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Sample records for drug-resistant clinical herpes

  1. Antiviral drug resistance of herpes simplex virus

    NARCIS (Netherlands)

    Stranska, Ruzena

    2004-01-01

    Infections with herpes simplex virus (HSV) usually have an asymptomatic or benign course. However, severe infections do occur, particularly in HIV/AIDS patients or transplant recipients, and may be life-threatening unless adequate antiviral therapy is given. Since its introduction in the early 1980

  2. Antiviral drug resistance of herpes simplex virus

    NARCIS (Netherlands)

    Stranska, Ruzena

    2004-01-01

    Infections with herpes simplex virus (HSV) usually have an asymptomatic or benign course. However, severe infections do occur, particularly in HIV/AIDS patients or transplant recipients, and may be life-threatening unless adequate antiviral therapy is given. Since its introduction in the early

  3. New strategies against drug resistance to herpes simplex virus

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    Jiang, Yu-Chen; Feng, Hui; Lin, Yu-Chun; Guo, Xiu-Rong

    2016-01-01

    Herpes simplex virus (HSV), a member of the Herpesviridae family, is a significant human pathogen that results in mucocutaneous lesions in the oral cavity or genital infections. Acyclovir (ACV) and related nucleoside analogues can successfully treat HSV infections, but the emergence of drug resistance to ACV has created a barrier for the treatment of HSV infections, especially in immunocompromised patients. There is an urgent need to explore new and effective tactics to circumvent drug resistance to HSV. This review summarises the current strategies in the development of new targets (the DNA helicase/primase (H/P) complex), new types of molecules (nature products) and new antiviral mechanisms (lethal mutagenesis of Janus-type nucleosides) to fight the drug resistance of HSV. PMID:27025259

  4. New strategies against drug resistance to herpes simplex virus

    Institute of Scientific and Technical Information of China (English)

    Yu-Chen Jiang; Hui Feng; Yu-Chun Lin; Xiu-Rong Guo

    2016-01-01

    Herpes simplex virus (HSV), a member of the Herpesviridae family, is a significant human pathogen that results in mucocutaneous lesions in the oral cavity or genital infections. Acyclovir (ACV) and related nucleoside analogues can successfully treat HSV infections, but the emergence of drug resistance to ACV has created a barrier for the treatment of HSV infections, especially in immunocompromised patients. There is an urgent need to explore new and effective tactics to circumvent drug resistance to HSV. This review summarises the current strategies in the development of new targets (the DNA helicase/primase (H/P) complex), new types of molecules (nature products) and new antiviral mechanisms (lethal mutagenesis of Janus-type nucleosides) to fight the drug resistance of HSV.

  5. [Drug resistant epilepsy. Clinical and neurobiological concepts].

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    Espinosa-Jovel, Camilo A; Sobrino-Mejía, Fidel E

    2015-08-16

    Drug-resistant epilepsy, is a condition defined by the International League Against Epilepsy as persistent seizures despite having used at least two appropriate and adequate antiepileptic drug treatments. Approximately 20-30% of patients with epilepsy are going to be resistant to antiepileptic drugs, with different patterns of clinical presentation, which are related to the biological basis of this disease (de novo resistance, relapsing-remitting and progressive). Drug resistant epilepsy, impacts negatively the quality of life and significantly increases the risk of premature death. From the neurobiological point of view, this medical condition is the result of the interaction of multiple variables related to the underlying disease, drug interactions and proper genetic aspects of each patient. Thanks to advances in pharmacogenetics and molecular biology research, currently some hypotheses may explain the cause of this condition and promote the study of new therapeutic options. Currently, overexpression of membrane transporters such as P-glycoprotein, appears to be one of the most important mechanisms in the development of drug resistant epilepsy. The objective of this review is to deepen the general aspects of this clinical condition, addressing the definition, epidemiology, differential diagnosis and the pathophysiological bases.

  6. In vivo fitness and virulence of a drug-resistant herpes simplex virus 1 mutant.

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    Pesola, Jean M; Coen, Donald M

    2007-05-01

    Two important issues regarding a virus mutant that is resistant to an antiviral drug are its ability to replicate in animal hosts (in vivo fitness) relative to other genetic variants, including wild type, and its ability to cause disease. These issues have been investigated for a herpes simplex virus 1 mutant that is resistant to thiourea compounds, which inhibit encapsidation of viral DNA. Following corneal inoculation of mice, the mutant virus replicated very similarly to its wild-type parent in the eye, trigeminal ganglion and brain. The mutant virus was as lethal to mice as its wild-type parent following this route of inoculation. Indeed, it exhibited increased virulence. Thus, unlike most drug-resistant virus mutants, this mutant retained in vivo fitness and virulence.

  7. Clinical Prediction Rule of Drug Resistant Epilepsy in Children

    OpenAIRE

    2015-01-01

    Background and Purpose: Clinical prediction rules (CPR) are clinical decision-making tools containing variables such as history, physical examination, diagnostic tests by developing scoring model from potential risk factors. This study is to establish clinical prediction scoring of drug-resistant epilepsy (DRE) in children using clinical manifestationa and only basic electroencephalography (EEG). Methods: Retrospective cohort study was conducted. A total of 308 children with diagnosed epileps...

  8. Drug resistance

    NARCIS (Netherlands)

    Gorter, J.A.; Potschka, H.; Noebels, J.L.; Avoli, M.; Rogawski, M.A.; Olsen, R.W.; Delgado-Escueta, A.V.

    2012-01-01

    Drug resistance remains to be one of the major challenges in epilepsy therapy. Identification of factors that contribute to therapeutic failure is crucial for future development of novel therapeutic strategies for difficult-to-treat epilepsies. Several clinical studies have shown that high seizure f

  9. Differential expression of putative drug resistance genes in Mycobacterium tuberculosis clinical isolates.

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    González-Escalante, Laura; Peñuelas-Urquides, Katia; Said-Fernández, Salvador; Silva-Ramírez, Beatriz; Bermúdez de León, Mario

    2015-12-01

    Understanding drug resistance in Mycobacterium tuberculosis requires an integrated analysis of strain lineages, mutations and gene expression. Previously, we reported the differential expression of esxG, esxH, infA, groES, rpmI, rpsA and lipF genes in a sensitive M. tuberculosis strain and in a multidrug-resistant clinical isolate. Here, we have evaluated the expression of these genes in 24 clinical isolates that belong to different lineages and have different drug resistance profiles. In vitro, growth kinetics analysis showed no difference in the growth of the clinical isolates, and thus drug resistance occurred without a fitness cost. However, a quantitative reverse transcription PCR analysis of gene expression revealed high variability among the clinical isolates, including those with similar drug resistance profiles. Due to the complexity of gene regulation pathways and the wide diversity of M. tuberculosis lineages, the use of gene expression as a molecular signature for drug resistance is not straightforward. Therefore, we recommend that the expression of M. tuberculosis genes be performed individually, and baseline expression levels should be verified among several different clinical isolates, before any further applications of these findings.

  10. Drug Resistance

    Science.gov (United States)

    HIV Treatment Drug Resistance (Last updated 3/2/2017; last reviewed 3/2/2017) Key Points As HIV multiplies in the ... the risk of drug resistance. What is HIV drug resistance? Once a person becomes infected with HIV, ...

  11. Total Protein Profile and Drug Resistance in Candida albicans Isolated from Clinical Samples

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    Kamal Uddin Zaidi

    2016-01-01

    Full Text Available This study was done to assess the antifungal susceptibility of clinical isolates of Candida albicans and to evaluate its total protein profile based on morphological difference on drug resistance. Hundred and twenty clinical isolates of C. albicans from various clinical specimens were tested for susceptibility against four antifungal agents, namely, fluconazole, itraconazole, amphotericin B, and ketoconazole. A significant increase of drug resistance in clinical isolates of C. albicans was observed. The study showed 50% fluconazole and itraconazole resistance at 32 μg mL−1 with a MIC50 and MIC90 values at 34 and 47 and 36 and 49 μg mL−1, respectively. All isolates were sensitive to amphotericin B and ketoconazole. The SDS-PAGE protein profile showed a prevalent band of ~52.5 kDa, indicating overexpression of gene in 72% strains with fluconazole resistance. Since the opportunistic infections of Candida spp. are increasing along with drug resistance, the total protein profile will help in understanding the evolutionary changes in drug resistance and also to characterize them.

  12. Interplay between Mutations and Efflux in Drug Resistant Clinical Isolates of Mycobacterium tuberculosis

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    Miguel Viveiros

    2017-04-01

    Full Text Available Numerous studies show efflux as a universal bacterial mechanism contributing to antibiotic resistance and also that the activity of the antibiotics subject to efflux can be enhanced by the combined use of efflux inhibitors. Nevertheless, the contribution of efflux to the overall drug resistance levels of clinical isolates of Mycobacterium tuberculosis is poorly understood and still is ignored by many. Here, we evaluated the contribution of drug efflux plus target-gene mutations to the drug resistance levels in clinical isolates of M. tuberculosis. A panel of 17 M. tuberculosis clinical strains were characterized for drug resistance associated mutations and antibiotic profiles in the presence and absence of efflux inhibitors. The correlation between the effect of the efflux inhibitors and the resistance levels was assessed by quantitative drug susceptibility testing. The bacterial growth/survival vs. growth inhibition was analyzed through the comparison between the time of growth in the presence and absence of an inhibitor. For the same mutation conferring antibiotic resistance, different MICs were observed and the different resistance levels found could be reduced by efflux inhibitors. Although susceptibility was not restored, the results demonstrate the existence of a broad-spectrum synergistic interaction between antibiotics and efflux inhibitors. The existence of efflux activity was confirmed by real-time fluorometry. Moreover, the efflux pump genes mmr, mmpL7, Rv1258c, p55, and efpA were shown to be overexpressed in the presence of antibiotics, demonstrating the contribution of these efflux pumps to the overall resistance phenotype of the M. tuberculosis clinical isolates studied, independently of the genotype of the strains. These results showed that the drug resistance levels of multi- and extensively-drug resistant M. tuberculosis clinical strains are a combination between drug efflux and the presence of target-gene mutations, a reality

  13. Clinical and epidemiological profiles of individuals with drug-resistant tuberculosis

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    Pedro, Heloisa da Silveira Paro; Nardi, Susilene Maria Tonelli; Pereira, Maria Izabel Ferreira; Oliveira, Rosângela Siqueira; Suffys, Philip Noel; Gomes, Harrison Magdinier; Finardi, Amanda Juliane; de Moraes, Eloise Brasil; Baptista, Ida Maria Foschiani Dias; Machado, Ricardo Luiz Dantas; Castiglioni, Lilian

    2015-01-01

    Drug-resistant tuberculosis (TB) is a growing global threat. Approximately 450,000 people developed multidrug-resistant TB worldwide in 2012 and an estimated 170,000 people died from the disease. This paper describes the sociodemographic, clinical-epidemiological and bacteriological aspects of TB and correlates these features with the distribution of anti-TB drug resistance. Mycobacterium tuberculosis (MT) cultures and drug susceptibility testing were performed according to the BACTEC MGIT 960 method. The results demonstrated that MT strains from individuals who received treatment for TB and people who were infected with human immunodeficiency virus were more resistant to TB drugs compared to other individuals (p < 0.05). Approximately half of the individuals received supervised treatment, but most drug-resistant cases were positive for pulmonary TB and exhibited positive acid-fast bacilli smears, which are complicating factors for TB control programs. Primary healthcare is the ideal level for early disease detection, but tertiary healthcare is the most common entry point for patients into the system. These factors require special attention from healthcare managers and professionals to effectively control and monitor the spread of TB drug-resistant cases. PMID:25946248

  14. Clinical and epidemiological profiles of individuals with drug-resistant tuberculosis

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    Heloisa da Silveira Paro Pedro

    2015-04-01

    Full Text Available Drug-resistant tuberculosis (TB is a growing global threat. Approximately 450,000 people developed multidrug-resistant TB worldwide in 2012 and an estimated 170,000 people died from the disease. This paper describes the sociodemographic, clinical-epidemiological and bacteriological aspects of TB and correlates these features with the distribution of anti-TB drug resistance. Mycobacterium tuberculosis (MT cultures and drug susceptibility testing were performed according to the BACTEC MGIT 960 method. The results demonstrated that MT strains from individuals who received treatment for TB and people who were infected with human immunodeficiency virus were more resistant to TB drugs compared to other individuals (p < 0.05. Approximately half of the individuals received supervised treatment, but most drug-resistant cases were positive for pulmonary TB and exhibited positive acid-fast bacilli smears, which are complicating factors for TB control programs. Primary healthcare is the ideal level for early disease detection, but tertiary healthcare is the most common entry point for patients into the system. These factors require special attention from healthcare managers and professionals to effectively control and monitor the spread of TB drug-resistant cases.

  15. Monitoring of early warning indicators for HIV drug resistance in antiretroviral therapy clinics in Zimbabwe.

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    Dzangare, J; Gonese, E; Mugurungi, O; Shamu, T; Apollo, T; Bennett, D E; Kelley, K F; Jordan, M R; Chakanyuka, C; Cham, F; Banda, R M

    2012-05-01

    Monitoring human immunodeficiency virus drug resistance (HIVDR) early warning indicators (EWIs) can help national antiretroviral treatment (ART) programs to identify clinic factors associated with HIVDR emergence and provide evidence to support national program and clinic-level adjustments, if necessary. World Health Organization-recommended HIVDR EWIs were monitored in Zimbabwe using routinely available data at selected ART clinics between 2007 and 2009. As Zimbabwe's national ART coverage increases, improved ART information systems are required to strengthen routine national ART monitoring and evaluation and facilitate scale-up of HIVDR EWI monitoring. Attention should be paid to minimizing loss to follow-up, supporting adherence, and ensuring clinic-level drug supply continuity.

  16. The population structure of drug-resistant Mycobacterium tuberculosis clinical isolates from Sichuan in China.

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    Zhao, Yuding; Feng, Qin; Tang, Ke; Zhang, Congcong; Sun, Honghu; Luo, Tao; Yang, Zhirong; Couvin, David; Rastogi, Nalin; Sun, Qun

    2012-06-01

    China ranks second next to India among 22 high-burden countries despite decades' effort on tuberculosis (TB) control. The Sichuan province today contains the second-largest number of TB cases among Chinese provinces, where the prevalence of drug-resistant TB, especially MDR-TB, is much higher than the average level in eastern China. In this study, the population structure and the transmission characteristics of drug-resistant TB in Sichuan province were studied by spoligotyping and 24-locus Mycobacterial interspersed repetitive units-variable number tandem DNA repeats (MIRU-VNTR), applied to a total of 306 clinical isolates. Spoligotyping-based analysis showed that Beijing family represented 69.28% of all isolates and constituted the largest group (66.24%) of MDR-TB in Sichuan. The remaining isolates, accounting for 33.76% of MDR isolates, belonged to the ill-defined T family, Manu2, H3, LAM9, and other minor unassigned clades. The discriminatory power evaluated for spoligotyping was poor (HGI=0.595), but high for 24-locus MIRU-VNTRs (HGI=0.999). The number of the most discriminatory loci (h>0.6) was 12, including locus 424, 802, 960, 1644, 1955, 2163b, 2996, 3007, 3192, 3690, 4348 and 4052. It was concluded that 24-locus MIRU-VNTRs could be a more discriminatory tool for differentiating clinical isolates from Sichuan region. The small clustering size obtained from the current population structure analysis suggested that the high prevalence of drug-resistant TB in this region might be attributed partially to the acquired resistance due to inappropriate drug use rather than active transmission of drug-resistant TB (primary resistance).

  17. Heat stable antimicrobial activity of Burkholderia gladioli OR1 against clinical drug resistant isolates

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    Bharti, Pratibha; Anand, Vivek; Chander, Jagdish; Singh, Inder Pal; Singh, Tej Vir; Tewari, Rupinder

    2012-01-01

    Background & objectives: Drug resistant microbes are a serious challenge to human health. During the search for novel antibiotics/inhibitors from the agricultural soil, a bacterial colony was found to inhibit the growth of clinical isolates including Staphylococcus (resistant to amikacin, ciprofloxacin, clindamycin, clinafloxacin, erythromycin, gentamicin and methicillin) and Candida (resistant to fluconazole and itraconazole). The culture was identified as Burkholderia gladioli and produced at least five different antimicrobial compounds which were highly stable at high temperature (121°C) and in the broad pH range (3.0-11.0). We report here the antimicrobial activity of B. gladioli against drug resistant bacterial pathogens. Methods: The bacterial culture was identified using morphological, biochemical and 16S rRNA gene sequencing techniques. The antimicrobial activity of the identified organism against a range of microbial pathogens was checked by Kirby-Bauer's disc diffusion method. The antimicrobial compounds in the cell free supernatant were chloroform-extracted and separated by thin layer chromatography (TLC). Results: B. gladioli OR1 exhibited broad spectrum antimicrobial activity against drug resistant clinical isolates belonging to various genera of bacteria (Staphylococcus, Enterobacter, Enterococcus, Acinetobacter and Citrobacter) and a fungus (Candida). Based on TLC profile and bioautography studies, the chloroform extract of B. gladioli OR1 consisted of at least three anti-staphylococcal and two anti-Candida metabolites. The antimicrobial activity was heat stable (121°C/20 min) as well as pH stable (3.0-11.0). Interpretation & conclusions: The bacterial soil isolate, B. gladioli OR1 possessed the ability to kill various drug resistant bacteria and a fungus. This organism produced many antimicrobial metabolites which might have the potential to be used as antibiotics in future. PMID:22771597

  18. Drug-resistant gene based genotyping for Acinetobacter baumannii in tracing epidemiological events and for clinical treatment within nosocomial settings

    Institute of Scientific and Technical Information of China (English)

    JIN Hui; XU Xiao-min; MI Zu-huang; MOU Yi; LIU Pei

    2009-01-01

    Background Acinetobacter baumannfi has emerged as an important pathogen related to serious infections and nosocomial outbreaks around the world. However, of the frequently used methods, pulsed-field gel electrophoresis (PFGE) and amplified fragment length polymorphism (AFLP) in Acinetobacter baumannii genotyping lack the direct molecular proof of drug resistance. This study was conducted to establish a typing method based on drug resistant gene identification in contrast to traditional PFGE and AFLP in the period of nosocomial epidemic or outbreak.Methods From January 2005 to October 2005, twenty-seven strains of Acinetobacter species from Intensive Care Units, the Second Affiliated Hospital in Ningbo were isolated, including both epidemic and sporadic events. Susceptibility test, PFGE, AFLP and drug resistance gene typing (DRGT) were carded out to confirm the drug resistance and analyze the genotyping, respectively. PFGE was used as a reference to evaluate the typeability of DRGT and AFLP.Results Twenty-seven strains of Acinetobacter displayed multiple antibiotic resistance and drug resistant genes, and β-lactamase genes were detected in 85.2% strains. The result of DRGT was comparable to PFGE in Acinetobacter strains with different drug resistance though a little difference existed, and even suggested a molecular evolution course of different drug-resistant strains. AFLP showed great polymorphism between strains and had weak ability in distinguishing the drug resistance.Conclusion Compared to AFLP and PFGE, DRGT is useful to analyze localized molecular epidemiology of nosocomial infections and outbreaks, which would benefit clinical diagnosis and therapy.

  19. Drug-resistant parietal lobe epilepsy: clinical manifestations and surgery outcome.

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    Asadollahi, Marjan; Sperling, Michael R; Rabiei, Amin H; Asadi-Pooya, Ali A

    2017-03-01

    We reviewed a large surgical cohort to investigate the clinical manifestations, EEG and neuroimaging findings, and postoperative seizure outcome in patients with drug-resistant parietal lobe epilepsy (PLE). All drug-resistant PLE patients, who were investigated for epilepsy surgery at Jefferson Comprehensive Epilepsy Center between 1986 and 2015, were identified. Demographic data, seizure data, EEG recordings, brain MRI, pathological findings, and postsurgical seizure outcome were reviewed. In total, 18 patients (11 males and seven females) were identified. Sixteen patients (88%) had tonic-clonic seizures, 12 (66%) had focal seizures with impaired awareness, and 13 (72%) described auras. Among 15 patients who had brain MRI, 14 patients (93%) had parietal lobe lesions. Only three of 15 patients (20%) who had interictal scalp EEG recordings showed parietal interictal spikes. Of 12 patients with available ictal surface EEG recordings, only three patients (25%) had parietal ictal EEG onset. After a mean follow-up duration of 8.6 years, 14 patients (77.7%) showed a favourable postoperative seizure outcome. In patients with PLE, semiology and EEG may be misleading and brain MRI is the most valuable tool to localize the epileptogenic zone. Postsurgical seizure outcome was favourable in our patients with drug-resistant parietal lobe epilepsy.

  20. Clinical and operational value of the extensively drug-resistant tuberculosis definition.

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    Migliori, G B; Besozzi, G; Girardi, E; Kliiman, K; Lange, C; Toungoussova, O S; Ferrara, G; Cirillo, D M; Gori, A; Matteelli, A; Spanevello, A; Codecasa, L R; Raviglione, M C

    2007-10-01

    Currently, no information is available on the effect of resistance/susceptibility to first-line drugs different from isoniazid and rifampicin in determining the outcome of extensively drug-resistant tuberculosis (XDR-TB) patients, and whether being XDR-TB is a more accurate indicator of poor clinical outcome than being resistant to all first-line anti-tuberculosis (TB) drugs. To investigate this issue, a large series of multidrug-resistant TB (MDR-TB) and XDR-TB cases diagnosed in Estonia, Germany, Italy and the Russian Federation during the period 1999-2006 were analysed. Drug-susceptibility testing for first- and second-line anti-TB drugs, quality assurance and treatment delivery was performed according to World Health Organization recommendations in all study sites. Out of 4,583 culture-positive TB cases analysed, 361 (7.9%) were MDR and 64 (1.4%) were XDR. XDR-TB cases had a relative risk (RR) of 1.58 to have an unfavourable outcome compared with MDR-TB cases resistant to all first-line drugs (isoniazid, rifampicin ethambutol, streptomycin and, when tested, pyrazinamide), and an RR of 2.61 compared with "other" MDR-TB cases (those susceptible to at least one first-line anti-TB drug among ethambutol, pyrazinamide and streptomycin, regardless of resistance to the second-line drugs not defining XDR-TB). The emergence of extensively drug-resistant tuberculosis confirms that problems in tuberculosis management are still present in Europe. While waiting for new tools which will facilitate management of extensively drug-resistant tuberculosis, accessibility to quality diagnostic and treatment services should be urgently ensured and adequate public health policies should be rapidly implemented to prevent further development of drug resistance.

  1. Antibacterial effect of Allium sativum cloves and Zingiber officinale rhizomes against multiple-drug resistant clinical pathogens

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    Ponmurugan Karuppiah

    2012-08-01

    Conclusions: Natural spices of garlic and ginger possess effective anti-bacterial activity against multi-drug clinical pathogens and can be used for prevention of drug resistant microbial diseases and further evaluation is necessary.

  2. New developments in the treatment of drug-resistant tuberculosis: clinical utility of bedaquiline and delamanid

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    Brigden G

    2015-10-01

    Full Text Available Grania Brigden,1 Cathy Hewison,2 Francis Varaine21Access Campaign, Médecins Sans Frontières, Geneva, Switzerland; 2Medical Department, Médecins Sans Frontières, Paris, France Abstract: The current treatment for drug-resistant tuberculosis (TB is long, complex, and associated with severe and life-threatening side effects and poor outcomes. For the first time in nearly 50 years, there have been two new drugs registered for use in multidrug-resistant TB (MDR-TB. Bedaquiline, a diarylquinoline, and delamanid, a nitromidoxazole, have received conditional stringent regulatory approval and have World Health Organization interim policy guidance for their use. As countries improve and scale up their diagnostic services, increasing number of patients with MDR-TB and extensively drug-resistant TB are identified. These two new drugs offer a real opportunity to improve the outcomes of these patients. This article reviews the evidence for these two new drugs and discusses the clinical questions raised as they are used outside clinical trial settings. It also reviews the importance of the accompanying drugs used with these new drugs. It is important that barriers hindering the use of these two new drugs are addressed and that the existing clinical experience in using these drugs is shared, such that their routine-use programmatic conditions is scaled up, ensuring maximum benefit for patients and countries battling the MDR-TB crisis. Keywords: MDR-TB, XDR-TB, tuberculosis drugs, group 5 drugs

  3. Inhibitory effect of Allium sativum and Zingiber officinale extracts on clinically important drug resistant pathogenic bacteria

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    Gull Iram

    2012-04-01

    Full Text Available Abstract Background Herbs and spices are very important and useful as therapeutic agent against many pathological infections. Increasing multidrug resistance of pathogens forces to find alternative compounds for treatment of infectious diseases. Methods In the present study the antimicrobial potency of garlic and ginger has been investigated against eight local clinical bacterial isolates. Three types of extracts of each garlic and ginger including aqueous extract, methanol extract and ethanol extract had been assayed separately against drug resistant Escherichia coli, Pseudomonas aeruginosa, Bacillus subtilis, Staphylococcus aureus, Klebsiella pneumoniae, Shigella sonnei, Staphylococcusepidermidis and Salmonella typhi. The antibacterial activity was determined by disc diffusion method. Results All tested bacterial strains were most susceptible to the garlic aqueous extract and showed poor susceptibility to the ginger aqueous extract. The (minimum inhibitory concentration MIC of different bacterial species varied from 0.05 mg/ml to 1.0 mg/ml. Conclusion In the light of several socioeconomic factors of Pakistan mainly poverty and poor hygienic condition, present study encourages the use of spices as alternative or supplementary medicine to reduce the burden of high cost, side effects and progressively increasing drug resistance of pathogens.

  4. Identification of multi-drug resistant Pseudomonas aeruginosa clinical isolates that are highly disruptive to the intestinal epithelial barrier

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    Shevchenko Olga

    2006-06-01

    Full Text Available Abstract Background Multi-drug resistant Pseudomonas aeruginosa nosocomial infections are increasingly recognized worldwide. In this study, we focused on the virulence of multi-drug resistant clinical strains P. aeruginosa against the intestinal epithelial barrier, since P. aeruginosa can cause lethal sepsis from within the intestinal tract of critically ill and immuno-compromised patients via mechanisms involving disruption of epithelial barrier function. Methods We screened consecutively isolated multi-drug resistant P. aeruginosa clinical strains for their ability to disrupt the integrity of human cultured intestinal epithelial cells (Caco-2 and correlated these finding to related virulence phenotypes such as adhesiveness, motility, biofilm formation, and cytotoxicity. Results Results demonstrated that the majority of the multi-drug resistant P. aeruginosa clinical strains were attenuated in their ability to disrupt the barrier function of cultured intestinal epithelial cells. Three distinct genotypes were found that displayed an extreme epithelial barrier-disrupting phenotype. These strains were characterized and found to harbor the exoU gene and to display high swimming motility and adhesiveness. Conclusion These data suggest that detailed phenotypic analysis of the behavior of multi-drug resistant P. aeruginosa against the intestinal epithelium has the potential to identify strains most likely to place patients at risk for lethal gut-derived sepsis. Surveillance of colonizing strains of P. aeruginosa in critically ill patients beyond antibiotic sensitivity is warranted.

  5. A Method for Amplicon Deep Sequencing of Drug Resistance Genes in Plasmodium falciparum Clinical Isolates from India.

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    Rao, Pavitra N; Uplekar, Swapna; Kayal, Sriti; Mallick, Prashant K; Bandyopadhyay, Nabamita; Kale, Sonal; Singh, Om P; Mohanty, Akshaya; Mohanty, Sanjib; Wassmer, Samuel C; Carlton, Jane M

    2016-06-01

    A major challenge to global malaria control and elimination is early detection and containment of emerging drug resistance. Next-generation sequencing (NGS) methods provide the resolution, scalability, and sensitivity required for high-throughput surveillance of molecular markers of drug resistance. We have developed an amplicon sequencing method on the Ion Torrent PGM platform for targeted resequencing of a panel of six Plasmodium falciparum genes implicated in resistance to first-line antimalarial therapy, including artemisinin combination therapy, chloroquine, and sulfadoxine-pyrimethamine. The protocol was optimized using 12 geographically diverse P. falciparum reference strains and successfully applied to multiplexed sequencing of 16 clinical isolates from India. The sequencing results from the reference strains showed 100% concordance with previously reported drug resistance-associated mutations. Single-nucleotide polymorphisms (SNPs) in clinical isolates revealed a number of known resistance-associated mutations and other nonsynonymous mutations that have not been implicated in drug resistance. SNP positions containing multiple allelic variants were used to identify three clinical samples containing mixed genotypes indicative of multiclonal infections. The amplicon sequencing protocol has been designed for the benchtop Ion Torrent PGM platform and can be operated with minimal bioinformatics infrastructure, making it ideal for use in countries that are endemic for the disease to facilitate routine large-scale surveillance of the emergence of drug resistance and to ensure continued success of the malaria treatment policy.

  6. Clinical Significance of HER-2 Splice Variants in Breast Cancer Progression and Drug Resistance

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    Claire Jackson

    2013-01-01

    Full Text Available Overexpression of human epidermal growth factor receptor (HER-2 occurs in 20–30% of breast cancers and confers survival and proliferative advantages on the tumour cells making HER-2 an ideal therapeutic target for drugs like Herceptin. Continued delineation of tumour biology has identified splice variants of HER-2, with contrasting roles in tumour cell biology. For example, the splice variant 16HER-2 (results from exon 16 skipping increases transformation of cancer cells and is associated with treatment resistance; conversely, Herstatin (results from intron 8 retention and p100 (results from intron 15 retention inhibit tumour cell proliferation. This review focuses on the potential clinical implications of the expression and coexistence of HER-2 splice variants in cancer cells in relation to breast cancer progression and drug resistance. “Individualised” strategies currently guide breast cancer management; in accordance, HER-2 splice variants may prove valuable as future prognostic and predictive factors, as well as potential therapeutic targets.

  7. Herpes

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    ... AACC products and services. Advertising & Sponsorship: Policy | Opportunities Herpes Testing Share this page: Was this page helpful? Also known as: Herpes Culture; Herpes Simplex Viral Culture; HSV DNA; HSV ...

  8. Herpes zoster oticus: A rare clinical entity

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    Shailesh Gondivkar

    2010-01-01

    Full Text Available Herpes zoster oticus also known as Ramsay Hunt syndrome is a rare complication of herpes zoster in which reactivation of latent varicella zoster virus infection in the geniculate ganglion causes otalgia, auricular vesicles, and peripheral facial paralysis. Ramsay Hunt syndrome is rare in children and affects both sexes equally. Incidence and clinical severity increases when host immunity is compromised. Because these symptoms do not always present at the onset, this syndrome can be misdiagnosed. Although secondary to Bell′s palsy in terms of the cause of acute atraumatic peripheral facial paralysis, Ramsay Hunt syndrome, with incidence ranged from 0.3 to 18%, has a worse prognosis. Herpes zoster oticus accounts for about 12% cases of facial palsy, which is usually unilateral and complete and full recovery occurs in only about 20% of untreated patients. The most advisable method to treat Ramsay Hunt syndrome is the combination therapy with acyclovir and prednisone but still not promising, and several prerequisites are required for better results. We present a case of 32-year-old man suffering from Ramsay Hunt syndrome with grade V facial palsy treated effectively with rehabilitation program, after the termination of the combination therapy of acyclovir and prednisone.

  9. Drug-resistant tuberculosis clinical trials: proposed core research definitions in adults.

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    Furin, J; Alirol, E; Allen, E; Fielding, K; Merle, C; Abubakar, I; Andersen, J; Davies, G; Dheda, K; Diacon, A; Dooley, K E; Dravnice, G; Eisenach, K; Everitt, D; Ferstenberg, D; Goolam-Mahomed, A; Grobusch, M P; Gupta, R; Harausz, E; Harrington, M; Horsburgh, C R; Lienhardt, C; McNeeley, D; Mitnick, C D; Nachman, S; Nahid, P; Nunn, A J; Phillips, P; Rodriguez, C; Shah, S; Wells, C; Thomas-Nyang'wa, B; du Cros, P

    2016-03-01

    Drug-resistant tuberculosis (DR-TB) is a growing public health problem, and for the first time in decades, new drugs for the treatment of this disease have been developed. These new drugs have prompted strengthened efforts in DR-TB clinical trials research, and there are now multiple ongoing and planned DR-TB clinical trials. To facilitate comparability and maximise policy impact, a common set of core research definitions is needed, and this paper presents a core set of efficacy and safety definitions as well as other important considerations in DR-TB clinical trials work. To elaborate these definitions, a search of clinical trials registries, published manuscripts and conference proceedings was undertaken to identify groups conducting trials of new regimens for the treatment of DR-TB. Individuals from these groups developed the core set of definitions presented here. Further work is needed to validate and assess the utility of these definitions but they represent an important first step to ensure there is comparability in clinical trials on multidrug-resistant TB.

  10. Clinical application of HIV drug resistance testing%HIV耐药检测的临床应用

    Institute of Scientific and Technical Information of China (English)

    李敬云

    2012-01-01

    检测HIV耐药毒株可采用基因型和表型方法.由于HIV及其准种的高度变异性、抗HIV药物种类及其作用机制的多样性及HIV耐药检测方法的复杂性,目前,熟练运用HIV耐药检测方法并将检测结果整合到临床常规治疗的管理还存在很大问题,制订合理的临床应用指南是耐药检测面临的最大挑战.本文针对常用的2种HIV耐药检测方法,分析解释检测结果使用的方法及存在的问题,介绍国际最新的HIV耐药检测临床使用规范,并提出未来HIV耐药检测及临床应用应关注和解决的问题.%Genotype and phenotype testing can be used for HIV drug resistance testing. Because of the high diversity of HIV and its quasispecies, the variety of antiretroviral drugs and its mechanism and the complexity of HIV drug resistance testing, skillful use of the drug resistance testing and integration of the testing results into clinical management remains a big problem, and working out the rational clinical application guideline is a rigorous challenge for HIV drug resistance testing. In this paper, the author interprets and analyzes the results of genotype and phenotype testing and the exsiting problems, introduces the updated international clinical specifications of HIV drug resistance testing, and puts forward the problems to be focused on and be resolved in the future in the field of HIV drug resistance testing and its clinical application.

  11. Herpes Zoster Vaccination: Controversies and Common Clinical Questions.

    Science.gov (United States)

    Van Epps, Puja; Schmader, Kenneth E; Canaday, David H

    2016-01-01

    Herpes zoster, clinically referred to as shingles, is an acute, cutaneous viral infection caused by reactivation of the varicella zoster virus, the same virus that causes chickenpox. The incidence of herpes zoster and its complications increase with decline in cell-mediated immunity, including age-associated decline. The most effective management strategy for herpes zoster is prevention of the disease through vaccination in those who are most vulnerable. Despite the demonstrated efficacy in reducing the incidence and severity of herpes zoster, the uptake of vaccine remains low. Here, we will discuss the controversies that surround the live herpes zoster vaccine and address the common clinical questions that arise. We will also discuss the new adjuvanted herpes zoster vaccine currently under investigation.

  12. Clinically relevant transmitted drug resistance to first line antiretroviral drugs and implications for recommendations.

    Directory of Open Access Journals (Sweden)

    Susana Monge

    Full Text Available BACKGROUND: The aim was to analyse trends in clinically relevant resistance to first-line antiretroviral drugs in Spain, applying the Stanford algorithm, and to compare these results with reported Transmitted Drug Resistance (TDR defined by the 2009 update of the WHO SDRM list. METHODS: We analysed 2781 sequences from ARV naive patients of the CoRIS cohort (Spain between 2007-2011. Using the Stanford algorithm "Low-level resistance", "Intermediate resistance" and "High-level resistance" categories were considered as "Resistant". RESULTS: 70% of the TDR found using the WHO list were relevant for first-line treatment according to the Stanford algorithm. A total of 188 patients showed clinically relevant resistance to first-line ARVs [6.8% (95%Confidence Interval: 5.8-7.7], and 221 harbored TDR using the WHO list [7.9% (6.9-9.0]. Differences were due to a lower prevalence in clinically relevant resistance for NRTIs [2.3% (1.8-2.9 vs. 3.6% (2.9-4.3 by the WHO list] and PIs [0.8% (0.4-1.1 vs. 1.7% (1.2-2.2], while it was higher for NNRTIs [4.6% (3.8-5.3 vs. 3.7% (3.0-4.7]. While TDR remained stable throughout the study period, clinically relevant resistance to first line drugs showed a significant trend to a decline (p = 0.02. CONCLUSIONS: Prevalence of clinically relevant resistance to first line ARVs in Spain is decreasing, and lower than the one expected looking at TDR using the WHO list. Resistance to first-line PIs falls below 1%, so the recommendation of screening for TDR in the protease gene should be questioned in our setting. Cost-effectiveness studies need to be carried out to inform evidence-based recommendations.

  13. MFS transporters of Candida species and their role in clinical drug resistance.

    Science.gov (United States)

    K Redhu, Archana; Shah, Abdul H; Prasad, Rajendra

    2016-06-01

    ABC (ATP-binding cassette) and MFS (major facilitator superfamily) exporters, belonging to two different superfamilies, are one of the most prominent contributors of multidrug resistance (MDR) in yeast. While the role of ABC efflux pump proteins in the development of MDR is well documented, the MFS transporters which are also implicated in clinical drug resistance have not received due attention. The MFS superfamily is the largest known family of secondary active membrane carriers, and MFS exporters are capable of transporting a host of substrates ranging from small molecules, including organic and inorganic ions, to complex biomolecules, such as peptide and lipid moieties. A few of the members of the drug/H(+) antiporter family of the MFS superfamily function as multidrug transporters and employ downhill transport of protons to efflux their respective substrates. This review focuses on the recent developments in MFS of Candida and highlights their role in drug transport by using the example of the relatively well characterized promiscuous Mdr1 efflux pump of the pathogenic yeast C. albicans.

  14. CLINICAL, NEUROPSYCHOLOGICAL AND NEUROPHYSIOLOGICAL CORRELATES OF DRUG RESISTANT JUVENILE MYOCLONIC EPILEPSY

    Directory of Open Access Journals (Sweden)

    Davis

    2015-09-01

    Full Text Available This study was designed to find the clinical, neuropsychologic, EEG and TMS (Transcranial Magnetic Stimulation characteristics of patients with treatment resistant Juvenile Myoclonic Epilepsy (JME. JME diagnosis was according to the criteria defined by Classification and Terminology Commission of the International League Against Epilepsy. For the purpose of this study, ‘treatment resistance’ was defined as having two or more generalized tonic - clonic sei zures (GTCS or disabling myoclonus resulting in falls, while on optimal dose of a first - line anti - epileptic drug for JME, with proper compliance. All the patients with JME presenting during the study period underwent detailed clinical and EEG evaluation. Hospital Anxiety and Depression score (HADS was used to screen for anxiety and depression. Single and paired pulse (TMS parameters were used to measure cortical excitability. We identified 190 patients with JME during the study period, of which 30 (15.8% were diagnosed as having treatment resistance JME. Patients with drug resistant JME were found to have statistically significant markers in the form of - later age of onset of myoclonic jerks, absence of typical early morning myoclonia, higher scores for depression and anxiety, low IQ scores and persistent EEG abnormalities while on treatment. Frequency of GTCS showed inverse correlation with IQ scores and direct correlation to the anxiety/depression scores. These patients also had paradoxically decreased cortical excitability, probably related to the high antiepileptic drug doses they were taking. We conclude that treatment resistance in JME is not very rare and that such patients form a distinct subtype with certain atypical clinical and electrophysiolog ical characteristics, with a higher risk of developing anxiety and depression

  15. Interferon susceptibility of herpes simplex virus strains isolated from patients enrolled in clinical trials.

    OpenAIRE

    Armstrong, J. A.; Skicki-Mullen, M B; Breinig, M K; Ho, M

    1983-01-01

    Herpes simplex virus type 1 strains isolated from patients who had received interferon in a clinical trial were not more resistant to human leukocyte interferon than strains derived from recipients of a placebo. The susceptibility of herpes simplex virus type 2 strains isolated from herpes genitalis was slightly less than that of herpes simplex virus type 1 strains causing herpes genitalis.

  16. Study of drug resistance and molecular typing of 59 cholerae01 clinical isolates from 1984 to 2002 in Chongqing, China

    OpenAIRE

    2013-01-01

    Objective: To analyze the correlation between drug resistance and Cholerae01 clinical isolates from 1984 to 2002 in Chongqing, China. Methods: K-B assay was applied to detect the sensitivity of 59 Cholerae01 clinical isolates (20 Ogawa, 39 Inaba) to 16 kinds of antibiotics. BioNumerics software was used for a cluster analysis of electrophoresis patterns obtained from the Not I enzyme-cutting genomic DNA by Pulsed-field gel electrophoresis (PFGE). Results: Vibrio cholerae01 in Chongqing area, ...

  17. Clinical factors predict surgical outcomes in pediatric MRI-negative drug-resistant epilepsy.

    Science.gov (United States)

    Arya, Ravindra; Leach, James L; Horn, Paul S; Greiner, Hansel M; Gelfand, Michael; Byars, Anna W; Arthur, Todd M; Tenney, Jeffrey R; Jain, Sejal V; Rozhkov, Leonid; Fujiwara, Hisako; Rose, Douglas F; Mangano, Francesco T; Holland, Katherine D

    2016-10-01

    Lack of a potentially epileptogenic lesion on brain magnetic resonance imaging (MRI) is a poor prognostic marker for epilepsy surgery. We present a single-center series of childhood-onset MRI-negative drug-resistant epilepsy (DRE) and analyze surgical outcomes and predictors. Children with MRI-negative DRE who had resective surgery from January 2007 to December 2013 were identified using an institutional database. Relevant clinical, neurophysiological, imaging, and surgical data was extracted. The primary outcome measure was seizure freedom. Predictors of seizure freedom were obtained using multivariate logistic regression. Out of 47 children with MRI-negative DRE, 12 (25.5%) were seizure free (International League Against Epilepsy [ILAE] outcome class I), after mean follow-up of 2.75 (±1.72) years. Seizure-free proportion was significantly higher in patients with single seizure semiology and concordant ictal EEG (50.0% vs. 15.2%, p=0.025). Multivariate analysis using only non-invasive pre-surgical data showed that children with daily seizures (OR 0.02, 95% CIseizures (OR 0.72, 95% CI 0.52-0.99) were less likely to be seizure-free. Also, each additional anti-epileptic drug (AED) tried before surgery decreased the probability of seizure-free outcome (OR 0.16, 95% CI 0.04-0.63). Repeat multivariate analysis after including surgical variables found no additional significant predictors of seizure-freedom. Cortical dysplasia (ILAE type IB) was the commonest histopathology. Surgical outcomes in children with MRI-negative DRE are determined by clinical factors including seizure frequency, age of onset of seizures, and number of failed AEDs. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  18. European recommendations for the clinical use of HIV drug resistance testing: 2011 update

    DEFF Research Database (Denmark)

    Vandamme, Anne-Mieke; Camacho, Ricardo J; Ceccherini-Silberstein, Francesca

    2011-01-01

    ) consider testing earliest detectable plasma RNA when a successful nonnucleoside reverse transcriptase inhibitor-containing therapy was inappropriately interrupted; (v) genotype source patient when postexposure prophylaxis is considered; for HIV-2, (vi) consider resistance testing where treatment change......The European HIV Drug Resistance Guidelines Panel, established to make recommendations to clinicians and virologists, felt that sufficient new information has become available to warrant an update of its recommendations, explained in both pocket guidelines and this full paper. The Panel makes...... the following recommendations concerning the indications for resistance testing: for HIV-1 (i) test earliest sample for protease and reverse transcriptase drug resistance in drug-naive patients with acute or chronic infection; (ii) test protease and reverse transcriptase drug resistance at virologic failure...

  19. European recommendations for the clinical use of HIV drug resistance testing: 2011 update

    DEFF Research Database (Denmark)

    Vandamme, Anne-Mieke; Camacho, Ricardo J; Ceccherini-Silberstein, Francesca;

    2011-01-01

    The European HIV Drug Resistance Guidelines Panel, established to make recommendations to clinicians and virologists, felt that sufficient new information has become available to warrant an update of its recommendations, explained in both pocket guidelines and this full paper. The Panel makes...... the following recommendations concerning the indications for resistance testing: for HIV-1 (i) test earliest sample for protease and reverse transcriptase drug resistance in drug-naive patients with acute or chronic infection; (ii) test protease and reverse transcriptase drug resistance at virologic failure......) consider testing earliest detectable plasma RNA when a successful nonnucleoside reverse transcriptase inhibitor-containing therapy was inappropriately interrupted; (v) genotype source patient when postexposure prophylaxis is considered; for HIV-2, (vi) consider resistance testing where treatment change...

  20. Assessment of clinical risk factors for drug-resistant epilepsy in children and teenagers

    Directory of Open Access Journals (Sweden)

    Marta Kasprzyk

    2014-09-01

    Full Text Available Introduction: Epilepsy is one of the most common neurological illnesses occurring in children. In approximately 20–30% of cases it is drug-resistant. Aim of the research: To assess the already-known risk factors, analyse the rarely described ones, and find new causes of epilepsy drug resistance in children, taking into account the level of impact of each factor. Material and methods : The study comprised 152 of all 383 children hospitalised in 2012 at the Neurology Department of the Polish Mother’s Memorial Hospital in Lodz due to epilepsy. Based on medical documentation, neurological examination, and our own questionnaire, we divided patients into two groups: drug-resistant epilepsy or drug-sensitive epilepsy. We compared the type, level of influence, and prevalence of different factors. For statistical analysis, the 2 test was used. Statistical significance was set at p < 0.05. Results: Drug-resistant epilepsy was found in 64 patients (42.1%, and drug-sensitive epilepsy was found in 88 patients (57.9%. Factors that were most probable to cause drug resistance included: high prevalence of seizures (Cramer’s V = 0.66, type of epileptic syndrome (V = 0.62, psychomotor developmental delay (V = 0.62, and occurrence of status epilepticus (V = 0.6. Factors such as infections of CNS in early childhood, repeated severe infections of airways in childhood, and mother’s infectious diseases with high fever during pregnancy were rare or non occurring (Cramer’s V = 0.41, 0.32, and 0.31, respectively. Conclusions : The study confirmed the previously known causes of drug resistance and indicated the significance of underestimated inflammatory and infectious factors involving pyrexia, in children and also in mothers during pregnancy.

  1. Clinical implications of molecular drug resistance testing for Mycobacterium tuberculosis: a TBNET/RESIST-TB consensus statement.

    Science.gov (United States)

    Domínguez, J; Boettger, E C; Cirillo, D; Cobelens, F; Eisenach, K D; Gagneux, S; Hillemann, D; Horsburgh, R; Molina-Moya, B; Niemann, S; Tortoli, E; Whitelaw, A; Lange, C

    2016-01-01

    The emergence of drug-resistant strains of Mycobacterium tuberculosis is a challenge to global tuberculosis (TB) control. Although culture-based methods have been regarded as the gold standard for drug susceptibility testing (DST), molecular methods provide rapid information on mutations in the M. tuberculosis genome associated with resistance to anti-tuberculosis drugs. We ascertained consensus on the use of the results of molecular DST for clinical treatment decisions in TB patients. This document has been developed by TBNET and RESIST-TB groups to reach a consensus about reporting standards in the clinical use of molecular DST results. Review of the available literature and the search for evidence included hand-searching journals and searching electronic databases. The panel identified single nucleotide mutations in genomic regions of M. tuberculosis coding for katG, inhA, rpoB, embB, rrs, rpsL and gyrA that are likely related to drug resistance in vivo. Identification of any of these mutations in clinical isolates of M. tuberculosis has implications for the management of TB patients, pending the results of in vitro DST. However, false-positive and false-negative results in detecting resistance-associated mutations in drugs for which there is poor or unproven correlation between phenotypic and clinical drug resistance complicate the interpretation. Reports of molecular DST results should therefore include specific information on the mutations identified and provide guidance for clinicians on interpretation and on the choice of the appropriate initial drug regimen.

  2. Identifying clinically relevant drug resistance genes in drug-induced resistant cancer cell lines and post-chemotherapy tissues.

    Science.gov (United States)

    Tong, Mengsha; Zheng, Weicheng; Lu, Xingrong; Ao, Lu; Li, Xiangyu; Guan, Qingzhou; Cai, Hao; Li, Mengyao; Yan, Haidan; Guo, You; Chi, Pan; Guo, Zheng

    2015-12-01

    Until recently, few molecular signatures of drug resistance identified in drug-induced resistant cancer cell models can be translated into clinical practice. Here, we defined differentially expressed genes (DEGs) between pre-chemotherapy colorectal cancer (CRC) tissue samples of non-responders and responders for 5-fluorouracil and oxaliplatin-based therapy as clinically relevant drug resistance genes (CRG5-FU/L-OHP). Taking CRG5-FU/L-OHP as reference, we evaluated the clinical relevance of several types of genes derived from HCT116 CRC cells with resistance to 5-fluorouracil and oxaliplatin, respectively. The results revealed that DEGs between parental and resistant cells, when both were treated with the corresponding drug for a certain time, were significantly consistent with the CRG5-FU/L-OHP as well as the DEGs between the post-chemotherapy CRC specimens of responders and non-responders. This study suggests a novel strategy to extract clinically relevant drug resistance genes from both drug-induced resistant cell models and post-chemotherapy cancer tissue specimens.

  3. Clinical study of distribution and drug resistance of pathogens in patients with severe acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    SU Mao-sheng; LIN Mao-hu; ZHAO Qing-hua; LIU Zhi-wei; HE Lei; JIA Ning

    2012-01-01

    Background Previous researches about necrotic pancreatic tissue infections are numerous,but the study on systemic infection related to the severe acute pancreatitis (SAP) treatment period is limited.This study aimed to investigate the distribution and drug resistance of pathogenic bacteria in patients who had hepatobiliary surgery for SAP during the past three years.Methods A retrospective study was conducted on the distribution,category and drug resistance of pathogenic bacteria in patients who had hepatobiliary surgery for SAP from 2008 to 2011.Results A total of 594 pathogenic bacteria samples were isolated.Among them 418 isolates (70.4%) were Gram bacteria negative,142 isolates (23.9%) were Gram bacteria positive,and 34 isolates (5.7%) were found fungi.The most common Gram negative bacteria were Escherichia coli (19.8%),and the dominant Gram positive pathogenic bacteria were Enterococcus faecium.The distribution of SAP-related infectious pathogens was mainly in peritoneal drainage fluid,sputum,bile,and wound secretions.Almost all the Gram negative pathogenic bacteria were sensitive to carbapenum.Extended-spectrum β-lactamases (ESBLs) producing strains were more resistant to penicillins and cephalosprins than the ESBLs non-producing strains.Staphylococcus was sensitive to vancomycin and linezolid.The drug resistance of meticillin-resistant staphylococcus (MRS) to commonly used antibiotics was higher than meticillin-sensitive streptococcus (MSS).Enterococcus sp.exhibited lower drug-resistance rates to vancomycin and linezolid.Conclusions Gram negative bacteria were the dominant SAP-related infection after hepatobiliary surgery.A high number of fungal infections were reported.Drug resistant rates were high.Rational use of antibiotics according to the site of infection,bacterial species and drug sensitivity,correctly executing the course of treatment and enhancing hand washing will contribute to therapy and prevention of SAP-related infection and decrease

  4. Clinical predictors of aminoglycoside-induced ototoxicity in drug-resistant Tuberculosis patients on intensive therapy.

    Science.gov (United States)

    Sogebi, Olusola Ayodele; Adefuye, Bolanle Olufunlola; Adebola, Stephen Oluwatosin; Oladeji, Susan Modupe; Adedeji, Taiwo Olugbemiga

    2017-08-01

    The study objectives were to determine the incidence of aminoglycoside-induced ototoxicity in institutionalized patients on intensive phase of therapy for drug-resistant Tuberculosis (DR Tb) and also to assess clinical factors which could predict the ototoxicity. The study was a prospective analytical study among consecutive DR Tb patients who were admitted for intensive phase of therapy (of 4 months) at the DR-Tb center over a 12-month period. Patients were diagnosed as DR Tb using the Gene Xpert machine to confirm Rifampicin resistance. All eligible 70 out of 87 consenting patients were consecutively recruited into the study. Patients had baseline (admission) and serial pure tone audiometries (PTAs) performed at 4 weekly intervals until discharge after 4 months of admission. Audiometric confirmation of aminoglycoside-induced ototoxicity was done by comparing serial with baseline PTA. Among the 70 patients the male:female ratio was 1.7:1. Nine patients (12.9%) were retroviral-positive, and 16 patients (22.9%) were confirmed to have ototoxicity by audiometric criteria. The duration of treatment when ototoxicity was detected in the patients ranged 4-17 (Mean±SD; 9.4±3.4) weeks. Ototoxicity was detected in the audiometric low frequency ranges in 7 (43.8%) and at the high frequencies in 4 (25.0%) of the patients. Univariate analyses of clinical parameters found that age, underlying diabetes mellitus, deranged baseline PTAv >25dB HL, BMI on admission and retroviral status were significantly associated, while sex and previous drug regimen failure were not associated with ototoxicity. Multivariate adjusted logistic regression analyses, controlling for sex, revealed age (OR=1.068, p=0.018), BMI on admission (OR=0.673, p=0.012) and retroviral positivity (OR=8.822, p=0.014) of patients could significantly predict aminoglycoside-induced ototoxicity. Incidence of aminoglycoside-induced ototoxicity in DR Tb patients was 22.9%. The clinical predictors for ototoxicity were age

  5. Antibacterial effect of Allium sativum cloves and Zingiber officinale rhizomes against multiple-drug resistant clinical pathogens

    Institute of Scientific and Technical Information of China (English)

    Ponmurugan Karuppiah; Shyamkumar Rajaram

    2012-01-01

    Objective: To evaluate the antibacterial properties of Allium sativum (garlic) cloves and Zingiberofficinale (ginger) rhizomes against multi-drug resistant clinical pathogens causing nosocomial infection. Methods: The cloves of garlic and rhizomes of ginger were extracted with 95% (v/v) ethanol. The ethanolic extracts were subjected to antibacterial sensitivity test against clinical pathogens. Results: Anti-bacterial potentials of the extracts of two crude garlic cloves and ginger rhizomes were tested against five gram negative and two gram positive multi-drug resistant bacteria isolates. All the bacterial isolates were susceptible to crude extracts of both plants extracts. Except Enterobacter sp. and Klebsiella sp., all other isolates were susceptible when subjected to ethanolic extracts of garlic and ginger. The highest inhibition zone was observed with garlic (19.45 mm) against Pseudomonas aeruginosa (P. aeruginosa). The minimal inhibitory concentration was as low as 67.00 μg/mL against P. aeruginosa. Conclusions: Natural spices of garlic and ginger possess effective anti-bacterial activity against multi-drug clinical pathogens and can be used for prevention of drug resistant microbial diseases and further evaluation is necessary.

  6. Antiretroviral salvage therapy for multiclass drug-resistant HIV-1-infected patients: from clinical trials to daily clinical practice.

    Science.gov (United States)

    Imaz, Arkaitz; Falcó, Vicenç; Ribera, Esteban

    2011-01-01

    Drug resistance is one of the key problems in the management of long-term HIV-1-infected patients. Due to cross-resistance patterns within classes, broad resistance to the three original antiretroviral classes can develop in some patients, mainly those with extensive antiretroviral treatment experience and multiple treatment failures. Triple-class-resistant HIV-1 infection has been associated with a higher risk of clinical progression and death. Additionally, it increases the probability of transmission of multidrug-resistant HIV-1 strains. Over the last years, the availability of new antiretroviral agents against novel targets (integrase inhibitors and CCR5 antagonists), and new drugs within old classes (nonnucleoside reverse transcriptase inhibitors and protease inhibitors) has opened a range of new therapeutic options for patients with multiclass drug-resistant HIV-1 infection and scarce therapeutic options with previous drugs. In randomized clinical trials, each of these new drugs has shown exceptional efficacy results, especially in patients who received other fully active drugs in the regimen. Indeed, in nonrandomized trials and observational studies, unprecedented rates of virologic suppression similar to those obtained in naive patients have been achieved when three of the currently available new drugs were combined, even in heavily experienced patients who had no viable salvage options with the previous classes. Thus, the goal of suppression and maintenance (plasma HIV-1 RNA infection. Treatment failure can still occur, however, and the management of patients with multidrug-resistant HIV-1 infection remains a challenge. Clinicians are encouraged to optimize use of the new drugs to obtain better control of HIV infection while avoiding emergence of new resistance-associated mutations. The aim of this article is to summarize current knowledge on the management of salvage therapy for patients with multidrug-resistant HIV-1 infection by analyzing the evidence

  7. Evaluation of antimicrobial and phytochemical screening of Fennel, Juniper and Kalonji essential oils against multi drug resistant clinical isolates

    Institute of Scientific and Technical Information of China (English)

    Sharmishtha Purkayastha; Rittee Narain; Praveen Dahiya

    2012-01-01

    Objective: The inhibitory effects of essential oils including fennel, juniper and kalonji from Foeniculum Vulgare, Juniperus Osteosperma and Nigella Sativa on multi drug resistant clinical isolates were investigated. All the oils have been evaluated for phytochemical constituents, antibacterial activity and TLC bioautography assay. Methods: Preliminary phytochemical analysis was performed. The antibacterial potential of essential oils from fennel, juniper and kalonji fennel, juniper and kalonji was evaluated by agar well diffusion method against multi drug resistant clinical isolates. The antibacterial effect was investigated using the TLC-bioautographic method. Results: Preliminary phytochemical analysis demonstrated the presence of most of the phytochemicals including saponins, cardiac glycosides, steroids, terpenoids, flavonoids and tannins. Antibacterial activity of essential oils was assessed on eight multi-drug resistant (MDR) clinical isolates from both Gram-positive and Gram-negative bacteria and two standard strains. All the oils tested showed significant to moderate antibacterial activity toward all tested strains except Acinetobacter sp and Staphylococcus aureus MRSA. The maximum zone of inhibition was found to be 25依0.12 mm for juniper oil followed by 21依0.085 mm for kalonji oil againstStaphylococcus aureus 2. Thin layer chromatography and bioautography assay demonstrated well-defined growth inhibition zones against Staphylococcus aureus 2 and E. coli for juniper essential oil in correspondence with tannins observed at Rf values of 0.07 and 0.57. Conclusions: Based on the present study, the essential oils from juniper and kalonji possess antibacterial activity against several multi drug resistant pathogenic bacteria and thus can be used as a base for the development of new potent drugs and phytomedicine.

  8. Drug resistant falciparum malaria and the use of artesunate-based combinations : focus on clinical trials sponsored by TDR

    Directory of Open Access Journals (Sweden)

    Walter R.J. Taylor, Jean Rigal & Piero L. Olliaro

    2003-09-01

    Full Text Available Antimalarial drug resistance has now become a serious global challenge and is the principal reasonfor the decline in antimalarial drug efficacy. Malaria endemic countries need inexpensive and efficaciousdrugs. Preserving the life spans of antimalarial drugs is a key part of the strategy for rollingback malaria. Artemisinin-based combinations offer a new and potentially highly effective way tocounter drug resistance. Clinical trials conducted in African children have attested to the good tolerabilityof oral artesunate when combined with standard antimalarial drugs. The cure rates of thedifferent combinations were generally dependent on the degree of resistance to the companiondrug. They were high for amodiaquine-artesunate, variable for sulfadoxine/pyrimethamine-artesunate,and poor for chloroquine-artesunate.

  9. MULTI DRUG RESISTANT ACINETOBACTER BAUMANNII: A SYSTEMATIC REVIEW FOR MICROBIAL AND CLINICAL STUDY

    OpenAIRE

    Buddha Bahadur Basnet; Til Bahadur Basnet; Bishnu Joshi; Rajan Kumar Dahal; Rajani Malla

    2013-01-01

    Infections due to Mutli Drug Resistant A. baumannii (MDRAB) is now recognized as a major public health problem worldwide. The nosocomial infection due to MDRAB has leaded to increased in morbidity and mortality which has added noticeably to significant challenge to modern antibiotic therapy system. This is due to rapid phenomenon of A. baumannii to acquire antibiotic resistance. Thus, in this review the overview of current knowledge on epidemiology, infections, mechanism of resistance and eff...

  10. Clinical Presentation of Atypical Genital Herpes

    Institute of Scientific and Technical Information of China (English)

    李俊杰; 梁沛杨; 罗北京

    2002-01-01

    Objective: To make a clinical analysis on the basis of 36cases of atypical genital herpes (GH) patients. Methods: Thirty-six cases of atypical GH were diagnosedclinically, and their case histories, symptoms and signs wererecorded in detail and followed up. Polymerase chain reaction(PCR) was adopted for testing HSV2-DNA with cotton-tippedswabs. Enzyme-linked immuno sorbent assay (ELISA) forserum anti-HSV2-IgM was done to establish a definfiivediagnosis. Other diagnoses were excluded at the same time bytesting for related pathogens including fungi, Chlamydia,Mycoplasma, Treponema pallidum, gonococci, Trichomonas,etc. Results: The main clinical manifestations of atypical GHwere: (1) small genital ulcers; (2) inflammation of urethralmeatus; (3) nonspecific genital erythema; (4) papuloid noduleson the glands; (5) nonspecific vaginitis. Twenty-three cases(64%) tested by PCR were HSV2-DNA sera-positive, and 36cases (100 %) anti-HSV2-IgM sera-positive by ELISA. Conclusion: atypical HSV is difficult to be diagnosed. Butthe combination of PCR and ELIAS will be helpful to thediagnosis of atypical HSV.

  11. Surveillance of transmitted antiretroviral drug resistance among HIV-1 infected women attending antenatal clinics in Chitungwiza, Zimbabwe.

    Directory of Open Access Journals (Sweden)

    Mqondisi Tshabalala

    Full Text Available The rapid scale-up of highly active antiretroviral therapy (HAART and use of single dose Nevirapine (SD NVP for prevention of mother-to-child transmission (pMTCT have raised fears about the emergence of resistance to the first line antiretroviral drug regimens. A cross-sectional study was conducted to determine the prevalence of primary drug resistance (PDR in a cohort of young (<25 yrs HAART-naïve HIV pregnant women attending antenatal clinics in Chitungwiza, Zimbabwe. Whole blood was collected in EDTA for CD4 counts, viral load, serological estimation of duration of infection using the BED Calypte assay and genotyping for drug resistance. Four hundred and seventy-one women, mean age 21 years; SD: 2.1 were enrolled into the study between 2006 and 2007. Their median CD4 count was 371cells/µL; IQR: 255-511 cells/µL. Two hundred and thirty-six samples were genotyped for drug resistance. Based on the BED assay, 27% were recently infected (RI whilst 73% had long-term infection (LTI. Median CD4 count was higher (p<0.05 in RI than in women with LTI. Only 2 women had drug resistance mutations; protease I85V and reverse transcriptase Y181C. Prevalence of PDR in Chitungwiza, 4 years after commencement of the national ART program remained below WHO threshold limit (5%. Frequency of recent infection BED testing is consistent with high HIV acquisition during pregnancy. With the scale-up of long-term ART programs, maintenance of proper prescribing practices, continuous monitoring of patients and reinforcement of adherence may prevent the acquisition and transmission of PDR.

  12. Antimicrobial Action of Water-Soluble β-Chitosan against Clinical Multi-Drug Resistant Bacteria

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    Seong-Cheol Park

    2015-04-01

    Full Text Available Recently, the number of patients infected by drug-resistant pathogenic microbes has increased remarkably worldwide, and a number of studies have reported new antibiotics from natural sources. Among them, chitosan, with a high molecular weight and α-conformation, exhibits potent antimicrobial activity, but useful applications as an antibiotic are limited by its cytotoxicity and insolubility at physiological pH. In the present study, the antibacterial activity of low molecular weight water-soluble (LMWS α-chitosan (α1k, α5k, and α10k with molecular masses of 1, 5, and 10 kDa, respectively and β-chitosan (β1k, β5k, and β10k was compared using a range of pathogenic bacteria containing drug-resistant bacteria isolated from patients at different pH. Interestingly, β5k and β10k exhibited potent antibacterial activity, even at pH 7.4, whereas only α10k was effective at pH 7.4. The active target of β-chitosan is the bacterial membrane, where the leakage of calcein is induced in artificial PE/PG vesicles, bacterial mimetic membrane. Moreover, scanning electron microscopy showed that they caused significant morphological changes on the bacterial surfaces. An in vivo study utilizing a bacteria-infected mouse model found that LMWS β-chitosan could be used as a candidate in anti-infective or wound healing therapeutic applications.

  13. Pyrosequencing for detection of drug resistant relevant mutation in the polymerase gene of hepatitis B virus and its clinical application

    Institute of Scientific and Technical Information of China (English)

    陈占国

    2014-01-01

    Objective To explore the accuracy and clinical application of pyrosequencing for detection of drug resistant relevant mutation in the polymerase gene of hepatitis B virus(HBV).Methods Compared with Sanger sequencing,the accuracy and sensitivity of pyrosequencing were assessed.Pyrosequencing was used to determine the serum of 1 164 patients with chronic Hepatitis B and its re-sults were analyzed.Results The sensitivity of pyrosequencing was 1×103KIU/L,the same as Sanger sequencing.But

  14. Trends in Prevalence of HIV-1 Drug Resistance in a Public Clinic in Maputo, Mozambique.

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    Dulce Celina Adolfo Bila

    Full Text Available An observational study was conducted in Maputo, Mozambique, to investigate trends in prevalence of HIV drug resistance (HIVDR in antiretroviral (ART naïve subjects initiating highly active antiretroviral treatment (HAART.To evaluate the pattern of drug resistance mutations (DRMs found in adults on ART failing first-line HAART [patients with detectable viral load (VL]. Untreated subjects [Group 1 (G1; n=99] and 274 treated subjects with variable length of exposure to ARV´s [6-12 months, Group 2 (G2;n=93; 12-24 months, Group 3 (G3;n=81; >24 months (G4;n=100] were enrolled. Virological and immunological failure (VF and IF were measured based on viral load (VL and T lymphocyte CD4+ cells (TCD4+ count and genotypic resistance was also performed. Major subtype found was C (untreated: n=66, 97,06%; treated: n=36, 91.7%. Maximum virological suppression was observed in G3, and significant differences intragroup were observed between VF and IF in G4 (p=0.022. Intergroup differences were observed between G3 and G4 for VF (p=0.023 and IF between G2 and G4 (p=0.0018. Viral suppression (5000 copies/ml identified 50% of subjects carrying DRM compared to 100% when lower VL cut-off was used (<50 copies/ml. Length of exposure to ARVs was directly proportional to the complexity of DRM patterns. In Mozambique, VL suppression was achieved in 76% of individuals after 24 months on HAART. This is in agreement with WHO target for HIVDR prevention target (70%.We demonstrated that the best way to determine therapeutic failure is VL compared to CD4 counts. The rationalized use of VL testing is needed to ensure timely detection of treatment failures preventing the occurrence of TDR and new infections.

  15. Phytochemical Screening and Antimicrobial Activity of Some Medicinal Plants Against Multi-drug Resistant Bacteria from Clinical Isolates.

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    Dahiya, Praveen; Dahiya, P; Purkayastha, Sharmishtha

    2012-09-01

    The in vitro antibacterial activity of various solvents and water extracts of aloe vera, neem, bryophyllum, lemongrass, tulsi, oregano, rosemary and thyme was assessed on 10 multi-drug resistant clinical isolates from both Gram-positive and Gram-negative bacteria and two standard strains including Staphylococcus aureus ATCC 25923 and Escherichia coli ATCC 25922. The zone of inhibition as determined by agar well diffusion method varied with the plant extract, the solvent used for extraction, and the organism tested. Klebsiella pneumoniae 2, Escherichia coli 3 and Staphylococcus aureus 3 were resistant to the plant extracts tested. Moreover, water extracts did not restrain the growth of any tested bacteria. Ethanol and methanol extracts were found to be more potent being capable of exerting significant inhibitory activities against majority of the bacteria investigated. Staphylococcus aureus 1 was the most inhibited bacterial isolate with 24 extracts (60%) inhibiting its growth whereas Escherichia coli 2 exhibited strong resistance being inhibited by only 11 extracts (28%). The results obtained in the agar diffusion plates were in fair correlation with that obtained in the minimum inhibitory concentration tests. The minimum inhibitory concentration of tulsi, oregano, rosemary and aloe vera extracts was found in the range of 1.56-6.25 mg/ml for the multi-drug resistant Staphylococcus aureus isolates tested whereas higher values (6.25-25 mg/ml) were obtained against the multi-drug resistant isolates Klebsiella pneumoniae 1 and Escherichia coli 1 and 2. Qualitative phytochemical analysis demonstrated the presence of tannins and saponins in all plants tested. Thin layer chromatography and bioautography agar overlay assay of ethanol extracts of neem, tulsi and aloe vera indicated flavonoids and tannins as major active compounds against methicillin-resistant Staphylococcus aureus.

  16. Phytochemical screening and antimicrobial activity of some medicinal plants against multi-drug resistant bacteria from clinical isolates

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    Praveen Dahiya

    2012-01-01

    Full Text Available The in vitro antibacterial activity of various solvents and water extracts of aloe vera, neem, bryophyllum, lemongrass, tulsi, oregano, rosemary and thyme was assessed on 10 multi-drug resistant clinical isolates from both Gram-positive and Gram-negative bacteria and two standard strains including Staphylococcus aureus ATCC 25923 and Escherichia coli ATCC 25922. The zone of inhibition as determined by agar well diffusion method varied with the plant extract, the solvent used for extraction, and the organism tested. Klebsiella pneumoniae 2, Escherichia coli 3 and Staphylococcus aureus 3 were resistant to the plant extracts tested. Moreover, water extracts did not restrain the growth of any tested bacteria. Ethanol and methanol extracts were found to be more potent being capable of exerting significant inhibitory activities against majority of the bacteria investigated. Staphylococcus aureus 1 was the most inhibited bacterial isolate with 24 extracts (60% inhibiting its growth whereas Escherichia coli 2 exhibited strong resistance being inhibited by only 11 extracts (28%. The results obtained in the agar diffusion plates were in fair correlation with that obtained in the minimum inhibitory concentration tests. The minimum inhibitory concentration of tulsi, oregano, rosemary and aloe vera extracts was found in the range of 1.56-6.25 mg/ml for the multi-drug resistant Staphylococcus aureus isolates tested whereas higher values (6.25-25 mg/ml were obtained against the multi-drug resistant isolates Klebsiella pneumoniae 1 and Escherichia coli 1 and 2. Qualitative phytochemical analysis demonstrated the presence of tannins and saponins in all plants tested. Thin layer chromatography and bioautography agar overlay assay of ethanol extracts of neem, tulsi and aloe vera indicated flavonoids and tannins as major active compounds against methicillin-resistant Staphylococcus aureus.

  17. Drug-resistant tuberculous meningitis.

    Science.gov (United States)

    Garg, Ravindra K; Jain, Amita; Malhotra, Hardeep S; Agrawal, Avinash; Garg, Rajiv

    2013-06-01

    Drug-resistant tuberculosis, including drug-resistant tuberculous meningitis, is an emerging health problem in many countries. An association with Beijing strains and drug resistance-related mutations, such as mutations in katG and rpoB genes, has been found. The pathology, clinical features and neuroimaging characteristics of drug-resistant tuberculous meningitis are similar to drug-responsive tuberculous meningitis. Detection of mycobacteria in cerebrospinal fluid (CSF) by conventional methods (smear examination or culture) is often difficult. Nucleic acid amplification assays are better methods owing to their rapidity and high sensitivity. The Xpert MTB/RIF assay (Cepheid, CA, USA) is a fully-automated test that has also been found to be effective for CSF samples. Treatment of multidrug-resistant tuberculous meningitis depends on the drug susceptibility pattern of the isolate and/or the previous treatment history of the patient. Second-line drugs with good penetration of the CSF should be preferred. Isoniazid monoresistant disease requires addition of another drug with better CSF penetration. Drug-resistant tuberculous meningitis is associated with a high mortality. HIV infected patients with drug-resistant tuberculous meningitis have severe clinical manifestations with exceptionally high mortality. Prevention of tuberculosis is the key to reduce drug-resistant tuberculous meningitis.

  18. Short Communication: Limited HIV Pretreatment Drug Resistance Among Adults Attending Free Antiretroviral Therapy Clinic of Pune, India.

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    Karade, Santosh; Patil, Ajit A; Ghate, Manisha; Kulkarni, Smita S; Kurle, Swarali N; Risbud, Arun R; Rewari, Bharat B; Gangakhedkar, Raman R

    2016-04-01

    In India, the roll out of the free antiretroviral therapy (ART) program completed a decade of its initiation in 2014. The success of first-line ART is influenced by prevalence of HIV pretreatment drug resistance (PDR) in the population. In this cross-sectional study, we sought to determine the prevalence of PDR among adults attending the state-sponsored free ART clinic in Pune in western India. Fifty-two individuals eligible for ART as per national guidelines with median CD4 cell count of 253 cells/mm(3) (inter quartile range: 149-326) were recruited between January 2014 and April 2015. Population-based sequencing of partial pol gene sequences from plasma specimen revealed predominant HIV-1 subtype C infection (96.15%) and presence of single-drug resistance mutations against non-nucleoside reverse transcriptase inhibitor in two sequences. The study supports the need for periodic surveillance, when offering PDR testing at individual level is not feasible.

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

    Institute of Scientific and Technical Information of China (English)

    钱超

    2016-01-01

    目的 探讨多重耐药铜绿假单胞菌临床分布及耐药性情况.方法 收集2014年1月~2015年4月长兴县中医院重症监护室248例患者铜绿假单胞菌临床标本,采用培养鉴定和药敏试验进行检测.结果 分离铜绿假单胞菌210株,其中,多重耐药菌60株,多重耐药菌检出率为28.6%.60株多重耐药铜绿假单胞菌主要分布在痰液(40株,66.7%),其次为伤口分泌物(11株,18.3%)、尿液(9株,15.0%).耐药情况分析结果显示,头孢他啶(41.7%)、头孢吡肟(38.3%)、哌拉西林(48.3%)、替卡西林(58.3%)、哌拉西林/他唑巴坦(58.3%)、替卡西林/克拉维酸(58.3%)、氨苄西林/舒巴坦(100.0%),耐药率均较高;氨曲南(33.3%)、亚胺培南(30.0%)、美罗培南(30.0%)、庆大霉素(40.0%)、阿米卡星(26.7%)、环丙沙星(33.3%)、左氧氟沙星(33.3%),耐药率均较低.检出10株泛耐药菌株,检出率为16.7%,通过补充药敏实验,6株(60.0%)对头孢哌酮/舒巴坦耐药,对于多黏菌素B无耐药发生.结论 对于多重耐药铜绿假单胞菌可以采用青霉烯类、喹诺酮类联合用药治疗,对于泛耐药菌株可以应用多黏菌素B进行治疗.%Objective To discuss the clinical distribution of multiple drug resistant pseudomonas aeruginosa and its drug resistance. Methods Clinical specimens of pseudomonas aeruginosa from 248 patients in ICU of Hospital of Tra-ditional Chinese Medicine of Changxing County from January 2014 to April 2015 were selected, which were detected by culture identification and drug sensitive test. Results There were 210 plants of pseudomonas aeruginosa separated, 60 plants had multiple drug resistance, the detection rate was 28.6%. 60 plants of multiple drug resistant pseudomonas aeruginosa mainly distributed in sputum (40 cases, 66.7%), following by wound secretion (11 cases, 18.3%), urine (9 cases, 15.0%). Drug resistance results analysis showed that the drug resistance rates of Ceftazidime (41.7%), Cefepime (38

  20. Clinical Determinants of HIV-1B Between-Host Evolution and their Association with Drug Resistance in Pediatric Patients

    Science.gov (United States)

    Rojas, Patricia; Ramos, José Tomás; Holguín, África

    2016-01-01

    Understanding the factors that modulate the evolution of virus populations is essential to design efficient control strategies. Mathematical models predict that factors affecting viral within-host evolution may also determine that at the between-host level. Although HIV-1 within-host evolution has been associated with clinical factors used to monitor AIDS progression, such as patient age, CD4 cells count, viral load, and antiretroviral experience, little is known about the role of these clinical factors in determining between-host HIV-1 evolution. Moreover, whether the relative importance of such factors in HIV-1 evolution vary in adult and children patients, in which the course of infection is different, has seldom been analysed. To address these questions, HIV-1 subtype B (HIV-1B) pol sequences of 163 infected children and 450 adults of Madrid, Spain, were used to estimate genetic diversity, rates of synonymous and non-synonymous mutations, selection pressures and frequency of drug-resistance mutations (DRMs). The role and relative importance of patient age, %CD4, CD4/mm3, viral load, and antiretroviral experience in HIV-1B evolution was analysed. In the pediatric HIV-1B population, three clinical factors were primary predictors of virus evolution: Higher HIV-1B genetic diversity was observed with increasing children age, decreasing CD4/mm3 and upon antiretroviral experience. This was mostly due to higher rates of non-synonymous mutations, which were associated with higher frequency of DRMs. Using this data, we have also constructed a simple multivariate model explaining between 55% and 66% of the variance in HIV-1B evolutionary parameters in pediatric populations. On the other hand, the analysed clinical factors had little effect in adult-infecting HIV-1B evolution. These findings highlight the different evolutionary dynamics of HIV-1B in children and adults, and contribute to understand the factors shaping HIV-1B evolution and the appearance of drug-resistance

  1. Assess drug resistance pattern and genetic profile of Mycobacterium tuberculosis clinical isolates by molecular typing methods using direct repeats and IS6110 in pulmonary tuberculosis cases

    Science.gov (United States)

    Kalo, Deepika; Kant, Surya; Srivastava, Kanchan; Sharma, Ajay K

    2017-01-01

    Background: Tuberculosis (TB), a highly contagious disease that sees no gender, age, or race is mainly a disease of lungs. According to World Health Organization, a TB patient can be completely cured with 6–9 months of anti-TB treatment under directly observed treatment short course. Objectives: The aim of this study was to check the mono, multi- and triple-drug resistance to first line drugs (FLDs) among TB patients and to access their genetic profile using DR 3074, DR 0270, DR 0642, DR 2068, and DR 4110 using molecular techniques. Material and Methods: To gain a better understanding of drug resistant TB, we characterized 121 clinical isolates recovered from 159 drug resistant pulmonary tuberculosis patients by IS6110 genotyping. MTB isolates recovered from HIV- negative, and smear positive cases of both genders, age varied from 18 to 70 years with drug resistant-TB that was refractory to chemotherapy given for > 12 months. Of a total of 159 sputum smear positive patients sum number of male and female patients was 121 (76.10%) and 38 (23.89%), respectively. Among these patients, number of literate and illiterate patients were 123 (77.3%) and 36 (22.6%). 25 (15.7%) patients had farming as their occupation, 80 (50.3%) had nonagricultural occupation and 54 (33.9%) women were housewives. Results: Mono drug resistant, multi-drug resistant, and totally drug resistant (TDR) cases of TB were calculated as 113.83%, 125.1%, and 67.9%. Isoniazid showed the highest percentage of resistance among the patients. Conclusion: Any noncompliance to TB medications, lack of knowledge, and poor management in health centers, etc., results in the emergence of deadly direct repeat forms of TB, which are further complicated and complex to treat. PMID:28360464

  2. Functional surgery in pediatric drug-resistant posterior cortex epilepsy: Electro-clinical findings, cognitive and seizure outcome.

    Science.gov (United States)

    Sierra-Marcos, A; Fournier-Del Castillo, M C; Álvarez-Linera, J; Budke, M; García-Fernández, M; Pérez-Jiménez, M A

    2017-09-22

    Epilepsies originated from the occipital, parietal and/or the posterior edge of the temporal lobe are grouped together into posterior cortex epilepsy (PCE). Our objective was firstly to describe electro-clinical and imaging findings in the presurgical evaluation of children with PCE, and secondly to identify potential factors associated with surgical and cognitive outcomes. From the total of patients referred to the Epilepsy Monitoring Unit of 'Hospital Universitario Niño Jesús' from 2003 to 2016, 55 had drug-resistant PCE. Different variables obtained from the multimodal presurgical work-up were analyzed among patients achieving seizure freedom after surgery (ILAE class 1) and patients with persistent seizures. Categorical variables were compared with Fisheŕs exact test and numeric variables with t-Student for independent samples, and multiple logistic regression were used to analyze predictive values. Median duration of epilepsy until surgery was 5 years [3-10 years]. Fifty patients showed lesions in the MRI, and 62.5% had concordant MRI-PET corregistration. 37 (67%) patients were operated (lesionectomy in 21 subjects, tailored resection based on intracranial studies in 16), and 23 (62,2%) reached ILAE class 1, with a mean follow-up period of 3.51 [1-12] years. A lower number of basal seizures and antiepileptic drugs, a well-defined lesion on the MRI, an epileptogenic zone (EZ) restricted to the posterior quadrant and the normalization of postsurgical EEGs were associated with seizure freedom (pEpilepsy surgery should be considered in children with drug-resistant PCE, especially in those with a restricted EZ. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  3. Clinical Correlates and Drug Resistance in HIV-Infected and -Uninfected Pulmonary Tuberculosis Patients in South India

    Science.gov (United States)

    Sara, Chandy; Elsa, Heylen; Baijayanti, Mishra; Lennartsdotter, Ekstrand Maria

    2016-01-01

    Objectives To examine demographics, clinical correlates, sputum AFB (acid fast bacilli) smear grading DOTS (Directly Observed Therapy Short Course) uptake, and drug resistance in a cohort of newly-diagnosed, smear positive pulmonary tuberculosis (TB) patients with respect to HIV status at baseline, and compare smear conversion rates, side effects and mortality after two months. Design A prospective study among 54 HIV positive and 41 HIV negative pulmonary TB patients. Data were collected via face-to-face interviews, review of medical records, and lab tests. Results HIVTB co-infected patients, though more symptomatic at baseline, showed more improvement in their symptoms compared to HIV-uninfected TB patients at follow-up. The HIV co-infected group had more prevalent perceived side effects, and sputum smear positivity was marginally higher compared to the HIV negative group at follow-up. Mortality was higher among the HIV-infected group. Both groups had high rates of resistance to first-line anti-tubercular drugs, particularly isoniazid. There was no significant difference in the drug resistance patterns between the groups. Conclusions Prompt initiation and provision of daily regimens of ATT (Anti-Tubercular treatment) along with ART (Anti-Retroviral treatment) via ART centers is urgently needed in India. As resistance to ART and/or ATT is directly linked to medication non-adherence, the use of counseling, regular reinforcement, early detection and appropriate intervention strategies to tackle this complex issue could help prevent premature mortality and development of resistance in HIV-TB co-infected patients. The high rate of isoniazid resistance might preclude its use in India as prophylaxis for latent TB in HIV infected persons as per the World Health Organization (WHO) guideline. PMID:27708985

  4. Detection of Rare Drug Resistance Mutations by Digital PCR in a Human Influenza A Virus Model System and Clinical Samples.

    Science.gov (United States)

    Whale, Alexandra S; Bushell, Claire A; Grant, Paul R; Cowen, Simon; Gutierrez-Aguirre, Ion; O'Sullivan, Denise M; Žel, Jana; Milavec, Mojca; Foy, Carole A; Nastouli, Eleni; Garson, Jeremy A; Huggett, Jim F

    2016-02-01

    Digital PCR (dPCR) is being increasingly used for the quantification of sequence variations, including single nucleotide polymorphisms (SNPs), due to its high accuracy and precision in comparison with techniques such as quantitative PCR (qPCR) and melt curve analysis. To develop and evaluate dPCR for SNP detection using DNA, RNA, and clinical samples, an influenza virus model of resistance to oseltamivir (Tamiflu) was used. First, this study was able to recognize and reduce off-target amplification in dPCR quantification, thereby enabling technical sensitivities down to 0.1% SNP abundance at a range of template concentrations, a 50-fold improvement on the qPCR assay used routinely in the clinic. Second, a method was developed for determining the false-positive rate (background) signal. Finally, comparison of dPCR with qPCR results on clinical samples demonstrated the potential impact dPCR could have on clinical research and patient management by earlier (trace) detection of rare drug-resistant sequence variants. Ultimately this could reduce the quantity of ineffective drugs taken and facilitate early switching to alternative medication when available. In the short term such methods could advance our understanding of microbial dynamics and therapeutic responses in a range of infectious diseases such as HIV, viral hepatitis, and tuberculosis. Furthermore, the findings presented here are directly relevant to other diagnostic areas, such as the detection of rare SNPs in malignancy, monitoring of graft rejection, and fetal screening. Copyright © 2016 Whale et al.

  5. STUDIES ON ANTIBACTERIAL EFFECT OF APAMARGA (ACHYRANTHES ASPERA ON MULTI-DRUG RESISTANT CLINICAL ISOLATES

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    Patil Usha

    2013-04-01

    Full Text Available Recent reports on emergence of multidrug resistant bacteria are cause of concern in medical world. Several ayurvedic drugs have been proved to contain the antimicrobial activity. Literature on effect of ayurvedic drugs on multidrug resistant bacterial pathogens is limited. Present study reports the antimicrobial effect of Achyranthes aspera (Apamarga crude extracts on the clinical isolates of multidrug resistant bacteria. The drug was evaluated by using phytochemical tests. Crude extracts of aqueous, methanol, ethanol and chloroform was prepared. Antibacterial activity against clinically isolated multidrug resistant bacteria belonging to groups of bacillus, citrobacter, E.coli, klebsiella, proteus and salmonella was tested. The drug showed highest efficacy against Bacillus organism while least effectiveness on Proteus spp bacteria. Results of the study conclude that the medicinal plant A. aspera might be useful against multidrug resistance in pathogens of clinical importance.

  6. Clinical, Virologic, Immunologic Outcomes and Emerging HIV Drug Resistance Patterns in Children and Adolescents in Public ART Care in Zimbabwe.

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    A T Makadzange

    Full Text Available To determine immunologic, virologic outcomes and drug resistance among children and adolescents receiving care during routine programmatic implementation in a low-income country.A cross-sectional evaluation with collection of clinical and laboratory data for children (0-<10 years and adolescents (10-19 years attending a public ART program in Harare providing care for pediatric patients since 2004, was conducted. Longitudinal data for each participant was obtained from the clinic based medical record.Data from 599 children and adolescents was evaluated. The participants presented to care with low CD4 cell count and CD4%, median baseline CD4% was lower in adolescents compared with children (11.0% vs. 15.0%, p<0.0001. The median age at ART initiation was 8.0 years (IQR 3.0, 12.0; median time on ART was 2.9 years (IQR 1.7, 4.5. On ART, median CD4% improved for all age groups but remained below 25%. Older age (≥ 5 years at ART initiation was associated with severe stunting (HAZ <-2: 53.3% vs. 28.4%, p<0.0001. Virologic failure rate was 30.6% and associated with age at ART initiation. In children, nevirapine based ART regimen was associated with a 3-fold increased risk of failure (AOR: 3.5; 95% CI: 1.3, 9.1, p = 0.0180. Children (<10 y on ART for ≥4 years had higher failure rates than those on ART for <4 years (39.6% vs. 23.9%, p = 0.0239. In those initiating ART as adolescents, each additional year in age above 10 years at the time of ART initiation (AOR 0.4 95%CI: 0.1, 0.9, p = 0.0324, and each additional year on ART (AOR 0.4, 95%CI 0.2, 0.9, p = 0.0379 were associated with decreased risk of virologic failure. Drug resistance was evident in 67.6% of sequenced virus isolates.During routine programmatic implementation of HIV care for children and adolescents, delayed age at ART initiation has long-term implications on immunologic recovery, growth and virologic outcomes.

  7. Antibacterial and antifungal activity of Terminalia arjuna Wight & Arn. bark against multi-drug resistant clinical isolates

    Institute of Scientific and Technical Information of China (English)

    Sukalyani Debnath; Diganta Dey; Sudipta Hazra; Subhalakshmi Ghosh; Ratnamala Ray; Banasri Hazra

    2013-01-01

    Objective: To evaluate antimicrobial activity of Terminalia arjuna (T. arjuna) bark against clinical strains of multi-drug resistant bacteria, and Candida spp. isolated from patients, as well as the corresponding reference strains.Methods:were evaluated by agar-well diffusion method, followed by determination of minimum inhibitory concentration (MIC) by broth micro-dilution method. The clinical isolates were studied for antibacterial susceptibility by Kirby and Bauer disk diffusion technique. The antimicrobial activity of water, methanol and chloroform extracts of T. arjuna bark Results: The water and methanolic extracts of T. arjuna bark produced significant zones of inhibition against twenty-two tested bacteria including eight uropathogens. MIC values against the bacteria were found in the range of 0.16 to 2.56 mg/mL. The chloroform extract did not exhibit antibacterial activity. The polar extracts of T. arjuna also demonstrated strong antifungal effect against eight species of Candida, with MIC between 0.16 and 0.64 mg/mL. The antimicrobial efficacy of the polar extracts was found to be commensurate with high polyphenol content in contrast to the non-polar (chloroform fraction). Conclusions: This study has revealed the therapeutic prospect of T. arjuna bark for the treatment of microbial diseases. The polar fraction of the bark could be used for development of novel antimicrobial agents, particularly against urinary tract infections, and candidiasis/candidaemia.

  8. Analysis on drug-resistance and molecular epidemiology of Acinetobacter baumannii isolated from the clinical samples in two Chinese hospitals

    Institute of Scientific and Technical Information of China (English)

    WEI FENG SHI; ZHI MI HUANG; NING XU

    2006-01-01

    In the present study, the drug-resistance genes encoding β-lactamases, aminoglycoside modifying enzymes, DNA topoisomerases and integron as well as their molecular epidemiology were investigated by means of analyzing the drug-resistance and molecular epidemiology of Acinebacter baumannii isolated from the clinical samples in two hospitals in Changzhou and Huzhou city of Jiangsu and Zhejiang province from July 2000 to March 2005. The minimal inhibitory concentrations (MICs) of these 307 isolates were detected by automatic microbiological system, and 35 strains against 5-fluoroquinolones were performed by agar dilution assay. Meanwhile, the resistant genes in 80 isolates were amplified by PCR with identification by DNA sequencer. It was found that most of the 307 isolates of A. baumannii were resistant to multiple antibiotics tested, in which the resistance rates of the isolates against piperacillin, piperacillin/tazobactam, amoxacillin/clavulanic acid, cefotaxime, ceftazidime,cefepime, gentamicin, amikacin, ciprofloxacin, chloramphenicol and sulfamethoxazole/trimethoprim were all above 35%, but those of imipenem and meropenem were quite low, ranged only 2.6% and 3.3 %. In addition, it was also demonstrated that the positive rates of TEM and SHV β-lactamase genes accounted for 93.8% and 22.5% respectively, and those of the aminoglycoside-modifying enzyme genes including aacC1, aacC2, aacC3, aacC4, aacC4A, aphA6, ant(2")-Ⅰ and ant(3")-Ⅰ were 58.8%, 8.8%, 7.5%, 28.8%, 45.0%, 2.5%, 28.8% and 65.0% respectively. The mutations in the quinolone-resistant determining region (QRDR) of gyrA and parC genes indicated that substitution in Ser-83 residue of GyrA protein was most frequently occurred among strains with MIC for ciprofloxacin of more than 4 μg/ml, whereas a double mutation at Ser-83 residue of gyrA and Ser-80 of parC was found in strains with MIC of ciprofloxacin of more than 8 μg/ml. As to the positive rates of class 1 integron (Int Ⅰ -1) and qacE△1-sul

  9. 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.

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

    Science.gov (United States)

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

    2013-11-01

    To explore the antibiotic resistance of Brucella melitensis and instruct rational use of antimicrobial agents in clinical treatment of Brucella infection. Bacteria were cultured and identified by BACTEC9120 and VITEK II automicrobic system. E-test was used to detect the minimal inhibitory concentration (MIC) of antimicrobial agents in the drug susceptivity experiment. A total of 19 brucella strains (all Brucella melitensis) were isolated from 19 patients, who had fever between January 2010 and June 2012, and 17 samples were blood, one was bone marrow, the other sample was cerebrospinal fluid. The MIC range of ceftazidime was 2.0-8.0 mg/L, rifampicin was 0.06-2.0 mg/L, amikacin was 4.0-12.0 mg/L, levofloxacin was 2.0-8.0 mg/L, doxycycline was 8.0-32.0 mg/L, sulfamethoxazole-trimethoprim was 4.0-16.0 mg/L, ampicillin was 1.5-2.0 mg/L and gentamicin was 0.50-0.75 mg/L. The drugs used in this experiment cover common drugs for treating Brucella. Meanwhile, the results are consistent with clinical efficacy. It is suggested personalized regimen according to patients' status in treatment of Brucella. Copyright © 2013 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

  11. Clinical Analysis of 2011~2013 Multi Drug Resistant Bacteria%2011~2013年多重耐药菌的临床分析

    Institute of Scientific and Technical Information of China (English)

    江胜娟

    2015-01-01

    目的对2011~2013年我院临床分离致病菌耐药监测结果作综合分析,为临床合理使用抗生素提供科学依据。方法开展细菌耐药目标性检测,对多重耐药菌病原菌分布、标本种类及抗生素耐药情况进行分析。结果通过开展监测,采取综合处理措施,有效控制了多重耐药菌感染。结论细菌耐药性逐年增长,耐药检测十分必要。%Objective To 2011 2013 clinical isolates resistant bacteria monitoring results to make a comprehensive analysis, to provide the scientific basis for clinical rational use of antibiotics. Methods The development of bacterial resistance to target detection, multi drug resistant bacteria pathogens distribution and antibiotic resistance of specimen types, analysis. Results Through monitoring, comprehensive treatment, control of multi drug resistant bacteria infection ef ectively. Conclusion The drug resistance of bacteria increased year by year, it is necessary to drug resistance detection.

  12. The Use of Chitosan to Enhance Photodynamic Inactivation against Candida albicans and Its Drug-Resistant Clinical Isolates

    Directory of Open Access Journals (Sweden)

    Tsuimin Tsai

    2013-04-01

    Full Text Available Drug-resistant Candida infection is a major health concern among immunocompromised patients. Antimicrobial photodynamic inactivation (PDI was introduced as an alternative treatment for local infections. Although Candida (C. has demonstrated susceptibility to PDI, high doses of photosensitizer (PS and light energy are required, which may be harmful to eukaryotic human cells. This study explores the capacity of chitosan, a polycationic biopolymer, to increase the efficacy of PDI against C. albicans, as well as fluconazole-resistant clinical isolates in planktonic or biofilm states. Chitosan was shown to effectively augment the effect of PDI mediated by toluidine blue O (TBO against C. albicans that were incubated with chitosan for 30 min following PDI. Chitosan at concentrations as low as 0.25% eradicated C. albicans; however, without PDI treatment, chitosan alone did not demonstrate significant antimicrobial activity within the 30 min of incubation. These results suggest that chitosan only augmented the fungicidal effect after the cells had been damaged by PDI. Increasing the dosage of chitosan or prolonging the incubation time allowed a reduction in the PDI condition required to completely eradicate C. albicans. These results clearly indicate that combining chitosan with PDI is a promising antimicrobial approach to treat infectious diseases.

  13. "Dynamic range" of inferred phenotypic HIV drug resistance values in clinical practice.

    Directory of Open Access Journals (Sweden)

    Luke C Swenson

    Full Text Available BACKGROUND: 'Virtual' or inferred phenotypes (vPhenotypes are commonly used to assess resistance to antiretroviral agents in patients failing therapy. In this study, we provide a clinical context for understanding vPhenotype values. METHODS: All HIV-infected persons enrolled in the British Columbia Drug Treatment Program with a baseline plasma viral load (pVL and follow-up genotypic resistance and pVL results were included up to October 29, 2008 (N = 5,277. Change from baseline pVL was determined as a function of Virco vPhenotype, and the "dynamic range" (defined here by the 10th and 90th percentiles for fold-change in IC₅₀ amongst all patients was estimated from the distribution of vPhenotye fold-changes across the cohort. RESULTS: The distribution of vPhenotypes from a large cohort of HIV patients who have failed therapy are presented for all available antiretroviral agents. A maximum change in IC₅₀ of at least 13-fold was observed for all drugs. The dideoxy drugs, tenofovir and most PIs exhibited small "dynamic ranges" with values of 99% of samples. In contrast, zidovudine, lamivudine, emtricitabine and the non-nucleoside reverse transcriptase inihibitors (excluding etravirine had large dynamic ranges. CONCLUSION: We describe the populational distribution of vPhenotypes such that vPhenotype results can be interpreted relative to other patients in a drug-specific manner.

  14. Clinical efficacy and drug resistance of anti-epidermalgrowth factor receptor therapy in colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    Colorectal cancer (CRC) ranked third in cancer relateddeath and its incidence has been increasing worldwide.In recent decades important therapeutic advances havebeen developed in treatment of metastatic CRC (mCRC),such as monoclonal antibodies against epidermal growthfactor receptor (anti-EGFR), which provided additionalclinical benefits in mCRC. However, anti-EGFR therapieshave limited usage due to approximately 95% ofpatients with KRAS mutated mCRC do not response toanti-EGFR treatment. Thus, KRAS mutation is predictiveof nonresponse to anti-EGFR therapies but it alone is nota sufficient basis to decide who should not be receivedsuch therapies because; approximately fifty percent(40%-60%) of CRC patients with wild-type KRASmutation also have poor response to anti-EGFR basedtreatment. This fact leads us to suspect that there mustbe other molecular determinants of response to anti-EGFR therapies which have not been identified yet. Currentarticle summarizes the clinical efficacy of anti-EGFRtherapies and also evaluates its resistance mechanisms.

  15. High prevalence of extensively drug-resistant and metallo beta-lactamase-producing clinical Acinetobacter baumannii in Iran.

    Science.gov (United States)

    Maspi, Hossein; Mahmoodzadeh Hosseini, Hamideh; Amin, Mohsen; Imani Fooladi, Abbas Ali

    2016-09-01

    Acinetobacter species particularly Acinetobacter baumannii (A. baumannii) have been widely reported as broad-spectrum antibiotic resistant pathogens. Expression of various types of metallo beta-lactamases (MBL), classified as Ambler class B, has been associated with carbapenem resistance. Here, we attempted to assess the frequency of extensively drug-resistant (XDR) and MBL-producing A. baumannii among clinical isolates. 86 clinical A. baumannii strains were collected from 2014 to 2015 and their susceptibility to meropenem (10 μg), imipenem (10 μg), azteronem (30 μg), pipracillin (100 μg) tazobactam (110 μg), tobramycin (10 μg), fosfomycin (200 μg), rifampicin (5 μg), colistin (10 μg), tigecycline (15 μg), sulbactam/ampicillin (10 μg + 10 μg) and polymixin B (300 U) was evaluated using disk diffusion method. The MBL-producing isolates were screened using combined disc diffusion method. Furthermore, the presence of blaVIM, blaIMP, blaSPM, blaGIM, blaSIM and blaNDM was detected by PCR. 34.9% of isolates were recovered from bronchoalveolar lavage (BAL). 81 (94.2%) and 62 (71.2%) isolates were multidrug resistance (MDR) and XDR, respectively. 44 (51.2%) and 65 (75.6%) isolates were MBL-producing strains with resistance to imipenem and meropenem, respectively. 2 (2.3%), 13 (15.1%), 2 (2.3%), 4 (4.7%) and 2 (2.3%) isolates carried blaVIM, blaIMP, blaSPM, blaGIM and blaSIM genes, respectively. Our data showed that the rate of XDR and MBL A. baumannii is on the rise.

  16. Application of concave microwells to pancreatic tumor spheroids enabling anticancer drug evaluation in a clinically relevant drug resistance model.

    Directory of Open Access Journals (Sweden)

    Sang-Eun Yeon

    Full Text Available Intrinsic drug resistance of pancreatic ductal adenocarcinoma (PDAC warrants studies using models that are more clinically relevant for identifying novel resistance mechanisms as well as for drug development. Tumor spheroids (TS mimic in vivo tumor conditions associated with multicellular resistance and represent a promising model for efficient drug screening, however, pancreatic cancer cells often fail to form spheroids using conventional methods such as liquid overlay. This study describes the induction of TS of human pancreatic cancer cells (Panc-1, Aspc-1, Capan-2 in concave polydimethylsiloxane (PDMS microwell plates and evaluation of their usefulness as an anticancer efficacy test model. All three cell lines showed TS formation with varying degree of necrosis inside TS. Among these, Panc-1 spheroid with spherical morphology, a rather rough surface, and unique adhesion structures were successfully produced with no notable necrosis in concave microwell plates. Panc-1 TS contained growth factors or enzymes such as TGF-β1, CTGF, and MT1-MMP, and extracellular matrix proteins such as collagen type I, fibronectin, and laminin. Panc-1 cells grown as TS showed changes in stem cell populations and in expression levels of miRNAs that may play roles in chemoresistance. Visualization of drug penetration and detection of viability indicators, such as Ki-67 and MitoSOX, were optimized for TS for quantitative analysis. Water-soluble tetrazolium (MTS and acid phosphatase (APH assays were also successfully optimized. Overall, we demonstrated that concave PDMS microwell plates are a novel platform for preparation of TS of weakly aggregating cells and that Panc-1 spheroids may represent a novel three-dimensional model for anti-pancreatic cancer drug screening.

  17. Application of concave microwells to pancreatic tumor spheroids enabling anticancer drug evaluation in a clinically relevant drug resistance model.

    Science.gov (United States)

    Yeon, Sang-Eun; No, Da Yoon; Lee, Sang-Hoon; Nam, Suk Woo; Oh, Il-Hoan; Lee, Jaehwi; Kuh, Hyo-Jeong

    2013-01-01

    Intrinsic drug resistance of pancreatic ductal adenocarcinoma (PDAC) warrants studies using models that are more clinically relevant for identifying novel resistance mechanisms as well as for drug development. Tumor spheroids (TS) mimic in vivo tumor conditions associated with multicellular resistance and represent a promising model for efficient drug screening, however, pancreatic cancer cells often fail to form spheroids using conventional methods such as liquid overlay. This study describes the induction of TS of human pancreatic cancer cells (Panc-1, Aspc-1, Capan-2) in concave polydimethylsiloxane (PDMS) microwell plates and evaluation of their usefulness as an anticancer efficacy test model. All three cell lines showed TS formation with varying degree of necrosis inside TS. Among these, Panc-1 spheroid with spherical morphology, a rather rough surface, and unique adhesion structures were successfully produced with no notable necrosis in concave microwell plates. Panc-1 TS contained growth factors or enzymes such as TGF-β1, CTGF, and MT1-MMP, and extracellular matrix proteins such as collagen type I, fibronectin, and laminin. Panc-1 cells grown as TS showed changes in stem cell populations and in expression levels of miRNAs that may play roles in chemoresistance. Visualization of drug penetration and detection of viability indicators, such as Ki-67 and MitoSOX, were optimized for TS for quantitative analysis. Water-soluble tetrazolium (MTS) and acid phosphatase (APH) assays were also successfully optimized. Overall, we demonstrated that concave PDMS microwell plates are a novel platform for preparation of TS of weakly aggregating cells and that Panc-1 spheroids may represent a novel three-dimensional model for anti-pancreatic cancer drug screening.

  18. Clinical deterioration during antitubercular treatment at a district hospital in South Africa: the importance of drug resistance and AIDS defining illnesses.

    Directory of Open Access Journals (Sweden)

    Dominique J Pepper

    Full Text Available BACKGROUND: Clinical deterioration on drug therapy for tuberculosis is a common cause of hospital admission in Africa. Potential causes for clinical deterioration in settings of high HIV-1 prevalence include drug resistant Mycobacterium tuberculosis (M.tb, co-morbid illnesses, poor adherence to therapy, tuberculosis associated-immune reconstitution inflammatory syndrome (TB-IRIS and subtherapeutic antitubercular drug levels. It is important to derive a rapid diagnostic work-up to determine the cause of clinical deterioration as well as specific management to prevent further clinical deterioration and death. We undertook this study among tuberculosis (TB patients referred to an adult district level hospital situated in a high HIV-1 prevalence setting to determine the frequency, reasons and outcome for such clinical deterioration. METHOD: A prospective observational study conducted during the first quarter of 2007. We defined clinical deterioration as clinical worsening or failure to stabilise after 14 or more days of antitubercular treatment, resulting in hospital referral. We collected data on tuberculosis diagnosis and treatment, HIV-1 status and antiretroviral treatment, and investigated reasons for clinical deterioration as well as outcome. RESULTS: During this period, 352 TB patients met inclusion criteria; 296 were admitted to hospital accounting for 17% of total medical admissions (n = 1755. Eighty three percent of TB patients (291/352 were known to be HIV-1 co-infected with a median CD4 count of 89cells/mm(3 (IQR 38-157. Mortality among TB patients admitted to hospital was 16% (n = 48. The median duration of hospital admission was 9.5 days (IQR 4-18, longer than routine in this setting (4 days. Among patients in whom HIV-1 status was known (n = 324, 72% of TB patients (n = 232 had an additional illness to tuberculosis; new AIDS defining illnesses (n = 80 were the most frequent additional illnesses (n = 208 in HIV-1 co-infected patients (n

  19. CLINICAL AND VIROLOGIC FOUNDATION FOR PATHOGENETIC THERAPY OF HUMAN HERPES VIRUS TYPE 6 INFECTION IN CHILDREN

    Directory of Open Access Journals (Sweden)

    N.A. Myukke

    2006-01-01

    Full Text Available Information about an infection caused by human herpes virus type 6, its' epidemiology, pathogenesis and clinical variants, is reviewed. Clinical cases, diagnosed at a time of study, are briefly reviewed.Key words: human herpes virus type 6, exanthema subitum (roseola infantum, fever of unknown origin, mononucleosis like syndrome, meningoencephalitis, children.

  20. Understanding drug resistance in human intestinal protozoa.

    Science.gov (United States)

    El-Taweel, Hend Aly

    2015-05-01

    Infections with intestinal protozoa continue to be a major health problem in many areas of the world. The widespread use of a limited number of therapeutic agents for their management and control raises concerns about development of drug resistance. Generally, the use of any antimicrobial agent should be accompanied by meticulous monitoring of its efficacy and measures to minimize resistance formation. Evidence for the occurrence of drug resistance in different intestinal protozoa comes from case studies and clinical trials, sometimes with a limited number of patients. Large-scale field-based assessment of drug resistance and drug sensitivity testing of clinical isolates are needed. Furthermore, the association of drug resistance with certain geographic isolates or genotypes deserves consideration. Drug resistance has been triggered in vitro and has been linked to modification of pyruvate:ferredoxin oxidoreductase, nitroreductases, antioxidant defense, or cytoskeletal system. Further mechanistic studies will have important implications in the development of second generation therapeutic agents.

  1. Research advance in clinical multi-drug resistant Acinetobacter baumannii%临床多重耐药鲍曼不动杆菌的研究进展

    Institute of Scientific and Technical Information of China (English)

    陆坤; 胡志东

    2013-01-01

    随着新型广谱抗菌药物的广泛应用,鲍曼不动杆菌的耐药率逐年升高,多重耐药甚至泛耐药鲍曼不动杆菌的临床分离率明显增高.此文对近年来国内外多重耐药鲍曼不动杆菌感染的耐药机制、分型检测方法及临床治疗作一综述.%With the extensive use of new broad-spectrum antibiotics,the resistant rate of Acinetobacter baumannii has increased gradually.While the clinical isolates of multi-drug resistant and pan-resistant Acinetobacter baumanniihave also increased significantly.In this review,the resistant mechanisms,typing methods and treatment of multi-drug resistant A cinetobacter baumanii are summarized.

  2. 肠球菌的临床感染与耐药性分析%Clinical infection and drug-resistance analysis of Enterococcus

    Institute of Scientific and Technical Information of China (English)

    卢星梅; 卢雅敏; 吴庆; 陈思思; 周铁丽

    2012-01-01

    目的 了解温州医学院附属第一医院临床分离主要肠球菌的分布及其对常用抗菌药物的耐药现状,以指导临床合理用药.方法 对2008年至2011年临床分离的635株粪肠球菌和屎肠球菌的标本来源和药敏结果进行回顾性分析.结果 各种临床标本中两种肠球菌的分布比例存在差异,总体以尿液标本所占比例最多,且屎肠球菌的总体分离率高于粪肠球菌.粪肠球菌对利奈唑胺、氨苄西林、万古霉素、呋喃妥因和替考拉宁的耐药率都在5.0%以下,对莫西沙星和青霉素G的耐药率也仅为7.0%和6.7%;屎肠球菌对莫西沙星、左旋氧氟沙星、环丙沙星、氨苄西林、青霉素G和红霉素的耐药率都在90.0%以上,对利奈唑胺、万古霉素、替考拉宁和奎奴敏感.粪肠球菌的多重耐药株占总数的26.4%,屎肠球菌的多重耐药株占总数的78.2%.结论 粪肠球菌和屎肠球菌对15种抗菌药物的耐药情况不同,屎肠球菌具有更高的耐药率和更广的耐药谱.临床应根据药敏试验的结果合理选择抗菌药物,以防止耐药菌株的产生和播散.%Objective To explore the current distribution and drug-resistance of the main types of clinically isolated Enterococci in the First Affiliated Hospital of Wenzhou Medical College to guide optimal clinical drug practice. Methods Retrospective analysis was performed with the source and antimicrobial susceptibility results of 635 strains of Enterococcus faecalis and Enterococcus faecium which were clinically isolated during 2008 to 2011. Results The ratios of the two types of Enterococci had a difference in different specimens. Most of Enterococci were isolated from urine specimens which accounted for the highest ratio in total, and the isolation rate of Enterococcus faecium was significantly higher than that of Enterococcus faecalis. The drug resistance rate of Enterococcus faecalis to linezolid, vancomycin, nitrofurantoin and

  3. Antimicrobial (Drug) Resistance

    Science.gov (United States)

    ... the past 70 years, antimicrobial drugs, such as antibiotics, have been successfully used to treat patients with bacterial and infectious diseases. Why Is the Study of Antimicrobial (Drug) Resistance a Priority for NIAID? Over time, many infectious ...

  4. Drug resistance and antiretroviral drug development

    OpenAIRE

    Shafer, Robert W.; Jonathan M Schapiro

    2005-01-01

    As more drugs for treating HIV have become available, drug resistance profiles within antiretroviral drug classes have become increasingly important for researchers developing new drugs and for clinicians integrating new drugs into their clinical practice. In vitro passage experiments and comprehensive phenotypic susceptibility testing are used for the pre-clinical evaluation of drug resistance. Clinical studies are required, however, to delineate the full spectrum of mutations responsible fo...

  5. Detection of HIV drug resistance during antiretroviral treatment and clinical progression in a large European cohort study

    DEFF Research Database (Denmark)

    Cozzi-Lepri, Alessandro; Phillips, Andrew N; Clotet, Bonaventura;

    2008-01-01

    OBJECTIVE(S): To investigate the relationship between detection of HIV drug resistance by 2 years from starting antiretroviral therapy and the subsequent risk of progression to AIDS and death. DESIGN: Virological failure was defined as experiencing two consecutive viral loads of more than 400......-up. We observed 829 AIDS events and 571 deaths during 38,814 person-years of follow-up resulting in an overall incidence of new AIDS and death of 3.6 per 100 person-years of follow-up [95% confidence interval (CI):3.4-3.8]. By 96 months from baseline, the proportion of patients with a new AIDS diagnosis...

  6. Report of rpoB mutation in clinically suspected cases of drug resistant leprosy: A study from Eastern India

    Directory of Open Access Journals (Sweden)

    Abu Hena Hasanoor Reja

    2015-01-01

    Full Text Available Background: The current strategy for leprosy control depends mainly on early case detection and providing the recommended multidrug therapy (MDT dosage. Understanding the molecular mechanisms of drug resistance to each of these drugs is essential in providing effective treatment and preventing the spread of resistant strains in the community. The progress of molecular biology research provides a very efficient opportunity for the diagnosis of drug resistance by in vitro method. Aim: We aimed to investigate the point mutations within the rpoB gene region of the Mycobacterium leprae genome, which are responsible for resistance to rifampicin, in order to determine the emergence of drug resistance in leprosy in the Kolkata region of West Bengal. Methods: A total of 50 patients with a relapse of leprosy were enrolled in the study. Skin smears were obtained for estimation of bacillary index and biopsies were obtained in 70% alcohol for extraction of DNA. The extracted DNA was amplified by M. leprae-polymerase chain reaction (PCR targeting rpoB gene region. Every single nucleotide base in the sequence is aligned to reference sequence and identity gaps were determined by NCBI - BLAST. Later in-silico analysis was done to identify the changes in the translated protein sequences. Results: A mutation at the base pair position 2275405 where G is replaced by C in the M. leprae genome, which corresponds to the coding region of rpoB gene (279 bp - 2275228 to2275506, was observed in two patients. This missense mutation in CAC codon brings about a glutamic acid to histidine change in the amino acid sequence of RNA polymerase beta subunit at the position 442 (Glu442His, a region specific for rifampicin interaction, which might be responsible for unresponsiveness to rifampicin by manifesting a stable bacteriological index in these 2 patients even after completion of 24 months of multibacillary multi-drug therapy (MB-MDT. Limitations: The major limitations of

  7. Complete genome analysis of three Acinetobacter baumannii clinical isolates in China for insight into the diversification of drug resistance elements.

    Directory of Open Access Journals (Sweden)

    Lingxiang Zhu

    Full Text Available BACKGROUND: The emergence and rapid spreading of multidrug-resistant Acinetobacter baumannii strains has become a major health threat worldwide. To better understand the genetic recombination related with the acquisition of drug-resistant elements during bacterial infection, we performed complete genome analysis on three newly isolated multidrug-resistant A. baumannii strains from Beijing using next-generation sequencing technology. METHODOLOGIES/PRINCIPAL FINDINGS: Whole genome comparison revealed that all 3 strains share some common drug resistant elements including carbapenem-resistant bla OXA-23 and tetracycline (tet resistance islands, but the genome structures are diversified among strains. Various genomic islands intersperse on the genome with transposons and insertions, reflecting the recombination flexibility during the acquisition of the resistant elements. The blood-isolated BJAB07104 and ascites-isolated BJAB0868 exhibit high similarity on their genome structure with most of the global clone II strains, suggesting these two strains belong to the dominant outbreak strains prevalent worldwide. A large resistance island (RI of about 121-kb, carrying a cluster of resistance-related genes, was inserted into the ATPase gene on BJAB07104 and BJAB0868 genomes. A 78-kb insertion element carrying tra-locus and bla OXA-23 island, can be either inserted into one of the tniB gene in the 121-kb RI on the chromosome, or transformed to conjugative plasmid in the two BJAB strains. The third strains of this study, BJAB0715, which was isolated from spinal fluid, exhibit much more divergence compared with above two strains. It harbors multiple drug-resistance elements including a truncated AbaR-22-like RI on its genome. One of the unique features of this strain is that it carries both bla OXA-23 and bla OXA-58 genes on its genome. Besides, an Acinetobacter lwoffii adeABC efflux element was found inserted into the ATPase position in BJAB0715. CONCLUSIONS

  8. De Novo Assembly of Human Herpes Virus Type 1 (HHV-1) Genome, Mining of Non-Canonical Structures and Detection of Novel Drug-Resistance Mutations Using Short- and Long-Read Next Generation Sequencing Technologies.

    Science.gov (United States)

    Karamitros, Timokratis; Harrison, Ian; Piorkowska, Renata; Katzourakis, Aris; Magiorkinis, Gkikas; Mbisa, Jean Lutamyo

    2016-01-01

    Human herpesvirus type 1 (HHV-1) has a large double-stranded DNA genome of approximately 152 kbp that is structurally complex and GC-rich. This makes the assembly of HHV-1 whole genomes from short-read sequencing data technically challenging. To improve the assembly of HHV-1 genomes we have employed a hybrid genome assembly protocol using data from two sequencing technologies: the short-read Roche 454 and the long-read Oxford Nanopore MinION sequencers. We sequenced 18 HHV-1 cell culture-isolated clinical specimens collected from immunocompromised patients undergoing antiviral therapy. The susceptibility of the samples to several antivirals was determined by plaque reduction assay. Hybrid genome assembly resulted in a decrease in the number of contigs in 6 out of 7 samples and an increase in N(G)50 and N(G)75 of all 7 samples sequenced by both technologies. The approach also enhanced the detection of non-canonical contigs including a rearrangement between the unique (UL) and repeat (T/IRL) sequence regions of one sample that was not detectable by assembly of 454 reads alone. We detected several known and novel resistance-associated mutations in UL23 and UL30 genes. Genome-wide genetic variability ranged from assembly of accurate, full-length HHV-1 genomes will be useful in determining genetic determinants of drug resistance, virulence, pathogenesis and viral evolution. The numerous, complex repeat regions of the HHV-1 genome currently remain a barrier towards this goal.

  9. [Clinical presentations of Herpes Zoster Ophthalmicus (diagnosis and therapy)].

    Science.gov (United States)

    Chernakova, G M; Kleshcheva, E A; Semenova, T B

    Approximately a quarter of the world's population at some point in life is at risk of developing shingles (Herpes Zoster). In 10-20% of cases the first branch of the trigeminal nerve gets involved (Herpes Zoster Ophthalmicus, HZO). Ophthalmic complications of HZO are able to cause a significant reduction in visual function.

  10. Clinical and morphological characteristics of herpes zoster in south India

    Directory of Open Access Journals (Sweden)

    Dubey Anand

    2005-01-01

    Full Text Available One hundred and seven cases (6 children and 101 adults of herpes zoster were recruited over a period of two years. The frequency of herpes zoster amongst skin OPD cases was found to be 0.34 per cent. The male to female ratio was 1.74:1. The most common prodromal symptom seen was paresthesia in 25 (23.36% cases followed by itching in 21 (19.62% cases.Most common presenting complaint was pain in 97 (90.65% cases. Ninety nine cases had classical herpes zoster followed by necrotic / ulcerated herpes zoster in 5 cases and hemorrhagic herpes zoster in 3 cases. Thoracic dermatome was the most common dermatome involved in 64 (59.8% cases followed by cervical in 17 (15.8% cases. Unidermatomal involvement was seen in 81 (75.7% cases, followed by multidermatomal in 18 (16.8% cases and disseminated in 8 (7.4% cases. Forty six cases were screened for HIV, out of them; six cases (4 males, 2 females were seropositive for HIV. Classical herpes zoster was a feature in four cases; however, one case each also had necrotic and hemorrhagic form of herpes zoster. To conclude, herpes zoster commonly occurs in young adults in India with presenting symptoms such as pain, itching and fever.

  11. 肺炎链球菌耐药情况的临床观察及意义%The Clinical Observation and Significance of Streptococcus Pneumoniae Drug Resistance

    Institute of Scientific and Technical Information of China (English)

    王惠; 刘伣; 赵坤

    2014-01-01

    目的:通过观察2011年1月至2013年10月共11个季度的肺炎链球菌耐药的情况,指导临床工作。方法对11个季度的肺炎链球菌耐药情况进行统计。结果在目前临床上常用的抗菌素中,二代头孢菌素(头孢呋辛)耐药率为33.0%、头孢曲松为6.0%、头孢噻肟为20.3%、阿莫西林/棒酸为0.1%、克林霉素为84.0%,作为经典的抗肺炎链球菌的青霉素,其耐药率为95.0%,而红霉素的耐为99.0%。结论肺炎链球菌作为社区获得性肺炎( CAP)的主要致病菌,耐药情况总体很不乐观,经典的抗菌素中,青霉素和红霉素几近无效。目前临床常用抗菌素中,对肺炎链球菌耐药率低的品种并不多,因此,规范、合理地使用好现有的抗菌素就显得尤为重要。%Objective To instruct clinical work through observing condition of Streptococcus pneumoniae drug resistance from 11 quarters of January 2011 to October 2013. Methods To collect the condition of Streptococcus pneumoniae drug resist-ance of 11 quarters. Results In antibiotics used clinically often now,drug resistant ratio of the 2rd generation cephalosporin(Ce-furoxime)is 33%,ceftriaxone is 6%,cefotaxime is 20. 3%,Amoxicillin/clavulanic acid is 0. 1%,clindamycin is 84%,Penicillin as a classic antibiotic,its drug resistant ratio is 95%,and erythromycin is 99%. Conclusion Streptococcus pneumoniae as a ma-jor pathogenic bacteria of CAP,its total condition of drug resistance is not very optimistical,in classic antibiotics,Penicillin and e-rythromycin is nearly inefficacious. In antibiotics used clinically often now,the species that its drug resistant ratio is low to Strepto-coccus pneumoniae is modicus. Accordingly,it is very important to use the existing antibiotics normatively and reasonably.

  12. 铜绿假单胞菌临床分布及耐药性变迁%Clinical distribution and drug resistance change of pseudomonas aeruginosa

    Institute of Scientific and Technical Information of China (English)

    郭宏

    2015-01-01

    目的:了解医院铜绿假单胞菌(PAE)感染分布及对多种抗菌药物耐药性的动态变迁,为临床治疗PAE感染提供参考。方法对临床科室送检标本中分离出115株PAE的分布和耐药性进行统计和分析。结果PAE感染主要发生在烧伤和内科病区。对常用的14种抗菌药物呈多重耐药,耐亚胺培南铜绿假单胞菌共分离42株,占36.52%,高于国内报道,呈上升趋势。结论PAE是引起医院感染的主要病原菌之一,定期进行耐药性监测分析,对指导临床合理应用抗生素和有效控制医院感染有重要意义。%Objective To understand the infection distribution of pseudomonas aeruginosa (PAE), and the change of its drug resistance for multiple antibiotics, so as to provide reference for clinical treatment of PAE infection.Methods The distribution and drug resistance of 115 PAE strains in clinical samples were summarized and analyzed.Results PAE infection occurred mainly in wards of burn and internal medicine, and it was multi-drug resistant for 14 antibiotics. There were 42 strains separated by imipenem, accounting for 36.52%. This result was higher than reports and in increasing trend.Conclusion PAE is one of the main pathogenic bacteria that causing nosocomial infection. Regular monitoring and analysis of drug resistance have important significance for appropriate using of antibiotics and effective controlling of nosocomial infection.

  13. Postencephalitic epilepsy and drug-resistant epilepsy after infectious and antibody-associated encephalitis in childhood: Clinical and etiologic risk factors.

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    Pillai, Sekhar C; Mohammad, Shekeeb S; Hacohen, Yael; Tantsis, Esther; Prelog, Kristina; Barnes, Elizabeth H; Gill, Deepak; Lim, Ming J; Brilot, Fabienne; Vincent, Angela; Dale, Russell C

    2016-01-01

    To define the risk factors for postencephalitic epilepsy (PE) and drug-resistant epilepsy (DRE) in childhood following infectious and autoimmune encephalitis, we included 147 acute encephalitis patients with a median follow-up of 7.3 years (range 2-15.8 years). PE was defined as the use of antiepileptic drugs (AEDs) for ≥24 months, and DRE was defined as the persistence of seizures despite ≥2 appropriate AEDs at final follow-up. PE and DRE were diagnosed in 31 (21%) and 15 (10%) of patients, respectively. The features during acute encephalitis predictive of DRE (presented as odds ratio [OR] with confidence intervals [CIs]) were status epilepticus (OR 10.8, CI 3.4-34.3), visual disturbance (6.4, 1.4-29.9), focal seizures (6.2, 1.9-20.6), magnetic resonance imaging (MRI) hippocampal/amygdala involvement (5.0, 1.7-15.4), intensive care admission (4.7, 1.4-15.4), use of >3 AEDs (4.5, 1.2-16.1), MRI gadolinium enhancement (4.1, 1.2-14.2), any seizure (3.9, 1.1-14.4), and electroencephalography (EEG) epileptiform discharges (3.9, 1.3-12.0). On multivariable regression analysis, only status epilepticus remained predictive of DRE in all models. DRE was common in herpes simplex virus (3/9, 33%) and unknown (8/40, 20%) encephalitis, but absent in acute disseminated encephalomyelitis (ADEM) (0/32, 0%), enterovirus (0/18), and anti-N-methyl-d-aspartate receptor-NMDAR encephalitis (0/9). We have identified risk factors for DRE and demonstrated "high-risk," and "low-risk" etiologies.

  14. Clinical and biological differences between recurrent herpes simplex virus and varicella-zoster virus infections

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    Straus, S.E. (National Institute of Allergy and Infectious Diseases, Bethesda, MD (USA))

    1989-12-01

    The major features that distinguish recurrent herpes simplex virus infections from zoster are illustrated in this article by two case histories. The clinical and epidemiologic features that characterize recurrent herpes simplex virus and varicella-zoster virus infections are reviewed. It is noted that herpesvirus infections are more common and severe in patients with cellular immune deficiency. Each virus evokes both humoral and cellular immune response in the course of primary infection. DNA hybridization studies with RNA probes labelled with sulfur-35 indicate that herpes simplex viruses persist within neurons, and that varicella-zoster virus is found in the satellite cells that encircle the neurons.

  15. Characterization of the genetic diversity of extensively-drug resistant Mycobacterium tuberculosis clinical isolates from pulmonary tuberculosis patients in Peru.

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    Omar Cáceres

    Full Text Available BACKGROUND: Peru holds the fourth highest burden of tuberculosis in the Americas. Despite an apparently well-functioning DOTS control program, the prevalence of multidrug resistant tuberculosis (MDR-TB continues to increase. To worsen this situation, cases of extensively drug resistance tuberculosis (XDR-TB have been detected. Little information exists about the genetic diversity of drug-susceptible vs. MDR-TB and XDR-TB. METHODS: Cryopreserved samples of XDR strains from 2007 to 2009 (second semester, were identified and collected. Starting from 227 frozen samples, a total of 142 XDR-TB strains of Mycobacterium tuberculosis complex (MTBC; 1 isolate per patient were retained for this study. Each strain DNA was analyzed by spoligotyping and the 15-loci Mycobacterial Interspersed Repetitive Unit (MIRU-15. RESULTS: Among the 142 isolates analyzed, only 2 samples (1.41% could not be matched to any lineage. The most prevalent sublineage was Haarlem (43.66%, followed by T (27.46%, LAM (16.2%, Beijing (9.15%, and X clade (1.41%. Spoligotype analysis identified clustering for 128/142 (90.1% isolates vs. 49/142 (34.5% with MIRUs. Of the samples, 90.85% belonged to retreated patients. The drug resistant profile demonstrated that 62.67% showed resistance to injectable drugs capreomycin (CAP and kanamycin (KAN vs. 15.5% to CAP alone and 21.8% to KAN alone. The SIT219/T1 and SIT50/H3 were the most prevalent patterns in our study. The spoligoforest analysis showed that SIT53/T1 was at the origin of many of the T lineage strains as well as a big proportion of Haarlem lineage strains (SIT50/H3, followed by SIT47/H1, SIT49/H3, and SIT2375/H1, as opposed to the SIT1/Beijing strains that did not appear to evolve into minor Beijing sublineages among the XDR-TB strains. CONCLUSION: In contrast with other Latin-American countries where LAM sublineage is the most predominant, we found the Haarlem to be the most common followed by T sublineage among the XDR-TB strains.

  16. Management of meningitis caused by multi drug-resistant Acinetobacter baumannii: clinical, microbiological and pharmacokinetic results in a patient treated with colistin methanesulfonate

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    Elisabetta Schiaroli

    2015-10-01

    Full Text Available This paper reports on a 71-year-old Caucasian male who underwent  neurosurgery for an oligodendroglioma, followed by a cranial-sinus fistula and cerebrospinal fluid rhinorrhea. The clinical course was complicated due to an extensively drug-resistant Acinetobacter baumannii meningitis. The patient was treated with colistin methanesulfonate, intrathecal for 24 days and intravenous for 46 days. In addition, the patient received meropenem and teicoplanin to treat a bacterial aspiration pneumonia, probably caused by methicillin resistant Staphylococcus aureus and multi drug-resistant Klebiesella pneumoniae. Cerebrospinal fluid trough colistin levels resulted above the MIC of A. baumannii. Colistin cerebrospinal fluid accumulation over the treatment period was not reported.  Meningitis was cured and A. baumannii eradicated. No side effects  from the antimicrobial therapy were observed. In conclusion, this case highlights the issues in treating infections caused by resistant Gram-negative bacteria and supports previous findings on the efficacy, pharmacokinetic and tolerability of intravenous and  intrathecal colistin treatments.

  17. Temperature-mediated heteroduplex analysis for the detection of drug-resistant gene mutations in clinical isolates of Mycobacterium tuberculosis by denaturing HPLC, SURVEYOR nuclease.

    Science.gov (United States)

    Shi, Ruiru; Otomo, Koji; Yamada, Hiroyuki; Tatsumi, Taiga; Sugawara, Isamu

    2006-01-01

    Denaturing high-performance liquid chromatography (DHPLC) is a relatively new technique, which utilizes heteroduplex formation between wild-type and mutated DNA strands to identify point mutations. Heteroduplex molecules are separated from homoduplex molecules by ion-pair, reverse-phase liquid chromatography on a special column matrix with partial heat denaturation of the DNA strands. In order to investigate the application of this method for point mutation detection in drug-resistant genes of Mycobacterium tuberculosis, katG, rpoB, embB, gyrA, pncA and rpsL genes, which are responsible for isoniazid, rifampicin, ethambutol, fluoroquinolone, pyrazinamide and streptomycin resistance, respectively, were detected by temperature-mediated DHPLC in 10 multidrug-resistant and 10 drug-susceptible clinical isolates. The DHPLC data were compared with those from a conventional MIC test. The results show that DHPLC is cost-effective with high capacity and accuracy, and is potentially useful for genotypic screening for mutations associated with anti-tuberculosis drug resistance.

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

    Institute of Scientific and Technical Information of China (English)

    胡蓉蓉; 马小琴; 张能华; 王静

    2014-01-01

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

  19. Clinical and immunologic features of recurrent herpes zoster (HZ).

    Science.gov (United States)

    Nakamura, Yuki; Miyagawa, Fumi; Okazaki, Aiko; Okuno, Yoshinobu; Mori, Yasuko; Iso, Hiroyasu; Yamanishi, Koichi; Asada, Hideo

    2016-11-01

    Recurrent herpes zoster (HZ) is thought to be rare, but there have been few large-scale studies of recurrent HZ. We conducted a large-scale prospective cohort study to characterize recurrent HZ. We examined 12,522 participants aged 50 years or older in Shozu County and followed them up for 3 years. We compared the incidence of HZ and postherpetic neuralgia, severity of skin lesions and acute pain, cell-mediated immunity, and varicella-zoster virus-specific antibody titer between primary and recurrent HZ. A total of 401 participants developed HZ: 341 with primary HZ and 60 with recurrent HZ. Skin lesions and acute pain were significantly milder and the incidence of postherpetic neuralgia was lower in patients aged 50 to 79 years with recurrent HZ than in those with primary HZ. Varicella-zoster virus skin test induced a stronger reaction in patients aged 50 to 79 years with recurrent HZ than in those with primary HZ. Information on previous HZ episodes was self-reported by participants, so it could not be confirmed that they actually had a history of HZ. Recurrent HZ was associated with milder clinical symptoms than primary HZ, probably because of stronger varicella-zoster virus-specific cell-mediated immunity in the patients with recurrence. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  20. Drug resistant tuberculosis: A diagnostic challenge

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    M Dash

    2013-01-01

    Full Text Available Tuberculosis (TB is responsible for 1.4 million deaths annually. Wide-spread misuse of anti-tubercular drugs over three decades has resulted in emergence of drug resistant TB including multidrug-resistant TB and extensively drug-resistant TB globally. Accurate and rapid diagnosis of drug-resistant TB is one of the paramount importance for instituting appropriate clinical management and infection control measures. The present article provides an overview of the various diagnostic options available for drug resistant TB, by searching PubMed for recent articles. Rapid phenotypic tests still requires days to weeks to obtain final results, requiring biosafety and quality control measures. For newly developed molecular methods, infrastructure, training and quality assurance should be followed. Successful control of drug resistant TB globally will depend upon strengthening TB control programs, wider access to rapid diagnosis and provision of effective treatment. Therefore, political and fund provider commitment is essential to curb the spread of drug resistant TB.

  1. RNA expression analysis of efflux pump genes in clinical isolates of multidrug-resistant and extensively drug-resistant Mycobacterium tuberculosis in South Korea.

    Science.gov (United States)

    Oh, Tae Sang; Kim, Young Jin; Kang, Hee Yoon; Kim, Chang-Ki; Cho, Sun Young; Lee, Hee Joo

    2017-04-01

    Tuberculosis (TB), caused by infection with Mycobacterium tuberculosis, is an important communicable disease. Various mechanisms of resistance to antituberculosis drugs have been reported; these are principally mutations in target genes. However, not all M. tuberculosis resistance can be explained by mutations in such genes. Other resistance mechanisms associated with drug transport, such as efflux pumps, have also been reported. In this study, we investigated the expression levels of three putative efflux pumps and mutations in target genes associated with injectable agents and fluoroquinolones with clinical MDR and XDR-TB isolates. Thirty clinical isolates of M. tuberculosis that had been phenotypically characterized were obtained from the Korean Institute of Tuberculosis. Of these, 14 were MDR-TB isolates resistant to at least one injectable aminoglycoside (amikacin; AMK, kanamycin; KAN, and/or capreomycin; CPM) and 16 were XDR-TB isolates. M. tuberculosis H37Rv (ATCC 27249) was used as a reference strain. Five putative genes (Rv1258c, Rv2686c, Rv2687c, Rv2688c and pstB) were selected for analysis in this study. Sequencing was performed to detect mutations in rrs and eis genes. qRT-PCR was performed to investigate expression levels of five efflux pump genes. Of the 30 isolates, 25 strains had mutations in rrs associated with resistance to KAN, CPM and AMK and two strains had eis mutations, as well as mutations in rrs. pstB (Rv0933) exhibited increased expression and Rv2687c and Rv2688c exhibited decreased expression compared to the reference strain. Increased expression of pstB in clinical drug-resistant tuberculosis isolates may contribute to drug resistance in M. tuberculosis. In our case, overexpression of Rv1258c may have been associated with resistance to kanamycin. No correlation was evident between Rv2686c, Rv2687c or Rv2688c expression and fluoroquinolone resistance. To explore the details of efflux pump drug-resistance mechanisms, further studies on

  2. Clinical and virologic follow-up in perinatally HIV-1-infected children and adolescents in Madrid with triple-class antiretroviral drug-resistant viruses.

    Science.gov (United States)

    Rojas Sánchez, P; de Mulder, M; Fernandez-Cooke, E; Prieto, L; Rojo, P; Jiménez de Ory, S; José Mellado, M; Navarro, M; Tomas Ramos, J; Holguín, Á

    2015-06-01

    Drug resistance mutations compromise the success of antiretroviral treatment in human immunodeficiency virus type 1 (HIV-1)-infected children. We report the virologic and clinical follow-up of the Madrid cohort of perinatally HIV-infected children and adolescents after the selection of triple-class drug-resistant mutations (TC-DRM). We identified patients from the cohort carrying HIV-1 variants with TC-DRM to nucleoside reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors and protease inhibitors according to IAS-USA-2013. We recovered pol sequences or resistance profiles from 2000 to 2011 and clinical-immunologic-virologic data from the moment of TC-DRM detection until December 2013. Viruses harbouring TC-DRM were observed in 48 (9%) of the 534 children and adolescents from 2000 to 2011, rising to 24.4% among those 197 with resistance data. Among them, 95.8% were diagnosed before 2003, 91.7% were Spaniards, 89.6% carried HIV-1-subtype B and 75% received mono/dual therapy as first regimen. The most common TC-DRM present in ≥50% of them were D67NME, T215FVY, M41L and K103N (retrotranscriptase) and L90M (protease). The susceptibility to darunavir, tipranavir, etravirine and rilpivirine was 67.7%, 43.7%, 33.3% and 33.3%, respectively, and all reported high resistance to didanosine, abacavir and nelfinavir. Despite the presence of HIV-1 resistance mutations to the three main antiretroviral families in our paediatric cohort, some drugs maintained their susceptibility, mainly the new protease inhibitors (tipranavir and darunavir) and nonnucleoside reverse transcriptase inhibitors (etravirine and rilpivirine). These data will help to improve the clinical management of HIV-infected children with triple resistance in Spain.

  3. Green synthesis of Al2O3 nanoparticles and their bactericidal potential against clinical isolates of multi-drug resistant Pseudomonas aeruginosa.

    Science.gov (United States)

    Ansari, Mohammad A; Khan, Haris M; Alzohairy, Mohammad A; Jalal, Mohammad; Ali, Syed G; Pal, Ruchita; Musarrat, Javed

    2015-01-01

    -β-lactamases strains of P. aeruginosa, regardless of their drug resistance patterns and mechanisms. The results elucidated the clinical significance of Al2O3-NPs in developing an effective antibacterial therapeutic regimen against the multi-drug resistant bacterial infections. The use of leaf extract of lemongrass for the synthesis of Al2O3-NPs appears to be cost effective, nontoxic, eco-friendly and its strong antibacterial activity against multi-drug resistant strains of P. aeruginosa offers compatibility for pharmaceutical and other biomedical applications.

  4. [Change in drug resistance of Staphylococcus aureus].

    Science.gov (United States)

    Lin, Yan; Liu, Yan; Luo, Yan-Ping; Liu, Chang-Ting

    2013-11-01

    To analyze the change in drug resistance of Staphylococcus aureus (SAU) in the PLA general hospital from January 2008 to December 2012, and to provide solid evidence to support the rational use of antibiotics for clinical applications. The SAU strains isolated from clinical samples in the hospital were collected and subjected to the Kirby-Bauer disk diffusion test. The results were assessed based on the 2002 American National Committee for Clinical Laboratory Standards (NCCLS) guidelines. SAU strains were mainly isolated from sputum, urine, blood and wound excreta and distributed in penology, neurology wards, orthopedics and surgery ICU wards. Except for glycopeptide drugs, methicillin-resistant Staphylococcus aureus (MRSA) had a higher drug resistance rate than those of the other drugs and had significantly more resistance than methicillin-sensitive Staphylococcus aureus (MSSA) (P resistance, we discovered a gradual increase in drug resistance to fourteen test drugs during the last five years. Drug resistance rate of SAU stayed at a higher level over the last five years; moreover, the detection ratio of MRSA keeps rising year by year. It is crucial for physicians to use antibiotics rationally and monitor the change in drug resistance in a dynamic way.

  5. High rates of virological failure and drug resistance in perinatally HIV-1-infected children and adolescents receiving lifelong antiretroviral therapy in routine clinics in Togo

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    Mounerou Salou

    2016-04-01

    Full Text Available Introduction: Antiretroviral treatment (ART has been scaled up over the last decade but compared to adults, children living with HIV are less likely to receive ART. Moreover, children and adolescents are more vulnerable than adults to virological failure (VF and emergence of drug resistance. In this study we determined virological outcome in perinatally HIV-1-infected children and adolescents receiving ART in Togo. Methods: HIV viral load (VL testing was consecutively proposed to all children and adolescents who were on ART for at least 12 months when attending HIV healthcare services for their routine follow-up visit (June to September 2014. Plasma HIV-1 VL was measured using the m2000 RealTime HIV-1 assay (Abbott Molecular, Des Plaines, IL, USA. Genotypic drug resistance was done for all samples with VL>1000 copies/ml. Results and discussion: Among 283 perinatally HIV-1-infected children and adolescents included, 167 (59% were adolescents and 116 (41% were children. The median duration on ART was 48 months (interquartile range: 28 to 68 months. For 228 (80.6%, the current ART combination consisted of two nucleoside reverse transcriptase inhibitors (NRTIs (zidovudine and lamivudine and one non-nucleoside reverse transcriptase inhibitor (NNRTI (nevirapine or efavirenz. Only 28 (9.9% were on a protease inhibitor (PI-based regimen. VL was below the detection limit (i.e. 40 copies/ml for 102 (36%, between 40 and 1000 copies/ml for 35 (12.4% and above 1000 copies/ml for 146 (51.6%. Genotypic drug-resistance testing was successful for 125/146 (85.6%; 110/125 (88.0% were resistant to both NRTIs and NNRTIs, 1/125 (0.8% to NRTIs only, 4/125 (3.2% to NNRTIs only and three harboured viruses resistant to reverse transcriptase and PIs. Overall, 86% (108/125 of children and adolescents experiencing VF and successfully genotyped, corresponding thus to at least 38% of the study population, had either no effective ART or had only a single effective drug in

  6. High rates of virological failure and drug resistance in perinatally HIV-1-infected children and adolescents receiving lifelong antiretroviral therapy in routine clinics in Togo

    Science.gov (United States)

    Salou, Mounerou; Dagnra, Anoumou Y; Butel, Christelle; Vidal, Nicole; Serrano, Laetitia; Takassi, Elom; Konou, Abla A; Houndenou, Spero; Dapam, Nina; Singo-Tokofaï, Assetina; Pitche, Palokinam; Atakouma, Yao; Prince-David, Mireille; Delaporte, Eric; Peeters, Martine

    2016-01-01

    Introduction Antiretroviral treatment (ART) has been scaled up over the last decade but compared to adults, children living with HIV are less likely to receive ART. Moreover, children and adolescents are more vulnerable than adults to virological failure (VF) and emergence of drug resistance. In this study we determined virological outcome in perinatally HIV-1-infected children and adolescents receiving ART in Togo. Methods HIV viral load (VL) testing was consecutively proposed to all children and adolescents who were on ART for at least 12 months when attending HIV healthcare services for their routine follow-up visit (June to September 2014). Plasma HIV-1 VL was measured using the m2000 RealTime HIV-1 assay (Abbott Molecular, Des Plaines, IL, USA). Genotypic drug resistance was done for all samples with VL>1000 copies/ml. Results and discussion Among 283 perinatally HIV-1-infected children and adolescents included, 167 (59%) were adolescents and 116 (41%) were children. The median duration on ART was 48 months (interquartile range: 28 to 68 months). For 228 (80.6%), the current ART combination consisted of two nucleoside reverse transcriptase inhibitors (NRTIs) (zidovudine and lamivudine) and one non-nucleoside reverse transcriptase inhibitor (NNRTI) (nevirapine or efavirenz). Only 28 (9.9%) were on a protease inhibitor (PI)-based regimen. VL was below the detection limit (i.e. 40 copies/ml) for 102 (36%), between 40 and 1000 copies/ml for 35 (12.4%) and above 1000 copies/ml for 146 (51.6%). Genotypic drug-resistance testing was successful for 125/146 (85.6%); 110/125 (88.0%) were resistant to both NRTIs and NNRTIs, 1/125 (0.8%) to NRTIs only, 4/125 (3.2%) to NNRTIs only and three harboured viruses resistant to reverse transcriptase and PIs. Overall, 86% (108/125) of children and adolescents experiencing VF and successfully genotyped, corresponding thus to at least 38% of the study population, had either no effective ART or had only a single effective drug in

  7. Clinical distribution and drug resistance of Acinetobacter baumannii%鲍氏不动杆菌临床感染分布与耐药性分析

    Institute of Scientific and Technical Information of China (English)

    王旭

    2014-01-01

    目的:研究鲍氏不动杆菌感染的临床科室分布及其对抗菌药物的耐药情况,为鲍氏不动杆菌感染的预防和治疗提供依据。方法收集2011年1月-2013年12月医院213例住院患者送检标本分离出的鲍氏不动杆菌,采用VITEK-32细菌鉴定仪鉴定,采用K-B琼脂法进行药敏试验。结果共检出鲍氏不动杆菌213株,其中来自痰液155株占72.7%;临床分布以重症监护病房(ICU)最多占41.5%。对美罗培南、亚胺培南的敏感性较高(>80%),其它药物耐药率大都在50%~70%,且大部分标本都存在多重耐药的现象。结论鲍氏不动杆菌的耐药性较严重,应加强对鲍氏不动杆菌的耐药性监测,防止耐药菌的播散流行。%Objective To analyze the distribution and drug resistance of Acinetbacter baumannii in hospital so as to provide basis for the clinical prevention and cure of the A.baumannii. Methods The A.buamannii strains were isolated from the submitted speci-mens obtained from 213 patients who were hospitalized from Jan 2011 to Dec 2013,then the isolation and culture of the A.bau-mannii strains were performed with the VITEK-32 system,and the drug susceptibility testing was carried out by using K-B method. Results Totally 213 A.baumannii were isolated,including 155 strains isolated from sputum (72.7%);41.5%of the strains were islat-ed from ICU.The drug susceptibility rates to meropenem and imipenem were more than 80.0%.Other drug resistance is mostly in 50%~70%,and most of the speciments are multidrug resistance phenomenon.Conclusion The A.baumannii strains are highly drug resistance,Monitoring the resistance of Acinetobacter baumannii should be strengthened for preventing resistant bacteria from spreading.

  8. Relative frequency of drug-resistant hepatitis B virus infection in patients with hepatitis B admitted to infectious diseases clinic of Khorramabad city in 2013-2016

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    Mohamadreza Nazer

    2016-11-01

    Full Text Available Background:Despite major advances in the treatment of chronic hepatitis B, resistance to antiviral drugs is an important factor in determining the success of long-term treatment for chronic hepatitis B. Given the lack of relevant studies, the current study aimed to determine relative frequency of drug-resistant hepatitis B in patients with chronic hepatitis B in Khorramabad. The findings of this study provide epidemiological data and can be used as a management strategy to better treat these patients. Methods: This retrospective study was carried out on 122 patients infected with hepatitis B admitted to infectious diseases clinic in 2013-2015 was by studying medical records; and in the end, 55 patients met the inclusion criteria. Age, sex, levels of ALT, AST and HBeAb as well as antiretroviral treatment history and drug of samples and type of drug used were recorded. After collecting and entering data in SPSS statistical software, results were reported in appropriate statistical charts and tables. Results: Of all patients, 23 patients (41.8% were female and the rest (58.2% were male. The mean age of patients was 37.53±13.103 years and the minimum age was 9 years old and the oldest was 70 years old. Average of values of ALT and AST were 34.27±20.872units per lit, and 27. 96±12.842 units per lit, respectively, which indicates that both were in the normal range.HBeAb was positive in 89.1% and 3% of patients showed drug resistance to two drugs of tenofovir and entecavir. Conclusion: The relative frequency of drug resistance in patients in this study was lower than values reported in other studies, and there's a big difference with the results of studies in Western countries; which can indicate the impact of geographical area and the lifestyle of its people on the relative frequency of resistance to the treatment of hepatitis. Prospective studies with larger sample size isrecommended for more accurate study.

  9. Prevalence of Hepatitis B in patients with drug-resistant Hepatitis B infection referring to infaction clinic of Khorramabad in years 2013-2015

    Directory of Open Access Journals (Sweden)

    Mohamad reza Nazer

    2016-11-01

    Full Text Available Background: Despite major advances in the treatment of chronic hepatitis B, resistance to antiviral drugs is an important factor in determining the success of long-term treatment for chronic hepatitis B. Given the lack of relevant studies, the current study aimed to determine the prevalence of drug-resistant hepatitis B in patients with chronic hepatitis B in Khorramabad. The findings of this study provideD epidemiological data and can be used as a management strategy to better treat these patients. Methods: This retrospective study was carried out on 122 patients infected with hepatitis B referring to infection clinic in 2013-2015 was by studying medical records; and in the end, 55 patients met the inclusion criteria. Age, sex, levels of ALT, AST and HBeAb as well as antiretroviral treatment history and drug of samples and type of drug used were recorded. After collecting and entering data in SPSS statistical software, results were reported in appropriate statistical charts and tables. Results: Of all patients, 23 patients (41.8% were female and the rest (58.2% were male. The mean age of patients was 37.53±13.103 years and the minimum age was 9 years old and the oldest was 70 years old. Average of values of ALT and AST were 34.27±20.872units per lit, and 27. 96±12.842 units per lit, respectively, which indicates that both were in the normal range. HBeAb was positive in 89.1% and 3% of patients showed drug resistance to two drugs of tenofovir and Entecavir. Conclusion: The prevalence of drug resistance in patients in this study was lower than values reported in other studies, and there's a big difference with the results of studies in Western countries; which can indicate the impact of geographical area and the lifestyle of its people on the prevalence of resistance to the treatment of hepatitis. Prospective studies with larger sample size is recoomended for more accurate study.

  10. [Treatment of drug resistant destructive pulmonary tuberculosis: gemifloxacin and other fluoroquinolones clinical efficiency and tolerance at the end of initial phase of treatment].

    Science.gov (United States)

    Petrenko, V I; Radysh, H V

    2013-12-01

    Gemifloxacin efficiency and tolerance in comparison to the ofloxacin, levofloxacin and gatifloxacin during the intensive phase of the antituberculosis therapy for drug resistant cases was evaluated. 156 drug resistant TB patients were examined in the open, prospective, randomized research, being divided into 2 groups with similar drug resistance profile. The 1st group received gemifloxacin, the 2nd--other fluoroquinolones. Gemifloxacin efficiency in the treatment regimen for the drug resistant TB patients did not differ from the efficiency of the use of other fluoroquinolones of the 4th generation and was significantly higher in comparison to ofloxacin. At the same time the identical level of side effects was registered in the course of treatment with mentioned drugs. Gemifloxacin is effective and safe at treatment of tuberculosis in comparison to other fluoroquinolones that allows considering it as the drug of choice among fluoroquinolones for treatment of drug resistant TB, including multidrug-resistant TB.

  11. Clinical Distribution and Drug Resistance of Acinetobacter Baumann%鲍曼不动杆菌的临床分布与耐药性分析

    Institute of Scientific and Technical Information of China (English)

    马滴露

    2011-01-01

    目的 了解鲍曼不动杆菌的分布特点及耐药情况,为临床治疗提供依据.方法 采用回顾性方法,统计分析280株鲍曼不动杆菌的来源,感染科室及耐药情况.结果 鲍曼不动杆菌以痰标本和支气管吸出物最多,其次是分泌物和血液,感染科室以ICU(重症监护室)和呼吸内科最多,鲍曼不动杆菌对美洛培南敏感性最高,敏感率为95%,其次为亚胺培南.结论 鲍曼不动杆菌是医院感染的重要致病菌,耐药率高且呈多重耐药,所以临床应合理使用抗生素,减少耐药菌株的产生.%Objective To investigate the Acinetobacter baumann infection and drug resistance for providing the experimental data for clinical medication.Methods, The drug resistance and sources of 280 samples from different departments were retrospectively analyzed.Results From 280 tested samples,the Acinetobacter baumann was departed most in sputum and exsuction of bronchus, next to secretion and blood.The infection rate of Acinetobacter baurnann was the highest among ICU and respiratory department.Drug sensitivity test showed that Acinetobacter baumann was highly susceptible to meropenem (95%), and then Imipenem.Conclusion Being the important pathogenic bacteria in hospital infection, Acinetobacter baumann had high antibiotic resistance and multidrug resistance.Rational use of antibiotics to decrease the resistant strains should advocated in hospital.

  12. Drug resistance and genetic characteristics of clinical isolates of staphylococci in Myanmar: high prevalence of PVL among methicillin-susceptible Staphylococcus aureus belonging to various sequence types

    Directory of Open Access Journals (Sweden)

    M.S. Aung

    2016-03-01

    Full Text Available Prevalence, drug resistance and genetic characteristics were analysed for a total of 128 clinical isolates of staphylococci obtained from a tertiary hospital in Myanmar. The dominant species were S. aureus (39% and S. haemolyticus (35%, followed by S. epidermidis (6% and S. saprophyticus (5%. The majority of S. haemolyticus isolates (71.1% harboured mecA, showing high resistance rates to ampicillin, cephalosporins, erythromycin and levofloxacin, while methicillin-resistant S. aureus (MRSA was only 8% (four isolates among S. aureus with type IV SCCmec. Panton-Valentine leukocidin (PVL genes were detected in 20 isolates of S. aureus (40%, among which only one isolate was MRSA belonging to sequence type (ST 88/agr-III/coa-IIIa, and the other 19 methicillin-susceptible S. aureus (MSSA isolates were classified into six STs (ST88, ST121, ST1153, ST1155, ST1930, ST3206. An ST1153 MSSA isolate with PVL was revealed to belong to a novel coa type, XIIIa. ST121 S. aureus was the most common in the PVL-positive MSSA (47%, 9/19, harbouring genes of bone sialoprotein and variant of elastin binding protein as a distinctive feature. Although PVL-positive MSSA was susceptible to most of the antimicrobial agents examined, ST1930 isolates were resistant to erythromycin and levofloxacin. ST59 PVL-negative MRSA and MSSA had more resistance genes than other MRSA and PVL-positive MSSA, showing resistance to more antimicrobial agents. This study indicated higher prevalence of mecA associated with multiple drug resistance in S. haemolyticus than in S. aureus, and dissemination of PVL genes to multiple clones of MSSA, with ST121 being dominant, among hospital isolates in Myanmar.

  13. Herpes Zoster of the Third Division of the Trigeminal Nerve. A Clinical Pathologic Conference.

    Science.gov (United States)

    Doan, Karen; Stoler, Kenneth; Logan, Keri

    2015-11-01

    Herpes zoster of the trigeminal nerve is a disease that often challenges dentists and dental specialists trying to make the proper diagnosis, as many ulcerative and vesiculobullous diseases of the mouth have a similar clinical appearance. We report a clinical case in which a 27-year-old patient sought care for this vesicular lesion. Included are the differential diagnosis and treatment modalities that we used to diagnose the disease. A clinical pathologic conference is provided to highlight the appropriate courses of action in the management of herpes zoster.

  14. Laboratory diagnosis, clinical management and infection control of the infections caused by extensively drug-resistant Gram-negative bacilli: a Chinese consensus statement.

    Science.gov (United States)

    Guan, X; He, L; Hu, B; Hu, J; Huang, X; Lai, G; Li, Y; Liu, Y; Ni, Y; Qiu, H; Shao, Z; Shi, Y; Wang, M; Wang, R; Wu, D; Xie, C; Xu, Y; Yang, F; Yu, K; Yu, Y; Zhang, J; Zhuo, C

    2016-03-01

    Extensively drug-resistant (XDR) Gram-negative bacilli (GNB) are defined as bacterial isolates susceptible to two or fewer antimicrobial categories. XDR-GNB mainly occur in Enterobacteriaceae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia. The prevalence of XDR-GNB is on the rise in China and in other countries, and it poses a major public health threat as a result of the lack of adequate therapeutic options. A group of Chinese clinical experts, microbiologists and pharmacologists came together to discuss and draft a consensus on the laboratory diagnosis, clinical management and infection control of XDR-GNB infections. Lists of antimicrobial categories proposed for antimicrobial susceptibility testing were created according to documents from the Clinical Laboratory Standards Institute (CLSI), the European Committee on Antimicrobial Susceptibility Testing (EUCAST) and the United States Food and Drug Administration (FDA). Multiple risk factors of XDR-GNB infections are analyzed, with long-term exposure to extended-spectrum antimicrobials being the most important one. Combination therapeutic regimens are summarized for treatment of XDR-GNB infections caused by different bacteria based on limited clinical studies and/or laboratory data. Most frequently used antimicrobials used for the combination therapies include aminoglycosides, carbapenems, colistin, fosfomycin and tigecycline. Strict infection control measures including hand hygiene, contact isolation, active screening, environmental surface disinfections, decolonization and restrictive antibiotic stewardship are recommended to curb the XDR-GNB spread. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. 老年病房真菌分布及耐药性分析%Clinical distribution and drug resistance of fungi from geriatric wards

    Institute of Scientific and Technical Information of China (English)

    龚美亮; 周玉; 李玉茹; 白洁; 蔡力力; 徐雅萍; 李晓霞

    2011-01-01

    OBJECTIVE To explore the clinical distribution and drug resistance characteristics of pathogens from eldly fungal infection patients to provide the gist for clinical therapy. METHODS The clinical isolates gathered from inpatients in geriatric ward during Jun 2010 to Jun 2011 were identified and tested for drug resistance: RESULTS Among 2 290 strains of fungi, 1322 strains were Candida albicans(57. 7%) , 336 strains were C. Trop-icalisdi. 7%)and.328 strains were C. Glabrata (14. 3%). The clinical departments with highest infective rate was department of Respiratory; The highest detection rate of 78. 3% was in sputum specimens, followed by 10. 1% in the urine. Susceptibility results showed that amphotericin B was the most sensitive drug with the sensitivity rate of 99.0%. CONCLUSION In geriatric wards, the majority isolated fungal strain is C. Albicans. The fungal infection is severe. It should pay attention to the fungi detection and rational use of antifungal agents.%目的 探讨老年患者真菌感染的分布及耐药性,为临床合理用药提供依据.方法 收集医院老年病房2010年6月-2011年6月临床送检标本,进行真菌分离、鉴定和药敏试验.结果 2290株真菌中,白色假丝酵母菌占57.7%,光滑假丝酵母菌占14.3%;真菌分离率较高的科室为呼吸科;检出真菌标本痰液占78.6%,尿液标本占10.1%;真菌对两性霉素B和5-氟胞嘧啶敏感率分别为99.0%和98.4%.结论 老年病房真菌感染以白色假丝酵母菌为主,真菌感染率较高,应重视真菌病原学检查及药敏检测,为临床合理用药提供依据.

  16. Study on clinical isolated pathogenic bacteria and drug resistance of a hospital%3087株病原菌分布及其耐药性分析

    Institute of Scientific and Technical Information of China (English)

    黄丽萍; 王芬; 郑玲

    2016-01-01

    目的 了解医院临床分离病原菌分布特征及耐药性情况,为临床合理选用抗菌药物提供参考.方法 采用回顾性调查方法,对某医院2014年度临床分离鉴定的病原菌及其耐药性情况进行调查与分析.结果 该医院2014年全年共分离出医院感染病原菌3 087株,革兰阴性菌、革兰阳性菌和真菌的构成比分别为63.72%、22.13%和14.16%.病原菌主要分离自呼吸道标本,占53.03%.检出的病原菌中,多重耐药菌1 105株,占病原菌总数的35.80%,分别以大肠埃希菌、金黄色葡萄球菌、凝固酶阴性葡萄球菌、肺炎克雷伯菌和铜绿假单胞菌居前5位.临床分离的病原菌普遍耐药,革兰阴性杆菌已经出现耐碳青霉烯类菌株,但革兰阳性球菌对万古霉素和替考拉宁敏感,未发现耐药真菌.结论 该医院临床分离病原菌耐药严重,应加强耐碳青霉烯类菌株的实时监测.%Objective To understand the distribution of clinical isolated pathogenic bacteria and drug resistance,provide reference for the rational use of antimicrobial drugs.Methods Retrospective study was used to survey the clinical isolated pathogenic bacteria and drug resistance of a hospital in 2014.Results 3 087 strains of pathogenic bacteria were isolated in 2014.The constituent ratio of Gram-negative bacteria,Gram-positive bacteria and fungi was 63.72% 、22.13% and 14.16%,respectively.The main source of pathogenic bacteria was respiratory tract specimen,accounting for 53.03%.There were 1 105 strains of MDROs isolated,accounting for 35.80%.Among all MDROs,Escherichia coli,Staphylococcus aureus,Coagulase negative Staphylococcus,Klebsiella pneumonia and Pseudomonas aeruginosa ranked the top five.The drug resistance of clinical isolated pathogens was serious,and carbapenem-resistant strains had been detected in gram-negative bacteria.Gram-positive cocci was sensitive to vancomycin and teicoplanin.No resistant fungii were detected

  17. Transmitted drug resistance in the CFAR network of integrated clinical systems cohort: prevalence and effects on pre-therapy CD4 and viral load.

    Directory of Open Access Journals (Sweden)

    Art F Y Poon

    Full Text Available Human immunodeficiency virus type 1 (HIV-1 genomes often carry one or more mutations associated with drug resistance upon transmission into a therapy-naïve individual. We assessed the prevalence and clinical significance of transmitted drug resistance (TDR in chronically-infected therapy-naïve patients enrolled in a multi-center cohort in North America. Pre-therapy clinical significance was quantified by plasma viral load (pVL and CD4+ cell count (CD4 at baseline. Naïve bulk sequences of HIV-1 protease and reverse transcriptase (RT were screened for resistance mutations as defined by the World Health Organization surveillance list. The overall prevalence of TDR was 14.2%. We used a Bayesian network to identify co-transmission of TDR mutations in clusters associated with specific drugs or drug classes. Aggregate effects of mutations by drug class were estimated by fitting linear models of pVL and CD4 on weighted sums over TDR mutations according to the Stanford HIV Database algorithm. Transmitted resistance to both classes of reverse transcriptase inhibitors was significantly associated with lower CD4, but had opposing effects on pVL. In contrast, position-specific analyses of TDR mutations revealed substantial effects on CD4 and pVL at several residue positions that were being masked in the aggregate analyses, and significant interaction effects as well. Residue positions in RT with predominant effects on CD4 or pVL (D67 and M184 were re-evaluated in causal models using an inverse probability-weighting scheme to address the problem of confounding by other mutations and demographic or risk factors. We found that causal effect estimates of mutations M184V/I (-1.7 log₁₀pVL and D67N/G (-2.1[³√CD4] and 0.4 log₁₀pVL were compensated by K103N/S and K219Q/E/N/R. As TDR becomes an increasing dilemma in this modern era of highly-active antiretroviral therapy, these results have immediate significance for the clinical management of HIV-1

  18. HIV-1 drug resistance and resistance testing.

    Science.gov (United States)

    Clutter, Dana S; Jordan, Michael R; Bertagnolio, Silvia; Shafer, Robert W

    2016-12-01

    The global scale-up of antiretroviral (ARV) therapy (ART) has led to dramatic reductions in HIV-1 mortality and incidence. However, HIV drug resistance (HIVDR) poses a potential threat to the long-term success of ART and is emerging as a threat to the elimination of AIDS as a public health problem by 2030. In this review we describe the genetic mechanisms, epidemiology, and management of HIVDR at both individual and population levels across diverse economic and geographic settings. To describe the genetic mechanisms of HIVDR, we review the genetic barriers to resistance for the most commonly used ARVs and describe the extent of cross-resistance between them. To describe the epidemiology of HIVDR, we summarize the prevalence and patterns of transmitted drug resistance (TDR) and acquired drug resistance (ADR) in both high-income and low- and middle-income countries (LMICs). We also review to two categories of HIVDR with important public health relevance: (i) pre-treatment drug resistance (PDR), a World Health Organization-recommended HIVDR surveillance metric and (ii) and pre-exposure prophylaxis (PrEP)-related drug resistance, a type of ADR that can impact clinical outcomes if present at the time of treatment initiation. To summarize the implications of HIVDR for patient management, we review the role of genotypic resistance testing and treatment practices in both high-income and LMIC settings. In high-income countries where drug resistance testing is part of routine care, such an understanding can help clinicians prevent virological failure and accumulation of further HIVDR on an individual level by selecting the most efficacious regimens for their patients. Although there is reduced access to diagnostic testing and to many ARVs in LMIC, understanding the scientific basis and clinical implications of HIVDR is useful in all regions in order to shape appropriate surveillance, inform treatment algorithms, and manage difficult cases. Copyright © 2016 Elsevier B

  19. Extremely high prevalence of antiseptic resistant Quaternary Ammonium Compound E gene among clinical isolates of multiple drug resistant Acinetobacter baumannii in Malaysia

    OpenAIRE

    Babaei, Mohammad Reza; Sulong, Anita; Hamat, Rukman Awang; Nordin, Syafinaz Amin; Neela, Vasantha Kumari

    2015-01-01

    Background Antiseptics are commonly used for the management of MDR (multiple drug resistance) pathogens in hospitals. They play crucial roles in the infection control practices. Antiseptics are often used for skin antisepsis, gauze dressing, preparation of anatomical sites for surgical procedure, hand sterilization before in contact with an infected person, before an invasive procedure and as surgical scrub. Methods We screened 122 multiple drug resistant Acinetobacter baumannii (MDRAB) isola...

  20. 临床感染中病原菌的分布及耐药性分析%Pathogen distribution and drug resistance analysis in clinical infection

    Institute of Scientific and Technical Information of China (English)

    陈玮; 方进

    2012-01-01

    Objective: To comprehend the distribution of common pathogens and drug resistance in clinical infection, and provide the basis for rational use of antimicrobial drugs to clinicians. Methods: The statistical distribution of 602 strains of bacteria isolated from clinical samples in 2009 and the bacterial resistance rates of common infection were analyzed. Results: There were 134 strains of Gram-positive bacteria(22. 26% ) ,468 strains of Gram-negative bacteria (77. 74% ) in 602 strains of isolated bacteria. In Gram-positive bacteria infection, Staphylococcus epidermidis infection was more common ( 11. 79% ) , followed by other streptococci ( 5. 81% ) ; while E. coli infection ( 29. 57%) was at the top in Gram-negative bacteria infection, followed by Enterobacter ( 13. 29%) and Klebsiella ( 12. 46% ). Drug susceptibility analysis revealed that Staphylococcus epidermidis was sensitive to novobiocin and ampicillin 100. 00% and resistant to aztreonam, azithromycin and penicillin, the resistance rates were respectively 96. 00% ,96. 00% and 92. 42%. E. coli was sensitive to nitrofurantoin and 100. 00% resistant to penicillin, rifampin and lincomycin. Conclusions: The drug resistant rates of penicillin, lincomycin and azithromycin were very high, the drug resistant rates of Gram-positive bacteria to ampicillin, vancomycin, novobiocin are low;the Gram-negative bacteria is the most sensitive to cefoperazone/sulbactam,tazobactam,piperacillin/tazobactam.%目的:了解临床感染中常见病原菌分布及耐药情况,为临床医生合理选用抗菌药物提供依据.方法:对2009年临床标本中分离的602株病原菌的分布情况进行统计,并分析常见感染菌的耐药率.结果:分离的602株细菌中,G+菌134株(22.26%),G-菌468株(77.74%).G+菌中以表皮葡萄球菌感染为多见(71株),其次为其他链球菌(35株);而G-菌中大肠埃希菌(178株)居于首位,其次是肠杆菌属(80株)和克雷伯菌属(75株).表皮葡萄球菌

  1. DRUG-RESISTANCE, SUPPORTIVE CARE AND DOSE INTENSITY

    NARCIS (Netherlands)

    DEVRIES, EGE; HAMILTON, TC; LIND, M; DAUPLAT, J; NEIJT, JP; OZOLS, RF

    1993-01-01

    Background: Both intrinsic and acquired drug resistance occur in ovarian cancer. Much work on in vivo or in vitro, obtained drug resistance has been done and this knowledge is presently being converted into clinical studies. Materials and methods: The review focuses on the detoxifying system, MDR (m

  2. Herpes Simplex Virus Infection in a University Health Population: Clinical Manifestations, Epidemiology, and Implications

    Science.gov (United States)

    Horowitz, Robert; Aierstuck, Sara; Williams, Elizabeth A.; Melby, Bernette

    2010-01-01

    Objective: The authors described clinical presentations of oral and genital herpes simplex virus (HSV) infections in a university health population and implications of these findings. Participants and Methods: Using a standardized data collection tool, 215 records of patients with symptomatic culture-positive HSV infections were reviewed. Results:…

  3. Herpes Simplex Virus Infection in a University Health Population: Clinical Manifestations, Epidemiology, and Implications

    Science.gov (United States)

    Horowitz, Robert; Aierstuck, Sara; Williams, Elizabeth A.; Melby, Bernette

    2010-01-01

    Objective: The authors described clinical presentations of oral and genital herpes simplex virus (HSV) infections in a university health population and implications of these findings. Participants and Methods: Using a standardized data collection tool, 215 records of patients with symptomatic culture-positive HSV infections were reviewed. Results:…

  4. Prevalence and clinical consequences of herpes simplex virus type 1 DNA in human cornea tissues

    NARCIS (Netherlands)

    L. Remeijer (Lies); R. Duan (Rui); J.M. van Dun (Jessica); M.A.W. Bettink; A.D.M.E. Osterhaus (Albert); G.M.G.M. Verjans (George)

    2009-01-01

    textabstractBackground. We determined the prevalence and clinical consequences of herpes simplex virus (HSV) type 1 (HSV-1), HSV type 2 (HSV-2), and varicella-zoster virus (VZV) in cornea tissues obtained after penetrating keratoplasty (PKP) was performed. Methods. The excised corneas of 83 patients

  5. Prevalence and clinical consequences of herpes simplex virus type 1 DNA in human cornea tissues

    NARCIS (Netherlands)

    L. Remeijer (Lies); R. Duan (Rui); J.M. van Dun (Jessica); M.A.W. Bettink; A.D.M.E. Osterhaus (Ab); G.M.G.M. Verjans (George)

    2009-01-01

    textabstractBackground. We determined the prevalence and clinical consequences of herpes simplex virus (HSV) type 1 (HSV-1), HSV type 2 (HSV-2), and varicella-zoster virus (VZV) in cornea tissues obtained after penetrating keratoplasty (PKP) was performed. Methods. The excised corneas of 83 patients

  6. Altered antibiotic transport in OmpC mutants isolated from a series of clinical strains of multi-drug resistant E. coli.

    Science.gov (United States)

    Lou, Hubing; Chen, Min; Black, Susan S; Bushell, Simon R; Ceccarelli, Matteo; Mach, Tivadar; Beis, Konstantinos; Low, Alison S; Bamford, Victoria A; Booth, Ian R; Bayley, Hagan; Naismith, James H

    2011-01-01

    Antibiotic-resistant bacteria, particularly gram negative species, present significant health care challenges. The permeation of antibiotics through the outer membrane is largely effected by the porin superfamily, changes in which contribute to antibiotic resistance. A series of antibiotic resistant E. coli isolates were obtained from a patient during serial treatment with various antibiotics. The sequence of OmpC changed at three positions during treatment giving rise to a total of four OmpC variants (denoted OmpC20, OmpC26, OmpC28 and OmpC33, in which OmpC20 was derived from the first clinical isolate). We demonstrate that expression of the OmpC K12 porin in the clinical isolates lowers the MIC, consistent with modified porin function contributing to drug resistance. By a range of assays we have established that the three mutations that occur between OmpC20 and OmpC33 modify transport of both small molecules and antibiotics across the outer membrane. This results in the modulation of resistance to antibiotics, particularly cefotaxime. Small ion unitary conductance measurements of the isolated porins do not show significant differences between isolates. Thus, resistance does not appear to arise from major changes in pore size. Crystal structures of all four OmpC clinical mutants and molecular dynamics simulations also show that the pore size is essentially unchanged. Molecular dynamics simulations suggest that perturbation of the transverse electrostatic field at the constriction zone reduces cefotaxime passage through the pore, consistent with laboratory and clinical data. This subtle modification of the transverse electric field is a very different source of resistance than occlusion of the pore or wholesale destruction of the transverse field and points to a new mechanism by which porins may modulate antibiotic passage through the outer membrane.

  7. Altered Antibiotic Transport in OmpC Mutants Isolated from a Series of Clinical Strains of Multi-Drug Resistant E. coli

    Science.gov (United States)

    Ceccarelli, Matteo; Mach, Tivadar; Beis, Konstantinos; Low, Alison S.; Bamford, Victoria A.; Booth, Ian R.; Bayley, Hagan; Naismith, James H.

    2011-01-01

    Antibiotic-resistant bacteria, particularly Gram negative species, present significant health care challenges. The permeation of antibiotics through the outer membrane is largely effected by the porin superfamily, changes in which contribute to antibiotic resistance. A series of antibiotic resistant E. coli isolates were obtained from a patient during serial treatment with various antibiotics. The sequence of OmpC changed at three positions during treatment giving rise to a total of four OmpC variants (denoted OmpC20, OmpC26, OmpC28 and OmpC33, in which OmpC20 was derived from the first clinical isolate). We demonstrate that expression of the OmpC K12 porin in the clinical isolates lowers the MIC, consistent with modified porin function contributing to drug resistance. By a range of assays we have established that the three mutations that occur between OmpC20 and OmpC33 modify transport of both small molecules and antibiotics across the outer membrane. This results in the modulation of resistance to antibiotics, particularly cefotaxime. Small ion unitary conductance measurements of the isolated porins do not show significant differences between isolates. Thus, resistance does not appear to arise from major changes in pore size. Crystal structures of all four OmpC clinical mutants and molecular dynamics simulations also show that the pore size is essentially unchanged. Molecular dynamics simulations suggest that perturbation of the transverse electrostatic field at the constriction zone reduces cefotaxime passage through the pore, consistent with laboratory and clinical data. This subtle modification of the transverse electric field is a very different source of resistance than occlusion of the pore or wholesale destruction of the transverse field and points to a new mechanism by which porins may modulate antibiotic passage through the outer membrane. PMID:22053181

  8. Altered antibiotic transport in OmpC mutants isolated from a series of clinical strains of multi-drug resistant E. coli.

    Directory of Open Access Journals (Sweden)

    Hubing Lou

    Full Text Available Antibiotic-resistant bacteria, particularly gram negative species, present significant health care challenges. The permeation of antibiotics through the outer membrane is largely effected by the porin superfamily, changes in which contribute to antibiotic resistance. A series of antibiotic resistant E. coli isolates were obtained from a patient during serial treatment with various antibiotics. The sequence of OmpC changed at three positions during treatment giving rise to a total of four OmpC variants (denoted OmpC20, OmpC26, OmpC28 and OmpC33, in which OmpC20 was derived from the first clinical isolate. We demonstrate that expression of the OmpC K12 porin in the clinical isolates lowers the MIC, consistent with modified porin function contributing to drug resistance. By a range of assays we have established that the three mutations that occur between OmpC20 and OmpC33 modify transport of both small molecules and antibiotics across the outer membrane. This results in the modulation of resistance to antibiotics, particularly cefotaxime. Small ion unitary conductance measurements of the isolated porins do not show significant differences between isolates. Thus, resistance does not appear to arise from major changes in pore size. Crystal structures of all four OmpC clinical mutants and molecular dynamics simulations also show that the pore size is essentially unchanged. Molecular dynamics simulations suggest that perturbation of the transverse electrostatic field at the constriction zone reduces cefotaxime passage through the pore, consistent with laboratory and clinical data. This subtle modification of the transverse electric field is a very different source of resistance than occlusion of the pore or wholesale destruction of the transverse field and points to a new mechanism by which porins may modulate antibiotic passage through the outer membrane.

  9. Putative histidine kinase inhibitors with antibacterial effect against multi-drug resistant clinical isolates identified by in vitro and in silico screens

    Science.gov (United States)

    Velikova, Nadya; Fulle, Simone; Manso, Ana Sousa; Mechkarska, Milena; Finn, Paul; Conlon, J. Michael; Oggioni, Marco Rinaldo; Wells, Jerry M.; Marina, Alberto

    2016-05-01

    Novel antibacterials are urgently needed to address the growing problem of bacterial resistance to conventional antibiotics. Two-component systems (TCS) are widely used by bacteria to regulate gene expression in response to various environmental stimuli and physiological stress and have been previously proposed as promising antibacterial targets. TCS consist of a sensor histidine kinase (HK) and an effector response regulator. The HK component contains a highly conserved ATP-binding site that is considered to be a promising target for broad-spectrum antibacterial drugs. Here, we describe the identification of putative HK autophosphorylation inhibitors following two independent experimental approaches: in vitro fragment-based screen via differential scanning fluorimetry and in silico structure-based screening, each followed up by the exploration of analogue compounds as identified by ligand-based similarity searches. Nine of the tested compounds showed antibacterial effect against multi-drug resistant clinical isolates of bacterial pathogens and include three novel scaffolds, which have not been explored so far in other antibacterial compounds. Overall, putative HK autophosphorylation inhibitors were found that together provide a promising starting point for further optimization as antibacterials.

  10. Suitability of IS6110-RFLP and MIRU-VNTR for Differentiating Spoligotyped Drug-Resistant Mycobacterium tuberculosis Clinical Isolates from Sichuan in China

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    Chao Zheng

    2014-01-01

    Full Text Available Genotypes of Mycobacterium tuberculosis complex (MTBC vary with the geographic origin of the patients and can affect tuberculosis (TB transmission. This study was aimed to further differentiate spoligotype-defined clusters of drug-resistant MTBC clinical isolates split in Beijing (n=190 versus non-Beijing isolates (n=84 from Sichuan region, the second high-burden province in China, by IS6110-restriction fragment length polymorphism (RFLP and 24-locus MIRU-VNTRs. Among 274 spoligotyped isolates, the clustering ratio of Beijing family was 5.3% by 24-locus MIRU-VNTRs versus 2.1% by IS6110-RFLP, while none of the non-Beijing isolates were clustered by 24-locus MIRU-VNTRs versus 9.5% by IS6110-RFLP. Hence, neither the 24-locus MIRU-VNTR was sufficient enough to fully discriminate the Beijing family, nor the IS6110-RFLP for the non-Beijing isolates. A region adjusted scheme combining 12 highly discriminatory VNTR loci with IS6110-RFLP was a better alternative for typing Beijing strains in Sichuan than 24-locus MIRU-VNTRs alone. IS6110-RFLP was for the first time introduced to systematically genotype MTBC in Sichuan and we conclude that the region-adjusted scheme of 12 highly discriminative VNTRs might be a suitable alternative to 24-locus MIRU-VNTR scheme for non-Beijing strains, while the clusters of the Beijing isolates should be further subtyped using IS6110-RFLP for optimal discrimination.

  11. Global dissemination of extensively drug-resistant carbapenemase-producing Enterobacteriaceae: clinical perspectives on detection, treatment and infection control.

    Science.gov (United States)

    Tängdén, T; Giske, C G

    2015-05-01

    The prevalence of carbapenem-resistant Gram-negative bacilli is on the rise worldwide, posing a major public health threat. Previously, this was mostly a problem in Pseudomonas and Acinetobacter, but during the last decade, carbapenem resistance has escalated in medically important species such as Klebsiella pneumoniae and Escherichia coli. In particular, the rising trend in E. coli is of concern, as this may lead to almost untreatable community-acquired infections. Resistance is conferred by carbapenemases, which are beta-lactamases that can breakdown essentially all beta-lactams. Moreover, bacteria carrying these resistance determinants are often resistant to other treatment options, due to the frequent co-acquisition of non-beta-lactam resistance genes located on the same mobile genetic elements. The detection of carbapenemase-producing Enterobacteriaceae (CPE) is a challenge, because some carbapenemases produce relatively discrete levels of carbapenem resistance. Current clinical evidence for treatment guidance is limited and based on retrospective observational studies and case reports. Existing data support the use of combination therapy for treatment of severe infections caused by CPE. Combination regimens including colistin, carbapenems, tigecycline, aminoglycosides and fosfomycin have been used. Randomized controlled studies of combination regimens are ongoing and may help to determine the optimal therapy. Novel beta-lactamase inhibitors may also have a role in future treatment of these infections. Strict infection control measures including isolation or cohort care of affected patients as well as contact tracing and active screening are needed to curb the spread of CPE. In this review, we provide a clinical perspective on the management of patients infected or colonized with CPE. © 2014 The Association for the Publication of the Journal of Internal Medicine.

  12. 临床分离的129株鲍曼不动杆菌的耐药性分析%Analysis of clinical distribution and drug resistance of the Bauman acinetobacter

    Institute of Scientific and Technical Information of China (English)

    闫雳

    2012-01-01

    Objective:To explore the drug resistance and clinical distribution of Bauman acinetobacter,and provide a basis for controlling hospital infection. Methods: The clinical distribution, drug resistance and sample separation of 129 strains of Bauman acinetobacter were analysed, and the resistance rate of 14 kinds of commonly used antimicrobial agents were calculated. Results: Sputum specimen's detection rate with 72.09% was highest, patients came mainly from physicians and intensive care treatment ward. The drug resistance rates of only 3 types of antimicrobial agents in 129 stains Bauman acinetobacter were less than 30% ,imipenem,piperacillin/tazobactam and ampicillin/Shu TAZ were 24.80% ,26.35% and 27.90% ,respectively,the others drug resistance rates were more than 50%. Conclusions:As to the serious multi-drug resistance of Bauman adnetobacters, the resistance monitoring should be strengthened for directing clinical medication.%目的:了解鲍曼不动杆菌的耐药和临床分布情况,为防控医院感染提供依据.方法:对129株鲍曼不动杆菌的临床分布和常用抗菌药物的耐药情况进行分析.结果:痰标本检出率最高,为72.09%;患者主要分布在内科和重症监护治疗病房;分离出的129株鲍曼不动杆菌仅有3种药物耐药率50%.结论:鲍曼不动杆菌多重耐药严重,应加强耐药性监测,了解耐药变迁,为临床用药提供依据.

  13. In vitro antibacterial activity of some antihistaminics belonging to different groups against multi-drug resistant clinical isolates

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    Moustafa A El-Nakeeb

    2011-09-01

    Full Text Available Antihistaminics are widely used for various indications during microbial infection. Hence, this paper investigates the antimicrobial activities of 10 antihistaminics belonging to both old and new generations using multiresistant Gram-positive and Gram-negative clinical isolates. The bacteriostatic activity of antihistaminics was investigated by determining their MIC both by broth and agar dilution techniques against 29 bacterial strains. Azelastine, cyproheptadine, mequitazine and promethazine were the most active among the tested drugs. Diphenhydramine and cetirizine possessed weaker activity whereas doxylamine, fexofenadine and loratadine were inactive even at the highest tested concentration (1 mg/ml. The MIC of meclozine could not be determined as it precipitated with the used culture media. The MBC values of antihistaminics were almost identical to the corresponding MIC values. The bactericidal activity of antihistaminics was also studied by the viable count technique in sterile saline solution. Evident killing effects were exerted by mequitazine, meclozine, azelastine and cyproheptadine. Moreover, the dynamics of bactericidal activity of azelastine were studied by the viable count technique in nutrient broth. This activity was found to be concentration-dependant. This effect was reduced on increasing the inoculum size while it was increased on raising the pH. The post-antimicrobial effect of 100 fg/ml azelastine was also determined and reached up to 3.36 h.

  14. Efflux as a mechanism of antimicrobial drug resistance in clinical relevant microorganisms: the role of efflux inhibitors.

    Science.gov (United States)

    Willers, Clarissa; Wentzel, Johannes Frederik; du Plessis, Lissinda Hester; Gouws, Chrisna; Hamman, Josias Hendrik

    2017-01-01

    Microbial resistance against antibiotics is a serious threat to the effective treatment of infectious diseases. Several mechanisms exist through which microorganisms can develop resistance against antimicrobial drugs, of which the overexpression of genes to produce efflux pumps is a major concern. Several efflux transporters have been identified in microorganisms, which infer resistance against specific antibiotics and even multidrug resistance. Areas covered: This paper focuses on microbial resistance against antibiotics by means of the mechanism of efflux and gives a critical overview of studies conducted to overcome this problem by combining efflux pump inhibitors with antibiotics. Information was obtained from a literature search done with MEDLINE, Pubmed, Scopus, ScienceDirect, OneSearch and EBSCO host. Expert opinion: Efflux as a mechanism of multidrug resistance has presented a platform for improved efficacy against resistant microorganisms by co-administration of efflux pump inhibitors with antimicrobial agents. Although proof of concept has been shown for this approach with in vitro experiments, further research is needed to develop more potent inhibitors with low toxicity which is clinically effective.

  15. Pretreatment HIV Drug Resistance and HIV-1 Subtype C Are Independently Associated With Virologic Failure: Results From the Multinational PEARLS (ACTG A5175) Clinical Trial

    Science.gov (United States)

    Kantor, Rami; Smeaton, Laura; Vardhanabhuti, Saran; Hudelson, Sarah E.; Wallis, Carol L.; Tripathy, Srikanth; Morgado, Mariza G.; Saravanan, Shanmugham; Balakrishnan, Pachamuthu; Reitsma, Marissa; Hart, Stephen; Mellors, John W.; Halvas, Elias; Grinsztejn, Beatriz; Hosseinipour, Mina C.; Kumwenda, Johnstone; La Rosa, Alberto; Lalloo, Umesh G.; Lama, Javier R.; Rassool, Mohammed; Santos, Breno R.; Supparatpinyo, Khuanchai; Hakim, James; Flanigan, Timothy; Kumarasamy, Nagalingeswaran; Campbell, Thomas B.; Eshleman, Susan H.

    2015-01-01

    Background. Evaluation of pretreatment HIV genotyping is needed globally to guide treatment programs. We examined the association of pretreatment (baseline) drug resistance and subtype with virologic failure in a multinational, randomized clinical trial that evaluated 3 antiretroviral treatment (ART) regimens and included resource-limited setting sites. Methods. Pol genotyping was performed in a nested case-cohort study including 270 randomly sampled participants (subcohort), and 218 additional participants failing ART (case group). Failure was defined as confirmed viral load (VL) >1000 copies/mL. Cox proportional hazards models estimated resistance–failure association. Results. In the representative subcohort (261/270 participants with genotypes; 44% women; median age, 35 years; median CD4 cell count, 151 cells/µL; median VL, 5.0 log10 copies/mL; 58% non-B subtypes), baseline resistance occurred in 4.2%, evenly distributed among treatment arms and subtypes. In the subcohort and case groups combined (466/488 participants with genotypes), used to examine the association between resistance and treatment failure, baseline resistance occurred in 7.1% (9.4% with failure, 4.3% without). Baseline resistance was significantly associated with shorter time to virologic failure (hazard ratio [HR], 2.03; P = .035), and after adjusting for sex, treatment arm, sex–treatment arm interaction, pretreatment CD4 cell count, baseline VL, and subtype, was still independently associated (HR, 2.1; P = .05). Compared with subtype B, subtype C infection was associated with higher failure risk (HR, 1.57; 95% confidence interval [CI], 1.04–2.35), whereas non-B/C subtype infection was associated with longer time to failure (HR, 0.47; 95% CI, .22–.98). Conclusions. In this global clinical trial, pretreatment resistance and HIV-1 subtype were independently associated with virologic failure. Pretreatment genotyping should be considered whenever feasible. Clinical Trials

  16. Antibacterial activity of novel cationic peptides against clinical isolates of multi-drug resistant Staphylococcus pseudintermedius from infected dogs.

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    Mohamed F Mohamed

    Full Text Available Staphylococcus pseudintermedius is a major cause of skin and soft tissue infections in companion animals and has zoonotic potential. Additionally, methicillin-resistant S. pseudintermedius (MRSP has emerged with resistance to virtually all classes of antimicrobials. Thus, novel treatment options with new modes of action are required. Here, we investigated the antimicrobial activity of six synthetic short peptides against clinical isolates of methicillin-susceptible and MRSP isolated from infected dogs. All six peptides demonstrated potent anti-staphylococcal activity regardless of existing resistance phenotype. The most effective peptides were RRIKA (with modified C terminus to increase amphipathicity and hydrophobicity and WR-12 (α-helical peptide consisting exclusively of arginine and tryptophan with minimum inhibitory concentration50 (MIC50 of 1 µM and MIC90 of 2 µM. RR (short anti-inflammatory peptide and IK8 "D isoform" demonstrated good antimicrobial activity with MIC50 of 4 µM and MIC90 of 8 µM. Penetratin and (KFF3K (two cell penetrating peptides were the least effective with MIC50 of 8 µM and MIC90 of 16 µM. Killing kinetics revealed a major advantage of peptides over conventional antibiotics, demonstrating potent bactericidal activity within minutes. Studies with propidium iodide and transmission electron microscopy revealed that peptides damaged the bacterial membrane leading to leakage of cytoplasmic contents and consequently, cell death. A potent synergistic increase in the antibacterial effect of the cell penetrating peptide (KFF3K was noticed when combined with other peptides and with antibiotics. In addition, all peptides displayed synergistic interactions when combined together. Furthermore, peptides demonstrated good therapeutic indices with minimal toxicity toward mammalian cells. Resistance to peptides did not evolve after 10 passages of S. pseudintermedius at sub-inhibitory concentration. However, the MICs of amikacin

  17. Antibacterial activity of novel cationic peptides against clinical isolates of multi-drug resistant Staphylococcus pseudintermedius from infected dogs.

    Science.gov (United States)

    Mohamed, Mohamed F; Hammac, G Kenitra; Guptill, Lynn; Seleem, Mohamed N

    2014-01-01

    Staphylococcus pseudintermedius is a major cause of skin and soft tissue infections in companion animals and has zoonotic potential. Additionally, methicillin-resistant S. pseudintermedius (MRSP) has emerged with resistance to virtually all classes of antimicrobials. Thus, novel treatment options with new modes of action are required. Here, we investigated the antimicrobial activity of six synthetic short peptides against clinical isolates of methicillin-susceptible and MRSP isolated from infected dogs. All six peptides demonstrated potent anti-staphylococcal activity regardless of existing resistance phenotype. The most effective peptides were RRIKA (with modified C terminus to increase amphipathicity and hydrophobicity) and WR-12 (α-helical peptide consisting exclusively of arginine and tryptophan) with minimum inhibitory concentration50 (MIC50) of 1 µM and MIC90 of 2 µM. RR (short anti-inflammatory peptide) and IK8 "D isoform" demonstrated good antimicrobial activity with MIC50 of 4 µM and MIC90 of 8 µM. Penetratin and (KFF)3K (two cell penetrating peptides) were the least effective with MIC50 of 8 µM and MIC90 of 16 µM. Killing kinetics revealed a major advantage of peptides over conventional antibiotics, demonstrating potent bactericidal activity within minutes. Studies with propidium iodide and transmission electron microscopy revealed that peptides damaged the bacterial membrane leading to leakage of cytoplasmic contents and consequently, cell death. A potent synergistic increase in the antibacterial effect of the cell penetrating peptide (KFF)3K was noticed when combined with other peptides and with antibiotics. In addition, all peptides displayed synergistic interactions when combined together. Furthermore, peptides demonstrated good therapeutic indices with minimal toxicity toward mammalian cells. Resistance to peptides did not evolve after 10 passages of S. pseudintermedius at sub-inhibitory concentration. However, the MICs of amikacin and

  18. Rapid Detection of Herpes Viruses for Clinical Applications

    Science.gov (United States)

    Pierson, Duane; Mehta, Satish

    2013-01-01

    There are eight herpes viruses that infect humans, causing a wide range of diseases resulting in considerable morbidity and associated costs. Varicella zoster virus (VZV) is a human herpes virus that causes chickenpox in children and shingles in adults. Approximately 1,000,000 new cases of shingles occur each year; post-herpetic neuralgia (PHN) follows shingles in 100,000 to 200,000 people annually. PHN is characterized by debilitating, nearly unbearable pain for weeks, months, and even years. The onset of shingles is characterized by pain, followed by the zoster rash, leading to blisters and severe pain. The problem is that in the early stages, shingles can be difficult to diagnose; chickenpox in adults can be equally difficult to diagnose. As a result, both diseases can be misdiagnosed (false positive/negative). A molecular assay has been adapted for use in diagnosing VZV diseases. The polymerase chain reaction (PCR) assay is a non-invasive, rapid, sensitive, and highly specific method for VZV DNA detection. It provides unequivocal results and can effectively end misdiagnoses. This is an approximately two-hour assay that allows unequivocal diagnosis and rapid antiviral drug intervention. It has been demonstrated that rapid intervention can prevent full development of the disease, resulting in reduced likelihood of PHN. The technology was extended to shingles patients and demonstrated that VZV is shed in saliva and blood of all shingles patients. The amount of VZV in saliva parallels the medical outcome.

  19. How do people with drug-resistant mesial temporal lobe epilepsy sleep? A clinical and video-EEG with EOG and submental EMG for sleep staging study

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    Aline Vieira Scarlatelli-Lima

    2016-09-01

    Full Text Available This study aimed to assess subjective and objective sleep parameters in a homogeneous group of drug-resistant mesial temporal lobe epilepsy (MTLE patients through internationally validated clinical questionnaires, video-electroencephalographic (VEEG and polysomnographic (PSG studies. Fifty-six patients with definite diagnosis of MTLE who were candidates for epilepsy surgery underwent a detailed clinical history, the Pittsburgh Sleep Quality Index (PSQI, Epworth Sleepiness Scale (ESS, Stanford Sleepiness Scale (SSS, neurological examination, 1.5 T brain magnetic resonance imaging, VEEG and PSG. Sixteen percent of patients reported significant daytime sleepiness as measured by ESS and 27% reported low levels of sleep quality as measured by PSQI. Patients with medically resistant epilepsy by MTLE showed increased wakefulness after sleep onset (WASO with mean ± standard deviation of 17.4 ± 15.6, longer non-rapid eye movement (NREM 1 (7.5 ± 4.6% and NREM3 sleep (26.6 ± 11.8%, abnormal rapid eye movement (REM latency in 30/56 patients, shorter REM sleep (16.7 ± 6.6%, and abnormal alpha delta patterns were observed in 41/56 patients. The analysis of interictal epileptic discharges (IEDs evidenced highest spiking rate during NREM3 sleep and higher concordance with imaging data when IEDs were recorded in sleep, mainly during REM sleep. We concluded that patients with MTLE showed disrupted sleep architecture that may result in daytime dysfunction and sleep complaints. Furthermore, NREM sleep activated focal IEDs and them - when recorded during sleep - had higher localizing value.

  20. ORIGINAL ARTICLE: Detection of β-Lactamase Activity in Various Clinical Bacterial Isolates by Three Different Methods and its Correlation with Drug Resistance.

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    Sanjay M Wavare

    2012-07-01

    Full Text Available Background: β-lactams such as penicillins are the most widely used antibiotics, and β-lactamases are the greatest source of resistance to penicillins. Aims and Objectives: To study β-lactamase production in clinical isolates of family Enterobacteriaceae, P. aeruginosa and Staphylococci by three different methods and to correlate its potential with drug resistance; with an endeavour to evaluate convenient and economical method duly supported by relevant Minimum Inhibitory Concentration (MIC studies. Material and Methods: Total 240 clinical isolates (Gram-negative bacilli-191, staphylococci-49 were subjected to antimicrobial susceptibility testing by Kirby-Bauer disk diffusion method and MIC for ampicillin and penicillin was determined by agar dilution method. β-lactamase was detected by broth acidometric, iodometric cell suspension and microbiological method. Results: Multidrug resistance was observed in more than 90% isolates. One hundred and ninety Gram-negative bacilli were resistant to ampicillin and 47 staphylococcal isolates were resistant to both penicillin and ampicillin. Though microbiological method gave highest positive results 210 (87.5%, iodometric method could detect β-lactamase in apparently sensitive isolates as well giving satisfactory [207 (86.25%] comparable results. Conclusion: In view of the noted bacterial resistance, tests for β-lactamase should be carried out on a routine basis for an early implementation of appropriate antimicrobial therapy. Iodometric method is eminently convenient, economical and reliable method. Isolates showing MIC <0.125µg/ml for penicillin and MIC <8µg/ml for ampicillin should be checked for β-lactamase production.

  1. Occurrence of extended-spectrum and AmpC β-lactamases in multiple drug resistant Salmonella isolates from clinical samples in Lagos, Nigeria

    Science.gov (United States)

    Akinyemi, KO; Iwalokun, Bamidele Abiodun; Oyefolu, Akeeb O Bola; Fakorede, CO

    2017-01-01

    Purpose Salmonella spp. are important foodborne pathogens exhibiting increasing resistance to antimicrobial drugs. Resistance to broad-spectrum β-lactams, mediated by extended-spectrum β-lactamase (ESBL) and AmpC β-lactamase enzymes is fast spreading and has had negative impacts on the clinical outcomes, particularly on third-generation cephalosporins. This study investigated the carriage of AmpC gene among multidrug-resistant Salmonella spp. from Lagos, Nigeria. Methods Forty Salmonella spp. from clinical samples (S. typhi = 13; S. typhimurium = 10; S. enteritidis = 8; S. choleraesuis = 5; S. paratyphi = 4) were subjected to in vitro susceptibility test by disk diffusion methods. Isolates that were resistant to cefoxitin and third-generation cephalosporins were screened for ESBL (Double Disk Synergy Test Method) and AmpC enzyme (AmpC disk test) production. Detection of AmpC fox gene was carried out by polymerase chain reaction. Results Thirty-two (80%) of the Salmonella isolates were cefoxitin resistant. Plasmid-mediated AmpC β-lactamase and ESBL enzymes were recorded in 10/40 (25%) and 16/40 (40%) of the Salmonella isolates, respectively. Specifically, 16/40 (40%) of the Salmonella isolates possessed 380 bp AmpC fox gene, with the highest occurrence found in S. typhi strains (43.8%) followed by S. typhimurium (25%). There was no AmpC fox gene detected in S. paratyphi strains. Interestingly, coproduction of enzymes occurred in some of the isolates, raising fears of resistance to a multitude of antibiotics in the treatment of bacterial infections. Conclusion Emergence of AmpC β-lactamase–producing Salmonella isolates in our environment was recorded for the first time, raising concern on increased antibiotic resistance among strains of Salmonella serovars in Lagos. Further genotypic study of the isolates could answer the questions on strain sources, clonal relatedness, and mechanism of spread. PMID:28144154

  2. 产气肠杆菌的临床分布及耐药性分析%Clinical distribution and drug resistance of Enterobacter aerogenes

    Institute of Scientific and Technical Information of China (English)

    钱晓琴; 钱小毛; 金海勇

    2012-01-01

    OBJECTIVE To study clinical distribution and drug resistance of Enterobacter aerogenes and provide basis for the rational use of antibiotics. METHODS We collected 138 strains of E. aerogenes in the last three years and tested the drug resistance to 16 kinds of antibiotics by means of KB methods and tested AmpC enzyme and ESBLs by means of three dimensional test. RESULTS Most of the strains were collected from ICU, bum department, respiratory department, urology department and liver and gall surgical departments the detection rates of the isolates were the highest from the specimen like sputum, throat swab,blood and wound) the drug susceptibility testing showed that the drug resistance rate of E. aerogenes to penicillin and the third generation of cephalosporins were 99. 3% and 74. 6%, the resistance rate to the fourth generation of cephalosporins was 53. 6%, no imipenem or meropenem-resistant strains were found, the resistance rates to cefoperazone/sulbactam and piperacillin/ tazobactam were only 8. 0% and 25. 4% ; the resistance rates to quinolones were relatively low, varying from 2. 9 % to 5. 1 % , the resistance rates to aminoglycoside were between 17. 4 % and 48. 6 %, and the resistance rate to trimethoprim-sulphamethoxazole was 74. 6% ; the detection rates of ESBLs-producing strains and the AmpC were 22. 5% and 29. 7%, respectively, there were 13 strains producing both ESBLs and AmpC enzyme. CONCLUSION E. aerogenes has become the major species of pathogens causing nosocomial infections, and the drug resistance is increasingly serious, so we should fulfill preventive measures in high risk wards and strengthen strict aseptic operation and the surveillance for susceptible population.%目的 了解医院感染产气肠杆菌在临床的分布及其耐药现状,为临床合理使用抗菌药物提供依据.方法 对近3年临床分离的138株产气肠杆菌,用K-B法检测对16种抗菌药物的耐药性,用三维试验检测AmpC酶和ESBLs.结果 菌株分离

  3. EFFICACY OF VIMPAT (LACOSAMIDE TN THE TREATMENT OF DRUG-RESISTANT CRYPTOGENIC FOCAL EPILEPSY WITH FOCAL AUTOMOTOR AND SECONDARILY GENERALIZED SEIZURES (A CLINICAL CASE

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    M. B. Mironov

    2012-01-01

    Full Text Available Despite the considerable advances of epileptology drug-resistant epilepsies consist about 30% among all forms of epilepsy. A case of successful using of a new antiepileptic drug lacosamide (vimpat in the treatment of 31 years old patient with the resistant form of cryptogenic focal epilepsy with focal automotor and secondarily generalized seizures is presented. Authors represent the review of the literature devoted to efficacy and tolerability of lacosamide in the treatment of drug-resistant epilepsy.

  4. Clinical Applications of Simultaneous PET/MR Imaging Using (R)-[11C]-Verapamil with Cyclosporin A: Preliminary Results on a Surrogate Marker of Drug-Resistant Epilepsy.

    Science.gov (United States)

    Shin, J-W; Chu, K; Shin, S A; Jung, K-H; Lee, S-T; Lee, Y-S; Moon, J; Lee, D Y; Lee, J S; Lee, D S; Lee, S K

    2016-04-01

    The development of resistance to antiepileptic drugs is explained well by the transporter hypothesis, which suggests that drug resistance is caused by inadequate penetration of drugs into the brain barrier as a result of increased levels of efflux transporter such as p-glycoprotein. To evaluate the brain expression of p-glycoprotein in patients with drug-resistant epilepsy, including neocortical epilepsy, we developed a noninvsive quantitative analysis including asymmetry indices based on (R)-[(11)C]-verapamil PET/MR imaging with cyclosporin A, a p-glycoprotein inhibitor. Six patients with drug-resistant epilepsy, 5 patients with drug-sensitive epilepsy, and 8 healthy controls underwent dynamic (R)-[(11)C]-verapamil PET/MR imaging with an intravenous infusion of cyclosporin A. Asymmetry indices [(Right Region - Left Region)/(Right Region + Left Region) × 200%] of the standard uptake values in each of the paired lobes were calculated. All patients with drug-resistant epilepsy had significantly different asymmetry from the healthy controls, whereas all patients with drug-sensitive epilepsy had asymmetry similar to that in healthy controls. In the temporal lobe, the asymmetry indices of patients with left temporal lobe drug-resistant epilepsy were more positive than those of healthy controls (healthy controls: 4.0413 ± 1.7452; patients: 7.2184 ± 1.8237; P = .048), and those of patients with right temporal drug-resistant epilepsy were more negative (patients: -1.6496 ± 3.4136; P = .044). In addition, specific regions that had significant asymmetry were different between the lateral and medial temporal lobe epilepsy groups. In the frontal lobe, the asymmetry index of patients with right frontal lobe drug-resistant epilepsy was more negative than that in healthy controls. We confirmed that statistical parametric mapping analysis by using asymmetry indices of (R)-[(11)C]-verapamil PET/MR imaging with cyclosporin A could be used as a surrogate marker for drug-resistant

  5. Herpes zoster: Epidemiología y clínica Clinical and epidemiological aspects of Herpes zoster

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    Claudia Vujacich

    2008-04-01

    Full Text Available El herpes zoster (HZ constituye una enfermedad de distribución mundial; sin embargo, existen es casos datos comunicados sobre la misma en países de Latinoamérica. Con el objetivo de evaluar aspectos clínicos y epidemiológicos de esta enfermedad en nuestra población, realizamos un análisis retrospectivo de historias clínicas de un centro privado de referencia en enfermedades infecciosas en Buenos Aires, Argentina (período: 2000-2005. Se realizó un análisis estadístico univariado para evaluar los factores asociados a neuralgia posherpética en este grupo de pacientes. Sobre un total de 302 casos evaluables, el 62% correspondieron a mujeres. La mediana de edad fue de 57 años. El 16.1% de los pacientes presentó condiciones predisponentes al desarrollo de zoster. Las localizaciones más frecuentes fueron la torácica, oftálmica y lumbosacra. El 7.75% presentó compromiso de más de dos metámeras. El 94% de los pacientes recibió medicación antiviral, siendo el aciclovir la droga más utilizada. El 94% recibió alguna medicación coadyuvante (antiinflamatorios no esteroideos, antineuríticos, corticoides. La complicación más frecuente fue la neuralgia posherpética (12% y se encontró estadísticamente asociada a edad mayor de 50 años.Herpes zoster (HZ is a public health problem worldwide. Although, there is paucity of data of this disease from South American countries. The objective of this study was to evaluate clinical and epidemiological aspects of HZ in a population of patients from South America. We underwent a retrospective analysis of clinical charts of an infectious diseases reference center (period: 2000-2005. Univariate analysis was performed to assess variables related to post herpetic neuralgia (PHN. From a total of 302 cases, 62% were in women. The median age was 57 years; 16.1% of the patients had a predisposing condition for the development of HZ. Most frequent dermatomes involved were: thoracic, ophthalmic and

  6. Extensively Drug-Resistant Klebsiella pneumoniae Causing Nosocomial Bloodstream Infections in China: Molecular Investigation of Antibiotic Resistance Determinants, Informing Therapy, and Clinical Outcomes

    Directory of Open Access Journals (Sweden)

    Wenzi Bi

    2017-06-01

    Full Text Available The rise in diversity of antimicrobial resistance phenotypes seen in Klebsiella pneumoniae is becoming a serious antibiotic management problem. We sought to investigate the molecular characteristics and clinical implications of extensively drug-resistant (XDR K. pneumoniae isolated from different nosocomial bloodstream infections (BSIs patients from July 2013 to November 2015. Even in combination treatment, meropenem did not protect against mortality of BSIs patients (P = 0.015. In contrast, tigecycline in combination with other antimicrobial agents significantly protected against mortality (P = 0.016. Antimicrobial susceptibility tests, molecular detection of antibiotic resistance determinants, conjugation experiments, multilocus sequence typing (MLST, S1-PFGE, Southern blot, SDS-PAGE, immunoblot analysis, and pulsed-field gel electrophoresis (PFGE were used to characterize these isolates. These XDR K. pneumoniae strains were resistant to conventional antimicrobials except tigecycline and polymyxin B and co-harbored diverse resistance determinants. rmtB, blaKPC−2 as well as blaCTX−M−9 were located on a transferable plasmid of ~54.2 kb and the most predominant replicon type was IncF. 23 of the 35 isolates belonging the predominant clone were found to incorporate the globally-disseminated sequence type ST11, but others including a unique, previously undiscovered lineage ST2281 (allelic profile: 4-1-1-22-7-4-35 were also found and characterized. The porins OmpK35 and OmpK36 were deficient in two carbapenemase-negative carbapenem-resistant strains, suggesting decreased drug uptake as a mechanism for carbapenem resistance. This study highlights the importance of tracking hospital acquired infections, monitoring modes of antibiotic resistance to improve health outcomes of BSIs patients and to highlight the problems of XDR K. pneumoniae dissemination in healthcare settings.

  7. Clinical Study of Drug-resistant Pulmonary Tuberculosis Treated by Combination of Anti-Tuberculosis Chemicals and Compound Astragalus Capsule(复方黄芪胶囊)

    Institute of Scientific and Technical Information of China (English)

    姜艳; 李新; 于志勇; 尹红义; 韩玉庆

    2004-01-01

    Objective: To observe and evaluate the therapeutic effect of anti-tuberculosis (anti-TB) chemicals and Compound Astragalus Capsule (CAC) in combinedly treating drug resistant pulmonary tuberculosis (DR-TB). Methods: Ninety-two patients with DR-TB were equally randomized into the treated group (treated with combination therapy) and the control group (treated with anti-TB chemicals alone). The therapeutic course for both groups was 18 months. Therapeutic effects between the two groups were compared at the end of the therapeutic course. Sputum bacterial negative rate, focal absorption effective rate, cavity closing rate, 10-day symptom improving rate, the incidence of adverse reaction and 2-year bacteriological recurrence rate between the two groups were compared. Results: In the treated group, the sputum bacterial negative conversion rate was 84. 8%, focal absorption effective rate 91.3 %, cavity closing rate 58. 7 % and 10-day symptom improving rate 54.4%, while in the control group, the corresponding rates were 65.2%,73.9 %, 37. 0% and 26.1%, respectively. Comparison between the groups showed significant difference in all the parameters ( P<0.05, P<0.05, P<0.05 and P<0.01 ). The incidence of adverse reaction and 2year bacteriological recurrence rate in the treated group were 23.9 % and 2.6 % respectively, while those in the control group 50.0% and 16.7%, which were higher than the former group with significant difference ( P<0.01 and P<0.05, respectively). Conclusion: The therapeutic effect of combined treatment with antiTB and CAC is superior to that of treatment with anti-TB chemicals alone, and the Chinese herbal medicine showed an adverse reaction alleviating effect, which provides a new therapy for DR-TB, and therefore, it is worth spreading in clinical practice.

  8. [Analysis on clinical features and treatment of herpes zoster patients hospitalized in real world].

    Science.gov (United States)

    Yuan, Ling-Lian; Wang, Lian-Xin; Xie, Yan-Ming; Yang, Wei; Yang, Zhi-Xin; Zhuang, Yan; Zhang, Yun-Bi

    2014-09-01

    From the hospital information system (HIS) of 20 national grade III-A general hospitals, 2 960 cases of herpes zoster as the research object, analyzes the relations between the general information, syndrome of traditional Chinese medicine (TCM), western medicine combined diseases, the relationship between the solar term and the incidence of herpes zoster, and the combined use of Chinese and western medicine. Among the patients with 46-65 year old has the highest percentage of diseased; admission to general outpatient clinic is the most; the most common medical payment is medicare; combined disease such as hypertension, diabetes and coronary heart disease is more common; early treatment effect of herpes zoster is better than the sequelae; summer and autumn solar term patients is hospitalized more, TCM syndrome is damp heat of liver fire; about drugs, western medicine is the most commonly used vitamin B1 and mecobalamin, traditional Chinese medicine is the most frequently used Danhong injection, combination therapy with promoting blood circulation drugs and neurotrophic drugs. Thus, herpes zoster, more common in elderly patients, with no obvious relationship between solar term, should be early diagnosis and early treatment, often with combination of Chinese traditional and western medicine treatment.

  9. Clinical distribution and drug resistance of Acinetobacter baumannii%鲍曼不动杆菌的临床分布及耐药性变迁

    Institute of Scientific and Technical Information of China (English)

    施芳; 邹义春; 柯俊

    2011-01-01

    Objective To investigate the isolation rate, distribution and trend of drug resistance of A cinetobacter baumannii from 2004 to 2010. Methods French bioMerieux VITEK32 bacterial identification system was used for identification. The K-B method was used for drug sensitivity test and the results of drug sensitivity test was determined using the CLSI/NCCLs standard. Results 26 670 specimens were analyzed from 2004 to 2010. 7 065 bacterial strains isolated from the positive samples, of which 6.67% (471/7 065) was Acinetobacter baumannii strains. The isolation rate of Acinetobacter baumannii was 1.77%. 409 strains were isolated from sputum samples accounted for 86.83% of the total number of Acinetobacter baumannii isolates. The isolation rate is the highest in the ICU ward(49.3%). Acinetobacter baumannii resistance to antimicrobial drugs is generally higher, and showing a trend of increasing, and some exhibit multidrug resistance characteristics. Conclusion There is a trend of increase in drug resistance in Acinetobacter baumannii. We should pay attention to clinical Acinetobacter baumannii infection and separation; beware of multi-resistance in A cinetobacter baumannii nosocomial infections and outbreaks.%目的 了解鲍曼不动杆菌在临床标本的分离率和病区分布及耐药性变化趋势.方法 菌株鉴定采用法国梅里埃VITEK32细菌鉴定系统进行鉴定,药敏试验采用K-B法,药敏试验结果判定以CLSI/NCCLS标准进行.结果 2004-2010年共收到26 670份标本,分离出阳性细菌7 065株,其中鲍曼不动杆菌471株(6.67%),分离率为1.77%(471/7065).在471株鲍曼不动杆菌中,从痰液标本分离出最多有409株(86.83%),分离率最高的是ICU,占49.3%.鲍曼不动杆菌对抗菌药物的耐药性普遍较高,且呈逐年升高趋势,部分表现出多重耐药特征.结论 鲍曼不动杆菌的耐药状况日益严重,应重视临床鲍曼不动杆菌的感染与分离,谨防多重耐药鲍曼不动杆菌的院内感染及暴发流行.

  10. In vitro susceptibility of multi-drug resistant Pseudomonas aeruginosa and extended-spectrum β-lactamase-producing Klebsiella pneumoniae isolated from clinical specimens at Bugando Medical Centre, Tanzania to Piperacillin-Tazobactam.

    Science.gov (United States)

    Petro, Daudi; Mushi, Martha F; Moremi, Nyambura; Iddi, Shabani; Mirambo, Mariam; Seni, Jeremiah; Mshana, Stephen E

    2014-01-01

    Pseudomonas spp. and Klebsiella pneumoniae are common causes of serious health care associated infections (HCAIs) worldwide. The treatment options for infections caused by multi-drug resistant (MDR) organisms are limited to tigecycline and carbapenems. A total of 172 isolates of multi-drug resistant Pseudomonas. spp and extended-spectrum β- (ESBL) producing Klebsiella pneumoniae isolated from clinical specimens at the Bugando Medical Centre were tested for their in vitro susceptibility to piperacillin-tazobactam 100/10μg using disc diffusion test as recommended by Clinical Laboratory Standard Institute (CLSI). Out of 59 multi-drug resistant Pseudomonas spp, 54 (92.0%) were susceptible to piperacillin-tazobactam while of 113 ESBL producing Klebsiella pneumoniae, 55 (48.7%) were susceptible to piperacillin-tazobactam 100/10μg. Also, 20 (34.0%) of the Pseudomonas spp were both ESBL producers and susceptible to piperacillin-tazobactam 100/10μg. A significant proportion of Pseudomonas spp isolates from clinical specimens in our setting are susceptible to piperacillin/tazobactam. This study shows that piperacillin-tazobactam offer a better option to clinicians for the treatment of health care associated infections due to Pseudomonas spp. and ESBL producing Klebsiella pneumoniae in our setting and other health facilities where these organisms are of significance.

  11. Recurrent zosteriform herpes simplex

    Directory of Open Access Journals (Sweden)

    Inamadar Arun

    1992-01-01

    Full Text Available A 25-year-old man had recurrent zosteriform herpes simplex for past 6 years. The attacks were precipitated by prolonged exposure to sunlight. Pain was mild and lesions used to subside each time in about 7 days. Clinical features which help in differentiating recurrent herpes simplex from recurrent herpes zoster are summarized.

  12. The clinical distribution and drug resistance monitoring of Streptococcus pneumonia%肺炎链球菌的临床分布及耐药性监测

    Institute of Scientific and Technical Information of China (English)

    梁培松; 孙各琴; 张秀明; 黄福达; 卢兰芬

    2015-01-01

    目的:了解该院肺炎链球菌的临床分布及监测其耐药变迁,为临床有效抗感染提供参考依据。方法用VITEK 2 Compact进行细菌鉴定和药敏数据分析,用WHONET5.3软件和SPSS13.0软件进行统计分析。结果2008~2013年共分离出588株肺炎链球菌,主要分布于重症监护病房(IC U ),其次为呼吸内科、普通儿科;主要来源于痰液标本,其次为咽拭子和血液标本。红霉素耐药率最高,其次为青霉素和复方磺胺甲噁唑;肺炎链球菌对左旋氧氟沙星、氧氟沙星、万古霉素、氯霉素、利奈唑烷仍然敏感。结论肺炎链球菌的耐药率不断上升,应重视细菌耐药性监测,根据药敏试验结果合理选用抗菌药物。%Objective To understand the clinical distribution and monitoring the change of resistance of Streptococcus pneumoni‐ae ,effective for clinical anti infection to provide reference .Methods Using VITEK 2 Compact to analyze the bacteria identification and drug sensitivity data ,and using WHONET5 .3 software and SPSS13 .0 software for statistical analysis .Results From 2008 to 2013 ,588 strains of Streptococcus pneumoniae were isolated ,mainly distributed in the intensive care unit (ICU) ,followed by respir‐atory department of internal medicine ,general pediatrics ;mainly from sputum samples ,followed by the throat swabs and blood samples .The highest resistant rate was erythromycin ,followed by penicillin and cotrimoxazole ;Streptococcus pneumoniae remains sensitive to ofloxacin ,levofloxacin ,vancomycin ,linezolid ,chloramphenicol .Conclusion The resistance rate of Streptococcus pneu‐moniae was rising ,and that great attention should be paid to the bacterial drug resistance so as to reasonably use a antibiotics based on the result of drug susceptibility testing .

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

    Institute of Scientific and Technical Information of China (English)

    陈美珺; 姚艺辉; 张国强; 余晓露; 余方友

    2011-01-01

    目的 了解鲍氏不动杆菌的临床分布及对常用抗菌药物的耐药性变迁趋势,为指导临床合理用药提供理论依据.方法 回顾性分析2005-2009年厦门大学附属中山医院临床分离的1967株鲍氏不动杆菌药敏结果.结果 医院鲍氏不动杆菌的分离率呈逐年增长趋势,由2005年的110株上升至2009年的1040株,标本来源以痰液为主,占87.5%;对抗菌药物的耐药率也日趋严重,其中庆大霉素、左氧氟沙星及亚胺培南的耐药率分别由2005的38.2%、17.3%及2.7%上升至2009年的68.9%、67.0%及68.8%;头孢哌酮/舒巴坦、氨苄西林/舒巴坦、哌拉西林/他唑巴坦和多黏菌素B耐药率较低.结论 鲍氏不动杆菌在临床的分离率逐年增加,耐药性逐渐增强.%OBJECTIVE To study the changing trends of drug resistance of Acinetobacter baumannii isolates. METHODS The bacterial susceptibility results of 1 967 isolates of A. Baumannii obtained from clinical patients in the Zhongshan Hospital of Xiamen University between 2005 and 2009 were retrospectively analyzed. RESULTS The isolating rate of A. Baumannii was increasing year-by-year from 110 in 2005 to 1040 in 2009, the highest appearing rate was the sputum, up to 87. 5%. The resistant rates of A. Baumannii to antibacterial drugs were increasing year by year. The resistant rates to gentamicin, levofloxacin and imipenem were increasing from 38.2%, 17. 3% and 2. 7% to 68. 9%,67. 0% and 68. 8%, respectively. The resistant rates to cefoperazone/ sulbactam,ampicillin/sulbactam,piperacillin/sulbactam and polymyxin B. Were low. CONCLUSIONS The isolation rate of ABA from clinics is increased year by year, and the resistance gradually becomes serious.

  14. Towards a Rational Design of an Asymptomatic Clinical Herpes Vaccine: The Old, the New, and the Unknown

    Directory of Open Access Journals (Sweden)

    Aziz Alami Chentoufi

    2012-01-01

    Full Text Available The best hope of controlling the herpes simplex virus type 1 and type 2 (HSV-1 and HSV-2 pandemic is the development of an effective vaccine. However, in spite of several clinical trials, starting as early as 1920s, no vaccine has been proven sufficiently safe and efficient to warrant commercial development. In recent years, great strides in cellular and molecular immunology have stimulated creative efforts in controlling herpes infection and disease. However, before moving towards new vaccine strategy, it is necessary to answer two fundamental questions: (i why past herpes vaccines have failed? (ii Why the majority of HSV seropositive individuals (i.e., asymptomatic individuals are naturally “protected” exhibiting few or no recurrent clinical disease, while other HSV seropositive individuals (i.e., symptomatic individuals have frequent ocular, orofacial, and/or genital herpes clinical episodes? We recently discovered several discrete sets of HSV-1 symptomatic and asymptomatic epitopes recognized by CD4+ and CD8+ T cells from seropositive symptomatic versus asymptomatic individuals. These asymptomatic epitopes will provide a solid foundation for the development of novel herpes epitope-based vaccine strategy. Here we provide a brief overview of past clinical vaccine trials, outline current progress towards developing a new generation “asymptomatic” clinical herpes vaccines, and discuss future mucosal “asymptomatic” prime-boost vaccines that could optimize local protective immunity.

  15. Multidrug- and Extensively Drug-Resistant Uropathogenic Escherichia coli Clinical Strains: Phylogenetic Groups Widely Associated with Integrons Maintain High Genetic Diversity

    Science.gov (United States)

    Ochoa, Sara A.; Cruz-Córdova, Ariadnna; Luna-Pineda, Victor M.; Reyes-Grajeda, Juan P.; Cázares-Domínguez, Vicenta; Escalona, Gerardo; Sepúlveda-González, Ma. Eugenia; López-Montiel, Fernanda; Arellano-Galindo, José; López-Martínez, Briceida; Parra-Ortega, Israel; Giono-Cerezo, Silvia; Hernández-Castro, Rigoberto; de la Rosa-Zamboni, Daniela; Xicohtencatl-Cortes, Juan

    2016-01-01

    In recent years, an increase of uropathogenic Escherichia coli (UPEC) strains with Multidrug-resistant (MDR) and Extensively Drug-resistant (XDR) profiles that complicate therapy for urinary tract infections (UTIs) has been observed and has directly impacted costs and extended hospital stays. The aim of this study was to determine MDR- and XDR-UPEC clinical strains, their virulence genes, their phylogenetic groups and to ascertain their relationship with integrons and genetic diversity. From a collection of 500 UPEC strains, 103 were selected with MDR and XDR characteristics. MDR-UPEC strains were mainly associated with phylogenetic groups D (54.87%) and B2 (39.02%) with a high percentage (≥70%) of several fimbrial genes (ecpA, fimH, csgA, and papGII), an iron uptake gene (chuA), and a toxin gene (hlyA). In addition, a moderate frequency (40–70%) of other genes (iutD, tosA, and bcsA) was observed. XDR-UPEC strains were predominantly associated with phylogenetic groups B2 (47.61%) and D (42.85%), which grouped with ≥80 virulence genes, including ecpA, fimH, csgA, papGII, iutD, and chuA. A moderate frequency (40–70%) of the tosA and hlyA genes was observed. The class 1 and 2 integrons that were identified in the MDR- and XDR-UPEC strains were associated with phylogenetic groups D, B2, and A, while the XDR-UPEC strains that were associated with phylogenetic groups B2, D, and A showed an extended-spectrum beta-lactamase (ESBL) phenotype. The modifying enzymes (aadA1, aadB, aacC, ant1, dfrA1, dfrA17, and aadA4) that were identified in the variable region of class 1 and 2 integrons from the MDR strains showed resistance to gentamycin (56.25 and 66.66%, respectively) and trimethoprim-sulfamethoxazole (84.61 and 66.66%, respectively). The MDR- and XDR-UPEC strains were distributed into seven clusters and were closely related to phylogenic groups B2 and D. The diversity analysis by PFGE showed 42.68% of clones of MDR-UPEC and no clonal association in the XDR

  16. 我院2006-2011年鲍曼不动杆菌临床分布及耐药性分析%Clinical Distribution and Drug Resistance of Acinetobacter baumannii in Our Hospital during 2006-2011

    Institute of Scientific and Technical Information of China (English)

    熊丽蓉; 刘耀; 谢林利; 吕军; 唐敏

    2012-01-01

    OBJECTIVE: To approach the clinical distribution and drug resistance of Acinetobacter baumannii (ABA) in our hospital in 6 years, and to guide rational drug use in the clinic. METHODS: A total of 2 225 strains of isolated ABA in our hospital during 2006—2011 were analyzed retrospectively in terms of clinical distribution and drug resistance. RESULTS: Top 3 departments were department of cerebral surgery (17.0% ), ICU (14.0% ), department of respiration (.13.3%); among specimens from which ABA was isolated, sputum accounted for 76.4% ; the drug resistance of ABA was serious, and among them, ABA was less resistant to carbopenems. CONCLUSION: The drug resistance of ABA is serious in our hospital. Great importance should be at-tached to rational use of antimicrobial agents to decrease the generation of drug-resistant bacterial strains.%目的:了解我院6年来鲍曼不动杆菌的临床分布和耐药情况,以指导临床合理用药.方法:回顾性分析我院2006-2011年分离的2 225株鲍曼不动杆菌临床分布及耐药情况.结果:分离前3位的科室依次为脑外科(17.0%)、重症监护室(14.0%)、呼吸科(13.3%);痰标本中检出率最高,为76.4%;鲍曼不动杆菌对碳青酶烯类耐药率较低,对其他常用抗菌药物耐药率较高.结论:我院鲍曼不动杆菌耐药情况十分严重,临床应重视合理应用抗菌药物,以减少耐药菌株的产生.

  17. Drug resistance reversal--are we getting closer?

    Science.gov (United States)

    Baird, R D; Kaye, S B

    2003-11-01

    Clinical drug resistance is a major barrier to overcome before chemotherapy can become curative for most patients presenting with metastatic cancer. Rational attempts to tackle clinical drug resistance need to be based on an understanding of the mechanisms involved; these are likely to be complex and multifactorial, and may be due to inadequate drug exposure or alterations in the cancer cell itself. This article reviews a number of strategies used to tackle drug resistance, focussing on work in our institution related to the treatment of ovarian cancer and resistance to platinum and taxane-based chemotherapy. Further progress towards drug resistance reversal will require a three-pronged approach, namely: the development of novel cytotoxics which exploit selectively expressed targets; modulation of resistance to conventional agents and, most importantly, a serious attempt to understand resistance mechanisms in tumour samples taken both pre- and post-chemotherapy.

  18. Extensively Drug-Resistant TB

    Centers for Disease Control (CDC) Podcasts

    2016-12-16

    Dr. Charlotte Kvasnovsky, a surgery resident and Ph.D. candidate in biostatistics, discusses various types of drug resistance in TB patients in South Africa.  Created: 12/16/2016 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 12/16/2016.

  19. Drug resistance in malaria

    Directory of Open Access Journals (Sweden)

    S C Parija

    2011-01-01

    Full Text Available Antimalarial chemotherapy is an important component of all malaria control programmes throughout the world. This is especially so in light of the fact that there are no antimalarial vaccines which are available for clinical use at present. Emergence and spread of malaria parasites which are resistant to many of the available antimalarials today is, therefore, a major cause for concern. Till date, resistance to all groups of antimalarials excluding artemisinin has been reported. In recent years, in vitro resistance to even artemisinin has been described. While resistance to antibacterial agents has come to prominence as a clinical problem in recent years, antiparasitic resistance in general and antimalarial resistance in particular has not received much attention, especially in the Indian scenario. The present review deals with commonly used antimalarial drugs and the mechanisms of resistance to them. Various methods of detecting antimalarial resistance and avoiding the same have also been dealt with. Newer parasite targets which can be used in developing newer antimalarial agents and antimalarials obtained from plants have also been mentioned.

  20. Diagnosis of genital herpes simplex virus infection in the clinical laboratory

    Science.gov (United States)

    2014-01-01

    Since the type of herpes simplex virus (HSV) infection affects prognosis and subsequent counseling, type-specific testing to distinguish HSV-1 from HSV-2 is always recommended. Although PCR has been the diagnostic standard method for HSV infections of the central nervous system, until now viral culture has been the test of choice for HSV genital infection. However, HSV PCR, with its consistently and substantially higher rate of HSV detection, could replace viral culture as the gold standard for the diagnosis of genital herpes in people with active mucocutaneous lesions, regardless of anatomic location or viral type. Alternatively, antigen detection—an immunofluorescence test or enzyme immunoassay from samples from symptomatic patients--could be employed, but HSV type determination is of importance. Type-specific serology based on glycoprotein G should be used for detecting asymptomatic individuals but widespread screening for HSV antibodies is not recommended. In conclusion, rapid and accurate laboratory diagnosis of HSV is now become a necessity, given the difficulty in making the clinical diagnosis of HSV, the growing worldwide prevalence of genital herpes and the availability of effective antiviral therapy. PMID:24885431

  1. Dendritic cell-based vaccines in treating recurrent herpes labialis: Results of pilot clinical study.

    Science.gov (United States)

    Leplina, Olga; Starostina, Nataliya; Zheltova, Olga; Ostanin, Alexandr; Shevela, Ekaterina; Chernykh, Elena

    2016-12-01

    Recurrent herpes simplex labialis caused predominantly with herpes simplexvirus 1(HSV-1) is a major problem, for which various treatments have minimal impact. Given the important role of the immune system in controlling virus infection, an activation of virus-specific immune responses, in particular,using dendritic cell (DCs) vaccines, seems to be a promising approach for the treatment of patients with frequent recurrences of herpes labialis. The current paper presents the results of a pilot study of the safety and efficacy of DC vaccines in 14 patients with recurrent HSV-1 infections. DCs were generated in presence of GM-CSF and IFN-alpha and were loaded with HSV-1 recombinant viral glycoprotein D (HSV1gD). DCs cells were injected subcutaneously as 2 courses of vaccination during 9 months. Immunotherapy with DCs did not induce any serious side effects and resulted in more than 2-fold reduction in the recurrence rate and significant enhancement of the inter-recurrent time during the 9 months of treatment and subsequent 6-month follow-up period. An obvious clinical improvement was accompanied with an induction of an antigen-specific response to HCV1gD and a normalization of reduced mitogenic responsiveness of mono-nuclear cells. According to long-term survey data (on average 48 months after the beginning of therapy), 87% of respondents reported the decreased incidence of recurrent infection. At this time, most patients (85.7%) responded to HCV1gD stimulation. The data obtained suggests that dendritic cell vaccines may be a promising new approach for the treatment of recurrent labial herpes.

  2. Population structure and circulating genotypes of drug-sensitive and drug-resistant Mycobacterium tuberculosis clinical isolates in São Paulo state, Brazil

    Science.gov (United States)

    Martins, Maria Conceição; Saraiva Giampaglia, Carmen M.; Oliveira, Rosângela S.; Simonsen, Vera; Latrilha, Fábio Oliveira; Moniz, Letícia Lisboa; Couvin, David; Rastogi, Nalin; Ferrazoli, Lucilaine

    2013-01-01

    São Paulo is the most populous Brazilian state and reports the largest number of tuberculosis cases in the country annually (over 18,500). This study included 193 isolates obtained during the 2nd Nationwide Survey on Mycobacterium tuberculosis Drug Resistance that was conducted in São Paulo state and 547 isolates from a laboratory based study of drug resistance that were analyzed by the Mycobacteria Reference Laboratory at the Institute Adolfo Lutz. Both studies were conducted from 2006 to 2008 and sought to determine the genetic diversity and pattern of drug resistance of M. tuberculosis isolates (MTC) circulating in São Paulo. The patterns obtained from the spoligotyping analysis demonstrated that 51/740 (6.9%) of the isolates corresponded to orphan patterns and that 689 (93.1%) of the isolates distributed into 144 shared types, including 119 that matched a preexisting shared type in the SITVIT2 database and 25 that were new isolates. A total of 77/144 patterns corresponded to unique isolates, while the remaining 67 corresponded to clustered patterns (n = 612 isolates clustered into groups of 2–84 isolates each). The evolutionarily ancient PGG1 lineages (Beijing, CAS1-DEL, EAI3-IND, and PINI2) were rarely detected in São Paulo and comprised only 13/740, or 1.76%, of the total isolates; all of the remaining 727/740, or 98.24%, of the MTC isolates from São Paulo state were from the recent PGG2/3 evolutionary isolates belonging to the LAM, T, S, X, and Haarlem lineages, i.e., the Euro-American group. This study provides the first overview of circulating genotypes of M. tuberculosis in São Paulo state and demonstrates that the clustered shared types containing seven or more M. tuberculosis isolates that are spread in São Paulo state included both resistant and susceptible isolates. PMID:23201043

  3. Clinical application of antibiotics and analysis of bacterial drug resistance%临床抗生素应用与细菌耐药性分析

    Institute of Scientific and Technical Information of China (English)

    卓丽娅

    2016-01-01

    Objective:To investigate the application of antibiotics and the drug resistance of bacteria.Methods:125 patients with infection were selected,and we analyzed the types and usage of antibiotics and the resistance of different strains to antibiotics. Results:The probability of using antibiotics was 96%,and the highest proportion was cephalosporins accounted for 96.7%.The average use time of antibiotics was(23.21±2.52)d.The combined drug use rate was 53.3%.The drug resistance of gram negative and positive bacteria was mainly reflected in the penicillins and cephalosporins.Conclusion:Clinicians should fully consider the bacterial drug resistance,use antibiotics reasonably and ensure the safety of drug use.%目的:探讨抗生素的应用情况及细菌耐药性情况。方法:收治感染患者125例,分析抗生素的种类、使用情况以及不同菌种对抗生素的耐药情况。结果:抗生素使用率96.0%,头孢菌素类所占比例最高(96.7%);抗生素平均使用时间(23.21±2.52)d;联合用药率53.3%;革兰阴性、阳性菌耐药性主要体现在青霉素类、头孢类抗生素。结论:临床医师应充分结合细菌耐药情况,合理使用抗生素,保障用药安全。

  4. Population structure and circulating genotypes of drug-sensitive and drug-resistant Mycobacterium tuberculosis clinical isolates in São Paulo state, Brazil.

    Science.gov (United States)

    Martins, Maria Conceição; Giampaglia, Carmen M Saraiva; Oliveira, Rosângela S; Simonsen, Vera; Latrilha, Fábio Oliveira; Moniz, Letícia Lisboa; Couvin, David; Rastogi, Nalin; Ferrazoli, Lucilaine

    2013-03-01

    São Paulo is the most populous Brazilian state and reports the largest number of tuberculosis cases in the country annually (over 18,500). This study included 193 isolates obtained during the 2nd Nationwide Survey on Mycobacterium tuberculosis Drug Resistance that was conducted in São Paulo state and 547 isolates from a laboratory based study of drug resistance that were analyzed by the Mycobacteria Reference Laboratory at the Institute Adolfo Lutz. Both studies were conducted from 2006 to 2008 and sought to determine the genetic diversity and pattern of drug resistance of M. tuberculosis isolates (MTC) circulating in São Paulo. The patterns obtained from the spoligotyping analysis demonstrated that 51/740 (6.9%) of the isolates corresponded to orphan patterns and that 689 (93.1%) of the isolates distributed into 144 shared types, including 119 that matched a preexisting shared type in the SITVIT2 database and 25 that were new isolates. A total of 77/144 patterns corresponded to unique isolates, while the remaining 67 corresponded to clustered patterns (n=612 isolates clustered into groups of 2-84 isolates each). The evolutionarily ancient PGG1 lineages (Beijing, CAS1-DEL, EAI3-IND, and PINI2) were rarely detected in São Paulo and comprised only 13/740, or 1.76%, of the total isolates; all of the remaining 727/740, or 98.24%, of the MTC isolates from São Paulo state were from the recent PGG2/3 evolutionary isolates belonging to the LAM, T, S, X, and Haarlem lineages, i.e., the Euro-American group. This study provides the first overview of circulating genotypes of M. tuberculosis in São Paulo state and demonstrates that the clustered shared types containing seven or more M. tuberculosis isolates that are spread in São Paulo state included both resistant and susceptible isolates.

  5. Emerging Infections Program as Surveillance for Antimicrobial Drug Resistance.

    Science.gov (United States)

    Fridkin, Scott K; Cleveland, Angela A; See, Isaac; Lynfield, Ruth

    2015-09-01

    Across the United States, antimicrobial drug-resistant infections affect a diverse population, and effective interventions require concerted efforts across various public health and clinical programs. Since its onset in 1994, the Centers for Disease Control and Prevention Emerging Infections Program has provided robust and timely data on antimicrobial drug-resistant infections that have been used to inform public health action across a spectrum of partners with regard to many highly visible antimicrobial drug-resistance threats. These data span several activities within the Program, including respiratory bacterial infections, health care-associated infections, and some aspects of foodborne diseases. These data have contributed to estimates of national burden, identified populations at risk, and determined microbiological causes of infection and their outcomes, all of which have been used to inform national policy and guidelines to prevent antimicrobial drug-resistant infections.

  6. Clinical distribution and drug resistance of Acinetobacter baumannii%鲍曼不动杆菌的临床分布与耐药性监测

    Institute of Scientific and Technical Information of China (English)

    赖映君; 吴劲松; 杨健

    2012-01-01

    Objective To investigate the clinical distribution and drug resistance of Acinetobacter baumannii and offer assistance for treatment of nosocomial infection. Methods Totally 339 Acinetobacter baumannii strains were isolated from January 2009 to December 2010. Susceptihility of Acinetobacter baumannii to antimicrobials were tested by using Kirby-Bauer method. The data were analyzed with WHONET5.3 software according to CLSI2009 standard. Results The samples were mainly collected from respiratory tract (74.9%),the noisocomial infection of Acinelobacter baumannii was higher in ICU (28.9%). The resistance rate at Acinetobacter baumanoii to cefoperazone/sulbactem was reduced from 25.3% in 2009 to 18.3% in 2010,the resistance rate to minocycline was increased from 20.3% in 2009 to 37.7% in 2010, while to imipenem and meropenem were increased from 57.5% and 62.7% in 2009 to 66.5% and 70.7% in 2010. The resistance rate to other antimicrobials were all over 50.3% . Conclusion The resistance of Acinelobacter baumannii to antimicrobials shows a asecending trend,but is still susceptible to cefoperazone/sulbactem and minocycline.%目的 了解临床分离的鲍曼不动杆菌临床分布和耐药情况,为有效治疗和临床控制感染提供依据.方法 收集2009年1月-2010年12月临床分离的339株鲍曼不动杆菌,记录标本来源、感染科室分布,并采用纸片扩散性进行药敏试验,按CLSI 2009年版标准判读药敏试验结果,采用WHONET5.3软件进行数据分析.结果 标本来源以呼吸道为主,占74.9%;科室分布以重症监护病房(ICU)最多,占28.9%.与2009年监测结果相比,鲍曼不动杆菌对头孢哌酮/舒巴坦的耐药率从25.3%下降至2010年的18.3%,对米诺环素的耐药率从20.3%上升至2010年的37.7%,对亚胺培南和美罗培南的耐药率分别从57.5%、62.7%上升至2010年的66.5%、70.7%,对其他抗菌药物的耐药率均>50.3%.结论 鲍曼不动杆菌耐药性仍呈增长趋

  7. Determinants of HIV-1 drug resistance in treatment-naïve patients and its clinical implications in an antiretroviral treatment program in Cameroon

    Directory of Open Access Journals (Sweden)

    Alexander Zoufaly

    2014-11-01

    Full Text Available Introduction: Facing the rapid scale-up of antiretroviral treatment (ART programs in resource-limited settings, monitoring of treatment outcome is essential in order to timely detect and tackle drawbacks [1]. Methods: In a prospective cohort study, 300 consecutive patients starting first-line ART were enrolled between 2009 and2010 in a large HIV treatment centre in rural Cameroon. Patients were followed up for 12 months. Virologic failure was defined as a VL >1000 cop/mL at month 12. Besides CD4 and viral load (VL analysis, HIV-1 drug resistance testing was performed in patients with VL>1000 copies (c/mL plasma. In those patients and controls, minority HIV-1 drug resistance mutations at baseline, and plasma drug levels were analyzed in order to identify the risk factors for virologic failure. Results: Most enrolled patients (71% were female. At baseline median CD4 cell count was 162/µL (IQR 59-259, median log10 VL was 5.4 (IQR 5.0–5.8 c/mL, and one-third of patients had World Health Organisation (WHO stage 3 or 4; 30 patients died during follow-up. Among all patients who completed follow-up 38/238 had virologic failure. These patients were younger, had lower CD4 cell counts and more often had WHO stage 3 or 4 at baseline compared to patients with VL<1000c/mL. Sixty-three percent of failing patients (24/38 had at least one mutation associated with high-level drug resistance. The M184V mutation was the most frequently detected nucleoside reverse transcriptase inhibitor (NRTI mutation (n=18 followed by TAMs (n=5 and multi-NRTI resistance mutations (n=4. The most commonly observed non-nucleoside reverse-transcriptase inhibitor (NNRTI resistance mutations were K103N (n=10, Y181C (n=7, and G190A (n=6. Drug resistance mutations at baseline were detected in 12/65 (18% patients, in 6 patients with and 6 patients without virological failure (p=0.77. Subtherapeutic NNRTI levels (OR 6.67, 95% CI 1.98–22.43, p<0.002 and poorer adherence (OR 1.54, 95% CI

  8. To Explore the Clinical Infection and Drug Resistance of Escherichia Coli%大肠埃希菌临床感染分布及耐药性探讨

    Institute of Scientific and Technical Information of China (English)

    袁春华

    2015-01-01

    Objective To explore the clinical distribution and drug resistance of Escherichia coli, and provide evidence for rational use of drug and clinical treatment.Methods Selected the drug resistance and distribution of 192 from August 2013 to January 2015 strains of escherichia coli.Results In specimen distribution isolated was 34.9% from sputum, 33.2% secretion specimens, both of them proportion was higher. In the department, the proportion of surgical, pediatric, respiratory department of internal medicine, department of endocrinology and department of cardiology were higher,P<0.05, had difference statistically significance. Conclusion The antibiotic resistance rate of escherichia coli is high, so the anti infection treatment for the drug resistant to the critically ill patients should be given.%目的 探究大肠埃希菌临床分布的特点和耐药性,为合理用药和临床治疗提供依据.方法 选取2013年8月~2015年1月的192株大肠埃希菌进行耐药性和分布的分析.结果 在标本分离中有43.2%来自痰液,24.0%为分泌物的标本,二者所占比例较高.在科室分布中,心内科、脾胃科、呼吸内科、老年科所占比例较高,P<0.05,差异具有统计学意义.结论 大肠埃希菌的耐药率高,因此对于危重患者要给予碳青霉烯类的药物进行抗感染的治疗.

  9. Strategies to manage antifungal drug resistance.

    Science.gov (United States)

    Tseng, Hsiang-Kuang; Perfect, John R

    2011-02-01

    Invasive fungal infections continue to cause significant morbidity and mortality in immunocompromised hosts. From more than half a million deaths from cryptococcosis in sub-Saharan Africa to an unchanging death rate from invasive candidiasis, despite three antifungal classes of drugs, insights into better strategies to reduce therapeutic failures or resistance are needed. This review examines the issues around antifungal drug resistance from both a basic description of the failures and how they are detected to the variety of issues that need to be addressed to help prevent failures for successful management. The reader will gain an understanding of the clinical complexities in this patient population for management of invasive fungal infections. Throughout the review, principles of management are given along with some specific clinical examples to illustrate the issues and frame the knowledge base. From this discussion it is hoped that the clinician can use the insights provided to manage individual patients and find links to the evidence-based material that support its conclusions. Also, this review specifically identifies the limitations of present management and directs clinicians to gather additional information and provide even better treatment strategies. Invasive fungal infections are life-threatening complications of serious underlying diseases. Their management can be complicated by both direct and clinical drug resistance and by understanding these possibilities and correcting them; most patients can be successfully managed with present antifungal drugs if the underlying diseases can be controlled.

  10. 207株肺炎克雷伯菌临床分布及耐药性分析%Clinical distribution and drug resistance analysis of 207 Klebsiella pneumoniae strains

    Institute of Scientific and Technical Information of China (English)

    龙绍芬; 黎铁斌

    2012-01-01

    目的 分析临床分离肺炎克雷伯菌对抗菌药物的耐药性.方法 对临床分离肺炎克雷伯菌用纸片扩散法(K-B)或微量稀释法对16种抗菌药物进行药物敏感试验.结果 产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌59株,对头孢曲松、头孢呋辛、头孢噻肟、头孢哌酮、头孢噻吩、复方新诺明、美洛西林有很高的耐药率,分别是91.53%、91.53%、100.00%、100.00%、93.22%、72.88%和91.53%,甚至出现多重耐药菌株.结论 产ESBLs肺炎克雷伯菌耐药情况非常严重,应加强医院感染监测和控制措施.%Objective To analyse the drug resistance of Klebsiella pneumoniae. Methods the disk diffusion method (KB) or mi cro dilution method (MIC) was used to detect the resistance rates of Klebsiella pneumoniae clinical isolates to 16 kinds of antibacte rial drugs. Results There were 59 strains of Klebsiella pneumoniae producing extended spectrum |3 lactamase (ESBLs) ,and they had high resistance rates to ceftriaxone(91. 53%) ,cefuroxime(91. 53%) , cefotaxime(100. 00%) ,cefoperazone(100. 00%) ,cepha lothin(93. 22%) ,co trimoxazole(72. 88%) ,mezlocillin(91. 53%) respectively. There are even multi drug resistant strains were de tected. Conclusion The drug resistance of ESBLs producing Klebsiella pneumoniae is very serious. The hospital infection surveil lance and control measures should be strengthen.

  11. CLINICAL AND IMMUNOLOGICAL CHARACTERISTICS OF PATIENTS WITH HERPES INFECTIONS OF VARYING SEVERITY

    Directory of Open Access Journals (Sweden)

    T. M. Lyuboshenko

    2014-01-01

    Full Text Available The peculiarities of clinical signs, immune and interferon status in 180 patients with laboratory confirmed infection of varying severity, caused by herpes simplex virus (VSHI have been studied. It was determined that frequency of bacterial infections is increased in patients with more severe clinical forms of VSHI. In patients with mild course furunculosis was more often detected than in other groups. In patients with moderate course of VSHI vaginal candidiasis was more common. In patients with severe VSHI course the combination of labial and genital herpes as well as infection caused by the human papilloma virus were more prevalent. In case of severe infection occurred an increased frequency of dysbiosis, fatigue, low grade temperature, iron deficiency anemia and malignancies. The highest frequency of allergic reactions is observed in patients with moderate course of VSHI. The autoimmune syndrome manifestations were not depend on the severity of VSHI. The degree of reduction of cell immunity and disorders in the system of interferon were closely related to severity of VSHI course.

  12. The Evaluation Clinical and Demographic Characteristics of 115 Patients Diagnosed with Herpes Zoster in Eeastern Turkey

    Directory of Open Access Journals (Sweden)

    Hatice Uce Özkol

    2013-12-01

    Full Text Available Objective: The aim of this study was to investigate the clinical and demographic characteristics of patients diagnosed with herpes zoster and to explore the similarities and differences with other epidemiological studies from Turkey and the world. Methods: We retrospectively reviewed the records of 115 patients diagnosed with herpes zoster in the Yuzuncu Yıl University Medical Faculty Dermatology Department between January 2007 and December 2010. Results: The mean age of the patients was 42.21±23.88 years. 115 patients, -47 female (40.9%, 68 male (59.1%- aged between 2 and 93 years were assessed. Pediatric age group, 20 (17.4%, adult age group, 95 (82.6% patients, respectively. The incidence of HZ was found to be 0.43%. HZ was observed winter rarely (13.04%. Is mostly seen in the months of March (17.39% The affected dermatome were thorasic (49 patient, 42.6%, servical (21 patient, 18.3%, ophtalmic (22 patient, 19.1%, lomber (16 patient, 13.9%, sacral (7 patient, 6.1% respectively. Complications developed in 13% of patients. Conclusion: We observed that our findings were more or less similar to the findings of the literature data. Cases of HZ in our study was very rare during the winter season. Multi-center studies are needed to the emergence of clinical and epidemiological characteristics of HZ in Turkey.

  13. 脑科医院鲍氏不动杆菌的分布与耐药性分析%Clinical distribution and drug resistance of Acinetobacter baumannii in brain hospitals

    Institute of Scientific and Technical Information of China (English)

    吴俊

    2012-01-01

    OBJECTIVE To study the distribution and drug resistance of Acinetobacter baumannii in brain hospitals in Wuhan. METHODS The distribution characteristics of 195 clinical isolates of A. baumannii causing infections was monitored from 2009 to 2011; the drug susceptibility testing was performed with K-B agar diffusion, the drug susceptibility of A. baumannii isolates was analyzed. RESULTS The 195 strains of A. baumannii were mainly isolated from the sputum specimens, accounted for 78. 0%, those isolates mainly distributed in the brain department(82. 1%), consisting of the neurosurgery department (35. 4%),ICU(32. 3%) and the neurology department( 14. 4%) ; the drug resistance rate of A. baumannii to imipenem was over 50. 0% in 2010 and 2011, and A. baumannii was mostly susceptible to cefoperazone/sulbactam and minocycline in 2010 and 2011, A. baumannii was highly resistant to other antibiotics, the drug resistance to most of the antibiotics was over 60. 0%. CONCLUSION The drug resistance rate is higher of the A. baumannii strains isolated from the brain department than those isolated from other department; the drug resistance spectrum of the A. baumannii is constantly changing, and there is a rapid increase in the drug resistance to most antibiotics so that it is necessary to strengthen the monitoring and reasonable use of antibiotics.%目的 分析武汉脑科医院鲍氏不动杆菌的分布及耐药性.方法 监测2009-2011年临床分离195株鲍氏不动杆菌感染分布特征;采用K-B琼脂扩散法药敏试验,分析鲍氏不动杆菌对抗菌药物敏感性.结果 195株鲍氏不动杆菌以痰标本的检出率最高,占78.0%,主要分布于脑科,占82.1%,包括神经外科、重症监护病房及神经内科,分别占35.4%、32.3%、14.4%;2010与2011年鲍氏不动杆菌对亚胺培南的耐药率>50.0%,而2010、2011年鲍氏不动杆菌对头孢哌酮/舒巴坦、米诺环素敏感性最高,对其他抗菌药物耐药严重,多数

  14. 耐甲氧西林金黄色葡萄球菌的临床调查与耐药性分析%Clinical investigation of methicillin-resistant Staphylococcus aureus and drug resistance

    Institute of Scientific and Technical Information of China (English)

    崔金国; 孙景生; 邹万芹

    2012-01-01

    OBJECTIVE To explore the characteristics of clinical infections caused by methicillin-resistant Staphylococcus aureus (MRSA). and drug resistance. METHODS From Jan 2009 to Jun 2011, the distribution of the specimens and the departments from which 103 strains of MRSA as well as the drug resistance was analyzed. RESULTS MRSA infection mainly distributed in neurosurgery department (35. 9%) and ICU(20. 4%) ; totally the 103 strains of MRSA were mainly isolated from the sputum and the wound secretion, accounting for 43. 7% and 22.3%; MRSA varied in drug resistance to macrolides, aminoglycosides, quinolones, and sulfonamides except vancomycin. CONCLUSION Only we grasp the distribution and the characteristics of MRSA infections, monitor its drug resistance and reasonably use antibiotics can we effectively control the MRSA infections and its spread.%目的 探讨耐甲氧西林金黄色葡萄球菌(MRSA)临床感染的特点及对抗菌药物的耐药性.方法 对2009年1月-2011年6月医院临床送检各类标本中分离出的103株MRSA,按照标本种类、科室分布、药物耐药性等进行分析.结果 医院感染MRSA较多科室为神经外科及ICU,分别占35.9%、20.4%;103株MRSA主要标本来源为痰液、伤口分泌物,分别占43.7%、22.3%;MRSA除对万古霉素敏感外,对大环内酯类、氨基糖苷类、喹诺酮类及磺胺类药物呈不同耐药性,对青霉素和苯唑西林的耐药性为100.0%.结论 只有正确掌握MRSA感染的分布与特征、监测其耐药性,合理使用抗菌药物,才能有效控制MRSA感染及扩散.

  15. ICU鲍曼不动杆菌感染分布及耐药性分析%Analysis on clinical distribution and drug resistance of Acinetobacter baumannii in ICU

    Institute of Scientific and Technical Information of China (English)

    林华; 张德伦; 杨思芸; 李胜前; 陈杰

    2012-01-01

    目的 分析我院重症监护病房(ICU)内鲍曼不动杆菌(AB)标本分布、耐药情况、感染的危险因素及临床抗菌药物使用情况,为预防与治疗AB感染提供依据.方法 对2011年我院ICU分离的41株AB标本(主要来源于痰标本85.37%)的分布、耐药情况及易感AB的危险因素和临床抗菌药物使用情况进行回顾性分析.结果 AB敏感率较高的是头孢哌酮舒巴坦(100%)、亚胺培南(92.5%),对其他抗菌药物的耐药率严重.结论 鲍曼不动杆菌对各种抗菌药物的耐药性逐渐增强,多重耐药和泛耐药鲍曼不动杆菌分离率高;应警惕并高度重视该菌感染及耐药监测,以减少耐药菌株的产生和播散.%Objective To investigate the clinical distribution and drug resistance of Acinetobacter baumannii and provide useful help for the prevention and treatment of A. baumannii infection. Methods A total of 41 nonduplicate strains of A. baumannii were collected from a crtain hospital's ICU in 2011. The basic information.drug susceptibility and the use of antibiotics in patients were retrospectively analyzed. Results 41 strains of A. baumannii mainly came from the sputum samples of patients (85. 37%). It was showed that the sensitive drugs of Acinetobacter baumannii were cefopera-zone sodium and sulbactam sodium and imipenem. The resistant drugs of Acinetobacter baumannii were aminoglycosides, quinolones , and bets-lactamases. Conclusion Antimicrobial resistance of A. baumannii and the isolation rate of multi-drug-resistant and pandrug-resistant A. baumannii are increasing. So we must keep an eye on A. baumannii infection and its drug-resistance changes in order to prevent the emergence and spread of drug-resistant strains.

  16. Herpes zoster: Epidemiología y clínica Clinical and epidemiological aspects of Herpes zoster

    OpenAIRE

    Claudia Vujacich; Emmanuel Poggi; Diego Cecchini; Pablo Luchetti; Daniel Stamboulian

    2008-01-01

    El herpes zoster (HZ) constituye una enfermedad de distribución mundial; sin embargo, existen es casos datos comunicados sobre la misma en países de Latinoamérica. Con el objetivo de evaluar aspectos clínicos y epidemiológicos de esta enfermedad en nuestra población, realizamos un análisis retrospectivo de historias clínicas de un centro privado de referencia en enfermedades infecciosas en Buenos Aires, Argentina (período: 2000-2005). Se realizó un análisis estadístico univariado para evaluar...

  17. 临床分离2230株革兰阴性杆菌种类分布及耐药性分析%Analysis of distribution and drug resistance of 2362 strains of gram negative bacillus isolated from clinics

    Institute of Scientific and Technical Information of China (English)

    黄蕊萍

    2016-01-01

    目的:研究某医院临床分离的革兰阴性杆菌种类分布及耐药性,为临床合理使用抗菌药物提供依据。方法采用细菌分离鉴定技术和药敏试验方法,对某医院患者送检病原学标本进行检测与分析。结果从该医院患者送检的5622份病原学标本中共分离出革兰阴性杆菌2230株,检出率为39.67%。排名前5位的有肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌和阴沟肠杆菌构成比依次为18.30%、14.62%、13.00%、6.55%和4.89%。临床分离的肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌和阴沟杆菌对阿莫西林的耐药率达到90%以上;鲍曼不动杆菌和铜绿假单胞对头孢噻吩的耐药率达到100%。结论该医院临床分离革兰阴性杆菌中主要优势菌耐药严重,应加强病原学标本检测,关注细菌耐药性变化趋势,指导临床合理选择抗菌药物。%Objective To study the species distribution and drug resistance of clinical isolates of gram negative bacillus in a hospital ,so as to provide the basis for clinical rational use of antibiotics .Methods The isolation and identification of bacteria and drug sensitivity test methods were used to detect and analyze the submission of pathogen of pathologic speci -mens from patients in a hospital .Results From 5 622 strains of pathogenic specimens isolated from this hospital patients 2 230 strains of gram negative bacilli were detected with the detection rate of 39.67%.The constituent ratios of Klebsiella pneumoniae,Escherichia coli,Pseudomonas aeruginosa,Acinetobacter baumannii and Enterobacter cloacae were 18.30%, 14.62%,13.00%,6.55%and 4.89%respectively,which were the top five ranking .The drug resistant rates of Klebsiella pneumoniae,Escherichia coli and Pseudomonas aeruginosa to Amoxicillin were more than 90%,and the drug resistant rates of Acinetobacter baumannii and Enterobacter cloacae to Cephalothin were

  18. Genital Herpes

    Science.gov (United States)

    Genital herpes is a sexually transmitted disease (STD) caused by a herpes simplex virus (HSV). It can cause sores on ... also infect their babies during childbirth. Symptoms of herpes are called outbreaks. You usually get sores near ...

  19. Local clinical phototreatment of herpes infection in São Paulo.

    Science.gov (United States)

    Tardivo, Joao Paulo; Wainwright, Mark; Baptista, Mauricio S

    2012-06-01

    The clinical use of topical photodynamic therapy in herpes simplex lesions in São Paulo is presented and discussed. Although previous attempts utilising this type of approach in the USA were discontinued in the early 1970s due to several presentations of post-treatment Bowen's disease, none of the cases from the clinic presented here have displayed any complications on follow-up. In addition, lesion recrudescence periods are generally much longer than with conventional approaches. This is thought to be due to improvements in the treatment protocol, viz. use of the non-toxic photosensitisers methylene blue and Hypericum perforatum extract in place of proflavine and neutral red in the original trials, differences in photosensitisation pathway and illumination of the treatment site with red rather than fluorescent/UV light. Post-treatment cosmesis is also excellent.

  20. Cancer Metabolism and Drug Resistance

    Directory of Open Access Journals (Sweden)

    Mahbuba Rahman

    2015-09-01

    Full Text Available Metabolic alterations, driven by genetic and epigenetic factors, have long been known to be associated with the etiology of cancer. Furthermore, accumulating evidence suggest that cancer metabolism is intimately linked to drug resistance, which is currently one of the most important challenges in cancer treatment. Altered metabolic pathways help cancer cells to proliferate at a rate higher than normal, adapt to nutrient limited conditions, and develop drug resistance phenotypes. Application of systems biology, boosted by recent advancement of novel high-throughput technologies to obtain cancer-associated, transcriptomic, proteomic and metabolomic data, is expected to make a significant contribution to our understanding of metabolic properties related to malignancy. Indeed, despite being at a very early stage, quantitative data obtained from the omics platforms and through applications of 13C metabolic flux analysis (MFA in in vitro studies, researchers have already began to gain insight into the complex metabolic mechanisms of cancer, paving the way for selection of molecular targets for therapeutic interventions. In this review, we discuss some of the major findings associated with the metabolic pathways in cancer cells and also discuss new evidences and achievements on specific metabolic enzyme targets and target-directed small molecules that can potentially be used as anti-cancer drugs.

  1. Cancer Metabolism and Drug Resistance

    Science.gov (United States)

    Rahman, Mahbuba; Hasan, Mohammad Rubayet

    2015-01-01

    Metabolic alterations, driven by genetic and epigenetic factors, have long been known to be associated with the etiology of cancer. Furthermore, accumulating evidence suggest that cancer metabolism is intimately linked to drug resistance, which is currently one of the most important challenges in cancer treatment. Altered metabolic pathways help cancer cells to proliferate at a rate higher than normal, adapt to nutrient limited conditions, and develop drug resistance phenotypes. Application of systems biology, boosted by recent advancement of novel high-throughput technologies to obtain cancer-associated, transcriptomic, proteomic and metabolomic data, is expected to make a significant contribution to our understanding of metabolic properties related to malignancy. Indeed, despite being at a very early stage, quantitative data obtained from the omics platforms and through applications of 13C metabolic flux analysis (MFA) in in vitro studies, researchers have already began to gain insight into the complex metabolic mechanisms of cancer, paving the way for selection of molecular targets for therapeutic interventions. In this review, we discuss some of the major findings associated with the metabolic pathways in cancer cells and also discuss new evidences and achievements on specific metabolic enzyme targets and target-directed small molecules that can potentially be used as anti-cancer drugs. PMID:26437434

  2. 医院感染褪色沙雷菌的临床分布与耐药性分析%Clinical distribution and drug resistance of Serratia marcescens causing nosocomial infection

    Institute of Scientific and Technical Information of China (English)

    王蓓; 刘红; 邹雪; 蒋晓飞

    2015-01-01

    OBJECTIVE To investigate the clinical distribution of Serratia marcescens causing nosocomial infections and observe the drug resistance to the commonly used antibiotics so as to guide the reasonable clinical use of antibi‐otics .METHODS A total of 434 strains of S .marcescens were isolated from the submitted specimens that were ob‐tained from the patients who were hospitalized Huashan Hospital from Jan 2009 to Dec 2013 .The drug susceptibil‐ity testing and the statistical analysis were performed .The drug resistance rates were analyzed with the use of Whonet5 .4 software .RESULTS Totally 434 strains of S .marcescens were isolated from the submitted specimens , most of which were isolated from the sputum ,wound ,urine ,and secretions specimens .The drug susceptibility rates of the S .marcescens to cefoperazone‐sulbactam ,piperacillin‐tazobactam ,imipenem ,meropenem ,and ertap‐enem were 74 .4% ,82 .5% ,84 .8% ,90 .2% ,and 88 .9% ,respectively ;while the drug resistance rate of the S . marcescens to carbapenems was increased year by year and continued to show an upward trend .CONCLUSION The drug resistance rate of the S .marcescens to carbapenems shows an upward trend ,therefore ,it is necessary for the hospital to monitor the nosocomial infections ,analyze the drug resistance of the pathogens ,reasonably use antibi‐otics based on the results of the drug susceptibility testing ,and curb the spread of drug‐resistant strains .%目的:了解患者医院感染褪色沙雷菌的临床分布特点及对常用抗菌药物的耐药性变化,指导临床合理使用抗菌药物。方法收集2009年1月-2013年12月华山医院住院患者送检标本分离出的褪色沙雷菌434株,进行药敏试验及统计分析;使用世界卫生组织耐药监控网提供的Whonet 5.4软件进行耐药率分析。结果从临床送检标本中共检出434株褪色沙雷菌,主要分离自痰液、伤口、尿液和分泌物等标本;褪色沙雷菌对头

  3. 2008-2010年产气肠杆菌分布特征与耐药性分析%Clinical distribution and drug resistance of Enterobacter aerogenes from 2008 to 2010

    Institute of Scientific and Technical Information of China (English)

    赵进良; 冯乐; 吴良娟; 何梅; 王春新

    2011-01-01

    OBJECTIVE To investigate the clinical distribution and drug resistance of Enterobacter aero genes from 2008 to 2010 to provide the scientific evidence for clinical diagnosis and treatment. METHODS The distribution and drug resistance of E. Aerogenes isolated from 2008 to 2010 were analyzed retrospectively. RESULTS Totally 570 strains of E. Aerogenes were mainly isolated from sputum (334 strains), urine (121 strains) and blood (-32 strains) .accounting for 58. 6% ,21. 2% and 5. 6% , respectively. The drug resistant rates to ampicillin.cefotaxim, cefoxitin, cefazolin, cefuroxime sodium, cefuroxime were more than 50. 0%. All isolates of E. Aerogenes distributed in many departments were more sensitive to carbapenem,amikacin and gentamicin. CONCLUSION E. Aerogenes clinical strains are mostly multidrug-resistant. Rational use of antibiotics is important for the containment of the resistance of E. Aerogenes.%目的 分析2008-2010年产气肠杆菌分离株的临床分布及耐药性特点,为临床医师诊断和治疗提供依据.方法 对2008-2010年住院患者各类标本分离到的产气肠杆菌,进行标本分布和耐药性回顾性统计分析.结果 3年内共分离出产气肠杆菌570株,主要来源于痰334株,占58.6%、尿液121株,占21.2%和血液32株,占5.6%,主要分布在呼吸内科220株,占38.6%、ICU174株,占30.5%和神经外科42株,占7.4%;药敏结果显示,对氨苄西林、头孢噻肟、头孢西丁、头孢唑林、头孢呋辛酯及头孢呋辛钠耐药率均>50.0%,对阿米卡星、庆大霉素、亚胺培南和美罗培南有较好的敏感性.结论 产气肠杆菌多为多药耐药,临床医师应根据药敏结果合理选择抗菌药物,以延缓产气肠杆菌耐药性的产生.

  4. Molecular surveillance for drug-resistant Plasmodium falciparum in clinical and subclinical populations from three border regions of Burma/Myanmar: cross-sectional data and a systematic review of resistance studies

    Science.gov (United States)

    2012-01-01

    Background Confirmation of artemisinin-delayed parasite clearance in Plasmodium falciparum along the Thai-Myanmar border has inspired a global response to contain and monitor drug resistance to avert the disastrous consequences of a potential spread to Africa. However, resistance data from Myanmar are sparse, particularly from high-risk areas where limited health services and decades of displacement create conditions for resistance to spread. Subclinical infections may represent an important reservoir for resistance genes that confer a fitness disadvantage relative to wild-type alleles. This study estimates the prevalence of resistance genotypes in three previously unstudied remote populations in Myanmar and tests the a priori hypothesis that resistance gene prevalence would be higher among isolates collected from subclinical infections than isolates collected from febrile clinical patients. A systematic review of resistance studies is provided for context. Methods Community health workers in Karen and Kachin States and an area spanning the Indo-Myanmar border collected dried blood spots from 988 febrile clinical patients and 4,591 villagers with subclinical infection participating in routine prevalence surveys. Samples positive for P. falciparum 18 s ribosomal RNA by real-time PCR were genotyped for P. falciparum multidrug resistance protein (pfmdr1) copy number and the pfcrt K76T polymorphism using multiplex real-time PCR. Results Pfmdr1 copy number increase and the pfcrt K76 polymorphism were determined for 173 and 269 isolates, respectively. Mean pfmdr1 copy number was 1.2 (range: 0.7 to 3.7). Pfmdr1 copy number increase was present in 17.5%, 9.6% and 11.1% of isolates from Karen and Kachin States and the Indo-Myanmar border, respectively. Pfmdr1 amplification was more prevalent in subclinical isolates (20.3%) than clinical isolates (6.4%, odds ratio 3.7, 95% confidence interval 1.1 - 12.5). Pfcrt K76T prevalence ranged from 90-100%. Conclusions Community

  5. Effect of mutation and genetic background on drug resistance in Mycobacterium tuberculosis.

    Science.gov (United States)

    Fenner, Lukas; Egger, Matthias; Bodmer, Thomas; Altpeter, Ekkehardt; Zwahlen, Marcel; Jaton, Katia; Pfyffer, Gaby E; Borrell, Sonia; Dubuis, Olivier; Bruderer, Thomas; Siegrist, Hans H; Furrer, Hansjakob; Calmy, Alexandra; Fehr, Jan; Stalder, Jesica Mazza; Ninet, Béatrice; Böttger, Erik C; Gagneux, Sebastien

    2012-06-01

    Bacterial factors may contribute to the global emergence and spread of drug-resistant tuberculosis (TB). Only a few studies have reported on the interactions between different bacterial factors. We studied drug-resistant Mycobacterium tuberculosis isolates from a nationwide study conducted from 2000 to 2008 in Switzerland. We determined quantitative drug resistance levels of first-line drugs by using Bactec MGIT-960 and drug resistance genotypes by sequencing the hot-spot regions of the relevant genes. We determined recent transmission by molecular methods and collected clinical data. Overall, we analyzed 158 isolates that were resistant to isoniazid, rifampin, or ethambutol, 48 (30.4%) of which were multidrug resistant. Among 154 isoniazid-resistant strains, katG mutations were associated with high-level and inhA promoter mutations with low-level drug resistance. Only katG(S315T) (65.6% of all isoniazid-resistant strains) and inhA promoter -15C/T (22.7%) were found in molecular clusters. M. tuberculosis lineage 2 (includes Beijing genotype) was associated with any drug resistance (adjusted odds ratio [OR], 3.0; 95% confidence interval [CI], 1.7 to 5.6; P mutations (OR, 6.4; 95% CI, 2.0 to 20.7; P = 0.002). We found that the genetic strain background influences the level of isoniazid resistance conveyed by particular mutations (interaction tests of drug resistance mutations across all lineages; P tuberculosis drug resistance mutations were associated with various levels of drug resistance and transmission, and M. tuberculosis lineages were associated with particular drug resistance-conferring mutations and phenotypic drug resistance. Our study also supports a role for epistatic interactions between different drug resistance mutations and strain genetic backgrounds in M. tuberculosis drug resistance.

  6. MR imaging in Bell's palsy and herpes zoster opticus: correlation with clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Jung Ho; Mo, Jong Hyun; Moon, Sung Hee; Lee, Sang Sun; Park, Yang Hee; Lee, Kyung Hee [National Police Hospital, Seoul (Korea, Republic of); Choi, Ik Joon [Sejong General Hospital, Seoul (Korea, Republic of)

    1998-09-01

    To evaluate the MRI findings of acute facial nerve paralysis in Bell's palsy and herpes zoster opticus, and to correlate these with the clinical findings. We retrowspectively reviewed the MRI findings in six cases of BEll's palsy(BP) and two of herpes zoster oticus(HZO), and compared them with the findings for 30 normal facial nerves. This nerve was considered abnormal when its signal intensity was greater than that of brain parenchyma or the contralateral normal side on Gd-enhanced T1-weighted axial and coronal MR images. We analysed the location and degree of contrast enhancement, interval change, and clinical progression in correlation with House-Brackmann(HB) grade and electroneuronography (ENoG) findings. Fifteen of 30 normal facial nerves(50%) seen on Gd-enhanced MRI were mildly enhanced in the geniculate ganglion, the proximal tympanic, and the proximal mastoid segment of the facial nerve. No enhancement of the internal auditory canal(IAC) or labyrinthine segment of the facial nerve was noted, however. In BP and HZO, Gd-enhanced MR images revealed fair to marked enhancement for more than two segments from the internal auditory canal to the mastoid segment of the facial nerve. During follow-up MRI, enhancement of the facial nerve varied in location and signal intensity, though gradually decreased in intensity approximately eight weeks after the onset of facial nerve palsy. No correlation between clinical HB grade, ENoG, and follow up MRI findings was noted. Except in the internal auditory canal and labyrinthine segment, normal facial nevemay show mild and relatively symmetrical enhancement. In BP and HZO, the facial nerve showed diffuse enhancement from the IAC to the mastoid segment.=20.

  7. Clinical study on pathogenic flux and drug resistance of neonatal sepsis%新生儿败血症病原学变迁及耐药性的临床研究

    Institute of Scientific and Technical Information of China (English)

    邓茂文; 蔡强

    2015-01-01

    Objective To study the characteristic of etiology and drug resistance of neonatal sepsis for rational use antibiotics in clinic.Methods The etiology and drug resistance of 167 positive hemoculture examples of 365 neonatal sepsis examples were retrospectively analyzed,and the characteristic of etiology diversify and drug resist-ance characteristic of neonatal sepsis were also analyzed.Results In 365 blood culture examples of neonatal sepsis, there were 167 positive cases,positive ratio was 45.75%.Among pathogenic bacterium,the first etiology was staphylo-coccus epidermidis,there were fifty -eight examples and account of 34.73%.The second was staphylococcus haemo-lyticus and accounts twenty -nine examples and 17.37%.The third was staphylococcus aureus which had twenty -two examples and account 13.17%.The annual infection rate of staphylococcus epidermidis and staphylococcus hae-molyticus in the second five years were increased obviously.Gram -positive coccus drug resistance to penicillin,cep-hazolin,oxazocilline and cefoxitin were very high and the rate of the second five years were higher than that of the first five years.Gram -positive coccus drug resistance to third -generation cephaloporins and imipenem and meropenem were higher than vancocin and the rate of the second five years were higher than that of the first five years.Gram -positive coccus was 100.00% sensitive to vancomycin.Gram negative bacilli drug resistance rate to penbritin and cep-hazolin and third -generation cephaloporins was the highest.Gram negative bacilli to meropenem and imipenem was hypersensitive in all antibiotics.Conclusion The chief pathogenic bacteria of neonatal septicemia is staphylococci. Among pathogenic bacterium,the main pathogenic bacteria is CoNS,and staphylococcus epidermidis and staphylococ-cus haemolyticus goes up significantly.Among gram -negative bacilli,the escherichia coli goes up.The drug resist-ance to bacteria goes up in neonatal sepsis,it is very important to monitor

  8. 喹诺酮类药对常见病原菌耐药变迁与耐药机制初探%Change of resistance and drug resistance mechanism of quinolone against common bacteria in clinical practice

    Institute of Scientific and Technical Information of China (English)

    黄小玲; 林渡娣; 杨春燕; 黄福新; 袁慧文

    2011-01-01

    Objective: To understand change of resistance and drug resistance mechanism of quinolone against common bacteria in clinical practice.Methods: To identify by Freneh Vitek-32 AMS analyzer, susceptibility test was performed with disc diffusion testing.The results were evaluated according to the standards of US Clinical and Laboratory Standards Institute (CLSI) to initially discuss bacterial resistance mechanisms by literature review.Results: Test results of resistance for 4 060 strains of common G+ and G- bacteria to quinolone indicated that drug resistance had increased in various degrees, the order of their resistance was: ciprofloxacin>levofloxacin>gatifloxacin>moxifloxacin, ciprofloxacin resistance against MRSA and MRCNS became more than 95.0% and 70.0% respectively.They were regarded as highly resistant to clinical medicine and should not be the first choice in clinical treatment any more.As for bacterial resistance mechanism it was mainly because of the decrease for intracellular drug accumulation concentration of bacteria and mutations at the target enzyme or target site, as well as resistance or multiple drug resistance caused by pLasmid mediation.Conclusion:Drug resistance against quinolone is increased annually.from the perspective of resistance mechanism, except drug sensitivity test should be performed in clinical practice, medicated drugs and dosage should also be optimized according to PK/PD parameters.%目的:了解喹诺酮类药对临床常见病原菌的耐药性变迁及耐药机制.方法:采用法国Vitek-32 AMS分析仪进行鉴定,纸片扩散法进行药敏试验;根据美国临床实验室标准化研究所(CLSI)标准判断结果,并查阅文献初探细菌耐药机制.结果:依据喹诺酮类药对常见G+和G-菌4060株耐药性的监测结果,耐药性均有不同程度增加,其耐药性排序为环丙沙星>左氧氟沙星>加替沙星>莫西沙星,环丙沙星对MRSA和MRCNS的耐药率分别超过95.0%和70.0%,已高度耐

  9. Computational Studies of Drug Resistance

    DEFF Research Database (Denmark)

    da Silva Martins, João Miguel

    Drug resistance has been an increasing problem in patient treatment and drug development. Starting in the last century and becoming a major worry in the medical and scienti c communities in the early part of the current millennium, major research must be performed to address the issues of viral...... and bacterial resistance to common-use inhibitors, in such cases as multiple targeted proteins in the human immunode ciency virus infection and penicillinresistant Staphylococcus aureus. Thus, understanding the evolutionary pressures by which these arise and predicting future possible resistance mutations...... is of the utmost importance in developing better and less resistance-inducing drugs. A drug's in uence can be characterized in many diff erent ways, however, and the approaches I take in this work re ect those same different in uences. This is what I try to achieve in this work, through seemingly unrelated...

  10. 不同时间段临床分离的鲍曼不动杆菌的耐药性及分布%Drug-resistance and distribution of Acinetobacter baumannii isolated in clinical at different times

    Institute of Scientific and Technical Information of China (English)

    李琳

    2014-01-01

    目的:分析院内不同时间段临床分离的鲍曼不动杆菌的耐药性及标本来源,以指导临床合理使用抗菌药物。方法对2012年10月至2012年12月(2012年第4季度)分离的157株鲍曼不动杆菌、2013年1月至2013年3月(2013年第1季度)分离的184株鲍曼不动杆菌、2013年4月至2013年6月(2013年第2季度)分离的127株鲍曼不动杆菌、2013年7月至2013年9月(2013年第3季度)分离的154株鲍曼不动杆菌,用WalkAway 96 PLUS NC50药敏板检测菌株对亚胺培南等13种抗菌药物的耐药性,并对检测结果分别进行分析。结果2012年第4季度和2013年第1季度分离的鲍曼不动杆菌对阿米卡星的耐药率分别为33.8%(53/157)和39.1%(72/184),对妥布霉素的耐药率分别为43.9%(69/157)和46.7%(86/184),对复方新诺明、环丙沙星、左氧氟沙星、头孢吡肟、庆大霉素、头孢他啶、哌拉西林、哌拉西林/他唑巴坦、头孢噻肟、亚胺培南和美罗培南耐药率为50.3%~93.5%,2013年第2季度和2013年第3季度对亚胺培南等13种抗菌药物的耐药率为44.8%~66.1%。不同阶段分离的鲍曼不动杆菌90.91%~95.54%的标本来源于痰液。结论连续4个季度监测本院院内分离的鲍曼不动杆菌对临床常用抗菌药物耐药率均很高,临床医师应根据药敏试验治疗鲍曼不动杆菌引起的感染。%Objective To investigate the drug-resistance and specimen source of Acinetobacter baumannii isolated in clinical at different times, so as to guide the clinical rational use of antimicrobial drugs. Methods Total of 157 strains of Acinetobacter baumannii were isolated from October 2012 to December 2012 (the fourth quarter of 2012), 184 strains of Acinetobacter baumannii isolated from January 2013 to March 2013 (the ifrst quarter of 2013), 127 strains of Acinetobacter baumannii isolated from April 2013 to June 2013 (the second quarter of 2013) and 154 strains of

  11. Fitness cost of chromosomal drug resistance-conferring mutations.

    Science.gov (United States)

    Sander, Peter; Springer, Burkhard; Prammananan, Therdsak; Sturmfels, Antje; Kappler, Martin; Pletschette, Michel; Böttger, Erik C

    2002-05-01

    To study the cost of chromosomal drug resistance mutations to bacteria, we investigated the fitness cost of mutations that confer resistance to different classes of antibiotics affecting bacterial protein synthesis (aminocyclitols, 2-deoxystreptamines, macrolides). We used a model system based on an in vitro competition assay with defined Mycobacterium smegmatis laboratory mutants; selected mutations were introduced by genetic techniques to address the possibility that compensatory mutations ameliorate the resistance cost. We found that the chromosomal drug resistance mutations studied often had only a small fitness cost; compensatory mutations were not involved in low-cost or no-cost resistance mutations. When drug resistance mutations found in clinical isolates were considered, selection of those mutations that have little or no fitness cost in the in vitro competition assay seems to occur. These results argue against expectations that link decreased levels of antibiotic consumption with the decline in the level of resistance.

  12. Clinical Distribution and Drug Resistance Analysis of 64 Strains of Pseudomonas Aeruginosa%64株铜绿假单胞菌的临床分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    荣仕成

    2015-01-01

    Objective:To analyze the clinical distribution and drug resistance of Pseudomonas Aeruginosa,and provide evidence for clinical rational use of antimicrobial agents.Method:The clinical distribution and antibiotic resistance of 64 strains of Pseudomonas Aeruginosa were reviewed and analyzed in our hospital in 2013.Result:64 strains of Pseudomonas Aeruginosa were mainly distributed in the sputum,wound secretions,accounted for 54.7%,25.0%,on display in the 16 kinds of antimicrobial agents in vitro sensitivity test results,Cotrimoxazole and Chloramphenicol resistance rate were the highest,up to 100%,to the other antimicrobial agents showed different degrees of resistance.Conclusion:Pseudomonas Aeruginosa is one of the leading pathogen in nosocomial infection and its drug resistance is severe,the hospital drug use situation in various regions,different,bacterial drug resistant spectrum are not the same,all hospitals should strengthen the monitoring of drug resistance,and to guide clinical rational drug use,avoid or has an important significance to reduce the emergence of resistant strains.%目的:分析铜绿假单胞菌的临床分布及耐药情况,为临床合理使用抗菌药物提供依据。方法:回顾性分析本院2013年临床标本分离出的64株铜绿假单胞菌的临床分布及耐药情况。结果:64株铜绿假单胞菌主要分布在痰液、伤口分泌物中,分别占54.7%、25.0%,对16种抗菌药物体外敏感试验结果显示,复方新诺明和氯霉素耐药率最高,达100%,对其他抗菌药物均呈现不同程度的耐药。结论:铜绿假单胞菌是导致医院感染的主要病原菌之一,其耐药性比较严峻,各地区、各医院用药情况不尽相同,细菌耐药谱也不尽相同,各医院应加强对其耐药性监测,以指导临床合理用药,避免或减少耐药菌株的产生具有重要意义。

  13. Antimicrobial Activities of Methanol, Ethanol and Supercritical CO2 Extracts of Philippine Piper betle L. on Clinical Isolates of Gram Positive and Gram Negative Bacteria with Transferable Multiple Drug Resistance.

    Directory of Open Access Journals (Sweden)

    Demetrio L Valle

    Full Text Available Piper betle L. has traditionally been used in alternative medicine in different countries for various therapeutic purposes, including as an anti-infective agent. However, studies reported in the literature are mainly on its activities on drug susceptible bacterial strains. This study determined the antimicrobial activities of its ethanol, methanol, and supercritical CO2 extracts on clinical isolates of multiple drug resistant bacteria which have been identified by the Infectious Disease Society of America as among the currently more challenging strains in clinical management. Assay methods included the standard disc diffusion method and the broth microdilution method for the determination of the minimum inhibitory concentration (MIC and the minimum bactericidal concentrations (MBC of the extracts for the test microorganisms. This study revealed the bactericidal activities of all the P. betle leaf crude extracts on methicillin-resistant Staphylococcus aureus (MRSA, vancomycin-resistant Enterococcus (VRE, extended spectrum β-lactamase-producing Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae, and metallo-β-lactamase-producing Pseudomonas aeruginosa and Acinetobacter baumannii, with minimum bactericidal concentrations that ranged from 19μg/ml to 1250 μg/ml. The extracts proved to be more potent against the Gram positive MRSA and VRE than for the Gram negative test bacteria. VRE isolates were more susceptible to all the extracts than the MRSA isolates. Generally, the ethanol extracts proved to be more potent than the methanol extracts and supercritical CO2 extracts as shown by their lower MICs for both the Gram positive and Gram negative MDRs. MTT cytotoxicity assay showed that the highest concentration (100 μg/ml of P. betle ethanol extract tested was not toxic to normal human dermal fibroblasts (HDFn. Data from the study firmly established P. betle as an alternative source of anti-infectives against multiple drug resistant

  14. Antimicrobial Activities of Methanol, Ethanol and Supercritical CO2 Extracts of Philippine Piper betle L. on Clinical Isolates of Gram Positive and Gram Negative Bacteria with Transferable Multiple Drug Resistance.

    Science.gov (United States)

    Valle, Demetrio L; Cabrera, Esperanza C; Puzon, Juliana Janet M; Rivera, Windell L

    2016-01-01

    Piper betle L. has traditionally been used in alternative medicine in different countries for various therapeutic purposes, including as an anti-infective agent. However, studies reported in the literature are mainly on its activities on drug susceptible bacterial strains. This study determined the antimicrobial activities of its ethanol, methanol, and supercritical CO2 extracts on clinical isolates of multiple drug resistant bacteria which have been identified by the Infectious Disease Society of America as among the currently more challenging strains in clinical management. Assay methods included the standard disc diffusion method and the broth microdilution method for the determination of the minimum inhibitory concentration (MIC) and the minimum bactericidal concentrations (MBC) of the extracts for the test microorganisms. This study revealed the bactericidal activities of all the P. betle leaf crude extracts on methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), extended spectrum β-lactamase-producing Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae, and metallo-β-lactamase-producing Pseudomonas aeruginosa and Acinetobacter baumannii, with minimum bactericidal concentrations that ranged from 19μg/ml to 1250 μg/ml. The extracts proved to be more potent against the Gram positive MRSA and VRE than for the Gram negative test bacteria. VRE isolates were more susceptible to all the extracts than the MRSA isolates. Generally, the ethanol extracts proved to be more potent than the methanol extracts and supercritical CO2 extracts as shown by their lower MICs for both the Gram positive and Gram negative MDRs. MTT cytotoxicity assay showed that the highest concentration (100 μg/ml) of P. betle ethanol extract tested was not toxic to normal human dermal fibroblasts (HDFn). Data from the study firmly established P. betle as an alternative source of anti-infectives against multiple drug resistant bacteria.

  15. 带状疱疹202例临床分析%Clinical analysis of 202 cases of herpes zoster

    Institute of Scientific and Technical Information of China (English)

    张源; 王青; 张腾

    2016-01-01

    目的:探究带状疱疹患者的临床特点及高危因素。方法:回顾性分析带状疱疹患者202例的临床资料。结果:73例患者发病年龄≥65岁。皮损位于肋间神经分布区域90例。误诊率12%。结论:带状疱疹在中老年人中发病率较高,最易累及肋间神经,心脑血管病是带状疱疹发病的高危因素。%Objective:To explore the clinical characteristics and high risk factors of patients with herpes zoster.Methods:The clinical data of 202 cases of patients with herpes zoster were analyzed retrospectively.Results:73 cases of patients were over 65 years old.90 cases had lesions in the distribution area of intercostal nerve.The misdiagnosis rate was 12%.Conclusion:Herpes zoster had higher incidence in the elderly and affected the intercostal nerve most easily,the cerebrovascular disease was high risk factors for the onset of herpes zoster.

  16. Clinical features and drug resistance of Listeria monocytogenes infection in neonates%单核细胞增生性李斯特菌感染临床特征及耐药性

    Institute of Scientific and Technical Information of China (English)

    杨梅; 王志刚; 封志纯; 王爱华; 赵文利; 张万巧; 王艳

    2014-01-01

    Objective To study the clinical distribution of Listeria monocytogenes infection and the changes in drug resistance of Listeria monocytogenes isolated from inpatients during recent 3 years,and to increase the awareness of the situation and provide data for clinical antibiotics application.Methods The clinical distribution of 22 cases of neonatal Listeria infection and drug resistance changes of Listeria were retrospectively analyzed in Bayi Children's Hospital from Jan.2011 to Dec.2013.Results Neonates began to be attacked by Listeria monocytogenes of 0.5 hours to 5 days (an average of 17.45 hours) after birth.The average birth weight was (2 331.82 ± 677.64) g.There were 7 full term cases and 15 premature infants,13 cases with low birth wcight.The average hospitalization was (21.91 ± 17.64)days.The cure rate was 45.45% (10/22 cases).All the mothers of 15 cases had fever in the third trimester of pregnancy and the temperature was 37.5-39.5 ℃.Infection rate with Listeria monocytogenes in neonatal was 0.03% (2/7 137 cases),0.11% (8/7 281 cases) and 0.19% (12/6 394 cases) in 3 years,respectively.From 2011 to 2013,the sensitive rate of antimicrobial drugs with Listeria monocytogencs to commonly used antimicrobial was 82.72%,75.40% and 50.66%,and the rate of drug resistance was 17.28%,17.50% and 11.01%,respectively.During 3 years,the rates of drug resistance had no significant difference (x2 =3.65,P > 0.05),and the sensitive rates had a trend of declination year by year(x2 =36.87,P < 0.01).The sensitive rates and the drugs resistant rates of penicillin were 33.93% (19/56 cases)and 51.79% (29/56 cases),respectively.In 3 years,the drugs resistant rates of penicillin was 100.00%,40.00%,and 46.43%,and the sensitive rate was 0,60.00%,25.00%,respectively.There was a high sensitivity of Listeria monocytogenes to ampicillin,aminoglycoside,sugar peptide,tetracycline,macrolides,lincosamides,quinolone,sulfa and other classes (such as

  17. Recent trends in HIV-1 drug resistance.

    Science.gov (United States)

    Siliciano, Janet D; Siliciano, Robert F

    2013-10-01

    Once considered an inevitable consequence of HIV treatment, drug resistance is declining. This decline supports the hypothesis that antiretroviral therapy can arrest replication and prevent the evolution of resistance. Further support comes from excellent clinical outcomes, the failure of treatment intensification to reduce residual viremia, the lack of viral evolution in patients on optimal therapy, pharmacodynamics studies explaining the extraordinarily high antiviral activity of modern regimens, and recent reports of potential cures. Evidence supporting ongoing replication includes higher rates of certain complications in treated patients and an increase in circular forms of the viral genome after intensification with integrase inhibitors. Recent studies also provide an explanation for the observation that some patients fail protease-inhibitor based regimens without evidence for resistance. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. 重症监护病房医院内感染临床特点及病原菌耐药性分析%Clinical characteristics of hospital infection and pathogens drug resistance in intensive care unit

    Institute of Scientific and Technical Information of China (English)

    高伟; 秦瑾; 冯忠军; 郑军廷

    2010-01-01

    Objective To investigate the clinical characteristics of hospital infection and the pathogen type,distribution and drug resistance,in the intensive care unit of our hospital,to direct proper antibiotics use and supply the scientific basis for hospital infection control. Methods The clinical data of 392 inpatients in our intensive care unit from April 2008 to March 2010 were monitored prospectively and analyzed retrospectively. Results Of the 392 impatients,78 cases had hospital infection (19.89% 78/392),112 time-case infection (28.57% 112/392). The most common infection was the main respiratory tract infections accounted for 54.46% (61/112) ,followed by urinary tract infections accounted for 15. 19% ( 17/112 ), blood infection accounted for 11.61% (13/112). 152strains pathogens were identified in the study,in which G- bacilli accounted for 69.7%, G+ bacteria accounted for 17. 8% and fungi accounted for 12.5%. Main pathogens such as acinetobacter baumannii ,pseudomonas aeruginosa,klebsiella pneumoniae, staphylococcus aureus showed multiple drug resistance in different degrees. Conclusions Intensive care unit has a high nosocomial infection rate,lower respiratory tract infection is the most frequent type and the main pathogens have different degrees of multi-drug resistance. Standardized, rational use of antibiotics,prevention of the multi-drug resistant bacteria spread may help to reduce the occurrence of hospital infection in intensive care unit.%目的 探讨重症监护病房(ICU)医院内感染的临床特点及病原菌种类、分布及其耐药情况,为临床合理使用抗菌药物、预防和控制医院感染提供参考和依据.方法 采用前瞻性监测与回顾性调查相结合的方法,对2008年4月至2010年3月我院ICU收治的392例住院患者临床资料进行统计分析.结果 发生医院感染78例,医院感染发生率为19.89%(78/392),感染112例次(28.57%);感染部位以下呼吸道为主,占54.46%(61/112),

  19. High Levels of Transmitted HIV Drug Resistance in a Study in Papua New Guinea.

    Science.gov (United States)

    Lavu, Evelyn; Kave, Ellan; Mosoro, Euodia; Markby, Jessica; Aleksic, Eman; Gare, Janet; Elsum, Imogen A; Nano, Gideon; Kaima, Petronia; Dala, Nick; Gurung, Anup; Bertagnolio, Silvia; Crowe, Suzanne M; Myatt, Mark; Hearps, Anna C; Jordan, Michael R

    2017-01-01

    Papua New Guinea is a Pacific Island nation of 7.3 million people with an estimated HIV prevalence of 0.8%. ART initiation and monitoring are guided by clinical staging and CD4 cell counts, when available. Little is known about levels of transmitted HIV drug resistance in recently infected individuals in Papua New Guinea. Surveillance of transmitted HIV drug resistance in a total of 123 individuals recently infected with HIV and aged less than 30 years was implemented in Port Moresby (n = 62) and Mount Hagen (n = 61) during the period May 2013-April 2014. HIV drug resistance testing was performed using dried blood spots. Transmitted HIV drug resistance was defined by the presence of one or more drug resistance mutations as defined by the World Health Organization surveillance drug resistance mutations list. The prevalence of non-nucleoside reverse transcriptase inhibitor transmitted HIV drug resistance was 16.1% (95% CI 8.8%-27.4%) and 8.2% (95% CI 3.2%-18.2%) in Port Moresby and Mount Hagen, respectively. The prevalence of nucleoside reverse transcriptase inhibitor transmitted HIV drug resistance was 3.2% (95% CI 0.2%-11.7%) and 3.3% (95% CI 0.2%-11.8%) in Port Moresby and Mount Hagen, respectively. No protease inhibitor transmitted HIV drug resistance was observed. The level of non-nucleoside reverse transcriptase inhibitor drug resistance in antiretroviral drug naïve individuals recently infected with HIV in Port Moresby is amongst the highest reported globally. This alarming level of transmitted HIV drug resistance in a young sexually active population threatens to limit the on-going effective use of NNRTIs as a component of first-line ART in Papua New Guinea. To support the choice of nationally recommended first-line antiretroviral therapy, representative surveillance of HIV drug resistance among antiretroviral therapy initiators in Papua New Guinea should be urgently implemented.

  20. High Levels of Transmitted HIV Drug Resistance in a Study in Papua New Guinea

    Science.gov (United States)

    Lavu, Evelyn; Kave, Ellan; Mosoro, Euodia; Markby, Jessica; Aleksic, Eman; Gare, Janet; Elsum, Imogen A.; Nano, Gideon; Kaima, Petronia; Dala, Nick; Gurung, Anup; Bertagnolio, Silvia; Crowe, Suzanne M.; Myatt, Mark

    2017-01-01

    Introduction Papua New Guinea is a Pacific Island nation of 7.3 million people with an estimated HIV prevalence of 0.8%. ART initiation and monitoring are guided by clinical staging and CD4 cell counts, when available. Little is known about levels of transmitted HIV drug resistance in recently infected individuals in Papua New Guinea. Methods Surveillance of transmitted HIV drug resistance in a total of 123 individuals recently infected with HIV and aged less than 30 years was implemented in Port Moresby (n = 62) and Mount Hagen (n = 61) during the period May 2013-April 2014. HIV drug resistance testing was performed using dried blood spots. Transmitted HIV drug resistance was defined by the presence of one or more drug resistance mutations as defined by the World Health Organization surveillance drug resistance mutations list. Results The prevalence of non-nucleoside reverse transcriptase inhibitor transmitted HIV drug resistance was 16.1% (95% CI 8.8%-27.4%) and 8.2% (95% CI 3.2%-18.2%) in Port Moresby and Mount Hagen, respectively. The prevalence of nucleoside reverse transcriptase inhibitor transmitted HIV drug resistance was 3.2% (95% CI 0.2%-11.7%) and 3.3% (95% CI 0.2%-11.8%) in Port Moresby and Mount Hagen, respectively. No protease inhibitor transmitted HIV drug resistance was observed. Conclusions The level of non-nucleoside reverse transcriptase inhibitor drug resistance in antiretroviral drug naïve individuals recently infected with HIV in Port Moresby is amongst the highest reported globally. This alarming level of transmitted HIV drug resistance in a young sexually active population threatens to limit the on-going effective use of NNRTIs as a component of first-line ART in Papua New Guinea. To support the choice of nationally recommended first-line antiretroviral therapy, representative surveillance of HIV drug resistance among antiretroviral therapy initiators in Papua New Guinea should be urgently implemented. PMID:28146591

  1. The main clinical change detection and analysis of drug resistance of gram negative bacilli producing Ampc enzyme%临床主要革兰阴性杆菌产Ampc酶的检测与耐药性分析

    Institute of Scientific and Technical Information of China (English)

    文宏宇

    2013-01-01

    Objective Research and analysis the Gram-negative bacilli produced AMPC enzyme and drug resistance, Method 1767 strains of Gram-negative bacilli isolated from clinical were identified and analyzed the sensitivity,using cefoxitin three dismensional test.Result 437 stains produced AMPC enzyme were detected from 1767 strains of Gram-negative bacilli,the highest detection rate of AMPC strains were Escherichia cloacae、Enterobacter cloacae and Klebsiella pneumoniae. Conclusion The detection rate and resistance rate of the Gram-negative bacilli produced AMPC enzyme are rising,we should pay attention on the detection and monitoring drug resistance of the Gram-negative bacilli produced AMPC enzyme.%目的研究分析临床主要革兰阴性杆菌产Ampc酶情况及其耐药性。方法对临床分离的1767株主要革兰阴性杆菌进行鉴定及相关药敏分析,采用头孢西丁三维试验检测产Apmc酶菌株。结果1767株主要革兰阴性杆菌共检出产Ampc酶株437株,产Ampc酶菌株检出率较高的依次为大肠埃希菌、阴沟肠杆菌和肺炎克雷伯菌。结论产Ampc酶的革兰阴性杆菌的检出率和耐药率呈上升趋势,应重视对产Ampc酶菌株的检测及其耐药性监控。

  2. Strategies to overcome antineoplastic drug resistance

    NARCIS (Netherlands)

    Cirkel, GA

    2016-01-01

    This thesis focuses on various strategies to deal with cancer drug resistance and improve treatment efficacy. Technological advances have enabled researchers to gain more insight in the immense molecular complexity of cancer and mechanisms of drug resistance. The ability to measure cancer-related

  3. Extensively drug-resistant Streptococcus pneumoniae, South Korea, 2011-2012.

    Science.gov (United States)

    Cho, Sun Young; Baek, Jin Yang; Kang, Cheol-In; Kim, So Hyun; Ha, Young Eun; Chung, Doo Ryeon; Lee, Nam Yong; Peck, Kyong Ran; Song, Jae-Hoon

    2014-05-01

    To better understand extensively drug resistant Streptococcus pneumoniae, we assessed clinical and microbiological characteristics of 5 extensively drug-resistant pneumococcal isolates. We concluded that long-term care facility residents who had undergone tracheostomy might be reservoirs of these pneumococci; 13- and 23-valent pneumococcal vaccines should be considered for high-risk persons; and antimicrobial drugs should be used judiciously.

  4. Analysis on clinical distribution of Acinetobacter baumannii and drug resistance haracteristics during 2005-2013%2005~2013年鲍曼不动杆菌临床分布与耐药特征分析

    Institute of Scientific and Technical Information of China (English)

    卢赞; 胡大春; 刘德华; 任宝军; 伏改芬; 赵红燕

    2015-01-01

    目的:了解该院鲍曼不动杆菌临床分布特征及耐药率变迁情况,为临床合理用药和院内感染管理提供依据。方法回顾分析该院2005年1月至2013年12月检出的鲍曼不动杆菌,分析其科室分布、标本分布及耐药率变化情况。结果9年共分离出964株鲍曼不动杆菌,其中713株为多重耐药菌。2005~2008年分离量较少,分别为30株、26株、22株、19株。2009年和2010年开始增多,分别为65株和50株,2011年开始检出率剧增,2011~2013年分别为157株、229株、366株。9年中分离率最高的前三位科室为 ICU、神经外科和呼吸科,标本来源始终以呼吸道标本为主,分泌物标本其次,近几年来血液、尿液及引流液等标本检出率有所增加。13种药物耐药率总体呈上升趋势,至2013年部分药物耐药率有一定下降。结论鲍曼不动杆菌易引起院内感染且不易清除,在重症患者集中科室高发,呼吸道感染是其主要致病类型,耐药性严重,多重耐药和泛耐药菌株比例较高,临床应依据药敏结果合理用药,配合控感部门做好消毒隔离工作,防止院内感染爆发。%Objective To understand the clinical distribution characteristics of Acinetobacter baumannii in our hospital and the change situation of drug resistance rates to provide a basis for the clinical rational drug use and the nosocomial infection manage-ment.Methods The Acinetobacter baumannii strains isolated in our hospital from January 2005 to December 2013 were performed the retrospective analysis on its department distribution,specimen distribution and change of drug resistance rates.Results 964 strains of Acinetobacter baumannii were isolated during these 9 years,in which 713 strains were multi-drug resistant.The isolated strains were less during 2005 -2008,which were 30,26,22,19 strains respectively.The isolated strains began to increase during 2009-2010,which were 65,50 strains

  5. Study on Distribution and Drug Resistance of Clinical Isolates of Pathogenic Bacteria in Critical Care Medicine%重症医学临床分离病原菌分布及耐药性研究

    Institute of Scientific and Technical Information of China (English)

    杨亚娟

    2015-01-01

    Objective To study on distribution and drug resistance of clinical isolates of pathogenic bacteria in critical care medicine. Methods The research objects selected from April 2013 to April 2014, pathogenic bacteria isolated from intensive care unit were studied on distribution and drug resistance. Results The results showed that the gram negative bacteria ratio was 5.00%, gram positive bacteria accounted for 35.00%, fungus occupied 10.00%, and highest proportion of these strains was gram negative bacteria;pseudomonas aeruginosa vs polymyxin E sensitivity ratio was higher;Acinetobacter baumannii vs Imipenem, polymyxin E resistance rate was relatively low, which was statistically significant(P<0.05). The results show that the proportion of Gram-negative bacteria is 5.00%, Gram-positive bacteria accounted for 35.00%, accounted for 10.00%of fungi, which is the highest proportion of species of gram-negative bacteria;Pseudomonas aeruginosa bacteria Polymyxa vitamin E higher than the sensitivity to appear; and Acinetobacter baumannii to imipenem resistance rate of polymyxin E is relatively low, there is statistical significance (P<0.05). Conclusion In the intensive care unit, the more common pathogenic bacteria was gram negative bacilli, the drug resistance of this kind of pathogenic bacteria was very serious and the monitoring of their drug resistance should be enhanced continuously.%目的:研究重症医学临床分离病原菌分布及耐药性。方法该次研究对象选取2013年4月-2014年4月在该院重症监护病房中进行分离的病原菌的分布以及其耐药性进行探讨。结果研究结果表明,革兰阴性菌比例是5.00%,革兰阳性菌占35.00%,真菌占据10.00%,而这些菌种中比例最高的是革兰性阴性菌;铜绿假单胞菌对多黏菌素E敏感度先比显得较高;而鲍曼不动杆菌对亚胺培南、多黏菌素E的耐药率显得相对较低,差异有统计学的意义(P<0.05)。结论重症监护病房中

  6. Antifungal Drug Resistance - Concerns for Veterinarians

    Directory of Open Access Journals (Sweden)

    Bharat B. Bhanderi

    2009-10-01

    Full Text Available In the 1990s, there were increased incidences of fungal infectious diseases in human population which might be due to increase in immunosuppressive diseases. But the major concern was increase in prevalence of resistance to antifungal drugs which were reported both in the fungal isolates of human beings and that of animal origin. In both animals and human beings, resistance to antimicrobial agents has important implications for morbidity, mortality and health care costs, because resistant strains are responsible for bulk of infection in animals and human beings, and large number of antimicrobial classes offers more diverse range of resistance mechanisms to study and resistance determinants move into standard well-characterized strains that facilitates the detailed study of molecular mechanisms of resistance in microorganisms. Studies on resistance to antifungal agents has been lagging behind that of antibacterial resistance for several reasons, the foremost reason might be fungal agents were not recognized as important animal and human pathogens, until relatively in recent past. But the initial studies of antifungal drug resistance in the early 1980s, have accumulated a wealth of knowledge concerning the clinical, biochemical, and genetic aspects of this phenomenon. Presently, exploration of the molecular aspects for antifungal drug resistance has been undertaken. Recently, the focus was on several points like developing a more detailed understanding of the mechanisms of antimicrobial resistance, improved methods to detect resistance when it occurs, methods to prevent the emergence and spread of resistance and new antimicrobial options for the treatment of infections caused by resistant organisms. [Vet. World 2009; 2(5.000: 204-207

  7. Update on Antifungal Drug Resistance

    Science.gov (United States)

    Shor, Erika; Zhao, Yanan

    2015-01-01

    Invasive fungal infections remain a major source of global morbidity and mortality, especially among patients with underlying immune suppression. Successful patient management requires antifungal therapy. Yet, treatment choices are restricted due to limited classes of antifungal agents and the emergence of antifungal drug resistance. In some settings, the evolution of multidrug-resistant strains insensitive to several classes of antifungal agents is a major concern. The resistance mechanisms responsible for acquired resistance are well characterized and include changes in drug target affinity and abundance, and reduction in the intracellular level of drug by biofilms and efflux pumps. The development of high-level and multidrug resistance occurs through a stepwise evolution of diverse mechanisms. The genetic factors that influence these mechanisms are emerging and they form a complex symphony of cellular interactions that enable the cell to adapt and/or overcome drug-induced stress. Drivers of resistance involve a complex blend of host and microbial factors. Understanding these mechanisms will facilitate development of better diagnostics and therapeutic strategies to overcome and prevent antifungal resistance. PMID:26120512

  8. Highly reliable heterologous system for evaluating resistance of clinical herpes simplex virus isolates to nucleoside analogues.

    Science.gov (United States)

    Bestman-Smith, J; Schmit, I; Papadopoulou, B; Boivin, G

    2001-04-01

    Clinical resistance of herpes simplex virus (HSV) types 1 and 2 to acyclovir (ACV) is usually caused by the presence of point mutations within the coding region of the viral thymidine kinase (TK) gene. The distinction between viral TK mutations involved in ACV resistance or part of viral polymorphism can be difficult to evaluate with current methodologies based on transfection and homologous recombination. We have developed and validated a new heterologous system based on the expression of the viral TK gene by the protozoan parasite Leishmania, normally devoid of TK activity. The viral TK genes from 5 ACV-susceptible and 13 ACV-resistant clinical HSV isolates and from the reference strains MS2 (type 2) and KOS (type 1) were transfected as part of an episomal expression vector in Leishmania. The susceptibility of TK-recombinant parasites to ganciclovir (GCV), a closely related nucleoside analogue, was evaluated by a simple measurement of the absorbance of Leishmania cultures grown in the presence of the drug. Expression of the TK gene from ACV-susceptible clinical isolates resulted in Leishmania susceptibility to GCV, whereas expression of a TK gene with frameshift mutations or nucleotide substitutions from ACV-resistant isolates gave rise to parasites with high levels of GCV resistance. The expression of the HSV TK gene in Leishmania provides an easy, reliable, and sensitive assay for evaluating HSV susceptibility to nucleoside analogues and for assessing the role of specific viral TK mutations.

  9. Management and Prevention of Herpes Zoster in the Immunocompromised Inflammatory Bowel Disease Patient: A Clinical Quandary.

    Science.gov (United States)

    Côté-Daigneault, Justin; Peerani, Farhad; MacMahon, Eithne; Delaporte, Emmanuel; Rahier, Jean-François; Colombel, Jean-Frédéric

    2016-10-01

    Crohn's disease (CD) and ulcerative colitis (UC), the 2 main clinical phenotypes of inflammatory bowel disease (IBD), are diseases that result from a dysregulated immune response to gut microbiota in genetically susceptible hosts. This aberrant immune response may intrinsically predispose IBD patients to infectious complications. Moreover, immunosuppressive medications used to treat IBD including corticosteroids, thiopurines, methotrexate, calcineurin inhibitors, anti-tumor necrosis factor (anti-TNF) agents and other biologics, further increase patients' susceptibility to opportunistic infections. Herpes zoster (HZ), also known as shingles, is an opportunistic viral reactivation often observed in IBD patients with several case reports demonstrating complicated or disseminated disease in those on immunosuppression. While HZ vaccination is recommended in all immunocompetent adults aged ≥60 years, as a live virus vaccine, it is currently contraindicated in IBD patients on anti-TNF therapy and in other significantly immunocompromised patient groups. While caution is still warranted in these circumstances, recent clinical data has emerged which has prompted us to review and examine the universal approach to HZ vaccination in the immunosuppressed IBD population. In the following narrative review, we will discuss and provide an overview of the clinical manifestations, incidence, management and prevention of HZ in the IBD patient.

  10. 198株屎肠球菌的临床分布及耐药性分析%198 Strains of Excrement Enterococcus Clinical Distribution and Drug Resistance Analysis

    Institute of Scientific and Technical Information of China (English)

    吴小娟; 汪泓

    2013-01-01

    Objective To understand the nosocomial Enterococcus faecium(EFM) clinical distribution and drug resistance,and provide reference for rational use of antibacterial drugs and clinical treat-ment. Methods The clinical isolates of Enterococcus faecium were cultured and identified, using disk diffusion method (K-B) for drug sensitivity test. Results 198 isolates of Enterococcus faeci-um, mainly from urine, sputum and stool samples, accounted for 50%,30.8% and 7.6%,were main-ly isolated from intensive care unit(ICU), and Respiratory Department of Internal Medicine Depart-ment of urology. Antimicrobial resistance in Enterococcus faecium, resistance to vancomycin, te-icoplanin is a low rate, respectively 1% and 2.5%. Enterococcus faecium to linezolid sensitive rate is 100%.Conclusions Enterococcus faecium clinical types can cause infection, and the multi drug resistance rate high, difficult to treat, should arouse more attention in clinic.%目的:了解医院屎肠球菌(EFM)的临床分布及耐药状况,为临床治疗与合理使用抗菌药物提供参考。方法将临床分离的屎肠球菌进行培养鉴定,采用纸片扩散法(K-B法)进行药物敏感试验。结果分离到198株屎肠球菌,主要来自于尿液、痰液和粪便标本,分别占50.0%、30.8%和7.6%,标本主要分离于重症监护病房(ICU)、泌尿外科和呼吸内科。屎肠球菌对多种抗菌药物耐药,对万古霉素、替考拉宁的耐药率较低,分别为1.0%和2.5%。屎肠球菌对利奈唑胺敏感率为100%。结论屎肠球菌可引起临床各类感染,且多耐药率高,治疗困难,应引起临床高度重视。

  11. Analysis on infection clinical distribution and drug resistance of acinetobacter baumannii%鲍曼不动杆菌感染的临床分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    罗祥文; 汤小燕

    2012-01-01

    目的 了解鲍曼不动杆菌的临床分布及其对常用抗生素的耐药情况.方法 收集我院2007年7月至2010年7月的临床标本,进行鲍曼不动杆菌分离培养及药敏试验.结果 3年共分离出鲍曼不动杆菌373株,在临床标本中,痰液分布率最高,占78.6%,感染分布以ICU为主,占36.2%.药敏试验显示对碳青霉烯类、含酶抑制剂、多粘菌素E敏感性较高,对氨基糖苷类、喹诺酮类、β-内酰胺类耐药率较高,多重耐药性明显.结论 鲍曼不动杆菌主要侵犯ICU患者、慢性呼吸系统疾病患者及术后感染者.%Objective To investigate the infection clinical distribution and drug resistance of acinetobacter baumannii, and to offer an aid for clinical therapy and control of hospital-acquired infection. Methods The clinical specimens were collected from July 2007 to July 2010 for performing isolation, culture and sensitivity test to Acinetobacter baumannii. Results 373 strains of Acinetobacter baumannii were isolated in three years, whose dietribution was the highest in the sputum(78. 6% ). The infection distribution was major in the intensive care unit (ICU), accounting for 36. 2%. It was showed that the sensitive drugs of Acinetobacter baumannii were carbapenems.and inhibitor, polymyxin E.and resistant drugs of Acinetobacter baumannii were aminoglycosides,quinolones,and bets-lactamases. Moreover, these strains showed multi-drug resistance. Conclusion Acinetobacter baumannii mainly offended the patients in ICU and with chronic respiratory diseases and postoperative infection. Therefore, laboratories should be strengthened to analyze the resistant strains of Acinetobacter baumannii in wards, especially the ICU wards and drug sensitivity monitoring to provide relevant information in time, and antibiotics should be used rationally so as to enhance clinical therapeutic efficacy.

  12. 重症监护病房鲍曼不动杆菌临床分布特征及耐药性变迁分析%Clinical distribution and drug resistance of Acinetobacter baumannii in intensive care unit

    Institute of Scientific and Technical Information of China (English)

    阮建锋; 林红燕; 钟韵

    2016-01-01

    Objective:o investigate the distribution of Acinetobacter baumannii in an intensive care unit ( ICU)and its resistance to common antibiotics. Methods:Samples of clinically isolated pathogens from ICU of Second Affiliated Hospital of Guangzhou Medical University between 2012 and 2014 were collected. We reviewed the characteristics of species distribution and sample sources,and analyzed the changing rate of drug resistance of Acinetobacter baumannii in our ICU with comparison with overall drug resistance rate of Acinetobacter baumannii in our hospital. Results:Of the 1322 bacteria strains detected from ICU,Acinetobacter baumannii strains ranked first in number(751,56.81%),with 617 strains(82.16%)isolated from sputum or bronchial aspirates. Between 2012 and 2014,the ICU-isolated Acinetobacter baumannii strains showed steadily increasing resistance to piperacillin and other 16 kinds of antibitics( P<0.05). Up to the second half of 2014,the drug resistance rates of Acinetobacter baumannii to the 17 kinds of antibiotics were above 80%;in particular,the resistant rate to cefoperazone was the highest of all,up to 100%. The resistance rates of ICU-isolated Acinetobacter baumannii to the 17 kinds of antibiotics were higher than the overall resistance rates of those isolated in our hospital( P<0.05). Conclusion:The drug resistance rate of Acinetobacter baumannii appears arduous. Measures to prevent nosocomial infections and promote rational use of antibiotics should be observed;otherwise,given persistently increasing trend of drug resistance,there would be no antibiotics available to combat multi-drug resistant Acinetobacter baumannii in the future.%目的:探讨ICU内鲍曼不动杆菌分布特征及其对常用抗菌药物耐药性。方法:收集2012—2014年广州医科大学附属第二医院ICU临床标本分离的致病菌,描述致病菌株的菌种分布特征以及标本来源分布特征,分析ICU鲍曼不动杆菌耐药率的变迁,比较ICU与全院

  13. 307例鲍氏不动杆菌的临床分布与耐药性分析%Analysis of Clinical Distribution and Drug Resistance of Acinetobacter Baumannii in 307 Cases

    Institute of Scientific and Technical Information of China (English)

    丁淑红; 穆金智

    2016-01-01

    目的:了解分析鲍氏不动杆菌感染的临床分布特点及对各种抗菌药物的耐药性,为临床合理应用抗菌药物及治疗提供科学的依据。方法:回顾性调查2014年1-12月确诊为鲍氏不动杆菌感染的病例,按照全国临床检验规程进行分离,并采用美国临床实验室标准化研究所(CLSI)推荐的K-B法进行药敏试验。结果:共分离出307株鲍氏不动杆菌,来自临床送检的各类标本,以痰标本分离率最高,占90.55%,其次分别是清洁中段尿、分泌物,分别占6.84%、1.63%;鲍氏不动杆菌对米诺环素、头孢哌酮/舒巴坦、美罗培南的耐药率较低,分别为3.91%、5.86%、7.17%;307株鲍氏不动杆菌主要分布于内科系统,其中呼吸内科90株,占29.32%;其次是神经内科62株,占20.20%;老年病科56株,占18.24%;ICU50株,占16.29%;胸外科34株,占11.07%;其他15株,占4.89%。结论:鲍氏不动杆菌是医院感染的常见致病菌之一,应加强鲍氏不动杆菌的耐药性监测,把握其耐药趋势,纠正不合理使用抗生素现象,积极采取有效的控制措施,避免出现泛耐药的超级细菌。%Objective:To understand and analyze the clinical distribution and drug resistance of acinetobacter baumannii in order to provide scientific basis for the clinical rational use of antibacterial drugs and treatment.Method:The cases who were diagnosed with infection of acinetobacter baumannii from January 2014 to December 2014 were investigated retrospectively.The bacteria was separated according to the national clinical inspection procedures.K-B method recommended by American clinical laboratory standardization institute(CLSI) was used for drug sensitive test.Result:A total of 307 strains of acinetobacter baumannii were isolated.They were from all kinds of clinical specimens,the separation rate of the sputum specimen was the highest,accounted for 90.55%,the following was clean

  14. Clinical Characteristics and Outcomes in a Population With Disseminated Herpes Zoster: A Retrospective Cohort Study.

    Science.gov (United States)

    Bollea-Garlatti, M L; Bollea-Garlatti, L A; Vacas, A S; Torre, A C; Kowalczuk, A M; Galimberti, R L; Ferreyro, B L

    2017-03-01

    Shingles is the cutaneous expression of the reactivation of latent varicella zoster virus infection in sensory ganglia. It presents as vesicles in the corresponding dermatome. The condition is called disseminated herpes zoster (DHZ) when more than 2 contiguous dermatomes are affected, more than 20 vesicles are observed outside the initial dermatome, or involvement is systemic. DHZ is rare and most frequently occurs in immunocompromised patients. To describe the epidemiology, predisposing factors, clinical presentation, laboratory findings, and clinical course of patients with DHZ, and to compare the findings in immunocompromised and immunocompetent patients. We analyzed a retrospective case series of adults hospitalized between February 2010 and October 2015. Forty-one patients with virologically confirmed manifestations of DHZ were included. Stress as a trigger factor was detected in 39% and immunodepression in 58.5%. Immunocompromised patients were younger than the immunocompetent patients (mean ages, 60.5 vs 82 years, P.01). Six patients died; there was no difference in mortality between the 2 groups. This study provides evidence on the relationship between DHZ, the presence of underlying immunodepression, and complications. Immunosenescence may play an important role in the onset of this disease in older immunocompetent patients. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. 肠球菌属细菌368株临床分布及耐药性分析%Clinical distribution and drug resistance of 368 strains of Enterococcus

    Institute of Scientific and Technical Information of China (English)

    韩兰芳

    2014-01-01

    目的 了解肠球菌属细菌在临床标本中的分布及对常用抗菌药物的耐药性,指导临床合理选择抗菌药物.方法 对2011年1月至2012年12月各临床标本中分离的368肠球菌属的细菌菌种分布及药敏结果进行回顾性分析.结果 368株肠球菌属细菌中屎肠球菌213株,占58.0%;粪肠球菌145株,占39.3%;鹑鸡肠球菌4株,占1.1%;铅黄肠球菌3株,占0.8%;耐久肠球菌3株,占0.8%.肠球菌属细菌主要分离自尿液、血液、切口分泌物中,检出率分别为53.0%、13.6%、12.2%.粪肠球菌对红霉素、环丙沙星、喹奴普汀/达福普汀和利福平的耐药性较高,耐药率均>60%,而对青霉素、氨苄西林的耐药率则<20%;屎肠球菌对青霉素、氨苄西林、红霉素、环丙沙星、利福平、左氧氟沙星的耐药率均>95%,而对喹奴普汀/达福普汀和四环素耐药率较低,分别为11.3%和35.6%;两种肠球菌对万古霉素、替考拉宁、利奈唑胺的耐药率均<2%.结论 肠球菌属细菌对抗茵药物的耐药性较高,而且屎肠球菌和粪肠球菌的耐药性明显不同,临床治疗时应根据菌株类别和药敏结果合理用药,尽量减少耐药菌株的产生.%Objective To investigate the distribution of Enterococcus in clinical specimens and their drug resistance to commonly used antibiotics,in order to guide the reasonable selection of antibiotics in clinics.Methods Retrospective analysis was performed with the bacterial distribution and antimicrobial susceptibility results of 368 strains of Enterococcus which were isolated clinically during January 2011 to December 2012.Results Among the 368 strains of Enterococcus,there were 213 strains(58.0%) of Enterococcus faecium,145 strains(39.3%) of Enterococcus faecalis,4 strains(1.1%) of Enterococcus gallimarum,3 strains(0.8%) of Enterococcus casseliflavus,3 strains(0.8%) of Enterococcus durans.The strains were mainly isolated from urine

  16. 金黄色葡萄球菌的临床分布特点及耐药性分析%Clinical distribution and drug-resistant analysis of Staphylococcus aureus

    Institute of Scientific and Technical Information of China (English)

    陈晓南; 唐海飞

    2011-01-01

    目的:了解本地区金黄色葡萄球菌的临床分布特点和耐药性,为临床抗感染治疗提供依据.方法:对2009年本院患者标本中分离的224株金黄色葡萄球菌进行标本分布、科室分布、耐药性等统计分析.结果:224株金黄色葡萄球菌主要分离自痰液、脓液等标本,科室分布以外科和儿科为主,MRSA的检出率为55.4%.未检出利奈唑胺和万古霉素耐药的菌株,耐药率较低的抗菌药物为呋喃妥因和利福平,耐药性较高的抗菌药物依次为青霉素G、复方新诺明、红霉素.MRSA的耐药率均显著高于MSSA.结论:金黄色葡萄球菌是本地区的重要病原菌,临床分布广、耐药性强,临床应根据药敏试验的结果合理使用抗生素.%Objective:To analyze clinical distribution state and drug resistance feature in Staphylococcus aureus in our region in order to guide clinical application of antibiotics reasonably.Methods: 224 strains of Staphylococcus aureus isolated from patients with infection during 2009 were identified and their drug resistance were analyzed.Results: Total 224 strains of Staphylococcus aureus were mainly isolated from sputum and abscess samples and surgery and paediatrics departments.The isolating rate of methicillin resistant Staphylococcus aureus(MRSA) was 55.4% but it was not found for Staphylococcus aureus isolates resistant to linezolid and vancomycin.Furthermore, the antibiotics with lower resistant rate were nitrofurantoin and rifampin and the antibiotics with higher resistant rate were penicillin, trimethoprim - sulfamethoxazole, and erythrocin, respectively.The resistance to antibiotics of MRSA was higher than MSSA ( methicillin sensitive Staphylococcus aureus) Conclusion: With wide clinical distribution and high antibiotics resistance,Staphylococcus aureus is one of the main pathogens in our region.As a result,it is very important to apply antibiotics reasonably according to antimicrobial susceptibility test.

  17. Analysis of Clinical Lower Respiratory Infection Pathogenic Bacteria Species and Drug Resistance in A Hospital%某院临床下呼吸道感染病原菌种类及耐药性的分析

    Institute of Scientific and Technical Information of China (English)

    孙凤国

    2015-01-01

    Objective To understand and grasp our hospital in 2013 clinical lower respiratory infection pathogenic bacteria species and drug resistance, to guide clinical rational drug use.Methods The BD phoenix 100 automatic bacteria identification application database data in 2013 and drug susceptibility testing system WHONET5.5 retrospective statistical analysis of bacterial drug resistance monitoring software.Results Gram-negative bacteria 60.42%;Gram-positive bacteria 9.98%; Fungi was 29.60%. Gram-negative bacteria klebsiella pneumoniae in 31.01%, 13.62% E. coli, pseudomonas aeruginosa 7.83%; Gram positive bacterium staphylococcus aureus 54.39%, streptococcus pneumoniae 22.81%; Fungi white candida yeast 55.03%, and 31.95% tropical candida.Conclusions The lower respiratory tract infection is given priority to with gram-negative bacteria 60.42%, klebsiella pneumoniae detection rate is highest, its to amoxicillin/clavulanic acid, piperacillin, ampicillin/shu ba present high drug resistance. E. coli resistance, resistance to an average of 33.68%. Gram-positive bacteria infection is given priority to with staphylococcus aureus, sugar peptide, pbo alkane ketone is still the most effective treatment of gram-positive bacteria infection. Bacteria merged fungi double infection should not be ignored, to strengthen the resistant monitoring and to guide clinical rational drug use.%目的:了解并掌握2013年我院临床下呼吸道感染病原菌种类及耐药性,指导临床合理用药。方法美国BD phoenix 100全自动细菌鉴定药敏检测系统数据库2013年数据并应用WHONET5.5细菌耐药监测软件进行回顾性统计分析。结果革兰阴性菌60.42%;革兰阳性菌9.98%;真菌29.60%。革兰阴性菌中肺炎克雷伯菌31.01%,大肠埃希菌13.62%,铜绿假单胞菌7.83%;革兰阳性菌中金黄色葡萄球菌54.39%,肺炎链球菌22.81%;真菌中白假丝酵母菌55.03%,热带假丝酵母菌31.95%。结论下呼吸道

  18. 凝固酶阴性葡萄球菌分布及耐药变迁%Drug-resistance of coagulase negativeStaphylococcus isolated clinically in our hospital these years

    Institute of Scientific and Technical Information of China (English)

    李霞

    2008-01-01

    目的 探讨凝固酶阴性葡萄球菌(CNS)感染分布及其耐药趋势与变迁,为临床治疗CNS感染提供正确选药依据.方法 收集本院2001~2003年484株CNS与2004~2007年问512株CNS进行对比分析,采用Kirby-Bauer法进行药敏试验,高盐琼脂扩散法对苯唑西林耐药的菌株作耐甲氧西林葡萄球菌(MRS)测定,按临床实验室标准化委员会(CLSI/LNCCLS)2007年标准判断结果.结果 996株凝固酶阴性葡萄球菌中,未发现万古霉素耐药菌株,分别对青霉素、红霉素、苯唑青霉素、阿莫两林/克拉维酸、克林霉素、头孢唑啉、头孢曲松、头孢吡肟等抗生素耐药率均大于70%;两组比较差异有统计学意义(P0.05).结论 近3年临床分离的CNS耐药谱与前3年相比,有很大的改变.临床医生应根据实验室药敏结果,合理使用抗生素,有效控制凝固酶阴性葡萄球菌的感染.%Objective To investigate the distribution and the characteristics of drug resista-nce of coagulase negative Staphylococcus,and to provide the reference for properly choosi-ng antibiotic therapy of coagulase negative Staphylococcal infecs.Methods Contrasted 484 coagulase negative Staphylococcus(CNS) species isolated in hospital from 2001 to 2003 and 512 species from 2004 to 2007.Nosocomial CNS was identified and then drug resistance test was performed by K-B method,Nitrocefin method was utilized to detect β-lactamase.Clinical and Laboratory Standards Institute.Perfor-mance Standards forantimicro-bial susceptibility testing;Fifteenth information supplement.CLSI/NCCLS document M100-S17[J].Clinical and Laboratory Standards.Results The drug-resistant rate of.CNS to penicillin,erythromycin,oxacillin,amoxicillin/clavulanate,clindamycin,cepzolin,ceftriaxone and cefepime was high(>70%),whereas that to rifampin,nitrofurantoin,amikacin,tetracycline and trimetholvrim/sulfamethoxazole was low(<50%).No drug-resistant CNS strains to vancomyein were found.Conclusions,and no

  19. Analysis of clinical characteristics and drug resistance of 224 strains of Acinetobacter baumannii infection%224例鲍曼不动杆菌感染的临床特征及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    徐薛芬; 徐爱晖

    2013-01-01

    目的 了解我院224例鲍曼不动杆菌感染的临床特征及耐药性.方法 采用常规方法进行细菌培养、菌株鉴定及药敏检测.结果 201名患者共分离出224株鲍曼不动杆菌,患者主要集中在ICU(33.8%)、外科(25.9%)、呼吸内科(14.4%)、骨科(6.1%),基础疾病以呼吸系统疾病(64.2%)、心血管系统疾病(30.8%)、神经系统疾病(29.8%)及糖尿病(22.9%)多见,与手术治疗及有创检查治疗(56.7%)、联合使用≥2种抗生素(80.6%)及使用时间≥15天(38.8%)可能存在相关性.224株鲍曼不动杆菌对米诺环素敏感性最高(66.1%),对美罗培南、氨苄西林/舒巴坦、头孢哌酮/舒巴坦敏感性超过55%.结论 鲍曼不动杆菌感染与患者有基础疾病、有创性检查治疗及使用广谱抗生素及时间过长有关,其耐药情况严重,多重耐药及泛耐药菌株日益增多,目前对米诺环素、舒巴坦、碳青酶烯类抗生素仍保持相对敏感性,临床应根据药敏结果合理选择使用抗生素.%Objective To investigate the clinical charateristics of infection of 224 Acinetobacter baumannii strains, and to analyze drug resistance of Acinetobacter baumannii strains. Methods The isolation of the bacterium was conducted according to the microorganical method of CLSI ( Clinical and Laboratory Standards Institute ). American DATE Company MicroScan Walkway-40 automatic analyzer was applied to identification and drug susceptibility test. Drug resistance was calculated with WH0NET5. 4 soitware. Results A total of 224 strains of Acinetobacter baumannii were isolated from 201 patients. The patients were mainly from ICU( intensive care uint) ( 33. 8% ), department of surgery ( 25. 9% ), department of respiratory medicine ( 14. 4% ), department of orthopedics ( 6. 1% ). Common underlying diseases were pulmonary diseases ( 64. 2% ), cardiovascular diseases ( 30. 8% ), diseases of nervous system ( 29. 8% ) and diabetes ( 22. 9% ). 56. 7% of the patients had

  20. Clinical characteristics of hypertrophic herpes simplex genitalis and treatment outcomes of imiquimod: a retrospective observational study

    Directory of Open Access Journals (Sweden)

    Charussri Leeyaphan

    2015-04-01

    Conclusions: Atypical manifestations of herpes simplex genitalis require careful consideration because their frequency is rising, particularly in patients with HIV infection. Although acyclovir is important in their treatment, imiquimod provides an additional benefit in resistant cases.

  1. Leukemia stem cells in drug resistance and metastasis

    Institute of Scientific and Technical Information of China (English)

    DENG Chao-hua; ZHANG Qiu-ping

    2010-01-01

    Objective To review the central role of leukemia stem cells (LSCs) in drug resistance and metastasis, aiming to provide key insights into leukemogenic pathology and developing novel therapeutic strategies against the relapse of leukemia.Data sources The data used in this review were obtained mainly from the studies reported in PubMed using the key terms "tumor-initiating cells", "leukemia stem cells", "drug resistance" and "metastasis".Study selection Relevant articles on studies of leukemia stem cells were selected.Results Increasing numbers of studies have suggested the importance of cancer stem cells (CSCs) in the initiation and maintenance of cancer, especially in leukemia. This review has summarized the origin, characteristics, isolation and identification of LSCs. It highlights the crucial role of LSCs in drug resistance and metastasis of leukemia by illustrating possible mechanisms and aims to provide novel therapeutic strategies for LSCs-targeted treatment.Conclusion LSCs play a crucial role in drug resistance and metastasis of leukemia and new promising LSCs-targeted therapies warrant investigation in both experimental models and clinical practice.

  2. Epigenetic strategies to reverse drug resistance in heterogeneous multiple myeloma.

    Science.gov (United States)

    Issa, Mark E; Takhsha, Farnaz Sedigheh; Chirumamilla, Chandra Sekhar; Perez-Novo, Claudina; Vanden Berghe, Wim; Cuendet, Muriel

    2017-01-01

    Multiple myeloma (MM) is a hematological malignancy, which remains incurable because most patients eventually relapse or become refractory to current treatments. Due to heterogeneity within the cancer cell microenvironment, cancer cell populations employ a dynamic survival strategy to chemotherapeutic treatments, which frequently results in a rapid acquisition of therapy resistance. Besides resistance-conferring genetic alterations within a tumor cell population selected during drug treatment, recent findings also reveal non-mutational mechanisms of drug resistance, involving a small population of "cancer stem cells" (CSCs) which are intrinsically more refractory to the effects of a variety of anticancer drugs. Other studies have implicated epigenetic mechanisms in reversible drug tolerance to protect the population from eradication by potentially lethal exposures, suggesting that acquired drug resistance does not necessarily require a stable heritable genetic alteration. Clonal evolution of MM cells and the bone marrow microenvironment changes contribute to drug resistance. MM-CSCs may not be a static population and survive as phenotypically and functionally different cell types via the transition between stem-like and non-stem-like states in local microenvironments, as observed in other types of cancers. Targeting MM-CSCs is clinically relevant, and different approaches have been suggested to target molecular, metabolic and epigenetic signatures, and the self-renewal signaling characteristic of MM CSC-like cells. Here, we summarize epigenetic strategies to reverse drug resistance in heterogeneous multiple myeloma.

  3. Herpes - oral

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000606.htm Herpes - oral To use the sharing features on this page, ... 374. Read More Atopic dermatitis Cancer Fever Genital herpes Mouth ulcers Vesicles Review Date 8/14/2015 Updated ...

  4. Hsp90 governs dispersion and drug resistance of fungal biofilms.

    Directory of Open Access Journals (Sweden)

    Nicole Robbins

    2011-09-01

    Full Text Available Fungal biofilms are a major cause of human mortality and are recalcitrant to most treatments due to intrinsic drug resistance. These complex communities of multiple cell types form on indwelling medical devices and their eradication often requires surgical removal of infected devices. Here we implicate the molecular chaperone Hsp90 as a key regulator of biofilm dispersion and drug resistance. We previously established that in the leading human fungal pathogen, Candida albicans, Hsp90 enables the emergence and maintenance of drug resistance in planktonic conditions by stabilizing the protein phosphatase calcineurin and MAPK Mkc1. Hsp90 also regulates temperature-dependent C. albicans morphogenesis through repression of cAMP-PKA signalling. Here we demonstrate that genetic depletion of Hsp90 reduced C. albicans biofilm growth and maturation in vitro and impaired dispersal of biofilm cells. Further, compromising Hsp90 function in vitro abrogated resistance of C. albicans biofilms to the most widely deployed class of antifungal drugs, the azoles. Depletion of Hsp90 led to reduction of calcineurin and Mkc1 in planktonic but not biofilm conditions, suggesting that Hsp90 regulates drug resistance through different mechanisms in these distinct cellular states. Reduction of Hsp90 levels led to a marked decrease in matrix glucan levels, providing a compelling mechanism through which Hsp90 might regulate biofilm azole resistance. Impairment of Hsp90 function genetically or pharmacologically transformed fluconazole from ineffectual to highly effective in eradicating biofilms in a rat venous catheter infection model. Finally, inhibition of Hsp90 reduced resistance of biofilms of the most lethal mould, Aspergillus fumigatus, to the newest class of antifungals to reach the clinic, the echinocandins. Thus, we establish a novel mechanism regulating biofilm drug resistance and dispersion and that targeting Hsp90 provides a much-needed strategy for improving

  5. 261株鲍曼不动杆菌临床分布及耐药性分析%Clinic distribution and drug resistance of 261 strains of Acinetobacter baumannii

    Institute of Scientific and Technical Information of China (English)

    廖娟; 方凤; 林如风

    2015-01-01

    Objective To investigate the resistance status of 261 strains of Acinetobacter baumannii detected in our hospital from August 2012 to July 2014, and provide basis for the clinical treatment of Acinetobacter baumannii infection. Methods Iso-lated bacteria were separated from kinds of clinical specimen including sputum, pus, secretions, urine, blood and purulent fluid of patients from August 2012 to July 2014. They were cultured by routine methods, also identified and performed drug susceptibility testing by automatic analysis system VITEK 2 compact. The drug resistance and its distribution of Acinetobacter baumannii were conducted by WHONET 5.6 software. Results A total of 261 stains of Acinetobacter baumannii were isolated, among them, there were 141 stains of multidrug resistant (54.0%) were identified, with 83 strains of multidrug resistant Acinetobacter baumannii were identified from ICU and respiratory department. Conclusion The drug resistance of Acinetobacter baumannii was serious, espe-cially the specimen separaed from ICU and respiratory department. It is essential to strengthen testing for the drug resistant of Acinetobacter baumannii, and to reasonably use antibiontics according to the bacterial drug sensitivity testing results by clinicians, as well as monitoring hospital infection, and isolating patients to perventiatrogenic transmission.%目的:对本院2012年8月至2014年7月检出的261株鲍曼不动杆菌进行耐药性分析,为临床治疗鲍曼不动杆菌感染提供依据。方法按常规方法进行细菌培养,检测本院2012年8月至2014年7月间送检的各种临床标本(包括痰液、脓液、分泌物、尿液、血液和引流液等),应用VITEK-2 Compact 全自动微生物分析系统对临床分离的病原菌进行鉴定和药敏试验,利用WHONT 5.6软件分析鲍曼不动杆菌的耐药性及其分布。结果共检出261株鲍曼不动杆菌,其中多重耐药菌141株(54.0%),83株多重耐药鲍曼不动

  6. 耐甲氧西林金黄色葡萄球菌的临床感染特点及耐药特性%Characteristics of clinical infections caused by meticillin-resistant Staphylococcus aureus and its drug resistance

    Institute of Scientific and Technical Information of China (English)

    张淑敏; 朱熠; 陈旭; 李辉; 娜依兰; 邹建文; 吴燕子

    2012-01-01

    目的 了解耐甲氧西林金黄色葡萄球菌(MRSA)感染状况,为有效预防与控制多药耐药菌医院感染及合理使用抗菌药物奠定基础.方法 前瞻性调查方法,由医院感染专职人员定期到微生物实验室获取培养阳性结果,深入临床了解患者用药、消毒隔离措施及医务人员个人防护措施落实情况;并对临床感染资料和病原菌耐药性进行统计分析.结果 2009年11月-2010年12月共分离出126株金黄色葡萄球菌,其中86株为耐甲氧西林金黄色葡萄球菌;医院感染病例中ICU感染病例占70.83%;MRSA仅对磺胺甲噁唑/甲氧苄啶、替考拉宁、万古霉素、喹奴普汀/达福普汀有较高的敏感率,分别为93.02%、97.67%、96.51%、93.02%.结论 MRSA医院感染率有明显上升趋势,且呈多耐药性;应加强多药耐药菌的医院感染预防与控制工作,积极开展多药耐药菌的主动筛查工作,做到早发现、早隔离、早治疗;提高MRSA的治愈率,减少MRSA的医院感染和死亡率.%OBJECTIVE To investigate the infection caused by meticillin-resistant Staphylococcus aureus (MRSA) for effective prevention and control of nosocomial infection caused by multiple drug resistant bacteria and rational use of antimicrobial agents. METHODS Prospective investigation was carried out. Cultivate positive results were collected for further understanding of the medication of patients, disinfection measures and protection for medical personnel individual in clinic. And the clinical infection data and drug-resistant pathogens were obtained for statistical analysis. RESULTS In the 126 isolated strains of S. Aureus from Nov. 2009 to Dec. 2010, 86 strains were MRSA, with ICU infection accounting for 70. 83% of the total nosocomial infection cases. MRSA only had high sensitivity to SMZ(93. 02%), teicoplantin (97. 67%), vancomycin (96. 51%) and Canute quetiapine leptin/ dalfopristin (93. 02%). CONCLUSION MRSA nosocomial

  7. Plasmodium falciparum drug resistance in Angola.

    Science.gov (United States)

    Fançony, Cláudia; Brito, Miguel; Gil, Jose Pedro

    2016-02-09

    Facing chloroquine drug resistance, Angola promptly adopted artemisinin-based combination therapy as the first-line to treat malaria. Currently, the country aims to consolidate malaria control, while preparing for the elimination of the disease, along with others African countries in the region. However, the remarkable capacity of Plasmodium to develop drug resistance represents an alarming threat for those achievements. Herein, the available, but relatively scarce and dispersed, information on malaria drug resistance in Angola, is reviewed and discussed. The review aims to inform but also to encourage future research studies that monitor and update the information on anti-malarial drug efficacy and prevalence of molecular markers of drug resistance, key fields in the context and objectives of elimination.

  8. GENOTYPE AND DRUG RESISTANCE OF CLINICAL AND ENVIRONMENTAL VIBRIO CHOLERAE NON-O1/NON-O139 IN NORTHEASTERN THAILAND.

    Science.gov (United States)

    Chomvarin, Chariya; Jumroenjit, Warin; Tangkanakul, Waraluk; Hasan, Nur A; Chaicumpar, Kunyaluk; Faksri, Kiatichai; Huq, Anwar

    2014-11-01

    A total of 124 V cholerae non-O1/non-O139 isolates were collected in Khon Kaen, Thailand from diarrheal patients, asymptomatic carriers and environmental water. The presence of virulence-associated and regulatory genes including ctxA, tcpA, zot, ace, ompU, stn, hlyA and toxR) were examined using multiplex PCR. The genomic diversity of the various V. cholerae isolates were differentiated using the random amplified polymorphic DNA (RAPD) method. Antimicrobial susceptibility was tested using disk diffusion. All of V. cholerae non-O/non-O139 isolates carried hlyA and toxR and none carried ctxA and tcpA. The zot, ace and both genes together were found in 1.6%, 4.7% and 4.7% of 64 clinical V. cholerae non-O1 isolates, respectively, while the environmental ones did not. The stn gene was found in 3.1% (2/64) of the clinical and 3.3% (2/60) of the environmental isolates. The RAPD patterns were differentiated into 45 types (A to 2S). RAPD type A (32.3%) was the most frequently found in both clinical and environmental V cholerae non-O1 strains (34.4% and 30.0%, respectively); indicating that there was a clonal relationship between some clinical and environmental isolates whereas almost all of the environmental isolates belonged to different clones. All strains were sensitive to ciprofloxacin and norfloxacin. The environmental isolates (30%) were more resistant than the clinical ones (21.9%). Resistance to sulfamethoxazole/trimethoprim and tetracycline among the clinical isolates occurred in 9.4% (6/64) in 2007, during which period the prevalence of V cholerae O1 increased. We conclude that V. cholerae non-O1/non-O139 from the aquatic environment are potentially pathogenic and this same aquatic environment may be a source of antimicrobial resistance in V. cholerae.

  9. Disinfectant-susceptibility of multi-drug-resistant Mycobacterium tuberculosis isolated in Japan

    Directory of Open Access Journals (Sweden)

    Noriko Shinoda

    2016-02-01

    Full Text Available Abstract Background Multi-drug-resistant Mycobacterium tuberculosis has been an important problem in public health around the world. However, limited information about disinfectant-susceptibility of multi-drug-resistant strain of M. tuberculosis was available. Findings We studied susceptibility of several Japanese isolates of multi-drug-resistant M. tuberculosis against disinfectants, which are commonly used in clinical and research laboratories. We selected a laboratory reference strain (H37Rv and eight Japanese isolates, containing five drug-susceptible strains and three multi-drug-resistant strains, and determined profiles of susceptibility against eight disinfectants. The M. tuberculosis strains were distinguished into two groups by the susceptibility profile. There was no relationship between multi-drug-resistance and disinfectant-susceptibility in the M. tuberculosis strains. Cresol soap and oxydol were effective against all strains we tested, regardless of drug resistance. Conclusions Disinfectant-resistance is independent from multi-drug-resistance in M. tuberculosis. Cresol soap and oxydol were effective against all strains we tested, regardless of drug resistance.

  10. Higher Desolvation Energy Reduces Molecular Recognition in Multi-Drug Resistant HIV-1 Protease

    Directory of Open Access Journals (Sweden)

    Ladislau C. Kovari

    2012-05-01

    Full Text Available Designing HIV-1 protease inhibitors that overcome drug-resistance is still a challenging task. In this study, four clinical isolates of multi-drug resistant HIV-1 proteases that exhibit resistance to all the US FDA-approved HIV-1 protease inhibitors and also reduce the substrate recognition ability were examined. A multi-drug resistant HIV-1 protease isolate, MDR 769, was co-crystallized with the p2/NC substrate and the mutated CA/p2 substrate, CA/p2 P1’F. Both substrates display different levels of molecular recognition by the wild-type and multi-drug resistant HIV-1 protease. From the crystal structures, only limited differences can be identified between the wild-type and multi-drug resistant protease. Therefore, a wild-type HIV-1 protease and four multi-drug resistant HIV-1 proteases in complex with the two peptides were modeled based on the crystal structures and examined during a 10 ns-molecular dynamics simulation. The simulation results reveal that the multi-drug resistant HIV-1 proteases require higher desolvation energy to form complexes with the peptides. This result suggests that the desolvation of the HIV-1 protease active site is an important step of protease-ligand complex formation as well as drug resistance. Therefore, desolvation energy could be considered as a parameter in the evaluation of future HIV-1 protease inhibitor candidates.

  11. Emergence of Extensively Drug Resistant Tuberculosis

    Centers for Disease Control (CDC) Podcasts

    2007-03-01

    Extensively drug-resistant tuberculosis (XDR TB) outbreaks have been reported in South Africa, and strains have been identified on 6 continents. Dr. Peter Cegielski, team leader for drug-resistant TB with the Division of Tuberculosis Elimination at CDC, comments on a multinational team's report on this emerging global public health threat.  Created: 3/1/2007 by Emerging Infectious Diseases.   Date Released: 3/26/2007.

  12. Plasmodium falciparum drug resistance in Angola

    OpenAIRE

    Fançony, Cláudia; Brito, Miguel; Gil, Jose Pedro

    2016-01-01

    Facing chloroquine drug resistance, Angola promptly adopted artemisinin-based combination therapy as the first-line to treat malaria. Currently, the country aims to consolidate malaria control, while preparing for the elimination of the disease, along with others African countries in the region. However, the remarkable capacity of Plasmodium to develop drug resistance represents an alarming threat for those achievements. Herein, the available, but relatively scarce and dispersed, information ...

  13. 大肠埃希菌临床感染的分布及耐药性分析%Analysis on Clinical Infection Distribution and Drug Resistance of Eschericbia coil

    Institute of Scientific and Technical Information of China (English)

    肖利君

    2011-01-01

    目的 了解临床各种标本分离的大肠埃希菌的耐药特点及差异,为临床合理使用抗菌药物提供依据.方法 收集2008年1月-2009年12月从305位患者中分离自中段尿.呼吸道及分泌物等标本的大肠埃希菌,采用天地人微生物分析系统及相配套的药敏试验卡进行细菌鉴定及药敏测定,并统计比较各种不同标本所检出大肠埃希菌对抗菌药物的耐药率.结果 共检出大肠埃希菌305株.其中中段尿检出121株,呼吸道88株,分泌物等96株.中段尿与呼吸道分离的大肠埃希菌对复方新诺明(85.12%,70.45%)、庆大霉素(67.77%,50.00%)、阿莫西林/克拉维酸(33.88%,60.23%)的耐药率差异均有统计学意义;中段尿与分泌物及其它分离大肠埃希菌对复方新诺明(85.12%,69.79%)、头孢他啶(37.19%,9.38%)、妥布霉素(42.15%,8.33%)、阿莫西林/克拉维酸(33.88%,15.62%)的耐药率差异均有统计学意义;呼吸道与分泌物及其它分离的大肠埃希菌对头孢他啶(43.18%,9.38%)、环丙沙星(73.86%,88.54%)、阿莫西林/克拉维酸(60.23%,15.62%)的耐药率差异有统计学意义.结论 不同标本分离的大肠埃希菌对同一抗菌药物耐药率不同,治疗不同部位大肠埃希菌引起的感染,要考虑由于感染部位不同而产生的耐药性以及药物有效浓度的差异,临床应依据药敏结果合理使用抗菌药物.%Objective To investigate the antibiotic resistant characteristics and differences of Escherichia coli isolated from different clinical samples, and to provide the evidence for guiding rational use of antimicrobial agents.Methods Escherichia coli isolated from 305 patients' mid- portion of urine, respiratory tract, and secretion from January, 2008 to December, 2009 was collected.Heaven- earth - man analytic system and matching susceptibility test cards were used to perform bacterial identification and detect antimicrobial susceptibility.The drug resistant rates of Escherichia coli

  14. Human herpes simplex labialis.

    Science.gov (United States)

    Fatahzadeh, M; Schwartz, R A

    2007-11-01

    Humans are the natural host for eight of more than 80 known herpes viruses. Infections with herpes simplex virus type 1 (HSV-1) are ubiquitous worldwide and highly transmissible. Herpes simplex labialis (HSL) is the best-recognized recrudescent infection of the lips and perioral tissues caused by HSV-1. Facial lesions of HSL may be unsightly, frequent outbreaks unpleasant, and the infection itself more severe locally and systemically in immunocompromised people. This article highlights the pathogenesis, clinical presentation, diagnostic features and management issues for HSL.

  15. Clinical distribution and drug resistance of Staphylococcus aureus causing bloodstream infections%金黄色葡萄球菌血流感染的临床分布与耐药性分析

    Institute of Scientific and Technical Information of China (English)

    陈世平; 冯旰珠; 李彤; 杜兴冉; 胡慧敏

    2016-01-01

    OBJECTIVE To investigate the clinical distribution and drug resistance of Staphylococcus aureus causing bloodstream infections so as to provide guidance for reasonable clinical use of antibiotics .METHODS The related clinical data were collected from 76 patients with S .aureus bloodstream infections who were hospitalized from Jan 2009 to May 2015 . The clinical distribution and drug resistance of the strains were retrospectively analyzed . RESULTS The S .aureus bloodstream infection was prevalent in elderly patients and neonates ;among the patients with bloodstream infection ,35 .5% distributed in the renal disease department ,13 .2% in the neonatal depart‐ment ,13 .2% in the ICU .The drug resistance rate of the S .aureus to penicillin was the highest (94 .7% );the drug susceptibility rates to teicoplanin ,vancomycin ,and linezolid were 100% ;the drug susceptibility rate to fu‐sidic acid was 96 .1% .The detection rate of methicillin‐resistant S .aureus (MRSA) reached up to 40 .8% ;the drug susceptibility rates of the M RSA strains to gentamicin ,clindamycin ,levofloxacin ,and sulfamethoxazole‐tri‐methoprim were significantly lower than those of the methicillin‐sensitive S .aureus (MSSA) (P<0 .05) .There was no significant difference in the drug susceptibility rate to the commonly used antibiotics between the MRSA strains causing the community‐acquired infection and the MRSA strains causing the hospital‐acquired infection or between the MSSA strains causing the community‐acquired infection and the MSSA strains causing the hospital‐ac‐quired infection .CONCLUSION The clinical distribution of the patients with S .aureus bloodstream infections is rel‐atively concentrated ,the detection rate of the MRSA strains is relatively high .The strains are highly drug‐resist‐ant .It is necessary for the hospital to conduct the anti‐infection therapy as early as possible and reasonably use an‐tibiotics so as to avoid the emergence of drug resistance

  16. Analysis of drug sensitivity and drug resistance of 303 strains of clinically isolated Klebsiella pneumoniae%303株肺炎克雷伯杆菌的药敏结果及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    赖秀花; 邹汉良; 钟彦云; 魏晟潇

    2016-01-01

    Objective To investigate the drug sensitivity and clinical commonly used drugs resistance of Klebsi-ella pneumoniae, and provide reference for using the medicine rationally. Methods The number of Klebsiella pneumoniae isolated from outpatients and inpatients in our hospital from January 2011 to November 2014, extended spectrum beta lac-tamases (ESBLs) detection rate and drug resistant spectrum were retrospective analyzed. Results A total of 303 strains of Klebsiella pneumoniae was isolated from 1 327 sputum samples with detection rate of 22.8%, of which 137 strains pro-duced extended spectrum beta lactamases (ESBLs), accounting for 45.2%. ESBLs producing Klebsiella pneumoniae has 100%resistance to penicillin, and 78.8%or more resistance to cephalosporins, which mainly isolated from the adult group. Aminoglycosides ESBLs producing Klebsiella pneumonia had the lowest resistance to Amikacin with 31.4%, which had 35.1%~43.8% resistance to beta lactamase inhibitor and 46.7% resistance to primaquine ketones. Conclusion The long-term dynamic monitoring of drug sensitivity and drug resistance tendency of Klebsiella pneumoniae, and regularly screening of ESBLs producing Klebsiella pneumoniae are very important to reasonable use of antibiotics.%目的:探讨肺炎克雷伯杆菌的药敏结果及其对临床常用药物的耐药性,为合理用药提供依据。方法回顾性分析2011年1月至2014年11月我院门诊和住院患者送检的痰标本中分离出的非重复性肺炎克雷伯杆菌的数量以及产超广谱β-内酰胺酶(ESBLs)检出率和耐药谱。结果1327份痰标本中分离出303株肺炎克雷伯杆菌,检出率为22.8%,其中产ESBLs检出137株,占45.2%。产ESBLs肺炎克雷伯菌青霉素类100%耐药,头孢类78.8%以上耐药,且以成人组居多,而氨基糖苷类在产ESBLs肺炎克雷伯菌中耐药性最低的是阿米卡星,占31.4%。β-内酰胺酶抑制剂占35.1%~43.8%、喹若酮类耐药率占46.7%

  17. Distribution and drug resistance of clinically isolated Alcaligenes xylosoxidans%木糖氧化产碱杆菌的临床分布与耐药性研究

    Institute of Scientific and Technical Information of China (English)

    王斌; 朴信爱; 蒋捍东

    2012-01-01

    OBJECTIVE To investigate the distribution and resistance of clinically isolated Alcaligenesxylosoxidans (AL xylosoxidans) strains. METHODS The distribution of 85 trains of Al. Xylosoxidans causing nosocomial infection was retrospectively analyzed. Antimicrobial susceptibility testing was performed by Kirby-Bauer method. RESULTS Of the specimens from which Al. Xylosoxidans strains were isolated, 95. 29% were from sputum, the minority were from wounds or keratitis secretions, which was mainly obtained from patients with low immunity. The infections distributed widely in respiratory department and ICU, accounting for 43. 53 % and 25. 88%, respectively, followed by cerebral surgery department (10. 59%) , neurology department (7. 06%) .endocrinology department (5. 88%), oncology department (3. 53%), orthopedics department (2. 35%) and ophthalmology department (1.18%). The drug resistance rates of the isolates to aztreonam and aminoglycoside antibiotics varied from 78. 82% to 87. 06%. The drug resistance rates to ceftriaxone, cefotaxim, cefepime, piperacillin, ciprofloxacin.and sulfamethoxazole/trimethoprim were 58. 82%, 63. 53%, 62. 35%, 52. 94%, 63. 53%, and 62.35%, respectively. The strains were susceptible to carbapenems,β-lactam/β-lactamase inhibitor combinations and ceftazidime with the drug resistance varying from 0 to 18. 82%. CONCLUSION Al. Xylosoxidans infections mainly occurs in respiratory tract. Disinfection of hospital environment with strict sterilization management system shall be strengthened and antibiotics should be used reasonably so as to reduce nosocomial infections.%目的 调查木糖氧化产碱杆菌在临床的分布及耐药性.方法 回顾性调查85株木糖氧化产碱杆菌的医院感染分布,采用K-B法分析细菌敏感性.结果 木糖氧化产碱杆菌多来自痰标本,占95.29%,少数来自于伤口及角膜炎分泌物标本中,后者均来自免疫力低下患者;感染主要分布于呼吸科和

  18. Integron involved drug-resistant mechanism in AmpC enzyme positive Enterobacter cloacae clinical strains%阴沟肠杆菌AmpC酶阳性菌株中整合子参与的多重耐药

    Institute of Scientific and Technical Information of China (English)

    缪应雷; 杜艳

    2009-01-01

    Objective To screen AmpC enzyme positive Enterobacter cloacae strains, and investigate the integron involved drug-resistant mechanism in AmpC enzyme positive strains were presented. Methods the antimicrobial susceptibility testing was carried out using the K B method . Disks phenotype screening and three dimensional test were to screen the AmpC enzyme positive strains, ampC, ampD and integron CS genes were amplified by PCR. PCR mapping was applied to study the certain position of ampC and ampD in integron. Results Seventy four Enterobacter cloacae strains were multi-drug resistant strains. The positive rate of disks phenotype screening test was 35. 1% ; whereas 28.4% in three dimensional test. The positive rate of PCR amplifying ampC was 89.2%, ampD was 86. 5% and integron CS was 49%. The positive rate of PCR mapping was 33.3% with bands all smaller than 1000bp. Conclusions Apart from imipenem and amikacin, 74 Enterobacter cloacae strains showed the resistant rate above 50% against penicillins, eephalosporins, quinolones and aminoglycosides respectively. Compared with the three dimensional test, five disks phenotype screening tests were more convenient and practical. So it was mainly used in the clinical laboratories. Although the three dimensional test was the most accurate and reliable, it was mainly applied in scientific research due to the complex and difficulty in advocating and the result revealed that the inserted drug-resistant genes may be located in the upstream of integron.%目的 筛选阴沟肠杆菌AmpC酶阳性菌株,探寻阳性菌株中整合子参与的耐药机制,指导合理用药,为临床治疗感染提供理论依据.方法 KB法药敏;纸片表型和三维试验筛选AmpC酶阳性菌株;PCR扩增ampC、ampD和整合子保守序列CS;PCRmapping研究阳性菌株中ampC和ampD在整合子中的位置.结果 74株阴沟肠杆菌对多种抗生素耐药.纸片表型筛选的阳性率为35.1%;三维试验为28.4%.PCR扩增定位的阳性率为89

  19. 医院感染鲍氏不动杆菌的临床分布及耐药性分析%Analysis on clinical distribution and drug resistance of acinetobacter baumannii in nosocomial infection

    Institute of Scientific and Technical Information of China (English)

    陆月明; 饶敏; 王红; 董甲贵; 张梦; 王展

    2015-01-01

    Objective To investigate the distribution characteristics and drug resistance of Acinetobacter baumannii in nosocomial infection and to provide evidence for appropriate prevention and therapy. Methods The clinical distribution and drug resistance of acinetobacter baumannii in 2013 were retrospectively analyzed. Results During one-year′s infection surveillance, 149 strains of acinetobacter baumannii were isolated in our hospital, and the majority of acinetobacter baumannii causing nosocomial infection was observed in department of emergency medicine and department of thoracic surgery ( 21. 5% and 11. 4%, respectively ) . Most of acinetobacter baumannii strains were isolated from sputum (88. 6%), followed by drainage (5. 4%). The resistance of acinetobacter baumannii to imipenem and meropenem was 49. 7% and 49. 0% respectively. Acinetobacter baumannii was totally susceptible to polymyxins. Conclusion Acinetobacter baumannii is a common cause of nosocomial infections in most of the depart-ments in hospital, and it is highly resistant to carbapenems. Therefore, the use of antibiotics should be based on the results of drug sensitivity test.%目的:了解鲍氏不动杆菌的临床分布和耐药情况,为有效预防和指导临床治疗提供依据。方法对2013年临床分离的鲍氏不动杆菌的临床分布及耐药性进行回顾性分析。结果2013年我院共分离鲍氏不动杆菌149株,广泛分布于临床各科室,最多见于急诊内科(占21.5%),其次为胸外科(占11.4%)。鲍氏不动杆菌以痰液中检出率最高(占88.6%),其次为伤口分泌物(占5.4%)。鲍氏不动杆菌对亚胺培南和美罗培南的耐药率分别为49.7%和49.0%,对多粘菌素全部敏感。结论鲍氏不动杆菌感染可见于许多临床科室,对碳青霉烯类具有较高的耐药性,临床医生必须合理使用抗生素,以降低医院感染率,减少细菌耐药性的产生。

  20. 液相芯片快速检测结核耐药基因方法建立%Rapid detection of drug-resistant genes of clinical isolates in Mycobatterium tuberculosis by Multi-analyte Suspension Array

    Institute of Scientific and Technical Information of China (English)

    王清; 丁显平; 李天俊; 罗涛; 韩婷婷

    2012-01-01

    基于Luminex100TM技术平台,结合多重PCR技术,以5’生物素标记引物为信号指示,在H37 RV结核标准株做对照下,对104株结核分枝杆菌分离株的LFP耐药rpoB基因和INH耐药的katG,inhA基因进行检测,并与药敏试验绝对浓度法和测序结果比较.结果表明:液相芯片检出结果与药敏法比较,104株分离株中LFP、INH、多重耐药的检出结果分别为:液态芯片检测73株、50株、48株;药敏检测结果为74株、58株、53株;对比检出率98.6%,86.2%,90.6%.液相基因芯片技术对耐药,耐多药结核的检测,具有特异性高,敏感性强的特点,是检测结核分枝杆菌耐药基因的有效方法,可用于临床检测.%104 Mycobacterium tuberculosis strains and H37 Rv strain as control were genotyped by muti-PCR based on Luminex 100?platform for detecting the mutant sequences in rpoB, katG and inhA gene to identify the result of the drug resistance. Of 104 strains, Mutations were found in 73 strains (98. 6%) of 74 randomly selected rifampin-resistant MTB , 50 strains (86. 2%) of 58 randomly selected isoniazid-resistant MTB and 48 strains (90. 6%) of 53 randomly selected both rifampin and isoniazid-resistant MTB by MASA. Multi-analyte Suspension Array technology has high sensitivity and specificity in detection of drug-resistant of MTB and may be applied in clinical diagnosis.

  1. 医院患者深部真菌感染的临床分布与耐药性分析%Clinical distribution and drug resistance of fungi causing deep fungal infections in hospitalized patients

    Institute of Scientific and Technical Information of China (English)

    彭丽娟; 胡妮娅; 杜经纬; 朱红; 李雪璐; 常晋霞; 杨健

    2015-01-01

    目的:了解医院临床分离的真菌分布及耐药性,指导临床合理用药。方法收集医院2013年1-12月临床真菌培养标本,采用法国生物梅里埃公司VITEK‐2 Compact全自动细菌分析仪进行分离、鉴定和药物敏感试验,采用SPSS16.0进行数据分析。结果1024株真菌中白色假丝酵母菌分离率最高为448株占43.8%,最低的是新型隐球酵母菌占0.8%;送检标本以尿液为主占78.1%;送检科室以内科为主,主要为消化内科、重症医学和呼吸内科,其次是泌尿外科;深部真菌感染率年龄段分布构成比差异不大,深部真菌感染率最高的是>60岁老年患者占36.0%;假丝酵母菌属对两性霉素B敏感率最高为100.0%,氟康唑耐药率最高占24.2%,新型隐球酵母菌对伏立康唑和伊曲康唑耐药;伊曲康唑的耐药率随年龄的增加耐药率下降。结论临床标本中真菌感染以白色假丝酵母菌为主,真菌感染主要发生于老年患者,耐药性具有种属间差异,应重视真菌病原学检查和药敏监测。%OBJECTIVE To investigate the distribution and drug resistance of the clinical isolates of fungi so as to provide guidance for reasonable clinical use of antibiotics .METHODS From Jan 2013 to Dec 2013 ,the clinical spec‐imens were collected for culture of fungi ,then the isolation and identification of the fungi were carried out by using VITEK‐2 Compact automatic bacteria analyzer of BioMerieux ,France ,the drug susceptibility testing was per‐formed ,and the data were analyzed with the use of SPSS16 .0 software .RESULTS Of 1 024 strains of fungi isola‐ted ,448 strains were Candida albicans with the highest isolation rate of 43 .8% ,and 0 .8% were Cryptococcus neoformans .The urine specimens were dominant among the submitted specimens ,accounting for 78 .1% .The de‐partment of gastroenterology ,critical care medicine department ,and respiratory

  2. Epidemiology of bloodstream infections caused by Acinetobacter baumannii and impact of drug resistance to both carbapenems and ampicillin-sulbactam on clinical outcomes.

    Science.gov (United States)

    Chopra, Teena; Marchaim, Dror; Awali, Reda A; Krishna, Amar; Johnson, Paul; Tansek, Ryan; Chaudary, Khawar; Lephart, Paul; Slim, Jessica; Hothi, Jatinder; Ahmed, Harris; Pogue, Jason M; Zhao, Jing J; Kaye, Keith S

    2013-12-01

    Acinetobacter baumannii has become a leading cause of bloodstream infections (BSI) in health care settings. Although the incidence of infection with carbapenem- and ampicillin-sulbactam-resistant (CASR) A. baumannii has increased, there is a scarcity of studies which investigate BSI caused by CASR A. baumannii. A retrospective cohort study was conducted on adult patients with BSI caused by A. baumannii and who were admitted to the Detroit Medical Center between January 2006 and April 2009. Medical records were queried for patients' demographics, antimicrobial exposures, comorbidities, hospital stay, and clinical outcomes. Bivariate analyses and logistic regression were employed in the study. Two hundred seventy-four patients with BSI caused by A. baumannii were included in the study: 68 (25%) caused by CASR A. baumannii and 206 (75%) caused by non-CASR A. baumannii. In multivariate analysis, factors associated with BSI caused by CASR A. baumannii included admission with a rapidly fatal condition (odds ratio [OR] = 2.83, 95% confidence interval [CI] = 1.27 to 6.32, P value = 0.01) and prior use of antimicrobials (OR = 2.83, 95% CI = 1.18 to 6.78, P value = 0.02). In-hospital mortality rates for BSI caused by CASR A. baumannii were significantly higher than those for non-CASR A. baumannii-induced BSI (43% versus 20%; OR = 3.0, 95% CI = 1.60 to 5.23, P value < 0.001). However, after adjusting for potential confounders, the association between BSI caused by CASR A. baumannii and increased risk of in-hospital mortality was not significant (OR = 1.15, 95% CI = 0.51 to 2.63, P value = 0.74). This study demonstrated that CASR A. baumannii had a distinct epidemiology compared to more susceptible A. baumannii strains; however, clinical outcomes were similar for the two groups. Admission with a rapidly fatal condition was an independent predictor for both CASR A. baumannii and in-hospital mortality.

  3. Antibacterial and Synergy of Berberines with Antibacterial Agents against Clinical Multi-Drug Resistant Isolates of Methicillin-Resistant Staphylococcus aureus (MRSA

    Directory of Open Access Journals (Sweden)

    Zhong-Qi Bian

    2012-08-01

    Full Text Available Antibacterial activity of berberine (Ber and 8-acetonyl-dihydroberberine (A-Ber alone and combined uses with antibacterial agents ampicillin (AMP, azithromycin (AZM, cefazolin (CFZ and levofloxacin (LEV was studied on 10 clinical isolates of SCCmec III type methicillin-resistant Staphylococcus aureus (MRSA. Susceptibility to each agent alone was tested using a broth microdilution method and the chequerboard and time-kill tests for the combined evaluations, respectively. The alone MICs/MBCs (mg/mL ranges were 32–128/64–256 (Ber and 32-128/128-512 (A-Ber. Significant synergies were observed for the Ber (A-Ber/AZM and Ber (A-Ber/LEV combinations against 90% of the tested MRSA strains, with fractional inhibitory concentration indices (FICIs values ranged  from 0.188 to 0.500. An additivity result was also observed for the Ber/AZM combination by time-kill curves. These results demonstrated for the first time that Ber and A-Ber enhanced the in vitro inhibitory efficacy of AZM and LEV to a same extent, which had potential for further investigation in combinatory therapeutic applications of patients infected with MRSA.

  4. A database of antimalarial drug resistance

    Directory of Open Access Journals (Sweden)

    Ringwald Pascal

    2006-06-01

    Full Text Available Abstract A large investment is required to develop, license and deploy a new antimalarial drug. Too often, that investment has been rapidly devalued by the selection of parasite populations resistant to the drug action. To understand the mechanisms of selection, detailed information on the patterns of drug use in a variety of environments, and the geographic and temporal patterns of resistance is needed. Currently, there is no publically-accessible central database that contains information on the levels of resistance to antimalaria drugs. This paper outlines the resources that are available and the steps that might be taken to create a dynamic, open access database that would include current and historical data on clinical efficacy, in vitro responses and molecular markers related to drug resistance in Plasmodium falciparum and Plasmodium vivax. The goal is to include historical and current data on resistance to commonly used drugs, like chloroquine and sulfadoxine-pyrimethamine, and on the many combinations that are now being tested in different settings. The database will be accessible to all on the Web. The information in such a database will inform optimal utilization of current drugs and sustain the longest possible therapeutic life of newly introduced drugs and combinations. The database will protect the valuable investment represented by the development and deployment of novel therapies for malaria.

  5. Antituberculosis drug resistance patterns in adults with tuberculous meningitis

    DEFF Research Database (Denmark)

    Senbayrak, Seniha; Ozkutuk, Nuri; Erdem, Hakan

    2015-01-01

    BACKGROUND: Tuberculous meningitis (TBM) caused by Mycobacterium tuberculosis resistant to antituberculosis drugs is an increasingly common clinical problem. This study aimed to evaluate drug resistance profiles of TBM isolates in adult patients in nine European countries involving 32 centers...... to provide insight into the empiric treatment of TBM. METHODS: Mycobacterium tuberculosis was cultured from the cerebrospinal fluid (CSF) of 142 patients and was tested for susceptibility to first-line antituberculosis drugs, streptomycin (SM), isoniazid (INH), rifampicin (RIF) and ethambutol (EMB). RESULTS...

  6. Study of Community and Nosocomial Uropathogens and Their Drug Resistance

    OpenAIRE

    Smita U Shevade, Gopal N Agrawal

    2013-01-01

    Background: Urinary tract infections (UTI) are amongst the most common infectionsencountered in clinical practice. Drug resistant uropatho-genshas been increasingly observed, not only in nosocomial UTI but also in community-acquired (CA) UTI leaving very few options for the treatment. CA and nosocomial UTI differ aetiologically, epidemiologically; they also have different antibiotic resistance pattern. Therefore, we planned to study the bacterial aetiology and antibiotic susceptibility of uro...

  7. 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

  8. Total hip prosthesis complication, periprosthetic infection with external fistulizing due to Enterobacter cloacae complex multiple drugs resistance: A clinical case report.

    Science.gov (United States)

    Amorese, V; Corda, M; Donadu, M; Usai, D; Pisanu, F; Milia, F; Marras, F; Sanna, A; Delogu, D; Mazzarello, V; Manzoni, G; Conti, M; Meloni, G B; Zanetti, S; Doria, C

    2017-01-01

    The Enterobacter cloacae is a microorganism found in the intestinal flora of the majority of animals, including humans. Primary infections caused by E. cloacae are rare in immunocompetent patients, but are very common in hospital settings in newborns and immunocompromised patients, and can be aggravated by the insurgence of antibiotic resistance. The incidence of periprosthetic hip infections is just below 2%. A 76year old woman with multiple comorbidities underwent surgical implantation of intermediary total hip prosthesis of the left hip, in a different health facility, in February 2014, after the basicervical fracture of the upper femur extremity due to trauma. After an episode of dislocation of the prosthetic implant, in September 2014, she underwent a surgical operation to implant the acetabular component. A month later not in our facility, following a re-hospitalization for the dislocation of the arthroprosthesis, an infection from E. cloacae complex was discovered. After 2 years of chronic infection she came to our attention; the clinical picture featured coxalgia and secreting fistula in the surgical wound. Following a specific antibiotic therapy, carried out intravenously over the course of a month, we decided to intervene removing the left hip arthroprosthesis and placing an antibiotic spacer following the direction deduced from the antibiogram study of August 2016. The patient was hospitalized in our facility and 2 months later she underwent another operation to remove the antibiotic spacer and to place a new total hip arthroprosthesis. Multiple swabs showed the complete healing from the infection, which was confirmed a couple of months later. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. 316株肠球菌属的临床分布及耐药分析%CLINICAL DISTRIBUTION AND DRUG RESISTANCE OF 316 ISOLATES OF ENTEROCOCCUS SPECIES

    Institute of Scientific and Technical Information of China (English)

    燕成岭

    2012-01-01

    Objective: To get knowledge of antimicrobial resistance of Enterococcus Faecalis and Enterococcus Faecium to antibiotics, and further provide basis for treatment. Methods:316 strians of enterococci composed of 126 strains of enterococcus faecalis and 190 strains of enterococcus faecium were cultured and isolated from samples of inpatients and outpatients, and distribution of infection sites and antimicrobial resistance were analyzed. Agar dilution method was used to do antibiotic susceptibility test, and the results were determined based on the standard of Clinical and Laboratory Standard Institute (CLSI). Results:The resistance rate of enterococcus faecium to penicillin G(93.7% ) is the highest among all of the antimicrobial tested, followed by erythromycin, ampicillin and ciprofloxacin. The resistance rate of enterococcus faecium to quinupristin/dalfopristin(74% )was the highest among all of the antimicrobials tested, followed by tetracycline, erythromycin and ciprofloxacin. The resistance rate of enterococcus faecalis and enterococcus faecium to linezolid and vancomycin were all lower than 2% , and that to teicoplanin was the lowest (0% ). Conclusions: The resistance rate of enterococcus faecalis and enterococcus faecium to different kinds of antibiotics differed much. Bacterial culture and antimicrobial susceptibility test should be performed before anti - infection treatment initiated and reasonable antibiotics be selected based on antimicrobial susceptibility test report.%目的:了解粪肠球菌和屎肠球菌对抗菌药物的耐药性,为临床提供治疗依据.方法:对住院及门诊病人送检样本中培养分离出316株肠球菌(粪肠球菌126株,屎肠球菌190株)的感染分布与耐药情况进行分析.采用稀释法进行药物敏感试验,结果按美国临床实验室标准化研究所标准判定.结果:屎肠球菌对青霉素G的耐药率最高(93.7%),其次为红霉素、氨苄西林和环丙沙星.粪肠球

  10. Clinical analysis of 616 herpes zoster cases%616例带状疱疹临床分析

    Institute of Scientific and Technical Information of China (English)

    王江涛

    2015-01-01

    目的:探讨带状疱疹的临床特点和发病规律,为带状疱疹的治疗提供参考依据。方法回顾性分析皮肤科门诊治疗的616例带状疱疹患者的临床资料。结果616例患者中,男370例,女246例,男性发病数是女性的1.5倍。带状疱疹发病时间以一、二季度较高,占401例(65.1%);发病年龄以中老年居多,占303例(49.2%)。结论带状疱疹患者中男性居多,发病率随年龄增大而增加,中老年患者病情重,容易导致后遗神经痛。早期规范治疗,可明显缩短病程及减少后遗神经痛的发生。%Objective To investigate clinical characteristics and occurrence regularity of herpes zoster, in order to provide reference for treating herpes zoster. Methods Clinical data of 616 herpes zoster patients in department of dermatology were retrospectively analyzed. Results Among 616 patients, there were 370 male and 246 female. Male had morbidity number as 1.5 times of female. The first and second quarters had higher occurrence of herpes zoster, accounting for 401 cases (65.1%). Middle-aged and elderly people accounted mostly as 303 cases (49.2%). Conclusion The majority of herpes zoster patients are male, and their morbidity increased with age. Middle-aged and elderly people had severe status, which can lead to postherpetic neuralgia. Early standard treatment can obviously shorten course of disease and reduce incidence of postherpetic neuralgia.

  11. Clinical Efficacy of Oral Ganciclovir for Prophylaxis and Treatment of Recurrent Herpes Simplex Keratitis

    Directory of Open Access Journals (Sweden)

    Xin Wang

    2015-01-01

    Full Text Available Background: Herpes simplex keratitis (HSK caused by herpes simplex virus 1 (HSV-1, which has high recurrent rate and incidence of severe vision loss, is the leading cause of infectious blindness in the world. The aim was to explore the clinical efficacy of oral ganciclovir (GCV in the prevention of recurrent HSK. Methods: A multicenter, prospective, randomized, single-blind, and controlled clinical trial was conducted from April 2010 to June 2013. One hundred seventy-three patients (173 eyes involved who were diagnosed as recurrent HSK definitely, including stromal keratitis and corneal endotheliitis, were divided into three groups randomly: negative control (placebo group was topically administered with 0.15% GCV ophthalmic gel, 4 times per day and 0.1% fluorometholone eye drops, 3 times per day until resolution of HSK; positive control acyclovir (ACV group was topically adopted the same ophthalmic gel and eye drops and additionally received oral ACV 400 mg 5 times a day for 10 weeks and followed by 400 mg 2 times per day for 6 months; test GCV group was topically adopted the same treatment as negative control group and additionally received oral GCV 1000 mg 3 times per day for 8 weeks. The symptoms and signs were evaluated before and after the therapy 1 st week, 2 nd week and then followed up every 2 weeks until recovery. Furthermore, we followed up recurrence of HSK for every 3 months after recovery and then assessed the cure time, recurrent rate and adverse reactions. Results: One hundred and seventy-three patients were followed up 7-48 months (mean 32.1 ± 12.3 months, but 34 patients were failed to follow-up. The cure time was 12.1 ± 4.3, 11.9 ± 4.0 weeks in negative control (placebo group and positive control ACV group respectively (P = 0.991, which was longer than that in test GCV group (8.6 ± 2.8 weeks and there was a significant difference between test GCV group and negative control (placebo group or positive control ACV group (P

  12. Clinical characteristics of headache or facial pain prior to the development of acute herpes zoster of the head.

    Science.gov (United States)

    Lee, Hye Lim; Yeo, Minju; Choi, Gi Hwa; Lee, Ji Yeoun; Kim, Ji Seon; Shin, Dong-Ick; Lee, Sang-Soo; Lee, Sung-Hyun

    2017-01-01

    When physicians encounter patients with headache or facial pain (preeruptive pain) associated with acute herpes zoster of the head, especially before the appearance of characteristic skin eruptions (preeruptive phase), they typically find it difficult to make clinical impressions and apply appropriate diagnostic or therapeutic procedures. The objectives of this study were to describe the clinical characteristics of headache or facial pain associated with acute herpes zoster of the head and to elucidate the association between the manifestation of these symptoms in the preeruptive phase and incoming herpes zoster. We retrospectively analyzed the clinical features of 152 patients with acute herpes zoster involving only the head who presented within 10days of rash onset at Chungbuk National University Hospital, a tertiary hospital in Chungcheongbuk-do in South Korea, between January 2011 and December 2015. The mean age of the patients was 54.3±19.8years. One hundred patients had herpes zoster in the trigeminal nerve, 34 in the nervus intermedius, and 18 in the upper cervical nerves. Preeruptive pain was present in 112 (73.7%) patients and had a mean duration of 3.0±1.3days (range, 1-6days). Severity of pain was associated with the presence of preeruptive pain (p=0.040). Headache or facial pain was limited to the ipsilateral side of the face and head in all patients, except for two who had with severe symptoms of meningitis, and was of moderate to severe intensity (90.1%). Pain of a stabbing nature was observed in 128 (84.2%) patients, and 146 (96.1%) reported experiencing this type of pain for the first time. Pain awakened 94 (61.8%) patients from sleep. Sixty-one (54.5%) of the 112 patients with preeruptive pain visited a hospital during the preeruptive phase; their preeruptive phase was significantly longer (pherpes zoster (n=5, 8.2%); migraine (n=3, 4.9%); pain associated with upper respiratory tract infection (n=3, 4.9%); parotitis (n=2, 3.3%); dry eye (n=2, 3

  13. 医院感染鲍氏不动杆菌的临床特点及耐药分析%Clinical characteristics and drug resistance of Acinetobacter baumannii in hospital infection

    Institute of Scientific and Technical Information of China (English)

    张颖; 王仙园; 周娟; 于庆华

    2014-01-01

    OBJECTIVE To investigate clinical characteristics and drug resistance of Acinetobacter baumannii in our hospital and to provide the basis for controlling hospital infection .METHODS A retrospective analysis was applied to the clinical data of 229 patients with hospital infection from 2011 to 2012 .The clinical characteristics and drug resistance of Acinetobacter baumannii strains in hospital infection were analyzed .The software SPSS10 .0 was used for statistical analysis .RESULTS There were 3 strains in 2011 and 18 strains in 2012 ,the hospital infection rates were 1 .97% and 12 .24% respectively .The difference was significant(P<0 .01) .Totally 21 A .baumannii strains were all from sputum specimens and respiratory tract was the first infection site .The 21 A .baumannii strains in hospital infection were resistant to antibiotics such as cefazolin ,cefuroxime ,aztreonam ,cefoperazone , ceftriaxone ,ceftazidime ,piperacillin ,norfloxacin ,gentamicin ,amikacin ,tobramycin ,ampicillin ,chlorampheni‐col ,and ciprofloxacin but sensitive to imipenem .CONCLUSION A .baumannii is the major pathogenic bacteria in hospital infection and shows an increasing trend year by year .Clinical nursing staff should strengthen the preven‐tion and control measures according to bacteriological characteristics .%目的:了解医院鲍氏不动杆菌的临床特点及耐药性,为控制医院感染提供参考依据。方法回顾性分析医院2011-2012年299例医院感染患者临床资料,分析鲍氏不动杆菌的临床特点及耐药性,数据采用SPSS10.0进行统计处理。结果2011、2012年鲍氏不动杆菌感染分别为3、18例,感染率分别为1.97%、12.24%,差异有统计学意义( P<0.01);21株鲍氏不动杆菌均来自痰培养标本,呼吸道为首发感染部位;21株鲍氏不动杆菌对头孢唑林、头孢呋辛、氨曲南、头孢哌酮、头孢曲松、头孢他啶、哌拉西林、诺氟沙星、庆大霉素、阿

  14. Overcoming drug resistance in multi-drug resistant cancers and microorganisms: a conceptual framework.

    Science.gov (United States)

    Avner, Benjamin S; Fialho, Arsenio M; Chakrabarty, Ananda M

    2012-01-01

    Resistance development against multiple drugs is a common feature among many pathogens--including bacteria such as Pseudomonas aeruginosa, viruses, and parasites--and also among cancers. The reasons are two-fold. Most commonly-used rationally-designed small molecule drugs or monoclonal antibodies, as well as antibiotics, strongly inhibit a key single step in the growth and proliferation of the pathogen or cancer cells. The disease agents quickly change or switch off this single target, or activate the efflux mechanisms to pump out the drug, thereby becoming resistant to the drug. A second problem is the way drugs are designed. The pharmaceutical industry chooses to use, by high-throughput screening, compounds that are maximally inhibitory to the key single step in the growth of the pathogen or cancer, thereby promoting selective pressure. An ideal drug would be one that inhibits multiple steps in the disease progression pathways with less stringency in these steps. Low levels of inhibition at multiple steps provide cumulative strong inhibitory effect, but little incentives or ability on the part of the pathogen/cancer to develop resistance. Such intelligent drug design involving multiple less stringent inhibitory steps is beyond the scope of the drug industry and requires evolutionary wisdom commonly possessed by bacteria. This review surveys assessments of the current clinical situation with regard to drug resistance in P. aeruginosa, and examines tools currently employed to limit this trend. We then provide a conceptual framework in which we explore the similarities between multi-drug resistance in pathogens and in cancers. We summarize promising work on anti-cancer drugs derived from the evolutionary wisdom of bacteria such as P. aeruginosa, and how such strategies can be the basis for how to look for candidate protein/peptide antibiotic drugs from bioengineered bugs. Such multi-domain proteins, unlike diffusible antibiotics, are not diffusible because of their

  15. Oral ulcers in children under chemotherapy: clinical characteristics and their relation with Herpes Simplex Virus type 1 and Candida albicans.

    Science.gov (United States)

    Sepúlveda, Ester; Brethauer, Ursula; Rojas, Jaime; Fernández, Eduardo; Le Fort, Patricia

    2005-04-01

    The objective of this study was to determine the clinical characteristics of oral ulcers in pediatric oncology patients undergoing chemotherapy and their relation with the presence of Herpes Simplex Virus (HSV) type 1 and Candida albicans. The sample consisted of 20 ulcerative lesions from 15 children treated with chemotherapy in the Pediatric Service of the Regional Hospital of Concepción, Chile. Two calibrated clinicians performed clinical diagnosis of the ulcers and registered general data from the patients (age, general diagnosis, absolute neutrophil count, and number of days after chemotherapy) and clinical characteristic of the ulcers: number, size, location, presence or absence of pain and inflammatory halo, edge characteristics, and exudate type. Additional to clinical diagnosis, culture for Candida albicans (C) and polymerase chain reaction (PCR) for Herpes Simplex Virus type 1 was performed. Ten ulcers occurred in patients with acute lymphoblastic leukemia, five in patients with acute myeloblastic leukemia and five in patients with other neoplastic diseases. Eight ulcers were HSV (+) / C (-), 6 HSV (-) / C (-), 4 HSV (+) / C (+) and 2 HSV (-) / C (+). Preferential location was the hard palate. Most lesions were multiple, painful, with inflammatory halo, irregular edges and fibrinous exudate. The average size was 6,5 millimeters, and the mean number of days after chemotherapy was 7.5 days. Oral ulcers in children with oncological diseases did not present a specific clinical pattern. They were strongly associated with HSV.

  16. 鲍曼不动杆菌170株临床分布与耐药性分析%Clinical characteristics and drug resistance analysis of acinetobacter baumannii

    Institute of Scientific and Technical Information of China (English)

    苏荣

    2009-01-01

    目的 探讨我院鲍曼不动杆菌的临床分布特点及耐药性分析.方法 采用VITEK2-Compact全自动微生物鉴定仪对170株鲍曼不动杆菌进行生化鉴定,并运用OSIRIS进行药物敏感试验结果分析.结果 170株鲍曼不动杆菌主要集中在骨伤科,占78.8%(134/170),主要分布标本为伤口分泌物,占77.1%(131/170).该菌对亚胺培南耐药率较低,为0.6%,其次为米诺环素,为24.7%,耐药率最高为头孢噻吩,为100%.结论 鲍曼不动杆菌的临床分离逐年增加,已成为医院感染的主要致病菌.应根据微生物药物敏感实验结果结合药物动力学合理使用抗菌药物、及时调整治疗方案,预防鲍曼不动杆菌感染的进一步加剧.%Objective To observe clinical characteristics and drug resistance analysis of acinetobacter baumannii at Foshan Chinese medicine hospital. Methods VITEK2-Compact Automatic Identification of micro-organisms instrument was used to analyze 170 strains of Acinetobacter baumannii. Meanwhile OSIRIS drug-sensitive teat was also used to do chemical and biological identifications. Results One hundred and seventy strains of acinetobacter baumannii were isolated mainly in orthopaedic patients (78. 8%). Conclusion Acinetobacter baumannii clinical separation has become a major pathogen of hospital infection.

  17. Drug resistance mutations for surveillance of transmitted HIV-1 drug-resistance: 2009 update

    NARCIS (Netherlands)

    D.E. Bennett (Diane); R.J. Camacho (Ricardo Jorge); D. Otelea (Dan); D.R. Kuritzkes (Daniel); H. Fleury (Hervé); M. Kiuchi (Mark); W. Heneine (Walid); R. Kantor (Rami); M.R. Jordan (Michael); J.M. Schapiro (Jonathan); A.M. Vandamme (Anne Mieke); P. Sandstrom (Paul); C.A. Boucher (Charles); D.A.M.C. van de Vijver (David); S.Y. Rhee (Soo Yoon); T.F. Liu (Tommy); D. Pillay (Deenan); R.W. Shafer (Robert)

    2009-01-01

    textabstractPrograms that monitor local, national, and regional levels of transmitted HIV-1 drug resistance inform treatment guidelines and provide feedback on the success of HIV-1 treatment and prevention programs. To accurately compare transmitted drug resistance rates across geographic regions an

  18. Bacteria distribution and drug-resistance of 223 isolated enterococci in clinical specimens%223株常见肠球菌的临床分布和耐药性分析

    Institute of Scientific and Technical Information of China (English)

    曾军荣; 李榕娇; 黄绰妤

    2009-01-01

    目的 分析常见肠球菌在临床标本中的分布及对常用抗菌药物的耐药性,为临床治疗提供参考.方法 采用法国梅里埃生物API鉴定系统进行菌种鉴定,并采用K-B纸片扩散法进行体外耐药监测及统计耐药率.结果 肠球菌的临床分离率为8.78%,分类以粪肠球菌为主,其次为屎肠球菌,肠球菌属对利福平、四环素、红霉素、达福普汀、氯霉素耐药率较高.而对万古霉素、替考拉宁和呋喃妥因仍然保持良好的敏感性.粪肠球菌对青霉素、氨苄西林、左旋氧氟沙星的耐药率分别为2.4%、2.4%、5.9%,均低于屎肠球菌的90.7%、88.9%、13.0%,屎肠球菌对四环索、氯霉素的耐药率分别为51.9%和48.1%,均低于粪肠球菌的95.3%和78.1%.结论 临床标本中,肠球菌在泌尿生殖道标本中的分布最高,粪肠球菌和屎肠球菌的耐药谱明显不同,在重症感染时可选用万古霉素、替考拉宁和呋喃妥因进行治疗.%Objective To investigate the distribution and resistance of common Enterococci isolated from clinical specimens in our hospital and to apply some suggestions for treating infections to the clinic.Methods The microbiological system API was used to identify bacteria and the drug-resistance in vitro was determined by K-B methods.Results The clinical isolation rate of enterococci was 8.78%. The main strain of enterococci was Enterococcus faecalis. Enterococcus faecium was the second one.The drug-resistance rate of Enterococci to Rifampin,Tetracycline,Erythromycin,Dalfopristin,Chloramphenicol was high.But it was still sensitive to Vancomycin,Teicoplanin,Nitrofurantoin.The resistance rate of Enterococcus faecalis to Penicillin,Ampicillin,Levofloxacin were2.4%,2.4% and 5.9% respectively .They were lower than Enterococcus faecium (90.7%, 88.9% and 13.0%); The resistance rate of Enterococcus faecium to tetracycline,chloramphenicol were 51.9%,48.1 %. Which were lower than the Enterococcus faecalis 95. 3

  19. Correlation between integron and drug-resistance in clinical isolates of Citrobacter freundii%弗氏柠檬酸杆菌临床分离株整合子与耐药相关性的研究

    Institute of Scientific and Technical Information of China (English)

    俞燕; 魏取好; 王卫忠

    2013-01-01

    目的 了解临床分离弗氏柠檬酸杆菌中整合子的分布,分析整合子与细菌耐药性的关系.方法 选取2011年7月至2013年2月非重复分离自浙江省人民医院就诊患者临床样本中的37株弗氏柠檬酸杆菌,用聚合酶链反应(PCR)检测菌株第Ⅰ、Ⅱ、Ⅲ类整合子.抗生素药敏试验采用微量肉汤稀释法.结果 37株弗氏柠檬酸杆菌中,有14株(37.8%)检测到第Ⅰ类整合子,未检出第Ⅱ类和第Ⅲ类整合子.对15种常用抗生素的耐药性检测显示,第Ⅰ类整合子阳性菌株对复方磺胺甲(噁)唑及环丙沙星的耐药率高于第Ⅰ类整合子阴性菌株(P均<0.05);对其他抗生素的耐药性,第Ⅰ类整合子阳性和阴性菌株间差异无统计学意义(P均>0.05).结论 第Ⅰ类整合子在弗氏柠檬酸杆菌中分布普遍.第Ⅰ类整合子与复方磺胺甲(噁)唑及环丙沙星的耐药性密切相关.%Objective To investigate the distribution of integrons in clinical Citrobacterfreundii strains and analyze the relationship between integrons and antibiotic resistance.Methods A total of 37 non-repeated clinical isolates of Citrobacter freundii from Zhejiang Provincial People's Hospital were selected from July 2011 to February 2013.The types of the interons(intIl、intI2、intI3) were identified by PCR and the drug-sensitivity tests were carried out by broth dilution method.Results Among 37 non-repeated isolates of Citrobacter freundii,intIl was detected in 14 isolates (37.8 %),intI2 and intI3 genes were not detected.After drug-resistance test of 15 common used antibiotics,the intI1-positive strains showed higher resistant rates of trimethoprim-sulfamethoxazole and ciprofloxacin than the intIl-negative strains (P all < 0.05).For resistance rates of the other antibiotics,there was no difference between theintIl-positive and intIl-negative strains(P all > 0.05).Conclusions In this study,the class Ⅰ integron is extensively found in clinical isolates

  20. The Clinical Distribution and Changing Trend Analysis of Drug Resistance of Pseudomonas Aeruginosa%铜绿假单胞菌院内分布及耐药性变化分析

    Institute of Scientific and Technical Information of China (English)

    敖要凤

    2015-01-01

    目的:了解铜绿假单胞菌( PEA )在院内的分布及耐药性变迁,为临床合理用药提供依据。方法:对我院2013—2014年住院患者送检做细菌培养的各类临床标本分离出的PEA及药敏结果进行回顾性分析。结果:2年共分离出74株PEA,其中以痰标本最多,占85.14%。 PEA主要来自神经内科、呼吸内科、神经外科及感染性疾病科,分别占35.14%、28.37%、13.52%、10.81%。 PEA 对常用抗生素的耐药率呈上升趋势。耐碳青霉烯类PEA菌株检出率也由2013年的12.50%上升至2014年的30.00%。结论:PEA的感染率和耐药率呈上升趋势,提示在临床工作中应注意手卫生及消毒隔离,保护易感患者,合理使用抗生素,做好多重耐药菌的预防与控制措施,减少耐药株的产生与传播。%Objective:To understand the basic -level of pseudomonas aeruginosa(PEA) in hospital clinical distribution and drug resistance change , and to provide the basis for clinical rational drug use .Methods:In 2013—2014,hospitalized patients with bacteria culture of pseudomonas aeruginosa from the clinical specimens and their drug susceptibility results were retrospectively analyzed.Results:A total of 2 years,74 strains of pseudomonas aeruginosa was isolated , sputum specimens were the most for 85.14%.There were from neurology , respiratory medicine , neurosurgery and infectious diseases department , accounted for 35.14%,28.37%,13.52% and 35.14% respectively .PEA irologic resistance was obviously rising trend .For commonly used antibiotics ,PEA strain detection rate in resistance to carbon penicillium alkene were also on the increase from 12.50%in 2013 to 30.00%in 2014.Conclusion:The infection and resistance of PEA are rising , pay attention to hand hygiene and disinfection isolation, protect susceptible patients , rational use of antibiotics , make the prevention and control measures of multi -resistant bacteria better , reduce

  1. Clinical distribution and drug resistance of 94 strains of Enterobacter aerogenes%94株产气肠杆菌的临床分布与耐药性分析

    Institute of Scientific and Technical Information of China (English)

    林奇龙; 陈琼娜; 方国安; 范淑欢

    2012-01-01

    目的 了解产气肠杆菌的临床分布及耐药性.方法 用常规方法检出可疑菌落,用法国生物梅里埃公司ID 32E条和ATB G-5条做菌种鉴定与药敏试验;分别用复合纸片表型确认试验和FOX琼脂平板试验检测ESBLs和AmpC酶.结果 临床标本主要来自痰液,占52.1%,其次为中段尿,占16.0%;临床科室中呼吸内科和肝胆外科检出最多,分别占43.6%和17.0%;亚胺培南、美罗培南对所有菌株均敏感;头孢吡肟和哌拉西林/他唑巴坦的耐药率<16.0%;产气肠杆菌对阿莫西林、头孢噻吩、头孢西丁的耐药率均>95.0%,对其余β-内酰胺类抗菌药物均有一定程度的耐药,对氨基糖苷类、喹诺酮类、磺胺甲噁唑/甲氧苄啶耐药率较低;ESBLs和AmpC酶的检出率分别为16.0%和11.7%.结论 产气肠杆菌临床主要来自痰液标本及呼吸内科;所有菌株均对亚胺培南、美罗培南敏感,对阿莫西林、头孢噻吩、头孢西丁的耐药率最高;产ESBLs和AmpC酶菌株已占一定比例.%OBJECTIVE To investigate the clinical distribution and antibiotic resistance of Enterobacter aerogens. METHODS Suspicious colonies were detected by conventional method, Meria ID 32E and ATBG-5 were used for bacterial identification and the drug susceptibility testing; complex phenotypic confirmatory test paper and FOX agar plate assay were respectively adopted to detect ESBLs and ArnpC enzymes. RESULTS Of the clinical specimens, the highest detection rate (52. l%)was sputum, followed by the midstream urine (16. 0%); of the clinical departments, the detection rates of respiratory medicine and hepatobiliary surgery were 43. 6% and 17.0%; imipenem and meropenem were susceptible to all the isolates; the drug resistance rates to cefepirne and piperacilhn/tazobactam were lower than 16. 0%; the drug resistance rates to amoxicillin, cefalotin and cefoxitin were all higher than 95. 0%, a certain degree of resistance to other

  2. Clinical distribution and drug resistance analysis of 2263 strains of pathogens causing nosocomial infection%2263株院内感染常见病原菌分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    翟如波; 张昊; 孙跃岭; 邱广斌

    2012-01-01

    Objective To provide a basis for clinical use of drugs and clinical isolates of the distribution of common pathogens and resistance to commonly used antibiotics were analyzed, retrospectively. Methods Bacteria were isolated from various clinical specimens from January to December 2010, and identified by VITEK-2 Compact automatic analyzer. Antimicrobial susceptibility test was carried out by Kirby-Bauer method, and the results were assessed according to CLSI ( version 2009 ) criteria. Results Total of 2263 nosocomial pathogens were collected, mainly gram-negative bacilli pathogens. The most common pathogens in sequence were Escherichia coli, Klebsiella, Pseudomonas aeruginosa, Staphylococcus aureus and Adnetobacter. Escherichia coli and Klebsiella with ESBL were more resistant to antibiotics than those without ESBL. Pseudomonas aeruginosa and Adnetobacter were multi-drug resistant and were more resistant to carbapenems antibiotics. MRSA appeared multi-drug resistance and heterogeneity, however, no linezolid-resistant and vancomycin-resistant staphylococcus strain was noted. Conclusions By the means of rational usage of antimicrobial drugs, cutting off pathogen transmission routes, strengthening disinfection and isolation and monitoring of critically ill patients, cross-infection prevention, the antibiotics appearance and propagation could be slowed down.%目的 回顾性分析临床分离的引起院内感染的常见病原菌分布及对常用抗菌药物的耐药情况,为临床合理用药提供一定的依据.方法 对本院2010年1月~12月临床送检的各类标本进行分离培养,采用VITEK-2 Compact全自动微生物仪进行菌株鉴定,采用K-B纸片扩散法检测对抗菌药物的敏感性,判定标准依据美国临床和实验室标准化研究所(CLSI)2009年的相关规定.结果 本研究分离出病原菌共2263株,以革兰阴性杆菌为主,常见病原菌依次为大肠埃希菌、克雷伯菌属、铜绿假单胞、金黄色葡萄球

  3. 带状疱疹89例临床分析%Clinical analysis of 89 patients with herpes zoster

    Institute of Scientific and Technical Information of China (English)

    徐勇梅

    2015-01-01

    Objective:To analyze the clinical characteristics of patients with herpes zoster. Methods:The retrospective studyof 89 patients withherpes zoster from Nov. 2013 to Oct. 2014 was conducted.Results:All patients received aciclovir and cobamamide. Among them, 66(74.16%) patients were cured in 2 to 8 weeks, and post-herpetic neuralgia was found in 6(6.74%) patients aged above 65 years. There were 32.58%(29/89) of the patients infected with virues of herpes zoster in winter.The herpes zoster was commonly seen in the chest of 32 patients(35.96%) and the patients over 50 years were susceptible to herpes zoster. Conclusion: The awareness of herpes zoster should be increased in patients as to early diagnosis and treatment.%目的:探讨带状疱疹的临床特点。方法:收集2013年11月至2014年10月门诊带状疱疹患者89例,回顾性分析患者的临床资料。结果:89例患者均采用阿昔洛韦联合腺苷钴胺治疗,其中66例(74.16%)在2~8周痊愈,后遗神经痛6例(6.74%),均为65岁以上患者。带状疱疹以冬季发病居多为32.58%(29/89),胸部发病最多见为35.96%(32/89),50岁以上患者较多占82.02%(73/89)。结论:应提高患者对带状疱疹的认知度,做到早就诊、早治疗。

  4. Vitamin D is closely linked to the clinical courses of herpes zoster: From pathogenesis to complications.

    Science.gov (United States)

    Chao, Chia-Ter; Chiang, Chih-Kang; Huang, Jenq-Wen; Hung, Kuan-Yu

    2015-10-01

    Vitamin D is renowned for its pleiotropic effects, including but not limited to bone integrity, and it has assumed an important role in the current research era. As vitamin D receptors are present in a variety of human tissues, particularly immune cells, the immunomodulatory potential of vitamin D cannot be overemphasized. Herpes zoster, which presents as grouped cutaneous vesicles over dermatomes or visceral/central nervous system infection in its severe form, has a higher incidence in immune-suppressed patients. Considering the importance of vitamin D in host immunity, we hypothesize that vitamin D acts as an effect-modifier for the entire herpes zoster spectrum with regard to disease susceptibility, manifestation, efficacy of pharmacologic management, and emergent complications during treatment. Moreover, the possibility exists that vitamin D might affect the course of postherpetic neuralgia. In line with this theory, we comprehensively searched the existing herpes zoster literature and provided important insight into the relationship between the disease courses of herpes zoster and vitamin D.

  5. Transporter protein and drug resistance of Trypanosoma.

    Science.gov (United States)

    Medina, Noraine P; Mingala, Claro N

    2016-01-01

    Trypanosoma infection is one of the most important infections in livestock and humans. One of the main problems of its therapeutic control and treatment is the resurgence of drug resistance. One of the most studied causes of such resistance is the function of its adenosine transporter gene. A trypanosomal gene TbAT1 from Trypanosoma brucei has been cloned in yeast to demonstrate its function in the transport of adenosine and trypanocidal agents. Drug resistant trypanosomes showed a defective TbAT1 variant; furthermore, deletion of the gene and set point mutations in the transporter gene has been demonstrated from isolates from relapse patients. The molecular understanding of the mechanism of action trypanocidal agents and function of transporter gene can lead to control of drug resistance of Trypanosomes.

  6. Chromosomal Instability Confers Intrinsic Multi-Drug Resistance

    Science.gov (United States)

    Lee, Alvin J X; Endesfelder, David; Rowan, Andrew J; Walther, Axel; Birkbak, Nicolai J; Futreal, P Andrew; Downward, Julian; Szallasi, Zoltan; Tomlinson, Ian P M; Kschischo, Maik; Swanton, Charles

    2011-01-01

    Aneuploidy is associated with poor prognosis in solid tumours. Spontaneous chromosome mis-segregation events in aneuploid cells promote Chromosomal Instability (CIN) that may contribute to the acquisition of multi-drug resistance in vitro and heighten risk for tumour relapse in animal models. Identification of distinct therapeutic agents that target tumour karyotypic complexity has important clinical implications. In order to identify distinct therapeutic approaches to specifically limit the growth of CIN tumours we focussed on a panel of colorectal cancer (CRC) cell lines, previously classified as either chromosomally-unstable (CIN+) or diploid/near-diploid (CIN−), and treated them individually with a library of kinase inhibitors targeting components of signal transduction, cell cycle and trans-membrane receptor signalling pathways. CIN+ cell lines displayed significant intrinsic multi-drug resistance compared to CIN− cancer cell lines and this appeared to be independent of somatic mutation status and proliferation rate. Confirming the association of CIN rather than ploidy status with multi-drug resistance, tetraploid isogenic cells that had arisen from diploid cell lines displayed lower drug sensitivity than their diploid parental cells only with increasing chromosomal heterogeneity, and isogenic cell line models of CIN+ displayed multi-drug resistance relative to their CIN− parental cancer cell line derivatives. In a meta-analysis of CRC outcome following cytotoxic treatment, CIN+ predicted worse progression-free or disease-free survival relative to patients with CIN− disease. Our results suggest that stratifying tumour responses according to CIN status should be considered within the context of clinical trials to minimize the confounding effects of tumour CIN status on drug sensitivity. PMID:21363922

  7. Analysis of clinical characteristics and drug resistance of nosocomial infection with multi-drug resistant organisms in intensive care unit%重症监护室多重耐药菌医院感染临床特点与耐药性分析

    Institute of Scientific and Technical Information of China (English)

    林佩贤; 黄宝添; 许斐斐; 林伟青

    2015-01-01

    Objective To explore the clinical feature and antibiotic resistance of nosocomial infection caused by multi-drug resistant organisms (MDRO) in intensive care unit (ICU),and to provide reference for clinical treatment and prevention measure of hospital infection.Methods The nosocomial infection patients who stayed in ICU were investigated.According to whether infected by MDRO,the patients were divided into case group and control group.Clinical characteristics,antimicrobial resistance of pathogen,and burden of diseases were compared between two groups.Results A total of 136 strains of pathogen were detected from 95 patients.There were 94 strains of MDRO isolated from 60 patients.The main types of MDRO were Acinetobacter baumannii,Pseudomonas aeruginosa,and Staphylococcus aureus.Pulmonary infection was the principal infection site [68 strains (72.34%)].Acinetobacter baumannii strains were resistant to many antibiotics,but sensitive to glycylcycline,and the resistant rate was 12.50%.Pseudomonas aeruginosa strains were found low resistant rate to levofloxacin and imipenem,and the rate were both 33.33%.Staphylococcus aureus strains were sensitive to nitrofurantoin,linozelid,vancomycin,glycylcycline,quinupristin/dalfopristin and teicoplanin.The APACHE Ⅱ score and mortality rate of case group were (23.05±8.45) and 25.00% respectively,and both higher than (18.86±7.04)and 8.57% of control group.Those differences had statistical significance (t=2.48,x2=3.88,P<0.05).Meanwhile,compared with control group,the hospitalization time of case group was longer,and cost was higher (Z=2.26,2.55,P<0.05).Conclusions The pathogens caused hospital infection are MDROs mainly,and the bacteria resistant to most antibacterial agents.MDRO infection may lead to aggravation,worse prognosis and heavier financial burden.%目的 了解ICU中多重耐药菌(MDRO)所致医院感染的临床特点和耐药情况,为临床抗菌治疗、院内感染防控提供依据.方法 以ICU医

  8. Clinical distribution and drug resistance of 3 206 strains of Enterobacteriaceae bacteria%3206株肠杆菌科细菌的临床分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    冯丽娜; 李从荣; 潘月华; 杨勇文

    2016-01-01

    目的 了解临床分离肠杆菌科细菌的临床分布及耐药性,为临床合理使用抗菌药物提供理论依据.方法 分析2014年1月至2015年6月武汉大学人民医院分离的肠杆菌科细菌分布特点及药敏结果,分离的所有肠杆菌科细菌均采用全自动细菌鉴定药敏系统BD-Phoenix-100进行鉴定.结果 共检出3 206株肠杆菌科细菌,其中主要为大肠埃希菌1 821株(56.8%)、肺炎克雷伯菌652株(20.4%)、阴沟肠杆菌201株(6.3%)、产气肠杆菌104株(3.2%),肠杆菌科细菌以尿液标本分离率最高(1 666株,52.0%),其次为痰标本(463株,14.4%)和血液标本(343株, 10.7%),科室分布以泌尿外科(599株,18.7%)和肾病内科(380株,11.9%)为主.肠杆菌科细菌敏感性最高的抗菌药物为亚胺培南和美罗培南,尤其是大肠埃希菌和肺炎克雷伯菌,耐药率均低于3.1%,阿米卡星和哌拉西林/他唑巴坦亦保持了良好的抗菌活性.结论 肠杆菌科细菌在泌尿外科和肾病内科分布比较集中,对抗菌药物呈现不同程度的耐药,碳青霉烯类抗生素亚胺培南和美罗培南仍是最敏感的抗肠杆菌科细菌药物,但已有耐药株的出现,临床应采取有效的防控措施从而减少耐药菌株的出现和播散流行.%Objective To analyze the clinical distribution and drug resistance of Enterobacteriaceae bacteria, and to provide theoretical basis for clinical rational use of antimicrobial agents. Methods The clinical distribution and drug susceptibility results of Enterobacteriaceae bacteria isolated from Renmin Hospital of Wuhan University from Janu-ary 2014 to June 2015 were analyzed. All the isolated Enterobacteriaceae bacteria were identified by automatic bacteria identification and drug susceptibility systems BD-Phoenix-100. Results A total of 3 206 strains of Enterobacteriaceae bacteria were detected, mainly including 1 821 strains (56.8%) of E. coli, 652 strains (20.4%) of Klebsiella pneumonia, 201 strains (6.3%) of

  9. Analysis on infection clinical distribution and drug resistance of Bauman Acinetobacter%鲍曼不动杆菌感染的临床特征及耐药性监测

    Institute of Scientific and Technical Information of China (English)

    涂建斌; 饶丽华; 沈思瑶

    2014-01-01

    目的:了解鲍曼不动杆菌的临床特征及其对常用抗生素的耐药状况,为临床使用抗生素治疗提供科学依据。方法用Vitek自动化细菌鉴定及药敏分析系统对菌落进行鉴定并做药敏试验,对检出的鲍曼不动杆菌的药敏结果进行统计分析。结果在检出鲍曼不动杆菌的217份标本中有痰液、血液、尿液、脑脊液、伤口分泌物等标本,其中主要为痰液,占所有标本的84.3%。在药敏结果中,鲍曼不动杆菌对亚胺培南、美罗培南耐药率分别为14.3%、16.6%,对氨苄西林/舒巴坦、哌拉西林+他唑巴坦、替卡西林/克拉维酸的耐药率分别为36.9%、34.6%、33.6%,对其余抗生素的耐药率均超过了50.0%,多重耐药性明显。结论鲍曼不动杆菌主要引起下呼吸道感染,其抗生素敏感谱窄,美罗培南、亚胺培南可作为治疗的首选药物,对常用抗生素的使用,临床医生应根据药敏试验结果针对性地合理用药,以便及时有效地控制感染并减少耐药菌株的产生。%Objective To investigate the clinical distribution and the drug resistance of Bauman Acinetobacter in order to offer reference for the clinical therapeutics. Methods The strains of Bauman Acinetobacter were detected and their sensitivity to an-tibiotics were determined by Vitek automatic bacterium identifying and drug sensitivity analyzing systems ,and the result of sensi-tivity to antibiotics were analyzed. Results Among the 217 specimens,there were sputum,blood,urine,cerebrospinal fluid (CSF) and the wound secretion,and etc,The dominant specimen was the sputum (84.3%).In the result of the sensitivity to antibiotics,the resistant rates to imipenem and meropenem were 14.3% and 16.6% respectively,the resistant rates to ampicillin/sulbacta, piperacillin/tazobactam,ticarcillin/clavulanic acid were 36.9%,34.6%,33.6%respectively,and the resistant rates to the other com-mon antimicrobial agents were more

  10. Clinical distribution and drug resistance monitoring of enterococcus faecalis and enterococcus faecium%粪肠球菌和屎肠球菌的临床分布及耐药监测研究

    Institute of Scientific and Technical Information of China (English)

    张雪梅; 孙成栋; 刘颖

    2016-01-01

    目的:研究临床感染患者中粪肠球菌和屎肠球菌的临床分布、对抗菌药物的敏感性以及耐药情况。方法北京积水潭医院2014年1月至2015年12月临床送检的感染标本,分离粪肠球菌和屎肠球菌进行鉴定和药敏分析。结果分离出粪肠球菌184株,屎肠球菌109株。粪肠球菌药物敏感性从高到低依次为万古霉素、替考拉宁、氨苄西林、呋喃妥因、利奈唑胺、高浓度庆大霉素。屎肠球菌药物敏感性从高到低依次为替考拉宁、利奈唑胺、万古霉素、四环素、高浓度庆大霉素。检测出耐高浓度庆大霉素(HLGR)粪肠球菌75株,分离率为40.76%,HLGR 屎肠球菌48株,分离率为44.04%。检测出2株耐万古霉素的粪肠球菌,分离率为1.09%,9株耐万古霉素霉素的屎肠球菌,分离率为8.26%。结论肠球菌属的总体耐药率较高,且综合评价屎肠球菌的耐药性高于粪肠球菌,但肠球菌属对于万古霉素、利奈唑胺、替考拉宁等仍然保持较高的敏感性,临床上应选用合适的方法对肠球菌属进行耐药性检测,根据药敏结果选择适当的抗菌药物治疗。%Objective To investigate the clinical distribution and drug sensitivity and drug resistance of Enterococcus Faecium and En-terococcus Faecalis. Methods From January 2014 to December 2015,identification and drug sensitivity analysis were carried on Enterococcus Faecium and Enterococcus Faecalis in Beijing Jishuitan Hospital. Results The identification results showed that,184 strains of Enterococcus Faecalis and 109 strains of Enterococcus Faecium were separated out. Drug susceptible rate of Enterococcus Faecalis from high to low were vanco-mycin,teicoplanin,ampicillin,nitrofurantoin,linezolid,gentamincin - syn,drug susceptible rate of Enterococcus Faecium from high to low were teicoplanin,linezolid,vancomycin,tetracycline,gentamincin - syn and so on. In Enterococcus Faecalis,there were 75

  11. Clinical distribution and drug resistance of acinetobacter baumannii in children%儿童患者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)

    何周康; 赵昕

    2011-01-01

    目的 了解儿童患者鲍曼不动杆菌的临床分布特征及耐药现状,为临床合理选用抗菌药物提供依据.方法 收集本院2010年1月至12月临床分离的124株鲍曼不动杆菌,采用K-B法检测药物敏感性.结果 124株鲍曼不动杆菌中,79株来自痰标本(占63.71%),20株来自血液标本(占16.13%).病区来源以ICU病房最高(40.32%),其次为呼吸内科(21.77%).在检测的19种药物中,耐药率超过50%的达13种(68.42%),且71株鲍曼不动杆菌呈多重耐药,占57.26%.耐药率最高为哌拉西林(81.45%),耐药率最低为多黏菌素B(1.61%),其次为头孢哌酮-舒巴坦(15.32%).结论 临床分离鲍曼不动杆菌多来源于呼吸道标本,以ICU和呼吸内科为主,且多重耐药现象十分严重.临床应加强对鲍曼不动杆菌耐药性监测,合理选用抗菌药物.%Objective To investigate the clinical distribution and drug resistance of acinetobacter baumannii in childrea Methods The K-B method was used to detect the drug sensitivity of 124 acinetobacter baumannii isolated from Jan to Dec in 2010. Results Among the 124 strains of acinetobacter baumannii, 79 (63. 71%) were isolated from sputum and 20 (16. 13%) from blood. Strains isolated from the Intensive Care Unit accounted for 40. 32%, followed by those from the Respiratory Department (21. 77%). Among the 19 antibiotics tested, 13 (68. 42%) had resistance rate higher than 50. 0%, and 71 (57. 26%) were multi-resistant stains. Resistant rate to piperacillin (81. 45%) was the highest Resistance rate to polymyxin B (1. 61%) was the lowest, followed by cefoperazone-sulbactam (15. 32%). Conclusion Most clinically isolated acinetobacter baumannii are from respiratory specimens. Strains are mainly isolated from the Intensive Care Unit, Neurosurgery Department and Respiratory Department, with serious multi-resistance. Monitor of drug resistance of acinetobacter baumannii should be strengthened, and antimicrobial drugs should be

  12. 老年患者真菌感染的临床特点和耐药性分析%Clinical ditribution and drug resistance of infection in senile patients

    Institute of Scientific and Technical Information of China (English)

    陈雪芳; 王佳良

    2011-01-01

    Objective:To investigate the clinical character and drug resistance of infection in senile patients. Methods: The related clinical datas and results of drug sensitivity tests of candida infection in hospitalized senile patients isolated from January 2007 to December 2009 were analyzed retrospectively. Results: Four hundred and forty one strains of fungi were isolated from 377 patients specimen and most of them were Candida Spp. (94.8%) ,the rest were aspergillus and mucorpusillus (5.2%). The departents ofrespiratory and ICU had the top relevance ratio which were (29.3%)和( 25.4%. )Most fungi were found in sputum (47.2%) and urine(23.1% ) got from patients. There had a highest susceptibility rate to amphoterien B and 5 - fluoruytosine according to drug sensitivity tests in vitro. Within eriazole antifurgals, the resistante rate of candida to voriconazole was low, and nevertheless, the resistante rate of non - candida albicans was high. Conclusion: Candida has been one of the most common pathogens proceed from senile patient nosocomial infection, and that drug resistance is increasing. Senile patients are high risk group and attention are necessary to whose physical symptom change. Strict standards of asepsis operation will help to reduce the incidence rate of fungi infection.%目的:了解老年患者真菌感染的临床特点.并分析其耐药性.方法:回顾性调查2007年1月-2009年12月住院的老年患者发生真菌感染的相关临床资料及药敏试验结果.结果:377例患者标本共分离真菌441株.菌种以假丝酵母菌为主,占94.8%,曲霉菌和毛霉菌占5.2%.呼吸内科和重症监护室的检出率最高,分别为29.3%和25.4%.痰液和尿液是检出菌株数最多的标本,构成比分别占47.2%和23.1%.体外药敏试验结果表明.两性霉素B和5-氟胞嘧啶的敏感性最高.三唑类抗真菌药物中.以伏立康唑耐药率较低,氟康唑对非白假丝酵母菌耐药性较强.结论:假丝酵母菌是老

  13. Emerging pathogens: Dynamics, mutation and drug resistance

    Energy Technology Data Exchange (ETDEWEB)

    Perelson, A.S.; Goldstein, B.; Korber, B.T. [and others

    1997-10-01

    This is the final report of a one-year, Laboratory Directed Research and Development (LDRD) project at Los Alamos National Laboratory (LANL). The objectives of this project were to develop models of the spread of pathogens, such as HIV-1 and influenza, in humans, and then to use the models to address the possibility of designing appropriate drug therapies that may limit the ability of the pathogen to escape treatment by mutating into a drug resistant form. We have developed a model of drug-resistance to amantidine and rimantadine, the two major antiviral drugs used to treat influenza, and have used the model to suggest treatment strategies during an epidemic.

  14. Primary antituberculosis drug resistance at Turkish military chest diseases hospital in Istanbul.

    Science.gov (United States)

    Kartaloglu, Zafer; Bozkanat, Erkan; Ozturkeri, Hakan; Okutan, Oguzhan; Ilvan, Ahmet

    2002-01-01

    The aim of this study was to investigate the prevalence of primary drug resistance to tuberculosis. We evaluated the clinical data, radiological features and sputum samples from 365 newly diagnosed patients with a positive culture of pulmonary tuberculosis at the Turkish Military Chest Diseases Hospital, Istanbul, Turkey. No patients had taken antituberculosis drugs previously. The Bactec method was used to perform drug susceptibility testing for isoniazid, rifampicin, ethambutol, and streptomycin. Primary resistance to one or more drugs was detected in 87 (23.8%) patients; resistance to isoniazid was most common (54 patients) followed by resistance to ethambutol (n = 39), rifampicin (n = 11), and streptomycin (n = 9). One-drug resistance was detected in 69 patients; two-drug resistance in 11, three-drug resistance in 6, and four-drug resistance in 1. Multidrug resistance (resistance to at least isoniazid and rifampicin) was detected in 10 patients. In logistic-regression analysis, primary drug resistance was associated with radiological advanced tuberculosis (p < 0.001). Primary resistance to one or more drugs used in treating tuberculosis is relatively high. It is necessary to regularly screen for and treat drug resistance among those who live in close quarters, such as army barracks, school dormitories and prisons. Regular surveillance of drug sensitivity patterns should be maintained to determine appropriate alternate drug regimens and detect the spread of resistant stains in the population. Copyright 2002 S. Karger AG, Basel

  15. 老年患者屎肠球菌感染的临床分布及耐药性分析%Clinical distribution of Enterococcus faecium infection in elderly patients and the a-nalysis of drug resistance

    Institute of Scientific and Technical Information of China (English)

    刘丹; 万小旭; 吴宝刚; 王佳贺

    2016-01-01

    目的:探讨老年患者屎肠球菌感染的临床分布特点,并分析其对临床常用抗菌药物的耐药性,为临床合理治疗屎肠球菌感染提供参考依据。方法采用回顾性分析及统计分析方法,收集我院2013年1月至2015年12月期间屎肠球菌感染的老年患者(≥65岁)的临床数据,对其进行感染现状及耐药性分析。结果3年内共检出屎肠球菌感染384例,其检出率呈逐年升高趋势。屎肠球菌感染的标本类型中尿液所占比例最高,达47.14%,其次为引流液和全血标本,分别占19.53%和16.15%。在科室分布中,标本主要分离于重症监护病房( ICU)、普通外科病房和呼吸内科病房,分别占23.96%、20.57%和16.41%。药敏结果显示:屎肠球菌对氨苄西林、红霉素、环丙沙星、克林霉素、莫西沙星、青霉素G、左氧氟沙星等抗菌药物的耐药性均超过90%,而对喹奴普汀/达福普汀、替加环素、万古霉素、利奈唑胺等药物具有高度敏感性。结论屎肠球菌对不同抗菌药物的敏感性不同,且其院内感染近年有增高趋势,对屎肠球菌感染的耐药性监测,有利于指导临床合理用药。%Objective To investigate the clinical distribution characteristics of Enterococcus faecium infection in elderly patients and analyze their drug resistance to clinical use of common antibiotics in order to provide some refer-ences for the rational treatment of Enterococcus faecium infection. Methods The retrospective analysis and statistical analysis were carried out to collect the clinical data and to analyze the infection status and drug resistance in elderly pa-tients (65 or higher) who were infected with Enterococcus faecium from January 2013 to December 2015. Results Totally 384 strains of Enterococcus faecium infection were detected in these three years and the detection rate was in-creased year by year. The type of specimen with highest proportion

  16. THE CLINICAL EFFICACY OF PNEUMONIA CAUSED BY PAN DRUG-RESISTANT ACINE-TOBACTER BAUMAN%泛耐药鲍曼不动杆菌肺部感染疗效分析

    Institute of Scientific and Technical Information of China (English)

    林冠文; 刘瑛; 刘蕴婷; 林茂锐; 方晓琳

    2015-01-01

    Objective To retrospectively analyze the clinical efficacy of different anti-inflammatory treat-ment of pneumonia caused by Pan drugresistant Acinetobacter Bauman ( PDRAB) , in order to provide reference for the clinical treatment.Methods Cases of positive PDRAB detected from lower respiratory tract specimens in our hospital from June 2012 to July 2014 were selected to make a retrospective summary of treatment and prognosis.Results The single drug group had 103 cases, with the total effective rate of 28.15%.The combined treatment group had 83 cases, with the total effective rate of 32.53%.There was no significant difference in efficacy of anti-inflam-matory treatment of PDRAB pneumonia between the two groups.Conclusion Clinically, PDRAB pneumonia is treated with empirical antimicrobial drugs.Cefoperazone sodium sulbactam sodium or cefoperazone he azole temple combined with levofloxacin are expected to improve the clinical efficacy of PDRAB pneumonia.%目的 回顾性调查分析我院泛耐药鲍曼不动杆菌( Pan Drug-Resistant Acinetobacter Bau-man,PDRAB)肺部感染病例不同抗感染方案的疗效,为临床治疗PDRAB肺部感染提供参考. 方法 收集我院2012年6月~2014年7月间下呼吸道标本检出PDRAB的病例,对治疗及预后进行回顾性总结分析. 结果单药组103例,总有效率为28.16%;联合用药组83例,总有效率为32.53%. 各组间抗感染疗效差异无统计学意义. 结论 临床上治疗PDRAB肺部感染以经验用药为主,头孢哌酮钠舒巴坦钠或头孢哌酮他唑巴坦联合左氧氟沙星治疗PDRAB肺部感染疗效较好.

  17. 凝固酶阴性葡萄球菌菌血症临床感染特征及耐药性分析%Coagulase-negative Staphylococci bacteremia clinical infection characteristics and drug resistance analysis

    Institute of Scientific and Technical Information of China (English)

    陈倩; 孙亚娟; 郭燕菊; 王会中

    2012-01-01

    Objective To investigate the clinical characteristics of patients with coagulase-negative staphylococci (CNS) bactere-mia and the drug resistance of isolates to provide basis for clinical diagnosis and treatment. Methods Medical records between Nov. 2009 and Oct. 2011 of 56 cases with CNS-induced bacteremia in this hospital were retrospectively analyzed. Results All of the cases were with fever and leukocytosis,treatment of a variety of catheter, pre-used antibiotics and positive blood culture alarm time less than 48 hours. Of the 56 strains of CNS,82. 5% were methicillin-resistant coagulase-negative the staphylococci(MRCNS) with rel-atively high sensitivity to vancomycin, teicoplanin and rifampin. The clinical treatment efficiency was 57. 1% and the mortality rate was 10. 7%. Conclusion CNS might be an important pathogen of bloodstream infections. To identify whether CNS is pathogen might be the key for clinical diagnosis. Vancomycin could still be preferred for the treatment of MRCNS bloodstream infection.%目的 分析凝固酶阴性葡萄球菌(CNS)菌血症患者临床资料及菌株耐药性,为临床诊断与治疗提供依据.方法 对该院2009年11月至2011年10月56例CNS菌血症患者临床资料进行回顾性统计分析.结果 CNS患者均有发热和白细胞升高、植入各种留置导管、先期使用过抗菌药物、血培养阳性报警时间小于48 h;56株CNS中,82.5%为甲氧西林耐药凝固酶阴性葡萄球菌(MRCNS),对万古霉素、替考拉宁、利福平较为敏感;临床治疗有效率57.1%、死亡率10.7%.结论 CNS已是菌血症的重要病原菌,正确鉴定CNS是否为病原菌是临床诊断的关键,万古霉素仍是治疗MRCNS菌血症首选药物.

  18. Delamanid expanded access novel treatment of drug resistant tuberculosis

    Directory of Open Access Journals (Sweden)

    Rustomjee R

    2015-10-01

    Full Text Available Roxana Rustomjee,1 Alimuddin Zumla2,31South African Medical Research Council, Cape Town, South Africa; 2Division of Infection and Immunity, University College London, London, UK; 3NIHR Biomedical Research Centre, University College Hospitals NHS Foundation Trust, London, UKAbstract: Tuberculosis (TB remains a global emergency and is one of the most common infectious disease causes of death in developing countries. Current treatment regimens for multi-drug resistant TB are associated with low treatment success rates, are toxic, and require long duration of treatment. The need for shorter and more effective treatment regimens is urgent. Delamanid (Deltyba, or formerly known as OPC-67683 is a new dihydro-imidazooxazole anti-TB drug active against resistant forms of pulmonary TB. Delamanid kills Mycobacterium tuberculosis by inhibiting the synthesis of mycolic acids required for cell wall synthesis. Whilst delamanid has been included in the WHO Model List of Essential Medicine by the World Health Organization Expert Committee on Selection and Use of Essential Medicines and in international guidance for the treatment of multi-drug resistant TB since April 2014, its access in countries with the greatest need, has proven challenging. This review provides an update on currently available clinical safety and efficacy data on delamanid and offers a discussion on research priorities and recommendations for expedited, expanded access.Keywords: delamanid, tuberculosis, drug resistance, MDR-TB, expanded access

  19. Personalized prediction of EGFR mutation-induced drug resistance in lung cancer

    OpenAIRE

    Wang, Debby D.; Weiqiang Zhou; Hong Yan; Maria Wong; Victor Lee

    2013-01-01

    EGFR mutation-induced drug resistance has significantly impaired the potency of small molecule tyrosine kinase inhibitors in lung cancer treatment. Computational approaches can provide powerful and efficient techniques in the investigation of drug resistance. In our work, the EGFR mutation feature is characterized by the energy components of binding free energy (concerning the mutant-inhibitor complex), and we combine it with specific personal features for 168 clinical subjects to construct a...

  20. The Clinical Specimens of Enterococcus Species Distribution and Drug Resistance of Bacteria%临床标本中肠球菌属细菌菌种分布及耐药性

    Institute of Scientific and Technical Information of China (English)

    闫忠

    2016-01-01

    Objective To investigate the clinical specimens of Enterococcus species distribution of bacteria and drug resistance situation.Methods Identification and drug sensitivity test of 358 strains of bacteria isolated from the genus.Results211 strains of Enterococcus faecium and 142 strains of Enterococcus faecalis and 2 strains of Enterococcus gallinarum, 2 strains of Enterococcus, 1 strains of Enterococcus casseliflavus. 358 strains of the bacteria in the clinical specimens of the most urine specimens. Enterococcus faecalis to penicillin, ampicillin, erythromycin resistance high, the Dafoe high leptin resistance in Enterococcus faecalis, two kinds of bacteria to vancomycin, teicoplanin and linezolid resistance was low. Conclusion The clinical specimens of Enterococcus bacteria distribution in Enterococcus faecium and Enterococcus faecalis, and there is a big difference between the two kinds of bacterial resistance.%目的:探讨临床标本中肠球菌属细菌菌种分布及耐药性状况。方法对358株肠球菌属细菌菌株进行菌种鉴定及药敏试验。结果211株屎肠球菌,142株粪肠球菌,2株鹑鸡肠球菌,2株耐久肠球菌,1株铅黄肠球菌。358株肠球菌属细菌菌种在临床标本中尿液标本最多。屎肠球菌对青霉素、氨苄西林、红霉素耐药性高,粪肠球菌对达福普汀耐药性高,两种细菌对对万古霉素、替考拉宁、利奈唑胺耐药性均较低。结论临床标本中肠球菌属细菌菌种分布中以屎肠球菌和粪肠球菌为主,且两种细菌耐药性存在较大差异。

  1. Malaria Epidemic and Drug Resistance, Djibouti

    OpenAIRE

    Rogier, Christophe; Pradines, Bruno; Bogreau, H.; Koeck, Jean-Louis; Kamil, Mohamed-Ali; Mercereau-Puijalon, Odile

    2005-01-01

    Analysis of Plasmodium falciparum isolates collected before, during, and after a 1999 malaria epidemic in Djibouti shows that, despite a high prevalence of resistance to chloroquine, the epidemic cannot be attributed to a sudden increase in drug resistance of local parasite populations.

  2. Streptococcus pneumoniae Drugs Resistance in Acute Rhinosinusitis

    Directory of Open Access Journals (Sweden)

    Chong Jie Hao

    2016-03-01

    Full Text Available Background: Acute rhinosinusitis that usually caused by Streptococcus pneumoniae becomes the reason why patients seek for medical care. Drugs resistance in Streptococcus pneumoniae is increasing worldwide. This study was conducted to determine drugs resistance of Streptococcus pneumonia from acute rhinosinusitis in Dr. Hasan Sadikin General Hospital. Methods: A descriptive laboratory study was conducted in June–October 2014 at the Laboratory of Microbiology Faculty of Medicine Universitas Padjadjaran. The sample was taken using nasopharyngeal swabbing from 100 acute rhinosinusitis patients in Dr. Hasan Sadikin General Hospital and planted on tryptic soy agar containing 5% sheep blood and 5 μg/ml of gentamicin sulphate and then incubated in 5% CO2 incubator at 37°C for 24 hours. The identification of Streptococcus pneumonia was performed by optochin test. The susceptibility test against Streptococcus pneumoniae was done using disk diffusion method.The antibiotic disks were trimethoprim-sulfamethoxazole, oxacillin, levofloxacin, azithromycin, and doxycycline. Results: Out of 100 samples, 8 of them were tested positive for Streptococcus pneumoniae. Three of Streptococcus pneumoniae isolates died with unknown reason after it were stored at -80 .The drugs resistance test showed the resistance of Streptococcus pneumonia to oxacillin, azithromycin and trimethoprim were 6, whereas levofloxacin and doxycycline are 4. Conclusions: Streptococcus pneumonia drugs resistance in acute rhinosinusitis shows the resistance of Streptococcus pneumoniae to oxacillin, azithromycin and trimethoprim are 6, whereas the resistance to levofloxacin and doxycycline are 4.

  3. Definition of drug-resistant epilepsy: is it evidence based?

    Science.gov (United States)

    Wiebe, Samuel

    2013-05-01

    Clinical case definitions are the cornerstone of clinical communication and of clinical and epidemiologic research. The ramifications of establishing a case definition are extensive, including potentially large changes in epidemiologic estimates of frequency, and decisions for clinical management. Yet, defining a condition entails numerous challenges such as defining the scope and purpose, incorporating the strongest evidence base with clinical expertise, accounting for patients' values, and considering impact on care. The clinical case definition of drug-resistant epilepsy, in addition, must address what constitutes an adequate intervention for an individual drug, what are the outcomes of relevance, what period of observation is sufficient to determine success or failure, how many medications should be tried, whether seizure frequency should play a role, and what is the role of side effects and tolerability. On the other hand, the principles of evidence-based medicine (EBM) aim at providing a systematic approach to incorporating the best available evidence into the process of clinical decision for individual patients. The case definition of drug-resistant epilepsy proposed by the the International League Against Epilepsy (ILAE) in 2009 is evaluated in terms of the principles of EBM as well as the stated goals of the authors of the definition.

  4. Detection rates and drug resistance of Candida from clinical specimens%临床标本中假丝酵母菌属的检出率及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    詹燏; 汤贝贝; 刘水逸; 卢忠心

    2012-01-01

    目的 了解医院假丝酵母菌属感染的临床分布及耐药率.方法 以萨布罗培养基分离真菌,用API 20 CAUX假丝酵母菌属鉴定板和ATB 3 Fungus假丝酵母菌属药敏板进行假丝酵母菌属的鉴定和药敏检测.结果 共分离假丝酵母菌属189株,检出率为9.6%,以白色假丝酵母菌的检出率居首位,占76.2%,其次为热带假丝酵母菌、光滑假丝酵母菌、近平滑假丝酵母菌,分别占8.5%、6.3%、5.3%;189株假丝酵母菌属所致的临床感染,主要为肺部感染,痰标本中共检出114株,占60.3%,其次为清洁中段尿、粪便,分别占15.3%、9.0%;189株假丝酵母菌属对5-氟胞嘧啶、两性霉素B、伏立康唑的敏感率较高.结论 必须重视假丝酵母菌属的培养鉴定和药敏试验,以指导临床合理使用抗真菌药物.%OBJECTIVE To analyze the distribution and drug resistance of clinical Candida. METHODS Sobaurand s agar culture medium was used for separating fungi. Fungi were identified by API20C AUX strips and susceptibility was detected with the ATB3 FUNGUS strips. RESULTS 189 strains of Candida strains were identified. Among all strains of Candida, the majority were C. Albicans (76. 2%), followed by C. Tropicalis (8.5%), C. Glabrata (6. 3%), C. Parapsilosis (5. 3%). 189 strains were isolated from sputum, urine, stool, blood, accounting for 60. 3%, 15. 3% and 9. 0%, respectively. The susceptibility of 189 strains of Candida to 5-fluorocystine, amphotricin B, voriconazole were low. CONCLUSION It is important to perform strain identification and susceptibility of Candida species to guide the rational clinical use of antifungal drugs.

  5. Molecular diagnosis and treatment of drug-resistant hepatitis B virus.

    Science.gov (United States)

    Kim, Jeong Han; Park, Yong Kwang; Park, Eun-Sook; Kim, Kyun-Hwan

    2014-05-21

    Oral antiviral agents have been developed in the last two decades for the treatment of chronic hepatitis B (CHB). However, antiviral resistance remains an important challenge for long-term CHB therapy. All of the clinically available oral antiviral agents are nucleoside or nucleotide analogues that target the activity of viral reverse transcriptase (RT), and all are reported to have resistant mutations. Since the hepatitis B virus (HBV) RT, like other viral polymerases, lacks proofreading activity, the emergence of drug-resistance occurs readily under selective pressure from the administration of antiviral agents. The molecular diagnosis of drug-resistant HBV is based on sequence variations, and current diagnostic methods include sequencing, restriction fragment polymorphism analysis, and hybridization. Here, we will discuss the currently available molecular diagnosis tools, in vitro phenotypic assays for validation of drug-resistant HBV, and treatment options for drug-resistant HBV.

  6. Clinical features and drug resistance in patients with acute Campylobacterjejuni-induced enteritis%急性空肠弯曲菌肠炎的临床特征及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    陈杰; 孙新婷; 曾争; 王贵强; 于岩岩

    2011-01-01

    目的 分析急性空肠弯曲菌肠炎的临床特征及耐药性特点,为北京地区该病流行病学的研究、临床诊断及合理用药提供依据.方法 回顾性分析2005-2009年夏秋季我院142例急性空肠弯曲菌肠炎患者的临床特点,应用Kirby-Bauer纸片扩散法行药敏检查.结果  6月为发病高峰,发病者以20~29岁最多(49例),临床表现为腹泻,以稀水样或黏液样便为主(138例,97.2%),脓血便或黏液脓血便少见.腹痛103例(725%)、发热92例(8%)、恶心30例(21.1%)、里急后重26例(18.3%)、呕吐15例(10.6%).对60例分离的空肠弯曲菌菌株行耐药检测,其中红霉素耐药4株(6.7%)、庆大霉素耐药7株(11.7%)、阿奇霉素耐药1株(1.7%)、头孢派酮耐药60株(100.0%)、左氧氟沙星耐药36株(60.0%).无死亡病例和并发吉兰-巴雷综合征及反应性关节炎者.结论 急性空肠弯曲菌肠炎临床表现及耐药状况呈多样化和复杂化,绝大多数患者表现为良性临床经过.患者对头孢类抗生素敏感程度低,红霉素类可考虑作为抗菌治疗的首选抗生素之一.%Objective To investigate clinical features and drug resistance in patients with acute Campylobacter jejuni-induced enteritis and to provide evidence for epidemiological study, clinical diagnosis and rational drug use of the disease in Beijing.Methods Clinical features were analyzed retrospectively in 142 patients with acute Campylobacterjejuni-induced enteritis treated in our hospital in the summer or autumn from 2005 to 2009. Antimicrobial susceptibility testing was performed by Kirby-Bauer disk diffusion method. Results Campylobacterjejuni-induced enteritis developed the most frequently in June and in the population aged 20-29. Diarrhea manifested itself mainly as watery stool or mucous stool (97.2%), and seldomly as bloody purulent stool or mucopurulent bloody stool. Other clinical manifestations were abdominal pain (72.5%), fever (64.8%), nausea (21.1

  7. 山区医院葡萄球菌属临床株的耐药性调查分析%Drug resistance of clinical isolates of staphylococcus spp in mountain area hospitals: investigation and analysis

    Institute of Scientific and Technical Information of China (English)

    常勇杰

    2011-01-01

    目的:探讨山区基层医院葡萄球菌属医院感染及耐药现状,采取有效措施控制医院感染.方法:2008年1月-2009年12月,从医院感染患者临床各类标本中分离出葡萄球菌属148株,对其进行了细菌鉴定、耐甲氧西林葡萄球菌(MRS)检测和K-B法药敏试验,并进行统计与分析.结果:148株葡萄球菌属分为6种,以金黄色葡萄球菌(SAU)分离率最高,占41.2%;其中耐甲氧西林金黄色葡萄球菌(MRSA)占SAU的41.0%;耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)占凝固酶阴性葡萄球菌的42.5%;甲氧西林敏感葡萄球菌耐药率明显低于MRS株.结论 山区基层医院同样存在MRS感染,且比较严重,应采取切实措施,控制MRS的产生与流行.%OBJECTIVE To approach nosocomial infection and antimicrobial resistance status of staphylococcus spp in mountain area grass-roots hospital and take effective measures to control the nosocomial infection. METHODS A total of 148 isolates of Staphylococcus spp from clinical infective specimens from Jan. 2008 to Dec. 2009 were included in the present study. The bacterial identification, detection of methicillin-resistant staphylococcus (MRS) were performed and the susceptibility testing was performed using K-B method. The testing results were retrospectively analyzed. RESULTS Of total 148 strains of Staphylococcus consisting of 6 species, the isolating rate of Staphylococcus aureus (SAU) was the highest, arriving at 41.2%. Among the Staphylococcus and coagulase negative Staphylococcus, methieillin-resistant S. aureus and methicillin-resistant coagulase negative Staphylococcus accounted for 41.0% and 42. 5 %, respectively. The drug resistant rate of methicillin-sensitive Staphylococcus (MSS) was significantly lower than MRS. CONCLUSION The serious infections caused by MRS occur in the grass-roots hospitals of mountain area, and the practical measures should be taken to control the occurrence and prevalence of MRS.

  8. Clinical and virologic response to episodic acyclovir for genital ulcers among HIV-1 seronegative, herpes simplex virus type 2 seropositive African women: a randomized, placebo-controlled trial.

    Science.gov (United States)

    Baeten, Jared M; Reid, Stewart E; Delany-Moretlwe, Sinead; Hughes, James P; Wang, Richard S; Wilcox, Ellen; Limbada, Mohammed; Akpomiemie, Godspower; Corey, Lawrence; Wald, Anna; Celum, Connie

    2012-01-01

    In a randomized trial among African women with recurrent genital herpes, episodic acyclovir therapy resulted in modestly greater likelihood of lesion healing (hazard ratio [HR] = 1.48, P = 0.098; mean, 5.1 vs. 6.0 days) and cessation of herpes simplex virus shedding (HR = 1.88, P = 0.008; mean, 3.0 vs. 5.0 days) compared with placebo, similar to results of studies in high-income countries (ClinicalTrials.gov registration NCT00808405).

  9. Serum herpes simplex antibodies

    Science.gov (United States)

    ... 2. HSV-1 most often causes cold sores (oral herpes). HSV-2 causes genital herpes. How the Test ... whether a person has ever been infected with oral or genital herpes . It looks for antibodies to herpes simplex virus ...

  10. Tuberculosis drug resistance in the Western Cape | Weyer | South ...

    African Journals Online (AJOL)

    Objectives: Drug resistance is a serious problem in the treatment of tuberculosis ... Design, setting, subjects, outcome measures: During a defined period, all adult ... Logistic regression analysis of the data indicated that drug resistance was not ...

  11. Mesenchymal change and drug resistance in neuroblastoma.

    Science.gov (United States)

    Naiditch, Jessica A; Jie, Chunfa; Lautz, Timothy B; Yu, Songtao; Clark, Sandra; Voronov, Dimitry; Chu, Fei; Madonna, Mary Beth

    2015-01-01

    Metastatic initiation has many phenotypic similarities to epithelial-to-mesenchymal transition, including loss of cell-cell adhesion, increased invasiveness, and increased cell mobility. We have previously demonstrated that drug resistance is associated with a metastatic phenotype in neuroblastoma (NB). The purpose of this project was to determine if the development of doxorubicin resistance is associated with characteristics of mesenchymal change in human NB cells. Total RNA was isolated from wild type (WT) and doxorubicin-resistant (DoxR) human NB cell lines (SK-N-SH and SK-N-BE(2)C) and analyzed using the Illumina Human HT-12 version 4 Expression BeadChip. Differentially expressed genes (DEGs) were identified. Volcano plots and heat maps were generated. Genes of interest with a fold change in expression >1.5 and an adjusted P change via multiple pathways in the transition to a drug-resistant state. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. [Travellers and multi-drug resistance bacteria].

    Science.gov (United States)

    Takeshita, Nozomi

    2012-02-01

    The number of international travellers has increased. There is enormous diversity in medical backgrounds, purposes of travel, and travelling styles among travellers. Travellers are hospitalized abroad because of exotic and common diseases via medical tourism. This is one way of transporting and importing human bacteria between countries, including multi-drug resistant organisms. In developing countries, the antimicrobial resistance in Shigella sp. and Salmonella sp. have been a problem, because of this trend, the first choice of antibiotics has changed in some countries. Community acquired infections as well as hospital acquired infections with MRSA, multi-drug resistance (MDR) Pseudomonas aeruginosa, and ESBL have been a problem. This review will discuss the risk of MDR bacterial infectious diseases for travellers.

  13. Cancer Exosomes as Mediators of Drug Resistance.

    Science.gov (United States)

    André, Maria do Rosário; Pedro, Ana; Lyden, David

    2016-01-01

    In the last decades, several studies demonstrated that the tumor microenvironment is a critical determinant not only of tumor progression and metastasis, but also of resistance to therapy. Exosomes are small membrane vesicles of endocytic origin, which contain mRNAs, DNA fragments, and proteins, and are released by many different cell types, including cancer cells. Mounting evidence has shown that cancer-derived exosomes contribute to the recruitment and reprogramming of constituents associated with the tumor microenvironment. Understanding how exosomes and the tumor microenvironment impact drug resistance will allow novel and better strategies to overcome drug resistance and treat cancer. Here, we describe a technique for exosome purification from cell culture, and fresh and frozen plasma, and further analysis by electron microscopy, NanoSight microscope, and Western blot.

  14. Delamanid: A new armor in combating drug-resistant tuberculosis

    Directory of Open Access Journals (Sweden)

    Alphienes Stanley Xavier

    2014-01-01

    Full Text Available Intense search has been made in the discovery of newer anti-TB drugs to tackle the issues such as drug resistance, HIV co-infection and risk of drug-drug interactions in the management of TB. Delamanid, a newer mycobacterial cell wall synthesis inhibitor, received a conditional approval from European medicines agency (EMA for the treatment of MDR-TB. Preclinical and clinical studies have shown that delamanid has high potency, least risk for drug-drug interactions and better tolerability.

  15. Multiple drug resistance and bacterial infection

    Institute of Scientific and Technical Information of China (English)

    Asad U Khan

    2008-01-01

    Drug resistance is becoming a great problem in developing countries due to excessive use and misuse of antibi-otics.The emergence of new pathogenic strains with resistance developed against most of the antibiotics which may cause,difficult to treat infection.To understand the current scenario in different mode of infection is most important for the clinicians and medical practitioners.This article summarized some common infections and an-tibiotic resistance pattern found among these pathogens.

  16. Clinical Distribution and Drug Resistance of 428 strains Pseudomonas aeruginosa%428株铜绿假单胞菌的临床分布与耐药性分析

    Institute of Scientific and Technical Information of China (English)

    邵璇璇; 贾建安; 鲍继鹏; 蔡心安

    2011-01-01

    Objective To explore the distribution and drug resistance of clinical isolates of Pseudomonas aeruginosas to provide reference for the prevention of hospital onset of infection and clinical rational drug use. Methods ATB Expression system was used to identify Pseudomonas aeruginosas, and antimicrobial resistance was determined by Kirby-Bauer method. Results Among the 1 165 clinical isolates, 428 strains(36.74%) were Pseudomonas aeruginosa. 82.00% of Pseudomonas aeruginosa were separated from the sputum. The antibiotic sensitive rates to PB,MEM,TZP,IPM were 100.00%, 59.80%, 59.70%and 57.10%. Conclusion The detection rate of Pseudomonas aeruginosa was higher than other clinical isolates. The infection risk factors maybe include the severity of diseases,the length of stay in hospital, the immune function and long-term use of antibiotic. Pseudomonas aeruginosa could be highly resistant to antibiotics with multidrug resistance. Antimicrobial agents should be chose more carefully according to the antimicrobial susceptibility test.%目的 分析临床分离铜绿假单胞菌的感染部位分布及耐药率,为减少和控制院内感染及临床合理选择抗菌剂提供依据.方法采用法国生物梅里埃公司ATB Expression微生物分析仪进行细菌鉴定,K-B纸片扩散法进行药敏试验.结果分离获得1 165株细菌,其中铜绿假单胞菌428株,检出率为36.74%;82.00%的铜绿假单胞菌分离自痰与咽拭子,41.44%分离自干部病区.铜绿假单胞菌菌株对多黏菌素B敏感率最高(100.00%),其次为美罗培南(59.80%)、哌拉西林/他唑巴坦(59.70%)和亚胺培南(57.10%).结论 铜绿假单胞菌临床检出率较高,主要分布在老干部病区.易感因素为患者病情严重、住院时间较长、免疫功能低下、大量使用抗菌剂等.铜绿假单胞菌表现为高度和多药耐药,建议临床应根据药敏试验结果进行抗感染治疗.

  17. Drug resistance in Schistosomiasis: a review

    Directory of Open Access Journals (Sweden)

    John I. Bruce

    1987-01-01

    Full Text Available Drug resistance associated with the treatment of human schistosomiasis appears to be an emerging problem requiring more attention from the scientific community than the subject currently receives. Drug-resistant strains of Schistosoma mansoni have been isolated by various investigators as a result of laboratory experimentation or from a combination of field and laboratory studies. Review of this data appears to indicate that the lack of susceptibility observed for some of the isolated strains cannot be ascribed solely to previous administration of antischistosome drugs and thus further studies are required to elucidate this phenomena. Strains of S. mansoni have now been identified from Brazil which are resistant to oxamniquine, hycanthone and niridazole; from Puerto Rico which are resistant to hycanthone and oxamniquine; and from Kenya which are resistant to niridazole and probably oxamniquine. Strains derived by in vitro selection and resistant to oxamniquine and possibly to oltipraz are also available. All of these strains are currently maintained in the laboratory in snails and mice, thus providing for the first time an opportunity for indepth comparative studies. Preliminary data indicates that S. haematobium strains resistant to metrifonate may be occurring in Kenya. This problem could poise great difficulty in the eventual development of antischistosomal agents. Biomphalaria glabrata from Puerto Rico and Brazil were found to be susceptible to drug-resistant S. mansoni from each country.

  18. 儿童感染耐碳青霉烯酶肠杆菌耐药基因及临床分析%Carbapenem-resistant Enterobacteriaceae infections in children and clinical analysis of the drug resistant genes

    Institute of Scientific and Technical Information of China (English)

    黄永建; 周华; 舒赛男; 陈中举; 汪玥; 方峰

    2013-01-01

    目的 检测儿童感染耐碳青霉烯酶肠杆菌科细菌耐药基因并分析其临床资料,以了解儿童耐碳青霉烯肠杆菌感染的高危因素.方法 通过药敏分析筛选出医院患儿的多药耐药肠杆菌科细菌;采用PCR法检测编码碳青霉烯酶的耐药基因与编码产超广谱β-内酰胺酶(ESBLs)的耐药基因;回顾性分析耐碳青霉烯酶肠杆菌感染患儿的临床特点、治疗经过及预后.结果 分离出6株来自感染患儿送检标本分离的耐碳青霉烯酶肠杆菌科细菌,药敏试验显示,对几乎所有碳青霉烯类及β-内酰胺类抗菌药物耐药,仅对部分喹诺酮类及氨基糖苷类抗菌药物敏感;均携带碳青霉烯酶耐药基因与1~2种ESBLs耐药基因;6例患儿长时间使用广谱抗菌药物,均存在相应感染部位;其中4例由外院转诊;收入院时5例病程迁延较长;5例存在基础疾病;除1例死亡和1例失访外,3例痊愈,1例反复感染间断接受治疗.结论 儿童耐碳青霉烯酶肠杆菌科菌株临床感染病例大多存在基础疾病、较长时间使用广谱抗菌药物(特别是碳青霉烯类)等,可能为其高危因素,尽早明确病原耐药变化,并根据药敏试验选择适宜抗菌药物对改善其预后具有重要意义.%OBJECTIVE To detect the drug resistance genes in the carbapenem-resistant Enterobacteriaceae causing infections in the children and review the clinical data so as to better understand the risk factors of carbapenem-re-sistant Enterobacteriaceae infections in the children. METHODS The multidrug-resistant Enterobacteriaceae were screened out through the drug susceptibility testing. PCR was employed to detect the encoding carbapenemase genes and extended spectrum β-lactamase genes. The clinical characteristics of carbapenem-resistant Enterobacteriaceae infections in the children, the treatment, and the prognosis were retrospectively analyzed. RESULTS A total of six strains of carbapenem

  19. Genital Herpes

    Science.gov (United States)

    ... fetal scalp electrode (tiny wire used to check fetal heart rate). Cesarean birth may be recommended if you have an active herpes sore or prodromal symptoms such as pain or burning when you go into labor. After ...

  20. Genital herpes

    Science.gov (United States)

    ... In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious ... JT and Corey L. Herpes simplex virus. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, ...

  1. Death receptor ligands, in particular TRAIL, to overcome drug resistance

    NARCIS (Netherlands)

    de Jong, S; Timmer, T; Heijenbrok, FJ; de Vries, EGE

    2001-01-01

    The efficacy of chemotherapeutic drugs is hampered by the occurrence of intrinsic and acquired drug resistance. A variety of mechanisms cause drug-resistance. A final common factor, however, is the reduced capacity of drug resistant cells to go into apoptosis following treatment with DNA damaging ag

  2. Clinical course and spectrum of intensive care unit patients reactivating herpes simplex-1 virus: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Sundar Krishna

    2008-01-01

    Full Text Available Background : Herpes simplex-1 virus (HSV-1 reactivation in the respiratory tract is common in intensive care unit (ICU patients. However, susceptible ICU populations are poorly defined. Clinical recognition of HSV infection of the respiratory tract is difficult and the impact of such reactivation is not understood. Materials and Methods : A retrospective analysis of HSV-1 positive patients encountered over a 5-year period at a multispecialty ICU was carried out. HSV-1 was identified in respiratory secretions using a qualitative polymerase chain reaction (PCR technique. Patient charts were reviewed for clinical features that would typify HSV-1 respiratory involvement, and the morbidity and mortality risks found with HSV-1 respiratory involvement. Results : A review of 48 HSV-1 positive ICU patients showed that patients reactivating HSV in the respiratory tract fell into one of the three categories: (1 septic elderly patients with and without ARDS, (2 immunosuppressed patients, especially those receiving high-dose steroids, and (3 post-thoracotomy patients. Abnormalities suggestive of HSV-1 reactivation in the respiratory tract included, haemorrhagic or excessive respiratory secretions, concomitant orofacial herpes (42%, and bronchoscopic abnormalities (hemorrhagic ulcers and mucosal friability (83%. Twenty eight percent of the HSV-1 infected patients experienced postextubation stridor. HSV-1 reactivation was associated with extended ventilator stays, significant mortality (42%, and ventilator-associated pneumonias (52%. Conclusions : Identification of susceptible populations and definition of clinical features of HSV-1 related respiratory disease can enable diagnosis of HSV-1 infection in ICU patients. Although detection by a PCR technique can rapidly diagnose HSV-1 reactivation, prospective studies are required to clarify HSV disease versus mere shedding, and understand the impact of HSV-1 reactivation in hospitalized patients.

  3. Clinical Analysis on 18 Cases of Child Herpes Zoster and Review the Literature%儿童带状疱疹18例及文献复习

    Institute of Scientific and Technical Information of China (English)

    杨珊; 迪丽努尔·阿布都热依木; 普雄明

    2013-01-01

    目的 探讨儿童带状疱疹的临床特征.方法 回顾性分析2008年1月-2011年12月本科收治的18例儿童带状疱疹的临床资料并进行文献复习.结果 儿童带状疱疹有轻微的前驱症状,皮疹少且散在分布,神经痛轻微,病程短(2 ~7d),且不发生后遗神经痛.结论 儿童带状疱疹临床少见、症状轻微,发病诱因以感染常见.%Objective To discuss the clinical features of children herpes zoster. Methods The pathogenesis,symptoms, experiences and treatments of eighteen children with herpes zoster were analysised. Results The children herpes zoster had minor precursory symptoms. The skin rash on children was few and scattered, neuralgia was slight in children, and course in children was short(2 ~7d). No PHN happened in children. Conclusion Children herpes zoster is rare in the clinic,clinical symptoms is minor. Infection was the common predisposing factor.

  4. 342株肠球菌的临床分类及耐药性分析%The Clinical Distribution and Analysis of Drug Resistance of 324 Strains of Enterococcus

    Institute of Scientific and Technical Information of China (English)

    余群秀

    2014-01-01

    Objective:To understand the distribution and drug resistance of commonly used antibiotics of enterococcus, in order to provide the basis for clinical rational drug use. Methods:Vitek 2 Compact method was used for routine bacteria identification and drug susceptibility test. Results: Among clinical isolated 342 strains of enterococcus, 140 cases were 40.9% in enterococcus, excrement enterococcus 186 rate of 54.4%;other enterococcus 16 cases were 4.7%. 342 strains of enterococcus were mainly isolated from urine of 254 cases (74.3%), 28 cases (8.2%) and blood cerebrospinal fluid 21 cases (6.1%), 15 cases (5.3%) of bile. Excrement enterococcus to penicillin, ampicillin, ciprofloxacin, levofloxacin, erythromycin and tetracycline resistance was close to or reached 90%, and dung bowel aureus to penicillin and ampicillin remained 100%sensitivity. There were no resistance to enterococcus among vancomycin, rina thiazole amine and Tigecycline. Conclusion: Enterococcus was one of the important pathogenic bacteria in hospital infection. According to the results of drug susceptibility, clinical treatment of enterococcus infection should choose reasonable antibiotics.%目的:了解肠球菌的临床分离率及其对常用抗生素的耐药性,指导临床合理使用抗生素。方法:用Vitek 2 Compact法进行细菌鉴定及常规药敏试验。结果:临床分离到的342株肠球菌中,粪肠球菌有140例,阳性率40.9%,屎肠球菌有186例,阳性率54.4%,其它肠球菌有16例,阳性率4.7%。342株肠球菌主要分离自尿液254例,阳性率74.3%;血液28例,阳性率8.2%;脑脊液21例,阳性率6.1%;胆汁15例,阳性率5.3%。屎肠球菌对青霉素、氨苄西林、环丙沙星、左氧氟沙星、红霉素和四环素的耐药率已接近或达到90%,而粪肠球菌对青霉素和氨苄西林仍保持100%敏感性。未发现肠球菌对万古霉素、利奈唑胺和替加环素耐药。结论:革兰阳性球菌中肠球菌

  5. Longitudinal Detection and Persistence of Minority Drug-Resistant Populations and Their Effect on Salvage Therapy.

    Directory of Open Access Journals (Sweden)

    Masako Nishizawa

    Full Text Available Drug-resistant HIV are more prevalent and persist longer than previously demonstrated by bulk sequencing due to the ability to detect low-frequency variants. To clarify a clinical benefit to monitoring minority-level drug resistance populations as a guide to select active drugs for salvage therapy, we retrospectively analyzed the dynamics of low-frequency drug-resistant population in antiretroviral (ARV-exposed drug resistant individuals.Six HIV-infected individuals treated with ARV for more than five years were analyzed. These individuals had difficulty in controlling viremia, and treatment regimens were switched multiple times guided by standard drug resistance testing using bulk sequencing. To detect minority variant populations with drug resistance, we used a highly sensitive allele-specific PCR (AS-PCR with detection thresholds of 0.3-2%. According to ARV used in these individuals, we focused on the following seven reverse transcriptase inhibitor-resistant mutations: M41L, K65R, K70R, K103N, Y181C, M184V, and T215F/Y. Results of AS-PCR were compared with bulk sequencing data for concordance and presence of additional mutations. To clarify the genetic relationship between low-frequency and high-frequency populations, AS-PCR amplicon sequences were compared with bulk sequences in phylogenetic analysis.The use of AS-PCR enabled detection of the drug-resistant mutations, M41L, K103N, Y181C, M184V and T215Y, present as low-frequency populations in five of the six individuals. These drug resistant variants persisted for several years without ARV pressure. Phylogenetic analysis indicated that pre-existing K103N and T215I variants had close genetic relationships with high-frequency K103N and T215I observed during treatment.Our results demonstrate the long-term persistence of drug-resistant viruses in the absence of drug pressure. The rapid virologic failures with pre-existing mutant viruses detectable by AS-PCR highlight the clinical importance of

  6. Genital herpes: Heisenberg revisited

    Science.gov (United States)

    Goldmeier, D.

    1998-01-01

    In the confirmation of recurrences of genital herpes, patient defined disease reactivation and virological data hold the scientific high ground. The influence of the psyche on recurrence rates and perception of recurrences has been largely neglected and marginalised up to the present, possibly because research work in that area has been and continues to be of poor calibre. However, neglected psychological variables may render otherwise relevant clinical trials uninterpretable. Psychological aspects of counselling before testing for serum herpes simplex type 2 antibodies are also discussed. 




 PMID:9849561

  7. Clinical characteristics of infections caused by 146 strains of streptococci and analysis of drug resistance%146株链球菌属临床感染特征及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    吴洪巧; 纪明宇; 裴凤艳; 汪运山

    2011-01-01

    OBJECTIVE To investigate the distribution and antibiotic resistance of streptococcus isolated from Jinan central hospital from Jan 2009 to Dec 2010. METHODS The minimum inhibitory concentrations (MICs) of penicillin for S. pneumoniae were determined by E-test. Other antimicrobial susceptibility was tested by KirbyBauer method. Drug resistance was judged according to the Clinical and Laboratory Standards Institute (CLSI)2009 M100-S19. RESULTS A total of 146 strains of Streptococcus were isolated during two years, which included 102 strains S. pneumonia and 43 strains S. β-hemolytic and 1 strain other Streptococcus. Of the αβ-hemolytic 43 strains, 14 were S. pyogenes (Group A), 11 were S. agalactiae (Group B) and 18 were S. constellatus (Group G). For specimens, respiratory tract secretion predominated, and secretion followed. The prevalence of penicillin non-susceptible S. pneumonia was 3.9 % (Non-meningitis). Strains of S. β-hemolytic were 100. 0 % susceptible to penicillin and cefotaxime sodium, which were the first-choice drugs for experimental treatment. The prevalence of S. viridians resistant erythromycin and clindamycin were lower than 20.0% respectively. cefepime resistance rate was 33.3 %, the mechanism was unclear. No vancomycin and linezolid resistant strains. CONCLUSION Most Streptococci isolated from our hospital are S. pneumonia strains and S. β-hemolytic strains. The prevalence of muti-drug resistant strains is increasing, especially erythromycin and clindamycin resistant strains. It is necessary to identify these resistant strains timely and prevent the dissemination and outbreaks in hospital.%目的 分析医院2009年1月-2010年12月临床分离的链球菌属构成比和对常用抗菌药物的耐药性.方法 采用E试验法检测肺炎链球菌对青霉素MIC,其他抗菌药物采用纸片扩散法进行药敏试验;根据CLSI2009年M100-S19判定耐药性.结果 2009年1月-2010年12月,医院临床样

  8. Clinical Misdiagnosis of Herpes Zoster and the Countermeasures%带状疱疹临床误诊分析及对策

    Institute of Scientific and Technical Information of China (English)

    杜策

    2016-01-01

    Objective To analyze the causes of herpes zoster misdiagnosis and to put forward the countermeasures to reduce the oc-currence of misdiagnosis. Methods The clinical data of 117 cases with herpes zoster were collected and analyzed. Results Herpes zos-ter misdiagnosis occurred in almost every department, department of internal medicine, department of surgery and department of rehabil-itation had the higher occurrence;herpes zoster on chest, abdomen, head, face and neck was often misdiagnosed;the misdiagnosis of her-pes zoster occurred more in the middle-age and elderly. Conclusions Different causes lead to the misdiagnosis of herpes zoster;more at-tention should be paid and certain countermeasures should be taken to reduce the occurrence of misdiagnosis.%目的:分析带状疱疹误诊原因,并提出减少误诊的对策。方法收集我院皮肤科确诊为带状疱疹117例患者的临床资料,进行分析、总结。结果带状疱疹误诊见于临床各科,尤以内科、外科、康复科等科室所占比例较高;误诊部位以胸腹部、头面颈部居多;误诊年龄以中老年患者居多。结论带状疱疹误诊原因较多,应该多方面加以重视,并采取相应对策,减少误诊的出现。

  9. 产ESBLs肺炎克雷伯菌临床分布特征及耐药性分析%Clinical distribution and drug resistance of ESBLs-producing Klebsiella pneumoniae

    Institute of Scientific and Technical Information of China (English)

    王玉红; 邓敏; 闵晓春

    2014-01-01

    OBJECTIVE To observe the distribution and drug resistance of ESBLs-producing K lebsiella pneumoniae so as to provide guidance for the reasonable clinical use of antibiotics .METHODS From Jan 2013 to Dec 2013 ,a to-tal of 105 strains of K .pneumoniae were isolated from the outpatients and the hospitalized patients ,the bacterial i-dentification was carried out by using APl system ,the drug susceptibility testing was performed with the use of agar dilution method ,the results were interpreted according to the NccLs ,and the data were statistically analyzed by using the WHONET4 software .RESULTS Among the 105 strains of K .pneumoniae ,50 strains of ESBLs-pro-ducing K .pneumoniae were detected with the detection rate of 47 .6% .The sputum ,urine ,and wound secretions were the predominant specimens sources ,52 .1% of the ESBLs-producing strains were isolated from the sputum specimens ,50 .0% from the urine specimens ,33 .3% from the wound secretions ;48 .0% of the ESBLs-producing strains distributed in the geriatric ward .The ESBLs-producing K .pneumoniae strains were highly susceptible to the carbapenems ,with the drug susceptibility rate of 100 .0% ,and the drug susceptibility rate to penicillin varied from 0 to 8 .0% .CONCLUSION The isolates of ESBLs-producing K .pneumoniae are highly resistant to the com-monly used antibiotics ,it is crucial to reasonably use antibiotics ;the bacterial culture and the drug susceptibility testing should be strengthened so as to guide the clinical use of antibiotics .%目的:分析产ESBLs肺炎克雷伯菌的分布特征及耐药性,以指导临床合理用药。方法收集医院2013年1-12月门诊和住院患者分离所得的105株肺炎克雷伯菌,采用A Pl系统进行细菌鉴定,药敏试验采用琼脂扩散法,结果判定按NCCLS标准执行,数据统计按世界卫生组织细菌耐药性监测组软件 WHONET4系统处理。结果105株肺炎克雷伯菌检出产ESBLs菌株50株,检出率47.6%;标

  10. Herpes simplex virus type 2-associated recurrent aseptic (Mollaret's meningitis in genitourinary medicine clinic: a case report

    Directory of Open Access Journals (Sweden)

    Abou-Foul AK

    2014-03-01

    Full Text Available Ahmad K Abou-Foul, Thajunisha M Buhary, Sedki L Gayed Department of Genitourinary Medicine, Royal Blackburn Hospital, East Lancashire Hospitals NHS Trust, Blackburn, UK Introduction: Cases of idiopathic recurrent benign aseptic meningitis were first described by Mollaret. Today, herpes simplex virus (HSV is considered the cause of most cases of Mollaret's meningitis. Case report: A 40-year-old male was referred to our genitourinary medicine clinic with recurrent genital herpetic lesions. He had HSV-2-positive genital ulcers 8 years earlier. One year after the first infection, he developed severe recurrent attacks of headache associated with meningitis symptoms. The results of all radiological and biochemical tests were normal, but the patient reported a correlation between his attacks and genital herpes flare-ups. We diagnosed the patient with Mollaret's meningitis and started him on continuous suppressive acyclovir therapy, which resulted in marked clinical improvement. Discussion: Mollaret's meningitis is a rare form of idiopathic recurrent aseptic meningitis that has a sudden onset, short duration, and spontaneous remission with unpredictable recurrence. We believe that the presence of concurrent or recurrent mucocutaneous herpetic lesions can aid its diagnosis, prior to which, affected patients usually have many unnecessary investigations and treatments. Therefore, detailed sexual history should be sought in all patients with aseptic meningitis, and clinicians should also ask about history of recurrent headaches in all patients with recurrent herpetic anogenital lesions. Continuous suppressive acyclovir therapy may reduce the frequency and severity of attacks and can dramatically improve lifestyle. Keywords: HSV-2 virus, acyclovir, Mollaret's meningitis, recurrent aseptic meningitis, HSV-2 virus, viral meningitis, acyclovir

  11. Determinants of virological failure and antiretroviral drug resistance in Mozambique.

    Science.gov (United States)

    Rupérez, María; Pou, Christian; Maculuve, Sonia; Cedeño, Samandhy; Luis, Leopoldina; Rodríguez, Judith; Letang, Emilio; Moltó, José; Macete, Eusébio; Clotet, Bonaventura; Alonso, Pedro; Menéndez, Clara; Naniche, Denise; Paredes, Roger

    2015-09-01

    The objective of this study was to inform public health actions to limit first-line ART failure and HIV drug resistance in Mozambique. This was a cross-sectional study. HIV-1-infected adults on first-line ART for at least 1 year attending routine visits in the Manhiça District Hospital, in a semi-rural area in southern Mozambique with no HIV-1 RNA monitoring available, were evaluated for clinical, socio-demographic, therapeutic, immunological and virological characteristics. Factors associated with HIV-1 RNA ≥1000 copies/mL and HIV drug resistance were determined using multivariate logistic regression. The study included 334 adults on first-line ART for a median of 3 years, of which 65% (214/332) had suppressed viraemia, 11% (37/332) had low-level viraemia (HIV-1 RNA 150-999 copies/mL) and 24% (81/332) had overt virological failure (HIV-1 RNA ≥1000 copies/mL). HIV drug resistance was detected in 89% of subjects with virological failure, but in none with low-level viraemia. Younger age [OR = 0.97 per additional year (95% CI = 0.94-1.00), P = 0.039], ART initiation at WHO stage III/IV [OR = 2.10 (95% CI = 1.23-3.57), P = 0.003] and low ART adherence [OR = 2.69 (95% CI = 1.39-5.19), P = 0.003] were associated with virological failure. Longer time on ART [OR = 1.55 per additional year (95% CI = 1.00-2.43), P = 0.052] and illiteracy [OR = 0.24 (95% CI = 0.07-0.89), P = 0.033] were associated with HIV drug resistance. Compared with HIV-1 RNA, clinician's judgement of ART failure, based on clinical and immunological outcomes, only achieved 29% sensitivity and misdiagnosed 1 out of every 4.5 subjects. Public health programmes in Mozambique should focus on early HIV diagnosis, early ART initiation and adherence support. Virological monitoring drastically improves the diagnosis of ART failure, enabling a better use of resources. © The Author 2015. Published by Oxford University Press on behalf of the British

  12. The action of Pseudomonas aeruginosa biofilms in intrinsic drug resistance

    Institute of Scientific and Technical Information of China (English)

    XIE Yi; JIA Wen-xiang; ZENG Wei; YANG Wei-qing; CHENG Xi; LI Xue-ru; WANG Lan-lan; KANG Mei; ZHANG Zai-rong

    2005-01-01

    Background There is a growing interest in studying the relationship between intrinsic resistance and biofilms resistance to drugs. However, the relationship still remains unclear in the macroscopic bacterial growth. Our study is to illuminate the change of bacterial drug resistance of gyrA mutant and active efflux pump during the development of Pseudomonas aeruginosa (P. aeruginosa) biofilms. Methods The strains of type Ⅱ topoisomerase gene mutant (gyrA mutant) and multidrug resistance (MDR) efflux pump were clinical isolates and detected by polymerase chain reaction (PCR). The process of bacterial biofilms development was observed by scanning electron microscope. Triparental mating experiments were performed to transfer report gene of green fluorescent protein (GFP) into P. aeruginosa biofilms strains and followed by analysis of bacterial survival rate between intrinsic resistance and biofilms resistance.Results The fluorescent strains with pGFPuv could develop mature biofilms on Teflon surface. Before a period of 72 hours, the survival rate of biofilms bacteria and intrinsic resistance strains in ciprofloxacin solution was significantly different (P0.05). The carbonyl cyanide m-chlorophenylhydrazone and azithromycin could significantly reduce the drug resistance of biofilm strains and efflux pump strains.Conclusions In the development of P. aeruginosa biofilms, the strains of gyrA mutation and MDR efflux could be conferred with new level of drug resistance. When co-cultured mutated strains with biofilm strains, biofilms may play a major role in bacterial resistance. But after 72 hours incubation (a mature biofilms had been developed), there was no clearly difference between the number of mutant strains and biofilm strains.

  13. Enterotoxin genes of Staphylococcus aureus of clinical specimens and drug resistance%临床患者标本金黄色葡萄球菌肠毒素基因及耐药性的检测分析

    Institute of Scientific and Technical Information of China (English)

    汪永禄; 王多春; 张萍; 陶勇; 王利; 王艳; 阚飙

    2013-01-01

    Objective To understand the enterotoxin carrying situation and drug resistance of Staphylococcus aureus(5. aureus ) isolated from clinical specimens. Methods Mini-VIDAS and PCR amplification were used to detect 5. aureus enterotoxin and its genes,5. aureus enterotoxin and enterotoxin genes sea ~ see(sea、seb、sec、sed、see)、seg ~ sej(seg、seh、 sei、sej) and tsst. Amplification products were tested by agarose gel electrophoresis. Cefoxitin was used to detect Methicillin-resistant Staphylococcus aureus (MRSA).The strain susceptibility was tested by agar dilution. Results 40(72.73%) out of 55 5. aureus strains were enterotoxin positive,mainly,sea 14.55% (8/55) , sec 12.73% (7/55) and seb 9. 10% (5/55) ,9. 09(5/55) strains carrying two or more enterotoxins; In addition,17 out of 19 MRSA strains carried enterotoxin (89.47% ) ,sea is the main enterotoxin gene,accounting for 26.32% (5/19) ; 23 out of 36 MSSA strains carried enterotoxin (63. 89% ) ,sec was the main enterotoxin gene,accounting for 16. 67% (6/36). 5. aureus was susceptible to furadantin, but resistant to 11 kinds of antibiotics, including penicillin, oxacillin, et al. MRSA had stronger resistance to MSSA. Conclusions More attention should be paid to the detection of S. aureus enterotoxin and MRSA, and rational use of antibiotics was important for the control of MRSA infection in hospital.%目的 了解临床标本分离的金黄色葡萄球菌的产肠毒素携带情况及耐药现状.方法 应用mini-VIDAS仪器检测金黄色葡萄球菌肠毒素、PCR扩增肠毒素基因sea~see(sea、seb、sec、sed、see)、seg~sej(seg、she、sei、sej)和tsst基因,电泳检测扩增产物,耐甲氧西林金黄色葡萄球菌(MRSA)检测用检测头孢西丁方法,药敏试验采用琼脂稀释法进行.结果 55株金黄色葡萄球菌中40株携带肠毒素基因,占72.73%,主要为sea型14.55%(8/55)、sec型12.73%(7/55)、seb型9.10% (5/55),同时携带≥2种肠毒素的占9.09%(5/55);

  14. Evidence-based interventional pain medicine according to clinical diagnoses. 17. Herpes zoster and post-herpetic neuralgia.

    Science.gov (United States)

    van Wijck, Albert J M; Wallace, Mark; Mekhail, Nagy; van Kleef, Maarten

    2011-01-01

    Herpes zoster infection is caused by a reactivation of the latent varicella zoster virus that causes chicken pox. It appears predominantly in older adults whose immunity for the virus has waned. The natural course of the disease is usually favorable, and the symptoms disappear spontaneously within a few weeks. Some patients, however, have prolonged pain: post-herpetic neuralgia. The diagnosis of acute zoster infection is made on the clinical signs including the appearance of rash. Post-herpetic neuralgia is described as sharp, burning, aching, or shooting constantly present in the dermatome that corresponds with the earlier rash. The objectives of treating herpes zoster are: (1) acute pain reduction; (2) promotion of recovery of epidermal defects and prevention of secondary infections; and (3) reduction or prevention of post-herpetic neuralgia. The objective of the treatment of post-herpetic neuralgia is primarily pain alleviation and improvement of the quality of life. Early treatment of the infection and the pain is believed to reduce the risk for post-herpetic neuralgia. This persistent pain syndrome is difficult to treat. Antiepileptic drugs and tricyclic antidepressants are the first choice. Interventional treatments, such as epidural injections of corticosteroids and local anesthetic drugs, have an effect on the acute pain but are of limited use in preventing post-herpetic neuralgia. When conservative treatment fails in providing satisfactory relief of post-herpetic neuralgia, a sympathetic block may be considered (2 C+); if this treatment provides unsatisfactory results, spinal cord stimulation may be considered, in a study context (2 C+).

  15. Acyclovir Prophylaxis Reduces the Incidence of Herpes Zoster Among HIV-Infected Individuals: Results of a Randomized Clinical Trial.

    Science.gov (United States)

    Barnabas, Ruanne V; Baeten, Jared M; Lingappa, Jairam R; Thomas, Katherine K; Hughes, James P; Mugo, Nelly R; Delany-Moretlwe, Sinead; Gray, Glenda; Rees, Helen; Mujugira, Andrew; Ronald, Allan; Stevens, Wendy; Kapiga, Saidi; Wald, Anna; Celum, Connie

    2016-02-15

    Human immunodeficiency virus (HIV)-infected persons have higher rates of herpes zoster than HIV-uninfected individuals. We assessed whether twice daily treatment with 400 mg of oral acyclovir reduces the incidence of herpes zoster in a randomized, double-blind, placebo-controlled trial among 3408 persons coinfected with HIV and herpes simplex virus type 2. During 5175 person-years of follow-up, 26 cases of herpes zoster occurred among those assigned acyclovir, compared with 69 cases among those assigned placebo (rates, 1.00 and 2.68/100 person-years, respectively), a relative decrease of 62% (hazard ratio, 0.38; 95% confidence interval, .24-.67; P herpes zoster incidence among HIV-infected persons.

  16. Pathogen distribution and drug resistance of nephrology patients with urinary tract infections

    Directory of Open Access Journals (Sweden)

    Yunqian Wang

    2016-05-01

    Full Text Available Objective: Pathogen distribution characteristics of nephrology patients with urinary tract infections are studied, and drug resistance of nephrology and urinary tract infection disease are analyzed, so as to provide sufficient evidence for treatment of patients. Methods: Conduct randomized control study of 3500 cases of nephrology patients with urinary tract infections treated in different hospitals from December 2013 to December 2015, isolate pathogens in patients’ urine samples, perform identification and drug sensitive test and then conduct detailed analysis of drug resistance of pathogens. Results: Through isolation of pathogens, it can be found that all pathogens include Escherichia coli, Gram-positive cocci, gram-negative bacteria, fungi, Acinetobacter baumannii, Enterococcus faecalis, and urinary Enterococcus. Among them, proportion of E. coli is the largest. Patients have relatively high drug resistance to ceftriaxone, gentamicin, ciprofloxacin and cotrimoxazole. Conclusion: For nephrology patients with urinary tract infection, the main pathogen is E. coli, which has had some drug resistance. Drug resistance detection of pathogen should be strengthened in clinics, so as to provide strong guidance for clinical treatment and promote effective treatment of patients.

  17. Predicted levels of HIV drug resistance

    DEFF Research Database (Denmark)

    Cambiano, Valentina; Bertagnolio, Silvia; Jordan, Michael R

    2014-01-01

    BACKGROUND: There is concern that the expansion of antiretroviral roll-out may impact future drug resistance levels and hence compromise the benefits of antiretroviral therapy (ART) at an individual and population level. We aimed to predict future drug resistance in South Africa and its long...... are maintained, in 20 years' time HIV incidence is projected to have declined by 22% (95% confidence interval, CI -23 to -21%), and the number of people carrying NNRTI resistance to be 2.9-fold higher. If enhancements in diagnosis and retention in care occur, and ART is initiated at CD4 cell count less than 500......  cells/μl, HIV incidence is projected to decline by 36% (95% CI: -37 to -36%) and the number of people with NNRTI resistance to be 4.1-fold higher than currently. Prevalence of people with viral load more than 500  copies/ml carrying NRMV is not projected to differ markedly according to future ART...

  18. Insulin-like growth factor 2 silencing restores taxol sensitivity in drug resistant ovarian cancer.

    Science.gov (United States)

    Brouwer-Visser, Jurriaan; Lee, Jiyeon; McCullagh, KellyAnne; Cossio, Maria J; Wang, Yanhua; Huang, Gloria S

    2014-01-01

    Drug resistance is an obstacle to the effective treatment of ovarian cancer. We and others have shown that the insulin-like growth factor (IGF) signaling pathway is a novel potential target to overcome drug resistance. The purpose of this study was to validate IGF2 as a potential therapeutic target in drug resistant ovarian cancer and to determine the efficacy of targeting IGF2 in vivo. An analysis of The Cancer Genome Atlas (TCGA) data in the serous ovarian cancer cohort showed that high IGF2 mRNA expression is significantly associated with shortened interval to disease progression and death, clinical indicators of drug resistance. In a genetically diverse panel of ovarian cancer cell lines, the IGF2 mRNA levels measured in cell lines resistant to various microtubule-stabilizing agents including Taxol were found to be significantly elevated compared to the drug sensitive cell lines. The effect of IGF2 knockdown on Taxol resistance was investigated in vitro and in vivo. Transient IGF2 knockdown significantly sensitized drug resistant cells to Taxol treatment. A Taxol-resistant ovarian cancer xenograft model, developed from HEY-T30 cells, exhibited extreme drug resistance, wherein the maximal tolerated dose of Taxol did not delay tumor growth in mice. Blocking the IGF1R (a transmembrane receptor that transmits signals from IGF1 and IGF2) using a monoclonal antibody did not alter the response to Taxol. However, stable IGF2 knockdown using short-hairpin RNA in HEY-T30 effectively restored Taxol sensitivity. These findings validate IGF2 as a potential therapeutic target in drug resistant ovarian cancer and show that directly targeting IGF2 may be a preferable strategy compared with targeting IGF1R alone.

  19. Determinants of Genetic Diversity of Spontaneous Drug Resistance in Bacteria.

    Science.gov (United States)

    Couce, Alejandro; Rodríguez-Rojas, Alexandro; Blázquez, Jesús

    2016-07-01

    Any pathogen population sufficiently large is expected to harbor spontaneous drug-resistant mutants, often responsible for disease relapse after antibiotic therapy. It is seldom appreciated, however, that while larger populations harbor more mutants, the abundance distribution of these mutants is expected to be markedly uneven. This is because a larger population size allows early mutants to expand for longer, exacerbating their predominance in the final mutant subpopulation. Here, we investigate the extent to which this reduction in evenness can constrain the genetic diversity of spontaneous drug resistance in bacteria. Combining theory and experiments, we show that even small variations in growth rate between resistant mutants and the wild type result in orders-of-magnitude differences in genetic diversity. Indeed, only a slight fitness advantage for the mutant is enough to keep diversity low and independent of population size. These results have important clinical implications. Genetic diversity at antibiotic resistance loci can determine a population's capacity to cope with future challenges (i.e., second-line therapy). We thus revealed an unanticipated way in which the fitness effects of antibiotic resistance can affect the evolvability of pathogens surviving a drug-induced bottleneck. This insight will assist in the fight against multidrug-resistant microbes, as well as contribute to theories aimed at predicting cancer evolution.

  20. The role of photodynamic therapy in overcoming cancer drug resistance

    Science.gov (United States)

    Spring, Bryan Q.; Rizvi, Imran; Xu, Nan; Hasan, Tayyaba

    2015-01-01

    Many modalities of cancer therapy induce mechanisms of treatment resistance and escape pathways during chronic treatments, including photodynamic therapy (PDT). It is conceivable that resistance induced by one treatment might be overcome by another treatment. Emerging evidence suggests that the unique mechanisms of tumor cell and microenvironment damage produced by PDT could be utilized to overcome cancer drug resistance, to mitigate the compensatory induction of survival pathways and even to re-sensitize resistant cells to standard therapies. Approaches that capture the unique features of PDT, therefore, offer promising factors for increasing the efficacy of a broad range of therapeutic modalities. Here, we highlight key preclinical findings utilizing PDT to overcome classical drug resistance or escape pathways and thus enhance the efficacy of many pharmaceuticals, possibly explaining the clinical observations of the PDT response to otherwise treatment-resistant diseases. With the development of nanotechnology, it is possible that light activation may be used not only to damage and sensitize tumors but also to enable controlled drug release to inhibit escape pathways that may lead to resistance or cell proliferation. PMID:25856800

  1. Attachment and penetration of acyclovir-resistant herpes simplex virus are inhibited by Melissa officinalis extract.

    Science.gov (United States)

    Astani, Akram; Navid, Mojdeh Heidary; Schnitzler, Paul

    2014-10-01

    Medicinal plants are increasingly of interest as novel source of drugs for antiherpetic agents, because herpes simplex virus (HSV) might develop resistance to commonly used antiviral drugs. An aqueous extract of Melissa officinalis and the phenolic compounds caffeic acid, p-coumaric acid and rosmarinic acid were examined for their antiviral activity against herpes simplex virus type 1 (HSV-1) acyclovir-sensitive and clinical isolates of acyclovir-resistant strains in vitro. When drugs were added during the intracellular replication of HSV-1 infected cells, no antiviral effect was observed by plaque reduction assay. However, Melissa extract interacted directly with free viral particles of two acyclovir-resistant HSV strains at low IC50 values of 0.13 and 0.23 µg/mL and high selectivity indices of 2692 and 1522, respectively. The Melissa extract and rosmarinic acid inhibited HSV-1 attachment to host cells in a dose-dependent manner for acyclovir-sensitive and acyclovir-resistant strains. These results indicate that mainly rosmarinic acid contributed to the antiviral activity of Melissa extract. Penetration of herpes viruses into cells was inhibited by Melissa extract at 80% and 96% for drug-sensitive and drug-resistant viruses, respectively. Melissa extract exhibits low toxicity and affects attachment and penetration of acyclovir-sensitive and acyclovir-resistant HSVs in vitro. Copyright © 2014 John Wiley & Sons, Ltd.

  2. Gene chip array for differentiation of mycobacterial species and detection of drug resistance

    Institute of Scientific and Technical Information of China (English)

    SHI Xiao-chun; LIU Xiao-qing; XIE Xiu-li; XU Ying-chun; ZHAO Zhi-xian

    2012-01-01

    Background Gene chip array can differentiate isolated mycobacterial strains using vadous mycobacterium specific probes simultaneously.Gene chip array can evaluate drug resistance to isoniazid and rifampin of tuberculosis strains by detecting drug resistance related gene mutation.This technique has great potential for clinical application.We performed a retrospective study to investigate the capability of gene chip array in the rapid differentiation of species and detection of drug resistance in mycobacterium,and to evaluate its clinical efficacy.Methods We selected 39 patients (54 clinical mycobacterium isolates),used gene chip array to identify the species of these isolates and detect drug resistance to isoniazid and rifampin in Mycobacterium tuberculosis isolates.Meanwhile,these patients' clinical data were analyzed retrospectively.Results Among these 39 patients whose mycopacterium culture were positive,32 patients' isolates were identified as Mycobacterium tubercu/osis, all of them were clinical infection. Seven patients' isolates were identified as non-tuberculosis mycobacterium.Analyzed with their clinical data,only two patients were considered as clinical infection,both of them were diagnosed as hematogenous disseminated Mycobacterium introcellulare infection.The other five patients' isolates were of no clinical significance; their clinical samples were all respiratory specimens.Clinical manifestations of tuberculosis and non-tuberculous mycobacterial infections were similar.Isoniazid resistance was detected in two tuberculosis patients,while rifampin resistance was detected in one tuberculosis patient; there was another patient whose Mycobacterium tuberculosis isolate was resistant to both isoniazid and rifampin (belongs to multidrug resistance tuberculosis).The fact that this patient did not respond to routine anti-tuberculosis chemotherapy also confirmed this result.Conclusions Gene chip array may be a simple,rapid,and reliable method for the

  3. Etiology and drug resistance of vaginal secretions infection in gynecological clinic%妇科门诊阴道分泌物感染病原学及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    何兰娟; 吴丽燕; 滕美君

    2015-01-01

    较为接近,分别为50.29%、47.40%、41.04%和40.46%,而对司帕沙星的耐药率较低,仅为3.47%,其次是氧氟沙星,耐药率为21.97%。结论:引起女性阴道分泌物感染的病原学分布较为广泛,其中以真菌和细菌最为常见,其次是支原体。在临床治疗中应根据不同病原菌感染的特点,为患者选择耐药性较低的药物进行治疗,以期获得良好效果,缩短治疗时间,而且应夫妻同治,避免反复发作。%Objectives:To investigate the etiology distribution and drug resistance of vaginal secretions in-fection in gynecology clinic,to provide basis and reference for the clinical treatment of vaginitis.Methods:678 pa-tients with gynecological clinic vaginitis were selected as study subjects.Their vaginal discharge were observed un-der microscopes for cleanliness,as well as the presence or absence of clue cells of Candida and Trichomonas,and dry film was produced by Gram staining to determine whether there was leather Gram -negative meningitis.Siali-dase was used for rapid detection of bacterial vaginosis.Pathogens were cultured for parallel detection of drug resist-ance.Results:Of the 678 patients,fungal infection was most common (237,34.96%),of which 218 cases were Candida albicans infection (32.15%)and the rest 19 patients were C.glabrata infection (2.80%).224 cases (33.04%)were of bacterial infection,of which the most common was E.coli (79,11.65%),followed by Strep-tococcus agalactiae,Enterococcus faecalis,Klebsiella pneumoniae were detected in 64 cases,56 cases and 25 cases respectively,accounting for 9.44%,8.26% and 3.69%.173 cases (25.52%)were of mycoplasma,of which UU in 96 cases (14.16%),Mycoplasma hominis in 49 cases (7.23%),two kinds of Mycoplasma coinfection in 28 cases (4.13%).In addition there were 19 cases (2.80%),14 cases (2.06%)and 11 cases (1.62%)patients were infected with chlamydia,trichomoniasis and Grand -negative meningitis accordingly.In general,Candida al-bicans and C

  4. Analysis of clinical efficacy early extensive drug resistant tuberculosis for 6 months%早期广泛耐药肺结核近期临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    李哲明; 谭守勇; 邝浩斌; 李艳; 覃红娟

    2016-01-01

    Objective To analyze the clinical efficacy of pre-extensive drug resistant tuberculosis (pre-XDR-TB), and to explore the feasibility of using the standard multidrug resistant tuberculosis (MDR-TB) therapeutic regimen to treat the patients with pre-MDR-TB. Methods A retrospective analysis was made for 126 cases of the MDR-TB patients who were received the treatment in Guangzhou chest hospital from 2009 to 2013. It was divided into MDR-TB group, pre-XDR-TB group and XDR-TB group according to the drug sensitive test (DST) of quinolone(levofloxacin, moxifloxacin) and aminoglycoside (amikacin). All patients were treated for 6-months with the standard therapeutic regimen including Am(Cm), Lfx(Mfx), Pto, PAS and PZA. Results (1) There were 126 cases of the MDR-TB patients in the study, 31 cases (24.6%) complicate with aminoglycosides-resistance, 69 cases (54.7%) complicate with quinolone-resistance. (2) The negative rate of MDR-TB group, pre-XDR-TB group and XDR-TB group was 82.0%, 55.8% and 29.2% respectively (χ² = 20.110, P < 0.001). (3)The negative rate of pre-XDR-TB group significantly lower than MDR-TB group (χ² = 8.146, P = 0.004). The negative rate of pre-XDR-TB group higher than XDR-TB group (χ²= 4.661, P = 0.031). Conclusions The situation of quinolone and aminoglycoside resistance was high in the patients with MDR-TB. We should carry out the detection of quinolone and aminoglycoside resistance in clinical treatment. The clinical efficacy for the patients with pre-XDR-TB was significantly poorer than the patients with MDR-TB using the standard MDR-TB therapeutic regiment treated.%目的:对早期广泛耐药肺结核病近期临床疗效进行分析,探讨采用标准耐多药结核病方案治疗早期广泛耐药结核病的可行性。方法:回顾性分析2009-2013年在广州市胸科医院治疗的耐多药肺结核126例。根据治疗前喹诺酮类或氨基糖苷类药物的耐药情况分为耐多药结核(MDR-TB)组、早期广泛耐

  5. 感染性腹泻临床与病原学分布特点及耐药分析%Clinical features, etiology distribution and drug resistance in patients with infectious diarrhea

    Institute of Scientific and Technical Information of China (English)

    蒋莹; 庄天彦; 郭祥萍

    2012-01-01

    hydrophila, Morganella. morganii strains and Reid Providencia stuartii (1 case in each infection, 3.8%). The detection of pathogenic bacteria was dominant in young and middle-aged patients. The main characteristics of stool specimens in Shigella were mucous and watery, while those in E.coli and Salmonella were loose. Shigella, E.coli and Salmonella were generally resistant to ampicillin,and with some level of resistantance to common antimicrobial agents,such as p-lactams,cephalosporins and quinolones. Pathogens resistant to carbapenems were not found. Conclusions The bacterial culture positive rate of stool samples from patients with infectious bacterial diarrhea is not high in Second Affiliated Hospital of Xinjiang Medical University, with the main pathogenic bacteria of Shigella. Monitoring of pathogen distribution, drug resistance, and rational use of antibacterial drugs are very important.

  6. Clinical Analysis of 50 Cases of Child Herpes Zoster%儿童带状疱疹50例临床分析

    Institute of Scientific and Technical Information of China (English)

    杨凤琼; 谢雪冰; 邓骥

    2011-01-01

    Objective To discuss the clinical features of children herpes zoster. Methods Fifty children with herpes zoster were compared with 50 cases of adults herpes zoster on their symptoms, experiences and treatments.Result The children herpes zoster had minor precursory symptoms(24% ). The skin rash on children was few and scattered while on adlut heavy. Neuralgia was slight in children but obvious in adult. and course in children was (7.5 ± 1. 8 d) and in adult was ( 18 ±2.5 d) respectively. No PHN happened in children but about 56% in adult patients. Discussion The incidence rate of children herpes zoster is low, and most of them have inducement.%目的 探讨儿童带状疱疹的临床特征.方法 分析50例儿童带状疱疹的诱因、症状、体征及治疗,并与同期50例成人带状疱疹患者临床资料相对照.结果 儿童带状疱疹有轻微前驱症状(24%),皮疹少且散在.神经痛轻微,病程短(7.5±1.8 d),且不发生后遗神经痛;而成人带状疱疹则皮疹重,神经痛明显,病程长(18±2.5d),有后遗神经痛(56%).讨论相对于成年人,儿童带状疱疹发病率低,发病多有诱因.

  7. Bacterial spectrum and drug-resistant clinical analysis in children with infectious diarrhea%儿童感染性腹泻细菌谱及耐药性变迁临床分析

    Institute of Scientific and Technical Information of China (English)

    时花; 杨晓云; 周瑞; 诸宏伟

    2013-01-01

    目的 探讨儿童感染性腹泻细菌谱的改变和耐药性的变迁,为临床合理选择抗菌药物提供依据.方法 将2005年1月至2007年12月我院股泻患儿大便培养阳性分离菌株设为A组,将2008年1月至2010年12月分离菌株设为B组,比较2组细菌谱及耐药性的变化.结果 共分离菌株1046株,其中革兰阳性菌(G+)149株(14.24%),革兰阴性菌(G-)860株(82.22%),念珠菌37株(3.54%);主要菌株及构成比(%):大肠埃希菌65.68 %、肠球菌12.24%、克雷伯杆菌4.78%、肠杆菌3.73%.B组分离菌株对常用抗菌药物耐药率高于A组,产超广谱β-内酰胺酶(ESBLs)菌株增加.结论 小儿消化道感染病原菌以革兰阴性菌为主,并有逐渐增长趋势;随着广谱抗菌药物的应用,细菌的耐药性增加明显.%Objective To investigate the bacterial spectrum and drug resistance changes in children with pediatric infective diarrhea and provide a basis for the correct use of antibiotics. Methods We retrospectively analysed the bacterial spectrum and drug resistance of the positive isolates from the sepsis strains of bacteria in diarrhea stool culture of patients from January 2005 to December 2010 in our hospital. The patients were divided into two groups: Group A were the patients from January 2005 to December 2007, and group B were from January 2008 to December 2010, then the bacterial spectrum and resistance of the two groups were compared. Results A total of 1046 strains were i-solated, of which the pathogens of Gram - positive bacteria was 149 ( 14. 24% ), Gram - negative bacteria 860 ( 82. 22% ), and candidias 37 ( 3. 54% ). Major strain and composition ratio ( % ): Escherichia coli accounted for 65. 68% , enterococcus 12. 24% , Klebsiella 4. 78% , and Enterobacter 3. 73% . Drug resistance for common antibiotics medicine of group B was higher than that of group A, and isolates producing extended - spectrum β- lactamases ( ESBLs ) strains increased. Conclusion Gram - negative bacteria

  8. Clinical common separated gram negative bacilli and drug resistance analysis in the years from2013 to 2014%2013-2014年临床分离常见革兰阴性杆菌及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    刘臣彪; 李稳; 栾耀芳; 潘玫; 石媛

    2015-01-01

    (9.19%).Pseudomonas aeruginosa and Acinetobacter baumannii have different resistance degree to most of the antibiotics and the drug resistance of Imipenem is 46% and 70% respectively,meanwhile most of the strains only have sensitivity to Amikacin. Serratia marcescens resistant to beta lactam, also have varying degrees resistant to the three and four generation cephalosporins, and have 11%Imipenem-resistant rate. E. coli and Klebsiella pneumonia have well drug sensitivity to most of antimicrobial agents ,especially carbapenems, only a few Imipenem-resistant strains. Conclusions:There are high relevance ratios of carbapenems-resistant Pseudomonas aeruginosa and Acinetobacter baumannii. Serratia marcescens have a downtrend sensitivity of common using antimicrobial drugs. So if we want to have more rational use of antimicrobial agents we have to conside these factors when choose drugs.

  9. Epidemiology and patterns of drug resistance among tuberculosis patients in Northwestern Iran

    Directory of Open Access Journals (Sweden)

    L Sahebi

    2016-01-01

    Full Text Available Background: Multidrug-resistant tuberculosis (MDR-TB has emerged as an important global health concern and is on the rise throughout the world. Objective: The aim of this study was to examine the epidemiology and pattern of TB drug resistance. Methods: In this cross-sectional study, 180 pulmonary TB patients from two Northwestern provinces of Iran were selected. The first and second line drug susceptibility testing was carried out using the 1% proportion method on the Lφwenstein-Jensen medium. Full demographic, environmental and clinical history was evaluated. Results: Prevalence of resistance to any TB drug was 13.8%. Eight (4.4% patients had MDR-TB (2.4% in the province of East Azerbaijan and 9.3% in the province of Ardabil and one patient had extensively drug-resistant TB. Patient resistance to both isoniazid and streptomycin was the most prevalent at a rate of 8.3%. Patients showed the least resistance to ethambutol (2.8%. There was a significant relationship between the previous history of TB drug treatment and TB drug resistance. Migrants from rural to urban areas were in high-risk groups for the occurrence of TB drug resistance. Conclusion: In our study, prevalence of MDR was less than the global average. It is essential to monitor the patients with previous history of TB treatment and migrants by rapid and accurate techniques in terms of drug-resistance odds.

  10. Global control of tuberculosis: from extensively drug-resistant to untreatable tuberculosis

    Science.gov (United States)

    Dheda, Keertan; Gumbo, Tawanda; Gandhi, Neel R; Murray, Megan; Theron, Grant; Udwadia, Zarir; Migliori, G B; Warren, Robin

    2017-01-01

    Extensively drug-resistant tuberculosis is a burgeoning global health crisis mainly affecting economically active young adults, and has high mortality irrespective of HIV status. In some countries such as South Africa, drug-resistant tuberculosis represents less than 3% of all cases but consumes more than a third of the total national budget for tuberculosis, which is unsustainable and threatens to destabilise national tuberculosis programmes. However, concern about drug-resistant tuberculosis has been eclipsed by that of totally and extremely drug-resistant tuberculosis—ie, resistance to all or nearly all conventional first-line and second-line antituberculosis drugs. In this Review, we discuss the epidemiology, pathogenesis, diagnosis, management, implications for health-care workers, and ethical and medicolegal aspects of extensively drug-resistant tuberculosis and other resistant strains. Finally, we discuss the emerging problem of functionally untreatable tuberculosis, and the issues and challenges that it poses to public health and clinical practice. The emergence and growth of highly resistant strains of tuberculosis make the development of new drugs and rapid diagnostics for tuberculosis—and increased funding to strengthen global control efforts, research, and advocacy—even more pressing. PMID:24717628

  11. Genital Herpes

    Science.gov (United States)

    ... best way to prevent genital herpes is abstinence. Teens who do have sex must properly use a latex condom every time ... Date reviewed: February 2016 previous 1 • ... Boyfriend Has an STD Before We Have Sex? Telling Your Partner You Have an STD Contact ...

  12. Anal herpes

    National Research Council Canada - National Science Library

    Andre Goulart; Jose Pinto; Pedro Leão

    2017-01-01

    ... that irradiated to the buttocks and the physical examination revealed red bumps with ulceration ( figure 1 ). Anal herpes was suspected and the patient was treated with an antiviral (brivudine) and carbamazepine for symptomatic relief. Seven days after treatment the patient had complete resolution of his symptoms and there were no cut...

  13. Pediatric cancer gone viral. Part II: potential clinical application of oncolytic herpes simplex virus-1 in children

    Directory of Open Access Journals (Sweden)

    Gregory K Friedman

    2015-01-01

    Full Text Available Oncolytic engineered herpes simplex viruses (HSVs possess many biologic and functional attributes that support their use in clinical trials in children with solid tumors. Tumor cells, in an effort to escape regulatory mechanisms that would impair their growth and progression, have removed many mechanisms that would have protected them from virus infection and eventual virus-mediated destruction. Viruses engineered to exploit this weakness, like mutant HSV, can be safely employed as tumor cell killers, since normal cells retain these antiviral strategies. Many preclinical studies and early phase trials in adults demonstrated that oncolytic HSV can be safely used and are highly effective in killing tumor cells that comprise pediatric malignancies, without generating the toxic side effects of nondiscriminatory chemotherapy or radiation therapy. A variety of engineered viruses have been developed and tested in numerous preclinical models of pediatric cancers and initial trials in patients are underway. In Part II of this review series, we examine the preclinical evidence to support the further advancement of oncolytic HSV in the pediatric population. We discuss clinical advances made to date in this emerging era of oncolytic virotherapy.

  14. Comparison of the Mechanisms of Drug Resistance among HIV, Hepatitis B, and Hepatitis C

    Directory of Open Access Journals (Sweden)

    Robert W. Shafer

    2010-12-01

    Full Text Available Human immunodeficiency virus (HIV, hepatitis B virus (HBV, and hepatitis C virus (HCV are the most prevalent deadly chronic viral diseases. HIV is treated by small molecule inhibitors. HBV is treated by immunomodulation and small molecule inhibitors. HCV is currently treated primarily by immunomodulation but many small molecules are in clinical development. Although HIV is a retrovirus, HBV is a double-stranded DNA virus, and HCV is a single-stranded RNA virus, antiviral drug resistance complicates the development of drugs and the successful treatment of each of these viruses. Although their replication cycles, therapeutic targets, and evolutionary mechanisms are different, the fundamental approaches to identifying and characterizing HIV, HBV, and HCV drug resistance are similar. This review describes the evolution of HIV, HBV, and HCV within individuals and populations and the genetic mechanisms associated with drug resistance to each of the antiviral drug classes used for their treatment.

  15. Targeting oncoprotein stability overcomes drug resistance caused by FLT3 kinase domain mutations.

    Directory of Open Access Journals (Sweden)

    Chuanjiang Yu

    Full Text Available FLT3 is the most frequently mutated kinase in acute myeloid leukemia (AML. Internal tandem duplications (ITDs in the juxta-membrane region constitute the majority of activating FLT3 mutations. Several FLT3 kinase inhibitors were developed and tested in the clinic with significant success. However, recent studies have reported the development of secondary drug resistance in patients treated with FLT3 inhibitors. Since FLT3-ITD is an HSP90 client kinase, we here explored if targeting the stability of drug-resistant FLT3 mutant protein could be a potential therapeutic option. We observed that HSP90 inhibitor treatment resulted in the degradation of inhibitor-resistant FLT3-ITD mutants and selectively induced toxicity in cells expressing FLT3-ITD mutants. Thus, HSP90 inhibitors provide a potential therapeutic choice to overcome secondary drug resistance following TKI treatment in FLT3-ITD positive AML.

  16. Drug resistance and adherence to human intestines of enteroaggregative Escherichia coli.

    Science.gov (United States)

    Yamamoto, T; Echeverria, P; Yokota, T

    1992-04-01

    Clinical isolates of enteroaggregative Escherichia coli (EAggEC) were tested for their in vitro susceptibilities to 27 antimicrobial agents. Marked drug resistance was observed with sulfamethoxazole, ampicillin, and chloramphenicol in contrast to such antimicrobial agents as cefixime, sparfloxacin, and ciprofloxacin. One of the EAggEC strains carried a plasmid that conferred on its host resistance to ampicillin, tetracycline, sulfamethoxazole, streptomycin, and spectinomycin and an ability to adhere to child ileal villi or HeLa cells in the characteristic aggregative pattern. This plasmid also mediated D-mannose-resistant hemagglutinin production and bacterial clump formation (autoagglutination). The data demonstrate appearance of marked drug resistance and an intestine-adherence and drug-resistance plasmid in the newest category of diarrheagenic E. coli.

  17. [Drug resistance in Mycobacterium tuberculosis. A multicenter study of the Barcelona area. Grupo de Trabajo sobre Resistencias en Tuberculosis].

    Science.gov (United States)

    Martin-Casabona, N; Alcaide, F; Coll, P; González, J; Manterola, J M; Salvadó, M; Caylà, J A

    2000-10-21

    The aims of this multicenter study was to establish the level of primary and acquired drug resistance of M. Tuberculosis strains isolated in Barcelona and to identify possible risk groups using clinical data. All tuberculosis patients with isolation and identification of M. tuberculosis strains from October 1995 to September 1997 were included. Susceptibility tests isoniazid, rifampin, ethambutol, streptomycin and pyrazinamide were performed using the Bactec 460 system and the proportions method on solid medium. Logistic progression was used for statistical analysis. The total number of patients included was 1,749 (1,535 non-treated and 214 previously treated). Primary drug resistance was 5.7% (isoniazid 3.8%; rifampin 1.0%, streptomycin 2.1%, ethambutol 0.3% and pyrazinamide 1.0%). Acquired drug resistance was 20.5% (isoniazid 17.3%, rifampin 9.8%, ethambutol 1.9%, streptomycin 4.7% and pyrazinamide 6.5%). Primary drug resistance was associated with people over 60 years old and women. The low level of drug resistance enables antituberculosis treatment of non-treated patients to start with the standardised three-drug regimes except in the case of foreign people from countries with a high level of drug resistance. Susceptibility tests are recommended on all M. tuberculosis strains isolated, together with controlled studies of drug resistance surveillance.

  18. The Clinical Distribution and Drug Resistance of Fungal Infection in Sterile Sites%无菌部位真菌感染的临床分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    王岚; 吴怡; 刘新; 张翀; 王东月

    2015-01-01

    Objective To investigate species and drug resistance characteristics of fungal infection commonly found in sterile sites and provide evidences for aetiological diagnosis and reasonable use of antifungal drugs in clinic practice. Methods We collected specimens of sterile sites delivered from the Central Hospital Affiliated to Shenyang Medical College between July and December in 2013. Fungi were cultured in and extracted from these specimens, and the species were then identified. Drug sensitive tests were conducted in common fungi. Results The result of the test on 122 strains of fungus extracted showed that the five involved sterile sites with the highest proportions were sequentially urine(68. 9%,84/122),various kinds of drainage fluid (9. 0%,11/122),blood(8. 2%,10/122),cerebrospinal fluid(3. 3%,4/122)and ascites(2. 4%,3/122);the involved departments with the highest proportions were geriatrics(21. 3%,26/122),ICU(18. 9%,23/122),endocrinology (16. 4%,20/122);the five species of fungus with the highest proportions were Candida albicans(29. 5%,36/122), Candida glabrata ( 24. 6%, 30/122 ), Candida tropicalis ( 22. 1%, 27/122 ), Monilia krusei ( 5. 7%, 7/122 ) and Cryptococcus neoformans(3. 3%,4/122). Common antifungal drugs,to which common fungi had the highest sensitivity rates, were amphotericin B ( 98. 1%, 102/104 ), 5 - flucytosine ( 97. 1%, 101/104 ), voriconazole ( 87. 5%, 91/104 ), fluconazole(82. 7%,86/104),and itraconazole(74. 0%,77/104). Conclusion The fungal infection in sterile sites primarily occurs as Candida albicans. Amphotericin B and 5 -flucytosine have relatively stronger fungistasis. Clinicians should attach more importance to the results of fungal culture and identification in laboratory and reasonable use of antifungal drugs.%目的:探讨临床常见无菌部位真菌感染种类及耐药性特点,为临床提供病原学诊断和合理使用抗真菌药物的依据。方法收集沈阳医学院附属中心医院2013年7—12月住院及

  19. Genital Herpes (For Parents)

    Science.gov (United States)

    ... Kids to Be Smart About Social Media Genital Herpes KidsHealth > For Parents > Genital Herpes Print A A A What's in this article? Symptoms Contagiousness Treatment Prevention Getting Help Genital herpes is a sexually transmitted disease (STD) that's usually ...

  20. Influence of clinical use of antibiotics on drug resistance of Klebsiella pneumoniae in our hospital from 2007 to 2012%我院2007-2012年抗菌药物临床应用对肺炎克雷伯菌耐药性变迁的影响

    Institute of Scientific and Technical Information of China (English)

    贾秀芹; 陈建忠; 庞峰; 李艳华; 蒋陆霞

    2013-01-01

    目的 探讨抗菌药物使用对肺炎克雷伯菌耐药率变化的影响,为临床合理使用抗菌药物提供理论依据.方法 回顾性分析我院2007-2012年抗菌药物年用量及肺炎克雷伯菌耐药率变化趋势,计算用药频度(DDDs),采用Pearson相关分析法对耐药率与DDDs进行分析.结果 2007-2008年肺炎克雷伯菌对大部分抗菌药物耐药率较高,2009年开始呈下降趋势;自2010年多数抗菌药物DDDs有不同程度下降;头孢他啶、头孢哌酮/舒巴坦、头孢吡肟、阿米卡星、左氧氟沙星和亚胺培南的DDDs与肺炎克雷伯菌耐药率呈高度正相关(r>0.800,P< 0.05).结论 抗菌药物用量与肺炎克雷伯菌耐药率之间存在一定相关性,应加强抗菌药物临床应用管理.%Objective To provide a theoretical basis for the rational use of antimicrobial drugs discussing the influence of the clinical use of antibiotics on drug resistance of Klebsiella pneumoniae.Methods The annual consumption of antimicrobial agents and the change trend of drug resistance of K.pneumoniae in our hospital from 2007 to 2012 were retrospectively analyzed,then the DDDs of antibiotics were calculated.The correlation between the drug resistance of K.pneumoniae and the DDDs of antibiotics were analyzed by pearson analysis.Results The resistance rates of K.pneumoniae to most of the antimicrobial were higher from 2007 to 2008 and then decreased since 2009.The DDDs of most antimicrobial had decreased in different degrees since 2010.The resistance rate of K.pneumoniae highly and positively correlated with the DDDs of ceftazidime,cefoperazone/sulbactam,cefepime,amikacin,levofloxacin,and imipenem(r > 0.800,P < 0.05).Conclusions The drug resistance of K.pneumoniae correlates with the consumption of antibiotics,so the management of antimicrobial application should be strengthen.

  1. Hospital costs of nosocomial multi-drug resistant Pseudomonas aeruginosa acquisition.

    Science.gov (United States)

    Morales, Eva; Cots, Francesc; Sala, Maria; Comas, Mercè; Belvis, Francesc; Riu, Marta; Salvadó, Margarita; Grau, Santiago; Horcajada, Juan P; Montero, Maria Milagro; Castells, Xavier

    2012-05-23

    We aimed to assess the hospital economic costs of nosocomial multi-drug resistant Pseudomonas aeruginosa acquisition. A retrospective study of all hospital admissions between January 1, 2005, and December 31, 2006 was carried out in a 420-bed, urban, tertiary-care teaching hospital in Barcelona (Spain). All patients with a first positive clinical culture for P. aeruginosa more than 48 h after admission were included. Patient and hospitalization characteristics were collected from hospital and microbiology laboratory computerized records. According to antibiotic susceptibility, isolates were classified as non-resistant, resistant and multi-drug resistant. Cost estimation was based on a full-costing cost accounting system and on the criteria of clinical Activity-Based Costing methods. Multivariate analyses were performed using generalized linear models of log-transformed costs. Cost estimations were available for 402 nosocomial incident P. aeruginosa positive cultures. Their distribution by antibiotic susceptibility pattern was 37.1% non-resistant, 29.6% resistant and 33.3% multi-drug resistant. The total mean economic cost per admission of patients with multi-drug resistant P. aeruginosa strains was higher than that for non-resistant strains (15,265 vs. 4,933 Euros). In multivariate analysis, resistant and multi-drug resistant strains were independently predictive of an increased hospital total cost in compared with non-resistant strains (the incremental increase in total hospital cost was more than 1.37-fold and 1.77-fold that for non-resistant strains, respectively). P. aeruginosa multi-drug resistance independently predicted higher hospital costs with a more than 70% increase per admission compared with non-resistant strains. Prevention of the nosocomial emergence and spread of antimicrobial resistant microorganisms is essential to limit the strong economic impact.

  2. Hospital costs of nosocomial multi-drug resistant Pseudomonas aeruginosa acquisition

    Directory of Open Access Journals (Sweden)

    Morales Eva

    2012-05-01

    Full Text Available Abstract Background We aimed to assess the hospital economic costs of nosocomial multi-drug resistant Pseudomonas aeruginosa acquisition. Methods A retrospective study of all hospital admissions between January 1, 2005, and December 31, 2006 was carried out in a 420-bed, urban, tertiary-care teaching hospital in Barcelona (Spain. All patients with a first positive clinical culture for P. aeruginosa more than 48 h after admission were included. Patient and hospitalization characteristics were collected from hospital and microbiology laboratory computerized records. According to antibiotic susceptibility, isolates were classified as non-resistant, resistant and multi-drug resistant. Cost estimation was based on a full-costing cost accounting system and on the criteria of clinical Activity-Based Costing methods. Multivariate analyses were performed using generalized linear models of log-transformed costs. Results Cost estimations were available for 402 nosocomial incident P. aeruginosa positive cultures. Their distribution by antibiotic susceptibility pattern was 37.1% non-resistant, 29.6% resistant and 33.3% multi-drug resistant. The total mean economic cost per admission of patients with multi-drug resistant P. aeruginosa strains was higher than that for non-resistant strains (15,265 vs. 4,933 Euros. In multivariate analysis, resistant and multi-drug resistant strains were independently predictive of an increased hospital total cost in compared with non-resistant strains (the incremental increase in total hospital cost was more than 1.37-fold and 1.77-fold that for non-resistant strains, respectively. Conclusions P. aeruginosa multi-drug resistance independently predicted higher hospital costs with a more than 70% increase per admission compared with non-resistant strains. Prevention of the nosocomial emergence and spread of antimicrobial resistant microorganisms is essential to limit the strong economic impact.

  3. Update On Emerging Antivirals For The Management Of Herpes Simplex Virus Infections: A Patenting Perspective

    OpenAIRE

    Vadlapudi, Aswani D.; Vadlapatla, Ramya K.; Mitra, Ashim K.

    2013-01-01

    Herpes simplex virus (HSV) infections can be treated efficiently by the application of antiviral drugs. The herpes family of viruses is responsible for causing a wide variety of diseases in humans. The standard therapy for the management of such infections includes acyclovir (ACV) and penciclovir (PCV) with their respective prodrugs valaciclovir and famciclovir. Though effective, long term prophylaxis with the current drugs leads to development of drug-resistant viral isolates, particularly i...

  4. Targeting efflux pumps to overcome antifungal drug resistance.

    Science.gov (United States)

    Holmes, Ann R; Cardno, Tony S; Strouse, J Jacob; Ivnitski-Steele, Irena; Keniya, Mikhail V; Lackovic, Kurt; Monk, Brian C; Sklar, Larry A; Cannon, Richard D

    2016-08-01

    Resistance to antifungal drugs is an increasingly significant clinical problem. The most common antifungal resistance encountered is efflux pump-mediated resistance of Candida species to azole drugs. One approach to overcome this resistance is to inhibit the pumps and chemosensitize resistant strains to azole drugs. Drug discovery targeting fungal efflux pumps could thus result in the development of azole-enhancing combination therapy. Heterologous expression of fungal efflux pumps in Saccharomyces cerevisiae provides a versatile system for screening for pump inhibitors. Fungal efflux pumps transport a range of xenobiotics including fluorescent compounds. This enables the use of fluorescence-based detection, as well as growth inhibition assays, in screens to discover compounds targeting efflux-mediated antifungal drug resistance. A variety of medium- and high-throughput screens have been used to identify a number of chemical entities that inhibit fungal efflux pumps.

  5. Mechanisms of drug resistance in veterinary oncology – A review with an emphasis on canine lymphoma

    NARCIS (Netherlands)

    Zandvliet, M.M.J.M.; Teske, E.

    2015-01-01

    Drug resistance (DR) is the major limiting factor in the successful treatment of systemic neoplasia with cytotoxic chemotherapy. DR can be either intrinsic or acquired, and although the development and clinical implications are different, the underlying mechanisms are likely to be similar. Most caus

  6. Signaling to P-glycoprotein-A new therapeutic target to treat drug-resistant epilepsy?

    NARCIS (Netherlands)

    Hartz, A.M.; Notenboom, S.; Bauer, B.

    2009-01-01

    Epilepsy affects more than 60 million people worldwide. While most patients can be treated with antiepileptic drugs, up to 40% of patients respond poorly to pharmacotherapy. This drug resistance is not well understood and presents a major clinical problem. In this short review we provide background

  7. Multi-drug-resistant tuberculosis in HIV positive patients in Eastern Europe

    DEFF Research Database (Denmark)

    Post, Frank A; Grint, Daniel; Efsen, Anne Marie Werlinrud

    2014-01-01

    Observational data from Eastern Europe on the management and outcome of multi-drug-resistant tuberculosis (MDR TB) in HIV positive populations remain sparse in the English-language literature.We compared clinical characteristics and outcomes of 55 patients who were diagnosed with HIV and MDR TB i...

  8. Clinical distribution and drug resistance analysis of AmpC β-lactamase and ESBLs producing Enterobacter cloacae%产AmpC酶和ESBLs阴沟肠杆菌的临床分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    唐振华; 朱义朗

    2009-01-01

    Objective To investigate the status of AmpC β-lactamase and extended spectrum β-lactamases (ESBLs) production and drug-resistance characteristic of Enterobacter cloacae.Methods Enterobacter cloacae was isolated and cultured from variety of specimens from April 2005 to July 2007. VITEK32 automatic microbial analytical system was applied to performing identification of bacteria and susceptibility test. ESBLs were confirmed by NCCLS double disc assay, and three-dimensional test was used to detect AmpC.Results A total of 63 strains of Enterobacter cloacae were isolated, including 13(20.6%) single AmpC producing strains, 24(31.8%) single ESBLs producing strains, 6(9.5%) both AmpC and ESBLs producing strains, and 20(38.1%) neither AmpC nor ESBLs producing strains. The resistance of lactamases producing strains was significantly higher than that of lactamases non-producing ones. Especially in both AmpC and ESBLs producing strains, the drug resistance was serous.Conclusion The prevalence of AmpC β-lactamases and/or ESBLs producing strains is a higher level in Fuyang area. The drug resistance of AmpC β-lactamases producing Enterobacter cloacae isn′t identical to that of ESBLs producing one. Different categories of antibacterials should be chosen according to the different types of producing lactamases.%目的 了解阴沟肠杆菌的耐药特性及其产AmpC酶和超广谱β-内酰胺酶(ESBLs)的情况.方法 对2005年4月-2007年7月的各类标本进行阴沟肠杆菌的分离培养,用VITEK32全自动微生物分析系统进行细菌鉴定及药敏试验.ESBLs检测采用NCCLS纸片确证试验,用酶提取三维试验检测AmpC酶.结果 在63株阴沟肠杆菌中,20.6%的菌株单产AmpC酶;38.1%的菌株单产ESBLs;9.5%的菌株同时产生AmpC酶和ESBLs;31.8%的菌株均不产AmpC酶和ESBLs.产酶株的耐药性明显高于非产酶株,耐药现象在同时产生AmpC酶和ESBLs的菌株中尤为严重.结论 本地区阴沟肠杆菌产AmpC酶和ESBLs的流

  9. The challenges of multi-drug-resistance in hepatology.

    Science.gov (United States)

    Fernández, Javier; Bert, Frédéric; Nicolas-Chanoine, Marie-Hélène

    2016-11-01

    Antimicrobial resistance has become a major global public health security problem that needs coordinated approaches at regional, national and international levels. Antibiotic overuse and the failure of control measures to prevent the spread of resistant bacteria in the healthcare environment have led to an alarming increase in the number of infections caused by resistant bacteria, organisms that resist many (multi-drug and extensively drug-resistant strains), if not all (pan-drug-resistant bacteria) currently available antibiotics. While Gram-positive cocci resistance (methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci) shows a heterogeneous geographical distribution, extended-spectrum β-lactamase-producing Enterobacteriaceae and carbapenem-resistant Enterobacteriaceae have become pandemic worldwide and endemic in some parts of the world, respectively. Moreover, currently available therapeutic options for resistant bacteria are very limited, with very few new agents in development. Antimicrobial resistance is especially relevant in decompensated cirrhosis. Firstly, cirrhotic patients are highly susceptible to develop infections caused by resistant bacteria as risk factors of multiresistance concentrate in this population (mainly repeated hospitalizations and antibiotic exposure). Secondly, inappropriate empirical antibiotic schedules easily translate into increased morbidity (acute kidney injury, acute-on-chronic liver failure, septic shock) and hospital mortality in advanced cirrhosis. Therefore, hepatologists must face nowadays a complex clinical scenario that requires new empirical antibiotic strategies that may further spread resistance. Global, regional and local preventive measures should therefore be implemented to combat antimicrobial resistance in cirrhosis including the restriction of antibiotic prophylaxis to high-risk populations, investigation on non-antibiotic prophylaxis, stewardship programs on adequate antibiotic

  10. First evaluation of drug-resistant Mycobacterium tuberculosis clinical isolates from Congo revealed misdetection of fluoroquinolone resistance by line probe assay due to a double substitution T80A-A90G in GyrA.

    Directory of Open Access Journals (Sweden)

    Alexandra Aubry

    Full Text Available BACKGROUND: Tuberculosis (TB is one of the major public health problems in Congo. However, data concerning Mycobacterium tuberculosis drug resistance are lacking because of the insufficient processing capacity. So, the aim of this study was to investigate for the first time the resistance patterns and the strain lineages of a sample of M. tuberculosis complex (MTBC isolates collected in the two main cities of Congo. METHODS: Over a 9-day period, 114 smear-positive sputa isolated from 114 patients attending centers for the diagnosis and treatment of TB in Brazzaville and Pointe Noire were collected for culture and drug susceptibility testing (DST. Detection of mutations conferring drug resistance was performed by using line probe assays (GenoType MTBDRplus and MTBDRsl and DNA sequencing. Strain lineages were determined by MIRU-VNTR genotyping. RESULTS: Of the 114 sputa, 46 were culture positive for MTBC. Twenty-one (46% were resistant to one or more first-line antiTB drugs. Of these, 15 (71% were multidrug resistant (MDR. The most prevalent mutations involved in rifampin and isoniazid resistance, D516V (60% in rpoB and S315T (87% in katG respectively, were well detected by MTBDRplus assay. All the 15 MDR strains were susceptible to fluoroquinolone and injectable second-line drug. No mutation was detected in the rrs locus involved in resistance to amikacin and capreomycin by both the MTBDRsl assay and DNA sequencing. By contrast, 9 MDR strains belonging to the same cluster related to T-family were identified as being falsely resistant to fluoroquinolone by the MTBDRsl assay due to the presence of a double substitution T80A-A90G in GyrA. CONCLUSIONS: Taken together, these data revealed a possible spread of a particular MDR clone in Congo, misidentified as fluoroquinolone resistant by MTBDRsl assay. Thus, this test cannot replace gold-standard culture method and should be interpreted carefully in view of the patient's native land.

  11. Genital herpes: Heisenberg revisited

    OpenAIRE

    Goldmeier, D

    1998-01-01

    In the confirmation of recurrences of genital herpes, patient defined disease reactivation and virological data hold the scientific high ground. The influence of the psyche on recurrence rates and perception of recurrences has been largely neglected and marginalised up to the present, possibly because research work in that area has been and continues to be of poor calibre. However, neglected psychological variables may render otherwise relevant clinical trials uninterpretable. Psycholog...

  12. Emergence of Pan-drug resistance amongst gram negative bacteria! The First case series from India

    Directory of Open Access Journals (Sweden)

    Abdul Ghafur

    2014-09-01

    Full Text Available Objective: Increasing prevalence of carbapenem resistant Gram negative bacteria is a serious clinical and public health challenge. Bacteria resistant to all available antibiotics (Pan Drug Resistance herald the onset of post antibiotics era. We hereby report clinical profile of 13 patients with pan drug resistant gram negative isolates. Methods:Retrospective analysis of 13 patients with pan drug resistant gram negative isolates over the last 18 months was done by medical records review. Identification of the isolates and susceptibility testing was done using VITEK auto analyzer in concordance with the corresponding CLSI guidelines. Results:Out of four patients with bacteremic isolates, three patients received colistin based combination therapy. Though two of these patients had microbiologic clearance, all the three died. Out of the 9 patients with non bacteremic isolates, 4 had infection and 5 had colonization. Three (out of four were treated with combination therapy including colistin and one patient received colistin monotherapy. All four patients had microbiological clearance. Three patients had clinical cure and were discharged. One patient later developed bacteremia and died. Conclusion:Infections, particularly blood stream with pan drug resistant organisms has a higher mortality. Urgent studies to reevaluate existing therapeutic options and research into new antibiotic molecules are the need of the hour. J Microbiol Infect Dis 2014; 4(3: 86-91

  13. In vitro development of chemotherapy and targeted therapy drug-resistant cancer cell lines: A practical guide with case studies

    Directory of Open Access Journals (Sweden)

    Martina eMcDermott

    2014-03-01

    Full Text Available The development of a drug-resistant cell line can take from 3-18 months. However, little is published on the methodology of this development process. This article will discuss key decisions to be made prior to starting resistant cell line development; the choice of parent cell line, dose of selecting agent, treatment interval and optimising the dose of drug for the parent cell line. Clinically-relevant drug-resistant cell lines are developed by mimicking the conditions cancer patients experience during chemotherapy and cell lines display between 2-8 fold resistance compared to their parental cell line. Doses of drug administered are low, and a pulsed treatment strategy is often used where the cells recover in drug-free media. High-level laboratory models are developed with the aim of understanding potential mechanisms of resistance to chemotherapy agents. Doses of drug are higher and escalated over time. It is common to have difficulty developing stable clinically-relevant drug-resistant cell lines. A comparative selection strategy of multiple cell lines or multiple chemotherapeutic agents mitigates this risk and gives insight into which agents or type of cell line develops resistance easily. Successful selection strategies from our research are presented. Pulsed-selection produced platinum or taxane-resistant large cell lung cancer (H1299, H460 and temozolomide-resistant melanoma (Malme-3M and HT144 cell lines. Continuous selection produced lapatinib-resistant breast cancer cell line (HCC1954. Techniques for maintaining drug-resistant cell lines are outlined including; maintaining cells with chemotherapy, pulse treating with chemotherapy or returning to master drug-resistant stocks. The heterogeneity of drug-resistant models produced from the same parent cell line with the same chemotherapy agent is explored with reference to P-glycoprotein. Heterogeneity in drug-resistant cell lines reflects the heterogeneity that can occur in clinical drug

  14. In vitro Development of Chemotherapy and Targeted Therapy Drug-Resistant Cancer Cell Lines: A Practical Guide with Case Studies.

    Science.gov (United States)

    McDermott, Martina; Eustace, Alex J; Busschots, Steven; Breen, Laura; Crown, John; Clynes, Martin; O'Donovan, Norma; Stordal, Britta

    2014-01-01

    The development of a drug-resistant cell line can take from 3 to 18 months. However, little is published on the methodology of this development process. This article will discuss key decisions to be made prior to starting resistant cell line development; the choice of parent cell line, dose of selecting agent, treatment interval, and optimizing the dose of drug for the parent cell line. Clinically relevant drug-resistant cell lines are developed by mimicking the conditions cancer patients experience during chemotherapy and cell lines display between two- and eight-fold resistance compared to their parental cell line. Doses of drug administered are low, and a pulsed treatment strategy is often used where the cells recover in drug-free media. High-level laboratory models are developed with the aim of understanding potential mechanisms of resistance to chemotherapy agents. Doses of drug are higher and escalated over time. It is common to have difficulty developing stable clinically relevant drug-resistant cell lines. A comparative selection strategy of multiple cell lines or multiple chemotherapeutic agents mitigates this risk and gives insight into which agents or type of cell line develops resistance easily. Successful selection strategies from our research are presented. Pulsed-selection produced platinum or taxane-resistant large cell lung cancer (H1299 and H460) and temozolomide-resistant melanoma (Malme-3M and HT144) cell lines. Continuous selection produced a lapatinib-resistant breast cancer cell line (HCC1954). Techniques for maintaining drug-resistant cell lines are outlined including; maintaining cells with chemotherapy, pulse treating with chemotherapy, or returning to master drug-resistant stocks. The heterogeneity of drug-resistant models produced from the same parent cell line with the same chemotherapy agent is explored with reference to P-glycoprotein. Heterogeneity in drug-resistant cell lines reflects the heterogeneity that can occur in clinical

  15. Adaptation and evolution of drug-resistant Mycobacterium tuberculosis

    NARCIS (Netherlands)

    Bergval, I.L.

    2013-01-01

    Many studies have been conducted on drug resistance and the evolution of Mycobacterium tuberculosis. Notwithstanding, many molecular mechanisms facilitating the emergence, adaptation and spread of drug-resistant tuberculosis have yet to be discovered. This thesis reports studies of the adaptive mech

  16. Adaptation and evolution of drug-resistant Mycobacterium tuberculosis

    NARCIS (Netherlands)

    Bergval, I.L.

    2013-01-01

    Many studies have been conducted on drug resistance and the evolution of Mycobacterium tuberculosis. Notwithstanding, many molecular mechanisms facilitating the emergence, adaptation and spread of drug-resistant tuberculosis have yet to be discovered. This thesis reports studies of the adaptive

  17. Management of multiple drug-resistant tuberculosis.

    Science.gov (United States)

    Hutchison, D C S; Drobniewski, F A; Milburn, H J

    2003-01-01

    There has been a worldwide increase in multiple drug-resistant tuberculosis (MDR-TB) which has in the past been associated with a poor prognosis. In the U.K., about half of the cases live in the London area and we have set out to obtain further information on their treatment and outcome. We examined the risk factors, drug resistance, drug treatment, sputum conversion, and outcome in patients with MDR-TB at three hospitals in South London and diagnosed during the period June 1995-January 1999. Human Immunodeficiency Virus (HIV)-positive patients were excluded. There were 760 patients resident in Lambeth, Southwark and Lewisham Health Authority (LSLHA) who were notified as tuberculosis (TB) during the time period and who were of negative or unknown HIV status. (The population of LSLHA is approx.750,000.) There was a total of 13 patients with MDR-TB, known or presumed to be HlV negative. Their median age was 28 years (range 15-53); nine (69%) were born outside the U.K. and 11 had pulmonary disease; they had organisms resistant to a median of two first-line drugs (range 2-4) and to a median of four of all drugs tested (range 2-10). They received treatment with a median of six drugs (range 3-9). Eight were followed up for at least 3 years (range 3-6) after the completion of treatment; at their last assessment none had features of active TB and all were sputum negative (smear and culture). Two returned to their countries of origin during treatment; they were sputum negative at that time. Two patients are well and continue on treatment in the U.K. One patient (known HIV negative) died following treatment failure. In conclusion, we obtained disease-free survival in eight cases of MDR-TB, known or presumed to be HIV negative and followed up for 3 years or more. The prognosis for patients treated at specialised centres is good (and better than is generally believed). We describe a new protocol for the detection and management of MDR-TB.

  18. Current Status of Natural Products from Plants as Anti-herpes Simplex Virus 1 Agents

    Institute of Scientific and Technical Information of China (English)

    Yang-fei XIANG; Ying PEI; Yi-fei WANG

    2008-01-01

    Nucleoside analogues have been the mainstay of clinical treatment of herpes simplex virus 1 (HSV-1) infections since their development. However, the emergence of drug resistant strains has underlined the urgency of the discovery of novel anti-HSV-1 drugs. Natural products, which provided many novel drug leads, are known to be an important source of anti-HSV-1 agents. Herein, we present an overview of natural products with anti-HSV-1 activities isolated from a variety of plants reported in recent years. Several different compounds, mainly belonging to the three groups of polysaccharides, polyphenols and terpenes, showed antiviral effects against HSV-1, indicating their potential to be promising anti-HSV-1 agents.

  19. Drug Resistance to EGFR Inhibitors in Lung Cancer

    Science.gov (United States)

    Tetsu, Osamu; Hangauer, Matthew J.; Phuchareon, Janyaporn; Eisele, David W.; McCormick, Frank

    2016-01-01

    Background The discovery of mutations in epidermal growth factor receptor (EGFR) has dramatically changed the treatment of patients with non-small cell lung cancer (NSCLC)—the leading cause of cancer death worldwide. EGFR-targeted therapies show considerable promise, but drug resistance has become a substantial issue. Methods We reviewed the literature to provide an overview of the drug resistance to EGFR tyrosine kinase inhibitors (TKIs) in NSCLC. Results The mechanisms causing primary, acquired, and persistent drug resistance to TKIs vary. Researchers and clinicians, who have used study findings to develop more effective therapeutic approaches, have found that the sequential use of single agents presents a formidable challenge, suggesting that multi-drug combinations must be considered. Conclusions In the era of precision medicine, oncologists should promptly obtain an accurate diagnosis of drug resistance in each patient to design the most relevant combination therapy to overcome patient-specific drug resistance. PMID:26910730

  20. Combined therapy for multi-drug-resistant Acinetobacter baumannii infection--is there evidence outside the laboratory?

    Science.gov (United States)

    Tuon, Felipe F; Rocha, Jaime L; Merlini, Alexandre B

    2015-09-01

    Acinetobacter are among the most common bacteria isolated in hospital infections, especially in developing countries. Multi-drug, extended-drug or pan-drug resistance makes treatment a real medical challenge. In the present review, the authors describe clinical and experimental data in order to present different current and potential future strategies to treat infections caused by multi-drug-resistant Acinetobacter. The therapeutic options for carbapenem-resistant Acinetobacter are scarce, and the current options have poor pharmacokinetic aspects and several side effects. Combined therapy has been an alternative for multi-drug-resistant Acinetobacter. However, this issue is always controversial. In some studies combined therapy has shown superiority for some strains of Acinetobacter in animal models and in vitro studies. However, studies with humans are scarce and too poor quality to suggest the best approach for the treatment of infections caused by multi-drug-resistant Acinetobacter baumannii.

  1. Herpes simplex encephalitis (HSE) and the immunocompromised: a clinical and autopsy study of HSE in the settings of cancer and human immunodeficiency virus-type 1 infection.

    Science.gov (United States)

    Schiff, D; Rosenblum, M K

    1998-03-01

    Although herpes simplex encephalitis (HSE) is not regarded as an opportunistic infection, the occurrence of HSE in immunocompromised patients has been documented and the suggestion made that unusual clinical and neuropathologic features characterize the disorder in this population. To further characterize HSE as it affects the immunodeficient, the authors reviewed the clinical and pathological findings in three immunocompromised patients with autopsy-proven HSE. Two patients had cancer (one with lymphoma and another with glioblastoma multiforme), one was known to be human immunodeficiency virus-type 1 (HIV-1)-seropositive and a second was suspected of harboring underlying HIV-1 infection. Two were receiving dexamethasone at onset of HSE. All had fever, mental status changes and new, focal neurological deficits or worsening of established deficits. Cerebrospinal fluid (CSF) pleocytosis was absent or minimal and head computerized tomographic (CT) scans, performed in all cases, were unrevealing. No patient was clinically suspected of having HSE, only one received acyclovir (for concurrent mucocutaneous herpes) and HSE played a major role in all deaths. Autopsy revealed an unusual form of HSE characterized by a noninflammatory, pseudoischemic histological presentation and the unexpected persistence of viral antigens in abundance despite survival beyond the clinical stage during which inflammatory responses usually peak and productive brain infection wanes. The incidence of HSE in the immunocompromised may be underestimated. Preexistent neurological disease, a noninflammatory CSF profile and negative CT scan may confound the diagnosis in this population, a typical clinical presentation notwithstanding. Increased clinical suspicion, the use of magnetic resonance imaging and polymerase chain reaction analysis of CSF for herpes simplex virus nucleic acid sequences may permit more rapid diagnosis and treatment. The absence of inflammatory infiltrates in some fatal cases of

  2. Mechanisms of Anticancer Drugs Resistance: An Overview

    Directory of Open Access Journals (Sweden)

    M. R. Chorawala

    2012-01-01

    Full Text Available The management of cancer involves surgery, radiotherapy and chemotherapy. Development of chemoresistance is a persistent problem during the chemotherapy treatment. Cytotoxic drugs that selectively, but not exclusively, target actively proliferating cells include such diverse groups as DNA-alkylating agents, anti-metabolites, intercalating agents and mitotic inhibitors. Resistance constitutes a lack of response to drug-induced tumour growth inhibition; it may be inherent in a subpopulation of heterogeneous cancer cells or be acquired as a cellular response to drug exposure. Principle mechanisms may include altered membrane transport involving the p-glycoprotein product of the multidrug resistance (MDR gene as well as other associated proteins, altered target enzyme, decreased drug activation, increased drug degradation due to altered expression of drug metabolising enzymes, drug inactivation due to conjugation with increased glutathione, subcellular redistribution, drug interaction, enhanced DNA repair and failure to apoptosis as a result of mutated cell cycle proteins such as p53. Attempts to overcome resistance involves the use of combination drug therapy using different classes of drugs with minimally overlapping toxicities to allow maximal dosages, necessary for bone marrow recovery. Adjuvant therapy with p-glycoprotein inhibitors and in specific instances, the use of growth factor and protein kinase C inhibitors are newer experimental approaches that may also prove effective in delaying onset of resistance. Gene knockout using antisense molecules may be effective way of blocking drug resistance.

  3. Preventing and managing antiretroviral drug resistance.

    Science.gov (United States)

    Kuritzkes, Daniel R

    2004-05-01

    Development of resistance to antiretroviral drugs (ARVs) is a major impediment to optimum treatment of HIV-1 infection. Although resistance testing can help to select subsequent regimens when virologic failure occurs, cross-resistance, which affects all classes of ARVs, may make it more difficult to achieve optimum control of HIV. We have known for some time that our first choice of antiretroviral therapy offers the best chance to control HIV replication and that initial therapy should be selected with an eye on future options. Potency is the first line of defense against the development of resistance. Other factors that affect resistance development include: tolerability, potential for optimum adherence, and genetic and pharmacologic barriers to development of resistance. If resistance emerges, only a single drug may be affected initially, and a rapid change in ARVs may preserve the efficacy of other components. One cautionary note is that we can no longer assume that a patient's HIV is fully susceptible to all ARVs even in the initial regimen. Transmission of drug-resistant HIV means that the genetic composition may be that of an "experienced" virus with reduced susceptibility to ARVs. Resistance testing at the time of transmission is most likely to reveal this resistance, but over time the dominant genetic pattern may revert to wild-type, and be missed by resistance testing. Because "archived" resistant HIV may emerge quickly once treatment is initiated, we need to keep this in mind when selecting initial therapy.

  4. Mechanisms of Candida biofilm drug resistance

    Science.gov (United States)

    Taff, Heather T; Mitchell, Kaitlin F; Edward, Jessica A; Andes, David R

    2013-01-01

    Candida commonly adheres to implanted medical devices, growing as a resilient biofilm capable of withstanding extraordinarily high antifungal concentrations. As currently available antifungals have minimal activity against biofilms, new drugs to treat these recalcitrant infections are urgently needed. Recent investigations have begun to shed light on the mechanisms behind the profound resistance associated with the biofilm mode of growth. This resistance appears to be multifactorial, involving both mechanisms similar to conventional, planktonic antifungal resistance, such as increased efflux pump activity, as well as mechanisms specific to the biofilm lifestyle. A unique biofilm property is the production of an extracellular matrix. Two components of this material, β-glucan and extracellular DNA, promote biofilm resistance to multiple antifungals. Biofilm formation also engages several stress response pathways that impair the activity of azole drugs. Resistance within a biofilm is often heterogeneous, with the development of a subpopulation of resistant persister cells. In this article we review the molecular mechanisms underlying Candida biofilm antifungal resistance and their relative contributions during various growth phases. PMID:24059922

  5. Antifungal drug resistance to azoles and polyenes.

    Science.gov (United States)

    Masiá Canuto, Mar; Gutiérrez Rodero, Félix

    2002-09-01

    There is an increased awareness of the morbidity and mortality associated with fungal infections caused by resistant fungi in various groups of patients. Epidemiological studies have identified risk factors associated with antifungal drug resistance. Selection pressure due to the continuous exposure to azoles seems to have an essential role in developing resistance to fluconazole in Candida species. Haematological malignancies, especially acute leukaemia with severe and prolonged neutropenia, seem to be the main risk factors for acquiring deep-seated mycosis caused by resistant filamentous fungi, such us Fusarium species, Scedosporium prolificans, and Aspergillus terreus. The still unacceptably high mortality rate associated with some resistant mycosis indicates that alternatives to existing therapeutic options are needed. Potential measures to overcome antifungal resistance ranges from the development of new drugs with better antifungal activity to improving current therapeutic strategies with the present antifungal agents. Among the new antifungal drugs, inhibitors of beta glucan synthesis and second-generation azole and triazole derivatives have characteristics that render them potentially suitable agents against some resistant fungi. Other strategies including the use of high doses of lipid formulations of amphotericin B, combination therapy, and adjunctive immune therapy with cytokines are under investigation. In addition, antifungal control programmes to prevent extensive and inappropriate use of antifungals may be needed.

  6. Genomic insights into intrinsic and acquired drug resistance mechanisms in Achromobacter xylosoxidans.

    Science.gov (United States)

    Hu, Yongfei; Zhu, Yuying; Ma, Yanan; Liu, Fei; Lu, Na; Yang, Xi; Luan, Chunguang; Yi, Yong; Zhu, Baoli

    2015-02-01

    Achromobacter xylosoxidans is an opportunistic pathogen known to be resistant to a wide range of antibiotics; however, the knowledge about the drug resistance mechanisms is limited. We used a high-throughput sequencing approach to sequence the genomes of the A. xylosoxidans type strain ATCC 27061 and a clinical isolate, A. xylosoxidans X02736, and then we used different bioinformatics tools to analyze the drug resistance genes in these bacteria. We obtained the complete genome sequence for A. xylosoxidans ATCC 27061 and the draft sequence for X02736. We predicted a total of 50 drug resistance-associated genes in the type strain, including 5 genes for β-lactamases and 17 genes for efflux pump systems; these genes are also conserved among other A. xylosoxidans genomes. In the clinical isolate, except for the conserved resistance genes, we also identified several acquired resistance genes carried by a new transposon embedded in a novel integrative and conjugative element. Our study provides new insights into the intrinsic and acquired drug resistance mechanisms in A. xylosoxidans, which will be helpful for better understanding the physiology of A. xylosoxidans and the evolution of antibiotic resistance in this bacterium.

  7. Post-Transcriptional Controls by Ribonucleoprotein Complexes in the Acquisition of Drug Resistance

    Directory of Open Access Journals (Sweden)

    Eun Kyung Lee

    2013-08-01

    Full Text Available Acquisition of drug resistance leads to failure of anti-cancer treatments and therapies. Although several successive chemotherapies are available, along with efforts towards clinical applications of new anti-cancer drugs, it is generally realized that there is a long way to go to treat cancers. Resistance to anti-cancer drugs results from various factors, including genetic as well as epigenetic differences in tumors. Determining the molecular and cellular mechanisms responsible for the acquisition of drug resistance may be a helpful approach for the development of new therapeutic strategies to overcome treatment failure. Several studies have shown that the acquisition of drug resistance is tightly regulated by post-transcriptional regulators such as RNA binding proteins (RBPs and microRNAs (miRNAs, which change the stability and translation of mRNAs encoding factors involved in cell survival, proliferation, epithelial-mesenchymal transition, and drug metabolism. Here, we review our current understanding of ribonucleoprotein complexes, including RBPs and miRNAs, which play critical roles in the acquisition of drug resistance and have potential clinical implications for cancer.

  8. Post-transcriptional controls by ribonucleoprotein complexes in the acquisition of drug resistance.

    Science.gov (United States)

    Kang, Hoin; Kim, Chongtae; Lee, Heejin; Kim, Wook; Lee, Eun Kyung

    2013-08-20

    Acquisition of drug resistance leads to failure of anti-cancer treatments and therapies. Although several successive chemotherapies are available, along with efforts towards clinical applications of new anti-cancer drugs, it is generally realized that there is a long way to go to treat cancers. Resistance to anti-cancer drugs results from various factors, including genetic as well as epigenetic differences in tumors. Determining the molecular and cellular mechanisms responsible for the acquisition of drug resistance may be a helpful approach for the development of new therapeutic strategies to overcome treatment failure. Several studies have shown that the acquisition of drug resistance is tightly regulated by post-transcriptional regulators such as RNA binding proteins (RBPs) and microRNAs (miRNAs), which change the stability and translation of mRNAs encoding factors involved in cell survival, proliferation, epithelial-mesenchymal transition, and drug metabolism. Here, we review our current understanding of ribonucleoprotein complexes, including RBPs and miRNAs, which play critical roles in the acquisition of drug resistance and have potential clinical implications for cancer.

  9. Sensitive analysis study in vitro of clinical multiple drug resistance enterobacteriaceae bacteria to tigecycline%临床多重耐药肠杆菌科细菌对替加环素的体外敏感性分析研究

    Institute of Scientific and Technical Information of China (English)

    古汉福; 张国雄

    2015-01-01

    Objective:To study clinical multiple drug resistant enterobacteriaceae bacteria for the in vitro sensitivity of ring element analysis, provide reference basis for clinical treatment. Methods:Take dilution test for added in multiple drug-resistant e. coli isolated from the clinical minimum bacteriostatic concentration (MIC), at the same time with other paper analyzes ten kinds of antimicrobial agents.Results:Clinical multiple drug resistant enterobacteriaceae bacteria sensitive to add ring element for rate is 91.6%, is sensitive to beauty efaecalis rate is 90%, with cefepime sensitive rate is 77.7%, for he totally cephalosporin rate 27.7%, sensitive to ceftriaxone rate is 27.7%, sensitive rate 55.3% to amoxicillin and susceptibility to his temple sensitivity was 0%, 88.9% sensitivity to amikacin, sensitivity to levofloxacin and 84.1% 67.9% of minocycline sensitivity. Conclusions:For add ring element of clinical multiple drug-resistant enterobacteriaceae bacteria in vitro antimicrobial sensitivity is higher, can be applied in clinical treatment.%目的:研究临床多重耐药肠杆菌科细菌对替加环素的体外敏感性分析,为临床治疗提供可参考依据。方法:采取稀释法检测替加环素对临床上分离出的多重耐药肠杆菌的最小抑菌浓度(MIC),同时与其他十种抗菌药物进行分析比较。结果:临床多重耐药肠杆菌科细菌对替加环素敏感率91.6%,对美罗培南敏感率90%,对头孢吡肟敏感率77.7%,对头孢他啶敏感率27.7%,对头孢曲松敏感率27.7%,对阿莫西林敏感率55.3%,对他唑巴坦敏感性0,对阿米卡星敏感性88.9%,对左氧氟沙星敏感性84.1%,对米诺环素敏感性67.9%。结论:替加环素对临床多重耐药肠杆菌科细菌体外抑菌敏感性较高,可以在临床治疗中推广应用。

  10. Clinical distribution in Pseudomonas aeruginosa and studies on drug resistance phenotype of β-Lactamases%多重耐药铜绿假单胞菌产酶状况及药物敏感性研究

    Institute of Scientific and Technical Information of China (English)

    李文波; 刘琼; 金凤玲; 张笠; 卢青云; 冯莉; 陈宝锦

    2012-01-01

    Objective To study the production of beta-lactamases on multi- drug resistant Pseudomonas aeruginosa and provide the guideline for treatment and control of Pseudomonas aeruginosa infection in hospital Methods Manal method and Biomerieux identification system were used to indentify bacterial strainsand agar diffusion method to detect drug susceptibility. K-B susceptibility method, three-dimensional method and synergetic test were used to detect extended spectrum beta-lactamases and AmpC beta-lactalases metallo-beta-lactamases. Results Specimens ranged from the first to the third of the isolation rate of PA was 71.1%, wound sedition and pus. Among 97 strains of multi-resistant Pseudomonas aeruginosa there were 21 strains Producing ESBLs beta-lactamases, 47 strains prouducing AmpC beta-lactamases, 16 strains producing ESBLs and AmpC beta-lactamases at the same time, 9 strains of them was producing metallo-beta-lactamases. The detection rate of AmpC was the most high. Conclusions The main beta-lactamases was AmpC beta-lactamases in the multi-resistant Pseudomonas aeruginosa cultured in our area. The sensitivity rates to imipenem amikacin and ciprofloxacin had better. In order to reduce the drug-resistance strains and control the infection of Pseudomonas aeruginosa antibiotics should be used reasonably according to drug susceptibility test.%目的 了解本地区多重耐药铜绿假单胞菌产酶情况及耐药性,为临床治疗及感染控制提供依据.方法 采用手工法及法国生物梅里埃鉴定系统对菌种进行鉴定,采用K-B琼脂扩散法进行药敏实验检测,改良三维试验、协同法分别对细菌ESBLs酶、AmpC酶、金属酶进行检测,根据CLSI标准进行判读.结果 临床标本主要以痰标本为主,分离率为71.1%,其次是伤口分泌物和脓汁,97株铜绿假单胞菌中产AmpC酶47株(48.5%),单产ESBLs酶菌株21株(21.6%),同时产ESBLs酶和AmpC酶菌株16株(16.4%),产金属酶的菌株9株(9.28%),产AmpC

  11. Meet the Herps.

    Science.gov (United States)

    Naturescope, 1987

    1987-01-01

    Describes some of the characteristics of "herps" (amphibians and reptiles). Contains teaching activities dealing with ancient herps, learning stations that encourage sensory experiences with herps, and games, puzzles, and a dramatic play about herps. Includes reproducible handouts designed to be used with the activities, as well as a quiz. (TW)

  12. Herpes zoster and diabetes.

    Science.gov (United States)

    Kalra, Sanjay; Chawla, Aastha

    2016-08-01

    This review is a succinct description of the relationship between herpes zoster and diabetes. It makes a strong case for screening for diabetes in all patients of herpes zoster, and for using insulin to achieve optimal glycaemic control in persons with concomitant diabetes and herpes zoster. It highlights potential impact of dipeptidyl peptidase 4 inhibitor therapy and statin usage on herpes zoster incidence.

  13. Analysis on the distribution and the drug resistance of clinical isolated Acinetobacter baumannii in our hospital from 2013 to 2015%2013~2015年临床分离的鲍曼不动杆菌的分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    吴振安

    2016-01-01

    目的:了解该院临床分离的鲍曼不动杆菌的分布特点及对临床常用抗菌药物耐药率的变化,为临床合理用药、院内感染控制提供依据。方法应用珠海迪尔体外细菌检测专用系统进行细菌鉴定和药敏试验,用WHONET 5.6软件进行数据分析。结果院内3年间分离的鲍曼不动杆菌主来源于痰液(82.98%~88.76%)。2015年分离的70株鲍曼不动杆菌对亚胺培南等17种抗菌药物的耐药率(5.7%~41.4%)低于2014年分离的94株鲍曼不动杆菌对亚胺培南等17种抗菌药物的耐药率(6.4%~47.9%) ,而高于2013年分离的89株鲍曼不动杆菌对亚胺培南等17种抗菌药物的耐药率(2.2%~18.0%)。鲍曼不动杆菌对米诺环素、多粘菌素B、头孢哌酮/舒巴坦、亚胺培南的总耐药率较低,分别为4.7%、5.1%、10.3%、15.4%;对四环素、氨苄西林/舒巴坦、哌拉西林、环丙沙星的总耐药率较高,分别为34.4%、31.2%、31.2%、29.3%。结论鲍曼不动杆菌主要引起呼吸道感染,本院临床分离的鲍曼不动杆菌对多数常用抗菌药物的耐药率均低于文献报道。加强耐药性监测,依据药敏试验结果合理使用抗菌药物,做好消毒隔离工作,可预防和减少院内多重耐药鲍曼不动杆菌的产生和传播。%Objective To investigate the distribution and drug resistances of clinical isolated Acinetobacter baumannii to the common antimicrobial ,and to provide theoretical basis for rational use of antibiotics and nosocomial infection control .Methods DL identification system was used for the identification of strains and drug sensitive test .The results of drug sensitivity were analyzed by WHONET 5 .6 software .Results Among the Acinetobacter baumannii isolates collected from 2013 to 2015 ,82 .98% -88 .76%were obtained from sputum .The drug resistances rates (5 .7%‐41 .4% ) of 70

  14. Paradoxical Hypersusceptibility of Drug-resistant Mycobacterium tuberculosis to β-lactam Antibiotics

    Directory of Open Access Journals (Sweden)

    Keira A. Cohen

    2016-07-01

    Full Text Available Mycobacterium tuberculosis (M. tuberculosis is considered innately resistant to β-lactam antibiotics. However, there is evidence that susceptibility to β-lactam antibiotics in combination with β–lactamase inhibitors is variable among clinical isolates, and these may present therapeutic options for drug-resistant cases. Here we report our investigation of susceptibility to β-lactam/β–lactamase inhibitor combinations among clinical isolates of M. tuberculosis, and the use of comparative genomics to understand the observed heterogeneity in susceptibility. Eighty-nine South African clinical isolates of varying first and second-line drug susceptibility patterns and two reference strains of M. tuberculosis underwent minimum inhibitory concentration (MIC determination to two β-lactams: amoxicillin and meropenem, both alone and in combination with clavulanate, a β–lactamase inhibitor. 41/91 (45% of tested isolates were found to be hypersusceptible to amoxicillin/clavulanate relative to reference strains, including 14/24 (58% of multiple drug-resistant (MDR and 22/38 (58% of extensively drug-resistant (XDR isolates. Genome-wide polymorphisms identified using whole-genome sequencing were used in a phylogenetically-aware linear mixed model to identify polymorphisms associated with amoxicillin/clavulanate susceptibility. Susceptibility to amoxicillin/clavulanate was over-represented among isolates within a specific clade (LAM4, in particular among XDR strains. Twelve sets of polymorphisms were identified as putative markers of amoxicillin/clavulanate susceptibility, five of which were confined solely to LAM4. Within the LAM4 clade, ‘paradoxical hypersusceptibility’ to amoxicillin/clavulanate has evolved in parallel to first and second-line drug resistance. Given the high prevalence of LAM4 among XDR TB in South Africa, our data support an expanded role for β-lactam/β-lactamase inhibitor combinations for treatment of drug-resistant M

  15. Exploiting bacterial drug resistance: a single construct for the diagnosis and treatment of drug resistant infections

    Science.gov (United States)

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

    2009-06-01

    β-lactamase enzyme-activated photosensitizer (β-LEAP). We aim to exploit drug resistance mechanisms to selectively release photosensitizers (PSs) for a specific photodynamic antimicrobial effect and reduced host tissue damage. Consequently, the fluorescence emission intensity of the PSs increases and allows for the detection of enzyme activity. In this work we sought to evaluate β-LEAP for use as a sensitive molecular probe. We have reported the enzyme specific antibacterial action of β-LEAP. Here we report the use of β-LEAP for the rapid functional definition of a β-lactamase.

  16. Role of drug transporters and drug accumulation in the temporal acquisition of drug resistance

    Directory of Open Access Journals (Sweden)

    Veitch Zachary

    2008-11-01

    Full Text Available Abstract Background Anthracyclines and taxanes are commonly used in the treatment of breast cancer. However, tumor resistance to these drugs often develops, possibly due to overexpression of drug transporters. It remains unclear whether drug resistance in vitro occurs at clinically relevant doses of chemotherapy drugs and whether both the onset and magnitude of drug resistance can be temporally and causally correlated with the enhanced expression and activity of specific drug transporters. To address these issues, MCF-7 cells were selected for survival in increasing concentrations of doxorubicin (MCF-7DOX-2, epirubicin (MCF-7EPI, paclitaxel (MCF-7TAX-2, or docetaxel (MCF-7TXT. During selection cells were assessed for drug sensitivity, drug uptake, and the expression of various drug transporters. Results In all cases, resistance was only achieved when selection reached a specific threshold dose, which was well within the clinical range. A reduction in drug uptake was temporally correlated with the acquisition of drug resistance for all cell lines, but further increases in drug resistance at doses above threshold were unrelated to changes in cellular drug uptake. Elevated expression of one or more drug transporters was seen at or above the threshold dose, but the identity, number, and temporal pattern of drug transporter induction varied with the drug used as selection agent. The pan drug transporter inhibitor cyclosporin A was able to partially or completely restore drug accumulation in the drug-resistant cell lines, but had only partial to no effect on drug sensitivity. The inability of cyclosporin A to restore drug sensitivity suggests the presence of additional mechanisms of drug resistance. Conclusion This study indicates that drug resistance is achieved in breast tumour cells only upon exposure to concentrations of drug at or above a specific selection dose. While changes in drug accumulation and the expression of drug transporters does

  17. Drug resistance mechanisms and novel drug targets for tuberculosis therapy.

    Science.gov (United States)

    Islam, Md Mahmudul; Hameed, H M Adnan; Mugweru, Julius; Chhotaray, Chiranjibi; Wang, Changwei; Tan, Yaoju; Liu, Jianxiong; Li, Xinjie; Tan, Shouyong; Ojima, Iwao; Yew, Wing Wai; Nuermberger, Eric; Lamichhane, Gyanu; Zhang, Tianyu

    2017-01-20

    Drug-resistant tuberculosis (TB) poses a significant challenge to the successful treatment and control of TB worldwide. Resistance to anti-TB drugs has existed since the beginning of the chemotherapy era. New insights into the resistant mechanisms of anti-TB drugs have been provided. Better understanding of drug resistance mechanisms helps in the development of new tools for the rapid diagnosis of drug-resistant TB. There is also a pressing need in the development of new drugs with novel targets to improve the current treatment of TB and to prevent the emergence of drug resistance in Mycobacterium tuberculosis. This review summarizes the anti-TB drug resistance mechanisms, furnishes some possible novel drug targets in the development of new agents for TB therapy and discusses the usefulness using known targets to develop new anti-TB drugs. Whole genome sequencing is currently an advanced technology to uncover drug resistance mechanisms in M. tuberculosis. However, further research is required to unravel the significance of some newly discovered gene mutations in their contribution to drug resistance.

  18. Detecting drug resistant genetic mutation among pneumoconiosis patients complicated with tuberculosis in Mycobacterium tuberculosis L-forms application of PCR-SSCP technique in Huainan mining district

    Institute of Scientific and Technical Information of China (English)

    Jun Lu; Shan Jiang; Song Ye; Chaopin Li

    2007-01-01

    Objective: To study the relationship between drug resistant genetic mutation and drug resistance in Mycobacterium tuberculosis L-form, discuss the internal relationship between drug resistances and drug-resistant related genes and explore the value of PCRSSCP to clinical application. Methods: A total of 52 clinically isolated strains of tuberculosis L-form were collected among 97pneumoconiosis patients complicated with tuberculosis. The gene mutations of katG, rpoB and rpsL were detected by PCR-SSCP,and the results were compared with those analyzed by traditional antimicrobial susceptibility test(AST). Results: The gene mutation rates of katG, rpoB and rpsL by PCR-SSCP were respectively 57.70% (30/52), 65.38% (32/52) and 40.38% (21/52). The rate of reversion was 78.85%(41/52) and the result of drug-resistant genes was invariable. The results of AST showed that there were 40 (76.92%) multi-drug resistant strains in 52 clinically isolated strains. The number for three-drug resistant strain was 21(40.38%) and that of two-drug resistant was 19(36.54%), but only 12 (23.08%) strains were one drug resistant. The rate of total drug-resistance was 100%, but there were 15 strains of allied mutation of three genes, 16 of two mutations and 6 of only one by PCR-SSCP. The coincidences were respectively 71.43%, 84.12% and 50.00%. Then there was no significant difference between the allied mutations of multi-drug resistant gene and the mutations of only one drug resistant gene (P > 0.05). Conclusion: PCRSSCP technique has a higher sensibility and specificity to detect the genes of katG, rpoB and rpsL in tuberculosis L-form among pneumoconiosis complicated with tuberculosis,and the detecting rate of two drug resistant strains and three drug resistant strains was higher. The combined application of PCR-SSCP and AST has advantages at earlier diagnosis and guidance of clinical medications.

  19. Analysis on the drug resistance and the distribution of clinical isolated Acinetobacter baumannii in a hospital from 2012 to 2014%2012至2014年某院临床分离的鲍曼不动杆菌的耐药性及分布

    Institute of Scientific and Technical Information of China (English)

    刘静; 姜梅杰; 王桂明

    2015-01-01

    目的:动态监测院内分离的鲍曼不动杆菌对临床常用抗菌药物耐药率的变化及分布,为院内感染控制提供理论依据。方法用WHONET 5.6对2012年1月至2014年12月山东省泰安市中心医院临床分离的鲍曼不动杆菌对亚胺培南等13种抗菌药物的耐药性及分布进行分析。结果2012年分离的616株鲍曼不动杆菌对亚胺培南等13种抗菌药物的耐药率(52.9%~94.0%)高于2013年分离的536株鲍曼不动杆菌对亚胺培南等13种抗菌药物的耐药率(37.7%~70.1%)。2014年分离的421株鲍曼不动杆菌对左旋氧氟沙星和妥布霉素的耐药率高于2013年分离的鲍曼不动杆菌对左旋氧氟沙星和妥布霉素的耐药率,但2014年分离的鲍曼不动杆菌对其余11种抗菌药物的耐药率(37.2%~65.6%)低于2013年分离的鲍曼不动杆菌的耐药率。院内3年间分离的鲍曼不动杆菌88.4%~92.5%的标本来源于痰液。结论3年间本院临床分离的鲍曼不动杆菌对多数常用抗菌药物的耐药率逐年下降。加强对多重耐药鲍曼不动杆菌的感染控制,可预防和减少院内多重耐药鲍曼不动杆菌的产生和传播。%Objective To monitoring dynamicly the distribution and drug resistances of clinical isolated Acinetobacter baumannii to the common antimicrobial, and to provide theoretical basis for nosocomial infection control. Methods The distribution and drug resistances of clinical isolated Acinetobacter baumannii collected from January 2012 to December 2014 to 13 antibacterial including imipenem were analyzed by WHONET 5.6, retrospectively. Results The drug resistances rates (52.9%-94.0%) of 616 strains Acinetobacter baumannii isolates collected during 2012 to 13 antibacterial were higher than the drug resistances of 536 strains Acinetobacter baumannii collected during 2013 (37.7%-70.1%). The drug resistances rates of 421 strains Acinetobacter baumannii isolates collected during 2014 to

  20. Engineered reversal of drug resistance in cancer cells--metastases suppressor factors as change agents.

    Science.gov (United States)

    Yadav, Vinod Kumar; Kumar, Akinchan; Mann, Anita; Aggarwal, Suruchi; Kumar, Maneesh; Roy, Sumitabho Deb; Pore, Subrata Kumar; Banerjee, Rajkumar; Mahesh Kumar, Jerald; Thakur, Ram Krishna; Chowdhury, Shantanu

    2014-01-01

    Building molecular correlates of drug resistance in cancer and exploiting them for therapeutic intervention remains a pressing clinical need. To identify factors that impact drug resistance herein we built a model that couples inherent cell-based response toward drugs with transcriptomes of resistant/sensitive cells. To test this model, we focused on a group of genes called metastasis suppressor genes (MSGs) that influence aggressiveness and metastatic potential of cancers. Interestingly, modeling of 84 000 drug response transcriptome combinations predicted multiple MSGs to be associated with resistance of different cell types and drugs. As a case study, on inducing MSG levels in a drug resistant breast cancer line resistance to anticancer drugs caerulomycin, camptothecin and topotecan decreased by more than 50-60%, in both culture conditions and also in tumors generated in mice, in contrast to control un-induced cells. To our knowledge, this is the first demonstration of engineered reversal of drug resistance in cancer cells based on a model that exploits inherent cellular response profiles.

  1. Primary drug resistance among pulmonary treatment-naïve tuberculosis patients in Amazonas State, Brazil.

    Science.gov (United States)

    da Silva Garrido, M; Ramasawmy, R; Perez-Porcuna, T M; Zaranza, E; Chrusciak Talhari, A; Martinez-Espinosa, F E; Bührer-Sékula, S

    2014-05-01

    Multidrug-resistant tuberculosis (MDR-TB) is the main indicator of previous treatment in tuberculosis (TB) patients. MDR-TB among treatment-naïve patients indicates infection with drug-resistant Mycobacterium tuberculosis strains, and such cases are considered primary drug-resistant cases. To estimate the prevalence of drug resistance in pulmonary TB (PTB) treatment-naïve patients and to identify the socio-demographic and clinical characteristics of the resistant population. A total of 205 treatment-naïve PTB patients from Manaus, Amazonas State, Brazil, were enrolled. Drug susceptibility testing (DST) was performed on all positive mycobacterial cultures using the 1% proportion method. Positive M. tuberculosis cultures were obtained from only 175 patients for DST. The prevalence of primary MDR-TB was 1.7% (3/175); 14.3% (25/175) of the cultures presented resistance to at least one of the drugs. Resistance to streptomycin, isoniazid, rifampicin and ethambutol was respectively 8.6%, 6.9%, 3.4% and 2.3%. An association between TB patients with resistance to more than one drug and known previous household contact with a TB patient was observed (P= 0.008, OR 6.7, 95%CI 1.2-67.3). Although the prevalence of primary MDR-TB currently is relatively low, it may become a major public health problem if tailored treatment is not provided, as resistance to more than one drug is significantly associated with household contact.

  2. Drug rechallenge and treatment beyond progression—implications for drug resistance

    Science.gov (United States)

    Kuczynski, Elizabeth A.; Sargent, Daniel J.; Grothey, Axel; Kerbel, Robert S.

    2015-01-01

    The established dogma in oncology for managing recurrent or refractory disease dictates that therapy is changed at disease progression, because the cancer is assumed to have become drug-resistant. Drug resistance, whether pre-existing or acquired, is largely thought to be a stable and heritable process; thus, reuse of therapeutic agents that have failed is generally contraindicated. Over the past few decades, clinical evidence has suggested a role for unstable, non-heritable mechanisms of acquired drug resistance pertaining to chemotherapy and targeted agents. There are many examples of circumstances where patients respond to reintroduction of the same therapy (drug rechallenge) after a drug holiday following disease relapse or progression during therapy. Additional, albeit limited, evidence suggests that, in certain circumstances, continuing a therapy beyond disease progression can also have antitumour activity. In this Review, we describe the anticancer agents used in these treatment strategies and discuss the potential mechanisms explaining the apparent tumour re-sensitization with reintroduced or continued therapy. The extensive number of malignancies and drugs that challenge the custom of permanently switching to different drugs at each line of therapy warrants a more in-depth examination of the definitions of disease progression and drug resistance and the resulting implications for patient care. PMID:23999218

  3. Drug resistance in multiple myeloma: latest findings and new concepts on molecular mechanisms

    Science.gov (United States)

    Abdi, Jahangir; Chen, Guoan; Chang, Hong

    2013-01-01

    In the era of new and mostly effective therapeutic protocols, multiple myeloma still tends to be a hard-to-treat hematologic cancer. This hallmark of the disease is in fact a sequel to drug resistant phenotypes persisting initially or emerging in the course of treatment. Furthermore, the heterogeneous nature of multiple myeloma makes treating patients with the same drug challenging because finding a drugable oncogenic process common to all patients is not yet feasible, while our current knowledge of genetic/epigenetic basis of multiple myeloma pathogenesis is outstanding. Nonetheless, bone marrow microenvironment components are well known as playing critical roles in myeloma tumor cell survival and environment-mediated drug resistance happening most possibly in all myeloma patients. Generally speaking, however; real mechanisms underlying drug resistance in multiple myeloma are not completely understood. The present review will discuss the latest findings and concepts in this regard. It reviews the association of important chromosomal translocations, oncogenes (e.g. TP53) mutations and deranged signaling pathways (e.g. NFκB) with drug response in clinical and experimental investigations. It will also highlight how bone marrow microenvironment signals (Wnt, Notch) and myeloma cancer stem cells could contribute to drug resistance in multiple myeloma. PMID:24327604

  4. Effect of repetitive transcranial magnetic stimulation in drug resistant depressed patients

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Yong An; Yoo, Ie Ryung; Kang, Bong Joo; Chae, Jeong Ho; Lee, Hye Won; Moon, Hyun Jin; Kim, Sung Hoon; Sohn, Hyung Sun; Chung, Soo Kyo [The Catholic University of Korea, Seoul (Korea, Republic of)

    2007-02-15

    Repetitive transcranial magnetic stimulation (rTMS) has recently been clinically applied in the treatment of drug resistant depressed patients. There are mixed findings about the efficacy of rTMS on depression. Furthermore, the influence of rTMS on the physiology of the brain is not clear. We prospectively evaluated changes of regional cerebral blood flow (rCBF) between pre- and post-rTMS treatment in patients with drug resistant depression. Twelve patients with drug-resistant depression (7 male, 5 female; age range; 19{approx} 52 years; mean age: 29.3 {+-} 9.3 years) were given rTMS on right prefrontal lobe with low frequency (1 Hz) and on left prefrontal lobe with high frequency (20 Hz), with 20-minute-duration each day for 3 weeks. Tc-99m ECD brain perfusion SPECT was obtained before and after rTMS treatment. The changes of cerebral perfusion were analyzed using statistical parametric mapping (SPM; t=3.14, uncorrected {rho} < 0.01, voxel = 100). Following areas showed significant increase in rCBF after 3 weeks rTMS treatment: the cingulate gyrus, fusiform gyrus of right temporal lobe, precuneus, and left lateral globus pallidus. Significant decrement was noted in the precental and middle frontal gyrus of right frontal lobe, and fusiform gyrus of left occipital lobe. Low-frequency rTMS on the right prefrontal cortex and high-frequency rTMS on the left prefrontal cortex for 3 weeks as an add-on regimen have increased and decreased rCBF in the specific brain regions in drug-resistant depressed patients. Further analyses correlating clinical characteristics and treatment paradigm with functional imaging data may be helpful in clarifying the pathophysiology of drug-resistant patients.

  5. Clinical efficacy of amoxicillin/clavulanate potassium combined with levofloxacin in the treatment of multi -drug resistant pulmonary tuberculosis%阿莫西林/克拉维酸钾联合左氧氟沙星治疗耐多药肺结核的临床效果

    Institute of Scientific and Technical Information of China (English)

    童维佳; 王永庆

    2015-01-01

    Objective To observe and evaluate the clinical effect of amoxicillin/ clavulanate potassium com-bined with levofloxacin in the treatment of multi-drug resistant pulmonary tuberculosis (MDR-TB). Methods 80 re-treated smear positive patients with multi-drug resistant pulmonary tuberculosis were randomly divided into the control group and the treatment group, 40 cases in each group. The control group was treated with levofloxacin combined with pasiniazid, ethambutol hydrochloride, rifapentine and pyrazinamide, and the treatment group was treated with amoxi-cillin/ clavulanate potassium and levofloxacin, combined with pasiniazid, ethambutol hydrochloride, rifapentine and pyrazinamide. All patients were treated for 12 months. Results At the end of the treatment, the sputum negative conversion rate was 52. 50% in the control group, and 75% in the treatment group (P 0. 05). Conclusion Amoxicillin/ clavulanate potassium combined with levofloxacin regimen can improve the sputum negative conversion and lesions absorption,with low adverse drug reaction in the treatment of multi-drug resistant pulmonary tuberculosis.%目的::观察并评价阿莫西林/克拉维酸钾联合左氧氟沙星在治疗耐多药肺结核(MDR-TB)的疗效。方法将80例复治涂阳耐多药肺结核患者随机分为对照组40例和治疗组40例;治疗方案:对照组以左氧氟沙星为主,联合对氨基水杨酸异烟肼、盐酸乙胺丁醇、利福喷丁、吡嗪酰胺,治疗组以阿莫西林/克拉维酸钾、左氧氟沙星为主,联合用药同对照组,所有病例疗程均为12个月。结果至疗程结束,对照组痰菌阴转率为52.50%,治疗组痰菌阴转率为75.00%,治疗组痰菌阴转率明显高于对照组(P 0.05)。结论对于耐多药肺结核,用阿莫西林/克拉维酸钾联合左氧氟沙星治疗利于痰菌阴转和病变吸收好转,药品不良反应低,具有推广价值。

  6. Verrucous herpes of the scrotum presenting clinically as verrucous squamous cell carcinoma: case report and review of the literature.

    Science.gov (United States)

    Quesada, Andres E; Galfione, Sarah; Colome, Maria; Brown, Robert E

    2014-01-01

    We report a case of a 36-year-old man with acquired immunodeficiency syndrome (AIDS) and an enlarging scrotal mass presumed to be of malignant origin but found to be a rare instance of verrucous herpes simplex type 2 infection of the scrotum. We also review the literature on this subject and discuss pathogenesis of the disease.

  7. Valaciclovir versus aciclovir in patient initiated treatment of recurrent genital herpes: A randomised, double blind clinical trial

    NARCIS (Netherlands)

    N.J. Bodsworth; R.J. Crooks; S. Borelli; G. Vejlsgaard; J. Paavonen; A.M. Worm; N. Uexkull; J. Esmann; A. Strand; A.J. Ingamells; A. Gibb (A.); S.E. Barton (Simon); C. Beylot (C.); J. Bingham (J.); G. Bojs (G.); D. Cheetham (D.); E. Curless (E.); B. Czarnetzki (B.); S. Davies (S.); A. Eichmann (A.); B. Goh; D. Goldmeir (D.); G. Gross; U.F. Haustein; G. Kinghorn (G.); J. Lauharanta; C. Law; G. Luzzi (G.); A. McMillan (A.); J. Meaden (J.); U. Montemagno (U.); P. Morel; M. Negosanti; J.E. Nielsen (Jorgen); A. Nilsen; E-K. Ong; J.P. Ortonne; R. Patel; J. Patten; D. Petzold; T. Rufli; S. Saari; M. Shahmanesh; A. Simpanen (A.); J. Soltz-Szots; J.P. Stahl; E. Stolz (Ernst); I. Thelin; N. von Uexkull; A. Wikstrom; P. Woolley

    1997-01-01

    textabstractObjective: To compare the efficacy and safety of twice daily valaciclovir with five times daily aciclovir in the treatment of an episode of recurrent genital herpes simplex virus (HSV) infection in immunocompetent individuals. Methods: 739 patients with a history of recurrent genital HSV

  8. Isolation rate and drug resistance patterns of Shigella species ...

    African Journals Online (AJOL)

    Isolation rate and drug resistance patterns of Shigella species among ... use of water from unprotected sources and absence of latrine were the risk factors that ... to identify changes in the prevalence and antimicrobial resistance patterns of ...

  9. Long Non-coding RNAs and Drug Resistance.

    Science.gov (United States)

    Pan, Jing-Jing; Xie, Xiao-Juan; Li, Xu; Chen, Wei

    2015-01-01

    Long non-coding RNAs (lncRNAs) are emerging as key players in gene expression that govern cell developmental processes, and thus contributing to diseases, especially cancers. Many studies have suggested that aberrant expression of lncRNAs is responsible for drug resistance, a substantial obstacle for cancer therapy. Drug resistance not only results from individual variations in patients, but also from genetic and epigenetic differences in tumors. It is reported that drug resistance is tightly modulated by lncRNAs which change the stability and translation of mRNAs encoding factors involved in cell survival, proliferation, and drug metabolism. In this review, we summarize recent advances in research on lncRNAs associated with drug resistance and underlying molecular or cellular mechanisms, which may contribute helpful approaches for the development of new therapeutic strategies to overcome treatment failure.

  10. Managing Drug Resistance in Cancer: Role of Cancer Informatics.

    Science.gov (United States)

    Gautam, Ankur; Chaudhary, Kumardeep; Kumar, Rahul; Gupta, Sudheer; Singh, Harinder; Raghava, Gajendra P S

    2016-01-01

    Understanding and managing cancer drug resistance is the main goal of the modern oncology programs worldwide. One of the major factors contributing to drug resistance in cancer cells is the acquired mutations in drug targets. Advances in sequencing technologies and high-throughput screening assays have generated huge information related to pharmaco-profiling of anticancer drugs and revealed the mutational spectrum of different cancers. Systematic meta-analysis of this complex data is very essential to make useful conclusions in order to manage cancer drug resistance. Bioinformatics can play a significant role to interpret this complex data into useful conclusions. In this chapter, the use of bioinformatics platforms, particularly CancerDR, in understanding the cancer drug resistance is described.

  11. Progress in Research on Drug-resistance of HIV-1%HIV-1耐药性的研究进展

    Institute of Scientific and Technical Information of China (English)

    贾峥

    2011-01-01

    The drug-resistance of HIV-1 is one of the important cause for failure in treatment of AIDS in humans.The research on drug-resistance of HIV-1 is of an important significance in controlling the epidemic of drug-resistance HIV-1 strain and clinical therapy of AIDS.This paper reviews the generation, evolution and epidemic of drug-resistant strain, mechanism of drug-resistance, drug-resistant mutation, test for drug-resistance as well as novel methods for drug-resistance test of HIV-1.%HIV-1耐药株的出现是人类艾滋病(AIDS)治疗失败的重要原因之一,HIV-1耐药性的研究对于控制耐药株的流行及临床治疗真有重要意义.本文就HIV-1耐药株的产生、进化和传播,HIV-1的耐药机制及耐药性突变,HIV-1耐药性检测以及新型HIV-1耐药性检测方法等作一综述.

  12. Clinical Analysis of 12 HIV-infected Patients with Herpes Zoster%HIV感染并发带状疱疹12例临床分析

    Institute of Scientific and Technical Information of China (English)

    张更建; 张信江; 罗显华; 董泽令; 黄健; 陈龙庆; 王磊

    2013-01-01

    Objective To explore the clinical characteristics of HIV-infected patients with herpes zoster. Methods A retrospective analysis was performed on patients diagnosed as HIV infection with herpes zoster from November 2008 to October 2011 in our hospital. Results There were 12 HIV-infected patients with herpes zoster, male nine cases, female three cases, aged 25 to 58 years, average 35 years old. Eight cases were farmers, one was worker, two cases were individual and the other one was company staff. All the patients had neuropathic pain syndromes, five cases of them paining obviously. Patients were all with the two nerve branches innervating the area except one . 11 cases were cured, the other one was better. There were two cases of HIV patients diagnosed in the first year, four cases in the second year and six cases in the third year. The incidence of HIV increased with year. Conclusion HIV infection complicated with herpes zoster easily. Herpes zoster should be recognized as a marker condition indicating the necessity of screening for HIV. Obviously neuropathic pain and larger scale of rash always occurred in the HIV patients with herpes zoster. The common treatment of HIV patients with herpes zoster were using medicine with antivirus, nerve nutrition, diminishing inflammation acetanilide and enhancing immunologic function, but not glucocorticoid. The treatment alleviated the symptom effectively.%目的 探讨HIV感染者并发带状疱疹的临床特点.方法 回顾性分析2008年11月-2011年10月本科收治的12例HIV感染并发带状疱疹患者的临床资料.结果 男9例,女3例;年龄25~58岁,大于50岁1例.农民8例,工人1例,个体2例,职员1例.11例皮损分布≥2个神经分支支配区,均出现神经痛症状,其中5例疼痛明显.临床治愈11例,好转1例.三年间检出HIV感染并发带状疱疹者分别为2例、4例和6例.结论 HIV感染者易并发带状疱疹,带状疱疹可为HIV感染的首要症状.HIV感染并发带状

  13. Comprehensive treatment of extensively drug-resistant tuberculosis.

    Science.gov (United States)

    Mitnick, Carole D; Shin, Sonya S; Seung, Kwonjune J; Rich, Michael L; Atwood, Sidney S; Furin, Jennifer J; Fitzmaurice, Garrett M; Alcantara Viru, Felix A; Appleton, Sasha C; Bayona, Jaime N; Bonilla, Cesar A; Chalco, Katiuska; Choi, Sharon; Franke, Molly F; Fraser, Hamish S F; Guerra, Dalia; Hurtado, Rocio M; Jazayeri, Darius; Joseph, Keith; Llaro, Karim; Mestanza, Lorena; Mukherjee, Joia S; Muñoz, Maribel; Palacios, Eda; Sanchez, Epifanio; Sloutsky, Alexander; Becerra, Mercedes C

    2008-08-07

    Extensively drug-resistant tuberculosis has been reported in 45 countries, including countries with limited resources and a high burden of tuberculosis. We describe the management of extensively drug-resistant tuberculosis and treatment outcomes among patients who were referred for individualized outpatient therapy in Peru. A total of 810 patients were referred for free individualized therapy, including drug treatment, resective surgery, adverse-event management, and nutritional and psychosocial support. We tested isolates from 651 patients for extensively drug-resistant tuberculosis and developed regimens that included five or more drugs to which the infecting isolate was not resistant. Of the 651 patients tested, 48 (7.4%) had extensively drug-resistant tuberculosis; the remaining 603 patients had multidrug-resistant tuberculosis. The patients with extensively drug-resistant tuberculosis had undergone more treatment than the other patients (mean [+/-SD] number of regimens, 4.2+/-1.9 vs. 3.2+/-1.6; P<0.001) and had isolates that were resistant to more drugs (number of drugs, 8.4+/-1.1 vs. 5.3+/-1.5; P<0.001). None of the patients with extensively drug-resistant tuberculosis were coinfected with the human immunodeficiency virus (HIV). Patients with extensively drug-resistant tuberculosis received daily, supervised therapy with an average of 5.3+/-1.3 drugs, including cycloserine, an injectable drug, and a fluoroquinolone. Twenty-nine of these patients (60.4%) completed treatment or were cured, as compared with 400 patients (66.3%) with multidrug-resistant tuberculosis (P=0.36). Extensively drug-resistant tuberculosis can be cured in HIV-negative patients through outpatient treatment, even in those who have received multiple prior courses of therapy for tuberculosis. 2008 Massachusetts Medical Society

  14. Proteomic insights into Acinetobacter baumannii drug resistance and pathogenesis.

    Science.gov (United States)

    Long, Quanxin; Huang, Changwu; Liao, Pu; Xie, Jianping

    2013-01-01

    Acinetobacter baumannii is an important opportunist pathogen, due to severe antibiotic resistance and nosocomial infection. The epidemiology and antibiotic resistance of A.baumannii have been extensively reviewed, but the pathogenesis and virulence remain unclear. Proteomics analysis has been applied to study the mechanism of drug resistance, biofilm, micronutrient acquisition, and the extracellular compartment. This review summarizes applications of proteomics in A. baumannii, aiming to summarize novel insights into the mechanism of A. baumannii pathogenesis and drug resistance.

  15. Anti-mycobacterial activity of garlic (Allium sativum) against multi-drug resistant and non-multi-drug resistant mycobacterium tuberculosis.

    Science.gov (United States)

    Hannan, Abdul; Ikram Ullah, Muhammad; Usman, Muhammad; Hussain, Shahid; Absar, Muhammad; Javed, Khursheed

    2011-01-01

    Emergence of multi-drug resistant (MDR) and extensively drug resistant (XDR) TB throughout the developing world is very disturbing in the present scenario of TB management. There is a fundamental need to explore alternative anti-TB agents. Hence natural plants should be investigated to understand their antimicrobial properties and safety. Garlic (Allium sativum) is one of natural plant which possesses variety of biological properties like anti-tumor, anti-hyperlipedemic and anti-microbial etc. The present study was evaluated for anti-bacterial activity of garlic against non-MDR and MDR isolates of M. tuberculosis. A total of 20 clinical isolates of MTB including 15 MDR and 5 non-MDR were investigated. Ethanolic extract of garlic was prepared by maceration method. Minimum inhibitory concentration (MIC) was performed by using 7H9 middle brook broth dilution technique. MIC of garlic extract was ranged from 1 to 3 mg/ml; showing inhibitory effects of garlic against both non-MDR and MDR M. tuberculosis isolates. Alternate medicine practices with plant extracts including garlic should be considered to decrease the burden of drug resistance and cost in the management of diseases. The use of garlic against MDR-TB may be of great importance regarding public health.

  16. Sentinel Surveillance of HIV-1 Transmitted Drug Resistance, Acute Infection and Recent Infection

    Science.gov (United States)

    Truong, Hong-Ha M.; Kellogg, Timothy A.; McFarland, Willi; Louie, Brian; Klausner, Jeffrey D.; Philip, Susan S.; Grant, Robert M.

    2011-01-01

    Background HIV-1 acute infection, recent infection and transmitted drug resistance screening was integrated into voluntary HIV counseling and testing (VCT) services to enhance the existing surveillance program in San Francisco. This study describes newly-diagnosed HIV cases and characterizes correlates associated with infection. Methodology/Principal Findings A consecutive sample of persons presenting for HIV VCT at the municipal sexually transmitted infections (STI) clinic from 2004 to 2006 (N = 9,868) were evaluated by standard enzyme-linked immunoassays (EIA). HIV antibody-positive specimens were characterized as recent infections using a less-sensitive EIA. HIV-RNA pooled testing was performed on HIV antibody-negative specimens to identify acute infections. HIV antibody-positive and acute infection specimens were evaluated for drug resistance by sequence analysis. Multivariable logistic regression was performed to evaluate associations. The 380 newly-diagnosed HIV cases included 29 acute infections, 128 recent infections, and 47 drug-resistant cases, with no significant increases or decreases in prevalence over the three years studied. HIV-1 transmitted drug resistance prevalence was 11.0% in 2004, 13.4% in 2005 and 14.9% in 2006 (p = 0.36). Resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI) was the most common pattern detected, present in 28 cases of resistance (59.6%). Among MSM, recent infection was associated with amphetamine use (AOR = 2.67; p<0.001), unprotected anal intercourse (AOR = 2.27; p<0.001), sex with a known HIV-infected partner (AOR = 1.64; p = 0.02), and history of gonorrhea (AOR = 1.62; p = 0.03). Conclusions New HIV diagnoses, recent infections, acute infections and transmitted drug resistance prevalence remained stable between 2004 and 2006. Resistance to NNRTI comprised more than half of the drug-resistant cases, a worrisome finding given its role as the backbone of first

  17. Sentinel surveillance of HIV-1 transmitted drug resistance, acute infection and recent infection.

    Directory of Open Access Journals (Sweden)

    Hong-Ha M Truong

    Full Text Available HIV-1 acute infection, recent infection and transmitted drug resistance screening was integrated into voluntary HIV counseling and testing (VCT services to enhance the existing surveillance program in San Francisco. This study describes newly-diagnosed HIV cases and characterizes correlates associated with infection.A consecutive sample of persons presenting for HIV VCT at the municipal sexually transmitted infections (STI clinic from 2004 to 2006 (N = 9,868 were evaluated by standard enzyme-linked immunoassays (EIA. HIV antibody-positive specimens were characterized as recent infections using a less-sensitive EIA. HIV-RNA pooled testing was performed on HIV antibody-negative specimens to identify acute infections. HIV antibody-positive and acute infection specimens were evaluated for drug resistance by sequence analysis. Multivariable logistic regression was performed to evaluate associations. The 380 newly-diagnosed HIV cases included 29 acute infections, 128 recent infections, and 47 drug-resistant cases, with no significant increases or decreases in prevalence over the three years studied. HIV-1 transmitted drug resistance prevalence was 11.0% in 2004, 13.4% in 2005 and 14.9% in 2006 (p = 0.36. Resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI was the most common pattern detected, present in 28 cases of resistance (59.6%. Among MSM, recent infection was associated with amphetamine use (AOR = 2.67; p<0.001, unprotected anal intercourse (AOR = 2.27; p<0.001, sex with a known HIV-infected partner (AOR = 1.64; p = 0.02, and history of gonorrhea (AOR = 1.62; p = 0.03.New HIV diagnoses, recent infections, acute infections and transmitted drug resistance prevalence remained stable between 2004 and 2006. Resistance to NNRTI comprised more than half of the drug-resistant cases, a worrisome finding given its role as the backbone of first-line antiretroviral therapy in San Francisco as well as worldwide. The integration of HIV-1 drug

  18. Investigation into the prevalence of coccidiosis and maduramycin drug resistance in chickens in China.

    Science.gov (United States)

    Zhang, Jian Jun; Wang, Li Xia; Ruan, Wen Ke; An, Jian

    2013-01-16

    Coccidiosis is a parasitic disease that affects the poultry industry worldwide, having major economic impacts on poultry by reducing performance and decreasing productivity. This disease not only hinders the growth of chickens but also facilitates other epidemic diseases. Coccidiosis is mainly controlled by prophylactic coccidiostats administrated in the feed. However, the extensive use of these drugs has resulted in the development of drug resistance by Eimeria spp., which causes coccidiosis. The aim of the survey was to acquire data on the prevalence of coccidiosis and drug resistance of field isolates in chickens in China. We examined 545 farms across nine different geographic provinces over a 5-year period. These included Beijing, Sichuan, Zhejiang, Shandong, Guangdong, Fujian, Liaoning Provinces, Inner Mongolia and Xinjiang Uygur Autonomous Regions. The results indicated that oocyst per gram faeces (OPG) and coccidiosis morbidity rate increased when non-prophylactic or low doses of coccidiostats were used. Coccidiosis morbidity rate in Guangdong Province was the highest, leading to greater, more frequent use of diverse types of coccidiostats. Consequently, the Guangdong Province had the most serious drug resistance problem. In contrast, coccidiosis morbidity rates in Inner Mongolia, Fujian and Liaoning were relatively low, leading to a reduced level of coccidiostats use, which resulted in less drug resistance. The threshold of a coccidiosis outbreak was an OPG level of >20000. When the OPG levels were ≥ 50000, chickens were in danger of clinical coccidiosis, and here coccidia generated a certain degree of resistance to the drug when administered. Coccidiostat resistance started to appear when the OPG level reached ca. 20000 using 2 mg kg(-1)/5 mg kg(-1), respectively, of maduramycin, whereas 5 mg kg(-1) of maduramycin developed severe drug resistance. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. 德宏地区艾滋病病人ART后的耐药性观察%Clinical observation of HIV-1 drug-resistance in HIV-infected individuals after antiretroviral therapy in Dehong, Yunnan

    Institute of Scientific and Technical Information of China (English)

    章银娣; 段兴钧; 周理存; 杨应彪; 赵文胜; 李太生

    2013-01-01

    Objective To investigate drug-resistance of human immunodeficiency virus (HIV) in HIV-infected individuals after antiretroviral therapy (ART) in Dehong, Yunnan. Methods Seventy eight HIV-infected individuals treated with ART were enrolled in this study. CD4 counts, HIV viral loads and genotype resistance tests were conducted. Data were analyzed by using SPSS 17. 0. Results Of the 78 individuals, 49 were male and 29 were female, and the dominant ethnics were Han (41. 0%) and Jingpo (34. 6%). Most of them were farmers (71. 8%) who were followed up at the sites of Longchuan (43. 6%) and Luxi (37. 2%). Sex transmission, transmission via intravenous drug use and mother to infant vertical transmission accounted for 53. 8%(42/78) , 30. 8% (24/78) and 15. 4%(12/ 78) , respectively. After 24 months of ART, the most common NRTI resistant mutations were M184I/V, D67N/S, T69F and T215F/Y. Among NNRTI mutations, K101E/I/Q, K103N/R/S/V, Y181C and G190A/S represented the highest rate. Only a few mutations were detected in protease region. Conclusions Many reverse transcriptase mutations occurred in patients after ART in Dehong, Yunnan, which reminds us to provide standard ART and enhance drug adherence.%目的 了解德宏地区艾滋病(AIDS)病人在进行抗反转录病毒治疗(ART)后,发生耐药的情况.方法 为德宏地区进行ART的病人检测CD4+T淋巴细胞计数、病毒载量及基因型耐药性,以SPSS 17.0分析病人的耐药数据.结果 78例病人中,男49例,女29例,以汉族(41.0%)和景颇族(34.6%)病人为多,农民占71.8%.随访地点主要在陇川(43.6%)和潞西(37.2%).性传播、静脉吸毒传播和母婴垂直传播分别占53.8%(42/78)、30.8%(24/78)和15.4%(12/78). ART24个月后最常见的核苷类反转录酶抑制剂的耐药突变是M184I/V、D67N/S、T69F和T215F/Y,非核苷类反转录酶抑制剂耐药突变中K101E/I/Q、K103N/R/S/V、Y181C和G190A/S发生率最高,蛋白酶抑制剂耐药突变较少.结论 德

  20. 2009-2014年我院抗菌药物临床应用对鲍曼不动杆菌耐药性变迁的影响%Influence of clinical use of antibiotics on drug resistance of acinetobacter baumannii at our hospital from 2009 to 2014

    Institute of Scientific and Technical Information of China (English)

    蒋陆霞; 贾秀芹; 庞峰; 陈建忠

    2016-01-01

    Objective To explore the influence of the clinical use of antibiotics on the drug resistance of acinetobacter baumannii and to provide a theoretical basis for the rational use of antimicrobial drugs.Methods The annual consumption of antimicrobial agents and the change trend of drug resistance of acinetobacter baumannii in our hospital from 2009 to 2014 were retrospectively analyzed.And the DDDs of antibiotics were calculated.The correlation between the drug resistance of A.baumannii and the DDDs of antibiotics were analyzed by Pearson analysis.Results 2 859 strains of A.baumannii had a trend of multidrug resistance to common antimicrobial agents.The resistance rate of most beta lactam,enzyme inhibitors,aminoglycosides,quinolones,carbapenems,and sulfonamides were over 65.0%.The resistance rate of cefoperazone/sulbactam and minocycline were relatively low,fluctuating between 32.1% and 54.2%.The DDDs of different antimicrobial drugs had different degrees of rises and falls from 2009 to 2014.There was a high positive correlation between the resistance rates of A.baumannii and the DDDs of gentamicin,cefepime,levofloxacin,and imipenem (r>0.800,P<0.05).Conclusions The resistance of acinetobacter baumannii to commonly used antibacterials is relatively serious.The drug resistance of A.baumannii associates with the consumption of antibiotics;and the integrated management of antimicrobial applications should be strengthened.%目的 研究鲍曼不动杆菌耐药性变迁趋势,探讨抗菌药物使用对鲍曼不动杆菌耐药率变化的影响,为临床合理使用抗菌药物提供理论依据.方法 回顾性分析2009-2014年鲍曼不动杆菌耐药率变化趋势及抗菌药物年用量,计算用药频度(DDDs),采用Pearson相关分析法对耐药率与DDDs进行分析.结果 2 859株鲍曼不动杆菌菌株对常用抗菌药物呈多重耐药趋势,对β-内酰胺类、大多β-内酰胺类加酶抑制剂、氨基糖苷类、喹诺酮类、碳青霉烯类

  1. Clinical distribution and trend of drug resistance of Acinetobacter baumannii causing infections in consecutive 11 years in Shenzhen%连续11年深圳地区鲍曼不动杆菌感染的临床分布及耐药趋势分析

    Institute of Scientific and Technical Information of China (English)

    李文青; 吴伟元; 卢月梅; 吴劲松; 程锦娥

    2013-01-01

    Objective To understand the distribution characteristics and drug resistance of Acinetobacter baumannii,so as to provide reference for rational use of antibiotics and infection control.Methods The results of drug susceptibility and clinical distribution of Acinetobacter baumannii from Jan 2001 to Dec 2011 in Shenzhen People's Hospital were retrospectively analyzed.The variations of isolation rate and resistance rate were analyzed by WHONET 5.4.Results Acinetobacter baumannii infections were mainly distributed at ICU wards and respiratory wards,accounting for 43.89% and 24.49% respectively; Most strains were isolated from sputum specimens (70.30%).The isolation rates of Acinetobacter baumannii and multi-drug resistant strains showed an increasing trend,so did the resistance rates of Acinetobacter baumannii to 15 commonly used antibacterial drugs,which increased sharply in 2009 and remained high in 2010 and 2011.Pan-drue resistant strains appeared in 2011,and the isolation rate was 57.55%.The resistance rate and medium rate of Acinetobacter baumannii to Ampicillin-Sulbactam,Cefperazone-Sulbactam and Minocycline also increased obviously in last three years.Conclusion The drug resistance of Acinetobacter baumannii is severe; the isolation rates of multi-drug and pan-drug resistant Acinetobacter baumannii are increasing sharply.Infection control should be enhanced in ICU and respiratory department.%目的 了解医院鲍曼不动杆菌的耐药性变迁和临床分布特点,为合理应用抗菌药物和预防控制医院感染提供依据.方法 回顾性分析2001年1月到2011年12月临床标本中分离的l 613株鲍曼不动杆菌资料;用WHONET 5.4分析鲍曼不动杆菌的分离率和耐药率变迁.结果 鲍曼不动杆菌感染主要发生在ICU和呼吸内科,分别占43.89%和24.49%;痰标本所占比例最高(70.30%).鲍曼不动杆菌、多药耐药鲍曼不动杆菌的分离率及对临床常用的15种抗菌药物

  2. [Herpes zoster and postherpetic neuralgia].

    Science.gov (United States)

    Wollina, U; Machetanz, J

    2016-08-01

    Herpes zoster develops by endogenous reactivation of varizella zoster virus (VZV). Incidence increases with age. Females are more frequently affected than males. The reactivation rate in seropositive individuals is about 20 %. After a short prodromal stage, herpetiform-grouped vesicles appear in segmental arrangement. Pain and paresthesia are typical zoster symptoms. Complications like bacterial superinfections, vasculopathy, paresis, and oculopathy may occur. During pregnancy herpes zoster is a threat for mother and child. Among elderly patients, cardiovascular risk is increased during the first week of herpes zoster infection. Postherpetic neuropathy is feared. Diagnosis can be made clinically and by the use of polymerase chain reaction. First-line treatment is systemic antiviral drug therapy with either acyclovir or brivudine. Adjuvant therapies consist of pain management and topical treatment.

  3. EFFICACY OF RUFINAMIDE IN THE TREATMENT OF DRUG-RESISTANT FOCAL EPILEPSIES IN PAEDIATRIC PRACTICE

    Directory of Open Access Journals (Sweden)

    I. O. Shchederkina

    2016-01-01

    Full Text Available Among drug-resistant epilepsies, epileptic syndromes, characterized by combination of several types of seizures, are considered to be the most difficult in terms of treatment. Lennox–Gastaut syndrome is one of them. It manifests with polymorphic seizures (tonic axial, myatonic, atypical absence seizures, status epilepticus of minor motor seizures, myoclonic, generalized convulsive, and focal seizures. This is a heterogeneous disease, represented by a complex of clinical and electroencephalographic manifestations with various etiology. Current review is devoted to a novel antiepileptic drug rufinamide, which has a new mechanism of action. The drug has been registered in Russia in 2015. The authors also describe their own experience of rufinamide usage in the treatment of drug-resistant focal epilepsy as a part of multicomponent therapy for polymorphic seizures. One patient achieved clinical remission for 16 months; the second one had more than 50 % decrease in seizures frequency with a remission of drop-attacks.

  4. Managing drug-resistant epilepsy: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Dalic L

    2016-10-01

    Full Text Available Linda Dalic,1 Mark J Cook2,3 1Department of Neurology, Austin Health, 2St Vincent’s Hospital, Centre for Clinical Neurosciences and Neurological Research, 3Department of Medicine, The University of Melbourne, Melbourne, Australia Abstract: Despite the development of new antiepileptic drugs (AEDs, ~20%–30% of people with epilepsy remain refractory to treatment and are said to have drug-resistant epilepsy (DRE. This multifaceted condition comprises intractable seizures, neurobiochemical changes, cognitive decline, and psychosocial dysfunction. An ongoing challenge to both researchers and clinicians alike, DRE management is complicated by the heterogeneity among this patient group. The underlying mechanism of DRE is not completely understood. Many hypotheses exist, and relate to both the intrinsic characteristics of the particular epilepsy (associated syndrome/lesion, initial response to AED, and the number and type of seizures prior to diagnosis and other pharmacological mechanisms of resistance. The four current hypotheses behind pharmacological resistance are the “transporter”, “target”, “network”, and “intrinsic severity” hypotheses, and these are reviewed in this paper. Of equal challenge is managing patients with DRE, and this requires a multidisciplinary approach, involving physicians, surgeons, psychiatrists, neuropsychologists, pharmacists, dietitians, and specialist nurses. Attention to comorbid psychiatric and other diseases is paramount, given the higher prevalence in this cohort and associated poorer health outcomes. Treatment options need to consider the economic burden to the patient and the likelihood of AED compliance and tolerability. Most importantly, higher mortality rates, due to comorbidities, suicide, and sudden death, emphasize the importance of seizure control in reducing this risk. Overall, resective surgery offers the best rates of seizure control. It is not an option for all patients, and there is

  5. HIV-GRADE: a publicly available, rules-based drug resistance interpretation algorithm integrating bioinformatic knowledge.

    Science.gov (United States)

    Obermeier, Martin; Pironti, Alejandro; Berg, Thomas; Braun, Patrick; Däumer, Martin; Eberle, Josef; Ehret, Robert; Kaiser, Rolf; Kleinkauf, Niels; Korn, Klaus; Kücherer, Claudia; Müller, Harm; Noah, Christian; Stürmer, Martin; Thielen, Alexander; Wolf, Eva; Walter, Hauke

    2012-01-01

    Genotypic drug resistance testing provides essential information for guiding treatment in HIV-infected patients. It may either be used for identifying patients with transmitted drug resistance or to clarify reasons for treatment failure and to check for remaining treatment options. While different approaches for the interpretation of HIV sequence information are already available, no other available rules-based systems specifically have looked into the effects of combinations of drugs. HIV-GRADE (Genotypischer Resistenz Algorithmus Deutschland) was planned as a countrywide approach to establish standardized drug resistance interpretation in Germany and also to introduce rules for estimating the influence of mutations on drug combinations. The rules for HIV-GRADE are taken from the literature, clinical follow-up data and from a bioinformatics-driven interpretation system (geno2pheno([resistance])). HIV-GRADE presents the option of seeing the rules and results of other drug resistance algorithms for a given sequence simultaneously. The HIV-GRADE rules-based interpretation system was developed by the members of the HIV-GRADE registered society. For continuous updates, this expert committee meets twice a year to analyze data from various sources. Besides data from clinical studies and the centers involved, published correlations for mutations with drug resistance and genotype-phenotype correlation data information from the bioinformatic models of geno2pheno are used to generate the rules for the HIV-GRADE interpretation system. A freely available online tool was developed on the basis of the Stanford HIVdb rules interpretation tool using the algorithm specification interface. Clinical validation of the interpretation system was performed on the data of treatment episodes consisting of sequence information, antiretroviral treatment and viral load, before and 3 months after treatment change. Data were analyzed using multiple linear regression. As the developed online

  6. Reaching consensus on drug resistance conferring mutations (Part 1

    Directory of Open Access Journals (Sweden)

    Daniela M Cirillo

    2016-01-01

    A user-friendly interface designed for nonexpert or expert operability.A standardized and validated analysis pipeline for variant analyses of M. tuberculosis next-generation sequencing (NGS data.Access to data beyond the published literature with dynamic and iterative updates of new data generated by global surveillance and clinical trials.A well-developed legal structure to ensure intellectual property rights and data ownership remain with contributors.A structured data-sharing architecture to restrict access to sensitive or unpublished data sets.Metadata standardization using CDISC: supports global, platform-independent data standards that enable information system interoperability.An emphasis on data quality and rigorous, expert curation with multiple quality control checks for whole-genome sequencing and other metadata.Validation of NGS analysis output by an expert committee with grading of resistance conferring mutations based on rigorous statistical standards.Regulatory-compliant analysis pipeline and database architecture. Successful execution of such an extensive database platform requires substantial collaboration from scientists investigating the genetic basis for drug resistance worldwide, and from developers with expertise in database design and implementation.

  7. Outbreak of extensively drug-resistant Acinetobacter baumannii indigo-pigmented strains

    OpenAIRE

    Vilacoba, Elisabet; Almuzara, Marisa; Gulone, Lucia; Rodriguez, Rocio; Pallone, Elida; Bakai, Romina; Centron, Daniela; Ramirez, Maria Soledad

    2016-01-01

    Acinetobacter baumannii pigmented strains are not common in clinical settings. In the present work we report an outbreak caused by indigo-pigmented A. baumannii strains isolated in an acute hospital in Argentina from March to September 2012. Pan-PCR assays exposed a unique pattern belonging to the recently described regional CC113B/CC79P that confirms the relevant relationships among the indigo-pigmented A. baumannii strains. All of them were extensively drug-resistant and harbored different ...

  8. Post-Transcriptional Controls by Ribonucleoprotein Complexes in the Acquisition of Drug Resistance

    OpenAIRE

    Eun Kyung Lee; Chongtae Kim; Wook Kim; Heejin Lee; Hoin Kang

    2013-01-01

    Acquisition of drug resistance leads to failure of anti-cancer treatments and therapies. Although several successive chemotherapies are available, along with efforts towards clinical applications of new anti-cancer drugs, it is generally realized that there is a long way to go to treat cancers. Resistance to anti-cancer drugs results from various factors, including genetic as well as epigenetic differences in tumors. Determining the molecular and cellular mechanisms responsible for the acquis...

  9. Prevalence of tuberculosis drug resistance in 10 provinces of China

    Directory of Open Access Journals (Sweden)

    Wang Li

    2008-12-01

    Full Text Available Abstract Background The emergence of drug-resistant tuberculosis (TB hampers TB control. Ten provinces in China performed drug resistance surveys among tuberculosis (TB patients in 1996–2004 to assess levels of drug resistance. Methods Provincial drug resistance surveys included all isolates from newly diagnosed, smear-positive TB patients. Drug susceptibility testing (DST against isoniazid, rifampicin, streptomycin and ethambutol was carried out in the provincial laboratories. For purposes of quality assurance, a random sample (11.6% was re-tested by the national reference laboratory (NRL. Results Of 14,059 patients tested 11,052 (79% were new TB cases. The weighted mean prevalence of multi-drug resistant tuberculosis (MDR-TB among all cases was 9.3% (range 2.2%–10.4%; 5.4% (range 2.1% – 10.4% among new cases and 25.6% (range 11.7%–36.9% among previously treated cases. Adjusting the drug resistance proportions using the re-testing results did not change the estimated national mean prevalence significantly. However, in some individual provinces the estimated resistance proportions were greatly influenced, especially among re-treatment patients. Conclusion MDR-TB levels varied greatly between provinces in China, but on average were high compared to the global estimated average of 4.8%. This study shows the importance of quality-assured laboratory performance. Programmatic management of drug-resistant TB, including high quality DST for patients at high risk of resistance and treatment with second-line drugs, should become the standard, especially in high MDR-TB settings.

  10. Typical case: herpes zoster

    Directory of Open Access Journals (Sweden)

    Guilherme Cristianini Baldivia

    2015-04-01

    Full Text Available Summary The varicella zoster virus is the causative agent of herpes zoster and varicella. In herpes zoster, the virus dormant within dorsal root ganglia is reactivated, resulting in painful vesicular lesions overlying an erythematous base.

  11. Low nasal carriage of drug-resistant bacteria among medical students in Vienna

    Science.gov (United States)

    Gualdoni, Guido A.; Lingscheid, Tilman; Tobudic, Selma; Burgmann, Heinz

    2012-01-01

    Background: Multi-drug resistant bacteria are increasing and remain a major public health challenge worldwide. In order to understand the potential role of medical students as a reservoir for circulating pathogenic bacteria and their transmission, we analysed the nasal colonisation among 86 clinically exposed medical students of the Medical University of Vienna, which is integrated into General Hospital of Vienna. Methods: Nasal swabs obtained from 79 students were eligible for further analysis. Nasal swabs were analysed for Gram-positive and Gram-negative bacteria with special emphasis on methicillin-resistant Staphylococcus aureus. Results: 25.3% of participants were positive for Staphylococcus aureus colonization; none of the isolates showed methicillin-resistance or expression of Pantoin-Valentine-leukocidin. However, 2.5% were positive for methicillin-resistant Staphylococcus epidermidis. No participant showed Streptococcus pneumoniae colonisation. Furthermore, 10.1% of the samples displayed growth of Gram-negative bacteria, yet none showed any relevant drug-resistance. Conclusion: In conclusion, our investigation did not reveal any clinically relevant multi-drug resistant bacterial colonisation among clinically exposed medical students in Vienna. This might be explained by well-established hygienic precautions or comparably low circulation of resistant bacteria. PMID:22558038

  12. Increased in vitro fitness of multi- and extensively drug-resistant F15/LAM4/KZN strains of Mycobacterium tuberculosis.

    Science.gov (United States)

    Naidoo, C C; Pillay, M

    2014-06-01

    The role of fitness in transmission of drug-resistant strains has been explored in previous studies; but has not been established for F15/LAM4/KZN strains, which were responsible for the extensively drug-resistant tuberculosis (XDR-TB) outbreak in Tugela Ferry, South Africa. The biological fitness of 15 clinical strains representing the F15/LAM4/KZN, Beijing, F11 and F28 families was determined by growth, viability and competition assays and correlated with DNA sequencing of eight genes associated with drug resistance and putative compensatory mechanisms. Similar growth rates were observed among susceptible, multidrug-resistant (MDR) and XDR strains of the KZN and F28 genotypes. In contrast, Beijing and F11 MDR strains demonstrated significantly reduced fitness. Resistant strains exhibited heterogeneous fitness profiles in competition with different susceptible strains, suggesting strain dependence. In addition, co-culture growth rates were consistently higher than independent growth rates in 13/14 competition pairs. All 14 drug-resistant strains retained viability, at a low CFU/mL, when paired with susceptible strains. The persistence of such resistant strains could consequently support the acquisition of additional drug-resistance-conferring mutations and/or the evolution of compensatory mechanisms. Frequently occurring mutations were detected in KZN and F28 resistant strains whereas, the Beijing MDR strain harboured a less common katG mutation and the F11 MDR strain had no katG mutation. Contrary to drug-resistant Beijing and F11 strains, the successful transmission of KZN strains, particularly during the outbreak, may be attributed to the presence of drug-resistance-conferring mutations associated with little or no associated fitness costs. Amplified growth in co-culture may be suggestive of in vivo trans-complementation.

  13. Pharmaceutical practice of clinical pharmacists participating in the treatment of a patient with pneumonia caused by multi-drug resistant Pseudomonas aeruginosa after operation%临床药师参与1例术后由多重耐药铜绿假单胞菌引起的肺炎治疗的药学实践

    Institute of Scientific and Technical Information of China (English)

    张晨; 陈燕

    2014-01-01

    1例高龄患者在因发生急性胃穿孔和急性腹膜炎而施行剖腹探查和乙结肠近端造瘘术后出现由多重耐药铜绿假单胞菌引起的肺炎,临床药师协助临床医师制定治疗方案并选择合理、有效的抗感染药物,挽救了患者的生命。临床药师及时提供临床药学服务可获得良好的效果。%An elderly patient suffered from the pneumonia caused by multi-drug resistant Pseudomonas aeruginosa after performing exploratory laparotomy and sigmoid colostomy due to acute gastric perforation and acute peritonitis. The clinical pharmacists collaborated with clinicians to develop a therapeutic program and select reasonable and effective anti-infective agents, resulting in saving the life of this patient. A good clinical outcome should be received in case clinical pharmacists can provide pharmaceutical care for patients in time.

  14. Prevalence and evolution of drug resistance HIV-1 variants in Henan, China

    Institute of Scientific and Technical Information of China (English)

    Jing; Yun; LI; Han; Ping; LI; Lin; LI; Hong; LI; Zhe; WANG; Kun; YANG; Zuo; Yi; BAO; Dao; Min; ZHUANG; Si; Yang; LIU; Yong; Jian; LIU; Hui; XING; Yi; Ming; SHAO

    2005-01-01

    To understand the prevalence and evolution of drug resistant HIV strains in Henan China after the implementation of free antiretroviral therapy for AIDS patients. 45 drug naive AIDS patients, 118 AIDS patients who received three months antiretroviral therapy and 124 AIDS patients who received six months antiretroviral treatment were recruited in the southern part of Henan province. Information on general condition, antiretroviral medicines, adherence and clinical syndromes were collected by face to face interview. Meanwhile, 14ml EDTA anticoagulant blood was drawn. CD4/CD8 T cell count, viral load and genotypic drug resistance were tested. The rates of clinical improvement were 55.1% and 50.8% respectively three months and six months after antiretroviral therapy. The mean CD4 cell count after antiretroviral therapy was significantly higher than in drug naive patients. The prevalence rate of drug resistant HIV strains were 13.9%, 45.4% and 62.7% in drug naive patients, three month treatment patients and six month treatment patients, respectively.The number of resistance mutation codons and the frequency of mutations increased significantly with continued antiretroviral therapy. The mutation sites were primarily at the 103, 106 and 215 codons in the three-month treatment group and they increased to 15 codon mutations in the six-month treatment group. From this result, the evolution of drug resistant strains was inferred to begin with the high level NNRTI resistant strain, and then develop low level resistant strains to NRTIs. The HIV strains with high level resistance to NVP and low level resistance to AZT and DDI were highly prevalent because of the AZT+DDI+NVP combination therapy. These HIV strains were also cross resistant to DLV, EFV, DDC and D4T. Poor adherence to therapy was believed to be the main reason for the emergence and prevalence of drug resistant HIV strains. The prevalence of drug resistant HIV strains was increased with the continuation of

  15. Herpes Zoster Oticus

    Science.gov (United States)

    ... Page You are here Home » Disorders » All Disorders Herpes Zoster Oticus Information Page Herpes Zoster Oticus Information Page What research is being ... neurotropic viruses and development of neurological diseases including herpes simplex and varicella-zoster viruses. × What research is ...

  16. Treatment of falciparum malaria in the age of drug resistance

    Directory of Open Access Journals (Sweden)

    Shanks G

    2006-01-01

    Full Text Available The growing problem of drug resistance has greatly complicated the treatment for falciparum malaria. Whereaschloroquine and sulfadoxine/pyrimethamine could once cure most infections, this is no longer true and requiresexamination of alternative regimens. Not all treatment failures are drug resistant and other issues such asexpired antimalarials and patient compliance need to be considered. Continuation of a failing treatment policyafter drug resistance is established suppresses infections rather than curing them, leading to increasedtransmission of malaria, promotion of epidemics and loss of public confidence in malaria control programs.Antifolate drug resistance (i.e. pyrimethamine means that new combinations are urgently needed particularlybecause addition of a single drug to an already failing regimen is rarely effective for very long. Atovaquone/proguanil and mefloquine have been used against multiple drug resistant falciparum malaria with resistance toeach having been documented soon after drug introduction. Drug combinations delay further transmission ofresistant parasites by increasing cure rates and inhibiting formation of gametocytes. Most currentlyrecommended drug combinations for falciparum malaria are variants of artemisinin combination therapy wherea rapidly acting artemisinin compound is combined with a longer half-life drug of a different class. Artemisininsused include dihydroartemisinin, artesunate, artemether and companion drugs include mefloquine, amodiaquine,sulfadoxine/pyrimethamine, lumefantrine, piperaquine, pyronaridine, chlorproguanil/dapsone. The standard ofcare must be to cure malaria by killing the last parasite. Combination antimalarial treatment is vital not only tothe successful treatment of individual patients but also for public health control of malaria.

  17. Clinical evaluation of a two-step infusion therapy with meropenem against nosocomial multi-drug resistant Pseudomonas aeruginosa infections in elderly patients with chronic obstructive pulmonary disease%美罗培南两步输注法治疗老年人慢性阻塞性肺疾病并铜绿假单胞菌肺炎疗效分析

    Institute of Scientific and Technical Information of China (English)

    吕燕平; 刘炯; 潘春香; 冯羡菊; 喻东; 梁珍珍

    2014-01-01

    目的:评价美罗培南两步输注法治疗老年人COPD并院内获得性多重耐药铜绿假单胞菌肺炎的疗效。方法选取老年COPD并院内获得性多重耐药铜绿假单胞菌肺炎患者112例,数字表法随机分为两组,各56例,观察组采用两步输注法,第一步,在30 min内把单次剂量中的一半药物快速滴注完;第二步,把单次剂量的剩余一半药物在2.5 h内持续缓慢滴注。对照组采用美罗培南常规30 min滴注法。观察两组患者的临床疗效及细菌学疗效。结果观察组、对照组有效率分别为82.2%(46/56)、57.1%(32/56),差异有统计学意义(χ2=10.185,P<0.05);观察组、对照组细菌清除率分别为75.0%(42/56)、46.4%(26/56),差异有统计学意义(χ2=10.265,P<0.05)。结论使用美罗培南两步输注法治疗老年人COPD并院内获得性多重耐药铜绿假单胞菌肺炎的疗效优于传统输注方案。%Objective To evaluate the efficacy of a two-step infusion therapy with meropenem against noso-comial multi-drug resistant Pseudomonas aeruginosa infections in elderly patients with chronic obstructive pulmonary disease.Methods 112 elderly patients with nosocomial multi-drug resistant Pseudomonas aeruginosa infections and chronic obstructive pulmonary disease were randomized into two groups:two-step infusion therapy group ( rapid first-step infusion in 30 minutes and slow second-step infusion in 2.5 hours) and traditional 30 minutes infusion therapy group.The antibiotic clinical efficacy and bacteriological efficacy were observed between two groups .Results The clinical efficacy of observation group and control group were 82.2%(46/56) vs 57.1%(32/56).The difference was statistically significant(χ2 =10.185,P<0.05);The bacteriological efficacy of observation group and control group were 75.0%(42/56) vs 46.4%(26/56),The difference was statistically significant (χ2 =10

  18. 临床分离表皮葡萄球菌的耐药性分析及与icaD基因表达关系的研究%Analysis of drug resistance and relationship with icaD genetypes of clinically isolated staphylococcus epidermidis

    Institute of Scientific and Technical Information of China (English)

    曹晓光; 周树生; 戴媛媛; 刘宝

    2012-01-01

    Objective To detect the drug resistance of our ICU staphylococcus epidermidis to antibiotics, and to provide evidence for reasonable prevention and control measures to guide clinical medication . Methods mecA gene and icaD gene of the 125 strains staphylococcus epidermidis from clinical specimens and healthy skin were inspected and analyzed the drug resistance by K -B disk diffusion method and molecular biology method Results In two groups, icaD gene expression was correlated with mecA' s ( r = 0. 528, P = 0. 000; r = 0. 309, P = 0. 016 ) MecA gene expression in humor of clinical patients group was significantly higher than that in non -humor of normal people, and there was significant difference (P <0. 01) , while there was no significant difference in bacterial strain of icaD gene expression. Staphylococcus epidermidis in two groups were sensitive to rifampicin , nitrofurantoin, linezol-id and Vancomycin. The resistant rates of mecA gene expression bacterial strain to antibacterial agents had no sig -nificant difference in two groups , but the resistant rates of icaD gene expression had significant difference in ampi -cillin, cefoxitin, bactrim, erythromycin and chloramphenicol( P < 0. 05 ) Conclusion That ICU staphylococcus epidermidis to antibacterial agents have high drug resistance ,we must strengthen resistance monitoring, and according to antimicrobial susceptibility test results to choose rational drug , control nosocomial infection.%目的 了解我院ICU表皮葡萄球菌对抗生素的耐药性,为制定合理的预防控制措施,指导临床用药提供依据.方法 采用K-B纸片扩散法和分子生物学方法 对临床标本和健康人皮肤分离的共125株表皮葡萄球菌的耐药性及其mecA和icaD基因进行检测分析.结果 ①两组在icaD基因的表达与mecA基因表达均存在相关性(r=0.528,P=0.000;r=0.309,P=0.016);②mecA基因表达在临床患者体液组中较健康自愿者非体液组明显增

  19. Expression of Uncoupling Protein 2 in Breast Cancer Tissue and Drug-resistant Cells

    Institute of Scientific and Technical Information of China (English)

    Sun Yan; Yuan Yuan; Zhang Lili; Zhu Hong; Hu Sainan

    2013-01-01

    Objective:To explore the expression of uncoupling protein-2 (UCP2) in clinical breast cancer tissue and drug-resistant cells. Methods:The expression of UCP2 in breast cancer tissue and normal tissue adjacent to carcinoma as well as breast cancer cell MCF-7 and paclitaxel-resistant cell MX-1/T were respectively detected by immunohistochemistry and Western blot. Results:The expression of UCP2 in breast cancer tissue was signiifcantly higher than in normal tissue adjacent to carcinoma, and that in paclitaxel-resistant cell MX-1/T obviously higher than in breast cancer cell MCF-7. Conclusion:UCP2 is highly expressed in breast cancer tissue and drug-resistant cells.

  20. 革兰阴性菌耐药%Drug resistance of Gram-negative bacterias

    Institute of Scientific and Technical Information of China (English)

    赵长安

    2016-01-01

    随着抗生素滥用状况的日趋严峻、使用监管的日渐复杂和发现新的尤其是针对革兰阴性菌(GNB)抗生素技术难度的日益增加,GNB 的耐药问题日趋严峻。现主要讨论临床上常见的 GNB 耐药的相关问题。%Along with the condition of antibiotic abuse,the regulatory hurdles to new antibiotics which have be-come increasingly complex and the technical difficulty of discovering new antibiotics,especially those able to penetrate Gram -negative bacteria(GNB),drug -resistant of GNB has become increasingly serious.This review focuses on com-mon clinical GNB drug resistance related issues.

  1. Evolution of Primary HIV Drug Resistance in a Subtype C Dominated Epidemic in Mozambique

    Science.gov (United States)

    Bila, Dulce Celina Adolfo; Young, Peter; Merks, Harriet; Vubil, Adolfo Salvador; Mahomed, Mussagy; Augusto, Angelo; Abreu, Celina Monteiro; Mabunda, Nédio Jonas; Brooks, James I.; Tanuri, Amilcar; Jani, Ilesh Vinodrai

    2013-01-01

    Objective In Mozambique, highly active antiretroviral treatment (HAART) was introduced in 2004 followed by decentralization and expansion, resulting in a more than 20-fold increase in coverage by 2009. Implementation of HIV drug resistance threshold surveys (HIVDR-TS) is crucial in order to monitor the emergence of transmitted viral resistance, and to produce evidence-based recommendations to support antiretroviral (ARV) policy in Mozambique. Methods World Health Organization (WHO) methodology was used to evaluate transmitted drug resistance (TDR) in newly diagnosed HIV-1 infected pregnant women attending ante-natal clinics in Maputo and Beira to non-nucleoside reverse transcriptase inhibitors (NNRTI), nucleoside reverse transcriptase inhibitors (NRTI) and protease inhibitors (PI). Subtypes were assigned using REGA HIV-1 subtyping tool and phylogenetic trees constructed using MEGA version 5. Results Although mutations associated with resistance to all three drug were detected in these surveys, transmitted resistance was analyzed and classified as Mozambique. PMID:23935858

  2. White paper: recommendations on the conduct of superiority and organism-specific clinical trials of antibacterial agents for the treatment of infections caused by drug-resistant bacterial pathogens.

    Science.gov (United States)

    2012-10-01

    There is a critical need for new pathways to develop antibacterial agents to treat life-threatening infections caused by highly resistant bacteria. Traditionally, antibacterial agents have been studied in noninferiority clinical trials that focus on one site of infection (eg, pneumonia, intra-abdominal infection). Conduct of superiority trials for infections caused by highly antibiotic-resistant bacteria represents a new, and as yet, untested paradigm for antibacterial drug development. We sought to define feasible trial designs of antibacterial agents that could enable conduct of superiority and organism-specific clinical trials. These recommendations are the results of several years of active dialogue among the white paper's drafters as well as external collaborators and regulatory officials. Our goal is to facilitate conduct of new types of antibacterial clinical trials to enable development and ultimately approval of critically needed new antibacterial agents.

  3. 1999-2010年医院铜绿假单胞菌感染的耐药趋势及临床分布特点%Drug resistance trend of Pseudomonas aeruginosa causing infection and characteristics of clinical distribution during 1999 -2010

    Institute of Scientific and Technical Information of China (English)

    周秀珍; 卢岩; 刘建华; 王艳玲; 张智杰; 孙继梅; 刘勇

    2011-01-01

    OBJECTIVE To understand the distribution characteristics and drug resistance of Pseudomonas aerugi-nosa(PAE) in clinical isolates, so as to provide reference for rational use of antibiotics and infection control. METHODS The results of drug susceptibility and clinical distribution of PAE from Jan 1999 to Dec 2010 in our hospital were analyzed. The antimicrobial resistance rates were analyzed by WHONET 5. 4 software. RESULTS The isolation rate of PAE, MDRPA, PDRPA and the resistance rate of PAE to 15 kinds of drugs appeared increasing and PAE strains were mainly distributed at ICU wards and surgery department, Their proportion was 15. 7% and (15. 5%) , respectively. The major strains was isolated from sputum (71.0%) , the older the age ,the higher the appearing rate, accounting for 50. 1%. CONCLUSION PAE has severe drug resistance, the isolation rate of PAE is increasing and the resistance rate to drugs appears increasing trend, the number of MDRPA and PDRPA had been increased sharply from Jan 1999 to Dec 2010, and appeared decreasing after 2009. Infection control should be enhanced in ICU and wards which includes elderly patients.%摘要:目的 了解医院铜绿假单胞菌(PAE)的耐药性变迁和临床分布特点,为合理应用抗菌药物和预防控制医院感染提供依据.方法 回顾性分析1999年1月-2010年12月临床标本中分离的3475株PAE资料;用Who-net 5.4软件分析PAE的耐药率变迁.结果 PAE、多药耐药PAE(MDRPA)和泛耐药PAE(PDRPA)分离率及对临床常用的15种抗菌药物耐药率总体呈上升趋势;PAE感染主要发生在ICU(15.7%)和外科病房(15.5%);痰标本所占比例最高(71.0%);高龄患者检出率高,占50.1%.结论 PAE的耐药形势严峻,2003-2008年MDRPA和PDRPA的检出率不断增加,2009年以后呈下降趋势;ICU及老年患者居多的科室是预防控制的重点科室.

  4. Drug resistance in the sexually transmitted protozoan Trichomonas vaginalis

    Institute of Scientific and Technical Information of China (English)

    REBECCA L DUNNE; LINDA A DUNN; PETER UPCROFT; PETER J O'DONOGHUE; JACQUELINE A UPCROFT

    2003-01-01

    Trichomoniasis is the most common, sexually transmitted infection. It is caused by the flagellated protozoan parasite Trichomonas vaginalis. Symptoms include vaginitis and infections have been associated with preterm delivery, low birth weight and increased infant mortality, as well as predisposing to HIV/AIDS and cervical cancer. Trichomoniasis has the highest prevalence and incidence of any sexually transmitted infection. The 5-nitroimidazole drugs, of which metronidazole is the most prescribed, are the only approved,effective drugs to treat trichomoniasis. Resistance against metronidazole is frequently reported and crossresistance among the family of 5-nitroimidazole drugs is common, leaving no alternative for treatment, with some cases remaining unresolved. The mechanism of metronidazole resistance in T. vaginalis from treatment failures is not well understood, unlike resistance which is developed in the laboratory under increasing metronidazole pressure. In the latter situation, hydrogenosomal function which is involved in activation of the prodrug, metronidazole, is down-regulated. Reversion to sensitivity is incomplete after removal of drug pressure in the highly resistant parasites while clinically resistant strains, so far analysed, maintain their resistance levels in the absence of drug pressure. Although anaerobic resistance has been regarded as a laboratory induced phenomenon, it clearly has been demonstrated in clinical isolates. Pursuit of both approaches will allow dissection of the underlying mechanisms. Many alternative drugs and treatments have been tested in vivo in cases of refractory trichomoniasis, as well as in vitro with some successes including the broad spectrum anti-parasitic drug nitazoxanide. Drug resistance incidence in T. vaginalis appears to be on the increase and improved surveillance of treatment failures is urged.

  5. Defeating pathogen drug resistance: guidance from evolutionary theory.

    Science.gov (United States)

    Pepper, John W

    2008-12-01

    Many of the greatest challenges in medicine and public health involve the evolution of drug resistance by pathogens. Recent advances in the theory of natural selection suggest that there are two broad classes of pathogen traits that can be targeted by drugs or vaccines. The first class, consisting of traits that benefit the individual organisms bearing them, causes a strong evolutionary response and the rapid emergence of drug resistance. The second class, consisting of traits that benefit groups of pathogen organisms including the individual provider, causes a weaker evolutionary response and less drug resistance. Although most previous drug development has targeted the first class, it would be advantageous to focus on the second class as targets for drug and vaccine development. Specific examples and test cases are discussed.

  6. Histone modification as a drug resistance driver in brain tumors

    Institute of Scientific and Technical Information of China (English)

    Guifa Xi; Barbara Mania-Farnell; Ting Lei; Tadanori Tomita

    2016-01-01

    Patients with brain tumors, specificaly, malignant forms such as glioblastoma, meduloblas-toma and ependymoma, exhibit dismal survival rates despite advances in treatment strategies. Chemotherapeutics, the primary adjuvant treatment for human brain tumors folowing surgery, commonly lack eficacy due to either intrinsic or acquired drug resistance. New treatments tar-geting epigenetic factors are being explored. Post-translational histone modification provides a critical regulatory platform for processes such as chromosome condensation and segregation, apoptosis, gene transcription, and DNA replication and repair. This work reviews how aberrant histone modifications and alterations in histone-modifying enzymes can drive the acquisition of drug resistance in brain tumors. Elucidating these mechanisms should lead to new treatments for overcoming drug resistance.

  7. HIV Drug-resistant Strains as Epidemiologic Sentinels

    Science.gov (United States)

    Grant, Robert M.; Porco, Travis C.; Getz, Wayne M.

    2006-01-01

    Observed declines in drug resistance to nucleoside reverse transcriptase inhibitors among persons recently infected with HIV-1 in monitored subpopulations can be interpreted as a positive sign and lead public health officials to decrease efforts towards HIV prevention. By means of a mathematical model, we identified 3 processes that can account for the observed decline: increase in high-risk behavior, decrease in proportion of acutely infected persons whose conditions are treated, and change in treatment efficacy. These processes, singly or in combination, can lead to increases or decreases in disease and drug-resistance prevalence in the general population. We discuss the most appropriate public health response under each scenario and emphasize how further data collection and analyses are required to more reliably evaluate the observed time trends and the relative importance of forces shaping the epidemic. Our study highlights how drug resistance markers can be used as epidemiologic sentinels to devise public health solutions. PMID:16494741

  8. Drug resistance in cancer: molecular evolution and compensatory proliferation.

    Science.gov (United States)

    Friedman, Ran

    2016-03-15

    Targeted therapies have revolutionized cancer treatment. Unfortunately, their success is limited due to the development of drug resistance within the tumor, which is an evolutionary process. Understanding how drug resistance evolves is a prerequisite to a better success of targeted therapies. Resistance is usually explained as a response to evolutionary pressure imposed by treatment. Thus, evolutionary understanding can and should be used in the design and treatment of cancer. In this article, drug-resistance to targeted therapies is reviewed from an evolutionary standpoint. The concept of apoptosis-induced compensatory proliferation (AICP) is developed. It is shown that AICP helps to explain some of the phenomena that are observed experimentally in cancers. Finally, potential drug targets are suggested in light of AICP.

  9. Drug resistance in Leishmania: similarities and differences to other organisms.

    Science.gov (United States)

    Papadopoulou, B; Kündig, C; Singh, A; Ouellette, M

    1998-01-01

    The main line of defense available against parasitic protozoa is chemotherapy. Drug resistance has emerged however, as a primary obstacle to the successful treatment and control of parasitic diseases. Leishmania spp., the causative agents of leishmaniasis, have served as a useful model for studying mechanisms of drug resistance in vitro. Antimonials and amphotericin B are the first line drugs to treat Leishmania followed by pentamidine and a number of other drugs. Parasites resistant against all these classes of drugs have been selected under laboratory conditions. A multiplicity of resistance mechanisms has been detected, the most prevalent being gene amplification and transport mutations. With the tools now available, it should be possible to elucidate the mechanisms that govern drug resistance in field isolates and develop more effective chemotherapeutic agents.

  10. Monitoring a Nuclear Factor-κB Signature of Drug Resistance in Multiple Myeloma*

    Science.gov (United States)

    Xiang, Yun; Remily-Wood, Elizabeth R.; Oliveira, Vasco; Yarde, Danielle; He, Lili; Cheng, Jin Q.; Mathews, Linda; Boucher, Kelly; Cubitt, Christopher; Perez, Lia; Gauthier, Ted J.; Eschrich, Steven A.; Shain, Kenneth H.; Dalton, William S.; Hazlehurst, Lori; Koomen, John M.

    2011-01-01

    The emergence of acquired drug resistance results from multiple compensatory mechanisms acting to prevent cell death. Simultaneous monitoring of proteins involved in drug resistance is a major challenge for both elucidation of the underlying biology and development of candidate biomarkers for assessment of personalized cancer therapy. Here, we have utilized an integrated analytical platform based on SDS-PAGE protein fractionation prior to liquid chromatography coupled to multiple reaction monitoring mass spectrometry, a versatile and powerful tool for targeted quantification of proteins in complex matrices, to evaluate a well-characterized model system of melphalan resistance in multiple myeloma (MM). Quantitative assays were developed to measure protein expression related to signaling events and biological processes relevant to melphalan resistance in multiple myeloma, specifically: nuclear factor-κB subunits, members of the Bcl-2 family of apoptosis-regulating proteins, and Fanconi Anemia DNA repair components. SDS-PAGE protein fractionation prior to liquid chromatography coupled to multiple reaction monitoring methods were developed for quantification of these selected target proteins in amounts of material compatible with direct translation to clinical specimens (i.e. less than 50,000 cells). As proof of principle, both relative and absolute quantification were performed on cell line models of MM to compare protein expression before and after drug treatment in naïve cells and in drug resistant cells; these liquid chromatography-multiple reaction monitoring results are compared with existing literature and Western blots. The initial stage of a systems biology platform for examining drug resistance in MM has been implemented in cell line models and has been translated to MM cells isolated from a patient. The ultimate application of this platform could assist in clinical decision-making for individualized patient treatment. Although these specific assays have

  11. Monitoring a nuclear factor-κB signature of drug resistance in multiple myeloma.

    Science.gov (United States)

    Xiang, Yun; Remily-Wood, Elizabeth R; Oliveira, Vasco; Yarde, Danielle; He, Lili; Cheng, Jin Q; Mathews, Linda; Boucher, Kelly; Cubitt, Christopher; Perez, Lia; Gauthier, Ted J; Eschrich, Steven A; Shain, Kenneth H; Dalton, William S; Hazlehurst, Lori; Koomen, John M

    2011-11-01

    The emergence of acquired drug resistance results from multiple compensatory mechanisms acting to prevent cell death. Simultaneous monitoring of proteins involved in drug resistance is a major challenge for both elucidation of the underlying biology and development of candidate biomarkers for assessment of personalized cancer therapy. Here, we have utilized an integrated analytical platform based on SDS-PAGE protein fractionation prior to liquid chromatography coupled to multiple reaction monitoring mass spectrometry, a versatile and powerful tool for targeted quantification of proteins in complex matrices, to evaluate a well-characterized model system of melphalan resistance in multiple myeloma (MM). Quantitative assays were developed to measure protein expression related to signaling events and biological processes relevant to melphalan resistance in multiple myeloma, specifically: nuclear factor-κB subunits, members of the Bcl-2 family of apoptosis-regulating proteins, and Fanconi Anemia DNA repair components. SDS-PAGE protein fractionation prior to liquid chromatography coupled to multiple reaction monitoring methods were developed for quantification of these selected target proteins in amounts of material compatible with direct translation to clinical specimens (i.e. less than 50,000 cells). As proof of principle, both relative and absolute quantification were performed on cell line models of MM to compare protein expression before and after drug treatment in naïve cells and in drug resistant cells; these liquid chromatography-multiple reaction monitoring results are compared with existing literature and Western blots. The initial stage of a systems biology platform for examining drug resistance in MM has been implemented in cell line models and has been translated to MM cells isolated from a patient. The ultimate application of this platform could assist in clinical decision-making for individualized patient treatment. Although these specific assays have

  12. Drug resistance pattern ofMycobacterium tuberculosis isolates from patients of five provinces of Iran

    Institute of Scientific and Technical Information of China (English)

    Mohammad Javad Nasiri; Faranak Rezaei; Samin Zamani; Davod Darban-Sarokhalil; Abbas Ali Imani Fooladi; Hasan Shojaei; Mohammad Mehdi Feizabadi

    2014-01-01

    Objective:To determine the patterns of resistance to first line anti-tuberculosis(TB) drugs among a collection ofMycobacterium tuberculosis(MTB) isolates from5 provinces ofIran. Methods:A total of the6426 clinical specimens from patients suspected of activeTB were collected fromMarch2010 toJune2012.All specimens were subjected for microscopy and culture tests in theTB centers of studies provinces.Drug susceptibility testing to the first line anti-TB drugs for culture positiveMTB was performed onLöwenstein-Jensen(LJ) medium using proportion method.Results:Of6426 clinical specimens,261 were culture positive for mycobacteria, of which252 wereMTB and9 wereMOTT(mycobacteria other than tuberculosis). Of252MTB isolates,211(83.7%) were pan-susceptible and41(16.3%) were resistant to at least one drug.Resistance was most common to streptomycin,30 isolates(12.0%), followed by isoniazid,20 isolates(8.0%), rifampin,15 isolates(6.0%) and ethambutol,14 isolates(5.5%).Sixteen(6.3%)MTB isolates wereMDR.A clear evidence of heterogeneity amongst the5 provinces in the proportions with resistance to one or more drugs was observed [χ² =12.209(4 degrees of freedom),P values =0.0159].Conclusions:The prevalence of drug resistance in this study area underscoring the need for further enforcement ofTB control strategies in theIran.Drug susceptibility testing for allTB cases to provide optimal treatment, establishing advanced diagnostic facilities for rapid detection ofMDR-TB and continuous monito