safety technology.

  7. Adsorption of low concentration ceftazidime from aqueous solutions using impregnated activated carbon promoted by Iron, Copper and Aluminum

    Science.gov (United States)

    Hu, Xiang; Zhang, Hua; Sun, Zhirong

    2017-01-01

    In this paper, three impregnated activated carbon IAC (AC-Cu, AC-Fe, and AC-Al) promoted by Iron, Copper and Aluminum were used for adsorption of ceftazidime. Iron(III), Copper(II) and Aluminum(III) nitrate were used as an impregnant. The IACs were characterized by scanning electron microscope (SEM), Brunauer-Emmett-Teller (BET) surface area analyzer, Fourier transform infrared spectroscopy (FTIR) and X-ray Photoelectron Spectroscopy (XPS).The influence of factors, such as ion strength, pH, temperature, initial concentration, and concentration of natural organic matter organic matter on the adsorption process were studied. The adsorption kinetics and isotherms of ceftazidime were studied for the three IACs. The results showed that the adsorption was accurately represented by pseudo-second order model. Under different temperature, the maximum adsorption quantity of ceftazidime on AC-Cu calculated by pseudo-second order kinetic model were 200.0 mg g-1 (298 K), 196.1 mg g-1 (303 K) and 185.2 mg g-1 (308 K). It was much higher than that of AC-Fe and AC-Al. And the process was controlled by both film diffusion and intra particle mass transport. The results also showed that, the Freundlich and Temkin isotherm fit the adsorption well.

  8. [A clinical study on the efficacy of ceftazidime and aspoxicillin in chorioamnionitis. Abdominal Infections Research Group].

    Science.gov (United States)

    Chimura, T; Hirayama, T; Oda, T; Saito, N; Sato, S; Numazaki, M

    1994-09-01

    Chorioamnionitis as a complication of threatened abortion and preterm labor and preterm PROM were treated with ceftazidime (CAZ) and aspoxicillin (ASPC) as a primary therapy. The following results were obtained. 1. Cases of threatened abortion and preterm labor (n = 25) and preterm PROM (n = 5) were treated with 2-4 g CAZ/day alone (n = 14) or in combination with 4 g ASPC/day (n = 16) along with a uterine contraction inhibitor (ritodrine hydrochloride etc. n = 28) and clinical evaluation was made. 2. In the cases of threatened abortion and preterm labor the efficacy ratio was 24/25 (96%). In the cases of preterm PROM, the latent period-delaying effect was observed in five out of the five patients. Upon analysis of the tocolysis index in the group of threatened abortion and preterm labor, the index values > or = 5 were observed in 12 out of 25 (60%), and the delivery incidence before the 35th week of gestation was 4/25 (16%). In all patients, the incidence of delivery after the 36th week of gestation was 24/30 (80%). 3. Bacteriological examinations showed a high detection rate for Gram-positive bacteria, and the combination effect between ASPC and CAZ was demonstrated against all 9 isolates examined. The above results indicated a high efficacy as well as safety of the combination of CAZ and ASPC as a primary therapeutic means against chorioamnionitis.

  9. In vitro activity of ceftazidime/avibactam against Gram-negative pathogens isolated from pneumonia in hospitalised patients, including ventilated patients.

    Science.gov (United States)

    Flamm, Robert K; Nichols, Wright W; Sader, Helio S; Farrell, David J; Jones, Ronald N

    2016-03-01

    The activities of the novel β-lactam/non-β-lactam β-lactamase inhibitor combination ceftazidime/avibactam and comparators were evaluated against isolates from pneumonia in hospitalised patients including ventilated patients (PHP, pneumonia not designated as VABP; VABP, pneumonia in ventilated patients). Isolates were from the European-Mediterranean region (EuM), China and the USA collected in the SENTRY Antimicrobial Surveillance Program between 2009 and 2011 inclusive. A total of 2393 organisms from PHP were from the EuM, 888 from China and 3213 from the USA; from VABP patients there were 918, 97 and 692 organisms collected, respectively. Among Enterobacteriaceae from PHP, ceftazidime/avibactam MIC90 values against Escherichia coli ranged from 0.25-0.5mg/L and Klebsiella spp. MIC90 values were 0.5mg/L in each region. Among VABP isolates, MIC90 values for ceftazidime/avibactam against E. coli were 0.25mg/L; for Klebsiella spp. from VABP patients, MIC90 values were similar to those obtained against PHP isolates. The MIC of ceftazidime/avibactam was ≤8mg/L against 92-96% of Pseudomonas aeruginosa isolated from PHP patients. Isolates of P. aeruginosa from VABP patients were of lower susceptibility to all antibacterial agents (e.g. depending on region, meropenem susceptibilities were 51.2-69.4% in contrast to 68.3-76.7% among PHP patients). However, ceftazidime/avibactam inhibited 79.2-95.4% of VABP isolates at an MIC of ≤8mg/L. Acinetobacter spp. were resistant to many agents and only rates of susceptibility to colistin were >90% across all regions both for PHP and VABP isolates. Ceftazidime/avibactam was generally active against a high proportion of isolates resistant to ceftazidime from PHP and VAPB patients.

  10. Structures of ceftazidime and its transition-state analogue in complex with AmpC beta-lactamase: Implications for resistance mutations and inhibitor design

    Energy Technology Data Exchange (ETDEWEB)

    Powers, R.A.; Caselli, E.; Focia, P.J.; Prati, F.; Shoichet, B.K.

    2010-03-08

    Third-generation cephalosporins are widely used {beta}-lactam antibiotics that resist hydrolysis by {beta}-lactamases. Recently, mutant {beta}-lactamases that rapidly inactivate these drugs have emerged. To investigate why third-generation cephalosporins are relatively stable to wild-type class C {beta}-lactamases and how mutant enzymes might overcome this, the structures of the class C {beta}-lactamase AmpC in complex with the third-generation cephalosporin ceftazidime and with a transition-state analogue of ceftazidime were determined by X-ray crystallography to 2.0 and 2.3 {angstrom} resolution, respectively. Comparison of the acyl-enzyme structures of ceftazidime and loracarbef, a {beta}-lactam substrate, reveals that the conformation of ceftazidime in the active site differs from that of substrates. Comparison of the structures of the acyl-enzyme intermediate and the transition-state analogue suggests that ceftazidime blocks formation of the tetrahedral transition state, explaining why it is an inhibitor of AmpC. Ceftazidime cannot adopt a conformation competent for catalysis due to steric clashes that would occur with conserved residues Val211 and Tyr221. The X-ray crystal structure of the mutant {beta}-lactamase GC1, which has improved activity against third-generation cephalosporins, suggests that a tandem tripeptide insertion in the {Omega} loop, which contains Val211, has caused a shift of this residue and also of Tyr221 that would allow ceftazidime and other third-generation cephalosporins to adopt a more catalytically competent conformation. These structural differences may explain the extended spectrum activity of GC1 against this class of cephalosporins. In addition, the complexed structure of the transition-state analogue inhibitor (K{sub i} 20 nM) with AmpC reveals potential opportunities for further inhibitor design.

  11. Characterization of ceftazidime resistance mechanisms in clinical isolates of Burkholderia pseudomallei from Australia.

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    Derek S Sarovich

    Full Text Available Burkholderia pseudomallei is a gram-negative bacterium that causes the serious human disease, melioidosis. There is no vaccine against melioidosis and it can be fatal if not treated with a specific antibiotic regimen, which typically includes the third-generation cephalosporin, ceftazidime (CAZ. There have been several resistance mechanisms described for B. pseudomallei, of which the best described are amino acid changes that alter substrate specificity in the highly conserved class A β-lactamase, PenA. In the current study, we sequenced penA from isolates sequentially derived from two melioidosis patients with wild-type (1.5 µg/mL and, subsequently, resistant (16 or ≥256 µg/mL CAZ phenotypes. We identified two single-nucleotide polymorphisms (SNPs that directly increased CAZ hydrolysis. One SNP caused an amino acid substitution (C69Y near the active site of PenA, whereas a second novel SNP was found within the penA promoter region. In both instances, the CAZ resistance phenotype corresponded directly with the SNP genotype. Interestingly, these SNPs appeared after infection and under selection from CAZ chemotherapy. Through heterologous cloning and expression, and subsequent allelic exchange in the native bacterium, we confirmed the role of penA in generating both low-level and high-level CAZ resistance in these clinical isolates. Similar to previous studies, the amino acid substitution altered substrate specificity to other β-lactams, suggesting a potential fitness cost associated with this mutation, a finding that could be exploited to improve therapeutic outcomes in patients harboring CAZ resistant B. pseudomallei. Our study is the first to functionally characterize CAZ resistance in clinical isolates of B. pseudomallei and to provide proven and clinically relevant signatures for monitoring the development of antibiotic resistance in this important pathogen.

  12. Cytotoxicity towards human endothelial cells, induced by neutrophil myeloperoxidase: protection by ceftazidime

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    M. Mathy-Hartert

    1995-01-01

    Full Text Available We investigated the effects of the antibiotic ceftazidime (CAZ on the cytolytic action of the neutrophil myeloperoxidase–hydrogen peroxide–chloride anion system (MPO/H2O2/Cl−. In this system, myeloperoxidase catalyses the conversion of H2O2 and CI− to the cytotoxic agent HOCl. Stimulated neutrophils can release MPO into the extracellular environment and then may cause tissue injury through direct endothelial cells lysis. We showed that human umbilical vein endothelial cells (HUVEC were capable of taking up active MPO. In presence of H2O2 (10−4 M, this uptake was accompanied by cell lysis. The cytolysis was estimated by the release of 51Cr from HUVEC and expressed as an index of cytotoxicity (IC. Dose dependent protection was obtained for CAZ concentrations ranging from 10−5 to 10−3 M;this can be attributed to inactivation of HOCl by the drug. This protection is comparable to that obtained with methionine and histidine, both of which are known to neutralize HOCl. This protection by CAZ could also be attributed to inactivation of H2O2, but when cytolysis was achieved with H2O2 or O2− generating enzymatic systems, no protection by CAZ was observed. Moreover, the peroxidation activity of MPO (action on H2O2 was not affected by CAZ, while CAZ prevented the chlorination activity of MPO (chlorination of monochlorodimedon. So, we concluded that CAZ acts via HOCl inactivation. These antioxidant properties of CAZ may be clinically useful in pathological situations where excessive activation of neutrophils occurs, such as in sepsis.

  13. [Clinical and pharmacokinetic evaluation of ceftazidime in neonates and young infants].

    Science.gov (United States)

    Fujita, K; Murono, K; Sakata, H; Kakehashi, H; Oka, T; Kaeriyama, M; Yoshioka, H; Maruyama, S; Sanae, N; Inyaku, F

    1986-08-01

    Seventeen newborn and young infants including 6 premature infants were treated with ceftazidime (CAZ) and the clinical efficacy and side effects were evaluated. Ages of the patients ranged from zero to 55 days, and their body weights ranged from 1.35 to 3.87 kg. Doses of CAZ ranged 10-50 mg/kg every 6 to 12 hours for 3 to 14 days. Twelve infants with infections including meningitis, sepsis, pneumonia and urinary tract infections, were considered to have responded to the CAZ treatment. Among them, results were excellent in 2, good in 9 and fair in 1 patient. The drug was well tolerated, but 1 had diarrhea and 3 patients had eosinophilia among the 17 patients. The pharmacokinetics of CAZ was studied in 22 patients including 11 premature infants. Their ages ranged from 1 to 60 days, and body weights ranged from 0.85 to 3.96 kg. Serum concentrations in 7 patients ranged from 24.2-38.5 micrograms/ml at 30 minutes after single doses of 10 mg/kg intravenous bolus injections and 4.36-12.4 micrograms/ml at 6 hours. Mean elimination half-lives of the drug were 3.20 hours in 2 patients under 7 days of age and 2.31 hours in 5 patients from 7 days of age or older. In 8 patients, serum concentrations ranged 32.6-57.9 micrograms/ml at 30 minutes and 8.10-20.7 micrograms/ml at 6 hours after single doses of 20 mg/kg. Elimination half-lives were 3.53 hours in 4 patients under 7 days of age and 2.79 hours in 4 patients from 7 days of age or older.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Cefazolin-Gentamicin versus Vancomycin-Ceftazidime Eye Drops for Bacterial Corneal Ulcers; a Randomized Clinical Trial

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    Ali-Reza Dehghani

    2009-01-01

    Full Text Available

    PURPOSE: To compare the efficacy of topical cefazolin-gentamicin versus vancomycin-ceftazidime for treatment of bacterial corneal ulcers. METHODS: This randomized double-masked clinical trial was performed on consecutive patients with bacterial corneal ulcers referred to Feiz Hospital, Isfahan, Iran from 2004 to 2005. Patients were randomly assigned to cefazolin-gentamicin or vancomycin-ceftazidime eye drops in a masked fashion. Outcome measures included time for resolution of stromal infiltration, re-epithelization of the epithelial defect, and clearance of anterior chamber inflammation as well as culture results and complications. RESULTS: The study included 89 eyes of 89 patients with bacterial corneal ulcers consisting of 57 (64% male and 32 (36% female subjects. Specimens were culture-negative in 46% of cases. Forty-one eyes received cefazolin-gentamicin and 48 eyes were treated with vancomycin-ceftazidime. Time for resolution of stromal infiltration was 17.7±4.3 days versus 13.8±3.6 days (P=0.04, time to complete re-epithelization was 13.2±3.1 days versus 9.6±2.7 days (P=0.01 and time for clearing of the anterior chamber was 11.6±2.9 days versus 8.1±2.3 days (P

  15. Persistent Bacteremia from Pseudomonas aeruginosa with In Vitro Resistance to the Novel Antibiotics Ceftolozane-Tazobactam and Ceftazidime-Avibactam

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    Louie Mar Gangcuangco

    2016-01-01

    Full Text Available Ceftazidime-avibactam and ceftolozane-tazobactam are new antimicrobials with activity against multidrug-resistant Pseudomonas aeruginosa. We present the first case of persistent P. aeruginosa bacteremia with in vitro resistance to these novel antimicrobials. A 68-year-old man with newly diagnosed follicular lymphoma was admitted to the medical intensive care unit for sepsis and right lower extremity cellulitis. The patient was placed empirically on vancomycin and piperacillin-tazobactam. Blood cultures from Day 1 of hospitalization grew P. aeruginosa susceptible to piperacillin-tazobactam and cefepime identified using VITEK 2 (Biomerieux, Lenexa, KS. Repeat blood cultures from Day 5 grew P. aeruginosa resistant to all cephalosporins, as well as to meropenem by Day 10. Susceptibility testing performed by measuring minimum inhibitory concentration by E-test (Biomerieux, Lenexa, KS revealed that blood cultures from Day 10 were resistant to ceftazidime-avibactam and ceftolozane-tazobactam. The Verigene Blood Culture-Gram-Negative (BC-GN microarray-based assay (Nanosphere, Inc., Northbrook, IL was used to investigate underlying resistance mechanism in the P. aeruginosa isolate but CTX-M, KPC, NDM, VIM, IMP, and OXA gene were not detected. This case report highlights the well-documented phenomenon of antimicrobial resistance development in P. aeruginosa even during the course of appropriate antibiotic therapy. In the era of increasing multidrug-resistant organisms, routine susceptibility testing of P. aeruginosa to ceftazidime-avibactam and ceftolozane-tazobactam is warranted. Emerging resistance mechanisms to these novel antibiotics need to be further investigated.

  16. Valutazione in vitro dell’associazione di glicopeptidi, ceftazidime e azitromicina nei confronti di Pseudomonas aeruginosa

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    Barbara Repetto

    2005-12-01

    Full Text Available Objectives: Pseudomonas aeruginosa is an opportunistic human pathogen which is intrinsically resistant to many antibiotics and easily develops resistance towards many currently available agents. Intrisic resistance can be attributed to the low permeability of the P. aeruginosa outer membrane to a variety of antibiotics, including glycopeptides (GLYs. These drugs are active against Gram-positive bacteria and resistance is very rare, it appeared of some interest to evaluate the effect of combining these antimicrobial agents with antibiotics that might disorganize the structure of the outer membrane allowing the entry of glycopeptides into the Gram-negative cells. In order to verify this hypothesis, ceftazidime (CAZ has been tested in association with vancomycin (VAN or teicoplanin (TEI. The same experiments have been carried out also in the presence of azithromycin (AZI, which has been shown to interfere with some cellular synthesis in P. aeruginosa. Methods: A bacterial suspension of about 109CFU/ml was seeded on plates containing a fixed concentration of GLYs (500 mg/l and increasing doses (2x,4x,8x,16x of CAZ. Survivors were counted after 48 hs at 37°C. Results were interpreted as synergism (99%, additivity (90%, and indifference (10% of the CFU/ml reduction found in the drugs combination in comparison to the drug alone. The same experiments have been repeated adding AZI (16 mg/l and using GLYs at concentrations ranging from 500 to 300 mg/l. Results: CAZ in combination with GLYs reacted synergically in 20 out of 59 cases, additivity was found in 31/59 interactions and indifference was noted in 8/59 tests. Preliminary results (12 tests performed indicated that the addition of AZI increased the incidence of synergisms and additivities even when using GLYs concentration of 300 mg/l (figure I. Conclusions: CAZ combined with GLYs gave additive or synergistic results in the geat majority of experiments, while the simultaneous combination of AZI, CAZ

  17. Comparison of efficiency of intravitreal ceftazidime and intravitreal cefepime in the treatment of experimental Pseudomonas aeruginosa endophthalmitis

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    Nurettin Deniz

    2013-01-01

    Full Text Available In this study, we evaluated the efficiency of cefepime in the treatment of experimental Pseudomonas aeruginosa endophthalmitis. We compared the findings with the standard dose of ceftazidime (1 mg/0.1 ml. Thirty-six New-Zealand White rabbits were divided into 6 equal groups and were treated with different methods (Group 1 = sham, Group 2 = 0.5 mg/0.1 ml cefepime, Group 3 = 1 mg/0.1 ml cefepime, Group 4 = 2 mg/0.1 ml cefepime, Group 5 = 1 mg/0.1 ml ceftazidime, Group 6 = control. The eyes of rabbits in each group were examined clinically on 1 st , 3 rd , and 6 th day of the experiment. At 6 th day, 0.1 ml vitreous humor aspirates were obtained and plated for quantification on the blood agar and the results were expressed as colony-forming unit/ml. Subsequently, the eyeballs were enucleated and the histopathological evaluation was performed. Our findings denoted beneficial effects of cefepime in treatment groups (especially, in Groups 3 and 4. Intravitreal cefepime may be an alternative drug in the treatment of P. aeruginosa endophthalmitis.

  18. Expression of the MexXY-OprM efflux system in Pseudomonas aeruginosa with discordant cefepime/ceftazidime susceptibility profiles

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    Somvadee Laohavaleeson

    2008-11-01

    Full Text Available Somvadee Laohavaleeson1, Karen Lolans2,3, John P Quinn2,3,4, Joseph L Kuti1, David P Nicolau11Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, CT, USA; 2John Stroger Hospital, Chicago, IL, USA; 3Chicago Infectious Disease Research Institute, Chicago, IL, USA; 4Rush University Medical Center, Chicago, IL, USAAbstract: While MIC distributions and percent susceptibility for cefepime and ceftazidime are generally similar among Pseudomonas aeruginosa, we noted an increasing discordance in susceptibility favoring ceftazidime at our hospital. Quantitative reverse transcriptase-polymerase chain reaction was utilized to explore overexpression of the MexXY-OprM efflux as the mechanism for this phenotype profile. Thirteen of 15 (87% randomly selected isolates had mexY gene expression levels of 5.8–40.8-fold relative to the wild-type reference strain. While mexY overexpression was noted in the majority of isolates, other resistance mechanisms appear to contribute to the observed phenotypic profile of the Pseudomonas aeruginosa studied. Clinicians must understand not only the magnitude of difference in the MIC profiles between agents, but also the mechanism(s responsible for these observations if strategies (ie, pharmacodynamic dosing are to be designed to optimize patient care outcomes in the face of increasing resistance.Keywords: Pseudomonas aeruginosa, efflux, MexXY-OprM, mexY, cefepime, resistance

  19. Natural Variants of the KPC-2 Carbapenemase have Evolved Increased Catalytic Efficiency for Ceftazidime Hydrolysis at the Cost of Enzyme Stability.

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    Shrenik C Mehta

    2015-06-01

    Full Text Available The spread of β-lactamases that hydrolyze penicillins, cephalosporins and carbapenems among Gram-negative bacteria has limited options for treating bacterial infections. Initially, Klebsiella pneumoniae carbapenemase-2 (KPC-2 emerged as a widespread carbapenem hydrolyzing β-lactamase that also hydrolyzes penicillins and cephalosporins but not cephamycins and ceftazidime. In recent years, single and double amino acid substitution variants of KPC-2 have emerged among clinical isolates that show increased resistance to ceftazidime. Because it confers multi-drug resistance, KPC β-lactamase is a threat to public health. In this study, the evolution of KPC-2 function was determined in nine clinically isolated variants by examining the effects of the substitutions on enzyme kinetic parameters, protein stability and antibiotic resistance profile. The results indicate that the amino acid substitutions associated with KPC-2 natural variants lead to increased catalytic efficiency for ceftazidime hydrolysis and a consequent increase in ceftazidime resistance. Single substitutions lead to modest increases in catalytic activity while the double mutants exhibit significantly increased ceftazidime hydrolysis and resistance levels. The P104R, V240G and H274Y substitutions in single and double mutant combinations lead to the largest increases in ceftazidime hydrolysis and resistance. Molecular modeling suggests that the P104R and H274Y mutations could facilitate ceftazidime hydrolysis through increased hydrogen bonding interactions with the substrate while the V240G substitution may enhance backbone flexibility so that larger substrates might be accommodated in the active site. Additionally, we observed a strong correlation between gain of catalytic function for ceftazidime hydrolysis and loss of enzyme stability, which is in agreement with the 'stability-function tradeoff' phenomenon. The high Tm of KPC-2 (66.5°C provides an evolutionary advantage as

  20. Natural Variants of the KPC-2 Carbapenemase have Evolved Increased Catalytic Efficiency for Ceftazidime Hydrolysis at the Cost of Enzyme Stability

    Science.gov (United States)

    Mehta, Shrenik C.; Rice, Kacie; Palzkill, Timothy

    2015-01-01

    The spread of β-lactamases that hydrolyze penicillins, cephalosporins and carbapenems among Gram-negative bacteria has limited options for treating bacterial infections. Initially, Klebsiella pneumoniae carbapenemase-2 (KPC-2) emerged as a widespread carbapenem hydrolyzing β-lactamase that also hydrolyzes penicillins and cephalosporins but not cephamycins and ceftazidime. In recent years, single and double amino acid substitution variants of KPC-2 have emerged among clinical isolates that show increased resistance to ceftazidime. Because it confers multi-drug resistance, KPC β-lactamase is a threat to public health. In this study, the evolution of KPC-2 function was determined in nine clinically isolated variants by examining the effects of the substitutions on enzyme kinetic parameters, protein stability and antibiotic resistance profile. The results indicate that the amino acid substitutions associated with KPC-2 natural variants lead to increased catalytic efficiency for ceftazidime hydrolysis and a consequent increase in ceftazidime resistance. Single substitutions lead to modest increases in catalytic activity while the double mutants exhibit significantly increased ceftazidime hydrolysis and resistance levels. The P104R, V240G and H274Y substitutions in single and double mutant combinations lead to the largest increases in ceftazidime hydrolysis and resistance. Molecular modeling suggests that the P104R and H274Y mutations could facilitate ceftazidime hydrolysis through increased hydrogen bonding interactions with the substrate while the V240G substitution may enhance backbone flexibility so that larger substrates might be accommodated in the active site. Additionally, we observed a strong correlation between gain of catalytic function for ceftazidime hydrolysis and loss of enzyme stability, which is in agreement with the ‘stability-function tradeoff’ phenomenon. The high Tm of KPC-2 (66.5°C) provides an evolutionary advantage as compared to other

  1. In vitro selection of meropenem resistance among ceftazidime-avibactam resistant, meropenem susceptible Klebsiella pneumoniae isolates with variant KPC-3 carbapenemases.

    Science.gov (United States)

    Shields, Ryan K; Nguyen, M Hong; Press, Ellen G; Chen, Liang; Kreiswirth, Barry N; Clancy, Cornelius J

    2017-02-27

    Ceftazidime-avibactam resistance is mediated by blaKPC-3 mutations, which restore carbapenem susceptibility. We subjected blaKPC-3 mutant (n=5) and wild-type (n=2) K. pneumoniae isolates to serial meropenem passage. Meropenem MICs against all isolates increased. Ompk36 porin mutations evolved in 5 isolates, including those with wild-type blaKPC-3 In different passage lineages, blaKPC-3 mutations reverted to wild-type, were replaced by new mutations, or were retained. Carbapenem treatment of ceftazidime-avibactam resistant K. pneumoniae infections may select for carbapenem resistance.

  2. Mutations in blaKPC-3 that confer ceftazidime-avibactam resistance encode novel KPC-3 variants that function as extended-spectrum β-lactamases.

    Science.gov (United States)

    Haidar, Ghady; Clancy, Cornelius J; Shields, Ryan K; Hao, Binghua; Cheng, Shaoji; Nguyen, M Hong

    2017-02-21

    We identified four blaKPC-3 mutations in ceftazidime-avibactam resistant clinical Klebsiella pneumoniae isolates, corresponding to D179Y, T243M, D179Y/T243M, and EL165 KPC-3 variants. Using site-directed mutagenesis and transforming vectors into Escherichia coli, we conclusively demonstrated that mutant blaKPC-3 encoded enzymes that functioned as extended-spectrum β-lactamases; mutations directly conferred higher MICs of ceftazidime-avibactam MICs, and decreased MICs of carbapenems and other β-lactams. Impact was strongest for the D179Y mutant, highlighting the importance of the KPC Ω-loop.

  3. The therapeutic effect of tigecycline, unlike that of Ceftazidime, is not influenced by whether the Klebsiella pneumoniae strain produces extended-spectrum beta-lactamases in experimental pneumonia in rats

    NARCIS (Netherlands)

    Goessens, W.H.F.; Mouton, J.W.; Kate, M.T. Ten; Sorgel, F.; Kinzig, M.; Bakker-Woudenberg, I.A.

    2013-01-01

    The efficacies of tigecycline and ceftazidime against fatal pneumonia in rats caused by an extended-spectrum beta-lactamase (ESBL)-positive Klebsiella pneumoniae strain or its wild-type (WT) progenitor were compared. Ceftazidime at 12.5 or 50 mg/kg of body weight twice daily (b.i.d.) was effective (

  4. The therapeutic effect of tigecycline, unlike that of ceftazidime, is not influenced by whether the Klebsiella pneumoniae strain produces extended-spectrum β-lactamases in experimental pneumonia in rats

    NARCIS (Netherlands)

    W.H.F. Goessens (Wil); J.W. Mouton (Johan); M.T. ten Kate (Marian); F. Sorgel (Fritz); M. Kinzig (Martina); I.A.J.M. Bakker-Woudenberg (Irma)

    2013-01-01

    textabstractThe efficacies of tigecycline and ceftazidime against fatal pneumonia in rats caused by an extended-spectrum β-lactamase (ESBL)-positive Klebsiella pneumoniae strain or its wild-type (WT) progenitor were compared. Ceftazidime at 12.5 or 50 mg/kg of body weight twice daily (b.i.d.) was ef

  5. Preparation of guar gum scaffold film grafted with ethylenediamine and fish scale collagen, cross-linked with ceftazidime for wound healing application.

    Science.gov (United States)

    Jana, Piyali; Mitra, Tapas; Selvaraj, Thirupathi Kumara Raja; Gnanamani, A; Kundu, P P

    2016-11-20

    Present study describes the synthesis of carboxymethyl guar gum (CMGG) from the native guar gum (GG) and the prepared CMGG is grafted with ethylenediamine (EDA) to form aminated CMGG. Then, fish scale collagen and aminated CMGG are cross-linked by ceftazidime drug through non- covalent ionic interaction. The resultant cross-linked film is subjected to the analysis of (1)HNMR, ATR-FTIR, TGA, SEM and XRD. The TNBS results revealed that 45% of interaction between EDA and CMGG and 90-95% of Ceftazidime is released from aminated CMGG-Ceftazidime-Collagen (ACCC) film after 96h of incubation at physiological pH. In vitro cell line studies reveal the biocompatibility of the cross-linked film and the antimicrobial studies display the growth inhibition against Staphylococcus aureus and Pseudomonas aeruginosa organisms. Overall, the study indicates that the incorporation of Ceftazidime into collagen and aminated CMGG can improve the functional property of aminated CMGG as well as collagen, leading to its biomedical applications.

  6. Differential selection of single-step AmpC or efflux mutants of Pseudomonas aeruginosa by using cefepime, ceftazidime, or ceftobiprole.

    Science.gov (United States)

    Queenan, Anne Marie; Shang, Wenchi; Bush, Karen; Flamm, Robert K

    2010-10-01

    Single-step Pseudomonas aeruginosa mutants, selected with ceftobiprole, ceftazidime, or cefepime, were generated at frequencies of 10(-6) to ceftobiprole did not overexpress AmpC; 90% of these produced elevated levels of mexXY RNA, indicating that increased efflux, not AmpC derepression, is the predominant response to ceftobiprole during first-step mutations in P. aeruginosa.

  7. Rapid development in vitro and in vivo of resistance to ceftazidime in biofilm-growing Pseudomonas aeruginosa due to chromosomal beta-lactamase

    DEFF Research Database (Denmark)

    Bagge, N; Ciofu, O; Skovgaard, L T;

    2000-01-01

    The aim of this study was to examine the development of resistance of biofilm-growing P. aeruginosa during treatment with ceftazidime. Biofilms were established in vitro using a modified Robbins device (MRD) and in vivo in the rat model of chronic lung infection. Three P. aeruginosa strains...

  8. High rates of susceptibility to ceftazidime among globally prevalent CTX-M-producing Escherichia coli: potential clinical implications of the revised CLSI interpretive criteria.

    Science.gov (United States)

    Williamson, D A; Roberts, S A; Smith, M; Heffernan, H; Tiong, A; Pope, C; Freeman, J T

    2012-05-01

    The CTX-M family of extended-spectrum β-lactamases (ESBLs) is a significant global public health threat. The prevalence of specific bla (CTX-M) genes varies geographically, but bla (CTX-M-15) and bla (CTX-M-14) dominate in most countries. We applied the latest Clinical Laboratory Standards Institute (CLSI) interpretive criteria (M100-S20) to a diverse collection of ESBL-producing Escherichia coli strains obtained from clinical specimens in our laboratory. Whereas under previous CLSI recommendations all isolates in this strain collection would have been reported as ceftazidime-resistant, under the new recommendations, approximately 11% of CTX-M-15-producing E. coli and 93% of CTX-M-14-producing E. coli respectively tested as ceftazidime-susceptible. We also found that, whilst many CTX-M-14-producers had minimum inhibitory concentrations (MICs) less than the breakpoint of 4 mg/L, the MIC distribution for these strains was higher than that of wild-type E. coli, with one CTX-M-14-producing isolate having an MIC of >64 mg/L. Although the new CLSI recommendations imply that ceftazidime can be safely used to treat serious infections due to CTX-M-producing E. coli, clinical outcome data are lacking. Consequently, the widespread use of ceftazidime in this setting could have profound clinical implications.

  9. Development of acquired factor V inhibitor after treatment with ceftazidime: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Cui QY

    2015-04-01

    Full Text Available Qing-ya Cui,1 Hong-shi Shen,1 Tian-qin Wu,1 Hai-fei Chen,1 Zi-qiang Yu,2 Zhao-yue Wang2 1Department of Hematology, PLA 100th Hospital, 2Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China Abstract: We report the case of a 59-year-old Chinese man who showed an asymptomatic coagulation factor V deficiency pattern after second intravenous treatment with ceftazidime. Normal pooled plasma failed to correct the abnormalities in a mixing test, and the presence of factor V inhibitor was confirmed by the Bethesda method. The coagulopathy was not corrected by transfusion of fresh frozen plasma and prothrombin complex concentrate, but rather by treatment with prednisone and withdrawal of dubious drugs. The findings reported here should prompt clinicians to watch for drug-induced coagulation factor deficiency. Keywords: acquired factor V deficiency, coagulopathy, prednisone

  10. [In vitro inhibition of granulopoiesis by beta-lactam antibiotics. Comparison of piperacillin, mezlocillin, ceftriaxone and ceftazidime].

    Science.gov (United States)

    Marie, J P; Thevenin, D; Zittoun, R

    1986-12-20

    The mechanism of neutropenia induced by beta-lactam antibiotics was explored by studying the action of these drugs on granulopoiesis in vitro. Normal bone marrows were cultivated in the presence of increasing concentrations of piperacillin (10 marrows), mezlocillin, ceftriaxone and ceftazidime (5 marrows each) in order to find out whether these antibiotics exhibited toxicity to granulocyte-monocyte precursors. A dose-dependent inhibition of granulopoiesis was found in all cases. When the doses used were equivalent to maximum plasma concentrations in vivo, inhibition was minimal with piperacillin and mezlocillin and much more pronounced with the cephalosporins. This dose-dependent inhibition suggests that toxicity is involved in the mechanism of neutropenia induced by beta-lactam antibiotics.

  11. Mutational Events in Cefotaximase Extended-Spectrum β-Lactamases of the CTX-M-1 Cluster Involved in Ceftazidime Resistance ▿

    Science.gov (United States)

    Novais, Ângela; Cantón, Rafael; Coque, Teresa M.; Moya, Andrés; Baquero, Fernando; Galán, Juan Carlos

    2008-01-01

    CTX-M β-lactamases, which show a high cefotaxime hydrolytic activity, constitute the most prevalent extended-spectrum β-lactamase (ESBL) type found among clinical isolates. The recent explosive diversification of CTX-M enzymes seems to have taken place due to the appearance of more efficient enzymes which are capable of hydrolyzing both cefotaxime and ceftazidime, especially among the CTX-M-1 cluster. A combined strategy of in vitro stepwise evolution experiments using blaCTX-M-1, blaCTX-M-3, and blaCTX-M-10 genes and site-directed mutagenesis has been used to evaluate the role of ceftazidime and other β-lactam antibiotics in triggering the diversity found among enzymes belonging to this cluster. Two types of mutants, P167S and D240G, displaying high ceftazidime MICs but reduced resistance to cefotaxime and/or cefepime, respectively, were identified. Such an antagonistic pleiotropic effect was particularly evident with P167S/T mutations. The incompatibility between P167S and D240G changes was demonstrated, since double mutants reduced susceptibility to both ceftazidime and cefotaxime-cefepime; this may explain the absence of strains containing both mutations in the clinical environment. The role of A77V and N106S mutations, which are frequently associated with P167S/T and/or D240G, respectively, in natural strains, was investigated. The presence of A77V and N106S contributes to restore a high-level cefotaxime resistance phenotype, but only when associated with mutations P167S and D240G, respectively. However, A77V mutation increases resistance to both cefotaxime and ceftazidime when associated with CTX-M-10. This suggests that in this context this mutation might be considered a primary site involved in resistance to broad-spectrum cephalosporins. PMID:18443114

  12. Exposing a β-Lactamase "Twist": the Mechanistic Basis for the High Level of Ceftazidime Resistance in the C69F Variant of the Burkholderia pseudomallei PenI β-Lactamase.

    Science.gov (United States)

    Papp-Wallace, Krisztina M; Becka, Scott A; Taracila, Magdalena A; Winkler, Marisa L; Gatta, Julian A; Rholl, Drew A; Schweizer, Herbert P; Bonomo, Robert A

    2016-02-01

    Around the world, Burkholderia spp. are emerging as pathogens highly resistant to β-lactam antibiotics, especially ceftazidime. Clinical variants of Burkholderia pseudomallei possessing the class A β-lactamase PenI with substitutions at positions C69 and P167 are known to demonstrate ceftazidime resistance. However, the biochemical basis for ceftazidime resistance in class A β-lactamases in B. pseudomallei is largely undefined. Here, we performed site saturation mutagenesis of the C69 position and investigated the kinetic properties of the C69F variant of PenI from B. pseudomallei that results in a high level of ceftazidime resistance (2 to 64 mg/liter) when expressed in Escherichia coli. Surprisingly, quantitative immunoblotting showed that the steady-state protein levels of the C69F variant β-lactamase were ∼4-fold lower than those of wild-type PenI (0.76 fg of protein/cell versus 4.1 fg of protein/cell, respectively). However, growth in the presence of ceftazidime increases the relative amount of the C69F variant to greater than wild-type PenI levels. The C69F variant exhibits a branched kinetic mechanism for ceftazidime hydrolysis, suggesting there are two different conformations of the enzyme. When incubated with an anti-PenI antibody, one conformation of the C69F variant rapidly hydrolyzes ceftazidime and most likely contributes to the higher levels of ceftazidime resistance observed in cell-based assays. Molecular dynamics simulations suggest that the electrostatic characteristics of the oxyanion hole are altered in the C69F variant. When ceftazidime was positioned in the active site, the C69F variant is predicted to form a greater number of hydrogen-bonding interactions than PenI with ceftazidime. In conclusion, we propose "a new twist" for enhanced ceftazidime resistance mediated by the C69F variant of the PenI β-lactamase based on conformational changes in the C69F variant. Our findings explain the biochemical basis of ceftazidime resistance in B

  13. Antibodies against beta-lactamase can improve ceftazidime treatment of lung infection with beta-lactam-resistant Pseudomonas aeruginosa in a rat model of chronic lung infection

    DEFF Research Database (Denmark)

    Ciofu, Oana; Bagge, Niels; Høiby, Niels

    2002-01-01

    To test the hypothesis that antibodies against the chromosomal beta-lactamase of Pseudomonas aeruginosa (a beta ab) might act as beta-lactamase inhibitors in patients with cystic fibrosis and chronic lung infection with P. aeruginosa, we compared in a rat model of chronic lung infection...... the efficacy of treatment with ceftazidime in beta-lactamase-immunized (group I) and non-immunized (group II) rats. Chronic lung infection was established with alginate-embedded P. aeruginosa producing high amounts of beta-lactamase in 133 Lewis rats. Prior to infection, group I (66 rats) was immunized three...... times at 2-week intervals with purified beta-lactamase in incomplete Freund's adjuvant (IFA) and group II (67 rats) received IFA. Ceftazidime treatment was initiated after challenge and continued for 10 days, after which the rats were sacrificed and the lung bacteriology and pathology were analysed. Rat...

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

    Science.gov (United States)

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

    2015-02-01

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

  15. A propensity score-matched analysis of the impact of minimum inhibitory concentration on mortality in patients with Pseudomonas aeruginosa bacteremia treated with cefepime or ceftazidime.

    Science.gov (United States)

    Ratliff, Angharad R; Gentry, Chris A; Williams, Riley J

    2017-04-01

    The United States Clinical and Laboratory Standards Institute recently elected not to revise ceftazidime and cefepime Pseudomonas aeruginosa minimum inhibitory concentration (MIC) susceptibility breakpoints but rather recommended specific dosage regimens to correspond to breakpoints. This study's objective was to examine mortality of low and high MIC P. aeruginosa isolates in bacteremic patients treated with cefepime or ceftazidime. Data were gathered through a Veterans Health Administration national administrative database for veterans with P. aeruginosa blood cultures who received cefepime or ceftazidime. Seventy-four patients in the low MIC (≤2 μg/mL) group and 29 patients in the high (4-8 μg/mL) MIC group were included. Independent baseline variables associated with 30-day all-cause mortality were determined through multivariate analysis to calculate propensity scores and perform matching. All-cause 30-day mortality was not statistically significant between the 2 resultant propensity score-matched groups (17.2% mortality in the low MIC group versus 27.6% in the high MIC group; P=0.34). Data suggested that P. aeruginosa bacteremia episodes where the cephalosporin MIC = 8 μg/mL may have higher mortality, however this may be reflective of higher propensity scores. Our study suggests that it is reasonable to designate a cefepime or ceftazidime MIC ≤8 μg/mL as susceptible for P. aeruginosa bacteremia infections, but potential suboptimal outcomes in episodes for which the P. aeruginosa MIC is 8 μg/mL may need further investigation.

  16. Microbiological activity of ceftolozane/tazobactam, ceftazidime, meropenem, and piperacillin/tazobactam against Pseudomonas aeruginosa isolated from children with cystic fibrosis.

    Science.gov (United States)

    Kuti, Joseph L; Pettit, Rebecca S; Neu, Natalie; Cies, Jeffrey J; Lapin, Craig; Muhlebach, Marianne S; Novak, Kimberly J; Nguyen, Sean T; Saiman, Lisa; Nicolau, David P

    2015-09-01

    The activity of ceftolozane/tazobactam was tested against 50 nonduplicate Pseudomonas aeruginosa from 18 cystic fibrosis children collected in 2012-2014. These isolates were multidrug resistant with susceptibility to meropenem, ceftazidime, and piperacillin/tazobactam of 46%, 58%, and 50%, respectively. Ceftolozane/tazobactam was the most active with MIC50, MIC90, and percent susceptibility of 2mg/L, 8 mg/L, and 86%.

  17. Antimicrobial activity of ceftazidime-avibactam and comparator agents when tested against bacterial isolates causing infection in cancer patients (2013-2014).

    Science.gov (United States)

    Sader, Helio S; Castanheira, Mariana; Jones, Ronald N; Flamm, Robert K

    2017-03-01

    We evaluated the antimicrobial susceptibility of 623 Gram-negative organisms causing infection in patients with cancer in 52 United States hospitals (2013-2014) as part of the International Network for Optimal Resistance Monitoring (INFORM) program. Isolates were tested for susceptibility by broth microdilution method. β-lactamase encoding genes were evaluated for all Escherichia coli and Klebsiella spp. with an extended-spectrum β-lactamase (ESBL) phenotype by microarray-based assay. ESBL-phenotype was observed among 17.3 and 9.9% of E. coli and Klebsiella pneumoniae, respectively; and 25.0% of Enterobacter cloacae were ceftazidime-non-susceptible. All Enterobacteriaceae (n=486) were susceptible to ceftazidime-avibactam (MIC50/90, 0.12/0.25μg/mL) with the highest MIC value at 1μg/mL. Meropenem was active against Enterobacteriaceae overall (MIC50/90, ≤0.06/≤0.06μg/mL; 99.6% susceptible); but showed more limited activity against Klebsiella spp. with an ESBL-phenotype (84.6% susceptible) and multidrug-resistant Enterobacteriaceae (93.3% susceptible). The most active agents tested against Pseudomonas aeruginosa were colistin (100.0% susceptible), amikacin (97.7% susceptible) and ceftazidime-avibactam (96.6% susceptible).

  18. Ceftazidime/avibactam: a novel cephalosporin/nonbeta-lactam beta-lactamase inhibitor for the treatment of complicated urinary tract infections and complicated intra-abdominal infections

    Directory of Open Access Journals (Sweden)

    Hidalgo JA

    2016-07-01

    Full Text Available Jose A Hidalgo,1,2 Celeste M Vinluan,1–3 Nishaal Antony3 1UTEP/UT Austin Cooperative Pharmacy Program, College of Health Sciences, University of Texas at El Paso, El Paso, 2Department of Pharmacy, College of Pharmacy, The University of Texas at Austin, Austin, 3Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA Abstract: There has been greater interest in developing additional antimicrobial agents due to the increasing health care costs and resistance resulting from bacterial pathogens to currently available treatment options. Gram-negative organisms including Enterobacteriaceae and Pseudomonas aeruginosa are some of the most concerning threats due to their resistance mechanisms: extended-spectrum beta-lactamase production and Klebsiella pneumoniae carbapenemase enzymes. Ceftazidime is a third-generation broad-spectrum cephalosporin with activity against P. aeruginosa and avibactam is a novel nonbeta-lactam beta-lactamase inhibitor. Avycaz®, the trade name for this new combination antibiotic, restores the activity of ceftazidime against some of the previously resistant pathogens. Avycaz was approved in 2015 for the treatment of complicated urinary tract infections, including pyelonephritis, and complicated intra-abdominal infections with the addition of metronidazole in patients with little to no other treatment options. This review article assesses the clinical trials and data that led to the approval of this antibiotic, in addition to its spectrum of activity and limitations. Keywords: ceftazidime/avibactam, Avycaz, complicated urinary tract infections, complicated intra-abdominal infections

  19. Ceftolozane/tazobactam and ceftazidime/avibactam: two novel β-lactam/β-lactamase inhibitor combination agents for the treatment of resistant Gram-negative bacterial infections.

    Science.gov (United States)

    Liscio, Jordan L; Mahoney, Monica V; Hirsch, Elizabeth B

    2015-09-01

    The rise in resistant Gram-negative bacteria is a major concern and has led to difficulty in treating multidrug-resistant (MDR) infections. Two recently approved combination antibiotics, ceftolozane/tazobactam and ceftazidime/avibactam, may be effective in treating these resistant infections. Ceftolozane is a novel cephalosporin that has been developed in combination with tazobactam, a recognised β-lactamase inhibitor (BLI). Avibactam is a novel BLI combined with ceftazidime, a cephalosporin with an established history. Both of these β-lactam/BLI combination agents have been shown to retain in vitro activity against selected resistant Gram-negative pathogens, including Enterobacteriaceae and Pseudomonas aeruginosa; notably, ceftazidime/avibactam has demonstrated consistent activity against Klebsiella pneumoniae carbapenemase (KPC)-producing organisms. Both agents have been approved for the indications of complicated intra-abdominal infection (with metronidazole) and complicated urinary tract infection, and have ongoing phase 3 trials for the treatment of ventilator-associated and nosocomial pneumonia. This manuscript will review current data available regarding the spectrum of activity and clinical trials that led to the US Food and Drug Administration (FDA) approval of these agents. Both agents appear to be well tolerated and show promise in the treatment of MDR Gram-negative infections.

  20. Development and Validation of High Performance Liquid Chromatographic Method for the Simultaneous Determination of Ceftazidime and Sulbactam in Spiked Plasma and Combined Dosage form-Zydotam

    Directory of Open Access Journals (Sweden)

    Masoom R. Siddiqui

    2009-01-01

    Full Text Available Problem statement: To develop a sensitive method to determine simultaneously ceftizidime and sulbactam in spiked plasma and combined formulation. Approach: In this study an isocratic High performance liquid chromatographic method with UV detection at 230 nm was described for simultaneous determination of Ceftazidime and sulbactam sodium in plasma and combined dosage form. Chromatographic separation of two drugs was achieved on a Hypersil ODS C-18 column using a mobile phase consisting of a binary mixture of acetonitrile and tetrabutyl ammonium hydroxide adjusted to pH 5.0 with orthophosphoric acid in ratio 25:75. Results: The developed performance liquid chromatographic method offers symmetric peak shape, good resolution and reasonable retention time for both drugs. Linearity, accuracy and precision were found to be acceptable over the concentration range of 125-625 ppm for Ceftazidime and 62.5-312.5 ppm for sulbactam sodium. Conclusion: The results showed that this method could be well used for the simultaneous estimation of Ceftazidime and Sulbactam in plasma and combined formulation.

  1. Methicillin-resistant Staphylococcus epidermidis isolation from the vitrectomy specimen four hours after initial treatment with vancomycin and ceftazidime

    Directory of Open Access Journals (Sweden)

    Golnaz Javey

    2010-02-01

    Full Text Available Golnaz Javey1, Stephen G Schwartz2, Andrew A Moshfeghi2, Sanjay Asrani3, Harry W Flynn Jr21Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, TX, USA; 2Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA; 3Department of Ophthalmology, Duke University Medical Center, Durham, NC, USAAbstract: A patient presented with acute-onset, postoperative endophthalmitis and visual acuity of light perception. Because of a time delay in arranging a pars plana vitrectomy (PPV, the patient was treated with a prompt vitreous tap for culture an injection of vancomycin and ceftazidime. Four hours later, the PPV was performed and additional antibiotics were injected. The cultures from both the initial needle tap and the subsequent PPV isolated methicillin-resistant Staphylococcus epidermidis sensitive to vancomycin, but resistant to fourth-generation fluoroquinolones. The patient eventually recovered a visual acuity of 20/80 before developing retinal detachment. This case illustrates the time lag necessary to sterilize the vitreous cavity, and suggests a possible two-step staged treatment strategy for situations in which access to PPV equipment and support staff may be limited.Keywords: endophthalmitis, pars plana vitrectomy, tap and inject

  2. Use of the D-R model to define trends in the emergence of Ceftazidime-resistant Escherichia coli in China.

    Directory of Open Access Journals (Sweden)

    Fan Ding

    Full Text Available OBJECTIVE: To assess the efficacy of the D-R model for defining trends in the appearance of Ceftazidime-resistant Escherichia coli. METHODS: Actual data related to the manifestation of Ceftazidime-resistant E. coli spanning years 1996-2009 were collected from the China National Knowledge Internet. These data originated from 430 publications encompassing 1004 citations of resistance. The GM(1,1 and the novel D-R models were used to fit current data and from this, predict trends in the appearance of the drug-resistant phenotype. The results were evaluated by Relative Standard Error (RSE, Mean Absolute Deviation (MAD and Mean Absolute Error (MAE. RESULTS: Results from the D-R model showed a rapid increase in the appearance of Ceftazidime-resistant E. coli in this region of the world. These results were considered accurate based upon the minor values calculated for RSE, MAD and MAE, and were equivalent to or better than those generated by the GM(1,1 model. CONCLUSION: The D-R model which was originally created to define trends in the transmission of swine viral diseases can be adapted to evaluating trends in the appearance of Ceftazidime-resistant E. coli. Using only a limited amount of data to initiate the study, our predictions closely mirrored the changes in drug resistance rates which showed a steady increase through 2005, a decrease between 2005 and 2008, and a dramatic inflection point and abrupt increase beginning in 2008. This is consistent with a resistance profile where changes in drug intervention temporarily delayed the upward trend in the appearance of the resistant phenotype; however, resistance quickly resumed its upward momentum in 2008 and this change was better predicted using the D-R model. Additional work is needed to determine if this pattern of "increase-control-increase" is indicative of Ceftazidime-resistant E. coli or can be generally ascribed to bacteria acquiring resistance to drugs in the absence of alternative

  3. Determination of Ceftazidime for Injection by HPLC%高效液相色谱法测定注射用头孢他啶聚合物

    Institute of Scientific and Technical Information of China (English)

    刘映倩; 吴群; 罗立骏; 唐倩

    2015-01-01

    目的:建立高效液相色谱法测定注射用头孢他啶聚合物的含量。方法采用高效液相色谱法,色谱柱为TSK-GEL G2000SWXL 凝胶色谱柱,流动相为磷酸盐缓冲液(pH7.0)0.005 mol·L-1磷酸氢二钠溶液-0.005 mol·L-1磷酸二氢钠溶液(61:39),检测波长231 nm,柱温30℃,进样量20μL 。结果头孢他啶对照品检测线性范围为0.51~25.64μg·mL-1(r=0.999),注射用头孢他啶聚合物检测线性范围为0.20~3.92 mg·mL-1(r =0.99),聚合物定量限为0.71μg。结论该方法快速,分离度好,可用于注射用头孢他啶聚合物的检测。%Objective To establish an HPLC method for the determination of ceftazidime for injection. Methods HPLC column was TSK-GEL G2000SWXL gel column. Mobile phase of phosphate buffer ( pH 7. 0) was 0. 005 mol · L-1 disodium hydrogen phosphate solution-0. 005 mol · L-1 sodium dihydrogen phosphate solution ( 61 : 39 ). The detection wavelength was 231 nm; column temperature was 30 ℃ ; the injection volume was 20 μL. Results Ceftazidime reference linear range was 0. 51-25. 64 μg·mL-1(r=0. 999), ceftazidime for injection polymer linear range was 0. 20-3. 92 mg·mL-1 (r=0. 99), and the limit of quantification polymer was 0. 71 μg. Conclusion The method is rapid and the separation was good. It can be used for the detection of ceftazidime for injection.

  4. Utility of the ceftazidime-imipenem antagonism test (CIAT to detect and confirm the presence of inducible AmpC beta-lactamases among enterobacteriaceae

    Directory of Open Access Journals (Sweden)

    Vlademir Vicente Cantarelli

    2007-04-01

    Full Text Available Detection of AmpC beta-lactamase production by enterobacteria has been problematic. Contrary to ESBLs, no specific guidelines are available for detection and confirmation of AmpC production by clinical relevant microorganisms. Moreover, some bacterial species may produce inducible AmpC beta-lactamases that can be easily overlooked by routine susceptibility tests. We reported here a new test based on the strong inducible effect of imipenem on AmpC genes and the consequent antagonism with ceftazidime. This test is very simple and proved to be helpful in detecting AmpC-inducible enzymes among several species of clinical isolates.

  5. Post-hemodialysis dosing of 1 vs. 2 g of ceftazidime in anuric end-stage renal disease patients on low-flux dialysis and its pharmacodynamic implications on clinical use.

    Science.gov (United States)

    Goh, Jessica Hui Fen; Lee, Siok Ying; Ooi, Say Tat; Lee Soon-U, Lawrence; Hee, Kim-Hor; Renaud, Claude J

    2016-04-01

    Ceftazidime is a cost-effective antimicrobial against Gram-negative pathogens associated with sepsis in end-stage renal disease (ESRD) hemodialysis patients with potential for wider use with the advent of ceftazidime-avibactam. Dosing ceftazidime post-hemodialysis appears attractive and convenient, but limited in vivo data on pharmacodynamic efficacy (PE) attainment, defined as >70% of the interdialytic period drug concentrations exceed susceptible pathogens minimal inhibitory concentrations (MICs) (%TMIC), warrants further assessment. We therefore evaluated PE and tolerability of 1 against 2 g regime in anuric ESRD patients on low-flux hemodialysis. Two doses of 1 or 2 g ceftazidime were administered post-hemodialysis prior to 48- and 72-hour interdialytic intervals in ESRD inpatients without active infections. Peak and trough concentrations (mg/L) were assayed using a validated liquid chromatography-tandem mass spectrometry method. Proportion of patients achieving PE for known pathogens with MICs ≤ 8 mg/L and adverse effects were assessed. Six (43%) and eight (57%) adult patients received 1 and 2 g dose, respectively. Median (25th-75th percentile), peak, 48- and 72-hour trough ceftazidime concentrations were 78 (60-98) vs. 158 (128-196), 37 (23-37) vs. 49 (39-71), and 13 (12-20) vs. 26 (21-41) mg/L, respectively, resulting in 100% TMIC for both doses. One patient on the 1-g dose experienced mild pruritus. Reliable and safe PE attainment over both 48- and 72-hour interdialytic interval was achievable with 1 g of ceftazidime dosed post-hemodialysis. The 2 g dose was equally effective and well tolerated but may not be necessary. These findings need validation in non-anuric patients, high-flux hemodialysis, and during avibactam co-administration.

  6. Pd-Au nanoparticle decorated carbon nanotube as a sensing layer on the surface of glassy carbon electrode for electrochemical determination of ceftazidime.

    Science.gov (United States)

    Shahrokhian, Saeed; Salimian, Razieh; Rastgar, Shokoufeh

    2014-01-01

    A simple electrodeposition method is employed to construct a thin film modifier of palladium-gold nanoparticles (Pd-AuNPs) decorated multi-walled carbon nanotube (MWCNT) on the surface of glassy carbon electrode (GCE). Morphology and property of Pd-AuNPs-MWCNT have been examined by scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS). Electrochemical performance of Pd-AuNPs-MWCNT/GCE for detection of ceftazidime (CFZ) has been investigated by cyclic voltammetry (CV). This nanostructured film modified electrode effectively exhibited enhanced properties for detection of ceftazidime (CFZ). The effects of various experimental variables such as, the amount of casted MWCNT, time and potential of deposition of metal nanoparticles and the pH of the buffered solution on the electrode response are optimized. The proposed electrode showed a linear dynamic range of 0.05-50μM and the detection limit of 1nM for the CFZ. The modified electrode successfully supports the sensitive detection of trace amounts of the CFZ in pharmaceutical and clinical preparations.

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

    Science.gov (United States)

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

    2015-01-01

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

  8. Biodegradable drug-eluting nanofiber-enveloped implants for sustained release of high bactericidal concentrations of vancomycin and ceftazidime: in vitro and in vivo studies.

    Science.gov (United States)

    Hsu, Yung-Heng; Chen, Dave Wei-Chih; Tai, Chun-Der; Chou, Ying-Chao; Liu, Shih-Jung; Ueng, Steve Wen-Neng; Chan, Err-Cheng

    2014-01-01

    We developed biodegradable drug-eluting nanofiber-enveloped implants that provided sustained release of vancomycin and ceftazidime. To prepare the biodegradable nanofibrous membranes, poly(D,L)-lactide-co-glycolide and the antibiotics were first dissolved in 1,1,1,3,3,3-hexafluoro-2-propanol. They were electrospun into biodegradable drug-eluting membranes, which were then enveloped on the surface of stainless plates. An elution method and a high-performance liquid chromatography assay were employed to characterize the in vivo and in vitro release rates of the antibiotics from the nanofiber-enveloped plates. The results showed that the biodegradable nanofiber-enveloped plates released high concentrations of vancomycin and ceftazidime (well above the minimum inhibitory concentration) for more than 3 and 8 weeks in vitro and in vivo, respectively. A bacterial inhibition test was carried out to determine the relative activity of the released antibiotics. The bioactivity ranged from 25% to 100%. In addition, the serum creatinine level remained within the normal range, suggesting that the high vancomycin concentration did not affect renal function. By adopting the electrospinning technique, we will be able to manufacture biodegradable drug-eluting implants for the long-term drug delivery of different antibiotics.

  9. Effect of ceftazidime of formation of biofilm of Pseudomonas aeruginosa and mechanism%头孢他啶对铜绿假单胞菌生物膜形成的影响与机制的探讨

    Institute of Scientific and Technical Information of China (English)

    李琬琛; 宋林; 李立艳; 孙续国; 魏爱琳; 魏殿军

    2016-01-01

    目的 探讨头孢他啶在铜绿假单胞菌(PAE)生物膜形成过程中的抑制 、清除作用与机制,更好的指导临床用药.方法 通过96孔板结晶紫染色方法,定量分析头孢他啶对PAE标准菌株生物膜的抑制 、清除作用,通过real time-PCR方法对生物膜形成相关基因的表达进行相对定量分析,探讨头孢他啶对PAE生物膜的作用机制.结果 未形成成熟生物膜时,头孢他啶对PAE生长的抑制效果较好,而在有成熟生物膜形成时,头孢他啶不能有效抑制PAE的生长;头孢他啶与PAE生物膜形成相关基因的增多表达相关.结论 头孢他啶能够促进PAE生物膜形成相关基因的表达,临床对慢性PAE感染患者的治疗应避免使用头孢他啶.%OBJECTIVE To observe the effect of ceftazidime on inhibition of formation and clearance of Pseudomonas aeruginosa biofilm and analyze the mechanisms so as to provide guidance for clinical use of antibiotics .METHODS The 96 well plate crystal violet staining method was used to quantitatively analyze the effect of ceftazidime on inhi-bition and clearance of the P .aeruginosa biofilm ,and the real-time PCR method was employed to perform the rela-tive quantitative analysis of the expression of biofilm formation-related genes so as to observe the effect of ceftazi-dime on the formation of P .aeruginosa biofilm .RESULTS Ceftazidime had better effect on inhibition of growth of P .aeruginosa when the mature biofilms were not formed ,however ,ceftazidime could not effectively inhibit the growth of P .aeruginosa when the mature biofilms were formed .Ceftazidime was associated with the increased ex-pression of the biofilm formation-related genes of P .aeruginosa .CONCLUSION Ceftazidime can promote the ex-pression of the biofilm formation-related genes of P .aeruginosa .It is necessary for the hospital to avoid the use of ceftazidime for the treatment of the patients with chronic P .aeruginosa infection .

  10. The Comparison Of The Efficacy Of Cefriaxon Monotherapy With Ceftazidim Plus Amikacin As Initial Empiric Antibiotic Therapy In Febrile Neutropenic Patients Emam Hospital (2000-2001

    Directory of Open Access Journals (Sweden)

    Mohammadi S M

    2003-07-01

    Full Text Available Neutropenic state with fever is exactly regarded as a medical emergency, with high mortality and morbidity rate, unless treated urgently and correctly. Every attempt should be made to find and establish the offending organism, but postponing treatment until obtaining culture results is not advised. Controversy exist on which antibiotic regimen to be used while waiting for culture results. Many antibiotic regiments both monotherapy or combination treatments have been used with varying result. The objective of this study is to compare the efficacy of cefriaxon monothenapy with ceftazidim. Plus Amikacin as initial empiric antibiotic therapy in febrile neutropenic patients."nMaterials and Methods: We performed a randomized, single blind clinical trial in 57 adult (age>12 years, neutropenic (PMN<1000 patients with fever (Temperature, oral >38.5c in Hematology ward, Imam khomeini hospital. After careful physical exam and obtaining blood & urine samples for culture, the patients were randomized to each of the two arms: Cefriaxon 2 grams daily, intravenously (arm A and; Ceftazidim 2g thrice daily plus amikacin 500 mg twice daily (arm B. Patients with shock, organ failure or previous antibiotic intake (during 48 hour before fever were excluded. If needed, dose adjustment of drugs were allowed. Effervescence in 3 days following initiation of treatment, lasting 48 hours or more, were regarded as effective (positive result."nResults: During a twelve months period of study, a total of 57 patients (17female, 40male were included. They were randomly selected to each arm of empirical treatment. Of 28 pts in arm A, 19 (67 percent, the treatment was effective, compared to 15 of 29 (51.7 percent in groups B. The duration of fever after initiation of treatment was 37.9 ± 17 hours in arm A and 40. 1 ± 20 h in arm B. Blood and / or urine culture was equally positive in two arms (25 percent in arm A and 27.6 percent in arm B."nConclusion: Cefriaxon monotherapy is at

  11. The therapeutic effect of tigecycline, unlike that of Ceftazidime, is not influenced by whether the Klebsiella pneumoniae strain produces extended-spectrum β-lactamases in experimental pneumonia in rats.

    Science.gov (United States)

    Goessens, Wil H F; Mouton, Johan W; Ten Kate, Marian T; Sörgel, Fritz; Kinzig, Martina; Bakker-Woudenberg, Irma A J M

    2013-01-01

    The efficacies of tigecycline and ceftazidime against fatal pneumonia in rats caused by an extended-spectrum β-lactamase (ESBL)-positive Klebsiella pneumoniae strain or its wild-type (WT) progenitor were compared. Ceftazidime at 12.5 or 50 mg/kg of body weight twice daily (b.i.d.) was effective (50% or 100% rat survival) in pneumonia caused by the WT isolate but unsuccessful (100% rat mortality) in pneumonia caused by the ESBL-positive variant. In contrast, tigecycline at 6.25, 12.5, or 25 mg/kg b.i.d. showed dosage-dependent efficacy up to 100% rat survival irrespective of the ESBL character of the infecting organism.

  12. 荧光探针法检测人体代谢中头孢他啶含量%Determination of ceftazidime content in the metabolism of human body by fluorescent probe

    Institute of Scientific and Technical Information of China (English)

    程定玺; 杨璐; 梁宇

    2013-01-01

    A new simple and fast method for the determination of ceftazidime (CAZ) was developed. In the Britton-Robinson(B-R) buffer solution at pH 4. 00, the fluorescence intensity of 2,4,5 -7-tetrabromofluorescein disodium salt (EY) is enhanced with addition of certain concentration of the cetyl trimethyl ammonium bromide (CTMAB). The enhanced fluorescence intensity declined obviously after adding ceftazidime and the reduced fluorescence intensity was proportional to the concentration of ceftazidime. Under optimal experimental conditions, the linear range is 0. 008 -0. 8 mg/L,and the detection limit is 0. 0018 mg/L. The system detected the content of ceftazidime in the metabolism of human body (serum and urine) , was detected by this method, and the average recoveries of the method ranged from 97. 5% ~ 102. 6% with the relative standard deviation ( RSD) range of 1.9% ~ 2. 1 % .%建立了一种快速测定头孢他啶含量的荧光探针法.在pH 4.00的Britton-Robinson缓冲溶液中,曙红Y与十六烷基三甲基溴化铵发生荧光增强反应,再加入头孢他啶,体系荧光强度降低,且降低程度与药品加入量有良好线性关系.在优化实验条件下,线性范围为0.008~0.8 mg/L,检出限为0.0018 mg/L.借此检测了头孢他啶在人体代谢(血清和尿液)中的含量,回收率97.5%~102.6%,相对标准偏差1.9% ~2.1%.

  13. Use of a novel medium, the Polymyxin Ceftazidime Oxford Medium, for isolation of Listeria monocytogenes from raw or non-pasteurized foods.

    Science.gov (United States)

    Martínez-Gonzáles, N E; Martínez-Chávez, L; Cabrera-Díaz, E; Martínez-Cárdenas, C; Gutiérrez-González, P; Castillo, A

    2016-05-01

    Polymyxin Ceftazidime Oxford Medium (PCOM), a novel selective and differential plating medium for Listeria monocytogenes was compared with Modified Oxford Agar (MOX) for efficacy to isolate L. monocytogenes and other Listeria spp. naturally present in non-pasteurized Mexican-style cheese (n = 50), non-pasteurized fresh squeezed orange juice (n = 50), raw beef chunks (n = 36), and fresh cabbage (n = 125). Samples were collected from retail markets and farms in Mexico and tested following the US Department of Agriculture enrichment technique. Listeria spp. were isolated from 23.4% of analyzed samples, and from those, 75.0% corresponded to raw beef chunks, 38.0% to non-pasteurized Mexican-style cheese, and 30.0% to fresh squeezed orange juice. No Listeria spp. were isolated from fresh cabbage samples. L. monocytogenes was recovered from 15.3% of food samples analyzed. Non-pasteurized Mexican-style cheese showed the highest proportion of L. monocytogenes positive samples (36.0%), followed by orange juice (26.0%) and raw beef (25.0%). The frequency of isolation of Listeria spp. and L. monocytogenes was not different (P > 0.05) between PCOM and MOX. The advantages of using PCOM when comparing to MOX, include the easier way to identify Listeria species, the lower cost per plate and the availability of its ingredients for Latin-American countries.

  14. Study on process of treating simulated wastewater of ceftazidime by graphene/ZnO composite material%石墨烯/ZnO 处理头孢他啶模拟废水的工艺研究

    Institute of Scientific and Technical Information of China (English)

    李雪; 左金龙; 鄂睿峰; 杨鑫国; 王笑月; 陈大祥; 王雪薇

    2016-01-01

    Nano ZnO/graphene composites were prepared by the oxidation of graphite and nano ZnO as the precursors under the condition of water temperature at 120 ℃.The photo-catalytic activity of the composite was detected to treat simulated antibiotic wastewater by u-sing the solution of ceftazidime with 300 W xenon lamp light source .The optimal conditions for the degradation of the composite material were obtained by single factor test and orthogo -nal test.The optimized conditions were obtained as follows: the amount of catalyst was 25 mg, the time was 3.5 h, and the pH value was 6.The ratio of ZnO and graphene oxide was 15∶1.The degradation rate of the solution of ceftazidime could reach 95%.%以氧化石墨和纳米氧化锌作为前驱物,在120℃水热条件下制备了纳米氧化锌/石墨烯复合物,以头孢他啶溶液模拟抗生素废水,在300 W氙灯光源下,对复合材料光催化性能进行检测.分别做了单因素试验和正交试验,得到复合材料降解头孢他啶废水的最佳条件是,催化剂用量为25 mg,光照时间为3.5 h,pH值为6,ZnO与氧化石墨烯配比为15∶1,对头孢他啶溶液的降解率达到了95%.

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

    Science.gov (United States)

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

    2008-03-01

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

  16. Simultaneous Determination of Ceftazidime and Tazobactam in Injectable Powder by Reversed-Phase High Performance Liquid Chromatography%RP-HPLC法同时测定注射用粉末中他唑巴坦和头孢他啶组分的含量

    Institute of Scientific and Technical Information of China (English)

    孟湘明; 孟志云; 张亮; 窦桂芳

    2004-01-01

    目的建立反相高效液相色谱法用于同时测定他唑巴坦和头孢他啶的含量.方法采用Zorbax 300SB-C18色谱柱, 流动相为甲醇-磷酸盐缓冲液 (pH=5.6),检测波长为220 nm.结果他唑巴坦和头孢他啶分别在0.62-631.8 μg·mL-1和 0.66-677.5 μg·mL-1内呈线性关系,平均加样回收率分别为98.8% - 101.4%和99.1%-100.2%,日内和日间精密度分别为0.2%-1.5%和0.1%-2.6%.结论该法简单、精确、快速、重复性好,可以满足其原料和制剂的质量控制要求.%Aim A reversed-phase high performance liquid chromatographic (RP-HPLC) method was developed and validated for the simultaneous determination of ceftazidime and tazobactam in injectable powder. Methods Chromatography was carried out on Zorbax 300SB-C18 column using a mixture of methanol and aqueous solution of phosphate buffer (pH=5.6) as mobile phase. The UV detection wavelength was 220 nm. Results The linear ranges of ceftazidime and tazobactam were 0.62-631.8 μg·mL-1 and 0.66-677.50μg·mL-1, respectively. The average recoveries were 98.8%-101.4% for ceftazidime, and 99.1%-100.2% for tazobactam. The RSD values of inter-day and intra-day assays were lower than 1.5% for ceftazidime and 2.6% for tazobactam. Conclusion This method is reproducible, simple, precise, and rapid for the quality control of ceftazidime and tazobactam in injectable powder.

  17. Nosocomial outbreak of a non-cefepime-susceptible ceftazidime-susceptible Pseudomonas aeruginosa strain overexpressing MexXY-OprM and producing an integron-borne PSE-1 betta-lactamase.

    Science.gov (United States)

    Peña, C; Suarez, C; Tubau, F; Juan, C; Moya, B; Dominguez, M A; Oliver, A; Pujol, M; Ariza, J

    2009-08-01

    Cefepime (FEP) and ceftazidime (CAZ) are broad-spectrum cephalosporins that display similar MICs for wild-type Pseudomonas aeruginosa strains. Recently, P. aeruginosa isolates showing a discordance in susceptibility to CAZ and FEP have been noted at the Hospital de Bellvitge in Barcelona, Spain, and a clustering was suspected. During the study period (March to December 2007), 51 patients, particularly those in an intensive care units (ICUs) (n = 29 [57%]), infected or colonized with at least one P. aeruginosa non-FEP-susceptible and CAZ-susceptible (Fep(ns) Caz(s)) phenotype strain were detected. Twenty-three (45%) patients were infected, and the respiratory tract was the most frequent site of infection. Changes in the consumption of antimicrobials in the ICUs were observed over time: a progressive reduction in the levels of consumption of carbapenems (247 defined daily doses [DDD]/1,000 patient days to 66 DDD/1,000 patient days; P = 0.008), after restriction of its use in 2006, and an expected increase in the rate of piperacillin-tazobactam use (42 DDD/1,000 patient days in 2004 to 200 DDD/1,000 patient days in 2007; P < 0.001). Throughout the whole study period, only a single clone of a P. aeruginosa Fep(ns) Caz(s) phenotype strain was identified by pulsed-field gel electrophoresis analysis to be associated with the hyperexpression of MexXY-OprM and the production of an integron-borne PSE-1 ss-lactamase. In conclusion, we identified an epidemic P. aeruginosa clone of an Fep(ns) Caz(s) phenotype strain involving 51 patients, in particular, ICU patients. The combination of the overexpression of an efflux pump and PSE-1 ss-lactamase production is associated with the multidrug-resistant phenotype. The dominant use of a single class of antibiotics could have provided the selective pressure required for the emergence and spread of this P. aeruginosa strain.

  18. Clinical Effect Verification of Amoxicillin and Clavulanate Potassium combined Ceftazidime for Treatment of Acute Stage of COPD%阿莫西林克拉维酸钾并头孢他啶联合治疗急性期慢性阻塞性肺疾病疗效验证

    Institute of Scientific and Technical Information of China (English)

    詹行闻

    2014-01-01

    目的验证阿莫西林克拉维酸钾口服并头孢他啶静脉滴注治疗急性期慢性阻塞性肺疾病疗效。方法将460例急性期慢性阻塞性肺疾病患者依照入我院治疗前后次序加入研究组或对照组,均230例。分别予阿莫西林克拉维酸钾口服并头孢他啶静脉滴注及单独使用头孢他啶静滴,疗程结束后比较两组有效率及不良反应出现情况。结果实验性结束治疗后,研究组及对照组总有效率分别为94.8%、81.3%,经比较<0.05,有差异。结论阿莫西林克拉维酸钾口服并头孢他啶静脉滴注治疗AECOPD效果较佳,适于普遍推广使用。%Objective To verify the clinical ef ect of amoxicillin and clavulanate potassium po.combined ceftazidime ivgtt.for treatment of acute stage of COPD.Methods 460 patients with acute stage of COPD were divided into study group and control group both with 230 cases according to precedence order.And they were given amoxicil in and clavulanate potassium po.combined ceftazidime ivgt .And single ceftazidime ivgt .respectively.Effective rate and adverse ef ect rate of the 2 groups were compared after treatment course.Results After treatment,total ef ective rate of study group and control group were respectively 94.8% and 81.3%, <0.05.Conclusion Amoxicil in and clavulanate potassium po.combined ceftazidime ivgt .for treatment of acute stage of COPD has good clinical ef ect and is worth of being popularized.

  19. 注射用头孢他啶/他唑巴坦(3∶1)在中国健康人体的单剂量药代动力学研究%Pharmacokinetics of ceftazidime/tazobactam (3∶1) after single intravenous infusion administration in Chinese healthy volunteers

    Institute of Scientific and Technical Information of China (English)

    孙路路; 单爱莲; 吕媛

    2012-01-01

    目的 评价单剂量头孢他啶/他唑巴坦注射剂(3∶1)在中国健康人体的药代动力学.方法 12名健康男性受试者先后接受单方头孢他啶1800 mg、他唑巴坦600 mg和复方头孢他啶/他唑巴坦1800/600 mg,用高效液相色谱-紫外检测法测定血药浓度、尿液浓度,用DAS程序求药代动力学参数.结果 血药浓度-时间曲线符合二房室模型.主要药代动力学参数分别如下:给药后单方和复方头孢他啶的Cmax为( 130.64±12.05),(136.03±15.27) mg·L-1;t1/2β为(1.50±0.25),(1.36±0.62)h;AUC0-t为(271.26 ±44.23),(285.36±42.87)mg·h·L-1.单方和复方他唑巴坦的Cmax为(23.72±8.06),(24.52±6.86)mg·L-1;t1/2β为(0.85±0.36),(0.89±0.45)h;AUC0-t为(28.06±12.18),(30.41±13.74) mg·h·L-1.单方和复方头孢他啶24h累积排泄率分别为(73.8±18.5)%和(79.0±23.0)%;单方和复方他唑巴坦24 h尿药累积排泄率分别为(66.1±27.0)%和(66.2±36.5)%.结论 头孢他啶与他唑巴坦两药联合应用,并不影响它们各自的体内过程.%Objective To investigate pharmacokinetics of ceftazidime / tazobactam ( 3: 1) after single intravenous infusion administration in Chi-nese healthy volunteers. Methods Twelve healthy male volunteers re-ceived ceftazidime 1800 mg, tazobactam 600 mg and ceftazidime/ tazobactam 1800/600 mg. The concentrations of ceftazidime and tazobac-tam in plasma and urine were assayed by HPLC - UV method. The phar-macokinetic parameters of ceftazidime and tazobactam were caculated by DAS software. Results It was found that concentration - time curves of ceftazidime and tazobactam were fitted to two compartment model. The main pharmacokinetic parameters were as follows; ceftazidime in single and combination preparations Cmax were (130. 64 ± 12. 05) , (136. 03 ± 15.27) mg · L-1;t1/2β were (1. 50 ±0. 25), (1.36 ± 0. 62) h; AUC0-t were (271. 26 ±44. 23), (285. 36 ±42. 87) mg · h · L-1. Tazobactam in single and combination preparations

  20. 耐头孢他啶大肠埃希菌与肺炎克雷伯菌对氟喹诺酮类药物的耐药性分析%Drug resistance of ceftazidime-resistant Escherichia coli and Klebsiella pneumoniae to fluoroquinolones antibiotics

    Institute of Scientific and Technical Information of China (English)

    饶冠利; 周文聪; 季青; 张德忠

    2013-01-01

    目的 了解临床耐头孢他啶大肠埃希菌与肺炎克雷伯菌分离株对氟喹诺酮类抗菌药物的耐药性,以合理使用氟喹诺酮类抗菌药物,采取有效措施控制耐药株的出现.方法 采用K-B和MIC法测定耐头孢他啶大肠埃希菌与肺炎克雷伯菌对8种常见氟喹诺酮类抗菌药物的敏感性.结果 共分离出耐头孢他啶大肠埃希菌与肺炎克雷伯菌276株,对加替沙星、莫西沙星、吉米沙星、左氧氟沙星、氧氟沙星、环丙沙星、帕珠沙星、司帕沙星的耐药率分别为46.38%、43.48%、42.72%、55.43%、65.22%、61.96%、52.54%、53.62%,且均明显高于头孢他啶敏感株(P<0.05);呼吸道、非呼吸道标本的耐头孢他啶大肠埃希菌与肺炎克雷伯菌分离株对加替沙星、莫西沙星、氧氟沙星、司帕沙星的耐药率不同,差异均有统计学意义(P<0.05).结论 耐头孢他啶大肠埃希菌与肺炎克雷伯菌分离株对氟喹诺酮类抗菌药物的耐药率较高,呼吸道、非呼吸道标本分离株对多种常见氟喹诺酮抗菌药物的耐药率不同.%OBJECTIVE To understand the drug resistance of ceftazidime-resistant Escherichia coli and Klebsiella pneumoniae strains to fluoroquinolones so as to reasonably use fluoroquinolones and take effective measures to control the drug resistant strains. METHODS The drug susceptibility testing for E . coli and K. pneumoniae to 8 common fluoroquinolone antimicrobial drugs were determined by K-B and MIC. RESULTS A total of 276 strains of ceftazidime-resistant E. coli and K. pneumoniae were isolated, the drug resistance rates to gatifloxacin, moxifloxacin, gemifloxacin, levofloxacin, ofloxacin, ciprofloxacin, pazufloxacin, and sparfloxacin were 46. 38%, 43. 48%,42. 72%, 55. 43% ,65. 22% , 61.96%, 52.54%, and 53.62%, respectively, significantly higher than that of the ceftazidime-sensitive E. coli and K. pneumoniae strains (P<0. 05). The ceftazidime-resistant E. coli and

  1. 中国大肠埃希菌头孢他啶耐药趋势规律的IMMI推测应用研究%Study on the prediction of trend and regularity of the ceftazidime-resistance of E.coli in China using the IMMI method

    Institute of Scientific and Technical Information of China (English)

    丁凡; 李怡; 栾进

    2011-01-01

    Objective To assess the application potential of the improved MMI (IMMI) to analyze the trend and regularity of ceftazidime-resistance of E.coli in China. Methods The puhlished data of drug-resistance of E.coli to Ceftazidime was collected from the China national knowledge internet (CNKI) during the period from 1996 to 2009. The annual mean drug-resistance data was analyzed by the X2 trend test and presumed by the IMMI method, IMMI presumed results and the comparations of the presumed results from IMMI and MMI were mainly by sum of squares of error (SSE) , relative standard error (RSE) and mean ahsolute deviation (MAD) methods. Results The annual mean drug-resistance data analyzed by the X2 trend test showed an escalating trend (P < 0.01). The IMMI assay revealed that SSE, RSE and MAD value closed to the smallest level when H equaled to 1.Data analysis hetween IMMI and MMI methods showed that, IMMI (H = 0.01) showed smallest value in the SSE, RSE and MAD value based-on IMMI method (H = 0.01) were smaller than those based-on MMl method (M = 2, K = 2/3). Conclusion The prediction result hase-on IMMI (H = 0.01) method is better than that based-on MMI (M = 2, K = 2/3) method. The IMMI (H = 0.01) analysis showed that the drugresistance data of E.coli to Ceftazidime was influenced mainly by the short-term data and was influenced little by the long-term data. Both MMI and IMMI are available methods for prediction the Ceftazidime-resistance of E.coli, however, the IMMI method is better, and the results would be influenced obviously by different parameter setting in both IMMI and MMI methods.%目的:探讨MMI改良法(IMMI)对中国大肠埃希菌头孢他啶耐药性及其规律的推测的应用价值.方法:收集1996-2009年期间中国期刊全文数据库(CNKI)中涉及大肠埃希菌头孢他啶耐药性文献所报道数据,以χ2趋势检验进行趋势检验.以IMMI对耐药数据进行推测,以误差平方和(SSE)、误差标准差(RSE)、平均绝对误

  2. 头孢吡肟与头孢他啶随机对照治疗细菌性感染129例%A randomized controlled clinical study of cefepime versus ceftazidime in the treatment of 129 patients with bacterial infections

    Institute of Scientific and Technical Information of China (English)

    李光辉; 张婴元; 汪复; 陈楠; 郑丽叶; 罗邦尧; 花天放; 周新; 周柱

    2000-01-01

    目的 评价头孢吡肟治疗细菌性感染的疗效和安全性.方法 以头孢他啶为对照药,在下呼吸道感染、腹腔、胆道感染、败血症中进行随机对照观察.给药方案为头孢吡肟每次2 g,2次/d,头孢他啶每次2 g,3次/d;治疗尿路感染头孢吡肟每次1 g,2次/d,头孢他啶每次1 g,3次/d;均为静脉滴注,疗程均为7~14 d.结果 头孢吡肟组65例,头孢他啶组64例.头孢毗肟组和头孢他啶组有效率分别为92.3%及90.6%,痊愈率各为72.3%及68.8%,细菌清除率分别为94.9%和87.5%,两组的不良反应发生率均为6%.两组的疗效和安全性经统计学处理无显著差异.头孢吡肟和其他抗菌药物对临床分离菌的体外抗菌活性测定结果显示,头孢吡肟对大肠杆菌、肠杆菌属、克雷伯菌属等肠杆菌科细菌,铜绿假单胞菌等假单胞菌属等革兰阴性杆菌具高度抗菌活性.结论 头孢吡肟治疗敏感菌所致的下呼吸道感染、尿路感染、腹腔、胆道感染、败血症等疗效确切,不良反应少见而轻微.%Objective To evaluate the efficacy and safety of cefepime in the treatment of patients with bacterial infections.Methods A randomized controlled study was conducted in patients with lower respiratory tract infection(LRTI),urinary tract infection(UTI),peritonitis,hepato-biliary infection and septicemia,Dosage regimens were cefepime 2 g bid and ceftazidime 2 g q8h;while cefepime 1 g hid and ceftazidime 1g q8h were given to patients with UTI.Duration of treatment was 7~14 days.Results Six-ty five patients were given cefepime and 64 patients were given ceftazidime.Clinical cure rates and total ef-fective rates were 72.3%,92.3%in the cefepime group,and 68,8%,90.6%in the eeftazidime group respectively.and the corresponding bacterial eradication rates were 94.9%and 87.5%respectively.The adverse reaction rates were 6%in both groups.There were no significant difference in clinicaI cure rates,total effective rates

  3. 金银花水煎液及联合头孢他啶对铜绿假单胞菌生物膜的体外影响%In vitro effects of honeysuckle aqueous-extracts alone and in combination with ceftazidime on Pseudomonas aeruginosa biofilm

    Institute of Scientific and Technical Information of China (English)

    陈一强; 覃雪军; 朱莲娜; 宋志军; 施焕中; 闫萍; 郭向华

    2004-01-01

    目的通过在体外复制铜绿假单胞菌(Pseudomonas aeruginosa, P.a)的生物膜(biofilm, BF)模型,研究金银花水煎液对BF的影响及其与头孢他啶(ceftazidime, CAZ)的协同杀菌效果. 方法选取临床分离呼吸道P.a,采用LB(Luria-Bertani medium)肉汤系统复制体外BF模型,扫描电子显微镜(scanning electron microscopy, SEM)观察BF,连续稀释法进行活菌计数,试管二倍稀释法测定药物的最低抑菌浓度(MIC). 结果 37℃培养24 h,P.a即表现出对固体表面的黏附性,3 d形成早期BF,7 d形成成熟BF.金银花组P.a在固体表面的黏附数明显少于空白对照组.62.5mg/ml的金银花可以抑制和破坏早期及成熟BF,并增强CAZ对BF内P.a的抗菌活性. 结论金银花水煎液在体外能抑制P.a对固体表面的黏附能力及BF形成能力,并能破坏P.a已形成的BF,增强CAZ对BF内铜绿假单胞菌的清除作用.

  4. 临床分离的铜绿假单胞菌对头孢吡肟敏感性低于头孢他啶的机制研究%Research on the mechanism of less susceptibility to cefepime than to ceftazidime in clinical isolates of Pseudomonas aeruginosa

    Institute of Scientific and Technical Information of China (English)

    曾章锐; 王卫萍; 黄梅; 邵海枫

    2014-01-01

    Objective To investigate the reasons of less susceptibility mechanism to cefepime (FEP)than to ceftazidime (CAZ)in clinical isolates of Pseudomonas aeruginosa.Methods A total of 60 isolates of Pseudomonas aeruginosa which had been tested being less susceptible to FEP than to CAZ for minimal inhibitory concentration (MIC) by Vitek 2 Compact automatic microorganism analyzer system were collected.Agar dilution method was used to reexamine the MIC of FEP and CAZ.The resistance genes were amplified by polymerase chain reaction (PCR).The expressions of efflux system were analyzed by real-time fluorescence quantitation PCR.Results The 5% of error rate was showed between agar dilution method and Vitek 2 Compact system.There were isolates with KPC and PSE-1 resistance genes by PCR amplification.There were mainly the expressions of mexB and mexD in efflux system.The sequencing of regulatory genes showed that there were 3 isolates for mexB which the Gly70(GGG)of nalC was substitute for Glu(GAG)(GGG→GAG)and 2 isolates for mexD which the Gly1 09(GGC)of nfxB was substitute for Val (GTC) (GGC→GTC).Conclusions Less susceptibility to FEP than to CAZ in clinical isolates of Pseudomonas aeruginosa is due to the production of KPC and PSE-1 resistance genes and the increasing expression levels of mexAB-OprM and mexCD-OprJ.%目的:探讨临床分离的铜绿假单胞菌对头孢吡肟(FEP)敏感性低于头孢他啶(CAZ)的原因。方法收集临床分离的经 Vitek 2 Compact 全自动微生物分析系统检测 PEF 最小抑菌浓度(MIC)高于 CAZ MIC 的铜绿假单胞菌60株,琼脂稀释法复查 FEP 和 CAZ 的 MIC 值,聚合酶链反应(PCR)扩增耐药基因,实时荧光定量 PCR分析细菌外排系统表达情况。结果手工琼脂稀释法检测与 Vitek 2 Compact 全自动微生物分析系统检测存在5%的差别,PCR 扩增发现部分菌株存在编码 KPC 和 PSE-1的耐药基因,外排系统表达显示以 mexB 和 mexD

  5. Influence of pulmonary surfactant on in vitro bactericidal activities of amoxicillin, ceftazidime, and tobramycin

    NARCIS (Netherlands)

    A. van 't Veen (Annemarie); J.W. Mouton (Johan); D.A.M.P.J. Gommers (Diederik); J.A.J.W. Kluytmans (Jan); P. Dekkers; B.F. Lachmann (Burkhard)

    1995-01-01

    textabstractThe influence of a natural pulmonary surfactant on antibiotic activity was investigated to assess the possible use of exogenous surfactant as a vehicle for antibiotic delivery to the lung. The influence of surfactant on the bactericidal activity of amoxicill

  6. A Phase 3 Randomized Double-Blind Comparison of Ceftobiprole Medocaril Versus Ceftazidime Plus Linezolid for the Treatment of Hospital-Acquired Pneumonia

    NARCIS (Netherlands)

    Awad, Samir S.; Rodriguez, Alejandro H.; Chuang, Yin-Ching; Marjanek, Zsuszanna; Pareigis, Alex J.; Reis, Gilmar; Scheeren, Thomas W. L.; Sanchez, Alejandro S.; Zhou, Xin; Saulay, Mikal; Engelhardt, Marc

    2014-01-01

    Background:  Ceftobiprole, the active moiety of ceftobiprole medocaril, is a novel broad-spectrum cephalosporin, with bactericidal activity against a wide range of gram-positive bacteria, including Staphylococcus aureus (including methicillin-resistant strains) and penicillin-and ceftriaxone-resista

  7. Clinical cure and mortality outcomes with ceftobiprole medocaril versus ceftazidime plus linezolid in patients with early versus late-onset hospital-acquired pneumonia.

    NARCIS (Netherlands)

    Scheeren, Thomas; Welte, T.; Capellier, G.; Saulay, Mikal; Engelhardt, M.

    2015-01-01

    Objectives: Ceftobiprole, the active moiety of the prodrug ceftobiprole medocaril, is a novel cephalosporin for intravenous use, approved in certain European countries for the treatment of community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP) excluding ventilator-associated pneumo

  8. First report of a novel extended-spectrum beta-lactamase KOXY-2 producing Klebsiella oxytoca that hydrolyses cefotaxime and ceftazidime.

    Science.gov (United States)

    Younes, A; Hamouda, A; Amyes, S G B

    2011-06-01

    Klebsiella oxytoca strains MU946294N and MB193997E were isolated from patients in Scotland. Strain MU946294N was resistant to pencillins, monbactams and cephalosporins. Isolate MB193997E displayed a β-lactam resistance phenotype consistent with chromosomal β-lactamase overproduction. No bla(TEM), bla(SHV) or bla(CTX-M) genes could be amplified in either strain; however, amplification by PCR was found with primers for the bla(OXY-2) gene. This β-lactamase gene in MU946294N differed by one mutation from the all other bla(OXY) genes previously reported, with an amino acid substitution Alanine237 Threonine enhancing the binding of cefotaxime. Strain MB193997E showed mutations at positions 255 and 283, neither of which affect function. Based on rpoB and gyrA characterization, both strains were assigned to the KoII phylogenic group but they were completely dissimilar from each other by PFGE. This study is the first to report the substitution of Alanine to Threonine at position 237 in a OXY- 2 β-lactamase and this enhances resistance to cefotaxime.

  9. Simultaneous identification of multiple β-lactamases in Acinetobacter baumannii in relation to carbapenem and ceftazidime resistance, using liquid chromatography-tandem mass spectrometry

    NARCIS (Netherlands)

    Trip, H.; Mende, K.; Majchrzykiewicz-Koehorst, J.A.; Sedee, N.J.A.; Hulst, A.G.; Jansen, H.J.; Murray, C.K.; Paauw, A.

    2015-01-01

    Shotgun proteomics using liquid chromatography-tandem mass spectrometry (LC-MS/MS) was applied to detect β-lactamases in clinical Acinetobacter baumannii isolates. The correlation of the detection of β-lactamase proteins (rather than PCR detection of the corresponding genes) with the resistance phen

  10. 梯度洗脱HPLC法检查头孢他啶原料药中的有关物质%Determination of Related Substances in Ceftazidime Raw Material Using Gradient Elution of HPLC

    Institute of Scientific and Technical Information of China (English)

    苑华; 张冬; 黄亚龙; 常旸

    2013-01-01

    目的:建立检查头孢他啶原料药中有关物质的方法.方法:采用高效液相色谱法.色谱柱为Apollo C18,以磷酸盐缓冲溶液(pH 3.4)和乙腈分别为流动相A和流动相B,梯度洗脱,检测波长为254 nm,流速为1.1 ml/min,柱温为45℃;同时与《中国药典》方法比较检查结果.结果:本方法可分离出头孢他啶的11个相关杂质,分析时间约为30 min,出峰均匀且各峰间分离度良好,检测限为0.4 ng;《中国药典》方法可分离出10个杂质,主峰前各杂质分离度不好,分析时间为55 min左右.结论:与《中国药典》方法比较,本方法具有分离杂质多、分离度好、分析时间短的优点,可作为头孢他啶原料药中有关物质的分析方法.

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

    Science.gov (United States)

    Srinivas, Nuggehally R

    2016-09-01

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

  12. Cost-effectiveness analysis of cefoaxime-sulbactam vs ceftazidime in treatment of lower respiratory tract infection%2种治疗方案治疗下呼吸道感染的费用-效果比较

    Institute of Scientific and Technical Information of China (English)

    吴淑兰; 张作昌; 王一田

    2003-01-01

    目的:比较头孢噻肟-舒巴坦和头孢他啶治疗下呼吸道感染的疗效及费用.方法:56例下呼吸道感染患者分为2组:A组(n=28)予头孢噻肟-舒巴坦2.5 g,iv gtt,bid;B组(n=28)予头孢他啶2.0 g,iv gtt,bid.2组均以7~10 d为一个疗程.结果:A组和B组临床有效率分别为96%和93%(P>0.05).总医疗费用B组较A组高,分别为(7 918±764)元和(5 948±659)元.结论:2组疗效相似,费用有显著差异,B组总医疗费用高.

  13. 一例注射头孢他定过敏的抢救与护理%Rescue and Nursing Care of A Case of Allergy Induced by Ceftazidime Injection

    Institute of Scientific and Technical Information of China (English)

    彭兰英; 李丽华

    2009-01-01

    过敏反应,又称变态反应,是由于患者体质特异,对某种药物所产生的病理性免疫反应,这种反应与剂量关系不大,一般在用药后数秒至几分钟内发生,少数患者可能发生于用药后或连续用药过程中。注射用头孢他定属第3代头孢菌素抗生素,具有抗菌谱广、抗菌性强、临床疗效高、不良反应少等优点。应用头孢他定患者情绪激动、多语、口吃、震颤、手抖、夜不能寐、躁狂、澹妄,致精神障碍的已有报道,但从中国医院知识仓库(CHKD)期刊全文数据库中未检到关于头孢他定过敏休克的报道:我们报告1例在使用头孢他定时发生过敏性休克的病例,希望能引起大家对头孢他定产生不良反应过敏休克的重视。

  14. 抗菌药物联用治疗发热性中性粒细胞减少症血液肿瘤患儿的临床研究%Ceftazidime Alone or with Vancomycin in Treatment of Febrile Neutropenia in Children with Cancers: A Clinical Study

    Institute of Scientific and Technical Information of China (English)

    杨光; 陆爱梅; 唐锁勤; 王建文

    2006-01-01

    目的 比较头孢他啶单用与联用万古霉素对治疗发热性中性粒细胞减少症血液肿瘤患儿的疗效.方法 62例中性粒细胞减少伴发热的血液肿瘤患儿随机分为两组,A组32例联合应用头孢他啶和万古霉素,B组30例单独应用头孢他啶.结果 A组总有效率为84.4%,高于B组的60.0%(P<0.05),A组退热时间亦较B组有降低的趋势,而两组不良反应发生率的差异无统计学意义(P>0.05).结论 头孢他啶和万古霉素联合应用的抗菌谱广,疗效优于单用头孢他啶,可作为治疗血液肿瘤患儿中性粒细胞减少伴发热的经验性用药之一.

  15. 头孢他啶单用与联用万古霉素治疗发热性中性粒细胞减少血液肿瘤患儿的疗效比较%A Study on Ceftazidime with or Without Vancomycin in the Treatment of Febrile Neutropenia in the Children with Cancers

    Institute of Scientific and Technical Information of China (English)

    杨光; 唐锁勤

    2006-01-01

    目的:比较头孢他啶单用与联用万古霉素对治疗发热性中性粒细胞减少血液肿瘤患儿的疗效.方法:62例中性粒细胞减少伴发热的血液肿瘤患儿随机分为两组,A组32例联合应用头孢他啶和万古霉素,B组30例单独应用头孢他啶.结果:A组总有效率为84.4%,高于B组的60.0(P<0.05),A组退热时间亦较B组有降低的趋势,而两组不良反应发生率的差异无显著性(P>0.05).结论:头孢他啶和万古霉素联合应用的抗菌谱广,疗效优于单用头孢他啶,可作为治疗血液肿瘤患儿中性粒细胞减少伴发热的经验性用药之一.

  16. 头孢吡肟或头孢他啶联合阿米卡星治疗白血病化疗后粒细胞缺乏合并感染的疗效比较%A comparative study of cefepime/amikacin versus ceftazidime/amikacin as empirical therapy for the treatment of febrile neutropenia in leukemia patients due to chemotherapy

    Institute of Scientific and Technical Information of China (English)

    高睿哲; 陈莉; 杨建民; 宋献民; 王斌; 王健民

    2006-01-01

    目的:比较头孢吡肟或头孢他啶联合阿米卡星在治疗白血病化疗后粒细胞缺乏合并感染中的疗效.方法:回顾分析我科近年收治的白血病患者化疗后粒细胞缺乏合并重症感染者共 117例,比较临床经验抗感染治疗方案头孢他啶+阿米卡星与头孢吡肟+阿米卡星的疗效.结果:头孢吡肟+阿米卡星组痊愈率为 51.61%,有效率为 64.52%;头孢他啶+阿米卡星组痊愈率为 49.02%,有效率为 62.75%.经统计学分析,两组患者的临床疗效差异无显著性.结论:头孢吡肟+阿米卡星与头孢他啶+阿米卡星在治疗白血病化疗后粒细胞缺乏合并重症感染时疗效相似.

  17. Environmental Survival, Military Relevance, and Persistence of Burkholderia Pseudomallei

    Science.gov (United States)

    2007-04-01

    septicaemic melioidosis (White el al., 1989). More recently, carbapenems have been found to be at least as effective and may have superior intracellular...whether the carbapenems are superior to ceftazidime in terms of clinical outcomes. Investigators think that a combination of ceftazidime and co

  18. 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

  19. Antibiotics and renal branching morphogenesis: comparison of toxicities

    NARCIS (Netherlands)

    Bueters, R.R.G.; Kusters, L.J.; Klaasen, A.; Heuvel, L.P.W.J. van den; Schreuder, M.F.

    2014-01-01

    BACKGROUND: Many premature born neonates receive antibiotic drugs to treat infections, which are applied during active nephrogenesis. We studied the impact of clinical concentrations of gentamicin and alternatives, ceftazidime and meropenem, on ureteric branching. METHODS: Mice metanephroi were diss

  20. Cost of Illness and Cost Containment Analysis Using Empirical Antibiotic Therapy in Sepsis Patients in Bandung

    Directory of Open Access Journals (Sweden)

    Rano K. Sinuraya

    2012-12-01

    Full Text Available The aims of this study were to analyze cost of illness (COI and cost containment analysis using empirical antibiotic therapy in sepsis patients with respiratory infection in a hospital in Bandung. A cross sectional method was conducted retrospectively. Data were collected from medical record of inpatients sepsis patients with respiratory infections with empirical antibiotic therapy ceftazidime-levofloxacin or cefotaxime-erythromycin. Direct and indirect cost were calculated and analyzed in this study. The result showed that the average COI for patients with combination ceftazidime-levofloxaxin was 13,369,055 IDR whereas combination of cefotaxime-erythromycin was 22,250,495 IDR. In summary, the COI empirical antibiotic therapy ceftazidime-levofloxacin was lower than cefotaxime-erythromycin. Cost containment using empirical antibiotic therapy ceftazidime-levofloxacin which without reducing the service quality was 8,881,440 IDR.

  1. Use of pharmacodynamic parameters to predict efficacy of combination therapy by using fractional inhibitory concentration kinetics

    NARCIS (Netherlands)

    J.G. den Hollander (Jan); J.W. Mouton (Johan); H.A. Verbrugh (Henri)

    1998-01-01

    textabstractCombination therapy with antimicrobial agents can be used against bacteria that have reduced susceptibilities to single agents. We studied various tobramycin and ceftazidime dosing regimens against four resistant Pseudomonas aeruginosa strains in an in vitro

  2. Extended-spectrum cephalosporins and the inoculum effect in tests with CTX-M-type extended-spectrum β-lactamase-producing Escherichia coli: potential clinical implications of the revised CLSI interpretive criteria.

    Science.gov (United States)

    Kang, Cheol-In; Cha, Min Kyeong; Kim, So Hyun; Wi, Yu Mi; Chung, Doo Ryeon; Peck, Kyong Ran; Lee, Nam Yong; Song, Jae-Hoon

    2014-05-01

    Based on the new recommendations of the Clinical and Laboratory Standards Institute (CLSI), the revised cephalosporin breakpoints may result in many CTX-M-producing Escherichia coli being reported as susceptible to ceftazidime. We determined the activity of ceftazidime and other parenteral β-lactam agents in standard- and high-inoculum minimum inhibitory concentration (MIC) tests against CTX-M-producing E. coli isolates. Antimicrobial susceptibility was determined using a broth microdilution MIC method with inocula that differed 100-fold in density. An inoculum effect was defined as an eight-fold or greater increase in MIC on testing with the higher inoculum. When the revised CLSI ceftazidime breakpoint of 4 μg/mL was applied, 34 (34.3%) of the 99 CTX-M-producers tested were susceptible. More specifically, for 42 CTX-M-14-producing E. coli isolates, 32 (76.2%) were susceptible at 4 μg/mL. Cefotaxime, ceftazidime, cefepime and piperacillin/tazobactam were found to be associated with inoculum effects in 100% of the evaluable tests for extended-spectrum β-lactamase-producing E. coli isolates. The MIC(50) (MIC required to inhibit 50% of isolates) of ceftazidime was 16 μg/mL in the standard-inoculum tests and >512 μg/mL in the high-inoculum tests. In the high-inoculum tests including isolates encoding CTX-M-14, ceftazidime was dramatically affected, with susceptibility decreasing from 82.1% of isolates inhibited at 4 μg/mL in the standard-inoculum tests to 0% at high inoculum. Although further studies may demonstrate that ceftazidime has a role in the treatment of infections caused by these organisms, we suggest that until more data become available, clinicians should be cautious about treating serious CTX-M-producing E. coli infections with ceftazidime or cefepime.

  3. High beta-Lactamase Levels Change the Pharmacodynamics of beta-Lactam Antibiotics in Pseudomonas aeruginosa Biofilms

    DEFF Research Database (Denmark)

    Wang, Hengzhuang; Ciofu, Oana; Yang, Liang

    2013-01-01

    Resistance to beta-lactam antibiotics is a frequent problem in Pseudomonas aeruginosa lung infection of cystic fibrosis (CF) patients. This resistance is mainly due to the hyperproduction of chromosomally encoded beta-lactamase and biofilm formation. The purpose of this study was to investigate...... the role of beta-lactamase in the pharmacokinetics (PK) and pharmacodynamics (PD) of ceftazidime and imipenem on P. aeruginosa biofilms. P. aeruginosa PAO1 and its corresponding beta-lactamase-overproducing mutant, PA Delta DDh2Dh3, were used in this study. Biofilms of these two strains in flow chambers...... activity of ceftazidime was observed for beta-lactamase-overproducing biofilms of P. aeruginosa in all three models. Ceftazidime showed time-dependent killing on planktonic PAO1 and PA Delta DDh2Dh3. This difference is probably due to the special distribution and accumulation in the biofilm matrix of beta...

  4. Detection of SPM and IMP metallo-β-lactamases in clinical specimens of Pseudomonas aeruginosa from a Brazilian public tertiary hospital

    Directory of Open Access Journals (Sweden)

    Carlos Henrique Camargo

    2011-10-01

    Full Text Available Phenotypic and genotypic SPM and IMP metallo-β-lactamases (MBL detection and also the determination of minimal inhibitory concentrations (MIC to imipenem, meropenem and ceftazidime were evaluated in 47 multidrug-resistant Pseudomonas aeruginosa isolates from clinical specimens. Polymerase chain reaction detected 14 positive samples to either blaSPM or blaIMP genes, while the best phenotypic assay (ceftazidime substrate and mercaptopropionic acid inhibitor detected 13 of these samples. Imipenem, meropenem and ceftazidime MICs were higher for MBL positive compared to MBL negative isolates. We describe here the SPM and IMP MBL findings in clinical specimens of P. aeruginosa from the University Hospital of Botucatu Medical School, São Paulo, Brazil, that reinforce local studies showing the high spreading of blaSPM and blaIMP genes among brazilian clinical isolates.

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

    Science.gov (United States)

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

    2001-05-01

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

  6. Tris-EDTA no teste de sensibilidade antimicrobiana in vitro em amostras de Pseudomonas aeruginosa

    Directory of Open Access Journals (Sweden)

    Tanaka E.M.

    2002-01-01

    Full Text Available In vitro antimicrobial susceptibility of strains of Pseudomonas aeruginosa by standard diffusion disk test and a modified method, by the addition Tris-EDTA, was evaluated. Increase in sensitivity of agent using modified method was observed mainly in aminoglycosides (amikacin, gentamicin, tobramycin, quinolones (ofloxacin and norfloxacin and cephalosporins (cefoperazone and ceftazidime groups. by standard diffusion disk test and a modified method, by the addition Tris-EDTA, was evaluated. Increase in sensitivity of agent using modified method was observed mainly in aminoglycosides (amikacin, gentamicin, tobramycin, quinolones (ofloxacin and norfloxacin and cephalosporins (cefoperazone and ceftazidime groups.

  7. Antimicrobial resistance among pilgrims: a retrospective study from two hospitals in Makkah, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Abdul Haseeb

    2016-06-01

    Conclusion: Overall, a high resistance was observed for beta-lactam antibiotics. In addition, a high resistance was noted for ceftazidime with A. baumannii species (n = 16, 77%. However, for quinolones, the highest resistance to ciprofloxacin was observed for E. coli, A. baumannii, methicillin-resistant Staphylococcus aureus, and K. pneumoniae.

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

    Science.gov (United States)

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

    2006-12-01

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

  9. Raoultella planticola peritonitis in a patient on continuous ambulatory peritoneal dialysis.

    Science.gov (United States)

    Kim, Sun Woo; Kim, Ji Eun; Hong, Yu Ah; Ko, Gang Jee; Pyo, Heui Jung; Kwon, Young Joo

    2015-12-01

    A 65-year-old man on continuous ambulatory peritoneal dialysis was admitted with peritonitis. Empirical antibiotic therapy was initiated, and Raoultella planticola was identified in the peritoneal fluid culture. We treated the patient with intraperitoneally administered ciprofloxacin and ceftazidime according to the antibiotic susceptibility. His condition improved, and he was well treated with a 2-week antibiotic course.

  10. Growth phenotypes of Pseudomonas aeruginosa lasR mutants adapted to the airways of cystic fibrosis patients

    DEFF Research Database (Denmark)

    D'Argenio, D.A.; Wu, M.H.; Hoffman, L.R.

    2007-01-01

    contribute to selection of lasR mutants both on rich medium and within the CF airway, supporting a key role for bacterial metabolic adaptation during chronic infection. Inactivation of lasR also resulted in increased beta-lactamase activity that increased tolerance to ceftazidime, a widely used beta-lactam...

  11. Diverse modulation of spa transcription by cell wall active antibiotics in Staphylococcus aureus

    DEFF Research Database (Denmark)

    Nielsen, Lene Nørby; Roggenbuck, Michael; Haaber, Jakob Krause

    2012-01-01

    , expression of all three genes were repressed by aminoglycosides and induced by fluoroquinolones and penicillins. In contrast, the beta-lactam sub-group cephalosporins enhanced expression of RNAIII and hla but diversely affected expression of spa. The compounds cefalotin, cefamandole, cefoxitin, ceftazidime...

  12. Antibiotic combination therapy can select for broad-spectrum multidrug resistance in Pseudomonas aeruginosa

    DEFF Research Database (Denmark)

    Vestergaard, Martin; Paulander, Wilhelm; Marvig, Rasmus L.

    2016-01-01

    Combination therapy with several antibiotics is one strategy that has been applied in order to limit the spread of antimicrobial resistance. We compared the de novo evolution of resistance during combination therapy with the β-lactam ceftazidime and the fluoroquinolone ciprofloxacin with the resi...

  13. Epidemiology of Gram Negative Antimicrobial Resistance in a Multi-State Network of Long Term Care Facilities

    Science.gov (United States)

    Lautenbach, Ebbing; Marsicano, Roseann; Tolomeo, Pam; Heard, Michael; Serrano, Steve; Stieritz, Donald D.

    2009-01-01

    We identified 1,805 gram-negative organisms in urine cultures from residents of 63 long-term care facilities (LTCFs) over 10 months. Fluoroquinolone resistance was 51% among E. coli, while 26% and 6% of Klebsiella were resistant to ceftazidime and imipenem, respectively. Resistance varied significantly by type of LTCF, LTCF size, and geographic region. PMID:19566445

  14. Effect of ceftobiprole treatment on growth of and toxin production by Clostridium difficile in cecal contents of mice.

    Science.gov (United States)

    Nerandzic, Michelle M; Donskey, Curtis J

    2011-05-01

    Ceftobiprole and ceftobiprole medocaril did not promote growth of or toxin production by Clostridium difficile in mouse cecal contents, whereas ceftazidime, cefoxitin, ceftriaxone, cefotaxime, and ertapenem did. The relatively low propensity of ceftobiprole to promote C. difficile was attributable to inhibitory activity against C. difficile and sparing of anaerobic microflora.

  15. Effect of Ceftobiprole Treatment on Growth of and Toxin Production by Clostridium difficile in Cecal Contents of Mice▿

    OpenAIRE

    2011-01-01

    Ceftobiprole and ceftobiprole medocaril did not promote growth of or toxin production by Clostridium difficile in mouse cecal contents, whereas ceftazidime, cefoxitin, ceftriaxone, cefotaxime, and ertapenem did. The relatively low propensity of ceftobiprole to promote C. difficile was attributable to inhibitory activity against C. difficile and sparing of anaerobic microflora.

  16. Molecular characterization of extended-spectrum beta-lactamases and its correlation with clinical laboratory standards institute interpretive criteria for disk diffusion susceptibility testing in enterobacteriaceae isolates in Thaialnd.

    Science.gov (United States)

    Tangkoskul, Teerawit; Tiengrim, Surapee; Onsomang, Supiluck; Pati, Naratchaphan; Aswapokee, Nalinee; Thamlikitkul, Visanu; Chayakulkeeree, Methee

    2012-11-01

    We performed extended-spectrum beta-lactamase (ESBL) phenotypic testing and molecular characterization of three ESBL genes (TEM, SHV and CTX-M) and susceptibility testing by Clinical Laboratory Standards Institute (CLSI) disk diffusion method against three cephalosporins (ceftriaxone, ceftazidime, cefepime) and a cephamycin (cefoxitin) among 128 Thai Escherichia coli and 84 Thai Klebsiella pneumoniae clinical isolates. ESBL production was discovered in 62% of E. coli and 43% of K. pneumoniae isolates. All isolates susceptible to ceftriaxone were ESBL-negative. Nearly all isolates non-susceptible to ceftriaxone, ceftazidime and cefepime produced ESBL; the presence of CTX-M genes in the isolates correlated with a ceftriaxone non-susceptible phenotype. Thirty-nine of 83 isolates (47%) of ceftazidime-susceptible E. coli and 50 of 99 isolates (50.5%) of cefepime-susceptible E. coli were ESBL-producing. SHV-type beta-lactamase genes were more prevalent among K. pneumoniae than E. coli isolates. CTX-M was the major ESBL gene harbored by ESBL-producers in both E. coli and K. pneumoniae isolates. Non-CTX-M ESBL-producers were found only among K. pneumoniae isolates. This study reveals an increase in ESBL-producing Enterobacteriaceae among Thai isolates and demonstrates gaps in the current CLSI disk diffusion susceptibility guidelines; it indicates the results of ceftazidime and cefepime disk diffusion susceptibility testing using CLSI criteria should be interpreted with caution.

  17. Characterization of Francisella sp., GM2212, the first Francisella isolate from marine fish, Atlantic cod (Gadus morhua)

    DEFF Research Database (Denmark)

    Ottem, Karl F; Nylund, Are; Karlsbakk, Egil

    2007-01-01

    from F. tularensis and F. philomiragia. GM2212(T) is catalase-positive, indole positive, oxidase-negative, do not produce H(2)S in Triple Sugar Iron agar, and does not hydrolyze gelatin, is resistant to erythromycin and susceptible to ceftazidime, the latter five characteristics separating it from F...

  18. Concentration-dependency of beta-lactam-induced filament formation in Gram-negative bacteria.

    NARCIS (Netherlands)

    Buijs, J.; Dofferhoff, A.S.M.; Mouton, J.W.; Wagenvoort, J.H.T.; Meer, J.W.M. van der

    2008-01-01

    Ceftazidime and cefotaxime are beta-lactam antibiotics with dose-related affinities for penicillin-binding protein (PBP)-3 and PBP-1. At low concentrations, these antibiotics inhibit PBP-3, leading to filament formation. Filaments are long strands of non-dividing bacteria that contain enhanced quant

  19. Selective Spectrum Antibiotic Modulation of the Gut Microbiome in Obesity and Diabetes Rodent Models.

    Directory of Open Access Journals (Sweden)

    Deepak K Rajpal

    Full Text Available The gastrointestinal tract microbiome has been suggested as a potential therapeutic target for metabolic diseases such as obesity and Type 2 diabetes mellitus (T2DM. However, the relationship between changes in microbial communities and metabolic disease-phenotypes are still poorly understood. In this study, we used antibiotics with markedly different antibacterial spectra to modulate the gut microbiome in a diet-induced obesity mouse model and then measured relevant biochemical, hormonal and phenotypic biomarkers of obesity and T2DM. Mice fed a high-fat diet were treated with either ceftazidime (a primarily anti-Gram negative bacteria antibiotic or vancomycin (mainly anti-Gram positive bacteria activity in an escalating three-dose regimen. We also dosed animals with a well-known prebiotic weight-loss supplement, 10% oligofructose saccharide (10% OFS. Vancomycin treated mice showed little weight change and no improvement in glycemic control while ceftazidime and 10% OFS treatments induced significant weight loss. However, only ceftazidime showed significant, dose dependent improvement in key metabolic variables including glucose, insulin, protein tyrosine tyrosine (PYY and glucagon-like peptide-1 (GLP-1. Subsequently, we confirmed the positive hyperglycemic control effects of ceftazidime in the Zucker diabetic fatty (ZDF rat model. Metagenomic DNA sequencing of bacterial 16S rRNA gene regions V1-V3 showed that the microbiomes of ceftazidime dosed mice and rats were enriched for the phylum Firmicutes while 10% OFS treated mice had a greater abundance of Bacteroidetes. We show that specific changes in microbial community composition are associated with obesity and glycemic control phenotypes. More broadly, our study suggests that in vivo modulation of the microbiome warrants further investigation as a potential therapeutic strategy for metabolic diseases.

  20. Selective Spectrum Antibiotic Modulation of the Gut Microbiome in Obesity and Diabetes Rodent Models

    Science.gov (United States)

    Rajpal, Deepak K.; Klein, Jean-Louis; Mayhew, David; Boucheron, Joyce; Spivak, Aaron T.; Kumar, Vinod; Ingraham, Karen; Paulik, Mark; Chen, Lihong; Van Horn, Stephanie; Thomas, Elizabeth; Sathe, Ganesh; Livi, George P.; Holmes, David J.; Brown, James R.

    2015-01-01

    The gastrointestinal tract microbiome has been suggested as a potential therapeutic target for metabolic diseases such as obesity and Type 2 diabetes mellitus (T2DM). However, the relationship between changes in microbial communities and metabolic disease-phenotypes are still poorly understood. In this study, we used antibiotics with markedly different antibacterial spectra to modulate the gut microbiome in a diet-induced obesity mouse model and then measured relevant biochemical, hormonal and phenotypic biomarkers of obesity and T2DM. Mice fed a high-fat diet were treated with either ceftazidime (a primarily anti-Gram negative bacteria antibiotic) or vancomycin (mainly anti-Gram positive bacteria activity) in an escalating three-dose regimen. We also dosed animals with a well-known prebiotic weight-loss supplement, 10% oligofructose saccharide (10% OFS). Vancomycin treated mice showed little weight change and no improvement in glycemic control while ceftazidime and 10% OFS treatments induced significant weight loss. However, only ceftazidime showed significant, dose dependent improvement in key metabolic variables including glucose, insulin, protein tyrosine tyrosine (PYY) and glucagon-like peptide-1 (GLP-1). Subsequently, we confirmed the positive hyperglycemic control effects of ceftazidime in the Zucker diabetic fatty (ZDF) rat model. Metagenomic DNA sequencing of bacterial 16S rRNA gene regions V1-V3 showed that the microbiomes of ceftazidime dosed mice and rats were enriched for the phylum Firmicutes while 10% OFS treated mice had a greater abundance of Bacteroidetes. We show that specific changes in microbial community composition are associated with obesity and glycemic control phenotypes. More broadly, our study suggests that in vivo modulation of the microbiome warrants further investigation as a potential therapeutic strategy for metabolic diseases. PMID:26709835

  1. Study on in vitro antibacterial effect of Berberine on ESBLs-producing K. Pneunmoniae Combing with Cephalothin%黄连素与头孢菌素联用对产ESBLs克雷伯菌的体外抗菌作用初探

    Institute of Scientific and Technical Information of China (English)

    米伟; 张永海

    2009-01-01

    Object To explore antibacterial effect of Berberine on ESBLs-producing K. Pneunmoniae combing with Ceftazidime.Methods ESBLs-producing K. Pneunmoniae confirmation test was done using the method of slip; MIC of Berberine and Ceftazidime on ESBLs-producing K. Pneunmoniae was detected by agar dilution test and double dilution; Evaluation of synergistic antibacterial effect was used by broth chessboard method. Antimicrobial susceptibilities test was done using the methods of Kirby-Bauer according to the standards of CLSI. Results MIC90 of Ceftazidime on ESBLs-producing K. Pneunmoniae is 19.55μg·ml-1,and MIC90 of Berberine on ESBLs-producing K. Pneunmoniae is 35.67mg·ml-1;Activity of β-Lactamase of Berberine is significant lower than Berberine+Ceftazidime by bacterio-lipid compared with bacterio-broth(P<0.05);The diameter of antibacterial ring of Ceftazidime on ESBLs-producing K. Pneunmoniae is 12~23mm,while that of Berberine+Ceftazidime is 13~24.5mm,which there is significant difference using t-test(P<0.05);FIC index of Berberine+Ceftazidime is additive action by antimicrobial susceptibilities test of ESBLs-producing K. pneunmoniae. Conclusion Antibacterial effect of Berberine on ESBLs-producing K. Pneunmoniae combing with Ceftazidime is additive action by antimicrobial susceptibilities test; Berberine can inhibit activity of β-Lactamase of ESBLs-producing K. pneunmoniae combing with Ceftazidime.%目的 探讨黄连素与头孢他啶联用对产ESBLs克雷伯菌抑菌作用. 方法 采用纸片扩散法、琼脂稀释法和液体稀释法测定. 结果 头孢他啶对产ESBLs克雷伯菌MIC90为19.55μg·ml-1 ,黄连素对产ESBLs大肠埃希菌MIC90为35.67mg·ml-1 ;黄连素及黄连素+头孢他啶使β-内酰胺酶活性降低, P<0.05;单用头孢他啶与头孢他啶联合黄连素所测抑菌圈直径均数比较, P<0.05,有统计学意义;头孢他啶、黄连素联合药敏试验对产ESBLs克雷伯菌FIC指数为0.75、0.625、0.625. 结论 黄

  2. Use of the Malthus Microbial Growth Analyser to study the post antibiotic effect of antibiotics.

    Science.gov (United States)

    Gould, I M; Jason, A C; Milne, K

    1989-10-01

    The post antibiotic effect (PAE) of ceftazidime, ciprofloxacin, mecillinam and imipenem alone and in combination against Gram-negative bacteria was assessed by a new technique using a Malthus Microbial Growth Analyser. Ciprofloxacin gave the most prolonged and consistent PAE (1.3-2.9 h) and imipenem also gave a significant PAE against some bacterial strains (up to 1.3 h). The PAE of both antibiotics was dependent on concentration. The PAE of combinations of ciprofloxacin and imipenem often showed less PAE than was present with either agent alone. Ceftazidime gave no significant PAE (-1.5-0.4 h), though mecillinam consistently gave a short PAE (approximately 0.5 h) against Escherichia coli. The new method allows for the rapid and labour saving evaluation of PAE. We believe that further studies on PAE of antibiotic combinations are desirable.

  3. Evaluation of Mannosidase and Trypsin Enzymes Effects on Biofilm Production of Pseudomonas aeruginosa Isolated from Burn Wound Infections

    Science.gov (United States)

    Banar, Maryam; Emaneini, Mohammad; Satarzadeh, Mhboubeh; Abdellahi, Nafiseh; Beigverdi, Reza; van Leeuwen, Willem B.; Jabalameli, Fereshteh

    2016-01-01

    Biofilm is an important virulence factor in Pseudomonas aeruginosa and has a substantial role in antibiotic resistance and chronic burn wound infections. New therapeutic agents against P. aeruginosa, degrading biofilms in burn wounds and improving the efficacy of current antimicrobial agents, are required. In this study, the effects of α-mannosidase, β-mannosidase and trypsin enzymes on the degradation of P. aeruginosa biofilms and on the reduction of ceftazidime minimum biofilm eliminating concentrations (MBEC) were evaluated. All tested enzymes, destroyed the biofilms and reduced the ceftazidime MBECs. However, only trypsin had no cytotoxic effect on A-431 human epidermoid carcinoma cell lines. In conclusion, since trypsin had better features than mannosidase enzymes, it can be a promising agent in combatting P. aeruginosa burn wound infections. PMID:27736961

  4. CXCR1/CXCR2 antagonism is effective in pulmonary defense against Klebsiella pneumoniae infection.

    Science.gov (United States)

    Wei, Jing; Peng, Jing; Wang, Bing; Qu, Hong; Wang, Shiyi; Faisal, Aziz; Cheng, Jia-Wei; Gordon, John R; Li, Fang

    2013-01-01

    Klebsiella pneumoniae-associated pathology is largely mediated by neutrophilic inflammation. In this study, we administered Klebsiella pneumoniae to experimental guinea pig groups and the ELR-CXC chemokine antagonist CXCL8(3-72), ceftazidime, and dexamethasone to different groups, respectively. After 24 h, we assessed the animal's pulmonary inflammatory levels, including gross histopathology, airway neutrophilia, lung myeloperoxidase levels, expressions of CXCL8 and TNF, and airway bacterial loads. Compared with ceftazidime and dexamethasone treatments, the administration of the ELR-CXC chemokine antagonist CXCL8(3-72) alone was more effective than other methods, although it did not markedly attenuate the bacterial load. These results suggest new methods for the treatment of Klebsiella pneumoniae pathology.

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

    Directory of Open Access Journals (Sweden)

    Flávia L. P. C. Pellegrino

    2006-08-01

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

  6. Prevalence of ESBL phenotype,blaCTX-M-1,blaSHV andblaTEM genes among uropathogenicEscherichia coli isolates from 3 military hospitals of Tehran, Iran

    Institute of Scientific and Technical Information of China (English)

    Farshad Nojoomi; Abdolmajid Ghasemian

    2016-01-01

    Objective:To determine the extended-spectrum beta-lactamase (ESBL) production and prevalence ofblaCTX-M-1,blaSHV andblaTEM genes among uropathogenic Escherichia coli(UPEC) isolates from 3 military hospitals of Tehran during 2015–2016. Methods: One-hundred and eleven isolates were adopted. The antibiotic susceptibility testing was conducted according to Clinical and Laboratory Standards Institute guidelines. The combine disk was used for phenotypicESBL production. The ceftazidimeMIC was conducted with the micro-broth dilution test. ThePCR assay was used to detect theblaCTX-M-1,blaSHV and blaTEM genes. Results:In the broth microdilution method, 103 (92.7%) isolates showed minimal inhibitory concentration (MIC)≥1µg/mL, and also in the combined disk method, 89 (80.1% of all) wereESBL positive. On the other hand, among 91 ceftazidime resistant isolates, 86 (77.4% of all) wereESBLpositive. The difference between the two methods forESBL confirmation was not significant. The result ofMIC was similar to the disk diffusion method in the detection of phenotypicESBL production. AmongESBLproducer isolates, the prevalence ofblaCTX-M-1, blaSHV andblaTEM was 77.4% (n= 86), 47.4% (n= 53) and 2.4% (n= 2), respectively. These genes were amplified in a wide rangeMIC of ceftazidime. Conclusions:The prevalence of multi-drug resistantUPEC andESBL positive isolates was high in military hospitals. The majority ofUPEC isolates amplifiedblaCTX-M-I andblaSHV typeβ-lactamase genes. One-third of isolates were positive in presence of both these genes. There was no relation between ceftazidimeMIC and presence of beta-lactamase genes.

  7. Chromosome-Encoded Extended-Spectrum Class A β-Lactamase MIN-1 from Minibacterium massiliensis

    OpenAIRE

    Bercot, Béatrice; Nordmann, Patrice; Drancourt, Michel; Poirel , Laurent

    2012-01-01

    Minibacterium massiliensis strain CIP107820 is a recently discovered waterborne Gram-negative rod isolated from hospital water samples. It harbors a chromosomally located gene encoding an Ambler class A extended-spectrum β-lactamase termed MIN-1, sharing 56%, 54%, and 51% amino acid identities with β-lactamases LUT-1, KPC-2, and CTX-M-2, respectively. β-Lactamase MIN-1 hydrolyzes penicillins, narrow-spectrum cephalosporins, cefotaxime, and, less efficiently, cefepime, while ceftazidime and ca...

  8. In vitro antibiotic susceptibilities of Burkholderia mallei (causative agent of glanders) determined by broth microdilution and E-test.

    Science.gov (United States)

    Heine, H S; England, M J; Waag, D M; Byrne, W R

    2001-07-01

    In vitro susceptibilities to 28 antibiotics were determined for 11 strains of Burkholderia mallei by the broth microdilution method. The B. mallei strains demonstrated susceptibility to aminoglycosides, macrolides, quinolones, doxycycline, piperacillin, ceftazidime, and imipenem. For comparison and evaluation, 17 antibiotic susceptibilities were also determined by the E-test. E-test values were always lower than the broth dilution values. Establishing and comparing antibiotic susceptibilities of specific B. mallei strains will provide reference information for assessing new antibiotic agents.

  9. Rhizobium (Agrobacterium) radiobacter Identified as a Cause of Chronic Endophthalmitis Subsequent to Cataract Extraction

    OpenAIRE

    Namdari, Hassan; Hamzavi, Sirus; Peairs, Randall R.

    2003-01-01

    Herein, we report a case of chronic endophthalmitis caused by a ceftazidime-resistant Rhizobium radiobacter strain in a 62-year-old male. The patient underwent an uneventful cataract extraction of the right eye a week prior to the appearance of symptoms (pain, redness, and blurring vision) which developed following a golf outing. Upon admission the patient received an emergency vitrectomy. The patient remained symptomatic, and R. radiobacter was isolated repeatedly from vitreous fluid culture...

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  11. Desenvolvimento de metodologia qualitativa para identificação de ceftazidima

    Directory of Open Access Journals (Sweden)

    ANDREIA HARO MORENO

    2010-12-01

    Full Text Available A partir deste estudo, métodos para análise qualitativa foram desenvolvidos a fim de identificar ceftazidima em matéria-prima e em formulações farmacêuticas. Esses métodos incluíram testes físico-químicos baseados em propriedades químicas por reações clássicas de coloração e testes instrumentais, tais como cromatografia em camada delgada, calorimetria e espectroscopia no ultravioleta. Os resultados foram obtidos diretamente através de identificação visual pela coloração desenvolvida e pela análise dos espectros obtidos nos testes instrumentais. Esses métodos mostraram-se reprodutíveis e rápidos para identificar ceftazidima na presença de outros antibióticos -lactâmicos, podendo ser usados rotineiramente em análises de controle de qualidade. Palavras-chave: Análise qualitativa. Controle de qualidade. Ceftazidima. ABSTRACT Qualitative methods for the identification of ceftazidime In this study, qualitative analytical methods were developed for the identification of ceftazidime in raw material and in pharmaceutical formulations. These methods included physicochemical tests based on chemical properties, performed by classical colorimetric reactions, and instrumental tests, such as thin-layer chromatography, calorimetry and ultraviolet spectroscopy. Results were obtained directly, through the visual identification of the drug by the color developed, and by analyzing the spectra obtained. These methods proved to be reproducible and fast means of identifying ceftazidime in the presence of other beta-lactam antibiotics and may be used for routine quality control tests. Keywords: Qualitative analysis. Quality control. Ceftazidime.

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

    Science.gov (United States)

    Ourghanlian, Clément; Soroka, Daria; Arthur, Michel

    2017-03-01

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

  13. Detection of Extended Spectrum β-Lactamase producing Escherichia coli (ESBL E.coli) from chicken meat in Niigata Prefecture, Japan

    OpenAIRE

    2015-01-01

    The extended-spectrum β-lactamases (ESBLs) are the enzymes which degrade oxyimino-cephalosporins such as cefotaxime and ceftazidime, and make the antibiotics ineffective. In the past decade, drug resistance derived from Extended-spectrum β-lactamase-producing Escherichia coli (ESBL E. coli) has been increasing dramatically worldwide. The ESBLs genes are located on plasmids that can be easily transferred between and within bacterial species. It is indicated the linkage of ESBL E. coli from the...

  14. Drug Use Evaluation of Three Widely Prescribed Antibiotics in a

    Directory of Open Access Journals (Sweden)

    Mehdi Mohammadi

    2015-10-01

    Full Text Available Background: Drug utilization studies are helpful in understanding the current practice. We have conducted a retrospective study to evaluate the relevant use of a group of most commonly prescribed antibiotics in a teaching hospital in Iran.  The results of this study may be of help for clinicians to improve the patient care.Methods: Patients who received parenteral ceftazidim, vancomycin and amikacin from December2010 to May 2011 were enrolled in this study. Patient’s data including demographic, length of Hospital stay, drug allergy, first and final diagnosis were recorded in a predesigned data collection form. American Hospital Formulary Services (AHFS book were used as a reference for evaluation of study drug indication and dosing according to diagnosis and microbiological culture. Defined Daily Dose (DDD of each drug extracted from Anatomic and Therapeutic Chemical classification system (ATC/DDD and drug usage data evaluated by calculating the ratio of prescribed drug to its DDD.Results: The ratio of prescribed daily dose to DDD was 0.78, 0.95 and 0.86 for amikacin, ceftazidime and vancomycin respectively. Between amikacin group, 43 patients (86% received drug empirically, the number of empiric treatments for ceftazidim and vancomycin were 45(90% and 44 patients (88%. The renal function tests (Blood Urea Nitrogen, Serum Creatinin were evaluated in 56% of amikacin group, 64% in ceftazidime group and 78% in vancomycin group.Conclusion: The results of this study indicate the need to establish continuing medical education (CME courses for physicians to familiarize them with standards required to use and monitor these agents.

  15. Effect of clavulanic acid on the activities of ten beta-lactam agents against members of the Bacteroides fragilis group.

    Science.gov (United States)

    Lamothe, F; Auger, F; Lacroix, J M

    1984-01-01

    Clavulanic acid reduced the MICs of amoxicillin, carbencillin , cefamandole, cefotaxime, ceftazidime, ceftizoxime, cephalothin, and penicillin G, but not of cefoxitin or moxalactam, against 77 isolates of the Bacteroides fragilis group, all rapidly beta-lactamase positive by the nitrocefin slide test. It had no effect on the susceptibilities of eight Bacteroides distasonis strains that were slowly beta-lactamase positive (18 h of incubation). PMID:6732233

  16. Genome Sequence of a Multidrug-Resistant Strain of Klebsiella pneumoniae, BAMC 07-18, Isolated from a Combat Injury Wound

    Science.gov (United States)

    2014-11-26

    including azithromycin, ceftazidime, chloramphenicol, and tetracycline; however, BAMC 07-18 is sensitive to imipenem, a carbapenem , both in vivo and in...alterations in morphology (7), leading us to question the genetic mechanisms of the pleiotropic effects of imipenem against this carbapenem -sensitive...RNA sequencing analysis (RNA-seq) will allow us to explore the pleiotropic effects of carbapenems on K. pneumoniae biofilms and provide novel

  17. PER, CTX-M, TEM and SHV Beta-lactamases in Clinical Isolates of Klebsiella pneumoniae Isolated from Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Leila Nasehi

    2010-06-01

    Full Text Available Objective(sDifferent types of extended spectrum beta-lactamases (ESBLs are encountered in the clinical settings worldwide. There are a few studies regarding the prevalence of ESBL genes among Klebsiella pneumoniae isolates at Tehran especially those of blaPER and blaCTX. The aim of this study was to determine the prevalence of blaSHV, blaTEM ,blaPER and blaCTX genes among clinical K. pneumoniae of different hospitals in Tehran.Materials and MethodsTwo hundred isolates of K. pneumoniae were received from different clinical specimens. The susceptibility of the isolates to 10 different antibiotics was examined by disk diffusion test. The MICs for ceftazidime were also determined using micro-broth dilution assay. Isolates showing MIC 4 μg/ml for ceftazidime were screened for ESBL production by phenotypic confirmatory test (PCT and subjected to PCR for studied genes. Variation among four amplified genes was evaluated using PCR-RFLP.ResultsBy disk diffusion test, resistance to ceftazidime and cefotaxime were 34.7% and 33.5% respectively. However, all strains were susceptible to imipenem. Eighty isolates showed MICs≥ 4 μg/ml for ceftazidime of which 77 (96% were positive for ESBL in PCT. The prevalence of blaSHV, blaCTX-M, blaTEM and blaPER among these isolates were 26%, 24.5%, 18% and 7.5%, respectively. No variation was detected in the genes by PCR-RFLP.ConclusionAs far as we know this is the first report of the blaPER-1 in K. pneumoniae in Iran. The blaCTX-M was the second most common gene detected among the ESBL positive isolates of K. pneumoniae. For rapid identification of ESBL producing isolates it was recommended that clinical laboratories adopt simple test based on CLSI recommendation for confirming ESBL production in enterobacterial species.

  18. Influence of human urine to antimicrobial susceptibility of clinical isolates of Klebsiella pneumoniae and Escherichia coli producing β-lactamase of different types

    Directory of Open Access Journals (Sweden)

    Ž. Žagar

    2007-02-01

    Full Text Available The purpose of the study was to determine the influence of human urine on the antibiotic susceptibilities of Klebsiella pneumoniae and Escherichia coli strains producing different types of extended-spectrum β-lactamases (ESBL. The study was performed on 26 ESBL negative strains of K. pneumoniae, 80 K. pneumoniae strains producing SHV-ESBLs (52-SHV-5, 31- SHV-2 and 7- SHV-12, 94 E. coli strains harbouring TEM- ESBLs and 14 E. coli strains possessing CTX-M group 1 β-lactamases. The minimum inhibitory concentrations of amoxycillin alone and combined with clavulanate (co-amoxilcav, cephalexin, cefuroxime, ceftazidime, cefotaxime, ceftriaxone, cefepime, gentamicin and ciprofloxacin were performed in parallel in Mueller-Hinton broth and urine by broth microdilution method. With ESBL negative strains, urine increased MIC90 of amoxycillin alone and combined with clavulanate, cephalexin, cefuroxime, ceftazidime, cefotaxime, ceftriaxone, cefepime, gentamicin and ciprofloxacin. Against SHV-5 producers, an increase in MIC90 was observed with cefotaxime, cefepime and ciprofloxacin when the test was performed in urine. SHV-2 producers showed elevated MIC90 of ceftazidime, cefotaxime, ceftriaxone and cefepime in the presence of urine, in contrast to SHV-12 producers which displayed elevated MIC90 only for cefotaxime. Urine increased MIC90 of amoxycillin/clavulanate, ceftazidime and cefepime against CTX-M producers, and of amoxycillin/clavulanate, cefotaxime, ceftriaxone, cefepime and ciprofloxacin for TEM producers. According to our results the activity of antibiotics used for the treatment of urinary tract infection could be overestimated by a standard in vitro testing. However, most of antibiotics used for the treatment of urinary tract infection achieve very high concentration in urine and that could abrogate the reduction of antimicrobial activity by biological fluid.

  19. Ofloxacin intravenous. Compatibility with other antibacterial agents.

    Science.gov (United States)

    Janknegt, R; Stratermans, T; Cilissen, J; Lohman, J J; Hooymans, P M

    1991-10-18

    The physical and chemical compatibility of ofloxacin (infusion solution 100 ml = 200 mg) with amoxicillin, amoxicillin + clavulanic acid, flucloxacillin, tobramycin, gentamicin, clindamycin, vancomycin, ceftazidime and piperacillin was investigated. Upon admixture with flucloxacillin a precipitate formed between 7 and 24 hours. No other physical or chemical incompatibilities were observed with any of the other combinations. Ofloxacin may be safely combined with the tested antimicrobial drugs, except for flucloxacillin.

  20. Drug: D07654 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available 22N6O7S2 546.0991 546.5761 D07654.gif Antibiotic, cephalosporin Same as: C06889 ATC code: J01DD02 Semisynthetic cephalosporin...: broad spectrum cephalosporin penicillin binding proteins inhibitor ko00550 Peptidoglycan ...USE J01D OTHER BETA-LACTAM ANTIBACTERIALS J01DD Third-generation cephalosporins J01DD02 Ceftazidime D07654 C

  1. Traumatic endophthalmitis caused by Nocardia kruczakiae in a patient with traumatic eye injury

    OpenAIRE

    Compte, Rafael Barraquer; Martínez-Osorio, Hernán; Carrasco, Gema; Lorente, Betty; Elizalde, Javier; Valdezate, Sylvia; Lorente, Ramón; Iglesias, Emilio; Saez-Nieto, Juan Antonio

    2015-01-01

    Background We describe a case of traumatic ocular endophthalmitis caused by Nocardia kruczakiae after vegetable trauma in an immunocompetent child. Findings A 5-year-old boy suffered from a trauma with a palm tree leaflet. Two months later, he was diagnosed with traumatic infectious uveitis and intumescent cataract with anterior capsule rupture. Intensive treatment with systemic and topical vancomycin, ceftazidime and methylprednisolone began. After 1 month, he underwent phacoemulsification w...

  2. 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...

  3. In vitro prevention of Pseudomonas aeruginosa early biofilm formation with antibiotics used in cystic fibrosis patients.

    Science.gov (United States)

    Fernández-Olmos, Ana; García-Castillo, María; Maiz, Luis; Lamas, Adelaida; Baquero, Fernando; Cantón, Rafael

    2012-08-01

    The ability of antibiotics used in bronchopulmonary infections in cystic fibrosis (CF) patients to prevent Pseudomonas aeruginosa early biofilm formation was studied using a biofilm microtitre assay with 57 non-mucoid P. aeruginosa isolates (44 first colonisers and 13 recovered during the initial intermittent colonisation stage) obtained from 35 CF patients. Minimum biofilm inhibitory concentrations (BICs) of levofloxacin, ciprofloxacin, imipenem, ceftazidime, tobramycin, colistin and azithromycin were determined by placing a peg lid with a formed biofilm onto microplates containing antibiotics. A modification of this protocol consisting of antibiotic challenge during biofilm formation was implemented in order to determine the biofilm prevention concentration (BPC), i.e. the minimum concentration able to prevent biofilm formation. The lowest BPCs were for fluoroquinolones, tobramycin and colistin and the highest for ceftazidime and imipenem. The former antibiotics had BPCs identical to or only slightly higher than their minimum inhibitory concentrations (MICs) determined by standard Clinical and Laboratory Standards Institute (CLSI) microdilution and were also active on formed biofilms as reflected by their low BIC values. In contrast, ceftazidime and imipenem were less effective for prevention of biofilm formation and on formed biofilms. In conclusion, the new BPC parameter determined in non-mucoid P. aeruginosa isolates recovered during early colonisation stages in CF patients supports early aggressive antimicrobial treatment guidelines in first P. aeruginosa-colonised CF patients.

  4. Concomitant detection of biofilm and metallo-beta-lactamases production in gram-negative bacilli

    Directory of Open Access Journals (Sweden)

    Monil Singhai

    2013-01-01

    Full Text Available Carbapenems are mainstay of treating serious multidrug resistant gram-negative biofilm-based infections. However, recent emergence of metallo-beta-lactamases (MbL producing gram-negative bacilli in different parts of world may be related to gain of virulence factors associated with biofilm production. Objectives: To explore the association of MbL and biofilm production in various gram-negative bacilli. Materials and Methods: In this study, 110 non-repetitive ceftazidime resistant gram-negative bacilli were evaluated for biofilm and MβL production. Biofilm forming ability of isolates obtained from various specimens was tested by the tube method. Disks of ceftazidime (30 μg and ceftazidime with ethylenediaminetetraacetic acid (30 μg + 750 μg, prepared in house for MβL detection were used. Chi-square test was used to study the association between biofilm and MβL production. P value <0.05 was considered significant. Results: 88 (80% bacilli had shown biofilm producing ability. The association of biofilm and MβL was significant in cases of non-fermenters as compared to enterobacteriaceae members. Conclusion: The particular combination of virulence factors (biofilm and MβL in bacteria may be a species specific effect which needs to be investigated at molecular level in detail. This may help in designing newer therapies based on interference with biofilm formation and thus countering clinical episodes of antibiotic resistance.

  5. Antibiotic susceptibility of sulfamethoxazole-trimethoprim resistant Stenotrophomonas maltophilia strains isolated at a tertiary care centre in Hungary.

    Science.gov (United States)

    Juhász, Emese; Pongrácz, Júlia; Iván, Miklós; Kristóf, Katalin

    2015-09-01

    Sulfamethoxazole-trimethoprim (SXT) is the drug-of-choice in Stenotrophomonas maltophilia caused infections. There has been an increase in resistance to SXT of S. maltophilia over recent years. In this study 30 S. maltophilia clinical isolates resistant to SXT were investigated. Antibiotic susceptibilities for ciprofloxacin, moxifloxacin, levofloxacin, doxycycline, tigecycline, ceftazidime, colistin and chloramphenicol were determined by broth microdilution method. None of the strains were susceptible to ciprofloxacin, tigecycline, ceftazidime or colistin. Only 37% of the isolates were susceptible to levofloxacin or moxifloxacin. Two isolates resistant to all tested antibiotic agents and two others susceptible only to doxycycline were further investigated: susceptibility for combinations of antibiotics was analyzed by checkerboard technique. According to the fractional inhibitory concentration indices calculated, moxifloxacin plus ceftazidime combination was found to be synergistic in each case. Genetic testing revealed the predominance of sul1 gene. Our study concluded that the range of effective antibiotic agents is even more limited in infections caused by SXT-resistant S. maltophilia. In these cases, in vitro synergistic antibiotic combinations could be potential therapeutic options.

  6. 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.

  7. Resistance to Cefepime and Cefpirome Due to a 4-Amino-Acid Deletion in the Chromosome-Encoded AmpC β-Lactamase of a Serratia marcescens Clinical Isolate

    Science.gov (United States)

    Mammeri, Hedi; Poirel, Laurent; Bemer, Pascal; Drugeon, Henri; Nordmann, Patrice

    2004-01-01

    A multiresistant Serratia marcescens strain, HD, isolated from a patient with a urinary tract infection, was resistant to amino-, carboxy-, and ureidopenicillins, ceftazidime, and cefepime and was susceptible to cefotaxime and ceftriaxone, according to the guidelines of the NCCLS. No synergy was found between expanded-spectrum cephalosporins and clavulanic acid, according to the double-disk synergy test. The blaAmpC gene of the strain was amplified by PCR and cloned into Escherichia coli DH10B, giving rise to high-level resistance to ceftazidime, cefepime, and cefpirome. Sequencing analysis revealed that the blaAmpC gene from S. marcescens HD had a 12-nucleotide deletion compared to the blaAmpC gene from reference strain S. marcescens S3, leading to a 4-amino-acid deletion located in the H-10 helix of the β-lactamase. Kinetic analysis showed that this enzyme significantly hydrolyzed ceftazidime, cefepime, and cefpirome. This work underlined that resistance to the latest expanded-spectrum cephalosporins may be mediated by structurally modified AmpC-type β-lactamases. PMID:14982755

  8. Resistance to cefepime and cefpirome due to a 4-amino-acid deletion in the chromosome-encoded AmpC beta-lactamase of a Serratia marcescens clinical isolate.

    Science.gov (United States)

    Mammeri, Hedi; Poirel, Laurent; Bemer, Pascal; Drugeon, Henri; Nordmann, Patrice

    2004-03-01

    A multiresistant Serratia marcescens strain, HD, isolated from a patient with a urinary tract infection, was resistant to amino-, carboxy-, and ureidopenicillins, ceftazidime, and cefepime and was susceptible to cefotaxime and ceftriaxone, according to the guidelines of the NCCLS. No synergy was found between expanded-spectrum cephalosporins and clavulanic acid, according to the double-disk synergy test. The bla(AmpC) gene of the strain was amplified by PCR and cloned into Escherichia coli DH10B, giving rise to high-level resistance to ceftazidime, cefepime, and cefpirome. Sequencing analysis revealed that the bla(AmpC) gene from S. marcescens HD had a 12-nucleotide deletion compared to the bla(AmpC) gene from reference strain S. marcescens S3, leading to a 4-amino-acid deletion located in the H-10 helix of the beta-lactamase. Kinetic analysis showed that this enzyme significantly hydrolyzed ceftazidime, cefepime, and cefpirome. This work underlined that resistance to the latest expanded-spectrum cephalosporins may be mediated by structurally modified AmpC-type beta-lactamases.

  9. Ceftobiprole medocaril in the treatment of hospital-acquired pneumonia.

    Science.gov (United States)

    Scheeren, Thomas W L

    2015-01-01

    Ceftobiprole medocaril is a fifth-generation cephalosporin approved in Europe as single-agent therapy for hospital-acquired pneumonia (HAP), excluding ventilator-associated pneumonia (VAP). It is rapidly converted to the active metabolite ceftobiprole following intravenous administration. Ceftobiprole has a broad spectrum of activity, notably against methicillin-resistant Staphylococcus aureus, ampicillin-susceptible enterococci, penicillin-resistant pneumococci and Enterobacteriaceae not producing extended-spectrum β-lactamase. Ceftobiprole is primarily excreted renally by glomerular filtration, with minimal propensity for interaction with co-administered drugs. Normal dose is ceftobiprole 500 mg, administered by 2-h intravenous infusion every 8 h, with dose adjustment according to renal function. In a pivotal Phase III trial in patients with HAP, ceftobiprole monotherapy was as efficacious as ceftazidime/linezolid for clinical and microbiological cure and was noninferior to ceftazidime/linezolid in the subgroup of patients with HAP excluding VAP. Ceftobiprole and ceftazidime/linezolid were similarly well tolerated. Ceftobiprole is an efficacious and well-tolerated option for empirical treatment of patients with HAP (excluding VAP).

  10. Interactions of ceftobiprole with beta-lactamases from molecular classes A to D.

    Science.gov (United States)

    Queenan, Anne Marie; Shang, Wenchi; Kania, Malgosia; Page, Malcolm G P; Bush, Karen

    2007-09-01

    The interactions of ceftobiprole with purified beta-lactamases from molecular classes A, B, C, and D were determined and compared with those of benzylpenicillin, cephaloridine, cefepime, and ceftazidime. Enzymes were selected from functional groups 1, 2a, 2b, 2be, 2d, 2e, and 3 to represent beta-lactamases from organisms within the antibacterial spectrum of ceftobiprole. Ceftobiprole was refractory to hydrolysis by the common staphylococcal PC1 beta-lactamase, the class A TEM-1 beta-lactamase, and the class C AmpC beta-lactamase but was labile to hydrolysis by class B, class D, and class A extended-spectrum beta-lactamases. Cefepime and ceftazidime followed similar patterns. In most cases, the hydrolytic stability of a substrate correlated with the MIC for the producing organism. Ceftobiprole and cefepime generally had lower MICs than ceftazidime for AmpC-producing organisms, particularly AmpC-overexpressing Enterobacter cloacae organisms. However, all three cephalosporins were hydrolyzed very slowly by AmpC cephalosporinases, suggesting that factors other than beta-lactamase stability contribute to lower ceftobiprole and cefepime MICs against many members of the family Enterobacteriaceae.

  11. Inhibition of Bacterial Adhesion by Subinhibitory Concentrations of Antibiotics

    Directory of Open Access Journals (Sweden)

    Vidya K

    2005-01-01

    Full Text Available Background: Urinary Tract Infections (UTIs due to Escherichia coli is one of the most common diseases encountered in clinical practice. Most common recognised pathogenic factor in E.coli is adhesion. There is accumulating evidence that through subinhibitory concentrations (sub - MICs of many antibiotics do not kill bacteria, they are able to interfere with some important aspects of bacterial cell function. Materials and Methods: A study was conducted to investigate the effect of sub MICs (1/2-1/8 MIC of ciprofloxacin, ceftazidime, gentamicin, ampicillin and co - trimoxazole on E. coli adhesiveness to human vaginal epithelial cells using three strains ATCC 25922, MTCC 729 and U 105. Results: The 1/2 MIC of all the antibiotics tested produced the greatest inhibition of bacterial adhesion. Morphological changes were observed with ciprofloxacin, ceftazidime and ampicillin at 1/2 MIC and to a lesser extent at 1/4 and 1/8 MIC. Co-trimoxazole caused the greatest suppression of adhesion at 1/2 MIC of E. coli strain MTCC 729 when compared with the controls, followed by ceftazidime. Conclusion: These results suggest that co - trimoxazole is the most effective antibiotic in the treatment of urinary tract infections caused by uropathogenic E. coli.

  12. Phenotypic and genotypic detection of extended-spectrum β-lactamase (ESBL) producing Escherichia coli isolated from urinary tract infections in Zabol, Iran

    Institute of Scientific and Technical Information of China (English)

    Saeide Saeidi; Mehdi Ghamgosha; Ramezan Ali Taheri; Yasub Shiri; Mahmood Solouki; Kazem Hassanpour; Gholamreza Farnoosh

    2014-01-01

    Objective: To investigate the role of a rapid polymerase chain reaction (PCR) assay in comparison with traditional empiric therapy in detection of extended spectrum β-lactamase (ESBL) producer Escherichia coli (E. coli). Methods: Ninety isolates of E. coli from urinary tract infection were collected and screening of ESBL resistance using disc diffusion method, minimum inhibitory concentration (MIC) for ceftazidime and detection of TEM resistant gene by PCR were done. Results: The results of disc diffusion method showed that forty out of ninety E. coli isolates were ESBLs producing organisms. Antibiotic susceptibility of E. coli isolates to 9 antibacterial agents were evaluated. However, all isolated E. coli were resistant to all 9 antibacterial agents by these percentage: ceftriaxon (100%), ceftazidime (100%), amoxicillin (100%), erythromycin (100%), azithromycin (95%), cefixime (87.5%), tetracyclin (87.5%), nalidixic acid (85%) and difloxcain (75%). The abundance of antibiotic-resistant TEM gene according to PCR was 30%. Totally 82.5% of strains tested by MIC were observed as ceftazidime-resistant.Conclusions:We conclude that the TEM gene PCR assay is a rapid, sensitive and clinically useful test, particularly for the early detection of ESBLs-producing E. coli.

  13. Rapid functional definition of extended spectrum β-lactamase activity in bacterial cultures via competitive inhibition of fluorescent substrate cleavage.

    Science.gov (United States)

    Sallum, Ulysses W; Zheng, Xiang; Verma, Sarika; Hasan, Tayyaba

    2010-01-01

    The functional definition of extended-spectrum β-lactamase (ESBL) activity is a clinical challenge. Here we report a rapid and convenient assay of β-lactamase activity through the competitive inhibition of fluorescent substrate hydrolysis that provides a read-out nearly 40× more rapidly than conventional techniques for functional definition. A panel of β-lactam antibiotics was used for competition against β-lactamase enzyme-activated photosensitizer (β-LEAP) yielding a competitive index (C(i)) in 30 min. Significant differences in the relative C(i) values of the panel of β-lactams were determined in vitro for Bacillus cereus penicillinase. Additionally, the relative C(i) values for whole bacterial cell suspensions of B. cereus 5/β were compared with the relative minimal inhibitory concentration (MIC) values and a correlation coefficient of 0.899 was determined. We further demonstrated the ability of β-LEAP to probe the capacity of ceftazidime to inhibit the enzyme activity of a panel of ESBL-producing Escherichia coli. The bacteria were assayed for susceptibility to ceftazidime and the relative MIC values were compared with the relative C(i) values for ceftazidime yielding a correlation coefficient of 0.984. This work demonstrates for the first time the whole cell assay of the competitive inhibition of β-lactamase enzyme activity and derivation of associated constants.

  14. Ceftazidime–avibactam: an evidence-based review of its pharmacology and potential use in the treatment of Gram-negative bacterial infections

    Directory of Open Access Journals (Sweden)

    Lagacé-Wiens P

    2014-01-01

    Full Text Available Philippe Lagacé-Wiens,1,2 Andrew Walkty,1,2 James A Karlowsky1,2 1Clinical Microbiology, Diagnostic Services Manitoba, 2Department of Medical Microbiology and Infectious Diseases, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada Abstract: Avibactam (NXL104, AVE1330A is a semi-synthetic, non-β-lactam, β-lactamase inhibitor that is active against Ambler class A, class C, and some class D serine β-lactamases. In this review, we summarize the in vitro data, pharmacology, mechanisms of action and resistance, and clinical trial data relating to the use of this agent combined with ceftazidime for the treatment of Gram-negative bacterial infections. The addition of avibactam to ceftazidime improves its in vitro activity against Enterobacteriaceae and Pseudomonas aeruginosa. Avibactam does not improve the activity of ceftazidime against Acinetobacter spp., Burkholderia spp., or most anaerobic Gram-negative rods. Pharmacodynamic data indicate that ceftazidime–avibactam is bactericidal at concentrations achievable in human serum. Animal studies demonstrate that ceftazidime–avibactam is effective in ceftazidime-resistant Gram-negative septicemia, meningitis, pyelonephritis, and pneumonia. Limited clinical trials published to date have reported that ceftazidime–avibactam is as effective as therapy with a carbapenem in complicated urinary tract infection and complicated intra-abdominal infection (combined with metronidazole including infection caused by cephalosporin-resistant Gram-negative isolates. Safety and tolerability of ceftazidime–avibactam in clinical trials has been excellent, with few serious drug-related adverse events reported. Given the abundant clinical experience with ceftazidime and the significant improvement that avibactam provides in its activity against contemporary β-lactamase-producing Gram-negative pathogens, it is likely this new combination agent will play a role in the empiric treatment of complicated

  15. Diversity of mechanisms conferring resistance to β-lactams among OXA-23-producing Acinetobacter baumannii clones.

    Science.gov (United States)

    Cardoso, Juliana Provasi; Cayô, Rodrigo; Girardello, Raquel; Gales, Ana Cristina

    2016-05-01

    A total of 31 unrelated OXA-23-producing Acinetobacter baumannii strains isolated from 14 hospitals located in distinct Brazilian regions were evaluated in this study. These isolates were grouped into 12 different sequence types (STs), of which 7 had unique allelic sequences (ST188, ST189, ST190, ST191, ST192, ST228, and ST299). Most isolates belonged to the clonal complex CC79 followed by CC15 and CC1. Only polymyxin B and minocycline showed good activity against the OXA-23-producing A. baumannii clones. The ISAba1 upstream blaOXA-23, blaOXA-51-like, or ampC was found in 100%, 54.8%, and 77.4% of the isolates, respectively. High resistance rates to ceftazidime and cefotaxime were observed among those isolates possessing ISAba1 upstream ampC, in contrast to those isolates that did not carry this configuration. Moreover, a ≥2 Log2 decrease in the MICs of meropenem and ceftazidime was observed in the presence of phenyl-arginine-β-naphthylamide for 80.6% and 54.8% of isolates, respectively. Overexpression of the adeB was observed in 61.3% of isolates, particularly among those isolates belonging to the ST1 (CC1). It was also verified that ompW was down-regulated in all isolates belonging to the ST15 (CC15). On the other hand, carO and omp33-36 genes were overexpressed in 48.4% and 58.1% of the isolates, respectively. In this study, we show that overexpression of AdeABC system could significantly contribute for resistance to meropenem and ceftazidime among OXA-23-producing A. baumannii clones in Brazil, demonstrating the complexity involved in the β-lactam resistance in such isolates.

  16. Novel Insights Into The Mode of Inhibition of Class A SHV-1 Beta-Lactamases Revealed by Boronic Acid Transition State Inhibitors

    Energy Technology Data Exchange (ETDEWEB)

    W Ke; J Sampson; C Ori; F Prati; S Drawz; C Bethel; R Bonomo; F van den Akker

    2011-12-31

    Boronic acid transition state inhibitors (BATSIs) are potent class A and C {beta}-lactamase inactivators and are of particular interest due to their reversible nature mimicking the transition state. Here, we present structural and kinetic data describing the inhibition of the SHV-1 {beta}-lactamase, a clinically important enzyme found in Klebsiella pneumoniae, by BATSI compounds possessing the R1 side chains of ceftazidime and cefoperazone and designed variants of the latter, compounds 1 and 2. The ceftazidime and cefoperazone BATSI compounds inhibit the SHV-1 {beta}-lactamase with micromolar affinity that is considerably weaker than their inhibition of other {beta}-lactamases. The solved crystal structures of these two BATSIs in complex with SHV-1 reveal a possible reason for SHV-1's relative resistance to inhibition, as the BATSIs adopt a deacylation transition state conformation compared to the usual acylation transition state conformation when complexed to other {beta}-lactamases. Active-site comparison suggests that these conformational differences might be attributed to a subtle shift of residue A237 in SHV-1. The ceftazidime BATSI structure revealed that the carboxyl-dimethyl moiety is positioned in SHV-1's carboxyl binding pocket. In contrast, the cefoperazone BATSI has its R1 group pointing away from the active site such that its phenol moiety moves residue Y105 from the active site via end-on stacking interactions. To work toward improving the affinity of the cefoperazone BATSI, we synthesized two variants in which either one or two extra carbons were added to the phenol linker. Both variants yielded improved affinity against SHV-1, possibly as a consequence of releasing the strain of its interaction with the unusual Y105 conformation.

  17. Antimicrobial activity of ceftobiprole, a novel anti-methicillin-resistant Staphylococcus aureus cephalosporin, tested against contemporary pathogens: results from the SENTRY Antimicrobial Surveillance Program (2005-2006).

    Science.gov (United States)

    Fritsche, Thomas R; Sader, Helio S; Jones, Ronald N

    2008-05-01

    Ceftobiprole is a 1st-in-class anti-methicillin-resistant Staphylococcus aureus (MRSA) extended-spectrum cephalosporin currently in clinical trials for the treatment of complicated skin and skin structure infections (cSSSIs) and nosocomial pneumonia. This agent is also active against other prominent Gram-positive and Gram-negative pathogens, making it an attractive candidate for broad-spectrum therapy. We evaluated the in vitro potency of ceftobiprole tested against the most commonly occurring bacterial pathogens as part of a global surveillance study for the years 2005 to 2006 (>60 medical centers in North America, Latin America, and Europe). All isolates (40 675) were susceptibility tested using reference broth microdilution methods. Ceftobiprole inhibited 100% and >99% of tested S. aureus and coagulase-negative staphylococci at Ceftobiprole was also broadly active against Streptococcus pneumoniae, beta-hemolytic and viridans group streptococci, inhibiting >98% of isolates at ceftobiprole was generally inactive against Enterococcus faecium, the majority of Enterococcus faecalis strains (95.7%) were inhibited at ceftobiprole and ceftazidime), ceftobiprole and cefepime were superior to ceftazidime against Enterobacter spp. and Citrobacter spp. Against Pseudomonas aeruginosa, ceftobiprole was equal in potency to ceftazidime (MIC50, 2 microg/mL) and 2-fold more potent than cefepime. None of these agents inhibited >45% of Acinetobacter spp. at 8 mug/mL. Ceftobiprole is a new anti-MRSA beta-lactam with recognized activity against the most commonly occurring Enterobacteriaceae and P. aeruginosa, similar to that of extended-spectrum cephems. These characteristics warrant continued evaluation of the agent as empiric therapy for cSSSIs, and in pneumonia, especially in those institutions/regions where MRSA and P. aeruginosa may be prevalent.

  18. Determination of antimicrobial resistance pattern and Extended-Spectrum Beta Lactamases producing Pseudomonas aeruginosa strains isolated from clinical specimens of Hajar and Kashani Hospitals,Shahrekord 1387

    Directory of Open Access Journals (Sweden)

    Mana Shojapour

    2011-09-01

    Full Text Available Background: Pseudomonas aeruginosa is one of the leading causes of hospital infections in patients hospitalized for a 10 day period or over. It is also considered to be the most important cause of the burn wound infection. Approximately 75% of deaths in burned patients are due to wound infection and the subsequent septicemia. Clinical use of antibiotics has increasingly led to the global distribution of P. aeruginosa isolates with multi-drug resistance. The study was launched to determine the antimicrobial susceptibility pattern and the presence of the extended-spectrum-beta lactamase (ESBL in P.aeruginosa strains isolated from clinical specimens. Methods: Totally, 175 P. aeruginosa strains were isolated from clinical samples and identified by standard methods. The pattern of antimicrobial resistance was then performed on the isolates using Disk Agar Diffusion (DAD according to CLSI Guideline. Primary screening test for ESBL producing strains was performed by ceftazidim antibiotic disk using disk diffusion method. Combined disk method was used to confirm ESBL producing bacteria. Results: The rate of antimicrobial resistance of P.aeruginosa isolates were 64% to ticarcillin, 52.2% to cefepime, 68.6% to ticarcillin/clavolanic acid, 68.6% to ceftazidime, 67.4% to amikacin, 68.6% to gentamicin, 48% to imipenem, 77.7% to ciprofloxacin and 5.1% to polymixcine B. In the primary screening test, 120 isolates of P.aeruginosa strains were resistant to ceftazidime. In the combined disk method, 66 isolates (55% were positive for ESBLs. Conclusion: Polymixcine B was found to be the most effective antimicrobial agent in this study. Bacteria carrying ESBL genes may increase mortality and morbidity. Thus, their accurate diagnosis is of extreme importance to prevent from the treatment failure resulted from improper antibiotic administration.

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

    Science.gov (United States)

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

    2014-01-01

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

  20. In vitro antibacterial screening of six proline-based cyclic dipeptides in combination with β-lactam antibiotics against medically important bacteria.

    Science.gov (United States)

    Kumar, S Nishanth; Lankalapalli, Ravi S; Kumar, B S Dileep

    2014-05-01

    The in vitro synergistic antibacterial activity of six proline-based cyclic dipeptides [cyclo(D-Pro-L-Leu), cyclo(L-Pro-L-Met), cyclo(D-Pro-L-Phe), cyclo(L-Pro-L-Phe), cyclo(L-Pro-L-Tyr), and cyclo(L-Pro-D-Tyr)] in combination imipenem and ceftazidime was investigated in the present manuscript. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the cyclic dipeptides were compared with those of the standard antibiotics (imipenem and ceftazidime). The synergistic antibacterial activities of cyclic dipeptides with imipenem or ceftazidime were assessed using the checkerboard and time-kill methods. The results of the present study showed that the combined effect of six cyclic dipeptides with imipenem predominantly recorded synergistic interaction (FIC index bacteria was completely attenuated after 12-24 h of treatment with a 50:50 ratio of proline-based cyclic dipeptides and antibiotics. These synergistic effects have a potential role in delaying the development of resistance as the antibacterial activity is achieved with the very low concentrations of cyclic dipeptides and antibiotics. The cytotoxicity of cyclic dipeptides was tested against VERO cell line (African green monkey kidney cell line), and no cytotoxicity was recorded for cyclic dipeptides up to 100 μg/mL. These findings suggest that combination of cyclic dipeptides and antibiotics might be a good strategy for the individualization of novel templates for the development of new antimicrobial agents or combinations of drugs for antimicrobial chemotherapy. Moreover, these combinations may lead to the development of a new and vital antimicrobial combination against the infections caused by pathogenic bacteria. The in vitro synergistic activity of cyclic dipeptides with antibiotics against medically important bacteria is reported here for the first time.

  1. Control of multi-resistant bacteria and ventilator-associated pneumonia: is it possible with changes in antibiotics?

    Directory of Open Access Journals (Sweden)

    Elisa M. Jukemura

    2007-08-01

    Full Text Available Potent antimicrobial agents have been developed as a response to the development of antibiotic-resistant bacteria, which especially affect patients with prolonged hospitalization in Intensive Care Units (ICU and who had been previously treated with antimicrobials, especially third-generation cephalosporins.This study was to determine how changes in the empirical treatment of infections in ICU patients affect the incidence of Gram-negative bacteria species and their susceptibility to antimicrobials, and examine the impact of these changes on nosocomial infections. A prospective interventional study was performed in a university hospital during two periods: 1 First period (September 1999 to February 2000; and 2 Second period (August 2000 to December 2000; empirical treatment was changed from ceftriaxone and/or ceftazidime in the first period to piperacillin/tazobactam in the second. ICU epidemiological and infection control rates, as well as bacterial isolates from upper airways were analyzed. Ceftazidime consumption dropped from 34.83 to 0.85 DDD/1000 patients per day (p=0.004. Piperacillin/tazobactam was originally not available; its consumption reached 157.07 DDD/1000 patients per day in the second period (p=0.0002. Eighty-seven patients and 66 patients were evaluated for upper airway colonization in the first and second periods, respectively. There was a significant decrease in the incidence of K. pneumoniae (p=0.004 and P. mirabilis (p=0.036, restoration of K. pneumoniae susceptibility to cephalosporins (p<0.0001 and reduction of ventilator-associated pneumonia rates (p<0.0001. However, there was an increase in P. aeruginosa incidence (p=0.005 and increases in ceftazidime (p=0.003 and meropenem (p<0.0001 susceptibilities. Changing antimicrobial selective pressure on multi-resistant Gram-negative bacteria helps control ventilator-associated pneumonia and decreases antimicrobial resistance.

  2. Prevalence of Extended –Spectrum-Beta-Lactamase-Producing Klebsiella Pneumonia Isolates from Clinical Samples

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    Alizade, H. (MSc

    2014-06-01

    Full Text Available Background and Objective: Klebsiella pneumonia (K.pneumonia is one of the common causes of nosocomial infections. The aim of this research was to determine the prevalence of beta-lactamase genes and phenotypic confirmation of extended–spectrum-beta-lactamase (ESBL producing K.pneumonia isolates from clinical samples. Material and Methods: In this study, 122 K.pneumonia were isolated from clinical specimens of Khoramabad city and were confirmed by standard bacteriological tests. The presence of ESBL enzymes was detected by combined disk diffusion method. PCR assay with specific primers was used to determine blaSHV, blaTEM, blaCTX-15 and blaCTX-M genes in the confirmed isolates. Results: of 122 K.pneumonia isolates, 78 (64.18% were positive for ESBL, using disk diffusion method. According to antibiogram results, 10.65% of isolates were resistant to cefotaxime, 3.27% to ceftazidime and 68.03% to both antibiotics. Ninety isolates (64.18% considered as ESBLs isolates, at the same time, with being resistant to cefotaxime and ceftazidime were also sensitive to cefotaxime-clavulanic acid and ceftazidime-clavulanic acid. In PCR assays, blaCTX-15, blaSHV, blaCTX-M and blaTEM genes were detected in 78.68%, 40.16%, 26.22% and 22.13% of isolates, respectively. Ten resistant patterns of genes were detected. Conclusion: The significance percentage of antibiotic resistant genes of K.pneumonia isolates from clinical samples in Khoramabad city had ESBLs genes; CTX-M category was the most prevalent encoding genes of these enzymes. Keywords: Klebsiella Pneumonia, Extended-Spectrum Beta-Lactamase, Antibiotic Resistance

  3. A surveillance study of antimicrobial resistance of gram-negative bacteria isolated from intensive care units in eight hospitals in Turkey.

    Science.gov (United States)

    Günseren, F; Mamikoğlu, L; Oztürk, S; Yücesoy, M; Biberoğlu, K; Yuluğ, N; Doğanay, M; Sümerkan, B; Kocagöz, S; Unal, S; Cetin, S; Calangu, S; Köksal, I; Leblebicioğlu, H; Günaydin, M

    1999-03-01

    This study was carried out with the participation of eight hospitals in Turkey to determine the frequency of gram-negative bacteria isolated in intensive care units (ICU) and to compare their resistance rates to selected antibiotics. Aerobic gram-negative bacteria isolated from ICUs during 1996 were studied. Antibiotic susceptibilities to imipenem, ceftazidime, ceftazidime-clavulanate, ceftriaxone, cefotaxime, cefepime, cefodizime, cefuroxime, piperacillin/tazobactam, amoxycillin-clavulanate, gentamicin, amikacin and ciprofloxacin were determined by Etest. A total of 748 isolates were obtained from 547 patients. The majority of organisms were isolated from the respiratory (38.8%) and urinary tracts (30.9%). Pseudomonas spp. were the most frequently isolated gram-negative species (26.8%), followed by Klebsiella spp. (26.2%). Escherichia coli, Acinetobacter spp. and Enterobacter spp. were the other commonly isolated organisms. High resistance rates were observed for all antibiotics studied. Imipenem appeared to be the most active agent against the majority of isolates. Although resistance rates exceeded 50%, ciprofloxacin, cefepime and amikacin were found to be relatively effective. Extended-spectrum beta-lactamase (ESBL) production appeared to be a major mechanism of resistance to beta-lactam antibiotics. In contrast to ceftazidime-clavulanate, piperacillin/tazobactam showed poor activity against organisms thought to produce ESBL, suggesting the presence of an enzyme resistant to tazobactam action. This study has yielded high rates of resistance in aerobic gram-negative isolates from ICUs in Turkey. High resistance rates to all the other antibacterials studied leave imipenem as the only reliable agent for the empirical treatment of ICU infections in Turkey.

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

    Science.gov (United States)

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

    2011-01-01

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

  5. Survey of antimicrobial resistance in clinical Burkholderia pseudomallei isolates over two decades in Northeast Thailand.

    Science.gov (United States)

    Wuthiekanun, Vanaporn; Amornchai, Premjit; Saiprom, Natnaree; Chantratita, Narisara; Chierakul, Wirongrong; Koh, Gavin C K W; Chaowagul, Wipada; Day, Nicholas P J; Limmathurotsakul, Direk; Peacock, Sharon J

    2011-11-01

    A 21-year survey conducted in northeast Thailand of antimicrobial resistance to parenteral antimicrobial drugs used to treat melioidosis identified 24/4,021 (0.6%) patients with one or more isolates resistant to ceftazidime (n = 8), amoxicillin-clavulanic acid (n = 4), or both drugs (n = 12). Two cases were identified at admission, and the remainder were detected a median of 15 days after starting antimicrobial therapy. Resistance to carbapenem drugs was not detected. These findings support the current prescribing recommendations for melioidosis.

  6. The soil microbiota harbors a diversity of carbapenem-hydrolyzing β-lactamases of potential clinical relevance

    DEFF Research Database (Denmark)

    Gudeta, Dereje Dadi; Bortolaia, Valeria; Amos, Greg

    2016-01-01

    to identification of seven new MBLs in presumptive Pedobacter roseus (PEDO-1), Pedobacter borealis (PEDO-2), Pedobacter kyungheensis (PEDO-3), Chryseobacterium piscium (CPS-1), Epilithonimonas tenax (ESP-1), Massilia oculi (MSI-1), and Sphingomonas sp. (SPG-1). Carbapenemase production was likely an intrinsic...... (PEDO-1), an unusual amino acid residue at a key position for MBL structure and catalysis (CPS-1), and overlap with a putative OXA β-lactamase (MSI-1). Heterologous expression of PEDO-1, CPS-1, and ESP-1in E. coli significantly increased the MICs of ampicillin, ceftazidime, cefpodoxime, cefoxitin...

  7. Rhizobium (Agrobacterium) radiobacter identified as a cause of chronic endophthalmitis subsequent to cataract extraction.

    Science.gov (United States)

    Namdari, Hassan; Hamzavi, Sirus; Peairs, Randall R

    2003-08-01

    Herein, we report a case of chronic endophthalmitis caused by a ceftazidime-resistant Rhizobium radiobacter strain in a 62-year-old male. The patient underwent an uneventful cataract extraction of the right eye a week prior to the appearance of symptoms (pain, redness, and blurring vision) which developed following a golf outing. Upon admission the patient received an emergency vitrectomy. The patient remained symptomatic, and R. radiobacter was isolated repeatedly from vitreous fluid cultures over a 5-month period. Ultimately, the infection responded to intravitreal gentamicin, oral ciprofloxacin, and removal of the lens implant.

  8. Susceptibility of meropenem and comparators tested against 30,634 Enterobacteriaceae isolated in the MYSTIC Programme (1997-2003).

    Science.gov (United States)

    Turner, Philip J

    2004-12-01

    A total of 30,634 global Enterobacteriaceae isolates collected from the MYSTIC (Meropenem Yearly Surveillance Test Information Collection) Programme were tested using a reference methodology against meropenem and seven other broad-spectrum agents commonly used in the hospital setting (1997-2003). The most active compound was meropenem (99.6% susceptible), followed by imipenem (98.4%), cefepime (94.0%), gentamicin (86.8%), piperacillin/tazobactam (85.8%), ceftazidime (85.0%), ciprofloxacin (84.6%), and tobramycin (84.5%). Continued surveillance of antimicrobial compounds' in vitro activity is necessary to recommend regimens that are likely to be effective in clinical practice.

  9. Coproduction of KPC-18 and VIM-1 Carbapenemases by Enterobacter cloacae: Implications for Newer β-Lactam–β-Lactamase Inhibitor Combinations

    Science.gov (United States)

    Thomson, Gina K.; Snyder, James W.; McElheny, Christi L.; Thomson, Kenneth S.

    2015-01-01

    Enterobacter cloacae strain G6809 with reduced susceptibility to carbapenems was identified from a patient in a long-term acute care hospital in Kentucky. G6809 belonged to sequence type (ST) 88 and carried two carbapenemase genes, blaKPC-18 and blaVIM-1. Whole-genome sequencing localized blaKPC-18 to the chromosome and blaVIM-1 to a 58-kb plasmid. The strain was highly resistant to ceftazidime-avibactam. Insidious coproduction of metallo-β-lactamase with KPC-type carbapenemase has implications for the use of next-generation β-lactam–β-lactamase inhibitor combinations. PMID:26719440

  10. The first report of infection with Klebsiella pneumoniae carrying the bla kpc gene in State of Mato Grosso do Sul, Brazil

    Directory of Open Access Journals (Sweden)

    Marilene Rodrigues Chang

    2013-01-01

    Full Text Available The increased frequency and dissemination of enterobacteria resistant to various antimicrobials is currently worldwide concern. In January 2010, a 94-year-old patient with chronic lymphocytic leukemia was admitted to the University Hospital. This patient died 21 days after hospitalization due to the clinical worsening. Klebsiella pneumoniae producing of extended-spectrum β-lactamases (ESBLs was isolated of urine culture. This bacterium demonstrated resistance to ceftazidime, ciprofloxacin, levofloxacin, ertapenem and imipenem. Susceptibility to cefoxitin, cefepime, meropenem, colistin and tigecycline. This study reports the first case of infection by Klebsiella pneumoniae carrying the bla kpc gene in the State of Mato Grosso do Sul, Brazil.

  11. Coproduction of KPC-18 and VIM-1 Carbapenemases by Enterobacter cloacae: Implications for Newer β-Lactam-β-Lactamase Inhibitor Combinations.

    Science.gov (United States)

    Thomson, Gina K; Snyder, James W; McElheny, Christi L; Thomson, Kenneth S; Doi, Yohei

    2016-03-01

    Enterobacter cloacae strain G6809 with reduced susceptibility to carbapenems was identified from a patient in a long-term acute care hospital in Kentucky. G6809 belonged to sequence type (ST) 88 and carried two carbapenemase genes, bla(KPC-18) and bla(VIM-1). Whole-genome sequencing localized bla(KPC-18) to the chromosome and bla(VIM-1) to a 58-kb plasmid. The strain was highly resistant to ceftazidime-avibactam. Insidious coproduction of metallo-β-lactamase with KPC-type carbapenemase has implications for the use of next-generation β-lactam-β-lactamase inhibitor combinations.

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

    Science.gov (United States)

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

    2017-03-01

    Urinary tract infections (UTIs) caused by antibiotic-resistant Gram-negative bacteria are a growing concern due to limited therapeutic options. Gram-negative bacteria, specifically Enterobacteriaceae, are common causes of both community-acquired and hospital acquired UTIs. These organisms can acquire genes that encode for multiple antibiotic resistance mechanisms, including extended-spectrum-lactamases (ESBLs), AmpC- β -lactamase, and carbapenemases. The assessment of suspected UTI includes identification of characteristic symptoms or signs, urinalysis, dipstick or microscopic tests, and urine culture if indicated. UTIs are categorized according to location (upper versus lower urinary tract) and severity (uncomplicated versus complicated). Increasing rates of antibiotic resistance necessitate judicious use of antibiotics through the application of antimicrobial stewardship principles. Knowledge of the common causative pathogens of UTIs including local susceptibility patterns are essential in determining appropriate empiric therapy. The recommended first-line empiric therapies for acute uncomplicated bacterial cystitis in otherwise healthy adult nonpregnant females is a 5-day course of nitrofurantion or a 3-g single dose of fosfomycin tromethamine. Second-line options include fluoroquinolones and β-lactams, such as amoxicillin-clavulanate. Current treatment options for UTIs due to AmpC- β -lactamase-producing organisms include fosfomycin, nitrofurantion, fluoroquinolones, cefepime, piperacillin-tazobactam and carbapenems. In addition, treatment options for UTIs due to ESBLs-producing Enterobacteriaceae include nitrofurantion, fosfomycin, fluoroquinolones, cefoxitin, piperacillin-tazobactam, carbapenems, ceftazidime-avibactam, ceftolozane-tazobactam, and aminoglycosides. Based on identification and susceptibility results, alternatives to carbapenems may be used to treat mild-moderate UTIs caused by ESBL-producing Enterobacteriaceae. Ceftazidime-avibactam, colistin

  13. New Approaches to Antibiotic Use and Review of Recently Approved Antimicrobial Agents.

    Science.gov (United States)

    Hahn, Andrew W; Jain, Rupali; Spach, David H

    2016-07-01

    Antimicrobial drug-resistance continues to force adaptation in our clinical practice. We explore new evidence regarding adjunctive antibiotic therapy for skin and soft tissue abscesses as well as duration of therapy for intra-abdominal abscesses. As new evidence refines optimal practice, it is essential to support clinicians in adopting practice patterns concordant with evidence-based guidelines. We review a simple approach that can 'nudge' clinicians towards concordant practices. Finally, the use of novel antimicrobials will play an increasingly important role in contemporary therapy. We review five new antimicrobials recently FDA-approved for use in drug-resistant infections: dalbavancin, oritavancin, ceftaroline, ceftolozane-tazobactam, and ceftazidime-avibactam.

  14. [Melioidosis in a Danish tourist returning from North-eastern Thailand].

    Science.gov (United States)

    Leth, Steffen; Wang, Mikala; Deutch, Susanna

    2014-06-09

    Melioidosis, an infectious disease caused by Burkholderia pseudomallei, is endemic in South East Asia and Northern Australia. It has a wide clinical diversity, spanning from asymptomatic cases to rapid septic shock and death. We present a case of pulmonary melioidosis in a Danish tourist returning from North-eastern Thailand. The patient was treated with intravenous ceftazidime followed by oral therapy with trimethoprim/sulfamethoxazole and subsequently switched to doxycycline due to abnormal liver function tests and eosinophilia, with no sign of relapse two months after antibiotic cessation.

  15. Evaluation of Methods for AmpC Beta-Lactamase in Gram Negative Clinical Isolates from Tertiary Care Hospitals

    OpenAIRE

    Singhal S; Mathur T; Khan S; Upadhyay D; Chugh S; Gaind R; Rattan A

    2005-01-01

    The purpose of this study was to simultaneously screen for Extended-spectrum b-lactamases (ESBL) and AmpC b-lactamases in gram negative clinical isolates from four tertiary care hospitals and further to compare two detection methods three-dimensional extraction method and AmpC disk test for AmpC b-lactamases. A total of 272 isolates were screened for ESBL and AmpC β-lactamase by modified double disk approximation method (MDDM). Synergy observed between disks of ceftazidime/cefotaxime a...

  16. Directory of Open Access Journals (Sweden)

    Marilene Rodrigues Chang

    2013-01-01

    Full Text Available The increased frequency and dissemination of enterobacteria resistant to various antimicrobials is currently worldwide concern. In January 2010, a 94-year-old patient with chronic lymphocytic leukemia was admitted to the University Hospital. This patient died 21 days after hospitalization due to the clinical worsening. Klebsiella pneumoniae producing of extended-spectrum β-lactamases (ESBLs was isolated of urine culture. This bacterium demonstrated resistance to ceftazidime, ciprofloxacin, levofloxacin, ertapenem and imipenem. Susceptibility to cefoxitin, cefepime, meropenem, colistin and tigecycline. This study reports the first case of infection by Klebsiella pneumoniae carrying the blakpc gene in the State of Mato Grosso do Sul, Brazil.

  17. Study of volatile compounds from the radiosterilization of solid cephalosporins

    Energy Technology Data Exchange (ETDEWEB)

    Barbarin, N.; Crucq, A.S.; Tilquin, B. [Universite Catholique de Louvain (UCL), Louvain-la-Neuve (Belgium)

    1996-12-01

    The use of {gamma}-rays is a promising method to sterilize thermosensitive drugs. Although radiosterilization does not modify drugs activity, this mode of sterilization produces new radiolytic products. This study is devoted to the analysis of volatile compounds which may induce a modification of odour. The volatile compounds produced by radiolysis of cefotaxime, cefuroxime and ceftazidime, three cephalosporins, were analyzed by gas chromatography with a headspace sampling. They were detected and identified by mass and infrared spectrometry. An explanation of their origin is proposed. (Author).

  18. TERMINALIA CHEBULA: A TREATMENT AGAINST PATHOGENIC PROTEUS VULGARIS STRAINS ASSOCIATED WITH URINARY TRACT INFECTION

    OpenAIRE

    Tariq. A. L; Reyaz. A. L

    2013-01-01

    Terminalia chebula was used to find out the new sort of treatment for the urinary tract infections caused by Proteus vulgaris. The causative agent was identified as Proteus vulgaris by staining and biochemical methods. It is responsible to cause urinary tract infection and most of strains show the resistance against the broad spectrum antibiotics: Ceftazidime (30μg), Ofloxacin (50μg), Norfloxacin (30μg), Tetracycline (30μg), Ampicillin (30μg), Chloramphenicol (25μg) and Gentamycin (20μg). The...

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

    OpenAIRE

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

    1994-01-01

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

  20. FEATURES OF THE LARGE INTESTINE MICROFLORA OF CHILDREN – DONOR LIVER TRANSPLANT RECIPIENTS

    Directory of Open Access Journals (Sweden)

    N. I. Gabrielyan

    2013-01-01

    Full Text Available Aim. The study microecology of the large intestine of children with cirrhosis before transplantation of the share liver. Materials and methods. Studied the flora of the colon 157 children of 1 to 17 years admitted to hospital for liver transplantation fragment from a related donor. Identification was carried out using microbial panels BD Crystal and databases BBL Crystal MIND. Methicillin-resistant staphylococci were determined by their sensiti- vity to oxacillin and cefoxitin. Beta-lactamase activity was tested using discs with ceftazidime and ceftazidime/ clavulanic acid. Results. Microecological revealed deep irregularities in the large intestine transplantation in children up lobe of the liver on a spectrum and composition of the microflora. Among the resident microflora decreased levels of bifidobacteria, lactobacilli and coliform bacteria, especially in children under one year. A sig- nificant portion of the children surveyed (over 60–70% had an increase of frequency of finding stateally bacteria, especially Klebsiella and enterobacteria in third children – non-fermenting bacteria – Pseudomonas and Acine- tobacter spp. Revealed the spread of strains of gram-negative bacteria with extended-spectrum betalaktamaz.Conclusion. Expressed microecological violations in the large intestine in children with higher levels of bac- teria are conditionally risk factor reeks of infectious complications in the postoperative period and require are complex tools to assist in eliminatsii.s given antibiotic resistance of bacteria. 

  1. Intravitreal Daptomycin for Recalcitrant Postoperative Endophthalmitis

    Directory of Open Access Journals (Sweden)

    Jennifer M. Sim

    2016-02-01

    Full Text Available Purpose: To report the first case to our knowledge of intravitreal daptomycin used to successfully treat culture-negative vancomycin resistant to exogenous endophthalmitis. Methods: Case report with preoperative, intraoperative, and postoperative findings. Results: A 63-year-old Caucasian male underwent routine pars plana vitrectomy with epiretinal membrane peeling. He developed acute postoperative endophthalmitis, and underwent vitreous tap and injection of intravitreal vancomycin/ceftazidime/dexamethasone. Gram stain showed Gram-positive cocci, but cultures were negative. His infection subsequently proved very recalcitrant and his treatment course involved pars plana vitrectomy with anterior chamber washout and repeat injection of antibiotics, followed by repeat intravitreal vancomycin and ceftazidime. Ultimately, a second vitrectomy with intravitreal daptomycin controlled his intraocular infection. On each occasion, cultures were negative. Conclusion: This case suggests that vancomycin resistance should be considered in culture-negative postoperative endophthalmitis, and intravitreal daptomycin should be considered as an important treatment alternative. Although vancomycin resistance is fairly rare in endophthalmitis, acknowledgment of its increasing occurrence rate is critical for optimal management.

  2. Corneal laceration caused by river crab

    Directory of Open Access Journals (Sweden)

    Vinuthinee N

    2015-01-01

    Full Text Available Naidu Vinuthinee,1,2 Anuar Azreen-Redzal,1 Jaafar Juanarita,1 Embong Zunaina2 1Department of Ophthalmology, Hospital Sultanah Bahiyah, Alor Setar, 2Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia Abstract: A 5-year-old boy presented with right eye pain associated with tearing and photophobia of 1-day duration. He gave a history of playing with a river crab when suddenly the crab clamped his fingers. He attempted to fling the crab off, but the crab flew and hit his right eye. Ocular examination revealed a right eye corneal ulcer with clumps of fibrin located beneath the corneal ulcer and 1.6 mm level of hypopyon. At presentation, the Seidel test was negative, with a deep anterior chamber. Culture from the corneal scrapping specimen grew Citrobacter diversus and Proteus vulgaris, and the boy was treated with topical gentamicin and ceftazidime eyedrops. Fibrin clumps beneath the corneal ulcer subsequently dislodged, and revealed a full-thickness corneal laceration wound with a positive Seidel test and shallow anterior chamber. The patient underwent emergency corneal toileting and suturing. Postoperatively, he was treated with oral ciprofloxacin 250 mg 12-hourly for 1 week, topical gentamicin, ceftazidime, and dexamethasone eyedrops for 4 weeks. Right eye vision improved to 6/9 and 6/6 with pinhole at the 2-week follow-up following corneal suture removal. Keywords: corneal ulcer, pediatric trauma, ocular injury

  3. Macrolides decrease the minimal inhibitory concentration of anti-pseudomonal agents against Pseudomonas aeruginosa from cystic fibrosis patients in biofilm

    Directory of Open Access Journals (Sweden)

    Lutz Larissa

    2012-09-01

    Full Text Available Abstract Background Biofilm production is an important mechanism for bacterial survival and its association with antimicrobial resistance represents a challenge for the patient treatment. In this study we evaluated the in vitro action of macrolides in combination with anti-pseudomonal agents on biofilm-grown Pseudomonas aeruginosa recovered from cystic fibrosis (CF patients. Results A total of 64 isolates were analysed. The biofilm inhibitory concentration (BIC results were consistently higher than those obtained by the conventional method, minimal inhibitory concentration, (MIC for most anti-pseudomonal agents tested (ceftazidime: P = 0.001, tobramycin: P = 0.001, imipenem: P P = 0.005. When macrolides were associated with the anti-pseudomonal agents, the BIC values were reduced significantly for ceftazidime (P  0.001 and tobramycin (P  0.001, regardless the concentration of macrolides. Strong inhibitory quotient was observed when azithromycin at 8 mg/L was associated with all anti-pseudomonal agents tested in biofilm conditions. Conclusions P. aeruginosa from CF patients within biofilms are highly resistant to antibiotics but macrolides proved to augment the in vitro activity of anti-pseudomonal agents.

  4. POLYCLONAL OUTBREAK OF BLOODSTREAM INFECTIONS CAUSED BY Burkholderia cepacia COMPLEX IN HEMATOLOGY AND BONE MARROW TRANSPLANT OUTPATIENT UNITS

    Directory of Open Access Journals (Sweden)

    Icaro Boszczowski

    2014-01-01

    Full Text Available Aim: The objective was to describe an outbreak of bloodstream infections by Burkholderia cepacia complex (Bcc in bone marrow transplant and hematology outpatients. Methods: On February 15, 2008 a Bcc outbreak was suspected. 24 cases were identified. Demographic and clinical data were evaluated. Environment and healthcare workers' (HCW hands were cultured. Species were determined and typed. Reinforcement of hand hygiene, central venous catheter (CVC care, infusion therapy, and maintenance of laminar flow cabinet were undertaken. 16 different HCWs had cared for the CVCs. Multi-dose heparin and saline were prepared on counter common to both units. Findings: 14 patients had B. multivorans (one patient had also B. cenopacia, six non-multivorans Bcc and one did not belong to Bcc. Clone A B. multivorans occurred in 12 patients (from Hematology; in 10 their CVC had been used on February 11/12. Environmental and HCW cultures were negative. All patients were treated with meropenem, and ceftazidime lock-therapy. Eight patients (30% were hospitalized. No deaths occurred. After control measures (multidose vial for single patient; CVC lock with ceftazidime; cleaning of laminar flow cabinet; hand hygiene improvement; use of cabinet to store prepared medication, no new cases occurred. Conclusions: This polyclonal outbreak may be explained by a common source containing multiple species of Bcc, maybe the laminar flow cabinet common to both units. There may have been contamination by B. multivorans (clone A of multi-dose vials.

  5. Endophthalmitis caused by Pantoea agglomerans: clinical features, antibiotic sensitivities, and outcomes

    Directory of Open Access Journals (Sweden)

    Venincasa VD

    2015-07-01

    Full Text Available Vincent D Venincasa, Ajay E Kuriyan, Harry W Flynn Jr, Jayanth Sridhar, Darlene Miller Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA Purpose: To report the clinical findings, antibiotic sensitivities, and visual outcomes associated with endophthalmitis caused by Pantoea agglomerans.Methods: A consecutive case series of patients with vitreous culture-positive endophthalmitis caused by P. agglomerans from January 1, 1990 to December 31, 2012 at a large university referral center. Findings from the current study were compared to prior published studies.Results: Of the three study patients that were identified, clinical settings included trauma (n=2 and post-cataract surgery (n=1. Presenting visual acuity was hand motion or worse in all three cases. All isolates were sensitive to ceftazidime, gentamicin, imipenem, and fluoroquinolones. All isolates were resistant to ampicillin. Initial treatment strategies were vitreous tap and intravitreal antibiotic injection (n=1 and pars plana vitrectomy with intravitreal antibiotic injection (n=2. At last follow-up, one patient had no light perception vision, while the other two had best-corrected visual acuity of 20/200 and 20/400.Conclusion: All Pantoea isolates were sensitive to ceftazidime, gentamicin, imipenem, and fluoroquinolones. All patients in the current study received at least one intravitreal antibiotic to which P. agglomerans was shown to be sensitive in vitro. In spite of this, the visual outcomes were generally poor.Keywords: ocular infection, trauma, antibiotic resistance

  6. Antibiotic combination therapy can select for broad-spectrum multidrug resistance in Pseudomonas aeruginosa.

    Science.gov (United States)

    Vestergaard, Martin; Paulander, Wilhelm; Marvig, Rasmus L; Clasen, Julie; Jochumsen, Nicholas; Molin, Søren; Jelsbak, Lars; Ingmer, Hanne; Folkesson, Anders

    2016-01-01

    Combination therapy with several antibiotics is one strategy that has been applied in order to limit the spread of antimicrobial resistance. We compared the de novo evolution of resistance during combination therapy with the β-lactam ceftazidime and the fluoroquinolone ciprofloxacin with the resistance evolved after single-drug exposure. Combination therapy selected for mutants that displayed broad-spectrum resistance, and a major resistance mechanism was mutational inactivation of the repressor gene mexR that regulates the multidrug efflux operon mexAB-oprM. Deregulation of this operon led to a broad-spectrum resistance phenotype that decreased susceptibility to the combination of drugs applied during selection as well as to unrelated antibiotic classes. Mutants isolated after single-drug exposure displayed narrow-spectrum resistance and carried mutations in the MexCD-OprJ efflux pump regulator gene nfxB conferring ciprofloxacin resistance, or in the gene encoding the non-essential penicillin-binding protein DacB conferring ceftazidime resistance. Reconstruction of resistance mutations by allelic replacement and in vitro fitness assays revealed that in contrast to single antibiotic use, combination therapy consistently selected for mutants with enhanced fitness expressing broad-spectrum resistance mechanisms.

  7. Comparison of resistance to third-generation cephalosporins in Shigella between Europe-America and Asia-Africa from 1998 to 2012.

    Science.gov (United States)

    Gu, B; Zhou, M; Ke, X; Pan, S; Cao, Y; Huang, Y; Zhuang, L; Liu, G; Tong, M

    2015-10-01

    We conducted a systematic review to compare resistance to third-generation cephalosporins (TGCs) in Shigella strains between Europe-America and Asia-Africa from 1998 to 2012 based on a literature search of computerized databases. In Asia-Africa, the prevalence of resistance of total and different subtypes to ceftriaxone, cefotaxime and ceftazidime increased markedly, with a total prevalence of resistance up to 14·2% [95% confidence interval (CI) 3·9-29·4], 22·6% (95% CI 4·8-48·6) and 6·2% (95% CI 3·8-9·1) during 2010-2012, respectively. By contrast, resistance rates to these TGCs in Europe-America remained relatively low--less than 1·0% during the 15 years. A noticeable finding was that certain countries both in Europe-America and Asia-Africa, had a rapid rising trend in the prevalence of resistance of S. sonnei, which even outnumbered S. flexneri in some periods. Moreover, comparison between countries showed that currently the most serious problem concerning resistance to these TGCs appeared in Vietnam, especially for ceftriaxone, China, especially for cefotaxime and Iran, especially for ceftazidime. These data suggest that monitoring of the drug resistance of Shigella strains should be strengthened and that rational use of antibiotics is required.

  8. Four cases of endophthalmitis after 25-gauge pars plana vitrectomy

    Directory of Open Access Journals (Sweden)

    Mutoh T

    2012-08-01

    Full Text Available Tetsuya Mutoh, Koji Kadoya, Makoto ChikudaDepartment of Ophthalmology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, JapanAbstract: We report our recent experience with four cases of endophthalmitis (one male, three females after 25-gauge pars plana vitrectomy (PPV. One was a case of persistent cystoid macular edema caused by branch retinal vein occlusion, whereas the remaining three were cases of epiretinal membrane. Preoperative antibiotics before the first PPV procedure were not administered in three of the four cases. Endophthalmitis occurred 2–4 days after the first procedure in all cases, for which ceftazidime 2.0 mg/0.1 mL and vancomycin 1.0 mg/0.1 mL were injected into the vitreous cavity. This was followed by emergent 20-gauge PPV and intraocular lens removal using an infusion fluid containing ceftazidime and vancomycin. After the second PPV procedure, progress was good in three cases while retinal detachment occurred in the remaining case one month after surgery; this case required a third PPV procedure. Final best-corrected visual acuity ranged from 20/100 to 20/25 for the four cases. Bacterial cultures were negative after the second PPV procedure in all cases. In conclusion, postoperative endophthalmitis occurred in four of 502 cases (0.80% that underwent 25-gauge PPV at our hospital. It is important to minimize the incidence of endophthalmitis after 25-gauge PPV.Keywords: 25-gauge pars plana vitrectomy, endophthalmitis, incidence

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

    Science.gov (United States)

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

    2011-06-01

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

  10. In-vitro profile of a new beta-lactam, ceftobiprole, with activity against methicillin-resistant Staphylococcus aureus.

    Science.gov (United States)

    Jones, M E

    2007-06-01

    Ceftobiprole is a novel, broad-spectrum cephalosporin with in-vitro activity against common Gram-positive and Gram-negative organisms. It forms a stable inhibitory complex with Staphylococcus aureus penicillin-binding protein (PBP) 2' (2a), resulting in enhanced activity against methicillin-resistant S. aureus (MRSA). In recent studies of methicillin-susceptible S. aureus, the ceftobiprole MIC(90) value was most frequently Ceftobiprole is active against Enterococcus faecalis (MIC(90) = 4 mg/L), but not generally active against Enterococcus faecium (MIC(90) > 16 mg/L). Ceftobiprole displayed bactericidal activity against Gram-negative pathogens comparable to that of cefepime, ceftazidime or piperacillin-tazobactam in early studies. However, recent data show activity against Pseudomonas aeruginosa similar to that of cefepime but less than that of ceftazidime. Ceftobiprole, like cefepime, is stable in the presence of most class A non-extended spectrum beta-lactamases and inducible class C beta-lactamases. Ceftobiprole is a poor inducer of AmpC beta-lactamase and a poor substrate for hydrolysis by AmpC beta-lactamase. Studies of ceftobiprole in several animal models have demonstrated potent in-vivo efficacy against infections caused by MRSA, including strains intermediately resistant to vancomycin. It was also efficacious in murine infections caused by Gram-negative bacteria with MIC values ceftobiprole in vitro and in vivo suggests that it may have potential for empirical treatment of suspected Gram-negative and Gram-positive infections, including those caused by MRSA.

  11. Ceftobiprole: a novel cephalosporin with activity against Gram-positive and Gram-negative pathogens, including methicillin-resistant Staphylococcus aureus (MRSA).

    Science.gov (United States)

    Barbour, April; Schmidt, Stephan; Rand, Kenneth H; Derendorf, Hartmut

    2009-07-01

    Ceftobiprole is a novel broad-spectrum cephalosporin with activity against a wide range of Gram-positive and Gram-negative bacteria, including several resistant species such as methicillin-resistant Staphylococcus aureus and penicillin-resistant Streptococcus pneumoniae. Ceftobiprole is administered intravenously as the prodrug ceftobiprole medocaril, which is almost immediately converted to the active form. It is currently under review by the US Food and Drug Administration (FDA) and is approved in Canada under the trade name Zeftera. The pharmacokinetics of ceftobiprole are non-complex as it displays a two-compartment model, dose proportionality, linear plasma protein binding and negligible accumulation. The volume of distribution is approximately equal to the extracellular fluid volume and it is cleared primarily by glomerular filtration, resulting in a half-life of approximately 3-4h. Ceftobiprole displays a low plasma protein binding of approximately 22%. The efficacy of ceftobiprole was demonstrated in two pivotal studies in patients with complicated skin and skin-structure infections (cSSSIs) that compared ceftobiprole with vancomycin in Gram-positive infections in one study and ceftobiprole with vancomycin plus ceftazidime in Gram-positive and Gram-negative infections in the other. The clinical cure rates were similar for ceftobiprole vs. comparator treatments: 93.3% vs. 93.5% with vancomycin only and 90.5% vs. 90.2% with vancomycin plus ceftazidime. The pharmacokinetic/pharmacodynamic profile supports the use of ceftobiprole to treat a wide range of cSSSIs.

  12. In vitro potentiation of carbapenems with ME1071, a novel metallo-beta-lactamase inhibitor, against metallo-beta-lactamase- producing Pseudomonas aeruginosa clinical isolates.

    Science.gov (United States)

    Ishii, Yoshikazu; Eto, Maki; Mano, Yoko; Tateda, Kazuhiro; Yamaguchi, Keizo

    2010-09-01

    ME1071, a maleic acid derivative, is a novel specific inhibitor for metallo-beta-lactamases (MBL). In this study, the potentiation of ME1071 in combination with several beta-lactams was evaluated using MBL-producing Pseudomonas aeruginosa isolates. The rates of susceptibility of MBL producers to carbapenems (imipenem, biapenem, and doripenem) and ceftazidime were increased by 8 to 27% in the presence of 32 microg/ml of ME1071. The corresponding resistance rates were decreased by 13 to 46%, respectively. On the other hand, ME1071 showed weaker or no potentiation with non-MBL producers. The K(i) value of ME1071 for IMP-1 was 0.4 microM, significantly lower than the K(m) values of carbapenems for the IMP-1 enzyme. On the other hand, the K(i) value of ME1071 for VIM-2 was 120 microM, higher than the K(m) values of carbapenems for the VIM-2 enzyme. Results of this study indicate that ME1071 can potentiate the activity of ceftazidime and carbapenems against MBL-producing strains of P. aeruginosa.

  13. 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

    Directory of Open Access Journals (Sweden)

    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

  14. Multidrug resistant Escherichia coli strains isolated from urine sample, University of Gondar Hospital, Northwest Ethiopia

    Institute of Scientific and Technical Information of China (English)

    Setegn Eshetie; Fentahun Tarekegn; Gemechu Kumera; Feleke Mekonnen

    2016-01-01

    Objective: To assess multidrug resistant (MDR) Escherichia coli (E. coli) isolates from patients with urinary tract infection. Methods: From February to June 2014, a cross sectional study was conducted among urinary tract infection patients at the University of Gondar Hospital. Culture and disk diffusion method were used for E. coli isolation and to determine the antibiotic susceptibility patterns. Data were entered and analyzed using SPSS version 20. P Results: A total of 112 E. coli isolates were identified and the rate of isolation was higher among female participants (28.7%; P = 0.03). Of the isolates, 104 (92.9%) were MDR E. coli; and the isolates showed high resistance rates towards ampicillin (99%), cotrimoxazole (69%), chloramphenicol (58.7%), gentamycin (56.7%) and ceftazidime (55.8%). However, comparative isolates showed low resistance rates to ciprofloxacin (1%), cefepime (8.7%), and ceftriaxone (11.5%). Moreover, resistance rates of MDR E. coli isolates were significantly higher than non-MDR strains for ceftazidime (55.8% versus 12.5%; P = 0.015), and ampicillin (99% versus 87.5%; P = 0.018). Conclusions: High prevalence of MDR E. coli isolates was observed in this study. Regular monitoring of antibiotic resistance rates is necessarily required to improve and revise empirical antibiotic therapy protocols.

  15. The relationship between antimicrobial consumption and the rates of resistance of Klebsiela pneumoniae in respiratory unit

    Institute of Scientific and Technical Information of China (English)

    YANG Xin-yun; ZHUO Chao; XIAO Xiang-lin; YUAN Jin-Ping; YANG Ling

    2008-01-01

    Objective To investigate the relationship between the consumption of antibacterial agents and resistance rate of Klebsiela pneumoniae(KP)in the hospital respiratory unit for 3 consecutive years in 2005-2007. Methods The total antibacterial consumption expressed as defined DDDs/100BD, as well as resistance rate of total KP and producing ESBLs KP were collected, and their correlation was analyzed. Results The rate of resistance of KP to cefoperazone/sulbactam, Cefepime, Imipenem, Moxifloxacin was significantly positively associated with the consumption of Cefotaxime, Ceftazidime, Moxifloxacin, Amikacin respectively;A significant positive association was observed between the rate of resistance of KP to Piperacillin/Tazobactam, Ceftriaxone and the consumption of Imipenem; The rate of resistance of KP to Piperacillin, Cefotaxime, Ciprofloxacin was significantly positively associated with the consumption of Levofloxacin. ESBLs producing bacilli of KP were detected in 44 of 75 isolates (58.7%), The rate of resistance of producing ES-BLs KP to Piperacillin/Tazobactarn, Ceftriaxone was significantly positively associated with the consumption of Imipenem, Ceftazidime; A significant positive association was observed between the rate of resistance of producing ESBLs KP to Piperacillin, Imipenem and the consumption of Moxifloxacin. There was no significant correlation in other drugs. Conclusions A relationship existed between antimicrobial consumption and rates of resistance of KP in the hospital respiratory unit. We must use antibiotics carefully and with reason to control and lessen the drug resistance of bacterial.

  16. Antimicrobial susceptibility of Pseudomonas aeruginosa isolates from dogs with otitis externa.

    Science.gov (United States)

    Mekić, S; Matanović, K; Šeol, B

    2011-07-30

    Pseudomonas aeruginosa is a common cause of otitis externa in dogs, and treatment of these infections is becoming problematic because of the increasing number of multiresistant strains. The aim of the present study was to compare the in vitro activities of cefepime, ceftazidime, enrofloxacin, ciprofloxacin, gentamicin and ticarcillin/clavulanic acid against 104 strains of P aeruginosa isolated from dogs with otitis externa. Antimicrobial susceptibility and minimum inhibitory concentrations, in µg/ml, were evaluated by the E test (bioMérieux). The most active compound was ceftazidime, with 100 per cent efficiency. The majority of tested strains were susceptible to ticarcillin/clavulanic acid (89.4 per cent), followed by ciprofloxacin (88.5 per cent) and cefepime (60.6 per cent). The highest resistance was observed to enrofloxacin (51.9 per cent) and gentamicin (43.3 per cent). Large numbers of strains were intermediately susceptible to antibiotics registered for use in veterinary medicine in Croatia--enrofloxacin (47.1 per cent) and gentamicin (41.3 per cent).

  17. Ceftobiprole: a review of a broad-spectrum and anti-MRSA cephalosporin.

    Science.gov (United States)

    Zhanel, George G; Lam, Ashley; Schweizer, Frank; Thomson, Kristjan; Walkty, Andrew; Rubinstein, Ethan; Gin, Alfred S; Hoban, Daryl J; Noreddin, Ayman M; Karlowsky, James A

    2008-01-01

    Ceftobiprole, an investigational cephalosporin, is currently in phase III clinical development. Ceftobiprole is a broad-spectrum cephalosporin with demonstrated in vitro activity against Gram-positive cocci, including meticillin-resistant Staphylococcus aureus (MRSA) and meticillin-resistant S. epidermidis, penicillin-resistant S. pneumoniae, Enterococcus faecalis, Gram-negative bacilli including AmpC-producing Escherichia coli and Pseudomonas aeruginosa, but excluding extended-spectrum beta-lactamase-producing strains. Like cefotaxime, ceftriaxone, ceftazidime, and cefepime, ceftobiprole demonstrates limited activity against anaerobes such as Bacteroides fragilis and non-fragilis Bacteroides spp. In single-step and serial passage in vitro resistance development studies, ceftobiprole demonstrated a low propensity to select for resistant subpopulations. Ceftobiprole, like cefepime, is a weak inducer and a poor substrate for AmpC beta-lactamases.Ceftobiprole medocaril, the prodrug of ceftobiprole, is converted by plasma esterases to ceftobiprole in ceftobiprole observed at the end of a single 30-minute infusion were 35.5 mug/mL for a 500-mg dose and 59.6 mug/mL for a 750-mg dose. The volume of distribution of ceftobiprole is 0.26 L/kg ( approximately 18 L), protein binding is 16%, and its serum half-life is approximately 3.5 hours. Ceftobiprole is renally excreted ( approximately 70% in the active form) and systemic clearance correlates with creatinine clearance, meaning that dosage adjustment is required in patients with renal dysfunction. Ceftobiprole has a modest post-antibiotic effect (PAE) of approximately 0.5 hours for MRSA and a longer PAE of approximately 2 hours for penicillin-resistant pneumococci. Ceftobiprole, when administered intravenously at 500 mg once every 8 hours (2-hour infusion), has a >90% probability of achieving f T(>MIC) (free drug concentration exceeds the minimum inhibitory concentration [MIC]) for 40% and 60%, respectively, of the dosing

  18. 多重耐药鲍曼不动杆菌外排泵机制的初步研究%Primary study on efflux pump mechanism in multidrug-resistant Acinetobacter baumannii

    Institute of Scientific and Technical Information of China (English)

    王友梅; 沈继龙; 沈继录; 徐元宏

    2012-01-01

    To study the phenotype of the efflux pumps in multidrug- resistant Acinetobacter baumannii providing foundation for further study the mechanism of multidrug-resistant in Acinetobacter baumannii. Methods The minimum inhibitory concentrations ( MIC ) of five antibiotics, including imipenem, meropenem, ciprofloxacin gentamicin and ceftazidime with or without efflux pump inhibitor PA(3N were determined by agar dilution method. Results In addition of PAβN, MIC of 45 strains to imipenem, 70 strains to meropenem, 45 strains to ceftazidime, only 4 strains to ciprofloxacin decreased more than 4 folds, but no one strain to gentamicin. Conclusion Efflux pump mechanism is one of the causes of imipenem , meropenem and ceftazidime resistant in Acinetobacter baumannii , while which is not account for ciprofloxacin and gentamicin.%目的 研究外排泵在多重耐药鲍曼不动杆菌中的存在情况,为进一步研究其耐药机制奠定基础.方法 采用M-H琼脂稀释法,测定添加和不添加抑制剂苯丙氨酸-精氨酸-β-萘胺(PAβN)前后鲍曼不动杆菌对亚胺培南、美罗培南、庆大霉素、环丙沙星和头孢他啶5种药的最低抑菌浓度(MIC).结果 添加PAβN后,74株多重耐药鲍曼不动杆菌对5种药的MIC值下降4倍以上的菌株数分别为亚胺培南45(60.81%)株、美罗培南70(94.59%)株、庆大霉素0(0%)株、环丙沙星4(5.41%)株、头孢他啶45(60.81%)株.结论 外排泵机制可能是引起鲍曼不动杆菌对亚胺培南、美罗培南、头孢他啶耐药的主要机制;外排泵机制对环丙沙星和庆大霉素耐药不起主要作用.

  19. Resistance to Third-Generation Cephalosporins and Other Antibiotics by Enterobacteriaceae in Western Nigeria

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    A. O. Okesola

    2009-01-01

    Full Text Available Problem statement: The emergence and spread of resistance to third-generation cephalosporins are threatening to create species resistant to all currently available agents. The most common cause of bacterial resistance to beta-lactam antibiotics is the production of beta-lactamases and many of the 2nd and 3rd-generation penicillins and cephalosporins were specifically designed to resist the hydrolytic action of major ß-lactamases. However new ß-lactamases emerged against each of the new classes of ß-lactams that were introduced and caused resistance. This study was designed to determine the rate of resistance to 3rd-generation cephalosporins and other classes of antibiotics by the Enterobacteriaceae in this environment. Approach: One hundred bacteria isolates belonging to the family Enterobacteriaceae identified from different clinical specimens between October and December 2007 using standard bacteriological methods. These were subjected to antibiotic susceptibility testing to third-generation cephalosporins and other classes of antibiotics which included quinolones and an aminoglycoside using the Kirby-Bauer method of disc diffusion test. Results: Out of the total number of Enterobacteriaceae isolated in the study period, only 54.8% of the klebsiella species isolated were sensitive to ceftazidime, 48.4% to ceftriaxone and 30.7% to cefotaxime. With Escherichia coli however, the susceptibility pattern to the 3rd-generation cephalosporins was better (65.6% were sensitive to ceftazidime, 62.5% to ceftriaxone and 71.9% to cefotaxime. In proteus species, the susceptibility pattern was generally poor to the three classes of antibiotics(50% were sensitive to ceftazidime and ceftriaxone, 0% to cefotaxime, 33.3% to ciprofloxacin, 50% to gentamycin and 0% to amoxycillin/clavulanate. Conclusion/Recommendations: The poor susceptibility to amoxicillin/clavulanate demonstrated by all the isolates in this

  20. Variants of β-Lactamase KPC-2 That Are Resistant to Inhibition by Avibactam

    Science.gov (United States)

    Papp-Wallace, Krisztina M.; Winkler, Marisa L.; Taracila, Magdalena A.

    2015-01-01

    KPC-2 is the most prevalent class A carbapenemase in the world. Previously, KPC-2 was shown to hydrolyze the β-lactamase inhibitors clavulanic acid, sulbactam, and tazobactam. In addition, substitutions at amino acid position R220 in the KPC-2 β-lactamase increased resistance to clavulanic acid. A novel bridged diazabicyclooctane (DBO) non-β-lactam β-lactamase inhibitor, avibactam, was shown to inactivate the KPC-2 β-lactamase. To better understand the mechanistic basis for inhibition of KPC-2 by avibactam, we tested the potency of ampicillin-avibactam and ceftazidime-avibactam against engineered variants of the KPC-2 β-lactamase that possessed single amino acid substitutions at important sites (i.e., Ambler positions 69, 130, 234, 220, and 276) that were previously shown to confer inhibitor resistance in TEM and SHV β-lactamases. To this end, we performed susceptibility testing, biochemical assays, and molecular modeling. Escherichia coli DH10B carrying KPC-2 β-lactamase variants with the substitutions S130G, K234R, and R220M demonstrated elevated MICs for only the ampicillin-avibactam combinations (e.g., 512, 64, and 32 mg/liter, respectively, versus the MICs for wild-type KPC-2 at 2 to 8 mg/liter). Steady-state kinetics revealed that the S130G variant of KPC-2 resisted inactivation by avibactam; the k2/K ratio was significantly lowered 4 logs for the S130G variant from the ratio for the wild-type enzyme (21,580 M−1 s−1 to 1.2 M−1 s−1). Molecular modeling and molecular dynamics simulations suggested that the mobility of K73 and its ability to activate S70 (i.e., function as a general base) may be impaired in the S130G variant of KPC-2, thereby explaining the slowed acylation. Moreover, we also advance the idea that the protonation of the sulfate nitrogen of avibactam may be slowed in the S130G variant, as S130 is the likely proton donor and another residue, possibly K234, must compensate. Our findings show that residues S130 as well as K234 and R

  1. New in silico insights into the inhibition of RNAP II by α-amanitin and the protective effect mediated by effective antidotes.

    Science.gov (United States)

    Garcia, Juliana; Carvalho, Alexandra T P; Dourado, Daniel F A R; Baptista, Paula; de Lourdes Bastos, Maria; Carvalho, Félix

    2014-06-01

    Poisonous α-amanitin-containing mushrooms are responsible for the major cases of fatalities after mushroom ingestion. α-Amanitin is known to inhibit the RNA polymerase II (RNAP II), although the underlying mechanisms are not fully understood. Benzylpenicillin, ceftazidime and silybin have been the most frequently used drugs in the management of α-amanitin poisoning, mostly based on empirical rationale. The present study provides an in silico insight into the inhibition of RNAP II by α-amanitin and also on the interaction of the antidotes on the active site of this enzyme. Docking and molecular dynamics (MD) simulations combined with molecular mechanics-generalized Born surface area method (MM-GBSA) were carried out to investigate the binding of α-amanitin and three antidotes benzylpenicillin, ceftazidime and silybin to RNAP II. Our results reveal that α-amanitin should affects RNAP II transcription by compromising trigger loop (TL) function. The observed direct interactions between α-amanitin and TL residues Leu1081, Asn1082, Thr1083, His1085 and Gly1088 alters the elongation process and thus contribute to the inhibition of RNAP II. We also present evidences that α-amanitin can interact directly with the bridge helix residues Gly819, Gly820 and Glu822, and indirectly with His816 and Phe815. This destabilizes the bridge helix, possibly causing RNAP II activity loss. We demonstrate that benzylpenicillin, ceftazidime and silybin are able to bind to the same site as α-amanitin, although not replicating the unique α-amanitin binding mode. They establish considerably less intermolecular interactions and the ones existing are essential confine to the bridge helix and adjacent residues. Therefore, the therapeutic effect of these antidotes does not seem to be directly related with binding to RNAP II. RNAP II α-amanitin binding site can be divided into specific zones with different properties providing a reliable platform for the structure-based drug design of

  2. Bloodstream infections in febrile neutropenic patients at a tertiary cancer institute in South India: A timeline of clinical and microbial trends through the years

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    K Govind Babu

    2016-01-01

    Full Text Available Introduction: Febrile neutropenia (FN is an oncological emergency. The choice of empiric therapy depends on the locally prevalent pathogens and their sensitivities, the sites of infection, and cost. The Infectious Diseases Society of America guidelines are being followed for the management of FN in India. Methods: This is a prospective observational study conducted at a tertiary care cancer centre from September 2012 to September 2014. Objectives: The objectives of this study were as follows: (1 To review the pattern of microbial flora, susceptibility pattern, and important clinical variables among bloodstream infections in febrile neutropenic patients with solid tumors and hematological malignancies. (2 As per the institutional protocol to periodically review the antibiotic policy and susceptibility pattern, and compare the findings with an earlier study done in our institute in 2010. This was a prospective study conducted from September 2012 to September 2014. Results: About 379 episodes of FN were documented among 300 patients. About 887 blood cultures were drawn. Of these, 137 (15% isolates were cultured. Isolates having identical antibiograms obtained from a single patient during the same hospitalization were considered as one. Hence, 128 isolates were analyzed. About 74 (58% cultures yielded Gram-negative bacilli, 51 (40% were positive for Gram-positive cocci, and 3 (2% grew fungi. Among Gram-negative organisms, Escherichia coli followed by Acinetobacter baumannii and Klebsiella pneumoniae accounted for 78% of the isolates. Among Gram-positive cocci, Staphylococcus species accounted for 84% of the isolates. We have noted a changing trend in the antibiotic sensitivity pattern over the years. Following the switch in empirical antibiotics, based on the results of the study done in 2010 (when the empirical antibiotics were ceftazidime + amikacin, the sensitivity to cefoperazone-sulbactam has plunged from about 80% to 60%%. Similar reduction in

  3. Sulfhydryl variable-5 extended spectrum β-lactamase in nosocomial enteric bacteria causing sepsis in mexican children

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    Angélica Flores-Pérez

    2015-10-01

    Full Text Available Introduction: Enteric bacteria causing nosocomial infections are often resistant to third-generation cephalosporins due to the production of extended-spectrum β-lactamases (ESBLs. Objective: To describe and characterize the ESBLs pattern present in Klebsiella pneumoniae and Serratia marcescens strains, isolated as causative of nosocomial sepsis in pediatric patients at Instituto Nacional de Pediatría (National Institute of Pediatrics. Material and methods: We analyzed 94 strains of K. pneumoniae and 7 of S. marcescens isolated from clinical specimens from 2002-2005, causative of sepsis in a children’s hospital. We evaluated antibiotic susceptibility and detection of ESBL phenotypes by disk diffusion methods; ceftazidime-resistant isolates were further characterized by pulsed field gel electrophoresis (PFGE; and ESBLs were phenotypically and genotypically characterized by isoelectric focusing, polymerase chain reaction (PCR and sequencing. We also assed for presence of conjugative plasmids bearing the ESBL gene. Results: 51/94 (54% of K. pneumoniae isolates, and 5/7 (71% of S. marcescens isolates were resistant to ceftazidime; all carried a blaSHV-5 gene. All K. pneumoniae isolates had a distinct PFGE profile, yet all carried a ~48-Kb plasmid, that was conjugatively transferable to an Escherichia coli receptor, which expressed the resistance phenotype. On the other hand, all S. marcescens isolates had a similar PFGE profile, were unable to transfer the ceftazidime-resistance phenotype, and were isolated from the same ward in a short time-span suggesting an outbreak. Conclusions: The overall prevalence of ESBL-producing enteric bacteria in this hospital is high but similar to other Latin American reports. The sulfhydryl variable-5 (SHV-5 ESBL gene appears to reside in a highly mobile plasmid, capable of spreading among different K. pneumoniae clones and perhaps even to S. marcescens.

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

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    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

  5. Streptococcus agalactiae Endophthalmitis in Boston Keratoprosthesis in a Patient with Steven–Johnson Syndrome

    Science.gov (United States)

    Al-Otaibi, Humoud M.; Talea, Mohammed; Kirat, Omar; Stone, Donald U.; May, William N.; Kozak, Igor

    2016-01-01

    A 25-year-old Syrian male with a previous episode of Stevens-Johnson syndrome with bilateral corneal cicatrization previously underwent surgery for Type 1 Boston Keratoprosthesis (K-Pro). Sixteen months after the K-Pro surgery, the patient presented with decreased vision to hand motion and microbial keratitis of the graft around the K-Pro with purulent discharge. Corneal scrapings were nonrevealing. B-scan in 3 days showed increased debris in the vitreous cavity and thickened retinochoroidal layer. Intravitreal tap and injections of vancomycin and ceftazidime were performed. The vitreous culture revealed β-hemolytic Streptococcus agalactiae; fungal cultures were negative. Repeat B-scan 3 days later demonstrated decreased vitreous opacity, and the patient felt more comfortable and was without pain. His visual acuity improved to 20/70, ocular findings have been stable for 9 months, and the patient continues to be monitored. PMID:27994401

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

    Science.gov (United States)

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

    2001-02-01

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

  7. Scleral buckle infection with Alcaligenes xylosoxidans

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    Chih-Kang Hsu

    2014-01-01

    Full Text Available We describe a rare case of extraocular inflammation secondary to scleral buckle infection with Alcaligenes xylosoxidans. A 60-year-old female with a history of retinal detachment repair with open-book technique of scleral buckling presented with purulent discharge and irritation in the right eye that had begun 4 weeks earlier and had been treated ineffectively at another hospital. Conjunctival erosion with exposure of the scleral buckle was noted. The scleral buckle was removed and cultured. The explanted material grew gram-negative rod later identified as A. xylosoxidans. On the basis of the susceptibility test results, the patient was treated by subconjunctival injection and fortified topical ceftazidime. After 4 weeks of treatment, the infection resolved.

  8. Workshop on treatment of and postexposure prophylaxis for Burkholderia pseudomallei and B. mallei Infection, 2010.

    Science.gov (United States)

    Lipsitz, Rebecca; Garges, Susan; Aurigemma, Rosemarie; Baccam, Prasith; Blaney, David D; Cheng, Allen C; Currie, Bart J; Dance, David; Gee, Jay E; Larsen, Joseph; Limmathurotsakul, Direk; Morrow, Meredith G; Norton, Robert; O'Mara, Elizabeth; Peacock, Sharon J; Pesik, Nicki; Rogers, L Paige; Schweizer, Herbert P; Steinmetz, Ivo; Tan, Gladys; Tan, Patrick; Wiersinga, W Joost; Wuthiekanun, Vanaporn; Smith, Theresa L

    2012-12-01

    The US Public Health Emergency Medical Countermeasures Enterprise convened subject matter experts at the 2010 HHS Burkholderia Workshop to develop consensus recommendations for postexposure prophylaxis against and treatment for Burkholderia pseudomallei and B. mallei infections, which cause melioidosis and glanders, respectively. Drugs recommended by consensus of the participants are ceftazidime or meropenem for initial intensive therapy, and trimethoprim/sulfamethoxazole or amoxicillin/clavulanic acid for eradication therapy. For postexposure prophylaxis, recommended drugs are trimethoprim/sulfamethoxazole or co-amoxiclav. To improve the timely diagnosis of melioidosis and glanders, further development and wide distribution of rapid diagnostic assays were also recommended. Standardized animal models and B. pseudomallei strains are needed for further development of therapeutic options. Training for laboratory technicians and physicians would facilitate better diagnosis and treatment options.

  9. Antibiotic resistance profiles of Pseudomonas aeruginosa strains isolated from patients with acute exacerbation of chronic obstructive pulmonary disease

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    Nagihan Demir

    2014-12-01

    For typing and antibiotic susceptibility of isolates the Phoenix bacterial identification system (Becton Dickinson, USA was used.[¤]RESULTS[|]The antibiotic resistance rates of P. aeruginosa were 42.3% for cefepime, 41% for levofloxacin, 38.7% for ciprofloxacin, 29.4% for ceftazidime, 21.7% for cefoperazone / sulbactam, 17.9% for gentamicin, 17.9% for piperacillin / tazobactam, 8.9% for imipenem, 5.1% for amikacin and 2.5% for meropenem. Twenty eight (35.9% of the isolates were found to be sensitive to all of these antibiotics. Forty six (58.9% of the patients had steroid and 56 (71.8% of the patients had broad-spectrum antibiotic use.[¤]CONCLUSION[|]In acute exacerbations of chronic obstructive pulmonary disease, the inspection of antibiotic susceptibility of Pseudomonas infection would be beneficial for patient's health and the country's economy.[¤

  10. Effects of antibiotics on quorum sensing in pseudomonas aeruginosa

    DEFF Research Database (Denmark)

    Skindersø, Mette Elena; Alhede, Morten; Phipps, Richard Kerry

    2008-01-01

    . Three of the antibiotics tested, AZM, ceftazidime (CFT), and ciprofloxacin (CPR), were very active in the assay and were further examined for their effects on QS-regulated virulence factor production in P. aeruginosa. The effects of the three antibiotics administered at subinhibitory concentrations were...... in animal infection models. Treatment of cystic fibrosis (CF) patients chronically infected with P. aeruginosa with the macrolide antibiotic azithromycin (AZM) has been demonstrated to improve the clinical outcome. Several studies indicate that AZM may accomplish its beneficial action in CF patients...... by impeding QS, thereby reducing the pathogenicity of P. aeruginosa. This led us to investigate whether QS inhibition is a common feature of antibiotics. We present the results of a screening of 12 antibiotics for their QS-inhibitory activities using a previously described QS inhibitor selector 1 strain...

  11. [New antibacterial agents on the market and in the pipeline].

    Science.gov (United States)

    Kern, W V

    2015-11-01

    After some years of stagnation there have been several new successful developments in the field of antibacterial agents. Most of these new developments have been in conventional antibacterial classes. New drugs among the beta-lactam agents are methicillin-resistant Staphylococcus aureus (MRSA) active cephalosporins (ceftaroline and ceftobiprole) and new combinations of beta-lactam with beta-lactamase inhibitors (ceftolozane/tazobactam, ceftazidime/avibactam, imipenem/relebactam and meropenem/RPX7009). New developments can also be observed among oxazolidinones (tedizolid, radezolid, cadazolid and MRX-I), macrolides/ketolides (modithromycin and solithromycin), aminoglycosides (plazomicin), quinolones (nemonoxacin, delafloxacin and avarofloxacin), tetracyclines (omadacycline and eravacycline) as well as among glycopeptides and lipopeptides (oritavancin, telavancin, dalbavancin and surotomycin). New agents in a very early developmental phase are FabI inhibitors, endolysines, peptidomimetics, lipid A inhibitors, methionyl-tRNA synthetase inhibitors and teixobactin.

  12. Improving known classes of antibiotics: an optimistic approach for the future.

    Science.gov (United States)

    Bush, Karen

    2012-10-01

    New antibiotic agents are desperately needed to treat the multidrug-resistant pathogens that continue to emerge at alarming rates. Many of the agents that have entered full clinical development since 1995 have been members of previously accepted classes of antibiotics. Among these are a new aminoglycoside (plazomicin), anti-MRSA cephalosporins (ceftobiprole and ceftaroline), a monocyclic β-lactam (BAL30072), the β-lactamase inhibitor combination of tazobactam with the anti-pseudomonal cephalosporin ceftolozane, β-lactam combinations with new non-β-lactam inhibitors (MK-7655 with imipenem, and avibactam with ceftazidime and ceftaroline), new macrolides (cethromycin and solithromycin), oxazolidinones (tedizolid phosphate and radezolid), and quinolones (delafloxacin, nemonoxacin and JNJ-Q2). Resistance and safety issues have been circumvented by some of these new agents that have well-established mechanisms of action and defined pathways leading toward regulatory approval.

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

    Science.gov (United States)

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

    2016-04-01

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

  14. Analysis of Etiology and Drug Resistance of Biliary Infections

    Institute of Scientific and Technical Information of China (English)

    王欣; 李秋; 邹声泉; 孙自庸; 朱峰

    2004-01-01

    The bile was collected from fro patients with biliary infections, with the bacterium isolated to study the sensitivity of each kind of the bacterium to several antibiotics in common use. Except G- bacterium, we also found some kinds of G+ bacterium in infection bile. G- bacterium were not sensitive to Clindamycin, G+ bacterium were sensitive to Ciprofloxacin. Escherichia coli,Xanthomonas maltophilia, Enterobacter cloacae, Pseudomonas aeruginosa were sensitive to Ampicillin. G+ bacterium were not sensitive to Azactam. Enterococcus faecalis, Enterococcus faecium,Enterobacter cloacae were not sensitive to Ceftazidime. Enterococcus faecalis, Staphylococcus coagulase negative, Staphylococcus epidermidis, Pseudomonas aeruginosa were not sensitive to Ceftriaxone Sodium. We didn't found any bacterium resistance Imipenem. The possibility of the existence of G+ bacterium as well as drug resistance should be considered n patients with biliary infections.The value of susceptibility test should be respected to avoid drug abuse of antibiotics.

  15. Prevalence and antimicrobial susceptibility of Salmonella spp. in small Indian mongooses (Herpestes auropunctatus) in Grenada, West Indies.

    Science.gov (United States)

    Miller, Steven; Amadi, Victor; Stone, Diana; Johnson, Roger; Hariharan, Harry; Zieger, Ulrike

    2014-09-01

    Intestinal samples from 156 small Indian mongooses (Herpestes auropunctatus) collected island-wide in Grenada from April 2011 to March 2013 were examined for the presence of Salmonella enterica spp. Nineteen (12%) mongooses were culture-positive for S. enterica spp. of which five serotypes were identified. Salmonella javiana and S. Montevideo were the most commonly isolated serotypes. The other serotypes isolated were S. Rubislaw, S. Panama and S. Arechavaleta. All isolates were susceptible to amoxicillin-clavulanic acid, ampicillin, cefotaxime, ceftazidime, ciprofloxacin, enrofloxacin, gentamicin, nalidixic acid, imipenem and trimethoprim-sulfamethoxazole. One isolate (S. Montevideo) showed resistance to tetracycline and intermediate resistance to streptomycin. The five isolated Salmonella serotypes are potential human pathogens suggesting that the mongoose may play a role in the epidemiology of human salmonellosis in Grenada.

  16. 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.

  17. Pharmacodynamic Profiling of Antimicrobials against Gram-negative Respiratory Isolates from Canadian Hospitals

    Directory of Open Access Journals (Sweden)

    Rebecca A. Keel

    2011-01-01

    Full Text Available The objective of this study was to assess the profile of a variety of dosing regimens for common intravenous antibiotics against contemporary Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa isolates collected in Canada during 2009, using pharmacodynamic modelling techniques. Monte Carlo simulation was conducted for standard and/or prolonged infusion regimens of cefepime, ceftazidime, ceftriaxone, ciprofloxacin, doripenem, ertapenem, meropenem and piperacillin/tazobactam. The cumulative fraction of response (CFR was calculated using bactericidal targets for each regimen against each species. All cefepime, doripenem, ertapenem and meropenem regimens achieved optimal exposures against Enterobacteriaceae, whereas target attainment was organism and dose dependent for the other agents. These results support that the currently recommended antimicrobial dosing regimens generally attain acceptable exposures to achieve the requisite pharmacodynamic targets against the Enterobacteriaceae species; however, they fall short of obtaining optimal bactericidal exposures against P aeruginosa.

  18. Detection of serum IgE antibody directed to aminothiazole using immobilized cephalosporins without protein conjugation

    Directory of Open Access Journals (Sweden)

    Akihito Yokoyama

    1999-01-01

    Full Text Available It is well known that allergic reactions may sometimes occur in patients under treatment with β-lactam antibiotics. For the detection of antidrug antibodies in vitro, conjugation with human serum albumin has been considered to be essential. In this study, we found that cefotiam, cefpirome, and ceftazidime could be immobilized without conjugation to carrier protein to construct a solid-phase enzyme-linked immunosorbent assay (ELISA system. We describe a patient (26-year-old female nurse with contact urticaria induced by antibiotics. Using the serum of this patient, we successfully detected IgE antibody directed to the aminothiazolyl group of cephalosporins, which has not previously been reported. Results suggest that the simple ELISA using unconjugated antibiotics could be applicable to patients with allergy to some cephalosporins and the aminothiazole side chain of the cephalosporins could cause an IgE-mediated allergic reaction.

  19. ANTIBACTERIAL RESISTANCE PATTERN OF PSEUDOMONAS AERUGINOSA CO - ISOLATED WITH OTHER AEROBIC BACTERIA FROM BURN WOUNDS IN TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Kalpana

    2014-01-01

    Full Text Available The antibacterial resistance pattern of 118 isolates from burn wounds in patients with thermal burns showing growth of Pseudomonas aeruginosa mixed with other aerobic bacteria over a period of two years ( January 2009 - Decemb er2010 were studied. Pseudomonas aeruginosa was found to be mixed with Klebsiella pneumoniae 63 ( 53.38% the most followed by Escherichia coli 27 ( 22.88% and other aerobic isolates. Pseudomonas aeruginosa was found to be highly resistant to Ceftazidime ( 72.88% and least to Imipenem ( 9.32%. Klebsiella pneumoniae was found to be most resistant to Ampicillin ( 100% and least to Amikacin ( 23.72%. Antibiotic susceptibility testing was performed for the other isolates as well

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

    Directory of Open Access Journals (Sweden)

    Nikolić Katarina

    2015-01-01

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

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

    Science.gov (United States)

    Bizet, C; Bizet, J

    1995-04-01

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

  2. Resistance to antibiotics and inorganic ions in virulent bacterial strains from a hospital.

    Science.gov (United States)

    Vazquez, F; Fidalgo, S; Mendez, F J; Mendoza, M C

    1989-08-01

    Virulent strains of Staphylococcus aureus, S. epidermidis, Escherichia coli and Pseudomonas aeruginosa were studied for their resistance to antibiotics and inorganic ions, the correlation with their clinical use and the usefulness as an epidemioliogical tool. Multiresistance was common, the antibiotypes were similar to those previously reported, but characteristic resistotypes endemic of our county were found. A correlation between resistance and metal ion consumption was not detected. Staphylococci strains were susceptible to vancomycin, cephalothin and mercury chloride; S. epidermidis showed higher rates of resistance to antibiotics and lower to cadmium chloride and potassium iodine than S. aureus. E. coli strains were susceptible to new beta-lactamans; resistance to cephalothin, gentamicin, tobramycin and amikacin was less than 10%. P, aeruginosa was the species with the most multiresistance and antibiotype diversity, only ceftazidime, amikacin and imipenem had a resistance rate less than 11%. In both E. coli and P. aeruginosa resistance to all tested metals (except silver nitrate) was found although with different percentages.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  4. Dynamics and spatial distribution of beta-lactamase expression in Pseudomonas aeruginosa biofilms

    DEFF Research Database (Denmark)

    Bagge, N.; Hentzer, Morten; Andersen, Jens Bo

    2004-01-01

    The development of resistance to beta-lactam antibiotics is a problem in the treatment of chronic Pseudomonas aeruginosa infection in the lungs of patients with cystic fibrosis. The main resistance mechanism is high-level expression of the chromosomally encoded AmpC beta-lactamase of P. aeruginosa...... cells growing in biofilms. Several genes have been shown to influence the level of ampC expression, but little is known about the regulation of ampC expression in P. aeruginosa biofilms. To study the expression of ampC in P. aeruginosa biofilms, we constructed a reporter that consisted of the fusion...... of the ampC promoter to gfp(ASV) encoding an unstable version of the green fluorescent protein. In vitro biofilms of P. aeruginosa were exposed to the beta-lactam antibiotics imipenem and ceftazidime. Sub-MICs of imipenem significantly induced the monitor system of the biofilm bacteria in the peripheries...

  5. Fabrication, characterization and in vitro profile based interaction with eukaryotic and prokaryotic cells of alginate-chitosan-silica biocomposite.

    Science.gov (United States)

    Balaure, Paul Catalin; Andronescu, Ecaterina; Grumezescu, Alexandru Mihai; Ficai, Anton; Huang, Keng-Shiang; Yang, Chih-Hui; Chifiriuc, Carmen Mariana; Lin, Yung-Sheng

    2013-01-30

    This work is focused on the fabrication of a new drug delivery system based on polyanionic matrix (e.g. sodium alginate), polycationic matrix (e.g. chitosan) and silica network. The FT-IR, SEM, DTA-TG, eukaryotic cell cycle and viability, and in vitro assay of the influence of the biocomposite on the efficacy of antibiotic drugs were investigated. The obtained results demonstrated the biocompatibility and the ability of the fabricated biocomposite to maintain or improve the efficacy of the following antibiotics: piperacillin-tazobactam, cefepime, piperacillin, imipenem, gentamicin, ceftazidime against Pseudomonas aeruginosa ATCC 27853 and cefazolin, cefaclor, cefuroxime, ceftriaxone, cefoxitin, trimethoprim/sulfamethoxazole against Escherichia coli ATCC 25922 reference strains.

  6. In vitro activity of ceftobiprole against Acinetobacter baumannii clinical isolates.

    Science.gov (United States)

    Marti, Sara; Sánchez-Céspedes, Javier; Espinal, Paula; Vila, Jordi

    2009-09-01

    Acinetobacter baumannii is a multiresistant opportunistic nosocomial pathogen responsible for outbreaks worldwide. The main infection caused by this microorganism is nosocomial pneumonia, in particular ventilator-associated pneumonia in patients in Intensive Care Units. Treatment of these nosocomial infections is becoming problematic because the level of resistance to antimicrobial agents is rising. Ceftobiprole is a new cephalosporin with activity against Gram-positive and Gram-negative pathogens. This study evaluated the in vitro activity of ceftobiprole against a collection of 58 A. baumannii clinical isolates and showed that the activity of ceftobiprole was superior to ceftazidime and cefepime when the bla(ADC)-like gene was not expressed or was expressed at a low level.

  7. Ceftobiprole for the treatment of pneumonia: a European perspective.

    Science.gov (United States)

    Liapikou, Adamantia; Cillóniz, Catia; Torres, Antonio

    2015-01-01

    Ceftobiprole, a new broad spectrum, parenteral cephalosporin, exhibits potent in vitro activity against a number of Gram-positive pathogens, including methicillin-resistant Staphylococcus aureus and penicillin-resistant Streptococcus pneumoniae, and Gram-negative pathogens associated with hospital-acquired pneumonia (HAP) and community-acquired pneumonia (CAP). Ceftobiprole has demonstrated noninferiority in two large-scale pivotal studies comparing it to ceftriaxone with or without linezolid in CAP, with clinical cure rates 86.6% versus 87.4%, or ceftazidime in HAP, with clinical cure rates of 77% versus 76%, respectively. However, ceftobiprole was inferior in the subgroup of patients undergoing mechanical ventilation. Ceftobiprole has so far demonstrated a good safety profile in preliminary studies, with similar tolerability to comparators. The most commonly observed adverse events of ceftobiprole included headache and gastrointestinal upset. It is the first cephalosporin monotherapy approved in the EU for the treatment of both CAP and HAP (excluding ventilator-associated pneumonia).

  8. Investigation of Burkholderia cepacia nosocomial outbreak with high fatality in patients suffering from diseases other than cystic fibrosis.

    Science.gov (United States)

    Shehabi, Asem A; Abu-Al-Soud, Waleed; Mahafzah, Azmi; Khuri-Bulos, Najwa; Abu Khader, Ilham; Ouis, Ibn-Sina; Wadström, Torkel

    2004-01-01

    Over a 1-y period, 26 inpatients at the Jordan University Hospital in Amman were detected with bacteraemia (23 cases) or respiratory tract colonized with B. cepacia (3 cases). A combination of genetic identification and molecular typing has proved that all cases were caused by a single epidemic strain of B. cepacia genomovar IIIa. Nosocomial infections could be documented in 21/26 (81%) patients, mostly with severe underlying or malignant diseases other than cystic fibrosis, but the source of infection was undetected. The overall mortality related to infection with B. cepacia was 42%. All B. cepacia isolates were resistant to ampicillin, amikacin, carbenicillin and gentamicin; and mostly susceptible to piperacillin, chloramphenicol, cotri-moxazole, tetracycline, ceftazidime, and tazocin (62-88%). This study demonstrates the nosocomial and high fatality of B. cepacia genomovar IIIa in Jordanian patients suffering from diseases other than cystic fibrosis.

  9. Primary Amoebic Meningoencephalitis in an Infant due to Naegleria fowleri

    Directory of Open Access Journals (Sweden)

    Vinay Khanna

    2011-01-01

    Full Text Available Primary amoebic meningoencephalitis (PAM caused by free-living amebae Naegleria fowleri is a rare and fatal condition. A fatal case of primary amoebic meningoencephalitis was diagnosed in a 5-month-old infant who presented with the history of decrease breast feeding, fever, vomiting, and abnormal body movements. Trophozoites of Naegleria fowleri were detected in the direct microscopic examination of CSF and infant was put on amphotericin B and ceftazidime. Patient condition deteriorated, and he was discharged against medical advice and subsequently expired. We also reviewed previously reported 8 Indian cases of primary amoebic meningoencephalitis (PAM and observed that for the last 5 years, none of the patients responded to amphotericin B. Has an era of amphotericin B-resistant Naegleria fowleri been emerged? Management strategy of PAM needs to be reviewed further.

  10. Study of Antimicrobial Resistance of Acinetobacter Strains Isolated From Blood Cultures

    Directory of Open Access Journals (Sweden)

    H Zandi

    2007-06-01

    Full Text Available Background: Acinetobacter spp are associated with various nosocomial infections like as septicemia and are isolated form blood cultures in hospitalized patients. Methods: In this study, 45 Acinetobacter strains were isolated from blood samples in Yazd shahid sadoughi hospital from 21 March 2005 to 20 September 2006 and were identified by biochemical tests. Antibiotic susceptibility of the strains was tested by standard disk diffusion method. Results: In this research, 45 isolates identified as Acinetobacter and of isolated strains, 88.8% of them found sensitive to imipenem and 80% to ciprofloxacin. Also 51.5% to nalidixic Acid 24.5% to trimethoprim/sulphametoxazole, 11.1% to ceftazidim and ceftriaxone, 8.8% to cefotaxime and cefexime and also 6.6% to ceftizoxime. Conclusion: Because of increasing of drug resistance in Acinetobacter spp. Isolated from blood samples, it is necessary to perform susceptibility testing, also imipenem and ciprofloxacin recommended for drug therapy.

  11. Klebsiella pneumoniae with multiple antimicrobial resistance

    Directory of Open Access Journals (Sweden)

    Caio Mendes

    2004-02-01

    Full Text Available A Klebsiella pneumoniae strain was isolated from the urine of a patient at one of the centers participating in the 2001 edition of the MYSTIC program in Brazil. The initial phenotypic findings of the isolated K. pneumoniae presented an unusual MIC of 8 mug/mL to meropenem, 2 mug/mL to imipenem, elevated MICs to broad spectrum cephalosporins (ceftazidime/cefotaxime/cefepime MIC > 256 mug/mL, aminoglycosides (gentamycin > 256 mug/mL and tobramycin = 48 mug/mL, piperacillin/tazobactam (MIC > 256 mug/mL and susceptibility to ciprofloxacin (MIC = 0.25 mug/mL. The strain also tested positive for ESBL production with double-disk and E-test methodologies. More detailed investigation revealed that the strain produced a SHV-4 type enzyme and also lacked a 36 kDa outer membrane porin.

  12. Morganella morganii Peritonitis Associated with Continuous Ambulatory Peritoneal Dialysis (CAPD) after Colonoscopy.

    Science.gov (United States)

    Kimura, Yukihiro; Ito, Ayano; Miyamoto, Kanyu; Suga, Norihiro; Miura, Naoto; Kasagi, Tomomichi; Yamagishi, Yuka; Mikamo, Hiroshige; Imai, Hirokazu

    2016-01-01

    A 79-year-old man on continuous ambulatory peritoneal dialysis (CAPD) developed abdominal pain and cloudy peritoneal fluid two days after colonoscopy that revealed multiple diverticula. The white blood cell count was 9,000 cells/μL, C-reactive protein level was 6.86 mg/dL, and the white blood cell count of the peritoneal fluid was 7,800 cells/μL, suggesting acute peritonitis. Empiric therapy consisting of cefazolin and ceftazidime slowly improved the patient's symptoms. The initial microbiological examination of the peritoneal fluid demonstrated Morganella morganii. He was changed from CAPD to hemodialysis. It is important to consider M. morganii peritonitis in patients with colonic diverticula.

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

    Directory of Open Access Journals (Sweden)

    Hancu Gabriel

    2013-01-01

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

  14. Achromobacter Xylosoxidans Bloodstream Infection in Elderly Patient with Hepatocellular Carcinoma: Case Report and Review of Literature.

    Science.gov (United States)

    Raghuraman, Kausalya; Ahmed, Nishat H; Baruah, Frincy K; Grover, Rajesh K

    2015-01-01

    Achromobacter xylosoxidansis a nonfermentative Gram-negative organism, known to cause opportunistic infection in humans. We report a case of septicemia in a 76-year-old male patient with underlying hepatocellular carcinoma due to A. xylosoxidans, which showed a different antimicrobial susceptibility pattern from what is usually reported. From aerobic blood culture of the patient, A. xylosoxidans was isolated which was found to be sensitive to amoxicillin-clavulanic acid, piperacillin-tazobactam, ceftazidime, cefoperazone-sulbactam, meropenem, minocycline, tigecycline, and trimethoprim/sulfamethoxazole. The patient recovered with amoxicillin-clavulanic acid treatment, which was given empirically to the patient. The present case highlights the possible role of amoxicillin-clavulanic acid for treatment of bloodstream infection with A. xylosoxidans.

  15. Scleral buckle infection with Alcaligenes xylosoxidans.

    Science.gov (United States)

    Hsu, Chih-Kang; Chang, Yun-Hsiang; Chen, Jiann-Torng

    2014-06-01

    We describe a rare case of extraocular inflammation secondary to scleral buckle infection with Alcaligenes xylosoxidans. A 60-year-old female with a history of retinal detachment repair with open-book technique of scleral buckling presented with purulent discharge and irritation in the right eye that had begun 4 weeks earlier and had been treated ineffectively at another hospital. Conjunctival erosion with exposure of the scleral buckle was noted. The scleral buckle was removed and cultured. The explanted material grew gram-negative rod later identified as A. xylosoxidans. On the basis of the susceptibility test results, the patient was treated by subconjunctival injection and fortified topical ceftazidime. After 4 weeks of treatment, the infection resolved.

  16. Achromobacter Xylosoxidans bloodstream infection in elderly patient with Hepatocellular Carcinoma: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Kausalya Raghuraman

    2015-01-01

    Full Text Available Achromobacter xylosoxidansis a nonfermentative Gram-negative organism, known to cause opportunistic infection in humans. We report a case of septicemia in a 76-year-old male patient with underlying hepatocellular carcinoma due to A. xylosoxidans, which showed a different antimicrobial susceptibility pattern from what is usually reported. From aerobic blood culture of the patient, A. xylosoxidanswas isolated which was found to be sensitive to amoxicillin-clavulanic acid, piperacillin-tazobactam, ceftazidime, cefoperazone-sulbactam, meropenem, minocycline, tigecycline, and trimethoprim/sulfamethoxazole. The patient recovered with amoxicillin-clavulanic acid treatment, which was given empirically to the patient. The present case highlights the possible role of amoxicillin-clavulanic acid for treatment of bloodstream infection with A. xylosoxidans.

  17. The first cases of human bacteremia caused by Acinetobacter seifertii in Japan.

    Science.gov (United States)

    Kishii, Kozue; Kikuchi, Ken; Tomida, Junko; Kawamura, Yoshiaki; Yoshida, Atsushi; Okuzumi, Katsuko; Moriya, Kyoji

    2016-05-01

    Acinetobacter seifertii, a novel species of Acinetobacter, was first reported in 2015. A. seifertii strains were isolated from human clinical specimens (blood, respiratory tract, and ulcer) and hospital environments. Here, we report the first cases of bacteremia caused by A. seifertii in patients with catheter-related bloodstream infection in Japan. The patients favorably recovered, without any complications, after removal of the peripheral intravenous catheters and administration of antibiotics. The pathogens were initially identified as Acinetobacter baumannii, using phenotypic methods and the MicroScan Walkaway System; however, rpoB gene sequence analysis indicated 99.54% similarity to A. seifertii. Moreover, antimicrobial susceptibility testing revealed that one of the strains was not susceptible to gentamicin and ceftazidime. Our report shows that Acinetobacter species other than A. baumannii can also cause nosocomial infections and that accurate methods for the identification of causative agents should be developed.

  18. Optimal sampling theory and population modelling - Application to determination of the influence of the microgravity environment on drug distribution and elimination

    Science.gov (United States)

    Drusano, George L.

    1991-01-01

    The optimal sampling theory is evaluated in applications to studies related to the distribution and elimination of several drugs (including ceftazidime, piperacillin, and ciprofloxacin), using the SAMPLE module of the ADAPT II package of programs developed by D'Argenio and Schumitzky (1979, 1988) and comparing the pharmacokinetic parameter values with results obtained by traditional ten-sample design. The impact of the use of optimal sampling was demonstrated in conjunction with NONMEM (Sheiner et al., 1977) approach, in which the population is taken as the unit of analysis, allowing even fragmentary patient data sets to contribute to population parameter estimates. It is shown that this technique is applicable in both the single-dose and the multiple-dose environments. The ability to study real patients made it possible to show that there was a bimodal distribution in ciprofloxacin nonrenal clearance.

  19. Amatoxin poisoning treatment decision-making: pharmaco-therapeutic clinical strategy assessment using multidimensional multivariate statistic analysis.

    Science.gov (United States)

    Poucheret, Patrick; Fons, Françoise; Doré, Jean Christophe; Michelot, Didier; Rapior, Sylvie

    2010-06-15

    Ninety percent of fatal higher fungus poisoning is due to amatoxin-containing mushroom species. In addition to absence of antidote, no chemotherapeutic consensus was reported. The aim of the present study is to perform a retrospective multidimensional multivariate statistic analysis of 2110 amatoxin poisoning clinical cases, in order to optimize therapeutic decision-making. Our results allowed to classify drugs as a function of their influence on one major parameter: patient survival. Active principles were classified as first intention, second intention, adjuvant or controversial pharmaco-therapeutic clinical intervention. We conclude that (1) retrospective multidimensional multivariate statistic analysis of complex clinical dataset might help future therapeutic decision-making and (2) drugs such as silybin, N-acetylcystein and putatively ceftazidime are clearly associated, in amatoxin poisoning context, with higher level of patient survival.

  20. Effects of two eflfux pump inhibitors on the drug susceptibility of Riemerella anatipestiferisolates from China

    Institute of Scientific and Technical Information of China (English)

    LI Ya-fei; JIANG Hong-xia; XIANG Rong; SUN Na; ZHANG Ya-nan; ZHAO Li-qing; GU Peng; WANG Li-qiao; ZENG Zhen-ling

    2016-01-01

    The objective of this study was to verify the supposition that eflfux might be involved in the drug resistance ofRiemerela anatipestiferisolates. Two broad-spectrum eflfux pump inhibitors, carbonyl cyanide 3-chlorophenylhydrazone (CCCP) and Phe-Arg-β-naphthylamide (PAβN), on the contribution of minimum inhibitory concentrations of amikacin, streptomycin, chloramphenicol, tetracycline, ceftriaxone, ceftazidime, nalidixic acid, levolfoxacin, enrolfoxacin, as wel as ciprolfoxacin against 69 clinicalR. anatipestiferisolates were investigated. We ifrst reported that the two eflfux pump inhibitors could restore the antimicrobial susceptibility ofR. anatipestifer isolates. It is suggested that active eflfux system is possible to be linked with the development of resistance inR. anatipestifer isolates.

  1. Imipenem resistance in nonfermenters causing nosocomial urinary tract infections.

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    Taneja N

    2003-07-01

    Full Text Available Nonfermenting gram-negative bacilli (nonfermenters have emerged as important nosocomial pathogens causing opportunistic infections in immunocompromised hosts. These organisms show high level of resistance to b-lactam agents, fluoroquinolones and aminoglycosides. Imipenem is a carbapenem antibiotic, which can be very useful for treatment of infections caused by nonfermenters. Eighty-five nonfermenters causing nosocomial UTI were tested for MIC to imipenem by agar dilution method. Resistance to other antimicrobial agents was compared between imipenem sensitive (S and resistance (R groups. Overall 36.4% of nonfermenters were resistant to imipenem. Forty two percent of P. aeruginosa and 18.5% of Acinetobacter baumanii were imipenem resistant. Other nonfermenters showed variable resistance, resistance in Alcaligenes spp. being very high. More than 70% of the nonfermenters were resistant to ceftazidime, gentamicin and ciprofloxacin. Piperacillin and amikacin had the best in vitro susceptibility. No significant difference was found in the antibiotic susceptibility profile among imipenem sensitive (S or resistant (R strains.

  2. The antibiotic susceptibility and extended spectrum β-lactamase genotype of clinical Klebsiella pneumoniae%肺炎克雷伯菌药敏分析及其超广谱β内酰胺酶基因分型研究

    Institute of Scientific and Technical Information of China (English)

    杨朵; 王占伟; 郭宇; 张正

    2011-01-01

    Objective To analyze the antibiotic susceptibility, ESBL genotype of clinical Klebsiella pneumoniae strains isolated from People′s hospital and facilitate the control of resistance spread. Methods Identification and antibiotic susceptibility tests of 1 205 strains from 2001 to 2007 were done by VITEK-2 system.The antibiotic susceptibility results were analyzed by whonet5.3.The ESBL gene was detected by PCR and the Chi-square test was used for statistical analysis.Results The rate of ESBL-producing strains in klebsiella pneumoniae has increased from 2001 to 2007[18.8% (40/213) in 2001, 20.9% (53/253) in 2002, 32.8% (42/128) in 2003, 33.6% (45/137) in 2004, 36.6% (60/164) in 2005, 45.3% (68/150) in 2006 and 45.6% (73/160) in 2007].The SHV gene was the most dominant in ESBL genotypes.There were 83.3% (50/60) ESBL strains in 2005 with SHV gene, 82.3%(56/68) in 2006 and 83.6%(61/73) in 2007.The rated of strains with CTX-M gene were increasing.There were 26.7%(16/60) ESBL strains with CTX-M gene in 2005, 36.7%(25/68) in 2006 and 54.8%(40/73) in 2007.The isolates with more than one type of ESBL gene were increasing.There were 45%(27/60) ESBL strains in 2005 with two types of ESBL gene, and no one had more than two types of ESBL gene in that year.There were 47.9%(35/73) ESBL strains in 2007 with two types of ESBL gene.In 2007 there were 9.6%(7/73) and 2.7%(2/73) ESBL strains with three types and four types of ESBL gene respectively.There was a statistical difference between the antibiotic resistance rates of cefotaxime, ceftriaxone and ceftazidime in SHV-gene-phore strains (χ2=13.22, P<0.01).The strains with SHV gene were more resistant to cefotaxime than ceftriaxone and ceftazidime.There also was a statistical difference of the antibiotic resistance rate of cefotaxime, ceftriaxone and ceftazidime between strains with TEM gene (χ2=9.91, P<0.01) and CTX-M gene (χ2=34.84, P<0.01) respectively.None of the strains with CTX-M gene was sensitive to cefotaxime, and

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

    Science.gov (United States)

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

    2000-04-01

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

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

    Science.gov (United States)

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

    2000-01-01

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

  5. Study on the Sensitivity of Chlorella sp.to Three Common Antibiotics%小球藻对3种常用抗生素的敏感性研究

    Institute of Scientific and Technical Information of China (English)

    麻晓霞; 石勋祥; 马丽萍; 马玉龙

    2011-01-01

    [目的]探讨小球藻(Chlorella sp.)对3种常用抗生素的敏感性.[方法]采用分光光度法研究了青霉素、氨苄青霉素、头孢他啶3种常用抗生素对小球藻生长的影响,以确定分离、纯化微藻时对藻细胞无害并能抑制伴生杂菌生长的抗生素浓度.[结果]小球藻对青霉素较为敏感,而对氨苄青霉素和头孢他啶敏感性较弱,低浓度(1.0 mg/L)的氨苄青霉素对微藻细胞生长有明显促进作用.[结论]氨苄青霉素可用于小球藻纯化过程中抑菌,其适宜浓度为1.0 mg/L.%[Objective] The aim was to esplore the sensitivity of Chlorella sp. To 3 kinds of common antibiotics. [ Method ] Effects of three common antibiotics such as penicillin, ampicillin, and ceftazidime on the growth of Chlorella sp. Were studied by spectrophotometric method. The aim was to determine the optimal antibiotic concentration, which was harmless to the growth of Chlorella sp. , but had an inhibitory action on bacteria. [ Result ] Penicillin had strong inhibition to the Chlorella sp. While ampicillin and ceftazidime exhibited a low inhibition. An a-mount of 1.0 mg/L of ampicillin significantly promoted the growth of the tested microalgae. [ Conclusion ] Ampicillin can be used to prevent microbial contamination during the purification of Chlorella sp.. The optimal content of ampicillin was 1.0 mg/ L.

  6. High-level Multi-Resistant and Virulent Escherichia coli in Abeokuta, Nigeria.

    Science.gov (United States)

    Akinduti, Paul Akinniyi; Aboderin, Bukola W; Oloyede, Rasaq; Ogiogwa, Joseph I; Motayo, Babatunde O; Ejilude, Oluwaseun

    2016-01-01

    Multi-resistant Escherichia coli (E. coli) strains co-harboring virulence genes is a cause of high morbidity in Abeokuta, Nigeria. This study was designed to determine some virulent factors among enteropathogenic E. coli in Abeokuta, Nigeria. Approximately non-repetitive 102 isolates of E. coli were recovered from clinical samples from two health facilities in Abeokuta. Biotyping using API and antibiotic susceptibility was determined, and eae and flic genes were assayed by PCR. Antibiotic resistance relatedness was performed by DendroUPGMA. Results showed that 48.0% and 52.0 % were intestinal and extra-intestinal E. coli, ampicillin recorded 100% resistance, amoxycilli/clavulanic acid 64.7%, cotrimoxazole 57.8% and 56.8% resistance against cefotaxime, at MIC >16 ug/mL, 100%, 57.8%, and 50% have MIC50 to ampicillin, tetracycline, and ceftazidime, while 74.5% and 48.0% have MIC90 to ampicillin and ceftazidime. Significant rates of 4.9%, 7.8%, and 9.8% flic, eae, and flic/eae genes were found in intestinal isolates, while 2.9%, 2.0%, and 3.9% were found in extra-intestinal (P < 0.05). Two major clades of the resistant isolates reveal significant antibiotic relatedness among intestinal and extra-intestinal isolates, at 54% resistance similarities with very high multi-antibiotic resistance index of 1.0 (MARI). A high rate of undetected virulent E. coli pathotypes with high resistance could trigger unprecedented morbidity and mortality, mostly among children and the elderly.

  7. In vitro synergistic effect of the CM11 antimicrobial peptide in combination with common antibiotics against clinical isolates of six species of multidrug-resistant pathogenic bacteria.

    Science.gov (United States)

    Amani, Jafar; Barjini, Kamal A; Moghaddam, Mehrdad M; Asadi, Asadollah

    2015-01-01

    During the last decades, increase of antibiotic resistance among pathogenic bacteria has been considered as a global concern. Therefore, it is important to find new antimicrobial agents and/or therapeutic strategies. In previous studies we investigated antibacterial activity of the CM11 peptide against multiple drug resistant clinical isolates of six bacteria species including Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae and Salmonella typhimurium. In this study, in order to reduce treatment costs and the cytotoxic effect of CM11 peptide, was analyzed its synergic interaction with selected antibiotics. In this reason, specific antibiotics for each bacterium were selected considering the guidelines of the "Clinical and Laboratory Standards Institute". Based on the results , using a checkerboard procedure through the broth microdilution method, MICs of antibiotic agents alone and in combination with the peptide were determined. In most cases, synergistic effects between CM11 peptide and selected antibiotics against six bacteria species were observed as partial synergy. However, for S. aureus and P. aeruginosaa synergic interaction between peptide and selective antibiotics was observed with penicillin and ceftazidime, respectively. For K. pneumoniae, synergic effect was observed when CM11 peptide was used in combination with norfloxacin and also the combination of peptide with norfloxacin showed synergic effect against A. baumannii. Combination between the CM11 peptide and ciprofloxacin showed synergic effect on E. coli while only partial synergy was observed for S. typhimurium in combination with cefotaxime and ceftazidime. These results suggest that when selected antibiotic used in combination with the CM11 peptide, the dose of some antibiotics, especially the dose independent antibiotics, may be reduced for eliminating drug resistant bacteria.

  8. In vitro susceptibility pattern of acinetobacter species to commonly used cephalosporins, quinolones, and aminoglycosides

    Directory of Open Access Journals (Sweden)

    Prashanth K

    2004-01-01

    Full Text Available PURPOSE: Acinetobacter spp. is an emerging important nosocomial pathogen. Clinical isolates of this genus are often resistant to many antibiotics. The in vitro susceptibility of Acinetobacter isolates obtained from patients were tested for currently used antibiotics. In addition, the study aimed at biotyping of Acinetobacter baumannii. METHODS: A total of 66 isolates were phenotypically characterised through a large panel of 25 carbon assimilation tests and susceptibility through disc diffusion method with 10 antimicrobial agents were tested. MICs were determined only for second line broad-spectrum drugs such as cefotaxime, ceftazidime, amikacin, ciprofloxacin, and ofloxacin using NCCLS guidelines. RESULTS: Multiple drug resistance (MDR was only witnessed in A. baumannii and not in other Acinetobacter species. Aminoglycosides such as amikacin, netilmicin were most active against the MDR isolates tested (60% susceptibility. Ceftazidime was more active than cefotaxime. MDR A. baumannii strains were susceptible only to amikacin, netilmicin and ceftadizime. Ciprofloxacin had poor activity irrespective of isolates belonging to different DNA groups tested (58% resistance overall, 79% among A. baumannii. Strains of Biotypes 6 and 19 of A. baumannii showed broader resistance than those of biotype 10 and others. CONCLUSIONS: Strains of A. baumannii from patients in our hospital, were generally more resistant to quinolones, -lactam antibiotics, first and second generation cephalosporins and partially resistant to third generation cephalosporins and aminoglycosides. The strains belonging to other DNA groups of Acinetobacter were comparatively less resistant than A.baumannii, except ciprofloxacin. This study suggests that, a combination therapy, using a third generation cephalosporin and amikacin, would be best choice for treating Acinetobacter infections.

  9. EpideMiology and control measures of outBreaks due to Antibiotic-Resistant orGanisms in EurOpe (EMBARGO): a systematic review protocol

    Science.gov (United States)

    Nithya, Babu Rajendran; Gladstone, Beryl Primrose; Rodríguez-Baño, Jesús; Sifakis, Frangiscos; Voss, Andreas; Carmeli, Yehuda; Burkert, Francesco Robert; Gkolia, Panagiota; Tacconelli, Evelina

    2017-01-01

    Introduction Improving our understanding of outbreaks due to antibiotic-resistant bacteria (ARB) and their control is critical in the current public health scenario. The threat of outbreaks due to ARB requires multifaceted efforts. However, a global overview of epidemiological characteristics of outbreaks due to ARB and effective infection control measures is missing. In this paper, we describe the protocol of a systematic review aimed at mapping and characterising the epidemiological aspects of outbreaks due to ARB and infection control measures in European countries. Methods and analysis The databases MEDLINE, Web of Knowledge and Cochrane library will be searched using a 3-step search strategy. Selection of articles for inclusion will be performed by 2 reviewers using predefined eligibility criteria. All study designs will be included if they report an outbreak and define the microbiological methods used for microorganism identification. The target bacteria will be methicillin-resistant and vancomycin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, ceftazidime-resistant and carbapenem-resistant Acinetobacter baumannii, ceftazidime-resistant and carbapenem-resistant Pseudomonas aeruginosa, ciprofloxacin-resistant Escherichia coli, extended-spectrum β-lactamase-producing E. coli and Klebsiella pneumoniae, carbapenem-resistant and carbapenamase-producing Enterobacteriaceae. Data will be extracted using a tailored pilot tested form and the quality of reporting will be assessed using the ORION (Outbreak Reports and Intervention Studies Of Nosocomial infections) tool. Data will be synthesised and reported by the type of ARB, setting and country. Infection control measures and bundles of measures will be described. The effectiveness will be reported as defined by the authors. Regression analysis will be used to define independent factors associated with outbreaks' control. Heterogeneity between studies will be assessed by forest plots and I

  10. Extended-Spectrum beta (β)-Lactamases and Antibiogram in Enterobacteriaceae from Clinical and Drinking Water Sources from Bahir Dar City, Ethiopia

    Science.gov (United States)

    Abera, Bayeh; Kibret, Mulugeta; Mulu, Wondemagegn

    2016-01-01

    Background The spread of Extended-Spectrum beta (β)-Lactamases (ESBL)-producing Enterobacteriaceae has become a serious global problem. ESBL-producing Enterobacteriaceae vary based on differences in antibiotic use, nature of patients and hospital settings. This study was aimed at determining ESBL and antibiogram in Enterobacteriaceae isolates from clinical and drinking water sources in Bahir Dar City, Northwest Ethiopia. Methods Enterobacteriaceae species were isolated from clinical materials and tap water using standard culturing procedures from September 2013 to March 2015. ESBL-producing-Enterobacteriaceae were detected using double-disk method by E-test Cefotaxim/cefotaxim+ clavulanic acid and Ceftazidime/ceftazidime+ clavulanic acid (BioMerieux SA, France) on Mueller Hinton agar (Oxoid, UK). Results Overall, 274 Enterobacteriaceae were isolated. Of these, 210 (44%) were from patients and 64 (17.1%) were from drinking water. The median age of the patients was 28 years. Urinary tract infection and blood stream infection accounted for 60% and 21.9% of Enterobacteriaceae isolates, respectively. Klebsiella pneumoniae was isolated from 9 (75%) of neonatal sepsis. The overall prevalence of ESBL-producing Enterobacteriaceae in clinical and drinking water samples were 57.6% and 9.4%, respectively. The predominant ESBL-producers were K. pneumoniae 34 (69.4%) and Escherichia coli 71 (58.2%). Statistically significant associations were noted between ESBL-producing and non- producing Enterobacteriaceae with regard to age of patients, infected body sites and patient settings (P = 0.001). ESBL-producing Enterobacteriaceae showed higher levels of resistance against chloramphenicol, ciprofloxacin and cotrimoxazole than non-ESBL producers (P = 0.001) Conclusions ESBL-producing Enterobacteriaceae coupled with high levels of other antimicrobials become a major concern for treatment of patients with invasive infections such as blood stream infections, neonatal sepsis and urinary

  11. Prevalence of SHV/CTX-M/TEM (ESBL Beta-lactamase Resistance Genes in Escherichia Coli Isolated from Urinary Tract Infections in Tehran, Iran

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    Yazdi M

    2010-01-01

    Full Text Available Background and objectives: Beta-lactamase enzymes are the most causes ofresistance to antibiotics among gram-negative bacteria. Nowadays, Infectionsdue to ESBLs are being increased throughout the world and is considered as anew burden to the health systems. This study aimed at determining thesensitivity pattern of E.coli isolates to beta-lactam antibiotics, andinvestigating the presence of blaCTX-M, blaTEM, and blaSHV genes in the urinesamples..Material and Methods: In this study, 244 E.coli isolates were screened in2009-2010. The antibiotic susceptibility of E. coli isolates were determined bydisc-diffusion method. Antimicrobial agents tested were cefoxatime,ceftazidime, imipenem, nalidixic acid, and ciprofloxacin. The combined disctest was used to confirm the results. The results were compared to the Clinicaland Laboratory Standards Institute (CLSI and ESBL positive isolates werefurther investigated for the presence of blaCTX-M, blaTEM, and blaSHV genes byPCR.Results: Of 244 E. coli isolates, 116 (47.1% are resistant to Ceftazidime, and96 (39.2% to cefoxatime. Also, 109 (44.3% isolates are ESBL positive.blaCTX-M, blaTEM, and blaSHV genes are found among 95 (87.1%, 75 (68.8%,and 77 (70.6% ESBL positive isolates, respectively. Forty (36.6% isolateshave all three genes, while 68 (62.3% include blaTEM and blaSHV genes.Moreover, 61 (55.9% isolates carry blaCTX-M and blaTEM genes, and 54(49.5%have blactx-M and blashv.Conclusion: Regarding the high frequency of resistance to the thirdgeneration cephalosporin antibiotics, precise antibiogram testing is highlyrecommended before any antibiotic prescription in cases of infections withESBL producing microorganisms.Key words: ESBL; Escherichia coli; blaCTX-M; blaTEM; blaSHV

  12. Child morbidity of salmonellosis and the level of resistance of clinical isolates of salmonella to antibacterial preparations in saint Petersburg

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    N. V. Gonchar

    2015-01-01

    Full Text Available The aim of the study was to study the dynamics of the incidence of salmonellosis children in St. Petersburg and phenotypic resistance of clinical isolates of S. Enteritidis and S. Typhimurium to antibiotics in recent years. Materials and methods. The incidence of salmonellosis children studied according to the report for the first nine months of Rospotrebnadzor in 2013–2014. Incidence of salmonellosis in the structure of bacterial intestinal infections caused by pathogens in children hospitalized in the Department of intestinal infections in 2013–2014, studied according to annual reports. Antibiotic sensitivity was studied 86 Salmonella isolates (S. Enteritidis strain 64 and strain 22 S. Typhimurium, isolated from patients in children 2010–2014. Used the method of serial microdilution broth. Salmonella isolates were divided into sensitive, resistant, intermediate sensitivity to antibiotics. The Results. Analysis of the incidence of salmonellosis children of St. Petersburg has revealed its decline in 2014 (109.2 compared to 2013 (123,9 but relatively long-term average level was an increase in incidence (107,6. In the structure of salmonellosis in children prevailed salmonellosis Group D. In hospitalized children in the structure of bacterial intestinal infections detected Excess of share of salmonellosis in 2014 (36,9±3,4% compared to 2013 (24,5±2,4%; p <0,01. A reduction in the frequency sensitivity of S. Enteritidis to ampicillin, cefepime, ceftazidime and chloramphenicol. Compared to S. Enteritidis S. Typhimurium isolates were more resistant to ceftazidime and ampicillin, but more sensitive to ciprofloxacin. Conclusion. Morbidity of salmonellosis in recent years characterized by a relatively long-term average increase of the level. In the structure of salmonellosis in children prevailed salmonellosis Group D. There was a reduction of sensitivity S. Enteritidis isolates to cephalosporins new generations, and S. Typhimurium isolates

  13. High Frequency of Class 1 Integrons in Escherichia coli Isolated From Patients With Urinary Tract Infections in Yasuj, Iran

    Science.gov (United States)

    Khoramrooz, Seyed Sajjad; Sharifi, Asghar; Yazdanpanah, Mahboubeh; Malek Hosseini, Seyed Ali Asghar; Emaneini, Mohammad; Gharibpour, Farzaneh; Parhizgari, Najmeh; Mirzaii, Mehdi; Zoladl, Mohammad; Khosravani, Seyed Abdolmajid

    2016-01-01

    Background: Most urinary tract infections (UTI) are caused by Escherichia coli. Integrons have an important role in distributing antibiotic resistance genes among bacteria. Objectives: The aim of this study was to investigate the presence of class 1, 2 and 3 integrons and their association with antibiotic resistance in E. coli isolated from patient with UTI in Yasuj, Iran. Patients and Methods: In this cross-sectional study a total of 200 E. coli were collected from 1820 patients diagnosed with UTI that had been referred to two clinical laboratories between February 2013 and November 2014 in Yasuj city, southwest of Iran. Susceptibility of isolates to 11 different antibiotics was determined by the disk agar diffusion method. multiplex-polymerase chain reaction (PCR) was used for detection of class 1, 2 and 3 integrons. The data were analyzed using the SPSS software (version 16) and the chi-square test. A P value of < 0.05 was considered statistically significant. Results: The highest rate of resistance was observed toward cephalothin (99%) and amoxicillin (76%) while only two (1%) isolates showed resistance to imipenem. Overall, 79% of isolates were multi drug resistant (MDR). Class 1 and 2 integrons were detected in 104 (52%) and 5 (2.5%) isolates respectively, while none of the isolates were positive for class 3 integrons. A significant association was observed between the presence of integrons and resistance to co-trimoxazole, nalidixic acid, ciprofloxacin, amoxicillin, ceftazidime and tetracycline (P < 0.05). Conclusions: High MDR isolates of E. coli were observed in this study. The significant association between class 1 integrons and resistance to ciprofloxacin, nalidixic acid, co-trimoxazole, amoxicillin, ceftazidime and tetracycline showed that class 1 integrons have an important role in resistance to these antibiotics in this region. PMID:26889395

  14. The Survey of Genes Encoding Beta-Lactamases, in Escherichia Coli Resistant to Beta-Lactam and Non-Beta-Lactam Antibiotics

    Directory of Open Access Journals (Sweden)

    Fereshteh Shahcheraghi

    2010-01-01

    Full Text Available Resistance to the new generation of cephalosporins which is mediated by Extended-Spectrum beta-lactamases (ESBLs has been found amongEscherichia coli isolates throughout the world. These resistance genes and their producers, the micro-organisms carrying beta-lactamases, are responsible for serious clinical and therapeutic problems among inpatients and it is necessary to pay more attention to detection of ESBLs producing organisms.Materiasl and MethodsCollectively 260 isolates of E. coli were obtained from 6 hospitals in Tehran (Iran during April-2006 to April-2007. The antibiotic susceptibility patterns of isolates were determined by disk diffusion method. phenotypic confirmatory test (PCT was carried out for screening of ESBLs. Microbroth dilution assay was used to determine the minimum inhibitory concentration (MIC of ceftazidime. Isolates showing MIC≥2 μg/ml were subjected to polymerase chain reaction (PCR targeting blaTEM, blaSHV, blaCTX and blaPER genes. ResultsThe PCT showed that 48.08% of isolates are ESBL producers (125 of 260. The majority of cefotaxime resistant (90.8% and ceftazidime resistant (92.5% isolates were ESBL producers. The obtained results by PCR revealed that 5.77% (n=15 of 260 and 24.23 (n=63 of isolates can produce SHV and TEM type enzymes respectively. blaCTX was detected in 20.38% of isolates (n=53 and none of them could produce blaPER type beta-lactamases. ConclusionThe results of our study showed that the ESBL genes have high prevalence among clinical isolates of E. coli. Such high dissemination of ESBLs is a serious problem for public health and therefore, it's necessary to seek a program for monitoring ESBLs in hospitals.

  15. Beta-lactamase characterization in Escherichia coli isolates with diminished susceptibility or resistance to extended-spectrum cephalosporins recovered from sick animals in Spain.

    Science.gov (United States)

    Briñas, Laura; Moreno, Miguel Angel; Teshager, Tirushet; Zarazaga, Myriam; Sáenz, Yolanda; Porrero, Concepción; Dominguez, Lucas; Torres, Carmen

    2003-01-01

    A total of 1439 Escherichia coli isolates from sick animals were received from the Spanish Network of Veterinary Antimicrobial Resistance Surveillance (VAV) from 1997 to 2001. Antimicrobial susceptibility tests were performed and diminished susceptibility to cefotaxime and ceftazidime was identified in 2.5% and 2.8% of the isolates, respectively. Beta-lactamase characterization was carried out in the group of 20 E. coli isolates with both characteristics. The MIC ranges of different beta-lactams showed by these 20 isolates were as follows (in microg/ml): ampicillin (64-->256), amoxicillin-clavulanic acid (4-64), ticarcillin (8-->128), cefazolin (32-->256), cefoxitin (4-->128), cefotaxime (1-64), ceftazidime (2-->64), ceftriaxone (0.5-64), imipenem (32). TEM, SHV, CMY, and FOX beta-lactamase genes were analyzed by PCR and sequencing. The beta-lactamase genes detected were the following ones (number of isolates): bla(TEM-1b) (3), bla(TEM-1a) (1), bla(TEM-30f) (2), bla(TEM-1b) + bla(CMY-2) (2), and bla(SHV-12) (1). Sequences of the promoter and/or attenuator region of the chromosomal ampC gene were studied in all the 20 isolates. Mutations at position -42 or -32 were detected in 16 isolates and these mutations were associated with the presence of a TEM type beta-lactamase in 6 isolates. Besides, a high variety of plasmidic beta-lactamases was detected including TEM-30 and CMY-2. To our knowledge, this is the first time that TEM-30 beta-lactamase has been detected in E. coli isolates of animal origin.

  16. Profile of antimicrobial susceptibility isolated microorganisms from hospitalized patients in PICU ward and detection of Methicillin-resistant Staphylococcus aureus and ESBL-producing bacteria by phenotypic methods

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    Shahla Abbas Poor

    2014-10-01

    Full Text Available Background: Hospital-acquired infections are a major challenge to patient. A range of gram-negative organisms are responsible for hospital-acquired infections, the Enterobacteriaceae family being the most commonly identified group overall. Infections by ESBL producers are associated with severe adverse clinical outcomes that have led to increased mortality, prolonged hospitalization, and rising medical costs. The aim of this study was to survey profile of antimicrobial susceptibility isolated microorganisms from hospitalized patients in PICU ward and detection of methicillin-resistant Staphylococcus aureus and ESBL-producing bacteria by phenotypic methods. Material and Methods: In this study participants were patients hospitalized in PICU part of Bahrami Hospital, Tehran, with attention to involved organ. For isolation of bacteria from patient’s samples, culture performed on different selective and differential media. After confirmation of bacteria by biochemical tests, susceptibility testing was performed by disc diffusion method. Phenotypic detection of MRSA strains was performed using cefoxcitin disc. ESBL producing strains were detected by ceftazidime (CAZ and ceftazidime/clavulanic acid (CAZ/CLA discs. Results: Among all isolated organisms from clinical samples, the most common isolated organisms were Escherichia coli (24 cases, Pseudomonas areoginosa (9 cases and Staphylococcus aureus (8 cases, respectively. Among eight MRSA isolated strains from different clinical samples, six strains (75% were MRSA. Among 52 isolated gram negative organisms, 5 strains (9/6% were ESBL. Conclusion: Standard interventions to prevent the transmission of antimicrobial resistance in health care facilities include hand hygiene, using barrier precautions in the care of colonized and infected patients, using dedicated instruments and equipment for these patients. The colonized or infected patients should be isolated in single rooms, multibed rooms or areas

  17. Comparison of E.test and Disk Diffusion Agar in Detection of Antibiotic Susceptibility of E.coli Isolated from Patients with Urinary Tract Infection in Tehran Shariati Hospital

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    Y. Erfani

    2008-07-01

    Full Text Available Introduction & Objective: UTI is one of the most common bacterial infections and Ecoli is known as an important cause of UTIs. Since bacterial resistances of antibiotics are increasing, reliable methods of antimicrobial resistance detection are of paramount importance in treatment and management of UTIs. The objective of the present study is to compare and to evaluate the performance of disk diffusion agar (Iranian and Italian and E.test (Epsilometer test (Sweden for antimicrobial susceptibility testing of Ecoli isolated from UTI.Materials & Methods: This study was done on 250 Isolates of Ecoli from patients with UTI in Shariati Hospital, Tehran University of Medical Sciences during 2004. Antibiotic susceptibility testing was performed by disk diffusion method using Iranian and Italian disk for Trimetoprim sulfamethoxazole, Gentamysin, Ceftazidim, Nitrofurantoin and Ciprofluxacin and Minimum Inhibitory concentration (MIC determination was performed by E.test for the same set of antimicrobial. All tests were performed on muller hinton agar. Results: Comparison of E.test and Iranian disk diffusion agar showed that paramount differences in antibiotic agreement (Max 37.8 % those differences in case of Ceftazidim and Gentamysin were respectively 76.8% and 62.2% whereas comparison of E.test and Italian disk diffusion agar showed less difference of antibiotics agreement (Max 11.2%.Conclusion: The results of this study showed that Iranian disk diffusion agar may be used as a preliminary screen for antibiotic susceptibility testing of E.coli and is less sensitive than Italian disk diffusion and E.test. Comparison of 3 mentioned methods have showed that E.test is the most sensitive and shows the effective dose of antibiotic for treatment and prevention of antibiotic resistance.

  18. Untargeted Metabolomics To Ascertain Antibiotic Modes of Action.

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    Vincent, Isabel M; Ehmann, David E; Mills, Scott D; Perros, Manos; Barrett, Michael P

    2016-04-01

    Deciphering the mode of action (MOA) of new antibiotics discovered through phenotypic screening is of increasing importance. Metabolomics offers a potentially rapid and cost-effective means of identifying modes of action of drugs whose effects are mediated through changes in metabolism. Metabolomics techniques also collect data on off-target effects and drug modifications. Here, we present data from an untargeted liquid chromatography-mass spectrometry approach to identify the modes of action of eight compounds: 1-[3-fluoro-4-(5-methyl-2,4-dioxo-pyrimidin-1-yl)phenyl]-3-[2-(trifluoromethyl)phenyl]urea (AZ1), 2-(cyclobutylmethoxy)-5'-deoxyadenosine, triclosan, fosmidomycin, CHIR-090, carbonyl cyanidem-chlorophenylhydrazone (CCCP), 5-chloro-2-(methylsulfonyl)-N-(1,3-thiazol-2-yl)-4-pyrimidinecarboxamide (AZ7), and ceftazidime. Data analysts were blind to the compound identities but managed to identify the target as thymidylate kinase for AZ1, isoprenoid biosynthesis for fosmidomycin, acyl-transferase for CHIR-090, and DNA metabolism for 2-(cyclobutylmethoxy)-5'-deoxyadenosine. Changes to cell wall metabolites were seen in ceftazidime treatments, although other changes, presumably relating to off-target effects, dominated spectral outputs in the untargeted approach. Drugs which do not work through metabolic pathways, such as the proton carrier CCCP, have no discernible impact on the metabolome. The untargeted metabolomics approach also revealed modifications to two compounds, namely, fosmidomycin and AZ7. An untreated control was also analyzed, and changes to the metabolome were seen over 4 h, highlighting the necessity for careful controls in these types of studies. Metabolomics is a useful tool in the analysis of drug modes of action and can complement other technologies already in use.

  19. 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

  20. Evidence for induction of integron-based antibiotic resistance by the SOS response in a clinical setting.

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    Didier Hocquet

    Full Text Available Bacterial resistance to β-lactams may rely on acquired β-lactamases encoded by class 1 integron-borne genes. Rearrangement of integron cassette arrays is mediated by the integrase IntI1. It has been previously established that integrase expression can be activated by the SOS response in vitro, leading to speculation that this is an important clinical mechanism of acquiring resistance. Here we report the first in vivo evidence of the impact of SOS response activated by the antibiotic treatment given to a patient and its output in terms of resistance development. We identified a new mechanism of modulation of antibiotic resistance in integrons, based on the insertion of a genetic element, the gcuF1 cassette, upstream of the integron-borne cassette bla(OXA-28 encoding an extended spectrum β-lactamase. This insertion creates the fused protein GCUF1-OXA-28 and modulates the transcription, the translation, and the secretion of the β-lactamase in a Pseudomonas aeruginosa isolate (S-Pae susceptible to the third generation cephalosporin ceftazidime. We found that the metronidazole, not an anti-pseudomonal antibiotic given to the first patient infected with S-Pae, triggered the SOS response that subsequently activated the integrase IntI1 expression. This resulted in the rearrangement of the integron gene cassette array, through excision of the gcuF1 cassette, and the full expression the β-lactamase in an isolate (R-Pae highly resistant to ceftazidime, which further spread to other patients within our hospital. Our results demonstrate that in human hosts, the antibiotic-induced SOS response in pathogens could play a pivotal role in adaptation process of the bacteria.

  1. Ceftobiprole medocaril: a review of its use in patients with hospital- or community-acquired pneumonia.

    Science.gov (United States)

    Syed, Yahiya Y

    2014-09-01

    Ceftobiprole, the active metabolite of the prodrug ceftobiprole medocaril (Zevtera(®)), is a new generation broad-spectrum intravenous cephalosporin with activity against methicillin-resistant Staphylococcus aureus. Ceftobiprole exhibits potent in vitro activity against a number of Gram-positive and Gram-negative pathogens associated with hospital-acquired pneumonia (HAP) and community-acquired pneumonia (CAP). It is the first cephalosporin monotherapy approved in the EU for the treatment of both HAP (excluding ventilator associated-pneumonia [VAP]) and CAP. In phase III trials, ceftobiprole medocaril was noninferior, in terms of clinical cure rates at the test-of-cure visit, to ceftazidime plus linezolid in patients with HAP and to ceftriaxone ± linezolid in patients with CAP severe enough to require hospitalization. In patients with HAP, noninferiority of ceftobiprole medocaril to ceftazidime plus linezolid was not demonstrated in a subset of patients with VAP. In patients with CAP, ceftobiprole medocaril was effective in those at risk for poor outcomes (pneumonia severity index ≥91, Pneumonia Patient Outcomes Research Team score IV-V or bacteraemic pneumonia). In the phase III trials, ceftobiprole medocaril was generally well tolerated, with ≈10 % of patients discontinuing the treatment because of adverse events. The most common treatment-related adverse events occurring in ceftobiprole recipients in the trials in patients with HAP or CAP included nausea, diarrhoea, infusion site reactions, vomiting, hepatic enzyme elevations and hyponatraemia. Therefore, ceftobiprole medocaril monotherapy offers a simplified option for the initial empirical treatment of patients with HAP (excluding VAP) and in those with CAP requiring hospitalization.

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

  3. Antibiotic Resistance and the Frequency of Extended-Spectrum B-Lactamase in Acinetobacter baumannii Isolated from Clinical Samples through Phenotypic Methods

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    Somayeh Vafaei

    2013-07-01

    Full Text Available AbstractBackground and objectives: Nowadays Acinetobacter baumannii is as one of the problematic opportunistic pathogens, especially in intensive care because of the incidence of drug-resistant strains in the world. The purpose of current study was to define the antibiotic susceptibility patterns and detect the prevalence of producing strains of extended-spectrum β-lactamase (ESBL in A. baumannii isolates which had been isolated from clinical samples with combined disk test.Materials and methods: This study was conducted in 3 major hospitals in Tehran on 500 clinical samples during 6 months. After identification of isolates in species level using cultural and biochemical methods, in order to determine sensitivity of 100 isolates of A. baumannii to 11 antibiotics, the susceptibility tests were carried out according to CLSI guidelines using disk diffusion method. Also MIC (Minimum inhibitory concentrations was determined for cefepime and ceftazidime, and finally to identify of producing strains of ESBL was applied phenotypic method of combined disk. Results: In this survey, 100 A. baumannii strains, 30 A. lwoffii strains and other Acinetobacter species were isolated from patients. The majority of isolates were from blood specimens. Isolates of A.baumannii revealed the highest resistance to cefepime, ceftriaxone, amikacin, imipenem, piperacillin - tazobactam, meropenem, gentamicin, tobramycina and tetracycline, respectively. Ampicillin - sulbactam and polymyxin B considered as effective drugs in this study. Multi-drug resistance in these strains was 70%. The Total isolates studied the Minimum inhibitory concentrations of ceftazidime in 84% samples was MIC ≥ 128 μg/ml and Minimum inhibitory concentrations of cefepime in 91% samples was MIC≥ 128 μg/ml. According to the results of combined disk test, 20% of total samples were demonstrated to be ESBL positive.Conclusion: Regarding to produce of ESBL in this bacterium and possibility of

  4. Prevalence PER and VEB beta-lactamase Genes among Acinetobacter baumannii Isolated from Patients in Tehran by PCR

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    Abbas Nazari Monazam

    2014-12-01

    Full Text Available Background and Aim: According to numerous reports of infections caused by spectrum beta lactamases (ESBLs producing Acinetobacter baumannii in our country in recent years, this study was performed to define the antibiotic susceptibility patterns and detect the prevalence PER  and VEB beta-lactamase genes among  A.baumannii isolated from patients in Tehran by PCR. Materials and Methods: 100 A.baumannii clinical isolates collected from various hospitals in Tehran during a year, using special culture media and biochemical tests were identified. The antibiograms of the isolates against 11 antibiotics by disk diffusion method (Disk diffusion according to Clinical and Laboratory Standards Institute (CLSI guidelines was performed. Then minimum inhibitory concentrations (MIC was determined for cefepime and ceftazidime and for the identification of ESBL-producing strains was used in combination disk method, and finally to assess the prevalence of PER and VEB beta-lactamase genes using specific primers PCR was performed. Results: Antibiograms results showed that the greatest resistance to the antibiotics amikacin, cefepime, and less resistance to polymyxin B were obtained. Rates of multi-drug resistant strains of about 70% was achieved. Of the isolates studied, the MIC of ceftazidime in 84% and for cefepime in 91% were ≥ 128 μg/ml. The results of the combined-disk test demonstrated that 20% of samples were ESBL positive. The PCR results showed that 47% and 32% of our isolates had PER and VEB genes respectively. Conclusions: Regarding to existence of PER and VEB genes in this bacterium and possibility of transformation of these genes to the other bacteria, reconsideration in antibiotics consumption patterns and more attention to nosocomial infections control criteria are inevitable.

  5. Identification of Class-1 Integron and Various Β-Lactamase Classes among Clinical Isolates of Pseudomonas aeruginosa at Children's Medical Center Hospital

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    Hossein Fazeli

    2015-10-01

    Full Text Available Background: Pseudomonas aeruginosa is one of the most important oppor- tunistic pathogens responsible for various types of infections. Children suffer significant morbidity and mortality due to nosocomial infections. The aim of this study was to investigate the presence of Class-1 integron, blaBEL, blaPER, blaKPC, blaVIM, blaIMP and blaOXA-group-1  genes among P. aeruginosa isolates at Children's Medical Center Hospital in Iran and to determine phenotypic evi- dence of ESBL and MBL production.Methods: Antibiotic susceptibility tests were analyzed for 72 P. aeruginosa clinical isolates. Isolates were identified by using biochemical tests and con- firmed by PCR assay for oprL gene. ESBL and MBL producer isolates were identified  by phenotypic  tests (double disc synergy tests. Detection of β- lactamase genes and class-1 integron were performed by PCR method. Results: All of the isolates were susceptible to ceftazidime / clavulanate, me- ropenem, imipenem and ciprofloxacin. About 83.3% and 16.7% of isolates were  resistant  to  ceftazidime  and  amikacin  respectively.  Approximately,83.3% of isolates were considered as potential ESBL producers. None of the clinical isolates showed above β-lactamase genes. It seems that, the reason is the absence of class-1 integron in all of isolates. About 16.7% of strains were identified  as multidrug  resistant.  Fortunately,  all of the isolates were sus- ceptible to meropenem and imipenem which are effective against ESBL pro- ducing strains.Conclusion:  The absences of class-1 integron decreases the probability of acquired β-lactamase especially MBL. Thus, absolute susceptibility to carba- penems and ciprofloxacin among P. aeruginosa isolates in pediatric hospital has important implications for empirical antimicrobial therapy. It seems that these properties help to decrease mortality of nosocomial infections within children.

  6. Antibiotic resistance of uropathogens in newborns and young children with acute pyelonephritis

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    Peco-Antić Amira

    2012-01-01

    Full Text Available Introduction. Urinary tract infection is common in childhood. Depending on the localization of the infection, severity of its clinical presentation and possible acute and long-term complications, it may be described as either acute cystitis or acute pyelonephritis. Objective. The aim of this study was to assess the resistance patterns of uropathogens during the last 5 years in newborns and young children with acute pyelonephritis. Methods. Uropathogens resistance to commonly usable anti-microbial agents (ampicillin, a combination of sulphamethoxasole and trimethoprim, cephalexin, ceftriaxone, cefotaxime, ceftazidime, gentamycin, amikacin, ciprofloxacin, imipenem and nalidixic acid was retrospectively studied in newborns and young children treated during early (2005-2007 and late (2008-2009 study periods. Anti-bacterial susceptibility testing of the urine isolates was performed by the standard disc diffusion method. Results. 117 newborns and 294 children aged 9.3±0.7 months were treated during early (n=136 or late (n=275 study period due to the first episode of acute pyelonephritis. Escherichia coli was the most common bacterial pathogen (85.5%. Compared to children older than one month, newborns had higher degree of antibacterial resistance to 2nd and 3rd generation cephalosporins, aminoglycosides, and nalidixic acid during early, and to ceftazidime, aminoglycosides and nalidixic acid during late study period. Also, multidrug resistance was more common in newborns during the early study period. Conclusion. Newborns had higher rate of antibacterial resistance than young children. The progressive increase of anti-microbial resistance in children with acute pyelonephritis is of great concern.

  7. 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.

  8. Contribution of Acinetobacter-derived cephalosporinase-30 to sulbactam resistance in Acinetobacter baumannii

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    Shu-Chen eKuo

    2015-03-01

    Full Text Available The sulbactam resistance rate in Acinetobacter baumannii has increased worldwide. Previous reports have shown that the β-lactamase blaTEM-1 confers resistance to sulbactam in A. baumannii. The purpose of this study was to examine whether other β-lactamases including, the Acinetobacter-derived cephalosporinase (ADC, OXA-23, OXA-24/72, and OXA-58 families, also contribute to sulbactam resistance in A. baumannii. The correlation between these β-lactamases and the sulbactam minimal inhibitory concentration (MIC was determined using A. baumannii clinical isolates from diverse clonality, which were collected in a nationwide surveillance program from 2002 to 2010 in Taiwan. A possible association between the genetic structure of ISAba1-blaADC-30 and sulbactam resistance was observed because this genetic structure was detected in 97% of sulbactam-resistant strains compared with 10% of sulbactam-susceptible strains. Transformation of ISAba1-blaADC-30 into susceptible strains increased the sulbactam MIC from 2 to 32 μg/ml, which required blaADC-30 overexpression using an upstream promoter in ISAba1. Flow cytometry showed that ADC-30 production increased in response to sulbactam, ticarcillin, and ceftazidime treatment. This effect was regulated at the RNA level but not by an increase in the blaADC-30 gene copy number as indicated by quantitative PCR. Purified ADC-30 decreased the inhibitory zone created by sulbactam or ceftazidime, similarly to TEM-1. In conclusion, ADC-30 overexpression conferred resistance to sulbactam in diverse clinical A. baumannii isolates.

  9. Antibiotic Resistance Pattern of Pseudomonas Aeruginosa, Isolated from Patient with Burn Wound Infection in Guilan,Iran

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    Iraj Nikokar

    2013-03-01

    Full Text Available Background and Objectives: Antibiotic resistance of Pseudomonas aeruginosa remains a major problem in burn patients. The main objective of this study was to determine the antibiotic resistance pattern and frequency of class 1 integrons among P. aeruginosa strains isolated from patients with burn wound infections in a new Burn Centre in Guilan, Iran.Materials and Methods: The bacterial isolates were collected from 182 patients with burn wound infections and P. aeruginosa species were identified by standard bacteriological methods. The drug susceptibility test, using 11 antimicrobial agents, was performed for all the isolates via agar disk diffusion method. PCR was carried out for the detection of integrons.Results: Out of a total of 182 hospitalized patients in the burn center assessed, 86 (47% found to have P. aeruginosa in their isolates. Resistance rates to various antibiotics were as follows: cloxacillin (91.8%, cotrimoxazole (86%, cephazolin (83.7%, carbenicillin (74.4%, piperacillin (69.9%, ceftazidime (68.8%, ciprofloxacin (66.3%, tobramycin (58.2%, amikacin (48.8% and gentamicin (37.2%, while the most effective antibiotic was imipenem with a resistance rate of 23.3%. Thirty nine (45.3% isolates were detected as multi-drug resistant. The PCR results showed that 37 (43% P. aeruginosa isolates and 27 (69.2% multi-drug resistant strains harbored class 1 integrons. A significant correlation was obtained between the presence of integrons and resistance against imipenem, ceftazidime, piperacillin and ciprofloxacin (P < 0.001.Conclusion: Optimization of using antimicrobial agents and control of infection is recommended to prevent the increasing population of drug resistant organisms in the new burn centre setting in this study. Furthermore, the high frequency of class 1 integrons among multi-drug resistant strains might be responsible for dissemination of antibiotic resistance gene.

  10. Determination of common pathogenic bacteria of blast injury to the limbs in plateau area and related research

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    Zheng-lei WANG

    2015-11-01

    Full Text Available Objective To investigate the common pathogenic bacteria and their drug susceptibility in the wounds in the limbs as a result of blast injury in plateau with a low temperature so as to provide a basis for prevention and treatment of war wound infection in such area. Methods The model of blast injury was reproduced to the hind legs of 800 rabbits in cold and dry plateau. 1, 3, 6, 12, 24, 48, 72 and 96h after injury, the general condition and vital signs of the wounded were observed, and bacterial culture, flora analysis and drug susceptibility test of excretion from wound tract, air, surface of snow, soil and animal fur were performed. Results Micrococciand Bacilliwere found in air and snow. Bacillus subtilis, Escherichia coliand Pseudomonas aeruginosawere found in soil, and Staphylococcus aureus, Acinetobacters, Pseudomonas aeruginosaand Escherichia coliin rabbit fur. The respiration and pulse became faster, and body temperature lowered after injury compared with that before injury. G+ bacteria were found in most wound tract secretions, and the frequency of the bacterial strains in descending order were Bacillus subtilis, coagulase-negative Staphylococci, E. coli, Pseudomonas aeruginosa, Stenotrophomonas maltophiliastrains. The sensitive antibiotics for these G+ bacteria were ofloxacin, ciprofloxacin, erythromycin. Susceptible G– bacteria were susceptible to ceftazidime, minocycline, sulfamethoxazole etc. Conclusions The growth of bacteria in the wounds as a result of blast injury grow slower in cold and dry alpine area. The time of debridement may be delayed for 2-3h. G+ bacteria were main susceptible flora to antibiotics, and it is related to the bacterial flora of the surrounding environment, thus it is suggested that a combination of different antibiotics (ofloxacin, ciprofloxacin or erythromycin alone combined with ceftazidime, minocycline or cotrimoxazole alone are needed to prevent infection after blast injury. DOI: 10.11855/j

  11. Epidemiology, Antimicrobial Resistance and β-lactamase Genotypic Features of Enteropathogenic Escherichia coli Isolated from Children with Diarrhea in Southern China.

    Science.gov (United States)

    Huang, Yong; Shan, Xue-feng; Deng, Haijun; Huang, Yu-jun; Mu, Xiao-ping; Huang, Ai-long; Long, Quan-xin

    2015-01-01

    The main objective of this study was to investigate the epidemiology, drug resistance and β-lactamase genotype distribution of enteropathogenic Escherichia coli (EPEC) isolated from pediatric patients with diarrhea in southern China. The prevalence of EPEC in children with diarrhea was 3.53%. The commonest serotypes were O55:K59 and O126:K71, and the typical EPEC were more prevalent than atypical EPEC (51 vs 7). Isolates from this region were most commonly found to be resistant to ampicillin and cotrimoxazole, followed by chloramphenicol, ceftriaxone, and ceftazidime. More than 96% of the strains were susceptible to cefoperazone/sulbactam and imipenem. The most common β-lactamase genotypes identified in 58 strains were blaCTX-M-1 (60.3%), blaTEM (56.9%), blaCTX-M-9 (27.6%), and blaSHV (15.5%). Among 58 isolates, 22 strains were found to harbor one β-lactamase gene, and the proportions of resistance to ampicillin, cotrimoxazole, chloramphenicol, ceftriaxone, and ceftazidime, were 81.8%, 63.6%, 40.9%, 18.2%, and 9.1%, respectively. A further 30 strains carrying multiple β-lactamase genes had increased resistance to the above antimicrobial agents (100%, 83.3%, 70.0%, 60.0%, and 30.0%, respectively). In contrast, antibiotic resistance in the last 6 strains without a detectable β-lactamase gene was substantially reduced. Drug resistance may be associated with the β-lactamase gene number, with a greater the number of β-lactamase genes resulting in higher antibiotic resistance.

  12. 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

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

    Institute of Scientific and Technical Information of China (English)

    刘明章; 沈翠芬; 吴原; 张晓祥; 王翔

    2011-01-01

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

  14. 产金属β-内酰胺酶的鲍氏不动杆菌在我国内地出现%Emerging metallo-β-lactamases in clinical isolates of Acinetobacter baumannii in China inland

    Institute of Scientific and Technical Information of China (English)

    宗志勇; 吕晓菊; 高燕渝; 俞汝佳

    2004-01-01

    Acquired metallo-β-lactamases (MBLs) are emerging globally and can confer resistance to near all β-lactams. Recently, MBLs were found in Pseudomonas aeruginosa and Citrobacter youngae from China inland, but not in Acinetobacter baumannii. In 2002 and 2003, a few imipenem-resistant and/or ceftazidime-highly-resistant A. baumannii were isolated from clinical specimens in West China Hospital, Sichuan University. By agar dilution method used imipenem with imipenem plus EDTA-1, 10-phenanthroline and/or ceftazidime with ceftazidime plus EDTA-1, 10-phenanthroline, MBLs were detected in 12 nonreplicate A. baumannii isolates. Most of the MBL producers were isolated from sputa of patients with ventilation-associated pneumonia in ICU. PCR for amplifying blaLMP-4 and blavLM-2 for the 12 MBL-producing isolates failed. It demonstrates that MBLs produced by the isolates are MBLs other than IMP-4, VIM-2, VIM-3 and VIM-6.This study is the first report that MBLs are found in A. baumannii in China inland.%获得性金属β-内酰胺酶(金属酶)已经在全球出现,并且能导致对几乎所有β-内酰胺类抗生素耐药.近来,金属酶已经在我国的铜绿假单胞菌和杨氏柠檬酸菌中发现,但尚未在鲍氏不动杆菌中发现.2002和2003年,从四川大学华西医院的临床标本中分离出一些亚胺培南耐药或头孢他啶高度耐药的鲍氏不动杆菌菌株.通过亚胺培南联合亚胺培南-EDTA-邻二氮菲或头孢他啶联合头孢他啶-EDTA-邻二氮菲的琼脂稀释法,检测出12株不重复的鲍氏不动杆菌产金属酶.这些产金属酶的菌株主要分离自机械通气相关性肺炎患者的痰标本.PCR扩增IMP-4和VIM-2的编码基因无阳性结果.说明这些菌株所产的金属酶并非IMP-4、VIM-2、VIM-3和VIM-6.这是首次在我国内地发现有产金属酶的鲍氏不动杆菌.

  15. Extended-spectrum beta-lactamases in Klebsiella spp and Escherichia coli obtained in a Brazilian teaching hospital: detection, prevalence and molecular typing beta-lactamases de espectro ampliado em Klebsiella spp e em Escherichia coli obtidas em um hospital escola brasileiro: detecção, prevalência e tipagem molecular

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    Ana Lúcia Peixoto de Freitas

    2003-12-01

    Full Text Available His study was performed to compare the methods of detection and to estimate the prevalence of extended-spectrum beta-lactamases (ESBL among Klebsiella spp and E.coli in a university hospital in southern Brazil. We also used a molecular typing method to evaluate the genetic correlation between isolates of ESBL K.pneumoniae. Production of ESBL was investigated in 95 clinical isolates of Klebsiella spp and Escherichia coli from Hospital de Clínicas de Porto Alegre, using Kirby-Bauer zone diameter (KB, double-disk diffusion (DD, breakpoint for ceftazidime (MIC CAZ, increased zone diameter with clavulanate (CAZ/CAC and ratio of ceftazidime MIC/ceftazidime-clavulanate MIC (MIC CAZ/CAC. Molecular typing was performed by DNA macrorestriction analysis followed by pulsed-field gel electrophoresis. The KB method displayed the highest rates of ESBL (up to 70% of Klebsiella and 59% of E.coli, contrasting with all the other methods (p Este estudo foi desenvolvido para comparar métodos de detecção e para estimar a prevalência de Klebsiella spp e E.coli produtoras de beta-lactamases de espetro ampliado (ESBL em um Hospital Universitário no sul do Brasil. A correlação genética, determinada através de método molecular de tipagem, entre as amostras de K. pneumoniae também foi determinada. A produção de ESBL foi investigada em 95 amostras de Klebsiella spp e E.coli obtidas de pacientes no Hospital de Clínicas de Porto Alegre usando-se: medida do diâmetro a zona de inibição (KB, dupla-difusão de disco (DD, valores de concentração inibitória mínima da ceftazidima (MIC CAZ, aumento do diâmetro da zona de inibição com adição de clavulanato (CAZ/CAC e a relação entre o MIC da ceftazidima/MIC ceftazidima com clavulanato (MIC CAZ/CAC. A tipagem molecular foi realizada utilizando-se o método de macrorestrição de DNA e eletroforese em campo pulsado (PFGE. O método KB apresentou as maiores taxas de produção de ESBL (> 70% para Klebsiella e

  16. Porin involvement in cephalosporin and carbapenem resistance of Burkholderia pseudomallei.

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    Anuwat Aunkham

    Full Text Available BACKGROUND: Burkholderia pseudomallei (Bps is a Gram-negative bacterium that causes frequently lethal melioidosis, with a particularly high prevalence in the north and northeast of Thailand. Bps is highly resistant to many antimicrobial agents and this resistance may result from the low drug permeability of outer membrane proteins, known as porins. PRINCIPAL FINDINGS: Microbiological assays showed that the clinical Bps strain was resistant to most antimicrobial agents and sensitive only to ceftazidime and meropenem. An E. coli strain defective in most porins, but expressing BpsOmp38, exhibited considerably lower antimicrobial susceptibility than the control strain. In addition, mutation of Tyr119, the most prominent pore-lining residue in BpsOmp38, markedly altered membrane permeability, substitution with Ala (mutant BpsOmp38Y119A enhanced uptake of the antimicrobial agents, while substitution with Phe (mutant BpsOmp38Y119F inhibited uptake. Channel recordings of BpsOmp38 reconstituted in a planar black lipid membrane (BLM suggested that the higher permeability of BpsOmp38Y119A was caused by widening of the pore interior through removal of the bulky side chain. In contrast, the lower permeability of BpsOmp38Y119F was caused by introduction of the hydrophobic side chain (Phe, increasing the 'greasiness' of the pore lumen. Significantly, liposome swelling assays showed no permeation through the BpsOmp38 channel by antimicrobial agents to which Bps is resistant (cefoxitin, cefepime, and doripenem. In contrast, high permeability to ceftazidime and meropenem was observed, these being agents to which Bps is sensitive. CONCLUSION/SIGNIFICANCE: Our results, from both in vivo and in vitro studies, demonstrate that membrane permeability associated with BpsOmp38 expression correlates well with the antimicrobial susceptibility of the virulent bacterium B. pseudomallei, especially to carbapenems and cephalosporins. In addition, substitution of the residue

  17. Endoftalmite: uma análise de 58 casos Endophthalmitis: an analysis of 58 cases

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    Tarciso Schirmbeck

    2000-02-01

    isolated species were susceptible to vancomicyn and ceftazidime. In 65.51% of the cases no light perception was the final visual acuity. Conclusions: These results suggest some changes that might be performed to improve prognosis of endophthalmitis, such as using intraocular vancomicyn and ceftazidime

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

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

    2017-02-01

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

  19. Comparative antimicrobial susceptibility of aerobic and facultative bacteria from community-acquired bacteremia to ertapenem in Taiwan

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    Fung Chang-Phone

    2007-07-01

    Full Text Available Abstract Background Ertapenem is a once-a-day carbapenem and has excellent activity against many gram-positive and gram-negative aerobic, facultative, and anaerobic bacteria. The susceptibility of isolates of community-acquired bacteremia to ertapenem has not been reported yet. The present study assesses the in vitro activity of ertapenem against aerobic and facultative bacterial pathogens isolated from patients with community-acquired bacteremia by determining and comparing the MICs of cefepime, cefoxitin, ceftazidime, ceftriaxone, ertapenem, piperacillin, piperacillin-tazobactam, ciprofloxacin, amikacin and gentamicin. The prevalence of extended broad spectrum β-lactamases (ESBL producing strains of community-acquired bacteremia and their susceptibility to these antibiotics are investigated. Methods Aerobic and facultative bacteria isolated from blood obtained from hospitalized patients with community-acquired bacteremia within 48 hours of admission between August 1, 2004 and September 30, 2004 in Chang Gung Memorial Hospital at Keelung, Taiwan, were identified using standard procedures. Antimicrobial susceptibility was evaluated by Etest according to the standard guidelines provided by the manufacturer and document M100-S16 Performance Standards of the Clinical Laboratory of Standard Institute. Antimicrobial agents including cefepime, cefoxitin, ceftazidime, ceftriaxone, ertapenem, piperacillin, piperacillin-tazobactam, ciprofloxacin, amikacin and gentamicin were used against the bacterial isolates to test their MICs as determined by Etest. For Staphylococcus aureus isolates, MICs of oxacillin were also tested by Etest to differentiate oxacillin-sensitive and oxacillin-resistant S. aureus. Results Ertapenem was highly active in vitro against many aerobic and facultative bacterial pathogens commonly recovered from patients with community-acquired bacteremia (128/159, 80.5 %. Ertapenem had more potent activity than ceftriaxone, piperacillin

  20. ISOLATION AND ANTIBIOTIC SENSITIVITY PATTERN OF CITROBACTER SPECIES WITH ESBL AND AMPC DETECTION AT TERTIARY CARE HOSPITAL, BANGALORE

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    Priyadarshini

    2016-04-01

    Full Text Available BACKGROUND Genus Citrobacter is one of the aerobic Gram negative non-sporing bacilli, from the Enterobacteriaceae family. Citrobacter koseri and Citrobacter freundii are the commonest species implicated in infections. It is emerging as an important nosocomial pathogen. It is associated with high mortality and morbidity rate. They are often resistant to routinely used antibiotics. Emerging drug resistance is a therapeutic concern for clinicians worldwide, thus isolation and antibiotic sensitivity of Citrobacter is critically needed. OBJECTIVES Identification of Citrobacter species and antibiotic sensitivity pattern with AmpC and ESBL Detection. METHODS Prospective study was done from June 2014 to March 2015. The samples were collected from patients attending VIMS and RC. The samples were processed and identified by standard protocol. Citrobacter isolates were tested for antibiotic sensitivity by Kirby-Bauer disc diffusion method as per clinical and standard institute guidelines. Detection of AmpC by Cephamycin Hodge test using Cefoxitin 30 μg with ATCC strains of Escherichia coli 25922 was done. ESBL detection was done by Ceftazidime (30 μg and Ceftazidime/clavulanic acid (30 μg/10 μg and Cefotaxime (30 ug Cefotaxime/clavulanic acid (30 ug/10 ug. RESULTS Out of 5695 Gram negative isolates identified, 690 were Citrobacter isolates. Citrobacter koseri 398 (62.5% and Citrobacter freundii 292 (37.5% were the commonest species isolated. The antibiogram as per CLSI Guidelines showed resistance to Fluoroquinolones, Cephalosporins and beta lactamase inhibitors. Carbapenems were found to be sensitive. The resistance to beta lactamase inhibitors increased with the presence of AmpC beta lactamase (76% and ESBL (50%. CONCLUSION Citrobacter species are emerging as an important nosocomial pathogen. Citrobacter koseri and Citrobacter freundii were the commonest species isolated. Antibiogram showing an increase in resistance among the beta lactamase

  1. Evaluation of a Mixing versus a Cycling Strategy of Antibiotic Use in Critically-Ill Medical Patients: Impact on Acquisition of Resistant Microorganisms and Clinical Outcomes.

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    Nazaret Cobos-Trigueros

    Full Text Available To compare the effect of two strategies of antibiotic use (mixing vs. cycling on the acquisition of resistant microorganisms, infections and other clinical outcomes.Prospective cohort study in an 8-bed intensive care unit during 35- months in which a mixing-cycling policy of antipseudomonal beta-lactams (meropenem, ceftazidime/piperacillin-tazobactam and fluoroquinolones was operative. Nasopharyngeal and rectal swabs and respiratory secretions were obtained within 48h of admission and thrice weekly thereafter. Target microorganisms included methicillin-resistant S. aureus, vancomycin-resistant enterococci, third-generation cephalosporin-resistant Enterobacteriaceae and non-fermenters.A total of 409 (42% patients were included in mixing and 560 (58% in cycling. Exposure to ceftazidime/piperacillin-tazobactam and fluoroquinolones was significantly higher in mixing while exposure to meropenem was higher in cycling, although overall use of antipseudomonals was not significantly different (37.5/100 patient-days vs. 38.1/100 patient-days. There was a barely higher acquisition rate of microorganisms during mixing, but this difference lost its significance when the cases due to an exogenous Burkholderia cepacia outbreak were excluded (19.3% vs. 15.4%, OR 0.8, CI 0.5-1.1. Acquisition of Pseudomonas aeruginosa resistant to the intervention antibiotics or with multiple-drug resistance was similar. There were no significant differences between mixing and cycling in the proportion of patients acquiring any infection (16.6% vs. 14.5%, OR 0.9, CI 0.6-1.2, any infection due to target microorganisms (5.9% vs. 5.2%, OR 0.9, CI 0.5-1.5, length of stay (median 5 d for both groups or mortality (13.9 vs. 14.3%, OR 1.03, CI 0.7-1.3.A cycling strategy of antibiotic use with a 6-week cycle duration is similar to mixing in terms of acquisition of resistant microorganisms, infections, length of stay and mortality.

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

    Science.gov (United States)

    Nakamura, Tatsuya; Komatsu, Masaru

    2005-02-01

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

  3. Update on management options in the treatment of nosocomial and ventilator assisted pneumonia: review of actual guidelines and economic aspects of therapy

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    Wilke M

    2013-12-01

    Full Text Available Michael Wilke,1 Rolf Grube1 1Dr. Wilke GmbH, Munich, Germany Objective: Nosocomial or more exactly, hospital-acquired (HAP and ventilator-associated pneumonia (VAP are frequent conditions when treating intensive care unit (ICU patients that are only exceeded by central line-associated bloodstream infections. In Germany, approximately 18,900 patients per year suffer from a VAP and another 4,200 from HAP. We therefore reviewed the current guidelines about HAP and VAP, from different sources, regarding the strategies to address individual patient risks and medication strategies for initial intravenous antibiotic treatment (IIAT. Material and methods: We conducted an analysis of the recent guidelines for the treatment of HAP. The current guidelines of the American Thoracic Society, the treatment recommendations of the Paul-Ehrlich-Gesellschaft (PEG, the guidelines from the British Society for Antimicrobial Chemotherapy, the VAP guideline of the Canadian Critical Care trials group, as well as the new German S3-guideline for HAP were examined. Results: All guidelines are based on grading systems that assess the evidence underlying the recommendations. However, each guideline uses different grading systems. One common aspect of these guidelines is the risk assessment of the patients for decision making regarding IIAT. Most guidelines have different recommendations depending on the risk of the presence of multidrug resistant (MDR bacteria. In guidelines using risk assessment, for low-risk patients (early onset, no MDR risk aminopenicillins with beta-lactamase inhibitors (BLI, second or third generation cephalosporins, quinolones, or ertapenem are recommended. For patients with higher risk, imipenem, meropenem, fourth generation cephalosporins, ceftazidime or piperacillin/tazobactam are recommended. The PEG recommendations include a combination therapy in cases of very high risk (late onset, MDR risk, ICU, and organ failure of either piperacillin

  4. Effect of frameshift mutagen acriflavine on control of resistance genes in Acinetobacter baumannii.

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    Lopes, B S; Hamouda, A; Findlay, J; Amyes, S G B

    2011-02-01

    Acinetobacter baumannii is a Gram-negative pathogenic bacterium that often exhibits a multidrug-resistant phenotype causing infections at various sites of the body and increasingly leading to septicaemic shock. This study evaluated the role of acriflavine, a frameshift mutagen, on the movement of insertion sequence ISAba1 in clinical isolates of A. baumannii, with the focus on changes in expression levels of the bla(ADC) and bla(OXA-51-like) genes. Resistance profiles were assessed with consideration of ISAba1 acting as a promoter upstream of the bla(ADC) or bla(OXA-51-like) gene. ISAba1 movement was observed in the acriflavine mutants Ab153M and Ab1225M. Ab153M exhibited an increase in the MIC values of carbapenems and ceftazidime, with ISAba1 gained upstream of the bla(ADC) and bla(OXA-51-like) genes, correlating with an increase in gene expression. Reduced expression of the 17, 23 and 25 kDa outer-membrane proteins (OMPs) was also observed in Ab153M. There was a significant decrease in MIC values of carbapenems with the loss of ISAba1 upstream of the bla(ADC) and bla(OXA-51-like) genes in strain Ab1225M, and a significant decrease in bla(OXA-51-like) gene expression and, to a lesser extent, in bla(ADC) expression. Ab1225M and a serially subcultured Ab1225 strain (Ab1225s) exhibited overexpression of the 17, 23, 25 and 27 kDa OMPs. There was a decrease in MIC values of the carbapenems and piperacillin/tazobactam but not of ceftazidime in Ab1225s, which had ISAba1 upstream of the bla(ADC) and bla(OXA-51-like) genes. A significant decrease in bla(OXA-51-like) expression was observed in Ab1225s, whereas the expression of bla(ADC) was similar to that in the Ab1225 parental strain. The attenuation in this strain may be due to overexpression of OMPs and it is clear that, even if ISAba1 is present upstream of an antibiotic resistance gene, it may not necessarily contribute towards the overexpression of antibiotic resistance genes (bla(OXA-51-like) in Ab

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

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    Mohd.

    2013-04-01

    Full Text Available ABSTRACT: BACKGROUND: Beta lactams are the most extensively used group of antimicrobials, however growing resistance to these invaluable drugs mediated by extended spectrum beta-lactamase (ESBL enzymes is a major co ncern. The frequency of ESBL producing strains among clinical isolates has been steadily i ncreasing over the past few years that has generated a major problem in clinical therapeutics. OBJECTIVES: Our aim was to determine the prevalence of ESBL producing Escherichia coli, study their antibiogram and to evaluate the association between ESBL production and antibiotic r esistance in Escherichia coli. SETTINGS AND DESIGN: This prospective study was conducted in the Department of Microbiology, Jawaharlal Nehru Medical College, Aligarh Muslim Un iversity, Aligarh. STATISTICAL ANALYSIS USED: Chi-square test was used to analyze the data stati stically. Probability values less than 0.05 were considered significant. MATERIALS AND METHODS: Two hundred and eighty six consecutive, non-repeated isolates of Escherichia c oli obtained from pus, urine, blood, stool, throat swab, cervical swab, sputum, CSF and conjunct ival swab samples received in our bacteriology laboratory were analyzed in this study . These bacterial isolates were identified and tested for antibiotic sensitivity by standard micro biological procedures. Subsequently, they were screened and then phenotypically confirmed for E SBL production by phenotypic confirmatory disk diffusion test (PCDDT. RESULTS : Out of 286 isolates of Escherichia coli screened for ESBL production, 65.03% (n=186 were de tected to be positive using either ceftazidime or cefotaxime. In the screen positives, 91.94% (n=171 were phenotypically confirmed ESBL producers by PCDDT method. The overal l prevalence of ESBL producing Escherichia coli was 59.79% (n=171/286 with 87.72% obtained from in-patients and 12.28% from out-patients. Majority of ESBL producing Escheri chia coli were recovered from stool (73

  6. 557株大肠埃希菌耐药性分析%Drug Resistance of 557 Strains of Escherichia coli

    Institute of Scientific and Technical Information of China (English)

    李晓云; 梁立全

    2011-01-01

    OBJECTIVE: To explore the drug resistance of Escherichia coli producing extended spectrum β-lactamases (ES-BLs) to commonly used antibiotics, and to provide reference for clinical anti-infective drug therapy. METHODS: Ceftazidime and ceftazidime plus clavulanic acid, cefotaxime and cefotaxime plus clavulanic acid in the double disk confirmatory test were adopted to detect ESBLs, and K-B disk diffusion assay was used to determine antibiotic resistance of Escherichia coli. RESULTS: The detection rates of E.coli ESBLs were 35.9%, 43.7% and 46.9% from 2007 to 2009. Antibiotic resistance rate of E.coli ESBLs to cefo-perazone/sulbactam, piperacillin/tazobactam, nitrofurantoin and amikacin was low, the rest of antibiotic resistance rate were more than 52%. CONCLUSIONS: Escherichia coli resistance in our hospital is severe. The key to increase the cure rate of bacterial infection, control hospital infection and reduce drug resistance of bacteria is to strengthen management of clinical use of antibiotics.%目的:了解大肠埃希菌产超广谱β-内酰胺酶(ESBLs)及对常用抗菌药物的耐药情况,为临床抗感染治疗提供用药依据.方法:采用头孢他啶与头孢他啶加克拉维酸、头孢噻肟与头孢噻肟加克拉维酸的双纸片确证试验检测ESBLs,采用纸片扩散法(K-B法)检测大肠埃希菌对常用抗菌药物的耐药性.结果:2007、2008、2009年产ESBLs大肠埃希菌的检出率分别为35.9%、43.7%、46.9%.大肠埃希菌对常用抗菌药物的耐药率以头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、呋喃妥因、阿米卡星较低,其余抗菌药物的耐药率在52%以上.结论:我院大肠埃希菌的耐药形势严峻.加强抗菌药物临床应用管理,是提高细菌感染治愈率和控制院内感染、降低细菌耐药性的重要手段.

  7. 增殖型坏疽性脓皮病伴毛囊炎样损害一例%Vegetative pyoderma gangrenosum associated with lesions resembling folliculitis: a case report

    Institute of Scientific and Technical Information of China (English)

    赵文; 吕雪莲; 夏玉坤; 崔红艳

    2011-01-01

    患者男,46岁,小腿溃疡增生、瘢痕伴疼痛2年。躯干毛囊炎样丘疹、红斑1年。皮损组织病理:小腿真皮血管壁纤维素样坏死,中性粒细胞浸润及核尘,偶见多核巨细胞;背部真皮残留毛囊上皮之小脓肿,浅、深层血管周围中等量淋巴细胞、中性粒细胞及核尘浸润,有红细胞外溢。细菌培养:小腿皮损活检组织细菌培养为摩氏摩根菌生长,对头孢他啶敏感;背部为阴性。诊断为增殖型坏疽性脓皮病,给予小剂量泼尼松、雷公藤及氨苯砜联合头孢他啶治疗有效。%A 46-year-old man presented with a two-year history of painful and vegetating ulcer and scarring of both legs, as well as a one-year history of folliculitis-like papules and erythema on the trunk. The histological examination of lesions on the legs revealed fibrinoid necrosis of the vascular wall and neutrophilic infiltration with nuclear dust and occasional multinucleated giant cells in the dermis, while that of lesions on the back demonstrated residual follicle epithelium at the edge of a small abscess, and perivascular infiltration with a moderate number of neutrophils, lymphocytes and nuclear dust in the superficial and deep dermis. Morganella morganii was isolated by bacterial culture from the tissue specimens from the lesions on the legs, but not from those on the trunk, and the isolate was sensitive to ceftazidime. The patient was diagnosed with vegetative pyoderma gangrenosum. The condition was controlled after treatment with low-dose prednisone,tripterygium glycosides, dapsone and ceftazidime.

  8. Indagine epidemiologica locale dell’eziologia delle infezioni delle vie urinarie (IVU nosocomiali e comunitarie e dell’antibiotico-sensibilità degli uropatogeni.

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    Agostina Ronca

    2007-12-01

    Full Text Available Background: Urinary tract infections (UTIs are common infectious diseases that can be associated with substantial morbidity. During the last decade, resistance to ampicillin and co-trimoxazole has increased in Escherichia coli, the most common uropathogen, and recent reports have shown increasing resistance even to fluoroquinolones. The aim of this local surveillance study was to determine the distribution of bacterial strains isolated from outpatients and inpatients with UTIs and antibiotic susceptibility patterns to antimicrobial agents currently used in the treatment of pathogens causing these infections. Materials and methods: Between January and March 2006 a total of 1596 urine specimens, 968 from outpatients and 628 from inpatients, respectively, were recovered. Urinary pathogens isolated were 235, identification and antimicrobial susceptibility testing were performed by Vitek II.The following antimicrobial agents were tested: ampicillin, amoxicillin-clavulanic acid, ceftazidime, imipenem, co-trimoxazole, ciprofloxacin, gentamicin and nitrofurantoin. E test® method were used to study the production of extended spectrum beta-lactamases (ESBL. Results:The most frequent pathogen found was Escherichia coli (68.5%, followed by Klebsiella spp. (8.5%, Proteus mirabilis (7.6%, and Enterococcus spp. (6%. E. coli resistance rates less than 10% was observed for ceftazidime, imipenem and nitrofurantoin. In strains isolated from outpatients resistance to ampicillin and trimethoprim-sulfamethoxazole was 37% and 19%, respectively, and resistance to fluoroquinolones was about 20%. Resistance rates of E. coli was significantly higher in complicated nosocomial-acquired infection: ampicillin 53.6%, cotrimossazole 35.7% and ciprofloxacin 33.9%. ESBL producer strains were 7 E.coli (4.3% and 6 Proteus spp. (33%. Conclusions: This study confirmed that E. coli and other Enterobacteriaceae are the predominant bacterial pathogens envolved in UTIs. Currently, the

  9. Evaluation of post-antibiotic effect in Gram-negative and Gram-positive bacteria

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    Elisa Tavella

    2008-03-01

    Full Text Available Although the postantibiotic effect (PAE is a well recognized phenomenon, the mechanism by which it is induced has not fully elucidated yet. It has been suggested that PAE is the time required by bacteria to synthesize proteins or mRNA characterized by a short half-life that are consumed during antibiotic treatment.This phenomenon is widely studied on Gram-positive cocci and Gram-negative rods, while information about Gram-positive rods and Gram-negative cocci are scanty.To gain new insights on the PAE, this study was addressed to evaluated the time required by Moraxella catarrhalis and Lactobacillus planctarum to resume their physiological growth rate after exposure to various antibiotics. Methods PAE was estimated in accordance with the method of Craig and Gudmundsson using the following drugs: penicillin, piperacillin-tazobactam, cefalotin, ceftazidime, imipenem, ciprofloxacin, gentamycin and azithromycin. Log-phase bacteria were exposed to drug at a concentration corresponding to 4 times the MIC value for 1h.The drug was inactivated by 1:1000 dilution. Bacterial counts were determined at time zero, immediately after drug dilution, and at each hour after removal for 6 - 7h by a pour-plate technique. The PAE was defined as the difference in time required by test and control cultures to increase by 1 log in CFU number. Results All drugs tested induced a PAE on the strains studied. M. catarrhalis registered PAE values ranging between 0,5 (gentamycin and 2 (ceftazidime, imipenem and azithromycin.With respect to L. plantarum a PAE between 0,8 (cefalotin and 3 hours (ciprofloxacin were detected. Conclusion. These findings demonstrated that all the drugs tested were able to induce a PAE on the strains tested.This observation differs from that observed on Gram-negative rods characterised by negative PAE values induced by penicillins and cephalosporins.This results might reflect the different target of these compounds on these Gram-positive rods or the

  10. Antibiotic multiresistance analysis of mesophilic and psychrotrophic Pseudomonas spp. isolated from goat and lamb slaughterhouse surfaces throughout the meat production process.

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    Lavilla Lerma, Leyre; Benomar, Nabil; Casado Muñoz, María del Carmen; Gálvez, Antonio; Abriouel, Hikmate

    2014-11-01

    The aim of this study was to investigate the phenotypic and genotypic antibiotic resistance profiles of pseudomonads isolated from surfaces of a goat and lamb slaughterhouse, which were representative of areas that are possible sources of meat contamination. Mesophilic (85 isolates) and psychrotrophic (37 isolates) pseudomonads identified at the species level generally were resistant to sulfamethoxazole, erythromycin, amoxicillin, ampicillin, chloramphenicol, trimethoprim, rifampin, and ceftazidime (especially mesophiles), as well as colistin and tetracycline (especially psychrotrophes). However, they generally were sensitive to ciprofloxacin, gentamicin, imipenem, and kanamycin regardless of species identity. Worryingly, in the present study, we found multidrug resistance (MDR) to up to 13 antibiotics, which was related to intrinsic and acquired resistance mechanisms. Furthermore, a link between various antimicrobial resistance genes was shown for beta-lactams and tetracycline, trimethoprim, and sulfonamides. The distribution and resistome-based analysis of MDR pseudomonads in different slaughterhouse zones indicated that the main sources of the identical or related pseudomonad strains were the animals (feet and wool) and the slaughterhouse environment, being disseminated from the beginning, or entrance environment, to the environment of the finished meat products. Those facts must be taken into consideration to avoid cross-contamination with the subsequent flow of mobile resistance determinants throughout all slaughterhouse zones and then to humans and the environment by the application of adequate practices of hygiene and disinfection measures, including those for animal wool and feet and also the entrance environment.

  11. Chronic suppurative joint effusion due to burkholderia pseudomallei: A case report

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    Madhavi Deshmukh

    2013-01-01

    Full Text Available Burkholderia pseudomallei, a Gram-negative bacillus is the causative agent of Melioidosis, a glanders-like disease, primarily a disease of animals. Melioidosis has been only a rare and sporadic disease in humans outside its endemic region. Currently, diagnosis of B. pseudomallei in the clinical laboratory is very difficult, owing to low awareness of physicians to the nonspecific clinical manifestations, lack of responsiveness among microbiologists outside endemic areas, identification systems in the average sentinel laboratory, and the biosafety conditions necessary to process these organisms. We report a case of chronic left hip joint effusion in a known case of diabetes mellitus. Gram stain of computed tomography (CT-guided aspirate from the joint revealed Gram-negative bacilli along with pus cells. Culture was confirmed as Burkholderia pseudomallei on Vitek2C, which was sensitive to ceftazidime and trimethoprim/sulfmethoxazole. Unfortunately, patient could not be started on appropriate antibiotics due to delay in detection and patient succumbed to severe septicemia. This case is reported to highlight importance of automated identification and sensitivity especially in nonendemic areas and unusual antibiogram of this organism for which disc diffusion method is not standardized.

  12. Beta-lactam hypersensitivity and cross-reactivity.

    Science.gov (United States)

    Terico, Adrienne T; Gallagher, Jason C

    2014-12-01

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

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

    Science.gov (United States)

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

    2014-11-13

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

  14. Prevalence and antimicrobial susceptibility of Vibrio parahaemolyticus isolated from seafoods in Lagos Lagoon Nigeria

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    Chigozie Oramadike

    2015-12-01

    Full Text Available In this study, a total of 90 seafood samples; croaker fish (Pseudotolithus senegalensis, shrimps (Penaeus notialis and blue crab (Callinectes sapidus collected from landing sites along the Lagos Lagoon in Nigeria were examined for the prevalence of Vibrio parahaemolyticus using both biochemical and molecular methods. Biochemical identification of the isolates was confirmed by Polymerase Chain Reaction (PCR. The presence of the virulence-associated tdh (thermostable direct haemolysin, trh1 (thermostable-related haemolysin and trh2 genes in the V. parahaemolyticus isolates was also detected by the PCR method. PCR products from the V.16S primers were sequenced. Antibiotics susceptibility of the isolates was also determined. About, eight isolates were presumptively identified as V. parahaemolyticus, PCR identified five and none of the isolates were positive for the genes tdh or trh. The five isolates sequenced were identified as different strains of V. parahaemolyticus. V. parahaemolyticus_RIMD_2210633 = 2MKSHa remained resistant to all antimicrobials tested. However, only V. parahaemolyticus_MP-2_AY911391 = TBSHy showed strong sensitivity to all the antimicrobials with ampicillin (minimum inhibitory concentration-4 μg/ml. In addition, the other three isolates showed sensitivity for Tetracycline, Ciprofloxacin, Gentamicin and Ceftazidime. Ampicillin resistance in most of the isolates suggests low efficiency of ampicillin in management of V. parahaemolyticus infection.

  15. Spectrum and Sensitivity of Bacterial Keratitis Isolates in Auckland

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    S. Marasini

    2016-01-01

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

  16. Patterns of antimicrobial resistance in a surgical intensive care unit of a university hospital in Turkey

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    Balci Iclal

    2006-10-01

    Full Text Available Abstract Background Several studies have reported higher rates of antimicrobial resistance among isolates from intensive care units than among isolates from general patient-care areas. The aims of this study were to review the pathogens associated with nosocomial infections in a surgical intensive care unit of a university hospital in Turkey and to summarize rates of antimicrobial resistance in the most common pathogens. The survey was conducted over a period of twelve months in a tertiary-care teaching hospital located in the south-eastern part of Turkey, Gaziantep. A total of 871 clinical specimens from 615 adult patients were collected. From 871 clinical specimens 771 bacterial and fungal isolates were identified. Results Most commonly isolated microorganisms were: Pseudomonas aeruginosa (20.3%, Candida species (15% and Staphylococcus aureus (12.9%. Among the Gram-negative microorganisms P. aeruginosa were mostly resistant to third-generation cephalosporins (71.3–98.1%, while Acinetobacter baumannii were resistant in all cases to piperacillin, ceftazidime and ceftriaxone. Isolates of S. aureus were mostly resistant to penicillin, ampicillin, and methicillin (82–95%, whereas coagulase-negative staphylococci were 98.6% resistant to methicillin and in all cases resistant to ampicillin and tetracycline. Conclusion In order to reduce the emergence and spread of antimicrobial-resistant pathogens in ICUs, monitoring and optimization of antimicrobial use in hospitals are strictly recommended. Therefore local resistance surveillance programs are of most value in developing appropriate therapeutic guidelines for specific infections and patient types.

  17. Antimicrobial resistance among Brazilian Corynebacterium diphtheriae strains

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    Gabriela Andrade Pereira

    2008-08-01

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

  18. Detection systems for carbapenemase gene identification should include the SME serine carbapenemase.

    Science.gov (United States)

    Bush, Karen; Pannell, Megan; Lock, John L; Queenan, Anne Marie; Jorgensen, James H; Lee, Ryan M; Lewis, James S; Jarrett, Deidre

    2013-01-01

    Carbapenemase detection has become a major problem in hospitals that encounter outbreaks of infections caused by carbapenem-resistant Gram-negative bacteria. Rapid detection systems have been reported using multiplex PCR analyses and DNA microarray assays. Major carbapenemases that are detected by these systems include the KPC and OXA serine carbapenemases, and the IMP, VIM and NDM families of metallo-β-lactamases. However, increasing numbers of the SME serine carbapenemase are being reported from Serratia marcescens, especially from North and South America. These organisms differ from many of the other carbapenemase-producing pathogens in that they are generally susceptible to the expanded-spectrum cephalosporins ceftazidime and cefepime while retaining resistance to almost all other β-lactam antibiotics. Thus, multiplex PCR assays or DNA microarray testing of carbapenem-resistant S. marcescens isolates should include analyses for production of the SME carbapenemase. Confirmation of the presence of this enzyme may provide reassurance that oxyimino-cephalosporins can be considered for treatment of infections caused by these carbapenem-resistant pathogens.

  19. The TFPI-2 derived peptide EDC34 improves outcome of gram-negative sepsis.

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    Praveen Papareddy

    Full Text Available Sepsis is characterized by a dysregulated host-pathogen response, leading to high cytokine levels, excessive coagulation and failure to eradicate invasive bacteria. Novel therapeutic strategies that address crucial pathogenetic steps during infection are urgently needed. Here, we describe novel bioactive roles and therapeutic anti-infective potential of the peptide EDC34, derived from the C-terminus of tissue factor pathway inhibitor-2 (TFPI-2. This peptide exerted direct bactericidal effects and boosted activation of the classical complement pathway including formation of antimicrobial C3a, but inhibited bacteria-induced activation of the contact system. Correspondingly, in mouse models of severe Escherichia coli and Pseudomonas aeruginosa infection, treatment with EDC34 reduced bacterial levels and lung damage. In combination with the antibiotic ceftazidime, the peptide significantly prolonged survival and reduced mortality in mice. The peptide's boosting effect on bacterial clearance paired with its inhibiting effect on excessive coagulation makes it a promising therapeutic candidate for invasive Gram-negative infections.

  20. Clinical Presentation and Antibiotic Susceptibility of Contact Lens Associated Microbial Keratitis

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    Hesam Hedayati

    2015-01-01

    Full Text Available Introduction. In recent years, the number of contact lens wearers has dramatically increased in Iran, particularly in youngsters. The purpose of current study was to assess the clinical presentation and antibiotic susceptibility of contact lens related microbial keratitis in Ahvaz, southwest of Iran. Methodology. A cross-sectional investigation of 26 patients (33 eyes with contact lens induced corneal ulcers who were admitted to Imam Khomeini Hospital, Ahwaz City, from June 2012 to June 2013 was done. In order to study microbial culture and susceptibility of corneal ulcers, all of them were scraped. Results. Eight samples were reported as sterile. Pseudomonas aeruginosa (80% in positive cultures was the most widely recognized causative organism isolated. This is followed by Staphylococcus aureus 12% and Enterobacter 8%. The results showed that 84% of the microorganism cases were sensitive to ciprofloxacin, while imipenem, meropenem, and ceftazidime were the second most effective antibiotics (76%. Conclusion. Results of current study show the importance of referring all contact lens wearers with suspected corneal infection to ophthalmologists for more cure. The corneal scraping culture and contact lens solution should be performed to guide antibiotic therapy.

  1. [Glanders--a potential disease for biological warfare in humans and animals].

    Science.gov (United States)

    Lehavi, Ofer; Aizenstien, Orna; Katz, Lior H; Hourvitz, Ariel

    2002-05-01

    Infection with Burkholderia mallei (formerly Pseudomonas mallei) can cause a subcutaneous infection known as "farcy" or can disseminate to condition known as Glanders. It is primarily a disease affecting horses, donkeys and mules. In humans, Glanders can produce four types of disease: localized form, pulmonary form, septicemia, and chronic form. Necrosis of the tracheobronchial tree and pustular skin lesions characterize acute infection with B. mallei. Other symptoms include febrile pneumonia, if the organism was inhaled, or signs of sepsis and multiple abscesses, if the skin was the port of entry. Glanders is endemic in Africa, Asia, the Middle East, and Central and South America. Glanders has low contiguous potential, but because of the efficacy of aerosolized dissemination and the lethal nature of the disease, B. mallei was considered a candidate for biological warfare. During World War I, Glanders was believed to have been spread to infect large numbers of Russian horses and mules on the Eastern front. The Japanese infected horses, civilians and prisoners of war during World War II. The USA and the Soviet Union have shown interest in B. mallei in their biological warfare program. The treatment is empiric and includes mono or poly-therapy with Ceftazidime, Sulfadiazine, Trimethoprim + Sulfamethoxazol, Gentamicin, Imipenem etc. Aggressive control measures essentially eliminated Glanders from the west. However, with the resurgent concern about biological warfare, B. mallei is now being studied in a few laboratories worldwide. This review provides an overview of the disease and presents the only case reported in the western world since 1949.

  2. Application of whonet for the surveillance of antimicrobial resistance

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    Sharma A

    2004-01-01

    Full Text Available World over antimicrobial resistance is a major public health problem. The WHONET software program puts each laboratory data into a common code and file format, which can be merged for national or global collaboration of antimicrobial resistance surveillance. In this study, antimicrobial sensitivity of 4,289 bacterial isolates was studied by Kirby-Bauer disk diffusion method. -lactamase production was assessed by iodometric test method. Extended spectrum -lactamase (ESBLs were screened by ceftazidime disk sensitivity. Drug resistance was high in most of the isolates. It was maximum (80-94% for ampicillin, nalidixic acid and cotrimoxazole. It varied between 40-60% for gentamicin, clindamycin, fluoroquinolones and coamoxyclav. It ranged from 21 to 38% for amikacin and third generation cephalosporins. Constitutive -lactamase production was highest in S.aureus (28.9% and ESBL production was maximum in Klebsiella spp. (53.6%. WHONET software has in-built analysis program which helps in forming hospital drug policy, identification of hospital outbreaks and recognition of quality control problems in the laboratory.

  3. ENTERIC FEVER IN BASTAR TRIBAL REGION-PREVALENCE AND SENSITIVITY PATTERNS

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    Vikas Chandra Yadav

    2016-07-01

    Full Text Available OBJECTIVE Currently, antibiotic resistance in bacterial populations is one of the greatest challenges to the effective management of infectious diseases. The aim of this research was to study the prevalence of salmonella species and its sensitivity pattern in a tertiary care medical college hospital in Bastar, Chhattisgarh. MATERIAL AND METHODS From the clinical samples cultured from Jan 2010 to June 2014. 690 cases of enteric fever were isolated and investigations were carried out for antibiotic susceptibility pattern of S. typhi and S. Paratyphi Result: Antimicrobial susceptibility pattern of S. typhi against various antibiotics tested were chloramphenicol 37%-52%, co-trimoxazole 22-33%, ampicillin 28-46%, ciprofloxacin 14-29%, ofloxacin 80-95%, amikacin 89%-97%, cefotaxime 56%-88%, ceftriaxone 69%-72%, ceftazidime 86-93%, and nalidixic 93-86%. Sensitivity pattern of S. Paratyphi showed 100% resistance to co-trimoxazole, 40% to ciprofloxacin while they were 100% sensitive to ofloxacin and amikacin. DISCUSSION Emergence of MDR Salmonella is the main problem of treating the patient as a consequence of extensive use of antibiotic. Resistance to antibiotic was found with increasing frequency in our study. Hence, there should be a national policy for antibiotic usage.

  4. Elizabethkingia meningosepticum in a Patient with Six-Year Bilateral Perma-Catheters

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    Konstantin Boroda

    2014-01-01

    Full Text Available Elizabethkingia meningosepticum (EM is a saprophyte which is ubiquitous in nature, but not normally present in the human flora. Instances of infection are rare in the USA, but EM may be an emerging pathogen among immune-compromised patients. EM can cause a variety of infections, but nosocomial pneumonia and bacteremia have been the most commonly reported among immune-compromised adults. EM has proven difficult to treat with a mortality rate of 23%–41% in adult bacteremia. This is likely due to its resistance to commonly used empiric antibiotics for Gram-negative infections. A review of the literature suggests that there has been a shift EM’s susceptibility profile over time along with a great variability in antibiotic susceptibilities reported. This signifies the importance of close monitoring of these changes. In this report we present a case of a 64-year-old male with end stage renal disease and bilateral subclavian perma-catheters, who was admitted with systemic inflammatory response syndrome. While initial peripheral blood cultures were negative, cultures later drawn from his perma-catheters revealed Corneybacterium species and EM. The patient was initially treated with empiric vancomycin and piperacillin-tazobactam. After antibiotics susceptibilities became available, he was treated with levofloxacin and ceftazidime. The patient improved, was culture negative, and later had perma-catheter removal.

  5. Spectrum and Sensitivity of Bacterial Keratitis Isolates in Auckland

    Science.gov (United States)

    Swift, S.; Dean, S. J.; Ormonde, S. E.

    2016-01-01

    Background. The bacteria isolated from severe cases of keratitis and their antibiotic sensitivity are recognised to vary geographically and over time. Objectives. To identify the most commonly isolated bacteria in keratitis cases admitted over a 24-month period to a public hospital in Auckland, New Zealand, and to investigate in vitro sensitivity to antibiotics. Methods. Hospital admissions for culture-proven bacterial keratitis between January 2013 and December 2014 were identified. Laboratory records of 89 culture positive cases were retrospectively reviewed and antibiotic sensitivity patterns compared with previous studies from other NZ centres. Results. From 126 positive cultures, 35 species were identified. Staphylococcus was identified to be the most common isolate (38.2%), followed by Pseudomonas (21.3%). Over the last decade, infection due to Pseudomonas species, in the same setting, has increased (p ≤ 0.05). Aminoglycosides, cefazolin, ceftazidime, erythromycin, tetracycline, and doxycycline were 100% effective against tested isolates in vitro. Amoxicillin (41.6%), cefuroxime (33.3%), and chloramphenicol (94.7%) showed reduced efficacy against Gram-negative bacteria, whereas penicillin (51%) and ciprofloxacin (98.8%) showed reduced efficacy against Gram-positive bacteria. Conclusions. Despite a shift in the spectrum of bacterial keratitis isolates, antibiotic sensitivity patterns have generally remained stable and show comparability to results within the last decade from NZ centres. PMID:27213052

  6. Successful treatment with rifampin for fulminant antibiotics-associated colitis in a patient with non-Hodgkin's lymphoma

    Institute of Scientific and Technical Information of China (English)

    Kenichi Nomura; Masafumi Taniwaki; Yosuke Matsumoto; Naohisa Yoshida; Sawako Taji; Naoki Wakabayashi; Shoji Mitsufuji; Shigeo Horiike; Masuji Morita; Takeshi Okanoue

    2004-01-01

    A 74-year-old man was admitted to the hospital because of chemotherapy for relapsed non-Hodgkin's lymphoma (NHL).The patient became febrile and experienced diarrhea after chemotherapy. Although ceftazidime and amikacin sulfate were administered as empiric therapy, diarrhea was continued.After several days, stool cytotoxin assay for clostridium difficile (C. difficile) was positive and he was diagnosed as having antibiotics-associated colitis (AAC). Although antibiotics were discontinued and both oral vancomycin and metronidazole were administrated, disease was not improved. To rule out the presence of an additional cause of diarrhea, colon fiberoscopic examination was performed. It revealed multiple deep ulcerative lesions at right side colon, surface erosive and minute erosive lesions in all continuous colon.Pseudomembranes were not seen. These findings are compatible with AAC without pseudomembranes. There are no reports that the rifampin is effective on refractory AAC.However, we administered oral rifampin for the current patient.The reasons are 1) conventional antibiotics were not effective,2) rifampin has excellent in vitro activity against C difficile,and 3) the efficacy of rifampin on relapsing colitis due to C.difficile is established. After administration of rifampin, fever alleviated and diarrhea was improved. Because AAC may result in significant mortality, patients with refractory or fulminant AAC should be treated with oral rifampin from outset.

  7. Antibiotic susceptibility profile of bacteria isolated from natural sources of water from rural areas of East Sikkim

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    Shubra Poonia

    2014-01-01

    Full Text Available Background: Contamination of water, food, and environment with antibiotic-resistant bacteria poses a serious public health issue. Objective: The objective was to study the bacterial pollution of the natural sources of water in east Sikkim and to determine the antimicrobial profile of the bacterial isolates. Materials and Methods: A total of 225 samples, 75 each during winter, summer, and monsoon season were collected from the same source in every season for bacteriological analysis by membrane filtration method. Antibiotic susceptibility test was performed using standard disc diffusion method. Results: A total of 19 bacterial species of the genera Escherichia, Klebsiella, Proteus, Salmonella, Shigella, Enterobacter, Citrobacter, Morganella, Pseudomonas, Acinetobacter, Flavobacterium, and Serratia were isolated and their antimicrobial sensitivity tested. Generally, most bacterial isolates except Salmonella and Shigella species were found resistant to commonly used antibiotics such as ampicillin (57.5%, trimethoprim/sulfamethoxaole (39.1%, amoxicillin/clavulanic acid (37.4%, cefixime (34.5%, tetracycline (29.1%, ceftazidime (26.3%, ofloxacin (25.9%, amikacin (8.7%, and gentamicin (2.7% but sensitive to imipenem and piperacillin/tazobactam. Conclusion: Natural sources of water in east Sikkim are grossly contaminated with bacteria including enteropathogens. The consumption of untreated water from these sources might pose health risk to consumers.

  8. The use of molecular typing to evaluate the dissemination of antimicrobial resistance among gram-negative rods in Brazilian hospitals

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    Iraci Tosin

    2003-12-01

    Full Text Available Antimicrobial resistance has increased rapidly in Brazil and worldwide during the past few years, giving rise to a growing necessity for antimicrobial resistance surveillance programs. These programs have been instituted in order to monitor bacterial resistance in various regions, and to guide empirical antimicrobial therapy. We evaluated the use of molecular typing in multicenter surveillance programs. We also studied the dissemination modes of selected resistance profiles. Antimicrobial susceptibility to various antimicrobial agents was evaluated by the reference broth microdilution method. Bacterial isolates with selected susceptibility patterns were characterized by pulsed field-gel electrophoresis (PFGE. A total of 119 Gram-negative bacteria were molecularly typed, including 22 imipenem-resistant Pseudomonas aeruginosa, 26 ESBL-producing Escherichia coli, 27 cefoxitin-resistant-ESBL-producing Klebsiella pneumoniae, 33 Enterobacter spp., 8 Citrobacter spp., and 3 S. marcescens isolates resistant to ceftazidime. The isolates were from clinically apparent bacteremia of patients hospitalized in medical centers located in 13 cities of 11 Brazilian states. Our molecular typing results revealed a great genetic diversity among isolates of the same species. However, some major PFGE patterns were found in more than one isolate. All repeated PFGE patterns were detected in only 2 isolates, which were isolated within the same institutions or in different medical centers. We conclude that the ability to characterize organisms phenotypically and genotypically is a powerful epidemiologic tool and it provides unique information that is very important for multicenter surveillance programs.

  9. 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.

  10. ESBL Detection: Comparison of a Commercially Available Chromogenic Test for Third Generation Cephalosporine Resistance and Automated Susceptibility Testing in Enterobactericeae

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    El-Jade, Mohamed Ramadan; Parcina, Marijo; Schmithausen, Ricarda Maria; Stein, Christoph; Meilaender, Alina; Hoerauf, Achim; Molitor, Ernst

    2016-01-01

    Rapid detection and reporting of third generation cephalosporine resistance (3GC-R) and of extended spectrum betalactamases in Enterobacteriaceae (ESBL-E) is a diagnostic and therapeutic priority to avoid inefficacy of the initial antibiotic regimen. In this study we evaluated a commercially available chromogenic screen for 3GC-R as a predictive and/or confirmatory test for ESBL and AmpC activity in clinical and veterinary Enterobacteriaceae isolates. The test was highly reliable in the prediction of cefotaxime and cefpodoxime resistance, but there was no correlation with ceftazidime and piperacillin/tazobactam minimal inhibitory concentrations. All human and porcine ESBL-E tested were detected with exception of one genetically positive but phenotypically negative isolate. By contrast, AmpC detection rates lay below 30%. Notably, exclusion of piperacillin/tazobactam resistant, 3GC susceptible K1+ Klebsiella isolates increased the sensitivity and specificity of the test for ESBL detection. Our data further imply that in regions with low prevalence of AmpC and K1 positive E. coli strains chromogenic testing for 3GC-R can substitute for more time consuming ESBL confirmative testing in E. coli isolates tested positive by Phoenix or VITEK2 ESBL screen. We, therefore, suggest a diagnostic algorithm that distinguishes 3GC-R screening from primary culture and species-dependent confirmatory ESBL testing by βLACTATM and discuss the implications of MIC distribution results on the choice of antibiotic regimen. PMID:27494134

  11. Characterization of Salmonella Gallinarum from an outbreak in Raigarh, Chhattisgarh

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    Chandrahas Sannat

    2017-02-01

    Full Text Available Aim: The present investigation was conducted to isolate and characterize Salmonella Gallinarum from an outbreak of fowl typhoid in layer birds. Materials and Methods: Clinically ill and dead layer birds from an outbreak were investigated. History, clinical signs, and postmortem lesions were suggestive of fowl typhoid. Postmortem samples including heart blood, intestinal contents, pieces of ovary, and liver were collected and processed immediately for bacterial culture, serotyping and antibiotic sensitivity tests. Isolates were further screened for the presence of extended spectrum beta lactamase (ESBL (blaTEM gene by polymerase chain reaction. Results: On the basis of cultural, staining and biochemical characteristics; three bacterial isolates were confirmed as S. Gallinarum. On serotyping, somatic antigen O: 9 and 12 with nonflagellated antigen were detected in all three isolates. Isolates were intermediate sensitive to amoxycillin, amoxyclav, gentamicin and ciprofloxacin and resistant to most of the antibiotics including chloramphenicol, ampicillin, ceftazidime, cefexime, cefepime, azithromycin, nalidixin, tetracycline, oxytetracycline, and streptomycin. Two isolates were found to harbor ESBL (blaTEM gene. Conclusion: Beta lactamase producer S. Gallinarum was confirmed as cause of increased mortality in layer birds during present investigation. Existence of multi drug resistant Salmonella poses serious threat to poultry industry in Chhattisgarh.

  12. Evaluation of the in vitro ocular toxicity of the fortified antibiotic eye drops prepared at the Hospital Pharmacy Departments.

    Science.gov (United States)

    Fernández-Ferreiro, Anxo; González-Barcia, Miguel; Gil-Martínez, María; Santiago Varela, María; Pardo, María; Blanco-Méndez, José; Piñeiro-Ces, Antonio; Lamas Díaz, María Jesús; Otero-Espinar, Francisco J

    2016-09-01

    The use of parenteral antibiotic eye drop formulations with non-marketed compositions or concentrations, commonly called fortified antibiotic eye drops, is a common practice in Ophthalmology in the hospital setting. The aim of this study was to evaluate the in vitro ocular toxicity of the main fortified antibiotic eye drops prepared in the Hospital Pharmacy Departments. We have conducted an in vitro experimental study in order to test the toxicity of gentamicin, amikacin, cefazolin, ceftazidime, vancomycin, colistimethate sodium and imipenem-cilastatin eye drops; their cytotoxicity and acute tissue irritation have been evaluated. Cell-based assays were performed on human stromal keratocytes, using a cell-based impedance biosensor system [xCELLigence Real-Time System Cell Analyzer (RTCA)], and the Hen's Egg Test for the ocular irritation tests. All the eye drops, except for vancomycin and imipenem, have shown a cytotoxic effect dependent on concentration and time; higher concentrations and longer exposure times will cause a steeper decline in the population of stromal keratocytes. Vancomycin showed a major initial cytotoxic effect, which was reverted over time; and imipenem appeared as a non-toxic compound for stromal cells. The eye drops with the highest irritating effect on the ocular surface were gentamicin and vancomycin. Those antibiotic eye drops prepared at the Hospital Pharmacy Departments included in this study were considered as compounds potentially cytotoxic for the ocular surface; this toxicity was dependent on the concentration used.

  13. 铜绿假单胞菌生物膜与亚抑菌浓度抗菌药物的相关研究%Effect of subinhibitory concentrations on formation of biofilm of Pseudomonas aeruginosa

    Institute of Scientific and Technical Information of China (English)

    李俊娟; 王强; 孙开宇; 蒋捍东

    2012-01-01

    OBJECTIVE To study the effects of the subinhibitory concentrations on the biofilm formation of Pseudomonas aeruginosa (PAE).- METHODS We first determined the minimal inhibitory concentration of azithromycin, amikacin, ciprofloxacin and ceftazidime of the PAE cultured in MHB and LB. We made the static biofilm model of P. aeruginosa in 96-well microtiter plates with the four antibiotics and medical silica gel with the azithromycin concentration, the OD value was determined with crystal violet staining microplate reader, and the biofilm was observed with silver staining microscope. RESULTS The MIC of azithromycin of PAE in MHB and LB were 512 mg/L and 16 mg/L, respectively; the MIC of amikacin, ciprofloxacin and ceftazidime of the PAE were 4 mg/L, 0. 125 mg/L and 4 mg/L, respectively; the results of the static-made biofilm were as follows: in the MHB and LB media, azithromycin could induce the biofilm formation of PAE at the subinhibitory concentration. Ciprofloxacin and ceftazidime could inhibit the biofilm formation at these concentrations. Amikacin could inhibit the biofilm formation at the concentration of 0. 25 to 4 mg/L (1/16MIC-MIC) , but could induce biofilm formation at the concentration of 0. 125 mg/L (1/16 MIC)in MHB; and when PAE was cultured in LB, amikacin could inhibit the biofilm formation at the concentration of 1 to 4 mg/L (1/4MIC-MIC) , and induce the biofilm formation at 0.25 mg/L(l/16MIC). All the results above had statistical differences compared with the control group. Silverstaining results: when the concentration of azithromycin was 8mg/L,the formation of the biofilm was the most, the second was the blank group and it was the least as the concentration was 256 mg/L. CONCLUSION The sensitivity of PAE planktonic bacteria to azithromycin varies in different culture condition; and the azithromycin may induce the biofilm formation at the subinhibitory concentration; ciprofloxacin and ceftazidime can inhibit the biofilm formation; the inhibitory of

  14. Metallo-β-lactamase and genetic diversity of Pseudomonas aeruginosa in intensive care units in Campo Grande, MS, Brazil

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    Ana Claudia Souza Rodrigues

    2011-06-01

    Full Text Available Infection by Pseudomonas aeruginosa has spread worldwide, with limited options for treatment. The purpose of this study was to investigate metallo-β-lactamase-producing P. aeruginosa strains and compare their genetic profile using samples collected from patients in intensive care units. Forty P. aeruginosa strains were isolated from two public hospitals in Campo Grande, Mato Grosso do Sul State, from January 1st, 2007 to June 31st, 2008. Profiles of antimicrobial susceptibility were determined using the agar diffusion method. Metallo-β-lactamase was investigated using the double-disk diffusion test and PCR. Molecular typing was performed by pulsed-field gel electrophoresis (PFGE. Respiratory and urinary tracts were the most common isolation sites. Of the 40 samples tested, 72.5% (29/40 were resistant to ceftazidime and 92.5% (37/40 to imipenem, whereas 65% (26/40 were resistant to both antimicrobials. Fifteen pan-resistant samples were found. Five percent (2/40 of samples were positive for metallo-β-lactamase on the phenotype test. No metallo-β-lactamase subtype was detected by PCR. Macrorestriction analysis revealed 14 distinct genetic patterns. Based on the superior accuracy of PCR, it can be inferred that P. aeruginosa isolates from the investigated hospitals have alternative mechanisms of carbapenem resistance. The results also suggest clonal spread of P. aeruginosa between the studied hospitals.

  15. Evaluation of the in vitro ocular toxicity of the fortified antibiotic eye drops prepared at the Hospital Pharmacy Departments

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    Anxo Fernández-Ferreiro

    2016-12-01

    Full Text Available The use of parenteral antibiotic eye drop formulations with non-marketed compositions or concentrations, commonly called fortified antibiotic eye drops, is a common practice in Ophthalmology in the hospital setting. The aim of this study was to evaluate the in vitro ocular toxicity of the main fortified antibiotic eye drops prepared in the Hospital Pharmacy Departments. We have conducted an in vitro experimental study in order to test the toxicity of gentamicin, amikacin, cefazolin, ceftazidime, vancomycin, colistimethate sodium and imipenem-cilastatin eye drops; their cytotoxicity and acute tissue irritation have been evaluated. Cell-based assays were performed on human stromal keratocytes, using a cell-based impedance biosensor system [xCELLigence Real-Time System Cell Analyzer (RTCA], and the Hen’s Egg Test for the ocular irritation tests. All the eye drops, except for vancomycin and imipenem, have shown a cytotoxic effect dependent on concentration and time; higher concentrations and longer exposure times will cause a steeper decline in the population of stromal keratocytes. Vancomycin showed a major initial cytotoxic effect, which was reverted over time; and imipenem appeared as a non-toxic compound for stromal cells. The eye drops with the highest irritating effect on the ocular surface were gentamicin and vancomycin. Those antibiotic eye drops prepared at the Hospital Pharmacy Departments included in this study were considered as compounds potentially cytotoxic for the ocular surface; this toxicity was dependent on the concentration used

  16. Isolation of Shiga toxin-producing Escherichia coli from raw milk in Kermanshah, Iran.

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    Pantea Mohammadi

    2013-09-01

    Full Text Available Infectious diarrhoeal diseases are great problem throughout the world and are responsible for considerable morbidity and mortality. Shiga toxin-producing Escherichia coli (STEC is a major cause of gastroenteritis that may be complicated by hemorrhagic colitis (HC or the hemolytic uremic syndrome (HUS, which is the main cause of acute renal failure in children. Food-borne outbreaks associated with Shiga toxin-producing Escherichia coli have been well documented worldwide. The aim of this study was to investigate the prevalence of Shiga toxin-producing Escherichia coli (STEC strains in raw milk samples.Raw milk samples collected from various cow farms in Kermanshah, Iran during June - September 2009 were investigated for STEC using PCR targeting stx1 and stx2 and then eaeA.Of 206 samples, 36 (17.47% were contaminated with STEC. STEC isolates harbored 56.41% and 43.59% stx 2 and stx 1 gene respectively. In antibiotic resistance test, all strains were sensitive to ceftazidime, cefepime, gentamicin, imipenem and ciprofloxacin. 23.08% of isolates were resistat to tetracycline, and 38.5% of them showed intermediate sensitvity to cephalothin.The high presence of STEC in raw milk confirms the important role of raw milk as putative vehicle of infection to human. Moreover, this study suggests that the development of antibiotic resistant STEC must be a major concern in Iran and more studies are needed to identify the prevalence of STEC in other food samples.

  17. PREVALENCE & ANTIBACTERIAL RESISTANCE OF ESBLs AMONG PREGNANT WOMEN WITH UTI

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    B. N. Selvakumar

    2011-11-01

    Full Text Available Urinary tract infection (UTI remains the common infections diagnosed in outpatients as well as in hospitalized patients. Worldwide data show that there is an increasing resistance among urinary tract pathogens to conventional drugs. Extended spectrum beta lactamases (ESBL hydrolyse expanded spectrum cephalosporins like ceftazidime, cephotaxime which are used in the treatment of UTI. ESBL-producers are not easily detected by the routine disk diffusion susceptibility test, and this result in the failure of treatments due to inappropriate use of antibiotics. No information on ESBL producing organisms causing UTI is available from Tiruchirappalli, Tamil Nadu.Urinary isolates from symptomatic UTI cases attending or admitted to a hospital in Tiruchirappalli were identified by conventional methods. Antimicrobial susceptibility testing was done by Kirby Bauer’s disc diffusion method. Isolates resistant to cephotaxime were tested for ESBL production by double disc synergy test method.Of the 936 isolates, 236 (25.2% were found to be ESBL producers. In the present study, a large number of uropathogens were found to be ESBL producers. Most of the ESBL producing isolates were multidrug resistant. Careful detection of ESBL production and antimicrobial susceptibility testing are necessary to avoid treatment failure in patients with UTI.

  18. Evaluation of the appropriate perioperative antibiotic prophylaxis in Italy.

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    Francesco Napolitano

    Full Text Available BACKGROUND: The appropriate use of antibiotics prophylaxis in the prevention and reduction in the incidence of surgical site infection is widespread. This study evaluates the appropriateness of the prescription of antibiotics prophylaxis prior to surgery amongst hospitalized patients in the geographic area of Avellino, Caserta, and Naples (Italy and the factors associated with a poor adherence. METHODS: A sample of 382 patients admitted to 23 surgical wards and undergoing surgery in five hospitals were randomly selected. RESULTS: Perioperative antibiotic prophylaxis was appropriate in 18.1% of cases. The multivariate logistic regression analysis showed that patients with hypoalbuminemia, with a clinical infection, with a wound clean were more likely to receive an appropriate antibiotic prophylaxis. Compared with patients with an American Society of Anesthesiologists (ASA score ≥4, those with a score of 2 were correlated with a 64% reduction in the odds of having an appropriate prophylaxis. The appropriateness of the timing of prophylactic antibiotic administration was observed in 53.4% of the procedures. Multivariate logistic regression model showed that such appropriateness was more frequent in older patients, in those admitted in general surgery wards, in those not having been underwent an endoscopic surgery, in those with a higher length of surgery, and in patients with ASA score 1 when a score ≥4 was chosen as the reference category. The most common antibiotics used inappropriately were ceftazidime, sultamicillin, levofloxacin, and teicoplanin. CONCLUSIONS: Educational interventions are needed to improve perioperative appropriate antibiotic prophylaxis.

  19. Development and validation of a reversed-phase column liquid chromatographic method for the determination of five cephalosporins in pharmaceutical preparations.

    Science.gov (United States)

    Elkady, Ehab F; Abbas, Samah S

    2011-01-01

    A new, simple, rapid, and precise RP-HPLC method has been developed and validated for the determination of five cephalosporins, namely, cefalexin, cefoperazone, ceftriaxone, ceftazidime, and cefepime. The method has been applied successfully for simultaneous determination of cefalexin in a binary mixture with sodium benzoate in a suspension, and cefoperazone in a binary mixture with sulbactam in vials. Chromatographic separation was achieved on a Waters microBondapak C18 column (250 x 4.6 mm id, 10 pm particle size) using the mobile phase monobasic potassium phosphate (50 mM, pH 4.6)-acetonitrile (80 + 20, v/v) with UV detection. A flow rate of 1 mL/min was applied. Linearity, accuracy, and precision were found to be acceptable over the concentration range of 30-300, 3-30, and 15-120 microg/mL for the studied cephalosporins, sodium benzoate, and sulbactam, respectively. The optimized method proved to be specific, robust, and accurate for QC of the cited drugs in their pharmaceutical preparations.

  20. PREVALENCE OF RESPIRATORY PATHOGENS IN VENTILATED PATIENTS: A STUDY FROM SOUTH INDIA

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    Jacob

    2014-04-01

    Full Text Available OBJECTIVE: To assess the bacterial profile of endotracheal (ET tube aspirates in ventilated patients and to know their drug sensitivity pattern. SETTING: A tertiary care teaching facility situated in Kerala, South India. All patients were on ventilator in the medical, surgical, trauma or neuro intensive care units of the hospital. Isolation of the organisms was done by inoculation of sample on agar medium, and after 24 hours of incubation each organism was identified. Antibiotic sensitivity testing was carried out by Disc Diffusion Method. The results were analyzed. RESULTS: A predominance of multi drug resistant (MDR gram negative microbes is evident in this analysis of endotracheal sample cultures. Of the 434 samples inoculated, 145 Acinetobacter, 100 pseudomonas aeruginosa and 92 klebsiella pneumonia were isolated. These lethal strains needed high end antibiotics mostly Inj. Colistin for their eradication. Prevention of pneumonia in ventilated patients is of paramount importance for obvious reasons. CONCLUSIONS: For these 3 major microbes mentioned, colistin was the best bet, and all 3 were uniformly resistant to ceftazidime and aminoglycosides. Piperacillin / tazobactam combination holds some promise in case of E.coli, non- fermenting Gram Negative Bacilli and Serratia. Staphylococcus aureus was 45% sensitive to cloxacillin. The remaining resistant (MRSA strains were sensitive to vancomycin and linezolid.

  1. CHARACTERISATION OF BACTERIAL ISOLATES FROM INFECTE D BURN WOUNDS OF PATIENTS ADMITTED IN A TERTIARY LEVEL HEA LTH CARE FACILITY IN NORTHERN REGION OF INDIA

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    Antariksh

    2013-04-01

    Full Text Available ABSTRACT: Infection is an important cause of mortality in bur ns. Emergence of multi drug resistant pathogens in hospital setting has seriously constrained the available therapeutic options. This necessitates periodic review of the iso lation pattern and study of antibiogram of the isolates to strengthen surveillance activities. To determine the bacteriological profile and antimic robial susceptibility pattern of pathogens isolated from infected burn wounds of pati ents admitted in the burns care unit. The present study was carried out over a duration of six months. Pus samples from infected burn wounds were processed following standard protocols. A ntimicrobial susceptibility of the bacterial isolates was performed by Kirby- Bauer dis c diffusion method. A total of 408 bacterial pathogens were isolated from 340 samples. The most fr equent cause of infection was found to be Pseudomonas aeruginosa (53%, followed by Staphyl ococcus aureus (9%, Escherichia coli (9%, Enterobacter spp. (8%, Citrobacter spp. (8%, Kl ebsiella spp. (5%, Acinetobacter spp. (3% and Proteus spp. (3%. High level of drug resist ance (95-100% was observed for cefepime, ceftazidime, amoxyclav, cotrimoxazole and doxycycline among gram negative pathogens. Meropenem, amikacin and ciprofloxacin were found to be most effective. Twenty one percent of the S. aureus isolates were resistant to methicillin. The high prevalence of antimicrobial resistance emphasizes the need for str engthening the infection control practices and regular and periodical surveillance activities t o contain the upward trend of resistance.

  2. Pathogenic effects of biofilm with chronic pseudomonas aeruginosa lung infection in rats

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    Ping Yan; Yiqiang Chen; Zhijun Song; Hong Wu; Jinliang Kong; Xuejun Qin

    2008-01-01

    Objective: To establish an animal model of P.aeruginosa biofilm associated with chronic pulmonary infection and investigate the pathogenic effects of biofilm. Methods: Experiments in vitro, measuring the MICS, MBCS of ievofloxacin(LFX), ceftazidime(CAZ) in PAO579 in alginate beads and planktonic PAO579. Rats were challenged with 0.1 ml of PAO579(109CFU/ml) in alginate beads or 0.1 ml of planktonic PAO579(109CFU/ml), 3,7,14 days after challenging, bacteriological, pathological features were observed. Results: The MICS, MBCS of LFX, CAZ in PAO579 in alginate beads were higher than those in planktonic PAO579 in vitro. CFU/lung in alginate beads group was significantly higher than that in planktonic bacteria group(P = 0.002, P =0.004, P = 0.002, respectively); macroscopic lung pathology and the inflammation in alginate beads group were significantly more severe compared to those in planktonic bacteria group in vivo. Conclusion: P.aeruginosa biofilm protected bacterium from killing of antibiotics and might mediate the host immune damage in the lung tissue and made bacterium evade the host immune defense.

  3. Multidrug Resistance of Acinetobacter Baumannii in Ladoke Akintola University Teaching Hospital, Osogbo, Nigeria

    Science.gov (United States)

    Odewale, G.; Adefioye, O. J.; Ojo, J.; Adewumi, F. A.; Olowe, O. A.

    2016-01-01

    Acinetobacter baumannii is a ubiquitous pathogen that has emerged as a major cause of healthcare-associated infections at Ladoke Akintola University Teaching Hospital. Isolates were assayed according to standard protocol. The isolates were subjected to molecular techniques to detect blaOXA, blaTEM, blaCTX-M, and blaSHV genes in strains of the A. baumannii isolates. The prevalence of A. baumannii was 8.5% and was most prevalent among patients in the age group 51–60 (36%); the male patients (63.6%) were more infected than their female counterparts. Patients (72.7%) in the intensive care unit (ICU) were most infected with this organism. The isolates showed 100% resistance to both amikacin and ciprofloxacin and 90.9% to both ceftriaxone and ceftazidime, while resistance to the other antibiotics used in this study were: piperacillin (81.8%), imipenem (72.7%), gentamycin (72.2%), and meropenem (63.6%). None of the isolates was, however, resistant to colistin. PCR results showed that blaOXA, blaTEM, and blaCTX-M genes were positive in some isolates, while blaSHV was not detected in any of the isolates. This study has revealed that the strains of A. baumannii isolated are multiple drug resistant. Regular monitoring, judicious prescription, and early detection of resistance to these antibiotics are, therefore, necessary to check further dissemination of the organism. PMID:27766173

  4. Clinical features and treatment of endophthalmitis after cataract surgery.

    Science.gov (United States)

    Zhu, J; Li, Z H

    2015-06-18

    The aim of this study was to investigate the clinical features and treatment results of endophthalmitis after cataract surgery. Five patients with endophthalmitis after phacoemulsification with intraocular lens implantation were enrolled in this study. The pathogenesis, clinical manifestation, and surgical outcomes of 5 patients were compared. Three patients were surgically treated with anterior chamber irrigation and vitrectomy with intravitreal injection. The remaining two patients were medically treated with an intravitreal injection of vancomycin and ceftazidime. Treatment results of the five patients were analyzed. Four patients had positive cultures for bacteria (two cases Staphylococcus epidermidis, one case Enterococcus faecalis, and one case head-like Staphylococcus). The culture of the fifth patient did not have bacterial growth. One year following treatment, four patients had restored visual acuity and a clear vitreous cavity. Retinal detachment and other complications were not observed. The remaining patient had a visual acuity of index at 30 cm one year following treatment. For patients with endophthalmitis after cataract surgery, a biochemical laboratory examination should be promptly performed and should include a bacterial culture and drug sensitivity test. When necessary, vitrectomy combined with an intravitreal injection of vancomycin should be performed to treat the infection early and to help retain useful vision.

  5. In vitro drug resistance of clinical isolated Brucella against antimicrobial agents

    Institute of Scientific and Technical Information of China (English)

    Xiu-Li Xu; Xiao Chen; Pei-Hong Yang; Jia-Yun Liu; Xiao-Ke Hao

    2013-01-01

    Objective:To explore the antibiotic resistance of Brucella melitensisand instruct rational use of antimicrobial agents in clinical treatment ofBrucella infection.Methods:Bacteria were cultured and identified byBACTEC9120 andVITEKⅡ automicrobic system.E-test was used to detect the minimal inhibitory concentration(MIC) of antimicrobial agents in the drug susceptivity experiment.Results:A total of19 brucella strains(allBrucella melitensis) wereisolated from19 patients, who had fever betweenJanuary2010 andJune2012, and17 samples were blood, one was bone marrow, the other sample was cerebrospinal fluid.TheMIC range of ceftazidime was2.0-8.0 mg/L, rifampicin was0.06-2.0 mg/L, amikacin was4.0-12.0 mg/L, levofloxacin was2.0-8.0 mg/L, doxycycline was8.0-32.0 mg/L, sulfamethoxazole-trimethoprim was4.0-16.0 mg/L, ampicillin was1.5-2.0 mg/L and gentamicin was0.50-0.75 mg/L.Conclusions:The drugs used in this experiment cover common drugs for treatingBrcella.Meanwhile, the results are consistent with clinical efficacy.It is suggested personalized regimen according to patients’ status in treatment of Brucella.

  6. Antibiotic sensitivity of escherichia coli isolated from urinary tract infection referred to Kermanshah central laboratory

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    Parviz Mohajeri

    2011-03-01

    Full Text Available Background: Escherichia coli (Ecoli has been considered as the most common agent of urinary tract infection in all regions. Recently, increased drug resistance has been lead to some problems in treatment related diseases. So, evaluation of resistance patterns of bacteria in each region could be a valuable guide for empirical treatment.Methods: All referred urine sample to Kermanshah Central Laboratory during 1998 that was reported positive to Ecoli were assessed. Susceptibility pattern to 19 antimicrobial agents was evaluated using Kirby Bauer method according to CLSI standards.Results: A total of 834 Ecoli isolated from 19,208 positive urine cultures. 84% of subjects were females and 16% males. Sensitivity rate for nitrofurantoin (84%, ceftizoxime (72%, norfloxacin (70%, cefotaxime (69%, Amikacin (66%, ciprofloxacin (65%, ceftriaxone (64%, ceftazidim (55% was higher than 50%. Sensitivity to nalidixic acid, cefexime, gentamicin, co-trimoxazole, ticarcillin, caphalexin, cephalotin, tetracycline, amoxicillin, amoxicillin clavulanate and ampicillin were determined less than 50%.Conclusion: Nitrofurantoin and ceftizoxime are currently effective against Ecoli, although an indiscriminate use of antibiotics should be avoided because of drug resistance probable. It seems that ampicillin could be excluded from routine sensitivity testing.

  7. Biological features of biofilm-forming ability of Acinetobacter baumannii strains derived from 121 elderly patients with hospital-acquired pneumonia.

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    Zhang, Duchao; Xia, Jingjing; Xu, Yaping; Gong, Meiliang; Zhou, Yu; Xie, Lixin; Fang, Xiangqun

    2016-02-01

    This study is to investigate a biological activity of Acinetobacter baumannii isolates from sputum specimens of 121 elderly patients with hospital-acquired pneumonia. The ability of the isolates to form biofilms was quantitatively assessed by crystal violet staining, and adhesive property was examined using Giemsa staining. Biofilm-forming ability by the isolates was employed to test antimicrobial resistance and examine sources and clinical manifestations. The isolates grew as biofilm on abiotic surface at the indicated temperatures after a 48 h of incubation. 27.3 % of the isolates were strongly biofilm-positive in the samples, and 84.8 % displayed high adhesion ability (P < 0.05). All of the isolates showed antibiotic resistance at different levels, and the isolates produced strong biofilm exhibited low-level resistance to gentamicin, minocycline and ceftazidime (P < 0.05). The patients' experience in ICU, use of antibiotics and estimation of APACHE II (<17) were related to incidence of strong biofilm formation with no clinical manifestations found in the study. All clinical isolates are able to form biofilms which refer to adhesive efficiency and antibiotic resistance. Patient experiences in ICU surveillance, use of antibiotics and APACHE II scores are involved in biofilm-forming ability by the nosocomial pathogen derived from the hospitalized patients.

  8. Antimicrobial Susceptibility and Genetic Characterisation of Burkholderia pseudomallei Isolated from Malaysian Patients

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    Yalda Khosravi

    2014-01-01

    Full Text Available Burkholderia pseudomallei, the causative agent of melioidosis, is intrinsically resistant to many antibiotics. Ceftazidime (CAZ, the synthetic β-lactam, is normally used as the first-line antibiotic therapy for treatment of melioidosis. However, acquired CAZ resistance can develop in vivo during treatment with CAZ, leading to mortality if therapy is not switched to a different antibiotic(s in a timely manner. In this study, susceptibilities of 81 B. pseudomallei isolates to nine different antimicrobial agents were determined using the disk diffusion method, broth microdilution test and Etest. Highest percentage of susceptibility was demonstrated to CAZ, amoxicillin/clavulanic acid, meropenem, imipenem, and trimethoprim/sulfamethoxazole. Although these drugs demonstrated the highest percentage of susceptibility in B. pseudomallei, the overall results underline the importance of the emergence of resistance in this organism. PCR results showed that, of the 81 B. pseudomallei, six multidrug resistant (MDR isolates carried bpeB, amrB, and BPSS1119 and penA genes. Genotyping of the isolates using random amplified polymorphic DNA analysis showed six different PCR fingerprinting patterns generated from the six MDR isolates clusters (A and eight PCR fingerprinting patterns generated for the remaining 75 non-MDR isolates clusters (B.

  9. Class I Integron and β-lactamase encoding genes of multidrug resistance Salmonella isolated from pigeons and their environments.

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    Yousef, S; Mamdouh, R

    2016-12-30

    Seroprevalence of Salmonella spp. was investigated in pigeon and its surrounding environment of Sharkia province, Egypt. Samples were randomly collected from fifty freshly dead squabs, forty freshly dead adults pigeons, sixty diseased adult pigeons and 100 apparently healthy adult pigeons. Bacterial isolates were tested for their susceptibility to 17 different antimicrobial discs, by using the disc diffusion method. The bacterial isolates were tested for Class I and β-lactamase encoding genes by using PCR. In vitro sensitivity of all Salmonella isolates were completely resistant to Streptomycin, Amoxicillin, clavulanic acid, Amoxicillin, Ampicillin and Ceftazidime (100%). Class1 integron were characterized in 70% Salmonella isolates from squabs, 42.9 % in adult pigeons and 14.3% in pigeon environment which confer their resistance to streptomycin and ampicillin. Meanwhile TEM-1 β-lactamase was characterized in 20% of tested Salmonella isolates from squabs including S. Entertidis, 42.9% of tested Salmonella isolates from adult pigeons including S. Entertidis which confer their resistance to cephalosporin and not detected in all isolates from pigeons environments. In conclusion TEM-1 β-lactamase was characterized in 20% of Salmonella isolates from squabs while Class1 integron was characterized in 70% Salmonella isolates from squabs.

  10. Characterization of Salmonella Gallinarum from an outbreak in Raigarh, Chhattisgarh

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    Sannat, Chandrahas; Patyal, Anil; Rawat, Nidhi; Ghosh, R. C.; Jolhe, D. K.; Shende, R. K.; Hirpurkar, S. D.; Shakya, Sanjay

    2017-01-01

    Aim: The present investigation was conducted to isolate and characterize Salmonella Gallinarum from an outbreak of fowl typhoid in layer birds. Materials and Methods: Clinically ill and dead layer birds from an outbreak were investigated. History, clinical signs, and postmortem lesions were suggestive of fowl typhoid. Postmortem samples including heart blood, intestinal contents, pieces of ovary, and liver were collected and processed immediately for bacterial culture, serotyping and antibiotic sensitivity tests. Isolates were further screened for the presence of extended spectrum beta lactamase (ESBL) (blaTEM) gene by polymerase chain reaction. Results: On the basis of cultural, staining and biochemical characteristics; three bacterial isolates were confirmed as S. Gallinarum. On serotyping, somatic antigen O: 9 and 12 with nonflagellated antigen were detected in all three isolates. Isolates were intermediate sensitive to amoxycillin, amoxyclav, gentamicin and ciprofloxacin and resistant to most of the antibiotics including chloramphenicol, ampicillin, ceftazidime, cefexime, cefepime, azithromycin, nalidixin, tetracycline, oxytetracycline, and streptomycin. Two isolates were found to harbor ESBL (blaTEM) gene. Conclusion: Beta lactamase producer S. Gallinarum was confirmed as cause of increased mortality in layer birds during present investigation. Existence of multi drug resistant Salmonella poses serious threat to poultry industry in Chhattisgarh. PMID:28344395

  11. Antimicrobial Resistant Pattern of Escherichia Coli Strains Isolated from Pediatric Patients in Jordan

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    Mohammad Alshara

    2011-05-01

    Full Text Available The present study was conducted to investigate antimicrobial resistant pattern of Escherichia coli (E. coli strains isolated from clinical specimens of Jordanian pediatric patients during the period from January to December 2008. A total of 444 E. coli strains were isolated from clinical specimens and tested for their susceptibility to different antimicrobial drugs. Overall, high resistance rate was observed for ampicillin (84%, followed by amoxicillin-clavulanic acid (74.3%, cotrimoxazole (71%, nalidixic acid (47.3%, cephalothin (41%. Lower resistance rates were observed for amikacin (0% followed by Cefotaxime (11%, Ceftriaxone (11.7%, ciprofloxacin (14.5%, Norfloxacin (16.5%, gentamicin (17.3% cephalexin (20.9%, Ceftazidime (22.5%, cefixime (29.6%, and cefaclor (32.8%. Ampicillin, amoxicillin-clavulanic acid and cotrimoxazole were found to be ineffective at in vitro inhibition of the E. coli of pediatric origin. Amikacin was highly effective for E. coli with susceptibility rate of 100%. The majority of E. coli strains were susceptible to third generation cephalosporins and fluoroquinolones.

  12. 联合使用抗菌药物对产KPC-2酶肺炎克雷伯菌的影响%Efficacy of synergistic antibiotic combinations against KPC-2 carbapenemase producing Klebsiella pneumoniae strains

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    杨青; 邹燕萍; 单志明; 魏泽庆; 沈萍; 孔海深; 俞云松

    2011-01-01

    Objective To investigate the synergistic efficacy of different antibiotic combinations against KPC-2 carbapenemase producing Klebsiella pneumoniae strains in vitro and search for effective antibiotic combination.Methods During 2008 - 2009,a total of 24 strains of K.pneumoniae producing KPC-2 carbapenemase were collected from 8 hospitals in the First Affiliated Hospital of Medical School of Zhejiang University,Ningbo LiHuiLi Hospital,Zhejiang People's Hospital,Hangzhou Third Hospital,the Second Hospital of Shaoxing,Hangzhou First Hospital,Fudan University Huashan Hospital,General Hospital of Nanjing Military Region.MLST technique was used for epidemiological analysis.The MIC of antibiotics,such as amikacin,minocycline,imipenem,amoxicillin/clavulanic-acid,ceftazidime,meropenem,gentamicin,cefoxitin,cefepime,rifampicin,polymyxinB,ciprofloxacin were determined by an agar dilution method,the MIC of tigecycline and piperacillin/tazobactain were determined by Etest.The antibacterial activities of cefepime in combination with amoxicillin/clavulanic-acid,amikacin,or ciprofloxacin,amikacin with ciprofloxacin,imipenem with amikacin,ciprofloxacin,polymyxinB,or minocycline,polymyxin B with rifampicin,ceftazidime with amoxicillin/clavulanic-acid were assessed by chequerboard synergy agar dilution tests against all the isolates.Results MLST showed 5 STs among 24 strains of KPC-2 carbapenemase producing K.pneumoniae,and the most prevalent clone was ST11 (15 strains).All isolates were susceptible to polymyxin B and tigecycline,and the resistance rate of minocycline was 4.2%.The synergetic effects were observed in cefepime-amoxicillin/clavulanic acid,imipenem-amikacin,ceftazidime-amoxicillin/clavulanic acid combinations as 19 isolates,13 isolates,and 13 isolates,respectively.Conclusions KPC-2 carbapenemase producing K.pneumoniae is sensitive to polymyxin B,tigecycline and minocycline.The synergetic effect is predominant in cefepime-amoxicillin/clavulanic acid

  13. 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.

  14. First Report of Group CTX-M-9 Extended Spectrum Beta-Lactamases in Escherichia coli Isolates from Pediatric Patients in Mexico

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    Merida-Vieyra, Jocelin; De Colsa, Agustin; Calderon Castañeda, Yair; Arzate Barbosa, Patricia; Aquino Andrade, Alejandra

    2016-01-01

    The aim of this study was to identify the presence of group CTX-M-9 extended spectrum beta-lactamases (ESBL) in clinical Escherichia coli isolates from pediatric patients. A total of 404 non-repeated positive ESBL E. coli isolates were collected from documented clinical infections in pediatric patients over a 2-year period. The identification and susceptibility profiles were determined using an automated system. Isolates that suggested ESBL production based on their resistance profiles to third and fourth generation cephalosporin and monobactam were selected. ESBL production was phenotypically confirmed using a diffusion method with cefotaxime and ceftazidime discs alone and in combination with clavulanic acid. blaESBL gene identification was performed through PCR amplification and sequencing. Pulsed Field Gel Electrophoresis (PFGE) and Multilocus Sequence Typing (MLST) were performed to establish the clonal relationships of the E. coli isolates. CTX-M-9-type ESBLs were detected in 2.5% of the isolates. The subtypes corresponded to blaCTX-M-14 (n = 4) and blaCTX-M-27 (n = 6). Additionally, coexistence with other beta-lactamases was observed. A clonal relationship was established in three isolates; the rest were classified as non-related. We found seven different sequence type (ST) in CTX-M-9- producing E. coli isolates. ST38 was the most frequent. This study is the first report in Mexico to document the presence of group CTX-M-9 ESBLs in E. coli isolates from pediatric patients. PMID:27992527

  15. ESBL Detection: Comparison of a Commercially Available Chromogenic Test for Third Generation Cephalosporine Resistance and Automated Susceptibility Testing in Enterobactericeae.

    Science.gov (United States)

    El-Jade, Mohamed Ramadan; Parcina, Marijo; Schmithausen, Ricarda Maria; Stein, Christoph; Meilaender, Alina; Hoerauf, Achim; Molitor, Ernst; Bekeredjian-Ding, Isabelle

    2016-01-01

    Rapid detection and reporting of third generation cephalosporine resistance (3GC-R) and of extended spectrum betalactamases in Enterobacteriaceae (ESBL-E) is a diagnostic and therapeutic priority to avoid inefficacy of the initial antibiotic regimen. In this study we evaluated a commercially available chromogenic screen for 3GC-R as a predictive and/or confirmatory test for ESBL and AmpC activity in clinical and veterinary Enterobacteriaceae isolates. The test was highly reliable in the prediction of cefotaxime and cefpodoxime resistance, but there was no correlation with ceftazidime and piperacillin/tazobactam minimal inhibitory concentrations. All human and porcine ESBL-E tested were detected with exception of one genetically positive but phenotypically negative isolate. By contrast, AmpC detection rates lay below 30%. Notably, exclusion of piperacillin/tazobactam resistant, 3GC susceptible K1+ Klebsiella isolates increased the sensitivity and specificity of the test for ESBL detection. Our data further imply that in regions with low prevalence of AmpC and K1 positive E. coli strains chromogenic testing for 3GC-R can substitute for more time consuming ESBL confirmative testing in E. coli isolates tested positive by Phoenix or VITEK2 ESBL screen. We, therefore, suggest a diagnostic algorithm that distinguishes 3GC-R screening from primary culture and species-dependent confirmatory ESBL testing by βLACTATM and discuss the implications of MIC distribution results on the choice of antibiotic regimen.

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

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

    2015-10-05

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

  17. [Extended-spectrum-beta-lactamase-producing Proteus mirabilis: laboratory-based surveillance in cooperation with 12 clinical laboratories in the Kinki Region of Japan].

    Science.gov (United States)

    Nakamura, Tatsuya; Komatsu, Masaru; Shimakawa, Kouichi; Sueyoshi, Noriyuki; Satoh, Kaori; Toyokawa, Masahiro; Nishio, Hisaaki; Wada, Yasunao; Orita, Tamaki; Kofuku, Tomomi; Sakamoto, Masako; Okamoto, Kiyotaka; Akagi, Masahiro; Kinoshita, Shohiro

    2006-05-01

    We studied 247 strains of Proteus mirabilis collected during the 6 months from November 2003 to April 2004 from 12 clinical laboratories in the Kinki region of Japan for the production of extended-spectrum beta-lactamase (ESBL). Eighteen strains (7.3%) showed MICs for cefpodoxime of > or = 2 microg/mL and 13 strains (5.2%) were positive for the double-disk synergy test. Susceptibility depended on genotype. MICs for cefepime, cefozopran, and cefpirome were high (> or = 8 microg/mL), and that for ceftazidime was low (0.12-0.5 microg/mL). Meropenem showed the lowest MIC (ESBL genotype by the polymerase chain reaction showed that 12 of 13 strains were CTX-M2 types. CTX-M9 was detected in a single laboratory. The clinical background showed 5 strains in urine samples. Twelve of 13 strains were detected in patients with minimal devices use. No symptoms were found in most cases of established syndrome. Analysis of PCR fingerprint profiles of random amplified polymorphic DNA patterns showed that 6 of 7 strains from hospital 1 showed the same pattern, and 5 of 5 strains from hospital 13 showed the same pattern, suggesting the nosocomial spread of P. mirabilis in each hospital.

  18. Mechanism of resistance and antibacterial susceptibility in extended-spectrum β-lactamase phenotype Klebsiella pneumoniae and Klebsiella oxytoca isolated between 2000 and 2010 in Japan.

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    Sato, Takafumi; Hara, Takafumi; Horiyama, Tsukasa; Kanazawa, Sachi; Yamaguchi, Takahiro; Maki, Hideki

    2015-05-01

    Clinical isolates of Klebsiella pneumoniae and Klebsiella oxytoca collected from 20 Japanese medical facilities between 2000 and 2010 were analysed to evaluate the mechanisms of resistance and antibacterial susceptibilities to 14 antimicrobials. Overall, eight of 484 (1.6%) K. pneumoniae and 19 of 359 (5.3%) K. oxytoca were determined to be extended-spectrum β-lactamase (ESBL) phenotype isolates, and the identified ESBLs amongst the K. pneumoniae isolates were CTX-M-2, -3, -14 and -15, and SHV-12. In contrast, overproduction of chromosomal β-lactamase OXY-2, which was due to a distinct mutation at the - 10 promoter region of this gene, conferred the ESBL phenotype to all the K. oxytoca isolates except one. Based on the Clinical and Laboratory Standards Institute breakpoints, all the ESBL phenotype K. pneumoniae were susceptible to doripenem, flomoxef, moxalactam (latamoxef), cefmetazole and tazobactam/piperacillin, whereas the ESBL phenotype K. oxytoca were susceptible to ceftazidime and ceftibuten in addition to the above, with the exception of tazobactam/piperacillin. Amongst the oral antimicrobials, ceftibuten was relatively effective against both ESBL phenotype Klebsiella species compared with levofloxacin and amoxicillin/clavulanic acid.

  19. Hospital clonal dissemination of Enterobacter aerogenes producing carbapenemase KPC-2 in a Chinese teaching hospital.

    Science.gov (United States)

    Qin, Xiaohua; Yang, Yang; Hu, Fupin; Zhu, Demei

    2014-02-01

    Carbapenems are first-line agents for the treatment of serious nosocomial infections caused by multidrug-resistant Enterobacteriaceae. However, resistance to carbapenems has increased dramatically among Enterobacteriaceae in our hospital. In this study, we report clonal dissemination caused by carbapenem-resistant Enterobacter aerogenes (CREA). In 2011, CREA was identified from 12 patients admitted to the neurosurgical ward. All 12 clinical isolates were non-susceptible to cefotaxime, ceftazidime, cefoxitin, ertapenem, imipenem or meropenem. All isolates carried the gene encoding Klebsiella pneumoniae carbapenemase-2 (KPC-2), except for the isolate E4. However, a remarkably lower expression level of the porin OmpF was detected in the non-KPC-2-producing isolate E4 on SDS-PAGE compared with the carbapenem-susceptible isolate. Epidemiological and molecular investigations showed that a single E. aerogenes strain (PFGE type A), including seven KPC-2-producing clinical isolates, was primarily responsible for the first isolation and subsequent dissemination. In a case-control study, we identified risk factors for infection/colonization with CREA. Mechanical ventilation, the changing of sickbeds and previous use of broad-spectrum antibiotics were identified as potential risk factors. Our findings suggest that further studies should focus on judicious use of available antibiotics, implementation of active antibiotic resistance surveillance and strict implementation of infection-control measures to avoid the rapid spread or clonal dissemination caused by carbapenem-resistant Enterobacteriaceae in healthcare facilities.

  20. Antimicrobial susceptibility patterns among bacteria isolated from intensive care units of the largest teaching hospital at the northwest of Iran

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    Hadi Hamishehkar

    Full Text Available ABSTRACT This study was conducted to determine the antimicrobial susceptibility patterns among common pathogens in the intensive care units (ICUs of a university hospital in northwestern Iran. A retrospective study was done on laboratory records of patients with nosocomial infection who were admitted to five ICUs of Imam Reza Hospital during a 21-month period from March 2010 to January, 2012. A total number of 556 isolates from 328 patients were evaluated. The most common sites of infections included respiratory (51.7%, urinary (24.8%, and blood (10.4%. The most frequently isolated microorganisms were Enterobacter aerogenes (50.6% followed by Escherichia coli (16.7% and Pseudomonas aeruginosa (7.5%. Staphylococcus aureus was the most frequent pathogen among gram-positives (39.7%. The rate of methicillin-resistant Staphylococcus aureus (MRSA was 87.5%. Multidrug-resistant (MDR gram-negative bacteria were documented in 25.8% of Acinetobacter, 20% of Klebsiella, and 16.6% of Pseudomonas. The most active antimicrobials were vancomycin (93.5% followed by amikacin (71.5% and gentamicin (46%. The overall antibiotic susceptibility was as follows: 36% ciprofloxacin, 19% imipenem, 20% trimethoprim-sulfamethoxazole, 20.5% ceftazidime, and 12% ceftriaxone. Due to the high rate of antimicrobial resistance in the ICU setting, more surveillance and control of the use of antimicrobials is needed to combat infections.

  1. Role of novel multidrug efflux pump involved in drug resistance in Klebsiella pneumoniae.

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    Vijaya Bharathi Srinivasan

    Full Text Available BACKGROUND: Multidrug resistant Klebsiella pneumoniae have caused major therapeutic problems worldwide due to the emergence of the extended-spectrum β-lactamase producing strains. Although there are >10 major facilitator super family (MFS efflux pumps annotated in the genome sequence of the K. pneumoniae bacillus, apparently less is known about their physiological relevance. PRINCIPAL FINDINGS: Insertional inactivation of kpnGH resulting in increased susceptibility to antibiotics such as azithromycin, ceftazidime, ciprofloxacin, ertapenem, erythromycin, gentamicin, imipenem, ticarcillin, norfloxacin, polymyxin-B, piperacillin, spectinomycin, tobramycin and streptomycin, including dyes and detergents such as ethidium bromide, acriflavine, deoxycholate, sodium dodecyl sulphate, and disinfectants benzalkonium chloride, chlorhexidine and triclosan signifies the wide substrate specificity of the transporter in K. pneumoniae. Growth inactivation and direct fluorimetric efflux assays provide evidence that kpnGH mediates antimicrobial resistance by active extrusion in K. pneumoniae. The kpnGH isogenic mutant displayed decreased tolerance to cell envelope stressors emphasizing its added role in K. pneumoniae physiology. CONCLUSIONS AND SIGNIFICANCE: The MFS efflux pump KpnGH involves in crucial physiological functions besides being an intrinsic resistance determinant in K. pneumoniae.

  2. Ceftolozane/tazobactam: a novel cephalosporin/β-lactamase inhibitor combination with activity against multidrug-resistant gram-negative bacilli.

    Science.gov (United States)

    Zhanel, George G; Chung, Phillip; Adam, Heather; Zelenitsky, Sheryl; Denisuik, Andrew; Schweizer, Frank; Lagacé-Wiens, Philippe R S; Rubinstein, Ethan; Gin, Alfred S; Walkty, Andrew; Hoban, Daryl J; Lynch, Joseph P; Karlowsky, James A

    2014-01-01

    Ceftolozane is a novel cephalosporin currently being developed with the β-lactamase inhibitor tazobactam for the treatment of complicated urinary tract infections (cUTIs), complicated intra-abdominal infections (cIAIs), and ventilator-associated bacterial pneumonia (VABP). The chemical structure of ceftolozane is similar to that of ceftazidime, with the exception of a modified side-chain at the 3-position of the cephem nucleus, which confers potent antipseudomonal activity. As a β-lactam, its mechanism of action is the inhibition of penicillin-binding proteins (PBPs). Ceftolozane displays increased activity against Gram-negative bacilli, including those that harbor classical β-lactamases (e.g., TEM-1 and SHV-1), but, similar to other oxyimino-cephalosporins such as ceftazidime and ceftriaxone, it is compromised by extended-spectrum β-lactamases (ESBLs) and carbapenemases. The addition of tazobactam extends the activity of ceftolozane to include most ESBL producers as well as some anaerobic species. Ceftolozane is distinguished from other cephalosporins by its potent activity versus Pseudomonas aeruginosa, including various drug-resistant phenotypes such as carbapenem, piperacillin/tazobactam, and ceftazidime-resistant isolates, as well as those strains that are multidrug-resistant (MDR). Its antipseudomonal activity is attributed to its ability to evade the multitude of resistance mechanisms employed by P. aeruginosa, including efflux pumps, reduced uptake through porins and modification of PBPs. Ceftolozane demonstrates linear pharmacokinetics unaffected by the coadministration of tazobactam; specifically, it follows a two-compartmental model with linear elimination. Following single doses, ranging from 250 to 2,000 mg, over a 1-h intravenous infusion, ceftolozane displays a mean plasma half-life of 2.3 h (range 1.9-2.6 h), a steady-state volume of distribution that ranges from 13.1 to 17.6 L, and a mean clearance of 102.4 mL/min. It demonstrates low

  3. A comparative study of bacterial isolates from the urine samples of AIDS and non-AIDS patients in Benue, Nigeria

    Institute of Scientific and Technical Information of China (English)

    Okwori EE; Nwadioha SI; Jombo GTA; Nwokedi EOP; Odimayo MS

    2010-01-01

    Objective:To determine the common bacterial causes of urinary tract infection and their antibiotic susceptibility pattern in AIDS patients versus non-AIDS patients. Methods: One thousand consecutive AIDS patients with signs and symptoms of AIDS and non-AIDS patients (served as control) each on admission were recruited into the study between January 2005 to January 2008, in Federal Medical Center, Makurdi. Urine samples were collected with sterile universal bottles and analysed with appropriate laboratory methods and antibiotic susceptibility test was carried out by disk diffusion technique in accordance with National Committee for Clinical Laboratory Standards (NCCLS, now CLSI) criteria. The results were analysed using SPSS 11.0 statistical software. Results:Urine samples of AIDS patients with urinary infection had a more spectrum of micro-organisms including Candida organisms, Pseudomonas aeruginosa and Staphylococcus aureus. Ceftriaxone, Ceftazidime or Ciprofloxacin had a remarkably high anti-bacterial activity across the two study groups. A general resistance was recorded in ampicillin, tetracycline and co-trimoxazole. There was no significant difference in antibiotic susceptibility patterns between AIDS and non-AIDS patients(P>0.05). Conclusions:A reduction in unnecessary use of antibiotics as well as infection control should be encouraged in our health facilities.

  4. Resistant patterns of Pseudomonas aeruginosa in a Malaysian teaching hospital

    Institute of Scientific and Technical Information of China (English)

    Zaidah AR; Siti SMN; Zahiruddin WM; Zeehaida M

    2009-01-01

    Objective:Pseudomonas aeruginosa is an opportunistic pathogen and the leading cause of nosocomial infec-tions.Currently a notable increase in the prevalence of multidrug-resistant P.aeruginosa worldwide has been reported in hospitalized patients and was associated with high morbidity and mortality.Methods:A retrospec-tive laboratory based analysis regarding the spectrum and distribution of P.aeruginosa from a wide range of clinical samples in Hospital Universiti Sains Malaysia since January 2003 to December 2007 was done.Re-sults:Altogether,there were 2 308 clinical isolates analyzed.The main sources of P.aeruginosa were from swab,respiratory,urine and blood specimens which accounted for 28.2 %,21.8 %,13.2 % and 12.8 %respectively.Results showed significant reduction in percentage of resistant towards three antibiotic namely ciprofloxacin,ceftazidime and imipenem.However the percentage of pan-resistant P.aeruginosa increased steadily over these years.Conclusion:This data is helpful to the clinician in guiding the choice of appropriate antibiotic to treat P.aeruginosa infection.At the same time,it warrants a more aggressive infection control ac-tivity to be implemented to control the spread of pan resistant strain in this centre.

  5. Evaluation of Risk Factors for Antibiotic Resistance in Patients with Nosocomial Infections Caused by Pseudomonas aeruginosa.

    Science.gov (United States)

    Sonmezer, Meliha Cagla; Ertem, Gunay; Erdinc, Fatma Sebnem; Kaya Kilic, Esra; Tulek, Necla; Adiloglu, Ali; Hatipoglu, Cigdem

    2016-01-01

    Background. Pseudomonas aeruginosa (P. aeruginosa) is resistant to various antibiotics and can cause serious nosocomial infections with high morbidity and mortality. In this clinical study, we investigated the risk factors in patients who were diagnosed with P. aeruginosa-related nosocomial infection. Methods. A retrospective case control study including patients with P. aeruginosa-related nosocomial infection. Patients who were resistant to any of the six antibiotics (imipenem, meropenem, piperacillin-tazobactam, ciprofloxacin, amikacin, and ceftazidime) constituted the study group. Results. One hundred and twenty isolates were isolated. Various risk factors were detected for each antibiotic in the univariate analysis. In the multivariate analysis, previous cefazolin use was found as an independent risk factor for the development of imipenem resistance (OR = 3.33; CI 95% [1.11-10.0]; p = 0.03), whereas previous cerebrovascular attack (OR = 3.57; CI 95% [1.31-9.76]; p = 0.01) and previous meropenem use (OR = 4.13; CI 95% [1.21-14.07]; p = 0.02) were independent factors for the development of meropenem resistance. For the development of resistance to ciprofloxacin, hospitalization in the neurology intensive care unit (OR = 4.24; CI 95% [1.5-11.98]; p = 0.006) and mechanical ventilator application (OR = 11.7; CI 95% [2.24-61.45]; p = 0.004) were independent risk factors. Conclusion. The meticulous application of contact measures can decrease the rate of nosocomial infections.

  6. Clinical guideline for diagnosis and management of melioidosis

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    Inglis Timothy J.J.

    2006-01-01

    Full Text Available Melioidosis is an emerging infection in Brazil and neighbouring South American countries. The wide range of clinical presentations include severe community-acquired pneumonia, septicaemia, central nervous system infection and less severe soft tissue infection. Diagnosis depends heavily on the clinical microbiology laboratory for culture. Burkholderia pseudomallei, the bacterial cause of melioidosis, is easily cultured from blood, sputum and other clinical samples. However, B. pseudomallei can be difficult to identify reliably, and can be confused with closely related bacteria, some of which may be dismissed as insignificant culture contaminants. Serological tests can help to support a diagnosis of melioidosis, but by themselves do not provide a definitive diagnosis. The use of a laboratory discovery pathway can help reduce the risk of missing atypical B. pseudomallei isolates. Recommended antibiotic treatment for severe infection is either intravenous Ceftazidime or Meropenem for several weeks, followed by up to 20 weeks oral treatment with a combination of trimethoprim-sulphamethoxazole and doxycycline. Consistent use of diagnostic microbiology to confirm the diagnosis, and rigorous treatment of severe infection with the correct antibiotics in two stages; acute and eradication, will contribute to a reduction in mortality from melioidosis.

  7. Antibiotic resistance and extended-spectrum β-lactamases in isolated bacteria from seawater of Algiers beaches (Algeria).

    Science.gov (United States)

    Alouache, Souhila; Kada, Mohamed; Messai, Yamina; Estepa, Vanesa; Torres, Carmen; Bakour, Rabah

    2012-01-01

    The aim of the study was to evaluate bacterial antibiotic resistance in seawater from four beaches in Algiers. The most significant resistance rates were observed for amoxicillin and ticarcillin, whereas they were relatively low for ceftazidime, cefotaxime and imipenem. According to sampling sites, the highest resistance rates were recorded for 2 sites subjected to chemical and microbiological inputs (amoxicillin, 43% and 52%; ticarcillin, 19.6% and 47.7%), and for 2 sites relatively preserved from anthropogenic influence, resistance rates were lowest (amoxicillin, 1.5% and 16%; ticarcillin, 0.8% and 2.6%). Thirty-four bacteria resistant to imipenem (n=14) or cefotaxime (n=20) were identified as Pseudomonas aeruginosa (n=15), Pseudomonas fluorescens (7), Stenotrophomonas maltophilia (4), Burkholderia cepacia (2), Bordetella sp. (1), Pantoea sp. (1), Acinetobacter baumannii (1), Chryseomonas luteola (1), Ochrobactrum anthropi (1) and Escherichia coli (1). Screening for extended spectrum β-lactamase showed the presence of CTX-M-15 β-lactamase in the E. coli isolate, and the encoding gene was transferable in association with the IncI1 plasmid of about 50 kbp. Insertion sequence ISEcp1B was located upstream of the CTX-M-15 gene. This work showed a significant level of resistance to antibiotics, mainly among environmental saprophytic bacteria. Transmissible CTX-M-15 was detected in E. coli; this may mean that contamination of the environment by resistant bacteria may cause the spread of resistance genes.

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

    Science.gov (United States)

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

    2015-06-01

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

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

    Science.gov (United States)

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

    1995-11-01

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

  10. Prevalence of Salmonella spp. in cane toads (Bufo marinus) from Grenada, West Indies, and their antimicrobial susceptibility.

    Science.gov (United States)

    Drake, M; Amadi, V; Zieger, U; Johnson, R; Hariharan, H

    2013-09-01

    Cloacal swabs and caecal contents sampled from 58 cane toads (Bufo marinus) in St George's parish, Grenada, during a 7-month period in 2011 were examined by an enrichment and selective culture method for presence of Salmonella spp. Twenty-four (41%) toads were positive for Salmonella spp. of which eight were Salmonella enterica serovar Javiana, and eight were S. enterica serovar Rubislaw. The other serovars were as follows: Montevideo, 6; Arechavaleta, 1; and serovar: IV:43:-:-, 1. The high frequency of isolation of serovar Javiana, an emerging human pathogen associated with several outbreaks in the recent years in the eastern United States, suggests a possible role for cane toads in transmission of this serovar. Although S. Rubislaw has been isolated from lizards, bats and cases of some human infections, there is no report of its carriage by cane toads, and in such high frequency. The rate of carriage of S. Montevideo, a cause for human foodborne outbreaks around the world was also over 10% in the 58 toads sampled in this study. The antimicrobial drug susceptibility tests against amoxicillin-clavulanic acid, ampicillin, cefotaxime, ceftazidime, ciprofloxacin, enrofloxacin, gentamicin, imipenem, nalidixic acid, streptomycin, tetracycline and trimethoprim-sulfamethoxazole showed that drug resistance is minimal and is of little concern. Antimicrobial resistance was limited to ampicillin and amoxicillin-clavulanic acid in one isolate of S. Javiana and one isolate of S. Rubislaw. This is the first report of isolation and antimicrobial susceptibilities of various Salmonella serovars not identified previously in cane toads in Grenada, West Indies.

  11. Prevalence, serovars and antimicrobial susceptibility of Salmonella spp. from wild and domestic green iguanas (Iguana iguana) in Grenada, West Indies.

    Science.gov (United States)

    Sylvester, W R B; Amadi, V; Pinckney, R; Macpherson, C N L; McKibben, J S; Bruhl-Day, R; Johnson, R; Hariharan, H

    2014-09-01

    Cloacal swabs from 62 green iguanas (Iguana iguana), including 47 wild and 15 domestic ones from five parishes of Grenada, were sampled during a 4-month period of January to April 2013 and examined by enrichment and selective culture for the presence of Salmonella spp. Fifty-five per cent of the animals were positive, and eight serovars of Salmonella were isolated. The most common serovar was Rubislaw (58.8%), a serovar found recently in many cane toads in Grenada, followed by Oranienburg (14.7%), a serovar that has been causing serious human disease outbreaks in Japan. Serovar IV:48:g,z51 :- (formerly, S. Marina) highly invasive and known for serious infections in children in the United States, constituted 11.8% of the isolates, all of them being from domestic green iguanas. Salmonella Newport, a serovar recently found in a blue land crab in Grenada, comprised 11.8% of the isolates from the green iguanas. The remaining four less frequent serovars included S. Javiana and S. Glostrup. Antimicrobial susceptibility tests conducted by a disc diffusion method against amoxicillin-clavulanic acid, ampicillin, cefotaxime, ceftazidime, ciprofloxacin, enrofloxacin, gentamicin, nalidixic acid, streptomycin, tetracycline and trimethoprim-sulfamethoxazole showed that drug resistance is minimal, with intermediate susceptibility, mainly to streptomycin, tetracycline and cefotaxime. This is the first report of isolation and antimicrobial susceptibilities of various Salmonella serovars from wild and domestic green iguanas in Grenada, West Indies.

  12. Virulence and antimicrobial susceptibility of clinical and environmental strains of Aeromonas spp. from northeastern Brazil.

    Science.gov (United States)

    Castelo-Branco, Débora de Souza Collares Maia; Guedes, Glaucia Morgana de Melo; Brilhante, Raimunda Sâmia Nogueira; Rocha, Marcos Fábio Gadelha; Sidrim, José Júlio Costa; Moreira, José Luciano Bezerra; Cordeiro, Rossana de Aguiar; Sales, Jamille Alencar; Riello, Giovanna Barbosa; de Alencar, Lucas Pereira; Paiva, Manoel de Araújo Neto; Vasconcelos, David Caldas; de Menezes, Isis Sousa Bezerra; de Ponte, Yago Brito; Sampaio, Célia Maria de Souza; Monteiro, André Jalles; Bandeira, Tereza de Jesus Pinheiro Gomes

    2015-08-01

    The aims of the present study were to isolate and identify clinical and environmental strains of Aeromonas spp. by means of biochemical tests and the automated method VITEK 2 and to investigate the presence of the virulence genes cytotoxic enterotoxin (act), hemolysin (asa-1), and type III secretion system (ascV), and also the in vitro antimicrobial susceptibility of the strains. From the clinical isolates, 19 Aeromonas hydrophila, 3 Aeromonas veronii bv. sobria, and 1 Aeromonas caviae were identified, while from the environmental strains, 11 A. hydrophila, 22 A. veronii bv. sobria, 1 A. veronii bv. veronii, and 1 A. caviae were recovered. The gene act was detected in 69.5% of clinical isolates, asa-1 in 8.6%, and ascV in 34.7%. In the environmental strains, the detection rates were 51.4%, 45.7%, and 54.2% for the genes act, asa-1, and ascV, respectively. Resistance to amoxicillin-clavulanate and piperacillin-tazobactam was observed in 15 and 3 clinical strains, respectively, and resistance to ceftazidime, meropenem, imipenem, ciprofloxacin, and trimethoprim-sulfamethoxazole was observed in 1 strain for each drug. Resistance to amoxicillin-clavulanate and piperacillin-tazobactam was detected in 17 and 1 environmental strain, respectively. Higher resistance percentages were observed in clinical strains, but environmental strains also showed this phenomenon and presented a higher detection rate of virulence genes. Thus, it is important to monitor the antimicrobial susceptibility and pathogenic potential of the environmental isolates.

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

    Science.gov (United States)

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

    2012-12-01

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

  14. Plasmid profiling and antibiotics resisitance of Escherichia coli strains isolated from Mytilus galloprovincialis and seawater

    Directory of Open Access Journals (Sweden)

    Cumhur Avşar

    2014-09-01

    Full Text Available Objective: To investigate plasmid DNA profiles and the antibiotic resistance of a total of 41 strains of Escherichia coli (E. coli isolated from seawater and mussel collected from 15 different sampling stations in Sinop, Turkey. Methods: Most probable number technique was used for detection of E. coli. Antibiotic susceptibilities of the isolates were determined by the disc diffusion method. Plasmid DNA of the strains was extracted by the alkaline lyses procedure. Results: According to morphological and physiological properties, it was determined that the isolates belonged to E. coli species. Antibiotic susceptibility of the strains was determined against seven standard drugs using disc diffusion method. All isolates were resistant to bacitracin (100%, novobiocin (100%, ampicillin (12.5%, tetracycline (7.5%, ceftazidime (5% and imipenem (2.5%, respectively, whereas the strains were susceptible to polymyxin B (100%. The multiple antibiotic resistance values for the strains were found in range from 0.28 to 0.57. In addition, plasmid DNA analyses results confirmed that 22 strains harbored a single or more than two plasmids sized approximately between 24.500 to 1.618 bp. The high-size plasmid (14.700 bp was observed as common in 21 of all strains. Conclusions: As a result, our study indicated that the presence of antibiotic resistant E. coli strains in seawater and mussel might be potential risk for public health issue.

  15. Evolution of CTX-M-type beta-lactamases in isolates of Escherichia coli infecting hospital and community patients.

    Science.gov (United States)

    Brigante, Gioconda; Luzzaro, Francesco; Perilli, Mariagrazia; Lombardi, Gianluigi; Colì, Alessandra; Rossolini, Gian Maria; Amicosante, Gianfranco; Toniolo, Antonio

    2005-02-01

    Escherichia coli isolates collected at our Institution from 1999 to 2003 (n=20,258) were studied to evaluate the production of CTX-M-type extended-spectrum beta-lactamases (ESBL). Isolates suspected of producing CTX-M enzymes were analyzed by the double-disk synergy test, hybridization with specific probes, PCR and direct DNA sequencing. Overall, 53 ESBL-positive isolates were found to carry CTX-M-type genes (blaCTX-M-1, n=51; blaCTX-M-15, n=2). The isolation of CTX-M-positive strains increased from 1 per year (1999) to 26 per year (2003). The first isolate carrying the blaCTX-M-15 gene appeared in 2003 and was obtained from a patient previously treated with ceftazidime. CTX-M-positive isolates were characterized by multi-drug resistance and were obtained both from inpatients (n=29) and outpatients (n=24). Most patients were over 60-year-old (n=45), had underlying chronic diseases (n=32), and had been hospitalized more than once (n=33). Strains were frequently isolated from the urinary tract, often after recurrent infections. Our study demonstrates that CTX-M-producing isolates are increasing among E. coli strains. Adequate laboratory detection may help in choosing appropriate treatment and in limiting the spread of this resistance trait.

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

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    Perpetua A. Ekwealor

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  18. Postoperative Endophthalmitis Caused by Staphylococcus haemolyticus following Femtosecond Cataract Surgery

    Directory of Open Access Journals (Sweden)

    Margaret Wong

    2015-12-01

    Full Text Available A 53-year-old Caucasian man underwent femtosecond cataract surgery and then presented with pain and hand motions vision 1 day following surgery. Anterior segment examination showed a 2-mm-layered hypopyon, a well-centered intraocular lens in the sulcus, and an obscured view to the fundus. B-scan ultrasonography showed significant vitritis and that the retina was attached. A tap and an injection of vancomycin 1 mg per 0.1 ml and of ceftazidime 2.25 mg per 0.1 ml were performed. The tap eventually yielded culture results positive for Staphylococcus haemolyticus, which was sensitive to vancomycin. We report a case of endophthalmitis that occurred on postoperative day 1 following complicated cataract surgery. This is an uncommon bacterium that is not widely reported in the literature as a cause of endophthalmitis in the postoperative period. We urge clinicians to consider S. haemolyticus as an offending agent, especially when the infection presents very early and aggressively in the postoperative period.

  19. Postoperative Endophthalmitis Caused by Staphylococcus haemolyticus following Femtosecond Cataract Surgery.

    Science.gov (United States)

    Wong, Margaret; Baumrind, Benjamin R; Frank, James H; Halpern, Robert L

    2015-01-01

    A 53-year-old Caucasian man underwent femtosecond cataract surgery and then presented with pain and hand motions vision 1 day following surgery. Anterior segment examination showed a 2-mm-layered hypopyon, a well-centered intraocular lens in the sulcus, and an obscured view to the fundus. B-scan ultrasonography showed significant vitritis and that the retina was attached. A tap and an injection of vancomycin 1 mg per 0.1 ml and of ceftazidime 2.25 mg per 0.1 ml were performed. The tap eventually yielded culture results positive for Staphylococcus haemolyticus, which was sensitive to vancomycin. We report a case of endophthalmitis that occurred on postoperative day 1 following complicated cataract surgery. This is an uncommon bacterium that is not widely reported in the literature as a cause of endophthalmitis in the postoperative period. We urge clinicians to consider S. haemolyticus as an offending agent, especially when the infection presents very early and aggressively in the postoperative period.

  20. Clinical cure of ventilator-associated pneumonia treated with piperacillin/tazobactam administered by continuous or intermittent infusion.

    Science.gov (United States)

    Lorente, Leonardo; Jiménez, Alejandro; Martín, María M; Iribarren, José Luis; Jiménez, Juan José; Mora, María L

    2009-05-01

    The standard mode of administration of piperacillin treatment is by intermittent infusion. However, continuous infusion may be advantageous as beta-lactam antibiotics exhibit time-dependent antibacterial activity. In previous studies, we found a higher rate of clinical cure of ventilator-associated pneumonia (VAP) by continuous infusion rather than intermittent infusion of meropenem and ceftazidime. Therefore, the objective of this historical cohort study was to establish the clinical efficacy of piperacillin/tazobactam (PIP/TAZ) administered by continuous and intermittent infusion in the treatment of VAP in patients without renal failure. Logistic regression analysis showed a higher probability of clinical cure of VAP by continuous compared with intermittent infusion when the microorganism responsible for VAP had a minimum inhibitory concentration (MIC) of 8 microg/mL [8/9 (88.9%) vs. 6/15 (40.0%); odds ratio (OR)=10.79, 95% confidence interval (CI) 1.01-588.24; P=0.049] or 16 microg/mL [7/8 (87.5%) vs. 1/6 (16.7%); OR=22.89, 95% CI 1.19-1880.78; P=0.03]. Thus, administration of PIP/TAZ by continuous infusion may be considered more effective than intermittent infusion for the treatment of VAP caused by Gram-negative bacteria when the MIC of the microorganism responsible for VAP is 8-16 microg/mL in patients without renal failure.

  1. 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

  2. Profiling of antimicrobial resistance and plasmid replicon types in β-lactamase producing Escherichia coli isolated from Korean beef cattle.

    Science.gov (United States)

    Shin, Seung Won; Jung, Myunghwan; Shin, Min-Kyung; Yoo, Han Sang

    2015-01-01

    In this study, 78 isolates of Escherichia coli isolated from Korean beef cattle farms were investigated for the production of extended-spectrum β-lactamase (ESBL) and/or AmpC β-lactamase. In the disc diffusion test with ampicillin, amoxicillin, cephalothin, ceftiofur, cefotaxime, ceftazidime, and cefoxitin, 38.5% of the isolates showed resistance to all of ampicillin, amoxicillin, and cephalothin. The double disc synergy method revealed that none of the isolates produced ESBL or AmpC β-lactamases. DNA sequencing showed that all isolates encoded genes for TEM-1-type β-lactamase. Moreover, 78.2% of the isolates transferred the TEM-1-type β-lactamase gene via conjugation. In plasmid replicon typing of all donors, IncFIB and IncFIA were identified in 71.4% and 41.0% of plasmids, respectively. In transconjugants, IncFIB and IncFIA were the most frequent types detected (61.5% and 41.0%, respectively). Overall, the present study indicates that selection pressures of antimicrobials on β-lactamases in beef cattle may be low relative to other livestock animals in Korea. Moreover, to reduce selection pressure and dissemination of β-lactamase, the long-term surveillance of antimicrobial use in domestic beef cattle should be established.

  3. Clinical significance of Roseomonas species isolated from catheter and blood samples: analysis of 36 cases in patients with cancer.

    Science.gov (United States)

    Dé, Indra; Rolston, Kenneth V I; Han, Xiang Y

    2004-06-01

    This report analyzes 36 cases of bacteremia or catheter-related infection caused by Roseomonas species, a group of pink, slimy, waterborne, gram-negative coccobacilli. The causative species included the newly described Roseomonas mucosa (22 cases [61%]) and Roseomonas gilardii subspecies rosea (8 cases [22%]) and known species R. gilardii subspecies gilardii (5 cases [14%]) and Roseomonas genomospecies 4 (1 case [3%]). Twenty-nine (81%) of the cases were symptomatic, with fever being the most common symptom (in 27 [75%] of the cases). Twenty (56%) of the infections were monomicrobic. Six cases (17%) involved persistent catheter colonization, and 5 of these cases required removal of the catheter to clear the infection. All infections resolved, most with empirical antibiotic treatment. A summary of the antibiotic susceptibility pattern of these strains and other reported series show that Roseomonas species are consistently susceptible to amikacin and imipenem and frequently susceptible to ciprofloxacin and ticarcillin, but essentially nonsusceptible to ceftazidime and cefepime. This result may guide future therapy for infections due to Roseomonas species.

  4. Bacteriologic characterization of 36 strains of Roseomonas species and proposal of Roseomonas mucosa sp nov and Roseomonas gilardii subsp rosea subsp nov.

    Science.gov (United States)

    Han, Xiang Y; Pham, Audrey S; Tarrand, Jeffrey J; Rolston, Kenneth V; Helsel, Leta O; Levett, Paul N

    2003-08-01

    We used a polyphasic approach (sequencing analysis of the 16S ribosomal RNA gene and phenotypic analyses) to characterize 36 strains of Roseomonas species isolated from blood. Five strains, represented by strain MDA5176 (M.D. Anderson Cancer Center), were identified as Roseomonas gilardii. One strain belonged to Roseomonas genomospecies 4. The 22 strains represented by strain MDA5527 showed significant differences genotypically and phenotypically with R gilardii and other Roseomonas species and represented a new Roseomonas species; Roseomonas mucosa sp nov was proposed to denote its prominent mucoid, almost runny colonies. Eight strains, represented by strain MDA5605, had minor differences with R gilardii and displayed obvious pink to red colonies; Roseomonas gilardii subsp rosea subsp nov was proposed. For subspecies differentiation, R gilardii was proposed to be R gilardii subsp gilardii subsp nov. Unique patterns of biochemical reactions were established for these Roseomonas species, which may assist routine identification of these organisms. All 36 strains and 2 American Type Culture Collection strains were susceptible to amikacin and ciprofloxacin but resistant to cefepime and ceftazidime. They also were frequently susceptible to imipenem and ticarcillin-clavulanate but far less susceptible to ceftriaxone, trimethoprim-sulfamethoxazole, and ampicillin. R mucosa strains were most resistant, whereas R gilardii subsp gilardii strains were most susceptible.

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

    Science.gov (United States)

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

    2003-08-29

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

  6. Rapid antimicrobial susceptibility test for identification of new therapeutics and drug combinations against multidrug-resistant bacteria.

    Science.gov (United States)

    Sun, Wei; Weingarten, Rebecca A; Xu, Miao; Southall, Noel; Dai, Sheng; Shinn, Paul; Sanderson, Philip E; Williamson, Peter R; Frank, Karen M; Zheng, Wei

    2016-11-09

    Current antimicrobial susceptibility testing has limited screening capability for identifying empirical antibiotic combinations to treat severe bacterial infections with multidrug-resistant (MDR) organisms. We developed a new antimicrobial susceptibility assay using automated ultra-high-throughput screen technology in combination with a simple bacterial growth assay. A rapid screening of 5170 approved drugs and other compounds identified 25 compounds with activities against MDR Klebsiella pneumoniae. To further improve the efficacy and reduce the effective drug concentrations, we applied a targeted drug combination approach that integrates drugs' clinical antimicrobial susceptibility breakpoints, achievable plasma concentrations, clinical toxicities and mechanisms of action to identify optimal drug combinations. Three sets of three-drug combinations were identified with broad-spectrum activities against 10 MDR clinical isolates including K. pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Citrobacter freundii, Enterobacter cloacae and Escherichia coli. Colistin-auranofin-ceftazidime and colistin-auranofin-rifabutin suppressed >80% growth of all 10 MDR strains; while rifabutin-colistin-imipenem inhibited >75% of these strains except two Acinetobacter baumannii isolates. The results demonstrate this new assay has potential as a real-time method to identify new drugs and effective drug combinations to combat severe clinical infections with MDR organisms.

  7. Community acquired pneumonia due to gram negative bacilli and its antibiotic sensitivity pattern in a tertiary care centre

    Directory of Open Access Journals (Sweden)

    Ashish Jitendranath

    2016-08-01

    Results: During the study period in 120 cases of pneumonia, there was growth of pathogenic organism. Among the GNB isolated Klebsiella spp was the most common organism isolated at 33.9% followed by Pseudomonas aeruginosa and Escherichia coli at 22.1%. Out of the 53 gram negative samples isolated 4 (7% were Amp C positive, 10 (18.8% were ESBL positive and there was one single case of MBL. The antibiotic sensitivity showed that all the isolates were sensitive to colisitin (100%, while Klebsiella spp, Pseudomonas spp, and Escherichia coli were 100% sensitive to imipenem and meropenem. Resistance pattern of all the isolates showed that the isolates exhibited high resistance to amoxycillin-clavulunate, cefuroxime and cotrimoxazole. While resistance against ceftazidime and cefipime was >40%. On the other hand, isolates showed a low level of resistance against piperacillin tazobactam and cefoperazone-sulbactam. Extremely low level of resistance was observed against imipenem and meropenem, while colistin showed no resistance among the isolates obtained in this study. Conclusions: The study showed that gram-negative bacteria and P. aeruginosa form a relevant part of the microbial pattern of CAP in patients who require hospitalization, particularly those with severe CAP. Initiating antibiotics with gram negative coverage should be considered in this subgroup of patients since initiating the correct antibiotic plays a critical role in the outcome of pneumonia. [Int J Res Med Sci 2016; 4(8.000: 3121-3124

  8. Salmonella infection in healthy pet reptiles: Bacteriological isolation and study of some pathogenic characters.

    Science.gov (United States)

    Bertelloni, Fabrizio; Chemaly, Marianne; Cerri, Domenico; Gall, Françoise Le; Ebani, Valentina Virginia

    2016-06-01

    The fecal samples from 213 captive reptiles were examined, and 29 (13.61%) Salmonella enterica isolates were detected: 14/62 (22.58%) from chelonians, 14/135 (10.37%) from saurians, and 1/16 (6.25%) from ophidians. The isolates were distributed among 14 different serotypes: Miami, Ebrie, Hermannsweder, Tiergarten, Tornov, Pomona, Poona, Goteborg, Abaetetube, Nyanza, Kumasi, Typhimurium, 50:b:z6, 9,12:z29:1,5, and a non-motile serotype with antigenic formula 1,4,[5],12:-:-. Salmonella typhimurium and 50:b:z6 isolates showed the spv plasmid virulence genes, responsible of the capability to induce extra-intestinal infections. In some cases, pulsed field gel electrophoresis revealed different profiles for the strains of the same serotypes, showing different origins, whereas a common source of infection was supposed when one pulsotype had been observed for isolates of a serovar. Twenty-seven (93.10%) isolates showed resistance to one or more antibiotics. Ceftazidime was active to all the tested isolates, whereas the highest percentages of strains were no susceptible to tigecycline (93.10%), streptomycin (89.66%), and sulfonamide (86.21%).

  9. Burkholderia pseudomallei musculoskeletal infections (melioidosis in India

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    Pandey Vivek

    2010-01-01

    Full Text Available Melioidosis, an infection due to gram negative Burkholderia pseudomallei, is an important cause of sepsis in east Asia especially Thailand and northern Australia. It usually causes abscesses in lung, liver, spleen, skeletal muscle and parotids especially in patients with diabetes, chronic renal failure and thalassemia. Musculoskeletal melioidosis is not common in India even though sporadic cases have been reported mostly involving soft tissues. During a two-year-period, we had five patients with musculoskeletal melioidosis. All patients presented with multifocal osteomyelitis, recurrent osteomyelitis or septic arthritis. One patient died early because of septicemia and multi-organ failure. All patients were diagnosed on the basis of positive pus culture. All patients were treated by surgical debridement followed by a combination of antibiotics; (ceftazidime, amoxy-clavulanic acid, co-trimoxazole and doxycycline for six months except for one who died due to fulminant septicemia. All other patients recovered completely with no recurrences. With increasing awareness and better diagnostic facilities, probably musculoskeletal melioidosis will be increasingly diagnosed in future.

  10. Prognostic factor of mortality and its clinical implications in patients with necrotizing fasciitis caused by Vibrio vulnificus.

    Science.gov (United States)

    Lee, Yao-Chou; Hor, Lien-I; Chiu, Haw-Yen; Lee, Jing-Wei; Shieh, Shyh-Jou

    2014-06-01

    In Taiwan, the aquatic environment and endemic hepatitis contribute to the high susceptibility of Vibrio vulnificus infection. A multidisciplinary treatment protocol for necrotizing fasciitis caused by V. vulnificus was developed in our institute, namely, ceftriaxone or ceftazidime combined with doxycycline or minocycline followed by an emergency fasciotomy and intensive care unit admission. We retrospectively reviewed 100 cases to evaluate the effectiveness of our treatment protocol and identify independent predictors of mortality to improve clinical outcomes. Cases of culture-confirmed V. vulnificus infection between January 1996 and December 2011 were reviewed. Necrotizing fasciitis was surgically diagnosed if these criteria were met: necrotic fascia, "dishwater discharge", and loss of resistance while doing finger dissection along the fascia plane. One hundred cases met these criteria and were included for analysis. Eighteen patients died (18 % mortality). Unknown injury events, presence of multiple skin lesions, leukocytes necrotizing fasciitis caused by V. vulnificus. Additional investigations to rescue patients with a prolonged disease course of necrotizing fasciitis (≥3 days) may be important.

  11. Efektifitas Minyak Atsiri Lengkuas Putih (Alpinia galangal terhadap Pertumbuhan Staphylococcus Aureus 302 yang Resisten Multiantibiotik

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    Rozie Puji Lestari

    2015-10-01

    Full Text Available The rhizome of white galangal (Alpinia galanga is one of the cultivated remedies traditionally administered for skin disease, asthma and anabolism troubles such as colic, food poisoning, and convulsions. A part of the chemical composition of white galangal rhizome is essential oil. The aim of this study was to determine the antibacterial effect of the esential oil of white galangal rhizome against the growth of Staphylococcus aureus 302 resistant to ampicillin, amoxicillin, penicillin G, kanamycin, mecillinam, and ceftazidime. Fifty µl essential oil of white galangal rhizome in concentrations of 5, 7.5, 10, 12.5 or 15% were dropped into 6 mm of diameter well in MHA media given to S.aureus 302. Propylene glycol (5% vol was used as a negative control and solvent. The treatment of each concentration group was repeated fifteen times. The diameter of radical zone of the growth of S. aureus 302 was measured using sliding calipers. The results of ANOVA (p<0.05 showed that the essential oil of white galangal rhizome had a significant antibacterial effect against S. aureus 302. The result of LSD test (p<0.05 showed a significant difference between the concentration groups, except for the 10 and 12.5% concentrations which had the same effect.

  12. Diversity of Clavulanic Acid-Inhibited Extended-Spectrum β-Lactamases in Aeromonas spp. from the Seine River, Paris, France▿

    Science.gov (United States)

    Girlich, Delphine; Poirel, Laurent; Nordmann, Patrice

    2011-01-01

    Environmental Aeromonas sp. isolates resistant to ceftazidime were recovered during an environmental survey performed with water samples from the Seine River, in Paris, France, in November 2009. Selected isolates were identified by sequencing of the 16S rRNA and rpoB genes. PCR and cloning experiments were used to identify broad-spectrum-β-lactamase-encoding genes and their genetic context. Clavulanic acid-inhibited extended-spectrum-β-lactamase (ESBL) genes were identified in 71% of the Aeromonas sp. isolates. A variety of ESBL genes were detected, including blaVEB-1a, blaSHV-12, blaPER-1, blaPER-6, blaTLA-2, and blaGES-7, suggesting an aquatic reservoir of those ESBL genes. Moreover, the repeated elements and different insertion sequences were identified in association with the blaPER-6 and the blaVEB-1a genes, respectively, indicating a wide diversity of mobilization events, making Aeromonas spp. a vehicle for ESBL dissemination. PMID:21149627

  13. 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

  14. Antibiotic sensitivity pattern of gram negative bacilli isolated from the lower respiratory tract of ventilated patients in the intensive care unit

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    Goel Nidhi

    2009-01-01

    Full Text Available Background: Lower respiratory tract infections (LRTIs are the most frequent infections among patients in Intensive care units (ICUs. Aims: To know the bacterial profile and determine the antibiotic susceptibility pattern of the lower respiratory tract isolates from patients admitted to the ICU. Settings and Design: Tertiary care hospital, retrospective study. Materials and Methods: Transtracheal or bronchial aspirates from 207 patients admitted to the ICU were cultured, identified, and antibiotic sensitivity was performed by standard methods. Statistical Analysis Used: SPSS software was used for calculation of % R of 95% confidence interval (CI. Results: Of 207 specimens, 144 (69.5% were culture positive and 63 (30.4% showed no growth. From 144 culture positives, 161 isolates were recovered, of which 154 (95.6% were Gram negative bacilli (GNB. In 17 (11.0% patients, two isolates per specimen were recovered. The most common GNB in order of frequency were Pseudomonas aeruginosa (35%, Acinetobacter baumannii (23.6%, and Klebsiella pneumoniae (13.6%. A very high rate of resistance (80-100% was observed among predominant GNB to ciprofloxacin, ceftazidime, co-trimoxazole, and amoxycillin/clavulanic acid combination. Least resistance was noted to meropenem and doxycycline. Conclusion: Nonfermenters are the most common etiological agents of LRTIs in ICU. There is an alarmingly high rate of resistance to cephalosporin and β-lactam-β-lactamase inhibitor group of drugs. Meropenem was found to be the most sensitive drug against all GNB. Acinetobacter and Klebsiella spp. showed good sensitivity to doxycycline.

  15. Constitutive high expression of chromosomal beta-lactamase in Pseudomonas aeruginosa caused by a new insertion sequence (IS1669) located in ampD

    DEFF Research Database (Denmark)

    Bagge, Niels; Ciofu, Oana; Hentzer, Morten

    2002-01-01

    The expression of chromosomal AmpC beta-lactamase in Pseudomonas aeruginosa is negatively regulated by the activity of an amidase, AmpD. In the present study we examined resistant clinical P. aeruginosa strains and several resistant variants isolated from in vivo and in vitro biofilms for mutations...... in the expression of high levels of AmpC beta-lactamase. Complementation of these isolates with ampD from the reference P. aeruginosa strain PAO1 caused a dramatic decrease in the expression of AmpC beta-lactamase and a parallel decrease of the MIC of ceftazidime to a level comparable to that of PAO1. One highly...... resistant, constitutive beta-lactamase-producing variant contained no mutations in ampD, but a point mutation was observed in ampR, resulting in an Asp-135-->Asn change. An identical mutation of AmpR in Enterobacter cloacae has been reported to cause a 450-fold higher AmpC expression. However, in many...

  16. Cefoxitin resistance mediated by loss of a porin in clinical strains of Klebsiella pneumoniae and Escherichia coli

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    Ananthan S

    2005-01-01

    Full Text Available PURPOSE: Porins are outer membrane protein (OMP that form water filled channels that permit the diffusion of small hydrophilic solutes like -lactam antibiotics across the outer membrane. Two major porins that facilitate diffusion of antimicrobials have been described in Klebsiella spp. and Escherichia coli. The present study was carried out to examine the role of porins among Extended Spectrum -Lactamase (ESBL and AmpC -Lactamase positive strains of Klebsiella spp. and E.coli. METHODS: Preparation of OMP from phenotypically characterized clinical isolates K.pneumoniae and E.coli and the separation of the proteins by sodium dodecyl sulfate - polyacrylamide gel electrophoresis were performed as per a previously described procedure. RESULTS: OMP analysis revealed that cefoxitin and ceftazidime resistance was mediated by loss of a porin Omp K35 in the isolates of K.pneumoniae and E.coli. CONCLUSIONS: Loss of porin mediated resistance mechanism against cefoxitin was observed among the multidrug resistant K.pneumoniae and E.coli.

  17. Antimicrobial activity of ceftobiprole against Gram-negative and Gram-positive pathogens: results from INVITA-A-CEFTO Brazilian study

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    Rosângela Ferraz Cereda

    2011-08-01

    Full Text Available Ceftobiprole is a broad-spectrum cephalosporin with potent activity against staphylococci, including those resistant to oxacillin, as well as against most Gram-negative bacilli including Pseudomonas aeruginosa. In this study, the in vitro activity of ceftobiprole and comparator agents was tested against bacterial isolates recently collected from Brazilian private hospitals. A total of 336 unique bacterial isolates were collected from hospitalized patients between February 2008 and August 2009. Each hospital was asked to submit 100 single bacterial isolates responsible for causing blood, lower respiratory tract or skin and soft tissue infections. Bacterial identification was confirmed and antimicrobial susceptibility testing was performed using CLSI microdilution method at a central laboratory. The CLSI M100-S21 (2011 was used for interpretation of the antimicrobial susceptibility results. Among the 336 pathogens collected, 255 (75.9% were Gram-negative bacilli and 81 (24.1% were Gram-positive cocci. Although ceftobiprole MIC50 values for oxacillin resistant strains were two-fold higher than for methicillin susceptible S. aureus, ceftobiprole inhibited 100% of tested S. aureus at MICs 6 µg/mL for both species. Our results showed that ceftobiprole has potent activity against staphylococci and E. faecalis, which was superior to that of vancomycin. Our data also indicates that ceftobiprole demonstrated potency comparable to that of cefepime and ceftazidime against key Gram-negative species.

  18. Ceftobiprole: a new cephalosporin for the treatment of skin and skin structure infections.

    Science.gov (United States)

    Schirmer, Patricia L; Deresinski, Stanley C

    2009-09-01

    Ceftobiprole is among the first of a new generation of cephalosporins with activity against aerobic Gram-negative bacilli, which extends to cefepime-sensitive Pseudomonas aeruginosa, and activity against Gram-positive organisms, which includes methicillin-resistant Staphylococcus aureus. Ceftobiprole is currently undergoing evaluation by the US FDA for the treatment of complicated skin and skin structure infections, with a decision pending further evaluation of study site monitoring. It is also being evaluated for the treatment of community-acquired and healthcare-associated pneumonia. Two Phase III multicenter trials have demonstrated noninferiority in complicated skin and skin structure infections when tested against vancomycin in primarily Gram-positive bacterial infections, and when tested against vancomycin plus ceftazidime in Gram-positive and Gram-negative bacterial infections. It is well tolerated, with the most common side effects being nausea and dysgeusia. Ceftobiprole is likely to prove useful as an empiric as well as directed monotherapy in patients with complicated skin and skin structure infections, in which both Gram-positive pathogens including methicillin-resistant S. aureus and Gram-negative pathogens including cefepime-sensitive P. aeruginosa may be involved.

  19. Exposure to ceftobiprole is associated with microbiological eradication and clinical cure in patients with nosocomial pneumonia.

    Science.gov (United States)

    Muller, A E; Punt, N; Mouton, J W

    2014-05-01

    The percentage of the dosing interval that the non-protein-bound plasma concentration is above the MIC (%fT>MIC) for cephalosporins has been shown to correlate with microbiological outcomes in preclinical studies. However, clinical data are scarce. Using data from a randomized double-blind phase 3 clinical trial, we explored the relationship of ceftobiprole exposure with microbiological and clinical outcomes in patients with nosocomial pneumonia. The individual ceftobiprole exposure was determined for different pharmacokinetic (PK)/pharmacodynamic (PD) indices using individual pharmacokinetic data and a previously published population model. The MICs used in the analysis were the highest MICs for any bacterium cultured at baseline or the end of treatment (EOT). Outcomes were microbiological cure at EOT and clinical cure at test of cure (TOC). Multiple logistic regression (MLR) and classification and regression tree (CART) analyses were applied to determine the relationships among exposure, patient characteristics, and outcomes. MLR indicated that the %fT>MIC of ceftobiprole was the best predictor for both microbiological eradication and clinical cure. CART analysis showed a breakpoint value of 51.1% (n = 159; P = 0.0024) for clinical cure, whereas it was 62.2% (n = 251; P ceftobiprole. The %fT>MIC required to result in a favorable clinical outcome is >51% of the dosing interval, which is in line with the values found for microbiological eradication, the comparator ceftazidime, and preclinical models.

  20. Antimicrobial activity of ceftobiprole against gram-negative and gram-positive pathogens: results from INVITA-A-CEFTO Brazilian study.

    Science.gov (United States)

    Cereda, Rosângela Ferraz; Azevedo, Heber Dias; Girardello, Raquel; Xavier, Danilo Elias; Gales, Ana C

    2011-01-01

    Ceftobiprole is a broad-spectrum cephalosporin with potent activity against staphylococci, including those resistant to oxacillin, as well as against most gram-negative bacilli including Pseudomonas aeruginosa. In this study, the in vitro activity of ceftobiprole and comparator agents was tested against bacterial isolates recently collected from Brazilian private hospitals. A total of 336 unique bacterial isolates were collected from hospitalized patients between February 2008 and August 2009. Each hospital was asked to submit 100 single bacterial isolates responsible for causing blood, lower respiratory tract or skin and soft tissue infections. Bacterial identification was confirmed and antimicrobial susceptibility testing was performed using CLSI microdilution method at a central laboratory. The CLSI M100-S21 (2011) was used for interpretation of the antimicrobial susceptibility results. Among the 336 pathogens collected, 255 (75.9%) were gram-negative bacilli and 81 (24.1%) were gram-positive cocci. Although ceftobiprole MIC50 values for oxacillin resistant strains were two-fold higher than for methicillin susceptible S. aureus, ceftobiprole inhibited 100% of tested S. aureus at MICs ceftobiprole MIC50 > 6 µg/mL for both species. Our results showed that ceftobiprole has potent activity against staphylococci and E. faecalis, which was superior to that of vancomycin. Our data also indicates that ceftobiprole demonstrated potency comparable to that of cefepime and ceftazidime against key gram-negative species.

  1. Ceftobiprole for the treatment of pneumonia: a European perspective

    Directory of Open Access Journals (Sweden)

    Liapikou A

    2015-08-01

    Full Text Available Adamantia Liapikou,1 Catia Cillóniz,2 Antonio Torres216th Respiratory Department, Sotiria Chest Diseases Hospital, Athens, Greece; 2Pulmonology Department, Clinic Institute of Thorax (ICT, Hospital Clinic of Barcelona, Spain Insitut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS, Barcelona, SpainAbstract: Ceftobiprole, a new broad spectrum, parenteral cephalosporin, exhibits potent in vitro activity against a number of Gram-positive pathogens, including methicillin-resistant Staphylococcus aureus and penicillin-resistant Streptococcus pneumoniae, and Gram-negative pathogens associated with hospital-acquired pneumonia (HAP and community-acquired pneumonia (CAP. Ceftobiprole has demonstrated noninferiority in two large-scale pivotal studies comparing it to ceftriaxone with or without linezolid in CAP, with clinical cure rates 86.6% versus 87.4%, or ceftazidime in HAP, with clinical cure rates of 77% versus 76%, respectively. However, ceftobiprole was inferior in the subgroup of patients undergoing mechanical ventilation. Ceftobiprole has so far demonstrated a good safety profile in preliminary studies, with similar tolerability to comparators. The most commonly observed adverse events of ceftobiprole included headache and gastrointestinal upset. It is the first cephalosporin monotherapy approved in the EU for the treatment of both CAP and HAP (excluding ventilator-associated pneumonia.Keywords: antibiotic resistance, methicillin-resistant staphylococci, community-acquired pneumonia, hospital-acquired pneumonia, cephalosporins

  2. Role of anaerobes in acute pelvic inflammatory disease

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    Saini S

    2003-01-01

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

  3. Role of anaerobes in acute pelvic inflammatory disease.

    Science.gov (United States)

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

    2003-01-01

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

  4. A STUDY ON THE POST SURGICAL WOUND INFECTIONS IN A TERTIARY CARE HOSPITAL IN KANCHIPURAM

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    Sivasankari

    2016-03-01

    Full Text Available BACKGROUND Surgical site infections are the infections that occur within thirty days after the operative procedure (Except in case of added implants. Surgical site infections are the 3rd most commonly reported nosocomial infections accounting for a quarter of all such infections. A wide range of organisms are known to infect wounds like gram positive cocci, gram negative bacilli, spore formers, aerobes and anaerobes. Despite the advances in operative technique and better understanding of the pathogenesis of wound infections and wound healing, surgical site infections still remain a major source of morbidity and mortality. Hence, this study was done to identify the aetiological bacterial agents and their antibiogram pattern and the risk factors associated with surgical site infections. METHODS Wounds were examined for signs and symptoms of infection in postoperative ward. All the pus swabs were processed and identified as per standard methods of identification. Antibiogram was performed as per CLSI guidelines. The isolates were screened and confirmed with double disc diffusion method using CLSI guidelines. RESULTS The rate of surgical site infections in our study was 8.3%. The rate of surgical site infections was higher (73.3% in emergency surgeries than the elective surgeries. E. coli was the commonest isolate among gram negative bacilli; 33.3% isolates of E. coli were ESBL procedures. E. coli were sensitive to cefepime and ciprofloxacin and showed maximum resistance to ampicillin and ceftazidime. All the E. coli were sensitive to imipenem.

  5. [Incidence of alginate-coding gene in carbapenem-resistant Pseudomonas aeruginosa strains].

    Science.gov (United States)

    Bogiel, Tomasz; Kwiecińska-Piróg, Joanna; Kozuszko, Sylwia; Gospodarek, Eugenia

    2011-01-01

    Pseudomonas aeruginosa rods are one of the most common isolated opportunistic nosocomial pathogens. Strains usually are capable to secret a capsule-like polysaccharide called alginate important for evasion of host defenses, especially during chronic pulmonary disease of patients with cystic fibrosis. Most genes for alginate biosynthesis and lysis are encoded by the operon. The aim of our study was to evaluate the incidence of algD sequence, generally use for alginate-coding gene detection, in 120 P. aeruginosa strains resistant to carbapenems. All isolates were obtained in the Department of Clinical Microbiology University Hospital no. 1 of dr A. Jurasz Collegium Medicum of L. Rydygier in Bydgoszcz Nicolaus Copernicus University in Toruń. Examined strains demonstrated resistance to carbenicillin (90,0%), ticarcillin (89,2%) and ticarcillin clavulanate (86,7%). All strains were susceptible to colistin. The majority of examined strains was susceptible to ceftazidime and cefepime (40,8% each) and norfloxacin (37,5%). Presence of algD gene - noted in 112 (93,3%) strains proves that not every strain is capable to produce alginate. It was also found out that differences in algD genes incidence in case of different clinical material that strains were isolated from were not statistically important.

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

    Science.gov (United States)

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

    2010-01-01

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

  7. Evaluation of different methods for detection of metallo-beta-lactamases in Pseudomonas aeruginosa clinical isolates.

    Science.gov (United States)

    Bogiel, Tomasz; Deptuła, Aleksander; Gospodarek, Eugenia

    2010-01-01

    Metallo-beta-lactamases (MBLs) produced by Pseudomnonas aeruginosa are a serious threat due to their ability to be transmitted between the same as well as different bacterial species. Different methods are applied in the clinical laboratory to detect MBLs. The aim of this study was to compare 4 phenotypic methods and a PCR assay for their ability to detect MBLs in clinical isolates of carbapenem-resistant P. aeruginosa strains. The study embraced a total of 70 carbapenem-resistant P. aeruginosa strains isolated in The Department of Microbiology of Dr. A. Jurasz University Hospital in Bydgoszcz. The highest percentage (42.9%) of the strains were isolated from Intensive Care Unit patients, mainly from urine samples (31.4%). Methods used in this study were: double-disc synergy tests in two combinations: using ceftazidime with 2-mercaptopropionic acid and imipenem with EDTA, differences in inhibition zone diameters between discs with imipenem/EDTA and imipenem, Etest MBL (AB Biodisk) and molecular amplification of bla(IMP) and bla(VIM) genes responsible for producing MBLs, using PCR assay. The lowest percentage (1.4%) of positive results in detection of MBLs was obtained using PCR assay, the highest (72.9%) by double-disc synergy tests with imipenem and EDTA, but the specificity of this method may be low.

  8. Comparative evaluation of Vitek 2 identification and susceptibility testing of Gram-negative rods directly and isolated from BacT/ALERT-positive blood culture bottles.

    Science.gov (United States)

    Munoz-Dávila, M J; Yagüe, G; Albert, M; García-Lucas, T

    2012-05-01

    The performance of Vitek 2 was evaluated for the identification and susceptibility testing of Gram-negative bacilli directly from positive blood cultures bottles. Direct inoculation of the positive blood cultures with the Vitek cards ID-GN and AST-NO58 was compared with the standard inoculation method based on the sub-culture of the positive blood culture to agar. A total of 142 blood cultures were included in the study; of those, 119 were from patients' clinical samples, while 23 were artificially prepared with strains showing different mechanisms of resistance. A total of 136 (95.8%) strains were correctly identified to the species level, only 2 (1.4%) were mis-identified and 4 (2.8%) were not identified. Susceptibility results were available for all isolates tested against 17 antibiotics, thus, resulting in a total of 2,414 isolate/anti-microbial combinations. The error rate was 2.8% (67/2,414) overall; 0.6% (14/2,414) very major errors, 0.1% (3/2,414) major errors and 2.1% (50/2,414) minor errors. The direct method detected 88.5% (22/25) of the strains producing extended-spectrum beta-lactamases (ESBLs). The susceptibility agreement among the added strains with ESBL, AMPc hyperproduction, resistance to ceftazidime, carbapenems and cefepime was very high. Direct identification and susceptibility testing gave rapid and reliable results, reducing by 24 h the turnaround time of the microbiology laboratory.

  9. Antibiotic Resistance Pattern in Pseudomonas Aeruginosa Species Isolated at a Tertiary Care Hospital, Ahmadabad

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    Rajat Rakesh M

    2012-04-01

    Full Text Available Introduction: Pseudomonas aeruginosa (Ps.aeruginosa is one of the important bacterial pathogens isolated from various samples. Despite advances in medical and surgical care and introduction of wide variety of antimicrobial agents against having anti-pseudomonal activities, life threatening infection caused by Ps. aeruginosa continues to cause complications in hospital acquired infections. Several different epidemiological studies indicate that antibiotic resistance is increasing in clinical isolates. Material and Method: This study was conducted during April 2009 to april 2010. During this period total of 630 samples were tested, in which 321 samples showed growth of bacteria. Out of 321 samples, 100 clinical isolates of Pseudomonas aeruginosa were isolated. The samples were selected on the basis of their growth on routine MacConkey medium which showed lactose Non-fermenting pale colonies which were oxidase test positive and on Nutrient agar pigmented and non-pigmented colonies with oxidase positive. Antimicrobial susceptibility of all the isolates was performed by the disc-diffusion (Modified-Kirby Baur disc diffusion method according to CLSIs guidelines. Result: In present study, maximum isolates of Ps. aeruginosa isolated from various samples are resistant to tobramycin (68% followed by gentamycin (63%, piperacillin (50%, ciprofloxacin (49% and ceftazidime (43%. Conclusion: To prevent the spread of the resistant bacteria, it is critically important to have strict antibiotic policies while surveillance programmes for multidrug resistant organisms and infection control procedures need to be implemented. [National J of Med Res 2012; 2(2.000: 156-159

  10. Isolation, enumeration, molecular identification and probiotic potential evaluation of lactic acid bacteria isolated from sheep milk

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    L.B. Acurcio

    2014-06-01

    Full Text Available Lactic acid bacteria species were molecularly identified in milk from Lacaune, Santa Inês and crossbred sheep breeds and their in vitro probiotic potential was evaluated. The species identified were Enterococcus faecium (56.25%, E. durans (31.25% and E. casseliflavus (12.5%. No other lactic acid bacteria species, such as lactobacilli, was identified. Most of the isolated enterococci were resistant to gastric pH (2.0 and to 0.3% oxgall. All tested enterococci were resistant to ceftazidime, oxacillin and streptomycin and sensible to clindamycin, erythromycin and penicillin. The resistance to ciprofloxacin, gentamicin, tetracycline and vancomycin varied among tested species. All tested enterococci strongly inhibited (P<0.05 Escherichia coli and Listeria monocytogenes, moderately inhibited E. faecalis and Staphylococcus aureus and did not inhibit Pseudomonas aeruginosa, Salmonella enterica var. Typhimurium and also one E. durans sample isolated from sheep milk. Four samples of E. faecium, one of E. durans and one of E. casseliflavus presented the best probiotic potential.

  11. CTX-M producing Escherichia coli isolated from cattle feces in Bogor slaughterhouse, Indonesia

    Institute of Scientific and Technical Information of China (English)

    Mirnawati Bachrum Sudarwanto; Denny Widaya Lukman; Hadri Latif; Herwin Pisestyani; Eddy Sukmawinata; Omer Akineden; Ewald Usleber

    2016-01-01

    Objective: To determine the occurrence of CTX-M producing Escherichia coli (E. coli) from cattle feces in Bogor slaughterhouse, Indonesia. Methods: A total of 220 cattle feces samples were collected from Bogor slaughterhouse from March to April 2015. Presence of extended-spectrum beta-lactamase (ESBL) producing E. coli was detected by disc diffusion test based on the recommendation from Clinical and Laboratory Standards Institute (2014). Bacterial strains which were confirmed as producing ESBLs were further analyzed for the presence of bla genes of the ESBL by PCR. Results: The results showed that CTX-M producing E. coli isolates were detected in 19 samples from 220 samples (8.6%). The b-lactamase genes detected were CTX-M-1 (n = 10) and CTX-M-9 (n = 9). All of the CTX-M producing E. coli isolates showed multidrug resistance phenotypes to at least four antibiotics. The highest incidence of an-tibiotics resistance was showed to ampicillin (100.0%), cefotaxime (100.0%), and cef-podoxime (100.0%), followed by streptomycin (84.3%), trimethoprim-sulfamethoxazole (73.7%), erythromycin (52.6%), kanamycin (26.3%), doxycycline (10.5%), and ceftazi-dime (0.0%). Conclusions: Detection of CTX-M-producing E. coli in cattle feces raises important questions as they can represent a potential risk factor to public health.

  12. Antibiotic resistance patterns of more than 120 000 clinical Escherichia coli isolates in Southeast Austria, 1998-2013.

    Science.gov (United States)

    Badura, A; Feierl, G; Pregartner, G; Krause, R; Grisold, A J

    2015-06-01

    Antibiotic resistance patterns of more than 120 000 clinical Escherichia coli isolates were retrospectively analysed. Isolates originated from both hospitalized patients and outpatients from the region of southeast Austria from 1998 to 2013. Except for amoxicillin/clavulanic acid, nitrofurantoin and piperacillin/tazobactam, all of the antibiotics analysed showed increasing proportions of resistant isolates over time, which were most prominent for ampicillin (from 25.4% in 1998 to 40% in 2013), cefotaxime (0.1% to 6.7%), ceftazidime (0.3% to 14.2%), ciprofloxacin (4.3% to 16.7%) and trimethoprim/sulfamethoxazole (14.6% to 24.8%). There was a marked increase in extended-spectrum β-lactamase-positive isolates (0.1% to 6.3%) starting in 2005, with male patients and hospital-related patients showing a higher increase than female patients and outpatients. Proportions of resistant isolates for most antibiotics were generally higher for male patients and hospital-related patients. Amikacin, nitrofurantoin and trimethoprim/sulfamethoxazole showed a marked increase in resistance proportions among male subjects aged 10 to 19 years which were absent for female subjects, indicating a strong modulation potential of host characteristics.

  13. Ertapenem Articulating Spacer for the Treatment of Polymicrobial Total Knee Arthroplasty Infection

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    Dragan Radoicic

    2016-01-01

    Full Text Available Introduction. Periprosthetic joint infections (PJIs are the primary cause of early failure of the total knee arthroplasty (TKA. Polymicrobial TKA infections are often associated with a higher risk of treatment failure. The aim of the study was to assess the efficacy of ertapenem loaded spacers in the treatment of polymicrobial PJI. Methods. There were 18 patients enrolled; nine patients with polymicrobial PJI treated with ertapenem loaded articulating spacers were compared to the group of 9 patients treated with vancomycin or ceftazidime loaded spacers. Results. Successful reimplantation with revision implants was possible in 66.67%. Ertapenem spacers were used in 6 cases in primary two-stage procedure and in 3 cases in secondary spacer exchange. Successful infection eradication was achieved in all cases; final reimplantation with revision knee arthroplasty implants was possible in 6 cases. Conclusion. Ertapenem can be successfully used as antimicrobial addition to the cement spacers in two-stage revision treatment of polymicrobial PJIs. However, this type of spacer may also be useful in the treatment of infections caused by monomicrobial extended spectrum beta-lactamases producing gram-negative bacilli. Further clinical studies are required to evaluate the efficacy and safety of ertapenem spacers in the treatment of polymicrobial and monomicrobial PJIs.

  14. 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.

  15. A structural, epidemiological & genetic overview of Klebsiella pneumoniae carbapenemases (KPCs

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    C H Swathi

    2016-01-01

    Full Text Available Klebsiella pneumoniae carbapenemases (KPCs are plasmid encoded carbapenem hydrolyzing enzymes which have the potential to spread widely through gene transfer. The instability of upstream region of blaKPC accelerates emergence of different isoforms. Routine antibiotic susceptibility testing failed to detect KPC producers and some commercial kits have been launched for early identification of KPC producers. Notable among the drugs under development against KPC are mostly derivatives of polymixin; ß-lactamase inhibitor NXL104 with combination of oxyimino cephalosporin as well as with ceftazidime; a novel tricyclic carbapenem, LK-157, potentially useful against class A and class C enzymes; BLI-489-a bicyclic penem derivative; PTK-0796, a tetracycline derivative and ACHN-490. Combination therapy might be preferable to control KPC infections in immediate future. Clinicians are likely to opt for unconventional combinations of antibiotics to treat KPC infections because of unavailability of alternative agents. The KPCs have become endemic in many countries but there is no optimal treatment recommendation available for bacteria expressing KPCs. Reports of outbreaks involving KPCs have focused mainly on laboratory identification, empirical treatment outcomes and molecular epidemiology. This review includes information on the emergence of KPC variants, limitations of phenotyping methods, available molecular methods for identification of the KPC variants and treatment options highlighting the drugs under development.

  16. Antimicrobial susceptibility of Acinetobacter clinical isolates and emerging antibiogram trends for nosocomial infection management

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    Muhammad Sohail

    2016-06-01

    Full Text Available Abstract: Introduction: The drug resistant Acinetobacter strains are important causes of nosocomial infections that are difficult to control and treat. This study aimed to determine the antimicrobial susceptibility patterns of Acinetobacter strains isolated from different clinical specimens obtained from patients belonging to different age groups. METHODS: In total, 716 non-duplicate Acinetobacter isolates were collected from the infected patients admitted to tertiary-care hospitals at Lahore, Pakistan, over a period of 28 months. The Acinetobacter isolates were identified using API 20E, and antimicrobial susceptibility testing was performed and interpreted according to Clinical and Laboratory Standards Institute (CLSI guidelines. RESULTS: The isolation rate of Acinetobacter was high from the respiratory specimens, followed by wound samples. Antibiotic susceptibility analyses of the isolates revealed that the resistance to cefotaxime and ceftazidime was the most common, in 710 (99.2% specimens each, followed by the resistance to gentamicin in 670 (93.6% isolates, and to imipenem in 651 (90.9% isolates. However, almost all isolates were susceptible to tigecycline, colistin, and polymyxin B. CONCLUSIONS: The present study showed the alarming trends of resistance of Acinetobacter strains isolated from clinical specimens to the various classes of antimicrobials. The improvement of microbiological techniques for earlier and more accurate identification of bacteria is necessary for the selection of appropriate treatments.

  17. SENSITIVITY TO ANTIBIOTICS, ANTISEPTICAL NOSOCOMIAL PSEUDOMONAS AERUGINOSA, ISOLATED IN UROLOGICAL PATIENTS

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    Rymsha E.V.

    2015-05-01

    cultures around the disks with antibiotics. To explore sensitivity to antiseptics used commercial samples drug Decesan® (decamethoxin of 0.02% solution ("YURI-PHARM", Ukraine, Miramistin® 0.01% solution (benzyldimethyl-myristoylation- Propylamine chloride monohydrate (ZAO Pharmaceutical firm "Darnitsa" and Chlorhexidine (chlorhexidine digluconate 0.05% solution (PJSC "Monfarm". Comparative evaluation of sensitivity of microorganisms to the test preparations was determined by the minimum bactericidal concentration (MBsC standard method, serial dilutions of the drug in a liquid medium (μg⁄ml. Results and discussion. Just received 20 nosocomially strains of P. аeruginosa. Isolated strains had the typical morphology polymorphic thin sticks, gramnegative on dense nutrient media formed a rounded, translucent colonies with a smooth edge, with a blue-green pigment. The biochemical properties referenceusa gram-negative bacteria were determined using Neverlast-24 (PLIVA – Lachema a. s. Brno, Czech Republic. The results of the determination of antibiotics susceptibility of tested strains P. aeruginosa. The greatest activity against the studied strains of P. аeruginosa had Meropenem, amikacin, ceftazidime and imipenem. Nimensa frequency of resistant strains identified to Meropenem were insensitive to 10% of strains of P. aeruginosa. From resistant to Meropenem 6 strains had perekhresne resistance to imipenem. The second activity with β-lactam antibiotics were identified ceftazidime. Insensitive to it were 5%. Antoniniani penicillins were less active than the carbapenems and ceftazidime.So resistant to Pirillo/tazobactam were 30% of the isolates. The most frequent combinations of stability were gentamicin – piperacillin 55,3%, gentamicin – piperacillin – piperacillin/tazobactam 35%. One strain of P. aeruginosa possessed simultaneously resistant to all antibiotics. Decesan and Miramistin had the same sensitivity P. aeruginosa (62.5± 8.94 μg∕ ml and 62.5±16,04

  18. Activity and interactions of antibiotic and phytochemical combinations against Pseudomonas aeruginosa in vitro

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    Premkumar Jayaraman, Meena K Sakharkar, Chu Sing Lim, Thean Hock Tang, Kishore R. Sakharkar

    2010-01-01

    Full Text Available In this study the in vitro activities of seven antibiotics (ciprofloxacin, ceftazidime, tetracycline, trimethoprim, sulfamethoxazole, polymyxin B and piperacillin and six phytochemicals (protocatechuic acid, gallic acid, ellagic acid, rutin, berberine and myricetin against five P. aeruginosa isolates, alone and in combination are evaluated. All the phytochemicals under investigation demonstrate potential inhibitory activity against P. aeruginosa. The combinations of sulfamethoxazole plus protocatechuic acid, sulfamethoxazole plus ellagic acid, sulfamethoxazole plus gallic acid and tetracycline plus gallic acid show synergistic mode of interaction. However, the combinations of sulfamethoxazole plus myricetin shows synergism for three strains (PA01, DB5218 and DR3062. The synergistic combinations are further evaluated for their bactericidal activity against P. aeruginosa ATCC strain using time-kill method. Sub-inhibitory dose responses of antibiotics and phytochemicals individually and in combination are presented along with their interaction network to suggest on the mechanism of action and potential targets for the phytochemicals under investigation. The identified synergistic combinations can be of potent therapeutic value against P. aeruginosa infections. These findings have potential implications in delaying the development of resistance as the antibacterial effect is achieved with lower concentrations of both drugs (antibiotics and phytochemicals.

  19. 头孢他定与头孢噻肟对泌尿系产超广谱β-内酰胺酶的大肠埃希菌检出率分析

    Institute of Scientific and Technical Information of China (English)

    张秀芳; 胡地侠; 李忠民; 韵国萍

    2008-01-01

    目的:了解头孢他定(Ceftazidime, CAZ)和头孢噻肟(Cefotaxime Sodium, CTX)对我院引起泌尿系感染的大肠埃希菌(Escheriehia coli, ECO)产超广谱β-内酰胺酶(extended-spectrum β-lactamase, ESBLs)菌株的体外检出特点,以更好的筛选出高度耐药菌株,避免漏检.方法:用K-B纸片筛选及确证试验,对126株大肠埃希菌(ECO)进行产超广谱β-内酰胺酶(ESBLs)检测分析.结果:头孢噻肟对产ESBLs的ECO检出率为93.10%、头孢他定对产ESBLs的ECO检出率为44.83%.结论:头孢噻肟对产ESBLs的ECO检出率显著高于头孢他定对产ESBLs的ECO检出率.

  20. Outbreak Caused by blaOXA-72-Producing Acinetobacter baumannii ST417 Detected in Clinical and Environmental Isolates.

    Science.gov (United States)

    Tamayo-Legorreta, Elsa; Turrubiartes-Martínez, Edgar; Garza-Ramos, Ulises; Niño-Moreno, Perla; Barrios, Humberto; Sánchez-Pérez, Alejandro; Reyna-Flores, Fernando; Tovar-Oviedo, Juana; Magaña-Aquino, Martin; Cevallos, Miguel Angel; Silva-Sanchez, Jesus

    2016-03-01

    We characterized an outbreak of imipenem-resistant Acinetobacter baumannii with clinical and environmental isolates from a tertiary care hospital in San Luis Potosi, Mexico. During a 4-month period, a total of 32 nonrepetitive imipenem-resistant clinical isolates of A. baumannii were collected. All isolates were susceptible to colistin and tigecycline and resistant to cefepime, ceftazidime, ceftriaxone, imipenem, and meropenem. Genotyping by pulsed-field gel electrophoresis showed a major clone (A). Multilocus sequence type (MLST) analysis was performed, revealing sequence type (ST) 417 (ST417) and 208 (ST208). The blaIMP-, blaVIM-, blaGIM-, blaSIM-, blaNDM-type, and blaOXA-type (blaOXA-23-like, blaOXA-24-like, blaOXA-51-like, and blaOXA-58-like) genes were screened and showed that the blaOXA-51-like and blaOXA-24-like genes were present in all isolates. Sequencing and southern hybridization were performed, confirming the presence of the blaOXA-72 gene and its plasmid-borne nature. In addition, the blaOXA-72-XerC/XerD-like association was identified. These findings indicate that a clonal spread of blaOXA-72-producing A. baumannii ST417 had occurred throughout the hospital. The ST417 corresponded with a previous ST described in the United States.

  1. LiF Reduces MICs of Antibiotics against Clinical Isolates of Gram-Positive and Gram-Negative Bacteria

    Directory of Open Access Journals (Sweden)

    H. C. Syed

    2012-01-01

    Full Text Available Antibiotic resistance is an ever-growing problem yet the development of new antibiotics has slowed to a trickle, giving rise to the use of combination therapy to eradicate infections. The purpose of this study was to evaluate the combined inhibitory effect of lithium fluoride (LiF and commonly used antimicrobials on the growth of the following bacteria: Enterococcus faecalis, Staphyloccoccus aureus, Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, Serratia marcescens, and Streptococcus pneumoniae. The in vitro activities of ceftazidime, sulfamethoxazole-trimethoprim, streptomycin, erythromycin, amoxicillin, and ciprofloxacin, doxycycline, alone or combined with LiF were performed by microdilution method. MICs were determined visually following 18–20 h of incubation at 37°C. We observed reduced MICs of antibiotics associated with LiF ranging from two-fold to sixteen-fold. The strongest decreases of MICs observed were for streptomycin and erythromycin associated with LiF against Acinetobacter baumannii and Streptococcus pneumoniae. An eight-fold reduction was recorded for streptomycin against S. pneumoniae whereas an eight-fold and a sixteen-fold reduction were obtained for erythromycin against A. baumannii and S. pneumoniae. This suggests that LiF exhibits a synergistic effect with a wide range of antibiotics and is indicative of its potential as an adjuvant in antibiotic therapy.

  2. Novel Aminoglycoside Resistance Transposons and Transposon-Derived Circular Forms Detected in Carbapenem-Resistant Acinetobacter baumannii Clinical Isolates.

    Science.gov (United States)

    Karah, Nabil; Dwibedi, Chinmay Kumar; Sjöström, Karin; Edquist, Petra; Johansson, Anders; Wai, Sun Nyunt; Uhlin, Bernt Eric

    2016-01-11

    Acinetobacter baumannii has emerged as an important opportunistic pathogen equipped with a growing number of antibiotic resistance genes. Our study investigated the molecular epidemiology and antibiotic resistance features of 28 consecutive carbapenem-resistant clinical isolates of A. baumannii collected throughout Sweden in 2012 and 2013. The isolates mainly belonged to clonal complexes (CCs) with an extensive international distribution, such as CC2 (n = 16) and CC25 (n = 7). Resistance to carbapenems was related to blaOXA-23 (20 isolates), blaOXA-24/40-like (6 isolates), blaOXA-467 (1 isolate), and ISAba1-blaOXA-69 (1 isolate). Ceftazidime resistance was associated with blaPER-7 in the CC25 isolates. Two classical point mutations were responsible for resistance to quinolones in all the isolates. Isolates with high levels of resistance to aminoglycosides carried the 16S rRNA methylase armA gene. The isolates also carried a variety of genes encoding aminoglycoside-modifying enzymes. Several novel structures involved in aminoglycoside resistance were identified, including Tn6279, ΔTn6279, Ab-ST3-aadB, and different assemblies of Tn6020 and TnaphA6. Importantly, a number of circular forms related to the IS26 or ISAba125 composite transposons were detected. The frequent occurrence of these circular forms in the populations of several isolates indicates a potential role of these circular forms in the dissemination of antibiotic resistance genes.

  3. 下呼吸道感染采用不同抗生素方案治疗药学探析%Lower Respiratory Tract Infection with Different Antibiotic Regimens for the Treatment of Pharmacy

    Institute of Scientific and Technical Information of China (English)

    钱海霞

    2015-01-01

    目的 探讨下呼吸道感染采用不同抗生素方案进行治疗的效果,总结出最佳的治疗方案,为临床治疗提供参照的依据.方法 选取下呼吸道感染患者160例,分为ⅠⅡⅢⅣ四个组别,各45例.分别采用头孢他啶、头孢替安、甲磺酸左氧氟沙星注射液、五水头孢唑啉治疗.结果 ⅠⅡⅢⅣ四个组总有效率无差异P > 0.05.Ⅰ组、Ⅲ组治疗费用明显低于Ⅱ组、Ⅳ组,P 0.05. I group, III group treatment cost werelower than those in group II, group IV,P < 0.05. Conclusion In the treatment of lower respiratory tract infections, ideal use of ceftazidime, Levofloxacin Mesylate Injection effect, low cost.

  4. Development and validation of a fast and uniform approach to quantify β-lactam antibiotics in human plasma by solid phase extraction-liquid chromatography-electrospray-tandem mass spectrometry.

    Science.gov (United States)

    Colin, Pieter; De Bock, Lies; T'jollyn, Huybrecht; Boussery, Koen; Van Bocxlaer, Jan

    2013-01-15

    Monitoring of plasma antibiotic concentrations is necessary for individualization of antimicrobial chemotherapy dosing in special patient populations. One of these special populations of interest are the post-bariatric surgery patients. Until today, little is known on the effect of this procedure on drug disposition and efficacy. Therefore, close monitoring of antimicrobial plasma concentrations in these patients is warranted. A fast and uniform ultra-high-performance liquid chromatography (UPLC) method with tandem mass spectrometric detection (MS/MS) has been developed and qualified for the simultaneous quantification of β-lactam antibiotics in human plasma. Compounds included in this multi-component analysis are: amoxicillin, ampicillin, phenoxymethylpenicillin, piperacillin, cefuroxime, cefadroxil, flucloxacillin, meropenem, cefepime, ceftazidime, tazobactam, linezolid and cefazolin. After spiking of five different stable isotope labelled internal standards, plasma samples were prepared for UPLC-MS/MS analysis by mixed-mode solid phase extraction. The developed method was proven to be free of (relative) matrix effects and proved to be reliable for the quantification of 12 out of 13 β-lactam antibiotics. As a proof of concept the method has been applied to plasma samples obtained from a healthy volunteer treated with amoxicillin. The analytical method is suitable for use in a therapeutic drug monitoring setting, providing the clinician with reliable measurements on β-lactam antibiotic plasma concentrations in a timely manner.

  5. Interactions of antimicrobial combinations in vitro: the relativity of synergism.

    Science.gov (United States)

    Blaser, J

    1990-01-01

    Interactions of combinations of netilmicin, amikacin, piperacillin, imipenem, azlocillin, ceftazidime or moxalactam were studied in vitro against Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus. Microtiter checkerboard technique was compared with standard killing curve method and with killing curves obtained in kinetic in vitro models mimicking single or multiple dosing regimens according to human pharmacokinetics. Antibiotic combinations were classified as antagonistic, indifferent or synergistic. Disagreement between classification by checkerboard and by kinetic model was found in 14 of 33 combinations studied (42%). Further analysis by standard killing curve method demonstrated that synergism or antagonism is a relative, not an absolute feature of drug combinations against given pathogens. Factors contributing to disagreements included the concentrations studied relative to the bacterial sensitivity, the ratio of concentrations of the two drugs tested, the size of the bacterial inoculum and the endpoint of the interaction assessment. Standard in vitro methods do not consider changes of antibiotic concentrations over time during combination therapy. Concentrations studied are defined according to bacterial sensitivity (fractions of MIC). Therefore, they may or may not relate to those at the infected site. The observed discrepancies between standard methods for testing drug interaction and a model which more closely reflects human pharmacokinetics support the argument that standard synergy testing provides incomplete data to reliably design clinical combination therapy.

  6. [Spreading and mechanisms of antibiotic resistance of microorganisms, producing beta-lactamases. Molecular mechanisms of resistance to beta-lactams of Klebsiella spp. strains, isolated in cases of nosocomial infections].

    Science.gov (United States)

    Ivanov, D V; Egorov, A M

    2008-01-01

    Antibiotic sensivity of nosocomial Klebsiella spp. strains (n = 212), isolated from patients treated in 30 medical centers of 15 various regions of Russia was investigated. The Klebsiella genus was represented by the following species: Klebsiella pneumoniae ss. pneumoniae--182 (85.8%), Klebsiella pneumoniae ss. ozaenae--1 (0.5%), Klebsiella oxytoca--29 (13.7%) isolates. The most active antibacterial agents against the investigated strains were carbapenems (imipenem and meropenem). Among 3rd generation cephalosporine the lowest MICs were observed for ceftazidime/clavulanic acid (MIC50--0.25 microg/ml, MIC90--64 microg/ml) and cefoperazone/sulbactam (MIC50--16 microg/ml, MIC90--64 microg/ml). Beta-lactamase genes (TEM, SHV, CTX) were detected in 42 Klebsiella pneumoniae ss. pneumoniae strains by PCR. Alone or in various combinations TEM type beta-lactamases have been found in 16 (38.1%) isolates, SHV--in 29 (69%), and CTX--in 27 (64.3%). Combinations of 2 different determinants were detected in 23.8% of the isolates, 3--in 26.2%. There were not isolates producing MBL class B among resistant to carbapenems nosocomial Klebsiella spp. strains.

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

  8. Silver nanoparticles strongly enhance and restore bactericidal activity of inactive antibiotics against multiresistant Enterobacteriaceae.

    Science.gov (United States)

    Panáček, Aleš; Smékalová, Monika; Večeřová, Renata; Bogdanová, Kateřina; Röderová, Magdaléna; Kolář, Milan; Kilianová, Martina; Hradilová, Šárka; Froning, Jens P; Havrdová, Markéta; Prucek, Robert; Zbořil, Radek; Kvítek, Libor

    2016-06-01

    Bacterial resistance to conventional antibiotics is currently one of the most important healthcare issues, and has serious negative impacts on medical practice. This study presents a potential solution to this problem, using the strong synergistic effects of antibiotics combined with silver nanoparticles (NPs). Silver NPs inhibit bacterial growth via a multilevel mode of antibacterial action at concentrations ranging from a few ppm to tens of ppm. Silver NPs strongly enhanced antibacterial activity against multiresistant, β-lactamase and carbapenemase-producing Enterobacteriaceae when combined with the following antibiotics: cefotaxime, ceftazidime, meropenem, ciprofloxacin and gentamicin. All the antibiotics, when combined with silver NPs, showed enhanced antibacterial activity at concentrations far below the minimum inhibitory concentrations (tenths to hundredths of one ppm) of individual antibiotics and silver NPs. The enhanced activity of antibiotics combined with silver NPs, especially meropenem, was weaker against non-resistant bacteria than against resistant bacteria. The double disk synergy test showed that bacteria produced no β-lactamase when treated with antibiotics combined with silver NPs. Low silver concentrations were required for effective enhancement of antibacterial activity against multiresistant bacteria. These low silver concentrations showed no cytotoxic effect towards mammalian cells, an important feature for potential medical applications.

  9. Diversity and antibiotic resistance of Aeromonas spp. in drinking and waste water treatment plants.

    Science.gov (United States)

    Figueira, Vânia; Vaz-Moreira, Ivone; Silva, Márcia; Manaia, Célia M

    2011-11-01

    The taxonomic diversity and antibiotic resistance phenotypes of aeromonads were examined in samples from drinking and waste water treatment plants (surface, ground and disinfected water in a drinking water treatment plant, and raw and treated waste water) and tap water. Bacteria identification and intra-species variation were determined based on the analysis of the 16S rRNA, gyrB and cpn60 gene sequences. Resistance phenotypes were determined using the disc diffusion method. Aeromonas veronii prevailed in raw surface water, Aeromonas hydrophyla in ozonated water, and Aeromonas media and Aeromonas puntacta in waste water. No aeromonads were detected in ground water, after the chlorination tank or in tap water. Resistance to ceftazidime or meropenem was detected in isolates from the drinking water treatment plant and waste water isolates were intrinsically resistant to nalidixic acid. Most of the times, quinolone resistance was associated with the gyrA mutation in serine 83. The gene qnrS, but not the genes qnrA, B, C, D or qepA, was detected in both surface and waste water isolates. The gene aac(6')-ib-cr was detected in different waste water strains isolated in the presence of ciprofloxacin. Both quinolone resistance genes were detected only in the species A. media. This is the first study tracking antimicrobial resistance in aeromonads in drinking, tap and waste water and the importance of these bacteria as vectors of resistance in aquatic environments is discussed.

  10. Resistance trends in gram-negative bacteria: surveillance results from two Mexican hospitals, 2005–2010

    Directory of Open Access Journals (Sweden)

    Morfin-Otero Rayo

    2012-06-01

    Full Text Available Abstract Background Hospital-acquired infections caused by multiresistant gram-negative bacteria are difficult to treat and cause high rates of morbidity and mortality. The analysis of antimicrobial resistance trends of gram-negative pathogens isolated from hospital-acquired infections is important for the development of antimicrobial stewardship programs. The information obtained from antimicrobial resistant programs from two hospitals from Mexico will be helpful in the selection of empiric therapy for hospital-acquired gram-negative infections. Findings Two thousand one hundred thirty two gram-negative bacteria collected between January 2005 and December 2010 from hospital-acquired infections occurring in two teaching hospitals in Mexico were evaluated. Escherichia coli was the most frequently isolated gram-negative bacteria, with >50% of strains resistant to ciprofloxacin and levofloxacin. Klebsiella spp. showed resistance rates similar to Escherichia coli for ceftazidime (33.1% vs 33.2%, but exhibited lower rates for levofloxacin (18.2% vs 56%. Of the samples collected for the third most common gram-negative bacteria, Pseudomonas aeruginosa, >12.8% were resistant to the carbapenems, imipenem and meropenem. The highest overall resistance was found in Acinetobacter spp. Enterobacter spp. showed high susceptibility to carbapenems. Conclusions E. coli was the most common nosocomial gram-negative bacilli isolated in this study and was found to have the second-highest resistance to fluoroquinolones (>57.9%, after Acinetobacter spp. 81.2%. This finding represents a disturbing development in a common nosocomial and community pathogen.

  11. Achromobacter xylosoxidans keratitis after contact lens usage.

    Science.gov (United States)

    Park, Jung Hyun; Song, Nang Hee; Koh, Jae Woong

    2012-02-01

    To report on Achromobacter xylosoxidans keratitis in two healthy patients who had worn contact lenses foran extended period of time. A 36-year-old female and a 21-year-old female visited our hospital with ocular pain and blurred vision. Both patients had a history of wearing soft contact lenses for over fve years with occasional overnight wear. At the initial presentation, a slit lamp examination revealed corneal stromal infiltrations and epithelial defects with peripheral neovascularization in both patients. Microbiological examinations were performed from samples of corneal scrapings, contact lenses, contact lens cases, and solution. The culture resulting from the samples taken from the contact lenses, contact lens cases, and solution were all positive for Achromobacter xylosoxidans. Confrming that the direct cause of the keratitis was the contact lenses, the frst patient was prescribed ceftazidime and amikacin drops sensitive to Achromobacter xylosoxidans. The second patient was treated with 0.3% gatifoxacin and fortifed tobramycin drops. After treatment, the corneal epithelial defects were completely healed, and subepithelial corneal opacity was observed. Two cases of Achromobacter xylosoxidans keratitis were reported in healthy young females who wore soft contact lenses. Achromobacter xylosoxidans should be considered a rare but potentially harmful pathogen for lens-induced keratitis in healthy hosts.

  12. Nosocomial infection by sequence type 357 multidrug-resistant Acinetobacter baumannii isolates in a neonatal intensive care unit in Daejeon, Korea.

    Science.gov (United States)

    Sung, Ji Youn; Koo, Sun Hoe; Cho, Hye Hyun; Kwon, Kye Chul

    2013-07-01

    Acinetobacter baumannii is an important microorganism responsible for a number of nosocomial outbreaks, in particular, in intensive care units (ICUs). We investigated a nosocomial infection caused by multidrug-resistant (MDR) A. baumannii in a neonatal intensive care unit (NICU) in Korea. A. baumannii isolates were characterized using Etest (AB Biodisk, Sweden), two multiplex PCR assays, and multilocus sequence typing (MLST) scheme. PCR and PCR mapping experiments were performed for detecting and characterizing the determinants of antimicrobial resistance. Eight strains isolated from an NICU belonged to European (EU) clone II and revealed only one sequence type (ST), namely, ST357. All the isolates were susceptible to imipenem but were resistant to amikacin, gentamicin, ceftazidime, cefepime, and ciprofloxacin. To the best of our knowledge, this is the first report of a nosocomial infection in an NICU in Korea caused by ST357 MDR/carbapenem-susceptible A. baumannii strains. This result demonstrates that nosocomial outbreaks of MDR/carbapenem-susceptible strains as well as MDR/carbapenem-resistant isolates may occur in NICUs.

  13. Increasing Trend of Resistance to Penicillin, Tetracycline, and Fluoroquinolone Resistance in Neisseria gonorrhoeae from Pakistan (1992–2009

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    Kauser Jabeen

    2011-01-01

    Full Text Available Emergence and spread of drug resistant Neisseria gonorrhoeae is global concern. We evaluated trends of antimicrobial resistance in Neisseria gonorrhoeae over years 1992–2009 in Pakistan. Resistance rates were compared between years (2007–2009 and (1992–2006. Antimicrobial susceptibility testing was performed and interpreted according to Clinical Laboratory Standards Institute (CLSI criteria using the disk diffusion methodology against penicillin, ceftriaxone, tetracycline and ofloxacin. Additional antibiotics tested in 100 strains isolated during 2007–2009, included cefotaxime, cefoxitin, cefuroxime, cefipime, ceftazidime, ceftizoxime, cefixime, cefpodoxime, spectinomycin and azithromycin. Neisseria gonorrhoeae ATCC 49226 was used as control. Chi-square for trend analysis was conducted to assess resistance trend over the study period. During study period significant increase in combined resistance to penicillin, tetracycline and ofloxacin was observed (P value <0.01. Resistance rates during the two study period also increased significantly (P value <0.01. Ceftriaxone resistance was not observed. None of the isolates were found to be resistant or with intermediate sensitivity to additional antibiotics. Our findings suggest that penicillin, ciprofloxacin, tetracycline should not be used in the empirical treatment of gonorrhea in Pakistan. Ceftriaxone and cefixime should be the first line therapy; however periodic MICs should be determined to identify emergence of strains with reduced susceptibility.

  14. Metallo-β-lactamase-producing Pseudomonas aeruginosa in two hospitals from southern Brazil

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    Fernanda W. Wirth

    2009-06-01

    Full Text Available This study determined the prevalence of metallo-β-lactamase (MBL-producing Pseudomonas aeruginosa in two hospitals located in the Southern part of Brazil and compare the performance of two different phenotypic tests. Thirty-one non-repetitive Pseudomonas aeruginosa isolates from various clinical samples from patients admitted to two hospitals located in Rio Grande do Sul, Brazil (twenty-three from a hospital in Porto Alegre City and eight isolates from a hospital in Vale dos Sinos Region. All strains suggestive of possessing MBLs by phenotypic methods were included in this study. Phenotypic detection of MBLs was carried out simultaneously by using both the MBL Etest® and disk approximation test using 2-mercaptopropionic acid close to a ceftazidime disk. Strains positive were further confirmed using molecular techniques for blaVIM, blaIMP and blaSPM-1. The prevalence of MBLs from samplesof inpatients from the hospital located in Porto Alegre was 30.4% and that of inpatients from Vale dos Sinos hospital was only 3.1%. Only MBL type SPM-1 was detected in these samples by molecular analysis and all were detected by the Etest® MBL strips. The prevalence of P. aeruginosa that produce MBLs can be markedly different in distinct geographical areas, even among different hospitals in the same area. In our study, the EDTA-based method was the only method able to detect all strains harboring the SPM-1 enzyme.

  15. CTX-M producing Escherichia coli isolated from cattle feces in Bogor slaughterhouse,Indonesia

    Institute of Scientific and Technical Information of China (English)

    Mirnawati Bachrum Sudarwanto; Denny Widaya Lukman; Hadri Latif; Herwin Pisestyani; Eddy Sukmawinata; mer Akineden; Ewald Usleber

    2016-01-01

    Objective: To determine the occurrence of CTX-M producing Escherichia coli(E. coli)from cattle feces in Bogor slaughterhouse, Indonesia.Methods: A total of 220 cattle feces samples were collected from Bogor slaughterhouse from March to April 2015. Presence of extended-spectrum beta-lactamase(ESBL) producing E. coli was detected by disc diffusion test based on the recommendation from Clinical and Laboratory Standards Institute(2014). Bacterial strains which were confirmed as producing ESBLs were further analyzed for the presence of bla genes of the ESBL by PCR.Results: The results showed that CTX-M producing E. coli isolates were detected in 19 samples from 220 samples(8.6%). The b-lactamase genes detected were CTX-M-1(n = 10) and CTX-M-9(n = 9). All of the CTX-M producing E. coli isolates showed multidrug resistance phenotypes to at least four antibiotics. The highest incidence of antibiotics resistance was showed to ampicillin(100.0%), cefotaxime(100.0%), and cefpodoxime(100.0%), followed by streptomycin(84.3%), trimethoprim-sulfamethoxazole(73.7%), erythromycin(52.6%), kanamycin(26.3%), doxycycline(10.5%), and ceftazidime(0.0%).Conclusions: Detection of CTX-M-producing E. coli in cattle feces raises important questions as they can represent a potential risk factor to public health.

  16. Plasmid profiling and antibiotics resisitance of Escherichia coli strains isolated from Mytilus galloprovincialis and seawater

    Institute of Scientific and Technical Information of China (English)

    Cumhur Avşar; İsmet Berber

    2014-01-01

    Objective: To investigate plasmid DNA profiles and the antibiotic resistance of a total of 41 strains of Escherichia coli (E. coli) isolated from seawater and mussel collected from 15 different sampling stations in Sinop, Turkey. Methods: Most probable number technique was used for detection of E. coli. Antibiotic susceptibilities of the isolates were determined by the disc diffusion method. Plasmid DNA of the strains was extracted by the alkaline lyses procedure.Results:According to morphological and physiological properties, it was determined that the isolates belonged to E. coli species. Antibiotic susceptibility of the strains was determined against seven standard drugs using disc diffusion method. All isolates were resistant to bacitracin (100%), novobiocin (100%), ampicillin (12.5%), tetracycline (7.5%), ceftazidime (5%) and imipenem (2.5%), respectively, whereas the strains were susceptible to polymyxin B (100%). The multiple antibiotic resistance values for the strains were found in range from 0.28 to 0.57. In addition, plasmid DNA analyses results confirmed that 22 strains harbored a single or more than two plasmids sized approximately between 24.500 to 1.618 bp. The high-size plasmid (14.700 bp) was observed as common in 21 of all strains.Conclusions:As a result, our study indicated that the presence of antibiotic resistant E. coli strains in seawater and mussel might be potential risk for public health issue.

  17. 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.

  18. Cephalosporin resistance in Pseudomonas aeruginosa, with special reference to the proposed trapping of antibiotics by beta-lactamase.

    Science.gov (United States)

    Livermore, D M; Williams, J D; Davy, K W

    1985-02-01

    Resistance of Pseudomonas aeruginosa strains to newer cephalosporins is often associated with stable derepression of synthesis of the chromosomal beta-lactamase. Similar resistance is developed by enzyme inducible (i.e. normal) strains in response to beta-lactamase inducers. By comparing the responses of otherwise isogenic P. aeruginosa beta-lactamase inducibility mutants to antipseudomonal cephalosporins alone or in combination with potent beta-lactamase inducers we confirmed that resistance to cefotaxime, ceftriaxone, cefoperazone, and ceftazidime and latamoxef was caused by beta-lactamase action. The low-level resistance to carbenicillin and cefsulodin which was exhibited by some fully beta-lactamase derepressed strains was not confirmed to be beta-lactamase determined and may have reflected concurrent target or permeability changes. The mechanism whereby the enzyme protected the cell against cefotaxime and ceftriaxone was also investigated. These agents are reportedly stable to the enzyme and some workers have suggested that resistance entails their being trapped rather than hydrolysed. However, the use of a novel model of cellular beta-lactamase function indicated that a hydrolytic resistance mechanism remained likely.

  19. [Bone marrow transplantation in Mexico. Report of the 1st successful case in acute myeloblastic leukemia. Grupo de Trasplante Medular Oseo del INNSZ].

    Science.gov (United States)

    León, E; Sosa, R

    1992-01-01

    The first case of allogeneic bone marrow transplantation in acute myelogenous leukemia (AML) done in Mexico is reported. The patient was a 26 year old Mexican woman who in October 1987 was diagnosed of having AML of the M2 subtype. After three cycles of the TADOP regimen (6-thioguanine, cytosine-arabinoside, doxorubicin, vincristine & prednisone), the patient entered complete remission. Unfortunately, after a seven month period of remission she suffered a relapse which was refractory to a new chemotherapy cycle. On 9/14/88 an allogeneic BMT from her HLA identical brother was performed. The conditioning regimen consisted of busulfan and cyclophosphamide. Prophylaxis for GVHD consisted of cyclosporine and methylprednisolone. The posttransplantation course was satisfactory, reaching > 500 neutrophils x 10(9)/L on day 14 and > 50,000 platelets x 10(9)/L without support on day 23 posttransplant. The patient developed fever of unknown etiology, which was satisfactorily resolved with ceftazidime, vancomycin and metronidazole. She also presented a grade II oral and esophageal mucositis. As a late complication, on day 90 posttransplant, she developed a bilateral pneumonia which was resolved with sulfamethoxazole-trimethoprim administration. Up to the time of this report (40 months posttransplant) the patient is completely asymptomatic, is under no immunosuppression, and shows no evidence of graft versus host disease or recurrent leukemia.

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

    Science.gov (United States)

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

    2015-03-01

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

  1. Fecal Carriage of ESbL types TEM, SHV, CTX Producing Genera Proteus, Morganella, Providencia in Patients of Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Taghi Akhi

    2016-10-01

    Full Text Available Diseases like urinary tract infection, wound infections, bacteremia and other infections are mainly caused by the members of the genus Proteus, Morganella and Providencia which are mainly either found freely in the environment or in the gastrointestinal tract of humans. We studied Fecal carriage of ESbL producing species in carrier patients.Stool samples obtained from outpatients and inpatients not suffering from diarrhea and were cultured in CTX-MC-Conkey agar. Lactose negative and cefotaxime resistant bacteria were identified by biochemical tests and ESbL-producing isolates were detected using Combined Test. TEM, SHV and CTX genes were investigated by PCR.Total 15 (7.35% isolates of 204 stool samples were identified as ESBL producing Proteus spp. (n=4, 1.96%, Morganella spp. (n=5, 2.45% and Providencia spp. (n=6, 2.94%. Further, amongst or of the 15 ESbL producing strains, blaTEM was the commonest genotype (86.66%, followed by blaSHV (26.66% and blaCTX-M (20%. All isolates were resistant to ampicillin, and cefotaxime whereas all Providencia and Morganella spp. were found to resist ceftazidime. Although the number of ESbL-producing Proteus, Morganella and Providencia isolates from fecal carriers were low, but still, they can be considered as a reservoir of TEM, SHV and CTX genes and capable to transfer these resistant bacteria to hospitals.

  2. Elizabethkingia meningosepticum in a Patient with Six-Year Bilateral Perma-Catheters.

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    Boroda, Konstantin; Li, Li

    2014-01-01

    Elizabethkingia meningosepticum (EM) is a saprophyte which is ubiquitous in nature, but not normally present in the human flora. Instances of infection are rare in the USA, but EM may be an emerging pathogen among immune-compromised patients. EM can cause a variety of infections, but nosocomial pneumonia and bacteremia have been the most commonly reported among immune-compromised adults. EM has proven difficult to treat with a mortality rate of 23%-41% in adult bacteremia. This is likely due to its resistance to commonly used empiric antibiotics for Gram-negative infections. A review of the literature suggests that there has been a shift EM's susceptibility profile over time along with a great variability in antibiotic susceptibilities reported. This signifies the importance of close monitoring of these changes. In this report we present a case of a 64-year-old male with end stage renal disease and bilateral subclavian perma-catheters, who was admitted with systemic inflammatory response syndrome. While initial peripheral blood cultures were negative, cultures later drawn from his perma-catheters revealed Corneybacterium species and EM. The patient was initially treated with empiric vancomycin and piperacillin-tazobactam. After antibiotics susceptibilities became available, he was treated with levofloxacin and ceftazidime. The patient improved, was culture negative, and later had perma-catheter removal.

  3. Microbiological Assessment of Poultry Feeds within Ilorin, Nigeria

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    Ismaila Olawale SULE

    2017-03-01

    Full Text Available The poultry feeds were obtained from 20 different poultry pens and their microbial contents were assessed. The antibiotics resistance patterns of the bacterial isolates were also determined. The bacterial count ranged from 5.0 × 103 to 1.76 × 106 cfu/g while the fungal count ranged from 3.5 × 104 to 1.9 × 105 cfu/g. The bacterial species isolated were Streptococcus salivarius, Streptococcus pyogenes, Micrococcus luteus, Micrococcus varians, Micrococcus roseus, Staphylococcus aureus, Staphylococcus saprophyticus and Staphylococcus hominis, while the fungal species isolated were Saccharomyces cerevisisae, Fusarium oxysporum, Penicillium sp., Humicola grisea, Aspergillus fumigatus, Hansenula sp. and Humicola fuscoatra. All the bacterial isolates were resistant to ceftazidime and cefuroxime and all the isolates were resistant to at least three antibiotics. Ofloxacin produced the highest zone of inhibition, followed by gentamicin, and then erythromycin. The presence of some pathogenic microorganisms in the poultry feeds revealed high level of contaminations. It is recommended that poultry feeds should be made from good quality grains and it should be prevented from environmental or other contamination.

  4. Pattern of chronic suppurative otitis media.

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    Kabir, M S; Joarder, A H; Ekramuddaula, F M; Uddin, M M; Islam, M R; Habib, M A

    2012-04-01

    This observational study was conducted to know the bacteriological pattern of chronic suppurative otitis media. For this 110 patients of Chronic Suppurative Otitis Media (CSOM) were selected from January 2006 to December 2007 at the out patient department of Otolaryngology and Head Neck surgery, BSMMU and Dhaka Medical College Hospital, Dhaka. Among the 110 patients unilateral involvement was 76.36% and bilateral involvement was 23.64%. Ninety percent patients presented with tubotympanic variety and 10% patients presented with attico-antral variety. Bacteriologically pure growth was found in 79.09% cases, mixed growth in 10.91% cases, no growth in 10% cases. Only aerobic bacteria were isolated in the present series. Pseudomonas aeruginosa was the most common organism (43.68%) isolated in pure culture followed by staphylococcus aureus 27.59%, E. coli 10.35%, Kleibsiella spp. 9.19%, proteus spp. 8.04%. Amikacin was the most effective antibiotic followed by Gentamycin, Ciprofloxacin, Ceftazidime, Cetriaxone. Before giving therapy bacterial growth and sensitivity pattern is to be known where facilities are available.

  5. Antibiotic sensitivity pattern of bacterial pathogens in the intensive care unit of Fatmawati Hospital, Indonesia

    Institute of Scientific and Technical Information of China (English)

    Maksum Radji; Siti Fauziah; Nurgani Aribinuko

    2011-01-01

    Objective: To evaluate the sensitivity pattern of bacterial pathogens in the intensive care unit (ICU) of a tertiary care of Fatmawati Hospital Jakarta Indonesia. Methods: A cross sectional retrospective study of bacterial pathogen was carried out on a total of 722 patients that were admitted to the ICU of Fatmawati Hospital Jakarta Indonesia during January 2009 to March 2010. All bacteria were identified by standard microbiologic methods, and their antibiotic susceptibility testing was performed using disk diffusion method. Results: Specimens were collected from 385 patients who were given antimicrobial treatment, of which 249 (64.68%) were cultured positive and 136 (35.32%) were negative. The most predominant isolate was Pseudomonas aeruginosa (P. aeruginosa) (26.5%) followed by Klebsiella pneumoniae (K. pneumoniae) (15.3%) and Staphylococcus epidermidis (14.9%). P. aeruginosa isolates showed high rate of resistance to cephalexin (95.3%), cefotaxime (64.1%), and ceftriaxone (60.9%). Amikacin was the most effective (84.4%) antibiotic against P. aeruginosa followed by imipenem (81.2%), and meropenem (75.0%). K. pneumoniae showed resistance to cephalexin (86.5%), ceftriaxone (75.7%), ceftazidime (73.0%), cefpirome (73.0%) and cefotaxime (67.9%), respectively. Conclusions: Most bacteria isolated from ICU of Fatmawati Hospital Jakarta Indonesia were resistant to the third generation of cephalosporins, and quinolone antibiotics. Regular surveillance of antibiotic susceptibility patterns is very important for setting orders to guide the clinician in choosing empirical or directed therapy of infected patients.

  6. Are we aware how contaminated our mobile phones with nosocomial pathogens?

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    Ulger Fatma

    2009-03-01

    Full Text Available Abstract Background The objective of this study was to determine the contamination rate of the healthcare workers' (HCWs' mobile phones and hands in operating room and ICU. Microorganisms from HCWs' hands could be transferred to the surfaces of the mobile phones during their use. Methods 200 HCWs were screened; samples from the hands of 200 participants and 200 mobile phones were cultured. Results In total, 94.5% of phones demonstrated evidence of bacterial contamination with different types of bacteria. The gram negative strains were isolated from mobile phones of 31.3% and the ceftazidime resistant strains from the hands were 39.5%. S. aureus strains isolated from mobile phones of 52% and those strains isolated from hands of 37.7% were methicillin resistant. Distributions of the isolated microorganisms from mobile phones were similar to hands isolates. Some mobile phones were contaminated with nosocomial important pathogens. Conclusion These results showed that HCWs' hands and their mobile phones were contaminated with various types of microorganisms. Mobile phones used by HCWs in daily practice may be a source of nosocomial infections in hospitals.

  7. Prevalence of Gram Negative Bacteria in Diabetic Foot -A Clinico-Microbiological Study

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    G.S.Banashankari

    2012-07-01

    Full Text Available Aim and Objective: To determine the bacterial spectrum in diabetic foot lesions and analyze the antibiotic susceptibility pattern of the isolated bacteria. Methods and Methodology: Tissue samples/discharge/pus/ were cultured from 202 patients admitted for the treatment of diabetic foot infections. Specimens were tested by gram stain, culture and antibiotic sensitivity. Results: A total of 202 specimens were cultured, yielding 246 bacteria at the end of 18-24hrs. Gram negative aerobes were the most frequently isolated bacteria constituting 162 isolates (66%, followed by gram- positive aerobes 78 isolates (32%. Enterobacteriaceae group and P. aeruginosa strains were largely susceptible to imipenem (100%, piperacillin-tazobactam, ceftazidime, aminoglycosides, and ciprofloxacin. More than 70% of staphylococcus aureus was sensitive to methicillin. Cefoperazone + sulbactum showed about 67% sensitivity, while ciprofloxacin and amikacin were only 23% and 44% sensitive. MRSA was isolated in 20 cases (47% of S.aureus and Methicillin resistant coagulase negative staphylococcus in 2 cases (15% of coagulase negative staphylococcus. Methicillin resistant organisms were sensitive to vancomycin (95%. Conclusion: Diabetic foot infections are predominantly due to gram positive bacteria like Staphylococcus aureus or polymicrobial. There is a growing trend of isolating gram negative bacteria in these naïve lesions of the diabetic foot. The need for adequate gram negative antibacterial coverage at the commencement of diabetic foot therapy is essential to prevent and treat limb/life threatening infections.

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

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    Maryam Mobarak-Qamsari

    2013-09-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  10. Resistencia bacteriana a antibióticos en el Hospital San Juan de Dios, 1995-1999

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    Ricardo Boza-Cordero

    2001-07-01

    reviewed. The files of the bacteriology laboratory of the hospital was done. We analized bacterial strains from 1995 to 1999. Data from 1996 were incomplete and were not studied. All isolates were analized in the automatized system VITEK®. Streptococcus pneumoniae strains from blood or sputum were studied by the E-test method and their sensitivity ranges met the NCCLS criteria. Results: We studied 2817 Gram positive cocci (GPC strains and 7626 isolates of Gram negative bacteria (GNB. Staphylococcus aureus was the most frequently GPC specie found and Escherichia coliwas the most common GNB. More than 90% of staphylococcal species produced ß-lactamase and were resistant to penicillin. Resistance to oxacillin (methicillin in Staphylococcus aureus increased from 35% to 52% in this period. In coagulase negative staphylococci the resistance to this antibiotic was very high (70-77%. Susceptibility to cephalotin and clindamycin in Staphylococcus aureus was similarly high (50-60% in the years studied and in coagulase negative staphylococci (Staphylococcus epidermidis the resistance stayed in high levels (65-70%. There were not resistance to vancomycin in the staphylococci analyzed. Ninety eight per cent of the 61 isolates of Streptococcus pneumoniae were susceptible to penicillin. Susceptibility to penicillin was observed in 80% of 483 isolates of Enterococcus faecalis. Fifty percent of the enterococci showed synergism between gentamicin and cell-wall active agents. Only a few isolates of Enterococcus faecuim were analized and no resistance to vancomycin was found. Resistance to aminoglycosides was demonstrated in 50% of enterococci isolates. Regarding enterobacterias, Escherichia colistrains presented high resistance to ampicillin (60%, sulfa trimetoprin (60% and a decrease in the susceptibility to ceftazidime from 90% in 1995 to 65% in 1999, to cefotaxime from 95% to 88%, from 67% to 57% to cephalotin and from 100% to 85% to amikacin in the same period. Resistance to

  11. Patrones de resistencia bacteriana en urocultivos en un hospital oncológico Antimicrobial resistance patterns of isolates from urine cultures at an oncological center

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    Patricia Cornejo-Juárez

    2007-10-01

    .4%. Escherichia coli was the most frequently isolated bacterium (41.3%; antimicrobial resistance was higher in nosocomial isolates than in community strains (amikacin 92.4 vs. 97%, ceftazidime 83.1 vs. 95.1% and ciprofloxacin 46.2 vs. 58.6%. Pseudomonas aeruginosa showed a greater resistance to amikacin and ceftazidime in nosocomial cultures compared to community-acquired bacterial cultures (55.7 vs. 66.6% and 65.5 vs. 84.8% respectively. Vancomycin-resistant enterococci were found in only 2.5% (3 of 119 E. faecium isolates. CONCLUSIONS: Higher bacterial resistance was observed in nosocomial cultures than in community ones. Antimicrobial resistance was found to be progressively increasing for E. coli, the most frequent pathogen isolated both in nosocomial and community infections. We consider imperative the establishment of an intense educational campaign for the use and control of antibiotics.

  12. Relevant factors of nosocomial infection in cervical cancer patients underwent radical surgery%宫颈癌根治术患者医院感染相关因素分析

    Institute of Scientific and Technical Information of China (English)

    祝英杰; 王毅; 魏向群

    2011-01-01

    目的 分析宫颈癌根治术后患者医院感染的状况、特点、病原菌分布及其耐药性,探究其预防措施.方法 对2009年10月-2010年9月在医院行宫颈癌根治术患者120例进行医院感染相关因素调查分析.结果 120例宫颈癌根治术患者发生医院感染40例次,例次感染率为33.3%;手术部位感染最多见,占52.5%,其次为消化道感染,占27.5%;检出病原菌24株,以真菌(12株)占首位,其次为大肠埃希菌(9株);大肠埃希菌对亚胺培南的耐药率为0,对头孢他啶、头孢吡肟、阿米卡星耐药率分别为12.5%、12.5%、12.5%.结论 为减少医院感染的发生,除应严格无菌技术操作及加强术后切口的引流外,合理使用抗菌药物是预防医院感染的重要环节.%OBJECTIVE To analyze the status, characteristics, pathogenic distribution and drug resistance of nosocomial infection (NI) in cervical cancer patients after'surgical procedures and explore preventive measures. METHODS Relevant factors of nosocomial infections in 120 patients with cervical cancer after radical hysterectomy and pelvic lymphadenectomy from Oct. 2009 to Sep. 2010 were investigated. RESULTS In the 120 patients with cervical cancer after radical surgery, there were 40 cases of nosocomial infections, with the infection rate of 30. 0%( the main infection site was surgical site infection (SSI) (52. 5%), followed by gastrointestinal infection (27.5%). Among the 24 strains of pathogenic microbes, the predominant microorganisms were fungi (12 strains) .followed by Escherichia coli (9 strains). E. Coli showed the lowest resistance rate to imipenem, followed by ceftazidime, cefepime and amikacin. The drug resistance rates were 0, 12. 5%, 12. 5% and 12. 5% respectively. CONCLUSION It is vital to prevent and control surgical nosocomial infections by strict application of aseptic technique, enhancing incision drain and rational use of antimicrobial agents. OBJECTIVE To analyze the

  13. Extended-spectrum -lactamases and the antibiotic resistance in uropathogeni escherichia coli in children%儿童泌尿系感染产 ESBLs 大肠埃希菌的检测及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    吴永忠; 李玉珍; 盛学梅; 黄永辉; 余连芝

    2014-01-01

    目的:了解儿童泌尿系感染分离大肠埃希菌中产 ESBLs 菌株的发生率和产 ESBLs 菌株和非产 ES-BLs 的耐药性。方法儿童泌尿系感染分离的产 ESBLs 大肠埃希菌48株,通过 CLSI 表型确证试验(纸片增强法)检测产 ESBLs 菌株,琼脂稀释法进行药敏试验。结果48株儿童泌尿系感染分离的大肠埃希菌中,产 ESBLs 菌株的发生率为45.8%(22/48),其中复杂性尿路感染产 ESBLs 菌株高达66.7%(12/18)。产 ESBLs 菌株对氨苄西林,第一、二代头孢菌素,头孢噻肟耐药显著;对头孢他啶、头孢吡肟和阿莫西林/克拉维酸耐药率超过30%;对头孢哌酮/舒巴坦、头孢美唑、阿米卡星耐药率在30%以下;对美罗培南耐药率为0。非产 ESBLs 菌株对氨苄西林,第一、二代头孢菌素类耐药率较高,对其他抗菌药物均较为敏感。产 ESBLs 菌株对第一、二代头孢菌素,头孢噻肟,头孢他啶,头孢吡肟耐药率显著高于非产 ESBLs 菌株(P <0.05)。结论儿童泌尿系感染分离大肠埃希菌中产 ESBLs菌株的发生率较高,产 ESBLs 菌株多重耐药显著,临床应加强检测和监测。%Objective To investigate the prevalence of extended-spectrum -lactamases(ESBLs)and the antibiotic resistance in uropathogeni escherichia coli in children. Methods A total of 48 uropathogenic escherichia coli strains isola-ted,ESBLs-producers were detected by CLSI phenotypic confirmatory test and susceptibilities were tested by agar dilution method. Results 45. 8% of isolates were ESBLs producers in those isolates,and ESBLs-producers account for 66. 7%strains in the complicated urinary tract infection. ESBLs producers were highly resistant to ampicillin,cefazolin,cefuroxime and cefotaxime. The resistant rate of ceftazidime,cefepime,amoxicillin-clavulanic acid was more than 30% ,cefoperazone-sulbactam,cefmetazole and aimikacin was less than 30% ,none was resistant to meropenem in

  14. Cepas de Pseudomonas spp. produtoras de metalo-betalactamase isoladas no Hospital Geral de Fortaleza Metallo-betalactamase producing Pseudomonas spp. strains isolated in the Hospital Geral de Fortaleza

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    Júlio César Nogueira Torres

    2006-10-01

    Full Text Available Pseudomonas sp. é um bacilo gram-negativo ubíquo de vida livre e freqüente em ambientes hospitalares. Bactérias produtoras de metalo-betalactamases (MBLs são em grande parte resistentes aos betalactâmicos de largo espectro, incluindo cefalosporinas e carbapenens. Este trabalho objetivou detectar cepas de Pseudomonas spp. resistentes ao imipenem e à ceftazidima, assim como identificar aquelas produtoras de MBLs. Foram estudadas (entre junho de 2002 e junho de 2003 311 cepas isoladas de diversas amostras clínicas no Hospital Geral de Fortaleza (HGF, bem como foram realizados testes de identificação e sensibilidade pelo sistema de automação MicroScan®/WalkAway, sendo as cepas multirresistentes confirmadas através do método de difusão em disco. A triagem para detecção de amostras produtoras de MBLs foi realizada pelo método de dupla difusão, utilizando discos com mercaptoacetato de sódio. Entre essas amostras, 24 (7,71% demonstraram produção de MBLs e padrão de multirresistência entre as cepas estudadas. Os antimicrobianos para os quais as cepas apresentaram maior sensibilidade foram a piperacilina/tazobactam com 255 (82% de sensibilidade, seguido da piperacilina isoladamente, com 229 (73,63%; imipenem com 195 (62,70%; ticarcilina/ácido clavulânico com 193 (62,05%; e ceftazidima com 138 (44,37%. A detecção dessas amostras configura um problema emergente, com importantes implicações na terapêutica antimicrobiana.Pseudomonas sp. is a ubiquitous gram-negative bacilli, of free and frequent life in hospital environment. Metallo-betalactamases (MBLs productive bacteria are largely resistant to betalactamics of wide spectrum, including cephalosporin and carbapenem. The objective of this work was to detect Pseudomonas spp. strains resistant to imipenem and ceftazidime, as well as to identify the MBLs producer ones. It was studied 311 isolated strains from several clinical samples at Fortaleza General Hospital (FGH, from June

  15. Analysis on the production of extended-spectrum β-Lactamases and drug-resistance of 906 strains of Escherichia coli%906株大肠埃希菌产超广谱β-内酰胺酶状况及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    陈捷; 李南洋; 李健平; 张伟嫦

    2012-01-01

    Objective To explore the production of extended spectrum β-lactamases (ESBLs) by Escherichia coli (E. coli) and the drug resistance of E. coli to commonly used antibiotics, and to provide reference for clinical anti-infective drug therapy. Methods Ceftazidime and ceftazidime plus clavulanic acid, cefotaxime and cefotaxime plus clavulanic acid in the double disk confirmatory test were adopted to detect ESBLs. K-B disk diffusion assay was used to determine antibiotic resistance of E. coli. Results The detection rates of E. coli ESBLs were 38.65%, 42.86%, 43.28% and 48.84% from 2007 to 2010, respectively. Antibiotic resistance rate of E. coli was low to ceforera-zone/sulbactam, imipenem, piperacillin/tazobactam, amoxicillin/clavulanic acid, cefoxitin and amikacin, and the resistance rates to other antibiotics tested were mostly more than 50%. Conclusion The drug resistance status of E. coli is severe. We should strengthen the drug-resistance monitoring of E. coli and the management of antibiotics use to control the spread and prevalence of the drug-resistant bacteria.%目的 了解大肠埃希菌产超广谱β-内酰胺酶(ESBLs)及其对常用抗菌药物的耐药情况,为临床抗感染治疗提供用药依据.方法 采用头孢他啶与头孢他啶/克拉维酸、头孢噻肟与头孢噻肟/克拉维酸的双纸片确证试验检测ESBLs,采用纸片扩散法(K-B法)检测大肠埃希菌对常用抗菌药物的耐药性.结果 2007年、2008年、2009年、2010年产ESBLs大肠埃希菌的检出率分别为38.65%、42.86%、43.28%和48.84%.大肠埃希菌对常用抗菌药物的耐药率以头孢哌酮/舒巴坦、亚胺培南、哌拉西林/也唑巴坦、阿莫西林/克拉维酸、头孢西丁、阿米卡星较低,其余抗菌药物的耐药率大多在50%以上,对氨苄西林和哌拉西林的耐药率甚至超过80%.结论 大肠埃希菌的耐药形势严峻,应加强其耐药性监测,合理使用抗菌药物,严格控制耐药菌的产生和医院感染暴发流行.

  16. Drug resistance of ESBLs-producing klebsiella pneumoniae and escherichia coli in south mountainous areas in Zhejiang%浙南山区产超广谱β-内酰胺酶大肠埃希菌与肺炎克雷伯菌的耐药性分析

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    黄声旗; 张青锋

    2011-01-01

    OBJECTIVE To study drug resistance of ESBLs-producing Klebsiella pneumoniae and Escherichia coli,to provide basis for rational application of antibiotics. METHODS Using doubt disk synergy test recommended by CLSI, which contained ceftazidime, ceftazidime/Clavulanic acid and cefotaxime, cefotaxime/clavulanic acid, A total of 107 strains of ESBLs-producing K. pneumoniae and 274 strains of ESBLs-producing E. coli isolated from clinical samples of our hospital during Jan 2008 - Dec 2009 were detected. The K-B assay was used for drug sensitivity test and the Lab management software produced by shanghai Xinhe was used to analyze the distribution and drug resistance of the tow bacteria. RESULTS The detection rates of ESBLs-producing K. pneumoniae and E.coli isolated during 2008-2009 were 51.6%, 21.5% ,47.0% and 17.9%, respectively. No imipenem-resistant strains was discovered. CONCLUSION The incidences of ESBLs-producing K. pneumoniae and E. coli in mountainous area of Zhejiang Province are similar to that of high occurrence areas. Fortunately the rate is droppped since the multiple-drug bacteria monitoring system is established.%目的 了解浙南山区产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌和肺炎克雷伯菌的耐药性,为临床合理使用抗菌药物提供依据.方法 采用CLSI推荐的双纸片协同试验;用头孢他啶、头孢他啶/克拉维酸和头孢噻肟、头孢噻肟/克拉维酸确证试验确认,检测医院2008年1月-2009年12月临床标本中分离出的107株产ESBLs肺炎克雷伯菌和274株产ESBLs大肠埃希菌;用K-B法进行药物敏感试验,并用上海新和实验室管理软件分析细菌分布和耐药性.结果 2008、2009年产ESBLs大肠埃希菌和肺炎克雷伯菌分别为51.6%,21.5%和47.0%、17.9%,未发现对亚胺培南耐药.结论 浙南山区产ESBLs大肠埃希菌和肺炎克雷伯菌与高发地区相近,但是在浙江建立多药耐药菌监测制度后,产ESBLs的菌发生率出现下降.

  17. The induced expression of AmpC gene in pseudomonas aeruginosa biofilms%生物膜铜绿假单胞菌AmpC基因诱导表达的研究

    Institute of Scientific and Technical Information of China (English)

    赵京明; 成炜; 蒋捍东

    2009-01-01

    目的 研究铜绿假单胞菌的产酶基因AmpC在浮游和生物膜状态下的表达差异.方法 改良的平板法建立铜绿假单胞菌生物膜模型,抗生素诱导浮游菌和生物膜菌AmpC基因表达,实时荧光定量聚合酶链反应测定PAOI的AmpC基因表达水平.结果 抗生素诱导前,PAO1浮游菌和生物膜菌的AmpC基因表达均较低,诱导后AmpC基因表达均明显上调.运用产最大AmpC酶活性浓度的抗生素诱导后,亚胺培南和头孢他啶诱导的生物膜菌的AmpC基因表达量高于其诱导的浮游菌.在浮游和生物膜状态下,亚胺培南诱导PAO1的AmpC基因表达量均高于头孢他啶.结论 生物膜PA较浮游菌更易被诱导产生AmpC酶,亚胺培南的诱导能力高于头孢他啶.%Objective To study the expression of AmpC gene in Pseudomonas aeruginosa induced by antibiotics at plank tonic and biofilms phases. Methods An in vitro model of PAO1 biofilms was established with modified flat-board method. Being induced by antibiotics at plank tonic and biofilms phases, the expression of AmpC gene in PAO1 was quantified by real-time quantitative PCR. Results Without the effect of antibiotics, the expres-sion of AmpC gene in PAO1 was low at both plank tonic and biofiims phases. Being induced by imipenem and eeftazidime that can induce the maximal AmpC β-lactamase activities, the expression of AmpC gene in biofilms PAO1 was higher than that in plank tonic PAO1. During both plank tonic and biofilms phases, the expression of AmpC gene in PAO1 induced by imipenem was higher than that induced by ceftazidime. Conclusion Induced by antibiotics,biofilms PAO1 showes stronger ability for the expression of AmpC gene than plank tonic PAO1. The ex-pression of AmpC gene induced by imipenem is higher than that induced by ceftazidime.

  18. Study on Screening the Concentration of Antibiotics of Agrobacterium tumefaciens Mediated Transformation in Populus%杨树农杆菌介导遗传转化中抗生素浓度的筛选

    Institute of Scientific and Technical Information of China (English)

    冯连荣; 张兴芬; 尹杰; 宋立志; 赵继梅; 彭儒胜; 矫丽曼; 张妍

    2014-01-01

    研究头孢噻肟钠、头孢曲松钠、头孢拉啶、头孢他啶4种头孢类抗生素对根癌农杆菌LBA4404和EHA105的抑制作用;以欧美杨111和盖杨组培苗为材料,研究卡那霉素(Km)对2种杨树叶片分化及茎段生根的影响,并分析头孢噻肟钠对欧美杨111叶片分化及茎段生根的影响。结果表明,头孢噻肟钠、头孢曲松钠和头孢他啶对LBA4404具有良好的抑菌效果,使用浓度为50 mg/L,其中头孢噻肟钠对农杆菌EHA105的抑菌效果最好,头孢拉啶抑菌效果较差。不同杨树品种对卡那霉素的耐受性差异不大,欧美杨111在叶片转化筛选培养时,使用浓度为10 mg/L,抗性芽生根阶段为20 mg/L;盖杨在叶片转化筛选培养时,卡那霉素使用浓度为20 mg/L,抗性芽生根阶段为25 mg/L,头孢噻肟钠对欧美杨111叶片分化和茎段生根影响不大。%The inhibitory effects of four antibiotics (Cefotaxime Sodium,Ceftriaxone Sodium,Cefradine, Ceftazidime)on Agrobacterium tumefaciens LBA4404 and EHA105 were analyzed.The tissue culture plantlets of P.×euramericana and P.×gaixianensis were chosen as the materials to study the effects of kanamycin on leaf dif-ferentiation and stem rhizogenesis of P.×euramericana and P.×gaixianensis.Besides,the effects of Cefotaxime Sodium on leaf differentiation and stem rhizogenesis of P.×euramericana also was analyzed.The result showed that Cefotaxime Sodium, Ceftriaxone Sodium, Ceftazidime had antibacterial effect on Agrobacterium tumefactions LBA4404,and the working concentration was 50 mg/L.Among them,the antibacterial effect of Cefotaxime Sodium was the best for Agrobacterium tumefactions EHA105,and the effect of Cefotaxime Sodium was the worse.The tol-erance of different Populus on kanamycin was similar.For P.×euramericana,the 10 mg/L concentration of kana-mycin was ideal to screen leaf differentiation culture,while the concentration was 20 mg/L in rooting

  19. Rapid detection of extended-spectrum β-lactamase producing bateriae with flow cytometry%流式细胞术快速检测产超广谱β-内酰胺酶细菌的研究

    Institute of Scientific and Technical Information of China (English)

    付亮; 龙军; 袁小澎

    2011-01-01

    目的 建立一种基于流式细胞术快速检测细菌是否具有产超广谱β-内酰胺酶(ESBL)的方法.方法 对36株临床分离已经确定为产ESBL的菌株,应用流式细胞药敏试验(FCST),分别检测每株细菌头孢他啶、头孢他啶/棒酸作用管的碘化丙啶荧光阳性百分率(PI%),依据统计学方法建立FCM检测产超广谱β-内酰胺酶细菌阴阳性的判断标准.对49株临床分离的大肠埃希菌和肺炎克雷伯菌同时应用NCCLS推荐的确证试验以及建立的流式细胞术检测标准进行双盲测定,采用统计学评价新的检测方法.结果 36株临床已经鉴定为产ESBL菌经两种药物作用后,PI%(CAZ+C)-PI%(CAZ)值各有不同.经统计学分析确定阳性株鉴定标准为PI%(CAZ+C)-PI%(CAZ)≥3.0.建立检测标准后49株临床菌株经双盲测定后对两种方法学进行统计学比较分析,证实两种方法相比灵敏度为78.3%,特异度为80.8%,粗一致性为79.6%,两种方法的检测结果差异无统计学意义.结论 流式细胞术检测产超广谱β-内酰胺酶细菌的方法与传统方法检测结果具有一致性,但是更为快速、客观、便于自动化,在联合药敏试验方面有较大的临床应用前景,为流式细胞仪应用到细菌药敏试验奠定基础.%Objective Establish a rapid detection method of extended - spectrum β - lactamase ( ESBL ) producing bateriae with Flow cytometry. Methods Propidium iodide fluorescent positive percentage ( PI% ) of negative control and reaction tubes for governing ceftazidime, ceftazidime/clavulanic acid was detected, respectively, by flow cytometry susceptibility testing ( FCST ) for definition of standard point of extended - spectrum β - lactamase producing bacteriae using statistical analysis. According to the standard, 49 strains clinical isolated Escherichia coli and Klebsiella pneumoniae were both detected with confirmatory test of the NCCLS and FCST. Results Positive ESBL was defined as the

  20. 我院2006-2010年抗菌药物用量与大肠埃希菌耐药的相关性分析%Correlation of Antibacterials Consumption and Drug Resistance of Escherichia coli in Our Hospital from 2006 to 2010

    Institute of Scientific and Technical Information of China (English)

    吕建平; 周红辉; 肖建宁

    2011-01-01

    OBJECTIVE: To explore the change of drug resistance of Escherichia coli and explore the relation between its development and antibacterials consumption to provide reference for antibacterials management. METHODS: Retrospective review was used to calculate the DDDs of 13 kinds of antibacterialsper 100 persons per day and resistant rate of Escherichia coli. The correlation of antibacterials consumption and drug resistance was analyzed by SPSS 17.0 software. RESULTS: Consumption of expensive antibacterials increased year by year, contrary to ordinary ones. Drug resistance of Escherichia coli to various antibacterials also increased year by year. The consumptions of gentamycin, ampicillin, piperacillin/sulbactam, cefazolin, cefuroxime, cefoxitin, ceftri-axome, ceftazidime, ciprofloxacin, levofloxacin and imipenem/cilastin were related to the drug resistance of Escherichia coli to amikacin, gentamycin, ampicillin, cefazolin, cefuroxime, cefoxitin, cefotaxime and ceftazidime in varying degree. CONCLUSION: High resistance rate has been found in Escherichia coli to various antibacterials. Antibacterials consumption is related to drug resistance of Escherichia coli.%目的:了解我院大肠埃希菌耐药性的现状和变迁,探讨其发展与抗菌药物用量之间的关系,为抗菌药物管理提供依据.方法:采用回顾性调查方法,计算13种抗菌药物平均每日每百张床位所消耗的用药频度(DDDs)及同期大肠埃希菌的耐药率,用SPSS 17.0统计软件对抗菌药物用量与耐药率进行相关性分析.结果:高档次的抗菌药物用量逐年增长,低档次的抗菌药物用量逐年缩减.大肠埃希菌对多种抗菌药物呈广泛耐药,且逐年增长.庆大霉素、氨苄西林、哌拉西林/舒巴坦、头孢唑林、头孢呋辛、头孢西丁、头孢曲松、头孢他啶、环丙沙星、左氧氟沙星、亚胺培南/西司他丁的用量与大肠埃希菌对阿米卡星、庆大霉素、氨苄西林、头孢唑林、头

  1. [Is there a relationship between rectal colonization and nosocomial infection of patients in intensive care unit?].

    Science.gov (United States)

    Yeşilbağ, Zuhal; Çağatay, Arif Atahan; Karadeniz, Aslı; Başaran, Seniha; Orhun, Günseli; Ergin Özcan, Perihan; Özsüt, Halit; Eraksoy, Haluk

    2015-07-01

    Nosocomial infections caused by multidrug-resistant (MDR) microorganisms are a major problem in intensive care units (ICUs) with high mortality and morbidity rates and the prior colonization is an important risk factor for these infections. The aim of this study was to investigate the prevalence of rectal colonization of MDR microorganisms and the association between the microorganisms that caused colonization and infection in the patients with nosocomial infections in ICUs. Rectal swabs were obtained on the day of 0, 3, 7, 14, 21 and weekly thereafter from 80 patients over 18 years of age hospitalized in ICU for more than 48 hours, and cultured for vancomycin-resistant enterococcus (VRE), methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum β-lactamase (ESBL)- producing gram-negative bacilli (GNB) and carbapenem-resistant enteric and nonenteric bacilli. Patients whose rectal swabs were not obtained on admission (on the day of 0), were excluded even they were hospitalized more than 48 hours. Bile esculin agar containing 64 μg/mL ceftazidime and 6 μg/mL vancomycin, chromogenic MRSA agar and blood agar media, MacConkey agar containing 1 mg/L ceftazidime and ceftriaxone, and 5 mL tryptic soy broth media containing 10 µg imipenem and meropenem discs were used for identification. Identification of GNB was determined by conventional methods and ESBL production was determined by double-disc synergy test. Patients have been followed up for nosocomial infections. Bacterial identification and antibiotic susceptibility tests were performed with standard microbiological methods. In 37 (46%) of the 80 patients, at least one MDR microorganism was isolated in rectal swab cultures on the day of 0. The most common microorganisms were ESBL-positive E.coli (19%), followed by ESBL-positive K.pneumoniae (13%), carbapenem-resistant P.aeruginosa (10%), ESBL-positive K.oxytoca (3%), MRSA (1%), VRE (1%), carbapenem-resistant Acinetobacter sp. (1%) and carbapenem

  2. Surveillance of antimicrobial susceptibility of aerobic and facultative Gram-negative bacilli isolated from patients with intra-abdominal infections in China: the 2002-2009 Study for Monitoring Antimicrobial Resistance Trends (SMART).

    Science.gov (United States)

    Yang, Qiwen; Wang, Hui; Chen, Minjun; Ni, Yuxing; Yu, Yunsong; Hu, Bijie; Sun, Ziyong; Huang, Wenxiang; Hu, Yunjian; Ye, Huifen; Badal, Robert E; Xu, Yingchun

    2010-12-01

    The objective of this study was to investigate the distribution and susceptibility of aerobic and facultative Gram-negative bacilli (GNB) isolated from patients with intra-abdominal infections (IAIs) in China. From 2002 to 2009, minimum inhibitory concentrations of 14 antibiotics for 3420 aerobic and facultative GNB from up to eight hospitals in six cities were determined by the broth microdilution method. Enterobacteriaceae comprised 82.9% (2834/3420) of the total isolates, with Escherichia coli (49.2%) being the most commonly isolated species followed by Klebsiella pneumoniae (17.0%), Enterobacter cloacae (5.8%) and Citrobacter freundii (2.3%). Amongst the antimicrobial agents tested, the three carbapenems (ertapenem, imipenem and meropenem) were the most active agents against Enterobacteriaceae, with susceptibility rates of 96.1-99.6% (2002-2009), 98.2-100% (2002-2009) and 99.6-100% (2002-2004), respectively, followed by amikacin (86.8-95.1%) and piperacillin/tazobactam (84.5-94.3%). Susceptibility rates of all tested third- and fourth-generation cephalosporins against Enterobacteriaceae declined by nearly 30%, with susceptibility rates of 40.2%, 39.1%, 56.3% and 51.8% in 2009 for ceftriaxone, cefotaxime, ceftazidime and cefepime, respectively. The occurrence of extended-spectrum β-lactamases increased rapidly, especially for E. coli (from 20.8% in 2002 to 64.9% in 2009). Susceptibility of E. coli to ciprofloxacin decreased from 57.6% in 2002 to 24.2% in 2009. The least active agent against Enterobacteriaceae was ampicillin/sulbactam (SAM) (25.3-44.3%). In conclusion, Enterobacteriaceae were the major pathogens causing IAIs, and carbapenems retained the highest susceptibility rates over the 8-year study period. Third- and fourth-generation cephalosporins, fluoroquinolones and SAM may not be ideal choices for empirical therapy of IAIs in China.

  3. Distribution and Antimicrobial Susceptibility Pattern of Gram Negative Bacteria Causing Urinary Tract Infection (UTI and Detection New Delhi Metallo-beta-lactamase-1 (NDM-1 Producing Isolates in Ahwaz

    Directory of Open Access Journals (Sweden)

    Parviz Afrugh

    2016-04-01

    Full Text Available Background: Urinary tract infection (UTI is the commonest bacterial infectious disease in worldwide (especially in developing countries with a high rate of morbidity and financial cost. The management of UTI infections has been jeopardized by increase in immergence of antimicrobial drug resistance. Knowledge of the local bacterial etiology and susceptibility patterns is required to trace any change that might have occurred in time so that updated recommendation for optimal empirical therapy of UTI can be made. The aim of this investigation was distribution and antimicrobial susceptibility pattern of gram negative bacteria causing urinary tract infection (UTI and detection NDM-1 (new-delhi-metallo-beta-lactamase-1 producing isolates in Ahwaz. Materials and Methods: This cross-sectional study was done during a period of one year from April 2013 to March 2014. Clean catch midstream urine samples were collected from suspected patients to UTI. The isolates were identified based on morphological and biochemical testes. Culture was performed on routine microbiological media. Susceptibility testing was performed according CLSI (2013 guidelines. Detection of carbapenemase producing isolates was performed by modified hodge test (MHT. Metallo-beta-lactamase isolates were detected by imipenem-EDTA combined disc test (CDT. Results: In this study 708 gram negative organisms were isolated from urine samples. E.coli was the most common isolated bacteria (67% followed by Klebsiella spp. (26.5% and Enterobacter spp. (2.5%. In antibiotic susceptibility testing more than 90% of isolates were sensitive to tetracycline, ceftazidime, meropenem, amikacin, cefotaxime, imipenem, and cefepime. Isolates were more resistant to cephalothin (32%, co-trimoxazol (30.5%, and nalidixic acid (25%. Conclusion: In our results isolated organisms from outpatients showed very high sensitivity to common antibiotics. Continuous and regular monitoring of susceptibility pattern of

  4. 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.

  5. SUSCEPTIBILITY AND DETECTION OF EXTENDED SPECTRUM β-LACTAMASE ENZYMES FROM OTITIS MEDIA PATHOGENS

    Directory of Open Access Journals (Sweden)

    Ejikeugwu Chika

    2013-01-01

    Full Text Available Otitis media is the bacterial infection of the middle ear usually accompanied with inflammation, effusions and pain. It can present clinically in two major forms: Acute Otitis Media (AOM and Otitis Media with Effusion (OME and it is one of the leading cause of hospital visits and antibiotic prescriptions amongst children and even adults. Antibiotic resistance is a global public health problem and Extended Spectrum β-Lactamase (ESBL enzymes is one of the new mechanisms of resistance in especially Gram negative bacteria including Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. ESBLs are plasmid-mediated β-lactamase enzymes that hydrolyze extended-spectrum oxyimino 3rd generation cephalosporins and monobactams. Organisms producing ESBLs have remained important nosocomial and community-acquired pathogens over the years. Ear swab specimens of children (aged 0-7 with suspected Otitis media infections and who attended a tertiary hospital in Enugu, Nigeria were cultured on growth media. E. coli, K. pneumoniae and P. aeruginosa were isolated and identified by standard microbiological techniques. Antibiogram was conducted on all isolated ear pathogens by Kirby-Bauer disk diffusion method and ESBL production was evaluated by the Double Disk Synergy Test (DDST method. Imipenem and meropenem were the most active antibiotics against the E. coli, K. pneumoniae and P. aeruginosa ear pathogens. Sulphamethoxazole-trimethoprim was the least active agent against the tested ear pathogens and this was followed by ofloxacin, ciprofloxacin, gentamicin, cefotaxime and ceftazidime. None of the E. coli, K. pneumoniae and P. aeruginosa ear pathogens produced ESBLs by the method used. ESBL production by pathogenic bacteria confers on organisms the ability to be multidrug resistant. Their prompt and accurate detection from clinical specimens, together with reporting them along with hospitals routine antibiogram results is vital as this will help to

  6. Effect of subtherapeutic administration of antibiotics on the prevalence of antibiotic-resistant Escherichia coli bacteria in feedlot cattle.

    Science.gov (United States)

    Alexander, T W; Yanke, L J; Topp, E; Olson, M E; Read, R R; Morck, D W; McAllister, T A

    2008-07-01

    Antibiotic-resistant Escherichia coli in 300 feedlot steers receiving subtherapeutic levels of antibiotics was investigated through the collection of 3,300 fecal samples over a 314-day period. Antibiotics were selected based on the commonality of use in the industry and included chlortetracycline plus sulfamethazine (TET-SUL), chlortetracycline (TET), virginiamycin, monensin, tylosin, or no antibiotic supplementation (control). Steers were initially fed a barley silage-based diet, followed by transition to a barley grain-based diet. Despite not being administered antibiotics prior to arrival at the feedlot, the prevalences of steers shedding TET- and ampicillin (AMP)-resistant E. coli were >40 and <30%, respectively. Inclusion of TET-SUL in the diet increased the prevalence of steers shedding TET- and AMP-resistant E. coli and the percentage of TET- and AMP-resistant E. coli in the total generic E. coli population. Irrespective of treatment, the prevalence of steers shedding TET-resistant E. coli was higher in animals fed grain-based compared to silage-based diets. All steers shed TET-resistant E. coli at least once during the experiment. A total of 7,184 isolates were analyzed for MIC of antibiotics. Across antibiotic treatments, 1,009 (13.9%), 7 (0.1%), and 3,413 (47.1%) E. coli isolates were resistant to AMP, gentamicin, or TET, respectively. In addition, 131 (1.8%) and 143 (2.0%) isolates exhibited potential resistance to extended-spectrum beta-lactamases, as indicated by either ceftazidime or cefpodoxime resistance. No isolates were resistant to ciprofloxacin. The findings of the present study indicated that subtherapeutic administration of tetracycline in combination with sulfamethazine increased the prevalence of tetracycline- and AMP-resistant E. coli in cattle. However, resistance to antibiotics may be related to additional environmental factors such as diet.

  7. Microbiological characterization of plasmid-mediated AmpC ß-lactamases and E. coli hyperproducers: how and why ?

    Directory of Open Access Journals (Sweden)

    Annibale Raglio

    2010-03-01

    Full Text Available The aim of this study is the evaluation of phenotypic method for the detection of plasmid-mediated AmpC producing Enterobacteriaceae by agar diffusion.We developed a phenotypic method with double disk test (CLSI and evaluation of synergism between Cloxacillin and/or Boronic Acid with cefotaxime and ceftazidime and cefepime with amoxicillin/clavulanic acid. As reference method for AmpC detection we used a multiplex PCR according to Perez-Perez. Among 7476 Enterobacteriaceae we detected 45 strains: 37 (82.2% plasmid-mediated AmpC producers, 6 (13.3% E. coli hyperproducers and 2 E. coli (4.5% positive for both.The AmpC phenotypic test was positive for all the isolates, showing a typical ghost zone between cloxacillin and cephalosporins or boronic acid and cephalosporins.The AmpC multiplex PCR confirmed that 28 P. mirabilis and 7 E. coli harboured a gene belonging to the bla-CMY-LAT family. Sequencing defined the presence of CMY-16 in all P. mirabilis, CMY-2 in E. coli, DHA-1 in 3 K. pneumoniae and FOX in 1 K. pneumoniae and allowed us to identify eight strains as E. coli hyperproducer: six E. coli yielded no amplicon and 2 were also producer of CMY-2. In this study the phenotypic method showed a sensitivity and a specificity of 100%.Waiting for the indication of international authorities, we think this phenotypic screening method could be useful in the routine of microbiological laboratories.

  8. The Soil Microbiota Harbors a Diversity of Carbapenem-Hydrolyzing β-Lactamases of Potential Clinical Relevance.

    Science.gov (United States)

    Gudeta, Dereje Dadi; Bortolaia, Valeria; Amos, Greg; Wellington, Elizabeth M H; Brandt, Kristian K; Poirel, Laurent; Nielsen, Jesper Boye; Westh, Henrik; Guardabassi, Luca

    2015-10-19

    The origin of carbapenem-hydrolyzing metallo-β-lactamases (MBLs) acquired by clinical bacteria is largely unknown. We investigated the frequency, host range, diversity, and functionality of MBLs in the soil microbiota. Twenty-five soil samples of different types and geographical origins were analyzed by antimicrobial selective culture, followed by phenotypic testing and expression of MBL-encoding genes in Escherichia coli, and whole-genome sequencing of MBL-producing strains was performed. Carbapenemase activity was detected in 29 bacterial isolates from 13 soil samples, leading to identification of seven new MBLs in presumptive Pedobacter roseus (PEDO-1), Pedobacter borealis (PEDO-2), Pedobacter kyungheensis (PEDO-3), Chryseobacterium piscium (CPS-1), Epilithonimonas tenax (ESP-1), Massilia oculi (MSI-1), and Sphingomonas sp. (SPG-1). Carbapenemase production was likely an intrinsic feature in Chryseobacterium and Epilithonimonas, as it occurred in reference strains of different species within these genera. The amino acid identity to MBLs described in clinical bacteria ranged between 40 and 69%. Remarkable features of the new MBLs included prophage integration of the encoding gene (PEDO-1), an unusual amino acid residue at a key position for MBL structure and catalysis (CPS-1), and overlap with a putative OXA β-lactamase (MSI-1). Heterologous expression of PEDO-1, CPS-1, and ESP-1in E. coli significantly increased the MICs of ampicillin, ceftazidime, cefpodoxime, cefoxitin, and meropenem. Our study shows that MBL producers are widespread in soil and include four genera that were previously not known to produce MBLs. The MBLs produced by these bacteria are distantly related to MBLs identified in clinical samples but constitute resistance determinants of clinical relevance if acquired by pathogenic bacteria.

  9. Enterobacter and Klebsiella species isolated from fresh vegetables marketed in Valencia (Spain) and their clinically relevant resistances to chemotherapeutic agents.

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    Falomir, María Pilar; Rico, Hortensia; Gozalbo, Daniel

    2013-12-01

    Occurrence of antibiotic-resistant pathogenic or commensal enterobacteria in marketed agricultural foodstuffs may contribute to their incorporation into the food chain and constitutes an additional food safety concern. In this work, we have determined the clinically relevant resistances to 11 common chemotherapeutic agents in Enterobacter and Klebsiella isolates from fresh vegetables from various sources (supermarkets and greengrocers' shops in Valencia, Spain). A total of 96 isolates were obtained from 160 vegetables analyzed (50% positive samples): 68 Enterobacter isolates (59 E. cloacae, two E. aerogenes, two E. cancerogenus, one E. gergoviae, and four E. sakazakii, currently Cronobacter spp.), and 28 Klebsiella isolates (19 K. oxytoca and 9 K. pneumoniae). Only seven isolates were susceptible to all agents tested, and no resistances to ceftazidime, ciprofloxacin, gentamicin, and chloramphenicol were detected. Most isolates were resistant to amoxicillin/clavulanic acid (74 [58 Enterobacter and 16 Klebsiella]) or to ampicillin (80 [55/25]). Other resistances were less frequent: nitrofurantoin (13 isolates [12/1]), tetracycline (6 [5/1]), co-trimoxazole (3 [3/0]), cefotaxime (1 [1/0]), and streptomycin (2 [1/1]). Multiresistant isolates to two (56 [41/15]), three (10 E. cloacae isolates), four (one E. cloacae and one K. pneumoniae isolate), and five (two E. cloacae isolates) chemotherapeutic agents were also detected. The presence of potential pathogens points to marketed fresh produce, which often is eaten raw, as a risk factor for consumer health. In addition, these results support the usefulness of these bacterial species as indicators of the spreading of antibiotic resistances into the environment, particularly in the food chain, and suggest their role as carriers of resistance determinants from farms to consumers, which may constitute an additional "silent" food safety concern. Therefore, there is a need to improve the hygienic quality of marketed fresh

  10. Characterization of two new CTX-M-25-group extended-spectrum β-lactamase variants identified in Escherichia coli isolates from Israel.

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    Jascha Vervoort

    Full Text Available OBJECTIVES: We characterized two new CTX-M-type extended-spectrum β-lactamase (ESBL variants in Escherichia coli isolates from stool samples of two elderly patients admitted at the Tel Aviv Sourasky Medical Center, Israel. Both patients underwent treatment with cephalosporins prior to isolation of the E. coli strains. METHODS: ESBLs were detected by the double-disk synergy test and PCR-sequencing of β-lactamase genes. The bla(CTX-M genes were cloned into the pCR-BluntII-TOPO vector in E. coli TOP10. The role of amino-acid substitutions V77A and D240G was analyzed by site-directed mutagenesis of the bla(CTX-M-94 and bla(CTX-M-100 genes and comparative characterization of the resulting E. coli recombinants. MICs of β-lactams were determined by Etest. Plasmid profiling, mating experiments, replicon typing and sequencing of bla(CTX-M flanking regions were performed to identify the genetic background of the new CTX-M variants. RESULTS: The novel CTX-M β-lactamases, CTX-M-94 and -100, belonged to the CTX-M-25-group. Both variants differed from CTX-M-25 by the substitution V77A, and from CTX-M-39 by D240G. CTX-M-94 differed from all CTX-M-25-group enzymes by the substitution F119L. Glycine-240 was associated with reduced susceptibility to ceftazidime and leucine-119 with increased resistance to ceftriaxone. bla(CTX-M-94 and bla(CTX-M-100 were located within ISEcp1 transposition units inserted into ∼93 kb non-conjugative IncFI and ∼130 kb conjugative IncA/C plasmids, respectively. The plasmids carried also different class 1 integrons. CONCLUSIONS: This is the first report on CTX-M-94 and -100 ESBLs, novel members of the CTX-M-25-group.

  11. First report of TEM-104-, SHV-99-, SHV-108-, and SHV-110-producing Klebsiella pneumoniae from Iran

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    Shahram Shahraki-Zahedani

    Full Text Available Abstract: INTRODUCTION: Extended-spectrum beta-lactamases (ESBLs are bacterial enzymes capable of hydrolyzing beta-lactams. The aim of this study was to describe the prevalence of TEM- and SHV-type ESBL-producing Klebsiella pneumoniae strains in Zahedan, Southeast Iran. METHODS: A total of 170 non-repetitive K. pneumoniae strains were collected from patients referred to three teaching hospitals of Zahedan. Antibiotic susceptibility testing was determined for 17 antibiotics using the Kirby-Bauer disc diffusion method. The frequency of ESBL-producing strains was calculated, and minimum inhibitory concentrations of ESBL-producing strains were determined for cefotaxime, ceftazidime, ceftriaxone, and cefpodoxime. The presence of bla TEM and bla SHV genes was tested in all ESBL-producing strains using polymerase chain reaction and DNA sequencing. RESULTS: Among the 170 K. pneumoniae clinical isolates, 55 (32.4% were ESBL producers; 92.7% (n=51 and 72.7% (n=40 of the isolates carried the bla SHV and bla TEM genes, respectively, and 67.3% (n=37 carried both genes. The sequencing results showed that all bla TEM types were bla TEM-1, except for two isolates that were bla TEM-104. The bla SHV types were bla SHV-1, bla SHV-11, bla SHV-12, bla SHV-99, bla SHV-108, and bla SHV-110. CONCLUSIONS: The percentage of bla TEM and bla SHV among ESBL-producing K. pneumoniae isolates from Zahedan is relatively high, indicating the need for further surveillance and consideration in antibiotic use. To the best of our knowledge, this is the first report of TEM-104-, SHV-99-, SHV-108-, and SHV-110-type ESBLs among clinical isolates of K. pneumoniae from Iran, and TEM-1, SHV-1, SHV-11, and SHV-12 appear to be the dominant ESBLs in this region.

  12. A Review of Clostridium difficile Infection at the University Hospital of the West Indies, Jamaica

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    Clare-Pascoe, N; Lee, MG; Murphy, T; Nicholson, A; Ferguson, TS

    2015-01-01

    ABSTRACT Objectives: This study examined the frequency of Clostridium difficile infection (CDI) among hospital admission and diarrhoeal stool samples over a six-year period. Methods: A review of all suspected cases of C difficile positive patients from 2007 to 2012 at the University Hospital of the West Indies (UHWI), Jamaica, was performed. Clostridium difficile infection was confirmed by clinical features and a positive enzyme-linked immunosorbent assay (ELISA) stool test for Clostridium Toxins A and B. The demographics, clinical features, risk factors, treatment and outcomes were also collated. Results: There were 56 patients reviewed. The most commonly affected age group was 40–59 years of age. The proportion of CDI cases per total stool samples increased from 0.5% in 2007 to 5.9% in 2010 then fell to 2.2% in 2011 but increased again to 4.3% in 2012. The proportion of cases per total UHWI admissions also increased from 0.12 cases per 1000 admissions in 2007 to 1.16 in 2010 and 1.36 in 2012 (p < 0.001). Most CDI cases were nosocomial (76% males, 48.6% females). Co-morbidities included hypertension and end-stage renal disease. Ceftazidime was the most common antibiotic associated with the development of CDI. Resolution occurred in 62.5% of patients. Duration of hospital stay was longer in males than females (≥ 21 versus < 7 days) and males had more adverse outcomes, with death in 23.8% versus 11.4%. Conclusion: There has been an increase in the frequency of CDI at UHWI with a greater than expected frequency of community acquired CDI. Increased awareness is needed of the increasing risk for CDI and measures must be taken to prevent the disease, especially in hospitalized patients. PMID:26624597

  13. Escherichia coli Isolated from Urinary Tract Infections of Lebanese Patients between 2005 and 2012: Epidemiology and Profiles of Resistance

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    Ziad eDaoud

    2015-04-01

    Full Text Available The early treatment of urinary tract infections is directly related to decrease in morbidity, which makes the empirical treatment of great importance. Recently, beta lactamases of several types have emerged as significant mechanisms of resistance in Gram negative bacilli, especially Escherichia coli. Our aim was to study the urinary E.coli isolated from Lebanese patients and to characterize their mechanisms of resistance. The study analyzed data between 2005 and 2012 of urinary tract infections caused by E.coli. The mechanisms of resistance were characterized by phenotypic and genotypic methods and the Pulsed Field Gel Electrophoresis was used to determine the different bacterial clusters. As expected, the highest incidence was observed with E. coli (60.53 to 73.98% followed by K pneumoniae (5.32 to 8.33%. ICU isolates were constantly associated with the lowest rates of susceptibility to extended spectrum cephalosporins, ciprofloxacin, as well as most of the tested antibiotics. A 100% occurrence of CTX-M in ESBL producing isolates was recorded, followed by TEM, SHV, and OXA. In addition, 15.9% harbored 4 different ESBL enzymes and only 13 isolates (14.8% harbored only one enzyme (CTX-M. Over the years, the simultaneous susceptibility of E. coli to ceftazidime and ciprofloxacin decreased from 62.5% in 2006 to 48.7% in 2012. PFGE results demonstrated that 10 clusters were 32 generated, denoting diversity among detected isolates. Understanding the epidemiology of resistance is 33 instrumental for the implementation of recommendations for the management of antimicrobials, infection 34 control measures, as well as active surveillance and antimicrobial stewardship.

  14. Prevalence and Characteristics of Salmonella Isolated from Free-Range Chickens in Shandong Province, China.

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    Zhao, Xiaonan; Gao, Yanxia; Ye, Chaoqun; Yang, Lingling; Wang, Tao; Chang, Weishan

    2016-01-01

    Compared with chickens raised in intensively managed breeding farms, free-range chickens in China are quite popular due to lower breeding density and less antibiotics usage. However, investigations about Salmonella enterica from free-range chickens are quite rare. The aim of the present study was to investigate prevalence and characteristics of Salmonella in free-range chickens in Shandong province, China. During the period of August and November 2015, 300 fresh fecal swabs from different broilers in three free-range chicken farms (100 samples per farm) were collected to isolate Salmonella, and then these isolates were subjected to serotyping, antibiotic sensitivity testing, enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR), and multilocus sequence typing (ST). A total of 38 Salmonella isolates (38/300, 12.7%) were recovered. The most common serotype was Enteritidis (81.6%), followed by Indiana (13.2%) and Typhimurium (5.3%). Twenty-two out of 38 isolates (57.9%) were resistant to ampicillin, the highest resistance rate, but resistance rates to cefazolin, cefotaxime, and ceftazidime were only 7.9%. The multidrug resistance (MDR) rate was 26.3%. Additionally, the Salmonella isolates could be classified into 25 genotypes by ERIC-PCR and were divided into three ST types (ST11, ST17, and ST19), with ST11 the highest isolation rate (81.6%). In summary, as with other poultry, free-ranging chickens may also serve as potential reservoir for antibiotic resistant Salmonella, thereby posing a threat to public health.

  15. Prevalence and Characteristics of Salmonella Isolated from Free-Range Chickens in Shandong Province, China

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    Xiaonan Zhao

    2016-01-01

    Full Text Available Compared with chickens raised in intensively managed breeding farms, free-range chickens in China are quite popular due to lower breeding density and less antibiotics usage. However, investigations about Salmonella enterica from free-range chickens are quite rare. The aim of the present study was to investigate prevalence and characteristics of Salmonella in free-range chickens in Shandong province, China. During the period of August and November 2015, 300 fresh fecal swabs from different broilers in three free-range chicken farms (100 samples per farm were collected to isolate Salmonella, and then these isolates were subjected to serotyping, antibiotic sensitivity testing, enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR, and multilocus sequence typing (ST. A total of 38 Salmonella isolates (38/300, 12.7% were recovered. The most common serotype was Enteritidis (81.6%, followed by Indiana (13.2% and Typhimurium (5.3%. Twenty-two out of 38 isolates (57.9% were resistant to ampicillin, the highest resistance rate, but resistance rates to cefazolin, cefotaxime, and ceftazidime were only 7.9%. The multidrug resistance (MDR rate was 26.3%. Additionally, the Salmonella isolates could be classified into 25 genotypes by ERIC-PCR and were divided into three ST types (ST11, ST17, and ST19, with ST11 the highest isolation rate (81.6%. In summary, as with other poultry, free-ranging chickens may also serve as potential reservoir for antibiotic resistant Salmonella, thereby posing a threat to public health.

  16. Prevalence and antimicrobial susceptibility of extended-spectrum beta-lactamase producing urinary isolates of Escherichia coli in outpatients

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    Marković Tatjana

    2013-01-01

    Full Text Available Introduction. In Gram-negative bacteria, the production of beta-lactamases is the most important mechanism of resistance to beta-lactam antibiotics. In the Banja Luka region, there were no extensive researches on the prevalence and antimicrobial resistance of the extended-spectrum beta-lactamase (ESBL producing Escherichia coli (E. coli isolates. Objective. The aim of the present study was to determine the presence of ESBL producing E. coli isolates as the cause of the urinary tract infections in outpatients, the distribution of these ESBL isolates according to age and gender of patients and their susceptibility to antimicrobials. Methods. Urine specimens obtained from outpatients were cultured on chromogenic CPS-ID3 media. All plates showing significant (>105 cfu/ml growth of E. coli in pure culture were further processed. Antimicrobial susceptibility testing was performed on VITEK TWO Compact using AST-GN27 cards for testing Gram negative bacteria and detection of ESBL producers. Results. Out of 2,195 isolates, 177 (8.1% were ESBL producers. Ninety-two isolates were obtained from female patients (5% of E. coli isolated from women and 85 isolates from male patients (23% of E. coli isolated from men. High percentage of ESBL isolates was detected in the infant age group under one year (36.7% and in the age group over 60 years (28.8%. All ESBL isolates were susceptible to imipenem and resistant to ampicillin, piperacillin, cefazolin, cefotaxime, ceftazidime and cefepime. There was a significant resistance to amikacin (79.1%, gentamicin (76.8%, amoxicillin/clavulanate (54.8% and trimethoprim/sulphamethoxazole (45.8%. Resistance to nutrofurantoin was 13.6%. Conclusion. This study has demonstrated the presence of ESBL producing E. coli urinary isolates in outpatients, and their extensive susceptibility to imipenem and nitrofurantoin.

  17. Rectal carriage of extended-spectrum beta-lactamase-producing gram-negative bacilli in community settings in Madagascar.

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    Perlinot Herindrainy

    Full Text Available BACKGROUND: Extended-spectrum ß-lactamase-producing Enterobacteria (ESBL-PE emerged at the end of the 1980s, causing nosocomial outbreaks and/or hyperendemic situations in hospitals and long-term care facilities. In recent years, community-acquired infections due to ESBL-PE have spread worldwide, especially across developing countries including Madagascar. OBJECTIVES: This study aimed to determine the prevalence and risk factors of intestinal carriage of ESBL-PE in the community of Antananarivo. METHODS: Non-hospitalized patients were recruited in three health centers in different socio economic settings. Fresh stool collected were immediately plated on Drigalski agar containing 3 mg/liter of ceftriaxone. Gram-negative bacilli species were identified and ESBL production was tested by a double disk diffusion (cefotaxime and ceftazidime +/- clavulanate assay. Characterization of ESBLs were perfomed by PCR and direct sequencing. Molecular epidemiology was analysed by Rep-PCR and ERIC-PCR. RESULTS: 484 patients were screened (sex ratio  =  1.03, median age 28 years. 53 ESBL-PE were isolated from 49 patients (carrier rate 10.1%. The isolates included Escherichia coli (31, Klebsiella pneumoniae (14, Enterobacter cloacae (3, Citrobacter freundii (3, Kluyvera spp. (1 and Pantoae sp. (1. In multivariate analysis, only the socioeconomic status of the head of household was independently associated with ESBL-PE carriage, poverty being the predominant risk factor. CONCLUSIONS: The prevalence of carriage of ESBL in the community of Antananarivo is one of the highest reported worldwide. This alarming spread of resistance genes should be stopped urgently by improving hygiene and streamlining the distribution and consumption of antibiotics.

  18. PREVALENCE AND ANTIBIOTIC RESISTANCE OF FOOD BORNE BACTERIAL CONTAMINATION IN SOME EGYPTIAN FOOD food

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    Samy Selim

    2015-09-01

    Full Text Available This study was undertaken to investigate the prevalence and antibiotic resistance of food borne bacterial contamination in some Egyptian food. Total viable bacteria and total coliform bacteriawere isolated from different sources of food; carbohydrates (bread, flour and basbousa, vegetables (outer and inner tissues of potato and outer and inner tissues of cucumber and proteins (mincedmeat, cheese and milk. The study resulted in maximum value of total viable bacteria found in outer tissue of potato 68X104±1.0, while the minimum value found in inner tissues of potato andcucumber. The study resulted in total coliform was maximum value in minced meat 6.4X103±0.3. Basbousa and inner tissue of potato and cucumber were free from coliforms. The ability of isolatesto producing proteolytic enzymes was tested, we found that 326 isolate (63.92% from all isolates had this ability, thus we selected most 2 potent proteolytic isolates. The two isolates were identifiedas Bacillus cereus and Escherichia coli. The identification confirmed by microlog 34.20 system and 16SrRNA for two isolates and the same result was founded. Sensitivity tested for the most potentproteolytic species to 12 of the most commonly used antibiotics in the Egyptian pharmacy. The results showed that all species were sensitive to most of antibiotics, except B. cereus which was strongly susceptible to azteronam and ceftazidim. The data showed that raw meat, cooked food products, and raw milk were most commonly contaminated with foodborne pathogens and many pathogens were resistant to different antibiotics. The study provided useful information for assessment of the possible risk posed to consumers, which has significant public health impact.

  19. Prevalence and antibiogram of Salmonella species isolated from poultry products in Ebonyi State, Nigeria

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    Iroha Ifeanyichukwu

    2016-12-01

    Full Text Available Objective: This study evaluated the occurrence and antimicrobial susceptibility profile of Salmonella species isolated from various poultry products including chicken meat, poultry eggs, poultry bird's drinking water, and poultry feed. Materials and methods: A total of 79 samples comprising of chicken meat (n=20, egg shell (n=15, poultry egg contents (n=18, drinking water (n=14, and poultry feed (n=12 were bacteriologically and microscopically analyzed for the isolation of Salmonella species. Results: Overall, this study reported a high prevalence of Salmonella species (62% from various poultry products especially in poultry (chicken meat and poultry egg contents where the percentage occurrence of Salmonella species was 100% and 20.4% respectively. The antibiogram conducted on the Salmonella species isolated from the various poultry samples reveal that all the isolates were multi-drug resistant to more than 50% of the tested antibiotics especially to tetracycline, gentamicin, tobramycin, nitrofurantoin and imipenem. However, most of the Salmonella species were also found to be highly susceptible to ceftriaxone, cefotaxime, ertapenem and ceftazidime. It was also observed in this study that the highest level of resistance to the tested antibiotics was recorded in Salmonella species isolated from poultry meat samples. Conclusion: Salmonellosis due to the consumption of contaminated or infected poultry products could pose serious public health problem to the general public if allowed. Thus, poultry farms and other poultry product outlets should be operated under sanitized conditions that ward-off the incidence of foodborne pathogens such as Salmonella. The use of antibiotics as growth promoting agents and prophylaxis in the production of poultry birds in this region should be discouraged and ndash; since such practices allowed drug-resistant bacteria to emerge and spread in the community. [J Adv Vet Anim Res 2016; 3(4.000: 353-359

  20. Spectrum and potency of ceftaroline against leading pathogens causing community-acquired respiratory tract and skin and soft tissue infections in Latin America, 2010

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    Robert K. Flamm

    2013-10-01

    Full Text Available Ceftaroline, the active metabolite of the prodrug ceftaroline fosamil, is a cephalosporin with in vitro bactericidal activity against Gram-positive organisms, including methicillinsusceptible and -resistant Staphylococcus aureus, β-haemolytic and viridans group streptococci, and Streptococcus pneumoniae, as well as common Gram-negative organisms. In this study a total of 986 isolates collected in 2010 from patients in 15 medical centers in five Latin American countries from the Assessing Worldwide Antimicrobial Resistance Evaluation Program were identified as community-acquired respiratory tract or skin and soft tissue infection pathogens. Ceftaroline was the most potent agent tested against S. pneumoniae with a MIC90 value (0.12 µg/mL that was eight-fold lower than ceftriaxone, levofloxacin, and linezolid. Its spectrum of coverage (100.0% susceptible was similar to tigecycline, linezolid, levofloxacin and vancomycin. Against Haemophilus influenzae and Moraxella catarrhalis, ceftaroline was the most active agent tested. The activity of ceftaroline against S. aureus (including MRSA was similar to that of vancomycin and tetracycline (MIC90,1 µg/mL and linezolid (MIC90,2 Jg/mL. The 1-haemolytic streptococci exhibited 100.0% susceptibility to ceftaroline. Ceftaroline activity against Escherichia coli, Klebsiella spp., and Enterobacter spp. was similar to that of ceftriaxone and ceftazidime. These parenteral cephalosporin agents have potent activity against non-extended-spectrum These parenteral cephalosporin agents have potent activity against non-extended-spectrum-lactamase-phenotype strains, but are not active against extended-spectrum β-lactamase-phenotype strains. These results confirm the in vitro activity of ceftaroline against pathogens common in communityacquired respiratory tract and skin and soft tissue infection in Latin America, and suggest that ceftaroline fosamil could be an important therapeutic option for these infections.

  1. In vitro biofilm formation by uropathogenic Escherichia coliand their antimicrobial susceptibility pattern

    Institute of Scientific and Technical Information of China (English)

    Poovendran Ponnusamy; Vidhya Natarajan; Murugan Sevanan

    2012-01-01

    Objective:To detect in vitro biofilm formation of uropathogenic Escherichia coli(E. coli)(UPEC) strains isolated from urine specimens and also to determine their antimicrobial susceptibility pattern using 13 commonly used antibiotics.Methods: The present study comprised of166 urine specimens collected from tertiary care hospitals in and around Coimbatore, South India. All the specimens were subjected to gram staining, bacterial culture and theE. coli strains were screened for biofilm formation using Tube Method(TM), Congo Red Agar(CRA) and Tissue Culture Plate method(TCP) respectively. Subsequently, the antimicrobial susceptibility test was performed by Kirby Bauer-disk diffusion method for the biofilm and non-biofilm producingE. colistrains.Results: Of the100 (60.2 %)E. coli strains,72 strains displayed a biofilm positive phenotype under the optimized conditions in the Tube Method and the strains were classified as highly positive(17, 23.6%), moderate positive(19, 26.3 %) and weakly positive(36, 50.0 %), similarly under the optimized conditions on Congo Red agar medium, biofilm positive phenotype strains were classified as highly positive(23, 23 %), moderate positive(37, 37 %)and weakly positive (40, 40%). While inTCP method, the biofilm positive phenotype strains were also classified as highly positive(6, 6 %), moderate positive (80, 80 %)and weakly positive(14, 14 %), it didn’t not correlate well with the tube method for detecting biofilm formation in E. coli. The rates of antibiotic resistance of biofilm producingE. coliwere found to be 100 % for chloramphenicol and amoxyclav (amoxicillin and clavulanic acid),86% for gentamicin and cefotaxime,84% for ceftazidime,83% for cotrimoxazole and piperacillin/tazobactam,75% for tetracycline and70% for amikacin.Conclusions: This study reveals the prevalence and antimicrobial susceptibility pattern of biofilm and non-biofilm producing uropathogenic E. coli strains.

  2. Antipseudomonal agents exhibit differential pharmacodynamic interactions with human polymorphonuclear leukocytes against established biofilms of Pseudomonas aeruginosa.

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    Chatzimoschou, Athanasios; Simitsopoulou, Maria; Antachopoulos, Charalampos; Walsh, Thomas J; Roilides, Emmanuel

    2015-04-01

    Pseudomonas aeruginosa is the most common pathogen infecting the lower respiratory tract of cystic fibrosis (CF) patients, where it forms tracheobronchial biofilms. Pseudomonas biofilms are refractory to antibacterials and to phagocytic cells with innate immunity, leading to refractory infection. Little is known about the interaction between antipseudomonal agents and phagocytic cells in eradication of P. aeruginosa biofilms. Herein, we investigated the capacity of three antipseudomonal agents, amikacin (AMK), ceftazidime (CAZ), and ciprofloxacin (CIP), to interact with human polymorphonuclear leukocytes (PMNs) against biofilms and planktonic cells of P. aeruginosa isolates recovered from sputa of CF patients. Three of the isolates were resistant and three were susceptible to each of these antibiotics. The concentrations studied (2, 8, and 32 mg/liter) were subinhibitory for biofilms of resistant isolates, whereas for biofilms of susceptible isolates, they ranged between sub-MIC and 2 × MIC values. The activity of each antibiotic alone or in combination with human PMNs against 48-h mature biofilms or planktonic cells was determined by XTT [2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide] assay. All combinations of AMK with PMNs resulted in synergistic or additive effects against planktonic cells and biofilms of P. aeruginosa isolates compared to each component alone. More than 75% of CAZ combinations exhibited additive interactions against biofilms of P. aeruginosa isolates, whereas CIP had mostly antagonistic interaction or no interaction with PMNs against biofilms of P. aeruginosa. Our findings demonstrate a greater positive interaction between AMK with PMNs than that observed for CAZ and especially CIP against isolates of P. aeruginosa from the respiratory tract of CF patients.

  3. D-amino acids enhance the activity of antimicrobials against biofilms of clinical wound isolates of Staphylococcus aureus and Pseudomonas aeruginosa.

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    Sanchez, Carlos J; Akers, Kevin S; Romano, Desiree R; Woodbury, Ronald L; Hardy, Sharanda K; Murray, Clinton K; Wenke, Joseph C

    2014-08-01

    Within wounds, microorganisms predominantly exist as biofilms. Biofilms are associated with chronic infections and represent a tremendous clinical challenge. As antibiotics are often ineffective against biofilms, use of dispersal agents as adjunctive, topical therapies for the treatment of wound infections involving biofilms has gained interest. We evaluated in vitro the dispersive activity of D-amino acids (D-AAs) on biofilms from clinical wound isolates of Staphylococcus aureus and Pseudomonas aeruginosa; moreover, we determined whether combinations of D-AAs and antibiotics (clindamycin, cefazolin, oxacillin, rifampin, and vancomycin for S. aureus and amikacin, colistin, ciprofloxacin, imipenem, and ceftazidime for P. aeruginosa) enhance activity against biofilms. D-Met, D-Phe, and D-Trp at concentrations of ≥ 5 mM effectively dispersed preformed biofilms of S. aureus and P. aeruginosa clinical isolates, an effect that was enhanced when they were combined as an equimolar mixture (D-Met/D-Phe/D-Trp). When combined with D-AAs, the activity of rifampin was significantly enhanced against biofilms of clinical isolates of S. aureus, as indicated by a reduction in the minimum biofilm inhibitory concentration (MBIC) (from 32 to 8 μg/ml) and a >2-log reduction of viable biofilm bacteria compared to treatment with antibiotic alone. The addition of D-AAs was also observed to enhance the activity of colistin and ciprofloxacin against biofilms of P. aeruginosa, reducing the observed MBIC and the number of viable bacteria by >2 logs and 1 log at 64 and 32 μg/ml in contrast to antibiotics alone. These findings indicate that the biofilm dispersal activity of D-AAs may represent an effective strategy, in combination with antimicrobials, to release bacteria from biofilms, subsequently enhancing antimicrobial activity.

  4. Enterobacter cloacae infection of an expanded polytetrafluoroethylene femoral-popliteal bypass graft: a case report

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    Schilling Jolyon

    2010-05-01

    Full Text Available Abstract Introduction Enterobacter cloacae infections are common among burn victims, immunocompromised patients, and patients with malignancy. Most commonly these infections are manifested as nosocomial urinary tract or pulmonary infections. Nosocomial outbreaks have also been associated with colonization of certain surgical equipment and operative cleaning solutions. Infections of an aortobifemoral prosthesis, an aortic graft, and arteriovenous fistulae are noted in the literature. To our knowledge, this is the first isolated account of an E. cloacae infection of a femoral-popliteal expanded polytetrafluoroethylene bypass graft. Case presentation A 68-year-old Caucasian man presented with fever and rest pain in the right lower extremity five months after the placement of a vascular expanded polytetrafluoroethylene graft for femoral-popliteal bypass. Computed tomography angiography demonstrated peri-graft fluid that was aspirated percutaneously with image guidance and cultured to reveal E. cloacae. The graft was revised and then removed. The patient completed a six-week course of ceftazidime and is currently without signs of infection. There were no other reports of E. cloacae graft infections in any patients receiving treatment in the same surgical suite within a month of this report. Conclusion Isolated cases of E. cloacae infection of surgical bypass grafts are rare (unique in this setting. Clinicians should have a high index of suspicion for device contamination in such cases and should consider testing for possible microbial reservoirs. Graft removal is required due to the formation of biofilm and the recent emergence of Enterobacteriaceae producing extended-spectrum beta-lactamase in community acquired infections.

  5. Antibiotic resistance patterns of Pseudomonas spp. isolated from the River Danube

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    Clemens eKittinger

    2016-05-01

    Full Text Available Spread and persistence of antibiotic resistance pose a severe threat to human health, yet there is still lack of knowledge about reservoirs of antibiotic resistant bacteria in the environment. We took the opportunity of the Joint Danube Survey 3 (JDS3, the world's biggest river research expedition of its kind in 2013, to analyse samples originating from different sampling points along the whole length of the river. Due to its high clinical relevance, we concentrated on the characterization of Pseudomonas spp. and evaluated the resistance profiles of Pseudomonas spp. which were isolated from eight sampling points. In total, 520 Pseudomonas isolates were found, 344 (66.0% isolates were identified as Pseudomonas putida, and 141 (27.1% as Pseudomonas fluorescens, all other Pseudomonas species were represented by less than five isolates, among those two P. aeruginosa isolates. Thirty seven percent (37% of all isolated Pseudomonas species showed resistance to at least one out of eleven tested antibiotics. The most common resistance was against meropenem (30.4% / 158 isolates piperacillin/tazobactam (10.6% / 55 isolates and ceftazidime (4.2% / 22 isolates. 16 isolates (3.1% / 16 isolates were multi-resistant. For each tested antibiotic at least one resistant isolate could be detected. Sampling points from the upper stretch of the River Danube showed more resistant isolates than downriver. Our results suggest that antibiotic resistance can be acquired by and persists even in Pseudomonas species that are normally not in direct contact with humans. A possible scenario is that these bacteria provide a reservoir of antibiotic resistance genes that can spread to related human pathogens by horizontal gene transfer.

  6. Assessing the antibiotic susceptibility of freshwater cyanobacteria spp.

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    Elsa eDias

    2015-08-01

    Full Text Available Freshwater is a vehicle for the emergence and dissemination of antibiotic resistance. Cyanobacteria are ubiquitous in freshwater, where they are exposed to antibiotics and resistant organisms, but their role on water resistome was never evaluated. Data concerning the effects of antibiotics on cyanobacteria, obtained by distinct methodologies, is often contradictory. This emphasizes the importance of developing procedures to understand the trends of antibiotic susceptibility in cyanobacteria. In this study we aimed to evaluate the susceptibility of four cyanobacterial isolates from different genera (Microcystis aeruginosa, Aphanizomenon gracile, Chrisosporum bergii, Planktothix agradhii, and among them nine isolates from the same specie (M. aeruginosa to distinct antibiotics (amoxicillin, ceftazidime, ceftriaxone, kanamycine, gentamicine, tetracycline, trimethoprim, nalidixic acid, norfloxacin. We used a method adapted from the bacteria standard broth microdilution. Cyanobacteria were exposed to serial dilution of each antibiotic (0.0015-1.6 mg/L in Z8 medium (20 ± 1 ºC; 14/10 h L/D cycle; light intensity 16 ± 4 µEm-2 s-1. Cell growth was followed overtime (OD450nm/microscopic examination and the minimum inhibitory concentrations (MICs were calculated for each antibiotic/isolate. We found that -lactams exhibited the lower MICs, aminoglycosides, tetracycline and norfloxacine presented intermediate MICs; none of the isolates were susceptible to trimethoprim and nalidixic acid. The reduced susceptibility of all tested cyanobacteria to some antibiotics suggests that they might be naturally non-susceptible to these compounds, or that that they might became non-susceptible due to antibiotic contamination pressure, or to the transfer of genes from resistant bacteria present in the environment.

  7. Prevalence of antimicrobial resistance of non-typhoidal Salmonella serovars in retail aquaculture products.

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    Zhang, Jianmin; Yang, Xiaowei; Kuang, Dai; Shi, Xianming; Xiao, Wenjia; Zhang, Jing; Gu, Zhen; Xu, Xuebin; Meng, Jianghong

    2015-10-01

    Aquaculture products can become sources of Salmonella by exposure to contaminated water or through processing practices, thus representing a public health hazard. A study was conducted on Salmonella contamination in aquaculture products sampled from marketplaces and retailers in Shanghai, China. A total of 730 samples (including fish, shellfish, bullfrog, clam, shrimp and others) were obtained from 2006 to 2011. Among them, 217 (29.7%) were positive for Salmonella. Thirty-eight serovars were identified in the 217 Salmonella isolates. The most prevalent were Salmonella Aberdeen (18.4%), S. Wandsworth (12.0%), S. Thompson (9.2%), S. Singapore (5.5%), S. Stanley (4.6%), S. Schwarzengrund (4.6%), S. Hvittingfoss (4.1%) and S. Typhimurium (4.1%). Many resistant isolates were detected, with 69.6% resistant to at least one antimicrobial drug. We observed high resistance to sulfonamides (56.5%), tetracycline (34.1%), streptomycin (28.6%), ampicillin (23.5%) and nalidixic acid (21.2%). Lower levels of resistance were found for gentamicin (3.2%), ciprofloxacin (2.3%), ceftiofur (1.3%), cefotaxime (0.9%), ceftazidime (0.5%) and cefepime (0.5%). A total of 43.3% of the Salmonella isolates were multidrug-resistant and 44 different resistance patterns were found. This study provided data on the prevalence, serovars and antimicrobial resistance of Salmonella from retail aquaculture products in Shanghai, and indicated the need for monitoring programs for microbiologic safety in such projects and for more prudent drug use in aquaculture production in order to reduce the risk of development and spread of antimicrobial resistance.

  8. Spread of CTX-M-type ESßLs in isolates of E. coli from long-term care and rehabilitation facilities in Northern Italy

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    Elisabetta Nucleo

    2008-09-01

    Full Text Available During the period March 2003 – May 2004 at the Laboratory of Clinical Microbiology “Redaelli” LTCRF in Milan, Italy, a total of 529 E. coli, obtained from inpatients of 3 different Long Term Care Rehabilitation Facilities (LTCRFs in Northern Italy, were processed and 77 ESßLs producers (14.5% were identified by Vitek System. The results were confirmed by double-disk synergy test with tazobactam (TZP. 61/77 isolates were characterized by higher levels of resistance to cefotaxime (CTX than to ceftazidime (CAZ. (ß-lactamase production was investigated by analytical isoelectric focusing (IEF coupled with a bioassay and showed multiple (ß-lactamase bands including one enzyme with pI 8.4 that, in a bioassay, was more active on CTX,ATM than on CAZ. The presence of (ß-lactamase genes was investigated by colony blot hybridization and by PCR amplification of blaTEM, blaSHV and blaCTX-M alleles. 43/61 isolates produced both TEM-1 and CTX-M-type enzymes, 14/61 expressed only CTX-M-type while in 4 cases were found blaCTX-M, blaTEM and blaSHV genes.The remainders (16/77, characterized by high levels of resistance to both CTX and CAZ, produced TEM-1 and SHV-5 enzymes (1/16 and TEM type ESßLs (15/16. Conjugation experiments, performed in liquid medium, confermed that the ESßLs determinants were transferable. Pulsed-field gel electrophoresis profiles of genomic DNA, digested with NotI, were analysed and revealed clonal heterogeneity. Our work confirms the emergence of CTX-M-type enzymes and their spread in Northern Italy also in longterm care and rehabilitation facilities that may be an important reservoir of ES?L producing E. coli.

  9. Impiego del sistema URO-QUICK per l’esecuzione rapida di antibiogrammi direttamente su campioni di urine

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    Eugenio A. Debbia

    2004-12-01

    Full Text Available During the period june-october 2003 the urine samples were examined employing routine methods for strain identification and the Kirby-Bauer technique for antibiotic susceptibility tests.This usual system was compared with the new rapid Uro-Quick method employed on samples resulting positive and mono-microbial after Gram coloration. Antibiotic (in appropriate concentration was introduced in a vial containing 2 ml of Mueller-Hinton broth, then 0.5 ml of urine were added in each vial containing the antimicrobial molecules and even in a vial without drug used as control.After 3-5 hours of incubation (for Gram negative or Gram positive strains respectively the instrument shows the results. No growth and a growth curve like the control are representative of a susceptible and resistant strain respectively. Gram negative strain were tested against ciprofloxacin, nitrofurantoin, co-clavulanate, ceftazidime, fosfomycin, imipenem, amikacin, and trimethoprim-sulfamethoxazole, while Gram positive bacteria against ciprofloxacin, nitrofurantoin, co-clavulanate, ampicillin, fosfomycin, gentamycin, oxacillin and trimethoprim-sulfamethoxazole.The Gram negative strains isolated were 1172 and the Gram positive were 261.With the first group agreement between the two methods was always more than 90%, against Gram positive pathogens there was more than 80% of agreement. In conclusion against the mayor urinary tract pathogens (E. coli, Enterococci, Klebsiella spp. and Proteus spp. agreement between the Uro-Quick system and the Kirby- Bauer was more than 90%.The rapid method appears useful not only for the determination of the antibiotic susceptibility of common uropathogens, but, on the basis of the present findings, it could be suggested the use of this rapid method in more severe nosocomial infections.

  10. Prevalence of Extended-spectrum β-Lactamases-producing Escherichia coli from Hospitals in Khartoum State, Sudan

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    Mutasim E. Ibrahim

    2013-03-01

    Full Text Available Objective: This study aimed to determine the prevalence and assess antimicrobial susceptibility of extended- spectrum β-lactamase-producing Escherichia coli isolated from clinical specimens of patients at hospitals in Khartoum State, Sudan.Methods: During April to August 2011, a total of 232 E. coli isolates were collected from various clinical specimens of patients. Isolates were identified, tested for antimicrobial susceptibility and screened for ESBL production as per standard methods. The double-disk diffusion method was used to confirm ESBL production using antimicrobial disks of ceftazidime (30 μg, cefotaxime (30 μg, with or without clavulanic acid (10 μg. A zone difference of >5 mm between disks was considered indicative of ESBL production.Results: Out of 232 E. coli isolates, 70 (30.2% were found to be positive for ESBL by the applied phenotypic methods. ESBL-producing isolates yielded high resistance rates for trimethoprim-sulfamethoxazole (98.6%, tetracycline (88.6%, nalidixic acid (81.4% and ciprofloxacin (81.4%. The highest antimicrobial activities of ESBL-producing isolates were observed for amikacin (95.7%, followed by tobramicin (74.3% and nitrofurantoin (68.6%. Resistance to quinolones, aminoglycosides, trimethoprim-sulfamethoxazole, tetracycline, nitrofurantoin and chloramphenicol was higher in ESBL than non-ESBL isolates (p<0.05. The frequency of ESBL-producing isolates varied among hospitals (18.2% to 45.1%, although a high prevalence was recorded as 45.1% at Khartoum Teaching Hospital. Wound specimens were the most common source of ESBL-producing isolates. The proportion of ESBL-producing E. coli did not differ significantly between adults and children (31% vs. 27%.Conclusion: The prevalence of ESBL-producing E. coli detected in this study is of great concern, which requires sound infection control measures including antimicrobial management and detection of ESBL-producing isolates.

  11. Clinical Characteristics of Stenotrophomonas maltophilia Bacteremia: A Regional Report and a Review of a Japanese Case Series

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    Ebara, Hirotaka; Hagiya, Hideharu; Haruki, Yuto; Kondo, Eisei; Otsuka, Fumio

    2017-01-01

    Objective Stenotrophomonas maltophilia is an emerging nosocomial pathogen that causes fatal infections in critically ill or immunocompromised patients. S. maltophilia bacteremia (SMB) is a rare condition, and its clinical characteristics in Japanese settings are not well known. Methods The medical charts of patients with SMB were retrospectively reviewed at two medical facilities (Okayama University Hospital and Tsuyama Chuo Hospital) for seven years. The data were analyzed along with those previously reported from other Japanese facilities. Result A total of 181 patients (110 men and 71 women) were evaluated. The major underlying diseases included hematologic malignancy (36.5%), solid organ malignancy (25.4%), and neutropenia (31.5%). The recent use of carbapenem was seen in 56.9% of the cases in total, and more than one-third of the patients in our hospitals were treated with carbapenem at the onset of SMB. Of 28 (63.6%) of 44 cases treated for S. maltophilia, those who did not survive were more likely to have been treated with broad-spectrum antibiotics. A multivariate analysis revealed that a higher updated Charlson Comorbidity Index [odds ratio (95% confidence interval), 1.75 (1.11-2.75); p=0.015] and intubation [odds ratio (95% confidence interval), 12.6 (1.62-97.9); p=0.016] were associated with mortality in our cases. Pathogens were often resistant to ceftazidime but susceptible to minocycline, trimethoprim/sulfamethoxazole, and fluoroquinolones. The overall mortality rates within 30 and 90 days were 37.5% and 62.5%, respectively. Conclusion The clinical characteristics of SMB in Japanese cases were similar to those reported from other countries. Clinicians should be aware that breakthrough infection by S. maltophilia may occur during administration of carbapenem. PMID:28090041

  12. National surveillance study on carbapenem non-susceptible Klebsiella pneumoniae in Taiwan: the emergence and rapid dissemination of KPC-2 carbapenemase.

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    Sheng-Kang Chiu

    Full Text Available OBJECTIVES: The global spread and increasing incidence of carbapenem non-susceptible Klebsiella pneumoniae (CnSKP has made its treatment difficult, increasing the mortality. To establish nationwide data on CnSKP spread and carbapenem-resistance mechanisms, we conducted a national surveillance study in Taiwanese hospitals. METHODS: We collected 100 and 247 CnSKP isolates in 2010 and 2012, respectively. The tests performed included antibiotic susceptibility tests; detection of carbapenemase, extended-spectrum β-lactamases (ESBL, and AmpC β-lactamases genes; outer membrane porin profiles; and genetic relationship with pulsed-field gel electrophoresis and multilocus sequence type. RESULTS: The resistance rate of CnSKP isolates to cefazolin, cefotaxime, cefoxitin, ceftazidime, and ciprofloxacin was over 90%. Susceptibility rate to tigecycline and colistin in 2010 was 91.0% and 83.0%, respectively; in 2012, it was 91.9% and 87.9%, respectively. In 2010, carbapenemase genes were detected in only 6.0% of isolates (4 bla IMP-8 and 2 bla VIM-1. In 2012, carbapenemase genes were detected in 22.3% of isolates (41 bla KPC-2, 7 bla VIM-1, 6 bla IMP-8, and 1 bla NDM-1. More than 95% of isolates exhibited either OmpK35 or OmpK36 porin loss or both. Impermeability due to porin mutation coupled with AmpC β-lactamases or ESBLs were major carbapenem-resistance mechanisms. Among 41 KPC-2-producing K. pneumoniae isolates, all were ST11 with 1 major pulsotype. CONCLUSIONS: In 2010 and 2012, the major mechanisms of CnSKP in Taiwan were the concomitance of AmpC with OmpK35/36 loss. KPC-2-KP dissemination with the same ST11 were observed in 2012. The emergence and rapid spread of KPC-2-KP is becoming an endemic problem in Taiwan. The identification of NDM-1 K. pneumoniae case is alarming.

  13. Antimicrobial susceptibility of Gram-negative bacteria causing intra-abdominal infections in China: SMART China 2011

    Institute of Scientific and Technical Information of China (English)

    Zhang Hui; Yang Qiwen; Xiao Meng; Chen Minjun; Robert E.Badal; Xu Yingchun

    2014-01-01

    Background The Study for Monitoring Antimicrobial Resistance Trends program monitors the activity of antibiotics against aerobic and facultative Gram-negative bacilli (GNBs) from intra-abdominal infections (IAIs) in patients worldwide.Methods In 2011,1 929 aerobic and facultative GNBs from 21 hospitals in 16 cities in China were collected.All isolates were tested using a panel of 12 antimicrobial agents,and susceptibility was determined following the Clinical Laboratory Standards Institute guidelines.Results Among the Gram-negative pathogens causing IAIs,Escherichia coli (47.3%) was the most commonly isolated,followed by Klebsiella pneumoniae (17.2%),Pseudomonas aeruginosa (10.1%),and Acinetobacter baumannii (8.3%).Enterobacteriaceae comprised 78.8% (1521/1929) of the total isolates.Among the antimicrobial agents tested,ertapenem and imipenem were the most active agents against Enterobacteriaceae,with susceptibility rates of 95.1% and 94.4%,followed by amikacin (93.9%) and piperacillin/tazobactam (87.7%).Susceptibility rates of ceftriaxone,cefotaxime,ceftazidime,and cefepime against Enterobacteriaceae were 38.3%,38.3%,61.1%,and 50.8%,respectively.The leastactive agent against Enterobacteriaceae was ampicillin/sulbactam (25.9%).The extended-spectrum β-lactamase (ESBL) rates among E.coli,K.pneumoniae,Klebsiella oxytoca,and Proteus mirabilis were 68.8%,38.1%,41.2%,and 57.7%,respectively.Conclusions Enterobacteriaceae were the major pathogens causing IAIs,and the most active agents against the study isolates (including those producing ESBLs) were ertapenem,imipenem,and amikacin.Including the carbapenems,most agents exhibited reduced susceptibility against ESBL-positive and multidrug-resistant isolates.

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

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

    2015-07-01

    Increasing numbers of clinical isolates of Enterobacteriaceae that produce carbapenemase are now being detected, with the most common carbapenemase found among Enterobacteriaceae in Japan being IMP-1-type metallo-β-lactamase. Clinical isolates of Enterobacteriaceae harbouring carbapenemases may be resistant to carbapenem antimicrobial agents, despite apparent in vitro susceptibility when tested according to Clinical and Laboratory Standards Institute criteria. We evaluated the prevalence of carbapenemase producers among isolates of Enterobacteriaceae at our hospital and assessed the performance of the modified Hodge test (MHT) for correctly identifying the phenotype. We studied 47 clinical isolates obtained between 2006 and 2010 for which the MIC of imipenem was 2 or 4 μg imipenem ml- 1. Antibacterial susceptibility testing was done for cephalosporins and carbapenems, the MHT was performed with meropenem and detection of the genes encoding IMP-1, VIM-2, KPC-2 and NDM-1-type metallo-β-lactamases was performed by PCR. Twelve isolates showed a positive result in the MHT with meropenem and were classified as carbapenemase producers. Of these 12 isolates, seven carried the gene for IMP-1 typ