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Sample records for ceftazidime

  1. A Weibull distribution model for intradermal administration of ceftazidime.

    Science.gov (United States)

    Bressolle, F; Laurelli, J M; Gomeni, R; Bechier, J G; Wynn, N R; Galtier, M; Eledjam, J J

    1993-11-01

    The pharmacokinetics of 1 g of ceftazidime administered intradermally was studied in seven healthy volunteers. The objective of the present study was to find the most appropriate mathematical model to describe the drug intake process. The concentration of ceftazidime in plasma was measured by HPLC. The disposition of the drug was described by a one-compartment pharmacokinetic model, with drug intake occurring by different processes: a zero-order process due to the administration and a first-order intake from the injection site to the systemic circulation. The Weibull model was considered as an approximation of the overall process. The mean Weibull parameters were td (time necessary to transfer 63% of the administered drug into the systemic circulation) of 2.75 +/- 0.75 h, and f (shape) of 1.04 +/- 0.15. The mean elimination half-life was 2.0 +/- 0.4 h. The area under the concentration versus time curve obtained in this study (139 +/- 46 mg.h/L) is very near to literature values reported after single intravenous doses of 1 g of ceftazidime, suggesting that the bioavailability of ceftazidime after intradermal administration may be approximately 100%. Moreover, the mean peak plasma concentration (37 +/- 16 mg/L) is in the same range as that reported in the literature after intramuscular administration of a single dose of 1 g. PMID:8289137

  2. 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.

  3. Stability and compatibility of ceftazidime administered by continuous infusion to intensive care patients.

    OpenAIRE

    Servais, Hélène; Tulkens, Paul M.

    2001-01-01

    The stability and compatibility of ceftazidime have been examined in the context of its potential use in concentrated solutions for continuous infusion in patients suffering from severe nosocomial pneumonia and receiving other intravenous medications by the same route. Ceftazidime stability in 4 to 12% solutions was found satisfactory (

  4. Role of beta-lactamase in in vivo development of ceftazidime resistance in experimental Pseudomonas aeruginosa endocarditis.

    OpenAIRE

    Bayer, A S; Peters, J.; Parr, T R; Chan, L; Hancock, R E

    1987-01-01

    Two ceftazidime-resistant variants of Pseudomonas aeruginosa (PA-48, PA-60), obtained from cardiac vegetations of rabbits with endocarditis receiving ceftazidime therapy, were studied for mechanisms of resistance. Both resistant variants were stably derepressed for the type Id beta-lactamase, which was ceftazidime inducible in the parental strain (PA-96) used to initially infect the rabbits. There was no evidence of ceftazidime bioinactivation by the resistant strains, and their outer membran...

  5. 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

  6. 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.

  7. In vitro selection of ceftazidime-avibactam resistance in Enterobacteriaceae with KPC-3 carbapenemase.

    Science.gov (United States)

    Livermore, David M; Warner, Marina; Jamrozy, Dorota; Mushtaq, Shazad; Nichols, Wright W; Mustafa, Nazim; Woodford, Neil

    2015-09-01

    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 bla KPC 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 bla KPC 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

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

    NARCIS (Netherlands)

    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

  9. Pharmacokinetic-pharmacodynamic modeling of activity of ceftazidime during continuous and intermittent infusion

    NARCIS (Netherlands)

    J.W. Mouton (Johan); A.A. Vinks; N.C. Punt

    1997-01-01

    textabstractWe developed and applied pharmacokinetic-pharmacodynamic (PK-PD) models to characterize in vitro bacterial rate of killing as a function of ceftazidime concentrations over time. For PK-PD modeling, data obtained during continuous and intermittent infusion of

  10. Ceftazidime resistance inBurkholderia pseudomallei:First report from India

    Institute of Scientific and Technical Information of China (English)

    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.

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

    OpenAIRE

    Rizky Abdulah; Raine D. Kumamba; Rano K. Sinuraya; Cherry Rahayu; Melisa I. Barliana

    2016-01-01

    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,...

  12. 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.

  13. Ceftazidime Injection

    Science.gov (United States)

    ... to treat certain infections caused by bacteria including pneumonia and other lower respiratory tract (lung) infections; meningitis ( ... effects. Call your doctor if you have any unusual problems while using this medication.If you experience ...

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

    Science.gov (United States)

    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.

  15. Pharmacokinetics of ceftazidime in serum and peritoneal exudate during continuous versus intermittent administration to patients with severe intra-abdominal infections

    NARCIS (Netherlands)

    S.L.C.E. Buijk (Steven); I.C. Gyssens (Inge); J.W. Mouton (Johan); A.C.M. van Vliet (Adrie); H.A. Verbrugh (Henri); H.A. Bruining (Hajo)

    2002-01-01

    textabstractCeftazidime demonstrates time-dependent killing, which is maximal at 4 x or 5 x MIC for the organism, consequently continuous infusion (CI) has been proposed to ensure adequate ceftazidime concentrations for the entire course of therapy. Severe intra-abdominal infection

  16. 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

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

    Science.gov (United States)

    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 (CN...

  18. 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.

  19. In Vitro Susceptibility of Global Surveillance Isolates of Pseudomonas aeruginosa to Ceftazidime-Avibactam (INFORM 2012 to 2014).

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    Nichols, Wright W; de Jonge, Boudewijn L M; Kazmierczak, Krystyna M; Karlowsky, James A; Sahm, Daniel F

    2016-08-01

    Broth microdilution antimicrobial susceptibility testing was performed for ceftazidime-avibactam and comparator agents against 7,062 clinical isolates of Pseudomonas aeruginosa collected from 2012 to 2014 in four geographic regions (Europe, Asia/South Pacific, Latin America, Middle East/Africa) as part of the International Network for Optimal Resistance Monitoring (INFORM) global surveillance program. The majority of isolates were susceptible to ceftazidime-avibactam, with the proportions susceptible differing marginally across the four regions (MIC90, 8 to 16 μg/ml; 88.7 to 93.2% susceptible), in contrast to lower susceptibilities to the following comparator β-lactam agents: ceftazidime (MIC90, 32 to 64 μg/ml; 71.5 to 80.8% susceptible), meropenem (MIC90, >8 μg/ml; 64.9 to 77.4% susceptible), and piperacillin-tazobactam (MIC90, >128 μg/ml; 62.3 to 71.3% susceptible). Compared to the overall population, susceptibility to ceftazidime-avibactam of isolates that were nonsusceptible to ceftazidime (n = 1,627) was reduced to between 56.8% (Middle East/Africa; MIC90, 64 μg/ml) and 68.9% (Asia/South Pacific; MIC90, 128 μg/ml), but these percentages were higher than susceptibilities to other β-lactam agents (0 to 44% susceptible, depending on region and agent; meropenem MIC90, >8 μg/ml; 26.5 to 43.9% susceptible). For this subset of isolates, susceptibilities to amikacin (MIC90, >32 μg/ml; 53.2 to 80.0% susceptible) and colistin (MIC90, 1 μg/ml; 98.5 to 99.5% susceptible) were comparable to or higher than that of ceftazidime-avibactam. A similar observation was made with isolates that were nonsusceptible to meropenem (n = 1,926), with susceptibility to ceftazidime-avibactam between 67.8% (Middle East/Africa; MIC90, 64 μg/ml) and 74.2% (Europe; MIC90, 32 μg/ml) but again with reduced susceptibility to comparators except for amikacin (MIC90, >32 μg/ml; 56.8 to 78.7% susceptible) and colistin (MIC90, 1 μg/ml; 98.9 to 99.3% susceptible). Of the 8% of isolates

  20. Efficacies of Imipenem, Meropenem, Cefepime, and Ceftazidime in Rats with Experimental Pneumonia Due to a Carbapenem-Hydrolyzing β-Lactamase-Producing Strain of Enterobacter cloacae

    OpenAIRE

    Mimoz, Olivier; Leotard, Sophie; Jacolot, Anne; Padoin, Christophe; Louchahi, Kamel; Petitjean, Olivier; Nordmann, Patrice

    2000-01-01

    The antibacterial activities of imipenem-cilastatin, meropenem-cilastatin, cefepime and ceftazidime against Enterobacter cloacae NOR-1, which produces the carbapenem-hydrolyzing β-lactamase NmcA and a cephalosporinase, and against one of its in vitro-obtained ceftazidime-resistant mutant were compared by using an experimental model of pneumonia with immunocompetent rats. The MICs of the β-lactams with an inoculum of 5 log10 CFU/ml were as follows for E. cloacae NOR-1 and its ceftazidime-resis...

  1. Antimicrobial action of zinc oxide nanoparticles in combination with ciprofloxacin and ceftazidime against multidrug-resistant Acinetobacter baumannii.

    Science.gov (United States)

    Ghasemi, F; Jalal, R

    2016-09-01

    Acinetobacter baumannii is a serious concern amongst hospitalised patients worldwide and its resistance to antibiotics has emerged as a threat to public health in recent years. Metal oxide nanoparticles were found to be effective for overcoming bacterial resistance owing to their antibacterial activities. The aim of this study was to investigate the combined effects of zinc oxide nanoparticles (ZnO-NPs) and the conventional antibiotics ciprofloxacin and ceftazidime as well as their mechanisms of action against resistant A. baumannii. ZnO-NPs were prepared by the solvothermal method and were characterised by various methods. Broth microdilution and disk diffusion methods were used to determine the antibacterial activities of ciprofloxacin and ceftazidime antibiotics in the absence and presence of a subinhibitory concentration of ZnO-NPs. The mechanism of action of ZnO-NPs alone and in combination with these antibiotics was assessed by flow cytometry, DNA extraction, fluorescence and scanning electron microscopy. The results showed that the antibacterial activities of both antibiotics increased in the presence of a subinhibitory concentration of ZnO-NPs. Combination of ZnO-NPs with antibiotics increased the uptake of antibiotics and changed the bacterial cells from rod to cocci forms. Bacterial filamentation was also observed and exhibited no DNA fragmentation. In conclusion, the results of this study indicate that ZnO-NPs potentiate the antimicrobial action of ciprofloxacin and ceftazidime. A mechanism is proposed to explain this phenomenon. PMID:27530853

  2. 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.

  3. 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.

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

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    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. PMID:26920105

  5. 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.

  6. 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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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

  12. Ceftazidime-avibactam activity tested against Enterobacteriaceae isolates from U.S. hospitals (2011 to 2013) and characterization of β-lactamase-producing strains.

    Science.gov (United States)

    Castanheira, Mariana; Mills, Janet C; Costello, Sarah E; Jones, Ronald N; Sader, Helio S

    2015-01-01

    Ceftazidime-avibactam (MIC50/90, 0.12/0.25 μg/ml) inhibited 99.9% (20,698/20,709) of Enterobacteriaceae isolates at ≤8 μg/ml. This compound was active against resistant subsets, including ceftazidime-nonsusceptible Enterobacter cloacae (MIC50/90, 0.25/0.5 μg/ml) and extended-spectrum β-lactamase (ESBL) phenotype isolates. An ESBL phenotype was noted among 12.4% (1,696/13,692 isolates from targeted species) of the isolates, including 776 Escherichia coli (12.0% for this species; MIC50/90, 0.12/0.25 μg/ml), 721 Klebsiella pneumoniae (16.3%; MIC50/90, 0.12/0.25 μg/ml), 119 Klebsiella oxytoca (10.3%; MIC50/90, 0.06/0.25 μg/ml), and 80 Proteus mirabilis (4.9%; MIC50/90, 0.06/0.12 μg/ml) isolates. The most common enzymes detected among ESBL phenotype isolates from 2013 (n = 743) screened using a microarray-based assay were CTX-M-15-like (n = 307), KPC (n = 120), SHV ESBLs (n = 118), and CTX-M-14-like (n = 110). KPC producers were highly resistant to comparators, and ceftazidime-avibactam (MIC50/90, 0.5/2 μg/ml) and tigecycline (MIC50/90, 0.5/1 μg/ml; 98.3% susceptible) were the most active agents against these strains. Meropenem (MIC50/90, ≤0.06/≤0.06 μg/ml) and ceftazidime-avibactam (MIC50/90, 0.12/0.25 μg/ml) were active against CTX-M-producing isolates. Other enzymes were also observed, and ceftazidime-avibactam displayed good activity against the isolates producing less common enzymes. Among 11 isolates displaying ceftazidime-avibactam MIC values of >8 μg/ml, three were K. pneumoniae strains producing metallo-β-lactamases (all ceftazidime-avibactam MICs, >32 μg/ml), with two NDM-1 producers and one K. pneumoniae strain carrying the bla(KPC-2) and bla(VIM-4) genes. Therapeutic options for isolates producing β-lactamases may be limited, and ceftazidime-avibactam, which displayed good activity against strains, including those producing KPC enzymes, merits further study in infections where such organisms occur. PMID:25845862

  13. 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. PMID:27561530

  14. The Assessment of Proteus mirabilis Susceptibility to Ceftazidime and Ciprofloxacin and the Impact of These Antibiotics at Subinhibitory Concentrations on Proteus mirabilis Biofilms

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    Joanna Kwiecińska-Piróg

    2013-01-01

    Full Text Available Rods of the Proteus genus are commonly isolated from patients, especially from the urinary tracts of the catheterised patients. The infections associated with biomaterials are crucial therapeutic obstacles, due to the bactericidal resistance of the biofilm. The aim of this study was to assess the susceptibility of P. mirabilis planktonic forms to ciprofloxacin and ceftazidime, the ability to form biofilm, and the impact of chosen sub-MIC concentrations of these antibiotics on biofilm at different stages of its formation. The research included 50 P. mirabilis strains isolated from wounds and the urinary tracts from patients of the University Hospital No. 1 in Bydgoszcz. The assessment of susceptibility to ciprofloxacin and ceftazidime was conducted using micromethods. The impact of sub-MIC concentrations of the chosen antibiotics on the biofilm was measured using the TTC method. The resistance to ciprofloxacin was confirmed for 20 strains (40.0% while to ceftazidime for 32 (64.0% of the tested P. mirabilis strains. All of the tested strains formed biofilm: 24.0% weakly, 26.0% moderately, and 50.0% strongly. It was determined that ciprofloxacin and ceftazidime caused eradication of the biofilm. Moreover, the connection between origin of the strains, biofilm maturity level, and resistance to antibiotics was proved.

  15. 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...

  16. [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.

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

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    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

  18. Changes in the F0F1-ATPase activity of irradiated Lactobacillus acidophilus in the presence of ceftazidime at low pH

    International Nuclear Information System (INIS)

    The aim of this study was the investigation of the effects of low intensity electromagnetic irradiation (EMI) at the frequencies of 51.8 and 53 GHz and of antibiotic ceftazidime on the N,N'-dicyclohexylcarbodiimide (DCCD) inhibited ATPase activity of membrane vesicles of lactic acid bacteria Lactobacillus acidophilus grown at low pH (pH 4.0 or 6.5) and assayed at the same pH. It was shown that both frequencies EMI stimulated ATPase activity of L. acidophilus grown at pH 4.0, but EMI combined with ceftazidime and DCCD decreased ATPase activity at pH 4.0 and pH 6.5. It was suggested that the F0F1-ATPase might be a target for EMI even at low pH

  19. 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...

  20. 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%.

  1. Spread of Escherichia coli Strains with High-Level Cefotaxime and Ceftazidime Resistance between the Community, Long-Term Care Facilities, and Hospital Institutions

    OpenAIRE

    Oteo, Jesús; Navarro, Carmen; Cercenado, Emilia; Delgado-Iribarren, Alberto; Wilhelmi, Isabel; Orden, Beatriz; García, Carmen; Miguelañez, Silvia; Pérez-Vázquez, María; García-Cobos, Silvia; Aracil, Belén; Bautista, Verónica; Campos, José

    2006-01-01

    A total of 151 Escherichia coli strains resistant to cefotaxime and ceftazidime were isolated during a prospective surveillance study. These strains were characterized by clinical, microbiological, and molecular analyses and were distributed into four clusters of 103, 11, 6, and 5 isolates, along with 25 unrelated strains. The principal cluster was isolated from urine, wound, blood, and other samples in three hospitals, eight nursing homes, and a community healthcare center. This cluster was ...

  2. 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

  3. 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.

  4. 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

  5. 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

  6. 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.

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

    Science.gov (United States)

    Hidalgo, Jose A; Vinluan, Celeste M; Antony, Nishaal

    2016-01-01

    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. PMID:27528799

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

    Science.gov (United States)

    Hidalgo, Jose A; Vinluan, Celeste M; Antony, Nishaal

    2016-01-01

    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. PMID:27528799

  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. Evaluation of Trimethoprim/Sulfamethoxazole (SXT), Minocycline, Tigecycline, Moxifloxacin, and Ceftazidime Alone and in Combinations for SXT-Susceptible and SXT-Resistant Stenotrophomonas maltophilia by In Vitro Time-Kill Experiments

    Science.gov (United States)

    Cai, Xuejiu; Zhao, Jin; Cui, Junchang

    2016-01-01

    Background The optimal therapy for infections caused by Stenotrophomonas maltophilia (S. maltophilia) has not yet been established. The objective of our study was to evaluate the efficacy of trimethoprim/sulfamethoxazole (SXT), minocycline, tigecycline, moxifloxacin, levofloxacin, ticarcillin-clavulanate, polymyxin E, chloramphenicol, and ceftazidime against clinical isolated S. maltophilia strains by susceptibility testing and carried out time-kill experiments in potential antimicrobials. Methods The agar dilution method was used to test susceptibility of nine candidate antimicrobials, and time-killing experiments were carried out to evaluate the efficacy of SXT, minocycline, tigecycline, moxifloxacin, levofloxacin, and ceftazidime both alone and in combinations at clinically relevant antimicrobial concentrations. Results The susceptibility to SXT, minocycline, tigecycline, moxifloxacin, levofloxacin, ticarcillin-clavulanate, chloramphenicol, polymyxin E, and ceftazidime were 93.8%, 95.0%, 83.8%, 80.0%, 76.3%, 76.3%, 37.5%, 22.5%, and 20.0% against 80 clinical consecutively isolated strains, respectively. Minocycline and tigecycline showed consistent active against 22 SXT-resistant strains. However, resistance rates were high in the remaining antimicrobial agents against SXT-resistant strains. In time-kill experiments, there were no synergisms in most drug combinations in time-kill experiments. SXT plus moxifloxacin displayed synergism when strains with low moxifloxacin MICs. Moxifloxacin plus Minocycline and moxifloxacin plus tigecycline displayed synergism in few strains. No antagonisms were found in these combinations. Overall, compared with single drug, the drug combinations demonstrated lower bacterial concentrations. Some combinations showed bactericidal activity. Conclusions In S. maltophilia infections, susceptibility testing suggests that minocycline and SXT may be considered first-line therapeutic choices while tigecycline, moxifloxacin, levofloxacin

  12. 氧化还原分光光度法测定针剂中头孢他啶含量%Spectrophotometric determination of Ceftazidime by the oxidation and reduction reactions

    Institute of Scientific and Technical Information of China (English)

    杜申道; 孙双姣; 黄增妍; 邝思群

    2012-01-01

    目的 建立分光光度法测定针剂头孢他啶的新方法.方法 采用分光光度法测定高锰酸钾525 nm处吸光度的降低情况以测定头孢他啶含量.结果 头孢他啶线性范围为0.80~40.00 μg/mL,回归方程为△A525=0.01ρ+0.051 4,相关系数r为0.998 7,检出限为0.64 μg/mL.结论 用于定量分析针剂中头孢他啶的含量,仪器简单,操作简便,选择性好,结果 满意.%Objective To establish a new spectrophotometry used for the determination of Ceftazidime content in injection. Methods The determinantion was done by determining the decreasing situation of absorbancy of Potassium Permanganate at 525 nm, in order to determine the content of Ceftazidime. Results Ceftazidime presented a good linear relationship with the range of 0.80-40.00 μg/mL, △A525=0.01ρ+0.0514, r = 0.998 7 and its detection limit was achieved at 0.64 μg/mL. Conclusion The proposed method is applied to the determination of Ceftazidime content in samples, with simplicity, sensitivity, good selectivity, and satisfactory results.

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

    Science.gov (United States)

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

    2016-08-01

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

  14. Simultaneous Determination of Eight β-Lactam Antibiotics, Amoxicillin, Cefazolin, Cefepime, Cefotaxime, Ceftazidime, Cloxacillin, Oxacillin, and Piperacillin, in Human Plasma by Using Ultra-High-Performance Liquid Chromatography with Ultraviolet Detection.

    Science.gov (United States)

    Legrand, Tiphaine; Vodovar, Dominique; Tournier, Nicolas; Khoudour, Nihel; Hulin, Anne

    2016-08-01

    A simple and rapid ultra-high-performance liquid chromatography (UHPLC) method using UV detection was developed for the simultaneous determination of eight β-lactam antibiotics in human plasma, including four penicillins, amoxicillin (AMX), cloxacillin (CLX), oxacillin (OXA), and piperacillin (PIP), and four cephalosporins, cefazolin (CFZ), cefepime (FEP), cefotaxime (CTX), and ceftazidime (CAZ). One hundred-microliter samples were spiked with thiopental as an internal standard, and proteins were precipitated by acetonitrile containing 0.1% formic acid. Separation was achieved on a pentafluorophenyl (PFP) column with a mobile phase composed of phosphoric acid (10 mM) and acetonitrile in gradient elution mode at a flow rate of 500 μl/min. Detection was performed at 230 nm for AMX, CLX, OXA, and PIP and 260 nm for CFZ, FEP, CTX, and CAZ. The total analysis time did not exceed 13 min. The method was found to be linear at concentrations ranging from 2 to 100 mg/liter for each compound, and all validation parameters fulfilled international requirements. Between- and within-run accuracy errors ranged from -5.2% to 11.4%, and precision was lower than 14.2%. This simple method requires small-volume samples and can easily be implemented in most clinical laboratories to promote the therapeutic drug monitoring of β-lactam antibiotics. The simultaneous determination of several antibiotics considerably reduces the time to results for clinicians, which may improve treatment efficiency, especially in critically ill patients. PMID:27216076

  15. 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.

  16. 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

  17. 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.

  18. In vivo synergistic interaction of liposome-coencapsulated gentamicin and ceftazidime

    NARCIS (Netherlands)

    R.M. Schiffelers (Raymond); G. Storm; M.T. ten Kate (Marian); L.E. Stearne-Cullen; J.G. den Hollander (Jan); H.A. Verbrugh (Henri); I.A.J.M. Bakker-Woudenberg (Irma)

    2001-01-01

    textabstractAntimicrobial agents may interact synergistically. But to ensure synergy in vivo, the drugs should both be present at the site of infection at sufficiently high concentrations for an adequate period of time. Coencapsulation of the drugs in a drug carrier may

  19. 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

  20. Synergism between tobramycin and ceftazidime against a resistant Pseudomonas aeruginosa strain, tested in an in vitro pharmacokinetic model

    NARCIS (Netherlands)

    J.G. den Hollander (Jan); A.M. Horrevorts; M.L. van Goor; H.A. Verbrugh (Henri); J.W. Mouton (Johan)

    1997-01-01

    textabstractSynergism between two antibiotics is usually tested by a checkerboard titration technique, or by time-kill methods. Both methods have the disadvantage that synergism is determined at constant concentrations of the antibiotics, which do not reflect reality in

  1. 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.

  2. Bactericidal interactions of a beta-lactam and beta-lactamase inhibitors in experimental Pseudomonas aeruginosa endocarditis caused by a constitutive overproducer of type Id beta-lactamase.

    OpenAIRE

    Bayer, A S; Selecky, M; Babel, K; Hirano, L; Yih, J; Parr, T R

    1987-01-01

    We investigated the in vitro and in vivo effects of a combination of a beta-lactam (ceftazidime) and a beta-lactamase inhibitor (dicloxacillin) to synergistically kill a ceftazidime-resistant variant, Pseudomonas aeruginosa PA-48, which overproduces type Id cephalosporinase constitutively. In vitro, dicloxacillin plus ceftazidime exerted bactericidal synergy at approximately 10(5) CFU/ml of inoculum (but not at approximately 10(7)-CFU inoculum), whereas other beta-lactamase inhibitors (sulbac...

  3. Observation on clinical efficacy of ceftazidime combined with lactobacillus complex capsules in treatment of acute bacterial diarrhea in the elderly%头孢他啶联合复合乳酸菌素胶囊治疗老年人急性细菌性腹泻效果评价

    Institute of Scientific and Technical Information of China (English)

    侯义林; 刘强

    2014-01-01

    目的 观察头孢他啶联合复合乳酸菌素胶囊治疗老年人急性细菌性腹泻的临床疗效.方法 将240例老年细菌性腹泻患者随机分为A组(左氧氟沙星组),B组(头孢他啶组)和C组(头孢他啶联合复合乳酸菌素胶囊组)各80例.结果 A组总有效率:88.75%,B组为96.25%,C组为97.5%,C组疗效优于A组,差异有统计学意义(P<0.05);C组显效率(78.75%)显著高于A组(56.25%)及B组(63.75%),差异有统计学意义(P<0.05);C组及B组不良反应率均低于A组,差异均有统计学意义(P<0.05).结论 头孢他啶联合复合乳酸菌素胶囊治疗老年人细菌性腹泻疗效确切,较左氧氟沙星显效快疗效好,不良反应发生率低,是治疗老年人急性细菌性腹泻安全有效的方法.

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. Disease: H01151 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available infections in patients with underlying diseases. Infectious disease Brevundimonas vesicularis Brevundimonas...d-stage renal disease Autoimmune diseases Vancomycin [ATC: J01XA01] Ceftazidime [ATC:J01DD02] Levofloxacin [

  9. 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

  10. 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.

  11. Results of Use of WHO Global Salm-Surv External Quality Assurance System for Antimicrobial Susceptibility Testing of Salmonella Isolates from 2000 to 2007

    DEFF Research Database (Denmark)

    Hendriksen, Rene S.; Seyfarth, Anne Mette; Jensen, Arne Bent;

    2009-01-01

    to 3% in 2007. Consistent difficulties were observed in susceptibility testing of amoxicillin-clavulanic acid, cefotaxime, ceftazidime, streptomycin, sulfonamides, and tetracycline. Regional variations in performance were observed, with laboratories in central Asia, Africa, and the Middle East...

  12. 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

  13. Cephalosporin-induced hypoprothrombinemia: is the N-methylthiotetrazole side chain the culprit?

    OpenAIRE

    Agnelli, G.; Del Favero, A.; Parise, P; Guerciolini, R; Pasticci, B; Nenci, G G; Ofosu, F

    1986-01-01

    The reported high incidence of vitamin-K-reversible hypoprothrombinemia associated with the new beta-lactamase-stable cephalosporins prompted us to evaluate the effect on hemostasis of three cephalosporins (cefamandole, ceftriaxone, and ceftazidime) in 30 patients with serious infections. Cefamandole and ceftriaxone, both containing a sulfhydryl group, induced a significant and similar prolongation of prothrombin time and decrease in factor VII activity. Ceftazidime, in contrast, had no effec...

  14. Melioidosis as a cause of acute abdomen in immuno-competent male from eastern India.

    Science.gov (United States)

    Karuna, Tadepalli; Khadanga, Sagar; Dugar, Dharmendra; Sau, Biyanka; Bhoi, Priyadarshini

    2015-01-01

    Though melioidosis is rare in India, it has gained importance as one of the most potent emerging infections. In India, the cases have been under-reported because of the lack of awareness. The majority of cases present with multifocal pyogenic infections with septicemia. We present an unusual case of melioidosis presenting as acute intestinal perforation. The organism was ceftazidime resistant, and we successfully treated the case with imipenem and doxycyclin. This case highlights ruling out the possibility of melioidosis in acute abdomen and existence of ceftazidime resistant cases in India. PMID:25949062

  15. 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

  16. Antibiotic susceptibility patterns of pseudomonas corneal ulcers in contact lens wearers

    Directory of Open Access Journals (Sweden)

    Mehrdad Mohammadpour

    2011-01-01

    Conclusion : P. aeruginosa was highly sensitive to ceftazidime, ciprofloxacin, and amikacin. All cases were resistant to cefazolin. Resistance to multiple antibiotics might be a significant concern in patients with corneal ulcers. In referral centers dealing with corneal ulcers, the initial antibiotic regimens should be changed from time to time to prevent this phenomenon.

  17. COMPARISON OF SCREENING TESTS FOR METALLO - BETA - LACTAMASE P RODUCING GRAM NEGATIVE BACTERIA

    Directory of Open Access Journals (Sweden)

    Niranjan

    2012-04-01

    Full Text Available ABSTRACT : BACKGROUND: The wide spread dissemination of metallo - beta - lactamase (MBL resistance to carbapenem antibiotics, such as Imipenem (IMP and other antibiotics, a mong gram negative pathogens have become a global concern. The present study is to evaluate various screening tests to determine Metallobetalactamase production. OBJECTIVES: 1To determine the frequency of metallo - beta - lactamases among Imipenem and ceftazi dime resistant isolates 2To evaluate four phenotypic tests for detection of metallo - beta - lactamase. MATERIALS AND METHODS: A total of 48 clinical isolates from various samples showing resistance to imepenem and ceftazidime were screened for MBL production by 4 different methods 1Imepenem with Ethylene - D iamine - T etra - A cetic acid ( EDTA combined disc test,2EDTA disc potentiation test with imepenem,3 EDTA disc potentiation test with ceftazidime and 4ceftazidime with EDTA combined disc test, and compared . RESULTS: In the present study, Of the 48 isolates tested , 34 (70.83% were positive for MBL production by at least one of the methods used. Pseudomonas aeruginosa was the predominant organism producing MBL 18 (52.94% followed by Klebsiella pneumoniae 4( 11.76%.EDTA disc potentiation test with imepenem was the most sensitive method 28(82.35%. CONCLUSION: In the present study, Imepenem with EDTA, both combined and double disc potentiation tests were more effective than ceftazidime with EDTA. Though there are several screening methods recommended for detection of MBL production, no single test when used alone is specific for these enzymes.

  18. Microbiological assessment of Burkholderia cepacia complex (Bcc isolates in Alexandria Main University Hospital

    Directory of Open Access Journals (Sweden)

    Nancy Omar

    2015-03-01

    Minimal Inhibitory Concentration (MIC determining tests showed that only 11.5% were resistant to meropenem at MIC > 16 μg/ml, while 40% of the strains were resistant to ceftazidime at MIC > 32 μg/ml. Those results for the time being indicate that meropenem is the best therapeutic option for Bcc infections in AMUH.

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

    OpenAIRE

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

    2015-01-01

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

  20. In vitro synergistic activities of tobramycin and selected beta-lactams against 75 gram-negative clinical isolates.

    OpenAIRE

    Owens, R C; Banevicius, M A; Nicolau, D. P.; Nightingale, C H; Quintiliani, R

    1997-01-01

    The microdilution checkerboard technique was utilized to distinguish synergistic activity between tobramycin and four beta-lactams: piperacillin-tazobactam, ticarcillin-clavulanate, ceftazidime, and ceftriaxone. Beta-lactam-aminoglycoside combinations were tested against 75 clinical isolates of Pseudomonas aeruginosa, Acinetobacter baumanii, Citrobacterfreundii, Serratia marcescens, and Enterobacter cloacae. Despite in vitro susceptibilities, all isolates demonstrated either synergism or indi...

  1. 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...

  2. 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.

  3. 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.

  4. Combination effect of recombinant human interleukin-1 alpha with antimicrobial agents.

    OpenAIRE

    Nakamura, S.; Minami, A.; Fujimoto, K; Kojima, T.

    1989-01-01

    Combination effects of recombinant human interleukin-1 alpha with ceftazidime, moxalactam, gentamicin, enoxacin, amphotericin B, miconazole, or an immunoglobulin preparation were evaluated in systemic infections with Pseudomonas aeruginosa, Klebsiella pneumoniae, and Candida albicans in normal mice and systemic infection with P. aeruginosa in mice with leukopenia induced by preadministration of cyclophosphamide. Synergistic effects were generally observed at interleukin-1 alpha doses as low a...

  5. Incidence of cephalosporin resistance among clinical isolates of Pseudomonas aeruginosa in Ibadan, South- Western Nigeria

    Directory of Open Access Journals (Sweden)

    Oladipo E.K

    2015-12-01

    Full Text Available Background: The emergence of beta-lactam resistance in Pseudomonas aeruginosa is a major global challenge, particularly, the rise in the resistance to 3rd and 4th generation cephalosporins. Aim: This study was carried out to determine the resistance pattern of Pseudomonas aeruginosa to different generations of cephalosporins. Methods: A total number of one hundred clinical isolates of Pseudomonas aeruginosa were collected from June to November 2014 at University Teaching Hospital Ibadan, Oyo State. These were tested for their sensitivity to antibiotics by means of disc diffusion method using prepared antibiotics disc containing different μ of antibiotics; Cefotaxine (30μ, Cefaclor (30μ, Cefamandole (30μ, Cefixime (5μ, Cefepime (30μ, Cefpodoxime (30μ and Ceftazidime (30μ. Results: Pseudomonas aeruginosa showed absolute resistance to all antibiotics used except Ceftazidime, and Cefepime which are third and fourth generation of cephalosporin respectively. Ceftazidime had minimal resistant of 21% and higher susceptibility rate of 76%, Cefepime had the highest susceptibility rate of 90% and minimal resistance of 6%. Cefotaxime and Cefpodoxime had minimal intermediate of 1%, Ceftazidime of 3% and Cefepime of 4%. Conclusion: The result from this study provided more evidence that among third generation of cephalosporins used, some are more active than the other while fourth generation is still the most effective of all other generations. Knowledge on the distribution of cephalosporin-resistant organisms is of ultimate importance as a guide in empirical therapy, taking note of preventive strategies as well as control measures against the spread of resistant microorganisms.

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

    Directory of Open Access Journals (Sweden)

    Rashmi

    2015-08-01

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

  7. Kinetic Spectrophotometric Determination of Certain Cephalosporins in Pharmaceutical Formulations

    OpenAIRE

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

    2009-01-01

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

  8. Pathophysiology of in-vitro induced filaments, spheroplasts and rod-shaped bacteria in neutropenic mice

    NARCIS (Netherlands)

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

    2006-01-01

    This study compared the in-vitro properties and in-vivo effects of Escherichia coli filaments, spheroplasts and normal cells in a murine thigh infection model. E. coli was exposed to ceftazidime, meropenem or saline to obtain filaments, spheroplasts or normal bacilli, which were then injected into n

  9. 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

  10. 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...... 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...

  11. 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.

  12. 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......, microtiter plates, and on alginate beads were treated with different concentrations of ceftazidime and imipenem. The kinetics of antibiotics on the biofilms was investigated in vitro by time-kill methods. Time-dependent killing of ceftazidime was observed in PAO1 biofilms, but concentration-dependent killing......-lactamase, which can hydrolyze the beta-lactam antibiotics. The PK/PD indices of the AUC/MBIC and C-max/MBIC (AUC is the area under concentration-time curve, MBIC is the minimal biofilm-inhibitory concentration, and C-max is the maximum concentration of drug in serum) are probably the best parameters to describe...

  13. 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.

  14. 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.

  15. In Vitro Susceptibilities of Burkholderia mallei in Comparison to Those of Other Pathogenic Burkholderia spp.

    OpenAIRE

    Kenny, D J; Russell, P; Rogers, D.; Eley, S M; Titball, R W

    1999-01-01

    The in vitro antimicrobial susceptibilities of isolates of Burkholderia mallei to 16 antibiotics were assessed and compared with the susceptibilities of Burkholderia pseudomallei and Burkholderia cepacia. The antibiotic susceptibility profile of B. mallei resembled that of B. pseudomallei more closely than that of B. cepacia, which corresponds to their similarities in terms of biochemistry, antigenicity, and pathogenicity. Ceftazidime, imipenem, doxycycline, and ciprofloxacin were active agai...

  16. Exogenous pulmonary surfactant as a drug delivering agent: influence of antibiotics on surfactant activity.

    OpenAIRE

    van 't Veen, A; Gommers, D.; Mouton, J. W.; Kluytmans, J.A.; Krijt, E. J.; Lachmann, B.

    1996-01-01

    1. It has been proposed to use exogenous pulmonary surfactant as a drug delivery system for antibiotics to the alveolar compartment of the lung. Little, however, is known about interactions between pulmonary surfactant and antimicrobial agents. This study investigated the activity of a bovine pulmonary surfactant after mixture with amphotericin B, amoxicillin, ceftazidime, pentamidine or tobramycin. 2. Surfactant (1 mg ml-1 in vitro and 40 mg ml-1 in vivo) was mixed with 0.375 mg ml-1 amphote...

  17. 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.

  18. 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

  19. Consecutive episodes of peritonitis in a patient undergoing peritoneal dialysis caused by unusual organisms: Brevibacterium and Pantoea agglomerans

    OpenAIRE

    Choi, Joon Seok; Kim, Chang Seong; Park, Jeong Woo; Bae, Eun Hui; Ma, Seong Kwon; Kim, Soo Wan

    2012-01-01

    A 52-year-old man undergoing continuous ambulatory peritoneal dialysis presented with two consecutive episodes of peritonitis caused by unusual organisms, namely, Brevibacterium and Pantoea agglomerans. The patient was successfully treated with a 2-week course of cefazolin and ceftazidime for the Brevibacterium-associated peritonitis, and a 3-week course of gentamicin for the P. agglomerans-associated peritonitis. Although these environmental organisms are rarely responsible for human infecti...

  20. Post-traumatic endophthalmitis due to Brevibacterium casei : A case report

    OpenAIRE

    Asima Banu; Sriprakash KS; Vidyadevi M; ER, Nagraj

    2013-01-01

    Endophthalmitis is a serious post-traumatic ocular complication that can lead to loss of vision. We report a case of acute post-traumatic endophthalmitis following a penetrating injury caused by an unusual organism, Brevibacterium casei . The patient was successfully treated with intravitreal antibiotics like ceftazidime and vancomycin, along with topical cefazolin and tobramycin. Brevibacterium casei can be added to the list of rare bacteria causing endophthalmitis and should be kept in mind...

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

    OpenAIRE

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

    1988-01-01

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

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

    OpenAIRE

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

    1986-01-01

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

  3. 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.

  4. Evaluation of a Potential Clinical Interaction between Ceftriaxone and Calcium▿

    Science.gov (United States)

    Steadman, Emily; Raisch, Dennis W.; Bennett, Charles L.; Esterly, John S.; Becker, Tischa; Postelnick, Michael; McKoy, June M.; Trifilio, Steve; Yarnold, Paul R.; Scheetz, Marc H.

    2010-01-01

    In April 2009, the FDA retracted a warning asserting that ceftriaxone and intravenous calcium products should not be coadministered to any patient to prevent precipitation events leading to end-organ damage. Following that announcement, we sought to evaluate if the retraction was justified. A search of the FDA Adverse Event Reporting System was conducted to identify any ceftriaxone-calcium interactions that resulted in serious adverse drug events. Ceftazidime-calcium was used as a comparator agent. One hundred four events with ceftriaxone-calcium and 99 events with ceftazidime-calcium were identified. Adverse drug events were recorded according to the listed description of drug involvement (primary or secondary suspect) and were interpreted as probable, possible, unlikely, or unrelated. For ceftriaxone-calcium-related adverse events, 7.7% and 20.2% of the events were classified as probable and possible for embolism, respectively. Ceftazidime-calcium resulted in fewer probable embolic events (4%) but more possible embolic events (30.3%). Among cases that considered ceftriaxone or ceftazidime and calcium as the primary or secondary drug, one case was classified as a probable embolic event. That patient received ceftriaxone-calcium and died, although an attribution of causality was not possible. Our analysis suggests a lack of support for the occurrence of ceftriaxone-calcium precipitation events in adults. The results of the current analysis reinforce the revised FDA recommendations suggesting that patients >28 days old may receive ceftriaxone and calcium sequentially and provide a transparent and reproducible methodology for such evaluations. PMID:20086152

  5. 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).

  6. Efficacy of ciprofloxacin in experimental aortic valve endocarditis caused by a multiply beta-lactam-resistant variant of Pseudomonas aeruginosa stably derepressed for beta-lactamase production.

    OpenAIRE

    Bayer, A S; Lindsay, P.; Yih, J; Hirano, L; Lee, D.; Blomquist, I K

    1986-01-01

    The emergence of multi-beta-lactam resistance is a limiting factor in treating invasive Pseudomonas infections with newer cephalosporins. The in vivo efficacy of ciprofloxacin, a new carboxy-quinolone, was evaluated in experimental aortic valve endocarditis caused by a strain of Pseudomonas aeruginosa which is stably derepressed for beta-lactamase production and is resistant to ceftazidime and multiple other beta-lactam agents. A total of 51 catheterized rabbits with aortic catheters in place...

  7. Comparative Activities of Clinafloxacin against Gram-Positive and -Negative Bacteria

    OpenAIRE

    Ednie, Lois M.; Jacobs, Michael R.; Appelbaum, Peter C.

    1998-01-01

    Activities of clinafloxacin, ciprofloxacin, levofloxacin, sparfloxacin, trovafloxacin, piperacillin, piperacillin-tazobactam, trimethoprim-sulfamethoxazole, ceftazidime, and imipenem against 354 ciprofloxacin-susceptible and -intermediate-resistant organisms were tested by agar dilution. Clinafloxacin yielded the lowest quinolone MICs (≤0.5 μg/ml against ciprofloxacin-susceptible organisms and ≤16.0 μg/ml against ciprofloxacin-intermediate-resistant organisms) compared to those of levofloxaci...

  8. Ciprofloxacin, a quinolone carboxylic acid compound active against aerobic and anaerobic bacteria.

    OpenAIRE

    Chin, N X; Neu, H C

    1984-01-01

    The in vitro activity of ciprofloxacin, a quinolone-carboxylic acid derivative, was compared with those of norfloxacin, cefotaxime, cephalexin, ceftazidime, moxalactam, amoxicillin, and methicillin and other agents, as appropriate. The MICs of ciprofloxacin for 90% of members of the family Enterobacteriaceae and for Pseudomonas aeruginosa, Neisseria spp., and Bacteroides fragilis were between 0.005 and 0.8 micrograms/ml, whereas streptococci and staphylococci were all inhibited by less than o...

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

    OpenAIRE

    Hancu Gabriel; Kelemen Hajnal; Rusu Aura; Gyéresi Árpád

    2013-01-01

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

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

    OpenAIRE

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

    1997-01-01

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

  11. Drug updates and approvals: 2015 in review.

    Science.gov (United States)

    Klibanov, Olga M; Phan, Diep; Ferguson, Kelli

    2015-12-12

    This article highlights important prescribing information for some drugs that received FDA approval within the past year. These include: atazanavir and cobicistat (Evotaz®), ceftazidime and avibactam (Avycaz®), edoxaban (Savaysa®), ivabradine (Corlanor®), liraglutide (rDNA origin) injection (Saxenda®), perindopril arginine and amlodipine besylate (Prestalia®), and secukinumab (Cosentyx®) subcutaneous injection. PMID:26545091

  12. In-vitro activity of oxymino-cephalosporins with and without sulbactam against Class A Extended-spectrum β-lactamase producing E.coli

    Directory of Open Access Journals (Sweden)

    Haluk Vahaboğlu

    2011-12-01

    Full Text Available Objectives: The primary aim of this study was to determine the activities of ceftazidime and cefepime combined tosulbactam against class A extended-spectrum β lactamases (ESBLs.Materials and methods: Eight university hospitals participated to the study by submitting isolates those were recoveredduring a six-month period in 2010 from various clinical materials. Sulbactam was tested in two fixed concentrationsof 4 mg/l and 8 mg/l. Isolates showing a fourfold or more decrease in the MIC of an oxyimino-cephalosporin withsulbactam were defined as ESBL producers. Isolates were screened for CTX-M group 1 extended-spectrum β lactamasesby PCR.Results: A total of 149 ESBL-positive E.coli were studied. Isolates were uniformly susceptible to carbapenems and highlyresistant to ciprofloxacin. According to CLSI breakpoints, 28% (42/149 of isolates were susceptible to ceftazidime and32% (47/149 to cefepime. With 4 mg/L and 8 mg/L sulbactam supplement, ceftazidime susceptibility rose to 69%(103/149 and 88% (131/149, while cefepime susceptibility rose to 86 % (128/149 and 95% (141/149, respectively.PCR screening revealed that 63% (94/149 of the isolates were positive for blaCTX-M and 38% (36/94 of these were onthe O25b-ST131 clone.Conclusion: Ceftazidime plus sulbactam and cefepime plus sulbactam showed remarkable activity against ESBL-positiveE.coli. J Microbiol Infect Dis 2011;1(3:87-92

  13. Interactions of Quinupristin-Dalfopristin with Eight Other Antibiotics as Measured by Time-Kill Studies with 10 Strains of Staphylococcus aureus for Which Quinupristin-Dalfopristin Alone Was Not Bactericidal

    OpenAIRE

    Fuchs, Peter C.; Barry, Arthur L.; Brown, Steven D.

    2001-01-01

    Quinupristin-dalfopristin (Q-D) and eight other antimicrobial agents were tested alone and in combination with Q-D in time-kill studies against 10 strains of macrolide-lincosamide-streptogramin B-resistant Staphylococcus aureus. Although Q-D is normally a bactericidal drug, it was only bacteriostatic for these isolates. Gentamicin alone was bactericidal against 7 of the 10 strains, and Q-D did not alter that killing effect. However, when vancomycin, cefepime, ceftazidime, imipenem, piperacill...

  14. 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.

  15. CXCR1/CXCR2 Antagonism Is Effective in Pulmonary Defense against Klebsiella pneumoniae Infection

    OpenAIRE

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

    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 ...

  16. Genetic Determinants Involved in the Susceptibility of Pseudomonas aeruginosa to  -Lactam Antibiotics

    OpenAIRE

    Alvarez-Ortega, C.; Wiegand, I.; Olivares, J.; Hancock, R. E. W.; Martinez, J.L.

    2010-01-01

    The resistome of P. aeruginosa for three β-lactam antibiotics, namely, ceftazidime, imipenem, and meropenem, was deciphered by screening a comprehensive PA14 mutant library for mutants with increased or reduced susceptibility to these antimicrobials. Confirmation of the phenotypes of all selected mutants was performed by Etest. Of the total of 78 confirmed mutants, 41 demonstrated a reduced susceptibility phenotype and 37 a supersusceptibility (i.e., altered intrinsic resistance) phenotype, w...

  17. Electron spin resonance studies of some irradiated pharmaceuticals

    Energy Technology Data Exchange (ETDEWEB)

    Gibella, M.; Crucq, A-S.; Tilquin, B. E-mail: tilquin@cham.ucl.ac.bc; Stocker, P.; Lesgards, G.; Raffi, J

    2000-03-01

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

  18. Molecular Characterization of Resistance to Extended-Spectrum Cephalosporins in Clinical Escherichia coli Isolates from Companion Animals in the United States ▿ †

    OpenAIRE

    Shaheen, Bashar W.; Nayak, Rajesh; Foley, Steven L.; Kweon, Ohgew; Deck, Joanna; Park, Miseon; Rafii, Fatemeh; Boothe, Dawn M.

    2011-01-01

    Resistance to extended-spectrum cephalosporins (ESC) among members of the family Enterobacteriaceae occurs worldwide; however, little is known about ESC resistance in Escherichia coli strains from companion animals. Clinical isolates of E. coli were collected from veterinary diagnostic laboratories throughout the United States from 2008 to 2009. E. coli isolates (n = 54) with reduced susceptibility to ceftazidime or cefotaxime (MIC ≥ 16 μg/ml) and extended-spectrum-β-lactamase (ESBL) phenotyp...

  19. 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

  20. Prevalence and risk factors for carriage of antimicrobial-resistant Escherichia coli on household and small-scale chicken farms in the Mekong Delta of Vietnam

    OpenAIRE

    Nguyen, V.T.; CARRIQUE-MAS, J. J.; Ngo, T.H; Ho, H M; Ha, T.T.; CAMPBELL, J. I.; Nguyen, T N; Hoang, N.N.; PHAM, V. M.; Wagenaar, J. A.; Hardon, A.; Thai, Q.H.; Schultsz, C

    2015-01-01

    Objectives: To describe the prevalence of antimicrobial resistance among commensal Escherichia coli isolates on household and small-scale chicken farms, common in southern Vietnam, and to investigate the association of antimicrobial resistance with farming practices and antimicrobial usage. Methods: We collected data on farming and antimicrobial usage from 208 chicken farms. E. coli was isolated from boot swab samples using MacConkey agar (MA) and MA with ceftazidime, nalidixic acid or gentam...

  1. Use of the chromosomal class A beta-lactamase of Mycobacterium fortuitum D316 to study potentially poor substrates and inhibitory beta-lactam compounds.

    OpenAIRE

    Galleni, M; Franceschini, N; Quinting, B; Fattorini, L.; Orefici, G.; Oratore, A; Frère, J M; Amicosante, G

    1994-01-01

    Sixteen different compounds usually considered beta-lactamase stable or representing potential beta-lactam inhibitors and inactivators were tested against the beta-lactamase produced by Mycobacterium fortuitum. The compounds exhibiting the most interesting properties were BRL42715, which was by far the best inactivator, and CGP31608 and ceftazidime, which were not recognized by the enzyme. These compounds thus exhibited adequate properties for fighting mycobacterial infections. Although cloxa...

  2. 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.

  3. Novel Ambler Class A Carbapenem-Hydrolyzing  -Lactamase from a Pseudomonas fluorescens Isolate from the Seine River, Paris, France

    OpenAIRE

    Girlich, D.; Poirel, L.; Nordmann, P

    2009-01-01

    A Pseudomonas fluorescens isolate (PF-1) resistant to carbapenems was recovered during an environmental survey performed with water from the Seine River (Paris). It expressed a novel Ambler class A carbapenemase, BIC-1, sharing 68 and 59% amino acid identities with β-lactamases SFC-1 from Serratia fonticola and the plasmid-encoded KPC-2, respectively. β-Lactamase BIC-1 hydrolyzed penicillins, carbapenems, and cephalosporins except ceftazidime and monobactams. The blaBIC-1 gene was chromosomal...

  4. A novel extended-spectrum TEM-type beta-lactamase, TEM-138, from Salmonella enterica serovar Infantis.

    OpenAIRE

    chouchani, chedli; Berlemont, Renaud; A. Masmoudi; Galleni, Moreno; Frère, Jean-Marie; O Belhadj; Ben-Mahrez, K.

    2006-01-01

    A novel natural TEM beta-lactamase with extended-spectrum activity, TEM-138, was identified in a ceftazidime-resistant clinical isolate of Salmonella enterica serovar Infantis. Compared to TEM-1, TEM-138 contains the following mutations: E104K, N175I, and G238S. The bla(TEM-138) gene was located on a 50-kb transferable plasmid. Expression studies with Escherichia coli revealed efficient ceftazidimase and cefotaximase activities for TEM-138.

  5. A Novel Extended-Spectrum TEM-Type β-Lactamase, TEM-138, from Salmonella enterica Serovar Infantis

    OpenAIRE

    CHOUCHANI, CHEDLY; Berlemont, Renaud; Masmoudi, Afef; Galleni, Moreno; Frere, Jean-Marie; Belhadj, Omrane; Ben-Mahrez, Kamel

    2006-01-01

    A novel natural TEM β-lactamase with extended-spectrum activity, TEM-138, was identified in a ceftazidime-resistant clinical isolate of Salmonella enterica serovar Infantis. Compared to TEM-1, TEM-138 contains the following mutations: E104K, N175I, and G238S. The blaTEM-138 gene was located on a 50-kb transferable plasmid. Expression studies with Escherichia coli revealed efficient ceftazidimase and cefotaximase activities for TEM-138.

  6. 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...

  7. 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.

  8. 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

  9. 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.

  10. 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.

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

    Science.gov (United States)

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

    2016-07-01

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

  12. 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.

  13. 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. PMID:22727530

  14. Dual delivery of active antibactericidal agents and bone morphogenetic protein at sustainable high concentrations using biodegradable sheath-core-structured drug-eluting nanofibers

    Science.gov (United States)

    Hsu, Yung-Hen; Lin, Chang-Tun; Yu, Yi-Hsun; Chou, Ying-Chao; Liu, Shih-Jung; Chan, Err-Cheng

    2016-01-01

    In this study, we developed biodegradable sheath-core-structured drug-eluting nanofibers for sustainable delivery of antibiotics (vancomycin and ceftazidime) and recombinant human bone morphogenetic protein (rhBMP-2) via electrospinning. To prepare the biodegradable sheath-core nanofibers, we first prepared solutions of poly(d,l)-lactide-co-glycolide, vancomycin, and ceftazidime in 1,1,1,3,3,3-hexafluoro-2-propanol and rhBMP-2 in phosphate-buffered solution. The poly(d,l)-lactide-co-glycolide/antibiotics and rhBMP-2 solutions were then fed into two different capillary tubes controlled by two independent pumps for coaxial electrospinning. The electrospun nanofiber morphology was observed under a scanning electron microscope. We further characterized the in vitro antibiotic release from the nanofibers via high-performance liquid chromatography and that of rhBMP-2 via enzyme-linked immunosorbent assay and alkaline phosphatase activity. We showed that the biodegradable coaxially electrospun nanofibers could release high vancomycin/ceftazidime concentrations (well above the minimum inhibition concentration [MIC]90) and rhBMP-2 for >4 weeks. These experimental results demonstrate that novel biodegradable nanofibers can be constructed with various pharmaceuticals and proteins for long-term drug deliveries. PMID:27574423

  15. 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.

  16. Dual delivery of active antibactericidal agents and bone morphogenetic protein at sustainable high concentrations using biodegradable sheath-core-structured drug-eluting nanofibers.

    Science.gov (United States)

    Hsu, Yung-Hen; Lin, Chang-Tun; Yu, Yi-Hsun; Chou, Ying-Chao; Liu, Shih-Jung; Chan, Err-Cheng

    2016-01-01

    In this study, we developed biodegradable sheath-core-structured drug-eluting nanofibers for sustainable delivery of antibiotics (vancomycin and ceftazidime) and recombinant human bone morphogenetic protein (rhBMP-2) via electrospinning. To prepare the biodegradable sheath-core nanofibers, we first prepared solutions of poly(d,l)-lactide-co-glycolide, vancomycin, and ceftazidime in 1,1,1,3,3,3-hexafluoro-2-propanol and rhBMP-2 in phosphate-buffered solution. The poly(d,l)-lactide-co-glycolide/antibiotics and rhBMP-2 solutions were then fed into two different capillary tubes controlled by two independent pumps for coaxial electrospinning. The electrospun nanofiber morphology was observed under a scanning electron microscope. We further characterized the in vitro antibiotic release from the nanofibers via high-performance liquid chromatography and that of rhBMP-2 via enzyme-linked immunosorbent assay and alkaline phosphatase activity. We showed that the biodegradable coaxially electrospun nanofibers could release high vancomycin/ceftazidime concentrations (well above the minimum inhibition concentration [MIC]90) and rhBMP-2 for >4 weeks. These experimental results demonstrate that novel biodegradable nanofibers can be constructed with various pharmaceuticals and proteins for long-term drug deliveries. PMID:27574423

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

    Directory of Open Access Journals (Sweden)

    Saeide Saeidi

    2014-09-01

    Full Text Available 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.

  18. 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

  19. 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.

  20. 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.

  1. The survey of bacterial etiology and their resistance to antibiotics of urinary tract infections in children of Birjand city

    Directory of Open Access Journals (Sweden)

    Azita Fesharakinia

    2012-08-01

    Full Text Available Background and Aim: Urinary tract infection is one of the most prevalent bacterial infections in childhood, which due to an inapproto determine the common bacteria and their antibiotic susceptibility in children with urinary tract infection.   Materials and Methods: This descriptive-analytical and prospective study was done in 2009-2010 on urine samples of all children under 13 years who had been referred to Emmam-Reza hospital laboratory in Birjand and had positive urine culture. Sex and age of children, the kind of isolated bacteria in urine culture, susceptibility and resistance of these bacteria to current antibiotics were studied.The obtained data was analyzed by means of SPSS using Fisher exact- test.   Results: 100 children (84 girls and 16 boys with positive urine culture were studied. The most common age of urinary tract infection was under two years. In all ages the rate of urinary tract infection in females was more than males. E.coli was the most common cause in both sexes. There was a significant relationship between kind of microorganism and age of infection. The most prevalent cause of urinary tract infection in all ages was E.coli (75% ,infection by Proteus was 11%, and other microorganism caused 14% of the cases. E.coli had the most susceptibility to ceftriaxone and ceftazidime and the most resistance to cephalexin and co-trimoxazol. Not taking the type of microorganism into consideration, the most sensitive antibiotics were ceftazidime, ceftriaxone, cefexim and nalidixic acid and the most resistance was against co-trimoxasol and cefalexin.   Conclusion: Regarding the results, it is recommended to use cefexime and nalidixic acid for outpatient treatment of urinary infection , and ceftazidime and ceftriaxon for inpatient treatment.Selecting of antibiotics for urinary infection therapy should be based on the local prevalence of pathogenic bacteria and antibiotic sensitivities rather than on a universal guideline.

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

    Directory of Open Access Journals (Sweden)

    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. 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.

  4. Characterization of the extended-spectrum beta-lactamase reference strain, Klebsiella pneumoniae K6 (ATCC 700603), which produces the novel enzyme SHV-18.

    Science.gov (United States)

    Rasheed, J K; Anderson, G J; Yigit, H; Queenan, A M; Doménech-Sánchez, A; Swenson, J M; Biddle, J W; Ferraro, M J; Jacoby, G A; Tenover, F C

    2000-09-01

    Klebsiella pneumoniae K6 (ATCC 700603), a clinical isolate, is resistant to ceftazidime and other oxyimino-beta-lactams. A consistent reduction in the MICs of oxyimino-beta-lactams by at least 3 twofold dilutions in the presence of clavulanic acid confirmed the utility of K. pneumoniae K6 as a quality control strain for extended-spectrum beta-lactamase (ESBL) detection. Isoelectric-focusing analysis of crude lysates of K6 demonstrated a single beta-lactamase with a pI of 7.8 and a substrate profile showing preferential hydrolysis of cefotaxime compared to ceftazidime. PCR analysis of total bacterial DNA from K6 identified the presence of a bla(SHV) gene. K6 contained two large plasmids with molecular sizes of approximately 160 and 80 kb. Hybridization of plasmid DNA with a bla(SHV)-specific probe indicated that a bla(SHV) gene was encoded on the 80-kb plasmid, which was shown to transfer resistance to ceftazidime in conjugal mating experiments with Escherichia coli HB101. DNA sequencing of this bla(SHV)-related gene revealed that it differs from bla(SHV-1) at nine nucleotides, five of which resulted in amino acid substitutions: Ile to Phe at position 8, Arg to Ser at position 43, Gly to Ala at position 238, and Glu to Lys at position 240. In addition to the production of this novel ESBL, designated SHV-18, analysis of the outer membrane proteins of K6 revealed the loss of the OmpK35 and OmpK37 porins. PMID:10952583

  5. 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...

  6. Post-traumatic endophthalmitis due to Brevibacterium casei : A case report

    Directory of Open Access Journals (Sweden)

    Asima Banu

    2013-02-01

    Full Text Available Endophthalmitis is a serious post-traumatic ocular complication that can lead to loss of vision. We report a case of acute post-traumatic endophthalmitis following a penetrating injury caused by an unusual organism, Brevibacterium casei . The patient was successfully treated with intravitreal antibiotics like ceftazidime and vancomycin, along with topical cefazolin and tobramycin. Brevibacterium casei can be added to the list of rare bacteria causing endophthalmitis and should be kept in mind by clinicians as a potential source of pathology.

  7. A case of wound infection caused by Shewanella algae in the south of Iran

    Directory of Open Access Journals (Sweden)

    M. Taherzadeh

    2014-01-01

    Full Text Available Shewanella algae was isolated from the purulent discharge in the navel area of a young male with a history of swimming in the Persian Gulf. A routine laboratory diagnosis procedure, followed by 16S rRNA gene sequence analyses, was used to avoid misidentification with other species of Shewanella. The bacterium was suscetible to ceftazidime, ciprofloxacin, nalidixic acid, nitrophorantion, amikacin, ceftriaxone, cefotaxime, gentamicin and co-trimoxazole but was resistant to amoxicillin, vancomycin, doxycycline, cephalexin, ampicillin, tetracycline, cephalothin and ceftizoxime. The patient successfully recovered after treatment with antibiotics.

  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. Profiling of antimicrobial resistance and plasmid replicon types in β-lactamase producing Escherichia coli isolated from Korean beef cattle

    OpenAIRE

    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-lactam...

  10. Worldwide Disseminated armA Aminoglycoside Resistance Methylase Gene Is Borne by Composite Transposon Tn1548

    OpenAIRE

    Galimand, M.; Sabtcheva, S.; Courvalin, P; Lambert, T.

    2005-01-01

    The armA (aminoglycoside resistance methylase) gene, which confers resistance to 4,6-disubstituted deoxystreptamines and fortimicin, was initially found in Klebsiella pneumoniae BM4536 on IncL/M plasmid pIP1204 of ca. 90 kb which also encodes the extended-spectrum β-lactamase CTX-M-3. Thirty-four enterobacteria from various countries that were likely to produce a CTX-M enzyme since they were more resistant to cefotaxime than to ceftazidime were studied. The armA gene was detected in 12 clinic...

  11. 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.

  12. 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.

  13. Characterization of the Extended-Spectrum β-Lactamase Reference Strain, Klebsiella pneumoniae K6 (ATCC 700603), Which Produces the Novel Enzyme SHV-18

    OpenAIRE

    Rasheed, J. Kamile; Anderson, Gregory J.; Yigit, Hesna; Queenan, Anne Marie; Doménech-Sánchez, Antonio; Swenson, Jana M.; Biddle, James W.; Ferraro, Mary Jane; Jacoby, George A.; Tenover, Fred C.

    2000-01-01

    Klebsiella pneumoniae K6 (ATCC 700603), a clinical isolate, is resistant to ceftazidime and other oxyimino-β-lactams. A consistent reduction in the MICs of oxyimino-β-lactams by at least 3 twofold dilutions in the presence of clavulanic acid confirmed the utility of K. pneumoniae K6 as a quality control strain for extended-spectrum β-lactamase (ESBL) detection. Isoelectric-focusing analysis of crude lysates of K6 demonstrated a single β-lactamase with a pI of 7.8 and a substrate profile showi...

  14. 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...

  15. 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.

  16. 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.

  17. In vitro Efficacy of Meropenem, Colistin and Tigecycline Against the Extended Spectrum Beta-Lactamase Producing Gram Negative Bacilli

    International Nuclear Information System (INIS)

    Objective:To compare the in vitroefficacy of meropenem, colistin and tigecycline against extended spectrum Betalactamase producing Gram negative bacilli by minimal inhibitory concentration. Study Design:Cross-sectional descriptive study. Place and Duration of Study: Department of Microbiology, Army Medical College, National University of Sciences and Technology, Rawalpindi, from June to December 2010. Methodology: Routine clinical specimens were subjected to standard microbiological procedures and the isolates were identified to species level. Extended spectrum beta-lactamase producing Gram negative bacilli were detected by Jarlier disc synergy method and confirmed by ceftazidime and ceftazidime-clavulanate Etest. Minimum Inhibitory Concentration (MIC90) of meropenem, colistin and tigecycline was determined by Etest (AB BIOMERIUX) and the results were interpreted according to the manufacturer's instructions and Clinical and Laboratory Standards Institute guidelines and Food and Drug Authority recommendations. Results were analyzed by using Statistical Package for the Social Sciences version 20. Results: A total of 52 non-duplicate extended spectrum Beta-lactamase-producing Gram negative bacilli were included in the study. The MIC90 of tigecycline (0.75 micro g/ml) was lowest as compared to the meropenem (2 micro g/ml) and colistin (3 micro g/ml). Conclusion: Tigecycline is superior in efficacy against the extended spectrum Beta-lactamase producing Gram negative bacilli as compared to colistin and meropenem. (author)

  18. 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

  19. 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

  20. Investigating Antibiotic Resistance in Pseudomonas Aeruginosa Strains Isolated from Various Clinical Specimens of Patients Referring to Hospitals in Yazd

    Directory of Open Access Journals (Sweden)

    M Kiani

    2015-02-01

    Full Text Available Introduction: Antibiotic resistance in Pseudomonas aeruginosa has become a worldwide problem, and is leading to multi-drug resistance (MDR: Multiple drug resistance. Therefore, this study aimed to determine the antibiotic strain patterns of Pseudomonas aeruginosa isolated from various clinical specimens of patients in hospitals in Yazd. Methods: In this descriptive cross- sectional study, 90 isolates of pseudomonas aeruginosa derived from different clinical samples was transferred to the microbiology lab of Shahid Sadoughi University of Medical Sciences in Yazd in 2013. Conventional biochemical tests were utilized to confirm the presence of bacteria, and then antibiotic resistance pattern was determined using standard disk diffusion (Kirby - Bauer method according to the CLSI guideline. Results: Out of 90 isolates of Pseudomonas aeruginosa isolated from various clinical samples, burn wound specimens had the most antibiotic-resistant pattern. As a matter of fact, all of 28 strains isolated from burn wounds were MDR. Ceftazidime involved the most resistant antibiotic (56%, whereas ciprofloxacin was the least resistant one (44.4%, and 66.6% of the isolates were detected as multi-drug resistant. Conclusion: The prevalence of MDR Pseudomans aeruginosa in the present study was high. As ceftazidime, Ertapenem, and meropenem had effective anti Pseudomonal activity against MDR Pseudomans aeruginosa (in this study increased resistance to these antibiotics was observed, it is necessary to evaluate antibiotic susceptibility as well as to determine antibiotic pattern prior to starting the treatment in order to prevent antibiotic-resistant strains.

  1. 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 coli pathotypes with high resistance could trigger unprecedented morbidity and mortality, mostly among children and the elderly.

  2. Recent Sensitivity Pattern of Escherichia Coli in Urinary Tract Infection

    Directory of Open Access Journals (Sweden)

    R Nalini

    2014-06-01

    Full Text Available The objective of the study is to assess the recent sensitivity pattern of Escherichia coli in Urinary tract infection (UTI.Widespread use of antibiotics has led to the emergence of resistant microorganisms. As the antibiotic sensitivity patterns of the microorganisms are frequently changing, this retrospective analysis was designed to assess the recent antibiotic sensitivity pattern of Escherichia coli (E.coli in urinary tract infection among the human population. Details of 412 urine culture positive reports for E.coli and their antibiotic sensitivity pattern pertaining to the study period of 12months from June 2012 to May 2013 were collected from Central Microbiology Laboratory of Tirunelveli Medical College and the results were statistically analysed. The antibiotics tested for sensitivity were Amikacin, Gentamycin, Ciprofloxacin, Cotrimoxazole, Nitrofurantoin, Ceftazidime, Ceftriaxone and Cefotaxime. The sensitivity pattern of E.coli to antibiotics in UTI were Nitrofurantoin (85.19%, Amikacin (66.50%, Co-trimoxazole(31.31%, Gentamycin (26.90%, Ceftazidime (26.69% ,Ciprofloxacin (22.57%, Cefotaxime (22.30%, Ceftriaxone (17.47%. The study highlighted the re-emergence of E. coli sensitive to Nitrofurantoin and marked resistance of E.coli to Aminoglycoside and third generation Cephalosporins.

  3. 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

  4. Prevalence of metallo-beta-lactamase among Pseudomonas aeruginosa and Acinetobacter baumannii in a Korean university hospital and comparison of screening methods for detecting metallo-beta-lactamase.

    Science.gov (United States)

    Oh, Eun-Jee; Lee, Seungok; Park, Yeon-Joon; Park, Jung Jun; Park, Kanggyun; Kim, Sang-Il; Kang, Moon Won; Kim, Byung Kee

    2003-09-01

    To identify the metallo-beta-lactamases (MBLs) prevalent in Korea, a total of 130 clinical isolates of Pseudomonas aeruginosa and Acinetobacter baumannii (99 P. aeruginosa and 31 A. baumannii) with a reduced susceptibility to imipenem (IPM) and/or ceftazidime (CAZ) was subjected to PCR analyses with primers specific to bla(IMP-1), bla(VIM-1), and bla(VIM-2). In addition, inhibitor-potentiated disk diffusion methods (IPD) using two kinds of substrate-inhibitor combinations (ceftazidime-2-mercaptopropionic acid (2MPA) and imipenem-EDTA) were investigated. Thirty-three isolates (29 P. aeruginosa and 4 A. baumannii) carried bla(VIM-2) and two P. aeruginosa isolates harbored bla(IMP-1). The enterobacterial repetitive intergenic consensus PCR (ERIC-PCR) pattern revealed that many of the VIM-2-producing P. aeruginosa isolates were clonally related, whereas the A. baumannii isolates were diverse. The inhibitor-potentiated disk diffusion test using imipenem-EDTA was highly sensitive and specific for detecting the VIM-2 producer. These results suggest that VIM-2 is an important MBL in P. aeruginosa and A. baumannii in the Korean hospital of this study and that the IMP-1-producing P. aeruginosa has also emerged. Screening for MBLs and strict infection control for these isolates will contribute to prevent further spread of resistance. PMID:12842488

  5. 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.

  6. 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.

  7. 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

  8. 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. 

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

    Directory of Open Access Journals (Sweden)

    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

  10. 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

  11. A bio-artificial poly([D,L]-lactide-co-glycolide drug-eluting nanofibrous periosteum for segmental long bone open fractures with significant periosteal stripping injuries

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    Chou YC

    2016-03-01

    Full Text Available Ying-Chao Chou,1,2 Yi-Shiun Cheng,1 Yung-Heng Hsu,1,2 Yi-Hsun Yu,1,2 Shih-Jung Liu1,2 1Biomaterials Lab, Department of Mechanical Engineering, Chang Gung University, 2Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan Abstract: Biodegradable poly([D,L]-lactide-co-glycolide (PLGA nanofibrous membrane embedded with two drug-to-polymer weight ratios, namely 1:3 and 1:6, which comprised PLGA 180 mg, lidocaine 20 mg, vancomycin 20 mg, and ceftazidime 20 mg, and PLGA 360 mg, lidocaine 20 mg, vancomycin 20 mg, and ceftazidime 20 mg, respectively, was produced as an artificial periosteum in the treatment of segmental femoral fractures. The nanofibrous membrane’s drug release behavior was assessed in vitro using high-performance liquid chromatography and the disk-diffusion method. A femoral segmental fracture model with intramedullary Kirschner-wire fixation was established for the in vivo rabbit activity study. Twenty-four rabbits were divided into two groups. Twelve rabbits in group A underwent femoral fracture fixation only, and 12 rabbits in group B underwent femoral fracture fixation and were administered the drug-loaded nanofibers. Radiographs obtained at 2, 6, and 12 weeks postoperatively were used to assess the bone unions. The total activity counts in animal behavior cages were also examined to evaluate the clinical performance of the rabbits. After the animals were euthanized, both femoral shafts were harvested and assessed for their torque strengths and toughness. The daily in vitro release curve for lidocaine showed that the nanofibers eluted effective levels of lidocaine for longer than 3 weeks. The bioactivity studies of vancomycin and ceftazidime showed that both antibiotics had effective and sustained bactericidal capacities for over 30 days. The findings from the in vivo animal activity study suggested that the rabbits with the artificial drug-eluting periosteum exhibited statistically increased

  12. 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.

  13. 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

  14. Antimicrobial resistance profiles and genetic characterisation of macrolide resistant isolates of Streptococcus agalactiae

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    Priscila AM Nakamura

    2011-03-01

    Full Text Available In this study, 100 clinical isolates of Streptococcus agalactiae recovered from genitourinary tract specimens of non-pregnant individuals living in Rio de Janeiro were submitted for antimicrobial susceptibility testing, detection of macrolide resistance genes and evaluation of the genetic diversity of erythromycin-resistant isolates. By agar diffusion method, all isolates were susceptible to ceftazidime, penicillin and vancomycin. Isolates were resistant to levofloxacin (1%, clindamycin (5%, erythromycin (11% and tetracycline (83% and were intermediated to erythromycin (4% and tetracycline (6%. Erythromycin-resistant and intermediated isolates presented the following phenotypes: M (n = 3, constitutive macrolide-lincosamide-streptogramin B (MLS B, n = 5 and inductive MLS B (n = 7. Determinants of macrolide resistance genes, erm and mef, were detected in isolates presenting MLS B and M phenotypes, respectively. Randomly amplified polymorphic DNA profiles of erythromycin-resistant isolates were clustered into two major groups of similarity.

  15. Pulmonary melioidosis presenting with pleural effusion: A case report and review of literature

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    Chun Ian Soo

    2015-01-01

    Full Text Available Melioidosis is a serious infection, which can involve multiple systems. We report a case of pulmonary melioidosis with the initial presentation mimicking a partially treated pneumonia complicated by right-sided pleural effusion. The patient is a 49-year old man who did not respond to parenteral ceftriaxone and tazobactam/piperacillin therapy. However, upon culture and sensitivity results from blood and pleural samples isolated Burkholderia pseudomallei; antimicrobial therapy was de-escalated to parenteral ceftazidime. Within 72 h duration, his fever subsided and other respiratory symptoms improved tremendously. This case highlights the importance of early recognition of B. pseudomallei in pulmonary infection in order for prompt institution of appropriate antibiotics treatment; thus reducing morbidity and mortality.

  16. Pseudomonas aeruginosa chromosomal beta-lactamase in patients with cystic fibrosis and chronic lung infection. Mechanism of antibiotic resistance and target of the humoral immune response

    DEFF Research Database (Denmark)

    Ciofu, Oana

    2003-01-01

    of chronic lung infection by assessing the effect of a beta ab raised by vaccination with purified chromosomal beta-lactamase on the outcome of the treatment with ceftazidime of bacteria resistant to beta-lactam antibiotics. Our results showed that significantly lower bacterial load and better lung pathology......The intensive antibiotic treatment of cystic fibrosis (CF) patients with chronic lung infection with Pseudomonas aeruginosa has improved the survival rate and the clinical condition of Danish patients. Acquirement of resistance to anti-pseudomonal antibiotics is one of the main drawbacks...... of this therapeutic strategy and our results showed the development of resistance of P. aeruginosa to several antibiotics during 25 years of intensive antibiotic treatment. Our studies have been concentrating on the development of resistance to beta-lactam antibiotics. We have shown an association between...

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

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    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

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

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    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

  19. Chemotherapeutic treatment for leukemia in a bearded dragon (Pogona vitticeps).

    Science.gov (United States)

    Jankowski, Gwen; Sirninger, Jeffrey; Borne, Jessica; Nevarez, Javier G

    2011-06-01

    A 4.5-yr-old, captive-bred, male bearded dragon (Pogona vitticeps) presented for lethargy, anorexia, and increased mucoid salivation with upper respiratory clicks. Diagnostics were declined and the bearded dragon was prescribed ceftazidime 20 mg/kg i.m. q 72 hr. The patient presented again 1 wk later with a marked monocytosis, heterophilia, and lymphocytosis, and a clinical diagnosis of chronic monocytic leukemia was made. Chemotherapy with cytosine arabinoside (100 mg/m2 over 48 hr i.v.) was initiated. Forty-four hours into the treatment the dragon became acutely unresponsive and died within 1 hr. Adverse effects as a result of i.v. cytosine arabinoside therapy were not identified despite previous reports suggestive that the drug induces renal failure. PMID:22946414

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

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    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.

  1. 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.

  2. In Vitro Activity of Cefepime/AAI101 and Comparators against Cefepime Non-susceptible Enterobacteriaceae

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    Jared L. Crandon

    2015-08-01

    Full Text Available We evaluated the in vitro potency of cefepime combined with AAI101, a novel extended-spectrum β-lactamase inhibitor, against a population of clinical Escherichia coli and Klebsiella pneumoniae collected from USA hospitals. Of the 223 cefepime non-susceptible isolates, 95% were ceftazidime non-susceptible, 49% ertapenem non-susceptible, 57% piperacillin/tazobactam non-susceptible, 90% were multidrug-resistant (resistant to ≥3 drug classes, 22% produced carbapenemases, and 67% produced ESBLs. Addition of AAI101 restored the activity of cefepime such that the MIC50 was reduced from >64 mg/L for cefepime to 0.13 mg/L for cefepime/AAI101, supporting its continued development treatment for infections caused by these organisms.

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

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    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.

  4. Effects of antibiotics on quorum sensing in pseudomonas aeruginosa

    DEFF Research Database (Denmark)

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

    2008-01-01

    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....... 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...

  5. [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.

  6. 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.

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

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    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.

  8. 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.

  9. Rhodococcus equi peritonitis in continuous ambulatory peritoneal dialysis: a first in Australia.

    Science.gov (United States)

    Azzam, Omar; Crowe, Amy; Sajiv, Cherian; Pawar, Basant

    2015-01-01

    A 33-year-old Caucasian man with end-stage renal disease secondary to biopsy-proven IgA nephropathy, managed with continuous ambulatory peritoneal dialysis (PD), presented with PD-related peritonitis, the causal organism being a non-branching Gram-positive bacillus, Rhodococcus equi. Initial empirical Gram positive and negative coverage with cefazolin and ceftazidime was unsuccessful, but following isolation of the organism, and conversion to intraperitoneal vancomycin and oral ciprofloxacin, the peritonitis episode resolved. At day 10, vancomycin was switched to azithromycin for a total of 6 weeks of antimicrobial therapy. The PD catheter was preserved, and the patient remained peritonitis-free at 6 months of follow-up.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Biocompatibility of antimicrobials to maggot debridement therapy: medical maggots Lucilia sericata (Diptera: Calliphoridae) exhibit tolerance to clinical maximum doses of antimicrobials.

    Science.gov (United States)

    Peck, George W; Kirkup, Benjamin C

    2012-09-01

    The larvae of calliphorid flies are used to debride wounds of patients with severe tissue destruction, often concurrently with antimicrobials. The current study evaluates the effects of ceftazidime, tobramycin, amikacin, gentamicin, polymyxin B, doxycycline, paromomycin, amphotericin B, sodium stibogluconate, and miltefosine at 1, 10, and 100 x the Maximum Clinical Concentration (mg/kg/d) in raw liver assays. Effects on larvae were small and depended on dose and antimicrobial formulation, with hours in assay (24 or 48 h) having a significant effect on larval survival. Sodium stibgluconate had the strongest effect on maggot survival (80.0% at 48 h). These results suggest that the antimicrobials tested here may be used simultaneously with maggot debridement therapy, and may actually increase the effectiveness of maggot debridement therapy in certain applications where >1 x Maximum Clinical Concentration is indicated, such as topical creams for cutaneous leishmaniasis.

  12. Shedding of antibiotic-resistant members of the family Enterobacteriaceae in healthy residents of France and Jordan.

    Science.gov (United States)

    Chachaty, E; Youssef, M T; Bourneix, C; Andremont, A

    1995-02-01

    We compared the frequency of shedding of members of the family Enterobacteriaceae resistant to ampicillin, tetracycline, chloramphenicol, kanamycin, gentamicin and ceftazidime in 83 French residents of the Paris urban area and in 101 subjects in Jordan, 64 of whom resided in the urban area of Irbid, 15 in rural areas, and 22 of whom had a nomadic lifestyle. There was no significant difference between these populations regarding (i) the percentages of subjects with strains resistant to any of the antimicrobial agents tested and (ii) the proportions of total counts of organisms of the Enterobacteriaceae resistant to these agents. The simultaneous shedding of strains resistant to ampicillin, chloramphenicol, tetracycline and kanamycin was significantly associated with (i) exposure to antibiotic treatment during the six months preceding the study and (ii) the presence of many children at home. PMID:7652211

  13. DRESS syndrome in ophthalmic patients.

    Science.gov (United States)

    Sousa, Jacqueline Martins de; Nascimento, Heloisa; Belfort, Rubens

    2016-01-01

    Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially fatal adverse drug reaction associated with skin rash, fever, eosinophilia, and multiple organ injury. A number of pharmacological agents are known to cause DRESS syndrome such as allopurinol, anticonvulsants, vancomycin, trimethoprime-sulfamethoxazole, and pyrimethamine-sulfadiazine. Here, we describe two patients who developed DRESS syndrome during ocular treatment. The first case was being treated for late postoperative endophthalmitis with topical antibiotics, intravenous cephalothin, meropenem, and intravitreal injection of vancomycin and ceftazidime before symptoms developed. We were unable to identify the causal drug owing to the large number of medications concurrently administered. The second case presented with DRESS syndrome symptoms during ocular toxoplasmosis treatment. In this case, a clearer association with pyrimethamine-sulfadiazine was observed. As a result of the regular prescription of pharmacological agents associated with DRESS syndrome, ophthalmologists should be aware of the potentially serious complications of DRESS syndrome. PMID:27463633

  14. Emerging trends in epidemiology and management of infections caused by carbapenem-resistant Enterobacteriaceae.

    Science.gov (United States)

    Martirosov, Dmitriy M; Lodise, Thomas P

    2016-06-01

    The recent emergence and spread of infections caused by carbapenem-resistant Enterobacteriaceae (CRE) are concerning because carbapenems have represented a last line of defense against resistant strains of gram-negative pathogens. Existing therapies against CRE include tigecycline, the recently approved drug ceftazidime-avibactam, and older drugs not widely used in recent years, such as colistin, fosfomycin, and aminoglycosides. Best practices for use of the available drugs are not well defined. New therapeutic options with activity against CRE offer the opportunity to enhance our current approach to managing patients with infections due to CRE. The purpose of this report is to review the evolving epidemiology and treatment of infections due to CRE. As part of the treatment overview, this manuscript will discuss supportive data for antibiotics currently being used in the treatment of infections due to CRE, as well as those recently approved and in late-stage development. PMID:27033631

  15. Considering Respiratory Tract Infections and Antimicrobial Sensitivity: An Exploratory Analysis

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    Amin, R.

    2009-01-01

    Full Text Available This study was conducted to observe the sensitivity and resistance of status of antibiotics for respiratory tract infection (RTI. Throat swab culture and sensitivity report of 383 patients revealed sensitivity profiles were observed with amoxycillin (7.9%, penicillin (33.7%, ampicillin (36.6%, co-trimoxazole (46.5%, azithromycin (53.5%, erythromycin (57.4%, cephalexin (69.3%, gentamycin (78.2%, ciprofloxacin (80.2%, cephradine (81.2%, ceftazidime (93.1%, ceftriaxone (93.1%. Sensitivity to cefuroxime was reported 93.1% cases. Resistance was found with amoxycillin (90.1%, ampicillin (64.1%, penicillin (61.4%, co-trimoxazole (43.6%, erythromycin (39.6%, and azithromycin (34.7%. Cefuroxime demonstrates high level of sensitivity than other antibiotics and supports its consideration with patients with upper RTI.

  16. 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.

  17. Analysis of 12 beta-lactam antibiotics in human plasma by HPLC with ultraviolet detection.

    Science.gov (United States)

    McWhinney, Brett C; Wallis, Steven C; Hillister, Tara; Roberts, Jason A; Lipman, Jeffrey; Ungerer, Jacobus P J

    2010-07-15

    A simple and economical high performance liquid chromatography method was developed and validated for routine analysis of 12 Penicillin, Cephalosporin and Carbapenem antibiotics in 200 microL of human plasma. Antibiotics determined were Ceftazidime, Meropenem, Ceftriaxone, Ampicillin, Cefazolin, Ertapenem, Cephalothin, Benzylpenicillin, Flucloxacillin, Dicloxacillin, Piperacillin and Ticarcillin. There was a common sample preparation approach involving precipitation of proteins with acetonitrile and removal of lipid-soluble components by a chloroform wash. Separations were performed on a Waters X-bridge C18 column with, depending on analytes, one of three acetonitrile-phosphate buffer mobile phases. Detection was by UV at 210, 260 and 304 nm. Validation has demonstrated the method to be linear, accurate and precise. The method has been used in a pathology laboratory for therapeutic drug monitoring (TDM) of beta-lactams in critically ill patients. PMID:20561826

  18. 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.

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

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    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.

  20. Presence of blaPER-1 and blaVEB-1 beta-lactamase genes among isolates of Pseudomonas aeruginosa from South West of Iran.

    Science.gov (United States)

    Davodian, Elham; Sadeghifard, Nourkhoda; Ghasemian, Abdolmajid; Noorbakhsh, Samileh

    2016-09-01

    Pseudomonas aeruginosa isolates have acquired resistance to antibiotics such as novel beta-lactams. The aim of this study was to investigate the blaPER-1, blaVEB-1, and blaPSE-1 genes among isolates of P. aeruginosa among intensive care unit (ICU) patients. Sixty-five isolates were collected. The antibiotic susceptibility testing and combined disk tests were performed to detect the isolates producing extended spectrum beta-lactamases (ESBLs) among ceftazidime-resistant isolates. Polymerase chain reaction (PCR) amplification of blaPER-1, blaVEB-1, and blaPSE-1 genes was conducted. Ten (15.3%) isolates were ESBL-positive, of which 40% (n=4) belonged to males and 60% (n=6) were collected from females. Moreover, two and one isolates harbored blaPER-1 and blaVEB-1 genes, respectively. PMID:26944896

  1. 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.[¤

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

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    Padmaja

    2012-10-01

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

  3. Twelve positions in a β-lactamase that can expand its substrate spectrum with a single amino acid substitution.

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    Hyojeong Yi

    Full Text Available The continuous evolution of β-lactamases resulting in bacterial resistance to β-lactam antibiotics is a major concern in public health, and yet the underlying molecular basis or the pattern of such evolution is largely unknown. We investigated the mechanics of the substrate fspectrum expansion of the class A β-lactamase using PenA of Burkholderia thailandensis as a model. By analyzing 516 mutated enzymes that acquired the ceftazidime-hydrolyzing activity, we found twelve positions with single amino acid substitutions (altogether twenty-nine different substitutions, co-localized at the active-site pocket area. The ceftazidime MIC (minimum inhibitory concentration levels and the relative frequency in the occurrence of substitutions did not correlate well with each other, and the latter appeared be largely influenced by the intrinsic mutational biases present in bacteria. Simulation studies suggested that all substitutions caused a congruent effect, expanding the space in a conserved structure called the omega loop, which in turn increased flexibility at the active site. A second phase of selection, in which the mutants were placed under increased antibiotic pressure, did not result in a second mutation in the coding region, but a mutation that increased gene expression arose in the promoter. This result suggests that the twelve amino acid positions and their specific substitutions in PenA may represent a comprehensive repertoire of the enzyme's adaptability to a new substrate. These mapped substitutions represent a comprehensive set of general mechanical paths to substrate spectrum expansion in class A β-lactamases that all share a functional evolutionary mechanism using common conserved residues.

  4. Analysis of quorum sensing-dependent virulence factor production and its relationship with antimicrobial susceptibility in Pseudomonas aeruginosa respiratory isolates.

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    Karatuna, O; Yagci, A

    2010-12-01

    Pseudomonas aeruginosa is an opportunistic pathogen causing severe respiratory infections. The pathogenesis of these infections is multifactorial and the production of many virulence factors is regulated by quorum sensing (QS), a cell-to-cell communication mechanism. The two well defined QS systems in P. aeruginosa, the las and rhl systems, rely on N-acyl homoserine lactone signal molecules, also termed autoinducers. We assessed the activity of QS-dependent virulence factors (including elastase, alkaline protease, pyocyanin and biofilm production) in respiratory isolates of P. aeruginosa and their relationship with antimicrobial susceptibility. We identified sixteen isolates displaying impaired phenotypic activity; among them, eleven isolates were also defective in autoinducer production, and therefore considered QS-deficient. Six of the QS-deficient isolates failed to amplify one or more of the four QS regulatory genes (lasI, lasR, rhlI, rhlR) with PCR: one isolate was negative for rhlR, two isolates were negative for rhlI and rhlR and three isolates were negative for all four genes. The isolates that were negative for virulence factor production were generally less susceptible to the antimicrobials and statistically significant correlations were observed between the lack of elastase production and resistance to piperacillin and ceftazidime; between failure in alkaline protease production and resistance to tobramycin, piperacillin, piperacillin-tazobactam, cefepime, imipenem and ciprofloxacin; and between failure in pyocyanin production and resistance to amikacin, tobramycin, ceftazidime, ciprofloxacin and ofloxacin. The results obtained indicate that, despite the pivotal role of QS in the pathogenesis of P. aeruginosa respiratory infections, QS-deficient strains are still capable of causing infections and tend to be less susceptible to antimicrobials. PMID:20132256

  5. A pilot study on water pollution and characterization of multidrug-resistant superbugs from Byramangala tank, Ramanagara district, Karnataka, India.

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    Skariyachan, Sinosh; Lokesh, Priyanka; Rao, Reshma; Kumar, Arushi Umesh; Vasist, Kiran S; Narayanappa, Rajeswari

    2013-07-01

    Urbanization and industrialization has increased the strength and qualities of municipal sewage in Bangalore, India. The disposal of sewage into natural water bodies became a serious issue. Byramangala reservoir is one such habitat enormously polluted in South India. The water samples were collected from four hotspots of Byramangala tank in 3 months. The biochemical oxygen demand (BOD) and bacterial counts were determined. The fecal coliforms were identified by morphological, physiological, and biochemical studies. The antibiotics sensitivity profiling of isolated bacteria were further carried out. We have noticed that a high content of BOD in the tank in all the 3 months. The total and fecal counts were found to be varied from 1.6 × 10(6) to 8.2 × 10(6) colony forming unit/ml and >5,500/100 ml, respectively. The variations in BOD and total count were found to be statistically significant at p > 0.05. Many pathogenic bacteria were characterized and most of them were found to be multidrug resistant. Salmonella showed resistance to cefoperazone, cefotaxime, cefixime, moxifloxacin, piperacillin/tazobactam, co-trimoxazole, levofloxacin, trimethoprim, and ceftazidime. Escherichia coli showed resistance to chloramphenicol, trimethoprim, co-trimoxazole, rifampicin, and nitrofurantoin while Enterobacter showed resistant to ampicillin, cefepime, ceftazidime, cefoperazone, and cefotaxime. Klebsiella and Shigella exhibited multiple drug resistance to conventional antibiotics. Staphylococcus showed resistance to vancomycin, methicillin, oxacillin, and tetracycline. Furthermore, Salmonella and Klebsiella are on the verge of acquiring resistance to even the strongest carbapenems-imipenem and entrapenem. Present study revealed that Byramanagala tank has become a cesspool of multidrug-resistant "superbugs" and will be major health concern in South Bangalore, India. PMID:23114918

  6. COMPARATIVE ACTIVITY OF DORIPENEM, IMIPENEM AND MEROPENEM AGAINST GRAM NEGATIVE PATHOGENS: A PRELIMINARY STUDY

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    Vipin Sam

    2016-06-01

    Full Text Available BACKGROUND AND OBJECTIVE Doripenem is a new parenteral carbapenems, which has beta-lactamase stability and is not inactivated by renal dehydropeptidases. Doripenem has a spectrum of activity similar to imipenem and ertapenem against Gram-positive cocci and similar to meropenem against Gram-negative pathogens. In this study, we summarize the activity of doripenem against Gram negative bacilli in comparison with other carbapenems (Imipenem, meropenem and select group of antimicrobial drugs by disk diffusion. SETTINGS AND DESIGN A retrospective study was conducted over a period of 3 months (December 2013 to February 2014 in the Department of Microbiology of a tertiary care hospital in Northern India. METHODS AND MATERIAL Gram negative bacillary isolates were subjected to antimicrobial susceptibility with the following antibiotics: imipenem, meropenem, doripenem, ceftazidime, ceftriaxone, amikacin, ciprofloxacin, piperacillin/tazobactam, and trimethoprimsulphamethoxazole by employing the Kirby-Bauer disk diffusion method. The results were interpreted as per CLSI guidelines. RESULTS A total of 498 isolates obtained from urine, skin and soft tissue specimens and lower respiratory specimens were included in the study. The most frequent Gram-negative bacilli isolated were E. coli (31.5%, Acinetobacter spp. (20.1%, Klebsiella spp. (19.5%, P. aeruginosa (16.7%, Enterobacter spp. (8.2%, Proteus spp. (3% and Citrobacter spp. (1%. The isolates showed highest rates of susceptibility to meropenem (65.5% followed by imipenem (63.7%, doripenem (55.8%, amikacin (53.4%, piperacillin/tazobactam (48.7%, trimethoprim-sulphamethoxazole (38.3%, ceftazidime (26.9%, ceftriaxone (23.9% and ciprofloxacin (25.3%. CONCLUSIONS In this study, the activity of doripenem was found to be lower than meropenem and imipenem against all the isolates tested. Further detailed evaluation of doripenem is required with in-vitro MIC studies and their correlation with clinical outcomes.

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

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    Prafulla

    2014-01-01

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

  8. Untargeted Metabolomics To Ascertain Antibiotic Modes of Action.

    Science.gov (United States)

    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. PMID:26833150

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

    Science.gov (United States)

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

    1993-08-01

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

  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. 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.

  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. 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.

  14. Etiology and antibiotic susceptibility patterns of bacteria collected from urinary tract infections in the ASL3 in Genoa

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    Manuela Fedele

    2010-06-01

    Full Text Available An epidemiological study addressed to identify the pathogens collected from urine samples and their antibiotic susceptibility patterns was conducted. From January 2008 to May 2009 56,435 urine samples were processed in the Clinical Microbiological Laboratory of the ASL3 in Genoa. Materials and methods. Urine samples were firstly screened by automated equipment Uroquik (ALIFAX.All urine cultures with microbial ≥105 CFU / ml were seeded on Chromagar Orientation (BD and incubated at 37 ° C °.The identification of the isolates and the evaluation of their susceptibility to antibiotics were determined by the automated system Vitek 2 (bioMérieux. Results. About 33% (18,543 of the urine samples gave positive results.The number and frequency of the microorganisms collected was: 13,379 (72% Gram-negative including 9179 (69% E.coli, 1382 (10% Klebsiella spp, 1209 (9% Proteus spp, 445 (3% Pseudomonas spp, and other species 1164 (9%, 4942 (27% Gram positive which included 3615 (73% Enterococcus spp, 821 (17% Staphylococcus spp, 506 (10% Streptococcus spp and 222 (1% fungi. In E. coli the incidence of susceptible strains ranged between 90-96% for gentamicin, fosfomycin, nitrofurantoin, piperacillin-tazobactam, between 87-89% for the cefepime, cefotaxime, ceftazidime, about 70% for quinolones ciprofloxacin, norfloxacin, and trimethoprim-sulfamethoxazole, 62% for piperacillin, about 50% to ampicillin. For Klebsiella spp and Proteus spp the percentage of susceptible strains ranged from 95-99% to piperacillin-tazobactam, gentamicin, and respectively 93% and between 68-52% for third-generation cephalosporins cefotaxime and ceftazidime and fluoroquinolones ciprofloxacin and norfloxacin. Conclusions. Present findings indicate that among the Enterobacteriaceae, E. coli, cause most of UTI and in vitro resulted susceptible various antibiotics.There was an increased resistance to fluoroquinolones among community-acquired E. coli and Proteus spp.A periodical

  15. In-vitro activity of fosfomycin trometamol and some other antibiotics against Escherichia coli strains isolated from urinary tract infections

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    Alicem Tekin

    2011-09-01

    Full Text Available Objectives: In recent years, in our country and the world, susceptibility of uropathogenic E.coli strains to commonly used antibiotics in the treatment of urinary tract infections has decreased. That decreased susceptibility has been caused to treatment failure, need to change the empirical treatment, increase in prescription costs, prolongation of hospital stay, increased social costs, increased morbidity and mortality. In this study, determination of susceptibility to different variety of antibiotics and fosfomycin in urinary tract infection isolate E.coli were aimed.Materials and methods: The study included E.coli positive urine samples which had been sent to State Hospital Central Laboratory in Kızıltepe between August 2010 and December 2010. These isolates were obtained from patients who have microscopically 10/mm3 leukocyte in urine. In this study, we tested susceptibility of isolated E.coli to FOT (Fosfomycin, CIP(ciprofloxacin, IP (İmipenem, TZP (Piperasilin-Tazobactam, CAZ (Ceftazidim. According to CLSI criteria, susceptibility testing was performed by Kirby-Bauer disc diffusion method.Results: E.coli strains isolated from urine samples examined between August 2010 and December 2010, all were susceptible to fosfomisine. The resistance rates of E.coli strains to Ceftazidim, Ciprofloxacin, İmipenem, Piperacillin-Tazobactam were found respectively 33.3%, 49.1%, 36.8%, 45.6% (Table 1.Conclusions: Because of the high susceptibility rates of fosfomycin at community-acquired urinary tract infection, it can be preferred to the non-complicated urinary tract infections as an antimicrobial agent.

  16. Bacterial keratitis in a tertiary eye centre in Iran: A retrospective study

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    Firoozeh Rahimi

    2015-01-01

    Full Text Available Purpose: To report the characteristics and laboratory findings of 182 patients with bacterial keratitis diagnosed at Farabi Eye Hospital in Tehran, Iran. Materials and Methods: In this retrospective study, data were collected on demographics, risk factors, location, size and depth of the ulcer, height of the hypopyon, uncorrected visual acuity, results of smear and culture tests, and antibiotic sensitivity of cultured bacteria. Results: There were 110 (60.4% males and 72 (39.6% females with an average age of 56.0 ± 2.3 years. Ocular trauma (17.6% and positive history of corneal surgery (14.3% were major risk factors. The mean age of contact lens users was 22.5 ± 7.7 years. Sixty patients (33% used topical antibiotics, 21 (11.5% patients utilized topical steroid, and 26 (14.3% cases used both topical antibiotic and steroid at presentation. Culture results were, 81 (44.5% cases were Gram-positive, 63 (34.6% were Gram-negative, 10 (5.5% were mixed bacteria and in 28 (15.4% cases had detected growth. The isolated bacterial species from the corneal ulcers were less resistant to ceftazidime (6% and amikacin (6%. The majority of patients were treated with medical therapy; however, 81 cases (44.5% received at least one surgical procedure. Conclusion: Among the patients with bacterial corneal ulcers, trauma was the most common risk factor. Over-the-counter antibiotic and steroid were commonly used in the majority of patients. The most common bacteria isolated were Gram-positives, and they were less resistant to ceftazidime and amikacin. Penetrating keratoplasty was the most common surgical procedure in patient who required surgery.

  17. Molecular Epidemiology of Aminoglycosides Resistance in Acinetobacter Spp. with Emergence of Multidrug-Resistant Strains

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    MH Nazem Shirazi

    2010-06-01

    Full Text Available Background: Acinetobacter spp. is characterized as an important nosocomial pathogen and increasing antimicrobial resistance. Our aim was to evaluate antimicrobial susceptibility and aminoglycosides resistance genes of Acinetobacter spp. isolated from hospitalized patients.Methods: Sixty isolates were identified as Acinetobacter species. The isolates were tested for antibiotic resistance by disc diffusion method for 12 antimicrobials. The presence of aphA6, aacC1 aadA1, and aadB genes were detected using PCR.Results: From the isolated Acinetobacter spp. the highest resistance rate showed against amikacin, tobramycin, and ceftazidim, respectively; while isolated bacteria were more sensitive to ampicillic/subactam. More than 66% of the isolates were resistant to at least three classes of antibiotics, and 27.5% of MDR strains were resistant to all seven tested classes of antimicrobials. The higher MDR rate presented in bacteria isolated from the ICU and blood samples. More than 60% of the MDR bacteria were resistance to amikacin, ceftazidim, ciprofloxacin, piperacillin/tazobactam, doxycycline, tobramycin and levofloxacin. Also, more than 60% of the isolates contained phosphotransferase aphA6, and acetyltransferase genes aacC1, but adenylyltransferase genes aadA1 (41.7%, and aadB (3.3% were less prominent. 21.7% of the strains contain three aminoglycoside resistance genes (aphA6, aacC1 and aadA1.Conclusion: The rising trend of resistance to aminoglycosides poses an alarming threat to treatment of such infections. The findings showed that clinical isolates of Acinetobacter spp. in our hospital carrying various kinds of aminoglycoside resistance genes.

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

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    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.

  19. Monitoring and Comparison of Antibiotic Resistant Bacteria and Their Resistance Genes in Municipal and Hospital Wastewaters

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    Rahim Aali

    2014-01-01

    Full Text Available Background: Human exposure to antibiotic resistant bacteria (ARB is a public health concern which could occur in a number of ways. Wastewaters seem to play an important role in the dissemination of bacteria and antibiotic resistant genes (ARGs in our environment. The aim of this study was to evaluate the occurrence of three groups of ARB and their resistance genes in hospital and municipal wastewaters (MWs as possible sources. Methods: A total of 66 samples were collected from raw MWs and hospital wastewaters (HWs and final effluents of related wastewater treatment plants (WWTPs. Samples were analyzed for the detection of three groups of ARB including gentamicin (GM, chloramphenicol (CHL and ceftazidime resistant bacteria and their ARGs (aac (3-1, cmlA1 and ctx-m-32, respectively. Results: The mean concentration of GM, CHL and ceftazidime resistant bacteria in raw wastewater samples was 1.24 × 10 7 , 3.29 × 10 7 and 5.54 × 10 7 colony forming unit/100 ml, respectively. There is a variation in prevalence of different groups of ARB in MWs and HWs. All WWTPs decreased the concentration of ARB. However, high concentration of ARB was found in the final effluent of WWTPs. Similar to ARB, different groups of ARGs were found frequently in both MWs and HWs. All genes also detected with a relative high frequency in effluent samples of MWs WWTPs. Conclusions: Discharge of final effluent from conventional WWTPs is a potential route for dissemination of ARB and ARGs into the natural environment and poses a hazard to environmental and public health.

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

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    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

  1. Effective immunosuppression with dexamethasone phosphate in the Galleria mellonella larva infection model resulting in enhanced virulence of Escherichia coli and Klebsiella pneumoniae.

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    Torres, Miquel Perez; Entwistle, Frances; Coote, Peter J

    2016-08-01

    The aim was to evaluate whether immunosuppression with dexamethasone 21-phosphate could be applied to the Galleria mellonella in vivo infection model. Characterised clinical isolates of Escherichia coli or Klebsiella pneumoniae were employed, and G. mellonella larvae were infected with increasing doses of each strain to investigate virulence in vivo. Virulence was then compared with larvae exposed to increasing doses of dexamethasone 21-phosphate. The effect of dexamethasone 21-phosphate on larval haemocyte phagocytosis in vitro was determined via fluorescence microscopy and a burden assay measured the growth of infecting bacteria inside the larvae. Finally, the effect of dexamethasone 21-phosphate treatment on the efficacy of ceftazidime after infection was also noted. The pathogenicity of K. pneumoniae or E. coli in G. mellonella larvae was dependent on high inoculum numbers such that virulence could not be attributed specifically to infection by live bacteria but also to factors associated with dead cells. Thus, for these strains, G. mellonella larvae do not constitute an ideal infection model. Treatment of larvae with dexamethasone 21-phosphate enhanced the lethality induced by infection with E. coli or K. pneumoniae in a dose- and inoculum size-dependent manner. This correlated with proliferation of bacteria in the larvae that could be attributed to dexamethasone inhibiting haemocyte phagocytosis and acting as an immunosuppressant. Notably, prior exposure to dexamethasone 21-phosphate reduced the efficacy of ceftazidime in vivo. In conclusion, demonstration of an effective immunosuppressant regimen can improve the specificity and broaden the applications of the G. mellonella model to address key questions regarding infection. PMID:26920133

  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. 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.

  4. Antimicrobial susceptibility to parenteral and oral agents in a largely polyclonal collection of CTX-M-14 and CTX-M-15-producing Escherichia coli and Klebsiella pneumoniae.

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    Titelman, Emilia; Iversen, Aina; Kahlmeter, Gunnar; Giske, Christian G

    2011-12-01

    Activity of oral and parenteral antimicrobials against consecutively isolated extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (n = 149) and Klebsiella pneumoniae (n = 20) was determined, and susceptibility test methods were compared for parenteral β-lactams. Polymerase chain reaction (PCR) targeting bla(CTX-M), bla(SHV) and bla(TEM), and DNA sequencing and epidemiological typing with pulsed-field gel electrophoresis were performed. PCR targeting pabB was screened for E. coli O25b-ST131. Minimum inhibitory concentrations (MICs) were determined using Etest and broth microdilution. Disc diffusion was performed according to European Committee on Antimicrobial Susceptibility Testing (EUCAST). Dominating genotypes were bla(CTX-M-15) (75%) and bla(CTX-M-14) (23%). Four E. coli clusters (7-18 isolates) were found. Forty-two per cent of E. coli belonged to O25b-ST131. Ciprofloxacin resistance was 72%, trimethoprim resistance was 70%. Among E. coli, resistance to mecillinam (13%), nitrofurantoin (7%) and fosfomycin (3%) was low, although resistance was high in K. pneumoniae (25%, 60%, 85%). Susceptibility to ertapenem was 99%, piperacillin-tazobactam 91%, tigecycline 96% and temocillin 76%. Susceptibility rates obtained with broth microdilution and Etest were in agreement for cefotaxime (2 vs 1%) and ceftazidime (9 vs 11%), but not for piperacillin-tazobactam (59 vs 91%). With disc diffusion major errors occurred with piperacillin-tazobactam (18/169). Several therapeutic alternatives exist for ESBL-producing E. coli, but few exist for K. pneumoniae. Disc diffusion and Etest can accurately predict susceptibility to cefotaxime and ceftazidime, but not to piperacillin-tazobactam with the present breakpoints. PMID:22085361

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

    Science.gov (United States)

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

    2007-01-01

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

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

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    Carattoli Alessandra

    2008-02-01

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

  7. 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.

  8. Determination of Extended-Spectrum Beta-lactamases Genes and Antibiotic Resistance Patterns in Escherichia coli Isolates from Healthy Cats

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    Baharak Akhtardanesh

    2016-01-01

    Full Text Available ne"> Background: This study was set to detect extended-spectrum beta-lactamases (ESBLsproducing E. coli isolates and the genes underlying their resistance in relation to phylogeneticbackground from fecal samples of healthy owned cats.Methods: A total of 50 E. coli isolates were confirmed by standard bacteriological tests. Thephylogenetic analyses of the isolates were carried out by combinations of three genetic markerschuA, yjaA and DNA fragment TspE4.C2 by a triplex PCR method. The ESBL (blaCTXM, blaTEM,blaSHV, blaOXA encoding genes were detected. To identify ESBL producing phenotypes, allselected isolates were screened with a double disk synergy test including cefotaxime, cefotaximewith clavulanic acid, ceftazidime and ceftazidime with clavulanic acid.Results: Results showed that E. coli isolates fell into four phylogenetic groups (A, D, B1 andB2 with prevalence of 78%, 4%, 8%, 10% and five phylogenetic subgroups including A0 (74%, A1 (4 %, B1 (8 %, B2–2 (6 %, B2–3 (4 % and D1 (4 %, respectively. Among all E. coliisolates, 4% were positive for bla SHV, blaCTX-M-15 and blaOXA-1 genes which distributed in B2-2,B2-3, A0 subgroups, respectively. According to antibiotic susceptibility test, 20 isolates wereresistant which belonged to D (D1 phylogenetic subgroup and A (A0 phylogenetic subgroupgroups.Conclusion: The results showed that healthy cats could be considered as potential source for thedissemination of ESBL-encoding genes. Further investigations in companion animals and theirowners are needed to clarify the importance of spreading of these zoonotic strains.

  9. 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.

  10. 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.

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

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    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.

  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. 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

  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. 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

  16. 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

  17. 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.

  18. 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

    Science.gov (United States)

    Cobos-Trigueros, Nazaret; Solé, Mar; Castro, Pedro; Torres, Jorge Luis; Rinaudo, Mariano; De Lazzari, Elisa; Morata, Laura; Hernández, Cristina; Fernández, Sara; Soriano, Alex; Nicolás, José María; Mensa, Josep; Vila, Jordi; Martínez, José Antonio

    2016-01-01

    Objective To compare the effect of two strategies of antibiotic use (mixing vs. cycling) on the acquisition of resistant microorganisms, infections and other clinical outcomes. Methods 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. Results 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). Conclusions 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. PMID:26982807

  19. 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

  20. 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

  1. 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.

  2. 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

  3. 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

  4. MANAGEMENT OF β-LACTAMASE PRODUCERS THROUGH INFECTION CONTROL MEASURES IN BURN ICU

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    Nachhatarjit

    2015-12-01

    Full Text Available BACKGROUND AND OBJECTIVES Multi-Drug Resistant (MDR pathogens due to various β-lactamases are major contributors in increasing morbidity and mortality rates in Burn Intensive Care Units, ICU. This study is aimed to apply the various infection control measures and to compare the results of two halves of study and to establish a relation between environment, Health Care Workers (HCWs and patients regarding manifestation of nosocomial infection. DESIGN AND SETTING Over a period of three years (June 2010 to June 2013, Clinical, Environment and Health care providers samples from Burn ICU were processed in the Department of Microbiology, Sri Guru Ramdas Institute of Medical Sciences and Research, Amritsar. Organisms were identified by standard microbiological techniques and their antibiotic susceptibility was determined by Kirby Bauer disc diffusion method. The MDR were further tested for various β-lactamases by Clinical Laboratory Standard Institute (CLSI disc diffusion method using Ceftazidime and Ceftazidime + clavulanate and Cefotaxime and Cefotaxime clavulanate for Extended Spectrum Beta Lactamases (ESBL, Meropenem and meropenem + EDTA for Metallo Beta Lactamases (MBLs and 3-Dimensional test for AmpC beta lactamases. MATERIAL AND METHODS 307 clinical, 210 environmental and 117 HCWs samples in 1st and 192 clinical, 62 environmental and 92 HCWs samples in 2nd half of study were processed by standard microbiological techniques. After identification all MDR isolates were first screened for ESBL, AmpC and MBL then confirmed by the respective confirmatory tests. Results of two halves were statistically analyzed. RESULTS Infection rate was reduced from 50.16% to 40.10% in Burn patients. Culture positivity was reduced from 38.0% to 27.41% in environmental and 27.35% to 7.60% in HCWs samples. β-lactamases prevalence in Gram positive was 54.23% and Gram negative was 60.86% before and 37.03% and 54.05% after interventions. CONCLUSION In addition to the

  5. Extended-spectrum beta-lactamase production among ampicillin-resistant Escherichia coli strains from chicken in Enugu State, Nigeria Produção de beta-lactamase de espectro expandido por cepas de Escherichia coli resistentes a ampicilina isoladas de frango em Enugu State, Nigéria

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    K.F. Chah

    2007-12-01

    Full Text Available One hundred and seventy-two ampicillin-resistant E. coli strains isolated from commercial chickens in Enugu State, Nigeria, were screened for beta-lactamase production using the broth method with nitrocefin® as the chromogenic cephalosporin to detect enzyme production. Beta-lactamase producing strains were further examined for extended-spectrum beta-lactamase (ESBL production using the Oxoid combination discs method. One hundred and seventy (98.8% of the 172 ampicillin-resistant E. coli strains produced beta-lactamase enzyme. Sixteen (9.4% beta-lactamase producers were phenotypically confirmed to produce ESBLs. Six of the ESBL producing strains were only detected with ceftazidime versus ceftazidime/clavulanate combination while ten of the ESBL producers were detected with cefotaxime versus cefotaxime/clavulanate combination. Chicken may serve as a reservoir of ESBL-producing E. coli strains which could be transferred to man and other animals.Cento e setenta e duas cepas de Escherichia coli resistentes a ampicilina isoladas de frangos em Enugu State, Nigéria, foram avaliadas quanto à produção de beta-lactamase através do uso de método em caldo com nitrocefin® como indicador cromogênico da produção da enzima. Em seguida, as cepas produtoras de beta-lactamase foram examinadas quanto à produção de beta-lactamase de espectro expandido (ESBL através do método de discos combinados Oxoid. Entre as cepas de Escherichia coli resistentes a ampicilina, cento e setenta (98,8% produziram beta-lactamase. Testes fenotípicos indicaram que dezesseis (9,4% das cepas produtoras de beta-lactamase produziram ESBL. Seis cepas produtoras de ESBL foram detectadas apenas com a combinação ceftazidima versus cefotaxime/clavulanato, enquanto dez cepas produtoras de ESBL foram detectadas com a combinação cefotaxime versus cefotaxime/clavulanato. Frangos podem ser reservatório de cepas de E.coli produtoras de ESBL, que podem ser transferidos para o homem

  6. 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

  7. 557株大肠埃希菌耐药性分析%Drug Resistance of 557 Strains of Escherichia coli

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    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.

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

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    Davood mansury

    2016-03-01

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

  9. Antimicrobial susceptibility and beta-lactamase production of selected gram-negative bacilli from two Croatian hospitals: MYSTIC study results.

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    Bedenic, B; Goic-Barisic, I; Budimir, A; Tonkic, M; Mihajkevic, L J; Novak, A; Sviben, M; Plecko, V; Punda-Polic, V; Kalenic, S

    2010-06-01

    The meropenem yearly Susceptibility Test Information Collection (MYSTIC) programme is a global, longitudinal resistance surveillance network that monitors the activity of meropenem and compares its activity with other broadspectrum antimicrobial agents. We now report the antimicrobial efficacy of meropenem compared to other broad-spectrum agents within the selective Gram-negative pathogen groups from two Croatian Hospitals investigated between 2002-2007. A total of 1510 Gram-negative pathogens were tested and the minimum-inhibitory concentrations (MICs) were determined by broth microdilution method according to CLSI.There was no resistance to either imipenem or meropenem observed for Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis in both medical centers. High resistance rates of K. pneumoniae to ceftazidime (18%), cefepime (17%) and gentamicin (39%) are raising concern. Acinetobacter baumannii turned out to be the most resistant Gram-negative bacteria with 81% resistant to ceftazidime, 73% to cefepime, 69% to gentamicin and 71% to ciprofloxacin. Almost 20% of Pseudomonas aeruginosa strains were resistant to imipenem, 13% to meropenem, 69% to gentamicin and 38% to ciprofloxacin.The prevalence of extended-spectrum beta-lactamases (ESBLs) in E. coli was 10% and in K. pneumoniae 49%. PCR and sequencing of the amplicons revealed the presence of SHV-5 in nine E. coli strains and additional tem-1 beta-lactamase five strains. Five K. pneumoniae strains were positive for bla(SHV-5 )gene. Eight ESBL positive Enterobacter spp. strains were found to produce tem and CtX-m beta-lactamases. Plasmid-mediated AmpC beta-lactamases were not found among K. pneumoniae, E. coli and Enterobacter spp. Three A. baumannii strains from Zagreb University Center were identified by multiplex PCR as OXA-58 like producers. Six A. baumannii strains from Split University Center were found to possess an ISAba1 insertion sequence upstream of bla(OXA-51 )gene. According to our results

  10. Carriage of antibiotic-resistant bacteria by healthy children.

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    Millar, M R; Walsh, T R; Linton, C J; Zhang, S; Leeming, J P; Bennett, P M

    2001-05-01

    The frequency of carriage of antibiotic-resistant bacteria in healthy 7- and 8-year-old children in Bristol was studied. Children born in Avon between 1 April 1991 and 31 December 1992, attending the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC) 7 year follow-up clinic, formed the study population. Carriage was estimated using mouth and stool samples. None of 105 children on whom information was available had received tetracycline, chloramphenicol, ciprofloxacin or an extended-spectrum cephalosporin in the previous year. Staphylococcus aureus was isolated from mouthwashes from 200 (37.1%) of 539 children sampled. Six (3%) of the isolates were resistant to chloramphenicol or tetracycline and four (2%) were methicillin resistant. Haemophilus spp. were isolated from 369 (72%) of 513 samples and 63 (17%) were ampicillin resistant, 49 (13.3%) were erythromycin resistant and seven (1.9%) were tetracycline resistant. Branhamella catarrhalis was isolated from 333 (74%) of 450 samples. Twenty-eight (8.4%) were erythromycin resistant and 14 (4.2%) strains were tetracycline resistant. Group A beta-haemolytic streptococci were isolated from 17 of 507 children sampled. One (5.9%) was tetracycline resistant. Stool samples were returned from 335 (62%) of 539 children from whom they were requested. Eleven per cent of samples yielded Gram-negative bacilli with high-level resistance to chloramphenicol, which was frequently linked to resistance to ampicillin, spectinomycin and streptomycin. Isolates demonstrating resistance to the third-generation cephalosporin ceftazidime were recovered from 17 subjects (3.2%). Six (35%) of 17 isolates possessed extended-spectrum beta-lactamases. Healthy children carry bacteria resistant to antibiotics to which children are not usually exposed. Resistance to ceftazidime, chloramphenicol and tetracycline may be co-selected by exposure to other antibiotics used in children or may be acquired from family members, pets, other children or

  11. 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.

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    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.

  12. Evaluation of extended spectrum beta lactamase enzymes prevalence in clinical isolates of Escherichia coli

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    Ronak Bakhtiari

    2011-10-01

    Full Text Available Resistance to b-lactam antibiotics by gramnegative bacteria, especially Escherichia coli (E. coli, is a major public health issue worldwide. The predominant resistance mechanism in gram negative bacteria particularly E. coli is via the production of extended spectrum beta lactamase (ESBLs enzymes. In recent years, the prevalence of b-lactamase producing organisms is increased and identification of these isolates by using disk diffusion method and no-one else is not satisfactory. So, this investigation focused on evaluating the prevalence of ESBL enzymes by disk diffusion method and confirmatory test (Combined Disk. Five hundred clinical samples were collected and 200 E. coli isolates were detected by standard biochemical tests. To performing initial screening of ESBLs was used from Disk diffusion method on E. coli isolates. A confirmation test (Combined Disk method was performed on isolates of resistant to cephalosporin's indicators. Up to 70% isolates exhibited the Multi Drug Resistance phenotype. In Disk diffusion method, 128(64% E. coli isolates which resistant to ceftazidime and cefotaxime while in Combined Disk, among 128 screened isolates, 115 (89.8% isolates were detected as ESBLs producers. This survey indicate beta lactamase enzymes are playing a significant role in antibiotic resistance and correct detection of them in phenotypic test by using disk diffusion and combined Disk is essential for accurate recognition of ESBLs.

  13. 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.

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

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    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

  15. 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

  16. 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.

  17. 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.

  18. Hospital Acquired Infections: Advantages of a Computerized Surveillance

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    Leonard Mada

    2008-01-01

    Full Text Available Objective: To assess the advantages of a computerized surveillance system to detect Healthcare-Associated Infections (HAI.Methods: All HAI reported to the Timis County branch of the Romanian National Health Insurance and the Public Health Authority during the year 2007 were collected and assessed for validity.Data sources: International data were used to estimate the true HAI rate. Electronic records from the microbiology lab were used to predict the rate of HAI. Advanced models using DRG data and pharmacy order forms were not possible due to lack of this data.Results: Only 10 out off 17 hospitals in Timis County reported the number of HAI. There were 529 cases during 2007, corresponding to <0.4 cases / 100 hospital admissions compared to 4.5 – 9.1 cases / 100 admissions in the medical literature. We estimated a true number of 6,000 HAI in Timis County during 2007. 29 MRSA and another 88 ceftazidime resistant strains were isolated during July 2007 in one of the hospitals. The total of 117 potential HAI comes close to the 150 HAI predicted for that hospital. Conclusions: Romanian hospitals report less than 10% of the HAI. Available electronic data can be used to estimate the true rate of HAI.

  19. 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.

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

    Science.gov (United States)

    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.

  1. 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.

  2. The etiology of neonatal sepsis and patterns of antibiotic resistance

    International Nuclear Information System (INIS)

    Objective: To study the patterns of causative bacteria and antibiotic resistance in neonatal sepsis. Results: Among 228 cases included in the study, the male to female ratio was 2.1 to 1. The gestational age was less than 36 weeks in 68 (30%) cases and low birth weight babies were 143 (62.6%). History of birth asphyxia was present in 103 (45%) cases. There were 142 (62.3%) cases of early onset (7 days). Out of 233 positive blood cultures Escherichia coli was found to be commonest (47.8%, n =111, p<0.05) both in early onset (47.8%, n=68, p <0.05) and late onset sepsis (47.3%,n=43, p<0.05). Staphylococcus aureus was the most common among gram positive organism. Resistance to cefotaxime, ceftazidime and amikacin was 34% to 80% and to ciprofloxacin 13% to 72%. A total of 64 cases (28%) died. Mortality was four times higher in early onset sespis. Conclusion: Gram negative bacteria are the commenst cause of neonatal sepsis. The resistance to the commonly used antibiotics is alarmingly high. Mortality is four times higher in early one set sepsis. (author)

  3. Postoperative Endophthalmitis Caused by Staphylococcus haemolyticus following Femtosecond Cataract Surgery

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    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.

  4. 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.

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

    Institute of Scientific and Technical Information of China (English)

    马立艳; 苏建荣

    2011-01-01

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

  6. Production, Optimization, and Characterization of Organic Solvent Tolerant Cellulases from a Lignocellulosic Waste-Degrading Actinobacterium, Promicromonospora sp. VP111.

    Science.gov (United States)

    Thomas, Lebin; Ram, Hari; Kumar, Alok; Singh, Ved Pal

    2016-07-01

    High costs of natural cellulose utilization and cellulase production are an industrial challenge. In view of this, an isolated soil actinobacterium identified as Promicromonospora sp. VP111 showed potential for production of major cellulases (CMCase, FPase, and β-glucosidase) utilizing untreated agricultural lignocellulosic wastes. Extensive disintegration of microcrystalline cellulose and adherence on it during fermentation divulged true cellulolytic efficiency of the strain. Conventional optimization resulted in increased cellulase yield in a cost-effective medium, and the central composite design (CCD) analysis revealed cellulase production to be limited by cellulose and ammonium sulfate. Cellulase activities were enhanced by Co(+2) (1 mM) and retained up to 60 °C and pH 9.0, indicating thermo-alkaline tolerance. Cellulases showed stability in organic solvents (25 % v/v) with log P ow  ≥ 1.24. Untreated wheat straw during submerged fermentation was particularly degraded and yielded about twofold higher levels of cellulases than with commercial cellulose (Na-CMC and avicel) which is especially economical. Thus, this is the first detailed report on cellulases from an efficient strain of Promicromonospora that was non-hemolytic, alkali-halotolerant, antibiotic (erythromycin, kanamycin, rifampicin, cefaclor, ceftazidime) resistant, multiple heavy metal (Mo(+6) = W(+6) > Pb(+2) > Mn(+2) > Cr(+3) > Sn(+2)), and organic solvent (n-hexane, isooctane) tolerant, which is industrially and environmentally valuable. PMID:26956574

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. 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

  19. Case of late-onset bleb associated endophthalmitis caused by Rothia mucilaginosa.

    Science.gov (United States)

    Oie, Shinya; Mochizuki, Kiyofumi; Ishida, Kyoko; Nakayama, Asami; Ohkusu, Kiyofumi

    2016-09-01

    Rothia mucilaginosa is a gram-positive coagulase-negative coccus of the family Micrococcaceae. Although R. mucilaginosa forms part of the oropharyngeal microflora, it has only recently been isolated in ocular infections. We report a case of a 41-year-old man who developed late-onset bleb-related endophthalmitis (BRE). He had undergone glaucoma surgery 21 years earlier and had a thin-walled cystic bleb prior to the development of endophthalmitis in his right eye. He immediately received intravitreal injections of ceftazidime and vancomycin, topical levofloxacin and cefmenoxime, and intravenous cefozopran. Culture of the aqueous humor specimen identified R. mucilaginosa by 16S rRNA sequence analysis. To our knowledge, this is the first report of late-onset BRE caused by R. mucilaginosa. Our case indicates that R. mucilaginosa can be a cause of late-onset BRE, and that molecular analysis is an accurate method to identify R. mucilaginosa. PMID:27008920

  20. THERAPEUTIC APPROACH IN THE COMPLICATIONS OF ACUTE PANCREATITIS

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    G. Veselu

    2006-10-01

    Full Text Available Acute pancreatitis is a disease with severe local, regional and general complications. Material and methods: During 1999 – 2004 in our unit were treated 32 cases of acute pancreatitis. The etiology of the pancreatitis was: biliary lithiasis in 25 cases (78.12%. Only 7 cases have a severe evolution. All the cases were evaluated by abdominal ultrasound exam, computed tomography and severity scores (Ranson and Apache. Also, the patients were treated and monitored in the intensive care unit. We performed the antibiotic prophylaxy with tienam (500 mg x 4/ day associated with metronidazole (1 g/ day. In some cases we used another therapy: ceftazidime + amikacina + metronidazole. We also used enteral nutrition where was possible, but in some cases total parenteral nutrition was required. Results: After the diagnosis of biliary lithiasis some surgical procedures were performed: cholecystectomies ? the drainage of the main biliary duct. For the 7 cases of severe acute pancreatitis we performed necrosectomies and the drainage of the pancreatic abcesses. Two patients with severe acute pancreatitis died. No surgical interventions were performed for non-biliary acute pancreatitis with good results. Conclusions: 1 The prophylactic use of antibiotics decrease the arte of pancreatic and extrapancreatic infections. 2 We performed the exploratory laparotomy in all the cases with uncertain diagnosis. 3 Cholecystectomies ? the drainage of the main biliary duct were performed in all the cases with biliary lithiasis. 4 In the cases with acute severe pancreatitis we prefer late surgical intervention

  1. Genetic Profiling of Pseudomonas aeruginosa Isolates from Iranian Patients with Cystic Fibrosis Using RAPD-PCR and PFGE

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    Fereshteh Eftekhar

    2009-09-01

    Full Text Available Objective(sPseudomonas aeruginosa is the most important cause of chronic lung infections and death in patients with cystic fibrosis. Determining the distribution of specific strains within patient populations is important in order to examine the epidemiology of the disease and the possibility of cross infection among patients. Materials and MethodsForty six Iranian patients with cystic fibrosis were studied for colonization with P. aeruginosa. Colony phenotype was recorded and antibiotic susceptibility to 11 antibiotics was determined using the disc diffusion method. Genetic fingerprinting was carried out by RAPD–PCR and by PFGE.ResultsForty five P. aeruginosa isolates were recovered from 31 patients including sequential cultures from 9 subjects. The rate of colonization increased with age. All isolates were susceptible to tobramycin and ciprofloxacin, 97.8% were sensitive to amikacin and piperacillin, 93.3% to gentamycin, 91.1% to ticarcillin, 86.7% to colistin, 80% to carbenicillin, 48.9% to cefotaxime, 26.7% to imipenem and 11.1% to ceftazidime. Genetic fingerprinting showed similar distribution profiles for RAPD-PCR and PFGE and the majority of the isolates had unique fingerprints. ConclusionNo relationship was observed between the obtained genotypes and antibiotic susceptibility profiles and common predominant virulent clones were not found among the isolates.

  2. 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

  3. Ertapenem Articulating Spacer for the Treatment of Polymicrobial Total Knee Arthroplasty Infection.

    Science.gov (United States)

    Radoicic, Dragan; Milanovic, Milomir; Marinkovic, Jugoslav; Radoicic, Danica

    2016-01-01

    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. PMID:27366173

  4. 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.

  5. 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.

  6. 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.

  7. 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%). PMID:27352973

  8. Detection and characterization of metallo beta lactamases producing Pseudomonas aeruginosa

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    Manoharan A

    2010-01-01

    Full Text Available This study was undertaken to evaluate phenotypic and genotypic methods for detection of Metallo-Beta-Lactamases (MBLs among nosocomial Pseudomonas aeruginosa. Sixty one among 176 P. aeruginosa isolates, collected as part of a multicentric study (2005-2007, were evaluated for carbapenem resistance (CARB-R; resistant to either imipenem/meropenem and screened for MBL by Combination Disk Diffusion Test (CDDT using imipenem (IMP, meropenem (MER and ceftazidime (CAZ with EDTA. MBL positives were further confirmed by IMP + EDTA Etest. Twenty strains (42.6% were found to be MBL producers among the 61 P. aeruginosa. PCR for IMP and VIM MBL was performed on 48 of the 61, 15 were positive for VIM MBL type. CDDT using IMP + EDTA had the highest sensitivity and specificity of 87.8% and 84.4% when compared to Etest, which was higher than the values obtained for CAZ + EDTA and MER + EDTA. CDDT using IMP + EDTA also compared very well with the PCR (specificity = 90.9%, sensitivity = 93.3%. CARB-R among P. aeruginosa is mediated predominantly via MBL production. Clinical P. aeruginosa isolates can be screened routinely using the less expensive IMP + EDTA CDDT in clinical microbiology laboratories.

  9. 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.

  10. 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.

  11. Valutazione farmacoeconomica di una casistica di pazienti con riacutizzazione di bronchite cronica

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    M. Liconti

    2001-09-01

    Full Text Available Aim of this study is to operate a pharmaeconomical evaluation on case histories of patients affected by chronic bronchitis relapse, comparing the effectiveness of different molecules with antibiotic activity and the total cost far each considered drogo. The observational retrospective study has been conducted at the Bronchopncumology Depaliment of the E. Morelli Hospital (Reggio Calabria on 344 patients aftècted by acute infective or chronic relapsed bronchopneumopaties between January, the 1st, 1997 and December, the 31th 1999. To avoid excessive data dispersal, the study considered only the active principles prescribed to at least 50 persons: ceftazidime, ceftriaxone, cefepime and piperacilline + tazobactam. AlI the patients have responded positively to the treatment, so the cost minimization analysis has been carried out far every dosage regimen, considering different parameters: nursing staff costs, consumable material and drug costs. The Prescribed Daily Dose (PDD has been taken as unit of measurement for drug costs. The single adminstration cost is based on nursing costs and consumable material costs. To get the total therapy cost, it’s necessary to add the single administration drug costo. In this study, the lowest total cost is guaranteed by treatment with ceftriaxone.

  12. Prevalence of antibiotic-resistant Acinetobacter baumannii in a 1000-bed tertiary care hospital in Tehran, Iran

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    Rahbar Mohammad

    2010-04-01

    Full Text Available Acinetobacter baumannii is a ubiquitous pathogen that has emerged as a major cause of healthcare-associated infections. Acinetobacter baumannii usually causes respiratory tract, urinary tract, blood stream and surgical site infections. They are of increasing importance because of its ability to rapidly develop resistance to the major groups of antibiotics. There are few data available on the antimicrobial susceptibility of A. baumannii in Iran. During the period of study from July 2005 to November 2006, a total of 88 strains of A. baumannii were isolated from clinical specimens obtained from patients hospitalized in an Iranian 1000-bed tertiary care hospital. Conventional bacteriological methods were used for identification of A. baumannii. Susceptibility testing was performed by the method recommended by Clinical Laboratory and Standards Institute (CLSI. The majority of isolates were from respiratory tract specimens. The organism showed high rate of resistance to ceftriaxone (90.9%, piperacillin (90.9%, ceftazidime (84.1%, amikacin (85.2% and ciprofloxacin (90.9%. Imipenem was the most effective antibiotic against A. baumannii and the rate of resistance for imipenem was 4.5%. The second most effective antibiotic was tobramycin, and 44.3% of A. baumannii isolates were resistant to this antibiotic. In conclusion, our study showed that the rate of resistance in A. baumannii to imipenem was low. There was a significant relationship between demographic features of patients such as age, undergoing mechanical ventilation, length of hospital stay and drug resistance.

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

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    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.

  14. 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.

  15. Update on infections caused by Stenotrophomonas maltophilia with particular attention to resistance mechanisms and therapeutic options

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    Ya Ting eChang

    2015-09-01

    Full Text Available Stenotrophomonas maltophilia is a Gram-negative, biofilm-forming bacterium. Although generally regarded as an organism of low virulence, S. maltophilia is an emerging multi-drug resistant opportunistic pathogen in hospital and community settings, especially among immunocompromised hosts. Risk factors associated with S. maltophilia infection include underlying malignancy, cystic fibrosis, corticosteroid or immunosuppressant therapy, the presence of an indwelling central venous catheter and exposure to broad spectrum antibiotics. In this review, we provide a synthesis of information on current global trends in S. maltophilia pathogenicity as well as updated information on the molecular mechanisms contributing to its resistance to an array of antimicrobial agents. The prevalence of S. maltophilia infection in the general population increased from 0.8%-1.4% during 1997-2003 to 1.3%-1.68% during 2007-2012. The most important molecular mechanisms contributing to its resistance to antibiotics include β-lactamase production, the expression of Qnr genes, and the presence of class 1 integrons and efflux pumps. Trimethoprim/sulfamethoxazole (TMP/SMX is the antimicrobial drug of choice. Although a few studies have reported increased resistance to TMP/SMX, the majority of studies worldwide show that S. maltophilia continues to be highly susceptible. Drugs with historically good susceptibility results include ceftazidime, ticarcillin-clavulanate, and fluoroquinolones; however, a number of studies show an alarming trend

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

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    Gabriel Hancu

    2015-06-01

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

  17. 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.

  18. 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.

  19. Catheter-associated urinary tract infections in Clinical Center of Banja Luka

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    Verhaz Antonija

    2003-01-01

    Full Text Available Introduction Catheter-associated urinary tract infections are the most common nosocomial infections of the urinary tract, and among the most common nosocomial infections in general. The major problems of these infections include antibiotic resistance and enormous direct and indirect cost of treatment. Material and methods A retrospective study on major causes of infections and antibiotic resistance was conducted at four clinics of the Clinical Center of Banja Luka. An anonymous questionnaire was distributed to nursing staff dealing with urinary catheters in order to get an overview of their clinical performance. Results The results showed that in 89% of cases (out of 198 patients with developed catheter-associated urinary tract infection infections were caused by gram-negative bacteria, in 7% by gram-positive bacteria and in 4% by Candida. The most common bacteria were: Escherichia coli (33.6%, Pseudomonas aeruginosa (14.1%, Proteus mirabilis (13.3%, and Enterobacter (10.5%. Majority of bacteria presented with extremely high resistance (72-100% to ampicillin, gentamycin and cotrimoxazole, and in some cases a significant resistance to ciprofloxacine, nalidixic acid, ceftriaxone and ceftazidime. The questionnaire showed that nursing staff did not follow guidelines for medical care of patients with urinary catheters. Conclusion It can be concluded that poor hygienic and epidemiological conditions, as well as irrational use of antibiotics contribute to uncontrolled development of urinary tract infections in catheterized patients.

  20. 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

  1. Outbreak of septicaemic cases caused by Acinetobacter ursingii in a neonatal intensive care unit.

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    Máder, Krisztina; Terhes, Gabriella; Hajdú, Edit; Urbán, Edit; Sóki, József; Magyar, Tibor; Márialigeti, Károly; Katona, Márta; Nagy, Elisabeth; Túri, Sándor

    2010-06-01

    Neonatal infections may be caused by various microorganisms, but as far as we are aware, Acinetobacter ursingii has not yet been reported in connection with nosocomial infections of premature infants. During 2 months, 3 premature babies were treated with nosocomial infection caused by A. ursingii at the same ward, and on the basis of molecular typing results the same strain was responsible for all of these cases. Traditional biochemical methods and automatic identification systems failed to identify this bacterium on the species level, and only 16S rDNA sequencing gave acceptable species identifications. The isolated strains proved to be susceptible to all of the tested antimicrobials, including ampicillin/sulbactam, doxycyclin, netilmicin, ciprofloxacin, piperacillin/tazobactam, ceftazidime, imipenem, meropenem, trimethoprim/sulfametoxazole, gentamicin, tobramycin, amikacin, and levofloxacin according to the CLSI standard. In spite of the environmental screening, the source of the infection could not be clarified. One of 3 neonates died, the others recovered and were discharged home after several months of hospitalization. PMID:19931486

  2. 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.

  3. Clinical efficacy of ciprofloxacin in lower respiratory tract infections.

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    Pedersen, S S

    1989-01-01

    The sputum pharmacokinetics and clinical efficacy of ciprofloxacin in lower respiratory tract infections is reviewed. Following intravenous administration, ciprofloxacin penetrates rapidly into bronchial tissue; the elimination half life is between 3 and 4 h and a dose dependency is seen. Following oral intake, the time to reach maximal concentrations is approximately two hours and after a dose of 750 mg the concentration may reach 1.7 mg/l in patients without cystic fibrosis and range from 0.5 to 3.4 mg/l in cystic fibrosis patients. Coadministration of ciprofloxacin increases serum levels and decreases total body clearance of theophylline. In controlled comparative clinical trials, ciprofloxacin has been found to have similar clinical efficacy as amoxycillin, ampicillin, cefalexin, doxycycline, co-trimoxazole, imipenem-cilastatin and ceftazidime for the treatment of a range of lower respiratory tract infections. Ciprofloxacin has been found to be superior in clinical efficacy to cefaclor. Experimental animal models suggest a role for ciprofloxacin in infections caused by Legionella pneumophila and Mycoplasma pneumoniae. The clinical and bacteriological efficacy of ciprofloxacin is less pronounced in lung infections caused by Pseudomonas aeruginosa, but is comparable to the combination of beta-lactams and aminoglycosides. Development of resistance is frequently observed during ciprofloxacin treatment of Ps. aeruginosa. Because of the availability of other oral and effective agents, ciprofloxacin is not recommended for empirical treatment of community acquired lower respiratory infections, but should be reserved for infections caused by multiply resistant organisms. PMID:2667111

  4. 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.

  5. Antibiotic Susceptibility of Potentially Probiotic Vaginal Lactobacilli

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    Virginia Ocaña

    2006-01-01

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

  6. 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.

  7. Antibiotic resistance patterns of more than 120 000 clinical Escherichia coli isolates in Southeast Austria, 1998-2013.

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    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.

  8. 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.

  9. 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.

  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. PMID:25172860

  11. Diversity and antibiotic resistance of Aeromonas spp. in drinking and waste water treatment plants.

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    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.

  12. Sensitivity patterns of pseudomonas aeruginosa isolates obtained from clinical specimens in peshawar

    International Nuclear Information System (INIS)

    Pseudomonas aeruginosa (P. aeruginosa) is a highly virulent opportunistic pathogen and a leading cause of nosocomial infections.Affected patients are often hospitalized in an intensive care unit, and are immuno-compromised as a result of disease and treatment. Suspected P. aeruginosa require timely, adequate and empirical antibiotic therapy to ensure improved outcomes. The purpose of the study was to find the sensitivity and resistance pattern of P. aeruginosa to various groups of drugs, in clinical isolates collected from two major tertiary care hospitals of Peshawar. Methods: Different clinical isolate were taken from patients admitted in various wards of Khyber Teaching Hospital and Lady Reading Hospital Peshawar. Results: A total of 258 clinical isolates were positive for P. aeruginosa out of 2058 clinical isolates. Pseudomonas showed high degree of resistance to third generation Cephalosporins (Ceftazidime, and Ceftriaxone) and moderate degree of resistance to Quinolones and Aminoglycosides (Ofloxacin, Ciprofloxacin, Levofloxacin and Amikacin). Low resistance was observed to different combinations (Cefoperazone + Sulbactum, Piperacillin + Tazobactum). Meropenem and Imipenem had negligible resistance. Conclusion: There is growing resistance to different classes of antibiotics. Combination drugs are useful approach for empirical treatment in suspected Pseudomonas infection. Imipenem and Meropenem are extremely effective but should be in reserve. (author)

  13. In vitro susceptibility of β-lactamase-producing carbapenem-resistant Enterobacteriaceae (CRE) to eravacycline.

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    Zhang, Yunliang; Lin, Xiaoyan; Bush, Karen

    2016-08-01

    Eravacycline is a novel, fully synthetic fluorocycline antibiotic of the tetracycline class being developed for the treatment of complicated urinary tract infections and complicated intra-abdominal infections. Eravacycline has activity against many key Gram-negative pathogens, including Enterobacteriaceae resistant to carbapenems, cephalosporins, fluoroquinolones and β-lactam/β-lactamase inhibitor combinations, including strains that are multidrug-resistant. Carbapenem-resistant Enterobacteriaceae (CRE) isolates from 2010 to 2013 (n=110) were characterized for carbapenemase genes by PCR and sequencing. MICs for eravacycline, tetracycline, tigecycline, amikacin, imipenem, ceftazidime, cefotaxime and levofloxacin were determined in broth microdilution assays. All isolates produced at least one carbapenemase, most frequently KPC-3. Nine isolates produced both a KPC serine carbapenemase and a metallo-β-lactamase, NDM-1 (n=1) or VIM-1 (n=8). The 110 isolates were highly resistant to all the β-lactams tested and to levofloxacin, and had MIC50/MIC90 values in the intermediate range for tetracycline and amikacin. MIC50/MIC90 values for eravacycline were 1/2 μg ml(-1) compared with 2/2 μg ml(-1) for tigecycline. Eravacycline MICs were often twofold lower than for tigecycline, with 64% of the eravacycline MICs <2 μg ml(-1) as compared with <4% of tigecycline MICs. Overall, eravacycline demonstrated the lowest cumulative MICs against this panel of recent CRE and may have the potential to treat infections caused by CRE. PMID:27353166

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

    Science.gov (United States)

    Mardaneh, Jalal; Soltan Dallal, Mohammad Mehdi

    2016-01-01

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

  15. Antimicrobial susceptibility pattern of acinetobacter species-one year experience in a tertiary care setting

    International Nuclear Information System (INIS)

    Objective: To find out antimicrobial susceptibility pattern of Acinetobacter species isolated from 1 January 2009 through 31 December 2009 at Department of Microbiology, Armed Forces Institute of Pathology Rawalpindi. Materials and Methods: A total of 276 isolates of Acinetobacter spp yielded from various clinical specimens during the study period were included Routine conventional methods were used to identify various species of Acinetobacter and modified Kirby-Bauer disk diffusion method was used for susceptibility testing. Out of total 276 isolates, 176 (63.8%) turned out to be Acinetobacter baumannii and 100 (36.2%) were Acinetobacter johnsonii. Overall sensitivity of Acinetobacter spp against piperacillin/sulbactam, tigecycline, sulbactam/cefoperazone, piperacillin/tazobactam, imipenem, doxycycline, ceftazidime, ciprofloxacin, chloramphenicol, trimethoprim /sulfamethoxazole, ampicillin, gentamycin, ceftriaxone, amoxicillin/clavulanic acid and ampicillin were 64%,63%, 48%, 47%, 41%,39%,35%, 34%, 32%, 31 %, 29%, 19%, 18% and 5% respectively. Out of 276 isolates, 181 (66 %) were multidrug resistant while 33 (18 %) isolates were pan-drug resistant. (author)

  16. Antibiotic Therapy in Pyogenic Meningitis in Paediatric Patients

    International Nuclear Information System (INIS)

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

  17. 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.

  18. 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.

  19. In vitro activity of antimicrobial combinations against multidrug-resistant Pseudomonas aeruginosa

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    Denissani Aparecida Ferrari dos Santos Lima

    2013-06-01

    Full Text Available Introduction Pseudomonas aeruginosa isolates related to nosocomial infections are often resistant to multiple antibacterial agents. In this study, antimicrobial combinations were evaluated to detect in vitro synergy against clinical isolates of P. aeruginosa. Methods Four clinical P. aeruginosa isolates were selected at random among other isolates from inpatients treated at the public University hospital in Ribeirão Preto, SP, Brazil. Two isolates were susceptible to imipenem (IPM-S and several other antimicrobials, while the other two isolates were imipenem and multidrug resistant (IPM-R. The checkerboard method was used to assess the interactions between antimicrobials. Results Combinations of imipenem or other anti-Pseudomonas drugs with complementary antibiotics, such as aminoglycosides, fosfomycin and rifampin, reached synergy rates of 20.8%, 50%, 62.5% and 50% for the two IPM-S and two IPM-R Pseudomonas isolates, respectively. Imipenem, piperacillin-tazobactam and ceftazidime yielded a greater synergy rate than cefepime or ciprofloxacin. Synergist combinations were more commonly observed when the complementary drug was tobramycin (65% or fosfomycin (57%. Conclusions Some antibacterial combinations led to significant reductions of the minimum inhibitory concentrations of both drugs, suggesting that they could be clinically applied to control infections caused by multidrug-resistant P. aeruginosa.

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

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    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.

  1. Detection of Methicillin-Resistance Gene (mec-A in Staphylococcus aureus Strains by PCR and Determination of Antibiotic Sensitivity

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    A.R. Zamani

    2007-10-01

    Full Text Available Introduction & Objective: Methicillin–Resistant Staphylococcus aureus (MRSA is one of the most important causes of hospital infections worldwide. Treatment of these infections has become more difficult because of resistance to methicillin/oxacillin and other antibiotics. The aim of this study was to determine the incidence of MRSA infections in hospitals affiliated to Hamadan University of Medical Sciences.Materials & Methods: Seventy S. aureus clinical strains were isolated from patients from June, 2005 to June, 2006 and examined by conventional microbiological tests and PCR, respectively. Then, the antibiotic susceptibility to methicillin/oxacillin and other antibiotic were performed by Disk Diffusion Agar (DDA.Results: The results of this study showed that Methicillin resistance gene was detected in 35 (50% and 22 (31.4% cases by PCR and DDA, respectively. The results of antibiotic sensitivity assays also showed there was high resistance in MRSA strains to Penicillin (100%, Cloxacillin (91.4%, Tetracycline (74.2%, Cotrimoxazole (68.6% Erythromycin (68.5% and Ceftazidim (51.4%. The strains of Methicillin-Sensitive Staphylococcus aureus (MSSA showed high sensitivity results to antibiotic used, except penicillin, which all of the isolates were penicillin resistance.Conclusion: As a conclusion, the resistant to methicillin/oxacillin in Hamadan hospitals has reached to 50% and they show multi-drug resistant.

  2. Study of Incidence, Risk Factors and Antibiotic Sensitivity Pattern of Acinetobacter baumannii in a Tertiary Care Hospital

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    Vijaya S Rajmane

    2015-01-01

    Full Text Available Background: Recently, Acinetobacter species has emerged as an important pathogen and the prevalence of infection has increased since last two decades worldwide. Objective: To see the impact of Acinetobacter infection in our hospital and antibiotic sensitivity and resistance pattern. Material and Methods: The study was carried out on clinical samples submitted to the Microbiology laboratory in Krishna institute of Medical Sciences and Research, Karad, over a period of one year (July 2012 to June 2013.Various risk factors like length of hospital stay, ICU admission, any interventions done were noted. Identification and antibiotic susceptibility of the isolates was performed using standard protocol. Results: Out of a total 2728 samples, 86 (3.15% were found to be due to Acinetobacter baumannii. Of the 86 isolates the organism was predominantly isolated from pus samples 48 (55.81% followed by sputum 17 (19.76%, urine 6 (6.97% and blood 4 (4.65%. Out of 86 Acinetobacter isolates, 76 (88.37% showed resistance to Cephalexin, 74 (86.04% each to Cefotaxime and Ceftazidime. The isolates also showed high level of resistance to Ciprofloxacin (82.55%, Ampicillin (77.90% and Gentamicin (74.41%. The isolates from urine samples showed 100% sensitivity to Nitrofurantoin. Imipenem and Meropenem were highly active against the isolate with least resistance of 12.79% each. Conclusion: The present study highlights Acinetobacter species as an important pathogen because of multidrug resistant strains jerking in the hospital environment.

  3. Antimicrobial susceptibility patterns of clinical Escherichia coli isolates from dogs and cats in the United States: January 2008 through January 2013.

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    Thungrat, Kamoltip; Price, Stuart B; Carpenter, D Mark; Boothe, Dawn Merton

    2015-09-30

    Escherichia coli is among the most common bacterial pathogens in dogs and cats. The lack of a national monitoring program limits evidence-based empirical antimicrobial choices in the United States. This study describes antimicrobial susceptibility patterns for presumed clinical E. coli isolates from dogs (n=2392) or cats (n=780) collected from six geographic regions in the United States between May 2008 and January 2013. Minimum inhibitory concentrations (MIC) were determined for 17 drugs representing 6 drug classes. Urinary tract isolates were most common (71%). Population MIC distributions were generally bimodal with the second mode above the resistant breakpoint for all drugs except gentamicin, amikacin, and meropenem. The MIC90 exceeded the susceptible breakpoint for ampicillin, amoxicillin-clavulanic acid, cephalothin (surrogate drug for cephalexin), and doxycycline but was below the susceptible breakpoint for all others. None of isolates was susceptible or resistant to all drug tested; 46% were resistant to 1 or 2 antimicrobial categories, and 52% to more than three categories. The resistance percentages were as follows: doxycycline (100%), cephalothin (98%)>ampicillin (48%)>amoxicillin-clavulanic acid (40%)>ticarcillin-clavulanic acid (18%)>cefpodoxime (13%), cefotaxime (12%), cefoxitin (11%), cefazolin (11%), enrofloxacin (10%), chloramphenicol (9.6%)>ciprofloxacin (9.2%), ceftazidime (8.7%), trimethoprim-sulfamethoxazole (7.9%), gentamicin (7.9%)>meropenem (1.5%), amikacin (0.7%) (Pcephalexin, ampicillin, or amoxicillin-clavulanic acid. Based on susceptibility patterns, trimethoprim-sulfonamides may be the preferred empirical oral treatment. PMID:26165272

  4. Kinetic Spectrophotometric Determination of Certain Cephalosporins in Pharmaceutical Formulations

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    Mahmoud A. Omar

    2009-01-01

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

  5. Multicentric study in five African countries of antibiotic susceptibility for three main pathogens: Streptococcus pneumoniae, Staphylococcus aureus, and Pseudomonas aeruginosa.

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    Zerouali, Khalid; Ramdani-Bouguessa, Nadjia; Boye, Cheikh; Hammami, Adnane

    2016-08-01

    Antibiotic resistance is a growing clinical and epidemiological problem. We report on the antibiotic susceptibility of three pathogens isolated from patients in Algeria, Egypt, Morocco, Senegal, and Tunisia during 2010-2011. In total, 218 Streptococcus pneumoniae, 428 Staphylococcus aureus, and 414 Pseudomonas aeruginosa strains were collected. S. pneumoniae resistance was noted against penicillin (30.2%), erythromycin (27.4%), cefpodoxime (19.1%), amoxicillin (12.0%), cefotaxime (7.4%), and levofloxacin (3.2%). All the strains were teicoplanin susceptible. Staphylococcus aureus methicillin resistance differed between countries, from 5.0% in Senegal to 62.7% in Egypt. Levofloxacin resistance was low in all countries, and the highest rate (in Egypt) was still only 13.6% for intermediate and resistant strains combined. Most strains were susceptible to fosfomycin (99.3%) and pristinamycin (94.2%). P. aeruginosa resistance was found against levofloxacin (30.4%), ciprofloxacin (29.9%), tobramycin (19.7%), ceftazidime (19.2%), and imipenem (17.9%), but not colistin. Antibiotic susceptibility varied widely between countries, with resistance typically most prevalent in Egypt. PMID:25363146

  6. 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.

  7. The growing threat of multidrug-resistant Gram-negative infections in patients with hematologic malignancies.

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    Baker, Thomas M; Satlin, Michael J

    2016-10-01

    Prolonged neutropenia and chemotherapy-induced mucositis render patients with hematologic malignancies highly vulnerable to Gram-negative bacteremia. Unfortunately, multidrug-resistant (MDR) Gram-negative bacteria are increasingly encountered globally, and current guidelines for empirical antibiotic coverage in these patients may not adequately treat these bacteria. This expansion of resistance, coupled with traditional culturing techniques requiring 2-4 days for bacterial identification and antimicrobial susceptibility results, have grave implications for these immunocompromised hosts. This review characterizes the epidemiology, risk factors, resistance mechanisms, recommended treatments, and outcomes of the MDR Gram-negative bacteria that commonly cause infections in patients with hematologic malignancies. We also examine the infection prevention strategies in hematology patients, such as infection control practices, antimicrobial stewardship, and targeted decolonization. Finally, we assess the strategies to improve outcomes of the infected patients, including gastrointestinal screening to guide empirical antibiotic therapy, new rapid diagnostic tools for expeditious identification of MDR pathogens, and use of two new antimicrobial agents, ceftolozane/tazobactam and ceftazidime/avibactam. PMID:27339405

  8. 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.

  9. Fibrin sealant as a carrier for sustained delivery of antibiotics

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    Selçuk Kara

    2014-06-01

    Full Text Available Objective: To evaluate the activity and sustained release of antibiotics from fibrin sealant against common strains of ocular bacteria. Methods: Vancomycin, ceftazidime, moxifloxacin and lomefloxacin were incorporated into fibrin sealant in the shape of discs. Each antibiotic disc and control fibrin disc without drug was tested in vitro against standard bacterial strains of Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae and Pseudomonas aeroginosa. After 24 hours of incubation at 37 °C, the discs were transferred to new plates of bacteria and triplicated for each antibiotic. Results: All antibiotic discs demonstrated detectable activity after 24 hours. Vancomycin had the longest duration of activity (4 days on the S. pneumonia grown plate. The moxifloxacin discs showed a prolonged inhibition of S. aureus and S. pneumonia for 3 days and inhibited the other strains for 2 days. Conclusion: Fibrin sealants provided prolonged drug delivery, which indicates that antibiotic-loaded fibrin clots could be useful for early ocular postoperative care and treatment. J Clin Exp Invest 2014; 5 (2: 194-199

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

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    Martin Reist

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

  11. LiF Reduces MICs of Antibiotics against Clinical Isolates of Gram-Positive and Gram-Negative Bacteria

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    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.

  12. Diversity of Clavulanic Acid-Inhibited Extended-Spectrum β-Lactamases in Aeromonas spp. from the Seine River, Paris, France▿

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    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 ▿

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    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 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.

  15. 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.

  16. 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

    Institute of Scientific and Technical Information of China (English)

    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

  17. 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.

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

    Science.gov (United States)

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

    2009-01-01

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

  19. Management of a widely disseminated skin rash.

    Science.gov (United States)

    Gallagher, E

    2001-01-01

    T.J.'s case was interesting from the standpoint of both diagnosis and management. The recommended treatment for this drug reaction was prednisone: however, the use of a steroid in a patient who is neutropenic and has a fever is risky because the because the steroid can mask the symptoms of infection (e.g., fever). Administration of prednisone did help, and the patient experienced a rapid resolution of the skin rash. T.J. will need to avoid the use of these antibiotic agents in the future. Because it is unknown which antibiotic, vancomycin or ceftazidime, caused the allergic reaction, both medicines should be avoided. The decision to rechallenge a patient with a specific drug must be made on an individual basis. Rechallenging of a drug in patients who have had urticarial, bullous, or erythema multiforme-like eruptions can be very dangerous (Padial et al., 2000). Pinpointing the cause of a skin rash can be puzzling. Always ask the patient "Do you take any medicine for any condition (including aspirin, laxatives, vitamins, etc.)? Have you received any shots any shots in the last month?" Keep in mind that any chemical that is ingested can cause a cutaneous drug eruption. PMID:11899630

  20. Cefoxitin resistance mediated by loss of a porin in clinical strains of Klebsiella pneumoniae and Escherichia coli

    Directory of Open Access Journals (Sweden)

    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.

  1. Antibiotic resistance in Burkholderia species.

    Science.gov (United States)

    Rhodes, Katherine A; Schweizer, Herbert P

    2016-09-01

    The genus Burkholderia comprises metabolically diverse and adaptable Gram-negative bacteria, which thrive in often adversarial environments. A few members of the genus are prominent opportunistic pathogens. These include Burkholderia mallei and Burkholderia pseudomallei of the B. pseudomallei complex, which cause glanders and melioidosis, respectively. Burkholderia cenocepacia, Burkholderia multivorans, and Burkholderia vietnamiensis belong to the Burkholderia cepacia complex and affect mostly cystic fibrosis patients. Infections caused by these bacteria are difficult to treat because of significant antibiotic resistance. The first line of defense against antimicrobials in Burkholderia species is the outer membrane penetration barrier. Most Burkholderia contain a modified lipopolysaccharide that causes intrinsic polymyxin resistance. Contributing to reduced drug penetration are restrictive porin proteins. Efflux pumps of the resistance nodulation cell division family are major players in Burkholderia multidrug resistance. Third and fourth generation β-lactam antibiotics are seminal for treatment of Burkholderia infections, but therapeutic efficacy is compromised by expression of several β-lactamases and ceftazidime target mutations. Altered DNA gyrase and dihydrofolate reductase targets cause fluoroquinolone and trimethoprim resistance, respectively. Although antibiotic resistance hampers therapy of Burkholderia infections, the characterization of resistance mechanisms lags behind other non-enteric Gram-negative pathogens, especially ESKAPE bacteria such as Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa. PMID:27620956

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2006-12-01

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

  4. Burkholderia Pseudomallei Causing Bone and Joint Infections: A Clinical Update.

    Science.gov (United States)

    Raja, Nadeem Sajjad; Scarsbrook, Christine

    2016-03-01

    Burkholderia pseudomallei (B. pseudomallei), a causative agent of an emerging infectious disease melioidosis, is endemic in the tropical regions of the world. Due to increased international travel, the infection is now also seen outside of the tropics. The majority of patients with identified risk factors such as diabetes mellitus, heavy alcohol use, malignancy, chronic lung and kidney disease, corticosteroid use, thalassemia, rheumatic heart disease, systemic lupus erythematosus and cardiac failure acquire this organism through percutaneous inoculation or inhalation. The clinical manifestations are variable, ranging from localized abscess formation to septicemia. Melioidotic bone and joint infections are rarely reported but are an established entity. The knee joint is the most commonly affected joint in melioidosis, followed by the ankle, hip and shoulder joints. Melioidosis should be in the differential diagnosis of bone and joint infections in residents or returning travelers from the endemic area. Melioidosis diagnosis is missed in many parts of the world due to the lack of awareness of this infection and limited laboratory training and diagnostic techniques. It also mimics other diseases such as tuberculosis. Delay in the diagnosis, or the initiation of appropriate and effective treatment against melioidosis, could worsen the outcome. Initial therapy with ceftazidime, or carbapenem with or without cotrimoxazole is recommended, followed by the oral eradication therapy (based on the antimicrobial susceptibility) with amoxicillin/clavulanic acid or cotrimoxazole. Surgical intervention remains important. This paper reviews current literature on the epidemiology, clinical features, diagnosis, and management of melioidotic bone and joint infections. PMID:26728713

  5. 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

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  10. 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

    2016-01-01

    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. PMID:27570987

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

    Science.gov (United States)

    Zhu, J; Li, Z H

    2015-01-01

    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. PMID:26125869

  12. 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.

  13. Increasing Trend of Resistance to Penicillin, Tetracycline, and Fluoroquinolone Resistance in Neisseria gonorrhoeae from Pakistan (1992–2009

    Directory of Open Access Journals (Sweden)

    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. Pattern of chronic suppurative otitis media.

    Science.gov (United States)

    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.

  15. [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

  16. 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

  17. Types of bacteria causing nosocomial infection in patients undergoing breast surgery and changes in their drug resistance%乳腺外科院内感染病菌类型及耐药性变迁分析

    Institute of Scientific and Technical Information of China (English)

    刘平贤

    2013-01-01

    Objectives To ascertain the prevalence of pathogenic bacteria in patients developing a nosocomial infection following breast surgery and to ascertain changes in drug resistance. Methods Pathogenic bacteria were isolated and i-dentified with a Vitek32 automated microbe analyzer. K-B disc diffusion was used to determine drug sensitivity. Results Of 656 patients who underwent breast surgery from January 2010 to December 2011. 185 developed a nosocomial infection for an incidence rate of 28. 20%. One hundred and sixty-three strains of pathogenic bacteria were isolated; 99 strains were Gram-positive bacteria, 56 strains were Gram-negative bacteria, and 8 stains were fungi. Gram-positive bacteria were resistant to ceftazidime, gentamycin. erythromycin, and piperacillin and sensitive to imipenem and gatifloxacin; Gram-negative bacteria were resistant to clindamycin, amoxicillin/clavulanic acid, piperacillin, and cefoperazone and sensitive to imi-penem. gatifloxacin and ceftazidime. Compared to 2010. there were no significant differences in drug resistance in 2011. Conclusion Pathogens causing a nosocomial infection in patients undergoing breast surgery were highly resistant. Changes in resistance were not marked. Rational use of antibiotics in accordance with drug sensitivity results is beneficial to the treatment of nosocomial infection.%目的 了解乳腺外科手术患者的院内感染病原菌及其耐药性变迁情况,为临床抗感染治疗提供依据. 方法 院内感染患者送检标本分离病原菌,Vitek32全自动微生物分析仪鉴定菌种,K-B纸片法作药物敏感性试验. 结果 2010年1月~2011年12月656例乳腺外科患者院内感染185例,院内感染发生率28.20%;分离病原菌163株,其中革兰阳性菌99株,占60.74%,革兰阴性菌56株,占34.36%,真菌8株,占4.91%.革兰阳性菌对头孢他啶、庆大霉素、红霉素、哌拉西林耐药率较高,对亚胺培南和加替沙星较敏感;革兰阴性菌对克林

  18. Pathogen distribution and analysis of drug resistance in patient with chronic obstructive pulmonary disease%慢性阻塞性肺疾病患者病原菌分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    闫伯强

    2011-01-01

    目的 探讨慢性阻塞性肺疾病患者的病原菌分布及耐药性分析,为临床合理用药提供依据.方法 选取2008年2月至2010年2月收治的120例慢性阻塞性肺疾病患者为研究对象,患者均伴有呼吸道感染,对其痰液进行细菌培养,采用药物敏感(药敏)一体化试剂盒进行药敏试验,并分析细菌的耐药性.结果 分离出的188例菌株中革兰阴性菌最多,有126株,占67.0%,其中以铜绿假单胞菌最多,占27.1%;革兰阳性菌54株,占28.7%,其中以金黄色葡萄球菌最多,占12.2%;真菌8株,占4.3%.药敏试验发现,对革兰阴性菌有效的抗生素为亚胺培南、阿莫西林、头孢他啶;对革兰阳性菌有效的抗生素为亚胺培南、头孢他啶、万古霉素.结论 慢性阻塞性肺疾病感染患者以革兰阴性菌为主,且耐药率较高,需不断检测病原菌的变化及药物药敏情况,选择合适抗生素.%Objective To investigate the pathogen distribution and analysis of drug resistance in patient with chronic obstructive pulmonary disease,and to provide the evidence for clinical use of drugs. Methods One hundred and twenty patients with chronic obstructive pulmonary disease from February 2008 to February 2010 were selected,all patients were associated with respiratory tract infections,bacterial culture was done for their sputum,drug sensitive test was done using sensitivity integration kit and bacteria resistance was analysed. Results There were 126 stains of Gram-negative bacteria in 188 cases of isolated strains (67.0% ) , in which Pseudomonas aeruginosa was the most, accounting for 27. 1%. There were 54 strains of Gram-positive bacteria(2%. 7% ) ,in which Staphylococcus aureus was the most,accounting for 12. 2 %. There were 8 strains of fungi .accounting for 4.3%. Drug sensitive test showed that effective antibiotics against Gram-negative bacteria were imipenem, amoxicillin and ceftazidime and effective antibiotics against Gram

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

    Institute of Scientific and Technical Information of China (English)

    孙珍; 向军; 宋菲; 郇京宁

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    杨莹莹; 王镇山; 薛欣; 聂大平; 李玉中

    2011-01-01

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

  1. 腹膜透析相关性腹膜炎的菌谱及其药敏分析%Bacterial spectrum and antimicrobial sensitivity in CAPD-related peritonitis

    Institute of Scientific and Technical Information of China (English)

    朱伟平; 崔彤霞; 徐庆东; 李中和; 张桦

    2011-01-01

    Objective To find out the antimicrobial sensitivity characteristics of bacteria from CAPD-related peritonitis patients in an attempt to optimize the clinical therapy. Methods We collected 79 episodes of peritonitis from 50 patients between January 2006 and August 2010. We then analyzed the changes of bacterial spectrum and the differences of bacterial resistance to antibiotics. SPSS 13.0 software was used for the analyses. Results In the 79 peritonitis episodes, gram-positive organism infection was found in 34 episodes (44.3%), gram-negative organism infection in 17 episodes (21.5%), fungus infection in one episode (1.3%), mycobacterium tuberculosis infection in one episode (1.3%), and bacterial culture was negative in 25 episodes (31.6%), with the positive culture rate of 68.4%. In staphylococcus strains, the percentage of resistance to Penicillin and Ampicillin was >90%, that of resistance to Cefazolin was 30.0%, and that of resistance to Cephradine was 0. Methicillin-resistant staphylococcus aureus (MRSA) was not found in this study. In streptococcus strains, the percentage of resistance to Streptomycin, Levofloxacin and Vancomycin was low. In gram-negative organisms, most of them were sensitive to Amikacin and Imipenem/Cilastatin, but the percentage of resistance to Ceftazidime was 17.6%. Conclusion In addition to the traditional antibiotics of Cefazolin and Ceftazidime, Cephradine combined with Amikacin are preferable for the treatment of CAPD-related peritonitis.%目的 通过分析腹膜透析相关性腹膜炎患者的资料,总结感染病菌的菌谱和药敏特点,以指导临床治疗.方法 收集中山大学附属第五医院腹膜透析中心50例持续性不卧床腹膜透析患者共79例次腹膜炎资料,分析菌谱并采用统计软件比较各种抗生素的耐药率之间是否存在差异.结果 在79例次腹膜炎中,G+菌感染共35例(44.3%),G -菌感染17例(21.5%),真菌及结核菌各1例(各1.3%),

  2. 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.

  3. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  4. 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

    2016-01-01

    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. PMID:26482314

  5. Prevalence and Characteristics of Salmonella Isolated from Free-Range Chickens in Shandong Province, China

    Directory of Open Access Journals (Sweden)

    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.

  6. Clonal evolution multi-drug resistant Acinetobacter baumannii by pulsed-field gel electrophoresis

    Directory of Open Access Journals (Sweden)

    P Mohajeri

    2015-01-01

    Full Text Available Background: Acinetobacter baumannii is usually multi-drug resistant (MDR, including third generation cephalosporins, amino glycosides and fluoroquinolone. Resistance to these antibiotics is mediated by multiple factors such as: lactamases, efflux pumps and other mechanisms of resistance. Pulsed-field gel electrophoresis (PFGE was then used to investigate the genetic relationships among the MDR isolates. Aim: The aim of this study was to determine MDR isolates and the existence of OXAs genes among MDR isolates of A. baumannii collected from Kermanshah hospitals in west of Iran. Materials and Methods: Forty-two MDR A. baumannii were collected from patients at Kermanshah hospitals. The isolates were identified by biochemical tests and API 20NE kit. The susceptibility to different antibiotics by disk diffusion method was determined. Polymerase chain reaction (PCR was performed for detection of blaOXA-23-like , blaOXA-24-like , blaOXA-51-like and blaOXA-58-like betalactamase genes in isolates and clonal relatedness was done by PFGE (with the restriction enzyme ApaI and patterns analyzed by Bionumeric software. Results: This study showed high resistant to ciprofloxacin, piperacillin, ceftazidime and also resistant to other anti-microbial agents and more spread blaOXA-23-like gene (93% in MDR isolate. The PFGE method obtained six clones: A (10, B (9, C (5, D (4, E (11 and F (3 that clone E was outbreak and dominant in different wards of hospitals studied. Conclusion: An isolate from the emergency ward of these hospitals had indistinguishable isolates PFGE profile and similar resistance profile to isolates from intensive care unit (ICU, suggesting likely transmission from ICU to emergency via patient or hospital staff contact.

  7. Acinetobacter infections prevalence and frequency of the antibiotics resistance: comparative study of intensive care units versus other hospital units

    Science.gov (United States)

    Uwingabiye, Jean; Frikh, Mohammed; Lemnouer, Abdelhay; Bssaibis, Fatna; Belefquih, Bouchra; Maleb, Adil; Dahraoui, Souhail; Belyamani, Lahcen; Bait, Abdelouahed; Haimeur, Charki; Louzi, Lhoussain; Ibrahimi, Azeddine; Elouennass, Mostafa

    2016-01-01

    Introduction This study aims to determine the Acinetobacter sp clinical isolates frequency and its antibiotic susceptibility pattern by comparing results obtained from the Intensive Care Units (ICUs) to that of other units at the Mohammed V Military Teaching Hospital in Rabat. Methods This is a retrospective study over a 2-years period where we collected all clinical isolates of Acinetobacter sp obtained from samples for infection diagnosis performed on hospitalized patients between 2012 to 2014. Results During the study period, 441 clinical and non-repetitive isolates of Acinetobacter sp were collected representing 6.94% of all bacterial clinical isolates (n = 6352) and 9.6% of Gram negative rods (n = 4569). More than a half of the isolates were from the ICUs and were obtained from 293 infected patients of which 65, 2% (191 cases) were males (sex ratio = 1.9) and the median age was 56 years (interquartile range: 42-68 years). Acinetobacter clinical isolates were obtained from respiratory samples (44.67%) followed by blood cultures (14.51%). The resistance to ciprofloxacin, ceftazidime, piperacillin / tazobactam, imipenem, amikacin, tobramycin, netilmicin, rifampicin and colistin was respectively 87%, 86%, 79%, 76%; 52%, 43%, 33% 32% and 1.7%. The difference in resistance between the ICUs and the other units was statistically significant (p <0.05) except for colistin, tetracycline and rifampicin. Conclusion This paper shows that solving the problem of prevalence and high rate of multidrug resistant Acinetobacter infection which represents a therapeutic impasse, requires the control of the hospital environment and optimizing hands hygiene and antibiotics use in the hospital. PMID:27347280

  8. Genomic characterization and antimicrobial susceptibility of bovine intrauterineEscherichia coli and its relationship with postpartum uterine infections

    Institute of Scientific and Technical Information of China (English)

    YANG Li-ming; WANG Yi-hao; PENG Yu; MIN Jiang-tao; HANG Su-qin; ZHU Wei-yun

    2016-01-01

    To investigate the roles ofEscherichia coli in the pathogenesis of postpartum uterine diseases in dairy cows, a total of 145E. coli isolates were recovered from 18 healthy cows (61 isolates) and 25 cows with clinical endometritis (84 isolates) at 25–35 days after parturition. Genomic characteristics including phylogenetic grouping, genetic diversity and virulence genes of E. coli isolates were screened to proifle the characteristics related to uterine infections. The susceptibility of the bacteria against 23 antibiotics was also evaluated to support prevention and treatment of clinical cases. Genetic diversity ofE. coli identiifed by random ampliifcation of polymorphic DNA (RAPD) revealed 103 clonal types, including 3 common types to unaffected cows and endometritis cows, 39 types speciifc to healthy cows and 61 types in endometritis subjects. In addition, the isolates from endometritis uteri showed more genetic variability compared with that of healthy cows. Ac-cording to the ifndings of phylogenetic grouping, theE. coli isolates were assigned to group A (35.9%), B1 (59.3%) and D (4.8%). The expression of 10 of 20 virulence gens were detected positively, and onlyifmH gene was revealed signiifcantly (P<0.05) associated with endometritis. From antimicrobial susceptibility test,E. coli was found highly resistant to tetracy-cline, ampicilin, carbenicilin and amoxicilin, but sensitive to amikacin, netilmicin, tobramycin, cefepime and ceftazidime. In conclusion,E. coliwere extensively observed in both healthy and endometritis cows, and presented a large clonal types, however, ifmH was the only gene observed associated with clinical endometritis. Our results suggest that the drugs like amikacin, netilmicin, tobramycin and cefepime could be considered for preventing and treating clinical endometritis in the practical management of dairy cow.

  9. Antipseudomonal agents exhibit differential pharmacodynamic interactions with human polymorphonuclear leukocytes against established biofilms of Pseudomonas aeruginosa.

    Science.gov (United States)

    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.

  10. D-amino acids enhance the activity of antimicrobials against biofilms of clinical wound isolates of Staphylococcus aureus and Pseudomonas aeruginosa.

    Science.gov (United States)

    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.

  11. Inhibitory effects of various essential oils and individual components against extended-spectrum beta-lactamase (ESBL) produced by Klebsiella pneumoniae and their chemical compositions.

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    Orhan, Ilkay Erdogan; Ozcelik, Berrin; Kan, Yüksel; Kartal, Murat

    2011-10-01

    In the current study, in vitro inhibitory activity of several essential oils obtained from the cultivated plants, Foeniculum vulgare, Mentha piperita and M. spicata, Ocimum basilicum, Origanum majorana, O. onites, O. vulgare, Satureja cuneifolia, and a number of individual essential oil components of terpene and aromatic types were screened against 10 isolated strains of Klebsiella pneumoniae producing extended-spectrum beta-lactamase (ESBL) enzyme, which makes this microorganism quite resistant against the antibiotics: trimetoprime-sulfametoksazol, sulbactam-ampicilin, clavulonate-amoxicilin, ceftriaxon, cefepime, imipenem, ceftazidime, tobramicine, gentamisine, ofloxacin, and ciprofloksasin. All of the essential oils and the components exerted a remarkable inhibition ranging between 32 and 64 μg/mL against all of these strains as strong as the references (ampicilin and oflaxocin) inhibiting at 32 μg/mL. Besides, chemical compositions of the essential oils were elucidated by gas chromatography-mass spectrometry (GC-MS). The essential oils and the pure components widely found in essential oils screened herein have shown remarkable inhibition against ESBL-producing K. pneumoniae strains, which leads to the suggestion that they may be used as food preservatives for this purpose. Practical Application:  The essential oils obtained from Foeniculum vulgare, Mentha piperita and M. spicata, O.cimum basilicum, Origanum majorana, O. onites, O. vulgare, and Satureja cuneifolia as well as common essential oil components have shown notable inhibitory effects against 10 isolated strains of Klebsiella pneumoniae producing extended-spectrum beta-lactamase (ESBL) enzyme and they might be used as food preservative or ingredient. PMID:22417594

  12. Clinico-microbiological study and antibiotic resistance profile of mecA and ESBL gene prevalence in patients with diabetic foot infections

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    CHAUDHRY, WAQAS NASIR; BADAR, RABIA; JAMAL, MUHSIN; JEONG, JASON; ZAFAR, JAMAL; ANDLEEB, SAADIA

    2016-01-01

    Diabetic foot infections (DFIs) constitute a major complication of diabetes mellitus. DFIs contribute to the development of gangrene and non-traumatic lower extremity amputations with a lifetime risk of up to 25%. The aim of the present study was to identify the presence of neuropathy and determine the ulcer grade, microbial profile and phenotypic and genotypic prevalence of the methicillin-resistance gene mecA and extended spectrum β-lactamase (ESBL)-encoding genes in bacterial isolates of DFI in patients registered at the Pakistan Institute of Medical Sciences (Islamabad, Pakistan). The results indicated that 46/50 patients (92%), exhibited sensory neuropathy. The most common isolate was Staphylococcus aureus (25%), followed by Pseudomonas aeruginosa (P. aeruginosa; 18.18%), Escherichia coli (16.16%), Streptococcus species (spp.) (15.15%), Proteus spp. (15.15%), Enterococcus spp. (9%) and Klebsiella pneumoniae (K. pneumoniae; 3%). The prevalence of the mecA gene was found to be 88% phenotypically and 84% genotypically. K. pneumoniae was shown to have the highest percentage of ESBL producers with a prevalence of 66.7% by double disk synergy test, and 100% by the cefotaxime + clavulanic acid/ceftazidime + clavulanic acid combination disk test. P. aeruginosa and K. pneumoniae had the highest (100%) proportion of metallo β-lactamase producers as identified by the EDTA combination disk test. The overall prevalence of β-lactamase (bla)-CTX-M, bla-CTX-M-15, bla-TEM, bla-OXA and bla-SHV genes was found to be 76.9, 76.9, 75.0, 57.7 and 84.6%, respectively, in gram-negative DFI isolates. The prevalence of mecA and ESBL-related genes was found to be alarmingly high in DFIs, since these genes are a major cause of antibiotic treatment failure. PMID:26998033

  13. Presence and antimicrobial profile of gram-negative facultative anaerobe rods in patients with chronic periodontitis and gingivitis.

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    Gamboa, Fredy; García, Dabeiba-Adriana; Acosta, Adriana; Mizrahi, Deborah; Paz, Andreína; Martínez, Diana; Arévalo, Azucena; Aristizabal, Fabio; Abba, Martín

    2013-01-01

    Chronic periodontitis is a multifactorial infectious disease associated with Gram-negative anaerobes which are part of the subgingival microflora. In recent years, studies have been conducted to assess the presence of Gram-negative facultative anaerobes (Enterobacteriaceae) and their participation in the development and progression of chronic periodontitis. The aim of this study was to determine the presence of Enterobacteriaceae in patients with chronic periodontitis and gingivitis and to assess antimicrobial susceptibility of clinical isolates. A descriptive, observational study was performed including 64 patients with chronic periodontitis and 22 patients with gingivitis. Microbiological samples were taken from the gingival sulcus using paper points, which then were placed in thioglycollate broth. Samples were incubated for 4 hours at 37 degrees C and finally replated on MacConkey agar Bacteria were identified using the API-20E system (Biomerieux, France) and antimicrobial susceptibility was determined using the disk diffusion method. The evaluation of samples showed presence of 29 enterobacterial species distributed as follows: 7 in the group with gingivitis and 22 in the group with chronic periodontitis. In the chronic periodontitis group the most common species were: K. oxytoca n = 5, S. liquefaciens n = 4 and K. pneumoniae and E. coli with n = 3. The gingivitis group had the highest frequency of Erwinia sp. (n = 2). Clinical isolates showed very low sensitivity levels to beta-lactam ampicillin and amoxicillin/ clavulanic acid, 17.2% and 27.6% respectively, and higher sensitivity levels to ciprofloxacin (96.6%), amikacin (79.3%), gentamicin (68.9%) and ceftazidime, ceftriaxone, kanamycin and trimethoprimsulfa (65.5%). In conclusion, the existence of a high frequency of enterobacteria in patients with chronic periodontitis and gingivitis shows that periodontologists should pay greater attention to prevention protocols, and develop mechanical and antimicrobial

  14. 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 Falmawati 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(heir 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 pallerns is very important for setting orders to guide the clinician in choosing empirical or directed therapy of infected patients.

  15. 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.

  16. Extended Spectrum β-lactamases and antimicrobial susceptibility among clinical isolates of Pseudomonas aeruginosa in the West Bank, Palestine

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    Tamer Essawi

    2013-06-01

    Full Text Available Objectives: Class D oxacillinases are frequently acquired by gram negative bacteria in general and P. aeruginosa in particular.P. aeruginosa is commonly implicated in causing nosocomial infections. The evolution of antibiotic resistance inP. aeruginosa and the acquisition of blaOXA genes interfere with successful treatment.Methods: A total of 49 clinical isolates of P. aeruginosa were obtained from Rafidia Hospital, West Bank, Palestine.Antimicrobial susceptibility testing of the isolates was performed by the standard disc diffusion method following theguidelines of CLSI. The prevalence of class D β-lactamases (OXA groups I, II and III as well as the pseudomonas specificenzymes (CARB-3 were determined by PCR.Results: Susceptibility of P. aeruginosa to carbapenems was the highest 89%, and lowest to ticarcillin/clavulanic acid70%. This study revealed that P. aeruginosa produced oxacillinase enzymes at rates of: OXA-10 (40.8%, OXA-2 (20.4%and OXA-1 (18.4%. All ceftazidime resistant strains expressed OXA-1 and OXA-2, 18.4%. PSE group was expressed in10.2%.Conclusions: This is the first research conducted to investigate the correlation between OXA genes (blaOXA-1, bla-OXA-2 and blaOXA-10 and antimicrobial resistance among P. aeruginosa clinical isolates in Palestine. The results obtainedcould contribute to better treatment and reduction of the evolution of resistant strains. In addition, it will provideimportant information regarding the geographical distribution of class D β-lactamases. J Microbiol Infect Dis 2013; 3(2:56-60Key words: P. aeruginosa, β-lactamase, susceptibility, oxacillinases, blaOXA genes

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

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

    2016-06-01

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

  18. Transcriptome analysis and physiology of Bifidobacterium longum NCC2705 cells under continuous culture conditions.

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    Mozzetti, V; Grattepanche, F; Moine, D; Berger, B; Rezzonico, E; Arigoni, F; Lacroix, C

    2012-12-01

    A central issue in the use of probiotics in food and food supplements is their sensitivity to many environmental stress factors. The resistance of probiotic cells to lethal stress can be improved by application of homologous or heterologous sub-lethal stress during culture. This screening procedure is generally performed using batch cultures. Continuous cultures could be a suitable and more efficient method to test different stress factors on one culture instead of repeating several batch cultures. However, before testing stresses using continuous cultures, the physiological stability of continuously produced cells over a considered time period must be first evaluated. A continuous culture of Bifidobacterium longum NCC2705 was maintained for 211 h at a dilution rate of 0.1 per h, mimicking a deceleration growth phase culture. Stable viable cell counts were measured over the culture period, decreasing only moderately from 8.8 to 8.6 log10 cfu/ml. A slight shift in metabolite production, characterized by increased lactate and decreased acetate, formate and ethanol concentrations was observed. Susceptibilities to antibiotics and stress conditions were stable (cefotaxim, ampicillin, ceftazidime) or moderately affected (simulated gastric juices, heat, bile salts, tetracycline, chloramphenicol, penicillin, vancomycin and neomycin) over culturing time. Comparison of gene transcription profiles between samples collected after 31 h of continuous culture and samples collected after 134 and 211 h revealed only limited changes in expression of 1.0 and 3.8% of total genes, respectively. Based on these results, we propose that continuous culture can be used to produce bacterial cells with stable physiological properties suitable for fast and efficient screening of sub-lethal stress conditions. PMID:23234728

  19. Antibiotic susceptibility pattern and analysis of plasmid profiles of Pseudomonas aeruginosa from human, animal and plant sources.

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    Odumosu, Bamidele Tolulope; Ajetunmobi, Olabayo; Dada-Adegbola, Hannah; Odutayo, Idowu

    2016-01-01

    Multidrug resistant organisms (MDROs) constitute a major public health threat globally. Clinical isolates of Pseudomonas aeruginosa remains one of the most studied MDROs however there is paucity of information regarding the susceptibility of its animal and plants isolates to antipseudomonas drug in Nigeria. From a total of 252 samples consisting of plants, animals and clinical samples, 54, 24 and 22 P. aeruginosa were isolated from vegetables, animals and clinical sources respectively. All the isolates were identified by standard biochemical methods. Antimicrobial susceptibility testing (AST) of the 100 P. aeruginosa isolates against 7 antipseudomonal drugs was carried out by disk diffusion method, the phenotypic detection of ESBL was done by double disk synergy test (DDST) while plasmid extraction on 20 selected isolates based on their resistance to 2 or more classes of antibiotics was carried out by alkaline lysis method and analysed with Lambda DNA/Hind lll marker respectively. The AST results revealed highest resistance of 91 and 55 % to ceftazidime and carbenicillin respectively while highest susceptibilities of 99 % for piperacillin-tazobactam and imipenem were recorded in overall assay. Fifteen out of 100 isolates specifically (10) from vegetables, (3) clinical and (2) poultry isolates showed synergy towards the beta-lactamase inhibitor indicating production of ESBL by DDST method. Detection of plasmids was among vegetable (n = 4), poultry (n = 4), cow (n = 3) and clinical isolates (n = 1). Plasmid profile for the selected isolates revealed 6 of the strains had one plasmids each while 5 strains possessed 2-4 plasmids and 1 strain had 5 plasmids. The sizes of the plasmid range from animal isolates of P. aeruginosa harbouring multiple mechanisms of resistance is of concern due to the danger it poses on the public health. PMID:27610300

  20. Antibiotic resistance pattern of bacterial isolates from cases of urinary tract infections among hospitalized and out-patients at a tertiary health facility in South Western Nigeria

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    Oyekale Oluwalana Timothy

    2014-01-01

    Full Text Available Aim: Urinary tract infections (UTIs are among the most common human infections with distribution of causative agents and their susceptibility pattern to antibiotics varying from region to region. This study aimed at determining the bacterial uropathogens and their antibiotic resistance profile among patients in a Nigerian tertiary health care facility. Materials and Methods: Appropriate urine specimens (midstream/catheter specimen urine of all suspected cases of UTI by clinicians were processed in the medical microbiology laboratory for detection of significant bacteriuria. Bacteria uropathogens isolated were identified by standard biochemical tests and antibiotic susceptibility test to eight antibiotics was carried out on them using Kirby-Bauer disc diffusion technique. Methicillin-resistant Staphylococcus aureus (MRSA was identified by cefoxitin disc diffusion technique and extended-spectrum beta-lactamase (ESBL producing enterobacteria were detected using double-disc synergy test. Results: Of the total 157 males and 189 females investigated, 35.7% and 66.1% respectively had significant bacteriuria. Escherichia coli was the most commonly isolated bacterial pathogen both among in- and out-patients (52.6% vs. 65.5%. Other isolated organisms were S. aureus (13.4% vs. 19.0%, Pseudomonas aeruginosa (10.3% vs. 2.4%, Klebsiella pneumoniae (7.2% vs. 7.1% and K. aerogenes (7.2% vs. 1.2%. Resistance rate of uropathogens to antibiotics was higher among in-patients. Resistance rate to ofloxacin, ceftazidime and ceftriaxone was generally very low compared to other tested antibiotics. Multiple resistant bacteria: MRSA and ESBL-producing enterobacteria were detected among both in-and out-patient with no significant difference in isolation rate. Conclusion: There is a need for continuous monitoring of uropathogens and their antibiotic sensitivity profile for evidence-based empirical treatment of UTI. There is an urgent need for the establishment of antibiotic

  1. Isolation and molecular characterization of Salmonella spp. from chevon and chicken meat collected from different districts of Chhattisgarh, India

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    V. K. Naik

    2015-06-01

    Full Text Available Aim: The aim was to assess the prevalence of Salmonella in raw chevon and chicken meat sold in the retail meat shops situated in and around Durg, Rajnandgaon, Dhamtari, Raipur, and Bilaspur districts of Chhattisgarh. Studies were also conducted to find out the antibiotic resistance in Salmonella isolates. Materials and Methods: A total of 400 samples comprising of 200 chevon meat and 200 chicken meat samples were processed for isolation of Salmonella and all isolates were further confirmed on the basis of cultural and biochemical characters and by targeting invA gene of Salmonella. All Salmonella isolates were also examined for their antimicrobial drug susceptibility/resistance pattern against commonly used antibiotics. Results: Out of 400 samples, the prevalence of Salmonella in chevon and chicken meat was found 9% and 7% respectively, with an overall prevalence of 8%. Polymerase chain reaction targeting invA gene of Salmonella showed positive result with 31 isolates. All 32 Salmonella isolates were found to be highly sensitive to ciprofloxacin while 96.87%, 96.87% and 93.75% were sensitive to gentamicin, imipenem, and ceftazidime, respectively. 93.75% and 59.37% isolates were resistant to erythromycin and oxytetracycline, respectively. Out of 32, 14 isolates had multiple antibiotic resistance index equal to or more than 0.2. Conclusion: Salmonella in chevon and chicken meat samples is prevailing in the areas of sampling due to poor hygienic conditions and also demonstrated the varied spectrum of antimicrobial resistance, including several multiple drug resistance phenotypes. Therefore, the present study emphasizes the need for continued surveillance of zoonotic foodborne pathogens including antimicrobial-resistant variants throughout the food production chain.

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

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    Xianyan Cui

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

  3. Drug susceptibility and biofilm formation of Burkholderia pseudomallei in nutrient-limited condition.

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    Anutrakunchai, C; Sermswan, R W; Wongratanacheewin, S; Puknun, A; Taweechaisupapong, S

    2015-06-01

    Burkholderia pseudomallei is the causative agent of melioidosis, which can form biofilms and microcolonies in vivo and in vitro. One of the hallmark characteristics of the biofilm-forming bacteria is that they can be up to 1,000 times more resistant to antibiotics than their free-living counterpart. Bacteria also become highly tolerant to antibiotics when nutrients are limited. One of the most important causes of starvation induced tolerance in vivo is biofilm growth. However, the effect of nutritional stress on biofilm formation and drug tolerance of B. pseudomallei has never been reported. Therefore, this study aims to determine the effect of nutrient-limited and enriched conditions on drug susceptibility of B. pseudomallei in both planktonic and biofilm forms in vitro using broth microdilution method and Calgary biofilm device, respectively. The biofilm formation of B. pseudomallei in nutrient-limited and enriched conditions was also evaluated by a modified microtiter-plate test. Six isolates of ceftazidime (CAZ)-susceptible and four isolates of CAZ-resistant B. pseudomallei were used. The results showed that the minimum bactericidal concentrations of CAZ against B. pseudomallei in nutrient-limited condition were higher than those in enriched condition. The drug susceptibilities of B. pseudomallei biofilm in both enriched and nutrient-limited conditions were more tolerant than those of planktonic cells. Moreover, the quantification of biofilm formation by B. pseudomallei in nutrient-limited condition was significantly higher than that in enriched condition. These data indicate that nutrient-limited condition could induce biofilm formation and drug tolerance of B. pseudomallei.

  4. 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.

  5. Ertapenem: a new carbapenem.

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    Odenholt, I

    2001-06-01

    Ertapenem is a new 1-beta-methyl carbapenem, stable to dehydropeptidase, which binds preferable to penicillin-binding proteins (PBP) 2 and 3. Ertapenem has a broad antibacterial spectrum with MIC90 values mode of action as shown by time-killing curves and exhibits a short PAE of 1.4 - 2.6 h against the Gram-positive strains but no PAE against Gram-negative strains. In an infection model in mice, it has been shown that ertapenem and imipenem were highly efficacious at a level of 2 mg/kg in bacterial clearance in comparison to ceftriaxone, cefepime, ceftazidime, cefazolin, cefonicid, cefotaxime and meropenem. In comparison to other available carbapenems, ertapenem has a long half-life of 4.5 h and is developed as a single daily dose carbapenem. The protein binding is dose-dependent and is estimated to 94% at concentrations under 100 mg/l and approximately 85% at 300 mg/l. Cmax after a dose of 1 g in healthy volunteers has been estimated to 190 mg/l. Given the pharmacokinetic/pharmacodynamic data, it may be predicted that ertapenem will have an effect on most Gram-positive and Gram-negative bacteria with the exception of Pseudomonas aeruginosa, Enterococcus spp. and Acinetobacter spp. For pathogens with a MIC of 0.5 mg/l, the estimated T > MIC will be 50% (of 24 h) and for pathogens with a MIC of 1 mg/l 31%. For anaerobic bacteria with MIC values between 1-2 mg/l, the T > MIC may not be sufficient for bacterial eradication. However, clinical trials have to confirm this hypothesis.

  6. A Flow Cytometric and Computational Approaches to Carbapenems Affinity to the Different Types of Carbapenemases

    Science.gov (United States)

    Pina-Vaz, Cidália; Silva, Ana P.; Faria-Ramos, Isabel; Teixeira-Santos, Rita; Moura, Daniel; Vieira, Tatiana F.; Sousa, Sérgio F.; Costa-de-Oliveira, Sofia; Cantón, Rafael; Rodrigues, Acácio G.

    2016-01-01

    The synergy of carbapenem combinations regarding Enterobacteriaceae producing different types of carbapenemases was study through different approaches: flow cytometry and computational analysis. Ten well characterized Enterobacteriaceae (KPC, verona integron-encoded metallo-β-lactamases –VIM and OXA-48-like enzymes) were selected for the study. The cells were incubated with a combination of ertapenem with imipenem, meropenem, or doripenem and killing kinetic curves performed with and without reinforcements of the drugs. A cephalosporin was also used in combination with ertapenem. A flow cytometric assay with DiBAC4-(3), a membrane potential dye, was developed in order to evaluate the cellular lesion after 2 h incubation. A chemical computational study was performed to understand the affinity of the different drugs to the different types of enzymes. Flow cytometric analysis and time-kill assays showed a synergic effect against KPC and OXA-48 producing-bacteria with all combinations; only ertapenem with imipenem was synergic against VIM producing-bacteria. A bactericidal effect was observed in OXA-48-like enzymes. Ceftazidime plus ertapenem was synergic against ESBL-negative KPC producing-bacteria. Ertapenem had the highest affinity for those enzymes according to chemical computational study. The synergic effect between ertapenem and others carbapenems against different carbapenemase-producing bacteria, representing a therapeutic choice, was described for the first time. Easier and faster laboratorial methods for carbapenemase characterization are urgently needed. The design of an ertapenem derivative with similar affinity to carbapenemases but exhibiting more stable bonds was demonstrated as highly desirable. PMID:27555844

  7. A flow cytometric and computational approaches to carbapenems affinity to the different types of carbapenemases

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    Cidália Pina-Vaz

    2016-08-01

    Full Text Available The synergy of carbapenem combinations regarding Enterobacteriaceae producing different types of carbapenemases was study through different approaches: flow cytometry and computa-tional analysis. Ten well characterized Enterobacteriaceae (KPC, verona integron-encoded metallo-β-lactamases –VIM and OXA-48-like enzymes were selected for the study. The cells were incubated with a combination of ertapenem with imipenem, meropenem or doripenem and killing kinetic curves performed with and without reinforments of the drugs. A cephalosporin was also used in combination with ertapenem. A flow cytometric assay with DiBAC4-(3, a membrane potential dye, was developed in order to evaluate the cellular lesion after 2 h incuba-tion. A chemical computational study was performed to understand the affinity of the different drugs to the different types of enzymes. Flow cytometric analysis and time-kill assays showed a synergic effect against KPC and OXA-48 producing-bacteria with all combinations; only ertapenem with imipenem was synergic against VIM producing-bacteria. A bactericidal effect was observed in OXA-48-like enzymes. Ceftazidime plus ertapenem was synergic against ESBL-negative KPC producing-bacteria. Ertapenem had the highest affinity for those enzymes according to chemical computational study. The synergic effect between ertapenem and others carbapenems against different carbapenemase-producing bacteria, representing a therapeutic choice, was described for the first time. Easier and faster laboratorial methods for car-bapenemase characterization are urgently needed. The design of an ertapenem derivative with similar affinity to carbapenemases but exhibiting more stable bonds was demonstrated as highly desirable.

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

    Science.gov (United States)

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

    2013-06-15

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

  9. 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.

  10. 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.

  11. 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.

  12. Diagnostic pitfalls in a young Romanian ranger with an acute psychotic episode.

    Science.gov (United States)

    Nagy, Előd Ernő; Rácz, Attila; Urbán, Edit; Terhes, Gabriella; Berki, Timea; Horváth, Emőke; Georgescu, Anca M; Zaharia-Kézdi, Iringó E

    2016-01-01

    The identification and distinction of the pathological conditions underlying acute psychosis are often challenging. We present the case of a 35-year-old ranger who had no history of acute or chronic infectious disease or any previous neuropsychiatric symptoms. He arrived at the Psychiatry Clinic and was admitted as an emergency case, displaying bizarre behavior, hallucinations, paranoid ideation, and delusional faults. These symptoms had first appeared 7 days earlier. An objective examination revealed abnormalities of behavior, anxiety, visual hallucinations, choreiform, and tic-like facial movements. After the administration of neuroleptic and antidepressant treatment, he showed an initial improvement, but on day 10 entered into a severe catatonic state with signs of meningeal irritation and was transferred to the intensive care unit. An electroencephalogram showed diffuse irritative changes, raising the possibility of encephalitis. Taking into consideration the overt occupational risk, Borrelia antibody tests were prescribed and highly positive immunoglobulin (Ig)M and IgG titers were obtained from serum, along with IgG and antibody index positivity in cerebrospinal fluid. In parallel, anti-N-methyl-D-aspartate receptor antibodies and a whole battery of other autoimmune encephalitis markers showed negative. A complex program of treatment was applied, including antibiotics, beginning with ceftazidime and ciprofloxacin - for suspected aspiration bronchopneumonia - and thereafter with ceftriaxone. A gradual improvement was noticed and the treatment continued at the Infectious Disease Clinic. Finally, the patient was discharged with a doxycycline, antidepressant, and anxiolytic maintenance treatment. On his first and second control (days 44 and 122 from the disease onset), the patient was stable with no major complaints, Borrelia seropositivity was confirmed both for IgM and IgG while the cerebrospinal fluid also showed reactivity for IgG on immunoblot. On the basis

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

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    Lucia Ratna Winata Muslimin

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-07-01

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

  15. A Flow Cytometric and Computational Approaches to Carbapenems Affinity to the Different Types of Carbapenemases.

    Science.gov (United States)

    Pina-Vaz, Cidália; Silva, Ana P; Faria-Ramos, Isabel; Teixeira-Santos, Rita; Moura, Daniel; Vieira, Tatiana F; Sousa, Sérgio F; Costa-de-Oliveira, Sofia; Cantón, Rafael; Rodrigues, Acácio G

    2016-01-01

    The synergy of carbapenem combinations regarding Enterobacteriaceae producing different types of carbapenemases was study through different approaches: flow cytometry and computational analysis. Ten well characterized Enterobacteriaceae (KPC, verona integron-encoded metallo-β-lactamases -VIM and OXA-48-like enzymes) were selected for the study. The cells were incubated with a combination of ertapenem with imipenem, meropenem, or doripenem and killing kinetic curves performed with and without reinforcements of the drugs. A cephalosporin was also used in combination with ertapenem. A flow cytometric assay with DiBAC4-(3), a membrane potential dye, was developed in order to evaluate the cellular lesion after 2 h incubation. A chemical computational study was performed to understand the affinity of the different drugs to the different types of enzymes. Flow cytometric analysis and time-kill assays showed a synergic effect against KPC and OXA-48 producing-bacteria with all combinations; only ertapenem with imipenem was synergic against VIM producing-bacteria. A bactericidal effect was observed in OXA-48-like enzymes. Ceftazidime plus ertapenem was synergic against ESBL-negative KPC producing-bacteria. Ertapenem had the highest affinity for those enzymes according to chemical computational study. The synergic effect between ertapenem and others carbapenems against different carbapenemase-producing bacteria, representing a therapeutic choice, was described for the first time. Easier and faster laboratorial methods for carbapenemase characterization are urgently needed. The design of an ertapenem derivative with similar affinity to carbapenemases but exhibiting more stable bonds was demonstrated as highly desirable. PMID:27555844

  16. Evaluation of Risk Factors for Antibiotic Resistance in Patients with Nosocomial Infections Caused by Pseudomonas aeruginosa

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    Meliha Cagla Sonmezer

    2016-01-01

    Full Text Available 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.

  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. International Nosocomial Infection Control Consortium (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module.

    Science.gov (United States)

    Rosenthal, Víctor Daniel; Maki, Dennis George; Mehta, Yatin; Leblebicioglu, Hakan; Memish, Ziad Ahmed; Al-Mousa, Haifaa Hassan; Balkhy, Hanan; Hu, Bijie; Alvarez-Moreno, Carlos; Medeiros, Eduardo Alexandrino; Apisarnthanarak, Anucha; Raka, Lul; Cuellar, Luis E; Ahmed, Altaf; Navoa-Ng, Josephine Anne; El-Kholy, Amani Ali; Kanj, Souha Sami; Bat-Erdene, Ider; Duszynska, Wieslawa; Van Truong, Nguyen; Pazmino, Leonardo N; See-Lum, Lucy Chai; Fernández-Hidalgo, Rosalia; Di-Silvestre, Gabriela; Zand, Farid; Hlinkova, Sona; Belskiy, Vladislav; Al-Rahma, Hussain; Luque-Torres, Marco Tulio; Bayraktar, Nesil; Mitrev, Zan; Gurskis, Vaidotas; Fisher, Dale; Abu-Khader, Ilham Bulos; Berechid, Kamal; Rodríguez-Sánchez, Arnaldo; Horhat, Florin George; Requejo-Pino, Osiel; Hadjieva, Nassya; Ben-Jaballah, Nejla; García-Mayorca, Elías; Kushner-Dávalos, Luis; Pasic, Srdjan; Pedrozo-Ortiz, Luis E; Apostolopoulou, Eleni; Mejía, Nepomuceno; Gamar-Elanbya, May Osman; Jayatilleke, Kushlani; de Lourdes-Dueñas, Miriam; Aguirre-Avalos, Guadalupe

    2014-09-01

    We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line-associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN.

  19. 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.

  20. The frequency and antimicrobial resistance patterns of nosocomial pathogens recovered from cancer patients and hospital environments

    Institute of Scientific and Technical Information of China (English)

    Aymen; Mudawe; Nurain; Naser; Eldin; Bilal; Mutasim; Elhadi; Ibrahim

    2015-01-01

    Objective:To determine the prevalence and antimicrobial resistance rates of nosocomial pathogens isolated from cancer patients and hospital environments.Methods:A descriptive cross-sectional study was conducted between December 2010 to May 2013 at Radiation and Isotopes Centre of Khartoum,Sudan.A total of 1 503 samples(505 clinical and 998 environmental)were examined.Isolates were identified,and their antimicrobial susceptibility was determined using standard laboratory procedures.Results:Out of 505 clinical samples,nosocomial pathogens were found as 48.1%.Among hospital environment samples,bacterial contaminants were detected in 29.7%of samples.The main microorganisms recovered from cancer patients were Proteus spp.(23.5%),Escherichia coli(22.2%),Pseudomonas aeruginosa(P.aeruginosa)(21.0%)and Staphylococcus aureus(20.2%).The most frequent isolates from hospital environments were Bacillus spp.(50.0%),Staphylococcus aureus(14.2%)and P.aeruginosa(11.5%).The proportions of resistance among Gram-negative pathogens from cancer patients were high for ampicillin,cefotaxime,ceftazidime and ceftriaxone.Moderate resistance rates were recorded to ciprofloxacin,such as 51.0%for P.aeruginosa,21.7%for Klebsiella pneumoniae and 55.5%for Escherichia coli.Except Klebsiella,there were no significant differences(P0.05)of resistance rates between Gram-negative isolates from cancer patients to those from the hospital environments.The proportions of extended-spectrum b-lactamase producing isolates from cancer patients were not differ significantly(P=0.763)from those collected from the hospital environments(49.2%;91/185 vs.47%;32/68).Conclusions:The prevalence of nosocomial infection among cancer patients was high(48.1%)with the increasing of antimicrobial resistance rates.Hospital environments are potential reservoirs for nosocomial infections,which calls for intervention program to reduce environmental transmission of pathogens.

  1. SUSCEPTIBILITY AND DETECTION OF EXTENDED SPECTRUM β-LACTAMASE ENZYMES FROM OTITIS MEDIA PATHOGENS

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    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

  2. Acinetobacter peritoneal dialysis peritonitis: a changing landscape over time.

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    Chia-Ter Chao

    Full Text Available Acinetobacter species are assuming an increasingly important role in modern medicine, with their persistent presence in health-care settings and antibiotic resistance. However, clinical reports addressing this issue in patients with peritoneal dialysis (PD peritonitis are rare.All PD peritonitis episodes caused by Acinetobacter that occurred between 1985 and 2012 at a single centre were retrospectively reviewed. Clinical features, microbiological data, and outcomes were analysed, with stratifications based upon temporal periods (before and after 2000.Acinetobacter species were responsible for 26 PD peritonitis episodes (3.5% of all episodes in 25 patients. A. baumannii was the most common pathogen (54%, followed by A. iwoffii (35%, with the former being predominant after 2000. Significantly more episodes resulted from breaks in exchange sterility after 2000, while those from exit site infections decreased (P = 0.01. The interval between the last and current peritonitis episodes lengthened significantly after 2000 (5 vs. 13.6 months; P = 0.05. All the isolates were susceptible to cefepime, fluoroquinolone, and aminoglycosides, with a low ceftazidime resistance rate (16%. Nearly half of the patients (46% required hospitalisation for their Acinetobacter PD-associated peritonitis, and 27% required an antibiotic switch. The overall outcome was fair, with no mortality and a 12% technique failure rate, without obvious interval differences.The temporal change in the microbiology and origin of Acinetobacter PD-associated peritonitis in our cohort suggested an important evolutional trend. Appropriate measures, including technique re-education and sterility maintenance, should be taken to decrease the Acinetobacter peritonitis incidence in PD patients.

  3. Comparison of disc and MIC reduction methods with polymerase chain reaction for the detection of metallo-β-lactamase in Pseudomonas aeruginosa

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    S Buchunde

    2012-01-01

    Full Text Available Purpose: The present study was undertaken to evaluate the screening antibiotic, confirmatory phenotypic test and agent against PCR as gold standard and to detect the prevalent MBL gene. Materials and Methods: Three hundred and twenty-six Pseudomonas aeruginosa isolates were screened for resistance to Imipenem (IPM, Meropemem (MEM and Ceftazidime (CAZ by disc diffusion. Isolates resistant to any of these were considered screen test-positive for MBL and were subjected to Double disc synergy test (DDST and Disc potentiation test (DPT: Using IPM, MEM and CAZ alone and with EDTA, Minimum inhibitory concentration (MIC reduction [four-fold or more reduction in MIC of IPM and MEM in presence of chelators: EDTA and 1,10-phenanthroline (EPI/EPM: EDTA-phenanthroline- Imipenem/Meropenem Broth Microdilution method] and polymerase chain reaction (PCR for blaIMP and blaVIM . Results: Screen test-positives by MEM and CAZ were 19.3% as against 17.8% by IPM. MEMDDST, DPT and EPM confirmed 100% screen-test positives as against 93.7% by CAZ DDST and DPT-2, 76.2% by CAZ DPT-1, 88.9% by IPM DDST, 85.7% by IPM DPT-1 and 92.1% by EPI. IPMand CAZ DDST together confirmed 100% while IPM and CAZ DPT-2 confirmed 96.8%. All 63 screen-test positives showed the presence of blaVIM . Conclusions: MEM was found to be the best screening and confirmatory agent for MBL detection and blaVIM was found to be the prevalent MBL gene in this part of the country.

  4. The Soil Microbiota Harbors a Diversity of Carbapenem-Hydrolyzing β-Lactamases of Potential Clinical Relevance.

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    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.

  5. Antibiotic Resistance of Isolated Bacteria from Urban and Hospital Wastewaters in Hamadan City

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    M Karimi

    2011-04-01

    Full Text Available "nBackground and Objectives: widely use of antibiotics as therapy and uncontrolled discharge of them to receiving waters increased the percentages of antibiotic resistant bacteria in various environments which may cause problems in therapy. The aim of this study was to investigate the antibiotic resistance of E. coli, K. pneumoniae and P. aeruginosa bacteria isolated from urban and hospital wastewaters. Nine antibiotics namely Chloramphenicol, Ciprofloxacin, Trimethoprim Sulfamethoxazol, Gentamycin, Ceftizoxime, Nalidixic Acid, Ceftazidime, Ceftriaxon and Cefalexin were investigated in this study."nMaterials and Methods: through a cross-sectional descriptive study the isolation of bacteria from hospital and urban wastewater samples was performed by microbiological identification techniques. The resistance to nine antibiotics was tested by application of the standard disc diffusion technique and zone-size interpretation chart of Kirby-Baeur. Non-parametric Mann-Whitney test was used to assessing two environments differences."nResults: The resistance percentage of E. coli to studied antibiotics was significantly less (ranged from 1.81 to 51.02% than the resistance percentage of P. aeroginosa (ranged from 3.57 to 61.76 and K. pneumoniae (ranged from 6.45 to 91.83%. the highest resistance to antibiotics studied was for K. pneumonia in comparison with others. E. coli, K. pneumonia and P. aeroginosa bacteria showed the highest resistance to CAZ, SXT and CN, respectively. The study showed the resistance rate in hospital wastewater is more than urban wastewater."nConclusion: Easy access and uncontrolled usage of antibiotics cause discharge of antibiotics to wastewaters and consequently diminish the drugs' effectiveness. High concentration of antibiotic and diversity in wastewater of hospital in comparison with urban wastewater causes to transfer resistant agents between bacteria and increased the multiple resistances.

  6. Health care associated infections, antibiotic resistance and clinical outcome: A surveillance study from Sanandaj, Iran

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    Soltani, Jafar; Poorabbas, Bahman; Miri, Neda; Mardaneh, Jalal

    2016-01-01

    AIM: To study the antibiotic susceptibility patterns of gram-negative healthcare associated bacterial infections at two tertiary hospitals in the Sanandaj city, Kurdistan Province, Iran. METHODS: From January 2012 to December 2012, all positive cultures from potentially sterile body fluids were gathered. They sent to professor Alborzi clinical microbiology center in Shiraz for further analysis and susceptibility testing. The antibiotic susceptibility was determined using the Kirby-Bauer method (disk diffusion technique). The Results were interpreted according to Clinical and Laboratory Standards Institute guidelines against a series of antimicrobials. World Health Organization definitions for Healthcare associated infections were followed. RESULTS: Seven hundred and thirty-two positive cultures were reported from both hospitals. Seventy-nine isolates/patients fulfilled the study criteria for health-care associated gram-negative infections. The most frequent bacterial cultures were from the pediatric wards (52%). Serratia marcescens (S. marcescens) (38%) Escherichia coli (E. coli) (19%), Klebsiella pneumoniae (K. pneumoniae) (19%), Acinetobacter baumannii (6%), Enterobacter species (6%), Serratia odorifera (4%) and Pseudomonas species (5%) were the most frequently isolated organisms. The susceptibility pattern of common isolates i.e., S. marcescens, E. coli and K. pneumoniae for commonly used antibiotics were as follows: Ampicillin 3.3%, 6.7%, 20%; gentamicin 73.3%, 73.3%, 46.7%; ceftazidim 80%, 73.3%, 33.3%; cefepim 80%, 86.7%, 46.7%; piperacillin/tazobactam 90%, 66.7%, 86.7%; ciprofloxacin 100%, 73.3%, 86.7%; imipenem 100%, 100%, 100%, respectively. CONCLUSION: The most effective antibiotics against gram-negative healthcare associated infections are imipenem followed by ciprofloxacin. The resistance rate is high against ampicillin and cephalothin. The high mortality rate (46.1%) associated with S. marcescens is alarming. PMID:26989670

  7. Update on infections caused by Stenotrophomonas maltophilia with particular attention to resistance mechanisms and therapeutic options.

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    Chang, Ya-Ting; Lin, Chun-Yu; Chen, Yen-Hsu; Hsueh, Po-Ren

    2015-01-01

    Stenotrophomonas maltophilia is a Gram-negative, biofilm-forming bacterium. Although generally regarded as an organism of low virulence, S. maltophilia is an emerging multi-drug resistant opportunistic pathogen in hospital and community settings, especially among immunocompromised hosts. Risk factors associated with S. maltophilia infection include underlying malignancy, cystic fibrosis, corticosteroid or immunosuppressant therapy, the presence of an indwelling central venous catheter and exposure to broad spectrum antibiotics. In this review, we provide a synthesis of information on current global trends in S. maltophilia pathogenicity as well as updated information on the molecular mechanisms contributing to its resistance to an array of antimicrobial agents. The prevalence of S. maltophilia infection in the general population increased from 0.8-1.4% during 1997-2003 to 1.3-1.68% during 2007-2012. The most important molecular mechanisms contributing to its resistance to antibiotics include β-lactamase production, the expression of Qnr genes, and the presence of class 1 integrons and efflux pumps. Trimethoprim/sulfamethoxazole (TMP/SMX) is the antimicrobial drug of choice. Although a few studies have reported increased resistance to TMP/SMX, the majority of studies worldwide show that S. maltophilia continues to be highly susceptible. Drugs with historically good susceptibility results include ceftazidime, ticarcillin-clavulanate, and fluoroquinolones; however, a number of studies show an alarming trend in resistance to those agents. Tetracyclines such as tigecycline, minocycline, and doxycycline are also effective agents and consistently display good activity against S. maltophilia in various geographic regions and across different time periods. Combination therapies, novel agents, and aerosolized forms of antimicrobial drugs are currently being tested for their ability to treat infections caused by this multi-drug resistant organism. PMID:26388847

  8. Characteristics of Klebsiella pneumoniae harboring QnrB32, Aac(6’-Ib-cr, GyrA and CTX-M-22 genes

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    Lianhua Yu

    2012-04-01

    Full Text Available Quinolone resistance in members of the Enterobacteriaceae family is mostly due to mutations in the quinolone resistance-determining regions of topoisomerase genes. CTX-M-22 is a member of the CTX-M family which can reduce extended-spectrum β-lactamase (ESBL production and modulate antibiotic resistance, resulting in low ceftazidime minimum inhibitory concentrations (MICs. There are four different genes in Klebsiella pneumoniae (KP4707 including qnrB32 (novel qnr allele gene, HQ704413, aac(6’-Ib-cr (novel aac(6’-Ib allele gene, HQ680690, gyrA (novel gyrA allele gene, HQ680691 and CTX-M-22 gene. Five point amino acid mutations Arn(N27 → Leu(L, Val(V129 → Ala(A, Iie(I142 → Met(M, Gly(G188 → Arg(R, Val(V212 → Iie(I were observed in the qnr32 gene when compared to qnrB1. Of all qnrB alleles, a novel variant of the qnrB32 gene, with qnrB31, had the highest amino acid homology. Three point amino acid mutations including Trp(W105 → Arg(R, Asp(D182 → Tyr(Y and Val(V201 → Asp(D were observed in aac(6’-Ib-cr gene, when compared to GenBank number AF479774. New variants of qnr32, aac(6’-Ib-cr, gyrA and CTX-M-22 or other genotype determinants continuously appear in different genomic sites and also outside the Enterobacteriaceae family.

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

    Institute of Scientific and Technical Information of China (English)

    刘广义; 曹永献; 张娜娜; 任立晟; 孙美娟; 曲海军; 刘双

    2015-01-01

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

  10. Evaluation of a modified double-disc synergy test for detection of extended spectrum β-lactamases in AMPC β-lactamase-producing proteus mirabilis

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    Khan MKR

    2008-01-01

    Full Text Available The detection of extended-spectrum β-lactamases (ESBLs in gram-negative bacteria that produce AmpC β-lactamases is problematic. In the present study, the performance of modified double-disc synergy test (MDDST that employs a combination of cefepime and piperacillin-tazobactam for the detection of Proteus mirabilis producing extended spectrum and AmpC β-lactamases was evaluated and compared with double-disc synergy test (DDST and NCCLS phenotypic disc confirmatory test (NCCLS-PDCT. A total of 90 clinical isolates of P. mirabilis , which met the CLSI (Clinical and Laboratory Standards Institute screening criteria that these had broth microdilution (BMD MIC of ≥2 mg/mL for at least one extended spectrum cephalosporin [ceftazidime (CAZ, cefotaxime (CTX and cefpodoxime], were selected for the study. MDDST detected ESBLs in 40/90 of the isolates, whereas DDST detected ESBLs in only 25 isolates. NCCLS-PDCT could detect ESBLs in 39 isolates using CAZ and CAZ + clavulanic acid (CLA combination, whereas CTX and CTX + CLA combination could detect only 37 isolates as ESBL positive. As many as 34/40 ESBL positive isolates were confirmed to be AmpC β-lactamase positive by the modified three-dimensional test (MTDT. MDDST and NCCLS-PDCT could detect ESBLs in all the 34 AmpC positive isolates, whereas DDST could detect ESBLs in only 19 isolates. The study demonstrated that MDDST is superior to DDST and as sensitive as NCCLS-PDCT. However, MDDST seems to have enhanced potential for the detection of ESBLs in AmpC β-lactamase-producing P. mirabilis .

  11. Urinary tract infections: etiology and antimicrobial susceptibility of uropathogens

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    Mario Laneve

    2009-03-01

    Full Text Available Background: Urinary tract infections are a serious health problem affecting millions of people each year.They are the second most common type of infection in the body.The objective of study was to determine the etiology and antimicrobial susceptibility patterns of urinary tract infections pathogens isolated in our Patology Clinic laboratory. Materials and Methods: During the period July 2007- July 2008,were analysed 1422 urine samples.The determination of the total microbe load were acquire with an kit of the BIO-DETECTOR while the identification of germs with Apy sistem. Antibiotic susceptibility tests were assaied with the ATB UR strip. Results: About the total of samples analysed, 320 (22% had significant bacteriuria. Escherichia coli was the most common etiologic agent isolated (62%, followed by Klebsiella ssp. (10%, Pseudomonas aeruginosa (5,95% and Proteus mirabilis (5%. Gram-positive bacteria accounted for only 7.32% , with prevalence of Staphylococcus ssp (5,32 and Enterococcus spp (2%. The most effective antibiotics for Gram- were: Imipenem, Amikacin, Ceftazidime and Cefotaxim, while for Gram+ were: Minocyclin,Vancomycin and Oxacillin. Conclusion: Escherichia coli was the microrganism more frequently isolated between Gram negative bacteria with very susceptible to Amoxicillin. Currently, the empirical use of Cotrimoxazole and Amoxicillin is not recommended for Enterobacteriaceae. Urinary tract infections are more common in women than in men. Men are more likely to get a UTI once past the age of 65. Current data on the prevalence of multidrug resistance among urinary tract isolates should be a consideration to change the current empiric treatment of IVU.

  12. Antibiotic resistance and molecular typing among cockle (Anadara granosa) strains of Vibrio parahaemolyticus by polymerase chain reaction (PCR)-based analysis.

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    Sahilah, A M; Laila, R A S; Sallehuddin, H Mohd; Osman, H; Aminah, A; Ahmad Azuhairi, A

    2014-02-01

    Genomic DNA of Vibrio parahaemolyticus were characterized by antibiotic resistance, enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR) and random amplified polymorphic DNA-polymerase chain reaction (RAPD-PCR) analysis. These isolates originated from 3 distantly locations of Selangor, Negeri Sembilan and Melaka (East coastal areas), Malaysia. A total of 44 (n = 44) of tentatively V. parahaemolyticus were also examined for the presence of toxR, tdh and trh gene. Of 44 isolates, 37 were positive towards toxR gene; while, none were positive to tdh and trh gene. Antibiotic resistance analysis showed the V. parahaemolyticus isolates were highly resistant to bacitracin (92%, 34/37) and penicillin (89%, 33/37) followed by resistance towards ampicillin (68%, 25/37), cefuroxime (38%, 14/37), amikacin (6%, 2/37) and ceftazidime (14%, 5/37). None of the V. parahaemolyticus isolates were resistant towards chloramphenicol, ciprofloxacin, ceftriaxone, enrofloxacin, norfloxacin, streptomycin and vancomycin. Antibiogram patterns exhibited, 9 patterns and phenotypically less heterogenous when compared to PCR-based techniques using ERIC- and RAPD-PCR. The results of the ERIC- and RAPD-PCR were analyzed using GelCompare software. ERIC-PCR with primers ERIC1R and ERIC2 discriminated the V. parahaemolyticus isolates into 6 clusters and 21 single isolates at a similarity level of 80%. While, RAPD-PCR with primer Gen8 discriminated the V. parahaemolyticus isolates into 11 clusters and 10 single isolates and Gen9 into 8 clusters and 16 single isolates at the same similarity level examined. Results in the presence study demonstrated combination of phenotypically and genotypically methods show a wide heterogeneity among cockle isolates of V. parahaemolyticus.

  13. 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.

  14. INCIDENCE OF VENTILATOR ASSOCIATED PNEUMONIA(VAP IN THE INTENSIVE CARE UNITS AND THE TREND ANALYSIS OF THE MICROBIAL PATHOGENS TO ARRIVE AT THE EMPIRICAL USAGE OF ANTIBIOTICS

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    Archana

    2013-12-01

    Full Text Available ABSTRACT : PURPOSE: To compare the VAP incidence in various (ICUs and analyze the trend of the microbial pathogens and their antimicrobial susceptibilit y pattern. METHOD: The prospective observational study with a surveillance module consisting of a ventilator bundle checklist and modified CPI score card was created for each patient on ventilator. The pathogens isolated by quantitative culture of the endotr acheal aspirate (ETA from suspected VAP cases were identified and the antimicrobial susceptibility was determined by Vitek 2 compact. RESULT: There was a decline in the overall incidence of VAP from 3.11 in 2011 to1.73 in 2012. A similar trend was seen in t he medical ICUs , from 4.16 to 1.07in MICU , 2.48 to 0 in LICU. A decline in the incidence in surgical ICUs , from 7.38 to 2.64 in CTVS , 7.55 to 2.41 in STICU was observed. Pseudomonas spp , Acinetobacterspp , ESBL producing Klebsieillapneumoniae were the most common pathogens causing late - onset VAP. The resistance to colistin has increased from 0 to 25% , ceftazidime from 36 to 95%in Pseudomonas spp.In case of Acinetobacterspp , susceptibility to colistin remained 100% but tegicycline resistance increased from 12 to 50%. For ESBL producing Klebsiellapneumoniae resistance to amikacin increased from 14 to 67% , imipenem and meropenem had no resistance. CONCLUSION: A high clinical suspi cion of pneumonia with prompt correlation with microbiological culture findings and radiological studies helps to identify VAP cases and reduce the incidence of VAP. Aggressive surveillance of the microbial pathogens with their antimicrobial susceptibility pattern gives an insight of the local Microbiologic milieu of a given unit , thereby helps us to arrive at an empirical usage of antibiotics. Antimicrobial resistant pattern has to be closely watched and corrective measures like rotation of or change of em pirical antibiotics will help in overcoming resistance

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

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

    2016-09-01

    This study aimed to characterise the molecular support of antibiotic resistance in expanded-spectrum cephalosporin (ESC)-resistant Escherichia coli isolates recovered from healthy broilers in Béjaïa, northeast Algeria. A total of 61 intestinal swabs from slaughtered broilers from four regions in Béjaïa locality, Algeria, were collected between February and April 2014, from which 20 ESC-resistant E. coli strains were isolated. Escherichia coli isolates were identified by classical biochemical and MALDI-TOF methods. Antibiotic susceptibility testing was performed using disk diffusion and Etest methods. Screening for β-lactamases, aminoglycoside-modifying enzyme (AME)-encoding genes and qnr determinants was performed by PCR and sequencing. Clonal relatedness was determined using molecular typing by multilocus sequence typing (MLST). Antibiotic susceptibility testing revealed that the isolates showed high rates of resistance (>90%) to amoxicillin, amoxicillin/clavulanic acid, piperacillin/tazobactam, aztreonam, ceftazidime, streptomycin, tobramycin, nalidixic acid and ciprofloxacin. Low rates of resistance were observed for kanamycin (35%), amikacin (30%), cefoxitin (20%) and cefotaxime (15%). Molecular characterisation revealed that all of the isolates expressed the blaTEM-1 gene. Fourteen of them harboured the blaSHV-12 gene, two harboured the blaCTX-M-1 gene and four isolates harboured blaCMY-2. Screening for AME-encoding genes demonstrated that all isolates contained the aadA gene. In addition, qnrA was detected as the quinolone resistance determinant in 13 isolates. MLST revealed four known sequence types (STs), including ST744, ST38, ST1011 and ST2179, as well as one new sequence type (ST5086). Here we report the first study describing the clonal diversity of extended-spectrum β-lactamase (ESBL)- and plasmid AmpC-producing E. coli isolated from healthy broilers in Algeria. PMID:27530851

  16. Melioidosis presenting with mediastinal lymphadenopathy masquerading as malignancy: a case report

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    Saravu Kavitha

    2012-01-01

    Full Text Available Abstract Introduction Melioidosis, endemic in Thailand and in the Northern Territory of Australia is an emerging infectious disease in India which can present with varied forms. A case of melioidosis, presenting as a rare anterior mediastinal mass which can masquerade as malignancy or tuberculosis, is described here. With treatment, our patient initially showed an increase in the size of mediastinal node and development of new submandibular node.. To the best of our knowledge, this phenomenon has not been documented in the literature and the same is highlighted in this case report. Case Presentation A 43-year-old Asian man with diabetes presented with fever, loss of appetite, weight loss for one month and painful swelling below his left mandible for five days. An examination revealed an enlarged left submandibular lymph node and bilateral axillary lymph nodes. A chest X-ray showed mediastinal widening. Computed tomography of his thorax showed a lobulated heterogeneously enhancing anterior mediastinal mass encasing the superior vena cava suggestive of malignancy. An excision biopsy of the lymph node showed granulomas suggestive of tuberculosis but bone marrow culture and lymph node aspirate culture grew Burkholderia pseudomallei. He was treated with parenteral ceftazidime and amoxicillin-clavulanic acid. During the course of treatment, he developed an enlargement of the submandibular lymph node on the opposite side. It gradually subsided with the continuation of therapy orally with a combination of cotrimoxazole and doxycycline for six months. A repeat computed tomography chest scan showed resolution of the mediastinal mass. Conclusion Melioidosis can present as a mediastinal mass that mimics tuberculosis or malignancy. During the initial phase of treatment of melioidosis, the appearance of new lymph nodes or an increase in the size of the existing lymph nodes does not mean treatment failure. Inexperienced clinicians may consider this as

  17. Shedding of Clostridium difficile, fecal beta-lactamase activity, and gastrointestinal symptoms in 51 volunteers treated with oral cefixime.

    Science.gov (United States)

    Chachaty, E; Bourneix, C; Renard, S; Bonnay, M; Andremont, A

    1993-07-01

    Microbial changes including the shedding of Clostridium difficile, fecal beta-lactamase activity, and gastrointestinal symptoms were assessed in 51 healthy volunteers given 200 mg of cefixime twice daily for 8 days. The number of organisms of the family Enterobacteriaceae (means +/- standard deviations) dropped from 6.9 +/- 1.1 to 3.9 +/- 1.8 log CFU/g of feces (P < 0.01), whereas counts of enterococci rose from 7.0 +/- 1.5 to 9.0 +/- 1.0 log CFU/g of feces (P < 0.01). Both counts returned to their initial levels 50 days after the cessation of treatment. Cefixime did not significantly modify the frequency of fecal excretion of Pseudomonas aeruginosa, Staphylococcus spp., yeasts, or members of the Enterobacteriaceae resistant to ceftazidime or ampicillin. The proportion of subjects shedding C. difficile rose from 6% before treatment to 57% (P < 0.01) at the end of treatment but returned to 8% 50 days thereafter. No case of pseudomembranous colitis was observed. Stool changes occurred in 13 volunteers during treatment (25%) and in 2 others more than 10 days after the end of treatment (4%). These changes were not significantly associated with the shedding of toxigenic strains of C. difficile or with the presence of toxin A in feces. By contrast, during treatment, stool changes occurred in 8 of the 18 volunteers (44%) who had antibiotic activity in their feces but in only 5 of the 33 (15%) for whom no such activity was found (P < 0.05). The absence of antibiotic activity in the feces was itself linked with the presence of beta-lactamase activity in the feces. Since we had found earlier that fecal beta-lactamase activity afforded protection against alteration in stool consistency during treatments with oral cephalosporins, the present study confirmed our previous preliminary results in this respect. PMID:8363371

  18. The frequency and antimicrobial resistance patterns of nosocomial pathogens recovered from cancer patients and hospital environments

    Institute of Scientific and Technical Information of China (English)

    Aymen Mudawe Nurain; Naser Eldin Bilal; Mutasim Elhadi Ibrahim

    2015-01-01

    Objective: To determine the prevalence and antimicrobial resistance rates of nosocomial pathogens isolated from cancer patients and hospital environments. Methods: A descriptive cross-sectional study was conducted between December 2010 to May 2013 at Radiation and Isotopes Centre of Khartoum, Sudan. A total of 1 503 samples (505 clinical and 998 environmental) were examined. Isolates were identified, and their antimicrobial susceptibility was determined using standard laboratory procedures. Results: Out of 505 clinical samples, nosocomial pathogens were found as 48.1%. Among hospital environment samples, bacterial contaminants were detected in 29.7%of samples. The main microorganisms recovered from cancer patients were Proteus spp. (23.5%), Escherichia coli (22.2%), Pseudomonas aeruginosa (P. aeruginosa) (21.0%) and Staphylococcus aureus (20.2%). The most frequent isolates from hospital environ-ments were Bacillus spp. (50.0%), Staphylococcus aureus (14.2%) and P. aeruginosa (11.5%). The proportions of resistance among Gram-negative pathogens from cancer patients were high for ampicillin, cefotaxime, ceftazidime and ceftriaxone. Moderate resistance rates were recorded to ciprofloxacin, such as 51.0%for P. aeruginosa, 21.7%for Klebsiella pneumoniae and 55.5%for Escherichia coli. Except Klebsiella, there were no significant differences (P ? 0.05) of resistance rates between Gram-negative isolates from cancer patients to those from the hospital environments. The proportions of extended-spectrum b-lactamase producing isolates from cancer patients were not differ significantly (P=0.763) from those collected from the hospital environments (49.2%;91/185 vs. 47%;32/68). Conclusions: The prevalence of nosocomial infection among cancer patients was high (48.1%) with the increasing of antimicrobial resistance rates. Hospital environments are potential reservoirs for nosocomial infections, which calls for intervention program to reduce environmental transmission of pathogens.

  19. Spectrum and antimicrobial resistance of common pathogenic bacteria isolated from patients with acute exacerbation of chronic obstructive pulmonary disease in mainland of China

    Institute of Scientific and Technical Information of China (English)

    YE Feng; HE Li-xian; CAI Bo-qiang; WEN Fu-qiang; CHEN Bai-yi; Mangunnegoro Hadiarto; CHEN Rong-chang

    2013-01-01

    Background Bacteria-induced respiratory infection has been long considered to be the major cause of acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Therefore,a clear picture about the distribution and drug-resistance of pathogenic bacteria in the lower airways should be helpful for treatment of the disease.So far,data on this topic among Chinese are lacking.Methods A surveillance study was performed in consecutive patients with AECOPD at five areas in China between October 2006 and April 2008.The sputum from these patients was cultured and isolated for bacteria.Agar dilution method was used to determine the minimal inhibitory concentrations (MICs) of levofloxacin and other 15 antibiotics against these strains.Results Three hundred and fifty-nine pathogenic bacterial strains were isolated among 884 patients with AECOPD.The predominant bacteria were Pseudomonas aeruginosa (21.7%),Klebsiella pneumoniae (12.3%),Haemophilus influenzae (14.2%) and Streptococcus pneumoniae (11.7%),followed by Haemophilus parainfluenzae (9.5%),Acinetobacter baumannii (7.8%),Moraxella catarrhalis (6.4%) and Escherichia coli (3.6%).The majority of bacterial pathogens isolated in this study were susceptible to fluoroquinolones,ceftazidime,cefepime and imipenem.Conclusions Gram-negative bacilli are the leading pathogens in patients with AECOPD in China.Haemophilus parainfluenzae may be one of the most important pathogens in AECOPD.This study provides evidence for local surveillance of AECOPD pathogens and appropriate choice of antimicrobials in China.

  20. Metallo-beta-lactamases in clinical Pseudomonas isolates in Taiwan and identification of VIM-3, a novel variant of the VIM-2 enzyme.

    Science.gov (United States)

    Yan, J J; Hsueh, P R; Ko, W C; Luh, K T; Tsai, S H; Wu, H M; Wu, J J

    2001-08-01

    A total of 209 clinical isolates of Pseudomonas (193 Pseudomonas aeruginosa, 10 P. putida, 4 P. stutzeri, and 2 P. fluorescens isolates) with reduced susceptibilities to imipenem and/or ceftazidime were subjected to PCR assays with primers specific for bla(IMP-1), bla(IMP-2), bla(VIM-1), and bla(VIM-2) and sequence analysis to identify the metallo-beta-lactamases (MBLs) prevalent among these organisms in Taiwan; and 21 isolates gave positive results. Five isolates including two P. putida and three P. stutzeri isolates were found to carry bla(IMP-1), and six isolates including five P. putida and one P. stutzeri isolates harbored bla(VIM-2). The remaining 10 isolates were P. aeruginosa, and all were found to carry a novel variant of bla(VIM-2), designated bla(VIM-3). There are only two nucleotide differences between bla(VIM-2) and bla(VIM-3), leading to two amino acid alterations. Our findings indicate that VIM-2 and its variant have become the most prevalent metalloenzymes in Pseudomonas in Taiwan. Southern hybridization with the bla(VIM-2)-, bla(VIM-3)-, and bla(IMP-1 )-specific probes revealed that only two VIM-2-producing P. putida isolates appeared to carry the MBL gene on plasmids. Pulsed-field gel electrophoresis showed that six VIM-3-producing P. aeruginosa isolates and two IMP-1-producing P. stutzeri isolates were genetically related, suggesting that the spread of these MBL genes in Taiwan could be due to clonal dissemination as well as genetic exchange between different clones. PMID:11451678

  1. PCR typing of genetic determinants for metallo-beta-lactamases and integrases carried by gram-negative bacteria isolated in Japan, with focus on the class 3 integron.

    Science.gov (United States)

    Shibata, Naohiro; Doi, Yohei; Yamane, Kunikazu; Yagi, Tetsuya; Kurokawa, Hiroshi; Shibayama, Keigo; Kato, Haru; Kai, Kumiko; Arakawa, Yoshichika

    2003-12-01

    From January 2001 to December 2002, 587 strains of gram-negative bacterial isolates demonstrating resistance to ceftazidime and a combination of sulbactam and cefoperazone were subjected to a disk diffusion screening test using sodium mercaptoacetic acid; 431 strains (73.4%) appeared to produce metallo-beta-lactamase (MBL). Of these 431 strains, 357 were found by PCR to carry genes for IMP-1 type MBL (bla(IMP-1)), while only 7 and 67 strains carried the IMP-2 gene (bla(IMP-2)) and the VIM-2 gene (bla(VIM-2)), respectively. Neither VIM-1 nor SPM-1 type MBL genes were found among the strains tested. Of 431 strains, 427 carried the intI1 gene, and 4 strains carrying both the intI1 and intI3 genes were reidentified as Pseudomonas putida harboring bla(IMP-1). Of these four P. putida strains, three strains and one strain, respectively, were separately isolated from two hospitals located in the same prefecture, and the three strains showed very similar pulsed-field gel electrophoresis patterns. Of 357 bla(IMP-1) carriers, 116, 53, 51, 47, and 30 strains were identified as Pseudomonas aeruginosa, Alcaligenes xylosoxidans, P. putida/fluorescens, Serratia marcescens, and Acinetobacter baumannii, respectively. Four strains carrying bla(IMP-2) were reidentified as P. putida. Sixty-three P. aeruginosa strains and four P. putida strains carried bla(VIM-2). Of 427 intI1-positive strains, 180, 53, 51, 47, and 35 were identified as P. aeruginosa, A. xylosoxidans, P. putida/fluorescens, S. marcescens, and A. baumannii, respectively. In the present study, it was confirmed that strains carrying bla(IMP-1) with a class 1 integron are the most prevalent type in Japan, although several intI3 carriers have also been identified sporadically in this country. PMID:14662918

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

    Science.gov (United States)

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

    2008-10-01

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

  3. Spectrum and antimicrobial susceptibility pattern of pathogens causing urinary tract infection experience in a tertiary care setting

    International Nuclear Information System (INIS)

    Objective: To determine the spectrum and antimicrobial susceptibility pattern of pathogens causing urinary tract infection from the samples received at AFIP Rawalpindi. Place and duration of study. The study was carried out at Department of Microbiology, Armed Forces Institute of Pathology from January 2010 to June 2010. Material and Method: This was descriptive cross-sectional study. A total of 500 bacterial isolates out of 2050 urine culture samples, for a period of six month were included in the study. Indentification was carried out by standard biochemical profile of the organisms. The antimicrobial susceptibilities of isolated organisms were performed by disk diffusion method as recommended by Clinical Laboratory Standard Institute. Results Out of the culture positive cases, gram-negative bacteria constituted the largest group with a total of 434 (87%) isolates, while gram-positive bacteria constituted only 44 (8.8%) isolates. E. coli was the most common isolate accounting for 63% of the total positive bacterial cultures followed by Klebsiella spp (9%) and P. aernginosa (7%). Susceptibility pattern of E. coli revealed that 96% of isolates were sensitive to imipenem, 91% to piperacillin-tazobactam and 87% to Nitrofurantoin. For Klebsiella spp, 86% of Isolates were susceptible to Imipenem and 71 % to piperacillin-tazobactam. As regards acinetobacter spp, 94% of Isolates were susceptible to piperacillin-tazobactam and 70 % to Imipenem an piperacilline-sulbactam. Antibiogram of P. aeruginosa revealed that 94% of isolates were sensitive to ceftazidime and 86% to imipenem. Nitrofurantoin was the most effective urinary antibiotic in case of enterococcus spp as 85% of isolates were susceptible to this compound. Conclusion: From the present study we conclude that E. coli was the predominant urinary pathogen in our set up. The antimicrobial susceptibility patterns of E. coli revealed that majority of isolates were susceptible to imipenem and piperacilline

  4. Evaluation of Risk Factors for Antibiotic Resistance in Patients with Nosocomial Infections Caused by Pseudomonas aeruginosa

    Science.gov (United States)

    Ertem, Gunay; Erdinc, Fatma Sebnem; Kaya Kilic, Esra; 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. PMID:27656220

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

    Directory of Open Access Journals (Sweden)

    Hamid Reza Goli

    2016-03-01

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

  6. Growing Burkholderia pseudomallei in biofilm stimulating conditions significantly induces antimicrobial resistance.

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    Chakrit Sawasdidoln

    Full Text Available BACKGROUND: Burkholderia pseudomallei, a gram-negative bacterium that causes melioidosis, was reported to produce biofilm. As the disease causes high relapse rate when compared to other bacterial infections, it therefore might be due to the reactivation of the biofilm forming bacteria which also provided resistance to antimicrobial agents. However, the mechanism on how biofilm can provide tolerance to antimicrobials is still unclear. METHODOLOGY/PRINCIPAL FINDINGS: The change in resistance of B. pseudomallei to doxycycline, ceftazidime, imipenem, and trimethoprim/sulfamethoxazole during biofilm formation were measured as minimum biofilm elimination concentration (MBEC in 50 soil and clinical isolates and also in capsule, flagellin, LPS and biofilm mutants. Almost all planktonic isolates were susceptible to all agents studied. In contrast, when they were grown in the condition that induced biofilm formation, they were markedly resistant to all antimicrobial agents even though the amount of biofilm production was not the same. The capsule and O-side chains of LPS mutants had no effect on biofilm formation whereas the flagellin-defective mutant markedly reduced in biofilm production. No alteration of LPS profiles was observed when susceptible form was changed to resistance. The higher amount of N-acyl homoserine lactones (AHLs was detected in the high biofilm-producing isolates. Interestingly, the biofilm mutant which produced a very low amount of biofilm and was sensitive to antimicrobial agents significantly resisted those agents when grown in biofilm inducing condition. CONCLUSIONS/SIGNIFICANCE: The possible drug resistance mechanism of biofilm mutants and other isolates is not by having biofilm but rather from some factors that up-regulated when biofilm formation genes were stimulated. The understanding of genes related to this situation may lead us to prevent B. pseudomallei biofilms leading to the relapse of melioidosis.

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

    Science.gov (United States)

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

    2004-01-01

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

  8. 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.

  9. Elevated liver enzymes levels related to cinepazide maleate%马来酸桂哌齐特相关肝酶水平升高

    Institute of Scientific and Technical Information of China (English)

    杨飞; 齐晓涟

    2013-01-01

    1例73岁男性因急性脑梗死合并癫痫、高血压、支气管炎、冠状动脉粥样硬化性心脏病、心房颤动入院,先后给予甘露醇、甘油果糖,缬沙坦、富马酸比索洛尔、马来酸桂哌齐特、奥扎格雷钠、哌拉西林钠他唑巴坦钠、头孢他啶、依替米星、阿托伐他汀钙.用药前丙氨酸转氨酶(ALT)18 U/L,天冬氨酸转氨酶(AST)25 U/L.第13天,ALT 243 U/L,AST 111 U/L.停用马来酸桂哌齐特并给予葡醛内酯、谷胱甘肽.停用马来酸桂哌齐特第7天,ALT36 U/L,AST 27 U/L.%A 73-year-old man was hospitalized for acute cerebral infarction accompanied by epilepsy,hypertension,bronchitis,coronary atherosclerotic heart disease,and atrial fibrillation.He received mannitol,glycerol and fructose,valsartan,bisoprolol fumarate,cinepazide maleate,ozagrel sodium,piperacillin sodium and tazobactam sodium,ceftazidime,etimicin,and atorvastatin calcium.Laboratory tests before treatment showed the following levels:alanine aminotransferase (ALT) 18 U/L,aspartate aminotransferase (AST) 25 U/L.On day 13,his ALT and AST levels increased to 243 U/L and 111 U/L.Cinepazide maleate was stopped.Glucurolactone and glutathione were given.On day 7 of cinepazide maleate withdrawal,his ALT and AST levels decreased to 36 U/L and 27 U/L.respectively.

  10. Frequency of Pseudomonas aeruginosa serotypes in burn wound infections and their resistance to antibiotics.

    Science.gov (United States)

    Estahbanati, Hamid Karimi; Kashani, Parnian Pour; Ghanaatpisheh, Fahimeh

    2002-06-01

    Pseudomonas aeruginosa plays a prominent role as an etiological agent involved in serious infections in burned patients. In this study P. aeruginosa infections were analyzed at the Motahari Burn Center in Tehran (from 22 December 1998 to April 1999) to estimate their frequency, antibiotic susceptibility and serotypes. One hundred and eighty-four positive cultures and 205 bacterial strains were isolated among swabs or biopsy specimens during the study period. Pseudomonas was found to be the most common (57%) followed by Acinetobacter (17%), Escherichia coli (12%), Staphylococcus aureus (8%) and other organisms (6%). The frequency of P. aeruginosa resistance to gentamicin, ceftizoxime, carbenicillin, cephalothin and ceftazidime was over 90%. The antibiotics to which P. aeruginosa was most sensitive were amikacin and tetracyclin. The "O" serotypes isolated from the 117 Pseudomona aeroginosa isolates were serotypes O:2, O:5, O:6, O:8, O:11, O:12 and O:16. The most common serotype was O:6 (20/17%) followed by O:11 (18/15%) and O:5 (14/12%). The serotype most resistant was O:16 (8%) and the most sensitive was O:8 (2%). Since treatment of infection with available antibiotics according to the results attained proved to be difficult, prevention of infection in the burned patients is considered as an appropriate means of conquering overcoming infection problems. The sum of frequencies of serotypes O:6, O:11, O:5 and O:16 was more than 60%, therefore vaccination of burn patients with polyvalent antiserum to these serotypes could possibly produce immunity in more than half of the burned patients. PMID:12052372

  11. 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.

  12. Fecal Colonization with Extended-Spectrum Beta-Lactamase and AmpC-Producing Escherichia coli

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    Mohamed H. Al-Agamy

    2016-01-01

    Full Text Available Background. Extended-spectrum β-lactamases (ESβLs and AmpC β-lactamases cause β-lactam resistance in Escherichia coli. Fecal colonization by ESβL- and/or AmpC-positive E. coli is a source of nosocomial infections. Methods. In order to investigate inpatient fecal colonization by ESβLs and AmpC, antibiotic sensitivity tests were conducted and minimum inhibitory concentrations (MICs were determined using the disk diffusion method and E-test, respectively. Characterization of ESβL and AmpC was performed using E-test strips, and a set of PCRs and DNA sequence analyses were used to characterize the ESβL and AmpC genes. Results. The whole collection of E. coli isolates (n=50 was sensitive to imipenem, tigecycline, colistin, and fosfomycin, while 26% of the isolates showed reduced susceptibility to ceftazidime (MIC ≥ 4 μg/mL. ESβL was phenotypically identified in 26% (13/50 of cases, while AmpC activity was detected in two ESβL-producing E. coli isolates. All ESβL-producing E. coli were positive for the CTX-M gene, eleven isolates carried blaCTX-M-15, and two isolates carried blaCTX-M-14 gene. Two CTX-M-positive E. coli isolates carried blaCMY-2. Conclusions. The alimentary tract is a significant reservoir for ESβL- and/or AmpC-producing E. coli, which may lead to nosocomial infection.

  13. Fecal Colonization with Extended-Spectrum Beta-Lactamase and AmpC-Producing Escherichia coli.

    Science.gov (United States)

    Al-Agamy, Mohamed H; El Mahdy, Taghrid S; Shibl, Atef M

    2016-01-01

    Background. Extended-spectrum β-lactamases (ESβLs) and AmpC β-lactamases cause β-lactam resistance in Escherichia coli. Fecal colonization by ESβL- and/or AmpC-positive E. coli is a source of nosocomial infections. Methods. In order to investigate inpatient fecal colonization by ESβLs and AmpC, antibiotic sensitivity tests were conducted and minimum inhibitory concentrations (MICs) were determined using the disk diffusion method and E-test, respectively. Characterization of ESβL and AmpC was performed using E-test strips, and a set of PCRs and DNA sequence analyses were used to characterize the ESβL and AmpC genes. Results. The whole collection of E. coli isolates (n = 50) was sensitive to imipenem, tigecycline, colistin, and fosfomycin, while 26% of the isolates showed reduced susceptibility to ceftazidime (MIC ≥ 4 μg/mL). ESβL was phenotypically identified in 26% (13/50) of cases, while AmpC activity was detected in two ESβL-producing E. coli isolates. All ESβL-producing E. coli were positive for the CTX-M gene, eleven isolates carried bla CTX-M-15, and two isolates carried bla CTX-M-14 gene. Two CTX-M-positive E. coli isolates carried bla CMY-2. Conclusions. The alimentary tract is a significant reservoir for ESβL- and/or AmpC-producing E. coli, which may lead to nosocomial infection. PMID:27340657

  14. Prevalence and Antimicrobial Resistance in Escherichia coli from Food Animals in Lagos, Nigeria.

    Science.gov (United States)

    Adenipekun, Eyitayo O; Jackson, Charlene R; Oluwadun, Afolabi; Iwalokun, Bamidele A; Frye, Jonathan G; Barrett, John B; Hiott, Lari M; Woodley, Tiffanie A

    2015-06-01

    Foodborne bacteria are often associated with human infections; these infections can become more complicated to treat if the bacteria are also resistant to antimicrobials. In this study, prevalence, antimicrobial resistance, and genetic relatedness of Escherichia coli among food producing animals from Lagos, Nigeria, was investigated. From December 2012 to June 2013, E. coli were isolated from fecal samples of healthy cattle, chicken, and swine. Antimicrobial susceptibility testing against 22 antimicrobials was performed using broth microdilution with the Sensititre™ system. Clonal types were determined by pulsed-field gel electrophoresis (PFGE). From the analysis, 211/238 (88.7%), 170/210 (81%), and 136/152 (89.5%) samples from cattle, chicken, and swine, respectively, were positive for E. coli. A subset of those isolates (n=211) selected based on β-lactamase production was chosen for further study. Overall, E. coli exhibited the highest resistance to tetracycline (124/211; 58.8%), trimethoprim/sulfamethoxazole (84/211; 39.8%), and ampicillin (72/211; 34.1%). Approximately 40% of the isolates were pan-susceptible, and none of the isolates were resistant to amikacin, cefepime, ceftazidime, ertapenem, meropenem, or tigecycline. Among the resistant isolates, 28 different resistance patterns were observed; 26 of those were characterized as multi-drug resistant (MDR; resistance to ≥2 antimicrobials). One isolate was resistant to 13 different antimicrobials representing five different antimicrobial classes. Using PFGE, MDR E. coli were genetically diverse and overall did not group based on source; identical PFGE patterns were detected among isolates from different sources. These results suggest that isolates cannot be attributed to specific sources, and some may be present across all of the sources. Results from this study indicate that food-producing animals in Nigeria are a reservoir of MDR E. coli that may be transferred to humans via the food chain. PMID

  15. Trends in Susceptibility Rates and Extended-Spectrum β-Lactamase Production of Klebsiella pneumoniae in Bloodstream Infections Across the United States Veterans Affairs Healthcare System.

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    Gentry, Chris A; Williams, Riley J

    2015-12-01

    Klebsiella pneumoniae is an important pathogen, increasingly notorious for its ability to become resistant to antimicrobial agents. This study sought to characterize trends in antimicrobial susceptibility rates for K. pneumoniae causing bacteremias across the United States (U.S.) Veterans Healthcare Administration (VHA) from 2007 through 2013 utilizing a national clinical database. K. pneumoniae grew in 9,235 blood cultures from 8,414 patients. Nationally, ampicillin-sulbactam, ceftazidime, cefepime, ertapenem, fluoroquinolones, and amikacin demonstrated statistically significant susceptibility rate increases against K. pneumoniae in the 2010-2013 period versus the 2007-2009 period. No antimicrobial agent had a statistically significant nationwide susceptibility rate decrease. Of the 126 antibiotic-organism pairs tested among 9 U.S. regions, 18 demonstrated statistically significant susceptibility rate increases while 6 demonstrated statistically significant susceptibility rate decreases. The East North Central (eight agents), Mid-Atlantic (five agents), and South Atlantic (four agents) regions demonstrated statistically significant susceptibility rate increases for multiple antimicrobial agents. Of the 70 antibiotic-organism pairs tested among 5 different medical center complexity levels, 11 antibiotics demonstrated statistically significant susceptibility rate increases and 1 demonstrated a statistically significant rate decrease. Extended-spectrum β-lactamase production did not significantly change over the study period across an available nationwide representation of 31 facilities (10.6% in 2007-2009 vs. 9.21% in 2010-2013, p=0.17). The South Atlantic and Mid-Atlantic regions had the highest prevalence of extended-spectrum ß-lactamase production in the two periods, respectively. The recent trend of generally increasing susceptibility rates for K. pneumoniae bloodstream isolates in this nationwide U.S. VHA study contrasts from other U.S. health system reports

  16. Prevalence of antimicrobial resistance of non-typhoidal Salmonella serovars in retail aquaculture products.

    Science.gov (United States)

    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.

  17. Resistance of Escherichia coli, the most frequent cause of urinary tract infection in children, to antibiotics

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    Stojanović Vesna

    2010-01-01

    Full Text Available Introduction. Urinary tract infections (UTI take the second place in the incidence of bacterial infection in children. Escherichia coli is a cause of infection in 85-90%. A periodic evaluation of the resistance to antimicrobial drugs has to be performed in each geographic region, since investigations confirmed that the resistance of bacteria causing UTI has been in progress. Material and methods. A retrospective investigation has been performed, comprising the two time periods in the range of 10 years in order to identify the prevalence and resistance of the bacteria causing UTI in the patients treated at the Department of Nephrology of Institute for Child and Youth Health Care of Vojvodina. Results. During the first investigated period from January 1996 up to December 1997, there were 163 urin analyses performed vs 134 urine analyses in the second period, starting from January 2006 to December 2007. In both periods, Escherichia coli, was the most frequent cause of UTI (82.1% in 1996/97 vs 86.50% in 2006/07. During this ten-year period, the resistance of Escherichia coli increased both to ampicillin (from 53% to 69% (p>0.05 and to trimethoprim/sulfamethoxazole (34% vs 55%; p<0.05 as well as to cephalexin (4% vs 36%; p<0.05 which has been lately used in our region as a drug of choice in empiric therapy of the suspect UTI. Discussion. There have been records on a slow increase of the Escherichia coli resistance to ceftazidim, gentamycin and nalidixic acid, but significant increase to ampicillin, trimethoprim/sulfamethoxazole and cephalexin. Conclusion. For the initial therapy of UTI in the Province of Vojvodina we recommend: per orally - cephalosporins I, II and III generation, and in case when the child is not capable to get therapy perorally, or in the case of highly febrile infant - cephalosporins III generation parenterally.

  18. Epidemiological study on distribution and antibiotic susceptibility patterns of Enterobacteriaceae and non-fermenting bacteria, isolated in Liguria and in a neighbouring area

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    Elisabetta Maioli

    2008-06-01

    Full Text Available Introduction. An epidemiological study addressed to identify gram-negative bacteria, isolated from laboratories in a Northern area of Italy, and their antibiotic resistance patterns was conducted. Methods. Twelve laboratories distributed on Ligurian territory or neighbouring areacollected all consecutive gram-negative isolates belonging to the Enterobacteriaceae family and non-fermenter group for 2 months and sent them to a reference laboratory. Results. A total of 1880 pathogens were collected, including 899 and 981 strains isolated from nosocomial- and community-acquired infections, respectively. Escherichia coli (63.3% of total was the most frequently isolated pathogen followed by Pseudomonas aeruginosa (9.6%, Proteus mirabilis (8.9% and Klebsiella pneumoniae (5.4%. Nosocomial samples were collected mainly from patients in general medicine wards (19.9% and healthcare settings (14.1%. Urine was the most common clinical sample (79.9% of the total. Other samples were sputum and bronchoaspirates (8%, skin wounds including those from decubitus (5.3% and blood (4.1%. E. coli and P. mirabilis were collected mainly from urinary tract infection while P. aeruginosa appears more involved in respiratory or other infections. Considering the resistance to representative classes of antibiotics, it was higher (% for piperacillin-tazobactam in P. mirabilis (30.3, for ceftazidime in Enterobacter aerogenes (40.8 and in Providencia stuartii (40, for imipenem and amikacin in P. aeruginosa (16.2 and 13.7 respectively, for ciprofloxacin in P. stuartii (66.6 and in P. mirabilis (44.7 than in others bacteria. Conclusions. The increasing age of the population in general medical wards and healthcare settings is associated with urinary tract and bedsore infections. E. coli confirms its epidemiologic and pathogenic role, but P. mirabilis and P. aeruginosa are emerging as alternativechallenges.

  19. 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.

  20. Isojacareubin from the Chinese Herb Hypericum japonicum: Potent Antibacterial and Synergistic Effects on Clinical Methicillin-Resistant Staphylococcus aureus (MRSA

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    Gen-Chun Wang

    2012-07-01

    Full Text Available Through bioassay-guided fractionation of the extracts from the aerial parts of the Chinese herb Hypericum japonicum Thunb. Murray, Isojacareubin (ISJ was characterized as a potent antibacterial compound against the clinical methicillin-resistant Staphylococcus aureus (MRSA. The broth microdilution assay was used to determine the minimal inhibitory concentrations (MICs and minimal bactericidal concentrations (MBCs of ISJ alone. The results showed that its MICs/MBCs ranged from 4/16 to 16/64 μg/mL, with the concentrations required to inhibit or kill 50% of the strains (MIC50/MBC50 at 8/16 μg/mL. Synergistic evaluations of this compound with four conventional antibacterial agents representing different types were performed by the chequerboard and time-kill tests. The chequerboard method showed significant synergy effects when ISJ was combined with Ceftazidime (CAZ, Levofloxacin (LEV and Ampicillin (AMP, with the values of 50% of the fractional inhibitory concentration indices (FICI50 at 0.25, 0.37 and 0.37, respectively. Combined bactericidal activities were also observed in the time-kill dynamic assay. The results showed the ability of ISJ to reduce MRSA viable counts by log10CFU/mL at 24 h of incubation at a concentration of 1 × MIC were 1.5 (LEV, additivity, 0.92 (CAZ, indifference and 0.82 (AMP, indifference, respectively. These in vitro anti-MRSA activities of ISJ alone and its synergy with conventional antibacterial agents demonstrated that ISJ enhanced their efficacy, which is of potential use for single and combinatory therapy of patients infected with MRSA.

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

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    Mirsalehian

    2008-08-01

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

  2. Nanomolar Inhibitors of AmpC [beta]-Lactamase

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    Morandi, Federica; Caselli, Emilia; Morandi, Stefania; Focia, Pamela J.; Blazquez, Jesus; Shoichet, Brian K.; Prati, Fabio (Degali); (NIH); (NWU); (UCSF)

    2010-03-08

    {beta}-lactamases are the most widespread resistance mechanism to {beta}-lactam antibiotics, such as the penicillins and the cephalosporins. In an effort to combat these enzymes, a combination of stereoselective organic synthesis, enzymology, microbiology, and X-ray crystallography was used to design and evaluate new carboxyphenyl-glycylboronic acid transition-state analogue inhibitors of the class C {beta}-lactamase AmpC. The new compounds improve inhibition by over 2 orders of magnitude compared to analogous glycylboronic acids, with K{sub i} values as low as 1 nM. On the basis of the differential binding of different analogues, the introduced carboxylate alone contributes about 2.1 kcal/mol in affinity. This carboxylate corresponds to the ubiquitous C3(4)' carboxylate of {beta}-lactams, and this energy represents the first thermodynamic measurement of the importance of this group in molecular recognition by class C {beta}-lactamases. The structures of AmpC in complex with two of these inhibitors were determined by X-ray crystallography at 1.72 and 1.83 {angstrom} resolution. These structures suggest a structural basis for the high affinity of the new compounds and provide templates for further design. The highest affinity inhibitor was 5 orders of magnitude more selective for AmpC than for characteristic serine proteases, such as chymotrypsin. This inhibitor reversed the resistance of clinical pathogens to the third generation cephalosporin ceftazidime; it may serve as a lead compound for drug discovery to combat bacterial resistance to {beta}-lactam antibiotics.

  3. 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.

  4. Prevalence and analysis of Pseudomonas aeruginosa in chinchillas

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    Aoyama Naoki

    2010-11-01

    Full Text Available Abstract Background Chinchillas (Chinchilla laniger are popular as pets and are often used as laboratory animals for various studies. Pseudomonas aeruginosa is a major infectious agent that causes otitis media, pneumonia, septicaemia enteritis, and sudden death in chinchillas. This bacterium is also a leading cause of nosocomial infections in humans. To prevent propagation of P. aeruginosa infection among humans and animals, detailed characteristics of the isolates, including antibiotic susceptibility and genetic features, are needed. In this study, we surveyed P. aeruginosa distribution in chinchillas bred as pets or laboratory animals. We also characterized the isolates from these chinchillas by testing for antibiotic susceptibility and by gene analysis. Results P. aeruginosa was isolated from 41.8% of the 67 chinchillas included in the study. Slide agglutination and pulsed-field gel electrophoresis discriminated 5 serotypes and 7 unique patterns, respectively. For the antibiotic susceptibility test, 40.9% of isolates were susceptible to gentamicin, 77.3% to ciprofloxacin, 77.3% to imipenem, and 72.7% to ceftazidime. DNA analyses confirmed that none of the isolates contained the gene encoding extended-spectrum β-lactamases; however, 2 of the total 23 isolates were found to have a gene similar to the pilL gene that has been identified in the pathogenicity island of a clinical isolate of P. aeruginosa. Conclusions P. aeruginosa is widely spread in chinchillas, including strains with reduced susceptibility to the antibiotics and highly virulent strains. The periodic monitoring should be performed to help prevent the propagation of this pathogen and reduce the risk of infection from chinchillas to humans.

  5. Prevalence and Diversity of Salmonella Serotypes in Ecuadorian Broilers at Slaughter Age

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    Cevallos, María; Ron-Garrido, Lenin; Bertrand, Sophie; De Zutter, Lieven

    2016-01-01

    Salmonella is frequently found in poultry and represent an important source for human gastrointestinal infections worldwide. The aim of this study was to investigate the prevalence, genotypes and antimicrobial resistance of Salmonella serotypes in broilers from Ecuador. Caeca content from 388 at random selected broiler batches were collected in 6 slaughterhouses during 1 year and analyzed by the ISO 6579/Amd1 protocol for the isolation for Salmonella. Isolates were serotyped and genotypic variation was acceded by pulsed field gel electrophoresis. MIC values for sulfamethoxazole, gentamicin, ciprofloxacin, ampicillin, cefotaxime, ceftazidime, tetracycline, streptomycin, trimethropim, chloramphenicol, colistin, florfenicol, kanamycin and nalidixic acid were obtained. Presence of blaCTX-M, blaTEM, blaSHV and blaCMY; and mcr-1 plasmid genes was investigated in resistant strains to cefotaxime and colistin respectively. Prevalence at batch level was 16.0%. The most common serotype was S. Infantis (83.9%) followed by S. Enteritidis (14.5%) and S. Corvallis (1.6%). The pulsed field gel electrophoresis analysis showed that S. Corvallis, S. Enteritidis and S. Infantis isolates belonged to 1, 2 and 12 genotypes respectively. S. Infantis isolates showed high resistance rates to 12 antibiotics ranging from 57.7% (kanamycin) up to 98.1% (nalidixic acid and sulfamethoxazole). All S. Enteritidis isolates showed resistance to colistin. High multiresistant patterns were found for all the serotypes. The blaCTX-M gene was present in 33 S. Infantis isolates while mcr-1 was negative in 10 colistin resistant isolates. This study provides the first set of scientific data on prevalence and multidrug-resistant Salmonella coming from commercial poultry in Ecuador. PMID:27414038

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

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

    2011-12-29

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

  7. 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.

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

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    Ifeoma Chinyere UGWU

    2015-09-01

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

  9. 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.

  10. Plasmid-mediated AmpC: prevalence in community-acquired isolates in Amsterdam, the Netherlands, and risk factors for carriage.

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    E Ascelijn Reuland

    Full Text Available The objective of this study was to determine the prevalence of pAmpC beta-lactamases in community-acquired Gram negative bacteria in the Netherlands, and to identify possible risk factors for carriage of these strains.Fecal samples were obtained from community-dwelling volunteers. Participants also returned a questionnaire for analysis of risk factors. Screening for pAmpC was performed with selective enrichment broth and a selective screening agar. Confirmation of AmpC-production was performed with two double disc combination tests: cefotaxime and ceftazidime with either boronic acid or cloxacillin as inhibitor. Multiplex PCR was used as gold standard for detection of pAmpC. 16S rRNA PCR and AFLP were performed as required, plasmids were identified by PCR-based replicon typing. Questionnaire results were analyzed with SPSS, version 20.0.Fecal samples were obtained from 550 volunteers; mean age 51 years (range: 18-91, 61% were females. pAmpC was present in seven E. coli isolates (7/550, 1.3%, 0.6-2.7 95% CI: six CMY-2-like pAmpC and one DHA. ESBL-encoding genes were found in 52/550 (9.5%, 7.3-12.2 95% CI isolates; these were predominantly blaCTX-M genes. Two isolates had both ESBL and pAmpC. Admission to a hospital in the previous year was the only risk factor we identified.Our data indicate that the prevalence of pAmpC in the community seems still low. However, since pAmpC-producing isolates were not identified as ESBL producers by routine algorithms, there is consistent risk that further increase of their prevalence might go undetected.

  11. Surveillance and Detection of Inhibitor-Resistant Beta-Lactamases in Clinical Isolates of Escherichia coli

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    Carl Urban

    2007-06-01

    Full Text Available In recent years, resistance to beta-lactam antibiotics, such as the widely-used cephalosporins and penicillins, has become a major challenge for disease therapy, particularly in common hospital-acquired infections. In the search for the mechanisms behind this increasingly prevalent form of resistance, microbiologists have identified a new type of beta-lactamase enzyme, called inhibitor-resistant TEMs (IRTs, which can withstand the effects of beta-lactamase inhibitor compounds, further reducing the arsenal of drugs available to physicians facing resistant bacteria. In this study, we examined the enzymatic and genetic basis of Escherichia coli isolates demonstrating such resistance to beta-lactam/beta-lactamase inhibitor combinations. Susceptibility trials played a major role in composing the experimental cohort for this project (n=50; each isolate was thoroughly tested to ensure that it was resistant to ampicillin-sulbactam, an inhibitor combination, but susceptible to the third-generation cephalosporin ceftazidime. Subsequently, a number of samples were subjected to assay by pulsed-field gel electrophoresis (n=18 and polymerase chain reaction (n=3 so that their genetic composition and relatedness might be known. In particular, the presence of genes coding for TEM-type beta-lactamases was investigated for each of the 3 isolates sequenced. Even though it was anticipated that the isolates would possess resistance to inhibitor combinations due to an IRT gene, this was not found to be the case. Instead, the mechanism of resistance turned out to be over-expression of a gene coding for a normal TEM enzyme. The results of these experiments have implications for ensuring successful therapy of bacterial infections and for preventing the spread of antimicrobial resistance.

  12. Epidemiology of acute otitis in pediatric patients

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    Maddalena Perotti

    2011-03-01

    Full Text Available Introduction. Acute otitis is one of the most common pediatric infectious diseases that requires an accurate diagnosis in order to direct appropriate therapy to reduce the risk of complications. In this study pathogens collected from pediatric patients and their antibiotic susceptibility patterns were evaluated. Methods. Between May 2009 and May 2010, 739 samples (swabs taken from nasopharynx in case of acute otitis media and/or from ears in case of acute external otitis, collected from 680 patients, suffering of otalgia, admitted to the emergency department of our Hospital were studied.The specimens were submitted for routine bacterial cultures and the susceptibility tests were performed according to Clinical Laboratory Standards. Nitrocefin was used to detect ß-lactamase activity. Results. 316 samples (42.8% of 739 were negative, 102 (13.8% were positive for Streptococcus pneumoniae, 97 (13.1% for Moraxella catarrhalis, 68 (9.2% for Haemophilus influenzae, 62 (8.4% for Pseudomonas aeruginosa, 49 (6.6% for Staphylococcus aureus, 36 (4.9% for Streptococcus pyogenes, 5 (0.7% for Gram negative and 4 (0.5% for Candida spp. Antibiotic susceptibility tests showed that amikacin, ceftazidime, ciprofloxacin, imipenem, meropenem and piperacillin/tazobactam were active against all Gram negative strains isolated.We found one strain of MRSA. Of 102 Streptococcus pneumoniae, 5 (4.9% were penicillin resistant and 25 (24.5% were erythromycin resistant, showing the prevalence of constitutive phenotype (80%. All M. catarrhalis strains were ß-lactamase producers while all H. influenzae were ß-lactamase negatives. Conclusions. The prevalent etiological agents in pediatric acute otitis are S. pneumoniae, M. catharralis, and H. influenzae, as reported in literature. In external acute otitis P. aeruginosa prevails in particular in summer.

  13. 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.

  14. Imipenem-resistant Acinetobacter baumannii carrying the ISAba1-bla OXA-23, 51 and ISAba1-bla ADC-7 genes in Monteria, Colombia

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    Pedro Martínez

    2012-12-01

    Full Text Available The purpose of this study was to identify the genes coding for resistance to ceftazidime and imipenem and describe the molecular epidemiology of A. baumannii strains isolated from a clinical center in Colombia. Twenty isolates of imipenem-resistant A. baumannii from an equal number of patients with nosocomial infections were obtained. Primers were used to amplify genes bla IMP, bla VIM, bla OXA-23, bla OXA-24, bla OXA-58, bla OXA-51 and bla ADC-7. To detect insertion sequences ISAba1/bla OXA-23, ISAba1/bla OXA-51 and ISAba1/bla ADC-7, mapping by PCR using combinations of reverse primers ISAba1 and reverse primers of bla OXA-23, bla OXA-51 and bla ADC-7 were used. The amplification products were purified and cloned into PCR 2.1-TOPO vector and transformed into chemically competent Escherichia coli TOP10. These amplicons were then sequenced. PFGE was performed on DNA of A. baumannii isolates digested with ApaI. Results. The DNA profiles obtained included 9 clusters with, four 2-7 isolates per profile, and 5 single-isolate profiles. Of the 20 isolates resistant to imipenem, 15 carried bla OXA-23 gene, 4 contained ISAba1 upstream of bla OXA-51 gene, and 6 contained ISAba1 upstream of bla OXA-23 gene. Eighteen of these isolates carried the bla ADC-7 gene, with 9 of the isolates having ISAba1 located upstream of this gene. This is the first report of the ISAba1 /ADC-7 associated with OXAs genes in A. baumannii isolates from Colombia.

  15. IDENTIFICATION OF SERINE CARBAPENEMASE AND METALLOCARBAPENEMASE ENZYMES IN PSEUDOMONAS AERUGINOSA IN GEMS MEDICAL COLLEGE, RAGOLU, SRIKAKULAM

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    Radhika

    2016-06-01

    Full Text Available Various carbapenems have been reported in Pseudomonas aeruginosa such as VIM, NDM & OXA-48, etc. In addition, carbapenemase producers are usually associated with many other non–β-lactam resistance determinants which give rise to multidrug and pan drug resistant isolates. Detection of these enzymes in infected patients and in carriers are the two main approaches for prevention of their spread. Potential carbapenemase producers are currently screened first by susceptibility testing, using breakpoint values for carbapenems. However, many carbapenemase producers do not confer obvious resistance levels to carbapenems. So there is need for Laboratories to search for carbapenemase producers. In such instance, phenotypic based test such as Modified Hodge Test (MHT is very much useful in confirming in vitro production of carbapenemase enzymes. But this test does not differentiate serine carbapenemase enzyme (i.e. Ambler class A & C from metallocarbapenemase (i.e. Ambler class B. To differentiate these two enzymes, MHT positive isolates can be subjected to Disc Synergy test. These two tests are highly sensitive and specific and adaptable to any laboratory in the world. Out of 100 ceftazidime resistant Pseudomonas aeruginosa, 75(75% were sensitive, 7(7% were intermediate sensitive and 18(18% were resistant to imipenem. When the 18 imipenem resistant strains were subjected to Modified Hodge test, 15 gave positive results. When the 15 MHT positive strains subjected to disc synergy test, 8 were positive and 7 were negative showing that 8 were producing metallocarbapenemases and 7 were producing serine carbapenemases. Out of 7 intermediately imipenem sensitive isolates, 2 were producing metallocarbapenemase and 3 were producing serine carbapenemase. Hence, total number of imipenem resistant Pseudomonas aeruginosa isolates were 23.

  16. 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.

  17. 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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  19. Screening of pregnant women attending the antenatal care clinic of a tertiary hospital in eastern Saudi Arabia for Chlamydia trachomatis and Neisseria gonorrhoeae infections

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    Alzahrani Alhusain

    2010-01-01

    Full Text Available Inroduction: Of the "top ten" sexually transmitted infections, Chlamydia trachomatis and Neisseria gonorrhoeae are ranked second and fifth, respectively, worldwide. Aim: The aim of this study was to screen the pregnant women for C. trachomatis and N. gonorrhoeae infections and to detect antimicrobial resistance pattern of N. gonorrhoeae. Materials and Methods: This study was a prospective, hospital-based analysis of a random sample of pregnant women visiting the antenatal clinic of a tertiary hospital in eastern Saudi Arabia. Endocervical and high vaginal swabs were collected both from pregnant women and female patients attending gynecology clinic with lower genital tract infection (control group. C. trachomatis antigen was detected using enzyme-linked immunosorbent assay (ELISA. N. gonorrhoeae was detected by culture and identification of isolates, and antimicrobial susceptibility testing was performed. Statistical Package for Social Sciences (SPSS version 13.0 and Chi-square test were used for statistical analysis. Results: C. trachomatis antigen was detected in 10.5% (10/95 and 34.4% (35/102 of pregnant women and control group, respectively (P < 0.001. The isolation rate of N. gonorrhoeae among pregnant women was 0.0% compared to 7.8% (8/102 among the control group (P < 0.01. N. gonorrhoeae were resistant to penicillin (62.5%, tetracycline (50%, ampicillin (25%, amoxycillin-clavulinic acid (25% and ciprofloxacin (37.5%, while they were susceptible to cefepime, ceftriaxone, ceftazidime, spectinomycin, and cefuroxime. Conclusion: Screening of pregnant women for C. trachomatis infection should be included in the antenatal care in this area. The detection rate of both organisms among the control group highlights the importance of preventive strategies. Certain antibiotics previously used in treating gonorrhea are no longer effective.

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

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

    2016-01-01

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

  1. Molecular characterization of Salmonella enterica serotype Enteritidis isolates from food and human samples by serotyping, antimicrobial resistance, plasmid profiling, (GTG)5-PCR and ERIC-PCR.

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    Fardsanei, F; Nikkhahi, F; Bakhshi, B; Salehi, T Z; Tamai, I A; Soltan Dallal, M M

    2016-11-01

    In recent years, Salmonella enterica serovar Enteritidis has been a primary cause of human salmonellosis in many countries. The major objective of this study was to investigate genetic diversity among Salmonella Enteritidis strains from different origins (food and human) by Enterobacterial Repetitive Intergenic Consensus (ERIC) -PCR, as well as to assess their plasmid profiling and antimicrobial resistance. A total of 30 Salmonella Enteritidis isolates, 15 from food samples (chicken, lamb, beef and duck meats) and 15 from clinical samples were collected in Tehran. Identification of isolates as Salmonella was confirmed by using conventional standard biochemical and serological tests. Multiplex-PCR was used for serotyping of isolates to identify Salmonella Enteritidis. Antimicrobial susceptibility testing to 16 agents founds drug resistance patterns among Salmonella Enteritidis isolates. No resistance was observed to cephalexin, ceftriaxone, ceftazidime and cefotaxime, ciprofloxacin, imipenem or meropenem, chloramphenicol and gentamicin. The highest resistance (96.7%) was observed to nitrofurantoin. Seven plasmid profiles (P1-P7) were detected, and a 68-kb plasmid was found in all isolates. Two different primers; ERIC and (GTG)5 were used for genotyping, which each produced four profiles. The majority of clinical and food isolates fell into two separate common types (CTs) with a similar percentage of 95% by ERIC-PCR. Using primer (GTG)5, 29 isolates incorporated in three CTs with 70% of isolates showing a single banding pattern. Limited genetic diversity among human and food isolates of Salmonella Enteritidis may indicate that contaminated foods were possibly the source of human salmonellosis. These results confirmed that ERIC-PCR genotyping has limited discriminatory power for Salmonella Enteritidis of different origin. PMID:27656286

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

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    Begum Shahanara

    2013-01-01

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

  3. Resistance and the management of complicated skin and skin structure infections: the role of ceftobiprole.

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    Barbour, April; Derendorf, Hartmut

    2010-01-01

    Antimicrobial resistant bacteria are an increasing concern due to the resulting increase in morbidity, mortality, and health-care costs associated with the administration of inadequate or delayed antimicrobial therapy. The implications of inadequate antimicrobial therapy in complicated skin and skin structure infections (cSSSIs) have gained more attention recently, most likely due to the recent emergence of community-acquired methicillin resistant Staphylococcus aureus (MRSA) and the already high prevalence of MRSA in the nosocomial setting. Due to the continuous threat of resistance arising and the limitations of currently available agents for the treatment of cSSSIs, it is necessary to develop new antimicrobials for this indication. Ceftobiprole medocaril, the prodrug of ceftobiprole, is a parental investigational cephalosporin for the treatment of cSSSIs displaying a wide-spectrum of activity against both Gram-positive and Gram-negative species, including MRSA. Ceftobiprole displays noncomplex linear pharmacokinetics, is eliminated primarily by glomerular filtration, and distributes to extracellular fluid. Additionally, it has been shown that the extent of distribution to the site of action with regard to cSSSIs, ie, the extracellular space fluid of subcutaneous adipose tissue and skeletal muscle, is expected to be efficacious, as free concentrations meet efficacy targets for most pathogens. Similar to other beta-lactams, it displays an excellent safety and tolerability profile with the primary adverse events being dysgeusia in healthy volunteers, resulting from the conversion of the prodrug to the active, and nausea in patients. Ceftobiprole has demonstrated noninferiority in two large-scale pivotal studies comparing it to vancomycin, clinical cure rates 93.3% vs 93.5%, respectively, or vancomycin plus ceftazidime, clinical cure rates 90.5% vs 90.2%, respectively. Given the pharmacokinetic and pharmacodynamic properties, ceftobiprole is a promising new agent

  4. A rare case of bilateral aspergillus endophthalmitis

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    Saurabh Gupta

    2015-12-01

    Full Text Available Aspergillus endophthalmitis is a devastating inflammatory condition of the intraocular cavities that may result in irreparable loss of vision and rapid destruction of the eye. Almost all cases in the literature have shown an identified source causing aspergillus endophthalmitis as a result of direct extension of disease. We present a rare case of bilateral aspergillus endophthalmitis. A 72-year-old woman with a history of diabetes mellitus, congenital Hirschsprung disease, and recent culture-positive candida pyelonephritis with hydronephrosis status post-surgical stent placement presented with difficulty opening her eyes. She complained of decreased vision (20/200 with pain and redness in both eyes – right worse then left. Examination demonstrated multiple white fungal balls in both retinas consistent with bilateral fungal endophthalmitis. Bilateral vitreous taps for cultures and staining were performed. Patient was given intravitreal injections of amphotericin B, vancomycin, ceftazidime, and started on oral fluconazole. Patient was scheduled for vitrectomy to decrease organism burden and to remove loculated areas of infection that would not respond to systemic antifungal agents. Four weeks after initial presentation, the fungal cultures revealed mold growth consistent with aspergillus. Patient was subsequently started on voriconazole and fluconazole was discontinued due to poor efficacy against aspergillus. Further workup was conducted to evaluate for the source of infection and seeding. Transthoracic cardiogram was unremarkable for any vegetation or valvular abnormalities. MRI of the orbits and sinuses did not reveal any mass lesions or bony destruction. CT of the chest was unremarkable for infection. Aspergillus endophthalmitis may occur because of one of these several mechanisms: hematogenous dissemination, direct inoculation by trauma, and contamination during surgery. Our patient's cause of bilateral endophthalmitis was through an

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

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    Forhad Monjur

    2010-01-01

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

  6. Atividade antimicrobiana in vitro da cefpiroma em comparação com outros beta-lactâmicos de amplo espectro contra 804 amostras clínicas de nove hospitais brasileiros Antimicrobial activity of Cefpirome compared to other broad-spectrum Beta-Lactam drugs against 804 clinical isolates from 9 Brazilian hospitals

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    H.S. Sader

    1998-12-01

    imipenem apresentou atividade um pouco superior. CONCLUSÃO: Os resultados desse estudo sugerem que, no Brasil, a cefpiroma apresenta espectro de ação superior ao das CTGs contra bactérias gram-negativas (Enterobacteriaceae e não-fermentadares e gram-positivas e semelhante ao do imipenem contra algumas espécies de enterobactérias e contra P. aeruginosa.OBJECTIVE: To evaluate the in vitro activity of the fourth-generation cephalosporin cefpirome in comparison to that of ceftazidime, ceftriaxone, cefotaxime and imipenem in a multicenter study involving nine hospitals from six cities (four States. MATERIAL AND METHOD: A total of 804 isolates from patients hospitalized in either intensive care units or Oncology/Hematology units was evaluated. The isolates were collected between June and November of 1995, i.e. before cefpirome became commercially available in Brazil, and susceptibility tested by broth microdilution following the NCCLS procedures. All isolates resistant to cefpirome were retested by E-test. RESULTS: Against Enterobacteriaceae (n=344, cefpirome demonstrated an activity 2 to 32-fold higher than that of the third-generation cephalosporins (TGCs and similar to that of imipenem. The percentages of Enterobacteriaceae susceptible were: 88%, 69% and 96% for cefpirome, TGCs and imipenem, respectively. The cefpirome spectrum was greater or equal than that of imipenem against Citrobacter freundii, Enterobacter aerogenes, Morganella morganii and Serratia marcescens. Against Acinetobacter sp. (n=77, cefpirome was slightly more active than ceftazidime; however, the percentages of isolates resistant to these compounds were high (84% and 88%, respectively. The activities of cefpirome, ceftazidime and imipenem were very similar against P. aeruginosa isolates (n=128, with MIC50(mg/ml/percent susceptible of 8/59%, 8/62% and 4/62% respectively. Against aerobic gram-positive bacteria, the cefpirome activity was 4 to 16-fold higher than that of TGCs but 2 to 8-fold lower than

  7. 常用抗生素在体外环境中对血清肿瘤标志物检测的影响%Effects of commonly used antibiotics in vitro environment on detection of serum tumor markers

    Institute of Scientific and Technical Information of China (English)

    孔梅; 邢长永; 甄君

    2011-01-01

    Objeetive To discuss the effects of 11 commonly used antibiotics in vitro environment on the detection of serum tumor markers. Methods To select 50 samples of serum tumor markers and 20 normal serum samples respectively,and to join in the serum of eleven commonly used antibiotics, and to detect AFP, CEA, CA125, CA153 and CA199 five types of tumor markers before and after the content changes by chemiluminescence immunoassay and to analyse the result by using the t-test. Results Joined the penicillin lactic acid sodium, acyclovir, ciprofloxacin and sodium chloride, ceftazidime, cefuroxime sodium, ornidazole tablets, ceph radine, the value of AFP was different after detection (P<0.05). Accession of chloride, ceftazidime, cefuroxime sodium, cephradine, azithromycin dihydrogen phosphate after CEA value differences (P<0. 05). Joined acyclovir, cefuroxime sodium, cephradine, imide cilasatin sodium CA125 after testing was different (P<0.05). In joining the penicillin sodium, cefuroxime sodium, piperacillin sodium and sulbactam sodium(2 : 1),ornidazole tablets,acyclovir CA199 detection value when there was a difference(P<0.05). In joining the penicillin sodium, cefuroxime sodium, piperacillin sodium and sulbactam sodium (2 : 1),ornidazole films, polyimide cilasatin sodium, ceftazidime CA153 detection value after differences ( P< 0. 05 ). Conclusion In most of the 11 commonly used antibiotics on tumor markers except gentamicin sulfate, they have clinical significance to improve the accuracy of tumor markers by exclude drug interference factors.%目的 探讨十一种常用抗生素在体外环境中对血清肿瘤标志物含量的影响.方法 50份肿瘤患者血清和20份正常血清中分别加入11种常用抗生素,采用免疫化学发光法检测AFP、CEA、CA125、CA153和CA199五种肿瘤标志物前后含量的变化,采用 T检验进行统计学分析.结果 加入青霉素钠、阿昔洛韦、乳酸环丙沙星氯化钠、头孢他啶、头孢呋辛

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

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

    可根据药敏结果结合临床情况合理选择抗菌药物,细菌室可不报告ESBL表型情况.S20 CAZ新折点与我国临床治疗结局相关性还有待进一步评估.%Objective To evaluate the influences of susceptibility interpretation of Escherichia coli,Klebsiella pneumonia and Proteus mirabilis in China mainland according to the old and new ceftazidime,cefotaxime and ceftriaxone breakpoints in CLSI M100-S20 and CLSI M100-S19. Methods First, We analyzed the antibacterial susceptibility results of the three bacteria by agar dilution method in the SEANIR surveillance item, which were collected from 15 national hospitals between the year of 2005 and 2007 and excluded the AmpC enzyme positive isolates according to the PGR-DNA sequencing method and/or the antibacterial susceptibility phenotype. ESBL phenotype was confirmed by the CLSI phenotypic confirmatory test. Antibacterial susceptibility of the total 2733 Escherichia coli, Klebsiella pneumonia, Proteus mirabilis isolates was retrospectively analyzed by WHONET 5. 4 software according to the breakpoints of the CLSI M100-S19 (S19) and CLSI M100-S20 (S20). Second, 207 isolates of Peking Union Medical College Hospital with the results of both agar dilution method and disk diffusion method were performed by recurrent analysis. Then we observed the inter-method agreement through the scatter diagram according to the breakpoints of S19 and S20. Results First, as to the ESBL positive Escherichia coli, Klebsiella pneumonia and Proteus mirabili.s, the resistant rate of cefotaxime increased from 65.2% , 55.5%, 14. 6% under S19 (64 μg/ml) to 99. 7%, 96. 2% , 93. 8% under S20 (4 μg/ml). The susceptibility rates decreased from 6. 0%, 11.5%, 33.3% under S19 (8 μg/ml) to 0%, 0. 2%, 0% under S20 ( 1 μg/ml). Ceftriaxone had the same trend as cefotaxime. Though ceftazidime was more active than cefotaxime and ceftriaxone, as to the ESBL positive Escherichia coli and Klebsiella pneumonia, the resistant rates slightly

  9. Clinical analysis of 24 cases of children with Salmonella typhimurium septicemia%儿童鼠伤寒沙门菌败血症24例临床分析

    Institute of Scientific and Technical Information of China (English)

    李迎飞; 王险峰; 王艳荣

    2014-01-01

    目的:探讨儿童鼠伤寒沙门菌败血症的临床特点及疗效。方法:对确诊为鼠伤寒沙门菌败血症的24例儿童患者进行回顾性分析,研究其临床表现及疗效。结果:婴幼儿多见,平均年龄9个月,主要表现为发热、消化道症状,外周血白细胞16例(66.7%)正常、2例(8.33%)减少,6例增高(25%),临床分离株对头孢他啶、头孢噻肟、头孢吡肟、左氧氟沙星、亚胺培南敏感率分别为83.3%、87.5%、91.7%、66.7%、100%,24例初治均采用头孢曲松钠,22例血培养正常,2例仍为阳性,根据药物敏感试验选用抗生素治疗后均治愈。结论:头孢三代耐药率相对较低,是治疗婴幼儿鼠伤寒沙门菌败血症的首选药物。%ObjectiveTo investigate the clinical characteristics and therapeutic effect of Salmonella typhimurium septicemia in children. Methods24 patients diagnosed as children with Salmonella typhimurium septicemia were analyzed retrospectively,to study the clinical manifestation and treatment effect.ResultsChildren see more,with an average age of 9 months,the main manifestations were fever,gastrointestinal symptoms,peripheral white blood cells in 16 patients(66.7%),2 cases of normal(8.33%) decreased,increased in 6 patients(25%),clinical isolates to ceftazidime,cefotaxime,cefepime,left oxygenfluorine Sha Xing,imipenem susceptibility rates were 83.3%,87.5%,91.7%,66.7%,100%,24 patients with the initial treatment with ceftriaxone sodium,blood culture in 22 cases of normal,2 cases remained positive,according to the drug sensitive test,use of antibiotics were cured.ConclusionThree generations of cephalosporins resistant rate is relatively low, is the drug of choice for the treatment of infants with Salmonella typhimurium septicemia.

  10. 头孢丙烯治疗儿童化脓性扁桃体炎的疗效观察%Efficacy Observation of Cefprozil in the Treatment of Pediatric Suppurative Tonsillitis

    Institute of Scientific and Technical Information of China (English)

    龙敏; 曹文霞; 詹倩

    2013-01-01

    OBJECTIVE: To evaluate the efficacy and safety of cefprozil in the treatment of pediatric suppurative tonsillitis. METHODS: 90 children with suppurative tonsillitis were randomly divided into group A and B. Group A was given cefprozil 7.5 mg/kg, bid, p.o. Group B was given ceftazidime( 15-50 mg/kg) ,bid,iv. RESULTS: There was no significant difference in total effective rate between group A (82.22% ) and group B (86.67% , P>0.05); but compliance of group A (95.56%) was significantly better than that of group B (48.89% , P<0.01). No serious adverse drug reactions was found in 2 groups. CONCLUSIONS: Cefprozil is effective and safe in the treatment of pediatric suppurative tonsillitis.%目的:观察头孢丙烯治疗儿童化脓性扁桃体炎的有效性和安全性.方法:将90例化脓性扁桃体炎患儿随机均分为A、B组:A组给予头孢丙烯7.5 mg/kg,bid,po;B组给予头孢他啶15~50 mg/kg,bid,iv.观察两组疗效、依从性及不良反应发生情况.结果:治疗后,A组总有效率为82.22%,与B组(86.67%)比较差异无统计学意义(P>0.05);但患者的依从性A组(95.56%)显著高于B组(48.89%,P<0.01).两组均未见严重不良反应发生.结论:头孢丙烯治疗儿童化脓性扁桃体炎有效、安全.

  11. Role of Non-Active-Site Residue Trp-93 in the Function and Stability of New Delhi Metallo-β-Lactamase 1

    Science.gov (United States)

    Rehman, M. Tabish

    2015-01-01

    New Delhi metallo-β-lactamase-1 (NDM-1) is expressed by various members of Enterobacteriaceae as a defense mechanism to hydrolyze β-lactam antibiotics. Despite various studies showing the significance of active-site residues in the catalytic mechanism, there is a paucity of reports addressing the role of non-active-site residues in the structure and function of NDM-1. In this study, we investigated the significance of non-active-site residue Trp-93 in the structure and function of NDM-1. We cloned blaNDM-1 from an Enterobacter cloacae clinical strain (EC-15) and introduced the mutation of Trp-93 to Ala (yielding the Trp93Ala mutant) by PCR-based site-directed mutagenesis. Proteins were expressed and purified to homogeneity by affinity chromatography. The MICs of the Trp93Ala mutant were reduced 4- to 8-fold for ampicillin, cefotaxime, ceftazidime, cefoxitin, imipenem, and meropenem. The poor hydrolytic activity of the Trp93Ala mutant was also reflected by its reduced catalytic efficiency. The overall catalytic efficiency of the Trp93Ala mutant was reduced by 40 to 55% (the Km was reduced, while the kcat was similar to that of wild-type NDM-1 [wtNDM-1]). Heat-induced denaturation showed that the ΔGDo and Tm of Trp93Ala mutant were reduced by 1.8 kcal/mol and 4.8°C, respectively. Far-UV circular dichroism (CD) analysis showed that the α-helical content of the Trp93Ala mutant was reduced by 2.9%. The decrease in stability and catalytic efficiency of the Trp93Ala mutant was due to the loss of two hydrogen bonds with Ser-63 and Val-73 and hydrophobic interactions with Leu-65, Val-73, Gln-123, and Asp-124. The study provided insight into the role of non-active-site amino acid residues in the hydrolytic mechanism of NDM-1. PMID:26525789

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

    Directory of Open Access Journals (Sweden)

    Valeria Di Marcello

    2007-03-01

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

  13. Detection of Bacterial Endotoxins in Coenzyme Complex for Injection by Tachypleus Amebocyte Lysate Test%鲎试剂方法检测注射用复合辅酶中细菌内毒素

    Institute of Scientific and Technical Information of China (English)

    王宗春; 姜俊勇; 宋金春

    2011-01-01

    目的:建立注射用复合辅酶细菌内毒素检查法.方法:按照中国药典2010年版(二部)附XIE细菌内毒素检查法进行干扰试验.结果:用灵敏度γ为0.5EU/ml的鲎试剂进行实验,当注射用复合辅酶中辅酶I的浓度为0.8μg/ml时,供试品不干扰鲎试剂与细菌内毒素的凝集反应.结论:使用鲎试剂方法检查注射片用复合辅酶中细菌内毒素是可行的.%Objective:To study the clinical related factors,the distribution and drug-resistance of the pathogen in 2 type diabetic with pulmonary infection,and the supervision for rational use of drugs in clinical practice.Methods:211 in-patients were chosen in recent three years, which were accompanied with diabetes mellitus and pulmonary infection.A retrospective investigation including the related factors(age,curse of disease,symptom) and 124 cases cultivated pathogen was performed.K-B method was used to test the drug-resistant strain and do drug-Sensitivity test.Results: The incidence of diabetes mellitus complicated by pulmonary infection related closely patients, age and curse of disease (P<0.05).The former five bacteria in diabetic with Pulmonary infection were klebsiella pneumonia(23.4%),pseudomonas aeruginose(18.5%),escherichia coli(16.9%),staphyloccocus aureus rosenbach (13.7)and Candida albicans (9.7%).The former five sensitive antibiotics were imipenem,sulperazon,ceftazidime,amikacin,levofloxacin.The former three antibiotics which were sensitive to G+ cocci,were vancomycin,Rifampicin,minocycline. The sensitive antifungal were Itraconazole and Fluconazole. Conclusion: The result of sputum cultivation and drug sensitivity wre useful to clinic.It was important to choose antibiotic under the direction of it.

  14. Antimicrobial Resistance Patterns of Acinetobacter baumannii, Pseudomonas aeruginosa and Staphylococcus aureus Isolated From Patients With Nosocomial Infections Admitted to Tehran Hospitals

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    Fallah

    1970-01-01

    antibiotics with 189 and 187 resistant isolates, respectively; however 155 isolates were susceptible to co-trimoxazole and ceftazidime. The high resistant rate amongst A. baumannii to carbapenems is likely consequence of heavy empirical usage of this group of antibiotics. Conclusions The high prevalence of antimicrobial resistance in the hospitals highlights the need for further infection control programs. Future regional epidemiological data on antimicrobial resistance patterns will be required to implement strict national antibiotic policies to restrict the spread of these resistance bugs.

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

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    Taslima T Lina

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

  16. [Evaluation of the ChromID ESBL agar for the detection of ESBL-positive Enterobacteriaceae and vancomycin-resistant enterococcus isolates from urine cultures].

    Science.gov (United States)

    Alışkan, Hikmet Eda; Colakoğlu, Sule; Turunç, Tuba; Demiroğlu, Yusuf Ziya

    2012-01-01

    Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae strains are frequent causative agents both in community-acquired infections and in nosocomial infections. The newly developed ChromID ESBL agar (bioMerieux, Marcy I'Etoile, France) is a chromogenic medium that helps rapid identification of ESBL-positive Enterobacteriaceae species from the clinical samples. The aim of this study was to evaluate the performance of ChromID ESBL agar in the rapid identification of ESBL-positive pathogens from the urine samples of the patients with urinary tract infections. A total of 672 urine samples (437 outpatients, 235 inpatients) were included in the study. All of the samples were inoculated simultaneously to 5% sheep blood agar, McConkey agar and ChromID ESBL agar media, and evaluated after incubation at 37°C for 18-24 hours. Gram-negative pathogens were tested for ESBL both by the standard combined double-disk diffusion (CDD) method using ceftazidime and cefotaxime disks and by doubledisk synergy (DDS) test. Among 672 urine cultures, 199 yielded microbial growth in routine media (sheep blood agar and/or McConkey agar), whereas 57 yielded bacterial growth in ChromID ESBL agar. When CDD method was accepted as the reference method according to Clinical and Laboratory Standards Institute (CLSI) recommendations, the sensitivity, specificity, positive and negative predictive values for ChromID ESBL agar for the detection of ESBL-positive bacteria in urinary tract infections were estimated as 97%, 92.9%, 89.1%, and 98.1%, respectively. Additionally, we also discovered that Chrom ID ESBL agar could detect vancomycin-resistant enterococci (VRE) as well as ESBL-positive bacteria, in our study. In order to investigate this observation we inoculated a total of 203 stock strains of Enterococcus spp. (118 vancomycin-sensitive, 85 vancomycin-resistant) to this medium. None of the vancomycinsensitive Enterococcus spp. did grow in ChromID ESBL medium, while 83 of the 85

  17. Occurrence and characteristics of extended-spectrum β-lactamases producing Escherichia coli in foods of animal origin and human clinical samples in Chhattisgarh, India

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    Bhoomika

    2016-09-01

    Full Text Available Aim: To assess the prevalence of antimicrobial resistance producing extended-spectrum β-lactamases (ESBL (blaTEM, blaSHV, and blaCTX-M genes in Escherichia coli isolated from chicken meat, chevon meat, raw milk, and human urine and stool samples collected from tribal districts of Chhattisgarh, viz., Jagdalpur, Dantewada, Kondagaon, and Kanker. Materials and Methods: A total of 330 samples, comprising 98 chicken meat, 82 chevon meat, 90 raw milk, and 60 human urine and stool samples, were processed for isolation of E. coli. Isolates were confirmed biochemically and further tested against commonly used antibiotics to know their resistant pattern. The resistant isolates were tested for ESBL production by phenotypic method followed by characterization with molecular method using multiplex-polymerase chain reaction technique. Results: Overall 57.87% (191/330 samples were found positive for E. coli, which include 66.32% (65/98 chicken meat, 46.34% (38/82 chevon meat, 81.11% (73/90 raw milk, and 25% (15/60 human urine and stool samples. Isolates showed the highest resistance against cefotaxime (41.36% followed by oxytetracycline (34.03%, ampicillin (29.31%, cephalexin (24.60%, cefixime (16.75%, and ceftazidime (13.08%. Phenotypic method detected 10.99% (21/191 isolates as presumptive ESBL producers, however, molecular method detected 3.66% (7/191, 2.09% (4/191, and 0.00% (0/191 prevalence of blaTEM, blaCTX-M, and blaSHV, respectively. Conclusion: The present study indicates a high prevalence of E. coli in raw chicken meat, chevon meat, and milk due to poor hygienic practices. The antibiotic susceptibility test detected the presence of the resistance pattern against ESBL in E. coli isolated from raw chicken meat, chevon meat, milk, and also in human clinical samples is of great concern. The appearance of E. coli in the human food chain is alarming and requires adaptation of hygienic practices and stipulate use of antibiotics.

  18. 2011年夏季某院分离志贺菌特点及某地区志贺菌血清型流行趋势分析%Characters of shigella strains in certain hospital and epidemic tendency analysis of shigella serotypes in ceratin area

    Institute of Scientific and Technical Information of China (English)

    刘志远; 马玉芝; 潘健; 张婷菊; 康利新; 刘贵建

    2012-01-01

    Objective To analyze the epidemiological features of shigella strains separated in this Hospital in 2011 ,and to the explore variation trend of shigella serotypes in Beijing. Methods Shigella strains were identified with Vitek Ⅱ Compact. Serotype was detected with serological testing. Drug susceptibility was determined by K-B methods. Results 15 strains of shigella were isolated, including 14 of Shigella sonnei and 1 of Shigella flexneri. No strains were sensitive to Trimethoprim-sulfamethoxazole, Pip-eracillin, Ampicillin. All Shigella sonnei strains were sensitive to Ciprofloxacin, Levofloxacin, Amikacin, Cefoxitin, Ceftazidime, Az-treonam,Cefepime,Imipenem,Piperacillin-tazobactam. Conclusion Shigella sonnei might be new prevalent serotype in Beijing. It might be improper to perform drug susceptibility only for ampicillin,a fluoroquinolone,and trimethoprim-sulfamethoxazole as suggested by CLSI.%目的 了解该院2011年分离的志贺菌及相关病例特点,结合其他区县志贺菌分离情况,总结北京市志贺菌血清型转变特点.方法 Vitek Ⅱ Compact鉴定志贺菌,血清玻片凝集法鉴定血清型,药敏试验采用K-B法.结果 共分离获得志贺菌15株,其中宋内Ⅰ型14株,福氏F2a型1株;15株菌对复方新诺明、哌拉西林、氨苄西林均耐药,14株宋内Ⅰ型菌对环丙沙星、左氧氟沙星、阿米卡星、头孢他啶、头孢西丁、亚胺培南、头孢吡肟、氨曲南、哌拉西林/他唑巴坦均敏感.结论 宋内Ⅰ型志贺菌为主要分离菌,对环丙沙星、左氧氟沙星、阿米卡星、头孢他啶、头孢西丁、亚胺培南、头孢吡肟、氨曲南、哌拉西林/他唑巴坦保持高度敏感;宋内志贺菌已成为北京市流行志贺菌的主要血清型.

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

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    Elisabetta Pezzati

    2005-06-01

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

  20. Commensal Enterobacteriaceae as reservoirs of extended-spectrum beta-lactamases, integrons and sul genes in Portugal

    Directory of Open Access Journals (Sweden)

    Elisabete eMachado

    2013-04-01

    Full Text Available Bacteria colonizing the human intestine have a relevant role in the spread of antimicrobial resistance. We investigated the faecal carriage of extended-spectrum beta-lactamase (ESBL-producing Enterobacteriaceae in healthy humans from Portugal and analysed the distribution of sul genes and class 1 and 2 integrons. Faecal samples (n=113 were recovered from healthy persons (North/Centre of Portugal, 2001-04 and plated on MacConkey agar with and without ceftazidime (1mg/L or cefotaxime (1mg/L. Isolates representing different morphotypes/plate and antibiotic susceptibility patterns (n=201 were selected. Isolates resistant to sulfonamides and/or streptomycin, gentamicin and trimethoprim were screened (PCR, sequencing for sul genes (sul1, sul2, sul3 and class 1 and 2 integrons. Presence of ESBLs was inferred using the DDST and further confirmed by PCR and sequencing. ESBL producers were selected for clonal analysis, plasmid characterization and conjugation assays by standard methods. ESBL-producing isolates were found in 1.8% (2/113 of samples, corresponding to Escherichia coli of phylogroups A (n=1 and B1 (n=1 carrying transferable blaCTX-M-14 and the new blaTEM-153, respectively. A 80kb IncK-blaCTX-M-14 was found, being highly related to that widely spread among CTX-M-14 producers of humans and animals from Portugal and other European countries. sul genes were found in 88% (22/25;sul2-60%, sul1-48%, sul3-4% of the sulfonamide resistant isolates. Class 1 integrons were more frequently found than class 2 (7% vs 3%. Interestingly, gene cassette arrangements within these platforms were identical to those commonly observed among Enterobacteriaceae from Portuguese food-producing animals, although aadA13 is here firstly described in Morganella morganii. These results reinforce the relevance of human commensal flora as reservoir of clinically relevant antibiotic resistance genes including blaESBLs, and highly transferable genetic platforms as IncK epidemic

  1. Transverse myelitis secondary to Melioidosis; A case report

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    Nandasiri Shanika

    2012-09-01

    Full Text Available Abstract Background Melioidosis has become an emerging infection in Sri Lanka; a country which is considered non endemic for it. Paraplegia due to Burkholderia pseudomallei is a very rare entity encountered even in countries where the disease is endemic. There are no reported cases of transverse myelitis due to melioidosis in Sri Lankan population thus we report the first case. Case presentation A 21 year old farmer presented with sudden onset bi lateral lower limb weakness, numbness and urine retention. Examination revealed flaccid aref