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Sample records for cephamycins

  1. Cephamycin C biosynthesis in Streptomyces cattleya: nitrogen source regulation.

    Science.gov (United States)

    Khaoua, S; Lebrihi, A; Germain, P; Lefebvre, G

    1991-05-01

    The production of cephamycin C by Streptomyces cattleya varies with the use of asparagine, glutamine or ammonium as nitrogen sources. Hydroxylase and expandase activities were demonstrated for the first time with this species. A study of the biosynthetic regulation of these enzymes by two different nitrogen sources, glutamine and asparagine, was carried out. Asparagine proved to be a better nitrogen source, both for enzymatic biosynthesis and production of cephamycin C. Moreover, an excess of asparagine in the culture environment provokes, simultaneously, a reduction in cephamycin C production and a decrease in the biosynthesis of expandase and hydroxylase.

  2. Production of cephamycin C by Streptomyces clavuligerus NT4 using solid-state fermentation.

    Science.gov (United States)

    Bussari, Baburao; Saudagar, Parag S; Shaligram, Nikhil S; Survase, Shrikant A; Singhal, Rekha S

    2008-01-01

    Cephamycin C is an extracellular broad spectrum beta-lactam antibiotic produced by Streptomyces clavuligerus, S. cattleya and Nocardia lactamdurans. In the present study, different substrates for solid-state fermentation were screened for maximum cephamycin C production by S. clavuligerus NT4. The fermentation parameters such as substrate concentration, moisture content, potassium dihydrogen phosphate, inoculum size and ammonium oxalate were optimized by response surface methodology (RSM). The optimized conditions yielded 21.68 +/- 0.76 mg gds(-1) of cephamycin C as compared to 10.50 +/- 1.04 mg gds(-1) before optimization. Effect of various amino acids on cephamycin C production was further studied by using RSM, which resulted in increased yield of 27.41 +/- 0.65 mg gds(-1).

  3. Cephamycins, a New Family of β-Lactam Antibiotics I. Production by Actinomycetes, Including Streptomyces lactamdurans sp. n1

    Science.gov (United States)

    Stapley, E. O.; Jackson, M.; Hernandez, S.; Zimmerman, S. B.; Currie, S. A.; Mochales, S.; Mata, J. M.; Woodruff, H. B.; Hendlin, D.

    1972-01-01

    A number of actinomycetes isolated from soil were found to produce one or more members of a new family of antibiotics, the cephamycins, which are structurally related to cephalosporin C. The cephamycins were produced in submerged fermentation in a wide variety of media by one or more of eight different species of Streptomyces, including a newly described species, S. lactamdurans. These antibiotics exhibit antibacterial activity against a broad spectrum of bacteria which includes many that are resistant to the cephalosporins and penicillins. PMID:4790552

  4. Identification of transcriptional activators for thienamycin and cephamycin C biosynthetic genes within the thienamycin gene cluster from Streptomyces cattleya.

    Science.gov (United States)

    Rodríguez, Miriam; Núñez, Luz Elena; Braña, Alfredo F; Méndez, Carmen; Salas, José A; Blanco, Gloria

    2008-08-01

    Two regulatory genes, thnI and thnU, were identified in the thienamycin (thn) gene cluster from Streptomyces cattleya. ThnI resembles LysR-type transcriptional activators and ThnU belongs to the SARP family of transcriptional activators. Their functional role was established after independent inactivation by gene replacement together with transcriptional analysis involving reverse transcription polymerase chain reaction (RT-PCR). Deletion of thnI abolished thienamycin production showing its involvement in thienamycin biosynthesis. Gene expression analysis applied to the thn gene cluster demonstrated that ThnI is a transcriptional activator essential for thienamycin biosynthesis that regulates the expression of nine genes involved in thienamycin assembly and export (thnH, thnJ, thnK, thnL, thnM, thnN, thnO, thnP and thnQ). Unexpectedly, the thnU disrupted mutant was not affected in thienamycin production but turned out to be essential for cephamycin C biosynthesis. Transcript analysis applied to early and late structural genes for cephamycin C biosynthesis (pcbAB and cmcI), revealed that ThnU is the transcriptional activator of these cephamycin C genes although they are not physically linked to the thn cluster. In addition, it was shown that deletion of thnI has an upregulatory effect on pcbAB and cmcI transcription consistent with a significant increase in cephamycin C biosynthesis in this mutant.

  5. Evaluation of cephamycins as supplements to selective agar for detecting Campylobacter spp. in chicken carcass rinses.

    Science.gov (United States)

    Chon, Jung-Whan; Kim, Young-Ji; Kim, Hong-Seok; Kim, Dong-Hyeon; Kim, Hyunsook; Song, Kwang-Young; Sung, Kidon; Seo, Kun-Ho

    2016-04-16

    Although cefoperazone is the most commonly used antibiotic in Campylobacter-selective media, the distribution of cefoperazone-resistant bacteria such as extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli is increasing. Here we evaluated the potential of cephamycins for use as supplements to improve modified charcoal-cefoperazone-deoxycholate agar (mCCDA) by replacing cefoperazone with the same concentrations (32 mg/L) of cefotetan (modified charcoal-cefotetan-deoxycholate agar, mCCtDA) and cefoxitin (modified charcoal-cefoxitin-deoxycholate agar, mCCxDA). In chicken carcass rinse samples, the number of mCCDA plates detecting for Campylobacter (18/70, 26%) was significantly lower than that of mCCtDA (42/70, 60%) or mCCxDA plates (40/70, 57%). The number of mCCDA plates (70/70, 100%) that were contaminated with non-Campylobacter species was significantly higher than that of mCCtDA (20/70, 29%) or mCCxDA plates (21/70, 30%). The most common competing species identified using mCCDA was ESBL-producing E. coli, while Pseudomonas species frequently appeared on mCCtDA and mCCxDA.

  6. Production of clavulanic acid and cephamycin C by Streptomyces clavuligerus under different fed-batch conditions

    Directory of Open Access Journals (Sweden)

    C. Bellão

    2013-06-01

    Full Text Available The effect of carbon source and feeding conditions on the production of clavulanic acid (CA and cephamycin C (CephC by Streptomyces clavuligerus was investigated. In fed-batch experiments performed with glycerol feeding, production of CA exceeded that of CephC, and reached 1022 mg.L-1. Highest CephC production (566.5 mg.L-1 was obtained in fed-batch cultivation with glycerol feeding. In fed-batch experiments performed with starch feeding, the production of CephC was in general higher than that of CA. A dissociation index (DI was used to identify feeding conditions that favored production of CephC relative to CA. In all cultures with glycerol, DI values were less than unity, indicating higher production of CA compared to CephC. Conversely, in cultures fed with starch, the DI values obtained were greater than unity. However, no carbon source or feeding condition was able to completely dissociate the production of CA from that of CephC.

  7. Dissociation of cephamycin C and clavulanic acid biosynthesis by 1,3-diaminopropane in Streptomyces clavuligerus.

    Science.gov (United States)

    Leite, Carla A; Cavallieri, André P; Baptista, Amanda S; Araujo, Maria L G C

    2016-01-01

    Streptomyces clavuligerus produces simultaneously cephamycin C (CephC) and clavulanic acid (CA). Adding 1,3-diaminopropane to culture medium stimulates production of beta-lactam antibiotics. However, there are no studies on the influence of this diamine on coordinated production of CephC and CA. This study indicates that 1,3-diaminopropane can dissociate CephC and CA productions. Results indicated that low diamine concentrations (below 1.25 g l(-1)) in culture medium increased CA production by 200%, but not that of CephC. Conversely, CephC production increased by 300% when 10 g l(-1) 1,3-diaminopropane was added to culture medium. Addition of just L-lysine (18.3 g l(-1)) to culture medium increased both biocompounds. On the other hand, while L-lysine plus 7.5 g l(-1) 1,3-diaminopropane increased volumetric production of CephC by 1100%, its impact on CA production was insignificant. The combined results suggest that extracellular concentration of 1,3-diaminopropane may trigger the dissociation of CephC and CA biosynthesis in S. clavuligerus.

  8. Characterization of DNA-binding sequences for CcaR in the cephamycin-clavulanic acid supercluster of Streptomyces clavuligerus.

    Science.gov (United States)

    Santamarta, I; López-García, M T; Kurt, A; Nárdiz, N; Alvarez-Álvarez, R; Pérez-Redondo, R; Martín, J F; Liras, P

    2011-08-01

    RT-PCR analysis of the genes in the clavulanic acid cluster revealed three transcriptional polycistronic units that comprised the ceaS2-bls2-pah2-cas2, cyp-fd-orf12-orf13 and oppA2-orf16 genes, whereas oat2, car, oppA1, claR, orf14, gcaS and pbpA were expressed as monocistronic transcripts. Quantitative RT-PCR of Streptomyces clavuligerus ATCC 27064 and the mutant S. clavuligerus ccaR::aph showed that, in the mutant, there was a 1000- to 10,000-fold lower transcript level for the ceaS2 to cas2 polycistronic transcript that encoded CeaS2, the first enzyme of the clavulanic acid pathway that commits arginine to clavulanic acid biosynthesis. Smaller decreases in expression were observed in the ccaR mutant for other genes in the cluster. Two-dimensional electrophoresis and MALDI-TOF analysis confirmed the absence in the mutant strain of proteins CeaS2, Bls2, Pah2 and Car that are required for clavulanic acid biosynthesis, and CefF and IPNS that are required for cephamycin biosynthesis. Gel shift electrophoresis using recombinant r-CcaR protein showed that it bound to the ceaS2 and claR promoter regions in the clavulanic acid cluster, and to the lat, cefF, cefD-cmcI and ccaR promoter regions in the cephamycin C gene cluster. Footprinting experiments indicated that triple heptameric conserved sequences were protected by r-CcaR, and allowed identification of heptameric sequences as CcaR binding sites.

  9. Transcriptomic analysis of Streptomyces clavuligerus ΔccaR::tsr: effects of the cephamycin C-clavulanic acid cluster regulator CcaR on global regulation.

    Science.gov (United States)

    Alvarez-Álvarez, R; Rodríguez-García, A; Santamarta, I; Pérez-Redondo, R; Prieto-Domínguez, A; Martínez-Burgo, Y; Liras, P

    2014-05-01

    Streptomyces clavuligerus ATCC 27064 and S. clavuligerus ΔccaR::tsr cultures were grown in asparagine-starch medium, and samples were taken in the exponential and stationary growth phases. Transcriptomic analysis showed that the expression of 186 genes was altered in the ccaR-deleted mutant. These genes belong to the cephamycin C gene cluster, clavulanic acid gene cluster, clavams, holomycin, differentiation, carbon, nitrogen, amino acids or phosphate metabolism and energy production. All the clavulanic acid biosynthesis genes showed Mc values in the order of -4.23. The blip gene-encoding a β-lactamase inhibitory protein was also controlled by the cephamycin C-clavulanic acid cluster regulator (Mc -2.54). The expression of the cephamycin C biosynthesis genes was greatly reduced in the mutant (Mc values up to -7.1), while the genes involved in putative β-lactam resistance were less affected (Mc average -0.88). Genes for holomycin biosynthesis were upregulated. In addition, the lack of clavulanic acid and cephamycin production negatively affected the expression of genes for the clavulanic acid precursor arginine and of miscellaneous genes involved in nitrogen metabolism (amtB, glnB, glnA3, glnA2, glnA1). The transcriptomic results were validated by quantative reverse transcription polymerase chain reaction and luciferase assay of luxAB-coupled promoters. Transcriptomic analysis of the homologous genes of S. coelicolor validated the results obtained for S. clavuligerus primary metabolism genes.

  10. CcaR is an autoregulatory protein that binds to the ccaR and cefD-cmcI promoters of the cephamycin C-clavulanic acid cluster in Streptomyces clavuligerus.

    Science.gov (United States)

    Santamarta, Irene; Rodríguez-García, Antonio; Pérez-Redondo, Rosario; Martín, Juan F; Liras, Paloma

    2002-06-01

    The putative regulatory CcaR protein, which is encoded in the beta-lactam supercluster of Streptomyces clavuligerus, has been partially purified by ammonium sulfate precipitation and heparin affinity chromatography. In addition, it was expressed in Escherichia coli, purified as a His-tagged recombinant protein (rCcaR), and used to raise anti-rCcaR antibodies. The partially purified CcaR protein from S. clavuligerus was able to bind DNA fragments containing the promoter regions of the ccaR gene itself and the bidirectional cefD-cmcI promoter region. In contrast, CcaR did not bind to DNA fragments with the promoter regions of other genes of the cephamycin-clavulanic acid supercluster including lat, blp, claR, car-cyp, and the unlinked argR gene. The DNA shifts obtained with CcaR were prevented by anti-rCcaR immunoglobulin G (IgG) antibodies but not by anti-rabbit IgG antibodies. ccaR and the bidirectional cefD-cmcI promoter region were fused to the xylE reporter gene and expressed in Streptomyces lividans and S. clavuligerus. These constructs produced low catechol dioxygenase activity in the absence of CcaR; activity was increased 1.7- to 4.6-fold in cultures expressing CcaR. Amplification of the ccaR promoter region lacking its coding sequence in a high-copy-number plasmid in S. clavuligerus ATCC 27064 resulted in a reduced production of cephamycin C and clavulanic acid, by 12 to 20% and 40 to 60%, respectively, due to titration of the CcaR regulator. These findings confirm that CcaR is a positively acting autoregulatory protein able to bind to its own promoter as well as to the cefD-cmcI bidirectional promoter region.

  11. Ácido clavulânico e cefamicina c: uma perspectiva da biossíntese, processos de isolamento e mecanismo de ação Clavulanic acid and cephamicin c: a perspective of the biosynthesis, isolation and action mechanism

    Directory of Open Access Journals (Sweden)

    Jaine H. H. Luiz de Oliveira

    2009-01-01

    Full Text Available The present article reviews different aspects of the chemistry of two widely used β-lactam antibiotics Clavulanic Acid and Cephamycin C. The article discusses important details of the biosynthesis of these compounds, their action mechanism and, principally, the methods employed in their isolation and purification, in accordance with the available literature. Despite the large quantity of available articles and patents concerning β-lactam antibiotics, those which describe the isolation and purification of Clavulanic Acid and Cephamycin C are rare. Overall, the intention of this article is to discuss the up-to-date scientific research related to the compounds under review.

  12. The times they are a-changin': carbapenems for extended-spectrum-β-lactamase-producing bacteria.

    Science.gov (United States)

    Rodríguez-Baño, Jesús

    2015-09-01

    Several antimicrobial agents are being investigated as alternatives to carbapenems in the treatment of infections caused by ESBL-producing Enterobacteriaceae, which may be useful in avoiding overuse of carbapenems in the context of recent global spread of carbapenem-resistant Enterobacteriaceae. The most promising candidates for invasive infections so far are β-lactam/β-lactamase inhibitor combinations and cephamycins.

  13. GenBank blastx search result: AK058791 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK058791 001-002-F06 S55763.1 cephamycin gene cluster: cefD=isopenicillin N epimerase, cefE=deacetoxycephalo...sporin C synthase [Nocardia lactamdurans, Genomic, 2169 nt].|BCT BCT 4e-15 +3 ...

  14. Complete genome sequence of Streptomyces cattleya NRRL 8057, a producer of antibiotics and fluorometabolites.

    Science.gov (United States)

    Barbe, Valérie; Bouzon, Madeleine; Mangenot, Sophie; Badet, Bernard; Poulain, Julie; Segurens, Béatrice; Vallenet, David; Marlière, Philippe; Weissenbach, Jean

    2011-09-01

    Streptomyces cattleya, a producer of the antibiotics thienamycin and cephamycin C, is one of the rare bacteria known to synthesize fluorinated metabolites. The genome consists of two linear replicons. The genes involved in fluorine metabolism and in the biosynthesis of the antibiotic thienamycin were mapped on both replicons.

  15. Biosynthesis of the beta-lactam antibiotic, thienamycin, by Streptomyces cattleya.

    Science.gov (United States)

    Williamson, J M; Inamine, E; Wilson, K E; Douglas, A W; Liesch, J M; Albers-Schönberg, G

    1985-04-25

    Radioactive- and stable isotope-containing substrates were used to identify the biosynthetic precursors of the beta-lactam antibiotic, thienamycin, in Streptomyces cattleya. Acetate is utilized by the organism to form C(6) and C(7) of the beta-lactam ring. The two carbons of the hydroxyethyl group attached to C(6) are both derived from the methyl of methionine. The cysteaminyl side chain attached to C(2) is derived from cysteine. Selective inhibition of thienamycin and cephamycin C biosynthesis has been achieved either through the addition of metabolic inhibitors or through manipulation of the growth medium. These results suggest that the two beta-lactam antibiotics, thienamycin and cephamycin C, are formed by different biosynthetic pathways.

  16. Utilization of ornithine and arginine as specific precursors of clavulanic acid.

    OpenAIRE

    Romero, J; Liras, P; Martín, J F

    1986-01-01

    Ornithine and arginine (5 to 20 mM), but not glutamic acid or proline, exerted a concentration-dependent stimulatory effect on the biosynthesis of clavulanic acid in both resting-cell cultures and long-term fermentations of Streptomyces clavuligerus. Ornithine strongly inhibited cephamycin biosynthesis in the same strain. [1-14C]-, [5-14C]-, or [U-14 C] ornithine was efficiently incorporated into clavulanic acid, whereas the incorporation of uniformly labeled glutamic acid was very poor. [U-1...

  17. AmpC beta lactamases among Gram negative clinical isolates from a tertiary hospital, South India

    OpenAIRE

    Parveen R. Mohamudha; Harish, B.N.; Parija, S.C.

    2010-01-01

    AmpC β-lactamases are cephalosporinases that hydrolyze cephamycins as well as other extended-spectrum cephalosporins and are poorly inhibited by clavulanic acid. Although reported with increasing frequency, the true rate of occurrence of AmpC β-lactamases in different organisms, including members of Enterobacteriaceae, remains unknown. The present study was designed to determine the occurrence of AmpC enzyme-harbouring Gram-negative clinical isolates in a tertiary care hospital in P...

  18. Prevalence of plasmid-mediated AmpC β-lactamase-producing Escherichia coli and spread of the ST131 clone among extended-spectrum β-lactamase-producing E. coli in Japan.

    OpenAIRE

    2012-01-01

    In 2010, a total of 1327 clinical Escherichia coli isolates from five hospitals in the Kyoto and Shiga regions of Japan were analysed by PCR. The prevalences of plasmid-mediated AmpC β-lactamase (pAmpC)-producers, extended-spectrum β-lactamase (ESBL)-producers and co-producers of pAmpC and ESBL were 1.7%, 9.7% and 0.3%, respectively. Less than one-half of the pAmpC-producers were reported to be resistant to third-generation cephalosporins, cephamycins and β-lactam/β-lactam inhibitors using th...

  19. The application of materials balancing to the characterization of sequential secondary metabolite formation in Streptomyces cattleya NRRL 8057.

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    Bushell, M E; Fryday, A

    1983-06-01

    The high substrate yield factor (0.73 g biomass g glucose-1) and low R.Q. (respiratory quotient, i.e. mol CO2 evolved per mol O2 consumed) value (0.8) measured during growth-phase batch cultures of Streptomyces cattleya could be rationalized in terms of the fermentation mass balance when the oxidized elemental composition of biomass was considered. R.Q. was also indicative of the sequence of secondary metabolite formation, the value rising in steps as each new product was formed. The period of maximum respiratory activity and phosphate uptake preceded maximum growth and glucose uptake. At the end of the lytic phase, a cyclopentenedione cobalt chelator was produced. The termination of lysis coincided with melanin production. Sequential cephamycin C and thienamycin production then took place. Specific hyphal protein content (per unit RNA) peaked before the production of each new metabolite. Melanin, cephamycin C and thienamycin production were initiated when glucose, ammonia and phosphate, respectively, became growth-limiting.

  20. Resistance patterns to beta-lactams and quinolones in clinical isolates of bacteria from Cuban hospitals.

    Science.gov (United States)

    Gonzáles, I; Niebla, A; Vallin, C

    1995-01-01

    The resistance patterns to 26 beta-lactams and 8 quinolones of clinical isolates from Cuban hospitals were evaluated using the disk susceptibility test, according to the NCCLS guidelines (1992). The genera studied were Escherichia sp (320), Enterobacter sp (10), Klebsiella sp (90), Proteus sp (10), Pseudomonas sp (90), Serratia sp (20), and Staphylococcus sp (80). Higher resistance to beta-lactams was observed in the genera Pseudomonas, Escherichia and Klebsiella. For fluoroquinolones we found no significant resistance, with the exception of the genus Klebsiella. The most effective antibiotics were cephalosporins of the second and third generations, fluoroquinolones, and non-classical beta-lactams (cephamycins, moxalactam and monobactams). On the contrary, a pronounced resistance was found to penicillin, oxacillin, ticarcillin, ampicillin, methicillin, nalidixic acid and cinoxacin. These resistance patterns correspond to the high consumption of these antibiotics throughout the country.

  1. Drug: D00260 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D00260 Drug Cefotetan (JP16/USP/INN); CTT C17H17N7O8S4 575.0021 575.619 D00260.gif ...cond-generation cephalosporins J01DC05 Cefotetan D00260 Cefotetan (JP16/USP/INN) Antiinfectives [BR:br08307]...bitor Cephems - Cephamycins Cefotetan [ATC:J01DC05] D00260 Cefotetan (JP16/USP/INN) CAS: 69712-56-7 PubChem:... 7847326 DrugBank: DB01330 LigandBox: D00260 NIKKAJI: J34.283A ATOM 36 1 C1y C 25.2124 -20.1395 2 N1y N 25.2

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

    Science.gov (United States)

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

    1999-08-17

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

  3. Utilization of ornithine and arginine as specific precursors of clavulanic acid.

    Science.gov (United States)

    Romero, J; Liras, P; Martín, J F

    1986-01-01

    Ornithine and arginine (5 to 20 mM), but not glutamic acid or proline, exerted a concentration-dependent stimulatory effect on the biosynthesis of clavulanic acid in both resting-cell cultures and long-term fermentations of Streptomyces clavuligerus. Ornithine strongly inhibited cephamycin biosynthesis in the same strain. [1-14C]-, [5-14C]-, or [U-14 C] ornithine was efficiently incorporated into clavulanic acid, whereas the incorporation of uniformly labeled glutamic acid was very poor. [U-14C] citrulline were not incorporated at all. Mutant nca-1, a strain that is blocked in clavulanic acid biosynthesis, did not incorporate arginine into clavulanic acid. S. clavuligerus showed arginase activity, converting arginine into ornithine, but not amidinotransferase activity. Both arginase activity and clavulanic acid formation were enhanced simultaneously by supplementing the production medium with 10 mM arginine. PMID:2877616

  4. Determination of in vitro susceptibility of Mycobacterium tuberculosis to cephalosporins by radiometric and conventional methods

    Energy Technology Data Exchange (ETDEWEB)

    Heifets, L.B.; Iseman, M.D.; Cook, J.L.; Lindholm-Levy, P.J.; Drupa, I.

    1985-01-01

    Among eight cephalosporins and cephamycins tested in preliminary in vitro screening against Mycobacterium tuberculosis, the most promising for further study was found to be ceforanide, followed by ceftizoxime, cephapirin, and cefotaxime. Moxalactam, cefoxitin, cefamandole, and cephalothin were found to be not active enough against M. tuberculosis to be considered for further in vitro studies. The antibacterial activity of various ceforanide concentrations was investigated by three methods: (i) the dynamics of radiometric readings (growth index) in 7H12 broth; (ii) the number of CFU in the same medium; and (iii) the proportion method on 7H11 agar plates. There was a good correlation among the results obtained with these methods. The MIC for most strains ranged from 6.0 to 25.0 micrograms/ml. The BACTEC radiometric method is a reliable, rapid, and convenient method for preliminary screening and determination of the level of antibacterial activity of drugs not commonly used against M. tuberculosis.

  5. 药师参与1例重症肺炎患者的治疗实践%Participation of Clinical Pharmacists in Treatment of One Patient with Severe Pneumonia

    Institute of Scientific and Technical Information of China (English)

    陈洁; 范璟蓉; 方忠宏

    2015-01-01

    OBJECTIVE:To probe into the participation of clinical pharmacists in treatment of one patient with severe pneumonia .METHODS:The clinical pharmacists participated in the medication treatment process of one patient with severe pneumonia , analyzed the change of disease , summarized the program with different kinds of antibiotics and the efficacy , and provided pharmaceutical services for the patient .RESULTS:The efficacy of cefoxitin , as one of cephamycin , in primary treatment of respiratory tract infection was poorer than the basic drugs———high dose of penicillin.CONCLUSIONS:It is necessary to conduct the pharmacodynamics evaluation on the antibiotics of cephamycin , and take effective management measures and medication education , so as to improve the medical quality . The clinical pharmacists go into the clinic and provide pharmaceutical services can assist the clinicians to formulate the safe and effective medication treatment program and promote ration drug use .%目的:探讨药师参与重症肺炎患者的治疗实践。方法:药师参与1例重症肺炎患者的药物治疗过程,分析患者病情变化,总结不同抗菌药物治疗方案及其疗效,并提供药学服务。结果:首诊用头霉素类抗菌药物头孢西丁对呼吸道感染的疗效较差,而大剂量的青霉素等基本药物却发挥了很好的疗效。结论:有必要对头霉素类抗菌药物等进行药效学评价,并采取有效管理措施与用药教育,以提高医疗质量。临床药师深入临床,提供药学服务,可协助临床医师制订安全、有效的药物治疗方案,促进合理用药。

  6. 新生儿血培养常见病原菌与抗生素耐药%Bacterial spectrum of neonatal blood cultures and antibiotic resistance

    Institute of Scientific and Technical Information of China (English)

    崔曙东; 邵小松; 胡毓华; 章晔; 陈筱青; 管亚飞

    2011-01-01

    目的 了解新生儿血培养细菌种类及抗生素耐药情况.方法 收集662份新生儿血培养标本,对其中培养结果阳性的45份标本进行细菌分类和抗生素耐药分析.结果 甲氧西林敏感凝固酶阴性葡萄球菌(MSCNS)占首位,其次是耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)、金黄色葡萄球菌、革兰氏阴性杆菌.在非头孢菌素类的抗生素中,对青霉素耐药的比例最高(87.18%),其次是红霉素;对头孢菌素及头霉素类耐药皆在50%以上,其中头孢呋肟耐药比例达100%.结论 新生儿条件致病菌感染比例增加,抗生素使用导致非自然选择耐药菌感染增多.%Objective To study the bacterial spectrum of neonatal blood cultures and antibiotic resistance Methods Six hundred and sixty-two blood cultures from newborn infants were collected.Forty-five positive bacterial blood cultures were performed by classification of bacteria and antibiotic resistance analysis. Results Methicillin-sensitive coagulase-negative staphylococci samples occupied the first place, which was followed in an order of methicillin-resistant coagulase-negative staphylococci >staphylococcus aureus>Gram-negative bacillus samples. Among antibiotic resistant bacteria (expect cephalosporin and cephamycins), penicillin-resistant bacteria occupied the first place(87. 18%), which was followed by erythromycir-resistant bacteria. Cephalosporin and cephamycins resistant bacteria were at least 50%, in which cefuroxime-resistant bacteria were 100%. Conclusion The incidence of coagulase-negative staphylococci sepsis in newborn infants increases. Non-natural selection based antibiotic-resistant bacteria infection is increased because of the extensive use of antibiotics.

  7. In vitro activities and detection performances of cefmetazole and flomoxef for extended-spectrum β-lactamase and plasmid-mediated AmpC β-lactamase-producing Enterobacteriaceae.

    Science.gov (United States)

    Matsumura, Yasufumi; Yamamoto, Masaki; Nagao, Miki; Tanaka, Michio; Takakura, Shunji; Ichiyama, Satoshi

    2016-04-01

    To investigate the in vitro activities of cephamycins (cefmetazole and flomoxef) for extended-spectrum β-lactamase (ESBL)- and plasmid-mediated AmpC β-lactamase (pAmpC)-producing Enterobacteriaceae, a total of 574 third-generation cephalosporin-resistant clinical isolates were collected at a Japanese multicenter study. PCR and sequencing identified 394 isolates with only ESBL genes, 63 isolates with only pAmpC genes, and 6 isolates with both ESBL and pAmpC genes. blaCTX-M types predominated 95.5% of the ESBL genes, and blaCMY-2 predominated 91.3% of the pAmpC genes. The MIC50/90 values of cefmetazole and flomoxef were ≤ 1/4 and ≤ 1/≤ 1 μg/mL for isolates with only ESBL genes, respectively, and 16/>16 and 8/16 μg/mL for isolates with only pAmpC genes, respectively. Flomoxef ≥ 4 μg/mL had the best screening performance for the detection of isolates with pAmpC genes. Flomoxef had better in vitro activities against ESBL-producing Enterobacteriaceae and provided a clearer distinction between ESBL and pAmpC-producing Enterobacteriaceae compared to cefmetazole.

  8. Clavulanic acid production by Streptomyces clavuligerus: biogenesis, regulation and strain improvement.

    Science.gov (United States)

    Paradkar, Ashish

    2013-07-01

    Clavulanic acid (CA) is a potent β-lactamase inhibitor produced by Streptomyces clavuligerus and has been successfully used in combination with β-lactam antibiotics (for example, Augmentin) to treat infections caused by β-lactamase-producing pathogens. Since the discovery of CA in the late 1970s, significant information has accumulated on its biosynthesis, and regarding molecular mechanisms involved in the regulation of its production. Notably, the genes directing CA biosynthesis are clustered along with the genes responsible for the biosynthesis of the β-lactam antibiotic, cephamycin C, and co-regulated, which makes this organism unique in that the production of an antibiotic and production of a small molecule to protect the antibiotic from its enzymatic degradation are controlled by shared mechanisms. Traditionally, the industrial strain improvement programs have relied significantly on random mutagenesis and selection approach. However, the recent availability of the genome sequence of S. clavuligerus along with the capability to build metabolic models, and ability to engineer the organism by directed approaches, has created exciting opportunities to improve strain productivity more efficiently. This review will include focus mainly on the gene organization of the CA biosynthetic genes, regulatory mechanisms that affect its production, and will include perspectives on improving strain productivity.

  9. 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.

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

    Institute of Scientific and Technical Information of China (English)

    包东武; 刘荣志

    2011-01-01

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

  11. Evaluation of MicroScan ESBL confirmation panel for Enterobacteriaceae-producing, extended-spectrum beta-lactamases isolated in Japan.

    Science.gov (United States)

    Komatsu, Masaru; Aihara, Masanori; Shimakawa, Kouichi; Iwasaki, Mizuho; Nagasaka, Yoko; Fukuda, Saori; Matsuo, Shuji; Iwatani, Yoshinori

    2003-06-01

    We assessed use of the MicroScan ESBL confirmation panel (Dade Behring, Tokyo, Japan) for the detection of eight Enterobacteriaceae-producing extended-spectrum beta-lactamases (ESBL) species. Of 137 bacterial strains isolated from patients in 32 hospitals in the Kinki area of Japan, 91 produced ESBL and comprised 60 bacteria (of E. coli, K. oxytoca, and K. pneumoniae) targeted by the NCCLS ESBL test and 31 non-target bacteria such as chromosomal AmpC-producing bacteria (e.g., Serratia marcescens, Enterobacter spp.). Sensitivity and specificity of the MicroScan panel for the target bacteria were 92% and 93%, respectively; sensitivity and specificity for non-target bacteria were 52% and 100%, respectively. There were 20 ESBL-positive strains that were not inhibited by clavulanic acid in the MicroScan panel (3 of 32 ESBL-producing E. coli strains, 1 of 24 K. pneumoniae, 1 of 4 K. oxytoca, 8 of 13 E. cloacae, and 7 of 14 S. marcescens), and most of them were bacteria not targeted by the NCCLS test. In 19 of the 20 strains, the synergy effect of clavulanic acid was observed in the modified-double-disk synergy test using only the cefepime-disk. Because these strains had high MICs of > or = 16 microg/ml for cephamycins such as cefoxitin and cefmetazole, these strains might produce high levels of AmpC in addition to ESBL. The MicroScan ESBL confirmation panel showed excellent performance in detecting target, but not other bacteria. Addition of cefepime and clavulanic acid to the MicroScan panel may significantly improve detection of non-target bacteria.

  12. Determination of thermodynamic parameters of benzylpenicillin hydrolysis by metallo-β-lactamase CcrA from Bacteroides fragilis

    Energy Technology Data Exchange (ETDEWEB)

    Zhai, Le; Zhou, Li-Sheng; Liu, Cheng-Cheng; Shi, Ying; Zhou, Ya-Jun [Key Laboratory of Synthetic and Natural Functional Molecule Chemistry of Ministry of Education, College of Chemistry and Materials Science, Northwest University, Xi’an 710069 (China); Yang, Ke-Wu, E-mail: kwyang@nwu.edu.cn [Key Laboratory of Synthetic and Natural Functional Molecule Chemistry of Ministry of Education, College of Chemistry and Materials Science, Northwest University, Xi’an 710069 (China)

    2013-03-20

    Highlights: ► First report the thermokinetic parameters of benzylpenicillin hydrolysis with CcrA. ► The hydrolysis is a spontaneous and exothermic reaction with order of 1.4. ► Summarized that CcrA prefer to hydrolyze penicillins among β-lactam antibiotics. - Abstract: One of the most common way that bacteria become resistant to antibiotics is by the production of metallo-β-lactamases (MβLs) to hydrolyze the β-lactam-containing antibiotics. In this paper, the thermodynamic parameters of benzylpenicillin hydrolysis with B1 subclasses MβL CcrA (carbapenem and cephamycin resistance) from Bacteroides fragilis were determined by microcalorimetry. The activation free energy ΔG{sub ≠}{sup θ} is 87.90 ± 0.03, 88.99 ± 0.01, 89.93 ± 0.04 and 90.93 ± 0.05 kJ mol{sup −1} at 293.15, 298.15, 303.15 and 308.15 K, activation enthalpy ΔH{sub ≠}{sup θ} is 29.21 ± 0.03 kJ mol{sup −1}, activation entropy ΔS{sub ≠}{sup θ} is −200.34 ± 0.08 J mol{sup −1} K{sup −1}, the reaction order is 1.4, and the apparent activation energy E is 31.71 kJ mol{sup −1}. The thermodynamic characterization indicated that CcrA prefer to hydrolyze penicillins among three kinds of β-lactam-containing antibiotics.

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

    Science.gov (United States)

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

    1997-01-01

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

  14. Cefoxitin as an alternative to carbapenems in a murine model of urinary tract infection due to Escherichia coli harboring CTX-M-15-type extended-spectrum β-lactamase.

    Science.gov (United States)

    Lepeule, Raphaël; Ruppé, Etienne; Le, Patrick; Massias, Laurent; Chau, Françoise; Nucci, Amandine; Lefort, Agnès; Fantin, Bruno

    2012-03-01

    We investigated the efficiency of the cephamycin cefoxitin as an alternative to carbapenems for the treatment of urinary tract infections (UTIs) due to Escherichia coli producing CTX-M-type extended-spectrum β-lactamases. The susceptible, UTI-inducing E. coli CFT073-RR strain and its transconjugant CFT073-RR Tc (pbla(CTX-M-15)), harboring a bla(CTX-M-15) carrying-plasmid, were used for all experiments. MICs of cefoxitin (FOX), ceftriaxone (CRO), imipenem (IMP), and ertapenem (ETP) for CFT073-RR and CFT073-RR Tc (pbla(CTX-M-15)) were 4 and 4, 0.125 and 512, 0.5 and 0.5, and 0.016 and 0.032 μg/ml, respectively. Bactericidal activity was similarly achieved in vitro against the two strains after 3 h of exposure to concentrations of FOX, IMI, and ETP that were 2 times the MIC, whereas CRO was not bactericidal against CFT073-RR Tc (pbla(CTX-M-15)). The frequencies of spontaneous mutants of the 2 strains were not higher for FOX than for IMP or ETP. In the murine model of UTIs, mice infected for 5 days were treated over 24 h. Therapeutic regimens in mice (200 mg/kg of body weight every 3 h or 4 h for FOX, 70 mg/kg every 6 h for CRO, 100 mg/kg every 2 h for IMP, and 100 mg/kg every 4 h for ETP) were chosen in order to reproduce the percentage of time that free-drug concentrations above the MIC are obtained in humans with standard regimens. All antibiotic regimens produced a significant reduction in bacterial counts (greater than 2 log(10) CFU) in kidneys and bladders for both strains (P carbapenems for the treatment of UTIs due to CTX-M-producing E. coli.

  15. Prevalence of plasmid-mediated AmpC β-lactamase-producing Escherichia coli and spread of the ST131 clone among extended-spectrum β-lactamase-producing E. coli in Japan.

    Science.gov (United States)

    Matsumura, Yasufumi; Yamamoto, Masaki; Higuchi, Takeshi; Komori, Toshiaki; Tsuboi, Fusayuki; Hayashi, Akihiko; Sugimoto, Yoshihisa; Hotta, Gou; Matsushima, Aki; Nagao, Miki; Takakura, Shunji; Ichiyama, Satoshi

    2012-08-01

    In 2010, a total of 1327 clinical Escherichia coli isolates from five hospitals in the Kyoto and Shiga regions of Japan were analysed by PCR. The prevalences of plasmid-mediated AmpC β-lactamase (pAmpC)-producers, extended-spectrum β-lactamase (ESBL)-producers and co-producers of pAmpC and ESBL were 1.7%, 9.7% and 0.3%, respectively. Less than one-half of the pAmpC-producers were reported to be resistant to third-generation cephalosporins, cephamycins and β-lactam/β-lactam inhibitors using the old 2009 Clinical and Laboratory Standards Institute (CLSI) breakpoints. CMY-2 was the most prevalent pAmpC type (95%), and CTX-M-14 (38%), CTX-M-15 (26%) and CTX-M-27 (19%) were the most prevalent ESBL types. The worldwide O25b-ST131-B2 clone accounted for 11% of pAmpC-producers and 41% of ESBL-producers. The O25b-ST131-B2 clone was characterised by a CTX-M-27- or CTX-M-15-type ESBL and ciprofloxacin-non-susceptibility with quadruple mutations in the quinolone resistance-determining regions (S83L and D87N in GyrA and S80I and E84V in ParC). A significant proportion of pAmpC-producers and the O25b-ST131-B2 clone were found in Japan by a recent regional surveillance programme.

  16. Analysis on drug resistance in Gram-negative bacilli producing AmpC enzyme%医院感染革兰阴性杆菌产AmpC酶状况及耐药性检测分析

    Institute of Scientific and Technical Information of China (English)

    李文波; 刘琼; 卢青云; 高武; 刘丽华; 王沛; 张玉娟

    2012-01-01

    Objective To investigate the nosocomial infection status and drug resistance of Gram-negative bacilli producing ceph-alosporinaseC AmpC enzyme). Methods Strains producing AmpC lactamases were detected by three-dimensional extract test. Drug susceptibility was determined by K - B disk diffusions method. Results The overall incidence rate of strains positive with AmpC lactamases was 18. 4% (109/331). The susceptibility rate of AmpC enzyme positive strains to third-generation cephalosporins, cephamycins,monobactam and antibiotics combined with inhibitors decreased,and relatively lower to Impenem,Cefepime and Ami-kacin, with resistace rate of (2/61) ,44. 26% (27/61) and 31. 1% (19/61) respectively. Resistance rates of AmpC enzyme positive strains were obviously greater than those of negative strains. Conclusion Drug resistance of Gram-negative bacilli might be associated with AmpC enzyme. Imipenem and forth-generation cephalosporins could be considered firstly for treatment of infection caused by AmpC enzyme positive Gram-negative bacilli.%目的 探讨产头孢菌素酶(AmpC酶)革兰阴性杆菌医院内感染现状及对药物敏感性的影响.方法 对临床标本进行分离鉴定,采用K-B法对常规药物进行耐药性检测,采用美国国家临床实验室标准化委员会(NCCLS)推荐的三维法检测AmpC酶.结果 在331株革兰阴性杆菌中检出产AmpC酶109株,产酶率为18.4%,产酶菌株对第3代头孢菌素、头霉素类、环丙沙星及含酶抑制剂复合物药物敏感率下降明显,对亚胺培南、头孢吡肟、丁胺卡那耐药率较低,分别为3.28%(2/61)、44.26%(27/61)、31.1%(19/61),产酶菌株对抗菌药物的耐药率明显高于非产酶菌株.结论 革兰阴性杆菌耐药与产AmpC酶有关,治疗该菌感染应选用亚胺培南、第4代头孢菌素等.

  17. [Comprehensive evaluation of cefotetan in pediatrics].

    Science.gov (United States)

    Fujii, R; Meguro, H; Yoshioka, H; Fujita, K; Maruyama, S; Sanae, N; Nagamatsu, I; Okuno, A; Izumi, Y; Aoyama, R

    1983-06-01

    Fundamental and clinical studies on cefotetan (CTT), a new cephamycin antibiotic, were carried out under a joint study programme in pediatric field, and the following results were obtained. Pharmacokinetic study In 20 pediatric patients with normal renal function, weighing 15 to 48 kg, CTT was injected intravenously at 20 mg/kg in 3 to 5 minutes. The mean blood concentration of CTT was 215.6 micrograms/ml at 15 minutes after the end of injection, 90.7 micrograms/ml at 1 hour, 57.2 micrograms/ml at 2 hours, 33.9 micrograms/ml at 4 hours and 10.2 micrograms/ml at 8 hours. The half-life of the drug in the beta-phase, computed from the mean blood concentrations up to 8 hours postdosing, was 2.61 hours. The peak of the mean urinary excretion of cefotetan appeared in 0 to 2 hours after the injection and 36.5% of the dose was recovered in the urine. The mean excretion at 0 to 8 hours was 68.1%. Clinical study Clinical effects of CTT was evaluated in 285 patients with 287 diseases, since 1 patient had both pneumonia and erysipelas, and another both pneumonia and acute otitis media. Daily dosage of CTT ranged from 15 to 123 mg/kg, and 266 patients (93.3%) received the drug either 2 or 3 times daily. The clinical response was seen in 83.3% of the 6 cases with sepsis, 89.3% of the 122 cases with pneumonia with or without pyothorax, 96.2% of the 52 cases with either acute bronchitis or tonsillitis, 92.5% of the 67 cases with urinary tract infection and 92.5% of the 40 cases with other infections. The causative organisms were detected in 160 patients and the rate of complete disappearance was 80.6%. Out of 310 patients, side effects were seen in 9 cases, diarrhea in 8 (2.6%) and rash in 1 (0.3%). Abnormal clinical laboratory findings were seen in 24 cases, elevation of serum transaminases in 19 (7.8%), elevation of TTT and LDH in 1 (0.4%) and eosinophilia in 4 (1.6%). None of these cases showed serious side effects or abnormal clinical laboratory findings. From the above

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

    Directory of Open Access Journals (Sweden)

    Priyadarshini

    2016-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Shrenik C Mehta

    2015-06-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  1. Analysis of the use of antimicrobial agents and the monitoring of bacterial resistance%2011-2013年我院抗菌药物使用与细菌耐药性监测的分析

    Institute of Scientific and Technical Information of China (English)

    宋桂芳; 王韵

    2015-01-01

    Objective:To analyze relevance between the DDDs of antimicrobial agents and the drug resistance of common clinical pathogens in our hospital during 2011-2013 so as to provide a basis for guiding rational drug use. Methods:The number of consumption of antimicrobial agents and the incidence of major drug resistant pathogens were statistically analyzed and the related data were compared. Results:The DDDs of the third generation of cephalosporins, cephamycins, carbapenems and macrolides showed an upward trend, and the rates of drug resistance of main bacteria such as Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa Bowman/hemolytic Acinetobacter, Staphylococcus aureus and so on also showed an increasing trend. Conclusion:The DDDs of antimicrobial agents and bacterial resistance are closely related and therefore the management of antimicrobial agents should be further strengthened and improved and great attention should be paid to the monitoring of bacterial resistance.%目的:分析我院抗菌药物用药频度及与临床常见致病菌耐药情况的关联性,为指导合理用药提供依据。方法:对本院2011-2013年抗菌药物消耗数量进行统计分析,并对主要致病菌的耐药率进行统计,分析比较相关数据。结果:三代头孢菌素、头霉素类、碳青霉烯类和大环内酯类的DDDs呈上升趋势,主要致病菌大肠埃希氏菌、肺炎克雷伯氏菌、铜绿假单胞菌、鲍曼/溶血不动杆菌、金黄色葡萄球菌等的耐药率也呈逐年上升的趋势。结论:抗菌药物的DDDs对细菌耐药率关联性高,医院需要进一步加强和完善抗菌药物的管理,对细菌耐药率监测应高度重视。

  2. Increase in resistance to extended-spectrum cephalosporins in Salmonella isolated from retail chicken products in Japan.

    Science.gov (United States)

    Noda, Tamie; Murakami, Koichi; Etoh, Yoshiki; Okamoto, Fuyuki; Yatsuyanagi, Jun; Sera, Nobuyuki; Furuta, Munenori; Onozuka, Daisuke; Oda, Takahiro; Asai, Tetsuo; Fujimoto, Shuji

    2015-01-01

    Extended-spectrum β-lactamase (ESBL)-producing Salmonella are one of the most important public health problems in developed countries. ESBL-producing Salmonella strains have been isolated from humans in Asian countries neighboring Japan, along with strains harboring the plasmid-mediated extended-spectrum cephalosporin (ESC)-resistance gene, ampC (pAmpC). However, only a few studies have investigated the prevalence of ESC-resistant Salmonella in chicken products in Japan, which are the main vehicle of Salmonella transmission. The aim of this study was to investigate the prevalence of ESBL-producing, pAmpC-harboring, or carbapenem-resistant Salmonella in chicken products in Japan. In total, 355 out of 779 (45.6%) chicken product samples collected from 1996-2010 contained Salmonella, resulting in 378 distinct isolates. Of these isolates, 373 were tested for resistance to ESCs, cephamycins, or carbapenems. Isolates that showed resistance to one or more of these antimicrobials were then examined by PCR and DNA sequence analysis for the presence of the bla(CMY), bla(CTX-M), bla(TEM), and bla(SHV) resistance genes. Thirty-five resistant isolates were detected, including 26 isolates that contained pAmpC (bla(CMY-2)), and nine ESBL-producing isolates harboring bla(CTX-M) (n = 4, consisting of two bla(CTX-M-2) and two bla(CTX-M-15 genes)), bla(TEM) (n = 4, consisting of one bla(TEM-20) and three bla(TEM-52) genes), and bla(SHV) (n = 1, bla(SHV-12)). All pAmpC-harboring and ESBL-producing Salmonella isolates were obtained from samples collected after 2005, and the percentage of resistant isolates increased significantly from 0% in 2004 to 27.9% in 2010 (P for trend = 0.006). This increase was caused in part by an increase in the number of Salmonella enterica subsp. enterica serovar Infantis strains harboring an approximately 280-kb plasmid containing bla(CMY-2) in proximity to ISEcp1. The dissemination of ESC-resistant Salmonella containing plasmid-mediated bla(CMY-2) in

  3. Increase in resistance to extended-spectrum cephalosporins in Salmonella isolated from retail chicken products in Japan.

    Directory of Open Access Journals (Sweden)

    Tamie Noda

    Full Text Available Extended-spectrum β-lactamase (ESBL-producing Salmonella are one of the most important public health problems in developed countries. ESBL-producing Salmonella strains have been isolated from humans in Asian countries neighboring Japan, along with strains harboring the plasmid-mediated extended-spectrum cephalosporin (ESC-resistance gene, ampC (pAmpC. However, only a few studies have investigated the prevalence of ESC-resistant Salmonella in chicken products in Japan, which are the main vehicle of Salmonella transmission. The aim of this study was to investigate the prevalence of ESBL-producing, pAmpC-harboring, or carbapenem-resistant Salmonella in chicken products in Japan. In total, 355 out of 779 (45.6% chicken product samples collected from 1996-2010 contained Salmonella, resulting in 378 distinct isolates. Of these isolates, 373 were tested for resistance to ESCs, cephamycins, or carbapenems. Isolates that showed resistance to one or more of these antimicrobials were then examined by PCR and DNA sequence analysis for the presence of the bla(CMY, bla(CTX-M, bla(TEM, and bla(SHV resistance genes. Thirty-five resistant isolates were detected, including 26 isolates that contained pAmpC (bla(CMY-2, and nine ESBL-producing isolates harboring bla(CTX-M (n = 4, consisting of two bla(CTX-M-2 and two bla(CTX-M-15 genes, bla(TEM (n = 4, consisting of one bla(TEM-20 and three bla(TEM-52 genes, and bla(SHV (n = 1, bla(SHV-12. All pAmpC-harboring and ESBL-producing Salmonella isolates were obtained from samples collected after 2005, and the percentage of resistant isolates increased significantly from 0% in 2004 to 27.9% in 2010 (P for trend = 0.006. This increase was caused in part by an increase in the number of Salmonella enterica subsp. enterica serovar Infantis strains harboring an approximately 280-kb plasmid containing bla(CMY-2 in proximity to ISEcp1. The dissemination of ESC-resistant Salmonella containing plasmid-mediated bla(CMY-2 in chicken

  4. 72株非伤寒沙门菌药敏分析及其所致儿童肠炎的临床特点%Drug sensitivity analysis of 72 non-typhoidal Salmonella and clinical characteristics of the caused enteritis in children

    Institute of Scientific and Technical Information of China (English)

    谢广清; 龙晓玲; 梁展图; 张泉山; 付四毛

    2011-01-01

    The present paper aims to explore drug resistance of 72 non-typhoidal Salmonella isolates and the clinical characteristics of resulting enteritis in children. Stool specimens from 1 665 children experiencing intestinal infection were collected by the Digestive Disorders Ward of Zhongshan Boai Hospital from March 2009 to October 2010. The drug sensitivity testing on 72 non-typhoidal Salmonella isolates was conducted after strain identification and separation. The clinical characteristics of non-typhoidal Salmonella infection were retrospectively analyzed. The results demonstrated that sensitivities of non-typhoidal Salmonella to cefoperazone-tazobactam, Tienam, levofloxacin, piperacillin-tazobactam, and ceftazidine were 100%, 98.61%, 95.83%, 87.50% and 77.78%, respectively. Antibiotic resistance rate of these non-typhoidal Salmonella to the first and second generation cephalosporins, aminoglycosides, non-enzyme penicillin and cephamycins were all>80%. Children with intestinal infection by non-typhoidal Salmonella typically presented with clinical characteristics specific to invasive enteritis such as mucous bloody stool, omitting and fever. Older children reported more abdominal pain and showed more abdominal distension and some may deteriorate to non-typhoidal Salmonella sepsis. This study suggests that non-typhoidal Salmonella may have a high sensitivity to carbapenems, enzyme-containing β-lactam compounds, and fluoroquinolones. Therefore, antibiotics should be chosen reasonably and prudently based on drug sensitivity testing as treatment for effectively controlling infection, and preventing the occurrence of further deterioration in patients.%为探讨非伤寒沙门菌的耐药性及其引起儿童肠炎的临床特点,收集2009年3月~2010年10月广东省中山市博爱医院儿科消化病区送检的1 665例肠道感染患儿粪便标本,将培养、分离所获的72株非伤寒沙门菌进行药敏试验,并回顾分析其感染后的临床特点.结

  5. Investigation and analysis of perioperative prophylactic application of antibiotics in 584 patients%普通外科584例患者围手术期抗生素应用分析

    Institute of Scientific and Technical Information of China (English)

    赵红; 张华; 胡爱民

    2013-01-01

    Objective:To evaluate the perioperative prophylactic application of antibiotics in our hospital. Methods Antibiotics evaluation medical records of 584 general surgical patients in our hospital in 2011 were analyzed retrospectively in respect of selection of antibiotics, medication time, treatment course, drug combination and drug expenditure, etc. Results Among 584 patients, perioperative prophylactic application of antibiotics accounted for 98.96% (578 cases) with 698 drug times totally. The frequency of antibiotics use was 1. 20 times. 240 cases(41. 96% ) received antibiotics 2 hours before operation. Mean medication duration was (7. 02 ±3. 23) days. 10 categories and 35 kinds of antibiotics were used in perioperative period. The top 3 drugs for type I and II incision operation were the first-generation and second-generation cephalosporins and cephamycins. Antimicrobial agents were mainly single use, two associated medication only 48 cases (8.28% ) , and no triple therapy. The adverse reaction rate was 3.01% (21/698). Conclusion The results show that irrational use of perioperative prophylactic antibiotics is common in general surgery, and it must be standardized with relevant measures.%目的 评价我院普通外科围手术期患者预防用抗生素情况.方法 对我院2011年584例外科患者抗生素专项点评病例资料进行回顾性总结分析,从抗生素品种选择、用药时机、疗程、联合用药、费用等指标进行分析比较.结果 在584例Ⅰ~Ⅲ类切口手术患者中,抗生素预防性用药为578例(98.97%),累计用药698次,平均每例应用1.20次.术前2h给药者240例(41.96%),用药时间(7.02±3.23)d,所用药物涉及10大类35种,第1、2代头孢菌素,头霉素在Ⅰ、Ⅱ类切口手术中列前3位.抗生素主要为单用,二联用药48例(8.28%),无三联用药.不良反应发生率为3.01% (21/698).结论 我院普通外科手术围手术期患者预防用抗生素仍存在一定不规范,需进

  6. Neonatal Escherichia Coli Septicemia: A Study of 40 Cases%新生儿大肠埃希菌败血症40例临床分析

    Institute of Scientific and Technical Information of China (English)

    罗玉蓉

    2012-01-01

    目的:探讨新生儿大肠埃希菌败血症的药物敏感特点,为合理治疗提供临床依据.方法:对成都市儿童医院新生儿科2007年1月~2010年12月收治的临床怀疑败血症的新生儿血标本进行培养、分离、鉴定,选择培养结果为大肠埃希菌的病例作药敏及临床分析.结果:40例大肠埃希菌对碳青霉烯类抗生素敏感率达100%,对头孢西丁敏感率达75.0%,对含酶抑制剂抗生素如哌拉西林/他唑巴坦、替卡西林/克拉维酸敏感率为87.5%,对新生儿较少应用的氨基糖苷类、喹诺酮类抗生素敏感率为62.5%~93.8%.对较常用的青霉素、头孢菌素均不敏感,对氨苄西林完全耐药.产超广谱β-内酰胺酶(ESBLs)菌株有逐步上升趋势,晚发型高于早发型,但晚发型治疗效果较早发型好.结论:新生儿大肠埃希菌败血症临床症状无特异性,但可伴严重的并发症,部分大肠埃希菌为产ESBLs菌株,耐药性强,对一般抗生素不敏感,故应根据药敏实验结果,指导选择敏感抗生素,以控制疾病发展,降低病死率.%Objective: To investigate the drug sensitivity of neonatal Escherichia coli septicemia in order to provide guidance for reasonable treatment. Methods-. Blood samples of clinical septicemia neonates in our hospital from January 2007 to December 2010 were cultured, isolated and tested, and those with positive blood culture results in Escherichia coli were selected to perform susceptibility tests and clinical analysis. Results: It was found that all the Escherichia coli strains were completely sensitive to carbapenems such as imipenem and meropenem. To cephamycins such as cefoxitin, the sensitivity rate was 75.0%. To the compound with enzyme inhibition, such as piperacillin tazobactam and ticarcillin clavulanate, the sensitivity rate was 87.5%. To aminoglycosiders and quinolones, which were hardly used in the newborn, the sensitivity rates were 62. 5% ~93.8%. The Escherichia coli

  7. 我院2009-2010年抗菌药物使用与细菌耐药性分析%Utilization of Antibacterial Agents and Analysis of Drug Resistance in Our Hospital during 2009-2010

    Institute of Scientific and Technical Information of China (English)

    董懿珍

    2012-01-01

    OBJECTIVE: To realize the change of the drug resistance and the application of antibacterial agents in recent 2 years, to discuss the relativity of the amount of antibacterial agents and the change of drug resistance in our hospital, and to guide the rational drug use in the clinic. METHODS: We collected the distribution, constitution and drug resistance of the pathogenic bac-teria which were isolated and cultivated from the clinical samples and the DDDs of the commonly used antibacterial agents in the clinic from 2009 to 2010 were analyzed retrospectively and comparatively. RESULTS: We isolated 1977 strains of pathogenic bacte-ria for two years. Gram-negative bacilli was 67.98% of all; Gram-positive coccus was 31.21% of all; the fung was 0.81% of all. Top 5 pathogenic bacteria were Escherichia coli, Staphylococcus epidermidis, Klebsiella pneumoniae, Staphylococcus aureus and Pseudomonas aeruginosa. DDDs of 12 kinds of antibacterial agents increased among the top 20 ones, especially the DDDs of cefox-itin and ceftazidime; the separation of the multiple drug-resistant strains and the drug resistance rate ascended in varying degrees year by year. CONCLUSION: With the large amount of the third generation cephalosporin and the cephamycins used, the drug re-sistance rate of bacteria is increasing yearly in our hospital. We need enhance the management of the clinical antibacterial drugs in grading application and monitoring of drug resistance.%目的:了解我院近2年抗菌药物使用情况及病原菌耐药性变化,探讨抗菌药物用量与细菌耐药性变迁间的相关性,指导临床合理用药.方法:采用收集、统计、时比分析方法,对我院2009-2010年临床各类标本培养分离出的病原菌分布、构成和耐药性及临床常用抗菌药物用药频度( DDDs)进行回顾性分析.结果:2年共分离出1 977株病原菌,其中革兰阴性杆菌占67.98%,革兰阳性球菌占31.21%,真菌占0.81%;分离率位于前5位的病原

  8. 牛源耐甲氧西林金黄色葡萄球菌的检测%Detection of Methicillin-resistant Staphylococcus aureus Strains Isolated from Bovine Mastitis

    Institute of Scientific and Technical Information of China (English)

    苏洋; 蒲万霞; 邓海平; 李春慧; 梁红雁; 陈智华

    2013-01-01

    本研究旨在了解甘肃地区奶牛乳房炎金黄色葡萄球菌的耐药性和耐甲氧西林金黄色葡萄球菌的感染情况,为奶牛乳房炎的防制提供理论依据.采用KB纸片扩散法,检测17株金黄色葡萄球菌对8种不同抗菌药物的敏感性;再用琼脂稀释法检测了苯唑西林、万古霉素对金黄色葡萄球菌的最小抑菌浓度(MICs);头孢西丁纸片扩散法和PCR扩增特异性mecA耐药基因对所有受试菌株进行全面的耐甲氧西林金黄色葡萄球菌检测.结果表明,菌株对青霉素、磺胺异恶唑具有较强抗性,而对环丙沙星、头孢唑啉、万古霉素和苯唑西林全敏感;头孢西丁纸片扩散法未能检测出表型为MRSA的阳性菌株,而PCR方法却检测出8株mecA基因阳性菌株,且这些菌株的苯唑西林MIC均小于2μg/mL.菌株的耐药情况较严重,对甲氧西林敏感而携带mecA基因的菌株高频存在于被调查地区的奶牛场中.%The aim of present study was to investigate the antimicrobial resistance, and the prevalence of methicillin-resistant Staphylococcus aureus (S. aureus) isolated from bovine mastitis in Gansu province, to provide credible theory evidence for prevention and treatment on bovine mastitis. Eight commonly used antimicrobial agents were used for determining antimicrobial susceptibility of 17 total S. aureus strains by disk diffusion method. Agar screen method was used for determining the oxacil-lin and vancomycin minimum inhibitory concentration value as well. Disk diffusion method using the cephamycin antibiotics ce-foxitin and detection of mecA gene by PCR assay were performed to detect the presence of MRSA. Most of strains showed a high resistance for penicillin and sulfafurazole, yet keeping complete sensitivity for ciprofloxacin, cefazolin, vancomycin and ox-acillin. None MRS A isolate was identified by the phenotypic detection method, but eight MRSA isolates with the MIC of oxac-illin lower than 2 μg/mL were

  9. 肾盂肾炎患者经验用抗菌药物与药敏结果符合率%Coincidence rates between empiric antimicrobial use and antimicrobial sus-ceptibility testing results in patients with pyelonephritis

    Institute of Scientific and Technical Information of China (English)

    张海谱; 梁霞; 贾克然; 赵会海; 史文俊; 王缚鲲

    2016-01-01

    antimicrobial agents were involved,the most frequently used antimicrobial agents were third generation ceph-alosporins,cephamycins,and fluoroquinolones.The overall,partial,and non-coincidence rate between antimicrobial use and antimicrobial susceptibility testing results were 64.32%(n=402),8.32%(n=52),and 27.36%(n=171)respective-ly.The overall coincidence rate in patients with acute pyelonephritis was higher than those with chronic pyelonephritis (77.61% [n=357]vs 58.79%[n=97],P <0.05).The overall coincidence rate in patients <50 years old and ≥50 years old were 68.12%(156/229)and 75.25%(298/396)respectively,there was no significant different between two groups (χ2 =2.93,P =0.09).Conclusion The non-coincidence rate between empiric antimicrobial use and antimicrobial suscepti-bility testing results is high,measures needs to be taken to improve the empiric antimicrobials use.

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

    Institute of Scientific and Technical Information of China (English)

    刘一力; 石毅

    2015-01-01

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

  11. 上海市某三级甲等妇产科专科医院2013-2015年抗菌药物类基本药物使用分析%Analysis of the Utilization of Antibiotic Essential Medicines in a Third Grade Class A Maternity Hospital in Shanghai from 2013 to 2015

    Institute of Scientific and Technical Information of China (English)

    张延菲; 吴志刚

    2016-01-01

    OBJECTIVE:To provide reference for promoting the rational use of antibiotic essential medicines in maternity hos-pitals. METHODS:Using hospital information system (HIS),relevant data of using antibiotics in a third grade class A maternity hospital in Shanghai from 2013 to 2015 was collected,and the use of its essential medicines was analyzed. RESULTS:The con-sumption sum of antibiotics was on the decrease from 2013 to 2015,while the essential medicine rose year by year. The consump-tion sum of macrolides and essential drugs ranked the first;cephamycins(non-essential medicines)showed downward trend in con-sumption sum;though the consumption sum of nitroimidazole ranked relatively front,its essential medicines accounted for low pro-portion. Most of top 10 antibiotics in term of consumption sum and DDDs were essential medicines within 3 years,showing a good trend,while the price of Erythromycin enteric capsule,an essential drug,was relatively higher in the similar drugs,consumption sum and DDDs ranking ratio was lower than 1,which showed a good economic benefit but not social benefit;while the consump-tion sum of Ornidazole sodium chloride injection,a non-essential medicine,was obviously higher than Metronidazole sodium chlo-ride injection,an essential medicine,showing front ranking. CONCLUSIONS:The utilization of antibiotic essential medicines is generally good,while there are still some problems in the priority and rational use of individual species in the clinic,which need further strengthened management.%目的:为促进抗菌药物类基本药物在妇产科专科医院的合理使用提供参考。方法:利用医院信息系统(HIS),收集上海市某三级甲等妇产科专科医院2013-2015年抗菌药物使用的相关数据,重点对其中基本药物的使用情况进行统计和分析。结果:2013-2015年该院抗菌药物使用金额呈下降趋势,而基本药物使用金额占比逐年升高。3年间大环内酯类药物使用金

  12. 卫生部全国细菌耐药监测网2011年女性尿标本来源细菌耐药监测%Ministry of Health National Antimicrobial Resistance Investigation Net annual report of 2011 : bacterial resistances monitor of women urine samples

    Institute of Scientific and Technical Information of China (English)

    齐慧敏; 吕媛

    2012-01-01

    Objective To summarize bacterial resistance in the women clinical urine culture samples collected in 2011 from 149 hospitals of Mohnarin. Methods Conventional culture, automatic clinical microbiological system, disk diffusion and E — test methods were used for antibacterial activity of antimicrobial agents and resistances and sensitivity were calculated by using WHONET5. 6 software. Results A total of 32682 strains of bacteria were isolated, of which of E. Coli, Enterococcus faeci-um, Enterococcus faecalis, Klebsiella pneumonia and Proteus mirabilis, respectively. The antimicrobial agents with lower antibiotic resistance rates of E. Coli were carbapenems ( 0.6%), piperacillin/tazobactam (3. 7% ) , nitrofurantoin ( 5. 3% ) , cefoperazone / sulbactam ( 5. 5% ) , amikacin (6. 0% ) ,fosfomycin (8. 7% ) .cefoxitin ( 12. 0% ) ,ticarcillin/ clavulanic acid (12. 5% ) , and amoxicillin/clavulanic acid ( 15. 5% ) , respectively. That of Enterococcus spp. Were teicoplanin(0. 4% -2. 4% ), vancomycin ( 1. 2% — 4. 6% ) , amoxicillin / clavulanic acid (1.4% — 11.3%), piperacillin/tazobactam (8. 1 - 15. 5% ) ,fosfomycin (5. 3% -20. 2% ) and nitrofurantoin (5. 9% - 49. 0% ) , respectively. No linezol id resistant Enterococcus were found. Conclusion E. Coli remains the urinary tract infection major pathogen but the proportion of Enterococci was significantly increased. The overall results of antibiotic resistance were serious. Nitrofurantoin, fosfomycin and amoxicillin / clavulanic acid can be chose as empirical treatment of oral antibiotics. Antimicrobial agents with enzyme inhibitor, cephamycin aminoglycosides and carbapenems can be chose as empirical treatment of injection antibiotics.%目的 总结我国2011年临床女性尿标本来源细菌耐药状况.方法 149家医院女性尿标本中的细菌,用自动化临床微生物测定方法、纸片法或E-test法测定细菌药物敏感性,用WHONET 5.6软件进行分析.结果 共分离细菌32682株,其中排在前5位