Parámetros cinéticos como herramienta para la caracterización de aislados de Aspergillus sección Nigri

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María Silvina Sobrero

2013-12-01

Full Text Available Las especies de Aspergillus dentro de la sección Nigri son importantes en procesos biotecnológicos, así como en el biodeterioro. Bajos condiciones de cultivo controladas, la velocidad de crecimiento es una característica de las especies de hongos y algunos autores utilizan la medida del diámetro de las colonias como herramienta de identificación. El objetivo de este estudio fue determinar si la velocidad de crecimiento obtenida por la Microbiología Predictiva puede ser utilizada como herramienta para la caracterización de aspergilos negros. Se construyeron las curvas de crecimiento de 5 aislados de aspergilos negros obtenidos de alimentos y ambiente de industria láctea. Estos aislados, también fueron estudiados por sus características morfológicas y estudios de microscopía electrónica. Se identificaron como A. awamori, A. niger (2 aislados, A. foetidus y A. carbonarius. Las velocidades máximas de crecimiento en medio Agar Extracto de Malta a 25 ºC fueron: 3,51; 4,85; 4,52; 12,73; y 5,84 mm/día, respectivamente. A foetidus fue el único que presentó fase de latencia y alcanzó el mayor radio. Con la ayuda de la Microbiología Predictiva se pudieron separar A. awamori de A. foetidus, pero las diferencias no fueron significativas (p > 0,05 para los otros aislados. Los caracteres morfológicos permitieron diferenciar a A. carbonarius. Los datos cinéticos por sí solos no fueron suficientes para diferenciar especies cercanas.

Desarrollo de un alimento funcional deshidratado constituido por microorganismos aislados de Kefir

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Bolla, Patricia Araceli

2011-01-01

A pesar de los numerosos estudios sobre probióticos que encontramos en la actualidad, poco se conoce respecto a complejos multicepas. En este trabajo de tesis se propuso: 1- Desarrollar una mezcla microbiana constituida por microorganismos aislados de kefir. 2- Estudiar sus características tecnológicas y potencialmente probióticas. 3- Determinar la capacidad inhibitoria frente a Shigella y Clostridium difficile. 4- Estudiar la capacidad de la mezcla mic...

Resistencia a carbapenemes en aislamientos de Pseudomonas aeruginosa: un ejemplo de interacción entre distintos mecanismos Carbapenem resistance in Pseudomonas aeruginosa isolates: an example of interaction between different mechanisms

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Gisela Santella

2011-12-01

Full Text Available OBJETIVO: Identificar la proteína de membrana externa ausente en los aislamientos resistentes y determinar tanto las causas de su ausencia en la membrana, como la presencia de otros mecanismos de resistencia a carbapenemes en aislamientos clínicos de Pseudomonas aeruginosa. MÉTODOS: Se estudió un brote de 20 aislamientos de P. aeruginosa previamente caracterizados como productores de la metalobetalactamasa IMP-13. Estos aislamientos presentaron igual expresión de la enzima IMP-13, pero solo cinco de ellos fueron resistentes a carbapenemes. En esos cinco aislamientos resistentes se confirmó la ausencia de una proteína de membrana externa. Se secuenciaron oprD y ampC; se identificaron las proteínas de membrana externa por desorción/ionización láser asistida por matriz/espectometría de masa tiempo de vuelo (MALDI-TOF; se determinó el nivel de expresión de oprD, de AmpC y de los sistemas de eflujo tipo Mex, por reacción en cadena de polimerasa en tiempo real, y por último, se determinó la contribución del déficit de oprD a la resistencia a carbapenemes. RESULTADOS: La proteína de la membrana externa ausente en el grupo R (resistentes a ambos carbapenemes fue identificada como OprD-TS, pero no se observaron variaciones en su expresión. El gen oprD presentó mutaciones en los cinco aislamientos resistentes. Se observó la misma producción de la enzima tipo AmpC PDC-5 y del sistema de eflujo Mex AB-OprM entre los aislamientos sensibles y resistentes a carbapenemes. Se analizó cómo la presencia conjunta de IMP-13 y el déficit de oprD contribuyen al aumento de la resistencia. CONCLUSIONES: Distintos mecanismos contribuyen a la resistencia de aislamientos productores de IMP-13 a carbapenemes. La posibilidad de no detectar estos aislamientos productores de IMP-13 representa un riesgo latente de selección de mutantes con mecanismos de resistencia que se suman para aumentar la resistencia a carbapenemes.OBJECTIVE: To identify the

Detección y caracterización de aislados de "escherichia coli" de origen clínico y fecal en gallinas ponedoras

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Gibert Perelló, Magdalena

2011-01-01

El objetivo de esta tesis ha sido realizar la caracterización de aislados de E. coli clínicos (responsables de cuadros de colibacilosis en gallinas ponedoras) y fecales. Tras llevar a cabo el aislamiento e identificación bioquímica de los aislados, se ha procedido a la determinación del serogrupo, patotipo (detección de factores de virulencia por PCR), sensibilidad a antimicrobianos y pulsotipo (mediante la técnica de Pulsed Field-Gel Electrophoresis, PFGE). Además, se ha realizado un estudio...

The outcome of treating ESBL infections with carbapenems vs. non carbapenem antimicrobials.

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Trivedi, Mayuri; Trivedi, Mayur; Patel, Vipul; Soman, Rajeev; Rodriguez, Camilla; Singhal, Tanu

2012-08-01

In India where the prevalence of extended spectrum beta lactamase (ESBL) producing organisms among gram negative organisms is 60-70% and Ertapenem was unavailable at the beginning of this study, exclusive use of Group 2 Carbapenems (Imipenem and Meropenem) for treatment raises issues of cost and development of resistance. Therefore the role of non-Carbapenem alternatives, chiefly Betalactam + Betalactamase inhibitors (BL-BLI) was explored in this prospective observational study at a private tertiary care teaching hospital. 522 consecutive in door patients from the period between June 2006 to March 2007and June 2008 to December 2008, who had true infections with ESBL producing organisms were enrolled in the study. Antimicrobials were prescribed or changed by the treating physicians on the basis of the nature and severity of infection, the susceptibility of the organism and the affordability of the patient. Patients who received a Carbapenem at any time during treatment were considered in the Carbapenem group. Those who never received a Carbapenem at any time during treatment were considered in the non-Carbapenem group. Of the 522 infections, 287 were urinary tract infections, 60 were skin structure infections, 60 were bacteremias, 55 were hospital acquired pneumonias, 31 were intra-abdominal infections and 29 were other infections. There were 351 E. coli, 119 K. pneumoniae, 23 K. oxytoca, 16 Enterobacter aerogenes, 5 Kozoanae, 4 Enterobacter agglomerans, 3 Citrobacter freundi, 1 E. cloacae, 1 Enterobacterspp. and 1 Morgenella morganii isolates. Clinical outcomes were available for 486 patients. 339 patients who were in the non-Carbapenem group and who might have had less serious infections had a clinical success rate of 79.6%. 147 patients who were in the Carbapenem group and who might have had more serious infections had a clinical success rate of 85.71%. It is possible to successfully treat at least the less serious infections due to ESBL producing gram negative

Carbapenem-resistant-only Pseudomonas aeruginosa infection in patients formerly infected by carbapenem-susceptible strains.

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Tsai, Ming-Han; Wu, Tsu-Lan; Su, Lin-Hui; Lo, Wei-Lin; Chen, Chyi-Liang; Liang, Yi-Hua; Chiu, Cheng-Hsun

2014-12-01

Pseudomonas aeruginosa isolates that were initially carbapenem-susceptible and later became selective carbapenem-resistant following antimicrobial therapy were identified from individual cases during the same hospitalisation. Cross-resistance to other β-lactams was not found and their susceptibilities remained identical in consecutive isolates. Real-time quantitative reverse transcription PCR was performed to investigate the role of OprD, an outer membrane protein regulating the entry of carbapenems, in the appearance of carbapenem-resistant-only P. aeruginosa (CROPA). Fifteen paired isolates of carbapenem-susceptible P. aeruginosa (CS-PA) and CROPA were identified. All of the cases had carbapenem exposure history within 1 month before the appearance of CROPA (mean 10 days). Reduced OprD expression was found in 93% (14/15) of the isolates, suggesting that oprD inactivation was the major contributor to selective carbapenem resistance. Of the 14 cases with CROPA due to oprD mutation, 71% (10/14) were persistent infection, as genotype analysis revealed that their paired strains were isogenic; 29% (4/14) represented re-infections as they were heterogenic, suggesting that oprD-deficient CROPA existed in the hospital and that carbapenem selective pressure promoted its spread to patients. We conclude that CROPA may occur soon after the use of carbapenems to treat CS-PA infections and that oprD mutation is the major mechanism of resistance in CROPA. Restriction of empirical use of carbapenems by antibiotic stewardship is important to halt the occurrence of CROPA. Copyright © 2014 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

FLAVONOIDES AISLADOS DE LAS INFLORESCENCIAS DE Piper hispidum Kunth (PIPERACEAE Y DERIVADOS ACETILADOS

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Luis Enrique Cuca

2009-04-01

Full Text Available A partir del extracto etanólico de las inflorescencias de la especie Piper hispidum Kunth (Piperaceae fueron aislados tres flavonoides: 5-hidroxi-7-metoxiflavanona, 5-hidroxi-4’,7-dimetoxiflavanona y 2’,4’,6’-trimetoxidihidrochalcona. De las flavanonas aisladas fueron obtenidos los  derivados acetilados: 5-acetoxi-7-metoxiflavanona y  5-acetoxi-4’,7-dimetoxiflavanona. Las estructuras fueron elucidadas empleando técnicas espectroscópicas y por comparación con datos de literatura. Los compuestos naturales y sus derivados fueron sometidos al bioensayo de letalidad frente a Artemia salina. El flavonoide 5-hidroxi-7-metoxiflavanona presenta la mayor actividad tóxica frente a los microcrustaceos CL50 1.8 µg/ml.

Effect of carbapenem consumption patterns on the molecular epidemiology and carbapenem resistance of Acinetobacter baumannii.

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Mózes, Julianna; Ebrahimi, Fatemeh; Gorácz, Orsolya; Miszti, Cecília; Kardos, Gábor

2014-12-01

This study investigated the molecular epidemiology of Acinetobacter baumannii in the University of Debrecen in relation to antibiotic consumption. Overall and ward-specific antibiotic consumption was measured by the number of defined daily doses (DDD) per 100 bed-days between 2002 and 2012. Consumption was analysed against the number of A. baumannii positive patients per 100 bed-days, number of isolates per positive sample, and proportion of carbapenem resistant A. baumannii, using time-series analysis. Altogether 160 A. baumannii isolates from different wards were collected and analysed. Carbapenemase genes bla(OXA-23-like), bla(OXA-24-like), bla(OXA-48-like), bla(OXA-51-like), bla(OXA-58-like) and integrons were sought by PCR. Relatedness of isolates was assessed by PFGE. Prevalence and carbapenem resistance of A. baumannii were statistically associated with carbapenem consumption. Prevalence data followed carbapenem usage with three quarterly lags (r = 0.51-0.53, Pcarbapenem consumption was associated with the carbapenem-susceptible cluster, as well as with the carbapenem-susceptible isolates in the cluster with variable susceptibility. Wards with high carbapenem usage almost exclusively harboured isolates from carbapenem-resistant clusters. All clusters were dominated by isolates of one or two wards, but most wards were represented in multiple clusters. Increases in prevalence and carbapenem resistance of A. baumannii were associated with usage of meropenem and ertapenem but not of imipenem, which led to the spread of multiple clones in the University. © 2014 The Authors.

Estabilidad a la congelación descongelación de emulsiones o/w preparadas con aislados de soja nativos y desnaturalizados con diferente solubilidad

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Gonzalo Palazolo

2011-05-01

Full Text Available En este trabajo se evaluó la estabilidad a la congelación de emulsiones modelo aceite en agua (o/w preparadas con cuatro aislados de soja: dos nativos (ASN-1 y ASN-2, de similar composición pero diferente solubilidad, >90% y ~75%, respectivamente y dos desnaturalizados (ASD-1 y ASD-2, resultantes de calentar los respectivos aislados nativos (90 ‹C, 5 minutos. Las emulsiones preparadas con dispersiones acuosas al 2% p/v de ASN o ASD y aceite de girasol refinado (ƒ³ =0,25, se congelaron a -20 ‹C por 24 horas y luego se descongelaron a 20 ‹C. La estabilidad se evaluo a partir de medidas de distribución de tamano de partícula (difraccion laser y aceite liberado (AL, metodo de dilucion del colorante. Las emulsiones preparadas con ASN-2 y ASD-2 resultaron muy inestables despues de ser congeladas y descongeladas, resultadoque se evidenció por el aumento del tamano de partícula y un AL>25%. Al usar el aislado ASN-1 de mayor solubilidad, las emulsiones fueron mas estables y se observó un marcado incremento de la estabilidad cuando sus proteínas eran desnaturalizadas (ASD-1, no observándose prácticamente coalescencia ni aceite separado. En conclusión, la solubilidad y la desnaturalización proteíca de los aislados de soja son factores decisivos en la estabilidad de emulsiones frente a la congelación-descongelación.

SME-type carbapenem-hydrolyzing class A beta-lactamases from geographically diverse Serratia marcescens strains.

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Queenan, A M; Torres-Viera, C; Gold, H S; Carmeli, Y; Eliopoulos, G M; Moellering, R C; Quinn, J P; Hindler, J; Medeiros, A A; Bush, K

2000-11-01

Three sets of carbapenem-resistant Serratia marcescens isolates have been identified in the United States: 1 isolate in Minnesota in 1985 (before approval of carbapenems for clinical use), 5 isolates in Los Angeles (University of California at Los Angeles [UCLA]) in 1992, and 19 isolates in Boston from 1994 to 1999. All isolates tested produced two beta-lactamases, an AmpC-type enzyme with pI values of 8.6 to 9.0 and one with a pI value of approximately 9.5. The enzyme with the higher pI in each strain hydrolyzed carbapenems and was not inhibited by EDTA, similar to the chromosomal class A SME-1 beta-lactamase isolated from the 1982 London strain S. marcescens S6. The genes encoding the carbapenem-hydrolyzing enzymes were cloned in Escherichia coli and sequenced. The enzyme from the Minnesota isolate had an amino acid sequence identical to that of SME-1. The isolates from Boston and UCLA produced SME-2, an enzyme with a single amino acid change relative to SME-1, a substitution from valine to glutamine at position 207. Purified SME enzymes from the U. S. isolates had beta-lactam hydrolysis profiles similar to that of the London SME-1 enzyme. Pulsed-field gel electrophoresis analysis revealed that the isolates showed some similarity but differed by at least three genetic events. In conclusion, a family of rare class A carbapenem-hydrolyzing beta-lactamases first described in London has now been identified in S. marcescens isolates across the United States.

SME-Type Carbapenem-Hydrolyzing Class A β-Lactamases from Geographically Diverse Serratia marcescens Strains

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Queenan, Anne Marie; Torres-Viera, Carlos; Gold, Howard S.; Carmeli, Yehuda; Eliopoulos, George M.; Moellering, Robert C.; Quinn, John P.; Hindler, Janet; Medeiros, Antone A.; Bush, Karen

2000-01-01

Three sets of carbapenem-resistant Serratia marcescens isolates have been identified in the United States: 1 isolate in Minnesota in 1985 (before approval of carbapenems for clinical use), 5 isolates in Los Angeles (University of California at Los Angeles [UCLA]) in 1992, and 19 isolates in Boston from 1994 to 1999. All isolates tested produced two β-lactamases, an AmpC-type enzyme with pI values of 8.6 to 9.0 and one with a pI value of approximately 9.5. The enzyme with the higher pI in each strain hydrolyzed carbapenems and was not inhibited by EDTA, similar to the chromosomal class A SME-1 β-lactamase isolated from the 1982 London strain S. marcescens S6. The genes encoding the carbapenem-hydrolyzing enzymes were cloned in Escherichia coli and sequenced. The enzyme from the Minnesota isolate had an amino acid sequence identical to that of SME-1. The isolates from Boston and UCLA produced SME-2, an enzyme with a single amino acid change relative to SME-1, a substitution from valine to glutamine at position 207. Purified SME enzymes from the U.S. isolates had β-lactam hydrolysis profiles similar to that of the London SME-1 enzyme. Pulsed-field gel electrophoresis analysis revealed that the isolates showed some similarity but differed by at least three genetic events. In conclusion, a family of rare class A carbapenem-hydrolyzing β-lactamases first described in London has now been identified in S. marcescens isolates across the United States. PMID:11036019

Resistencia y susceptibilidad de microorganismos aislados en pacientes atendidos en una institución hospitalaria de tercer nivel, Villavicencio-Colombia, 2012

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Oscar Alexander Gutiérrez Lesmes

2015-05-01

Full Text Available Introducción: La resistencia bacteriana es problema significativo de salud pública y está asociada al uso indiscriminado e irracional de antibióticos, lo que afecta la eficacia de los tratamientos. Objetivo: Estimar la resistencia antimicrobiana a los antibióticos resultado de las pruebas invitro de susceptibilidad en una institución hospitalaria de tercer nivel de Villavicencio, Colombia. Materiales y Métodos: Se realizó un estudio observacional, descriptivo de tipo retrospectivo, análisis univariado, calculando medias de las variables susceptibilidad, resistencia, antibiótico, microorganismos, y tipo de muestra resultados de las pruebas de susceptibilidad realizadas mediante técnica de Kirby-Bauer de 485 pruebas de susceptibilidad de la institución hospitalaria. Resultados y Discusión: Los microorganismos más frecuentemente aislados, fueron: Escherichia coli, Klebsiella pneumoniae ss. Pneumoniae, Staphylococcus aureus ss. Aureus representando el 49% de total de microorganismos, los mayores reportes de resistencia en la pruebas invitro las presentaron Serratia marcescens, Staphylococcus saprophyticus ss. Saprophytic, Enterobacter cloacae, presentan una resistencia media superior al 50%, y una susceptibilidad inferior 40%, la mayor resistencia media se presentó para los siguientes antibióticos, Cefalotina 72,2%, Cefazolina 59,9%, Nitrofurantoina 54,4%, Ceftriaxona 52,7%. Conclusiones: Antibióticos como la Cefalotina, Nitrofurantoina, Cefazolina y Ceftriaxona  pierden su utilidad terapéutica dada la elevada resistencia demostrada por los microorganismos aislados en las pruebas invitro, es necesario reforzar las medidas de uso adecuado de antibióticos para disminuir la posibilidad de adaptación y resistencia a los mismos,  el fenómeno de resistencia bacteriana ocurre fuera del ámbito hospitalario evidenciando la necesidad de iniciar también control y vigilancia en infecciones ocurridas en la comunidad.Cómo citar este

Association of ertapenem and antipseudomonal carbapenem usage and carbapenem resistance in Pseudomonas aeruginosa among 12 hospitals in Queensland, Australia.

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McDougall, David A J; Morton, Anthony P; Playford, E Geoffrey

2013-02-01

The objective of this study was to determine the association between ertapenem and antipseudomonal carbapenem use and carbapenem resistance in Pseudomonas aeruginosa in 12 hospitals in Queensland, Australia. Data on usage of ertapenem and other antipseudomonal carbapenems, measured in defined daily doses per 1000 occupied bed-days, were collated using statewide pharmacy dispensing and distribution software from January 2007 until June 2011. The prevalence of unique carbapenem-resistant P. aeruginosa isolates derived from statewide laboratory information systems was collected for the same time period. Mixed-effects models were used to determine any relationship between ertapenem and antipseudomonal carbapenem usage and carbapenem resistance among P. aeruginosa isolates in the 12 hospitals analysed. No relationship between ertapenem usage and P. aeruginosa carbapenem resistance was observed. The introduction of ertapenem did not replace antipseudomonal carbapenem prescribing to any significant extent. However, an association between greater usage of antipseudomonal carbapenems and greater P. aeruginosa carbapenem resistance was demonstrated. It is likely that the only mechanism by which ertapenem can improve P. aeruginosa resistance patterns is by being used as a substitute for, rather than in addition to, antipseudomonal carbapenems.

Effects of Group 1 versus Group 2 carbapenems on the susceptibility of Acinetobacter baumannii to carbapenems: a before and after intervention study of carbapenem-use stewardship.

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Young Kyung Yoon

Full Text Available OBJECTIVE: Antimicrobial stewardship programs have been proposed for reducing bacterial resistance in the hospital environment. The purpose of this study was to investigate the impact of a carbapenem-use stewardship program on the susceptibility of Acinetobacter baumannii to Group 2 carbapenems. METHODS: A before and after intervention study was conducted at a university hospital from September 2008 to February 2013. Three study periods were defined: Phase I, pre-intervention (months 1-18; Phase II, a postintervention period during which ertapenem use was mandated but carbapenem use was not restricted (months 19-36; and Phase III, a postintervention period during which Group 2 carbapenem use was restricted (months 37-54. RESULTS: During the study period, intervention resulted in diminished consumption of Group 2 carbapenems (antimicrobial use density (AUD: 21.3±6.0 in Phase I, 18.8±6.0 in Phase II, 16.1±4.4 in Phase III; P = 0.028 and increased consumption of ertapenem (AUD: 2.7±1.7 in Phase I, 7.2±4.5 in Phase II, 9.1±5.3 in Phase III; P<0.001. The use of autoregressive-error models showed that in contrast with ertapenem use, the use of Group 2 carbapenem during the previous one month was positively and significantly associated with a subsequent increase in the proportion of carbapenem-resistant A. baumannii (CRAB (P = 0.031. CONCLUSIONS: Implementing a carbapenem-use stewardship program featuring the preferential use of ertapenem for treating appropriate indications of infection resulted in reduced use of Group 2 carbapenems and had a positive impact on the susceptibility of A. baumannii to carbapenems. This approach could be integrated into CRAB-control strategies in hospitals.

Effects of Group 1 versus Group 2 carbapenems on the susceptibility of Acinetobacter baumannii to carbapenems: a before and after intervention study of carbapenem-use stewardship.

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Yoon, Young Kyung; Yang, Kyung Sook; Lee, Seung Eun; Kim, Hyun Jeong; Sohn, Jang Wook; Kim, Min Ja

2014-01-01

Antimicrobial stewardship programs have been proposed for reducing bacterial resistance in the hospital environment. The purpose of this study was to investigate the impact of a carbapenem-use stewardship program on the susceptibility of Acinetobacter baumannii to Group 2 carbapenems. A before and after intervention study was conducted at a university hospital from September 2008 to February 2013. Three study periods were defined: Phase I, pre-intervention (months 1-18); Phase II, a postintervention period during which ertapenem use was mandated but carbapenem use was not restricted (months 19-36); and Phase III, a postintervention period during which Group 2 carbapenem use was restricted (months 37-54). During the study period, intervention resulted in diminished consumption of Group 2 carbapenems (antimicrobial use density (AUD): 21.3±6.0 in Phase I, 18.8±6.0 in Phase II, 16.1±4.4 in Phase III; P = 0.028) and increased consumption of ertapenem (AUD: 2.7±1.7 in Phase I, 7.2±4.5 in Phase II, 9.1±5.3 in Phase III; Pcarbapenem during the previous one month was positively and significantly associated with a subsequent increase in the proportion of carbapenem-resistant A. baumannii (CRAB) (P = 0.031). Implementing a carbapenem-use stewardship program featuring the preferential use of ertapenem for treating appropriate indications of infection resulted in reduced use of Group 2 carbapenems and had a positive impact on the susceptibility of A. baumannii to carbapenems. This approach could be integrated into CRAB-control strategies in hospitals.

Benzoquinona e hidroquinona preniladas y otros constituyentes aislados de Piper Bogotense C. DC.

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Luz Angela Peña

2010-11-01

Full Text Available Dos compuestos, que innovan la química conocida del género Piper, (2'E,6'E-2- famesilhidroquinona, (2'E,6'E-2-famesil- 1,4-benzoquinona, y a-D-glucosa fueron aislados de los frutos de Piper bogotense C. DC; los tallos y las hojas presentaron, como constimyentes mayoritarios, lactama del ácido 10-amino-4-hidroxi-2,3-dimetoxifenantreno carboxílico, 1,2-metilendioxi- 6-metil-4H-dibenzo lde,g] quinolina- ,5(6H-diona (Cefaradiona A, estigmasterol y sitosterol. Adicionalmente de las hojas de esta planta se aisló SC-P-D-glucopiranosil-4'-0-metilapigenina (4'-0-metilvitexina, Cytisosido o Trematina. Sus estructuras fueron determinadas por métodos espectroscópicos y comparación con datos de la literatura.

Options for treating carbapenem-resistant Enterobacteriaceae.

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Rafailidis, Petros I; Falagas, Matthew E

2014-12-01

To address the therapeutic management of carbapenem-resistant Enterobacteriaceae on the basis of literature of the last 12 months. Retrospective and prospective (nonrandomized noncontrolled) studies provide data regarding the management of infections due to carbapenem-resistant Enterobacteriaceae. The combination of a carbapenem with colistin or high-dose tigecycline or aminoglycoside or even triple carbapenem-containing combinations if the minimum inhibitory concentration (MIC) range of carbapenem (meropenem and imipenem) resistance is 8 mg/l or less seems to have an advantage over monotherapy with either colistin or tigecycline or fosfomycin. For Enterobacteriaceae with MIC for carbapenems over 8 mg/l, combination regimens involve colistin, tigecycline usually administered in a double dose than that suggested by its manufacturer, fosfomycin and aminoglycosides in various combinations. Suggestions based on the limited literature cannot be made safely. Combination regimens involving carbapenems for Enterobacteriaceae with MICs 8 mg/l or less for carbapenems (in dual combination with colistin or high-dose tigecycline or aminoglycoside or even triple combinations) seem to confer some therapeutic advantage over monotherapy. For Enterobacteriaceae with higher than the above-mentioned MICs, a combination of two or even three antibiotics among colistin, high-dose tigecycline, aminoglycoside and fosfomycin seems to confer decreased mortality.

Caracterización de Staphylococcus Aureus aislados del personal de salud de un hospital de mediana complejidad de la ciudad de Cali en el año 2012

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Mónica Chávez

2014-04-01

Full Text Available Introducción. Los estudios de Staphylococcus aureus en personal de salud permiten reducir su diseminación en las infecciones intrahospitalarias y mejorar la calidad de vida de los pacientes. La colonización por S. aureus en personal de salud de un hospital de tercer nivel, se evaluó caracterizándolo fenotípica y molecularmente. Métodos: Una población de 62 trabajadores y 216 estudiantes de medicina, mediante análisis del antibiograma y polimorfismo del gen agr. Resultados: S. aureus colonizó el 30,1% del personal; 17,5% trabajadores, 33,8% estudiantes. El 10,8% fueron meticilino-resistentes, 9 aislados presentaron el gen mecA, ocho resistentes a oxacilina y cefoxitina (88,9% de sensibilidad. La variante II considerada de origen hospitalario, se presentó en el 7,7% de aislados, el agr tipo III de origen comunitario en el 27,6% de aislados meticilino-sensibles. Conclusión. El personal hospitalario presentó colonización por S. aureus de origen hospitalario y comunitario. Es necesario adoptar medidas profilácticas e higiénicas para evitar diseminación y prevenir infecciones.

Global prevalence of carbapenem resistance in neutropenic patients and association with mortality and carbapenem use: systematic review and meta-analysis.

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Righi, Elda; Peri, Anna Maria; Harris, Patrick N A; Wailan, Alexander M; Liborio, Mariana; Lane, Steven W; Paterson, David L

2017-03-01

Carbapenem-resistant Gram-negative bacteria are recognized as a cause of difficult-to-treat infections associated with high mortality. To perform a systematic review of currently available data on distribution, characteristics and outcome associated with carbapenem-resistant bloodstream infections in adult neutropenic patients. Included studies were identified through Medline, Embase and Cochrane databases between January 1995 and April 2016. Random effect meta-analysis was used to quantify the association between carbapenem resistance and mortality and between carbapenem exposure and resistance. A total of 30 studies from 21 countries were included. Overall carbapenem resistance varied from 2% to 53% (median 9%) among studies. Infections due to carbapenem-resistant Pseudomonas spp . were reported in 18 (60%) studies showing high median resistance rates (44% of all carbapenem-resistant Gram-negatives and 19% of Pseudomonas isolates). Resistance of Enterobacteriaceae was less commonly reported and bloodstream infections due to carbapenem-resistant Klebsiella spp. were mainly documented from endemic areas (Greece, Italy, Israel). Carbapenem resistance in Acinetobacter spp. was reported in 9 (30%) studies (median resistance 58% of Acinetobacter isolates). Mortality rates ranged from 33% to 71% (median 50%) in patients with carbapenem-resistant infections. Carbapenem resistance appeared to correlate with mortality (OR 4.89, 95% CI 3.30-7.26) and previous exposure to carbapenems (OR 4.63, 95% CI 3.08-6.96). Carbapenem resistance represents a threat to neutropenic patients. In this group, resistance is likely promoted by previous carbapenem use and leads to high mortality rates. The knowledge of resistance patterns is crucial and can direct clinicians in the use of alternatives to carbapenem-based regimens. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please

Costo-efectividad del tratamiento con interferón beta en pacientes con síndrome clínico aislado de alto riesgo en Colombia

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Luis Alfonso Zarco

2014-03-01

Full Text Available Introducción. En 85 % de los pacientes con esclerosis múltiple se presenta como manifestación inicial un primer evento desmielinizante o síndrome clínico aislado. En estos casos, el tratamiento con interferón beta retrasa hasta dos años la progresión a esclerosis múltiple. Sin embargo, en Colombia este medicamento es costoso. Objetivo. Determinar si el tratamiento del síndrome clínico aislado con interferón beta es costo-efectivo al retrasar la esclerosis múltiple en dos años. Materiales y métodos. Se realizó un análisis de costo-efectividad empleando un árbol de decisiones basado en la perspectiva del paciente y la sociedad. A partir de una revisión sistemática de la literatura y de conceptos de expertos se definieron las diversas probabilidades. Los costos de la enfermedad se calcularon por medio de la revisión de historias y la aplicación de encuestas a los pacientes atendidos en el Hospital Universitario San Ignacio. Para controlar la incertidumbre se realizó un análisis de sensibilidad mediante una simulación de Monte Carlo con mil pacientes. Resultados. El costo del tratamiento con interferón sobrepasa los Col$ 95’000.000 (US$ 50.000 por paciente durante los dos años. Aproximadamente, 80 % corresponde a los costos del medicamento. El costo de la recaída se acerca a Col$ 39’139.200 (US$ 21.744, y los costos indirectos corresponden a Col$ 10’958.400 (US$ 6.088. La tasa representativa del mercado fue de Col$ 1.800. Con el tratamiento se ganan sólo 0,06 años de vida ajustados por discapacidad (AVAD adicionales. La razón de costo-efectividad ‘incremental’ (sic. supera el umbral, incluso en el análisis de sensibilidad. Conclusión. La administración de interferón beta en pacientes con síndrome clínico aislado de alto riesgo en los primeros dos años no es costo-efectiva en Colombia.

Recent updates of carbapenem antibiotics.

Science.gov (United States)

El-Gamal, Mohammed I; Brahim, Imen; Hisham, Noorhan; Aladdin, Rand; Mohammed, Haneen; Bahaaeldin, Amany

2017-05-05

Carbapenems are among the most commonly used and the most efficient antibiotics since they are relatively resistant to hydrolysis by most β-lactamases, they target penicillin-binding proteins, and generally have broad-spectrum antibacterial effect. In this review, we described the initial discovery and development of carbapenems, chemical characteristics, in vitro/in vivo activities, resistance studies, and clinical investigations for traditional carbapenem antibiotics in the market; imipenem-cilastatin, meropenem, ertapenem, doripenem, biapenem, panipenem/betamipron in addition to newer carbapenems such as razupenem, tebipenem, tomopenem, and sanfetrinem. We focused on the literature published from 2010 to 2016. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Microorganismos con capacidad degradativa de aceites lubricantes usados, aislados de estratos superficiales de suelos contaminados y optimización de condiciones de crcimiento. Ayacucho 2009

OpenAIRE

Palomino Felices, Sonia Haydeé

2014-01-01

La biorremediación, consiste principalmente en el uso de los organismos nativos (bacterias, hongos, plantas) para descomponer o degradar sustancias peligrosas convirtiéndolas en sustancias de caracteres menos tóxicos o inocuos para el ambiente y la salud humana. La investigación tuvo los siguientes objetivos: a) utilizar los microorganismos aislados de suelos contaminados con hidrocarburos para degradar "aceite lubricante usado" en suelos de experimentación en condiciones de laboratorio, b) e...

Principales géneros bacterianos aislados de leche de cabra en dos granjas del municipio de Tequisquiapan, Querétaro, México

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Rocío Angélica Ruiz Romero

2013-01-01

Full Text Available El término "mastitis" se utiliza para referirse a la inflamación de la glándula mamaria. A pesar de las pérdidas económicas que produce en cabras lecheras, existe escasa información relativa al estado epidemiológico de la misma en nuestro país. El objetivo de este trabajo fue identificar bacterias presentes en leche cruda de cabras clínicamente sanas, obtenida en sistemas de producción intensivo y semi-intensivo por métodos microbiológicos tradicionales. Se trabajaron con 28 animales en sistema de producción intensiva y 33 animales en sistema de producción semiintensiva, provenientes del Centro de Enseñanza, Investigación y Extensión en Producción Animal en Altiplano (CEIEPAA perteneciente a la FMVZ-UNAM y la granja del Carmen, ambas ubicadas en Tequisquiapan, Querétaro, México. De cada una de las cabras se obtuvieron muestras de ambas glándulas, se realizaron muestreos cada 45 días junto con la prueba de California de las cabras seleccionadas hasta los 240 días de lactación. Se recibieron un total de 484 muestras para análisis bacteriológico tradicional, 90 muestras (18.6 % presentaron crecimiento bacteriano, de las cuales se recuperaron 97 aislados. Los géneros bacterianos aislados con mayor frecuenciafueron Staphylococcus coagulasa Negativo (SCN 62/97 (63.9 %, Streptococus uberis 10/97 (10.3 % y Staphylococcus aureus 5/97 (5.1 %. De acuerdo al análisis estadístico, no existen diferencias entre los dos principales géneros bacterianos aislados en ambos sistemas de producción.

Medida de distensibilidad en pulmones aislados de rata: demostración del efecto de la tensión superficial

OpenAIRE

Araya, Romina Elizabeth; De Francesco, Pablo Nicolás; Smaldini, Paola Lorena; Iarossi, M. B.; Lastra, María Laura; Pérez, Pablo Fernando; Rebolledo, Alejandro; Rinaldi, Gustavo

2016-01-01

Uno de los TP de nuestra Cátedra consiste en la medición de la distensibilidad de un pulmón aislado de rata. La interfase aire-líquido en la superficie alveolar determina la existencia de tensión superficial (TS) en el líquido, la cual disminuye la distensibilidad pulmonar (DP). Si bien el surfactante pulmonar disminuye la TS, ésta continúa siendo importante. Los métodos para medir la TS de un líquido suelen ser bastante dificultosos (Ej: balanza de torsión de Du Noüy). El objetivo de este...

Infectividad y efectividad de rizobios aislados de Suelos de la Costa Caribe Colombiana en Vigna unguiculata

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Jonathan Alberto Mendoza Labrador

2014-07-01

Full Text Available Título en español: Infectividad y efectividad de rizobios aislados de Suelos de la Costa Caribe Colombiana  en Vigna unguiculata Título en ingles: Infectivity and effectiveness of isolated rhizobia from colombian caribbean soils in Vigna unguiculata Título corto: Infectividad y efectividad de rizobios aislados de Suelos Resumen:  Es el primer estudio en Colombia que abarca una evaluación de rizobios nativos asociados a frijol Caupí (Vigna unguiculata L. Walp. en los departamentos del Cesar y la Guajira. En esta investigación, se demostró que la utilización de  aislamientos de rizobios nativos aislados a partir de  nódulos,  mejoraron el desarrollo del frijol Caupí  (Vigna unguiculata L. Walp., siendo estas bacterias más eficientes que los tratamientos químicos y absolutos (sin inóculo ni fertilización y que las cepas inducidas mejorando además, la fijación biológica de nitrógeno y la tasa fotosintética. Como aportes del estudio, se determinó que en condiciones de invernadero la fertilización biológica fue más eficiente que la química y que, de acuerdo a los resultados obtenidos de las diferentes variables agronómicas evaluadas, esto podría influir positivamente en los rendimientos nutricionales del cultivo, base alimentaria de los sistemas ganaderos de estas regiones del país y  fuente alimenticia  de la comunidad indígena y de bajos recursos económicos.  Palabras clave Nodulación, fijación Biológica de Nitrógeno, Fertilización, Tasa Fotosintética Abstract:  This is the first study in Colombia which covers an evaluation of native rhizobium associated to the Caupí bean   (Vigna unguiculata L. Walp. in the departaments of Cesar and Guajira. In this research it was demonstrated that the use of native rhizobium isolated from nodes, improved the development of the Caupí bean (Vigna unguiculata L. Walp., being this bacteria more efficient than the chemical and absolute treatments (without inoculum and

Frecuencia de enzimas asociadas a sensibilidad disminuida a betalactámicos en aislados de enterobacterias, Caracas, Venezuela Frequency of enzymes associated with reduced sensitivity to beta-lactam antibiotics in enterobacteria isolates, Caracas, Venezuela

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Daniel Marcano

2011-12-01

Full Text Available OBJETIVO: Determinar la frecuencia de los mecanismos enzimáticos asociados a sensibilidad disminuida a los antibióticos betalactámicos de amplio espectro en aislados de enterobacterias obtenidos de centros hospitalarios de Caracas, Venezuela. MÉTODOS: Se realizó un estudio transversal con enterobacterias aisladas de pacientes de ocho centros hospitalarios de Caracas, Venezuela, desde el 15 de octubre de 2009 al 15 de enero de 2010. La identificación se realizó mediante pruebas bioquímicas convencionales, y la susceptibilidad a los antimicrobianos mediante antibiograma (Kirby-Bauer, según las normas de 2010 del Instituto de Estándares Clínicos y de Laboratorio. La detección de los genes de resistencia a betalactámicos se realizó mediante amplificación por reacción en cadena de polimerasa. RESULTADOS: De 1 235 aislados, 207 (16,8% mostraron resistencia a cefalosporinas de tercera y cuarta generación o a carbapenemes o a ambos. De esos, 93,8% presentaron fenotipo betalactamasa de espectro extendido (BLEE; 4,3%, fenotipo AmpC derreprimido, y 1,9%, fenotipo carbapenemasa. La caracterización de los dos primeros fenotipos determinó que 36,7% eran tipo SHV; 22,3%, grupo CTX-M-1; 21,7%, tipo TEM; 5,2%, grupo CTX-M-1 + impermeabilidad; 4,5%, combinación de dos enzimas; 4,3%, grupo CTX-M-2; 3,4%, tipo PER, y 1,9%, tipo KPC. Se observó un predominio del tipo SHV en las cepas obtenidas de hospitales públicos y del grupo CTX-M-1, en los privados. CONCLUSIONES: De los mecanismos enzimáticos investigados, el tipo SHV fue el más frecuente, seguido del grupo CTX-M-1 y tipo TEM. Asimismo, se encontró un alto porcentaje de carbapenemasas tipo KPC. Este es uno de los pocos estudios multicéntricos realizados en Venezuela donde se evalúa la frecuencia de este tipo de mecanismo de resistencia a los antimicrobianos, incluida la caracterización fenotípica y molecular. Se demostró que los métodos de detección requieren una interpretaci

Carbapenems: Past, Present, and Future ▿

Science.gov (United States)

Papp-Wallace, Krisztina M.; Endimiani, Andrea; Taracila, Magdalena A.; Bonomo, Robert A.

2011-01-01

In this review, we summarize the current “state of the art” of carbapenem antibiotics and their role in our antimicrobial armamentarium. Among the β-lactams currently available, carbapenems are unique because they are relatively resistant to hydrolysis by most β-lactamases, in some cases act as “slow substrates” or inhibitors of β-lactamases, and still target penicillin binding proteins. This “value-added feature” of inhibiting β-lactamases serves as a major rationale for expansion of this class of β-lactams. We describe the initial discovery and development of the carbapenem family of β-lactams. Of the early carbapenems evaluated, thienamycin demonstrated the greatest antimicrobial activity and became the parent compound for all subsequent carbapenems. To date, more than 80 compounds with mostly improved antimicrobial properties, compared to those of thienamycin, are described in the literature. We also highlight important features of the carbapenems that are presently in clinical use: imipenem-cilastatin, meropenem, ertapenem, doripenem, panipenem-betamipron, and biapenem. In closing, we emphasize some major challenges and urge the medicinal chemist to continue development of these versatile and potent compounds, as they have served us well for more than 3 decades. PMID:21859938

Carbapenem stewardship: does ertapenem affect Pseudomonas susceptibility to other carbapenems? A review of the evidence.

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Nicolau, David P; Carmeli, Yehuda; Crank, Christopher W; Goff, Debra A; Graber, Christopher J; Lima, Ana Lucia L; Goldstein, Ellie J C

2012-01-01

The group 2 carbapenems (imipenem, meropenem and, more recently, doripenem) have been a mainstay of treatment for patients with serious hospital infections caused by Pseudomonas aeruginosa, Enterobacteriaceae and other difficult-to-treat Gram-negative pathogens as well as mixed aerobic/anaerobic infections. When ertapenem, a group 1 carbapenem, was introduced, questions were raised about the potential for ertapenem to select for imipenem- and meropenem-resistant Pseudomonas. Results from ten clinical studies evaluating the effect of ertapenem use on the susceptibility of Pseudomonas to carbapenems have uniformly shown that ertapenem use does not result in decreased Pseudomonas susceptibility to these antipseudomonal carbapenems. Here we review these studies evaluating the evidence of how ertapenem use affects P. aeruginosa as well as provide considerations for ertapenem use in the context of institutional stewardship initiatives. Copyright © 2011 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

Comparative pharmacodynamics of four different carbapenems in combination with polymyxin B against carbapenem-resistant Acinetobacter baumannii.

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Lenhard, Justin R; Gall, Jonathan S; Bulitta, Jurgen B; Thamlikitkul, Visanu; Landersdorfer, Cornelia B; Forrest, Alan; Nation, Roger L; Li, Jian; Tsuji, Brian T

2016-12-01

The objective of this study was to determine the comparative pharmacodynamics of four different carbapenems in combination with polymyxin B (PMB) against carbapenem-resistant Acinetobacter baumannii isolates using time-kill experiments at two different inocula. Two A. baumannii strains (03-149-1 and N16870) with carbapenem minimum inhibitory concentrations (MICs) ranging from 8 to 64 mg/L were investigated in 48-h time-kill experiments using starting inocula of 10 6  CFU/mL and 10 8  CFU/mL. Concentration arrays of ertapenem, doripenem, meropenem and imipenem at 0.25×, 0.5×, 1×, 1.5× and 2× published maximum serum concentration (C max ) values (C max concentrations of 12, 21, 48 and 60 mg/L, respectively) were investigated in the presence of 1.5 mg/L PMB. Use of carbapenems without PMB resulted in drastic re-growth. All carbapenem combinations were able to achieve a ≥3 log 10 CFU/mL reduction by 4 h against both strains at 10 6  CFU/mL, whereas maximum reductions against strain 03-149-1 at 10 8  CFU/mL were 1.0, 3.2, 2.2 and 3.3 log 10 CFU/mL for ertapenem, doripenem, meropenem and imipenem, respectively. None of the combinations were capable of reducing 10 8  CFU/mL of N16870 by ≥2 log 10 CFU/mL. Ertapenem combinations consistently displayed the least activity, whereas doripenem, meropenem and imipenem combinations had similar activities that were poorly predicted by carbapenem MICs. As doripenem, meropenem, or imipenem displayed similar pharmacodyanmics in combination, the decision of which carbapenem to use in combination with PMB may be based on toxicodynamic profiles if drastic discordance in MICs is not present. Copyright © 2016. Published by Elsevier B.V.

In vitro activities of carbapenems in combination with amikacin, colistin, or fosfomycin against carbapenem-resistant Acinetobacter baumannii clinical isolates.

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Singkham-In, Uthaibhorn; Chatsuwan, Tanittha

2018-01-31

Carbapenem-resistant Acinetobacter baumannii clinical isolates (n=23) were investigated for carbapenem resistance mechanisms and in vitro activities of carbapenems in combination with amikacin, colistin, or fosfomycin. Major carbapenem resistance mechanism was OXA-23 production. The vast majority of these isolates were OXA-23-producing A. baumannii ST195 and ST542, followed by novel STs, ST1417, and ST1423. The interuption of carO by a novel insertion sequence, ISAba40, was found in two isolates. The combinations of imipenem and fosfomycin, meropenem and amikacin, imipenem and amikacin, and imipenem and colistin were synergistic against carbapenem-resistant A. baumannii by 65.2%, 46.2%, 30.8%, and 17.4%, respectively. Surprisingly, the combination of imipenem and fosfomycin was the most effective in this study against A. baumannii, which is intrinsically resistant to fosfomycin. Imipenem and fosfomycin inhibit cell wall synthesis; therefore, fosfomycin may be an adjuvant and enhance the inhibition of cell wall synthesis of carbapenem-resistant A. baumannii when combined with imipenem. Copyright © 2018. Published by Elsevier Inc.

Sparing carbapenem usage.

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Wilson, A Peter R

2017-09-01

Carbapenem resistance in Gram-negative bacteria is increasing in many countries and use of carbapenems and antibiotics to which resistance is linked should be reduced to slow its emergence. There are no directly equivalent antibiotics and the alternatives are less well supported by clinical trials. The few new agents are expensive. To provide guidance on strategies to reduce carbapenem usage. A literature review was performed as described in the BSAC/HIS/BIA/IPS Joint Working Party on Multiresistant Gram-negative Infection Report. Older agents remain active against some of the pathogens, although expectations of broad-spectrum cover for empirical treatment have risen. Education, expert advice on treatment and antimicrobial stewardship can produce significant reductions in use. More agents may need to be introduced onto the antibiotic formulary of the hospital, despite the poor quality of scientific studies in some cases. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Audit of carbapenem prescriptions comparing 2 assessment periods.

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Lefébure, A; Papy, E; Rioux, C; Diamantis, S; Armand-Lefèvre, L; Longuet, P; Lescure, F X; Wolff, M; Arnaud, P; Lucet, J C

2015-07-01

The emergence of extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae has resulted in the increase of carbapenem prescriptions. The objective of our study was to determine the appropriateness of carbapenem prescriptions from initiation to reassessment of treatment, between 2009 and 2011. A questionnaire drafted by infectious diseases specialists (IDS) and microbiologists was used to collect clinical and microbiological data concerning carbapenem prescriptions in 2009 and 2011. An IDS then compared the results to assess carbapenem prescription compliance with our hospital's local recommendations. Seventy-one prescriptions were included in 2009 and 32 in 2011. The carbapenem treatment had been most frequently probabilistic to treat nosocomial infections. The microbiological data revealed that the number of multidrug-resistant (MDR) infections had increased between 2009 and 2011, especially infections involving ESBL-producing Enterobacteriaceae. At treatment reassessment, in 2009 and 2011, 15 (21%) and 12 (38%) carbapenem prescriptions were appropriate and continued. Overall, when comparing the 2 periods, prescriptions complied with local guidelines from initiation to reassessment of treatment without any statistically significant difference (68% in 2009 and 75% in 2011). Our study results showed that MDR infections had increased and especially infections due to ESBL-producing Enterobacteriaceae; this was consistent with epidemiological data. We also proved that most carbapenem prescriptions were compliant with recommendations. The increased mobile IDS interventions in medical and surgical departments helped reach this rate of compliance. Carbapenem stewardship may be promoted even in a difficult epidemiological context, especially with IDS interventions for the duration of treatment or at treatment reassessment. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

The risk of seizures among the carbapenems: a meta-analysis.

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Cannon, Joan P; Lee, Todd A; Clark, Nina M; Setlak, Paul; Grim, Shellee A

2014-08-01

A consensus exists among clinicians that imipenem/cilastatin is the most epileptogenic carbapenem, despite inconsistencies in the literature. We conducted a meta-analysis of all randomized controlled trials comparing carbapenems with each other or with non-carbapenem antibiotics to assess the risk of seizures for imipenem, meropenem, ertapenem and doripenem. In the risk difference (RD) analysis, there were increased patients with seizure (2 per 1000 persons, 95% CI 0.001, 0.004) among recipients of carbapenems versus non-carbapenem antibiotics. This difference was largely attributed to imipenem as its use was associated with an additional 4 patients per 1000 with seizure (95% CI 0.002, 0.007) compared with non-carbapenem antibiotics, whereas none of the other carbapenems was associated with increased seizure. Similarly, in the pooled OR analysis, carbapenems were associated with a significant increase in the risk of seizures relative to non-carbapenem comparator antibiotics (OR 1.87, 95% CI 1.35, 2.59). The ORs for risk of seizures from imipenem, meropenem, ertapenem and doripenem compared with other antibiotics were 3.50 (95% CI 2.23, 5.49), 1.04 (95% CI 0.61, 1.77), 1.32 (95% CI 0.22, 7.74) and 0.44 (95% CI 0.13, 1.53), respectively. In studies directly comparing imipenem and meropenem, there was no difference in epileptogenicity in either RD or pooled OR analyses. The absolute risk of seizures with carbapenems was low, albeit higher than with non-carbapenem antibiotics. Although imipenem was more epileptogenic than non-carbapenem antibiotics, there was no statistically significant difference in the imipenem versus meropenem head-to-head comparison. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Actinomicetos aislados del compost y su actividad antagonista a fitopatógenos de la papa (Solanum tuberosum spp. andigena Hawkes)

OpenAIRE

Pérez-Rojas, Fernanda; León-Quispe, Jorge; Galindo-Cabello, Nadia

2015-01-01

Una de las formas de control de fitopatógenos es a través del uso de microorganismos antagonistas. El compost, un producto orgánico es fuente de microorganismos capaces de producir metabolitos secundarios de interés agrícola. Se aislaron y evaluaron mediante cultivos in vitro la capacidad antagonista de 85 actinomicetos frente a fitopatógenos que afectan a Solanum tuberosum. De los aislados, 23.5% tuvieron actividad antagonista a Ralstonia solanacearum, 16.4% a Pectobacterium carotovorum, 43....

Characterization of carbapenem-nonsusceptible Klebsiella pneumoniae bloodstream isolates at a Taiwanese hospital: clinical impacts of lowered breakpoints for carbapenems.

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Lee, N Y; Wu, J J; Lin, S H; Ko, W C; Tsai, L H; Yan, J J

2012-08-01

This study was conducted in order to characterize carbapenem-nonsusceptible Klebsiella pneumoniae isolates and to evaluate the impacts of recently lowered interpretative breakpoints for carbapenems for Enterobacteriaceae. Among 152 K. pneumoniae bloodstream isolates suspected as AmpC or extended-spectrum β-lactamase (ESBL) producers, 58 (38.2%) isolates were currently interpreted as nonsusceptible to ertapenem, imipenem, or meropenem, and 42 (72.4%) of them were categorized as carbapenem-susceptible by the previous criteria. The high revision rate was associated with the predominance (79.3%) of DHA-1 among the carbapenem-nonsusceptible isolates due to both polyclonal and clonal spread. ESBLs were common (~57%) in both ertapenem-susceptible and -nonsusceptible isolates; however, 84.8% of the carbapenem-nonsusceptible isolates were also AmpC producers. The IMP-8 metallo-β-lactamase was detected in three isolates. Polyacrylamide gel electrophoresis suggested decreased OmpK35 expression in all but one ertapenem-nonsusceptible isolate, and genetic disruptions of ompK35 and ompK36 were detected in 30 and six ertapenem-nonsusceptible isolates, respectively. A comparison between patients infected by AmpC- or ESBL-producing ertapenem-susceptible (n=62) isolates and those with isolates revised as ertapenem-nonsusceptible (n=41) revealed more cases of malignancies (36.6% versus 14.5%; p=0.01) and higher Charlson score (p=0.033) among the patients with ertapenem-nonsusceptible isolates; however, the acquisition of an isolate revised as carbapenem-nonsusceptible was not identified as an independent mortality risk factor.

Compliance with carbapenem guidelines in a university hospital.

Science.gov (United States)

Van Hollebeke, M; Chapuis, C; Bernard, S; Foroni, L; Stahl, J P; Bedouch, P; Pavese, P

2016-03-01

We aimed to evaluate carbapenem prescription compliance with guidelines for nosocomial and community-acquired infections. We conducted a prospective study over a four-month period at our university hospital. We included all adult and pediatric hospitalized patients who had received at least one dose of carbapenem. Data was collected from patients' medical records (hard copy and computerized data; CristalLink software). Compliance with guidelines was assessed by two infectious disease specialists. Assessment criteria included indication, antibiotic choice, dosage, and treatment duration. We included 152 patients in the study (65.4% of men). Carbapenem prescription was appropriate for 76.3% of prescriptions. The use of carbapenems was considered appropriate for 73.9% of empirical prescriptions and for 77.8% of documented prescriptions. Non-compliance with guidelines was mainly due to prescriptions for community-acquired infections. Antibiotic de-escalation could not be initiated in 40.3% of patients and was only initiated in 51.7% of patients for whom it could be considered. Although the average treatment duration was 7.5 days, 23.7% of patients received carbapenems for more than 10 days. These results highlight the need for a strong carbapenem stewardship program in our hospital. Copyright © 2016. Published by Elsevier SAS.

Perfil microbiológico y sensibilidad a antibióticos de microorganismos aislados de infecciones conjuntivales en el Instituto de Oftalmología Fundación Conde de Valenciana. Reporte del año 2012

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Patricia Chirinos-Saldaña

2014-04-01

Conclusiones: Staphylococcus epidermidis fue el microorganismo aislado con mayor frecuencia en muestras provenientes de infecciones conjuntivales. Todas las cepas de S. epidermidis fueron sensibles a vancomicina, gentamicina y moxifloxacino y la mayoría de ellas fueron multirresistentes a los antibióticos en evaluación.

Clinical and Epidemiological Significance of Carbapenem Resistance in Acinetobacter baumannii Infections.

Science.gov (United States)

Tal-Jasper, Ruthy; Katz, David E; Amrami, Nadav; Ravid, Dor; Avivi, Dori; Zaidenstein, Ronit; Lazarovitch, Tsilia; Dadon, Mor; Kaye, Keith S; Marchaim, Dror

2016-05-01

Carbapenems are considered the treatment of choice for Acinetobacter baumannii infections. Many facilities implement preventive measures toward only carbapenem-resistant A. baumannii (CRAB). However, the independent role of the carbapenem resistance determinant on patient outcomes remains controversial. In a 6-year analysis of adults with A. baumannii bloodstream infection (BSI), the outcomes of 149 CRAB isolates were compared to those of 91 patients with carbapenem-susceptible A. baumannii In bivariable analyses, CRAB BSIs were significantly associated with worse outcomes and with a delay in the initiation of appropriate antimicrobial therapy (DAAT). However, in multivariable analyses, carbapenem resistance status was no longer associated with poor outcomes, while DAAT remained an independent predictor. The epidemiological significance of A. baumannii should not be determined by its resistance to carbapenems. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Las TIC en los entornos educativos

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Melchor Gómez García

2015-07-01

Full Text Available Sin duda una de las características relevantes de la sociedad en que vivimos es la incorporación de las Tecnologías de la Información y la Comunicación (TIC en todos los ámbitos de la vida. El entorno educativo no está aislado a esta tendencia de incorporación de las tecnologías, y vive un periodo de cambios y transformaciones que genera reflexiones y debates entre los profesionales del sector.

Clinical laboratory detection of carbapenem-resistant and carbapenemase-producing Enterobacteriaceae.

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Miller, Shelley; Humphries, Romney M

2016-08-01

Carbapenemases, enzymes that hydrolyze carbapenem-class antimicrobials, pose serious clinical and diagnostic challenges, including their recent rapid spread among members of the Enterobacteriaceae, a family with no inherent carbapenem resistance. Currently there is no one-size-fits-all method for detecting carbapenem-resistant Enterobacteriaceae (CRE) in the laboratory, nor how to differentiate carbapenemase-producers (CP) from isolates that are carbapenem-resistant via other or combined mechanisms. This article reviews definitions for CRE and CP-CRE, and discusses current phenotypic and molecular methods available to the clinical laboratory for the detection of both CP and non-CP CRE. Expert commentary: Routine evaluation of carbapenem resistance mechanism by the routine clinical laboratory are not necessary for patient care, as clinical breakpoints best predict response. However, evaluation for carbapenemase is integral to infection control efforts, and laboratories should have the capacity to do such testing, either in house or by submitting isolates to a reference laboratory.

Widespread increase of empirical carbapenem use in acute care hospitals in Catalonia, Spain.

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Grau, Santiago; Fondevilla, Esther; Echeverría-Esnal, Daniel; Alcorta, Amaia; Limon, Enric; Gudiol, Francesc

2018-04-24

The overall increase in the use of carbapenems could lead to the selection of carbapenem-resistant bacteria. The objectives of this study were to analyze carbapenem use from 2008 to 2015 and their prescription profile in 58 hospitals affiliated to the VINCat Programme (nosocomial infection vigilance system). Retrospective, longitudinal and descriptive study of carbapenem use. Consecutive case-series study, looking for carbapenem prescription characteristics, conducted in January 2016. Use was calculated in defined daily doses (DDD)/100 patient-days (PD); prescription profiles were assessed using a standardized survey. Carbapenem use increased 88.43%, from 3.37 DDD/100-PD to 6.35 DDD/100-PD (pCatalonia. Stewardship interventions are required to prevent carbapenem overuse. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Wastewater as a Source of Carbapenem Resistant Escherichia coli

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Clinical studies have reported that the occurrence of carbapenem resistant E. coli is on the rise. This is of concern because carbapenem antibiotics are typically reserved for treating infections caused by bacteria resistant to other classes of antibiotics. Current literature st...

Outbreak of carbapenem-resistant Providencia rettgeri in a tertiary ...

African Journals Online (AJOL)

Carbapenem resistance in Enterobacteriaceae is often plasmid mediated, necessitating stringent infection control practices. We describe an outbreak of carbapenem-resistant Providencia rettgeri involving 4 patients admitted to intensive care and high-care units at a tertiary hospital. Clinical and demographic characteristics ...

Obtención y caracterización de aislados proteicos de colza

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Gonçalves, N.

1997-10-01

Full Text Available A method for the obtention of protein isolates from defatted rapeseed flour has been designed. The process includes a basic extraction followed by a precipitation at the isoelectric point of the proteins. The precipitate is washed with water (pH 4.5, ethanol and acetone, obtaining a protein isolate with 86% of protein and reducing the contents in polyphenols and soluble sugars in more than 90% with respect to the defatted flour. The final product have physico-chemical characteristics that make it atractive to be used as food and for the obtention of protein hydrolizates.

Se ha diseñado un proceso de obtención de aislados proteicos a partir de harina de colza desengrasada. El método incluye la extracción básica de las proteínas solubles seguido de una precipitación acida en el punto isoeléctrico. El precipitado es lavado con agua (pH 4.5, etanol y acetona, obteniéndose un aislado proteico con un 86% de proteína y reduciéndose el contenido en polifenoles y azúcares solubles en más de un 90% respecto a la harina desengrasada. El aislado final presenta unas características físico-químicas que lo hacen atractivo para su uso en alimentación y obtención de hidrolizados proteicos.

Vigilancia de la resistencia a los antibacterianos en Argentina. Programa WHONET, 1995-1996 Monitoring antimicrobial resistance in Argentina: the WHONET program, 1995-1996

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Alicia Rossi

1999-10-01

Full Text Available La Organización Mundial de la Salud ha puesto en marcha un programa para la vigilancia de la resistencia a los antibacterianos, denominado WHONET, que se desarrolló en Argentina mediante una red de 23 laboratorios de instituciones hospitalarias públicas y privadas sometidos a programas nacionales e internacionales de control de calidad. Entre enero de 1995 y diciembre de 1996 se determinó por el método de difusión en agar la sensibilidad a los antibacterianos de 16 073 aislados clínicos consecutivos, siguiendo las recomendaciones del Comité Nacional de Estándares para Laboratorios Clínicos (National Committee for Clinical Laboratory Standards: NCCLS de los Estados Unidos de América. Más de la mitad de los aislados urinarios de Escherichia coli fueron resistentes a la ampicilina, y más de 30% a la trimetoprima-sulfametoxazol. Cuando se comparó la sensibilidad de los aislados urinarios de pacientes ambulatorios y hospitalizados, se observó una marcada diferencia en los perfiles de actividad (porcentaje de microorganismos resistentes aislados en pacientes hospitalizados frente a pacientes ambulatorios de la gentamicina (8% frente a 2%, la norfloxacina (6% frente a 2% y las cefalosporinas de tercera generación (18% frente a 10%. Los aislados de Klebsiella pneumoniae recuperados de hemocultivos presentaron resistencia a las cefalosporinas de tercera generación y a la gentamicina en 71 y 60% de los casos, respectivamente. La proporción de Staphylococcus aureus resistentes a la oxacilina fue de 39%. Cerca de la mitad de los aislados de Enterococcus spp. presentaron resistencia de alto nivel a los aminoglucósidos, pero no se detectó resistencia a los glicopéptidos. En nuestro medio, la ampicilina y la trimetoprima-sulfametoxazol no fueron apropiadas para el tratamiento de las diarreas; Shigella flexneri presentó mayor porcentaje de aislados resistentes a ambos fármacos (87 y 74%, respectivamente que Shigella sonnei (47 y 71

Tipificación fágica de aislados de Salmonella enteritidis de muestras clínicas, alimentarias y avícolas en Chile Phage typing of Salmonella enteritidis isolates from clinical, food, and poultry samples in Chile

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Soledad Prat

2001-01-01

Full Text Available Desde 1994 Chile ha sido afectado por una extensa epidemia de infecciones por Salmonella enteritidis (S. enteritidis. Para conocer la diversidad de fuentes infectantes, el posible origen de la epidemia y las relaciones epidemiológicas entre aislados clínicos, alimentarios y avícolas, se realizó la tipificación fágica de 310 muestras de S. enteritidis de origen clínico recolectadas entre los años 1975 y 1996 junto con 47 aislados alimentarios obtenidos durante brotes de S. enteritidis y 27 cepas aisladas en estudios de vigilancia de establecimientos de avicultura. En total, en las muestras clínicas se identificaron 13 fagotipos, dos aislados no pudieron tipificarse y uno se consideró atípico. Los tipos fágicos que se identificaron con mayor frecuencia fueron el 1 (56,8% y el 4 (31,3%, seguidos de los tipos 8 (4,8% y 28 (1,9%. La presencia regional y temporal de estos fagotipos indica que ha habido cambios importantes en su distribución: en los primeros años de recolección solo se registraron los fagotipos 8 y 28, que desaparecieron hacia 1980 para reaparecer de forma aislada en 1996. A partir de la expansión paulatina de S. enteritidis que se inició en 1988, se empezaron a aislar en las zonas central y sur del país fagos del tipo 4, que no se habían encontrado anteriormente en Chile. En 1991 emergió como predominante en la zona norte el fagotipo 1, tampoco registrado previamente. En los aislados alimentarios se identificaron solamente los tipos 1 y 4, que fueron también los más comunes en los aislados avícolas. La tipificación fágica de S. enteritidis es de utilidad para orientar el análisis epidemiológico de las infecciones por este agente patológico.Since 1994 an extensive epidemic of infections with Salmonella enteritidis (S. enteritidis has affected Chile. In order to understand the diversity of infective sources, the possible origin of the epidemic, and the epidemiological relationships between clinical, food, and

The rapid spread of carbapenem-resistant Enterobacteriaceae

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Potter, Robert F.; D’Souza, Alaric W.; Dantas, Gautam

2016-01-01

Carbapenems, our one-time silver bullet for multidrug resistant bacterial infections, are now threatened by widespread dissemination of carbapenem-resistant Enterobacteriaceae (CRE). Successful expansion of Enterobacteriaceae clonal groups and frequent horizontal gene transfer of carbapenemase expressing plasmids are causing increasing carbapenem resistance. Recent advances in genetic and phenotypic detection facilitate global surveillance of CRE diversity and prevalence. In particular, whole genome sequencing enabled efficient tracking, annotation, and study of genetic elements colocalized with carbapenemase genes on chromosomes and on plasmids. Improved characterization helps detail the co-occurrence of other antibiotic resistance genes in CRE isolates and helps identify pan-drug resistance mechanisms. The novel β-lactamase inhibitor, avibactam, combined with ceftazidime or aztreonam, is a promising CRE treatment compared to current colistin or tigecycline regimens. To halt increasing CRE-associated morbidity and mortality, we must continue quality, cooperative monitoring and urgently investigate novel treatments. PMID:27912842

Correlation between carbapenem consumption and resistance to carbapenems among Enterobacteriaceae isolates collected from patients with intra-abdominal infections at five medical centers in Taiwan, 2006-2010.

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Ho, Cheng-Mao; Ho, Mao-Wang; Liu, Yung-Ching; Toh, Han-Siong; Lee, Yu-Lin; Liu, Yuag-Meng; Huang, Chi-Chang; Lu, Po-Liang; Liu, Chun-Eng; Chen, Yen-Hsu; Ko, Wen-Chien; Tang, Hung-Jen; Yu, Kwok-Woon; Chen, Yao-Shen; Chuang, Yin-Ching; Wang, Jen-Hsien; Hsueh, Po-Ren

2012-06-01

We investigated the trend in resistance to carbapenems among isolates of Enterobacteriaceae that had been collected from patients with intra-abdominal infections at five medical centers in Taiwan from 2006 to 2010 and evaluated the correlation between resistance to carbapenems and consumption of said agents as part of the Study for Monitoring Antimicrobial Resistance Trends (SMART). During the study period, the usage of ertapenem and that of total carbapenems (ertapenem, imipenem, and meropenem) increased significantly from 6.13 to 13.38 defined daily doses per 1000 patient-days for ertapenem and from 20.43 to 34.25 defined daily doses per 1000 patient-days for total carbapenems. The most common species were Escherichia coli (n = 1095), Klebsiella spp. (n = 663), and Enterobacter spp. (n = 202). The susceptibility of all isolates to ertapenem and to imipenem varied during the study period. For ertapenem, the rates of nonsusceptibility ranged from 3.5% to 10.3% and those for imipenem ranged from 3.5% to 10.7%. Although the use of carbapenems increased during the study period, there was no marked increase in resistance to carbapenems. Continuous monitoring of resistance trends is necessary so that antimicrobial prescription policies can be adjusted and infection control intervention programs can be implemented. Copyright © 2012 Elsevier B.V. All rights reserved.

Investigating of four main carbapenem-resistance mechanisms in high-level carbapenem resistant Pseudomonas aeruginosa isolated from burn patients

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Soodabeh Rostami

2018-02-01

Conclusion: Emerging antimicrobial resistance in burn wound bacterial pathogens is a serious therapeutic challenge for clinicians. In the present study, most of the isolates were MDR. This finding indicated an alarming spread of resistant isolates and suggested that infection control strategies should be considered. Resistance to carbapenems is influenced by several factors, not all of which were evaluated in our study; however, the results showed that production of MBLs and overexpression of the mexB gene were the most frequent mechanisms in carbapenem-resistant isolates.

Factors associated with acquisition of carbapenem-resistant Enterobacteriaceae

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Lilian Silva Lavagnoli

2017-10-01

Full Text Available ABSTRACT Objective: to identify possible risk factors for acquisition of Enterobacterial strains with a marker for resistance to carbapenems. Methods: exploratory case-control study performed in hospital settings. The study sample consisted of patients with biological specimens that tested positive for carbapenem-resistant Enterobacteriaceae (cases, with the disk diffusion test and Etest, and controls with biological samples testing negative for carbapenem-resistant Enterobacteriaceae. In all, 65 patients were included: 13 (20% cases and 52 (80% controls. Results: the microorganisms isolated were Serratia marcescens (6, Klebsiella pneumoniae (4, and Enterobacter cloacae (3. Univariate analysis revealed that length of hospitalization prior to sample collection (p=0.002 and having a surgical procedure (p=0.006 were statistically significant. In the multivariable logistic regression model, both were still significant, with odds ratios of 0.93 (p = 0.009; 95% CI: 0.89 to 0.98 for length of hospitalization prior to sample collection, and 9.28 (p = 0.05; 95% CI: 1.01 to 85.14 for having a surgical procedure. Conclusion: shorter hospitalization times and increased surveillance of patients undergoing surgery could play a decisive role in reducing the spread of carbapenem-resistant microorganisms in hospital settings.

Bulgecin A as a β-lactam enhancer for carbapenem-resistant Pseudomonas aeruginosa and carbapenem-resistant Acinetobacter baumannii clinical isolates containing various resistance mechanisms.

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Skalweit, Marion J; Li, Mei

2016-01-01

Genetic screening of Pseudomonas aeruginosa (PSDA) and Acinetobacter baumannii (ACB) reveals genes that confer increased susceptibility to β-lactams when disrupted, suggesting novel drug targets. One such target is lytic transglycosylase. Bulgecin A (BlgA) is a natural product of Pseudomonas mesoacidophila and a lytic transglycosolase inhibitor that works synergistically with β-lactams targeting PBP3 for Enterobacteriaceae. BlgA also weakly inhibits di-Zn 2+ metallo-β-lactamases like L1 of Stenotrophomonas maltophilia . We hypothesized that because of its unique mechanism of action, BlgA could restore susceptibility to carbapenems in carbapenem-resistant PSDA (CR-PSDA) and carbapenem-resistant ACB, as well as ACB resistant to sulbactam. A BlgA-containing extract was prepared using a previously published protocol. CR-PSDA clinical isolates demonstrating a variety of carbapenem resistance mechanisms (VIM-2 carbapenemases, efflux mechanisms, and AmpC producer expression) were characterized with agar dilution minimum inhibitory concentration (MIC) testing and polymerase chain reaction. Growth curves using these strains were prepared using meropenem, BlgA extract, and meropenem plus BlgA extract. A concentrated Blg A extract combined with low concentrations of meropenem, was able to inhibit the growth of clinical strains of CR-PSDA for strains that had meropenem MICs ≥8 mg/L by agar dilution, and a clinical strain of an OXA-24 producing ACB that had a meropenem MIC >32 mg/L and intermediate ampicillin/sulbactam susceptibility. Similar experiments were conducted on a TEM-1 producing ACB strain resistant to sulbactam. BlgA with ampicillin/sulbactam inhibited the growth of this organism. As in Enterobacteriaceae, BlgA appears to restore the efficacy of meropenem in suppressing the growth of CR-PSDA and carbapenem-resistant ACB strains with a variety of common carbapenem resistance mechanisms. BlgA extract also inhibits VIM-2 β-lactamase in vitro. BlgA may prove to be

Recent advances in the chemistry and biology of carbapenem antibiotics.

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Coulton, S; Hunt, E

1996-01-01

The discovery of the olivanic acids and thienamycin aroused considerable interest amongst medicinal chemists and microbiologists around the world. The susceptibility of these agents to metabolic degradation has, however, been a major obstacle in their development. For many years the only notable success from such intensive research was the combination of imipenem with cilastatin, an inhibitor of the renal dipeptidase enzyme DHP-1. The enormous success of Primaxin for the treatment of a range of life-threatening bacterial infections provided the impetus for the discovery of totally synthetic, non-natural carbapenem derivatives that combine the broad spectrum of antimicrobial activity with stability to enzymatic degradation. This has indeed been realised in the development of meropenem; it possesses the broad spectrum of activity and resistance to beta-lactamases that are embodied in imipenem as well as displaying increased stability to human dehydropeptidases. Most recent research has focused upon the development of carbapenem antibiotics which combine broad spectrum antimicrobial activity and metabolic stability with oral absorption, for the treatment of community-acquired infections. Indeed, the pro-drug esters of the tricyclic carbapenems represent the first significant advance in this respect. However, the increased use of carbapenem antibiotics would undoubtedly accelerate the emergence of carbapenem-hydrolysing enzymes. The ultimate challenge could therefore be the design and synthesis of carbapenem derivatives that are resistant to these metallo-beta-lactamases. Due to the enormous problems encountered in the development of the carbapenem antibiotics, this area of research has, in the past, been described as a battlefield that did not bode well for the future [181]. Primaxin and meropenem proved however that these problems were not insurmountable, and are therefore a testimony to the persistence and dedication of those scientists in their war against

The rapid spread of carbapenem-resistant Enterobacteriaceae.

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Potter, Robert F; D'Souza, Alaric W; Dantas, Gautam

2016-11-01

Carbapenems, our one-time silver bullet for multidrug resistant bacterial infections, are now threatened by widespread dissemination of carbapenem-resistant Enterobacteriaceae (CRE). Successful expansion of Enterobacteriaceae clonal groups and frequent horizontal gene transfer of carbapenemase expressing plasmids are causing increasing carbapenem resistance. Recent advances in genetic and phenotypic detection facilitate global surveillance of CRE diversity and prevalence. In particular, whole genome sequencing enabled efficient tracking, annotation, and study of genetic elements colocalized with carbapenemase genes on chromosomes and on plasmids. Improved characterization helps detail the co-occurrence of other antibiotic resistance genes in CRE isolates and helps identify pan-drug resistance mechanisms. The novel β-lactamase inhibitor, avibactam, combined with ceftazidime or aztreonam, is a promising CRE treatment compared to current colistin or tigecycline regimens. To halt increasing CRE-associated morbidity and mortality, we must continue quality, cooperative monitoring and urgently investigate novel treatments. Copyright © 2016 Elsevier Ltd. All rights reserved.

Outbreak of carbapenem-resistant Providencia rettgeri in a tertiary hospital

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V S Tshisevhe

2017-01-01

Full Text Available The emergence of resistance to multiple antimicrobial agents in pathogenic bacteria is a significant public health threat, as there are limited effective antimicrobial agents for infections caused by multidrug-resistant (MDR bacteria. Several MDR bacteria are now frequently detected. Carbapenem resistance in Enterobacteriaceae is often plasmid mediated, necessitating stringent infection control practices. We describe an outbreak of carbapenem-resistant Providencia rettgeri involving 4 patients admitted to intensive care and high-care units at a tertiary hospital. Clinical and demographic characteristics of 4 patients with carbapenem-resistant P. rettgeri were documented. All P. rettgeri isolated in these cases had a carbapenem-resistant antibiogram, with resistance to imipenem, ertapenem and meropenem. These cases could be epidemiologically linked. A multiprong approach, simultaneously targeting antibiotic stewardship, universal precautions and appropriate transmission-based precaution practices, is integral to prevention and control of nosocomial infections.

Wastewater as a Source of Carbapenem-Resistant E. coli (Webinar)

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Clinical studies have reported that the occurrence of carbapenem-resistant E. coli is on the rise. This is of concern because carbapenem antibiotics are typically reserved for treating infections caused by bacteria resistant to other classes of antibiotics. Current literature st...

Plasmid borne Carbapenem-Hydrolyzing Class D β-Lactamases (CHDLs) and AdeABC efflux pump conferring carbapenem-tigecycline resistance among Acinetobacter baumannii isolates harboring TnAbaRs.

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Savari, Mohammad; Ekrami, Alireza; Shoja, Saeed; Bahador, Abbas

2017-03-01

Here we studied the prevalence and mechanisms of simultaneous resistance to carbapenem and tigecycline and accumulation of resistance determinants reservoirs in genome of Acinetobacter baumannii (A. baumannii) clinical isolates. Susceptibility of the isolates were measured to 18 antimicrobial agents. Genetic diversity of the microbial population was determined using the International Clonal lineage typing (IC typing), multiple locus VNTR analysis (MLVA) and plasmid profiling methods. To detect the AbaRs, Carbapenem-Hydrolyzing Class D β-Lactamases (CHDLs) genes, AdeABC efflux pump genes and resistance determinants, PCR was used. Filter mating experiments were used to prove that if carbapenem resistance genes are located on conjugative plasmids or not. Among the A. baumannii clinical isolates, 40.8% were carbapenem-tigecycline resistant and in this population, 46.9% were belonging to IC I, IC II or IC III and 53.1% were IC variants. These isolates had fallen in 40 MLVA types and were harboring plasmids in multiple numbers and sizes. In this study, bla OXA-23-like was the most prevalent CHDL and conjugation analysis proved that the carbapenem resistance genes are located on conjugative plasmids. All efflux pump genes, except for adeC, were detected in all carbapenem-tigecycline resistant A. baumannii (CTRAb) isolates. Resistance determinants were distributed in both TnAbaRs and R plasmids with a shift toward the R plasmids. Emerging of carbapenem resistant A. baumannii (CRAB) with simultaneous resistance to the last line therapy including tigecycline represent emerging of extensively drug resistance (XDR) and pandrug resistance (PDR) phenotypes that would be a great threat to our public health system. Copyright © 2017 Elsevier Ltd. All rights reserved.

Transrectal ultrasound-guided biopsy sepsis and the rise in carbapenem antibiotic use.

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Leahy, Olivia R; O'Reilly, Mary; Dyer, David R; Phillips, David; Grummet, Jeremy P

2015-12-01

This study sought to determine the number of hospital admissions for sepsis following transrectal ultrasound-guided (TRUS) biopsy, and the rate of both prophylactic and therapeutic use of carbapenem antibiotics for TRUS biopsy, at a single institution. A retrospective review of prospectively collected data from the medical records electronic database of Cabrini Health, a private metropolitan hospital, was queried for coding of admissions under any admitting urologist for sepsis and prostate-related infections from 2009 to 2012. Records were examined for whether a TRUS biopsy had been performed within 14 days prior and if a therapeutic carbapenem was required. The database also queried the use of carbapenems as prophylaxis in patients undergoing TRUS biopsy. Of the 63 admissions for TRUS biopsy sepsis, multi-drug-resistant organisms were isolated from 26 (41%). Twenty-three admissions were from the 1937 patients who underwent a TRUS biopsy at Cabrini (a sepsis rate of 1.2%) and 40 were following TRUS biopsies at other centres. Thirty-seven (58.7%) patients received therapeutic carbapenems either empirically, or after culture results. Of the 1937 Cabrini TRUS biopsy patients, 154 (8%) were given a carbapenem as prophylaxis, with a rapid increase in prophylactic use over the 4 years studied from 0.25% to 13%. This study did not show evidence of an increasing rate of hospital admissions for TRUS biopsy sepsis at this institution. However, there was a dramatic uptake in prophylactic administration of carbapenems. Increasing carbapenem use may contribute to development of carbapenem-resistant bacteria. Alternative methods of prostate biopsy that avoid sepsis should be considered. © 2014 Royal Australasian College of Surgeons.

Efecto de sedimentos naturales enriquecidos con zinc, en modelos aislados y en microcosmos, sobre tres especies de invertebrados bentónicos

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Marcela Galar Martínez

2006-06-01

Full Text Available En los cuerpos acuáticos la disponibilidad de los tóxicos es limitada por las características fisicoquímicas de los sedimentos y agua, así como por las interacciones entre los diversos xenobióticos y entre las especies que los habitan. Por lo anterior, el objetivo del presente trabajo fue relacionar el efecto producido por el zinc (Zn sembrado en sedimentos del embalse Ignacio Ramírez (PIR, en modelos aislados y en microcosmos, sobre el ATP de tres organismos bentónicos con la biodisponibilidad del metal. Las especies seleccionadas fueron: Hyalella azteca, Limnodrilus hoffmeisteri y Stagnicola attenuata, dado que se encuentran en altas proporciones en el embalse y ocupan espacios diferentes en el bentos. Las muestras de sedimentos y organismos se colectaron en la estación de sequía (febrero de 1999. A los primeros se les determinó el pH, textura, tamaño de partícula, nitrógeno total, materia orgánica y concentración de metales (Zn, Fe, Cu y Ni. Posteriormente se realizó un estudio de toxicidad subletal utilizando dos tipos de sistemas estáticos (organismos aislados y en microcosmos. Ambos modelos contenían sedimentos de la PIR enriquecidos con Zn (concentración nominal de 0.8129 mg/kg y agua sintética en una proporción de 1:4. Los organismos de prueba fueron adicionados una vez alcanzado el equilibrio (2 hr considerando la cantidad de biomasa con respecto al volumen (1.0 g de organismo por cada 100 ml de agua:sedimento. Después de 0, 12, 24, 36, 48 y 72 hr de exposición se tomaron muestras del sedimento y de los hidrobiontes, a los cuales se les cuantificó el contenido de Zn por absorción atómica. A los organismos también se les determinó la concentración de ATP. Los resultados obtenidos muestran que el efecto producido por los sedimentos naturales enriquecidos se ve potenciado por la presencia de más de una especie en el sistema (microcosmos. Con respecto a los niveles de Zn, dos de los organismos (L. hoffmeisteri

Evaluación de la actividad desulfurizadora de aislados nativos de Pseudomonas spp. en presencia de hidrocarburo Desulfurization activity evaluation of native strains of Pseudomonas spp. in the presence of hydrocarbon

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Alméciga-Díaz Carlos Javier

2005-07-01

Full Text Available El principal inconveniente en la combustión de los hidrocarburos es la conversión del azufre y el nitrógeno a sus respectivos óxidos, los cuales participan en la formación de lluvia acida y deterioran el medio ambiente e infraestructuras. La remoción de azufre a partir de compuestos órgano-azufrados mediante el uso de microorganismos ha surgido como una alternativa frente al proceso catalítico de hidrodesulfurización (HDS. En el presente trabajo se evaluó la actividad desulfurizadora de veintitrés aislados nativos de Pseudomonas spp. sobre dibenzotiofeno (DBT, usando un sistema de fermentación con igual proporción de fase acuosa y orgánica (n-hexano en presencia de oleato de etanolamina. Los aislados 02,05 y 06 conservaron su viabilidad en este medio y presentaron una remoción de azufre entre 6,0 y 9,4%, generando los metabolitos DBT-sulfona, DBT-sulfóxido, 2-hidroxibifenilo (2-HBP y sulfato presentes en la ruta metabólica 4S. Con estos aislados se evaluó la actividad desulfurizadora sobre keroseno y se observó una remoción de azufre entre 19,9 y 62,6% y una disminución del poder calorífico entre 0,45 y 5,55%. Palabras clave: dibenzotiofeno, desulfurización, Pseudomonas spp., keroseno.The main difficulty with fossil fuel combustión lies in sulphur and nitrogen becoming converted to their respective oxides, forming part of the acid rain which deteriorates the environment and infrastructure. Removing sulphur from organo-sulfur compounds by using micro-organisms has become an alternative to hydrodesulphurisation (HDS. Twenty-three Pseudomonas spp. native strains' desulphurisation activity on dibenzothiophene (DBT was evaluated by using a fermentation system having equal proportions of aqueous and organic (n-hexane phases in the presence of ethanolamine oléate. The 02, 05 and 06 strains maintained their viability in this médium, presenting 6,0% to 9,4% sulphur removal, producing DBT-sulphone, DBT-sulphoxide, 2

Cefmetazole for bacteremia caused by ESBL-producing enterobacteriaceae comparing with carbapenems.

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Fukuchi, Takahiko; Iwata, Kentaro; Kobayashi, Saori; Nakamura, Tatsuya; Ohji, Goh

2016-08-18

ESBL (Extended spectrum beta-lactamase) producing enterobacteriaceae are challenging organisms with little treatment options. Carbapenems are frequently used, but the emergence of carbapenem resistant enterobacteriaceae is a concerning issue, which may hinder the use of carbapenems. Although cephamycins such as cefoxitin, cefmetazole or cefotetan are effective against ESBL-producers in vitro, there are few clinical data demonstrating effects against bacteremia caused by these organisms. We performed a retrospective observational study on cases of bacteremia caused by ESBL-producers to investigate the efficacy of cefmetazole compared with carbapenems. We also evaluated whether the trend of antibiotic choice changed over years. Sixty-nine patients (male 34, age 69.2 ± 14.4), including two relapse cases, were reviewed for this analysis. The most common causative organisms were Escherichia coli (64, 93 %), followed by Klebsiella pneumoniae and K. oxytoca (2 each, 4 %). The group that received carbapenem therapy (43, 62 %) had increased severity in the Pittsburgh Bacteremic score than the group that received cefmetazole therapy, (1.5 ± 1.5 vs 2.5 ± 2.1, p = 0.048), while analysis of other factors didn't reveal any statistical differences. Five patients in the carbapenem group and one patient in the cefmetazole group died during the observation period (p = 0.24). CTX-M-9 were predominant in this series (59 %). Infectious disease physicians initially recommended carbapenems at the beginning of the current research period, which gradually changed over time favoring the use of cefmetazole instead (p = 0.002). Cefmetazole may be safely given to patients with bacteremia caused by ESBL-producers as a definitive therapy, if one can select out relatively stable patients.

[Carbapenem antibiotics in hospitalised paediatric patients. Adherence to a therapeutic protocol].

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Montesinos-Sanchis, Elena; Moraga-Llop, Fernando A; Soler-Palacín, Pere; Oliveras-Arenas, María; Larrosa Escartín, M Nieves; Martínez Gómez, Xavier; Figueras-Nadal, Concepción

2014-12-01

To describe the use of carbapenems in children hospitalised outside intensive care and onco-haematology units, and assess adherence to a therapeutic protocol. A retrospective observational study was conducted on the use of carbapenems between January 2009 and December 2010. The study included children with a community-acquired infectious disease or a health care-associated infectious disease, and who were admitted to paediatric areas of the Vall d'Hebron University Hospital (Barcelona, Spain), other than intensive care, neonatology and onco-haematology units. Clinical data were collected and antibiotic consumption data were provided by the Pharmacy Department. A total of 51 episodes fulfilled the inclusion criteria. Carbapenem as initial empirical treatment was indicated in 31.4%, and applied as rescue therapy in the remainder. The instructions of the protocol were adhered to in 70.6% of the empirical and 87.5% of the targeted prescriptions (77.6% overall). A better match was found for empirical carbapenem in patients with a previous admission or underlying condition. Factors such as diagnosis, age or antibiotic use prior to admission did not affect the empirical indication of carbapenem. The establishment of a treatment protocol with carbapenem indications in our centre since 2007 has yielded significantly better results on the appropriateness of the prescription than those obtained in other studies. Copyright © 2012 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Phenotypic characterization and colistin susceptibilities of carbapenem-resistant of Pseudomonas aeruginosa and Acinetobacter spp.

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Mohanty, Srujana; Maurya, Vijeta; Gaind, Rajni; Deb, Monorama

2013-11-15

Pseudomonas aeruginosa and Acinetobcter spp. are important nosocomial pathogens and carbapenem resistance is an emerging threat. Therapeutic options for infections with these isolates include colistin. This study was conducted to determine the prevalence of carbapenem resistance in P. aeruginosa and Acinetobacter spp. bloodstream isolates, phenotypically characterize the resistance mechanisms and evaluate the in vitro activity of colistin. Consecutive 145 (95 P.aeruginosa and 50 Acinetobacter spp.) non-repeat isolates were included. Antibiotic susceptibility testing was performed per CLSI guidelines. MIC for carbapenems and colistin was performed using Etest. Isolates showing reduced susceptibility or resistance to the carbapenems were tested for metallo-β-lactamase (MBL) production using imipenem-EDTA combined disk and MBL Etest. Carbapenem resistance was observed in 40% P. aeruginosa and 66.0% Acinetobacter spp. Carbapenem-resistant (CA-R) isolates were significantly (p carbapenem-susceptible isolates. Approximately half of the CA-R strains were multidrug-resistant, and 3.1-5.5% were resistant to all antibiotics tested. MBL was found in 76.3% and 69.7% of the P. aeruginosa and Acinetobacter spp., respectively. Colistin resistance was observed in three (6.0%) Acinetobacter isolates and eight (8.4%) P. aeruginosa. MIC50 for carbapenems were two to four times higher for MBL-positive compared to MBL-negative isolates, but no difference was seen in MIC for colistin. Carbapenem resistance was observed to be mediated by MBL in a considerable number of isolates. Colistin is an alternative for infections caused by CA-R isolates; however, MIC testing should be performed whenever clinical use of colistin is considered.

In vitro activity of SecA inhibitors in combination with carbapenems against carbapenem-hydrolysing class D β-lactamase-producing Acinetobacter baumannii.

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Chiu, Chun-Hsiang; Liu, Yu-Han; Wang, Yung-Chih; Lee, Yi-Tzu; Kuo, Shu-Chen; Chen, Te-Li; Lin, Jung-Chung; Wang, Fu-Der

2016-12-01

According to our previous study, OXA-58 translocates to the periplasm via the Sec pathway in carbapenem-resistant Acinetobacter baumannii (CRAb). In the present study, carbapenem-hydrolysing class D β-lactamases (CHDLs) belonging to the OXA-23, OXA-40 and OXA-51 families were examined to determine whether they are also Sec-dependent. Additionally, the effects of SecA inhibitors combined with carbapenems against CHDL-producing CRAb were examined. Cell fractionation and western blot analyses were performed to detect periplasmic His-tagged CHDLs. A chequerboard analysis with pairwise combinations of carbapenems (imipenem or meropenem) and SecA inhibitors (rose bengal, sodium azide or erythrosin B) was performed using six clinical CRAb isolates harbouring different CHDL genes. The fractional inhibitory concentration (FIC) index was determined. The combination with the lowest FIC index was subjected to a time-kill analysis to examine synergistic effects. In an in silico analysis, the CHDLs OXA-23, OXA-40 and OXA-51 were preferentially translocated via the Sec system. The SecA inhibitor rose bengal decreased periplasmic translocation of His-tagged OXA-23 and OXA-83 (belonging to the OXA-51 family), but not OXA-72 (belonging to the OXA-40 family) from ATCC 15151 transformants. Imipenem or meropenem with rose bengal showed synergistic effects (FIC index, ≤0.5) for six and four clinical isolates, respectively. Imipenem or meropenem with sodium azide showed no interactions (FIC index, 0.5-4) against all clinical isolates. Imipenem and rose bengal had the lowest FIC index and showed synergy at 24 h in the time-kill assay. Combinations of SecA inhibitors and carbapenems have synergistic effects against CHDL-producing CRAb. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Caracterización molecular de la región determinante de resistencia a quinolonas (QRDR de la topoisomerasa IV de Bartonella bacilliformis en aislados clínicos

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Abraham Espinoza-Culupú

2014-05-01

Full Text Available Bartonella bacilliformis es el agente etiológico de la Enfermedad de Carrión, endémica del Perú. Pocas investigaciones han sido realizadas acerca de los genes asociados a la resistencia antimicrobiana en aislados clínicos de este patógeno. Estos genes no están caracterizados molecularmente, ni se conoce la región asociada a dicha resistencia. Por ello, el objetivo del este trabajo fue caracterizar molecularmente la región determinante de la resistencia a las quinolonas (QRDR en la topoisomerasa IV, que está codificada por los genes parC y parE, así como también desarrollar una prueba de susceptibilidad antimicrobiana para B. bacilliformis. Las muestras sanguíneas de 65 pacientes procedentes de La Libertad, Cusco, Ancash y Piura, se sembraron en placas de agar sangre e incubaron a 30 °C con 5% CO2. Luego se procedió a: (1 determinar la susceptibilidad antimicrobiana y (2 extraer el DNA genómico, amplificar los genes mencionados, secuenciarlos y analizarlos mediante herramientas bioinformáticas. Se obtuvieron 6 cultivos positivos. Los aislados fueron sensibles a la ciprofloxacina (excepto uno procedente de Quillabamba-Cusco, que presentó susceptibilidad disminuida y resistentes al ácido nalidíxico. Del análisis de las secuencias aminoacídicas de ParC y ParE de B. bacilliformis se concluye que presentan diferencias aminoacídicas en comparación con las secuencias de las proteínas respectivas de E. coli K12 MG1655, que probablemente confieran resistencia al ácido nalidíxico pero no a la ciprofloxacina. Se determinó que las QRDR de las proteínas ParC y ParE de B. bacilliformis están comprendidas entre los aminoácidos 67 al 118 y 473 al 530, respectivamente. El antibiograma y la concentración mínima inhibitoria se evalúan mejor usando inóculos a escala 1 de McFarland y a los 6 días de incubación.

Carbapenem Breakpoints for Acinetobacter baumannii Group: Supporting Clinical Outcome Data from Patients with Bacteremia.

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Lee, Yi-Tzu; Chiang, Mei-Chun; Kuo, Shu-Chen; Wang, Yung-Chih; Lee, I-Hsin; Chen, Te-Li; Yang, Ya-Sung

2016-01-01

The carbapenem breakpoints set by different organizations for Acinetobacter are discordant, but supporting clinical data are lacking. This study aimed to provide the first clinical outcome data to support the carbapenem breakpoints for Acinetobacter baumannii (Ab) group in patients with bacteremia. This study included 117 adults who received carbapenems for treatment of Ab group bacteremia in Taipei Veterans General Hospital over an 8-year period. We analyzed 30-day mortality rates among patient groups acquiring isolates with different carbapenem minimal inhibitory concentrations (MICs). The carbapenem MIC breakpoint derived from classification and regression tree (CART) analysis to delineate the risk of 30-day mortality was between MICs of ≤ 4 mg/L and ≥ 8 mg/L. Mortality rate was higher in patients acquiring isolates with carbapenem MIC ≥ 8 mg/L than ≤ 4 mg/L, by bivariate (54.9% [28/51] vs 25.8% [17/66]; P = 0.003) and survival analysis (P = 0.001 by log-rank test). Multivariate analysis using logistic regression and Cox regression models including severity of illness indices demonstrated that treating patients with Ab group bacteremia caused by isolates with a carbapenem MIC ≥ 8 mg/L with carbapenem was an independent predictor of 30-day mortality (odds ratio, 5.125; 95% confidence interval [CI], 1.946-13.498; P = 0.001, and hazard ratio, 2.630; 95% CI, 1.431-4.834; P = 0.002, respectively). The clinical outcome data confirmed that isolates with MIC ≤ 4 mg/L were susceptible to carbapenem, and those with MIC ≥ 8 mg/L were resistant in patients with Ab group bacteremia.

Carbapenem-resistant Klebsiella pneumoniae colonization in pediatric and neonatal intensive care units: risk factors for progression to infection.

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Akturk, Hacer; Sutcu, Murat; Somer, Ayper; Aydın, Derya; Cihan, Rukiye; Ozdemir, Aslı; Coban, Asuman; Ince, Zeynep; Citak, Agop; Salman, Nuran

2016-01-01

Little is known about factors associated with carbapenem-resistant Klebsiella pneumoniae infections in pediatric patients, who are initally colonized with carbapenem-resistant Klebsiella pneumoniae. A retrospective case-control study was conducted involving pediatric and neonatal intensive care units throughout a five-year period (January 2010-December 2014). Clinical and microbiological data were extracted from Hospital Infection Control Committee reports and patients' medical records. Risk factors were assessed in carbapenem-resistant Klebsiella pneumoniae colonized patients who developed subsequent systemic infection (cases) and compared to carbapenem-resistant Klebsiella pneumoniae colonized patients who did not develop infection (controls). Throughout the study period, 2.6% of patients admitted to neonatal intensive care units and 3.6% of patients admitted to pediatric intensive care units had become colonized with carbapenem-resistant Klebsiella pneumoniae. After a mean of 10.6±1.9 days (median: 7 days, range: 2-38 days) following detection of colonization, 39.0% of the carbapenem-resistant Klebsiella pneumoniae colonized patients in pediatric intensive care units and 18.1% of carbapenem-resistant Klebsiella pneumoniae colonized patients in neonatal intensive care units developed systemic carbapenem-resistant Klebsiella pneumoniae infection. Types of systemic carbapenem-resistant Klebsiella pneumoniae infections included bacteremia (n=15, 62.5%), ventilator-associated pneumonia (n=4, 16.6%), ventriculitis (n=2, 8.3%), intraabdominal infections (n=2, 8.3%), and urinary tract infection (n=1, 4.1%). A logistic regression model including parameters found significant in univariate analysis of carbapenem resistant Klebsiella pneumoniae colonization and carbapenem resistant Klebsiella pneumoniae infection groups revealed underlying metabolic disease (OR: 10.1; 95% CI: 2.7-37.2), previous carbapenem use (OR: 10.1; 95% CI: 2.2-40.1), neutropenia (OR: 13.8; 95% CI: 3

ST37 Klebsiella pneumoniae: development of carbapenem resistance in vivo during antimicrobial therapy in neonates.

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Li, Pengling; Wang, Min; Li, Xianping; Hu, Feihu; Yang, Min; Xie, Yixin; Cao, Wei; Xia, Xiaomeng; Zheng, Rong; Tian, Jingjing; Zhang, Kan; Chen, Fang; Tang, Aiguo

2017-08-01

To investigate the mechanism leading to in vivo carbapenem resistance development in Klebsiella pneumoniae. Carbapenemase was detected using the modified carbapenem inactivation method. β-lactamases resistant genes were identified by PCR and sequencing. Clonal relatedness was evaluated by random amplified polymorphic DNA and multiple locus sequence typing. The relationship between sequence typing and resistant genes was analyzed by using the chi-squared test. All ST37 carbapenem-resistant isolates were bla OXA-1 positive and all ST37 carbapenem-sensitive isolates were bla OXA-1 negative at Stage I. A significant relationship between carbapenem resistance and bla OXA-1 was observed. The bla OXA-1 -positive rate was significantly higher in ST37 K. pneumoniae than others. This is the first study about the development of carbapenem resistance in vivo potentially mediated by bla OXA-1 in ST37 K. pneumoniae among neonates.

Characterization of carbapenem-resistant Gram-negative bacteria from Tamil Nadu.

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Nachimuthu, Ramesh; Subramani, Ramkumar; Maray, Suresh; Gothandam, K M; Sivamangala, Karthikeyan; Manohar, Prasanth; Bozdogan, Bülent

2016-10-01

Carbapenem resistance is disseminating worldwide among Gram-negative bacteria. The aim of this study was to identify carbapenem-resistance level and to determine the mechanism of carbapenem resistance among clinical isolates from two centres in Tamil Nadu. In the present study, a total of 93 Gram-negative isolates, which is found to be resistant to carbapenem by disk diffusion test in two centres, were included. All isolates are identified at species level by 16S rRNA sequencing. Minimal inhibitory concentrations (MICs) of isolates for Meropenem were tested by agar dilution method. Presence of blaOXA, blaNDM, blaVIM, blaIMP and blaKPC genes was tested by PCR in all isolates. Amplicons were sequenced for confirmation of the genes. Among 93 isolates, 48 (%52) were Escherichia coli, 10 (%11) Klebsiella pneumoniae, nine (%10) Pseudomonas aeruginosa. Minimal inhibitory concentration results showed that of 93 suspected carbapenem-resistant isolates, 27 had meropenem MICs ≥ 2 μg/ml. The MIC range, MIC50 and MIC90 were 128 μg/ml, 0.12 and 16 μg/ml, respectively. Fig. 1 . Among meropenem-resistant isolates, E. coli were the most common (9/48, 22%), followed by K. pneumoniae (7/9, 77%), P. aeruginosa (6/10, 60%), Acinetobacter baumannii (2/2, 100%), Enterobacter hormaechei (2/3, 67%) and one Providencia rettgeri (1/1, 100%). PCR results showed that 16 of 93 carried blaNDM, three oxa181, and one imp4. Among blaNDM carriers, nine were E. coli, four Klebsiella pneumoniae, two E. hormaechei and one P. rettgeri. Three K. pneumoniae were OXA-181 carriers. The only imp4 carrier was P. aeruginosa. A total of seven carbapenem-resistant isolates were negatives by PCR for the genes studied. All carbapenem-resistance gene-positive isolates had meropenem MICs >2 μg/ml. Our results confirm the dissemination of NDM and emergence of OXA-181 beta-lactamase among Gram-negative bacteria in South India. This study showed the emergence of NDM producer in clinical isolates of E

Effects of Carbapenem consumption on the prevalence of Acinetobacter infection in intensive care unit patients.

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Ogutlu, Aziz; Guclu, Ertugrul; Karabay, Oguz; Utku, Aylin Calica; Tuna, Nazan; Yahyaoglu, Mehmet

2014-01-09

The consumption of carbapenems has increased worldwide, together with the increase in resistant gram negative bacilli. Subsequently, the prevalence of carbapenem-resistant Acinetobacter infections has increased rapidly and become a significant problem particularly in intensive care unit patients. The aim of the present study was to evaluate the changes in the prevalence of Acinetobacter infection by restricting the consumption of carbapenems in intensive care unit patients. This study was conducted between May 1, 2011 and February 28, 2013. The amount of carbapenem consumption and the number of patients with multi-drug resistant Acinetobacter baumannii (MDRAB) isolates during the study period were retrospectively obtained from the records of the patients, who were hospitalized in the intensive care unit. The study period was divided into two periods named as: Carbapenem non-restricted period (CNRP) and carbapenem-restricted period (CRP). During CNRP, no restrictions were made on the use of carbapenems. During CRP, the use of carbapenems was not allowed if there was an alternative to carbapenems. Primary Endpoint: MDRAB infection after ICU admission. The definition of nosocomial infections related to Acinetobacter spp. was based on the criteria of the Center for Disease Control (CDC). The correlation between the amount of carbapenem consumption and the number of infections with MDRAB strains between the two periods were evaluated. During the study period, a total of 1822 patients' (1053 patients in CNRP and 769 patients in CRP) records were evaluated retrospectively. A total of 10.82 defined daily dose (DDD/100 ICU days) of anti-pseudomonal carbapenem were used in CNRP, and this figure decreased to 6.95 DDD/100 ICU days in CRP. In the 8-month CNRP, 42 (3.98%) MDRAB-related nosocomial infections were detected, and 14 (1.82%) infections were detected in CRP (p = 0.012). The prevalence of MDRAB strains isolated in the CNRP was 2.24-fold higher than the prevalence in

Molecular mechanisms associated with nosocomial carbapenem-resistant Acinetobacter baumannii in Mexico.

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Alcántar-Curiel, María Dolores; García-Torres, Luis Francisco; González-Chávez, María Inés; Morfín-Otero, Rayo; Gayosso-Vázquez, Catalina; Jarillo-Quijada, Ma Dolores; Fernández-Vázquez, José Luis; Giono-Cerezo, Silvia; Rodríguez-Noriega, Eduardo; Santos-Preciado, José Ignacio

2014-10-01

Acinetobacter baumannii is an emerging pathogen worldwide that is most commonly associated with nosocomial infections and multi-drug resistance. In the present study we determined the mechanisms of carbapenem resistance and clonal diversity of A. baumannii nosocomial isolates in Hospital Civil de Guadalajara, Mexico. A total of 303 clinical isolates of A. baumannii identified during a period expanding from 2004-2011 were analyzed for carbapenem resistance using several microbiological and molecular methods. Clonal relatedness of these isolates was determined using pulsed-field gel electrophoresis. Of the 303 isolates, 84% were resistant to meropenem, 71.3% to imipenem and 78.3% the resistant isolates were positive for metallo-β-lactamases as determined by the phenotypic assay. In addition, 49.6% of carbapenem-intermediate or -resistant isolates carried the blaOXA-72 gene and 1.2% carried the blaVIM-1 gene. Efflux pump phenotype was responsible for reduced susceptibility to meropenem in 14.5% and to imipenem in 31.6% of the resistant isolates, respectively in the presence of the efflux pump inhibitor, carbonyl cyanide 3-chlorophenylhydrazone. Strains representing different carbapenem-resistant patterns exhibited reduced expression of 22, 29, 33, and 43 kDa OMPs. Among the bacterial collection studied, 48 different clones were identified, two of which were predominant and persistently transmitted. Carbapenemase production in combination with efflux pump expression, reduction in OMPs expression and the cross-transmission of clones appear to be major contributors to the high frequency of carbapenem-resistance observed in A. baumannii. To our knowledge, this is the first study to define the molecular mechanisms associated with carbapenem-resistance in A. baumannii in Mexico. Copyright © 2014 IMSS. Published by Elsevier Inc. All rights reserved.

A retrospective study of risk factors for carbapenem-resistant Klebsiella pneumoniae acquisition among ICU patients.

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Hu, Yangmin; Ping, Yanting; Li, Leiqing; Xu, Huimin; Yan, Xiaofeng; Dai, Haibin

2016-03-31

Carbapenem-resistant Klebsiella pneumoniae (CRKP) is rapidly emerging as a life-threatening nosocomial infection. In this study, we aim to identify risk factors, especially antibiotic use, for CRKP infection among intensive care unit (ICU) patients. This was a matched case-control study of a 67-bed ICU in a tertiary care teaching hospital from 1 January 2011 through 30 June 2013. The control cases were selected among the patients with carbapenem-susceptible Klebsiella pneumoniae (CSKP) and were matched with CRKP cases for year of ICU admission and site of infection. The clinical outcomes and antibiotic treatments were analyzed. One hundred and thirty patients were included in the study (65 cases and 65 controls). Bivariable analysis showed that age of patients (p = 0.044), number of antibiotic groups (p = 0.001), and exposure to carbapenems (p carbapenems, previous carbapenem exposure (p carbapenems is an independent risk factor for CRKP infection. Patients with this clinical factor should be targeted for interventions to reduce the subsequent risk of infection.

[Risk factors for Pseudomonas aeruginosa infections, resistant to carbapenem].

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Ghibu, Laura; Miftode, Egidia; Teodor, Andra; Bejan, Codrina; Dorobăţ, Carmen Mihaela

2010-01-01

Since their introduction in clinical practice,carbapenems have been among the most powerful antibiotics for treating serious infections cased by Gram-negative nosocomial pathogens, including Pseudomonas aeruginosa. The emergence of betalactamases with carbapenem-hydrolyzing activity is of major clinical concern. Pseudomonas aeruginosa is a leading cause of nosocomial infection. Risk factors for colonization with carbapenems-resistant Pseudomonas in hospital are: history of P. aeruginosa infection or colonization within the previous year, (length of hospital stay, being bedridden or in the ICU, mechanical ventilation, malignant disease, and history of chronic obstructive pulmonary disease have all been identified as independent risk factors for MDR P. aeruginosa infection. Long-term-care facilities are also reservoirs of resistant bacteria. Risk factors for colonization of LTCF residents with resistant bacteria included age > 86 years, antibiotic treatment in the previous 3 months, indwelling devices, chronic obstructive pulmonary disease, physical disability, and the particular LTCF unit.

Acquisition of carbapenem resistance by plasmid-encoded-AmpC-expressing Escherichia coli

NARCIS (Netherlands)

Tommassen - van Boxtel, Ria; Wattel, Agnes A.; Arenas Busto, Jesus; Goessens, Wil H.F.; Tommassen, J

2017-01-01

Although AmpC β-lactamases can barely degrade carbapenems, if at all, they can sequester them and prevent them from reaching their targets. Thus, carbapenem resistance in Escherichia coli and other Enterobacteriaceae can result from AmpC production and simultaneous reduction of antibiotic influx

Clinical review: Balancing the therapeutic, safety, and economic issues underlying effective antipseudomonal carbapenem use

Science.gov (United States)

Slama, Thomas G

2008-01-01

Antipseudomonal carbapenems have played a useful role in our antimicrobial armamentarium for 20 years. However, a review of their use during that period creates concern that their clinical effectiveness is critically dependent on attainment of an appropriate dosing range. Unfortunately, adequate carbapenem dosing is missed for many reasons, including benefit/risk misconceptions, a narrow therapeutic window for imipenem and meropenem (due to an increased rate of seizures at higher doses), increasingly resistant pathogens requiring higher doses than are typically given, and cost containment issues that may limit their use. To improve the use of carbapenems, several initiatives should be considered: increase awareness about appropriate treatment with carbapenems across hospital departments; determine optimal dosing regimens for settings where multidrug resistant organisms are more likely encountered; use of, or combination with, an alternative antimicrobial agent having more favorable pharmacokinetic, pharmacodynamic, or adverse event profile; and administer a newer carbapenem with lower propensity for resistance development (for example, reduced expression of efflux pumps or greater stability against carbapenemases). PMID:18983709

Molecular epidemiology of carbapenem non-susceptible Acinetobacter nosocomialis in a medical center in Taiwan.

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Yang, Ya-Sung; Lee, Yi-Tzu; Wang, Yung-Chih; Chiu, Chun-Hsiang; Kuo, Shu-Chen; Sun, Jun-Ren; Yin, Ti; Chen, Te-Li; Lin, Jung-Chung; Fung, Chang-Phone; Chang, Feng-Yee

2015-04-01

The mechanism by which carbapenem non-susceptible Acinetobacter nosocomialis (CNSAN) is disseminated is rarely described in the literature. In this study, we delineated the molecular epidemiology of CNSAN isolated from patients in a medical center in Taiwan. Fifty-four non-duplicate bloodstream isolates of CNSAN were collected at the Taipei Veterans General Hospital between 2001 and 2007. Pulsed-field gel electrophoresis (PFGE) was performed to determine their clonal relationship. Carbapenem-resistance genes and associated genetic structures were detected by polymerase chain reaction (PCR) mapping. Southern hybridization was performed to determine the plasmid location of carbapenem-resistance genes. Transmissibility of these genes to Acinetobacterbaumannii was demonstrated by conjugation tests. The overall carbapenem non-susceptibility rate among A. nosocomialis isolates during the study period was 21.6% (54/250). PFGE revealed three major pulsotypes: H (n=23), I (n=10), and K (n=8). The most common carbapenem-resistance gene was blaOXA-58 (43/54, 79.6%), containing an upstream insertion sequence IS1006 and a truncated ISAba3 (IS1006-ΔISAba3-like-blaOXA-58). All isolates belonging to the pulsotypes H, I, and K carried plasmid located IS1006-ΔISAba3-like-blaOXA-58. A common plasmid carrying ISAba1-blaOXA-82 was found in six isolates, which belonged to five pulsotypes. A type 1 integron that carried blaIMP-1 was detected in different plasmids of seven isolates, which belonged to five pulsotypes. Plasmids carrying these carbapenem-resistant determinants were transmissible from A. nosocomialis to A. baumannii via conjugation. In this medical center, CNSAN mainly emerged through clonal dissemination; propagation of plasmids and integrons carrying carbapenem-resistant determinants played a minor role. This study showed that plasmids carrying carbapenem-resistant determinants are transmissible from A. nosocomialis to A. baumannii. Copyright © 2015 Elsevier B.V. All

The basis for carbapenem hydrolysis by class A β-lactamases: a combined investigation using crystallography and simulations.

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Fonseca, Fátima; Chudyk, Ewa I; van der Kamp, Marc W; Correia, António; Mulholland, Adrian J; Spencer, James

2012-11-07

Carbapenems are the most potent β-lactam antibiotics and key drugs for treating infections by Gram-negative bacteria. In such organisms, β-lactam resistance arises principally from β-lactamase production. Although carbapenems escape the activity of most β-lactamases, due in the class A enzymes to slow deacylation of the covalent acylenzyme intermediate, carbapenem-hydrolyzing class A β-lactamases are now disseminating in clinically relevant bacteria. The reasons why carbapenems are substrates for these enzymes, but inhibit other class A β-lactamases, remain to be fully established. Here, we present crystal structures of the class A carbapenemase SFC-1 from Serratia fonticola and of complexes of its Ser70 Ala (Michaelis) and Glu166 Ala (acylenzyme) mutants with the carbapenem meropenem. These are the first crystal structures of carbapenem complexes of a class A carbapenemase. Our data reveal that, in the SFC-1 acylenzyme complex, the meropenem 6α-1R-hydroxyethyl group interacts with Asn132, but not with the deacylating water molecule. Molecular dynamics simulations indicate that this mode of binding occurs in both the Michaelis and acylenzyme complexes of wild-type SFC-1. In carbapenem-inhibited class A β-lactamases, it is proposed that the deacylating water molecule is deactivated by interaction with the carbapenem 6α-1R-hydroxyethyl substituent. Structural comparisons with such enzymes suggest that in SFC-1 subtle repositioning of key residues (Ser70, Ser130, Asn132 and Asn170) enlarges the active site, permitting rotation of the carbapenem 6α-1R-hydroxyethyl group and abolishing this contact. Our data show that SFC-1, and by implication other such carbapenem-hydrolyzing enzymes, uses Asn132 to orient bound carbapenems for efficient deacylation and prevent their interaction with the deacylating water molecule.

Risk factors and outcomes of carbapenem-resistant Klebsiella pneumoniae infections

Directory of Open Access Journals (Sweden)

Eleonora Pistella

2016-12-01

Full Text Available In the nosocomial setting, antimicrobial-resistant Enterobacteriaceae are a growing challenge, and alarming trends in resistance are currently reported all over the world. Isolates of Enterobacteriaceae producing ampC β-lactamases and extended spectrum β-lactamases are endemic in many hospitals, and are frequently resistant also to other classes of antibiotics, such as fluoroquinolones and aminoglycosides. The risk of infections due to multi-drug resistant strains should be considered also for outpatients who have had recent contact with the health system. Both nosocomial and health-care associated infections should be treated with a combination of antibiotics active against multi-drug resistant Gram negative and methicillin-resistant Staphylococcus aureus. In the absence of effective antimicrobial stewardship programs, this aggressive therapeutic approach might lead to abuse of broad-spectrum antibiotics, with consequent increase in resistances. To contain the possible antibiotic overuse, several decisional strategies, often based on risk-score systems supporting the clinical decisions, have been proposed. In this context of high antibiotic selection pressure, carbapenem-resistant pathogens recently began to spread in many hospitals. Carbapenem-resistant Klebsiella pneumoniae, as well as carbapenem-resistant Acinetobacter baumannii and P. aeruginosa, represent the new major challenges to patient safety. Against these organisms the initial empiric treatment is generally ineffective. The poor clinical outcome associated with carbapenem- resistant K. pneumoniae infections is probably due to the delete in the beginning of an appropriate antibiotic treatment, rather than to the increased virulence of pathogens. Only few therapeutic options are available, including colistin, tigecycline, aminoglycosides and carbapenems in selected cases. Several combinations of these antibiotics have been used, but no ideal regimen has been currently established.

Treatment Options for Carbapenem-Resistant and Extensively Drug-Resistant Acinetobacter baumannii Infections

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Viehman, J. Alexander; Nguyen, Minh-Hong; Doi, Yohei

2014-01-01

Acinetobacter baumannii is a leading cause of healthcare-associated infections worldwide. Due to various intrinsic and acquired mechanisms of resistance, most β-lactam agents are not effective against many strains, and carbapenems have played an important role in therapy. Recent trends show many infections are caused by carbapenem-resistant, or even extensively drug-resistant (XDR) strains, for which effective therapy is not well established. Evidence to date suggests that colistin constitutes the backbone of therapy, but the unique pharmacokinetic properties of colistin have led many to suggest the use of combination antimicrobial therapy. However, the combination of agents and dosing regimens that delivers the best clinical efficacy while minimizing toxicity is yet to be defined. Carbapenems, sulbactam, rifampin and tigecycline have been the most studied in the context of combination therapy. Most data regarding therapy for invasive, resistant A. baumannii infections come from uncontrolled case series and retrospective analyses, though some clinical trials have been completed and others are underway. Early institution of appropriate antimicrobial therapy is shown to consistently improve survival of patients with carbapenem-resistant and XDR A. baumannii infection, but the choice of empiric therapy in these infections remains an open question. This review summarizes the most current knowledge regarding the epidemiology, mechanisms of resistance, and treatment considerations of carbapenem-resistant and XDR A. baumannii. PMID:25091170

The purpose and appropriateness of carbapenem use in a single university hospital, 2009-2013.

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Yoon, Doran; Koo, Hei Lim; Choe, Pyeong Gyun; Song, Kyoung-Ho; Park, Wan Beom; Bang, Ji Hwan; Kim, Eu Suk; Park, Sang Won; Kim, Hong Bin; Oh, Myoung-Don; Kim, Nam Joong

2016-06-01

This is a retrospective review study to investigate changes in carbapenem consumption and to evaluate the proportion of inappropriate empirical use of carbapenem in the months of September and October of 2009, 2011, and 2013 in a single university-affiliated hospital. Total carbapenem use was classified into 3 categories: prophylactic, directed, and empirical. If an empirical prescription was continued without documentation of any eligible etiologic microorganism, we defined this as 'inappropriate' use. We also considered it 'inappropriate' when a patient's culture revealed no pathogen and the patient was initially not in severe sepsis or septic shock and did not have a history of admission to a health-care facility or of colonization with a pathogen eligible for carbapenem within 3 months. The total amount was 48.1, 51.1, and 91.0 defined daily doses/1000 patient-days in 2009, 2011, and 2013, respectively. Empirical use accounted for 78.4% of all prescriptions. The proportion of inappropriate empirical use ranged from 15.0 to 38.9% of the empirical carbapenem prescriptions.

A general reaction mechanism for carbapenem hydrolysis by mononuclear and binuclear metallo-β-lactamases.

Science.gov (United States)

Lisa, María-Natalia; Palacios, Antonela R; Aitha, Mahesh; González, Mariano M; Moreno, Diego M; Crowder, Michael W; Bonomo, Robert A; Spencer, James; Tierney, David L; Llarrull, Leticia I; Vila, Alejandro J

2017-09-14

Carbapenem-resistant Enterobacteriaceae threaten human health, since carbapenems are last resort drugs for infections by such organisms. Metallo-β-lactamases (MβLs) are the main mechanism of resistance against carbapenems. Clinically approved inhibitors of MBLs are currently unavailable as design has been limited by the incomplete knowledge of their mechanism. Here, we report a biochemical and biophysical study of carbapenem hydrolysis by the B1 enzymes NDM-1 and BcII in the bi-Zn(II) form, the mono-Zn(II) B2 Sfh-I and the mono-Zn(II) B3 GOB-18. These MβLs hydrolyse carbapenems via a similar mechanism, with accumulation of the same anionic intermediates. We characterize the Michaelis complex formed by mono-Zn(II) enzymes, and we identify all intermediate species, enabling us to propose a chemical mechanism for mono and binuclear MβLs. This common mechanism open avenues for rationally designed inhibitors of all MβLs, notwithstanding the profound differences between these enzymes' active site structure, β-lactam specificity and metal content.Carbapenem-resistant bacteria pose a major health threat by expressing metallo-β-lactamases (MβLs), enzymes able to hydrolyse these life-saving drugs. Here the authors use biophysical and computational methods and show that different MβLs share the same reaction mechanism, suggesting new strategies for drug design.

Sustained pediatric antimicrobial stewardship program with consultation to infectious diseases reduced carbapenem resistance and infection-related mortality.

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Horikoshi, Yuho; Suwa, Junichi; Higuchi, Hiroshi; Kaneko, Tetsuji; Furuichi, Mihoko; Aizawa, Yuta; Fukuoka, Kahoru; Okazaki, Kaoru; Ito, Kenta; Shoji, Takayo

2017-11-01

The impact of pediatric antimicrobial stewardship programs (ASP) on antimicrobial resistance (AMR) remains largely unknown. This study aimed to evaluate the AMR for carbapenem of Gram-negative bacilli (GNB) and carbapenem use with infectious diseases consultation after the implementation of an ASP. This quasi-experimental study was conducted at Tokyo Metropolitan Children's Medical Center in Japan. The pre- and post-intervention periods were April 2010 to September 2011 and October 2011 to March 2017, respectively. The pre-intervention phase consisted of consultations with the infectious diseases service alone. The ASP was implemented during the post-intervention phase. The carbapenem resistance rates of GNB were calculated. The correlation between carbapenem resistance rates and carbapenem day of therapy (DOT) was examined. The outcome metrics were compared by average length of hospitalization, all-cause mortality, and infection-related mortality. A positive correlation was observed between the carbapenem resistance rate in Pseudomonas aeruginosa and DOT (0.76, p=0.04). The carbapenem resistance rate in P. aeruginosa (pcarbapenem use and resistance in P. aeruginosa, leading to favorable outcomes in terms of length of hospitalization and infection-related mortality. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Carbapenem use in French hospitals: A nationwide survey at the patient level.

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Gauzit, Rémy; Pean, Yves; Alfandari, Serge; Bru, Jean-Pierre; Bedos, Jean-Pierre; Rabaud, Christian; Robert, Jérôme

2015-12-01

The objective of this study was to evaluate the characteristics of carbapenem use in French healthcare settings in order to guide future actions. Healthcare facilities voluntarily participated in a nationwide cross-sectional survey in 2011. Medical data and reasons for carbapenem treatment (CPR) and discontinuation were recorded for all patients treated with carbapenems. A total of 2338 patients were recorded by 207 facilities. The median duration of CPR was 8 days, and 31.4% of patients received CPR for >10 days. An antibiotic consultant was involved in the initial choice of CPR in 36.8% of cases. CPR was chosen on an empirical (EP) basis for 1229 patients (52.6%), mainly because of severe sepsis (48.6%) or a perceived risk of bacterial resistance (33.7%). Among EP patients, de-escalation was more frequent in the case of intervention of an antibiotic consultant (35.1%) than without intervention (22.9%) (Pcarbapenems or to fluoroquinolones. Among the latter, de-escalation was performed in 59 cases (14.9%). The intervention of an antibiotic consultant did not favour de-escalation in this group. In conclusion, carbapenems are frequently used for treating suspected or confirmed multidrug-resistant bacteria, and overall CPR duration is long. De-escalation is frequently not implemented despite isolates being susceptible to other drugs. More frequent antibiotic consultant intervention may help to decrease carbapenem use in the case of EP treatment. Copyright © 2015 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

Treatment and Outcome of Carbapenem-Resistant Gram-Negative Bacilli Blood-Stream Infections in a Tertiary Care Hospital.

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Shah, Pooja G; Shah, Sweta R

2015-07-01

Infections caused by carbapenem-resistant bacteria constitute a major challenge for current medical practice. To describe treatment and outcome of carbapenem-resistant Gram-negative bacilli (GNB) blood-stream infection (BSI) caused by these organisms at a tertiary care hospital in Mumbai. Carbapenem-resistant isolates from blood cultures were collected from January 2013 to April 2013. Identification and antimicrobial susceptibility testing were performed using Vitek 2 analyzer (Biomerieux Ltd.). Carbapenemase production was detected by modified Hodge's test (MHT). Patient's medical history, treatment and co-morbid conditions were noted. Outcomes of BSIs were evaluated. Forty-two isolates of carbapenem-resistant GNB isolated from BSIs were Enterobacteriaceae spp. (19), Acinetobacter baumannii (15), and Pseudomonas aeruginosa (8). Colistin had maximum in vitro activity with 97% against Enterobacteriaceae, 100% against Acinetobacter, and 100% activity against Pseudomonas aeruginosa isolates. Positivity of MHT was 92.9%. Outcome of colistin mono and combination therapy was comparable with 83% and 79%, respectively. Outcome of colistin and carbapenem combination therapy was found to be 100 percent. High incidences of bacteremia by carbapenem-resistant GNB including Enterobacteriaceae is a worrisome trend. Treatment options are compromised and only available option is colistin which has its own limitation. Colistin monotherapy may be non-inferior compared to combination therapy for treating BSIs caused by isolates with minimum inhibitory concentration (MIC) for colistin as ≤0.5 mg/l. Combined use of the colistin and carbapenem may provide good therapeutic options for BSI caused by carbapenem-resistant GNB and warrants further investigations.

NNDSS - Table II. Carbapenemase-producing carbapenem-resistant Enterobacteriaceae

Data.gov (United States)

U.S. Department of Health & Human Services — NNDSS - Table II. Carbapenemase-producing carbapenem-resistant Enterobacteriaceae - 2018. In this Table, provisional cases of selected notifiable diseases (≥1,000...

Deaths Attributable to Carbapenem-Resistant Enterobacteriaceae Infections

Centers for Disease Control (CDC) Podcasts

2014-08-06

Dr. Mike Miller reads an abridged version of the article, Deaths Attributable to Carbapenem-Resistant Enterobacteriaceae Infections.  Created: 8/6/2014 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 8/13/2014.

Determinación de la sensibilidad a amoxicilina y a clindamicina de staphylococcus spp aislado de cavidad oral de pacientes con alto riesgo de endocarditis infecciosa

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Silvia Barrientos

2011-01-01

Full Text Available En la literatura existen pocos estudios acerca de la distribución de Staphylococcus spp en boca y los que hay sobre estos microorganismos como residentes de la cavidad oral son controversiales.El género Staphylococcus spp conforma un importante grupo de patógenos en el ser humano y origina distintas enfermedades, entre ellas, la Endocarditis Infecciosa; de igual forma, la literatura reporta tasas de resistencia a amoxicilina y clindamicina antibióticos usados comúnmente para la profilaxis en odontología. Objetivo: Conocer la sensibilidad de Staphylococcus spp a amoxicilina y la clindamicina aislados de cavidad oral de pacientes con alto riesgo de Endocarditis Infecciosa.

Evaluating the Impact of Antibiotic Exposures as Time-Dependent Variables on the Acquisition of Carbapenem-Resistant Acinetobacter baumannii.

Science.gov (United States)

Munoz-Price, L Silvia; Rosa, Rossana; Castro, Jose G; Laowansiri, Panthipa; Latibeaudiere, Rachel; Namias, Nicholas; Tarima, Sergey

2016-10-01

To determine the time-dependent effect of antibiotics on the initial acquisition of carbapenem-resistant Acinetobacter baumannii. Retrospective cohort study. Forty-bed trauma ICU in Miami, FL. All consecutive patients admitted to the unit from November 1, 2010, to November 30, 2011. None. Patients underwent surveillance cultures at admission to the unit and weekly thereafter. The primary outcome was the acquisition of carbapenem-resistant A. baumannii on surveillance cultures. Daily antibiotic exposures during the time of observation were used to construct time-dependent variables, including cumulative exposures (in grams and daily observed doses [defined daily doses]). Among 360 patients, 45 (12.5%) became colonized with carbapenem-resistant A. baumannii. Adjusted Cox models showed that each additional point in the Acute Physiologic and Chronic Health Evaluation score increased the hazard by 4.8% (hazard ratio, 1.048; 95% CI, 1.010-1.087; p = 0.0124) and time-dependent exposure to carbapenems quadrupled the hazard (hazard ratio, 4.087; 95% CI, 1.873-8.920; p = 0.0004) of acquiring carbapenem-resistant A. baumannii. Additionally, adjusted Cox models determined that every additional carbapenem defined daily dose increased the hazard of acquiring carbapenem-resistant A. baumannii by 5.1% (hazard ratio, 1.051; 95% CI, 1.007-1.093; p = 0.0243). Carbapenem exposure quadrupled the hazards of acquiring A. baumannii even after controlling for severity of illness.

PHARMACOEPIDEMIOLOGY OF CARBAPENEMS APPLICATION AMONG THE PREMATURE NEWBORNS IN SAINT PETERSBURG. WORLD EXPERIENCE IN NEONATOLOGY

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A.S. Kolbin

2008-01-01

Full Text Available Premature newborns are a high risk group in terms of the infection complications growth. therefore, it is highly urgent to choose the efficient and safe antibacterial medications for the given category of patients. The authors carried out a pharma coepidemiological study of the carbapenems application among 353 newborns with very low body weight at birth, as well as the literature analysis on the use of this medications group in compliance with the evidence based medicine. As a result, they showed that for the last 8 years the frequency of the carbapenems application in Saint-Petersburg among the newborns has grown from 10 to 52%. It is statistically accurate that imipenem/cilastatin was more often used to the amount of 25 mg/kg twice a day. In 71% of cases, carbapenems were applied in the form of the empiric therapy against the general bacterial infection in combination with vancomycin and/or metronidazole. Antibiotics proved to be safe. The literature analysis showed that there is no data, which would allow one to compare the efficiency of carbapenems with other antibiotics among the newborns based on the results of the meta analyses and randomized clinical studies. Nowadays, carbapenems demonstrated high efficiency and safety in the small clinical observations.Key words: carbapenems, imipenem, meropenem, newborns with very low body weight at birth.

Genetic Characterization of Carbapenem-Resistant Enterobacteriaceae and the Spread of Carbapenem-Resistant Klebsiella pneumonia ST340 at a University Hospital in Thailand

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Netikul, Thidarat; Kiratisin, Pattarachai

2015-01-01

Carbapenem-resistant Enterobacteriaceae (CRE) has increasingly spread worldwide in the past decade. The prevalence and characteristics of CRE in Thailand are unknown. In this study, we conducted a 2-year surveillance of CRE among 12,741 clinical isolates of Enterobacteriaceae at the largest university hospital in Thailand with molecular characterization of beta-lactamase (bla) genes, including carbapenemase genes. The CRE prevalence was 1.4%. blaKPC-13 and blaIMP-14a were the only carbapenemase genes detected among these CRE isolates. blaKPC-13 gene was found in a single isolate of Escherichia coli, Enterobacter cloacae and Citrobacter freundii, and blaIMP-14a was found in four isolates of Klebsiella pneumoniae. Carbapenem-resistant K. pneumoniae (CRKP) isolates were resistant to multiple carbapenems at a higher ratio than other CRE species, and thus were further characterized for resistance phenotypes, bla genotypes and molecular epidemiology. Most CRKP isolates harboured multiple bla genes, especially those related to extended-spectrum beta-lactamases. Seven CRKP isolates were resistant to all tested carbapenems, and showed decreased ompK35 and/or ompK36 porin gene expression. Molecular typing of CRKP based on pulsed-field gel electrophoresis (PFGE) demonstrated several unrelated clones. Multilocus sequence typing (MLST) was partially concordant with PFGE results and revealed that ST340, a member of drug-resistant K. pneumoniae clonal complex 258, was the most predominant clone, followed by ST48, ST11 and ST273. The novel ST1645 was identified from this study. ST340 has neither been shown to be predominated among CRKP from other studies, nor been reported in Thailand. Therefore, it emphases a critical concern to monitor and control the spread of CRKP. PMID:26407326

Impact of carbapenem heteroresistance among clinical isolates of invasive Escherichia coli in Chongqing, southwestern China.

Science.gov (United States)

Sun, J D; Huang, S F; Yang, S S; Pu, S L; Zhang, C M; Zhang, L P

2015-05-01

Although heteroresistance is common in a wide range of microorganisms, carbapenem heteroresistance among invasive Escherichia coli infections has not been reported. The objective of this study was to evaluate the clinical significance of carbapenem heteroresistance and to identify risk factors for its acquisition. A case-control study was conducted at a 3200-bed teaching hospital in Chongqing, southwestern China. Successive and non-duplicate nosocomial E. coli isolates (n = 332) were obtained from July 2011 to June 2013. Bloodstream isolates made up 50.6% of the strains collected. The rates of heteroresistance were 25.0% to imipenem, 17.2% to ertapenem, and 3.9% to meropenem. The population analysis profile revealed the presence of subpopulations with higher carbapenem resistance, showing MICs ranging from 2.0-128.0mg/L. Male gender, invasive intervention, antibiotic use and bacterial extended-spectrum β-lactamase (ESBL) production contributed to invasive infections by carbapenem-heteroresistant E. coli (CHEC). The production of ESBL was identified as the common independent risk factor for heteroresistance to both ertapenem and imipenem. Pulsed-field gel electrophoresis revealed clonal diversity among the CHEC isolates. Most importantly, characterization of two successive E. coli strains isolated from the same patient indicated that carbapenem resistance evolved from heteroresistance. In conclusion, the high prevalence of heteroresistance to carbapenem among invasive E. coli merits great attention. Routine detection of ESBLs and the prudent use of imipenem and ertapenem are advocated. The early targeted intervention should be formulated to reduce CHEC infection and carbapenem resistance of E. coli. Copyright © 2014 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Evaluación in vitro de la actividad inhibitoria de extractos vegetales sobre aislados de Colletotrichum spp In vitro evaluation of inhibitory activity of plant extracts on Colletotrichum spp

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Alexander Pérez Cordero

2011-04-01

Full Text Available Se evaluó la actividad inhibitoria in vitro de extractos de hojas de Melissa officinalis, Origanum vulgare, Jatropha gossypilia, Eucalyptus sp., Melia azederach y Mascagnia concinna sobre aislados de hongo del género Colletotrichum, causante de la enfermedad antracnosis en el cultivo del ñame (Dioscorea alata, D. rotundata en el departamento de Sucre, Colombia. Para la obtención de extractos etanólicos de hojas de M. officinalis y O. vulgare, se utilizó el método de percolación y para las otras especies vegetales, el método de Soxhlet. Una vez preparados los extractos de hojas, se evaluó su actividad inhibitoria sobre seis aislados de hongo del género Colletotrichum (BVC 279a, BVC 279b, BVC 853, BVC 040, BVC 342 y BVC 507. Para la prueba inhibitoria se utilizó el método de siembra directa sobre la superficie del medio papa-dextrosa-agar. Sobre las diferentes cepas se adicionaron 250 µl de cada extracto por separado. Se utilizó un control positivo con nistatina (4 mg/ml y un testigo absoluto sin ningún tipo de tratamiento. La prueba se evaluó midiendo el crecimiento radial de cada cepa con los diferentes tratamientos a 96 y 168 h. Se utilizó un diseño de bloques completamente al azar con tres repeticiones, para probar diferencias significativas entre tratamientos, cepas (aislados y tiempo de inhibición. Los resultados expresados en porcentaje de inhibición, mostraron una alta actividad de los extractos obtenidos de las hojas de las plantas de M. azederach y M. concinna, sobre los hongos evaluados y su acción fue similar al control positivo.The objective of this study was to evaluate in vitro inhibitory activity of extracts from leaves of Melissa officinalis, Origanum vulgare, Jatropha gossypilia, Eucalyptus sp. Melia azederach and Mascagnia concinna on isolated fungus of the genus Colletotrichum, which causes anthracnose disease in the crop of yam (Dioscorea alata, D. rotundata in the department of Sucre, Colombia. To obtain

Carbapenem-Resistant Bacteria Recovered from Faeces of Dairy Cattle in the High Plains Region of the USA.

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Webb, Hattie E; Bugarel, Marie; den Bakker, Henk C; Nightingale, Kendra K; Granier, Sophie A; Scott, H Morgan; Loneragan, Guy H

2016-01-01

A study was conducted to recover carbapenem-resistant bacteria from the faeces of dairy cattle and identify the underlying genetic mechanisms associated with reduced phenotypic susceptibility to carbapenems. One hundred and fifty-nine faecal samples from dairy cattle were screened for carbapenem-resistant bacteria. Phenotypic screening was conducted on two media containing ertapenem. The isolates from the screening step were characterised via disk diffusion, Modified Hodge, and Carba NP assays. Carbapenem-resistant bacteria and carbapenemase-producing isolates were subjected to Gram staining and biochemical testing to include Gram-negative bacilli. Whole genome sequencing was performed on bacteria that exhibited either a carbapenemase-producing phenotype or were not susceptible to ertapenem and were presumptively Enterobacteriaceae. Of 323 isolates collected from the screening media, 28 were selected for WGS; 21 of which were based on a carbapenemase-producing phenotype and 7 were presumptively Enterobacteriaceae and not susceptible to ertapenem. Based on analysis of WGS data, isolates included: 3 Escherichia coli harbouring blaCMY-2 and truncated ompF genes; 8 Aeromonas harbouring blacphA-like genes; 1 Acinetobacter baumannii harbouring a novel blaOXA gene (blaOXA-497); and 6 Pseudomonas with conserved domains of various carbapenemase-producing genes. Carbapenem resistant bacteria appear to be rare in cattle. Nonetheless, carbapenem-resistant bacteria were detected across various genera and were found to harbour a variety of mechanisms conferring reduced susceptibility. The development and dissemination of carbapenem-resistant bacteria in livestock would have grave implications for therapeutic treatment options in human medicine; thus, continued monitoring of carbapenem susceptibility among enteric bacteria of livestock is warranted.

Transcriptional analysis of bla NDM-1 and copy number alteration under carbapenem stress

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Deepjyoti Paul

2017-02-01

Full Text Available Abstract Background New Delhi metallo beta-lactamase is known to compromise carbapenem therapy and leading to treatment failure. However, their response to carbapenem stress is not clearly known. Here, we have investigated the transcriptional response of bla NDM-1 and plasmid copy number alteration under carbapenem exposure. Methods Three bla NDM-1 harboring plasmids representing three incompatibility types (IncFIC, IncA/C and IncK were inoculated in LB broth with and without imipenem, meropenem and ertapenem. After each 1 h total RNA was isolated, immediately reverse transcribed into cDNA and quantitative real time PCR was used for transcriptional expression of bla NDM-1. Horizontal transferability and stability of the plasmids encoding bla NDM-1 were also determined. Changes in copy number of bla NDM-1 harboring plasmids under the exposure of different carbapenems were determined by real time PCR. Clonal relatedness among the isolates was determined by pulsed field gel electrophoresis. Results Under carbapenem stress over an interval of time there was a sharp variation in the transcriptional expression of bla NDM-1 although it did not follow a specific pattern. All bla NDM-1 carrying plasmids were transferable by conjugation. These plasmids were highly stable and complete loss was observed between 92nd to 96th serial passages when antibiotic pressure was withdrawn. High copy number of bla NDM-1 was found for IncF type plasmids compared to the other replicon types. Conclusion This study suggests that the single dose of carbapenem pressure does not significantly influence the expression of bla NDM-1 and also focus on the stability of this gene as well as the change in copy number with respect to the incompatible type of plasmid harboring resistance determinant.

Comportamiento de la resistencia antimicrobiana de gérmenes aislados en heridas por quemaduras Behavior of antimicrobial resistance germs isolated from burn wounds

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Frank Pérez Hera

2009-09-01

Full Text Available INTRODUCCIÓN. Son objetivos de este trabajo determinar el comportamiento de la resistencia de diferentes microorganismos aislados frente a antimicrobianos probados en las heridas por quemadura, en pacientes ingresados en el servicio de quemados del Hospital General Provincial «Dr. Antonio Luaces Iraola», durante los años 2001, 2003 y 2005. MÉTODOS. Se realizó un estudio observacional, descriptivo y retrospectivo, cuyo universo estuvo constituido por 96 pacientes, a los cuales se les realizó cultivo con antibiograma según la técnica descrita para el método de Kirby Bauer, y en algunos pacientes se empleó el sistema DIRAMIC. Se procesaron los datos en el programa computarizado Microsoft Excel, y los resultados se representaron en tablas y gráficos, con números absolutos y porcentajes. RESULTADOS. Durante el 2001, la resistencia antimicrobiana alcanzada por el germen que con mayor frecuencia se aisló (Pseudomonas aeruginosa abarca a la kanamicina (65,5 % y la ceftriazona (55,1 %, en orden decreciente. Durante el 2003 el resultado fue muy similar y se aisló, también en orden de frecuencia, Pseudomonas aeruginosa y Proteus mirabilis, este último con una resistencia sobre el 33,3 % a todos los antimicrobianos probados. En el 2005 se observó predominio de Pseudomonas aeruginosa y Escherichia coli, con una resistencia marcada a los aminoglucósidos y betalactámicos superior al 50 %. CONCLUSIONES. Se diagnosticaron 8 especies bacterianas con una elevada resistencia antimicrobiana. Los gérmenes aislados con mayor frecuencia fueron Pseudomonas aeruginosa, Escherichia coli y Klebsiella sp. Pseudomonas aeruginosa mostró una tendencia al aumento de la resistencia frente a antimicrobianos como el cloranfenicol, los aminoglucósidos y las cefalosporinas.INTRODUCTION: The aims of present paper is to determine the resistance behavior of different isolated microorganisms towards antimicrobials detected in burn wounds in patients admitted in

Low Prevalence of Carbapenem-Resistant Bacteria in River Water: Resistance Is Mostly Related to Intrinsic Mechanisms.

Science.gov (United States)

Tacão, Marta; Correia, António; Henriques, Isabel S

2015-10-01

Carbapenems are last-resort antibiotics to handle serious infections caused by multiresistant bacteria. The incidence of resistance to these antibiotics has been increasing and new resistance mechanisms have emerged. The dissemination of carbapenem resistance in the environment has been overlooked. The main goal of this research was to assess the prevalence and diversity of carbapenem-resistant bacteria in riverine ecosystems. The presence of frequently reported carbapenemase-encoding genes was inspected. The proportion of imipenem-resistant bacteria was on average 2.24 CFU/ml. Imipenem-resistant strains (n=110) were identified as Pseudomonas spp., Stenotrophomonas maltophilia, Aeromonas spp., Chromobacterium haemolyticum, Shewanella xiamenensis, and members of Enterobacteriaceae. Carbapenem-resistant bacteria were highly resistant to other beta-lactams such as quinolones, aminoglycosides, chloramphenicol, tetracyclines, and sulfamethoxazole/trimethoprim. Carbapenem resistance was mostly associated with intrinsically resistant bacteria. As intrinsic resistance mechanisms, we have identified the blaCphA gene in 77.3% of Aeromonas spp., blaL1 in all S. maltophilia, and blaOXA-48-like in all S. xiamenensis. As acquired resistance mechanisms, we have detected the blaVIM-2 gene in six Pseudomonas spp. (5.45%). Integrons with gene cassettes encoding resistance to aminoglycosides (aacA and aacC genes), trimethoprim (dfrB1b), and carbapenems (blaVIM-2) were found in Pseudomonas spp. Results suggest that carbapenem resistance dissemination in riverine ecosystems is still at an early stage. Nevertheless, monitoring these aquatic compartments for the presence of resistance genes and its host organisms is essential to outline strategies to minimize resistance dissemination.

Clinical study of carbapenem sensitive and resistant Gram-negative bacteremia in neutropenic and nonneutropenic patients: The first series from India.

Science.gov (United States)

Ghafur, A K; Vidyalakshmi, P R; Kannaian, P; Balasubramaniam, R

2014-01-01

Carbapenem resistance is a growing global concern. There is a lack of published clinical studies on the topic from Indian subcontinent. Aim of this study was to analyze clinical profile of patients with carbapenem sensitive and resistant bacteremia among neutropenic and nonneutropenic patients. Retrospective analysis of 141 patients who had carbapenem resistant or sensitive Gram-negative bacteremia, identified over a period of 1-year was done by medical records review, in Apollo Specialty Hospital, a 300-bedded tertiary care Oncology, neurosurgical and orthopedic center in South India. Of the total 141 patients with Gram-negative bacteremia, 44 had carbapenem resistant ones. Of these 44 patients, 17 were neutropenics (resistant neutropenic group) and 27 nonneutropenic patients (resistant nonneutropenic group). Of the 97 patients with carbapenem sensitive bacteremia, 43 were neutropenic (sensitive neutropenic group) and 54 nonneutropenics (sensitive nonneutropenic group). The 28 days mortality was significantly higher in carbapenem resistant bacteremic group compared to the sensitive one (P = 0.008). This is the first study from India comparing clinical features of patients with carbapenem sensitive and resistant blood stream infections. Patients with carbapenem resistant bacteremia had higher mortality compared to patients with sensitive bacteremia.

Antibiotic prescription in intensive care units in Latin America

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Daniel J Curcio

2011-09-01

son a menudo consideradas el epicentro de la resistencia a los antibióticos. En este sentido, el consumo total de antibióticos es aproximadamente diez veces mayor en las UCI que en las salas de internación general. El objetivo de este estudio fue evaluar el hábito prescriptivo de antibióticos en las UCI de varios países de Latinoamérica. A tal fin, se realizó un estudio transversal con tres evaluaciones puntuales de un día de duración cada una, para determinar la prevalencia del uso de antibióticos en las 43 UCI ubicadas en distintos países del continente americano. De los 1644 pacientes admitidos, 688 estaban recibiendo tratamiento antibiótico en los días en que se realizó el relevamiento (41,8 %, en 392 casos (57 %, debido a infecciones nosocomiales. De todas las infecciones, 22 % (151/688 correspondieron a shock séptico y 22 % (151/688 a neumonía nosocomial (de estas últimas, el 33 % [50/151] fueron neumonías asociadas a ventilación mecánica. En 485 pacientes (70,5 % se obtuvieron cultivos antes del inicio del tratamiento antibiótico. Entre los aislamientos, los microorganismos más comúnmente aislados fueron las enterobacterias productoras de ß-lactamasas de espectro extendido (BLEE (30,5 % y Pseudomonas aeruginosa (17 %. Los carbapenems (imipenem o meropenem fueron los antibióticos prescriptos con mayor frecuencia (151/688, 22 %, seguidos por la vancomicina (103/688, 15 %, la piperacilina-tazobactama (86/688, 12,5 % y las cefalosporinas de amplio espectro (principalmente cefepima (83/688, 12 %. En conclusión, los carbapenems fueron los antibióticos más frecuentemente prescriptos en las UCI de los países latinoamericanos evaluados. Esta práctica podría estar justificada por las altas tasas de enterobacterias productoras de BLEE halladas en los pacientes de esas regiones. Más allá de esta razón, el problema de la resistencia bacteriana en muchos países del continente requiere que los médicos optimicen el uso de los carbapenems

Invasive carbapenem-resistant Enterobacteriaceae infection at a ...

African Journals Online (AJOL)

Background. There are no paediatric reports of invasive infection caused by carbapenem-resistant Enterobacteriaceae (CRE) from Africa. Objectives. To document a series of cases of CRE infections at a tertiary children's hospital in Cape Town, South Africa, describing the clinical and microbiological findings in these ...

Sublethal Concentrations of Carbapenems Alter Cell Morphology and Genomic Expression of Klebsiella pneumoniae Biofilms

Science.gov (United States)

Van Laar, Tricia A.; Chen, Tsute; You, Tao

2015-01-01

Klebsiella pneumoniae, a Gram-negative bacterium, is normally associated with pneumonia in patients with weakened immune systems. However, it is also a prevalent nosocomial infectious agent that can be found in infected surgical sites and combat wounds. Many of these clinical strains display multidrug resistance. We have worked with a clinical strain of K. pneumoniae that was initially isolated from a wound of an injured soldier. This strain demonstrated resistance to many commonly used antibiotics but sensitivity to carbapenems. This isolate was capable of forming biofilms in vitro, contributing to its increased antibiotic resistance and impaired clearance. We were interested in determining how sublethal concentrations of carbapenem treatment specifically affect K. pneumoniae biofilms both in morphology and in genomic expression. Scanning electron microscopy showed striking morphological differences between untreated and treated biofilms, including rounding, blebbing, and dimpling of treated cells. Comparative transcriptome analysis using RNA sequencing (RNA-Seq) technology identified a large number of open reading frames (ORFs) differentially regulated in response to carbapenem treatment at 2 and 24 h. ORFs upregulated with carbapenem treatment included genes involved in resistance, as well as those coding for antiporters and autoinducers. ORFs downregulated included those coding for metal transporters, membrane biosynthesis proteins, and motility proteins. Quantitative real-time PCR validated the general trend of some of these differentially regulated ORFs. Treatment of K. pneumoniae biofilms with sublethal concentrations of carbapenems induced a wide range of phenotypic and gene expression changes. This study reveals some of the mechanisms underlying how sublethal amounts of carbapenems could affect the overall fitness and pathogenic potential of K. pneumoniae biofilm cells. PMID:25583711

Emergence and mechanism of carbapenem-resistant Escherichia coli in Henan, China, 2014

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Wen-juan Liang

2018-05-01

Full Text Available The emergence and dissemination of carbapenem-resistant Escherichia coli (E. coli strains is a main risk for global public health, but little is known of carbapenemase producing E. coli in Henan, China. The study was undertaken to investigate the prevalence and mechanism of carbapenem-resistant E. coli strains in a hospital in Xinxiang, Henan, China, 2014. A total of 5 carbapenemase-producing E. coli strains were screened from 1014 isolates. We found that they were all resistant to meropenem and imipenem. Amikacin showed the best sensitivity, with gentamicin coming up next. The positive rate of blaNDM was 80% (4/5. The sequencing results showed that two isolates belonged to blaNDM-1 whereas other 2 isolates carried the blaNDM-5. Other carbapenemase genes including blaIMP, blaVIM, blaKPC and blaOXA-48 were not detected. The blaCTX-M-15, blaTEM-1, sul2, aad, and aac(6”–Ib–cr were also detected. MLST analysis showed that NDM-producing E. coli were sporadic. Conjugation test indicated blaNDM could be transferred. In conclusion, the blaNDM was the principal resistance mechanism of carbapenem-resistant E. coli in the hospital, Henan, China. Keywords: blaNDM, Carbapenem-resistant, Escherichia coli

Carbapenems to Treat Multidrug and Extensively Drug-Resistant Tuberculosis: A Systematic Review.

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Sotgiu, Giovanni; D'Ambrosio, Lia; Centis, Rosella; Tiberi, Simon; Esposito, Susanna; Dore, Simone; Spanevello, Antonio; Migliori, Giovanni Battista

2016-03-12

Carbapenems (ertapenem, imipenem, meropenem) are used to treat multidrug-resistant (MDR-) and extensively drug-resistant tuberculosis (XDR-TB), even if the published evidence is limited, particularly when it is otherwise difficult to identify the recommended four active drugs to be included in the regimen. No systematic review to date has ever evaluated the efficacy, safety, and tolerability of carbapenems. A search of peer-reviewed, scientific evidence was carried out, aimed at evaluating the efficacy/effectiveness, safety, and tolerability of carbapenem-containing regimens in individuals with pulmonary/extra-pulmonary disease which was bacteriologically confirmed as M/XDR-TB. We used PubMed to identify relevant full-text, English manuscripts up to the 20 December 2015, excluding editorials and reviews. Seven out of 160 studies satisfied the inclusion criteria: two on ertapenem, one on imipenem, and four on meropenem, all published between 2005 and 2016. Of seven studies, six were retrospective, four were performed in a single center, two enrolled children, two had a control group, and six reported a proportion of XDR-TB cases higher than 20%. Treatment success was higher than 57% in five studies with culture conversion rates between 60% and 94.8%. The safety and tolerability is very good, with the proportion of adverse events attributable to carbapenems below 15%.

Virulence factors analysis of Staphylococcus aureus isolated from bovine mastitis in México

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Julio C. Franco G.

2008-01-01

Full Text Available Un total de 117 aislados bacterianos obtenidos de casos de mastitis bovina positivos a las pruebas de catalasa, coagulasa, termonucleasa, manitol y PCR fueron analizados para determinar la producción de los siguientes factores de virulencia: hemolisisnas (alfa y beta, factor de agregación y cápsula. Adicionalmente fue también evaluada la sensibilidad a oxitetraciclina, penicilina, oxacilina y estreptomicina. La producción de hemolisinas y el factor de agregación fueron los 2 factores de virulencia expresados en la mayoría de los aislados (78% y (83% respectivamente, mientras que la formación de cápsula se detectó en 31% de los aislados bovinos. Una fuerte correlación entre ausencia de cápsula y producción de hemolisinas fue observado, ya que 72 de un total de 92 cepas hemolíticas no mostraron cápsula. La ausencia de cápsula fue asociada a la producción del factor de agregación en 89% de los aislados bacterianos positivos a este factor. El 68% y 69% de los aislados bacterianos resultaron positivos a penicilina y oxacilina respectivamente. La mayoría de los aislados (116 expresaron al menos 1 factor de virulencia (hemolisinas, cápsula o factor de agregación. Finalmente, el papel de los factores de virulencia y su relación en la patogenicidad de S. aureus en la mastitis bovina en México es discutido.

Emergence and nosocomial spread of carbapenem-resistant OXA-232-producing Klebsiella pneumoniae in Brunei Darussalam

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Abdul Momin, Muhd Haziq Fikry; Liakopoulos, Apostolos; Phee, Lynette M.; Wareham, David W.

2017-01-01

Objectives Carbapenem-resistant Enterobacteriaceae (CRE) are identified as a major global health concern. The success of CRE is facilitated by the emergence, acquisition and spread of successful clones carrying plasmid-encoded resistance genes. In this study, an outbreak of carbapenem-resistant

The Implementation of a Hospital-wide Practice for the Selective Use of Carbapenems Based on the Monitoring of Susceptibility of Pseudomonas aeruginosa Isolates.

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Ohshima, Toshio; Asai, Satomi; Miyazawa, Miki; Yamamoto, Yukari; Hisada, Akifumi; Kumazawa, Chie; Hashimoto, Masayoshi; Fukawa, Katsuji; Iwashita, Hideo; Umezawa, Kazuo; Yamada, Sanetoshi; Yamamoto, Yoshiro; Miyachi, Hayato

2017-12-20

To control carbapenem-resistant Pseudomonas aeruginosa, we implemented a hospital-wide policy concerning the selective use of carbapenems based on the monitoring of P. aeruginosa isolates for susceptibility to five carbapenems using a customized dry plate method. In this study, we retrospectively investigated the outcome of our measures to control carbapenem-resistant P. aeruginosa. To select effective carbapenems, 100 clinical isolates were collected, and the minimum inhibitory concentration (MIC) to 5 carbapenems (IPM/CS, MEPM, DRPM, BIPM and PAPM/BP) was monitored using a customized dry plate method from 2006 to 2013. Carbapenems, which were associated with a high rate of drug resistance in P. aeruginosa, were restricted from use during our intervention study. The antimicrobial use density per 100 bed-days (AUD 100 ) of carbapenems and the detection rates of carbapenem (IPM/CS and MEPM)-resistant P. aeruginosa were determined during the period of the intervention. The isolates consistently showed higher rates of drug-resistant P. aeruginosa in IPM/CS and PAPM/BP. Thus, DRPM, MEPM and BIPM were adopted for hospital-wide use. The detection rates of all IPM/Cs and MEPM-resistant P. aeruginosa significantly decreased. Meanwhile, the consumption of carbapenems showed an increasing trend. The outcome of the hospital-wide implementation of the selective use of carbapenems based on periodic monitoring of the susceptibility of P. aeruginosa isolates was retrospectively studied. Implementation of this measure might have contributed in part to the control of carbapenem-resistant P. aeruginosa in our hospital.

Definition of the Common and Divergent Steps in Carbapenem β-Lactam Antibiotic Biosynthesis

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Bodner, Micah J.; Li, Rongfeng; Phelan, Ryan M.; Freeman, Michael F.; Moshos, Kristos A.; Lloyd, Evan P.

2012-01-01

Approximately 50 naturally occurring carbapenem β-lactam antibiotics are known. All but one of these have been isolated from Streptomyces species and are disubstituted structural variants of a simple core that is synthesized by Pectobacterium carotovorum (Erwinia carotovora), a phylogenetically distant plant pathogen. While the biosynthesis of the simple carbapenem, (5R)-carbapen-2-em-3-carboxylic acid, is impressively efficient requiring only three enzymes, CarA, CarB and CarC, the formation of thienamycin, one of the former group of metabolites from Streptomyces, is markedly more complex. Despite their phylogenetic separation, bioinformatic analysis of the encoding gene clusters suggests that the two pathways could be related. Here we demonstrate with gene swapping, stereochemical and kinetics experiments that CarB and CarA and their S. cattleya orthologues, ThnE and ThnM, respectively, are functionally and stereochemically equivalent, although their catalytic efficiencies differ. The biosynthetic pathways, therefore, to thienamycin, and likely to the other disubstituted carbapenems, and to the simplest carbapenem, (5R)-carbapen-2-em-3-carboxylic acid, are initiated in the same manner, but share only two common steps before diverging. PMID:21913298

Minocycline and Tigecycline: What Is Their Role in the Treatment of Carbapenem-Resistant Gram-Negative Organisms?

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Shankar, Chaitra; Nabarro, Laura E B; Anandan, Shalini; Veeraraghavan, Balaji

2017-06-01

Carbapenem-resistant organisms are increasingly common worldwide, particularly in India and are associated with high mortality rates especially in patients with severe infection such as bacteremia. Existing drugs such as carbapenems and polymyxins have a number of disadvantages, but remain the mainstay of treatment. The tetracycline class of antibiotics was first produced in the 1940s. Minocycline, tetracycline derivative, although licensed for treatment of wide range of infections, has not been considered for treatment of multidrug-resistant organisms until recently and needs further in vivo studies. Tigecycline, a derivative of minocycline, although with certain disadvantages, has been frequently used in the treatment of carbapenem-resistant organisms. In this article, we review the properties of minocycline and tigecycline, the common mechanisms of resistance, and assess their role in the management of carbapenem-resistant organisms.

Empiric Piperacillin-Tazobactam versus Carbapenems in the Treatment of Bacteraemia Due to Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae.

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Ng, Tat Ming; Khong, Wendy X; Harris, Patrick N A; De, Partha P; Chow, Angela; Tambyah, Paul A; Lye, David C

2016-01-01

Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae are a common cause of bacteraemia in endemic countries and may be associated with high mortality; carbapenems are considered the drug of choice. Limited data suggest piperacillin-tazobactam could be equally effective. We aimed to compare 30-day mortality of patients treated empirically with piperacillin-tazobactam versus a carbapenem in a multi-centre retrospective cohort study in Singapore. Only patients with active empiric monotherapy with piperacillin-tazobactam or a carbapenem were included. A propensity score for empiric carbapenem therapy was derived and an adjusted multivariate analysis of mortality was conducted. A total of 394 patients had ESBL-Escherichia.coli and ESBL-Klebsiella pneumoniae bacteraemia of which 23.1% were community acquired cases. One hundred and fifty-one received initial active monotherapy comprising piperacillin-tazobactam (n = 94) or a carbapenem (n = 57). Patients who received carbapenems were less likely to have health-care associated risk factors and have an unknown source of bacteraemia, but were more likely to have a urinary source. Thirty-day mortality was comparable between those who received empiric piperacillin-tazobactam and a carbapenem (29 [30.9%] vs. 17 [29.8%]), P = 0.89). Those who received empiric piperacillin-tazobactam had a lower 30-day acquisition of multi-drug resistant and fungal infections (7 [7.4%] vs. 14 [24.6%]), Pcarbapenem.

Single or in Combination Antimicrobial Resistance Mechanisms of Klebsiella pneumoniae Contribute to Varied Susceptibility to Different Carbapenems

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Tsai, Yu-Kuo; Liou, Ci-Hong; Fung, Chang-Phone; Lin, Jung-Chung; Siu, L. Kristopher

2013-01-01

Resistance to carbapenems has been documented by the production of carbapenemase or the loss of porins combined with extended-spectrum β-lactamases or AmpC β-lactamases. However, no complete comparisons have been made regarding the contributions of each resistance mechanism towards carbapenem resistance. In this study, we genetically engineered mutants of Klebsiella pneumoniae with individual and combined resistance mechanisms, and then compared each resistance mechanism in response to ertapenem, imipenem, meropenem, doripenem and other antibiotics. Among the four studied carbapenems, ertapenem was the least active against the loss of porins, cephalosporinases and carbapenemases. In addition to the production of KPC-2 or NDM-1 alone, resistance to all four carbapenems could also be conferred by the loss of two major porins, OmpK35 and OmpK36, combined with CTX-M-15 or DHA-1 with its regulator AmpR. Because the loss of OmpK35/36 alone or the loss of a single porin combined with bla CTX-M-15 or bla DHA-1-ampR expression was only sufficient for ertapenem resistance, our results suggest that carbapenems other than ertapenem should still be effective against these strains and laboratory testing for non-susceptibility to other carbapenems should improve the accurate identification of these isolates. PMID:24265784

The outcome of non-carbapenem-based empirical antibacterial ...

African Journals Online (AJOL)

Background: Febrile neutropenia (FN) is generally a complication of cancer chemotherapy. Objective: ... Furthermore, non-carbapenem-based empirical therapy provides benefit in regard to cost-effectiveness and antimicrobial stewardship when local antibiotic resistance patterns of gram-negative bacteria are considered.

La infección del tracto urinario (ITU en un hospital universitario de Santafé de Bogotá: etiología y evaluación de los antimicrobianos

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S. Máttar

1994-09-01

Full Text Available Los objetivos de este trabajo fueron determinar la etiología y la sensibilidad antimicrobiana en la infección del tracto urinario (ITU. Para ello, se analizaron prospectivamente 245 orinas extra e intrahospitalarias del Hospital Universitario San Ignacio de Santafé de Bogotá. Las orinas se estudiaron a través del sedimento, Gram, tira reactiva y cultivo bacteriológico; la susceptibilidad antimicrobiana se realizó por el método de Kirby Bauer. De las 245 orinas se descartaron 45; las 200 orinas restantes fueron cultivadas, resultando 100 positivas y 100 negativas. El agente más frecuentemente aislado fue E. coli (85%, seguido de Proteus sp. (6%. Los microorganismos aislados presentaron una alta sensibilidad a la cefotaxima (100%, norflocacina (98%, netilmicina (98%, amikacina (98%, nitrofurantoína (92%, gentamicina (86%, ácido nalidixico (78% y una sensibilidad del 57% frente al trimetoprim-sulfametoxasol y el 25% a la ampicilina. Los antimicrobianos eficaces para el tratamiento de la ITU, por su bajo costo y alta actividad sobre los microorganismos encontrados, son: nitrofurantoina, norfloxacina, amikacina, netilmicina, gentamicina y ácido nalidíxico.

Biofilm Production in Carbapenem Resistant Isolates from Chronic Wound Infections

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Swarna SR

2017-02-01

Full Text Available Biofilms are communities of microorganisms covered with extracellular polymeric substances. Such biofilm phenotype makes the microorganism resistant to antibiotics and plays a role in wound chronicity. This results in prolonged hospital stays in ICU, greater cost, and increased mortality. Methods: Pus swabs (59 were collected from a tertiary care hospital near Chennai were processed and identified using standard procedure followed by antibiotic susceptibility testing and identification of carbapenem resistance by Modified Hodge test as per CLSI guidelines. The biofilm formation was tested using plastic microtiter plate method. Results: Out of 59 pus swabs, 51 yielded growth with 69 isolates and 8 yielded no growth. Among the 69 isolates, 51 were GNB and 18 were GPC. Biofilm detection was noted in 84.31% (43/51 GNB isolates with 0.1% crystal violet whereas 100% (51/51 showed biofilm positive with 0.1% safranin. About 74.50% (38/51 isolates of GNB were carbapenem resistant by screening with disk diffusion method. Only 24% (6/25 of GNB isolates among Enterobacteriaceae were positive by Modified Hodge test method. Conclusion: The result shows the association of biofilm production among carbapenem resistant isolates obtained from chronic wound infections.

The influence of carbapenem resistance on mortality in solid organ transplant recipients with Acinetobacter baumannii infection

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de Gouvêa Erika

2012-12-01

Full Text Available Abstract Background Infection with carbapenem-resistant Acinetobacter baumannii has been associated with high morbidity and mortality in solid organ transplant recipients. The main objective of this study was to assess the influence of carbapenem resistance and other potential risk factors on the outcome of A. baumannii infection after kidney and liver transplantation. Methods Retrospective study of a case series of A. baumannii infection among liver and renal transplant recipients. The primary outcome was death associated with A. baumannii infection. Multivariate logistic regression was used to assess the influence of carbapenem resistance and other covariates on the outcome. Results Forty-nine cases of A. baumannii infection affecting 24 kidney and 25 liver transplant recipients were studied. Eighteen cases (37% were caused by carbapenem-resistant isolates. There were 17 (35% deaths associated with A. baumannii infection. In unadjusted analysis, liver transplantation (p = 0.003, acquisition in intensive care unit (p = 0.001, extra-urinary site of infection (p A. baumannii infection. The number of deaths associated with A. baumannii infection was higher among patients infected with carbapenem-resistant isolates, but the difference was not significant (p = 0.28. In multivariate analysis, the risk of A. baumannii-associated mortality was higher in patients with infection acquired in the intensive care unit (odds ratio [OR] = 34.8, p = 0.01 and on mechanical ventilation (OR = 15.2, p = 0.04. Appropriate empiric antimicrobial therapy was associated with significantly lower mortality (OR = 0.04, p = 0.03, but carbapenem resistance had no impact on it (OR = 0.73, p = 0.70. Conclusion These findings suggest that A. baumannii-associated mortality among liver and kidney transplant recipients is influenced by baseline clinical severity and by the early start of appropriate therapy, but not by carbapenem

Risk factors for hospital-acquired bacteremia due to carbapenem-resistant Pseudomonas aeruginosa in a Colombian hospital.

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Valderrama, Sandra Liliana; González, Pedro Felipe; Caro, María Alejandra; Ardila, Natalia; Ariza, Beatriz; Gil, Fabián; Álvarez, Carlos

2016-02-23

Bacteremia due to Pseudomonas aeruginosa resistant to carbapenems is a public health problem due to the limitations it places on therapeutic options, as well as the increased time patients must spend in hospital, costs and the risk of mortality.  To evaluate the risk factors for presentation of bacteremia due to carbapenem-resistant P. aeruginosa acquired in the Hospital Universitario San Ignacio between January 2008 and June 2014.  This was a case control study in which the case patients presented bacteremia due to P. aeruginosa resistant to carbapenems and the control group included patients with P. aeruginosa susceptible to this group of antibiotics. Variables such as the previous use of meropenem and ertapenem, immunosuppression and neoplasia were measured. Mortality and duration of hospital were also described.  In all, 168 patients were evaluated, of which 42 were cases and 126 controls. Using a multivariate model, the risk factors related to bacteremia due to carbapenem-resistant P. aeruginosa acquired in hospital were the following: use of parenteral nutrition (OR=8.28; 95% CI: 2.56-26.79; p=0); use of meropenem (OR=1.15; 95% CI: 1.03-1.28; p=0.01); and use of ciprofloxacin (OR=81.99; 95% CI: 1.14-5884; p=0.043).  In order to prevent the emergence of carbapenem-resistant P. aeruginosa, antimicrobial control programs should be strengthened by promoting the prudent administration of carbapenems and quinolones. The correct use of parenteral nutrition should also be monitored.

ACCIÓN NEUROPROTECTORA Y NEURORREGENERADORA DE LAS SALES DE ÁCIDOS RESÍNICOS AISLADOS DE COLOFONIA DE CONÍFERAS DEL OCCIDENTE DE CUBA

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Yasiel Arteaga-Crespo

2012-01-01

Full Text Available Las enfermedades neuropsiquiátricas afectan a más de 10 % de la población cubana y alcanzan 25 % a nivel mundial. La mayoría de los fármacos empleados para el tratamiento de trastornos del sistema nervioso central son costosos y generan severas reacciones colaterales. Actualmente, se desarrollan esfuerzos para la aplicación de metabolitos secundarios como fuentes ecológicamente sostenibles para tratamiento de patologías del sistema nervioso -incluyendo isquemias y otras neuropatologías tipo Parkinson, Alzheimer y trastornos motores de Huntington-, que permitan una neuroprotección efectiva, así como una neurorregeneración en cortos periodos, con mínimas secuelas. El objetivo del trabajo fue evaluar la acción neurorregeneradora y neuroprotectora de la sal de sodio de ácidos resínicos aislados de colofonia de coníferas cubanas; los resultados del estudio sugieren que esta sal puede utilizarse en calidad de precursores estructurales de isoanálogos bioisostéricos con acción terapéutica específica tipo neuroprotectora y neurorregeneradora en el tratamiento de patologías isquémicas.

Duodenoscope-Related Outbreak of a Carbapenem-Resistant Klebsiella pneumoniae Identified Using Advanced Molecular Diagnostics.

Science.gov (United States)

Humphries, Romney M; Yang, Shuan; Kim, Stephen; Muthusamy, Venkatara Raman; Russell, Dana; Trout, Alisa M; Zaroda, Teresa; Cheng, Quen J; Aldrovandi, Grace; Uslan, Daniel Zachary; Hemarajata, Peera; Rubin, Zachary Aaron

2017-10-01

Carbapenem-resistant Klebsiella pneumoniae infections are increasingly prevalent in North American hospitals. We describe an outbreak of carbapenem-resistant K. pneumoniae containing the blaOXA-232 gene transmitted by contaminated duodenoscopes during endoscopic retrograde cholangiopancreatography (ERCP) procedures. An outbreak investigation was performed when 9 patients with blaOXA-232 carbapenem-resistant K. pneumoniae infections were identified at a tertiary care hospital. The investigation included 2 case-control studies, review of duodenoscope reprocessing procedures, and culture of devices. Carbapenem-resistant Enterobacteriacieae (CRE) isolates were evaluated with polymerase chain reaction analysis for carbapenemase genes, and isolates with the blaOXA-232 gene were subjected to whole-genome sequencing and chromosome single-nucleotide polymorphism analysis. On recognition of ERCP as a key risk factor for infection, targeted patient notification and CRE screening cultures were performed. Molecular testing ultimately identified 17 patients with blaOxa-232 carbapenem-resistant K. pneumoniae isolates, including 9 with infections, 7 asymptomatic carriers who had undergone ERCP, and 1 additional patient who had been hospitalized in India and was probably the initial carrier. Two case-control studies established a point-source outbreak associated with 2 specific duodenoscopes. A field investigation of the use, reprocessing, and storage of deuodenoscopes did not identify deviations from US Food and Drug Administration or manufacturer recommendations for reprocessing. This outbreak demonstrated the previously underappreciated potential for duodenoscopes to transmit disease, even after undergoing high-level disinfection according to manufacturers' guidelines.

Clinical evaluation of the need for carbapenems to treat community-acquired and healthcare-associated pneumonia.

Science.gov (United States)

Kamata, Kazuhiro; Suzuki, Hiromichi; Kanemoto, Koji; Tokuda, Yasuharu; Shiotani, Seiji; Hirose, Yumi; Suzuki, Masatsune; Ishikawa, Hiroichi

2015-08-01

Carbapenems have an overall broad antibacterial spectrum and should be protected against from the acquisition of drug resistance. The clinical advantages of carbapenem in cases of pneumonia have not been certified and the need for antipseudomonal antimicrobial agents to treat healthcare-associated pneumonia (HCAP) remains controversial. We introduced an antimicrobial stewardship program for carbapenem and tazobactam/piperacillin use and investigated the effects of this program on the clinical outcomes of 591 pneumonia cases that did not require intensive care unit management, mechanical ventilation or treatment with vasopressor agents [221 patients with community-acquired pneumonia (CAP) and 370 patients with HCAP]. Compared with the pre-intervention period, age, comorbidities and the severity and etiology of pneumonia did not differ during the intervention period. Carbapenems were rarely used during the intervention period in cases of pneumonia (CAP: 12% vs. 1%, HCAP: 13% vs. 1%), while antipseudomonal beta-lactam use was reduced from 33% to 8% among cases with HCAP. This reduction in the rate of carbapenem administration did not have an impact on the prognosis in the cases of CAP, and the in-hospital mortality was lower among the patients with HCAP during the intervention period (15% vs. 5%, p = 0.013). The causes of death in the cases of HCAP were not directly related to pneumonia during the intervention period. The current study shows that carbapenem use can be avoided in cases of CAP or HCAP that are not in a critical condition. The frequent use of antipseudomonal beta-lactams does not improve the clinical outcomes of HCAP. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Outbreak of carbapenem-resistant Providencia rettgeri in a tertiary ...

African Journals Online (AJOL)

2017-01-31

Jan 31, 2017 ... discharged, transmission from inanimate objects and healthcare workers is a ... Isolation of carbapenem-resistant NDM-1-positive Providencia rettgeri in Mexico. ... Australian Commission on Safety and Quality in Health Care.

Increasing Resistance to Extended-Spectrum Cephalosporins, Fluoroquinolone, and Carbapenem in Gram-Negative Bacilli and the Emergence of Carbapenem Non-Susceptibility in Klebsiella pneumoniae: Analysis of Korean Antimicrobial Resistance Monitoring System (KARMS) Data From 2013 to 2015.

Science.gov (United States)

Kim, Dokyun; Ahn, Ji Young; Lee, Chae Hoon; Jang, Sook Jin; Lee, Hyukmin; Yong, Dongeun; Jeong, Seok Hoon; Lee, Kyungwon

2017-05-01

National surveillance of antimicrobial resistance becomes more important for the control of antimicrobial resistance and determination of treatment guidelines. We analyzed Korean Antimicrobial Resistance Monitoring System (KARMS) data collected from 2013 to 2015. Of the KARMS participants, 16 secondary or tertiary hospitals consecutively reported antimicrobial resistance rates from 2013 to 2015. Data from duplicate isolates and institutions with fewer than 20 isolates were excluded. To determine the long-term trends, previous KARMS data from 2004 to 2012 were also considered. The prevalence of methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus faecium from 2013 to 2015 was 66-72% and 29-31%, respectively. The resistance rates of Escherichia coli to cefotaxime and cefepime gradually increased to 35% and 31%, respectively, and fluoroquinolone resistance reached 48% in 2015. The resistance rates of Klebsiella pneumoniae to cefotaxime, cefepime, and carbapenem were 38-41%, 33-41%, and carbapenem susceptibility rates of E. coli and K. pneumoniae decreased from 100% and 99.3% in 2011 to 99.0% and 97.0% in 2015, respectively. The resistance rate of Pseudomonas aeruginosa to carbapenem increased to 35% and the prevalence of carbapenem-resistant Acinetobacter baumannii increased from 77% in 2013 to 85% in 2015. Between 2013 and 2015, the resistance rates of E. coli to third- and fourth-generation cephalosporins increased continuously, while carbapenem-susceptibility gradually decreased, particularly in K. pneumoniae. The prevalence of carbapenem-resistant P. aeruginosa and A. baumannii increased significantly; therefore, few treatment options remain for these resistant strains. © The Korean Society for Laboratory Medicine

Caracterización parcial de un potexvirus aislado de Musa coccinea afectada por rayado necrótico en Colombia

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Reichel Helena

2008-08-01

Full Text Available

Se observaron síntomas de rayado necrótico en las hojas de una planta de Musa coccinea (banano escarlata, procedente de Antioquia (Colombia. Mediante inmunocaptura, transcripción reversa y reacción en cadena de la polimerasa (IC-RT-PCR, se amplificó un fragmento de aproximadamente 377 pares de bases, con una identidad de secuencia de aminoácidos de 57% con el gen de la cubierta proteica del Alstroemeria virus X [AlsVX, AB206396] del género Potexvirus. Este es el primer reporte de un potexvirus en M. coccinea. El análisis comparativo de la 3'UTR del potexvirus aislado de M. coccinea con el correspondiente del AlsVX muestra que estos dos virus difieren significativamente en esta región, lo que sugiere que el potexvirus aislado de M. coccinea en Colombia es una nueva especie del género Potexvirus. Se propone el nombre de virus de la raya necrótica del banano escarlata (Scarlet banana necrotic streak virus [SBanNSV] para este virus aislado de M. coccinea en Colombia.

OXA beta-lactamase-mediated carbapenem resistance in Acinetobacter baumannii

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S M Amudhan

2011-01-01

Full Text Available Objectives: Acinetobacter baumannii is a significant pathogen in health care settings. In recent years, an increase in carbapenem resistance among A. baumannii due to Ambler class B metallo-beta-lactamases or class D OXA carbapenamases has been reported. In this study we detected the presence of OXA carbapenamases and coproduction of metallo-beta-lactamases (blaVIM and blaIMP by phenotypic and genotypic methods in carbapenem resistant clinical isolates of Acinetobacter baumannii. Materials and Methods: A total of 116 consecutive, non-duplicate carbapenem resistant A. baumannii isolated from various clinical specimens were included in the study. The modified Hodge test and inhibitor potentiated disk diffusion tests were done for the screening of carbapenamase and metallo-beta-lactamase production, respectively. Polymerase chain reaction (PCR was performed for the detection of OXA (blaOXA 23 like, blaOXA 24 like, blaOXA-51 like and blaOXA-58 like genes and metallo-beta-lactamases (blaVIM and blaIMP genes. Gene sequencing was performed for representative isolates. Results: Among 116 A. baumannii, OXA genes were detected in 106 isolates. BlaOXA 51 like (n = 99 and blaOXA -23 like (n = 95 were the most common and they coexisted in 89 isolates. blaOXA-24 like gene was detected in two isolates of which one also carried blaOXA-51 like and blaOXA-58 like genes. The modified Hodge test was positive in 113 isolates. The metallo-beta-lactamase screening test was positive in 92 isolates. blavim was detected in 54 isolates of which 1 also carried the blaIMP gene. Conclusions: blaOXA-23 like and bla OXA 51 like genes are the most common types of OXA carbapenamases while the blaVIM type is the most common type of metallo-beta-lactamase contributing to carbapenem resistance in clinical isolates of A. baumannii. The coproduction of OXA and metallo-beta-lactamases is not an uncommon phenomenon in A. baumannii.

Phenotypic and genotypic characterization of Klebsiella pneumoniae strains with reduced susceptibiliy to carbapenems

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Simone Ambretti

2009-12-01

Full Text Available Reduced susceptibility to carbapenems in Gram-negative pathogens is an emerging feature of the antibiotic-resistance phenomenom Reports about strains resistant to this class of antibiotics among Enterobacteriaceae, particularly in Klebsiella pneumoniae, are increasing.The aims of this study were to assess the incidence of Klebsiella pneumoniae with reduced susceptibility to carbapenems in Bologna area and to carry out the characterization of these strains.The study included isolates of K. pneumoniae that showed reduced susceptibility to carbapenems, as detected by an automated system (Vitek2, bioMérieux. Between January and May 2009, 26 strains were collected (mainly isolated from urinary samples.These isolates were tested for susceptibility to carbapenems by E-test, to define MIC values for meropenem and ertapenem. Moreover, to detect the production of metallo-beta lactamases (MBL and carbapenemases (KPC were respectively performed the Etest with imipenem and imipenem/EDTA (IPM-IPM/EDTA and the modified Hodge test. Susceptibility assays performed by E-test showed that 25/26 strains were susceptible to meropenem, while for ertapenem 20/26 strains resulted resistant.The modified Hodge test was positive for 1 strain, while all the isolates were negative to the IPM-IPM/EDTA E-test.These results show that, as recently reported, the majority of strains of K. pneumoniae exhibiting reduced susceptibility to carbapenems, especially to ertapenem, are characterized by the production of ESBLs, which likely is associated with the loss of porins. On the other side, one strain was found to produce KPC and this finding confirms that the diffusion of carbapenemases producing K. pneumoniae has also to be considered in this geographic area.

Acquisition of Carbapenem Resistance by Plasmid-Encoded-AmpC-Expressing Escherichia coli.

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van Boxtel, Ria; Wattel, Agnes A; Arenas, Jesús; Goessens, Wil H F; Tommassen, Jan

2017-01-01

Although AmpC β-lactamases can barely degrade carbapenems, if at all, they can sequester them and prevent them from reaching their targets. Thus, carbapenem resistance in Escherichia coli and other Enterobacteriaceae can result from AmpC production and simultaneous reduction of antibiotic influx into the periplasm by mutations in the porin genes. Here we investigated the route and genetic mechanisms of acquisition of carbapenem resistance in a clinical E. coli isolate carrying bla CMY-2 on a plasmid by selecting for mutants that are resistant to increasing concentrations of meropenem. In the first step, the expression of OmpC, the only porin produced in the strain under laboratory conditions, was lost, leading to reduced susceptibility to meropenem. In the second step, the expression of the CMY-2 β-lactamase was upregulated, leading to resistance to meropenem. The loss of OmpC was due to the insertion of an IS1 element into the ompC gene or to frameshift mutations and premature stop codons in this gene. The bla CMY-2 gene was found to be located on an IncIγ plasmid, and overproduction of the CMY-2 enzyme resulted from an increased plasmid copy number due to a nucleotide substitution in the inc gene. The clinical relevance of these genetic mechanisms became evident from the analysis of previously isolated carbapenem-resistant clinical isolates, which appeared to carry similar mutations. Copyright © 2016 American Society for Microbiology.

Overexpression of an Outer Membrane Protein Associated with Decreased Susceptibility to Carbapenems in Proteus mirabilis

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Tsai, Yi-Lin; Wang, Min-Cheng; Hsueh, Po-Ren; Liu, Ming-Che; Hu, Rouh-Mei; Wu, Yue-Jin; Liaw, Shwu-Jen

2015-01-01

Proteus mirabilis isolates commonly have decreased susceptibility to imipenem. Previously, we found P. mirabilis hfq mutant was more resistant to imipenem and an outer membrane protein (OMP) could be involved. Therefore, we investigated the role of this OMP in carbapenem susceptibility. By SDS-PAGE we found this OMP (named ImpR) was increased in hfq mutant and LC-MS/MS revealed it to be the homologue of Salmonella YbfM, which is a porin for chitobiose and subject to MicM (a small RNA) regulation. We demonstrated that ImpR overexpression resulted in increased carbapenem MICs in the laboratory strain and clinical isolates. Chitobiose induced expression of chb (a chitobiose utilization operon). Real-time RT-PCR and SDS-PAGE were performed to elucidate the relationship of hfq, impR, chb and MicM in P. mirabilis. We found MicM RNA was decreased in hfq mutant and chbBC-intergenic region (chbBC-IGR) overexpression strain (chbIGRov), while impR mRNA was increased in hfq mutant, micM mutant and chbIGRov strain. In addition, mutation of hfq or micM and overexpression of chbBC-IGR increased ImpR protein level. Accordingly, chitobiose made wild-type have higher levels of ImpR protein and are more resistant to carbapenems. Hfq- and MicM-complemented strains restored wild-type MICs. Mutation of both impR and hfq eliminated the increase in carbapenem MICs observed in hfq mutant and ImpR-complementation of hfq/impR double mutant resulted in MICs as hfq mutant, indicating that the ImpR-dependent decreased carbapenem susceptibility of hfq mutant. These indicate MicM was antisense to impR mRNA and was negatively-regulated by chbBC-IGR. Together, overexpression of ImpR contributed to the decreased carbapenem susceptibility in P. mirabilis. PMID:25756370

Incidence of carbapenem-resistant gram negatives in Italian transplant recipients: a nationwide surveillance study.

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Lanini, Simone; Costa, Alessandro Nanni; Puro, Vincenzo; Procaccio, Francesco; Grossi, Paolo Antonio; Vespasiano, Francesca; Ricci, Andrea; Vesconi, Sergio; Ison, Michael G; Carmeli, Yehuda; Ippolito, Giuseppe

2015-01-01

Bacterial infections remain a challenge to solid organ transplantation. Due to the alarming spread of carbapenem-resistant gram negative bacteria, these organisms have been frequently recognized as cause of severe infections in solid organ transplant recipients. Between 15 May and 30 September 2012 we enrolled 887 solid organ transplant recipients in Italy with the aim to describe the epidemiology of gram negative bacteria spreading, to explore potential risk factors and to assess the effect of early isolation of gram negative bacteria on recipients' mortality during the first 90 days after transplantation. During the study period 185 clinical isolates of gram negative bacteria were reported, for an incidence of 2.39 per 1000 recipient-days. Positive cultures for gram negative bacteria occurred early after transplantation (median time 26 days; incidence rate 4.33, 1.67 and 1.14 per 1,000 recipient-days in the first, second and third month after SOT, respectively). Forty-nine of these clinical isolates were due to carbapenem-resistant gram negative bacteria (26.5%; incidence 0.63 per 1000 recipient-days). Carbapenems resistance was particularly frequent among Klebsiella spp. isolates (49.1%). Recipients with longer hospital stay and those who received either heart or lung graft were at the highest risk of testing positive for any gram negative bacteria. Moreover recipients with longer hospital stay, lung recipients and those admitted to hospital for more than 48h before transplantation had the highest probability to have culture(s) positive for carbapenem-resistant gram negative bacteria. Forty-four organ recipients died (0.57 per 1000 recipient-days) during the study period. Recipients with at least one positive culture for carbapenem-resistant gram negative bacteria had a 10.23-fold higher mortality rate than those who did not. The isolation of gram-negative bacteria is most frequent among recipient with hospital stays >48 hours prior to transplant and in those

Incidence of carbapenem-resistant gram negatives in Italian transplant recipients: a nationwide surveillance study.

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Simone Lanini

Full Text Available Bacterial infections remain a challenge to solid organ transplantation. Due to the alarming spread of carbapenem-resistant gram negative bacteria, these organisms have been frequently recognized as cause of severe infections in solid organ transplant recipients.Between 15 May and 30 September 2012 we enrolled 887 solid organ transplant recipients in Italy with the aim to describe the epidemiology of gram negative bacteria spreading, to explore potential risk factors and to assess the effect of early isolation of gram negative bacteria on recipients' mortality during the first 90 days after transplantation. During the study period 185 clinical isolates of gram negative bacteria were reported, for an incidence of 2.39 per 1000 recipient-days. Positive cultures for gram negative bacteria occurred early after transplantation (median time 26 days; incidence rate 4.33, 1.67 and 1.14 per 1,000 recipient-days in the first, second and third month after SOT, respectively. Forty-nine of these clinical isolates were due to carbapenem-resistant gram negative bacteria (26.5%; incidence 0.63 per 1000 recipient-days. Carbapenems resistance was particularly frequent among Klebsiella spp. isolates (49.1%. Recipients with longer hospital stay and those who received either heart or lung graft were at the highest risk of testing positive for any gram negative bacteria. Moreover recipients with longer hospital stay, lung recipients and those admitted to hospital for more than 48h before transplantation had the highest probability to have culture(s positive for carbapenem-resistant gram negative bacteria. Forty-four organ recipients died (0.57 per 1000 recipient-days during the study period. Recipients with at least one positive culture for carbapenem-resistant gram negative bacteria had a 10.23-fold higher mortality rate than those who did not.The isolation of gram-negative bacteria is most frequent among recipient with hospital stays >48 hours prior to transplant

Dissemination of carbapenem-resistant Acinetobacter baumannii in patients with burn injuries.

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Shoja, Saeed; Moosavian, Mojtaba; Rostami, Soodabeh; Farahani, Abbas; Peymani, Amir; Ahmadi, Khadijeh; Ebrahimifard, Nasim

2017-04-01

Carbapenem-resistant Acinetobacter baumannii has emerged as an important cause of infection in burn patients. This study aimed to characterize the antimicrobial susceptibility pattern, determine the prevalence of oxacillinase and metallo-beta-lactamase (MBL) genes, and type the A. baumannii isolates obtained from burn patients. During a 1-year period, a total of 40 nonduplicated isolates of A. baumannii were obtained from burn patients who were hospitalized in the Taleghani Burn Hospital in Ahvaz, in the southwest of Iran. Testing for antimicrobial susceptibility was carried out by disk diffusion and E-test. To screen MBL production, a double disk synergy and MBL E-test were performed. The presence of bla OXA-23-like , bla OXA-24-like , bla OXA-51-like and bla OXA-58-like , bla VIM , bla IMP and bla SPM , and bla NDM was sought by polymerase chain reaction (PCR). Repetitive extragenic palindromic sequence-based PCR was carried out for determination of isolates clonality. Overall, 92.5% of isolates were carbapenem-resistant. Polymyxin B, colistin, and ampicillin-sulbactam were the most effective agents in vitro, with a susceptibility rate of 100%, 97.5%, and 72.5%, respectively. According to the double disk synergy and E-test, 55.6% and 97.3% of isolates were MBL producers, respectively. Furthermore, 70% of isolates harbored bla OXA-23-like and 20% were positive for bla OXA-24-like. However, no encoding genes were detected for bla VIM , bla IMP and bla SPM , bla NDM , and bla OXA-58-like . Repetitive extragenic palindromic sequence-based PCR revealed that carbapenem-resistant isolates belonged to four clones, including A, B, C, and D; the predominant clones were B and C. The rate of carbapenem resistance was high, and it appeared that bla OXA-23-like and bla OXA-24-like contributed to the carbapenem resistance of A. baumannii isolates. This result suggests that the two predominant clones of A. baumannii were spread among burn patients. In order to prevent future

CARBAPENEM-RESISTANT ACINETOBACTER BAUMANII POSTOPERATIVE MENINGITIS

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Laura Ghibu; Egidia Miftode; Olivia Dorneanu; Carmen Dorobat

2011-01-01

Acinetobacter baumannii is an opportunistic pathogen of increasing relevance in hospital infections during the last 15 years.This organism causes a wide range of infection .Extensive use of antibiotics within hospitals has contribute to the emergence of multidrug-resistent A.baumannii strains that exhibit resistance to a wide range of antibiotics ,including carbapenems.We report the case of an 37 years old man diagnosed with Acinetobacter multidrug-resistant post-neurosurgical meningitis with...

Carbapenem-resistant and cephalosporin-susceptible: a worrisome phenotype among Pseudomonas aeruginosa clinical isolates in Brazil.

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Campana, Eloiza Helena; Xavier, Danilo Elias; Petrolini, Fernanda Villas-Boas; Cordeiro-Moura, Jhonatha Rodrigo; Araujo, Maria Rita Elmor de; Gales, Ana Cristina

The mechanisms involved in the uncommon resistance phenotype, carbapenem resistance and broad-spectrum cephalosporin susceptibility, were investigated in 25 Pseudomonas aeruginosa clinical isolates that exhibited this phenotype, which were recovered from three different hospitals located in São Paulo, Brazil. The antimicrobial susceptibility profile was determined by CLSI broth microdilution. β-lactamase-encoding genes were investigated by PCR followed by DNA sequencing. Carbapenem hydrolysis activity was investigated by spectrophotometer and MALDI-TOF assays. The mRNA transcription level of oprD was assessed by qRT-PCR and the outer membrane proteins profile was evaluated by SDS-PAGE. Genetic relationship among P. aeruginosa isolates was assessed by PFGE. Carbapenems hydrolysis was not detected by carbapenemase assay in the carbapenem-resistant and cephalosporin-susceptible P. aueruginosa clinical isolates. OprD decreased expression was observed in all P. aeruginosa isolates by qRT-PCR. The outer membrane protein profile by SDS-PAGE suggested a change in the expression of the 46kDa porin that could correspond to OprD porin. The isolates were clustered into 17 genotypes without predominance of a specific PFGE pattern. These results emphasize the involvement of multiple chromosomal mechanisms in carbapenem-resistance among clinical isolates of P. aeruginosa, alert for adaptation of P. aeruginosa clinical isolates under antimicrobial selective pressure and make aware of the emergence of an uncommon phenotype among P. aeruginosa clinical isolates. Copyright © 2016 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. All rights reserved.

Susceptibilities to carbapenems and presence of cphA gene on food-borne Aeromonas

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Bibiana María Martín Talavera

2006-07-01

Full Text Available The purpose of this study was to determine the susceptibilities of food-borne Aeromonas to carbapenems, as well as to investigate the presence of a metallo carbapenemase-encoding gene, named cphA. Minimum Inhibitory Concentration (MIC was determined following NCCLS standards. All the tested microorganisms were susceptible to imipenem, meropenem and biapenem. However, a strong inoculum size effect on carbapenem MICs was observed for most of the strains. Six strains, out of seven, showed the presence of metallo--beta-lactamases but cphA gene was detected in only two strains of A. veronii bv. sobria.O objetivo deste estudo foi determinar a suscetibilidade de aeromonas de origem alimentar a carbapenems bem como investigar a presença de um gene codificante de metalocarbapenemase, denominado "cph A". A suscetibilidade in vitro foi determinada pelo metodo de diluição em agar. Todas as cepas foram suscetíveis a Imipenem, Meropenem e Biapenem. Porém foi observado um forte efeito de tamanho do inóculo sobre as CIM das carbapenems na maioria das cepas. A detecção de metalo-beta-lactamase foi realizada pelo metodo lodometrico. Seis cepas das sete testadas demostraron a presença da enzima. A presença do gene cphA foi determinada por PCR e foi detectada em duas cepas de A veronii bv. sobria.

Impact of carbapenem resistance on the outcome of patients' hospital-acquired bacteraemia caused by Klebsiella pneumoniae.

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Hussein, K; Raz-Pasteur, A; Finkelstein, R; Neuberger, A; Shachor-Meyouhas, Y; Oren, I; Kassis, I

2013-04-01

Carbapenem-resistant Enterobacteriaceae, especially Klebsiella spp., have become a major health problem recently worldwide. Since 2006 the incidence of carbapenem-resistant Klebsiella pneumoniae (CRKP) infections has increased substantially in Israel. Bloodstream infections (BSIs) caused by these strains have been associated with high rates of treatment failure and mortality. This study was designed to identify risk factors for carbapenem resistance among patients with healthcare-related (HCR) K. pneumoniae bacteraemia and predictors of mortality associated with HCR-CRKP bacteraemia compared with carbapenem-susceptible K. pneumoniae (CSKP). In this retrospective case-control study, all cases of K. pneumoniae bacteraemia during 2006-2008 were identified. Resistance patterns, underlying morbidities, risk factors for drug resistance and mortality rates were compared for patients with CRKP and CSKP bacteraemia. Two hundred and fourteen patients with CSKP bacteraemia were compared with 103 patients with CRKP bacteraemia. Severe, chronic comorbidities and prior antibiotic use were more frequent among patients with CRKP bacteraemia. On multivariate analysis prior use of macrolides and antibiotic exposure for ≥14 days remained the only independent factors associated with CRKP bacteraemia. Mortality rates of CRKP patients were significantly higher than those of CSKP patients. On multivariate analyses: bedridden status, chronic liver disease, Charlson comorbidity index ≥5, mechanical ventilation, and haemodialysis remained independently associated with mortality among patients with K. pneumoniae bacteraemia. Carbapenem resistance was not a risk factor for mortality. Previous antibiotic exposure is a risk factor for CRKP-BSI. Mortality among patients with K. pneumoniae bacteraemia is associated with serious comorbidities, but not with carbapenem resistance. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Treatment of ESBL-producing Klebsiella pneumoniae bacteraemia with carbapenems or flomoxef: a retrospective study and laboratory analysis of the isolates.

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Lee, Chen-Hsiang; Su, Lin-Hui; Tang, Ya-Fen; Liu, Jien-Wei

2006-11-01

To better understand the clinical outcomes of patients with extended-spectrum beta-lactamase-producing Klebsiella pneumoniae (ESBL-KP) bacteraemia treated with either flomoxef or a carbapenem, and to evaluate the in vitro activities of these antibiotics against ESBL-KP. Retrospective analyses to identify risk factors for mortality in patients with flomoxef-susceptible ESBL-KP, especially addressing the therapeutic roles of flomoxef and carbapenem. In vitro activities of flomoxef and carbapenem against flomoxef-susceptible ESBL-KP isolates were evaluated by susceptibility testing and time-kill study. Twenty-seven patients (flomoxef group, n=7; carbapenem group, n=20) were included. Clinical severity reflected by high Pitt bacteraemia score (>or=6) was an independent risk factor for mortality (OR 13.43; 95% CI, 1.08-166.73; P=0.043), while use of flomoxef or a carbapenem was not. The MICs of flomoxef and carbapenem indicated that the tested ESBL-KP were susceptible to these antibiotics regardless of the inoculum size of 10(5) or 10(7) cfu/mL. Time-kill study showed that these antibiotics (flomoxef 8 mg/L and meropenem 4 mg/L) each acted actively against and inhibited the regrowth of the tested ESBL-KP for at least 24 h. Flomoxef might be as clinically effective as a carbapenem in treating flomoxef-susceptible ESBL-KP bacteraemia.

Impact of Combination Antimicrobial Therapy on Mortality Risk for Critically Ill Patients with Carbapenem-Resistant Bacteremia

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Bauer, Seth R.; Neuner, Elizabeth A.; Lam, Simon W.

2015-01-01

There are limited treatment options for carbapenem-resistant Gram-negative infections. Currently, there are suggestions in the literature that combination therapy should be used, which frequently includes antibiotics to which the causative pathogen demonstrates in vitro resistance. This case-control study evaluated risk factors associated with all-cause mortality rates for critically ill patients with carbapenem-resistant Gram-negative bacteremia. Adult patients who were admitted to an intensive care unit with sepsis and a blood culture positive for Gram-negative bacteria resistant to a carbapenem were included. Patients with polymicrobial, recurrent, or breakthrough infections were excluded. Included patients were classified as survivors (controls) or nonsurvivors (cases) at 30 days after the positive blood culture. Of 302 patients screened, 168 patients were included, of whom 90 patients died (53.6% [cases]) and 78 survived (46.4% [controls]) at 30 days. More survivors received appropriate antibiotics (antibiotics with in vitro activity) than did nonsurvivors (93.6% versus 53.3%; P carbapenems) (87.2% versus 80%; P = 0.21). After adjustment for baseline factors with multivariable logistic regression, combination therapy was independently associated with decreased risk of death (odds ratio, 0.19 [95% confidence interval, 0.06 to 0.56]; P carbapenem-resistant Gram-negative bacteremia. However, that association is lost if in vitro activity is not considered. PMID:25845872

Higher third-generation cephalosporin prescription proportion is associated with lower probability of reducing carbapenem use: a nationwide retrospective study

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Allison Muller

2018-01-01

Full Text Available Abstract Background The ongoing extended spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE pandemic has led to an increasing carbapenem use, requiring release of guidelines for carbapenem usage in France in late 2010. We sought to determine factors associated with changes in carbapenem use in intensive care units (ICUs, medical and surgical wards between 2009 and 2013. Methods This ward-level multicentre retrospective study was based on data from French antibiotic and multidrug-resistant bacteria surveillance networks in healthcare facilities. Antibiotic use was expressed in defined daily doses per 1000 patient-days. Factors associated with the reduction in carbapenem use (yes/no over the study period were determined from random-effects logistic regression model (493 wards nested within 259 healthcare facilities: ward characteristics (type, size…, ward antibiotic use (initial antibiotic use [i.e., consumption of a given antibiotic in 2009], initial antibiotic prescribing profile [i.e., proportion of a given antibiotic in the overall antibiotic consumption in 2009] and reduction in the use of a given antibiotic between 2009 and 2013 and regional ESBL-PE incidence rate in acute care settings in 2011. Results Over the study period, carbapenem consumption in ICUs (n = 85, medical (n = 227 and surgical wards (n = 181 was equal to 73.4, 6.2 and 5.4 defined daily doses per 1000 patient-days, respectively. Release of guidelines was followed by a significant decrease in carbapenem use within ICUs and medical wards, and a slowdown in use within surgical wards. The following factors were independently associated with a higher probability of reducing carbapenem use: location in Eastern France, higher initial carbapenem prescribing profile and reductions in consumption of fluoroquinolones, glycopeptides and piperacillin/tazobactam. In parallel, factors independently associated with a lower probability of reducing carbapenem use were

Caracterización fenotípica y genotípica de doce rizobios aislados de diversas regiones geográficas de Venezuela

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María Eugenia Marquina

2011-09-01

Full Text Available Rasgos fenotípicos y marcadores moleculares de ADN se utilizaron para investigar la variación fenotípica y genética entre 12 aislados rizobianos venezolanos y 10 cepas de referencia internacionales. Para ello, se realizó un PCR-RFLP del gen rDNA 16S, la presencia de plásmidos grandes, análisis metabólicos en medios sólidos, resistencia a la salinidad, condiciones del crecimiento a diferentes pH y temperaturas y la resistencia intrínseca a antibióticos. En referencia a las cualidades fenotípicas, se diferenciaron tres grupos principales, un grupo I que abarcó a todas aquellas cepas que metabolizaban entre 67.5% y 90% de las fuentes de C y de N. También eran tolerantes a la acidez y productoras de ácido, capaces de crecer a 40ºC y a altas condiciones de salinidad (NaCl 2-2.5%. Con respecto a la sensibilidad a antibióticos, este grupo era susceptible a un 30% de los antibióticos empleados. Las cepas que pertenecen al grupo II exhibieron una tolerancia salina más baja (0.1- 1.5%NaCl, así como una menor tolerancia a la acidez, puesto que crecieron bien en valores de pH iguales o mayores a 5.0. Este grupo era resistente a todos los antibióticos probados y metabolizaban solamente entre 52.5%-82.5% de las fuentes de C y de N. Una sola cepa bacteriana representó al grupo III, con una baja tolerancia salina (0.1% NaCl. Este aislado creció a un pH mayor o igual a 5.6, era susceptible a 50% de los antibióticos probados y metabolizó el 72% de las fuentes de C y de N. Al tener como base el PCR-RFLP del 16S rDNA, se diferenciaron también tres grupos. Los miembros del grupo A demostraron una estrecha relación con Rhizobium tropici CiAT 899 y Sinorhizobium americanum CFN-Ei156, mientras que el grupo B está estrechamente vinculado a Bradyrhizobium spp. El grupo C, está representado por solo un aislado. El aislado Trebol, fue la única cepa capaz de formar nódulos y no aparece relacionado con ninguna cepa de referencia, y sugiere una

Dinámica poblacional del rotífero Brachionus ibericus aislado de estanques para camarón, alimentado con diferentes dietas

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José Cristóbal Román-Reyes

2014-11-01

Full Text Available La producción de microalgas vivas para cultivar rotíferos constituye uno de los mayores costos de operación en la larvicultura de peces, por lo que se están desarrollando sustitutos comerciales de microalgas para la alimentación y producción de rotíferos. Se desconoce el efecto que tienen las formulaciones comerciales sobre la dinámica poblacional de rotíferos nativos del noroeste de México y en este estudio se evaluó el efecto de cuatro dietas comerciales (Espirulina, RotiMac®, Nanno 3600®, RotiGrow-Plus® y la microalga viva Nannochloropsis sp., sobre el crecimiento poblacional y fecundidad del rotífero Brachionus ibericus (GenBank KJ949043, aislado de una granja de camarón blanco (Litopenaeus vannamei. Se realizaron cinco réplicas por tratamiento alimenticio utilizando recipientes con volumen de 12 L de agua, con temperatura de 29 ± 1°C y salinidad de 35 ± 1, respectivamente. Los resultados mostraron que durante los periodos experimentales, las dietas probadas resultaron adecuadas para alimentar a B. ibericus, con tasas de crecimiento, tiempos de duplicación, densidades máximas y fecundidades que fluctuaron entre 0.20 a 0.27 rotíferos día-1, 2.60 a 3.42 días, 215 a 344 rotíferos mL-1 y de 0.16 a 0.39 huevos hembra-1, respectivamente. Las diferencias entre tratamientos fueron significativas (P 0.05 a las obtenidas con Nanno 3600®.

Carbapenem MICs in Escherichia coli and Klebsiella Species Producing Extended-Spectrum β-Lactamases in Critical Care Patients from 2001 to 2009.

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Johnson, J Kristie; Robinson, Gwen L; Pineles, Lisa L; Ajao, Adebola O; Zhao, LiCheng; Albrecht, Jennifer S; Harris, Anthony D; Thom, Kerri A; Furuno, Jon P

2017-04-01

Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae strains are increasing in prevalence worldwide. Carbapenem antibiotics are used as a first line of therapy against ESBL-producing Enterobacteriaceae We examined a cohort of critical care patients for gastrointestinal colonization with carbapenem-resistant ESBL-producing strains (CR-ESBL strains). We cultured samples from this cohort of patients for ESBL-producing Klebsiella spp. and Escherichia coli and then tested the first isolate from each patient for susceptibility to imipenem, doripenem, meropenem, and ertapenem. Multilocus sequence typing was performed on isolates that produced an ESBL and that were carbapenem resistant. Among all patients admitted to an intensive care unit (ICU), 4% were positive for an ESBL-producing isolate and 0.64% were positive for a CR-ESBL strain on surveillance culture. Among the first ESBL-producing E. coli and Klebsiella isolates from the patients' surveillance cultures, 11.2% were carbapenem resistant. Sequence type 14 (ST14), ST15, ST42, and ST258 were the dominant sequence types detected in this cohort of patients, with ST15 and ST258 steadily increasing in prevalence from 2006 to 2009. Patients colonized by a CR-ESBL strain were significantly more likely to receive antipseudomonal and anti-methicillin-resistant Staphylococcus aureus (anti-MRSA) therapy prior to ICU admission than patients colonized by carbapenem-susceptible ESBL-producing strains. They were also significantly more likely to have received a cephalosporin or a carbapenem antibiotic than patients colonized by carbapenem-susceptible ESBL-producing strains. In conclusion, in a cohort of patients residing in intensive care units within the United States, we found that 10% of the isolates were resistant to at least one carbapenem antibiotic. The continued emergence of carbapenem-resistant ESBL-producing strains is of significant concern, as infections due to these organisms are notoriously difficult to

Algunos elementos para interpretar la presencia de los varones en los procesos de salud reproductiva

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Juan Guillermo Figueroa-Perea

Full Text Available El objetivo del trabajo es identificar vertientes analíticas para ubicar a los varones en los procesos de salud reproductiva. Se propone cuestionar la interpretación que los identifica solamente como actores que pueden apoyar mejorías en la salud de las mujeres y de los hijos. Es reciente la inquietud por redimensionar su papel, como seres que se reproducen y enfrentan riesgos en su aparato, comportamiento y proceso reproductivos. Una posibilidad para explicitar la presencia de los varones en dichos procesos es identificar cuáles son sus ausencias y presencias que condicionan las consecuencias favorables o no para las mujeres y los hijos. Se trata de ver de qué manera dificultan o contribuyen a mejorar las condiciones de la morbimortalidad materna. Una segunda posibilidad es incursionar en el carácter relacional, social y potencialmente conflictivo de la reproducción "sexualizada". Implica replantear el análisis de la reproducción como un proceso relacional y no como eventos aislados de hombres y mujeres, al mismo tiempo que recuperar la especificidad de unos y de otras. Se utiliza la perspectiva de género con el fin de imaginar los procesos sin negar la dimensión del poder. Así, se replantean la sexualidad, la reproducción y la salud en términos de interacción, con el fin de construir referencias más claras respecto a la población masculina.

Carbapenem-resistance and pathogenicity of bovine Acinetobacter indicus-like isolates.

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Peter Klotz

Full Text Available The objective of this study was to characterize blaOXA-23 harbouring Acinetobacter indicus-like strains from cattle including genomic and phylogenetic analyses, antimicrobial susceptibility testing and evaluation of pathogenicity in vitro and in vivo. Nasal and rectal swabs (n = 45 from cattle in Germany were screened for carbapenem-non-susceptible Acinetobacter spp. Thereby, two carbapenem resistant Acinetobacter spp. from the nasal cavities of two calves could be isolated. MALDI-TOF mass spectrometry and 16S rDNA sequencing identified these isolates as A. indicus-like. A phylogenetic tree based on partial rpoB sequences indicated closest relation of the two bovine isolates to the A. indicus type strain A648T and human clinical A. indicus isolates, while whole genome comparison revealed considerable intraspecies diversity. High mimimum inhibitory concentrations were observed for carbapenems and other antibiotics including fluoroquinolones and gentamicin. Whole genome sequencing and PCR mapping revealed that both isolates harboured blaOXA-23 localized on the chromosome and surrounded by interrupted Tn2008 transposon structures. Since the pathogenic potential of A. indicus is unknown, pathogenicity was assessed employing the Galleria (G. mellonella infection model and an in vitro cytotoxicity assay using A549 human lung epithelial cells. Pathogenicity in vivo (G. mellonella killing assay and in vitro (cytotoxicity assay of the two A. indicus-like isolates was lower compared to A. baumannii ATCC 17978 and similar to A. lwoffii ATCC 15309. The reduced pathogenicity of A. indicus compared to A. baumannii correlated with the absence of important virulence genes encoding like phospholipase C1+C2, acinetobactin outer membrane protein BauA, RND-type efflux system proteins AdeRS and AdeAB or the trimeric autotransporter adhesin Ata. The emergence of carbapenem-resistant A. indicus-like strains from cattle carrying blaOXA-23 on transposable elements and

Screening of nursing home residents for colonization with carbapenem-resistant Enterobacteriaceae admitted to acute care hospitals: Incidence and risk factors.

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Cunha, Cheston B; Kassakian, Steven Z; Chan, Ryan; Tenover, Fred C; Ziakas, Panos; Chapin, Kimberle C; Mermel, Leonard A

2016-02-01

There are increasing reports of multidrug-resistant gram-negative bacilli in nursing homes and acute care hospitals. We performed a point prevalence survey to detect fecal carriage of gram-negative bacteria carrying carbapenem resistance genes or which were otherwise resistant to carbapenem antibiotics among 500 consecutive admissions from local nursing homes to 2 hospitals in Providence, Rhode Island. We performed a case-control study to identify risk factors associated with carriage of carbapenem-resistant Enterobacteriaceae (CRE). There were 404 patients with 500 hospital admissions during which they had rectal swab samples cultured. Fecal carriage of any carbapenem-resistant or carbapenemase- producing gram-negative bacteria was found in 23 (4.6%) of the 500 hospital admissions, including 7 CRE (1.4%), 2 (0.4%) of which were Klebsiella pneumoniae carbapenemase (ie, blaKPC) producing (CPE) Citrobacter freundii, 1 of which was carbapenem susceptible by standard testing methods. Use of a gastrostomy tube was associated with CRE carriage (P = .04). We demonstrated fecal carriage of carbapenem-resistant or carbapenemase-producing gram-negative bacteria in 4.6% of nursing home patients admitted to 2 acute care hospitals, but only 0.4% of such admissions were patients with fecal carriage of CPE. Use of gastrostomy tubes was associated with fecal carriage of gram-negative bacteria with detectable carbapenem resistance. CRE fecal carriage is uncommon in our hospital admissions from nursing homes. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Spatial molecular epidemiology of carbapenem-resistant and New Delhi metallo beta-lactamase (blaNDM)-producing Escherichia coli in the piglets of organized farms in India.

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Pruthvishree, B S; Vinodh Kumar, O R; Sinha, D K; Malik, Y P S; Dubal, Z B; Desingu, P A; Shivakumar, M; Krishnaswamy, N; Singh, B R

2017-06-01

A cross-sectional study was conducted in 10 government-organized pig farms between 2014 and 2016 representing seven states of India to understand the epidemiology of carbapenem resistance in the Escherichia coli. In this study, fecal sample (n = 673) from non-diarrheic (n = 501) and diarrheic (n = 172) piglets were processed for isolation of carbapenem resistant E. coli. Of 673, E. coli isolate (n = 112) was genotyped for confirming the carbapenem resistance and associated virulence factors. Of the 112 isolates, 23 were phenotypically resistant to carbapenem and 8 were carrying the New Delhi metallo beta-lactamase (blaNDM) gene. The carbapenem-resistant isolates also produced extended spectrum beta-lactamases and were multidrug resistant. The PCR-based pathotyping revealed the presence of stx1, stx2, eae and hlyA genes. The enterobacterial repetitive intergenic consensus PCR dendrogram analysis of the isolates yielded three distinct clusters. The statistical analysis revealed no association between carriages of carbapenem-resistant E. coli in different breed of piglets however, location, sex, health status of piglets and age showed significant difference. The spatial analysis with SaTScan helped in identification of carbapenem-resistant clusters. The presence of carbapenem resistant E. coli isolates with virulence genes in the piglet poses a potential public health risk through possible access and spread via the food chain and environment. Efflux pump may also play an important role in carbapenem resistance in piglet E. coli isolates. Furthermore, identification of risk factors in relation to spatial clusters will help in designing preventive strategies for reducing the risk of spread of carbapenem resistant bacteria. 1. Piglets harbor carbapenem resistant E. coli and have great public health significance. 2. Apart from carbapenemase, efflux pump is also important for carbapenem resistance. 3. This is the first report of blaNDM in the piglets from India. © 2017

Carbapenem-Resistant Acinetobacter baumannii and Enterobacteriaceae in South and Southeast Asia

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Apisarnthanarak, Anucha; Khan, Erum; Ghafur, Abdul

2016-01-01

SUMMARY Carbapenem-resistant Gram-negative bacteria, in particular the Acinetobacter baumannii-calcoaceticus complex and Enterobacteriaceae, are escalating global public health threats. We review the epidemiology and prevalence of these carbapenem-resistant Gram-negative bacteria among countries in South and Southeast Asia, where the rates of resistance are some of the highest in the world. These countries house more than a third of the world's population, and several are also major medical tourism destinations. There are significant data gaps, and the almost universal lack of comprehensive surveillance programs that include molecular epidemiologic testing has made it difficult to understand the origins and extent of the problem in depth. A complex combination of factors such as inappropriate prescription of antibiotics, overstretched health systems, and international travel (including the phenomenon of medical tourism) probably led to the rapid rise and spread of these bacteria in hospitals in South and Southeast Asia. In India, Pakistan, and Vietnam, carbapenem-resistant Enterobacteriaceae have also been found in the environment and community, likely as a consequence of poor environmental hygiene and sanitation. Considerable political will and effort, including from countries outside these regions, are vital in order to reduce the prevalence of such bacteria in South and Southeast Asia and prevent their global spread. PMID:27795305

Carbapenem-Resistant Acinetobacter baumannii and Enterobacteriaceae in South and Southeast Asia.

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Hsu, Li-Yang; Apisarnthanarak, Anucha; Khan, Erum; Suwantarat, Nuntra; Ghafur, Abdul; Tambyah, Paul Anantharajah

2017-01-01

Carbapenem-resistant Gram-negative bacteria, in particular the Acinetobacter baumannii-calcoaceticus complex and Enterobacteriaceae, are escalating global public health threats. We review the epidemiology and prevalence of these carbapenem-resistant Gram-negative bacteria among countries in South and Southeast Asia, where the rates of resistance are some of the highest in the world. These countries house more than a third of the world's population, and several are also major medical tourism destinations. There are significant data gaps, and the almost universal lack of comprehensive surveillance programs that include molecular epidemiologic testing has made it difficult to understand the origins and extent of the problem in depth. A complex combination of factors such as inappropriate prescription of antibiotics, overstretched health systems, and international travel (including the phenomenon of medical tourism) probably led to the rapid rise and spread of these bacteria in hospitals in South and Southeast Asia. In India, Pakistan, and Vietnam, carbapenem-resistant Enterobacteriaceae have also been found in the environment and community, likely as a consequence of poor environmental hygiene and sanitation. Considerable political will and effort, including from countries outside these regions, are vital in order to reduce the prevalence of such bacteria in South and Southeast Asia and prevent their global spread. Copyright © 2016 American Society for Microbiology.

Could Frequent Carbapenem Use Be a Risk Factor for Colistin Resistance?

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Gundogdu, Aycan; Ulu-Kilic, Aysegul; Kilic, Huseyin; Ozhan, Esra; Altun, Dilek; Cakir, Ozlem; Alp, Emine

2017-10-13

The antibiotic colistin, which had been previously abandoned, is being brought back as a last line of defense against bacterial infection. However, colistin resistance was reported shortly after its reintroduction. This study evaluated the risk factors for colonization/infections due to colistin-resistant Acinetobacter baumannii (ColR-Ab) and Klebsiella pneumoniae (ColR-Kp) strains and characterized the molecular epidemiology of these two strains. Age, previous hospitalization duration, and previous use of carbapenem and colistin were risk factors for ColR-Kp, whereas previous use of carbapenem and colistin was a risk factor for ColR-Ab. According to pulsed-field gel electrophoresis analysis, most ColR-Kp strains could be grouped into two major pulsotypes. This appears to be an indicator of cross contamination of ColR-Kp strain, since different isolates appeared to be belonging to the same clones. The existence of colistin-susceptible (ColS) and colistin-resistant (ColR) strains in the same pulsotypes might also be an indicator of the recent emergence of resistance mechanisms. The results highlight the emergence of ColR pathogens in Turkey, which is considered to be developing country, and that carbapenem use coupled with insufficient infection control measures might increase the risk of ColR outbreaks.

Heterogeneity of Carbapenem Resistance Mechanisms Among Gram-Negative Pathogens in Lebanon: Results of the First Cross-Sectional Countrywide Study.

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Hammoudi Halat, Dalal; Moubareck, Carole Ayoub; Sarkis, Dolla Karam

2017-09-01

Carbapenem-resistant Gram-negative pathogens have progressively disseminated to different countries worldwide, presenting a serious public health concern. The aims of this study were to determine the prevalence of carbapenem resistance in Gram-negative bacteria in Lebanon, to elucidate molecular mechanisms, and to identify genetic relatedness of incriminated strains. Carbapenem nonsusceptible Enterobacteriaceae, Acinetobacter baumannii, and Pseudomonas were collected from 11 Lebanese hospitals in 2012. Antimicrobial susceptibility was assessed with phenotypic tests, genes encoding carbapenemases were screened via PCR-sequencing, and genetic relatedness was examined by PGFE and ERIC-PCR. A total of 398 nonrepetitive carbapenem nonsusceptible isolates were studied, of which 44 were Enterobacteriaceae, 142 were A. baumannii, and 212 were Pseudomonas. Among Enterobacteriaceae, 70.4% carried bla OXA-48-like gene on IncL/M-type plasmids, while acquired AmpC cephalosporinases, extended-spectrum-β-lactamases, and efflux-pump were additional contributors to carbapenem resistance. Among A. baumannii, 90% produced OXA-23 and GES-11 and carried insertion sequence ISAba1 upstream and adjacent to bla OXA-23 and bla Acinetobacter -derived cephalosporinases . Among Pseudomonas, 16% harbored VIM-2, 4.2% IMP-2, and 1.4% IMP-1 metallo-β-lactamases. Fingerprint analysis indicated that the spread of OXA-48-like carbapenemases was mostly mediated by horizontal transfer, while OXA-23 and GES-11 diffusion in A. baumannii and VIM-2 diffusion in P. aeruginosa were primarily due to clonal dissemination. This study is the first nationwide investigation of carbapenem resistance in Lebanon, showing low level of resistance in Enterobacteriaceae, and higher levels in A. baumannii and Pseudomonas. With current changes in the region, continuous surveillance of carbapenem resistance is crucial.

Carbapenem therapy is associated with improved survival compared with piperacillin-tazobactam for patients with extended-spectrum β-lactamase bacteremia.

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Tamma, Pranita D; Han, Jennifer H; Rock, Clare; Harris, Anthony D; Lautenbach, Ebbing; Hsu, Alice J; Avdic, Edina; Cosgrove, Sara E

2015-05-01

The effectiveness of piperacillin-tazobactam (PTZ) for the treatment of extended-spectrum β-lactamase (ESBL) bacteremia is controversial. We compared 14-day mortality of PTZ vs carbapenems as empiric therapy in a cohort of patients with ESBL bacteremia who all received definitive therapy with a carbapenem. Patients hospitalized between January 2007 and April 2014 with monomicrobial ESBL bacteremia were included. A decrease of >3 doubling dilutions in the minimum inhibitory concentration for third-generation cephalosporins tested in combination with 4 µg/mL of clavulanic acid was used to confirm ESBL status. The primary exposure was empiric therapy, defined as antibiotic therapy administered to a patient before ESBL status was known. Patients were excluded if they did not receive a carbapenem after ESBL production was identified. The primary outcome was time to death from the first day of bacteremia. Propensity scores using inverse probability of exposure weighting (IPW) were used to estimate the probability that a patient would receive PTZ vs carbapenems empirically. We calculated overall hazard ratios for mortality censored at 14 days using Cox proportional hazards models on an IPW-adjusted cohort. A total of 331 unique patients with ESBL bacteremia were identified. One hundred three (48%) patients received PTZ empirically and 110 (52%) received carbapenems empirically. The adjusted risk of death was 1.92 times higher for patients receiving empiric PTZ compared with empiric carbapenem therapy (95% confidence interval, 1.07-3.45). PTZ appears inferior to carbapenems for the treatment of ESBL bacteremia. For patients at high risk of invasive ESBL infections, early carbapenem therapy should be considered. Our findings should not be extended to β-lactam/β-lactamase inhibitor combinations in development, as limited clinical data are available for these agents. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of

A systematic review and meta-Analyses show that carbapenem use and medical devices are the leading risk factors for carbapenem- resistant pseudomonas aeruginosa

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A.F. Voor (Anne); J.A. Severin (Juliëtte); E.M.E.H. Lesaffre (Emmanuel); M.C. Vos (Margreet)

2014-01-01

textabstractA systematic review and meta-Analyses were performed to identify the risk factors associated with carbapenem-resistant Pseudomonas aeruginosa and to identify sources and reservoirs for the pathogen. A systematic search of PubMed and Embase databases from 1 January 1987 until 27 January

Surveillance of adamantane resistance among influenza A H3 viruses isolated in Argentina between 2001 and 2007 Vigilancia de la resistencia a los adamantanos entre los virus influenza A H3 aislados en Argentina entre 2001 y 2007

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A. Pontoriero

2008-09-01

los fenotipos de resistencia. También se analizó la secuencia de la porción HA1 de cepas resistentes y sensibles, para intentar establecer alguna relación con las mutaciones de M2. De un total de 55 cepas, 20 (36% fueron resistentes debido a un cambio aminoacídico en la posición 31 (serina 31 asparagina. No se detectaron cepas resistentes entre 2001 y 2005. Las cepas aisladas en el 2006 y 4 de 5 cepas obtenidas en el 2007 fueron resistentes. Ninguno de los pacientes de los que se habían aislado esas cepas había recibido tratamiento antiviral con anterioridad. En la porción secuenciada de HA1 se encontraron dos cambios (serina 193 fenilalanina y ácido aspártico 225 asparagina, presentes sólo en las cepas que tuvieron la mutación en la posición 31 de M2. Desde el año 2006 se ha registrado en Argentina un aumento significativo de la circulación de virus influenza A H3 con genotipo resistente, lo que genera expectativa con respecto a su diseminación en nuestro país.

Genetic characterization of blaNDM-harboring plasmids in carbapenem-resistant Escherichia coli from Myanmar.

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Yo Sugawara

Full Text Available The bacterial enzyme New Delhi metallo-β-lactamase hydrolyzes almost all β-lactam antibiotics, including carbapenems, which are drugs of last resort for severe bacterial infections. The spread of carbapenem-resistant Enterobacteriaceae that carry the New Delhi metallo-β-lactamase gene, blaNDM, poses a serious threat to public health. In this study, we genetically characterized eight carbapenem-resistant Escherichia coli isolates from a tertiary care hospital in Yangon, Myanmar. The eight isolates belonged to five multilocus-sequence types and harbored multiple antimicrobial-resistance genes, resulting in resistance against nearly all of the antimicrobial agents tested, except colistin and fosfomycin. Nine plasmids harboring blaNDM genes were identified from these isolates. Multiple blaNDM genes were found in the distinct Inc-replicon types of the following plasmids: an IncA/C2 plasmid harboring blaNDM-1 (n = 1, IncX3 plasmids harboring blaNDM-4 (n = 2 or blaNDM-7 (n = 1, IncFII plasmids harboring blaNDM-4 (n = 1 or blaNDM-5 (n = 3, and a multireplicon F plasmid harboring blaNDM-5 (n = 1. Comparative analysis highlighted the diversity of the blaNDM-harboring plasmids and their distinct characteristics, which depended on plasmid replicon types. The results indicate circulation of phylogenetically distinct strains of carbapenem-resistant E. coli with various plasmids harboring blaNDM genes in the hospital.

Risk factors for the acquisition of carbapenem-resistant Escherichia coli at a tertiary care center in South Korea: a matched case-control study.

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Ahn, Jin Young; Song, Je Eun; Kim, Min Hyung; Choi, Heun; Kim, Jae Kyung; Ann, Hea Won; Kim, Jung Ho; Jeon, Yongduk; Jeong, Su Jin; Kim, Sun Bean; Ku, Nam Su; Han, Sang Hoon; Song, Young Goo; Yong, Dongeun; Lee, Kyungwon; Kim, June Myung; Choi, Jun Yong

2014-06-01

Carbapenem resistance among gram-negative bacilli is an emerging threat worldwide. The objective of this study was to identify risk factors for the acquisition of carbapenem-resistant Escherichia coli (CRE). We conducted a matched case-control study comprising 57 cases of acquisition of CRE and 114 controls (1:2 matched) selected from patients with a culture of carbapenem-susceptible E coli between January 2006 and December 2010 at a 2000-bed tertiary care center in South Korea. On univariate analysis, previous use of carbapenem (P carbapenem (odds ratio [OR], 4.56; 95% confidence interval [CI] 1.44-14.46; P = .01) and previous use of fluoroquinolone (OR, 2.81; 95% CI, 1.14-6.99; P = .03) were independent risk factors. At this institute, the antibiotic selective pressure of carbapenems and fluoroquinolones was shown to be an important risk factor for the acquisition of CRE. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Impact of antibiotic exposure on occurrence of nosocomial carbapenem-resistant Acinetobacter baumannii infection: a case control study.

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Chusri, Sarunyou; Silpapojakul, Kachornsakdi; McNeil, Edward; Singkhamanan, Kamonnut; Chongsuvivatwong, Virasakdi

2015-02-01

Carbapenem-resistant Acinetobacter baumannii (CRAB) infection is one of the most important healthcare associated diseases worldwide. Although antibiotic use is recognized as a risk factor for CRAB infection, the impact of antibiotic class and length of use on CRAB infection is still unclear. A case-control study was conducted in adult intensive care units and general wards of Songklanagarind Hospital, a tertiary-care hospital in southern Thailand, to investigate the effect of different antibiotic exposure and the duration of use on the risk of developing CRAB infection. Cases were defined as patients with carbapenem-susceptible A. baumannii (CSAB) or CRAB infection. Controls were randomly selected from patients and matched 1:1 with cases using ward and date of admission. Multinomial logistic regression was used to compute relative risk ratios (RRR) and 95% confidence intervals (CI) for CRAB infection. Of 197 cases with A. baumannii infection, there were 139 with CRAB infection and 58 with CSAB infection. Compared to the control group, use of fluoroquinolones, broad-spectrum cephalosporins and carbapenems for more than three days increased the risk of CRAB infection with RRR (95% CI) of 81.2 (38.1-862.7), 31.3 (9.9-98.7) and 112.1 (7.1-1770.6), respectively. The RRR (95% CI) for one to three day treatment of fluoroquinolones, broad-spectrum cephalosporins and carbapenems were 5.4 (0.8-38.7), 6.2 (0.1-353.2) and 63.3 (15.6-256.9), respectively. Long-term use of certain antibiotics and even short term use of carbapenems increased the risk of CRAB infection. In this setting, use of these antibiotics, especially carbapenems, should be limited to reduce CRAB infection. Copyright © 2014. Published by Elsevier Ltd.

Incidencia, caracterización y epidemiología del virus de la tristeza de los cítricos en Chile

OpenAIRE

BESOAIN CANALES, JIMENA ALEJANDRA

2011-01-01

El virus de la tristeza de los cítricos (CTV) ha causado millonarias pérdidas a la citricultura a nivel mundial. En Chile, la situación real era desconocida aunque se había reportado su presencia en limoneros Meyer, los que fueron erradicados. El objetivo de esta tesis fue analizar la situación actual de CTV en Chile, realizar una amplia prospección y estimar su incidencia, estudiar su epidemiología y realizar una caracterización biológica, serológica y molecular de 100 aislados chilenos de C...

Carbapenem-resistant Pseudomonas aeruginosa: association with virulence genes and biofilm formation

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Iara Rossi Gonçalves

Full Text Available Abstract Pseudomonas aeruginosa is an opportunistic pathogen that causes frequently nosocomial infections, currently becoming more difficult to treat due to the various resistance mechanisms and different virulence factors. The purpose of this study was to determine the risk factors independently associated with the development of bacteremia by carbapenem-resistant P. aeruginosa, the frequency of virulence genes in metallo-β-lactamases producers and to evaluate their ability to produce biofilm. We conducted a case–control study in the Uberlândia Federal University – Hospital Clinic, Brazil. Polymerase Chain Reaction was performed for metallo-β-lactamases and virulence genes. Adhesion and biofilm assays were done by quantitative tests. Among the 157 strains analyzed, 73.9% were multidrug-resistant, 43.9% were resistant to carbapenems, 16.1% were phenotypically positive for metallo-β-lactamases, and of these, 10.7% were positive for blaSPM gene and 5.3% positive for blaVIM. The multivariable analysis showed that mechanical ventilation, enteral/nasogastric tubes, primary bacteremia with unknown focus, and inappropriate therapy were independent risk factors associated with bacteremia. All tested strains were characterized as strongly biofilm producers. A higher mortality was found among patients with bacteremia by carbapenem-resistant P. aeruginosa strains, associated independently with extrinsic risk factors, however it was not evident the association with the presence of virulence and metallo-β-lactamases genes.

Fatal septicemia caused by Chromobacterium violaceum in a child from Colombia Septicemia mortal causada por Chromobacterium violaceum en una paciente pediátrica de Colombia

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Pedro Martinez

2007-12-01

Full Text Available A 4-year old child living in Colombia presented with a history of fever and severe abdominal pain for four days. The patient developed pneumonia, septic shock, multiple organ failure and died on the fifth day of hospitalization. Chromobacterium violaceum was isolated from admission blood cultures and was resistant to ampicillin, cephalosporins, carbapenems and aminoglycosides.Una niña de 4 años que vivía en Colombia presentó historia de fiebre y dolor abdominal severo por cuatro días. La paciente desarrollo neumonía, shock séptico, múltiple falla de órganos y muerte el quinto día de hospitalización. Chromobacterium violaceum fue aislado de cultivos de sangre y mostró resistencia a ampicilina, cefalosporinas, carbapenems y aminoglicosidos.

Modified Carbapenem Inactivation Method for Phenotypic Detection of Carbapenemase Production among Enterobacteriaceae.

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Pierce, Virginia M; Simner, Patricia J; Lonsway, David R; Roe-Carpenter, Darcie E; Johnson, J Kristie; Brasso, William B; Bobenchik, April M; Lockett, Zabrina C; Charnot-Katsikas, Angella; Ferraro, Mary Jane; Thomson, Richard B; Jenkins, Stephen G; Limbago, Brandi M; Das, Sanchita

2017-08-01

The ability of clinical microbiology laboratories to reliably detect carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CP-CRE) is an important element of the effort to prevent and contain the spread of these pathogens and an integral part of antimicrobial stewardship. All existing methods have limitations. A new, straightforward, inexpensive, and specific phenotypic method for the detection of carbapenemase production, the carbapenem inactivation method (CIM), was recently described. Here we describe a two-stage evaluation of a modified carbapenem inactivation method (mCIM), in which tryptic soy broth was substituted for water during the inactivation step and the length of this incubation was extended. A validation study was performed in a single clinical laboratory to determine the accuracy of the mCIM, followed by a nine-laboratory study to verify the reproducibility of these results and define the zone size cutoff that best discriminated between CP-CRE and members of the family Enterobacteriaceae that do not produce carbapenemases. Bacterial isolates previously characterized through whole-genome sequencing or targeted PCR as to the presence or absence of carbapenemase genes were tested for carbapenemase production using the mCIM; isolates with Ambler class A, B, and D carbapenemases, non-CP-CRE isolates, and carbapenem-susceptible isolates were included. The sensitivity of the mCIM observed in the validation study was 99% (95% confidence interval [95% CI], 93% to 100%), and the specificity was 100% (95% CI, 82% to 100%). In the second stage of the study, the range of sensitivities observed across nine laboratories was 93% to 100%, with a mean of 97%; the range of specificities was 97% to 100%, with a mean of 99%. The mCIM was easy to perform and interpret for Enterobacteriaceae , with results in less than 24 h and excellent reproducibility across laboratories. Copyright © 2017 American Society for Microbiology.

Caracterización del gen mecA de Staphylococcus aureus resistentes a meticilina aislados de tres grupos poblacionales de la ciudad de Medellín

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Marcela Sanchez

Full Text Available Introducción: Staphylococcus aureus resistente a la meticilina (SARM es responsable de infecciones intrahospitalarias, las que constituyen una importante causa de morbilidad y mortalidad en nuestro medio, por lo cual la rápida identificación y tipificación molecular de la resistencia como el complejo SSCmec es esencial para entender la epidemiología de la infección. Objetivo: Caracterizar fenotípicamente la resistencia a meticilina y genotípicamente el casete cromosomal SSCmec en cepas de S. aureus aislados de individuos de la ciudad de Medellín mediante PCR múltiple. Materiales y métodos: A 41 aislamientos (hospitalarios y de la comunidad de S. aureus se les estableció la resistencia a cefoxitin mediante la técnica de Kirby-Bauer y la concentración inhibitoria mínima para oxacilina. Mediante PCR convencional se les confirmó la presencia del gen mecA. Para la tipificación del complejo SSCmec se utilizó PCR múltiple para amplificar 6 loci diferentes de este gen. Resultados: A todos los aislamientos se les confirmó resistencia a meticilina y la presencia del gen mecA, de los cuales 17 fueron clasificados como SSC mec I, 1 como SSC mec II, 21 como SSC mecIV; dos aislamientos no fue posible clasificarlos. Conclusiones: Con el uso de esta técnica clasificamos el 95% de los aislamientos del estudio, encontrando una mayor prevalencia de los SSCmec I y IV. La implementación de esta técnica permite una fácil caracterización de los aislamientos SARM y un apropiado manejo de la información de los integrantes de los comités de infecciones hospitalarios, lo cual podría impactar positivamente en el tratamiento a los pacientes y el control de enfermedades infecciosas intrahospitalarias.

[Investigation of OXA type beta-lactamases and PFGE patterns in Acinetobacter baumannii strains resistant to carbapenems].

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Keyik, Serafettin; Arslan, Uğur; Türk Dağı, Hatice; Seyhan, Tuba; Fındık, Duygu

2014-10-01

Acinetobacter baumannii is an important opportunistic and multidrug-resistant pathogen leading to nosocomial infections. Over the last 10 years, a significant and threatening increase in resistance to carbapenems, mainly due to the dissemination of class D beta-lactamases, has been reported in A.baumannii worldwide. The most common types of beta-lactamases causing carbapenem resistance in A.baumannii are the OXA-23, OXA-24, OXA-40, OXA-58 and OXA-143 type serine beta-lactamases. The aim of this study was to investigate the presence of OXA type beta-lactamases in carbapenem-resistant A.baumannii strains and the clonal relationship between the strains. A total of 105 non-duplicate carbapenem-resistant A.baumannii strains isolated from various clinical samples (68 blood, 18 bronchoalveolar lavage, 13 drainage, 3 urine, 2 cerebrospinal fluid and 1 catheter samples) in the Microbiology Laboratories of Selcuk University, Meram (2009-2012) and Selcuklu (2007-2008) Medical School Hospitals, were included in the study. The isolates were identified by conventional methods and Phoenix 100 BD (BD Diagnostic, USA) and Vitek II (bioMerieux, France) automated systems. Carbapenem susceptibility test was performed by Kirby-Bauer disk diffusion method according to the CLSI standards. bla(OXA 23-like), bla(OXA 24-like), bla(OXA 58-like) and bla(OXA 51-like) genes were amplified by multiplex PCR assay and clonal relatedness was investigated by pulsed-field gel electrophoresis (PFGE) using ApaI enzyme. The bla(OXA 51-like) gene was determined in all carbapenem-resistant A.baumannii isolates, while the bla(OXA 23-like) and bla(OXA 58-like) genes were detected in 46.6% and 53.3% of isolates, respectively. However bla(OXA 24-like) gene was not demonstrated in any isolates. bla(OXA 23-like) gene was determined in both Meram and Selcuklu Medical School hospitals, but bla(OXA 58-like) gene was detected only in Meram Medical School hospital. PFGE analysis of the isolates revealed 32 different

Isolation of Klebsiella pneumoniae strains with altered susceptibility to carbapenems not carbapenemase mediated

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Franca Cian

2009-12-01

Full Text Available The spread of enterobacteria producing extended-spectrum ß-lactamases (ESBLs is sharply increasing in Italy, while the detection of isolates resistant to carbapenems is still sporadic. Isolates of Klebsiella pneumoniae resistant to all cephalosporins, aminoglycosides and fluoroquinolones have been isolated in Trieste since 2008. Because of the altered profile of resistance to carbapenems, these strains were reported as ESBL-negative and possible carbapenemases producer by the expert system, leaving tigecycline as the only therapeutic choice.The purpose of this study is the characterization of the mechanisms involved in resistance to carbapenems in these strains and the evaluation of a reliable and simple test for phenotypic confirmation of ESBL and/or carbapenemase production. 25 isolates of MDR K. pneumoniae were collected between October 2008 and May 2009, mainly from urinary samples of elderly patients hospitalized in medicine wards. Identification and susceptibility testing were performed using the Vitek 2 system.The double-disc (DD test was used to check the production of ESBLs, while imipenem and imipenem-EDTA synergy test was used to detect the production of metallo-ßlactamase (MBL. Carbapenemase activity was tested by an hydrolysis assay and the production of MBLs was also investigated by PCR. The DD synergy test highlighted the possible production of ESBLs in 18 out of 22 strains, considered as negative by Vitek. All ESBLs producers tested positive for the blaCTX-M-15 allele. Only one isolate was resistant to carbapenems and resulted positive for production of MBL by the phenotypic test.The crude extract showed carbapenemase activity inhibited by EDTA; PCR test gave positive result for a blaVIM-type allele. PCR analysis performed on representative isolates, followed by sequencing, showed that coding sequence of ompk35 was not functional. Results of this study confirmed the emergence of ESBL-positive strains of K. pneumoniae that

Molecular insight on the non-covalent interactions between carbapenems and uc(l,d)-transpeptidase 2 from Mycobacterium tuberculosis: ONIOM study

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Ntombela, Thandokuhle; Fakhar, Zeynab; Ibeji, Collins U.; Govender, Thavendran; Maguire, Glenn E. M.; Lamichhane, Gyanu; Kruger, Hendrik G.; Honarparvar, Bahareh

2018-05-01

Tuberculosis remains a dreadful disease that has claimed many human lives worldwide and elimination of the causative agent Mycobacterium tuberculosis also remains elusive. Multidrug-resistant TB is rapidly increasing worldwide; therefore, there is an urgent need for improving the current antibiotics and novel drug targets to successfully curb the TB burden. uc(l,d)-Transpeptidase 2 is an essential protein in Mtb that is responsible for virulence and growth during the chronic stage of the disease. Both uc(d,d)- and uc(l,d)-transpeptidases are inhibited concurrently to eradicate the bacterium. It was recently discovered that classic penicillins only inhibit uc(d,d)-transpeptidases, while uc(l,d)-transpeptidases are blocked by carbapenems. This has contributed to drug resistance and persistence of tuberculosis. Herein, a hybrid two-layered ONIOM (B3LYP/6-31G+(d): AMBER) model was used to extensively investigate the binding interactions of LdtMt2 complexed with four carbapenems (biapenem, imipenem, meropenem, and tebipenem) to ascertain molecular insight of the drug-enzyme complexation event. In the studied complexes, the carbapenems together with catalytic triad active site residues of LdtMt2 (His187, Ser188 and Cys205) were treated at with QM [B3LYP/6-31+G(d)], while the remaining part of the complexes were treated at MM level (AMBER force field). The resulting Gibbs free energy (ΔG), enthalpy (ΔH) and entropy (ΔS) for all complexes showed that the carbapenems exhibit reasonable binding interactions towards LdtMt2. Increasing the number of amino acid residues that form hydrogen bond interactions in the QM layer showed significant impact in binding interaction energy differences and the stabilities of the carbapenems inside the active pocket of LdtMt2. The theoretical binding free energies obtained in this study reflect the same trend of the experimental observations. The electrostatic, hydrogen bonding and Van der Waals interactions between the carbapenems and Ldt

Carbapenem inactivation: a very affordable and highly specific method for phenotypic detection of carbapenemase-producing Pseudomonas aeruginosa isolates compared with other methods.

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Akhi, Mohammad Taghi; Khalili, Younes; Ghotaslou, Reza; Kafil, Hossein Samadi; Yousefi, Saber; Nagili, Behroz; Goli, Hamid Reza

2017-06-01

This investigation was undertaken to compare phenotypic and molecular methods for detection of carbapenemase-producing Pseudomonas aeruginosa. A total of 245 non-duplicated isolates of P. aeruginosa were collected from hospitalized patients. Disc diffusion method was used to identify carbapenem-resistant bacteria. Three phenotypic methods, including Modified Hodge Test (MHT), Modified Carba NP (MCNP) test and Carbapenem Inactivation Method (CIM) were used for investigation of carbapenemase production. In addition, polymerase chain reaction (PCR) was used to detect carbapenemase encoding genes. Of 245 P. aeruginosa isolates investigated, 121 isolates were carbapenem-resistant. Among carbapenem-resistant isolates, 40, 39 and 35 isolates exhibited positive results using MHT, MCNP test and CIM, respectively. PCR indicated the presence of carbapenemase genes in 35 of carbapenem-resistant isolates. MHT showed low sensitivity and specificity for carbapenemase detection among P. aeruginosa isolates in comparison to PCR. CIM was most affordable and highly specific than MCNP test compared with the molecular method.

Influencia de la procedencia de los componentes del medio de cultivo en la calidad de los ensayos microbiológicos para la determinación de bacteriófagos

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Annia González-Crespo

2017-12-01

Full Text Available La contaminación por virus bacterianos es uno de los problemas más difíciles de evaluar en la industria biotecnológica moderna, sobre todo en las producciones de proteínas que están basadas en cepas recombinante de Escherichia coli. Para certificar que un banco de cepas está libre de bacteriófagos el método más recomendado sigue siendo la inducción de la fase del ciclo lítico sobre placas con medios semisólidos. En este trabajo nos propusimos evaluar medios de cultivos elaborados con bases de diferentes casas comerciales para la detección de bacteriófagos contaminantes. Para ello utilizamos un aislado de bacteriófago ambiental y la cepa sensible LE 392 y bases de las firmas OXOID, BioCen y Biolife. Después de estandarizar la metodología de ensayo se evaluó la habilidad de una preparación concentrada del aislado ambiental de formar placas de lisis en los medios elaborados con reactivos de las tres casas comerciales. La mayor cantidad de placas de lisis se obtuvo cuando se emplearon las bases provenientes del Centro Nacional de Biopreparados, el medio donde menos placas de lisis observamos fue empleando bases proveniente de la Casa comercial Biolife con dos órdenes de magnitud menos. El medio preparado con bases provenientes de la casa comercial OXOID fue el que mostró mejor consistencia entre lotes.

Association between hypoalbuminemia and mortality among subjects treated with ertapenem versus other carbapenems: prospective cohort study.

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Zusman, O; Farbman, L; Tredler, Z; Daitch, V; Lador, A; Leibovici, L; Paul, M

2015-01-01

The aim of this study was to determine whether ertapenem, being highly protein bound, is less effective than other carbapenems in the presence of hypoalbuminemia. In a prospective cohort study, we included adults with clinically and microbiologically documented infections caused by carbapenem-susceptible Enterobacteriaceae who were hospitalized in a tertiary medical center from March 2010 to September 2012. We tested whether hypoalbuminemia (serum albumin carbapenem drug and the interaction between albumin and the carbapenem. Of 279 individual subjects included, 173 were treated with ertapenem and 106 with I/M. The odds ratio (OR) for 30-day mortality with hypoalbuminemia was 4.6 (95% confidence interval (CI) 2.1-10.1) among subjects with ertapenem versus 1.2 (95% CI 0.5-2.70) with I/M (p = 0.02 for difference between groups). In the regression model, the interaction between carbapenem type and albumin levels was significant (p = 0.03); for ertapenem lower albumin levels were associated with increased 30-day mortality (OR 2.45, 95% CI 1.19-5.05), while for I/M the change was not significant (OR 0.67, 95% CI 0.31-1.41). The model suggests that the risk of death for ertapenem-treated subjects quintupled when albumin was 2 g/dL compared to 4 g/dL. Hypoalbuminemia was associated with mortality significantly more among subjects treated with ertapenem compared to subjects treated with I/M. The effectiveness of current dosing schemes of ertapenem in subjects with significant hypoalbuminemia should be revisited. Copyright © 2014 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Virulence factors of non-O1 non-O139 Vibrio cholerae isolated in Córdoba, Argentina Factores de virulencia de Vibrio cholerae no-O1 no-O139 aislados en Córdoba, Argentina

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C. Bidinost

2004-12-01

Full Text Available V. cholerae non-O1 non-O139 serogroups isolated from clinical and environmental sources in Córdoba, Argentina, were analyzed for the presence and expression of virulence genes. Most of the strains studied contained the genes toxR and hlyA, but lacked ctxA, zot, ace, tcpA and stn. The culture supernatants were tested for hemolytic and cytotoxic activity. The enterotoxic potential of the strains was studied in a rabbit ileal loop assay and their genetic profiles were compared by PFGE. The environmental strains varied in their virulence phenotype and showed no-clonal relationships. The clinical strains were highly enterotoxic, hemolytic, proteolytic and showed indistinguishable PFGE profiles, although they differed in their cytotoxic activity. This is the first description, using cell culture and “in vivo” studies, of the virulence properties of non-O1 non-O139 V. cholerae from Argentina.En este trabajo se analizó la presencia y expresión de genes de virulencia en V. cholerae no-O1 no-O139 de origen clínico y ambiental, aislados en Córdoba, Argentina. La mayoría de las cepas estudiadas contiene los genes toxR y hlyA, pero no ctxA, zot, ace, tcpA y stn. Se analizó la actividad hemolítica y citotóxica de estas cepas en los sobrenadantes de cultivo, así como su potencial enterotóxico en ensayos de asa ileal ligada de conejo. Además, los aislamientos fueron comparados por sus perfiles genéticos en PFGE. Las cepas del medio ambiente mostraron variación en su fenotipo de virulencia y no mostraron relación clonal. Las cepas clínicas fueron muy enterotóxicas, hemolíticas, proteolíticas y mostraron perfiles indistinguibles de PFGE, aunque mostraron diferencias en su actividad citotóxica. En este trabajo se describen por primera vez, utilizando ensayos de cultivo celular e “in vivo”, propiedades de virulencia de V. cholerae no-O1 no-O139 aislados en Argentina.

Inactivation of Mycobacterium tuberculosis l,d-Transpeptidase LdtMt1 by Carbapenems and Cephalosporins

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Dubée, Vincent; Triboulet, Sébastien; Mainardi, Jean-Luc; Ethève-Quelquejeu, Mélanie; Gutmann, Laurent; Marie, Arul; Dubost, Lionel

2012-01-01

The structure of Mycobacterium tuberculosis peptidoglycan is atypical since it contains a majority of 3→3 cross-links synthesized by l,d-transpeptidases that replace 4→3 cross-links formed by the d,d-transpeptidase activity of classical penicillin-binding proteins. Carbapenems inactivate these l,d-transpeptidases, and meropenem combined with clavulanic acid is bactericidal against extensively drug-resistant M. tuberculosis. Here, we used mass spectrometry and stopped-flow fluorimetry to investigate the kinetics and mechanisms of inactivation of the prototypic M. tuberculosis l,d-transpeptidase LdtMt1 by carbapenems (meropenem, doripenem, imipenem, and ertapenem) and cephalosporins (cefotaxime, cephalothin, and ceftriaxone). Inactivation proceeded through noncovalent drug binding and acylation of the catalytic Cys of LdtMt1, which was eventually followed by hydrolysis of the resulting acylenzyme. Meropenem rapidly inhibited LdtMt1, with a binding rate constant of 0.08 μM−1 min−1. The enzyme was unable to recover from this initial binding step since the dissociation rate constant of the noncovalent complex was low (carbapenem side chains affected both the binding and acylation steps, ertapenem being the most efficient LdtMt1 inactivator. Cephalosporins also formed covalent adducts with LdtMt1, although the acylation reaction was 7- to 1,000-fold slower and led to elimination of one of the drug side chains. Comparison of kinetic constants for drug binding, acylation, and acylenzyme hydrolysis indicates that carbapenems and cephems can both be tailored to optimize peptidoglycan synthesis inhibition in M. tuberculosis. PMID:22615283

Anti-Restriction Protein, KlcAHS, Promotes Dissemination of Carbapenem Resistance

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Xiaofei Jiang

2017-05-01

Full Text Available Carbapenemase-producing Klebsiella pneumoniae (KPC has emerged and spread throughout the world. A retrospective analysis was performed on carbapenem-resistant K. pneumoniae isolated at our teaching hospital during the period 2009–2010, when the initial outbreak occurred. To determine the mechanism(s that underlies the increased infectivity exhibited by KPC, Multilocus Sequence Typing (MLST was conducted. A series of plasmids was also extracted, sequenced and analyzed. Concurrently, the complete sequences of blaKPC−2-harboring plasmids deposited in GenBank were summarized and aligned. The blaKPC−2 and KlcAHS genes in the carbapenem-resistant K. pneumoniae isolates were examined. E. coli strains, carrying different Type I Restriction and Modification (RM systems, were selected to study the interaction between RM systems, anti-RM systems and horizontal gene transfer (HGT. The ST11 clone predominated among 102 carbapenem-resistant K. pneumoniae isolates, all harbored the blaKPC−2 gene; 98% contained the KlcAHS gene. KlcAHS was one of the core genes in the backbone region of most blaKPC−2 carrying plasmids. Type I RM systems in the host bacteria reduced the rate of pHS10842 plasmid transformation by 30- to 40-fold. Presence of the anti-restriction protein, KlcAHS, on the other hand, increased transformation efficiency by 3- to 6-fold. These results indicate that RM systems can significantly restrict HGT. In contrast, KlcAHS can disrupt the RM systems and promote HGT by transformation. These findings suggest that the anti-restriction protein, KlcAHS, represents a novel mechanism that facilitates the increased transfer of blaKPC-2 and KlcAHS-carrying plasmids among K. pneumoniae strains.

Absorción renal de agua: del nefrón aislado a los canales de agua a Aquaporinas

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Guillermo Whittembury

1997-10-01

Full Text Available Se revisan brevemente: Los sitios de absorción del filtrado glomerular en diversos segmentos del nefrón, los sitios de acción de la hormona antidiurética (HAD, los conceptos que llevan a proponer que existen canales de agua en el túbulo renal proximal. llamados ahora Aquaporinas (AQP, algunas características biofísicas (diámetro equivalente y longitud del filtro de selectividad de la AQP-l en el túbulo renal proximal, estructura molecular de las AQP, algunas características de las AQP- 1-5, localización de las AQP 1-4 en el nefrón y algunos ejemplos de "fisiopatología molecular", que muestran que fallas genéticas en etapas de la acción de HAD en los túbulos colectores de los nefrones permiten describir varias formas de "diabetes insípida" renal. Hay métodos para dosar AQP-2 en orina. Esto simplificará el diagnóstico diferencial entre diversas formas de diabetes insípida. Estos hallazgos han sido posibles por los avances recientes en la biología molecular de las AQP. Sólo se citan algunas referencias críticas. (Rev Med Hered 1997; 8: 158-161

Systematic review and meta-analysis of in vitro synergy of polymyxins and carbapenems.

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Zusman, Oren; Avni, Tomer; Leibovici, Leonard; Adler, Amos; Friberg, Lena; Stergiopoulou, Theodouli; Carmeli, Yehuda; Paul, Mical

2013-10-01

Our objective was to examine the evidence of in vitro synergy of polymyxin-carbapenem combination therapy against Gram-negative bacteria (GNB). A systematic review and meta-analysis were performed. All studies examining in vitro interactions of antibiotic combinations consisting of any carbapenem with colistin or polymyxin B against any GNB were used. A broad search was conducted with no language, date, or publication status restrictions. Synergy rates, defined as a fractional inhibitory concentration index of ≤0.5 or a >2-log reduction in CFU, were pooled separately for time-kill, checkerboard, and Etest methods in a mixed-effect meta-analysis of rates. We examined whether the synergy rate depended on the testing method, type of antibiotic, bacteria, and resistance to carbapenems. Pooled rates with 95% confidence intervals (CI) are shown. Thirty-nine published studies and 15 conference proceeding were included, reporting on 246 different tests on 1,054 bacterial isolates. In time-kill studies, combination therapy showed synergy rates of 77% (95% CI, 64 to 87%) for Acinetobacter baumannii, 44% (95% CI, 30 to 59%) for Klebsiella pneumoniae, and 50% (95% CI, 30 to 69%) for Pseudomonas aeruginosa, with low antagonism rates for all. Doripenem showed high synergy rates for all three bacteria. For A. baumannii, meropenem was more synergistic than imipenem, whereas for P. aeruginosa the opposite was true. Checkerboard and Etest studies generally reported lower synergy rates than time-kill studies. The use of combination therapy led to less resistance development in vitro. The combination of a carbapenem with a polymyxin against GNB, especially A. baumannii, is supported in vitro by high synergy rates, with low antagonism and less resistance development. These findings should be examined in clinical studies.

Systematic Review and Meta-Analysis of In Vitro Synergy of Polymyxins and Carbapenems

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Avni, Tomer; Leibovici, Leonard; Adler, Amos; Friberg, Lena; Stergiopoulou, Theodouli; Carmeli, Yehuda; Paul, Mical

2013-01-01

Our objective was to examine the evidence of in vitro synergy of polymyxin-carbapenem combination therapy against Gram-negative bacteria (GNB). A systematic review and meta-analysis were performed. All studies examining in vitro interactions of antibiotic combinations consisting of any carbapenem with colistin or polymyxin B against any GNB were used. A broad search was conducted with no language, date, or publication status restrictions. Synergy rates, defined as a fractional inhibitory concentration index of ≤0.5 or a >2-log reduction in CFU, were pooled separately for time-kill, checkerboard, and Etest methods in a mixed-effect meta-analysis of rates. We examined whether the synergy rate depended on the testing method, type of antibiotic, bacteria, and resistance to carbapenems. Pooled rates with 95% confidence intervals (CI) are shown. Thirty-nine published studies and 15 conference proceeding were included, reporting on 246 different tests on 1,054 bacterial isolates. In time-kill studies, combination therapy showed synergy rates of 77% (95% CI, 64 to 87%) for Acinetobacter baumannii, 44% (95% CI, 30 to 59%) for Klebsiella pneumoniae, and 50% (95% CI, 30 to 69%) for Pseudomonas aeruginosa, with low antagonism rates for all. Doripenem showed high synergy rates for all three bacteria. For A. baumannii, meropenem was more synergistic than imipenem, whereas for P. aeruginosa the opposite was true. Checkerboard and Etest studies generally reported lower synergy rates than time-kill studies. The use of combination therapy led to less resistance development in vitro. The combination of a carbapenem with a polymyxin against GNB, especially A. baumannii, is supported in vitro by high synergy rates, with low antagonism and less resistance development. These findings should be examined in clinical studies. PMID:23917322

Carbapenems versus alternative antibiotics for the treatment of bloodstream infections caused by Enterobacter, Citrobacter or Serratia species: a systematic review with meta-analysis.

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Harris, Patrick N A; Wei, Jane Y; Shen, Andrew W; Abdile, Ahmed A; Paynter, Stuart; Huxley, Rachel R; Pandeya, Nirmala; Doi, Yohei; Huh, Kyungmin; O'Neal, Catherine S; Talbot, Thomas R; Paterson, David L

2016-02-01

This systematic review and meta-analysis compared effects of different antibiotics on mortality in patients with bloodstream infections caused by Enterobacteriaceae with chromosomal AmpC β-lactamase. Databases were systematically searched for studies reporting mortality in patients with bloodstream infections caused by AmpC producers treated with carbapenems, broad-spectrum β-lactam/β-lactamase inhibitors (BLBLIs), quinolones or cefepime. Pooled ORs for mortality were calculated for cases that received monotherapy with these agents versus carbapenems. PROSPERO international prospective register of systematic reviews (CRD42014014992; 18 November 2014). Eleven observational studies were included. Random-effects meta-analysis was performed on studies reporting empirical and definitive monotherapy. In unadjusted analyses, no significant difference in mortality was found between BLBLIs versus carbapenems used for definitive therapy (OR 0.87, 95% CI 0.32-2.36) or empirical therapy (OR 0.48; 95% CI 0.14-1.60) or cefepime versus carbapenems as definitive therapy (OR 0.61; 95% CI 0.27-1.38) or empirical therapy (0.60; 95% CI 0.17-2.20). Use of a fluoroquinolone as definitive therapy was associated with a lower risk of mortality compared with carbapenems (OR 0.39; 95% CI 0.19-0.78). Three studies with patient-level data were used to adjust for potential confounders. The non-significant trends favouring non-carbapenem options in these studies were diminished after adjustment for age, sex and illness severity scores, suggestive of residual confounding. Despite limitations of available data, there was no strong evidence to suggest that BLBLIs, quinolones or cefepime were inferior to carbapenems. The reduced risk of mortality observed with quinolone use may reflect less serious illness in patients, rather than superiority over carbapenems. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights

Development of carbapenem resistance in Pseudomonas aeruginosa is associated with OprD polymorphisms, particularly the amino acid substitution at codon 170.

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Shu, Jwu-Ching; Kuo, An-Jing; Su, Lin-Hui; Liu, Tsui-Ping; Lee, Ming-Hsun; Su, I-Ning; Wu, Tsu-Lan

2017-09-01

Pan-susceptible Pseudomonas aeruginosa (PSPA) clinical isolates carrying an OprD with loop 7 shortening (the group-1A allele) were found to rapidly develop carbapenem resistance under continuous selection pressure. We further studied whether OprD polymorphisms are associated with the potential to develop carbapenem resistance. OprD amino acid sequences of 126 PSPA clinical isolates were analysed to determine their STs using P. aeruginosa strain PAO1 as the control strain. Site-directed mutagenesis was performed in PAO1 to generate polymorphisms of interest. A disc diffusion method was used to select carbapenem-resistant variants from the mutant strains. Expression levels of oprD were determined by quantitative RT-PCR. MICs of carbapenems were determined by Etest. Forty-eight (38.1%) of the tested isolates carried the group-1A allele. Another two major STs, C1 and C2, both of which harboured an F170L polymorphism, were found in 21 (16.7%) and 39 (31.0%) isolates, respectively. The PAO1 type was also found in 14 (11.1%) isolates. Under continuous selective pressure, isolates of most STs developed carbapenem resistance at different numbers of passaging events; only those belonging to the PAO1 type remained susceptible. However, PAO1 mutants carrying either the oprD group-1A allele or the OprD-F170L polymorphism were able to develop carbapenem resistance. Reduced oprD expression triggered by continuous imipenem challenge was found in PAO1 mutants, but not in the PAO1 WT strain. OprD polymorphisms, particularly the F170L substitution and the specific shortening in loop 7, appear to determine the potential for P. aeruginosa to develop carbapenem resistance. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Outcomes of an Enhanced Surveillance Program for Carbapenem-Resistant Enterobacteriaceae

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Fitzpatrick, Margaret; Zembower, Teresa; Malczynski, Michael; Qi, Chao; Bolon, Maureen K.

2014-01-01

Optimal surveillance strategies for identifying patients colonized with and at risk for transmitting carbapenem-resistant Enterobacteriaceae (CRE) are urgently needed. We instituted an enhanced surveillance program for CRE that identified unrecognized CRE-colonized patients but failed to identify possible CRE transmissions. We also identified risk factors associated with transmitting CRE.

Novel carbapenem antibiotics for parenteral and oral applications: in vitro and in vivo activities of 2-aryl carbapenems and their pharmacokinetics in laboratory animals.

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Fujimoto, Koichi; Takemoto, Koji; Hatano, Kazuo; Nakai, Toru; Terashita, Shigeyuki; Matsumoto, Masahiro; Eriguchi, Yoshiro; Eguchi, Ken; Shimizudani, Takeshi; Sato, Kimihiko; Kanazawa, Katsunori; Sunagawa, Makoto; Ueda, Yutaka

2013-02-01

SM-295291 and SM-369926 are new parenteral 2-aryl carbapenems with strong activity against major causative pathogens of community-acquired infections such as methicillin-susceptible Staphylococcus aureus, Streptococcus pneumoniae (including penicillin-resistant strains), Streptococcus pyogenes, Enterococcus faecalis, Klebsiella pneumoniae, Moraxella catarrhalis, Haemophilus influenzae (including β-lactamase-negative ampicillin-resistant strains), and Neisseria gonorrhoeae (including ciprofloxacin-resistant strains), with MIC(90)s of ≤ 1 μg/ml. Unlike tebipenem (MIC(50), 8 μg/ml), SM-295291 and SM-369926 had no activity against hospital pathogens such as Pseudomonas aeruginosa (MIC(50), ≥ 128 μg/ml). The bactericidal activities of SM-295291 and SM-369926 against penicillin-resistant S. pneumoniae and β-lactamase-negative ampicillin-resistant H. influenzae were equal or superior to that of tebipenem and greater than that of cefditoren. The therapeutic efficacies of intravenous administrations of SM-295291 and SM-369926 against experimentally induced infections in mice caused by penicillin-resistant S. pneumoniae and β-lactamase-negative ampicillin-resistant H. influenzae were equal or superior to that of tebipenem and greater than that of cefditoren, respectively, reflecting their in vitro activities. SM-295291 and SM-369926 showed intravenous pharmacokinetics similar to those of meropenem in terms of half-life in monkeys (0.4 h) and were stable against human dehydropeptidase I. SM-368589 and SM-375769, which are medoxomil esters of SM-295291 and SM-369926, respectively, showed good oral bioavailability in rats, dogs, and monkeys (4.2 to 62.3%). Thus, 2-aryl carbapenems are promising candidates that show an ideal broad spectrum for the treatment of community-acquired infections, including infections caused by penicillin-resistant S. pneumoniae and β-lactamase-negative ampicillin-resistant H. influenzae, have low selective pressure on antipseudomonal

In vitro activity of colistin in antimicrobial combination against carbapenem-resistant Acinetobacter baumannii isolated from patients with ventilator-associated pneumonia in Vietnam.

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Le Minh, Vien; Thi Khanh Nhu, Nguyen; Vinh Phat, Voong; Thompson, Corinne; Huong Lan, Nguyen Phu; Thieu Nga, Tran Vu; Thanh Tam, Pham Thi; Tuyen, Ha Thanh; Hoang Nhu, Tran Do; Van Hao, Nguyen; Thi Loan, Huynh; Minh Yen, Lam; Parry, Christopher M; Trung Nghia, Ho Dang; Campbell, James I; Hien, Tran Tinh; Thwaites, Louise; Thwaites, Guy; Van Vinh Chau, Nguyen; Baker, Stephen

2015-10-01

Acinetobacter baumannii has become one of the major infection threats in intensive care units (ICUs) globally. Since 2008, A. baumannii has been the leading cause of ventilator-associated pneumonia (VAP) in our ICU at an infectious disease hospital in southern Vietnam. The emergence of this pathogen in our setting is consistent with the persistence of a specific clone exhibiting resistance to carbapenems. Antimicrobial combinations may be a strategy to treat infections caused by these carbapenem-resistant A. baumannii. Therefore, we assessed potential antimicrobial combinations against local carbapenem-resistant A. baumannii by measuring in vitro interactions of colistin with four antimicrobials that are locally certified for treating VAP. We first performed antimicrobial susceptibility testing and multilocus variable number tandem repeat analysis (MLVA) genotyping on 74 A. baumannii isolated from quantitative tracheal aspirates from patients with VAP over an 18-month period. These 74 isolates could be subdivided into 21 main clusters by MLVA and >80 % were resistant to carbapenems. We selected 56 representative isolates for in vitro combination synergy testing. Synergy was observed in four (7 %), seven (13 %), 20 (36 %) and 38 (68 %) isolates with combinations of colistin with ceftazidime, ceftriaxone, imipenem and meropenem, respectively. Notably, more carbapenem-resistant A. baumannii isolates (36/43; 84 %) exhibited synergistic activity with a combination of colistin and meropenem than carbapenem-susceptible A. baumannii isolates (2/13; 15 %) (P = 0.023; Fisher's exact test). Our findings suggest that combinations of colistin and meropenem should be considered when treating carbapenem-resistant A. baumannii infections in Vietnam, and we advocate clinical trials investigating combination therapy for VAP.

EFFECT OF TOBRACEF IN CARBAPENEM RESISTANT PNEUMONIA INFECTION

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A. Ahmad, V.K. Dwivedi * , and M. Chaudhary

2010-01-01

To determine ef ect of Tobracef and imipenem drug on antioxidant enzyme actvity and lipid peroxidation leveland some biochemical parametrs in carbapenem resistant pneumonia infection rat model. Total 40 rats wereselected and diveded into 4 groups of 10 rats each. Group I was control group; group II was infected via A.baumanni bacterial strain. Group III and IV were infected plus treated group with tobracef and imipenemdrugs.Our results showed that a significant (p

Resistance to Carbapenems in Non-Typhoidal Salmonella enterica Serovars from Humans, Animals and Food

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Javier Fernández

2018-04-01

Full Text Available Non-typhoidal serovars of Salmonella enterica (NTS are a leading cause of food-borne disease in animals and humans worldwide. Like other zoonotic bacteria, NTS have the potential to act as reservoirs and vehicles for the transmission of antimicrobial drug resistance in different settings. Of particular concern is the resistance to critical “last resort” antimicrobials, such as carbapenems. In contrast to other Enterobacteriaceae (e.g., Klebsiella pneumoniae, Escherichia coli, and Enterobacter, which are major nosocomial pathogens affecting debilitated and immunocompromised patients, carbapenem resistance is still very rare in NTS. Nevertheless, it has already been detected in isolates recovered from humans, companion animals, livestock, wild animals, and food. Five carbapenemases with major clinical importance—namely KPC (Klebsiella pneumoniae carbapenemase (class A, IMP (imipenemase, NDM (New Delhi metallo-β-lactamase, VIM (Verona integron-encoded metallo-β-lactamase (class B, and OXA-48 (oxacillinase, class D—have been reported in NTS. Carbapenem resistance due to the production of extended spectrum- or AmpC β-lactamases combined with porin loss has also been detected in NTS. Horizontal gene transfer of carbapenemase-encoding genes (which are frequently located on self-transferable plasmids, together with co- and cross-selective adaptations, could have been involved in the development of carbapenem resistance by NTS. Once acquired by a zoonotic bacterium, resistance can be transmitted from humans to animals and from animals to humans through the food chain. Continuous surveillance of resistance to these “last resort” antibiotics is required to establish possible links between reservoirs and to limit the bidirectional transfer of the encoding genes between S. enterica and other commensal or pathogenic bacteria.

Resistance to Carbapenems in Non-Typhoidal Salmonella enterica Serovars from Humans, Animals and Food.

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Fernández, Javier; Guerra, Beatriz; Rodicio, M Rosario

2018-04-08

Non-typhoidal serovars of Salmonella enterica (NTS) are a leading cause of food-borne disease in animals and humans worldwide. Like other zoonotic bacteria, NTS have the potential to act as reservoirs and vehicles for the transmission of antimicrobial drug resistance in different settings. Of particular concern is the resistance to critical "last resort" antimicrobials, such as carbapenems. In contrast to other Enterobacteriaceae (e.g., Klebsiella pneumoniae , Escherichia coli , and Enterobacter , which are major nosocomial pathogens affecting debilitated and immunocompromised patients), carbapenem resistance is still very rare in NTS. Nevertheless, it has already been detected in isolates recovered from humans, companion animals, livestock, wild animals, and food. Five carbapenemases with major clinical importance-namely KPC ( Klebsiella pneumoniae carbapenemase) (class A), IMP (imipenemase), NDM (New Delhi metallo-β-lactamase), VIM (Verona integron-encoded metallo-β-lactamase) (class B), and OXA-48 (oxacillinase, class D)-have been reported in NTS. Carbapenem resistance due to the production of extended spectrum- or AmpC β-lactamases combined with porin loss has also been detected in NTS. Horizontal gene transfer of carbapenemase-encoding genes (which are frequently located on self-transferable plasmids), together with co- and cross-selective adaptations, could have been involved in the development of carbapenem resistance by NTS. Once acquired by a zoonotic bacterium, resistance can be transmitted from humans to animals and from animals to humans through the food chain. Continuous surveillance of resistance to these "last resort" antibiotics is required to establish possible links between reservoirs and to limit the bidirectional transfer of the encoding genes between S. enterica and other commensal or pathogenic bacteria.

Mecanismo de acción antiinflamatoria de 5-O-desmetilnobiletina y derivados del catalpol en hipersensibilidad retardada.

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Bas Infante, Esperanza

2007-01-01

RESUMEN La presente Tesis Doctoral se ha centrado en el estudio de 5-O-desmetilnobiletina (DMN), aislado de Sideritis tragoricanum sp. mugronensis, y los iridoides derivados del catalpol denominados escrovalentinósido (SV) y escropoliósido A (SC), aislados de Scrophularia auriculata sp. valentina. La selección de estos tres principios se basó en los estudios previos realizados en los cuales se demostraron las propiedades en modelos experimentales de inflamación aguda. Como métodos exper...

Carbapenem-Resistant Non-Glucose-Fermenting Gram-Negative Bacilli: the Missing Piece to the Puzzle

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Gniadek, Thomas J.; Carroll, Karen C.

2016-01-01

The non-glucose-fermenting Gram-negative bacilli Pseudomonas aeruginosa and Acinetobacter baumannii are increasingly acquiring carbapenem resistance. Given their intrinsic antibiotic resistance, this can cause extremely difficult-to-treat infections. Additionally, resistance gene transfer can occur between Gram-negative species, regardless of their ability to ferment glucose. Thus, the acquisition of carbapenemase genes by these organisms increases the risk of carbapenemase spread in general. Ultimately, infection control practitioners and clinical microbiologists need to work together to determine the risk carried by carbapenem-resistant non-glucose-fermenting Gram-negative bacilli (CR-NF) in their institution and what methods should be considered for surveillance and detection of CR-NF. PMID:26912753

A systematic review: can one prescribe carbapenems to patients with IgE-mediated allergy to penicillins or cephalosporins?

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Kula, Brittany; Djordjevic, Gordana; Robinson, Joan L

2014-10-15

Cross-reactivity between penicillins or cephalosporins and carbapenems is anticipated as all have a beta lactam ring. However, the true incidence of immunoglobulin (Ig)E-mediated cross-reactivity is not known. A systematic review was conducted to collect and combine all published data on children and adults reported to have a clinical history of IgE-mediated hypersensitivity to a penicillin and/or cephalosporin who were subsequently given a carbapenem. Reactions were classified as proven, suspected, or possible IgE-mediated and non-IgE-mediated. Ten studies and 12 case reports describing 854 participants fit the study criteria. For patients with previous proven, suspected, or possible IgE-mediated penicillin reactions (N = 838), the incidence of any type of suspected hypersensitivity reaction to a carbapenem was 36/838 (4.3%; 95% confidence interval [CI], 3.1%-5.9%) and the incidence of proven (1/838), suspected (0/838), or possible (19/838) IgE-mediated reactions was 20/838 (2.4%; 95% CI, 1.6%-3.7%). Of the subset of patients with positive penicillin skin tests (n = 295), only 1 had a hypersensitivity reaction (0.3%; 95% CI, .06%-1.9%), and this was a possible IgE-mediated reaction. For patients with previous proven, suspected, or possible IgE-mediated cephalosporin reactions (N = 12), the incidence of any type of hypersensitivity reaction to a carbapenem was 3/12 (25%); this included 2 non-IgE-mediated reactions and 1 possible IgE-mediated reaction. The cross-reactivity between penicillins and carbapenems for IgE-mediated reactions is very low, but caution is still advised. Cross-reactivity rates may be higher between cephalosporins and carbapenems; however, minimal data are available. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Reduction in Fluoroquinolone Use following Introduction of Ertapenem into a Hospital Formulary Is Associated with Improvement in Susceptibility of Pseudomonas aeruginosa to Group 2 Carbapenems: a 10-Year Study▿

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Cook, Paul P.; Gooch, Michael; Rizzo, Shemra

2011-01-01

We examined the effect of the addition of ertapenem to our hospital formulary on the resistance of nosocomial Pseudomonas aeruginosa to group 2 carbapenems (imipenem, meropenem, and doripenem). This was a retrospective, observational study conducted between 1 January 2000 and 31 January 2009 at a large, tertiary-care hospital. Autoregressive integrated moving average (ARIMA) regression models were used to evaluate the effect of ertapenem use on the susceptibility of Pseudomonas aeruginosa to group 2 carbapenems as well as on the use of the group 2 carbapenems, ciprofloxacin, and other antipseudomonal drugs (i.e., tobramycin, cefepime, and piperacillin-tazobactam). Resistance was expressed as a percentage of total isolates as well as the number of carbapenem-resistant bacterial isolates per 10,000 patient days. Pearson correlation was used to assess the relationship between antibiotic use and carbapenem resistance. Following the addition of ertapenem to the formulary, there was a statistically significant decrease in the percentage of Pseudomonas aeruginosa isolates resistant to the group 2 carbapenems (P = 0.003). Group 2 carbapenem use and the number of carbapenem-resistant Pseudomonas aeruginosa isolates per 10,000 patient days did not change significantly over the time period. There was a large decrease in the use of ciprofloxacin (P = 0.0033), and there was a correlation of ciprofloxacin use with the percentage of isolates resistant to the group 2 carbapenems (ρ = 0.47, P = 0.002). We suspect that the improvement in susceptibility of Pseudomonas aeruginosa to group 2 carbapenems was related to a decrease in ciprofloxacin use. PMID:21968357

Reduction in fluoroquinolone use following introduction of ertapenem into a hospital formulary is associated with improvement in susceptibility of Pseudomonas aeruginosa to group 2 carbapenems: a 10-year study.

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Cook, Paul P; Gooch, Michael; Rizzo, Shemra

2011-12-01

We examined the effect of the addition of ertapenem to our hospital formulary on the resistance of nosocomial Pseudomonas aeruginosa to group 2 carbapenems (imipenem, meropenem, and doripenem). This was a retrospective, observational study conducted between 1 January 2000 and 31 January 2009 at a large, tertiary-care hospital. Autoregressive integrated moving average (ARIMA) regression models were used to evaluate the effect of ertapenem use on the susceptibility of Pseudomonas aeruginosa to group 2 carbapenems as well as on the use of the group 2 carbapenems, ciprofloxacin, and other antipseudomonal drugs (i.e., tobramycin, cefepime, and piperacillin-tazobactam). Resistance was expressed as a percentage of total isolates as well as the number of carbapenem-resistant bacterial isolates per 10,000 patient days. Pearson correlation was used to assess the relationship between antibiotic use and carbapenem resistance. Following the addition of ertapenem to the formulary, there was a statistically significant decrease in the percentage of Pseudomonas aeruginosa isolates resistant to the group 2 carbapenems (P = 0.003). Group 2 carbapenem use and the number of carbapenem-resistant Pseudomonas aeruginosa isolates per 10,000 patient days did not change significantly over the time period. There was a large decrease in the use of ciprofloxacin (P = 0.0033), and there was a correlation of ciprofloxacin use with the percentage of isolates resistant to the group 2 carbapenems (ρ = 0.47, P = 0.002). We suspect that the improvement in susceptibility of Pseudomonas aeruginosa to group 2 carbapenems was related to a decrease in ciprofloxacin use.

Echinococcus granulosus: biological comparison of cattle isolates from endemic regions of Argentina and Spain Echinococcus granulosus: comparación biológica de aislados de bovinos de regiones endémicas de Argentina y España

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M. V. Andresiuk

2009-12-01

Full Text Available In the present study we have compared cattle isolates of Echinococcus granulosus from Argentina and Spain. The aim was to compare and determine if there exist phenotypic and genetic differences within E. granulosus cattle isolates between an endemic area of Spain (where the disease is mainly restricted to a sheep-dog cycle and an endemic area of Argentina (where cattle are the most abundant intermediate hosts. The Spanish samples were previously identified as G1 genotype. The Argentinean samples were also identified as G1, but some variants were found for the cytochrome c oxidase-1 (CO1 and NADH dehydrogenase-1 (ND1 mitochondrial genes. When comparing the cyst features and the morphology of the larval rostellar hooks in both regions, some differences were found. The morphometric analyses of the larval rostellar hooks showed the existence of two distinct clearly separated groups (one corresponding to the Argentinean samples and the other to the Spanish ones. In conclusion, there are some genetic and phenotypic differences within E. granulosus cattle isolates from Argentina and Spain. Probably these differences, more important from an epidemiological point of view, are related to different steps in the disease control in both countries. Further studies involving other epidemiological, morphometric and molecular data, including other types of livestock, would contribute to clarify and expand the present work.El objetivo del presente trabajo fue determinar si existen diferencias fenotípicas y genéticas entre los aislados de Echinococcus granulosus de origen bovino provenientes de dos regiones geográficas donde la hidatidosis es endémica, una de España (donde predomina el ciclo perro-oveja y una de Argentina (donde el bovino es el hospedador intermediario más importante. Las muestras españolas fueron previamente identificadas como pertenecientes al genotipo G1. Las muestras argentinas también correspondían al genotipo G1, pero entre ellas se

Identificación y expresión diferencial del factor de transcripción asociado a microftalmia en corazón y cardiomiocitos aislados de cobayo, posible papel en hipertrofia y en viabilidad

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Luis Alberto Gómez

2014-09-01

Full Text Available Introducción. El factor de transcripción asociado a microftalmia (MITF regula la expresión de genes específicos y no se conoce su expresión y su función a nivel cardiaco. Objetivo. Identificar la expresión de MITF en corazón y en cardiomiocitos aislados de cobayo, describir cambios morfológicos asociados con su disminución y evaluar niveles relativos de su expresión en cardiomiocitos aislados en condiciones de preacondicionamiento isquémico. Materiales y métodos. El análisis de expresión relativa de la isoforma específica cardiaca, MITF-H, se determinó por PCR en tiempo real semicuantitativa, secuenciación y western blot. La disminución del mRNA de MITF se indujo con un shRNAi específico. El tamaño, el diámetro y número de fibras musculares se evaluó por observación directa microscopía de luz. Resultados. Se amplificó un fragmento de 281 pb de cDNA, el análisis de la secuencia confirmó la identidad del exón 1 y la isoforma H de MITF. La interferencia del mRNA de MITF se asoció con un mayor  índice cardiaco (peso corazón/peso corporal 5,46x10-3 vs 4,6x10-3 y un incremento del diámetro de las fibras cardiacas (50,2±16 μm vs 38,7±14,7 μm p<0.05, n= 150. En cardiomiocitos aislados en condiciones de preacondicionamiento isquémico, se observó una expresión relativa mayor de MITF-H, que en miocitos en normoxia y expuestos a lesión por isquemia simulada (ochenta y cien veces más n=5, p< 0,05 n=3. Conclusión. Los resultados sugieren que MITF-H podría estar involucrado en hipertrofia, en la respuesta al estrés por isquemia y en la supervivencia de cardiomiocitos de cobayo.

Molecular Epidemiology of Carbapenem Non-Susceptible Acinetobacter baumannii in France

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Jeannot, Katy; Diancourt, Laure; Vaux, Sophie; Thouverez, Michelle; Ribeiro, Amandina; Coignard, Bruno; Courvalin, Patrice; Brisse, Sylvain

2014-01-01

Carbapenem-resistant Acinetobacter baumannii have emerged globally. The objective of this study was to investigate the epidemiology, clonal diversity and resistance mechanisms of imipenem non-susceptible A. baumannii isolates in France. Between December 2010 and August 2011, 132 notifications were collected, including 37 outbreaks corresponding to 242 cases (2 to 55 per cluster). Multilocus sequence typing, pulsed-field gel electrophoresis (PFGE) and characterisation of carbapenemase-encoding genes were performed on 110 non-repetitive isolates. Gene bla OXA-23 was the most frequently detected (82%), followed by bla OXA-24 (11%) and bla OXA-58 (7%). Eleven sequence types (ST) were distinguished, among which sequence types ST1, ST2 (64%), ST20, ST25, ST85 and ST107. Isolates from epidemiological clusters had the same ST and resistance genes, indicating probable transmission within centres. In contrast, PFGE types of isolates differed among centres, arguing against transmission among centers. This study provides the first epidemiological snapshot of the population of A. baumannii with reduced susceptibility to carbapenems from France, and further underlines the predominance of international clones. PMID:25517732

Relación entre ansiedad y actitud hacia los feminicidios

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Paloma María Guadalupe Montiel Merino

2014-01-01

Full Text Available Inicialmente, escuchar sobre la muerte de una mujer tras haber sido privada de su libertad y violentada sexualmente sonaba como un caso aislado en el que las circunstancias habían “pro - piciado” ese acontecimiento. La cantidad y frecuencia de tales acontecimientos, obligó a dar un significante específico para tan específico significado: feminicidio. El interés social y psicológico condujo a investigar de qué manera estos feminicidios influyen en la actitud y en las emociones de las mujeres juarenses, específicamente en los niveles de ansiedad; el presente trabajo tiene como objetivo dar a conocer los resultados obtenidos en dicha investigación. A fin de establecer la relación entre la actitud hacia los feminicidios y la ansiedad, se tomaron dos grupos de estu - dio: mujeres estudiantes de psicología (n=181 y mujeres trabajadoras de maquila (n=186, a los cuales se les aplicaron dos instrumentos de medición (Inventario de Ansiedad Rasgo-Estado e Inventario de Actitud hacia los feminicidios que permitieran: a determinar los niveles de ansiedad (rasgo-estado y los niveles de actitud hacia los feminicidios en cada grupo de estudio, b correlacionar tales niveles, y c establecer una comparación entre los resultados de cada grupo de estudio. No se encontraron diferencias significativas entre los grupos respecto a la actitud hacia los feminicidios, sin embargo, se obtuvo una diferencia significativa en los niveles más altos de ansiedad rasgo-estado presentados en las trabajadoras de maquila, respecto a los niveles de ansiedad rasgo-estado presentados en las estudiantes de psicología.

Associated factors and outcomes for OXA-232 Carbapenem-resistant Enterobacteriaceae infections in a tertiary care centre in Mexico City: A case-control-control study.

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Torres-González, Pedro; Ortiz-Brizuela, Edgar; Cervera-Hernandez, Miguel Enrique; Bobadilla-Del Valle, Miriam; Martínez-Gamboa, Areli; Sifuentes-Osornio, José; Ponce-de-Leon, Alfredo

2016-10-01

We describe the outcomes and factors associated with OXA-232 producing carbapenem-resistant Enterobacteriaceae infections. A case-control-control study was performed; each case of infection by a carbapenem-resistant/OXA-232 (OXA-232-cases, n=27) was matched by isolation site, species, and date, with 2 cases of infection by carbapenem-susceptible/third-generation cephalosporin-susceptible (TGCS-controls, n=54) and 2 cases by carbapenem-susceptible/ESBL producing Enterobacteriaceae (ESBL-controls, n=54); 66% were urinary tract and 18.5% intra-abdominal infections. In the multivariable analysis with ESBL-controls, previous use β-lactam/β-lactamase antibiotics (OR 6.2; 95% CI 1.6-23.8) and, third-generation cephalosporins (OR 0.2; 95% CI 0.05-0.8) were associated with OXA-232 infection; with TGSC-controls previous use of β-lactam/β-lactamase antibiotics (OR 3.7; 95% 1.1-12.0) was associated. Among the OXA-232-cases, 29% received imipenem/cilastatin or meropenem, 11.1% ceftriaxone, 22.2% a carbapenem-based combination and 33.3% other antimicrobials as treatment. Previous β-lactam/β-lactamase antibiotics are associated with OXA-232 infections, and some may be treated with other active carbapenems or, in the absence of ESBL, third-generation cephalosporins. Copyright © 2016 Elsevier Inc. All rights reserved.

Low overlap between carbapenem resistant Pseudomonas aeruginosa genotypes isolated from hospitalized patients and wastewater treatment plants.

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Andrej Golle

Full Text Available The variability of carbapenem-resistant Pseudomonas aeruginosa strains (CRPA isolated from urine and respiratory samples in a large microbiological laboratory, serving several health care settings, and from effluents of two wastewater treatment plants (WWTP from the same region was assessed by PFGE typing and by resistance to 10 antibiotics. During the 12-month period altogether 213 carbapenem-resistant P. aeruginosa isolates were cultured and distributed into 65 pulsotypes and ten resistance profiles. For representatives of all 65 pulsotypes 49 different MLSTs were determined. Variability of clinical and environmental strains was comparable, 130 carbapenem-resistant P. aeruginosa obtained from 109 patients were distributed into 38 pulsotypes, while 83 isolates from WWTPs were classified into 31 pulsotypes. Only 9 pulsotypes were shared between two or more settings (hospital or WWTP. Ten MLST were determined for those prevalent pulsotypes, two of them (ST111 and ST235 are among most successful CRPA types worldwide. Clinical and environmental carbapenem-resistant P. aeruginosa strains differed in antibiotic resistance. The highest proportion of clinical isolates was resistant to piperacillin/tazobactam (52.3% and ceftazidime (42.3%. The highest proportion of environmental isolates was resistant to ceftazidime (37.1% and ciprofloxacin (35.5%. The majority of isolates was resistant only to imipenem and/or meropenem. Strains with additional resistances were distributed into nine different patterns. All of them included clinically relevant strains, while environmental strains showed only four additional different patterns.

Carbapenem-Nonsusceptible Enterobacteriaceae in Taiwan

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Wang, Jann-Tay; Wu, Un-In; Lauderdale, Tsai-Ling Yang; Chen, Mei-Chen; Li, Shu-Ying; Hsu, Le-Yin; Chang, Shan-Chwen

2015-01-01

A total of 1135 carbapenem-resistant (nonsusceptible) Enterobacteriaceae (CRE) isolates were recovered between November 2010 and July 2012 (517 from 2010-2011 and 618 from 2012) from 4 hospitals in Taiwan. Carbapenemase-producing Enterobacteriaceae (CPE) comprised 5.0% (57 isolates), including 17 KPC-2 (16 Klebsiella pneumoniae and 1 Escherichia coli), 1 NDM-1 (K. oxytoca), 37 IMP-8 (26 Enterobacter cloacae, 4 Citrobacter freundii, 4 Raoultella planticola, 1 K. pneumoniae, 1 E. coli and 1 K. oxytoca), and 2 VIM-1 (1 E. cloacae, 1 E. coli). The KPC-2-positive K. pneumoniae were highly clonal even in isolates from different hospitals, and all were ST11. IMP-8 positive E. cloacae from the same hospitals showed higher similarity in PFGE pattern than those from different hospitals. A total of 518 CRE isolates (45.6%) were positive for bla ESBL, while 704 (62.0%) isolates were bla AmpC-positive, 382 (33.6% overall) of which carried both bla ESBL and bla AmpC. CTX-M (414, 80.0%) was the most common bla ESBL, while DHA (497, 70.6%) and CMY (157, 22.3%) were the most common bla AmpC. Co-carriage of bla ESBL and bla AmpC was detected in 31 (54.4%) and 15 (26.3%) of the 57 CPE, respectively. KPC-2 was the most common carbapenemase detected in K. pneumoniae (2.8%), while IMP-8 was the most common in E. cloacae (9.7%). All KPC-2-positive CRE were resistant to all three tested carbapenems. However, fourteen of the 37 IMP-8-positive CRE were susceptible to both imipenem and meropenem in vitro. Intra- and inter-hospital spread of KPC-2-producing K. pneumoniae and IMP-8-producing E. cloacae likely occurred. Although the prevalence of CPE is still low, careful monitoring is urgently needed. Non-susceptibility to ertapenem might need to be considered as one criterion of definition for CRE in areas where IMP type carbapenemase is prevalent. PMID:25794144

RESPUESTA ANTAGÓNICA DE MICROORGANISMOS AISLADOS DE LOS CULTIVOS DE MICROALGAS EN EL LABORATORIO DE CULTIVOS MARINOS

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Carmen Ruíz Huamán

2013-10-01

Full Text Available Durante el 2012, el Laboratorio de Cultivos Marinos obtuvo bacterias aisladas de los cultivos de microalgas. Se trabajó 60 colonias de los cultivos. Se confrontó una a una las colonias aisladas del cultivo de microalgas con las bacterias patógenas tipo ATCC, estas fueron: Flavobacterium psychrophilum, Aeromona hydrophila, Lactococcus garviaceae y Vibrio herveyi. Solo una bacteria tuvo interacción antagónica ya que formó el halo de inhibición.

Antibacterial activity of exogenous glutathione and its synergism on antibiotics sensitize carbapenem-associated multidrug resistant clinical isolates of Acinetobacter baumannii.

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Alharbe, Roaa; Almansour, Ayidh; Kwon, Dong H

2017-10-01

A major clinical impact of A. baumannii is hospital-acquired infections including ventilator-associated pneumonia. The treatment of this pathogen is often difficult due to its innate and acquired resistance to almost all commercially available antibiotics. Infections with carbapenem-associated multidrug resistant A. baumannii is the most problematic. Glutathione is a tripeptide thiol-antioxidant and antibacterial activity of exogenous glutathione was reported in some bacteria. However, clinical relevance and molecular details of the antibacterial activity of glutathione are currently unclear. Seventy clinical isolates of A. baumannii including 63 carbapenem-associated multidrug resistant isolates and a type strain A. baumannii ATCC 19606 were used to determine minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Fractional inhibitory concentration (FIC) and time-killing activity with meropenem and/or glutathione were also determined in the carbapenem-associated multidrug resistant isolates. In addition, the roles of exogenous glutathione in multidrug efflux pumps and β-lactamase production were examined. Levels of MIC and MBC were ranged from 10 to 15mM of exogenous glutathione. All tested carbapenem-associated multidrug resistant isolates were sensitized by all tested antibiotics in combination with subinhibitory concentrations of glutathione. FIC levels of glutathione with carbapenem (meropenem) were allcarbapenem-associated multidrug resistant isolates were killed by subinhibitory concentrations of both glutathione and meropenem at>2log10 within 12h, suggesting glutathione synergistically interacts with meropenem. The roles of multidrug efflux pumps and β-lactamase production were excluded for the glutathione-mediated antibiotic susceptibility. Overall results demonstrate that the antibacterial activity of glutathione is clinically relevant and its synergism on antibiotics sensitizes clinical isolates of A. baumannii regardless

Treatment Outcomes in Infections Caused by "SPICE" (Serratia, Pseudomonas, Indole-positive Proteus, Citrobacter, and Enterobacter) Organisms: Carbapenem versus Noncarbapenem Regimens.

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Moy, Stanley; Sharma, Roopali

2017-01-01

Techniques used to identify AmpC β-lactamases in SPICE (Serratia, Pseudomonas, indole-positive Proteus, Citrobacter, and Enterobacter) organisms are not yet optimized for the clinical laboratory and are not routinely used. Clinicians are often left with an uncertainty on the choice of antibiotic when a SPICE organism is isolated. The purpose of this study was to evaluate the outcomes of carbapenem versus noncarbapenem regimens in treating bacteremia or urinary tract infection from a SPICE organism in clinical practice. This single-center, retrospective, cohort study analyzed data from adult patients who had clinical infection with a SPICE organism isolated from blood or urine cultures. Patients were assigned to a carbapenem- or noncarbapenem-treated group. The primary end point was clinical response, defined as a resolution of signs and symptoms of infection at the end of therapy. A total of 332 patients were assessed, and 145 patients met the inclusion criteria for the study. There were 20 patients who received a carbapenem, while 125 received a noncarbapenem regimen. The percentage of patients who were bacteremic was 46.2%. Clinical response overall was achieved in 80% of patients on a carbapenem versus 90.3% of patients on a noncarbapenem regimen (P = 0.24). The rate of microbiologic cure was 90% in patients on a carbapenem versus 91.2% in patients on a noncarbapenem regimen (P = 1). In this study in patients treated for infection with a SPICE organism in clinical practice, the rates of clinical response did not differ significantly between the carbapenem and noncarbapenem groups. Current CLSI breakpoints set for SPICE organisms may still be reliable and may not require additional testing for AmpC β-lactamases. Copyright © 2017 Elsevier HS Journals, Inc. All rights reserved.

Rapid Increase in Prevalence of Carbapenem-Resistant Enterobacteriaceae (CRE) and Emergence of Colistin Resistance Gene mcr-1 in CRE in a Hospital in Henan, China.

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Li, Yi; Sun, Qiao-Ling; Shen, Yingbo; Zhang, Yangjunna; Yang, Jun-Wen; Shu, Ling-Bin; Zhou, Hong-Wei; Wang, Yang; Wang, Bing; Zhang, Rong; Wang, Shaolin; Shen, Zhangqi

2018-04-01

The global spread of carbapenem-resistant Enterobacteriaceae (CRE) is one of the most severe threats to human health in a clinical setting. The recent emergence of plasmid-mediated colistin resistance gene mcr-1 among CRE strains greatly compromises the use of colistin as a last resort for the treatment of infections caused by CRE. This study aimed to understand the current epidemiological trends and characteristics of CRE from a large hospital in Henan, the most populous province in China. From 2014 to 2016, a total of 7,249 Enterobacteriaceae isolates were collected from clinical samples, among which 18.1% (1,311/7,249) were carbapenem resistant. Carbapenem-resistant Klebsiella pneumoniae and carbapenem-resistant Escherichia coli were the two most common CRE species, with Klebsiella pneumoniae carbapenemases (KPC) and New Delhi metallo-β-lactamases (NDM), respectively, responsible for the carbapenem resistance of the two species. Notably, >57.0% ( n = 589) of the K. pneumoniae isolates from the intensive care unit were carbapenem resistant. Furthermore, bla NDM-5 and mcr-1 were found to coexist in one E. coli isolate, which exhibited resistance to almost all tested antibiotics. Overall, we observed a significant increase in the prevalence of CRE isolates during the study period and suggest that carbapenems may no longer be considered to be an effective treatment for infections caused by K. pneumoniae in the studied hospital. Copyright © 2018 American Society for Microbiology.

A Five-Year Experience of Carbapenem Resistance in Enterobacteriaceae Causing Neonatal Septicaemia: Predominance of NDM-1

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Datta, Saswati; Roy, Subhasree; Chatterjee, Somdatta; Saha, Anindya; Sen, Barsha; Pal, Titir; Som, Tapas; Basu, Sulagna

2014-01-01

Treatment of neonatal sepsis has become a challenge with the emergence of carbapenemase-producing bacteria. This study documents the trend of carbapenem susceptibility in Enterobacteriaceae that caused septicaemia in neonates over a five year period (2007–2011) and the molecular characterisation of Enterobacteriaceae resistant to carbapenems and cephalosporins. Hundred and five Enterobacteriaceae including Escherichia coli (n = 27), Klebsiella pneumoniae (n = 68) and Enterobacter spp. (n = 10) were isolated from blood of septicaemic neonates followed by antibiotic susceptibility tests, determination of MIC values, phenotypic and genotypic detection of β-lactamases. Carbapenem was the most active antimicrobial tested after tigecycline. CTX-M type was the most prevalent ESBL throughout the period (82%). New Delhi Metallo-β-lactamase-1 (NDM-1), which is a recent addition to the carbapenemase list, was the only carbapenemase identified in our setting. Fourteen percent of the isolates possessed bla NDM-1. Carbapenem non-susceptibility was first observed in 2007 and it was due to loss of Omp F/Ompk36 in combination with the presence of ESBLs/AmpCs. NDM-1 first emerged in E. coli during 2008; later in 2010, the resistance was detected in K. pneumoniae and E. cloacae isolates. NDM-1-producing isolates were resistant to other broad-spectrum antibiotics and possessed ESBLs, AmpCs, 16S-rRNA methylases, AAC(6′)-Ib-cr, bleomycin resistant gene and class 1 integron. Pulsed field gel electrophoresis of the NDM-1-producing isolates indicated that the isolates were clonally diverse. The study also showed that there was a significantly higher incidence of sepsis caused by NDM-1-harbouring isolates in the male sex, in neonates with low birth weight and neonates born at an extramural centre. However, sepsis with NDM-1-harbouring isolates did not result in a higher mortality rate. The study is the first to review the carbapenem resistance patterns in neonatal sepsis

Emergence of Serratia marcescens isolates possessing carbapenem-hydrolysing β-lactamase KPC-2 from China.

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Lin, X; Hu, Q; Zhang, R; Hu, Y; Xu, X; Lv, H

2016-09-01

Eighty-three carbapenem-resistant Serratia marcescens isolates were recovered from Zhejiang Provincial People's Hospital, China. The minimum inhibitory concentrations of imipenem, meropenem, and ertapenem for all isolates were 2 to >128 μg/mL. Polymerase chain reaction indicated that 63 S. marcescens isolates produced Klebsiella pneumoniae carbapenemase (KPC)-2. Clone A (15 isolates) and clone B (41 isolates) were the two dominant clones and clone A strains were gradually replaced by clone B strains between 2011 and 2014. The results indicate that blaKPC-2-positive S. marcescens emerged in our hospital as the major mechanism of carbapenem resistance. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Comparison of Molecular and Phenotypic Methods for the Detection and Characterization of Carbapenem Resistant Enterobacteriaceae.

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Somily, Ali M; Garaween, Ghada A; Abukhalid, Norah; Absar, Muhammad M; Senok, Abiola C

2016-03-01

In recent years, there has been a rapid dissemination of carbapenem resistant Enterobacteriaceae (CRE). This study aimed to compare phenotypic and molecular methods for detection and characterization of CRE isolates at a large tertiary care hospital in Saudi Arabia. This study was carried out between January 2011 and November 2013 at the King Khalid University Hospital (KKUH) in Saudi Arabia. Determination of presence of extended-spectrum beta-lactamases (ESBL) and carbapenem resistance was in accordance with Clinical and Laboratory Standards Institute (CLSI) guidelines. Phenotypic classification was done by the MASTDISCS(TM) ID inhibitor combination disk method. Genotypic characterization of ESBL and carbapenemase genes was performed by the Check-MDR CT102. Diversilab rep-PCR was used for the determination of clonal relationship. Of the 883 ESBL-positive Enterobacteriaceae detected during the study period, 14 (1.6%) isolates were carbapenem resistant. Both the molecular genotypic characterization and phenotypic testing were in agreement in the detection of all 8 metalo-beta-lactamases (MBL) producing isolates. Of these 8 MBL-producers, 5 were positive for blaNDM gene and 3 were positive for blaVIM gene. Molecular method identified additional blaOXA gene isolates while MASTDISCS(TM) ID detected one AmpC producer isolate. Both methods agreed in identifying 2 carbapenem resistant isolates which were negative for carbapenemase genes. Diversilab rep-PCR analysis of the 9 Klebsiella pneumoniae isolates revealed polyclonal distribution into eight clusters. MASTDISCS(TM) ID is a reliable simple cheap phenotypic method for detection of majority of carbapenemase genes with the exception of the blaOXA gene. We recommend to use such method in the clinical laboratory.

Determinación de aislados nativos de pseudomonas desulfurizadoras mediante el estudio del perfil de ácidos grasos

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Edilberto Silva Gómez

2010-09-01

Full Text Available Utilizando CGAR se determinó el contenido de ácidos grasos celulares de doce aislados colombianos, Pseudomonas aeruginosa 17, 18, 19, 20, 21, 22 y 103, Pseudomonas sp 23, 24, 25, 26 y 27 con capacidad desulfurizadora, Pseudomonas aeruginosa ATCC 9027 y 10145, Pseudomonas sp ATCC 39327 y Pseudomonas flúores cens. Se encontraron 53 ácidos grasos diferentes, entre saturados e insaturados de cadena lineal, y principalmente hidroxiácidos y ramificados.

Infection control implications of heterogeneous resistance mechanisms in carbapenem-resistant Enterobacteriaceae (CRE).

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Goodman, K E; Simner, P J; Tamma, P D; Milstone, A M

2016-01-01

The Centers for Disease Control and Prevention (CDC) defines carbapenem-resistant Enterobacteriaceae (CRE) based upon a phenotypic demonstration of carbapenem resistance. However, considerable heterogeneity exists within this definitional umbrella. CRE may mechanistically differ by whether they do or do not produce carbapenemases. Moreover, patients can acquire CRE through multiple pathways: endogenously through antibiotic selective pressure on intestinal microbiota, exogenously through horizontal transmission or through a combination of these factors. Some evidence suggests that non-carbapenemase-producing CRE may be more frequently acquired by antibiotic exposure and carbapenemase-producing CRE via horizontal transmission, but definitive data are lacking. This review examines types of CRE resistance mechanisms, antibiotic exposure and horizontal transmission pathways of CRE acquisition, and the implications of these heterogeneities to the development of evidence-based CRE healthcare epidemiology policies. In our Expert Commentary & Five-Year View, we outline specific nosocomial CRE knowledge gaps and potential methodological approaches for their resolution.

The Complex Epidemiology of Carbapenem-Resistant Enterobacter Infections: A Multicenter Descriptive Analysis.

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Lazarovitch, Tsilia; Amity, Keren; Coyle, Joseph R; Ackerman, Benjamin; Tal-Jasper, Ruthy; Ofer-Friedman, Hadas; Hayakawa, Kayoko; Bogan, Christopher; Lephart, Paul R; Kaplansky, Tamir; Maskit, Moran; Azouri, Tal; Zaidenstein, Ronit; Perez, Federico; Bonomo, Robert A; Kaye, Keith S; Marchaim, Dror

2015-11-01

The pandemic of carbapenem-resistant Enterobacteriaceae (CRE) was primarily due to clonal spread of bla KPC producing Klebsiella pneumoniae. Thus, thoroughly studied CRE cohorts have consisted mostly of K. pneumoniae. To conduct an extensive epidemiologic analysis of carbapenem-resistant Enterobacter spp. (CREn) from 2 endemic and geographically distinct centers. CREn were investigated at an Israeli center (Assaf Harofeh Medical Center, January 2007 to July 2012) and at a US center (Detroit Medical Center, September 2008 to September 2009). bla KPC genes were queried by polymerase chain reaction. Repetitive extragenic palindromic polymerase chain reaction and pulsed-field gel electrophoresis were used to determine genetic relatedness. In this analysis, 68 unique patients with CREn were enrolled. Sixteen isolates (24%) were from wounds, and 33 (48%) represented colonization only. All isolates exhibited a positive Modified Hodge Test, but only 93% (27 of 29) contained bla KPC. Forty-three isolates (63%) were from elderly adults, and 5 (7.4%) were from neonates. Twenty-seven patients died in hospital (40.3% of infected patients). Enterobacter strains consisted of 4 separate clones from Assaf Harofeh Medical Center and of 4 distinct clones from Detroit Medical Center. In this study conducted at 2 distinct CRE endemic regions, there were unique epidemiologic features to CREn: (i) polyclonality, (ii) neonates accounting for more than 7% of cohort, and (iii) high rate of colonization (almost one-half of all cases represented colonization). Since false-positive Modified Hodge Tests in Enterobacter spp. are common, close monitoring of carbapenem resistance mechanisms (particularly carbapenemase production) among Enterobacter spp. is important.

Predominance of carbapenem-resistant Pseudomonas aeruginosa isolates carrying blaIMP and blaVIM metallo-β-lactamases in a major hospital in Costa Rica.

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Toval, Francisco; Guzmán-Marte, Anel; Madriz, Vivian; Somogyi, Teresita; Rodríguez, César; García, Fernando

2015-01-01

This study aimed to assess the molecular basis of the resistance to carbapenems in clinical isolates of Pseudomonas aeruginosa recovered from a tertiary-level health facility in San José, Costa Rica. A total of 198 non-duplicated isolates were evaluated for their susceptibility to β-lactams, aminoglycosides and fluoroquinolones. The production of metallo-β-lactamases (MBLs), the presence of MBL encoding genes (blaIMP, blaVIM and blaGIM-1) and the occurrence of these genes within class 1 integrons were investigated. In addition, an ERIC2 PCR fingerprinting method was used to elucidate the distribution of the detected MBL genes within the strain collection. Of the 198 isolates tested, 125 (63.1 %) were categorized as carbapenem-resistant. The majority (88.8 %) of the carbapemen-resistant isolates also showed resistance to ceftazidime, cefepime, aztreonam, ticarcillin/clavulanic acid, amikacin, gentamicin, tobramycin, ciprofloxacin and gatifloxacin. Among the carbapenem-resistant isolates, 102 (81.6 %) showed MBL activity. Strikingly, both blaIMP and blaVIM genes were simultaneously detected in most (94.1 %) of the 102 MBL producers. Five carbapenem-resistant MBL producers were positive only for blaIMP genes. Almost 70 % of the isolates examined harboured the intI1 gene, accompanied by the sul1 and qacEΔ1 genes in 136 (99 %) and 122 (89 %) isolates, respectively. The majority (94.4 %) of the carbapenem-resistant isolates carried the intI1 gene, in contrast to 26 % of the carbapenem-susceptible isolates. Ninety-three out of 96 (96.9 %) isolates carrying both blaIMP and blaVIM genes also harboured the intI1, sul1 and qacEΔ1 genes. Gene cassettes from carbapenem-susceptible and MBL-negative carbapenem-resistant isolates encoded aminoglycoside-resistance enzymes (aadA2, aadA4 and aadA6) as well as orfD and qacF genes. RAPD analysis distributed 126 of the isolates in 29 clusters. Eighty of the 90 blaIMP (+) blaVIM (+) isolates were sorted into 16

Degradación de tiocianato por hongos aislados de ambientes mineros y evaluación de su capacidad degradativa

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Susan Medina

2012-10-01

Full Text Available El Perú es uno de los principales países en la extracción de minerales como el oro, zinc, plomo y estaño. En la producción de oro se utiliza cianuro, el cual es tóxico para el medio ambiente, y que por reacción natural con el azufre se convierte en tiocianato (-SCN. En el presente trabajo se aislan hongos con capacidad de degradar tiocianato procedentes de aguas y suelos de zonas mineras de Junín y Tumbes. Estas cepas se sometieron a ensayos con concentraciones de tiocianato entre 5 y 600 mM. Asimismo, se evaluó la cinética de degradación de tiocianato en medio Kwon partiendo de 1,2 g.L-1 de KSCN y luego se realizó la identificación morfológica. De un total de 58 mohos aislados, obtuvimos 4 mohos con excelentes capacidades de degradar tiocianato y que pueden ser utilizados en biorremediación. La capacidad degradativa de estas cepas fue en promedio 10,05 mg.L-1 de -SCN con una velocidad de 28,77 mg.L-1.h-1. Dos cepas fueron identificadas fenotípica y molecularmente como Fusarium trincictum usando el marcador ITS del gen rDNA.

Antibiotic trapping by plasmid-encoded cmy-2-lactamase combined with reduced outer membrane permeability as a mechanism of carbapenem resistance in escherichia coli

NARCIS (Netherlands)

W.H.F. Goessens (Wil); A.K. van der Bij (Akke); R. van Boxtel (Ria); J.D.D. Pitout (J. D D); P. van Ulsen (Peter); D.C. Melles (Damian); J. Tommassen (Jan)

2013-01-01

textabstractA liver transplant patient was admitted with cholangitis, for which meropenem therapy was started. Initial cultures showed a carbapenem-susceptible (CS) Escherichia coli strain, but during admission, a carbapenem-resistant (CR) E. coli strain was isolated. Analysis of the outer membrane

Colistin- and Carbapenem-Resistant Escherichia coli Harboring mcr-1 and blaNDM-5, Causing a Complicated Urinary Tract Infection in a Patient from the United States.

Science.gov (United States)

Mediavilla, José R; Patrawalla, Amee; Chen, Liang; Chavda, Kalyan D; Mathema, Barun; Vinnard, Christopher; Dever, Lisa L; Kreiswirth, Barry N

2016-08-30

Colistin is increasingly used as an antibiotic of last resort for the treatment of carbapenem-resistant Gram-negative infections. The plasmid-borne colistin resistance gene mcr-1 was initially identified in animal and clinical samples from China and subsequently reported worldwide, including in the United States. Of particular concern is the spread of mcr-1 into carbapenem-resistant bacteria, thereby creating strains that approach pan-resistance. While several reports of mcr-1 have involved carbapenem-resistant strains, no such isolates have been described in the United States. Here, we report the isolation and identification of an Escherichia coli strain harboring both mcr-1 and carbapenemase gene blaNDM-5 from a urine sample in a patient without recent travel outside the United States. The isolate exhibited resistance to both colistin and carbapenems, but was susceptible to amikacin, aztreonam, gentamicin, nitrofurantoin, tigecycline, and trimethoprim-sulfamethoxazole. The mcr-1- and blaNDM-5-harboring plasmids were completely sequenced and shown to be highly similar to plasmids previously reported from China. The strain in this report was first isolated in August 2014, highlighting an earlier presence of mcr-1 within the United States than previously recognized. Colistin has become the last line of defense for the treatment of infections caused by Gram-negative bacteria resistant to multiple classes of antibiotics, in particular carbapenem-resistant Enterobacteriaceae (CRE). Resistance to colistin, encoded by the plasmid-borne gene mcr-1, was first identified in animal and clinical samples from China in November 2015 and has subsequently been reported from numerous other countries. In April 2016, mcr-1 was identified in a carbapenem-susceptible Escherichia coli strain from a clinical sample in the United States, followed by a second report from a carbapenem-susceptible E. coli strain originally isolated in May 2015. We report the isolation and identification of

Safety and clinical outcomes of carbapenem de-escalation as part of an antimicrobial stewardship programme in an ESBL-endemic setting.

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Lew, Kaung Yuan; Ng, Tat Ming; Tan, Michelle; Tan, Sock Hoon; Lew, Ee Ling; Ling, Li Min; Ang, Brenda; Lye, David; Teng, Christine B

2015-04-01

To evaluate the safety and clinical outcomes of patients who received carbapenem de-escalation as guided by an antimicrobial stewardship programme (ASP) in a setting where ESBL-producing Enterobacteriaceae are endemic. Patients receiving meropenem or imipenem underwent a prospective ASP review for eligibility for de-escalation according to defined institutional guidelines. Patients in whom carbapenem was de-escalated or not de-escalated, representing the acceptance and rejection of the ASP recommendation, respectively, were compared. The primary outcome was the clinical success rate; secondary outcomes included the 30 day readmission and mortality rates, the duration of carbapenem therapy, the incidence of adverse drug reactions due to antimicrobials, the acquisition of carbapenem-resistant Gram-negative bacteria and the occurrence of Clostridium difficile-associated diarrhoea (CDAD). The de-escalation recommendations for 300 patients were evaluated; 204 (68.0%) were accepted. The patient demographics and disease severity were similar. The clinical success rates were similar [de-escalated versus not de-escalated, 183/204 (89.7%) versus 85/96 (88.5%), P=0.84], as was the survival at hospital discharge [173/204 (84.8%) versus 79/96 (82.3%), P=0.58]. In the de-escalated group, the duration of carbapenem therapy was shorter (6 versus 8 days, Pcarbapenem-resistant Acinetobacter baumannii acquisition [4/204 (2.0%) versus 7/96 (7.3%), P=0.042] and there was a lower incidence of CDAD [2/204 (1.0%) versus 4/96 (4.2%), P=0.081]. This study suggests that the ASP-guided de-escalation of carbapenems led to comparable clinical success, fewer adverse effects and a lower incidence of the development of resistance. This approach is safe and practicable, and should be a key component of an ASP. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Investigación científica sobre genotipificación y distribución de Giardia intestinalis en humanos y caninos de América

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Giovanny Torres Lindarte

2011-01-01

Full Text Available Objetivo: Describir la distribución geográfica en América de los genotipos A, B, C y D de Giardia intestinalis hallados en humanos y en perros, y los marcadores y técnicas usadas, de acuerdo con la literatura científica. Materiales y métodos: Revisión sistemática en la que se seleccionaron 19 artículos, y en todos se caracterizaron aislados de humanos; solo 10 de estos caracterizaron aislados de perros. Resultados: México fue el país que más estudios realizó (31,6%. El genotipo A fue reportado en el 89,5% de los trabajos que analizaron aislados de humanos y el genotipo B en el 52,3%. En los que analizaron aislados de perros, el genotipo A se informó en el 60%, el genotipo B en el 20%, el genotipo C en el 30% y el genotipo D en un 20%. La técnica y el marcador más usados fueron la PCR-RFLP y el gen de b-Giardin. Conclusiones: El genotipo A es el responsable de la mayoría de infecciones en humanos como perros de América, aunque los genotipos B, C y D también fueron identificados. El hallazgo de perros infectados con genotipos zoonóticos sustentan su papel como fuentes potenciales de infección de G. intestinalis para humanos.

Risk factors for and role of OprD protein in increasing minimal inhibitory concentrations of carbapenems in clinical isolates of Pseudomonas aeruginosa.

Science.gov (United States)

Hirabayashi, Aki; Kato, Daizo; Tomita, Yuka; Iguchi, Mitsutaka; Yamada, Keiko; Kouyama, Yuichi; Morioka, Hiroshi; Tetsuka, Nobuyuki; Yagi, Tetsuya

2017-11-01

This study examined the risk factors for, and molecular mechanisms underlying, the increase in carbapenem minimum inhibitory concentrations (MICs) in clinical isolates of Pseudomonas aeruginosa. Consecutive clinical isolates of P. aeruginosa were collected. The MicroScan WalkAway system detected more than fourfold increases in the MICs of carbapenems in P. aeruginosa isolates serially recovered from some patients during their clinical course. The clinical risk factors associated with this increase were examined by multiple logistic regression analysis. Western blot analysis and nucleotide sequencing of the oprD gene of 19 clonally related and paired P. aeruginosa isolates from the same patients were undertaken to examine the mechanisms underlying the increase in MICs. The results showed that prior use of carbapenems (OR, 2.799; 95 % CI, 1.088-7.200; P=0.033) and the use of ventilators or tracheostomies (OR, 2.648; 95 % CI, 1.051-6.671; P=0.039) were risk factors for increased carbapenem MICs. Analysis of the underlying mechanisms revealed that loss of functional OprD protein due to mutation of the oprD gene tended to occur in P. aeruginosa isolates with imipenem MICs of more than 8 µg ml -1 ; a reduction in OprD expression was observed in P. aeruginosa isolates with imipenem MICs of 4 or 8 µg ml -1 . This difference in the resistance mechanism was not correlated with the MICs of meropenem. This difference in the resistance mechanism of P. aeruginosa indicates a critical breakpoint at an imipenem MIC of 8 µg ml -1 , in accordance with EUCAST criteria. Reducing carbapenem use will prevent P. aeruginosa clinical isolates from developing resistance to carbapenems.

Antibiotic Trapping by Plasmid-Encoded CMY-2 beta-Lactamase Combined with Reduced Outer Membrane Permeability as a Mechanism of Carbapenem Resistance in Escherichia coli

NARCIS (Netherlands)

Goessens, W.H.F.; van der Bij, A.K.; van Boxtel, R.; Pitout, J.D.D.; van Ulsen, J.P.; Melles, D.C.; Tommassen, J.

2013-01-01

A liver transplant patient was admitted with cholangitis, for which meropenem therapy was started. Initial cultures showed a carbapenem-susceptible (CS) Escherichia coli strain, but during admission, a carbapenem-resistant (CR) E. coli strain was isolated. Analysis of the outer membrane protein

Relación existente entre la infección por los diferentes genotipos del Virus del Papiloma Humano y la presencia de patología premaligna y maligna del cuello uterino

OpenAIRE

Mazarico Gallego, Edurne

2012-01-01

1) Introducción Hasta el momento se han secuenciado total o parcialmente más de 100 tipos y subtipos de VPH. De todos ellos, aproximadamente 40 tipos se han aislado en lesiones de tracto genital inferior y unos 35, según diferentes estudios, en carcinomas. Según su riesgo oncogénico, se clasifican en tipos de VPH de bajo riesgo (VPH-BR), VPH de probable alto riesgo y VPH de alto riesgo (VPH-AR). Uno de los descubrimientos más importantes en la investigación etiológica del cáncer en los...

Polyvinylpyrrolidone-Capped Silver Nanoparticle Inhibits Infection of Carbapenem-Resistant Strain of Acinetobacter baumannii in the Human Pulmonary Epithelial Cell

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Vishvanath Tiwari

2017-08-01

Full Text Available Acinetobacter baumannii, an opportunistic ESKAPE pathogen, causes respiratory and urinary tract infections. Its prevalence increases gradually in the clinical setup. Pathogenicity of Acinetobacter is significantly influenced by its ability to infect and survive in human pulmonary cells. Therefore, it is important to study the infection of A. baumannii in human pulmonary host cell (A-549, monitoring surface interacting and internalized bacteria. It was found that during infection of A. baumannii, about 40% bacteria adhered to A-549, whereas 20% got internalized inside pulmonary cell and induces threefold increase in the reactive oxygen species production. We have synthesized polyvinylpyrrolidone (PVP-capped AgNPs using chemical methods and tested its efficacy against carbapenem-resistant strain of A. baumannii. PVP-capped silver nanoparticles (PVP-AgNPs (30 µM have shown antibacterial activity against carbapenem-resistant strain of A. baumannii and this concentration does not have any cytotoxic effect on the human pulmonary cell line (IC50 is 130 µM. Similarly, PVP-AgNPs treatment decreases 80% viability of intracellular bacteria, decreases adherence of A. baumannii to A-549 (40 to 2.2%, and decreases intracellular concentration (20 to 1.3% of A. baumannii. This concludes that PVP-AgNPs can be developed as a substitute for carbapenem to control the infection caused by carbapenem-resistant A. baumannii.

The role of the genetic elements bla oxa and IS Aba 1 in the Acinetobacter calcoaceticus-Acinetobacter baumannii complex in carbapenem resistance in the hospital setting.

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Kobs, Vanessa Cristine; Ferreira, Jéssica Augustini; Bobrowicz, Thaís Alexandra; Ferreira, Leslie Ecker; Deglmann, Roseneide Campos; Westphal, Glauco Adrieno; França, Paulo Henrique Condeixa de

2016-01-01

Members of the Acinetobacter genus are key pathogens that cause healthcare-associated infections, and they tend to spread and develop new antibiotic resistance mechanisms. Oxacillinases are primarily responsible for resistance to carbapenem antibiotics. Higher rates of carbapenem hydrolysis might be ascribed to insertion sequences, such as the ISAba1 sequence, near bla OXA genes. The present study examined the occurrence of the genetic elements bla OXA and ISAba1 and their relationship with susceptibility to carbapenems in clinical isolates of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex. Isolates identified over 6 consecutive years in a general hospital in Joinville, Southern Brazil, were evaluated. The investigation of 5 families of genes encoding oxacillinases and the ISAba1 sequence location relative to bla OXA genes was conducted using polymerase chain reaction. All isolates presented the bla OXA-51-like gene (n = 78), and 91% tested positive for the bla OXA-23-like gene (n = 71). The presence of ISAba1 was exclusively detected in isolates carrying the bla OXA-23-like gene. All isolates in which ISAba1 was found upstream of the bla OXA-23-like gene (n = 69) showed resistance to carbapenems, whereas the only isolate in which ISAba1 was not located near the bla OXA-23-like gene was susceptible to carbapenems. The ISAba1 sequence position of another bla OXA-23-like-positive isolate was inconclusive. The isolates exclusively carrying the bla OXA-51-like gene (n = 7) showed susceptibility to carbapenems. The presence of the ISAba1 sequence upstream of the bla OXA-23-like gene was strongly associated with carbapenem resistance in isolates of the A. calcoaceticus-A. baumannii complex in the hospital center studied.

Caracterización de Grupos de Compatibilidad Vegetativa de Fusarium mexicanum Causante de la Malformación del Mango en Jalisco, México

OpenAIRE

Rodríguez Alvarado, Gerardo; Betancourt Resendes, Isai; Rodríguez Fernández, Rodrigo; Velázquez Monreal, José Joaquín; Fernández Pavía, Sylvia Patricia; Gómez Dorantes, Nuria

2012-01-01

Aislados de Fusarium mexicanum obtenidos de árboles de mango con la enfermedad malformación en Jalisco, fueron caracterizados de acuerdo a grupos de compatibilidad vegetativa (GCVs). F. mexicanum ha sido detectado causando malformación del mango en varias regiones de México. Los aislados fueron cultivados en medio mínimo suplementado con clorato de potasio (KClO3), NO3- y L-asparagina, para generar mutantes (nit). Los mutantes son detectados como sectores de micelio resistente al clorato, inc...

Characterization of the etiological structure and genotypically determined phenotypic resistance to carbapenems of infectious complications leading pathogens in critically ill patients

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O. A. Nazarchuk

2018-06-01

Full Text Available The aim is to investigate the genotypically determined phenotypic resistance to carbapenems of gram-negative microorganisms isolated from patients with critical states. Material and methods. Microbiological etiology of infectious complications in critically ill patients (n = 726 was investigated. In total, during the years 2011–2016, 933 clinical strains of infectious complications pathogens from patients with severe burns (n = 435 and from patients treated in intensive care units (n = 291 were isolated and identified. The sensitivity of microorganisms clinical isolates to antibiotics was investigated by means of the standard microbiological methods. In gram-negative bacteria resistant to carbapenems, a molecular genetic study of mechanisms of resistance, determined by the presence of VIM genes, was carried out using the method of real-time polymerase chain reaction. Results. Studies have shown that gram-negative microorganisms (Acinetobacter spp. – 36.3 %, P. aeruginosa – 31.7 %, Enterobacter spp. – 13.5 %, Proteus spp. – 7.9 %, E. coli – 3.8 %; K. pneumoniae – 3.6 %, etc. account for a significant part of infectious complications pathogens structure in critically ill patients. A. baumannii strains (67 % have expressed phenotypic resistance to most antibiotics, in particular to carbapenems (up to 63.2 %. Poly-antibiotic resistance was also found in P. aeruginosa (72 %, and above one the 3rd part of strains of this pathogen was found to have phenotypic resistance to carbapenems. In-depth study of molecular genetic determinants of the resistance mechanism to β-lactam antibiotics among clinical strains of gram-negative bacteria there was proved VIM-induced resistance to carbapenems in A. baumannii, P. aeruginosa, P. mirabilis. Conclusions. Enterobacteriaceae and non-fermenting gram-negative microorganisms (P. aeruginosa, P. mirabilis, A. baumannii, which are the leading causative agents of infectious complications in patients with

Excess Mortality Associated With Colistin-Tigecycline Compared With Colistin-Carbapenem Combination Therapy for Extensively Drug-Resistant Acinetobacter baumannii Bacteremia: A Multicenter Prospective Observational Study.

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Cheng, Aristine; Chuang, Yu-Chung; Sun, Hsin-Yun; Sheng, Wang-Huei; Yang, Chia-Jui; Liao, Chun-Hsing; Hsueh, Po-Ren; Yang, Jia-Ling; Shen, Ni-Jiin; Wang, Jann-Tay; Hung, Chien-Ching; Chen, Yee-Chun; Chang, Shan-Chwen

2015-06-01

Since few therapeutic options exist for extensively drug resistant Acinetobacter baumannii, an emerging threat in ICUs worldwide, and comparative prospective studies of colistin-based combination therapies are lacking, our objective was to compare the outcomes of patients with extensively drug-resistant A. baumannii bacteremia, treated with colistin-carbapenem and colistin-tigecycline combinations. Prospective, observational, multicenter study. Adults with extensively drug-resistant A. baumannii bacteremia were prospectively followed from 2010 to 2013 at three hospitals in Taiwan. Extensively drug-resistant A. baumannii was defined as A. baumannii (genospecies 2) nonsusceptible to all drug classes except for colistin and tigecycline, and standard combination therapy as use of parenteral colistin-carbapenem or colistin-tigecycline for at least 48 hours after onset of bacteremia. Primary outcome measure was 14-day mortality. Of the 176 episodes of extensively drug-resistant A. baumannii bacteremia evaluated, 55 patients with a median (interquartile range) age of 62 years (44-79 yr) and Sequential Organ Failure Assessment score of 9 (5-13) points received standard combination therapy: colistin-tigecycline in 29 patients and colistin-carbapenem in 26. Crude 14-day and in-hospital mortality rates for patients receiving colistin-tigecycline versus patients receiving colistin-carbapenem were 35% versus 15% (p=0.105) and 69% versus 50% (p=0.152), respectively. Breakthrough extensively drug-resistant A. baumannii bacteremia under steady state concentrations of combination therapy for colistin-tigecycline group was 18% and for colistin-carbapenem group was 0% (p=0.059). Eleven patients (20.0%) developed nephrotoxicity. After adjusting for age, sex, comorbidity, initial disease severity, loading colistin dose, polymicrobial infection, and primary infection site, excess 14-day mortality was associated with the use of colistin-tigecycline in the subgroup with tigecycline

In vitro Evaluation of the Colistin-Carbapenem Combination in Clinical Isolates of A. baumannii Using the Checkerboard, Etest, and Time-Kill Curve Techniques.

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Soudeiha, Micheline A H; Dahdouh, Elias A; Azar, Eid; Sarkis, Dolla K; Daoud, Ziad

2017-01-01

The worldwide increase in the emergence of carbapenem resistant Acinetobacter baumannii (CRAB) calls for the investigation into alternative approaches for treatment. This study aims to evaluate colistin-carbapenem combinations against Acinetobacter spp., in order to potentially reduce the need for high concentrations of antibiotics in therapy. This study was conducted on 100 non-duplicate Acinetobacter isolates that were collected from different patients admitted at Saint George Hospital-University Medical Center in Beirut. The isolates were identified using API 20NE strips, which contain the necessary agents to cover a panel of biochemical tests, and confirmed by PCR amplification of bla OXA-51-like . Activities of colistin, meropenem and imipenem against Acinetobacter isolates were determined by ETEST and microdilution methods, and interpreted according to the guidelines of the Clinical and Laboratory Standards Institute. In addition, PCR amplifications of the most common beta lactamases contributing to carbapenem resistance were performed. Tri locus PCR-typing was also performed to determine the international clonality of the isolates. Checkerboard, ETEST and time kill curves were then performed to determine the effect of the colistin-carbapenem combinations. The synergistic potential of the combination was then determined by calculating the Fractional Inhibitory Concentration Index (FICI), which is an index that indicates additivity, synergism, or antagonism between the antimicrobial agents. In this study, 84% of the isolates were resistant to meropenem, 78% to imipenem, and only one strain was resistant to colistin. 79% of the isolates harbored bla OXA-23-like and pertained to the International Clone II. An additive effect for the colistin-carbapenem combination was observed using all three methods. The combination of colistin-meropenem showed better effects as compared to colistin-imipenem ( p carbapenems could be a promising antimicrobial strategy in

Efficacy of non-carbapenem antibiotics for pediatric patients with first febrile urinary tract infection due to extended-spectrum beta-lactamase-producing Escherichia coli.

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Abe, Yoshifusa; Inan-Erdogan, Işil; Fukuchi, Kunihiko; Wakabayashi, Hitomi; Ogawa, Yasuha; Hibino, Satoshi; Sakurai, Shunsuke; Matsuhashi, Kazuhiko; Watanabe, Yoshitaka; Hashimoto, Kaori; Ugajin, Kazuhisa; Itabashi, Kazuo

2017-08-01

Although carbapenem is the recommended for urinary tract infection (UTI) caused by extended-spectrum beta-lactamase (ESBL)-producing organisms, non-carbapenems have been reported to be effective for adult patients with UTI caused by ESBL-producing organisms. The purpose of this study was to evaluate the efficacy of non-carbapenems for pediatric patients with UTI due to ESBL-producing Escherichia coli (E. coli) based on the microbiologic and clinical outcomes. Fifteen children, who were treated for first febrile UTI caused by ESBL-producing E. coli were enrolled in this study. Antimicrobial susceptibilities and ESBL production were determined according to the Clinical and Laboratory Standards Institute guidelines. To detect CTX-M genes, polymerase chain reaction was performed with specific primers for bla CTX-M detection. Of the 15 enrolled patients, 10 (66.7%) were boys and 5 (33.3%) were girls, with a median age of four months. VUR was detected in six patients (40%). For detection of bla CTX-M by PCR, CTX-M-3, CTX-M-8, CTX-M-14, and CTX-M-15 were detected in five, one, eight, and one patient, respectively. Overall, 14 of the 15 isolates (93.3%) were susceptible for fosfomycin (FOM), and all isolates were susceptible for cefmetazole (CMZ), flomoxef (FMOX), and imipenem/cilastatin (IPM/CS). Of the 15 patients, 12 (80%) clinically improved without the use of carbapenems. In conclusion, even if isolates of ESBL-producing E. coli are multidrug resistant based on MIC assessment, clinical susceptibility to non-carbapenems, such as CMZ, FMOX, and FOM, is possible. Accordingly, carbapenems may not be required all the time for treatment of pediatric UTI in clinical practice. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Outbreak of Imipenemase-1-Producing Carbapenem-Resistant in an Intensive Care Unit

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Jin Young Lee

2017-02-01

Full Text Available Background Carbapenem-resistant Enterobacteriaceae (CRE with acquired metallo β-lactamase (MBL resistance have been increasingly reported worldwide and associated with significant mortality and morbidity. Here, an outbreak of genetically related strains of Klebsiella pneumoniae producing the imipenemase (IMP-1 MBL in a medical intensive care unit (MICU in Korea is reported. Methods Since isolating carbapenem-resistant K. pneumoniae (CRKP at the MICU of the hospital on August 10, 2011, surveillance cultures for CRE in 31 hospitalized patients were performed from August to September 2011. Carbapenem resistance was determined based on the disk diffusion method outlined in the Clinical and Laboratory Standards Institute guidelines. Polymerase chain reaction (PCR was performed for genes coding for β-lactamase. Associations among isolates were assessed via pulsed-field gel electrophoresis (PFGE. In addition, a surveillance study of environmental cultures and health-care workers (HCWs was conducted in the MICU during the same time frame. Results During the study period, non-duplicated CRKP specimens were discovered in four patients in the MICU, suggestive of an outbreak. On August 10, 2011, CRKP was isolated from the sputum of a 79-year-old male patient who was admitted to the MICU. A surveillance study to detect additional CRE carriers by rectal swab revealed an additional three CRKP isolates. PCR and sequencing of the four isolates identified the presence of the IMP-1 gene. In addition, PFGE showed that the four isolated strains were genetically related. CRE was not identified in specimens taken from the hands of HCWs or other environmental sources during surveillance following the outbreak. Transmission of the carbapenemase-producing Enterobacteriaceae strain was controlled by isolation of the patients and strict contact precautions. Conclusions This study shows that rapid and systemic detection of CRE and strict infection controls are important

Ceftazidime-Avibactam as Salvage Therapy for Infections Caused by Carbapenem-Resistant Organisms

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Temkin, Elizabeth; Torre-Cisneros, Julian; Beovic, Bojana; Benito, Natividad; Giannella, Maddalena; Gilarranz, Raúl; Jeremiah, Cameron; Loeches, Belén; Machuca, Isabel; Jiménez-Martín, María José; Martínez, José Antonio; Mora-Rillo, Marta; Navas, Enrique; Osthoff, Michael; Pozo, Juan Carlos; Ramos Ramos, Juan Carlos; Rodriguez, Marina; Sánchez-García, Miguel; Viale, Pierluigi; Wolff, Michel

2016-01-01

ABSTRACT Ceftazidime-avibactam (CAZ-AVI) is a recently approved β-lactam–β-lactamase inhibitor combination with the potential to treat serious infections caused by carbapenem-resistant organisms. Few patients with such infections were included in the CAZ-AVI clinical trials, and clinical experience is lacking. We present a case series of patients with infections caused by carbapenem-resistant Enterobacteriaceae (CRE) or Pseudomonas aeruginosa (CRPa) who were treated with CAZ-AVI salvage therapy on a compassionate-use basis. Physicians who had prescribed CAZ-AVI completed a case report form. We used descriptive statistics to summarize patient characteristics and treatment outcomes. We used the Wilcoxon rank sum test and Fisher's exact test to compare patients by treatment outcome. The sample included 36 patients infected with CRE and two with CRPa. The most common infections were intra-abdominal. Physicians categorized 60.5% of patients as having life-threatening infections. All but two patients received other antibiotics before CAZ-AVI, for a median of 13 days. The median duration of CAZ-AVI treatment was 16 days. Twenty-five patients (65.8%) concurrently received other antibiotics to which their pathogen was nonresistant in vitro. Twenty-eight patients (73.7%, 95% confidence interval [CI], 56.9 to 86.6%) experienced clinical and/or microbiological cure. Five patients (20.8%) with documented microbiological cure died, whereas 10 patients (71.4%) with no documented microbiological cure died (P = 0.01). In three-quarters of cases, CAZ-AVI (alone or combined with other antibiotics) cured infections caused by carbapenem-resistant organisms, 95% of which had failed previous therapy. Microbiological cure was associated with improved survival. CAZ-AVI shows promising clinical results for infections for which treatment options are limited. PMID:27895014

Risk factors for carbapenem resistant bacteraemia and mortality due to gram negative bacteraemia in a developing country

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Kalam, K.; Kumar, S.; Ali, S.; Baqi, S.; Qamar, F.

2014-01-01

Objective: To identify the risk factors for carbapenem resistant bacteraemia and mortality due to gram negative bacteraemia in a developing country. Methods: A prospective cohort study was conducted at the Sindh Institute of Urology and Transplantation (SIUT) from June to October 2012. Hospitalized patients > 15 years of age with gram negative bacteraemia were included and followed for a period of 2 weeks for in hospital mortality. Data was collected and analyzed for 243 subjects. Multivariate analysis was used to determine the risk factors for carbapenem resistant bacteraemia and mortality due to gram negative bacteraemia. Crude and adjusted odds ratio and 95% CI are reported. Results: A total of 729 out of 1535 (47.5%) cultures were positive for gram negative isolates. Out of 243 subjects, 117 (48%) had an MDR isolate. Having an MDR isolate on culture (AOR, 2.33; 95% CI, 1.35 -4.0), having multiple positive cultures (AOR, 1.8; 95% CI, 0.94 -3.4) and stay in ICU >48 hours (AOR, 2.0 ; 95% CI, 1.12 -3.78) were identified as significant risk factors for mortality due to gram negative organisms. Risk factors for carbapenem resistant bacteraemia were age >50 years (AOR, 1.83; 95% CI, 1.0-3.5), septic shock on presentation (AOR 2.53; 95% CI, 1.03 -6.2) , ICU stay of >72 hours (AOR 2.40; 95% CI, 1.14-5.0) and receiving immunosuppressant medications (AOR 2.23; 95% CI, 0.74 - 6.7). Conclusion: There is a high burden of MDR and carbapenem resistant gram negative bacteraemia, with a high mortality rate. (author)

[Isolation of a carbapenem-resistant K1 serotype Klebsiella pneumonia strain and the study of resistance mechanism].

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Zhang, Rong; Wang, Xuan; Lü, Jianxin

2014-12-16

To study the virulence and mechanism of carbapenem resistance of a clinical isolate of carbapenem-resistant K1 serotype Klebsiella pneumonia strain. Identification of isolate was carried out with VITEK-2 compact system. Antimicrobial susceptibility was determined by E-test; Metallo β-lactamases and carbapenemases screening were conducted by imipenem-EDTA double disc synergy test and modified Hodge test, respectively.Specific polymerehse chain reaction (PCR) and DNA sequencing were preformed to detect the virulence genes including K1, K2, K5, K20, K54, K57, magA, rmpA, wcaG and a series of β-lactamase resistence genes. Conjunction experiment was also performed. The plasmids of transconjugants were submitted to PCR-based replicon typing (PBRT) method. Molecular typing was performed by multilocus sequence typing (MLST). Antimicrobial susceptibility testing revealed that the Klebsiella pneumonia strain was resistant to most of the antibiotics used in clinic. Phynotype confirmary rest revealed the production of carbapanemases, while Metallo β-lactamases were negative; PCR and DNA sequencing confirmed the isolate was positive for blaKPC-2, blaCTX-M-15, blaTEM-1, blaSHV-1 and virulence genes K1, magA, rmpA, wcaG simultaneously; blaKPC-2 was transferred from donor to Escherichia EC600 by conjunction experiment, while no virulence genes were found in the transconjugants. PBRT revealed that Frep plasmid was found in transconjugants. MLST analysis revealed that this strain belonged to ST23. K1 serotype Klebsiella pneumonia strain carries virulence genes and carbapenem resistance gene blaKPC-2, noteworthily the carbapenem resistance genes can be transferred through horizontal transmission on plasmids.

The role of the genetic elements bla oxa and IS Aba 1 in the Acinetobacter calcoaceticus-Acinetobacter baumannii complex in carbapenem resistance in the hospital setting

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Vanessa Cristine Kobs

Full Text Available Abstract: INTRODUCTION: Members of the Acinetobacter genus are key pathogens that cause healthcare-associated infections, and they tend to spread and develop new antibiotic resistance mechanisms. Oxacillinases are primarily responsible for resistance to carbapenem antibiotics. Higher rates of carbapenem hydrolysis might be ascribed to insertion sequences, such as the ISAba1 sequence, near bla OXA genes. The present study examined the occurrence of the genetic elements bla OXA and ISAba1 and their relationship with susceptibility to carbapenems in clinical isolates of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex. METHODS: Isolates identified over 6 consecutive years in a general hospital in Joinville, Southern Brazil, were evaluated. The investigation of 5 families of genes encoding oxacillinases and the ISAba1 sequence location relative to bla OXA genes was conducted using polymerase chain reaction. RESULTS: All isolates presented the bla OXA-51-like gene (n = 78, and 91% tested positive for the bla OXA-23-like gene (n = 71. The presence of ISAba1 was exclusively detected in isolates carrying the bla OXA-23-like gene. All isolates in which ISAba1 was found upstream of the bla OXA-23-like gene (n = 69 showed resistance to carbapenems, whereas the only isolate in which ISAba1 was not located near the bla OXA-23-like gene was susceptible to carbapenems. The ISAba1 sequence position of another bla OXA-23-like-positive isolate was inconclusive. The isolates exclusively carrying the bla OXA-51-like gene (n = 7 showed susceptibility to carbapenems. CONCLUSIONS: The presence of the ISAba1 sequence upstream of the bla OXA-23-like gene was strongly associated with carbapenem resistance in isolates of the A. calcoaceticus-A. baumannii complex in the hospital center studied.

Spread of carbapenem-resistant Acinetobacter baumannii global clone 2 in Asia and AbaR-type resistance islands.

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Kim, Dae Hun; Choi, Ji-Young; Kim, Hae Won; Kim, So Hyun; Chung, Doo Ryeon; Peck, Kyong Ran; Thamlikitkul, Visanu; So, Thomas Man-Kit; Yasin, Rohani M D; Hsueh, Po-Ren; Carlos, Celia C; Hsu, Li Yang; Buntaran, Latre; Lalitha, M K; Song, Jae-Hoon; Ko, Kwan Soo

2013-11-01

In this surveillance study, we identified the genotypes, carbapenem resistance determinants, and structural variations of AbaR-type resistance islands among carbapenem-resistant Acinetobacter baumannii (CRAB) isolates from nine Asian locales. Clonal complex 92 (CC92), corresponding to global clone 2 (GC2), was the most prevalent in most Asian locales (83/108 isolates; 76.9%). CC108, or GC1, was a predominant clone in India. OXA-23 oxacillinase was detected in CRAB isolates from most Asian locales except Taiwan. blaOXA-24 was found in CRAB isolates from Taiwan. AbaR4-type resistance islands, which were divided into six subtypes, were identified in most CRAB isolates investigated. Five isolates from India, Malaysia, Singapore, and Hong Kong contained AbaR3-type resistance islands. Of these, three isolates harbored both AbaR3- and AbaR4-type resistance islands simultaneously. In this study, GC2 was revealed as a prevalent clone in most Asian locales, with the AbaR4-type resistance island predominant, with diverse variants. The significance of this study lies in identifying the spread of global clones of carbapenem-resistant A. baumannii in Asia.

RpoN Modulates Carbapenem Tolerance in Pseudomonas aeruginosa through Pseudomonas Quinolone Signal and PqsE

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Murakami, Keiji; Amoh, Takashi; Ono, Tsuneko; Miyake, Yoichiro

2016-01-01

The ability of Pseudomonas aeruginosa to rapidly modulate its response to antibiotic stress and persist in the presence of antibiotics is closely associated with the process of cell-to-cell signaling. The alternative sigma factor RpoN (σ54) is involved in the regulation of quorum sensing (QS) and plays an important role in the survival of stationary-phase cells in the presence of carbapenems. Here, we demonstrate that a ΔrpoN mutant grown in nutrient-rich medium has increased expression of pqsA, pqsH, and pqsR throughout growth, resulting in the increased production of the Pseudomonas quinolone signal (PQS). The link between pqsA and its role in carbapenem tolerance was studied using a ΔrpoN ΔpqsA mutant, in which the carbapenem-tolerant phenotype of the ΔrpoN mutant was abolished. In addition, we demonstrate that another mechanism leading to carbapenem tolerance in the ΔrpoN mutant is mediated through pqsE. Exogenously supplied PQS abolished the biapenem-sensitive phenotype of the ΔrpoN ΔpqsA mutant, and overexpression of pqsE failed to alter the susceptibility of the ΔrpoN ΔpqsA mutant to biapenem. The mutations in the ΔrpoN ΔrhlR mutant and the ΔrpoN ΔpqsH mutant led to susceptibility to biapenem. Comparison of the changes in the expression of the genes involved in QS in wild-type PAO1 with their expression in the ΔrpoN mutant and the ΔrpoN mutant-derived strains demonstrated the regulatory effect of RpoN on the transcript levels of rhlR, vqsR, and rpoS. The findings of this study demonstrate that RpoN negatively regulates the expression of PQS in nutrient-rich medium and provide evidence that RpoN interacts with pqsA, pqsE, pqsH, and rhlR in response to antibiotic stress. PMID:27431228

High mortality of bloodstream infection outbreak caused by carbapenem-resistant P. aeruginosa producing SPM-1 in a bone marrow transplant unit.

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Chaves, Lucas; Tomich, Lísia Moura; Salomão, Matias; Leite, Gleice Cristina; Ramos, Jessica; Martins, Roberta Ruedas; Rizek, Camila; Neves, Patricia; Batista, Marjorie Vieira; Amigo, Ulysses; Guimaraes, Thais; Levin, Anna Sara; Costa, Silvia Figueiredo

2017-12-01

Carbapenem resistance in P. aeruginosa is increasing worldwide. In Brazil, SPM-1 is the main P. aeruginosa carbapenemase identified. Little is known about the virulence factor in SPM-1 clones.Methodolgy. We describe a carbapenem-resistant P. aeruginosa bloodstream infection (CRPa-BSI) outbreak in a bone marrow transplant Unit (BMT). Twenty-nine CRPa-BSI cases were compared to 58 controls. Microbiological characteristics of isolates, such as sensitivity, carbapenemase gene PCR for P. aeruginosa, and PFGE are described, as well as the whole-genome sequence (WGS) of three strains.Results/Key findings. The cultures from environmental and healthcare workers were negative. Some isolates harboured KPC and SPM. The WGS showed that the 03 strains belonged to ST277, presented the same mutations in outer membrane protein, efflux pump, and virulence genes such as those involved in adhesion, biofilm, quorum-sensing and the type III secretion system, but differ regarding the carbapenemase profile. A predominant clone-producing SPM harbouring Tn 4371 was identified and showed cross-transmission; no common source was found. Overall mortality rate among cases was 79 %. The first multivariate analysis model showed that neutropenia (P=0.018), GVHD prophylaxis (P=0.016) and prior use of carbapenems (P=0.0089) were associated with CRPa-BSI. However, when MASCC>21 points and platelets were added in the final multivariate analysis, only prior use of carbapenems remained as an independent risk factor for CRPa-BSI (P=0.043). The predominant clone belonging to ST277 showed high mortality. Carbapenem use was the only risk factor associated with CRPa-BSI. This finding is a wake-up call for the need to improve management in BMT units.

Carbapenem-Resistant E. cloacae in Southwest China: Molecular Analysis of Resistance and Risk Factors for Infections Caused by NDM-1-Producers

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Xiaojiong Jia

2018-04-01

Full Text Available Carbapenem-resistant Enterobacteriaceae (CRE has been considered a serious global threat, but carbapenem resistance remains relatively uncommon in E. cloacae, especially in China. The aim of this study was to characterize carbapenem-resistant E. cloacae (CR-ECL isolates from 2012 to 2016 in Southwest China. Our study revealed that 20 (15.2% of the 132 CR-ECL isolates obtained from patients were identified as NDM-1, with most isolates carrying the IncFIIA plasmids. Notably, we initially observed that the E. cloacae strain co-harbored NDM-1 and IMP-8 carbapenemases simultaneously. Analysis of the genetic environment of these two genes has revealed that the highly conserved regions (blaNDM-1-bleMBL-trpF-tat are associated with the dissemination of NDM-1, while IS26, intI1, and tniC could be involved in the spread of IMP-8. Molecular epidemiology studies showed the nosocomial outbreak caused by NDM-1-producing E. cloacae ST88. Transferring from another hospital and previous carbapenem exposure were identified as independent risk factors for the acquisition of NDM-1-producing E. cloacae. These findings emphasize the need for intensive surveillance and precautions to monitor the further spread of NDM-1 in China.

The emergence of carbapenem-resistant Klebsiella pneumoniae isolates producing OXA-48 and NDM in the Southern (Asir) province, Saudi Arabia.

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Al-Zahrani, Ibrahim A; Alsiri, Bander A

2018-01-01

To identify the prevalence of carbapenem-resistant Klebsiella pneumoniae (CRKP) and the most common types of cabapenemases among CRKP in the Southern (Asir) province hospitals, Saudi Arabia. Methods: The cross-sectional study was conducted between late April and September in 2015. A total of 54 Klebsiella pneumoniae (K. pneumoniae) isolates with reduced sensitivity to carbapenems were obtained from various clinical specimens of the 2 largest hospitals in the Southern province. Minimum inhibitory concentrations (MICs) of carbapenems were confirmed using E-test. Molecular detection of the most common carbapenemase genes (blaIMP, bla-carbapenem-hydrolyzing oxacillinase [OXA-48], blaVIM, bla-New Delhi metallo-ß-lactamas [NDM], and blaKPC) was performed using multiplex-polymerase chain reaction. Results: The current study found that increasing age and intensive care unit admission were associated with CRKP isolation. The major type of carbapenemases was OXA-48 with 81.5% (n=44) and it seems to reach an endemic level. New Delhi metallo-ß-lactamas (NDM) was the second most frequent carbapenemase by 7.4% (n=4) of isolates while Verona integron-encoded metallo-ß-lactamase (VIM) was reported only in one isolate. Conclusion: Saudi Arabia receives large numbers of visitors and migrant workers from OXA-48 and NDM endemic countries such as Turkey, India, and Pakistan every year.

The emergence of carbapenem-resistant Klebsiella pneumoniae isolates producing OXA-48 and NDM in the Southern (Asir province, Saudi Arabia

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Ibrahim A. Al-Zahrani

2018-01-01

Full Text Available Objectives: To identify the prevalence of carbapenem-resistant Klebsiella pneumoniae (CRKP and the most common types of cabapenemases among CRKP in the Southern (Asir province hospitals, Saudi Arabia. Methods: The cross-sectional study was conducted between late April and September in 2015. A total of 54 Klebsiella pneumoniae (K. pneumoniae isolates with reduced sensitivity to carbapenems were obtained from various clinical specimens of the 2 largest hospitals in the Southern province. Minimum inhibitory concentrations (MICs of carbapenems were confirmed using E-test. Molecular detection of the most common carbapenemase genes (blaIMP, bla-carbapenem-hydrolyzing oxacillinase [OXA-48], blaVIM, bla-New Delhi metallo-ß-lactamas [NDM], and blaKPC was performed using multiplex-polymerase chain reaction. Results: The current study found that increasing age and intensive care unit admission were associated with CRKP isolation. The major type of carbapenemases was OXA-48 with 81.5% (n=44 and it seems to reach an endemic level. New Delhi metallo-ß-lactamas (NDM was the second most frequent carbapenemase by 7.4% (n=4 of isolates while Verona integron-encoded metallo-ß-lactamase (VIM was reported only in one isolate. Conclusion: Saudi Arabia receives large numbers of visitors and migrant workers from OXA-48 and NDM endemic countries such as Turkey, India, and Pakistan every year.

Los espacios de la transnacionalidad. Una tipología de la integración relacional de los migrantes

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Ainhoa de Federico de la Rúa

2004-01-01

Full Text Available Siguiendo los community studies, Ferrand (2002 recuerda la importancia dela “comunidad local” como agencia de regulación social intermediaria, meso-social,entre el nivel macro social de regulación nacional y el nivel micro social interper-sonal. Una característica importante de las “comunidades locales” es su nivel dedes-localización o de apertura: las redes sociales atraviesan las fronteras, puedenser “duales”, simultáneamente locales y no locales. La dualidad local / no local pue-de ser formulada en términos estructurales con el concepto de puente: una relacióncuyos extremos pertenecen a dos sub-redes diferentes y no relacionadas. Apoyán-dose en la idea de que la eficiencia de los “puentes” depende del tipo de cliques queconectan (Lin 2001, es posible definir tipos variados de micro-estructuras, cuyasdistribuciones son indicadores sucedáneos o aproximaciones de las diferentesmeso-estructuras de sistemas relacionales como combinaciones de redes “locales”y “no locales”. Estas nociones son particularmente interesantes para caracterizar losmodos de integración relacional de los migrantes, actores simultáneamente localesy no locales por excelencia. Proponemos una triple distinción de sus lazos: locales(personas de la sociedad de acogida, nacionales (personas de su mismo origen ytransnacionales (personas de otras procedencias. La identificación de las estructu-ras elementales de la integración relacional permite simultáneamente caracterizar lasmodalidades de integración de los actores (perfiles de integración aislado, nacio-nal, apátrida, tránsfuga, extranjero, bi-local, fugado o cosmopolita y, mediante lacombinatoria hallada en un espacio social definido, la caracterización de los distin-tos tipos de comunidades transnacionales, espacios sociales de la transna-cionalidad.

Novel ambler class A carbapenem-hydrolyzing beta-lactamase from a Pseudomonas fluorescens isolate from the Seine River, Paris, France.

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Girlich, Delphine; Poirel, Laurent; Nordmann, Patrice

2010-01-01

A Pseudomonas fluorescens isolate (PF-1) resistant to carbapenems was recovered during an environmental survey performed with water from the Seine River (Paris). It expressed a novel Ambler class A carbapenemase, BIC-1, sharing 68 and 59% amino acid identities with beta-lactamases SFC-1 from Serratia fonticola and the plasmid-encoded KPC-2, respectively. beta-Lactamase BIC-1 hydrolyzed penicillins, carbapenems, and cephalosporins except ceftazidime and monobactams. The bla(BIC-1) gene was chromosomally located and was also identified in two other P. fluorescens strains isolated from the Seine River 3 months later.

Detección de virus herpes canino tipo 1 en Chile

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NAVARRO, C; CELEDON, M; PIZARRO, J

2003-01-01

RESUMEN Este trabajo informa la detección del virus herpes canino tipo 1 (VHC-1) en nuestro país, confirmando la fuerte sospecha clínica de su existencia. Se logró obtener un aislado viral, denominado RP5, a partir de casos clínicos diagnosticados como enfermedad hemorrágica de los cachorros. Este aislado inoculado en monocapas celulares produce el típico efecto citopático de miembros de la subfamilia alphaherpesvirinae, familia Herpesviridae: lisis celular a tiempos cortos. Este aislado mani...

Detección de virus herpes canino tipo 1 en Chile Canine herpesvirus-1 detection in Chile

OpenAIRE

C NAVARRO; M CELEDON; J PIZARRO

2003-01-01

RESUMEN Este trabajo informa la detección del virus herpes canino tipo 1 (VHC-1) en nuestro país, confirmando la fuerte sospecha clínica de su existencia. Se logró obtener un aislado viral, denominado RP5, a partir de casos clínicos diagnosticados como enfermedad hemorrágica de los cachorros. Este aislado inoculado en monocapas celulares produce el típico efecto citopático de miembros de la subfamilia alphaherpesvirinae, familia Herpesviridae: lisis celular a tiempos cortos. Este aislado mani...

Efecto in vitro de aceites esenciales de tres especies de Lippia sobre Moniliophthora roreri (Cif. y Par. Evans et al., agente causante de la moniliasis del cacao (Theobroma cacao L.

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Betty Stefany Lozada

2012-04-01

Full Text Available Se evaluó el efecto antifúngico in vitro de cinco aceites esenciales (AEs (AE1, AE2, AE3, AE4 y AE5 extraídos de Lippia origanoides, L. citriodora y L. alba sobre aislados de monilia (Moniliophthora roreri obtenidos de frutos de cacao infectados provenientes de San Vicente de Chucurí, Santander, Colombia. Las plantas de Lippia fueron colectadas en cinco localidades colombianas. Los aislados de monilia (M1, M2, M3, M4 y M5 fueron caracterizados por su morfología, germinación y crecimiento en medios de cultivo. La actividad antifúngica de diferentes concentraciones de los AEs fue evaluada contra el aislado M2 y la cepa de M. roreri (ATCC 64239, para determinar su efecto sobre la germinación y la inhibición del crecimiento micelial. Los AEs estudiados inhibieron 100% de la germinación y del crecimiento micelial cuando fueron utilizados en concentraciones de 800 - 1000 µg/ml. Concentraciones de 200 µg/ml también mostraron efecto sobre los aislamientos fúngicos, siendo los AEs obtenidos de L. origanoides (AE2 y AE3 los más activos. Estos estaban compuestos principalmente por timol, p-cimeno, g-terpineno, acetato de timilo, carvacrol, b-mirceno, trans-b-cariofileno. Diferencias significativas (P < 0.05 sobre la susceptibilidad se observaron entre las dos cepas fúngicas estudiadas, siendo en general más susceptible el aislado M2 que la cepa ATCC. Los AEs de L. origanoides son candidatos para ser usados como posibles biofungicidas en el control de la moniliasis. Son necesarios estudios futuros orientados a determinar la actividad in vivo antifúngica de estos AEs y sus principales componentes.

Aislamiento y caracterización de microorganismos con actividad lipolítica provenientes de sedimentos del Humedal El Jaboque (Bogotá, Colombia

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Lilia Carolina Mora Moreno

2006-07-01

sedimentos, mediante la utilización de medios de cultivo selectivos (agar tributirina, agar aceite de girasol. Primero se evaluó la concentración del sustrato (aceite de girasol en la cual se encontraba el mayor número de morfotipos aislados, luego se comparó la eficiencia de los dos medios de cultivo de acuerdo a la cantidad de morfotipos aislados. Se evaluaron tres concentraciones diferentes de sustrato. Se aisló un total de 18 cepas pertenecientes a los géneros Bacillus, Pseudomonas, Acinetobacter, Streptomyces, Penicillium, Alternaria. Los medios evaluados constituyen alternativas sencillas de aislamiento de microorganismos con actividad lipolítica en sedimentos.

The Epidemiology of Carbapenem-Resistant Enterobacteriaceae: The Impact and Evolution of a Global Menace

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Weinstein, Robert A.

2017-01-01

Abstract Carbapenem-resistant Enterobacteriaceae (CRE) are a serious public health threat. Infections due to these organisms are associated with significant morbidity and mortality. Mechanisms of drug resistance in gram-negative bacteria (GNB) are numerous; β-lactamase genes carried on mobile genetic elements are a key mechanism for the rapid spread of antibiotic-resistant GNB worldwide. Transmissible carbapenem-resistance in Enterobacteriaceae has been recognized for the last 2 decades, but global dissemination of carbapenemase-producing Enterobacteriaceae (CPE) is a more recent problem that, once initiated, has been occurring at an alarming pace. In this article, we discuss the evolution of CRE, with a focus on the epidemiology of the CPE pandemic; review risk factors for colonization and infection with the most common transmissible CPE worldwide, Klebsiella pneumoniae carbapenemase–producing K. pneumoniae; and present strategies used to halt the striking spread of these deadly pathogens. PMID:28375512

Primer registro de Allomyces neomoniliformis (Chytridiomycota y Dictyuchus missouriensis (Oomycota aislados de un suelo agrícola (Buenos Aires, Argentina

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Mónica M. Steciow

2001-01-01

Full Text Available Allomyces neomoniliformis y Dictyuchus missouriensis fueron aislados de un suelo agrícola conteniendo materia orgánica (hojas, raíces y tallos en Argentina. Ambas especies son citadas por primera vez para la Argentina y por segunda vez para Sudamérica, siendo el hallazgo más austral para el hemisferio occidental. Constituye el segundo aislamiento en Argentina de especies del género Allomyces y Dictyuchus. Se realizan consideraciones acerca de la distribucion de ambas especies

Bacillus sp. G3 un microorganismo promisorio en la biorremediación de aguas industriales contaminadas con cromo hexavalente

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Alexander Mora Collazos

2016-01-01

Full Text Available Introducción: El presente trabajo tuvo como objetivo identificar y caracterizar microorganismos provenientes de un agua residual industrial potencialmente útiles en biorremediación de aguas contaminadas con cromo hexavalente. Metodología: Se realizó el aislamiento de tres microorganismos partiendo de un agua residual industrial proveniente de una empresa de galvanoplastia. Se evaluó el potencial de los microorganismos aislados en su capacidad para reducir cromo hexavalente; escogiéndose al aislado bacteriano G3 por mostrase potencialmente útiles en biorremediación de cromo hexavalente. Se realizó la caracterización morfológica, bioquímica e inferencias filogenéticas basadas en el gen del ARNr 16S del aislado seleccionado; se evaluó el potencial de reducción de cromo hexavalente asociado a la actividad microbiana y la actividad enzimática utilizando un extracto libre de células; de forma adicional, se realizaron bioensayos de reducción de cromo evaluando la acción conjunta de los 3 microorganismos. Resultados: Los datos moleculares y pruebas bioquímicas sugieren que el asilado bacteriano G3 pertenece al grupo de Bacillus cereus sensu lato. Los bioensayos de reducción de cromo hexavalente (10 mg/L realizados con Bacillus sp. G3 mostraron una reducción química del 100% del contaminante al cabo de diez horas en medio LB y de 34 horas en agua residual industrial. El extracto libre de células obtenido a partir del aislado bacteriano G3 mostró actividad de cromato reductasa al reducir el cromo hexavalente a su forma trivalente, mostrando valores óptimos de actividad relativa a 28ºC y 6.5 de pH. La acción conjunta de los microorganismos sobre la reducción de cromo se mostró cinco veces menos eficiente que los ensayos realizados solo con la cepa G3. Discusión o conclusión: Los resultados sugieren, que el aislado bacteriano G3 se muestra como un microorganismo con buen potencial para utilizarse en procesos de biorremediaci

Factors associated with carriage of carbapenem-non-susceptible Enterobacteriaceaein North-Eastern France and outcomes of infected patients.

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Muggeo, Anaëlle; Guillard, Thomas; Barbe, Coralie; Thierry, Aurore; Bajolet, Odile; Vernet-Garnier, Véronique; Limelette, Anne; Brasme, Lucien; De Champs, Christophe

2017-05-01

Carbapenems are frequently used as a last resort to treat infections caused by multidrug-resistant Gram-negative organisms, thus carbapenem-non-susceptible Enterobacteriaceae (CNSE) is an emerging health threat. To assess risk factors and outcomes of CNSE carriage. We conducted a matched case-control study in six hospitals in North-Eastern France. The controls were patients harbouring carbapenem-susceptible Enterobacteriaceae. Fifty-five cases and 110 controls were included. Most of the CNSE isolates were Enterobacter cloacae and Klebsiella pneumoniae . Carbapenemase production was observed in 40% of isolates and they produced OXA-48 only. CNSE carriage was significantly associated with recent antibiotic use ( P =  0.014), particularly carbapenems ( P =  0.03) and fluoroquinolones ( P =  0.016). A multivariate analysis using conditional logistic regression showed that the presence of concomitant infection(s) (OR: 9.83; 95% CI 3.04-21.39, P =  0.0031), nosocomial infections (OR: 7.84; 95% CI 2.00-12.54, P  =   0.0063) and a high age (OR: 1.07; 95% CI 1.01-1.06, P =  0.038) were independently associated with CNSE carriage. Moreover, patients infected with CNSE had worse outcomes: fewer resolved infections at 1 month ( P =  0.02), and they had a higher mortality rate ( P =  0.0004) and longer hospital stays ( P =  0.02). We identified three independent risk factors for CNSE carriage as well as worse outcomes in infected patients in North-Eastern France. This highlights the importance of early detection of CNSE and the need for antimicrobial therapy re-evaluation after bacteriological analysis has been performed. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Sensibilidad in vitro de dos especies de Sclerotinia spp. y Sclerotium cepivorum a agentes de control biológico y fungicidas

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Pérez-Moreno, Luis; Belmonte-Vargas, José Roberto; Núñez-Palenius, Héctor Gordon; Guzmán-Mendoza, Rafael; Mendoza-Celedón, Briseida

2015-01-01

Se evaluó la respuesta in vitro de dos aislados de Sclerotinia minor,cinco de S. sclerotiorum,y dos de Sclerotium cepivoruma 16 agentes biológicos y ocho fungicidas en un diseño experimental de parcelas divididas con arreglo factorial por cada patógeno. El factor A correspondió a los aislados del hongo y el factor B a los productos de control. La comparación de medias se realizó con la prueba de Tukey (P < 0.05). Se hicieron 11 evaluaciones cada 24 horas del crecimiento promedio radial miceli...

Carbapenem resistance, inappropriate empiric treatment and outcomes among patients hospitalized with Enterobacteriaceae urinary tract infection, pneumonia and sepsis.

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Zilberberg, Marya D; Nathanson, Brian H; Sulham, Kate; Fan, Weihong; Shorr, Andrew F

2017-04-17

Drug resistance among gram-negative pathogens is a risk factor for inappropriate empiric treatment (IET), which in turn increases the risk for mortality. We explored the impact of carbapenem-resistant Enterobacteriaceae (CRE) on the risk of IET and of IET on outcomes in patients with Enterobacteriaceae infections. We conducted a retrospective cohort study in Premier Perspective database (2009-2013) of 175 US hospitals. We included all adult patients with community-onset culture-positive urinary tract infection (UTI), pneumonia, or sepsis as a principal diagnosis, or as a secondary diagnosis in the setting of respiratory failure, treated with antibiotics within 2 days of admission. We employed regression modeling to compute adjusted association of presence of CRE with risk of receiving IET, and of IET on hospital mortality, length of stay (LOS) and costs. Among 40,137 patients presenting to the hospital with an Enterobacteriaceae UTI, pneumonia or sepsis, 1227 (3.1%) were CRE. In both groups, the majority of the cases were UTI (51.4% CRE and 54.3% non-CRE). Those with CRE were younger (66.6+/-15.3 vs. 69.1+/-15.9 years, p pneumonia or sepsis was comparable to other national estimates. Infection with CRE was associated with a four-fold increased risk of receiving IET, which in turn increased mortality, LOS and costs.

Incidence of carbapenem resistant nonfermenting gram negative bacilli from patients with respiratory infections in the intensive care units

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Gladstone P

2005-01-01

Full Text Available Resistance to carbapenems is commonly seen in nonfermenting gram negative bacilli (NFGNB. We document herein the prevalence of carbapenem resistance in NFGNB isolated from patients with respiratory tract infections in the intensive care units (ICUs. A total of 460 NFGNB were isolated from 606 endotracheal aspirate specimens during January through December 2003, of which 56 (12.2% were found to be resistant to imipenem and meropenem. Of these, 24 (42.8% were Pseudomonas aeruginosa , 8 (14.2% were Acinetobacter spp. and 24 (42.8% were other NFGNB. Stringent protocols such as antibiotic policies and resistance surveillance programs are mandatory to curb these bacteria in ICU settings.

Study of Klebsiella pneumoniae strains resistant to carbapenems isolated from blood in eastern Liguria

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Giulia Carnesecchi

2012-12-01

Full Text Available Objectives. Study of multi-resistant Klebsiella pneumoniae strains isolated from blood cultures collected from in-patients of hospitals located in eastern Liguria, and evaluation of the susceptibility to carbapenems and other antibiotics by E-test and automated methods. Methods. At the Laboratory of Clinical Microbiology, of Lavagna Hospital in eastern Liguria, 397 Klebsiella pneumoniae strains were collected from in-patients from different wards of hospitals sites, during the year 2011. They included 115 isolates from blood cultures (aerobic and anaerobic and various biological materials. All strains were tested in the laboratory for their susceptibility to antibiotics. Results. Of the 115 strains of Klebsiella pneumoniae collected from blood cultures 59.1% showed resistance to imipenem, ertapenem, meropenem. Conclusions. The data show a high incidence of resistance to carbapenems in Klebsiella pneumoniae isolated from blood cultures.This is important to implement surveillance programs for control and prevention, but also reduce the intake of antibiotics when they are not strictly necessary.

Phenotypic and genotypic characteristics of carbapenem-resistant Enterobacteriaceae in a tertiary-level reference hospital in Turkey.

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Baran, Irmak; Aksu, Neriman

2016-04-06

Enterobacteriaceae are among the most common pathogens that are responsible for serious community-acquired, hospital-acquired, and health-care associated infections. The emergence and spread of carbapenem-resistant Enterobacteriaceae (CRE) have become an increasing concern for healthcare services worldwide. Infections caused by these bacteria have been associated with significant morbidity and mortality and treatment options have been limited. The rapid and accurate detection of carbapenem resistance in these bacteria is important for infection control. The aim of this study was to investigate the phenotypic and genotypic features of CRE strains isolated in a tertiary-level reference hospital in Turkey. A total of 181 CRE strains were included in the study. Antimicrobial susceptibility rates were tested using Vitek 2 system. Modified Hodge test (MHT) was performed using meropenem and ertapenem discs. Metallo-β-lactamase antimicrobial gradient test (E-test MBL strips) were used for evaluation of metallo-β-lactamase production. A multiplex PCR was used for detection of carbapenems resistance genes (IMP, VIM, KPC, NDM-1 and OXA-48). The OXA-48 gene was detected in 86 strains, NDM-1 gene in six strains, VIM gene in one strain. IMP and KPC genes were not identified. Three strains produced both OXA-48 and NDM-1 and one strain produced both OXA-48 and VIM. In two patients more than one genus of OXA-48 positive CREs was isolated. Ninety-two of the isolates were multidrug-resistant. One hundred and ten isolates were MHT with meropenem (MEM-MHT) positive and 109 isolates were MHT with ertapenem (ERT-MHT) positive. Nine of the isolates were positive with E-test MBL strips. The sensitivity of MEM-MHT and ERT-MHT for detection of OXA-48 was 70.9 and 70.6 %, respectively. MEM-MHT was found highly discriminative for OXA-48 Escherichia coli (p Enterobacteriaceae in the hospital environment. While OXA-48 is still the most common source of carbapenem resistance in

Usos y gratificaciones de los ordenadores en personas mayores en Sudáfrica

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Tanja Bosch

2015-07-01

Full Text Available A partir de entrevistas en profundidad, realizadas en un hogar de la tercera edad en Ciudad del Cabo (Sudáfrica, este estudio analiza los principales usos y gratificaciones que reciben las personas mayores en interacción con los ordenadores. En África, mientras el énfasis investigador se ha puesto en los últimos años en la salud de los mayores, especialmente en cuanto al SIDA, existe muy poca investigación sobre el uso de los mayores en cuanto a nuevas tecnologías, ya que la investigación en relación con las mismas se ha centrado principalmente en la juventud. En este estudio se halló que los participantes utilizan el correo electrónico y las redes sociales para mantener el contacto con familiares y amigos y a veces incluso con su vecindario. Además, mantener el contacto suponía no solo comunicación, sino también observación de actividades, como noticias, fotografías y conversaciones. En el contexto de los usos y gratificaciones, el trabajo ha evidenciado que los participantes se sentían conectados con la sociedad, tanto por su comunicación como por la observación de las personas, y por mantenerse informados de las noticias y los temas de interés actuales. Mediante el uso de Internet, las personas de edad avanzada se comunicaban mucho más de lo que antes se habían comunicado con otras personas. Algunos de los participantes se sentían menos aislados y solos, debido a su uso del ordenador. Sin embargo, se demostró también que el uso de los ordenadores no obstaculizó los contactos interpersonales tradicionales.

Hispanoamérica gaditana: cambios y continuidades en el estudio de los procesos independentistas

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Luis Antonio Blanco Cebada

2015-01-01

Full Text Available La historiografía nacionalista del siglo XIX , y casi todo el siglo XX , consolidó a la historia de las independencias como hechos aislados entre sí, y de ruptura respecto a las añejas estructuras coloniales. Los historiadores marginaron la influencia del liberalismo español y la Constitución de Cádiz de 1812 en la formación de movimientos y agrupaciones sociopolíticas en Hispanoamérica. A la par, el estudio de las independencias hispanoamericanas fue relegado ante las revoluciones acaecidas a principios del siglo XX . De ahí que se hace imperioso revisar los fundamentos de la historiografía independentista, y su legado explicativo de las transformaciones sociopolíticas desde el enfoque de la historia hispanista. La tesis que aquí se sostiene es que los procesos de independencia hispanoamericanos sí supusieron un cambio en las estructuras coloniales. Empero, más allá de las historias nacionales, la matriz que explica la serie de transformaciones, establece una relación entre éstas y el proceso gaditano.

Preparación de genotecas de ADNc de Plasmodium falciparum para la búsqueda de los genes de proteínas de unión a calmodulina, GOGAT y Pfmyo A.

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Dary L. Mendoza

2002-09-01

Full Text Available Se construyó una genoteca de ADNc representativa de los estadios asexuales de Plasmodium falciparum, en el vector lZipLox. Esta genoteca (de la cepa colombiana FCB2 y otra genoteca construida en lZAP II (de la cepa Dd2, se rastrearon en busca de genes de proteínas que se unen a calmodulina (CaM o a proteínas relacionadas con CaM. Para el rastreo se usó tanto el ensayo de Hot-start PCR como la hibridización de filtros réplica con sondas radiomarcadas. Se identificaron clones de actina I, calmodulina (CaM, glutamato sintasa (GOGAT y las tres miosinas Pfmyo A, Pfmyo B y Pfmyo C. Se aislaron clones para actina I, CaM y GOGAT en la genoteca construida en lZipLox y clones para GOGAT y Pfmyo A en la genoteca construida en lZAP II. Uno de los clones de GOGAT contiene un inserto de 2.413 pb que corresponde al 24,8% de la secuencia codificante informada. El inserto de Pfmyo A aislado tiene 2.457 pb y representa el mensajero completo del gen. La identidad de este inserto se confirmó mediante análisis de restricción. Este es el primer informe de un clon de ADNc completo de la miosina A de P. falciparum. Los clones aislados se utilizarán en estudios futuros, tales como la obtención de las proteínas recombinantes, producción de anticuerpos y ensayos de funcionalidad.

Potencial biofertilizante de bacterias diazótrofas aisladas de muestras de suelo rizosférico

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Laura Y Moreno

Full Text Available Las bacterias promotoras del crecimiento vegetal son capaces de adaptarse, colonizar y persistir en la rizosfera de la planta, lo cual favorece su crecimiento y desarrollo. En este trabajo se aislaron 32 cepas nativas de bacterias diazótrofas, a partir de muestras de suelo rizosférico de diferentes cultivos, identificadas mediante los medios de cultivo tradicionales y el sistema BBL CRYSTAL. La identificación bioquímica se realizó a través de la reacción en cadena de la polimerasa (PCR, del inglés Polymerase Chain Reaction. Nueve aislados se determinaron como Stenotrophomonas maltophilia y uno como Azotobacter vinelandii, de los cuales tres coincidieron en la identificación bioquímica y la molecular. Se realizó un ensayo en invernadero para evaluar el efecto fertilizante en plantas de maíz, según un diseño experimental de bloques al azar y nueve tratamientos, por triplicado: tratamiento 1: A. vinelandii ATCC 9046; tratamientos del 2 al 7 para los seis aislados; tratamiento 8 para fertilización química; y tratamiento 9 para suelo sin fertilización (testigo. Los aislados M8-10, M10-1 y M11-3, identificados como S. maltophilia por PCR, tuvieron mejores resultados en la emergencia de las plantas, el diámetro del tallo y la longitud de las hojas y los tallos. Finalmente se determinó que M10-1 mostró valores de emergencia y crecimiento de la planta por encima de la media y el límite superior, con respecto a los demás aislados y controles, lo cual lo convierte en un potencial biofertilizante.

The distribution of carbapenem- and colistin-resistance in Gram-negative bacteria from the Tamil Nadu region in India.

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Manohar, Prasanth; Shanthini, Thamaraiselvan; Ayyanar, Ramankannan; Bozdogan, Bulent; Wilson, Aruni; Tamhankar, Ashok J; Nachimuthu, Ramesh; Lopes, Bruno S

2017-07-01

The occurrence of carbapenem- and colistin-resistance among Gram-negative bacteria is increasing worldwide. The aim of this study was to understand the distribution of carbapenem- and colistin-resistance in two areas in Tamil Nadu, India. The clinical isolates (n=89) used in this study were collected from two diagnostic centres in Tamil Nadu, India. The bacterial isolates were screened for meropenem- and colistin-resistance. Further, resistance genes blaNDM-1, blaOXA-48-like, blaIMP, blaVIM, blaKPC, mcr-1 and mcr-2 and integrons were studied. The synergistic effect of meropenem in combination with colistin was assessed. A total of 89 bacterial isolates were studied which included Escherichia coli (n=43), Klebsiella pneumoniae (n=18), Pseudomonas aeruginosa (n=10), Enterobacter cloacae (n=6), Acinetobacter baumannii (n=5), Klebsiella oxytoca (n=4), Proteus mirabilis (n=2) and Salmonella paratyphi (n=1). MIC testing showed that 58/89 (65 %) and 29/89 (32 %) isolates were resistant to meropenem and colistin, respectively, whereas 27/89 (30 %) isolates were resistant to both antibiotics. Escherichia coli, K. pneumoniae, K. oxytoca, Pseudomonas aeruginosa, and Enterobacter cloacae isolates were blaNDM-1-positive (n=20). Some strains of Escherichia coli, K. pneumoniae and K. oxytoca were blaOXA-181-positive (n=4). Class 1, 2 and 3 integrons were found in 24, 20 and 3 isolates, respectively. Nine NDM-1-positive Escherichia coli strains could transfer carbapenem resistance via plasmids to susceptible Escherichia coli AB1157. Meropenem and colistin showed synergy in 10/20 (50 %) isolates by 24 h time-kill studies. Our results highlight the distribution of carbapenem- and colistin-resistance in Gram-negative bacteria isolated from the Tamil Nadu region in South India.

Carbapenems and piperacillin/tazobactam for the treatment of bacteremia caused by extended-spectrum β-lactamase-producing Proteus mirabilis.

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Tsai, Hsih-Yeh; Chen, Yen-Hsu; Tang, Hung-Jen; Huang, Chi-Chang; Liao, Chun-Hsing; Chu, Fang-Yeh; Chuang, Yin-Ching; Sheng, Wang-Huei; Ko, Wen-Chien; Hsueh, Po-Ren

2014-11-01

This study was intended to delineate the role of carbapenems and piperacillin/tazobactam in treating bacteremia caused by extended-spectrum β-lactamase (ESBL)-producing Proteus mirabilis. We performed a multicenter and retrospective study of the patients with ESBL-producing P. mirabilis bacteremia. The outcomes of the patients treated by piperacillin/tazobactam or a carbapenem for at least 48 hours and the MICs of the prescribed drugs for these isolates were analyzed. Forty-seven patients with available clinical data were included. The overall 30-day mortality rate was 29.8%. All available isolates (n = 44) were susceptible to ertapenem, meropenem, and doripenem, and 95.6% were susceptible to piperacillin/tazobactam; however, only 11.4% of the isolates were susceptible to imipenem. Among the 3 patients infected with isolates exhibiting non-susceptibility to imipenem (MIC ≥2 mg/L) who were treated with imipenem, none died within 28 days. The 30-day (14.3% versus 23.1%, P = 0.65) or in-hospital (19.1% versus 30.8%, P = 0.68) mortality rate of 21 patients treated by a carbapenem was lower than that of 13 treated by piperacillin/tazobactam. However, among those treated by piperacillin/tazobactam, the mortality rate of those infected by the isolates with lower piperacillin/tazobactam MICs (≤0.5/4 mg/L) was lower than that of the isolates with MICs of ≥1/4 mg/L (0%, 0/7 versus 60%, 3/5; P = 0.045). ESBL-producing P. mirabilis bacteremia is associated with significant mortality, and carbapenem therapy could be regarded as the drugs of choice. The role of piperacillin/tazobactam, especially for the infections due to the isolates with an MIC ≤0.5/4 mg/L, warrants more clinical studies. Copyright © 2014 Elsevier Inc. All rights reserved.

Comparative activity of carbapenem testing (the COMPACT study in Turkey

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Leblebicioglu Hakan

2012-02-01

Full Text Available Abstract Background Recent evidence indicates that Gram-negative bacterial pathogens, the most common of which are Pseudomonas spp., Enterobacteriaceae, and Acinetobacter baumannii, are frequent causes of hospital-acquired infections. This study aims to evaluate the in vitro activity of doripenem and comparator carbapenem antibiotics against Gram-negative clinical isolates collected from COMParative Activity of Carbapenem Testing (COMPACT study centres in Turkey. Methods Ten centres in Turkey were invited to submit Pseudomonas aeruginosa, Enterobacteriaceae, and other Gram-negative isolates from intensive care unit (ICU/non-ICU patients with complicated intra-abdominal infections, bloodstream infections, or nosocomial pneumonia, including ventilator-associated pneumonia, between May and October 2008. Susceptibility was determined by each centre using E-test. A central laboratory performed species confirmation as well as limited susceptibility and quality-control testing. Results Five hundred and ninety six isolates were collected. MIC90 values for doripenem, meropenem, and imipenem, respectively, were 32, ≥ 64, and ≥ 64 mg/L against Pseudomonas spp.; 0.12, 0.12, and 0.5 mg/L against Enterobacteriaceae; and ≥ 64 mg/L for each against other Gram-negative isolates. In determining the susceptibility of hospital isolates of selected Gram-negative pathogens to doripenem, imipenem, and meropenem, we found that against all pathogens combined, the MIC90 for ICU compared with non-ICU isolates was higher. Conclusions Doripenem showed similar or slightly better activity than meropenem and better activity than imipenem against the Gram-negative pathogens collected in Turkey.

Caracterización de actinobacterias raras, degradadoras de lignocelulosa: demostración de actividad lacasa en dos aislados de Tsukamurella sp y Cellulosimicrobium sp

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Enrique Luis Revollo Escudero

2012-07-01

Full Text Available Título en ingles: Characterization of lignocelluloses-degrading rare actinobacteria: Demostration of laccase activity in two isolates of Tsukamurella sp and Cellulosimicrobium sp Resumen: Las características fisicoquímicas de la lignina y su compactación con la celulosa han dificultado la explotación biotecnológica de enormes cantidades de biomasa vegetal. Las lacasas constituyen una subfamilia de oxidasas multicobre que intervienen en la despolimerización de la lignina. Si bien han sido ampliamente caracterizadas en los hongos, los estudios de la diversidad y las funcionalidades de las lacasas en los procariotas se han centrado especialmente en isoformas enzimáticas de Streptomyces sp. En este trabajo se aislaron 20 cepas de actinobacterias del suelo. La actividad lacasa de 17 de ellas fue evidenciada en ensayos cualitativos con guayacol y dos cepas seleccionadas fueron caracterizadas en detalle. Las pruebas morfológicas y el análisis de las secuencias del gen 16S rRNA apuntan a que estos dos aislados pertenecen a los géneros Tsukamurella y Cellulosimicrobium. En cultivo sumergido con agitación, AC01 (Tsukamurella sp. expresó una máxima actividad de oxidación de ABTS (2,2’-azino-bis-(3-etilbenzotiazolin-6-sulfonato de 108 U/L. Por otra parte, AC18 (Cellulosimicrobium sp. que había exhibido una actividad oxidativa de guayacol superior a las 16 cepas restantes y demostró ser resistente a niveles tóxicos de cobre, logró un valor máximo de oxidación del ABTS de 0,56 U/L. Estos resultados sugieren que en el aislado AC18 operaría un fenómeno de especificidad de sustrato o de inductor, regulador de la expresión y de la actividad lacasa cuantificable. La caracterización genómica y funcional de las lacasas de nuevas actinobacterias lignocelulósicas ampliará la gama de centros redox con aplicaciones biotecnológicas específicas, además de facilitar el establecimiento de sus relaciones evolutivas con las eucariotas

Informing Antibiotic Treatment Decisions: Evaluating Rapid Molecular Diagnostics To Identify Susceptibility and Resistance to Carbapenems against Acinetobacter spp. in PRIMERS III.

Science.gov (United States)

Evans, Scott R; Hujer, Andrea M; Jiang, Hongyu; Hill, Carol B; Hujer, Kristine M; Mediavilla, Jose R; Manca, Claudia; Tran, Thuy Tien T; Domitrovic, T Nicholas; Higgins, Paul G; Seifert, Harald; Kreiswirth, Barry N; Patel, Robin; Jacobs, Michael R; Chen, Liang; Sampath, Rangarajan; Hall, Thomas; Marzan, Christine; Fowler, Vance G; Chambers, Henry F; Bonomo, Robert A

2017-01-01

The widespread dissemination of carbapenem-resistant Acinetobacter spp. has created significant therapeutic challenges. At present, rapid molecular diagnostics (RMDs) that can identify this phenotype are not commercially available. Two RMD platforms, PCR combined with electrospray ionization mass spectrometry (PCR/ESI-MS) and molecular beacons (MB), for detecting genes conferring resistance/susceptibility to carbapenems in Acinetobacter spp. were evaluated. An archived collection of 200 clinical Acinetobacter sp. isolates was tested. Predictive values for susceptibility and resistance were estimated as a function of susceptibility prevalence and were based on the absence or presence of beta-lactamase (bla) NDM, VIM, IMP, KPC, and OXA carbapenemase genes (e.g., bla OXA-23 , bla OXA-24/40 , and bla OXA-58 found in this study) against the reference standard of MIC determinations. According to the interpretation of MICs, 49% (n = 98) of the isolates were carbapenem resistant (as defined by either resistance or intermediate resistance to imipenem). The susceptibility sensitivities (95% confidence interval [CI]) for imipenem were 82% (74%, 89%) and 92% (85%, 97%) for PCR/ESI-MS and MB, respectively. Resistance sensitivities (95% CI) for imipenem were 95% (88%, 98%) and 88% (80%, 94%) for PCR/ESI-MS and MB, respectively. PRIMERS III establishes that RMDs can discriminate between carbapenem resistance and susceptibility in Acinetobacter spp. In the context of a known prevalence of resistance, SPVs and RPVs can inform clinicians regarding the best choice for empiric antimicrobial therapy against this multidrug-resistant pathogen. Copyright © 2016 American Society for Microbiology.

Susceptibilidad in vitro a los medicamentos anti-tuberculosos de aislados de cepas del complejo Mycobacterium tuberculosis obtenidos a partir de lobos marinos

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Amelia Bernardelli

2004-06-01

Full Text Available Se han hallado cepas de micobacterias aisladas de lobos marinos del Atlántico sur y pertenecen al complejo de Mycobacterium tuberculosis. Los animales se recibieron en las instalaciones del Oceanario Mundo Marino y fueron tratados apropiadamente para su recuperación con la terapia convencional, cuidados intensivos y suplemento alimentario pero no se observó mejoría en su estado general. Se practicaron necropsias en todos los animales y se observaron lesiones extensas compatibles con tuberculosis en pulmones, hígado, bazo y ganglios linfáticos. Para la identificación de las micobacterias, se realizaron pruebas bioquímicas y técnicas de biología molecular con la sonda IS6110. Además, se identificaron todas las cepas como pertenecientes al complejo M. tuberculosis mediante el equipo LCx M. tuberculosis Assay (Abbott Laboratories. El objetivo de este estudio fue determinar in vitro la sensibilidad de las cepas patrón BCG, H37Rv (M. tuberculosis y AN5 (Mycobacterium bovis y la de las siete aisladas de lobos marinos a isoniacida, rifampicina, estreptomicina y etambutol. La concentración inhibitoria mínima (CIM de las drogas antituberculosas se llevó a cabo con el equipo Mycobacterial Growth Indicator Tube (MGIT, BD, Argentina y la microdilución con el ensayo colorimétrico con bromuro de 3-(4-5 dimetiltiazol-2-2,5 difeniltetrazolio. Todos los aislamientos y las cepas de referencia BCG y AN5 se inhibieron con valores CIM de los de H37Rv con buena concordancia entre los resultados obtenidos con ambas técnicas. Los hallazgos permiten sugerir que podrían ser una importante ayuda terapéutica en los lobos marinos con diagnóstico de tuberculosis y evaluar el posible papel sanitario en la prevención y transmisión de la tuberculosis de los animales a los humanos y el trabajo en conjunto.

Estudio de actinomicetos marinos aislados de la costa central del Perú y su actividad antibacteriana frente a Staphylococcus aureus Meticilina Resistentes y Enterococcus faecalis Vancomicina Resistentes Study of marine actinomycetes isolated from the central coast of Peru and their antibacterial activity against Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococcus faecalis

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Jorge León

2011-06-01

Full Text Available Objetivos. Determinar el potencial antimicrobiano de actinomicetos marinos frente a cepas S. aureus meticilino-resistentes (MRSA y E. faecalis vancomicina-resistentes (VRE. Materiales y métodos. En dos medios de cultivo se sembraron 29 cepas de actinomicetos aislados de sedimento marino. Se evaluó la capacidad inhibitoria mediante pruebas de antagonismo in vitro para MRSA y VRE. Se procesó los extractos orgánicos de tres actinomicetos seleccionados para determinar la Concentración Mínima Inhibitoria (CMI del compuesto activo. Resultados. La mayoría de los actinomicetos aislados correspondieron a un grupo homogéneo de blanco-grisáceos (62% con buen nivel de crecimiento en agar marino. Los porcentajes inhibitorios fueron superiores a 85% para ambos patógenos con halos de inhibición mayores a 69 y 78 mm de diámetro para MRSA y VRE respectivamente. Los extractos diclorometánicos de tres de los actinomicetos aislados (I-400A, B1-T61, M10-77 mostraron gran potencial inhibitorio de ambos patógenos, siendo M10-77 la cepa de actinomiceto de mayor actividad antibiótica frente a S. aureus ATCC 43300 resistente a meticilina y E. faecalis ATCC 51299 resistente a vancomicina con una Concentración Mínima Inhibitoria (CMI de 7,9 y 31,7 μg/ mL respectivamente. El análisis filogenético de la cepa M10- 77 presenta un 99% de similaridad con la especie marina Streptomyces erythrogriseus. Conclusiones. El sedimento marino de la costa central del Perú es fuente promisorio de cepas de actinomicetos con gran capacidad de producir compuestos bioactivos capaces de inhibir patógenos tipificados como multidrogo-resistentes tales como S. aureus meticilino resistentes y E. faecalis vancomicina resistentes.Objectives. To determine the antimicrobial potential of marine actinomycetes against drug-resistant pathogens represented by strains of methicillin-resistant Staphylococcus aureus (MRSA and vancomycin-resistant Enterococcus faecalis (VRE. Materials and

¿Son los errores congénitos del metabolismo causa prevenible de muerte súbita?

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Roberto Álvarez Fumero

Full Text Available El síndrome de muerte súbita del lactante (SMSL no es un proceso aislado, sino un hecho multifactorial y multicausal, del cual cada día se restan alteraciones potencialmente diagnosticables, para pasar a ser un diagnóstico de exclusión. Algunos errores congénitos del metabolismo (ECM han sido asociados al SMSL y/o a episodios aparentemente letales EAL, aunque la mayoría de ellos suelen tener alguna expresión clínica que los hace potencialmente diagnosticables antes de la muerte, lo que permite ser descartados de entre las causas del SMSL. De ellos, los más estrechamente relacionados con el SMSL son los trastornos de la betaoxidación mitocondrial de ácidos grasos. Solo del 3 al 5 % de los SMSL pueden guardar relación con ECM. El mayor impacto que representa el conocimiento de la asociación de SMSL y estos trastornos, es precisamente la posibilidad de su prevención. El personal médico debe conocer que la más eficiente forma de prevenir el SMSL relacionado con los ECM, es la búsqueda activa de lactantes de riesgo al realizar una exhaustiva anamnesis. Estos casos deben ser objeto de estudios metabólicos especializados, para lo cual es imprescindible conocer los requisitos de obtención, conservación y traslado de muestras al Laboratorio de Referencia.

In vitro Evaluation of the Colistin-Carbapenem Combination in Clinical Isolates of A. baumannii Using the Checkerboard, Etest, and Time-Kill Curve Techniques

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Micheline A. H. Soudeiha

2017-05-01

Full Text Available The worldwide increase in the emergence of carbapenem resistant Acinetobacter baumannii (CRAB calls for the investigation into alternative approaches for treatment. This study aims to evaluate colistin-carbapenem combinations against Acinetobacter spp., in order to potentially reduce the need for high concentrations of antibiotics in therapy. This study was conducted on 100 non-duplicate Acinetobacter isolates that were collected from different patients admitted at Saint George Hospital-University Medical Center in Beirut. The isolates were identified using API 20NE strips, which contain the necessary agents to cover a panel of biochemical tests, and confirmed by PCR amplification of blaOXA−51−like. Activities of colistin, meropenem and imipenem against Acinetobacter isolates were determined by ETEST and microdilution methods, and interpreted according to the guidelines of the Clinical and Laboratory Standards Institute. In addition, PCR amplifications of the most common beta lactamases contributing to carbapenem resistance were performed. Tri locus PCR–typing was also performed to determine the international clonality of the isolates. Checkerboard, ETEST and time kill curves were then performed to determine the effect of the colistin-carbapenem combinations. The synergistic potential of the combination was then determined by calculating the Fractional Inhibitory Concentration Index (FICI, which is an index that indicates additivity, synergism, or antagonism between the antimicrobial agents. In this study, 84% of the isolates were resistant to meropenem, 78% to imipenem, and only one strain was resistant to colistin. 79% of the isolates harbored blaOXA−23−like and pertained to the International Clone II. An additive effect for the colistin-carbapenem combination was observed using all three methods. The combination of colistin-meropenem showed better effects as compared to colistin-imipenem (p < 0.05. The colistin-meropenem and

Producción social, proceso participativo e intervención sostenible en el espacio público de los centros históricos. El caso de Pamplona, Colombia

OpenAIRE

Giraldo Giraldo, Huber

2015-01-01

La formación académica de profesionales arquitectos bajo enfoques cientificistas y disciplinares, aislados de la realidad espacial y social para la cual proyectan, como modelo de conocimiento y formación, da paso al desarrollo de una praxis contemporánea de consulta y creación colectiva, tomada por los diseñadores como punto de partida para la exploración formal de proyectos de diseño urbano concertados y de investigación social. Este proyecto de investigación formativa, con i...

The Epidemiology of Carbapenem-Resistant Enterobacteriaceae: The Impact and Evolution of a Global Menace.

Science.gov (United States)

Logan, Latania K; Weinstein, Robert A

2017-02-15

Carbapenem-resistant Enterobacteriaceae (CRE) are a serious public health threat. Infections due to these organisms are associated with significant morbidity and mortality. Mechanisms of drug resistance in gram-negative bacteria (GNB) are numerous; β-lactamase genes carried on mobile genetic elements are a key mechanism for the rapid spread of antibiotic-resistant GNB worldwide. Transmissible carbapenem-resistance in Enterobacteriaceae has been recognized for the last 2 decades, but global dissemination of carbapenemase-producing Enterobacteriaceae (CPE) is a more recent problem that, once initiated, has been occurring at an alarming pace. In this article, we discuss the evolution of CRE, with a focus on the epidemiology of the CPE pandemic; review risk factors for colonization and infection with the most common transmissible CPE worldwide, Klebsiella pneumoniae carbapenemase-producing K. pneumoniae; and present strategies used to halt the striking spread of these deadly pathogens. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

RASGOS DEL TEMPERAMENTO DE LOS PERROS DOMÉSTICOS (CANIS FAMILIARIS: EVALUACIONES CONDUCTUALES

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ADRIANA JAKOVCEVIC

2009-08-01

Full Text Available

Los rasgos del temperamento se definen como tendencias conductuales estables entre situaciones similares y a lo largo del tiempo. En el presente trabajo se revisan las pruebas conductuales diseñadas para la evaluación de rasgos aislados del temperamento en los perros domésticos. Para cada dimensión se describen los estímulos empleados, las respuestas evaluadas y el correlato fisiológico de las mismas. Los rasgos más estudiados fueron la temerosidad, la agresividad y la sociabilidad. Sin embargo, sólo la primera cuenta con correlatos fisiológicos bien establecidos. Finalmente, las evaluaciones conductuales resultan de suma importancia para la selección de los perros para las distintas funciones que cumplen en la sociedad humana: detección de drogas, compañía, guardia, rescate de personas, etc.

SURVEILLANCE of CARBAPENEM NON-SUSCEPTIBLE GRAM NEGATIVE STRAINS and CHARACTERIZATION of CARBAPENEMASES of CLASSES A, B and D in a LEBANESE HOSPITAL.

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Hammoudi, Dalal; Moubareck, Carole Ayoub; Kanso, Abeer; Nordmann, Patrice; Sarkis, Dolla Karam

2015-01-01

The production of carbapenem-hydrolyzing enzymes has been recognized as one of the most currently relevant resistance mechanisms in gram negative bacterial isolates, and is being detected in various countries. In Lebanon, carbapenem resistance was studied among gram negative pathogens collected from a university hospital from January to June of years 2011 and 2012. All isolates were subjected to phenotypic tests including antibiotic susceptibility, cloxacillin effect, modified Hodge test, and Etest for metallo-β-lactamase detection. They were also subjected to genotyping by PCR sequencing to characterize β-lactamases. Between January and June 2011, 48 carbapenem non-susceptible strains were collected. Of these, one Klebsiella pneumoniae harbored OXA-48 and insertion sequence IS 1999; four Acinetobacter baumanni harbored simultaneously OXA-23 and GES-11, and three Pseudomonas harbored VIM-2 carbapenemase. Between January and June 2012, 100 carbapenem non-susceptible strains were collected. Of these, one K. pneumoniae harbored simultaneously OXA-48, IS 1999, and an acquired AmpC of the ACC group; four Serratia marcescens harbored OXA-48, while among eight A. baumannii, one strain co-harbored OXA-23 and GES-11, six harbored OXA-23 and one OXA-24. Fifteen P, aeruginosa and two Pseudomonas species harbored VIM-2; two P. aeruginosa strains produced IMP-1 and two others IMP-2. This epidemiological survey demonstrates the presence of carbapenemases of Ambler classes A, B, and D in a Lebanese hospital and indicates increase in the number and variety of such enzymes.

Humoral response of paracoccidioidomycosis sera in hamsters with different Venezuelan isolates

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Lilian M Spencer

2009-09-01

Full Text Available Humoral response of paracoccidioidomycosis sera in hamsters with different Venezuelan isolates. Paracoccidioidomycosis (PCM is a progressive systemic mycosis caused by the fungus Paraccocidioides brasiliensis (Pb, endemic to Venezuela and Latin America. In this study, eight different Venezuelan isolates obtained from patients with PCM, were inoculated intraperitoneally in Syrian hamsters (Cricetus auratus and studied by immune-serum. Each strain was collected by gently scraping the surface of the culture medium (Sabouraud Dextrose Agar and suspended in 3ml of 0.15 M phosphate-buffered saline. The antigen obtained was called Paraccocidioides brasiliensis Crude Antigen (CAP. Immunoblotting results showed that the immune-sera from hamsters recognized at least 3 bands: one over 200 kDa, and two of 80 and 15-20 kDa. This study suggests that IgG anti-CAP can reveal a significant variability in the eight Venezuelan isolates. Sera from 88 infected hamsters were evaluated by ELISA with eight different CAPs and Western blot with CAP 37383. ELISA results showed that, the antigen of the virulent isolate 37383 had the highest percentage (38% of positivity, while the non-virulent isolate 1458 had the lowest one (13.6%. Furthermore, scanning densitometry revealed that the isolate 37383 had less bands than the non-virulent isolates. These results suggest that the ELISA test with CAP 37383 can detect circulating antibodies, and that this virulent isolate may be useful for the diagnosis of PCM, and to monitor disease responses to treatments. Rev. Biol. Trop. 57 (3: 505-513. Epub 2009 September 30.La Paracoccidioidomicosis (PCM, es una micosis sistémica causada por el hongo Paraccocidioides brasiliensis (Pb, endémica en Venezuela y Latino América. En este estudio ocho diferentes aislados venezolanos, obtenidos de pacientes con PCM, fueron inoculados intraperitonealmente en hámsteres y fueron estudiados por ELISA e inmunoblotting. Los antígenos obtenidos de P

EVALUACIÓN DE MICROORGANISMOS AISLADOS DE GALLINAZA POR SU POTENCIAL PARA EL BIOCONTROL DE FUSARIUM (F. OXYSPORUM EN PLÁNTULAS DE UCHUVA (PHYSALIS PERUVIANA EVALUATION OF MICROORGANISMS INSOLATED FROM HEN MANURE FOR THEIR POTENCIAL AS BIOCONTROL AGENTS OF FUSARIUM (F. OXYSPORUM IN GOOSEBERRY (PHYSALIS PERUVIANA SEEDLINGS

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Jorge Enrique Rodríguez Amézquita

2010-12-01

Full Text Available En Colombia, las pérdidas económicas ocasionadas por Fusarium oxysporum en el cultivo de uchuva son considerables. Se evaluaron hongos y bacterias aislados de 2 fuentes de gallinaza, su potencial como agentes de biocontrol de este patógeno. La evaluación se realizó en cajas de Petri con PDA para lo cual se colocó en el centro de las mismas, un disco de 5 mm de diámetro colonizado por el patógeno y a 3 cm del centro, sobre los ejes horizontal y vertical, cada uno de los aislamientos de la gallinaza. Los aislamientos que mostraron antagonismo fueron posteriormente evaluados in vitro por su capacidad de restringir el crecimiento y esporulación de F. oxysporum. Cada uno de los aislamientos que mostró el mayor potencial antagónico fue inoculado simultáneamente con el patógeno en plántulas de uchuva y evaluado por sus efectos en contra de la incidencia de la enfermedad y la muerte de las plántulas. Los resultados indicaron que de los 39 microorganismos aislados de la gallinaza pura, 6 mostraron antagonismo contra F. oxysporum y entre ellos los más efectivos para restringir in vitro su crecimiento y esporulación fueron los hongos H2 y H6 y las bacterias B17 y B19. Las bacterias B17 y B19 resultaron ser las más efectivas en reducir no sólo la incidencia sino también la muerte de plántulas ocasionada por el patógeno. Según los resultados de la identificación, los hongos H2 y H6 pertenecen a los géneros Geotrichum sp. y Trichoderma sp, respectivamente y las bacterias B17 y B19 al género Bacillus.In Colombia, economic losses due to attack of Fusarium oxysporum in the gooseberry plantation are considerable. Fungi and bacteria isolated from 2 hen manure sources were evaluated for their potential as biological control agents of this pathogen. The evaluation was conducted in Petri dishes containing PDA by placing a 5 mm diameter disk, colonized by this pathogen, in the center of the plates and at 3 cm from the center, over the

Colistin- and Carbapenem-Resistant Escherichia coli Harboring mcr-1 and blaNDM-5, Causing a Complicated Urinary Tract Infection in a Patient from the United States

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José R. Mediavilla

2016-08-01

Full Text Available Colistin is increasingly used as an antibiotic of last resort for the treatment of carbapenem-resistant Gram-negative infections. The plasmid-borne colistin resistance gene mcr-1 was initially identified in animal and clinical samples from China and subsequently reported worldwide, including in the United States. Of particular concern is the spread of mcr-1 into carbapenem-resistant bacteria, thereby creating strains that approach pan-resistance. While several reports of mcr-1 have involved carbapenem-resistant strains, no such isolates have been described in the United States. Here, we report the isolation and identification of an Escherichia coli strain harboring both mcr-1 and carbapenemase gene blaNDM-5 from a urine sample in a patient without recent travel outside the United States. The isolate exhibited resistance to both colistin and carbapenems, but was susceptible to amikacin, aztreonam, gentamicin, nitrofurantoin, tigecycline, and trimethoprim-sulfamethoxazole. The mcr-1- and blaNDM-5-harboring plasmids were completely sequenced and shown to be highly similar to plasmids previously reported from China. The strain in this report was first isolated in August 2014, highlighting an earlier presence of mcr-1 within the United States than previously recognized.

Mutant prevention concentrations of four carbapenems against gram-negative rods.

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Credito, Kim; Kosowska-Shick, Klaudia; Appelbaum, Peter C

2010-06-01

We tested the propensities of four carbapenems to select for resistant Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii mutants by determining the mutant prevention concentrations (MPCs) for 100 clinical strains with various ss-lactam phenotypes. Among the members of the Enterobacteriaceae family and A. baumannii strains, the MPC/MIC ratios were mostly 2 to 4. In contrast, for P. aeruginosa the MPC/MIC ratios were 4 to > or =16. The MPC/MIC ratios for beta-lactamase-positive K. pneumoniae and E. coli isolates were much higher (range, 4 to >16 microg/ml) than those for ss-lactamase-negative strains.

Tolerance of Norway spruce (Picea abies [L.] Karst.) embryogenic tissue to penicillin, carbapenem and aminoglycoside antibiotics

Czech Academy of Sciences Publication Activity Database

Malá, J.; Pavingerová, Daniela; Cvrčková, H.; Bříza, Jindřich; Dostál, J.; Šíma, P.

2009-01-01

Roč. 55, č. 4 (2009), s. 156-161 ISSN 1212-4834 R&D Projects: GA MZe QH71290 Institutional research plan: CEZ:AV0Z50510513 Keywords : somatic embryogenesis * Norway spruce * penicillin antibiotics * Agrobacterium tumefaciens * carbapenem antibiotics Subject RIV: EB - Genetics ; Molecular Biology

Antibacterial activity of epigallocatechin-3-gallate (EGCG) and its synergism with β-lactam antibiotics sensitizing carbapenem-associated multidrug resistant clinical isolates of Acinetobacter baumannii.

Science.gov (United States)

Lee, Spencer; Razqan, Ghaida Saleh Al; Kwon, Dong H

2017-01-15

Infections caused by Acinetobacter baumannii were responsive to conventional antibiotic therapy. However, recently, carbapenem-associated multidrug resistant isolates have been reported worldwide and present a major therapeutic challenge. Epigallocatechin-3-Gallate (EGCG) extracted from green tea exhibits antibacterial activity. We evaluated the antibacterial activity of EGCG and possible synergism with antibiotics in carbapenem-associated multidrug resistant A. baumannii. A potential mechanism for synergism was also explored. Seventy clinical isolates of A. baumannii collected from geographically different areas were analyzed by minimal inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of EGCG. Checkerboard and time-killing assays were performed to exam the synergism between EGCG and antibiotics. The effects of EGCG on a multidrug efflux pump inhibitor (1-[1-naphthylmethyl] piperazine; NMP) and β-lactamase production were also examined in A. baumannii. Sixty-three of 70 clinical isolates of A. baumannii carried carbapenemase-encoding genes with carbapenem-associated multidrug resistance. Levels of MIC and MBC of EGCG ranged from 64 to 512µg/ml and from 128 to ≥1024µg/ml, respectively among the clinical isolates. MIC 90 and MBC 86 levels were 256µg/ml and 512µg/ml of EGCG, respectively. Subinhibitory concentration of EGCG in combination with all antibiotics tested, including carbapenem, sensitized (MICs fall≤1.0µg/ml) all carbapenem-associated multidrug resistant isolates. Checkerboard and time-killing assays showed synergism between EGCG and meropenem (or carbenicillin) counted as fractional inhibitory concentration of 2log10 within 12h, respectively. EGCG significantly increased the effect of NMP but was unrelated to β-lactamase production in A. baumannii, suggesting EGCG may be associated with inhibition of efflux pumps. Overall we suggest that EGCG-antibiotic combinations might provide an alternative approach to treat

Determinación de la eficacia de los desinfectantes empleados en las áreas asépticas de un centro productor de biofarmacéuticos

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Eidelys Díaz-Enriquez

2017-08-01

Full Text Available En la industria biofarmacéutica, la desinfección se ha hecho parte fundamental de las actividades para controlar el nivel de microorganismos contaminantes que puedan llegar a comprometer la calidad del producto final. El objetivo de este trabajo fue evaluar la eficacia de los desinfectantes AniosSpecial DJP SF, Aniosurf Premium, Bacteranios SF, Aniospray 29, Aseptanios AD y Surfanios utilizados en la limpieza y desinfección del área aséptica de la Planta de Productos Parenterales 2 del Centro Nacional de Biopreparados (Mayabeque, Cuba. Se comprobó la eficacia con pruebas de desafío en superficies y en condiciones prácticas de uso. Se comparó estadísticamente el número de microorganismos aislados y la microbiota presente en el área antes y después del uso de los desinfectantes. Todos los desinfectantes cumplieron con los requisitos establecidos. Por lo tanto, se demostró su eficacia para realizar la limpieza de las áreas asépticas.

Presencia de agentes potenciales causantes de infecciones subcutáneas humanas en suelo y plantas en el estado de Puebla, México

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Alejandra P. Espinosa Texis

2017-04-01

Full Text Available Los hongos y actinomicetos asociados a infecciones en humanos, se encuentran ampliamente distribuidos en la naturaleza. El suelo y las plantas son el hábitat de numerosos hongos y bacterias. Los campesinos son altamente vulnerables a sufrir heridas y pueden contaminarse con estos microorganismos. Con la finalidad de conocer el número de colonias de los agentes causantes de micosis subcutáneas humanas a partir de la naturaleza, se realizó el aislamiento de los microorganismos respectivos a partir de suelo y plantas en 11 municipios del estado de Puebla. De cada municipio se colectaron 50 muestras, cada una consistió de 10 g de suelo y 10 g de hojas de la planta más cercana; se prepararon suspensiones respectivas, las cuales fueron inoculadas en agar dextrosa Sabouraud, incubadas a 28 ºC, y revisadas periódicamente para identificar los microorganismos de interés con base en su morfología. De 110 muestras procesadas, se obtuvieron 441 aislados, de los cuales 281 fueron hongos (133 de suelo y 148 de plantas y 160 actinomicetos (96 de suelo y 64 plantas. Los hongos aislados fueron identificados por su morfología macroscópica y microscópica. Los actinomicetos fueron identificados por su morfología macroscópica (colonial y microscópica, y por pruebas bioquímicas. En mayor proporción se aislaron agentes potenciales de cromoblastomicosis (Fonsecaea pedrosoi y Cladophialophora carrionii, seguidos del agente de esporotricosis (Sporothrix schenckii y de los agentes de actinomicetoma (Nocardia brasiliensis y N. otitidis-caviarum. Del suelo de Cholula y de plantas de Tecali de Herrera, se obtuvieron el mayor número de aislados fúngicos. Del suelo de Chignahuapan y de plantas de Izúcar de Matamoros se obtuvo el mayor número de aislados de actinomicetos. En este estudio se encontraron, tanto en suelo como en plantas de 11 municipios del estado de Puebla, un alto número de colonias de hongos y actinomicetos causantes de infecciones subcut

EFSA BIOHAZ Panel (EFSA Panel on Biological Hazards), 2013. Scientific Opinion on Carbapenem resistance in food animal ecosystems

DEFF Research Database (Denmark)

Hald, Tine; Baggesen, Dorte Lau

-1-encoding genes were located on IncHI2 plasmids. A methodology including selective culture is proposed for the detection of CP strains of Enterobacteriaceae and Acinetobacter spp. The choice of selective media for the surveillance of carbapenem resistance for testing animal and food samples needs...... and effective option. As genes encoding carbapenemase production are mostly plasmid-mediated, and co-resistance may be an important issue in the spread of such resistance mechanisms, decreasing the frequency of use of antimicrobials in animal production in the EU in accordance with prudent use guidelines......Carbapenems are broad-spectrum β-lactam antimicrobials used for the treatment of serious infections in humans. To date only sporadic studies have reported the occurrence of carbapenemase-producing (CP) bacteria in food-producing animals and their environment. The bacteria and enzymes isolated...

Investigación científica sobre genotipificación y distribución de Giardia intestinalis en humanos y caninos de América

OpenAIRE

Giovanny Torres Lindarte; Mario Zapata Tamayo; Marcos Restrepo Isaza; Leonardo Ríos Osorio

2011-01-01

Objetivo: Describir la distribución geográfica en América de los genotipos A, B, C y D de Giardia intestinalis hallados en humanos y en perros, y los marcadores y técnicas usadas, de acuerdo con la literatura científica. Materiales y métodos: Revisión sistemática en la que se seleccionaron 19 artículos, y en todos se caracterizaron aislados de humanos; solo 10 de estos caracterizaron aislados de perros. Resultados: México fue el país que más estudios realizó (31,6%). El genotipo A fue reporta...

Reacción a Moniliophthora roreri en Theobroma spp. en Caquetá, Colombia

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Armando Sterling Cuéllar

2015-09-01

Full Text Available El objetivo de este estudio fue evaluar in situ la reacción de 50 materiales genéticos de tres especies de Theobroma(T. cacao, T. grandiflorum y T. bicolor a la inoculación controlada de tres aislados autóctonos de Moniliophthora roreri (agente causal de la moniliasis del cacao en el Departamento de Caquetá (Amazonia colombiana. Las variables incidencia de la enfermedad (IMr, severidad externa (SE y severidad interna (SI, se evaluaron nueve semanas después de la inoculación de mazorcas de 2 a 3 meses de edad con una suspensión de esporas de 1,2 x 105 esporas/mL. La enfermedad se evidenció en las tres especies de Theobroma, sin embargo, ésta no se presentó en 13 de los 50 materiales genéticos evaluados, representados así: seis T. grandiflorum, cinco T. bicolor y dos T. cacao. Los materiales genéticos de T. bicolor y T. grandiflorum fueron los menos afectados comparados con los de T. cacao. Se encontraron diferencias significativas para IMr, SE y SI entre las tres especies de Theobroma y entre los 50 materiales genéticos. Diferencias significativas entre los aislados solo ocurrieron para SE. La incidencia y la severidad de la enfermedad entre materiales genéticos, fueron influenciadas por el patógeno aislado. Los materiales genéticos con menor reacción a M. roreri pueden ser utilizados en programas de mejoramiento por resistencia a la moniliasis.

Role of the interplay between quorum sensing regulator VqsR and the Pseudomonas quinolone signal in mediating carbapenem tolerance in Pseudomonas aeruginosa.

Science.gov (United States)

Viducic, Darija; Murakami, Keiji; Amoh, Takashi; Ono, Tsuneko; Miyake, Yoichiro

2017-06-01

Pseudomonas aeruginosa coordinates its response to environmental conditions through activation of a quorum sensing (QS) system. In this study, we investigated the regulatory interaction between the QS transcriptional regulator VqsR and the Pseudomonas quinolone signal (PQS) through integration of sigma factor RpoS, and we addressed whether one of the pathways controlling carbapenem tolerance can be attributed to VqsR. We demonstrate that vqsR expression at the transcriptional level is regulated by pqsA, pqsR, and pqsE. Assessment of the transcriptional expression of vqsR, lasI, rhlI, and qscR in ΔpqsA and ΔpqsAΔrpoS mutants provided insight into pqsA- and rpoS-dependent regulation of vqsR and vqsR-controlled genes. Exogenously supplemented PQS reversed expression of vqsR and vqsR-controlled genes in the ΔpqsA mutant to wild-type levels, but failed to increase expression levels of lasI and qscR in the ΔpqsAΔrpoS mutant to levels observed in wild-type PAO1. The ΔvqsR mutant showed reduced survival when challenged with carbapenems compared to wild-type PAO1. Introduction of a pqsA mutation into the ΔvqsR mutant completely abolished its carbapenem-sensitive phenotype. We conclude that a regulatory link between PQS and vqsR exists, and that RpoS is important in their interaction. We also demonstrate that VqsR affects carbapenem tolerance. Copyright © 2017 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.

Leishmania mexicana: aspectos taxonómicos y rareza de la infección humana en Três Braços, Bahia, Brasil

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César Augusto Cuba Cuba

1984-09-01

Full Text Available Del estúdio de 51 stocks de Leishmania aislados de pacientes humanos de leishmaniasis cutaneomucosa en Três Braços, Bahia, Brasil, los autores describen, en detalle, el análisis de los dos únicos stocks de L. mexicana, identificando uno de ellos como L. mexicana amazonensis. El otro aislado permanece en posición taxonómica no definida pues considerándosele como un miembro de L. mexicana, encuéntranse dificultades para su identificación subespecífica. Evaluan también los parâmetros biológicos e isoenzimáticos y discuten el papel de los anticuerpos monoclonales en la tipificación de éstos stocks. Los autores remarcan la rareza de la transmisión de parásitos del complejo L. mexicana en esta región, aun cuando estudien epidemiológicamente por mais de 8 anos la infección humana.

Tras las huella del silencio: Potosí, los incas y Toledo

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Tristan Platt

2010-12-01

Full Text Available ¿Por qué los señores aymaras de Charcas y el Inca Paullo, después de entregar las minas de plata de Porco a Hernando Pizarro en 1538, guardaron silencio sobre Potosí (distante a unas pocas leguas, que no se descubrió hasta abril de 1545? Reuniendo un mosaico de datos aparentemente inconexos, este artículo revisa las versiones corrientes del descubrimiento del cerro e interroga un curioso silencio presente en las fuentes. Reconstruyendo una red previamente desconocida de incas y españoles, se propone que, más que el hallazgo providencial de un yanacona aislado (la versión recibida, Potosí se manifestó como continuación de la política de “obediencia” subyacente en la entrega de Porco, ahora dirigida por el rival del Inca Paullo: el Inca Manco refugiado en Vilcabamba. Esta política de Manco buscaba apoyar al Rey y las Nuevas Leyes (1542 en contra de la amenaza mayor representada por Gonzalo Pizarro y los encomenderos. El artículo comenta, asimismo, la promoción toledana de la “leyenda providencial”, retomando en cambio la interpretación de Guaman Poma de la entrega de Potosí como una iniciativa de los incas, quienes lo habrían fundado bajo Inca Túpac Yupanqui. Esta versión concuerda con las últimas investigaciones geológicas y arqueológicas.

Genomically Informed Surveillance for Carbapenem-Resistant Enterobacteriaceae in a Health Care System.

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Pecora, Nicole D; Li, Ning; Allard, Marc; Li, Cong; Albano, Esperanza; Delaney, Mary; Dubois, Andrea; Onderdonk, Andrew B; Bry, Lynn

2015-07-28

Carbapenem-resistant Enterobacteriaceae (CRE) are an urgent public health concern. Rapid identification of the resistance genes, their mobilization capacity, and strains carrying them is essential to direct hospital resources to prevent spread and improve patient outcomes. Whole-genome sequencing allows refined tracking of both chromosomal traits and associated mobile genetic elements that harbor resistance genes. To enhance surveillance of CREs, clinical isolates with phenotypic resistance to carbapenem antibiotics underwent whole-genome sequencing. Analysis of 41 isolates of Klebsiella pneumoniae and Enterobacter cloacae, collected over a 3-year period, identified K. pneumoniae carbapenemase (KPC) genes encoding KPC-2, -3, and -4 and OXA-48 carbapenemases. All occurred within transposons, including multiple Tn4401 transposon isoforms, embedded within more than 10 distinct plasmids representing incompatibility (Inc) groups IncR, -N, -A/C, -H, and -X. Using short-read sequencing, draft maps were generated of new KPC-carrying vectors, several of which were derivatives of the IncN plasmid pBK31551. Two strains also had Tn4401 chromosomal insertions. Integrated analyses of plasmid profiles and chromosomal single-nucleotide polymorphism (SNP) profiles refined the strain patterns and provided a baseline hospital mobilome to facilitate analysis of new isolates. When incorporated with patient epidemiological data, the findings identified limited outbreaks against a broader 3-year period of sporadic external entry of many different strains and resistance vectors into the hospital. These findings highlight the utility of genomic analyses in internal and external surveillance efforts to stem the transmission of drug-resistant strains within and across health care institutions. We demonstrate how detection of resistance genes within mobile elements and resistance-carrying strains furthers active surveillance efforts for drug resistance. Whole-genome sequencing is increasingly

Molecular epidemiology of carbapenem resistant gram-negative bacilli from infected pediatric population in tertiary - care hospitals in Medellín, Colombia: an increasing problem.

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Vanegas, Johanna M; Parra, O Lorena; Jiménez, J Natalia

2016-09-01

Gram-negative bacilli are a cause of serious infections in the pediatric population. Carbapenem are the treatment of choice for infections caused by multidrug-resistant Gram-negative bacilli, but the emergence of carbapenem resistance has substantially reduced access to effective antimicrobial regimens. Children are a population vulnerable to bacterial infections and the emergence of resistance can worsen prognosis. The aim of this study is to describe the clinical and molecular characteristics of infections caused by carbapenem-resistant Gram-negative bacilli in pediatric patients from five tertiary-care hospitals in Medellín, Colombia. A cross-sectional study was conducted in five tertiary-care hospitals from June 2012 to June 2014. All pediatric patients infected by carbapenem-resistant Gram-negative bacilli were included. Clinical information for each patient was obtained from medical records. Molecular analyses included PCR for detection of bla VIM, bla IMP bla NDM, bla OXA-48 and bla KPC genes and PFGE and MLST for molecular typing. A total of 59 patients were enrolled, most of them less than 1 year old (40.7 % n = 24), with a previous history of antibiotic use (94.9 %; n = 56) and healthcare-associated infections - predominately urinary tract infections (31.0 %; n = 18). Klebsiella pneumoniae was the most frequent bacteria (47.4 %), followed by Enterobacter cloacae (40.7 %) and Pseudomonas aeruginosa (11.9 %). For K. pneumoniae, KPC was the predominant resistance mechanism (85.7 %; n = 24) and ST14 was the most common clone (39.3 % n = 11), which included strains closely related by PFGE. In contrast, E. cloacae and P. aeruginosa were prevailing non-carbapenemase-producing isolates (only KPC and VIM were detected in 1 and 3 isolates, respectively) and high genetic diversity according to PFGE and MLST was found in the majority of the cases. In recent years, increasing carbapenem-resistant bacilli in children has become in a matter

Epidemiología molecular de epizootias de rabia en Colombia, 1994-2002: evidencia de rabia humana y canina asociada a quirópteros.

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Andrés Páez

2003-03-01

Full Text Available Tres brotes de rabia canina han sido informados en Colombia durante las pasadas dos décadas, uno de los cuales aún ocurre en la Región Caribe. Los otros dos ocurrieron en el departamento de Arauca y en la Región Central (departamentos de Boyacá y Cundinamarca hasta 1997. Con la finalidad de investigar las relaciones filogenéticas existentes entre los virus rábicos aislados en las regiones mencionadas, se empleó la técnica de RT-PCR para obtener fragmentos de ADN de 902 nucleótidos complementarios a una región del ARN rábico codificante para el endodominio de la proteína G, para una parte de la proteína L, fragmentos que, además, contienen la región intergénica no codificante G-L. Los amplificados fueron secuenciados y agrupados en árboles filogenéticos. Los resultados mostraron la existencia de tres grupos de virus. Los virus rábicos pertenecientes a la variante genética colombiana I fueron aislados exclusivamente en el departamento de Arauca y la Región Central colombiana hasta 1997 y, aparentemente, se encuentran extintos. Los virus rábicos pertenecientes a la variante genética colombiana II fueron aislados exclusivamente en la Región Caribe, en donde actualmente su tranmisión continúa. Un tercer grupo se compone de variantes rábicas originarias de quirópteros, que fueron aisladas de dos murciélagos insectívoros, tres perros y un humano. Con este trabajo se estableció una asociación entre los quirópteros y la rabia en perros y humanos en Colombia, lo cual los muestra como reservorios de importancia en salud pública.

Liberación de endotelina-1 por angiotensina ll en miocitos cardíacos aislados Angiotensin II-induced endothelin-1 release in cardiac myocytes

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María C. Villa-Abrille

2006-06-01

Full Text Available Muchos de los efectos de la angiotensina II (Ang II son mediados en realidad por la acción de endotelina (ET endógena liberada y/o producida en respuesta a la Ang II. En este trabajo evaluamos la interacción Ang II/ET-1, sus consecuencias en la contractilidad cardíaca y el papel de las especies reactivas del oxígeno (EROs. Se usaron cardiomiocitos aislados de gato. La Ang II, 1 nM, produjo un efecto inotrópico positivo (EIP de 31.8±3.8% que fue cancelado por inhibición de los receptores AT1, de los receptores de ET, del intercambiador Na+/H+ (NHE, del modo inverso del intercambiador Na+/Ca2+ (NCX o por el secuestro de EROs. La Ang II, 100 nM, produjo un EIP de 70.5±7.6% que fue cancelado por inhibición de los receptores AT1 y bloqueado en parte por inhibición de los receptores de ET, del NHE, del modo inverso del NCX o por el secuestro de EROs. La Ang II, 1 nM, incrementó el ARNm de la preproET-1 lo cual fue anulado por el bloqueo de los receptores AT1. Los resultados permiten concluir que el EIP de la Ang II es debido a la acción de la ET-1 endógena liberada/formada por la Ang II. La ET-1 produce: estimulación del NHE, activación del modo inverso del NCX y un consecuente EIP. Dentro de esta cascada también participarían los EROs.Many of the effects thought to be due to angiotensin II (Ang II are due to the release/formation of endothelin (ET. We tested whether Ang II elicits its positive inotropic effect (PIE by the action of endogenous ET-1 and the role played by the reactive oxygen species (ROS in this mechanism. Experiments were performed in cat isolated ventricular myocytes in which sarcomere shortening (SS was measured to asses contractility after pharmacological interventions and the effect of Ang II on inotropism were analyzed. Ang II 1 nM increased SS by 31.8±3.8% (p<0.05. This PIE was cancelled by AT1 receptor blockade, by ET-1 receptors blockade, by Na+/H+ exchanger (NHE inhibition, by reverse mode Na+/Ca2

Retrospective and prospective evaluation of the Carbapenem inactivation method for the detection of carbapenemase-producing Enterobacteriaceae

Science.gov (United States)

Gauthier, Lauraine; Dortet, Laurent; Naas, Thierry

2017-01-01

Background There is an urgent need for accurate and rapid diagnostic tests to identify carbapenemase producing enterobacteria (CPE). Here, we have evaluated the Carbapenem Inactivation Method (CIM) test to detect CPEs from cultured colonies. Methods A total of 256 enterobacterial isolates were used to evaluate the performance of the CIM in comparison to Carba NP test and molecular detection used a reference method. Ninety three well-characterized isolates (including 29 non-CPE and 63 CPEs of worldwide origin) with decreased susceptibility to at least one carbapenem were used to (i) evaluate the efficacy of CIM test and (ii) to compare it to the Carba NP test. We also tested different carbapenems to determine the best substrate for this test. Finally, the CIM test was then evaluated prospectively against 164 isolates referred to the French National Reference Center (NRC) for Antimicrobial Resistance from may 2016 to july 2016. Results Based on the results of this retrospective study, sensitivity and specificity of the CIM and the Carba NP test were 92.1% and 100%, respectively. We demonstrated that the meropenem was the best substrate to perform the CIM test since sensitivity and specificity were 81.1% and 100% using ertapenem disk, and 100% and 65,6% using imipenem disk, and respectively. Taking in account the results of retrospective and prospective studies, CIM and Carba NP tests have similar sensitivity, specificity, positive predictive value and negative predictive values being 96.3%, 98.9%, 99.0% and 98.4% for the CIM test versus 96.9%, 100%, 100% and 100% for the Carba NP test. Conclusions Our results confirm that the CIM test may be a useful tool for the reliable confirmation of carbapenemase-activity in enterobacterial isolates, especially in clinical microbiological laboratories with limited resources, no trained personnel, and no specialized equipment. PMID:28158310

Characterization of resistance mechanisms and genetic relatedness of carbapenem-resistant Acinetobacter baumannii isolated from blood, Italy.

Science.gov (United States)

Migliavacca, Roberta; Espinal, Paula; Principe, Luigi; Drago, Monica; Fugazza, Giulia; Roca, Ignasi; Nucleo, Elisabetta; Bracco, Silvia; Vila, Jordi; Pagani, Laura; Luzzaro, Francesco

2013-02-01

The aim of this study was to characterize the resistance mechanisms and genetic relatedness of 21 carbapenem-resistant Acinetobacter baumannii blood isolates collected in Italy during a 1-year multicenter prospective surveillance study. Genes coding for carbapenemase production were identified by polymerase chain reaction (PCR) and sequencing. Pulsed-field gel electrophoresis (PFGE), multiplex PCRs for group identification, and multilocus sequence typing (MLST) were used to determine genetic relationships. Carbapenem resistance was consistently related to the production of oxacillinases, mostly the plasmid-mediated OXA-58 enzyme. Strains producing the OXA-23 enzyme (chromosomally mediated) were also detected. Seven PFGE clones were identified, some of which being related to international (ICL- I and ICL-II) or national clonal lineages. Multiplex PCRs identified 4 different groups (group 2 being dominant), further distinguishable in 6 sequence types by MLST. The heterogeneity of profiles highlights the diffusion of international and national clonal lineages in Italy. Continuous surveillance is needed for monitoring the spread of these worrisome strains equipped with multiple drug resistance mechanisms. Copyright © 2013 Elsevier Inc. All rights reserved.

Prevalence of carbapenem resistant Enterobacteriaceae from a tertiary care hospital in Mumbai, India

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Pravin K. Nair

2013-12-01

Full Text Available Objective: The emergence of Carbapenem Resistant Enterobacteriaceae (CRE in recent times has become a serious threat to public health due to the high mortality, potential dissemination rates and limited treatment options associated with these organisms. Thus, the present study was conducted in our tertiary care hospital in Mumbai, to retrospectively analyze the prevalence of CRE in the hospital. Methods: The study was carried out in the microbiology department of the tertiary care hospital over a period of 12 months. The samples tested were clinical samples from hospitalized and Out-Patient Department (OPD patients sent to the department for microbiological testing. CRE isolates were identified using the Vitek 2- Compact system (BioMérieux, France. Results: A CRE prevalence rate of 12.26% was obtained from the study, from which the majority of the isolates were detected in urine samples (46%. Although most of the CRE isolates were detected in patient samples from the wards (42% and the ICU (26%, a significant number of isolates was also detected from the OPD patients (19%. Conclusion:Thus, the study shows a significant rate of carbapenem resistance among Enterobacteriaceae isolated from hospitalized and OPD patients. This emphasizes the urgent need for CRE control at the hospital and community level, and to rationalize the use of antibiotics. J Microbiol Infect Dis 2013;3(4: 207-210

Endemic carbapenem-nonsusceptible Acinetobacter baumannii-calcoaceticus complex in intensive care units of the national referral hospital in Jakarta, Indonesia

NARCIS (Netherlands)

Saharman, Y.R. (Yulia Rosa); Karuniawati, A. (Anis); Sedono, R. (Rudyanto); Aditianingsih, D. (Dita); Sudarmono, P. (Pratiwi); W.H.F. Goessens (Wil); Klaassen, C.H.W. (Corné H.W.); H.A. Verbrugh (Henri); J.A. Severin (Juliëtte)

2018-01-01

textabstractBackground: Carbapenem-nonsusceptible A. baumannii-calcoaceticus complex have emerged worldwide, but the epidemiology in Indonesian hospitals has not been studied. Methods: A prospective observational study was performed on the intensive care units (ICUs) of the national referral

La gestión de las listas de espera quirúrgicas por los centros sanitarios y los profesionales

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Martí J.

2002-01-01

Full Text Available Las listas de espera para recibir asistencia no urgente, en procesos diagnósticos o tratamientos, se dan fundamentalmente en los sistemas sanitarios de financiación pública como el español y otros muchos países europeos. Si éstas son moderadas, pueden ser útiles en el proceso de gestión de estos pacientes y son aceptadas por profesionales y usuarios. Las listas de espera para intervenciones quirúrgicas se pueden interpretar, erróneamente, como un simple desajuste entre la demanda y la oferta de un determinado procedimiento. Si así fuera, sólo deberíamos ir aumentando los recursos hasta terminar con las listas. Sin embargo, existen muchas evidencias de que el aumento aislado de los recursos no es la solución, ya que el tiempo medio de espera disminuye pero la lista se alarga por la cola. Serán necesarias, pues, otras medidas de gestión. Es necesario gestionar las listas, tanto en el plano social, de administración sanitaria y, sobre todo, en el ámbito del centro sanitario. La gestión clínica en los servicios y la gestión de cada profesional, con criterios de inclusión de evidencia científica en la indicación y en los resultados esperados de cada paciente (efectividad del procedimiento, y con criterios éticos y de eficiencia en la utilización de recursos, priorizando por gravedad, probabilidad de mejora y criterios sociales, es una obligación ineludible para mejorar el problema de las listas de espera. En este proceso de priorización, la sociedad debe tener su voz, su opinión, pues existen factores no médicos que pueden influir en la distribución y priorización de recursos. En este camino existen experiencias en otros países que deberíamos analizar. Finalmente, como decía Archie Cochrane¹, «todo tratamiento eficaz ha de ser gratuito», que, dicho de otra manera, sería: no está justificada la financiación en el sistema público de procedimientos que no aporten un beneficio significativo para el paciente.

Presence of the KPC carbapenemase gene in Enterobacteriaceae causing bacteremia, and the correlation with in vitro carbapenem susceptibility

Science.gov (United States)

During six months, we obtained Enterobacteriaceae isolates from patients with Gram-negative bacteremia at a 1250-bed teaching hospital in St. Louis, Missouri, and compared carbapenem susceptibility with the presence of blaKPC, a transferable carbapenemase gene. Three (1.2%) out of 243 isolates were ...

ISAba1 Regulated OXA-23 Carbapenem Resistance in Acinetobacter baumannii Strains in Durban, South Africa.

Science.gov (United States)

Agoba, Esther Eyram; Govinden, Usha; Peer, Abdool Kader Cassim; Osei Sekyere, John; Essack, Sabiha Yusuf

2018-03-20

This study investigated the molecular mechanisms of resistance to carbapenems and cephalosporins in 24 consecutive, multidrug-resistant Acinetobacter baumannii (MDRAB) isolates collected between January and April 2015 by a private sector laboratory in Durban, South Africa. All isolates were resistant to all carbapenems tested. bla OXA-23 and bla OXA-51 genes were found in 23 isolates, while bla OXA-24 , bla OXA-48 , and bla OXA-58 were absent in all isolates. The most prevalent extended-spectrum β-lactamase was TEM-116 (92%). bla ADC was present in 83.3% of isolates, of which two were new variants with three and five amino acid differences compared to Acinetobacter-derived cephalosporinase (ADC)-1, the first at positions 64E → K, 341N → T, and 342R → G and the second at positions 24G → D, 167S → P, 283R → F, 341N → T, and 342R → G, respectively. All isolates were negative for bla PER , bla CMY , bla GES , bla KPC , bla CTX-M , and bla SHV . Metallo-β-lactamase IMP and VIM were absent in all isolates, and NDM-1 was present in 1 isolate. ISAba1 was located upstream bla OXA-23 in all isolates and upstream bla ADC (30, 78, 79, 87 and the ADC variants) in 54.2% of the ADC-carrying isolates. None of the isolates had ISAba1 inserted upstream bla OXA-51 gene. Four isolates were clonally related and showed two clusters (A and B), while 20 isolates remained unclustered. There was no direct relationship between the clusters and the hospitals they were isolated from. This study reports the first NDM-1-producing carbapenem resistant Acinetobacter baumannii isolate in South Africa and highlights the presence of OXA-23, the known ADCs (ADC-30, ADC-78, ADC-79, and ADC-87), and two new ADC variants associated with ISAba1 from the private health sector in Durban, South Africa. The complexity and diversity of MDRAB severely limit treatment options.

Comparative studies of antifugal potentialities for some natural plant oils against different fungi isolated from poultry

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Ahmed, F. H.

1994-08-01

Full Text Available The inhibitory effect of eight natural oils on ten pathogenic fungi isolated from the digestive and respiratory tracts of dead chickens in Kena Governorate showed that crude peppermint oil only has a highest effect against some isolated fungi and a low response against others. While its 10% and 2% oil concentrations failed to give any effect against all the tested fungi. Crude chamomile and pelargonium oils showed moderate effect against all isolated fungi. The effect of different dilutions of chamomile, cumin and celery oils appeared that the 10% concentration showed more effective than the crude oil. Lemongrass and basil oils have almost the same behaviour towards the isolated fungi as the crude oils and the 10% concentration affected them greatly. On the other hand 2% basil oil gave no effect at all. Critical concentrations of the efficient oils against isolated fungi were calculated. The most efficient oils were lemongrass against Aspergillus flavipes, chamomile against A. fumigatus and cumin against A. nidulans, while cumin against A. glaucus, clove against A. flavus were chamomile against A. flavus and clove against A. flavipes were the lowest efficient oils.

El efecto inhibidor de ocho aceites naturales sobre diez aislados de hongos patógenos de los tractos digestivo y respiratorio de pollos muertos en "Kena Governorate" mostró que el aceite de menta crudo tiene un mayor efecto frente a algunos aislados y una repuesta menor frente a otros. Aunque sus concentraciones en aceite al 10% y 2% consiguieron dar algún efecto frente a todos los hongos ensayados. Aceites de geranio y manzanilla crudo mostraron efecto moderado frente a todos los aislados de hongos. El efecto de disoluciones diferentes de aceites de manzanilla, comino y apio dieron como resultado que la concentración al 10% era más efectiva que el aceite crudo. Aceites de lemongras y albahaca tienen casi el mismo

Los repositorios de acceso abierto en Argentina: situación actual Open access repositories in Argentine: an update

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Carolina De Volder

2008-12-01

Full Text Available Se llevó a cabo una caracterización básica y descriptiva de los repositorios argentinos de acceso abierto. Se identificaron quince repositorios: siete institucionales pertenecientes a cinco universidades nacionales; cuatro temáticos; tres de tesis y disertaciones y una biblioteca digital exclusivamente de revistas. De la investigación, se desprende que en nuestro país no hay políticas públicas ni mandatos relacionados con el acceso abierto; sí proyectos aislados surgidos y mantenidos en general por la iniciativa y el trabajo de los bibliotecarios, sobre todo en el ámbito universitario.A basic and descriptive characterization of the Argentinean repositories of open access was carried out. Fifteen repositories were identified: seven institutional belonging to five national universities; four thematic; three of thesis and dissertations and a digital library exclusively of journals. The results show that Argentina has not public policies or mandates in relation to open access. However, it has only isolated projects generally supported by the initiative and work of librarians, most of them in the university field.

Mutant Prevention Concentrations of Four Carbapenems against Gram-Negative Rods▿ †

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Credito, Kim; Kosowska-Shick, Klaudia; Appelbaum, Peter C.

2010-01-01

We tested the propensities of four carbapenems to select for resistant Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii mutants by determining the mutant prevention concentrations (MPCs) for 100 clinical strains with various ß-lactam phenotypes. Among the members of the Enterobacteriaceae family and A. baumannii strains, the MPC/MIC ratios were mostly 2 to 4. In contrast, for P. aeruginosa the MPC/MIC ratios were 4 to ≥16. The MPC/MIC ratios for β-lactamase-positive K. pneumoniae and E. coli isolates were much higher (range, 4 to >16 μg/ml) than those for ß-lactamase-negative strains. PMID:20308376

Determinación del potencial promotor del crecimiento vegetal de Azotobacter spp. aislados de la rizósfera de malezas en cultivos de maíz (Zea mays L.

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Luis H. León

2015-01-01

Full Text Available Los fertilizantes químicos representan entre 20% y 30% de los costos de producción de un cultivo, utilizados correctamente incrementan la productividad y rentabilidad; sin embargo, cada año aumenta la cantidad de fertilizantes por aplicar, debido a la deficiencia de adsorción en el suelo y absorción por la planta. Siendo el maíz el tercer cultivo de importancia en Perú, con un impacto significativo en la actividad económica y social, en el 2014, solo el 40% del maíz ofertado correspondió a la producción nacional. En busca de alternativas para disminuir el uso de fertilizantes químicos se realizan investigaciones con denominadas rizobacterias promotoras del crecimiento vegetal (PGPR, por sus siglas en ingles. Se identificaron 37 malezas en cultivos de maíz procedentes de campos agrícolas de los distritos de Monsefú y Reque, Región Lambayeque, siendo dicotiledóneas predominantes con 68 % con respecto a monocotiledóneas con 32%. Las bacterias se aislaron de la rizósfera de malezas, obteniendo 305 cultivos puros de bacterias, de los cuales 133 cultivos puros (43,7% se identificaron como Azotobacter spp., investigándose su reacción bioquímica en reducción de nitratos, utilización de sacarosa, glucosa, maltosa, manitol, ramnosa, glicerol y sorbitol, identificándose A. vinelandii (58%, A. paspali (13%, A. armeniacus (8%, A. nigricans (8% y en 13 cultivos no se identificó la especie. Con los cultivos Azotobacter spp. se cuantificó hasta 36,03 ppm de nitrógeno fijado como amonio; 60,75 ppm de ácido indol acético y 6,06 ppm de fósforo solubilizado, se determinó actividad antagónica contra Fusarium verticillioides, proteolítica y quitinolítica y. El 20% de Azotobacter spp. no afectó la emergencia de maíz amarillo duro hibrido simple AGRI- 144, el 33 % la afectó positivamente y el 47% la afectó negativamente. A su vez, ningún Azotobacter spp. afectó la sobrevivencia. Demostrándose el potencial promotor del

SME-3, a Novel Member of the Serratia marcescens SME Family of Carbapenem-Hydrolyzing β-Lactamases

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Queenan, Anne Marie; Shang, Wenchi; Schreckenberger, Paul; Lolans, Karen; Bush, Karen; Quinn, John

2006-01-01

Imipenem-resistant Serratia marcescens isolates were cultured from a lung transplant patient given multiple antibiotics over several months. The strains expressed SME-3, a β-lactamase of the rare SME carbapenem-hydrolyzing family. SME-3 differed from SME-1 by a single amino acid substitution of tyrosine for histidine at position 105, but the two β-lactamases displayed similar hydrolytic profiles. PMID:17005839

SME-3, a novel member of the Serratia marcescens SME family of carbapenem-hydrolyzing beta-lactamases.

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Queenan, Anne Marie; Shang, Wenchi; Schreckenberger, Paul; Lolans, Karen; Bush, Karen; Quinn, John

2006-10-01

Imipenem-resistant Serratia marcescens isolates were cultured from a lung transplant patient given multiple antibiotics over several months. The strains expressed SME-3, a beta-lactamase of the rare SME carbapenem-hydrolyzing family. SME-3 differed from SME-1 by a single amino acid substitution of tyrosine for histidine at position 105, but the two beta-lactamases displayed similar hydrolytic profiles.

Bacteremia due to carbapenem-resistant Enterobacteriaceae in neutropenic patients with hematologic malignancies.

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Satlin, Michael J; Cohen, Nina; Ma, Kevin C; Gedrimaite, Zivile; Soave, Rosemary; Askin, Gülce; Chen, Liang; Kreiswirth, Barry N; Walsh, Thomas J; Seo, Susan K

2016-10-01

To determine the prevalence, risk factors, treatments, and outcomes of bloodstream infections (BSIs) due to carbapenem-resistant Enterobacteriaceae (CRE) in adult neutropenic patients with hematologic malignancies. We reviewed all BSIs between 2008 and 2012 in this population at two New York City oncology centers. A case-control study was conducted to identify CRE BSI risk factors, using three controls of non-CRE BSIs per case. CRE caused 43 (2.2%) of 1992 BSIs overall and 4.7% of Gram-negative bacteremias. Independent risk factors for CRE BSI were prior β-lactam/β-lactamase inhibitor (adjusted odds ratio [aOR] 3.2; P = 0.03) or carbapenem (aOR 3.0; P = 0.05) use, current trimethoprim-sulfamethoxazole (aOR 24; P = 0.001) or glucocorticoid (aOR 5.4, P = 0.004) use, and having a prior CRE culture (aOR 12; P = 0.03). Patients with CRE bacteremia had a median of 52 h from culture collection until receipt of active therapy. They had a 51% BSI-related mortality rate, with a median of 4 days from bacteremia onset until death. CRE-active empirical therapy was associated with a lower 30-day mortality rate (17% vs. 59%; P = 0.08). CRE are lethal emerging causes of bacteremia in neutropenic patients. New strategies are needed to shorten the delay in administration of CRE-active agents and improve outcomes in this vulnerable population. Copyright © 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

High minimum inhibitory concentration of imipenem as a predictor of fatal outcome in patients with carbapenem non-susceptible Klebsiella pneumoniae.

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Wu, Ping-Feng; Chuang, Chien; Su, Chin-Fang; Lin, Yi-Tsung; Chan, Yu-Jiun; Wang, Fu-Der; Chuang, Yin-Ching; Siu, L Kristopher; Fung, Chang-Phone

2016-09-02

Carbapenem resistance in Klebsiella pneumoniae is important because of its increasing prevalence and limited therapeutic options. To investigate the clinical and microbiological characteristics of patients infected or colonized with carbapenem non-susceptible K. pneumoniae (CnsKP) in Taiwan, we conducted a retrospective study at Taipei Veterans General Hospital from January 2012 to November 2013. Carbapenem non-susceptibility was defined as a minimum inhibitory concentration (MIC) of ≥2 mg/L for imipenem or meropenem. A total of 105 cases with CnsKP were identified: 49 patients with infection and 56 patients with colonization. Thirty-one isolates had genes that encoded carbapenemases (29.5%), including K. pneumoniae carbapenemase (KPC)-2 (n = 27), KPC-3 (n = 1), VIM-1 (n = 1) and IMP-8 (n = 2). The in-hospital mortality among patients with CnsKP was 43.8%. A MIC for imipenem ≥16 μg/mL, nasogastric intubation and Acute Physiology and Chronic Health Evaluation II score were independent risk factors for in-hospital mortality for all patients with CnsKP. A MIC for imipenem ≥16 μg/mL was also an independent risk factor for 14-day mortality in patients with CnsKP. In conclusion, a positive culture for CnsKP was associated with high in-hospital mortality. A high imipenem MIC of CnsKP can predispose a patient to a poor prognosis.

Evaluación del potencial biofertilizante de bacterias diazótrofas aisladas de suelos con cultivo de cacao (Theobroma cacao L.

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Adriana Zulay Argüello-Navarro

2014-09-01

Full Text Available La adaptabilidad del cacao (Theobroma cacao L. en condiciones adversas permite sugerir que la microbiota asociada con la rizosfera desempeña una función importante para la nutrición y el desarrollo de la planta. En el trabajo se evaluó el potencial biofertilizante de bacterias fijadoras de nitrógeno (diazótrofas aisladas de suelos cacaoteros por la técnica de diluciones seriadas. Las bacterias se aislaron en medios semiselectivos (NFb, JMV, LGI, JNFb. Los aislados puros se caracterizaron morfológica y bioquímicamente y complementariamente se evaluó la capacidad de fijación biológica de nitrógeno (FBN por el método de Micro-Kjeldahl. Los aislados con mejor capacidad de fijación de nitrógeno fueron seleccionados para evaluar su potencial promotor de crecimiento durante 120 días en plantas de cacao clon CCN 51 establecidas a partir de semillas. El análisis de datos mostró que las plantas de cacao respondieron efectivamente a los tratamientos con bacterias donde las variables de crecimiento y N (% foliar incrementaron significativamente, en comparación con el testigo. Se destacó el aporte de los aislados DKA2J24, DKB3J73 presuntamente del género Burkholderia sp. y DKA1L3 semejante al género Gluconacetobacter sp., todos con un gran potencial como biofertilizantes en la prueba de bioensayo.

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

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Carattoli Alessandra

2008-02-01

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

Caracterización molecular y agronómica de aislados de Trichoderma spp nativos del noreste de México

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José Luis Hernández Mendoza

2011-07-01

Full Text Available Título en ingles: Molecular and agronomic characterization of Trichoderma spp natives of northeastern Mexico  Resumen Trichoderma sp es un hongo frecuentemente usado en actividades agrícolas, pues actúa como antagonista de diversas especies de hongos fitopatógenos. En este estudio se realizó el aislamiento de cuatro cepas de Trichoderma sp nativas del noreste de México, las cuales fueron identificadas a nivel molecular mediante la secuenciación del ITS 1. Además se evaluó su capacidad antagonista en contra los hongos fitopatógenos Macrophomina phaseolina y Fusarium oxysporum, que afectan severamente cultivos de sorgo, maíz y fríjol en el noreste de México. La identificación se realizó de acuerdo al grado de concordancia con secuencias reportadas y corresponden a las especies T. hammatum (HK701;  T. koningiopsis (HK702; T. asperellum (HK703 y Trichoderma sp (HK704. Por otra parte, las pruebas de antagonismo muestran que los aislados HK701, HK703 y HK704 inhiben por competencia el crecimiento de M. phaseolina y F. oxysporum, mientras que HK702 tiene la capacidad para hiperparasitar dichos fitopatógenos. Finalmente, se evaluó la promoción de crecimiento de T. asperellum HK703, en maíz (Pionner 30P49®, usando para ello concentraciones de tratamiento de 1x10e2 hasta 1x10e6 esp/mL. En estos ensayos se midió la producción de biomasa. Los resultados muestran que en concentraciones intermedias se tiene el mayor incremento en altura de plantas y mayor producción de peso seco en follaje y raíz. Entre los parámetros antes mencionados existen diferencias significativas. Palabras clave: control biológico, antagonismo, biofertilizantes, Zea maiz, Sorghum bicolor. Abstract Trichoderma sp is a fungus often used in agricultural activities, because it acts as an antagonist of several species of plant pathogenic fungi. In this study four strains of Trichoderma sp was isolated from the northeastern Mexico, which were identified by

Expresión específica de los genes de la respuesta inflamatoria en subpoblaciones de macrófagos.

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Vera María Ripoll

2005-06-01

Full Text Available Como brazo efectivo de la respuesta inmune, los macrófagos reconocen, fagocitan y destruyen patógenos potenciales. También, coordinan respuestas adicionales del hospedero mediante la síntesis de un amplio rango de mediadores de la inflamación que, en últimas, activan la respuesta inmune adaptativa y establecen la inmunidad protectora. Aunque son componentes claves del sistema de defensa de los mamiferos, el resultado de su actividad no siempre es beneficioso para el hospedero. El papel central jugado en la enfermedad hace que su regulaci6n se convierta en un blanco importante en la prevención, el control y la curación de los procesos inflamatorios. De hecho, los genes de expresión restringida en macrófagos pueden ser puntos cruciales de la intervención terapeutica. Este trabajo revisa el uso de los microarreglos de cADN para la comparaci6n de los genes de la inflamación que se expresan de diferente forma en dos poblaciones de macrófagos, derivados de la médula ósea y macrófagos peritoneales obtenidos despues de inducir una inflamación con tioglicolato, con genes expresados en fibroblastos primarios aislados de embrión y células esplenicas no adherentes. La comparación de los perfiles de expresión indica que los genes de la inflamación de los macrófagos estén asociados con categorias funcionales esperadas como la degradación lisosómica, la fagocitosis, la defensa del hospedero y de la homeostasis. La información revisada por este estudio contribuye a entender la biologia de los macrófagos.

Aislamiento y caracterización de microorganismos con actividad lipolítica provenientes de sedimentos del Humedal El Jaboque (Bogotá, Colombia)

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Lilia Carolina Mora Moreno; Hernando Valencia Zapata

2006-01-01

En el humedal el Jaboque (Engativá) Bogotá, Colombia, se aislaron microorganismos lipolíticos provenientes de
sedimentos, mediante la utilización de medios de cultivo selectivos (agar tributirina, agar aceite de girasol). Primero se evaluó la concentración del sustrato (aceite de girasol) en la cual se encontraba el mayor número de morfotipos aislados, luego se comparó la eficiencia de los dos medios de cultivo de acuerdo a la cantidad de morfotipos aislados. Se evaluaron tres conc...

Carbapenem-resistant Acinetobacter baumannii from Serbia: revision of CarO classification.

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Katarina Novovic

Full Text Available Carbapenem-resistant A. baumannii present a significant therapeutic challenge for the treatment of nosocomial infections in many European countries. Although it is known that the gradient of A. baumannii prevalence increases from northern to southern Europe, this study provides the first data from Serbia. Twenty-eight carbapenem-resistant A. baumannii clinical isolates were collected at a Serbian pediatric hospital during a 2-year period. The majority of isolates (67.68% belonged to the sequence type Group 1, European clonal complex II. All isolates harbored intrinsic OXA-51 and AmpC cephalosporinase. OXA-23 was detected in 16 isolates (57.14%, OXA-24 in 23 isolates (82.14% and OXA-58 in 11 isolates (39.29%. Six of the isolates (21.43% harbored all of the analyzed oxacillinases, except OXA-143 and OXA-235 that were not detected in this study. Production of oxacillinases was detected in different pulsotypes indicating the presence of horizontal gene transfer. NDM-1, VIM and IMP were not detected in analyzed clinical A. baumannii isolates. ISAba1 insertion sequence was present upstream of OXA-51 in one isolate, upstream of AmpC in 13 isolates and upstream of OXA-23 in 10 isolates. In silico analysis of carO sequences from analyzed A. baumannii isolates revealed the existence of two out of six highly polymorphic CarO variants. The phylogenetic analysis of CarO protein among Acinetobacter species revised the previous classification CarO variants into three groups based on strong bootstraps scores in the tree analysis. Group I comprises four variants (I-IV while Groups II and III contain only one variant each. One half of the Serbian clinical isolates belong to Group I variant I, while the other half belongs to Group I variant III.

Actividad inhibitoria de un polímero de quitosana en el crecimiento vegetativo y la reproducción asexual de un aislado de Phytophthora palmivora Butler

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González-Peña Fundora, Dianevys; Gómez Izaguirre, Guadalupe; Fernández Morales, Ana; Vaillant Flores, Daymara; Falcón-Rodríguez, Alejandro B.

2016-01-01

El objetivo del trabajo fue evaluar el efecto de la quitosana sobre el crecimiento vegetativo y las fases de reproducción asexual del ciclo de vida de Phytophthora palmivora Butler. Soluciones con diferentes concentraciones de quitosana, que oscilaron desde 0,5 hasta 2,5g.l-1 se mezclaron con medio de cultivo V8 antes de verterse en placas Petri, donde luego se inoculó un disco de micelio del aislado. Se evaluaron aspectos morfoculturales y el crecimiento radial cuando las colonias del tratam...

Carbapenem and cefoxitin resistance of Klebsiella pneumoniae strains associated with porin OmpK36 loss and DHA-1 β-lactamase production

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Weifeng Shi

2013-01-01

Full Text Available Clinical isolates of carbapenem-resistant Klebsiella pneumoniae (K. pneumoniae strains are being increased worldwide. Five pan-resistant K. pneumoniae strains have been isolated from respiratory and ICU wards in a Chinese hospital, and reveal strong resistance to all β-lactams, fluoroquinolones and aminoglycosides. Totally 27 β-lactamase genes and 2 membrane pore protein (porin genes in 5 K. pneumoniae strains were screened by polymerase chain reaction (PCR. The results indicated that all of 5 K. pneumoniae strains carried blaTEM-1 and blaDHA-1 genes, as well as base deletion and mutation of OmpK35 or OmpK36 genes. Compared with carbapenem-sensitive isolates by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE, the resistant isolates markedly lacked the protein band of 34-40 kDa, which might be the outer membrane proteins of OmpK36 according to the electrophoresis mobility. In addition, the conjugation test was confirmed that blaDHA-1 mediated by plasmids could be transferred between resistant and sensitive strains. When reserpine (30 µg/mL and carbonyl cyanide m-chlorophenylhydrazone (CCCP (50 µg/mL were added in imipenem and meropenem, the MICs had no change against K. pneumoniae strains. These results suggest that both DHA-1 β-lactamase and loss or deficiency of porin OmpK36 may be the main reason for the cefoxitin and carbapenem resistance in K. pneumoniae strains in our hospital.

Aislamiento y caracterización de cepas de rizobios aisladas de diferentes leguminosas en la región de Cascajal, Villa Clara Isolation and characterization of rhizobia strains isolated from different legumes in the Cascajal region, Villa Clara

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Pérez Guianeya

2008-06-01

Full Text Available Se aislaron 19 cepas de rizobio a partir de los nódulos de las leguminosas Canavalia ensiformis, Stylosanthes guianensis, Centrosema molle, Pueraria phaseoloides y Macroptilium atropurpureum, con el objetivo de obtener inoculantes efectivos para dichos cultivos en suelos ácidos. Para la caracterización de los aislados bacterianos se estudiaron sus características micromorfológicas, tintoriales y culturales, así como algunas respuestas fisiológico-bioquímicas, tales como la excreción de ácido o base al medio de cultivo y el ensayo de la cetolactasa. Se hizo un ensayo de nodulación in vitro con cada una de las leguminosas para determinar la efectividad de los aislados. De acuerdo con las características culturales, la tasa de crecimiento en medio LMA y la producción de ácido o base, los aislados obtenidos pudieran pertenecer a los géneros Bradyrhizobium y Rhizobium y/o Sinorhizobium. La prueba de la cetolactasa permitió conocer que ninguno de los aislados en estudio pertenece al género Agrobacterium. El ensayo con plantas inoculadas mostró que todas las cepas aisladas fueron efectivas en la nodulación, ya que nodularon en las leguminosas probadas. Se concluye que de las cepas aisladas 11 pudieran pertenecer al género Bradyrhizobium, mientras que las ocho restantes comparten características similares con los géneros Rhizobium y/o Sinorhizobium; todos los aislados fueron efectivos en la nodulación y pueden considerarse cepas promisorias para la obtención de inoculantes para las leguminosas forrajeras en estudio.Nineteen rhizobium strains were isolated from the nodules of the legumes Canavalia ensiformis, Stylosanthes guianensis, Centrosema molle, Pueraria phaseoloides and Macroptilium atropurpureum, with the objective of obtaining effective inoculants for such crops in acid soils. For the characterization of the bacterial isolates, their micromorphological, staining and cultural characteristics were studied, as well as some

Estudio de la concentración microbiana del aire en depósitos del Archivo Nacional de Cuba

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Sofía Flavia Borrego Alonso

2010-09-01

Full Text Available Actualmente el estudio de la microbiota en ambientes interiores es de interés para los especialistas, pues los microorganismos pueden provocar afectaciones a la salud de las personas y causar el biodeterioro de colecciones valiosas. Los objetivos del trabajo fueron: determinar la concentración microbiana del aire en depósitos del Archivo Nacional de Cuba, realizar la identificación taxonómica de los hongos aislados y definir el riesgo potencial que ellos representan para el biodeterioro del patrimonio documental y la salud del personal. El muestreo microbiológico se realizó en verano e invierno y en 6 depósitos, empleando un método de sedimentación. Para aislar hongos y bacterias se emplearon placas de Petri con medios de cultivo adecuados que se colocaron por triplicado a 3m de altura. Se determinó cualitativamente la actividad celulolítica, la producción de pigmentos y de ácidos a los hongos aislados. La microbiota viable total fue mayor en invierno que en verano, siendo la concentración bacteriana significativamente superior en esta estación (sequía en tanto que la fúngica es más elevada en verano. Los géneros fúngicos que predominaron en invierno fueron Aspergillus, Cladosporium, Penicillium, Curvularia y Alternaria, mientras que en verano prevaleció Cladosporium y se aislaron los géneros Fusarium, Mucor y Chrysonilia que llegaron a alcanzar niveles significativos en algunos depósitos. Los hongos aislados degradaron celulosa, produjeron pigmentos y ácidos. Asimismo, se evidenció que pueden provocar estados alérgicos y enfermedades respiratorias a las personas. Con relación a las bacterias del aire, predominaron las Gram positivas y se identificaron los géneros Enterobacter, Hafnia, Serratia, Streptomyces, Bacillus, Streptococcus y Staphylococcus. De igual manera, se detectó que las bacterias identificadas son capaces de producir afectaciones a la salud del personal.

De los recursos didácticos para el aula a los contenidos para espacios virtuales educativos con componentes activos y herramientas de autor

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Francisco José García Peñalvo

2004-01-01

Full Text Available El uso de las Tecnologías de la Información y la Comunicación en los procesos educativos en general, y en la Universidad en particular, comienza a ser una realidad, al menos en apariencia y en infraestructura. Es cotidiano el uso de medios audiovisuales como apoyo a la tradicional lección magistral, así como la publicación de diversos materiales en diversos sitios web relacionados con la docencia. Sin embargo, un análisis más profundo de la situación quizás nos lleve a una realidad menos alentadora, donde el conjunto de los autores de contenidos didácticos no reúne todo el potencial humano que la Universidad podría ofrecer. En consecuencia el número de materiales didácticos se ve afectado negativamente, de modo que la calidad, organización y accesibilidad de los mismos es susceptible de importantes mejoras. Desde este artículo, apoyándonos en las experiencias desarrolladas en el Laboratorio de Diseños Educativos Multimedia y Teleeducación del Instituto de Ciencias de la Educación de la Universidad de Salamanca, se aboga por la necesidad de superar la mera creación de elementos docentes aislados y caminar hacia el establecimiento efectivo de verdaderos espacios virtuales educativos, que deberían estar soportados por componentes educativos activos y herramientas de autor para la población de dichos espacios con contenidos de calidad. En el caso de las herramientas de autor, defendemos que las interfaces autor-herramienta han de estar pensadas para facilitar el acercamiento como autores de contenidos a un personal que no tiene por qué ser experto en informática

Emergence and clonal dissemination of carbapenem-hydrolysing OXA-58-producing Acinetobacter baumannii isolates in Bolivia.

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Sevillano, Elena; Fernández, Elena; Bustamante, Zulema; Zabalaga, Silvia; Rosales, Ikerne; Umaran, Adelaida; Gallego, Lucía

2012-01-01

Acinetobacter baumannii is an emerging multidrug-resistant pathogen and very little information is available regarding its imipenem resistance in Latin American countries such as Bolivia. This study investigated the antimicrobial resistance profile of 46 clinical strains from different hospitals in Cochabamba, Bolivia, from March 2008 to July 2009, and the presence of carbapenemases as a mechanism of resistance to imipenem. Isolates were obtained from 46 patients (one isolate per patient; 30 males,16 females) with an age range of 1 day to 84 years, and were collected from different sample types, the majority from respiratory tract infections (17) and wounds (13). Resistance to imipenem was detected in 15 isolates collected from different hospitals of the city. These isolates grouped into the same genotype, named A, and were resistant to all antibiotics tested including imipenem, with susceptibility only to colistin. Experiments to detect carbapenemases revealed the presence of the OXA-58 carbapenemase. Further analysis revealed the location of the bla(OXA-58) gene on a 40 kb plasmid. To our knowledge, this is the first report of carbapenem resistance in A. baumannii isolates from Bolivia that is conferred by the OXA-58 carbapenemase. The presence of this gene in a multidrug-resistant clone and its location within a plasmid is of great concern with regard to the spread of carbapenem-resistant A. baumannii in the hospital environment in Bolivia.

Estudios sobre la fisostigmina (eserina y productos derivados

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Gonzalo Montes D.

1943-01-01

Full Text Available En los últimos años se han desarrollado trabajos que muestran claramente cómo los efectos del sistema nervioso parasimpátíco se producen mediante la liberación de una substancia química en las terminaciones nerviosas, la cual es directamente responsable de la excitación de las células inervadas. Esta substancia tiene acción idéntica a la de la acetilcolina. Como trabajos básicos en el descubrimiento de este mecanismo deben citarse los de Loewi, quien probó que la estimulación del vago en el corazón aislado de la rana producía acetilcolina, mientras que la estimulación del simpático liberaba una substancia semejante a la adrenalina. Este descubrimiento fué luégo confirmado por otros investigadores en otros órganos aislados y ha servido para sentar la teoría hormonal del control autónomo.

Efecto de las cepas nativas Paecilomyces sp. (Bainier y Lecanicillium sp. (Zimm en el control de Carmenta foraseminis Eichlin (Lepidoptera: Sesiidae en cultivos de cacao (Theobroma cacao L.

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Wilmer Figueroa Medina

2013-07-01

Full Text Available El pasador del fruto, Carmenta foraseminis Eichlin, es un insecto que ha acentuado su ataque en cultivos de cacao (Theobroma cacao L. en los últimos años en Norte de Santander (Colombia. El objetivo de este estudio fue evaluar la patogenicidad de las cepas nativas Giav-3 Paecilomyces sp. y Giav-4 Lecanicillium sp. sobre larvas de C. foraseminis. Para el efecto, se realizaron aislamientos a partir de muestras de suelo recolectadas en el municipio de Tibú, Norte de Santander. Después de obtenidos los cultivos puros se procedió a la caracterización macroscópica y microscópica para la identificación del género de los aislados mediante claves taxonómicas. La infección fue realizada mediante inmersión de larvas en las suspensiones de los aislados en concentraciones de 0, 10(6, 10(7 y 10(8 conidios/ml. En ambos aislados se observó una tendencia lineal respecto a la mortalidad, la cual fue directamente proporcional a las concentraciones del inóculo. La CL50 y CL90 para Giav-3 fue de 10(6.95 y 10(8.70 conidios/ml y para Giav-4 de 10(6.6 y 10(8.04 conidios/ml, respectivamente. Lo cual indica que esta última requirió la menor concentración de inóculo para eliminar el 50% y 90% de la población tratada, lo que supone una mayor efectividad contra las larvas.

Prevalence of Invasive Infections Due to Carbapenem-Resistant Enterobacteriaceae among Adult Patients in U.S. Hospitals.

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Lodise, Thomas; Ye, Michael J; Zhao, Qi

2017-08-01

This large-scale retrospective analysis ( n = 60,551) of the Premier inpatient database (1 January 2011 to 31 December 2014) found an overall prevalence of carbapenem-resistant Enterobacteriaceae strains of 2.3% (range, 0.9% to 5.8% by geographic region) among patients with infections due to Enterobacteriaceae Ongoing monitoring and development of decision support tools/algorithms are needed for identification of high-risk patients. Copyright © 2017 American Society for Microbiology.

Alterations of OprD in Carbapenem-Intermediate and -Susceptible Strains of Pseudomonas aeruginosa Isolated from Patients with Bacteremia in a Spanish Multicenter Study

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Cabot, Gabriel; Rodríguez, Cristina; Roman, Elena; Tubau, Fe; Macia, María D.; Moya, Bartolomé; Zamorano, Laura; Suárez, Cristina; Peña, Carmen; Domínguez, María A.; Moncalián, Gabriel; Oliver, Antonio; Martínez-Martínez, Luis

2012-01-01

We investigated the presence of OprD mutations in 60 strains of metallo-ß-lactamase-negative Pseudomonas aeruginosa intermediately susceptible (IS [n = 12]; MIC = 8 μg/ml) or susceptible (S [n = 48]; MICs ≤ 1 to 4 μg/ml) to imipenem and/or meropenem that were isolated from patients with bacteremia in order to evaluate their impact on carbapenem susceptibility profiles. The presence of mutations in oprD was detected by sequencing analysis. OprD expression was assessed by both outer membrane protein (OMP) analysis and real-time PCR (RT-PCR). Fourteen (23%) isolates had an OprD identical to that of PAO1, and OprD modifications were detected in 46 isolates (77%). Isolates were classified as OprD “full-length types” (T1 [n = 40, including both wild-type OprD and variants showing several polymorphisms]) and OprD “deficient types” (T2 [n = 3 for OprD frameshift mutations] and T3 [n = 17 for premature stop codons in oprD]). RT-PCR showed that 5 OprD type T1 isolates presented reduced transcription of oprD (0.1- to 0.4-fold compared to PAO1), while oprD levels increased more than 2-fold over that seen with PAO1 in 4 OprD type T1 isolates. A total of 50% of the isolates belonging to OprD “deficient types” were susceptible to both carbapenems, and 40% were susceptible to meropenem and intermediately susceptible to imipenem. Only one isolate (5%) within this group was intermediately susceptible to both carbapenems, and one (5%) was susceptible to imipenem and intermediately susceptible to meropenem. We concluded that OprD inactivating mutations in clinical isolates of P. aeruginosa are not restricted only to carbapenem-resistant isolates but are also found in isolates with imipenem or meropenem MICs of only 0.06 to 4 μg/ml. PMID:22290967

Comparison of synergism between colistin, fosfomycin and tigecycline against extended-spectrum β-lactamase-producing Klebsiella pneumoniae isolates or with carbapenem resistance

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Yee-Huang Ku

2017-12-01

Full Text Available Purpose: To investigate the synergistic and bactericidal effects of antimicrobial combinations of any two of colistin, fosfomycin and tigecycline against the nine extended-spectrum β-lactamase (ESBL-producing Klebsiella pneumoniae (KP clinical isolates, including 4 carbapenem-susceptible strains and five imipenem and/or meropenem-resistant strains. Methods: In vitro synergism and bactericidal activity of combination of colistin, fosfomycin and tigecycline were evaluated by time-kill studies in standard inoculum of bacterial densities of a suspension containing 5 × 105 CFU/mL by using 1/2× MIC for each alone, and both 1/2× and 1/4× MIC for any two drugs. The settings of low MIC dosing were allowed to rapidly survey the most active drug combination. Results: The most active combination group was colistin plus tigecycline, showing synergy in 8 isolates and bactericidal activities in 6 isolates by using concentrations of 1/2× MIC and 1/4× MIC, respectively. The least active combination was tigecycline plus fosfomycin, which showed synergy in only 4 isolates and no bactericidal activities by using concentrations of 1/2× MIC and 1/4× MIC, respectively. Conclusions: The combination of tigecycline and colistin may be considered as a last-resort approach to the ESBL-producing KP infections, especially those isolates with carbapenem resistance. Keywords: Carbapenem resistance, Colistin, ESBL, Fosfomycin, Tigecycline

Capacidad de los laboratorios nacionales de referencia en Latinoamérica para detectar mecanismos de resistencia emergentes Capability of national reference laboratories in Latin America to detect emerging resistance mechanisms

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Alejandra Corso

2011-12-01

Full Text Available OBJETIVO: Evaluar la capacidad de 17 laboratorios nacionales de referencia que participan en el Programa Latinoamericano de Control de Calidad en Bacteriología y Resistencia a los Antimicrobianos (LA-EQAS para detectar mecanismos de resistencia emergentes, a saber: resistencia de enterobacterias a carbapenemes por presencia de Klebsiella pneumoniae carbapenemasa (KPC; resistencia de enterobacterias a carbapenemes por presencia de metalobetalactamasas (MBL tipo IMP, y resistencia intermedia a vancomicina de aislamientos de Staphylococcus aureus (VISA. MÉTODOS: Se enviaron los siguientes tres aislamientos a los 17 laboratorios participantes del LA-EQAS: Klebsiella pneumoniae OPS-161 productor de KPC, Enterobacter cloacae OPS-166 productor de IMP y S. aureus OPS-165 con resistencia intermedia a vancomicina. Se evaluó la interpretación de las pruebas de sensibilidad y detección del mecanismo de resistencia y el tamaño de los halos de inhibición (método de difusión por discos o valor de la concentración inhibitoria mínima (CIM. RESULTADOS: La concordancia en la detección de los mecanismos de resistencia fue de 76,4%, 73,3% y 66,7% con respecto a la cepas K. pneumoniae OPS-161, E. cloacae OPS-166 y S. aureus OPS-165, respectivamente. La concordancia entre las zonas de inhibición obtenidas por los laboratorios participantes y los rangos establecidos por el laboratorio coordinador fue aceptable en los tres aislamientos, ya que alcanzó 90,8%, 92,8% y 88,9%, respectivamente, para cada cepa. CONCLUSIONES: La concordancia global en la detección de los mecanismos de resistencia KPC, MBL y VISA fue de 72,1%. Consideramos que los laboratorios nacionales de referencia de América Latina son capaces de reconocer estos mecanismos de resistencia emergentes y se espera que en el futuro la concordancia alcance su nivel máximo.OBJECTIVE: To evaluate the capability of 17 national reference laboratories participating in the Latin American Quality

Características clínicas y microbiológicas de los pacientes neutropénicos febriles con neoplasias hematológicas

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Fabián Alberto Jaimes Barragán

2008-02-01

Full Text Available Se estudiaron en forma retrospectiva 441 historias clínicas en el período comprendido entre enero de 2003 y diciembre de 2005. De éstas, se identificaron las características de 117 episodios de neutropenia febril en 96 pacientes. La mediana de edad fue 34 años y el 56,4% de los episodios ocurrieron en hombres. Las más frecuentes neoplasias hematológicas relacionadas con neutropenia febril fueron leucemia linfoide aguda (LLA y leucemia mieloide aguda (LMA con 45 episodios de cada una, que corresponden al 76,9%. La mediana de duración de la neutropenia fue 8 días y el 60,7% de los casos entraron en la categoría de neutropenia grave. La mortalidad global fue del 32% y el 81,5% de estas muertes estuvieron asociadas directamente con la infección. Se obtuvo aislamiento microbiológico en el 51% de los eventos. Los bacilos gram negativos (BGN constituyeron el 59% de los aislamientos microbiológicos y los cocos gram positivos el 32%. El 14,3% de los BGN aislados fueron positivos para beta lactamasas de espectro extendido (BLEE y la resistencia global a ciprofloxacina alcanzó el 31,4%. El esquema antimicrobiano empírico más frecuentemente utilizado fue ciprofloxacina más ceftriaxona; la respuesta terapéutica fue desfavorable en 65% de los casos. En el Hospital San Vicente de Paúl de Medellín siguen primando los gérmenes gram negativos y son altas las tasas de resistencia a los antibióticos utilizados tradicionalmente como de primera línea, lo que sugiere la necesidad de reevaluar la pertinencia de estos esquemas.

WCK 4234, a novel diazabicyclooctane potentiating carbapenems against Enterobacteriaceae, Pseudomonas and Acinetobacter with class A, C and D β-lactamases.

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Mushtaq, Shazad; Vickers, Anna; Woodford, Neil; Livermore, David M

2017-06-01

Several diazabicyclooctanes (DBOs) are under development as inhibitors of class A and C β-lactamases. Inhibition of OXA (class D) carbapenemases is variable, with those of Acinetobacter spp. remaining notably resistant. We describe a novel DBO, WCK 4234 (Wockhardt), with distinctive activity against OXA carbapenemases. MICs of imipenem and meropenem were determined by CLSI agar dilution with WCK 4234 added at 4 or 8 mg/L. Test organisms were clinical Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa with carbapenemases or carbapenem resistance via porin loss plus AmpC or ESBL activity. AmpC mutants were also tested. WCK 4234, which lacked direct antibacterial activity, strongly potentiated imipenem and meropenem against Enterobacteriaceae with OXA-48/OXA-181 or KPC enzymes, or with combinations of impermeability and AmpC or ESBL activity, with MICs reduced to ≤2 mg/L in almost all cases. Carbapenems likewise were potentiated against P. aeruginosa ( n  =   2) with OXA-181 enzyme, with MICs reduced from 64-128 to 2-8 mg/L and against A. baumannii with OXA carbapenemases, particularly OXA-23 or hyperproduced OXA-51, with MICs reduced to ≤2 mg/L for 9/10 acinetobacters with OXA-23 enzyme. Carbapenems were not potentiated against Enterobacteriaceae or non-fermenters with metallo-β-lactamases. WCK 4234 distinctively overcame resistance mediated by OXA-type carbapenemases, including those of A. baumannii . It behaved similarly to other DBOs against strains with KPC carbapenemases or combinations of impermeability and ESBL or AmpC activity. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Whole-Genome Sequences of Two Carbapenem-Resistant Klebsiella quasipneumoniae Strains Isolated from a Tertiary Hospital in Johor, Malaysia.

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Gan, Han Ming; Rajasekaram, Ganeswrie; Eng, Wilhelm Wei Han; Kaniappan, Priyatharisni; Dhanoa, Amreeta

2017-08-10

We report the whole-genome sequences of two carbapenem-resistant clinical isolates of Klebsiella quasipneumoniae subsp. similipneumoniae obtained from two different patients. Both strains contained three different extended-spectrum β-lactamase genes and showed strikingly high pairwise average nucleotide identity of 99.99% despite being isolated 3 years apart from the same hospital. Copyright © 2017 Gan et al.

Susceptibilidad antifúngica en dermatofitos

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Colella, María Teresa; Castro, María; Montiel, Marvia; Vásquez, Erika; Mata-Essayag, Sofía; Magaldi, Sylvia; Hartung de Capriles, Claudia; Pérez, Celina; Olaizola, Carolina; Arántza, Roselló

2006-01-01

No existe hasta los momentos una prueba estandarizada para realizar la susceptibilidad antifúngica de los dermatofitos. El objetivo de este estudio fue implementar la técnica de los pozos de difusión para el estudio de la susceptibilidad de los dermatofitos. Se utilizaron un total de 100 aislados de dermatofitos (74 Trichophyton rubrum, 18 Trichophyton mentagrophytes, 1 Trichophyton tonsurans, 5 Microsporum canis y 2 Epidermophyton floccosum) provenientes de muestras clínicas aisladas e ident...

Isovaleramida, principio anticonvulsivo aislado de Valeriana pavonii

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Sara Emilia Giraldo

2010-08-01

Conclusión. La isovaleramida es uno de los principios activos anticonvulsivos de V. pavonii, por primera vez reportado en esta especie. Estos resultados dan soporte al uso tradicional de V. pavonii y a su interés como fuente de principios útiles en terapéutica.

Emergence of carbapenem-resistant Acinetobacter baumannii ST787 in clinical isolates from blood in a tertiary teaching hospital in Northern Taiwan

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Yi-Fan Hu

2017-10-01

Conclusion: To the best of our knowledge, this study is the first to describe the microbiological characteristics of CRAB ST787, which carried high genetic resistance to carbapenem, but remained susceptible to colistin. CRAB ST787 was the predominant clone in our hospital in the study period.

Ventilator-associated pneumonia caused by carbapenem-resistant Enterobacteriaceae carrying multiple metallo-beta-lactamase genes

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Dwivedi Mayank

2009-07-01

Full Text Available Context: Ventilator-associated pneumonia (VAP is a leading nosocomial infection in the intensive care unit (ICU. Members of Enterobacteriaceae are the most common causative agents and carbapenems are the most commonly used antibiotics. Metallo-beta-lactamase (MBL production leading to treatment failure may go unnoticed by routine disc diffusion susceptibility testing. Moreover, there is not much information on association of MBL-producing Enterobacteriaceae with ICU-acquired VAP. Therefore, a study was undertaken to find out the association of MBL-producing Enterobacteriaceae with VAP. Settings: This study was conducted in a large tertiary care hospital of North India with an eight-bed critical care unit. Materials and Methods: The respiratory samples (bronchoalveolar lavage, protected brush catheter specimens and endotracheal or transtracheal aspirates obtained from VAP patients (during January 2005-December 2006 were processed, isolated bacteria identified and their antibiotic susceptibilities tested as per standard protocols. The isolates of Enterobacteriaceae resistant to carbapenem were subjected to phenotypic and genotypic tests for the detection of MBLs. Results: Twelve of 64 isolates of Enterobacteriaceae were detected as MBL producers, bla IMP being the most prevalent gene. Additionally, in three strains, simultaneous coexistence of multiple MBL genes was detected. Conclusion: The coexistence of multiple MBL genes in Enterobacteriaceae is an alarming situation. As MBL genes are associated with integrons that can be embedded in transposons, which in turn can be accommodated on plasmids thereby resulting in a highly mobile genetic apparatus, the further spread of these genes in different pathogens is likely to occur.

Polisacáridos de líquenes : aplicación en sistemática y variaciones estacionales

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Pereyra de la Iglesia, Mª Teresa

2000-01-01

Los polisacáridos más abundantes de los hongos liquenizados son los glucanos como el liquenano, el isoliquenano o el pustulano. También varios autores han aislado diferentes galactomananos complejos que, junto a los otros polisacáridos, se han empleado para caracterizar grupos taxonómicos de diferente categoria. Los mananos y heteropolisacáridos también son de utilidad para clasificación de los hongos no liquenizados. El objetivo principal de esta Tesis ha sido la purificación y caracterizaci...

Trapping and Characterization of a Reaction Intermediate in Carbapenem Hydrolysis by B. cereus Metallo-β-lactamase

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Tioni, Mariana F.; Llarrull, Leticia I.; Poeylaut-Palena, Andrés A.; Martí, Marcelo A.; Saggu, Miguel; Periyannan, Gopal R.; Mata, Ernesto G.; Bennett, Brian; Murgida, Daniel H.; Vila, Alejandro J.

2009-01-01

Metallo-β-lactamases hydrolyze most β-lactam antibiotics. The lack of a successful inhibitor for them is related to the previous failure to characterize a reaction intermediate with a clinically useful substrate. Stopped-flow experiments together with rapid freeze-quench EPR and Raman spectroscopies were used to characterize the reaction of Co(II)-BcII with imipenem. These studies show that Co(II)-BcII is able to hydrolyze imipenem both in the mono- and dinuclear forms. In contrast to the situation met for penicillin, the species that accumulates during turnover is an enzyme-intermediate adduct in which the β-lactam bond has already been cleaved. This intermediate is a metal-bound anionic species, with a novel resonant structure, that is stabilized by the metal ion at the DCH or Zn2 site. This species has been characterized based on its spectroscopic features. This represents a novel, previously unforeseen intermediate, that is related to the chemical nature of carbapenems, as confirmed by the finding of a similar intermediate for meropenem. Since carbapenems are the only substrates cleaved by B1, B2 and B3 lactamases, the identification of this intermediate could be exploited as a first step towards the design of transition state based inhibitors for all three classes of metallo-β-lactamases. PMID:18980308

Mundos aislados: segregación urbana y desigualdad en la ciudad de México

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GONZALO A SARAVÍ

2008-12-01

Full Text Available De qué nos habla la segregación urbana en México y cuáles son sus implicaciones en este contexto en particular, son las dos preguntas centrales que guían el análisis desarrollado en este artículo. El argumento que responde a estas dos preguntas se estructura en torno a la hipótesis de una "coexistencia de mundos aislados". Para sustentar dicha hipótesis, el autor analiza teórica y empíricamente la relación entre las dimensiones objetiva y simbólica de la segregación urbana. El análisis se basa en datos secundarios y en información obtenida a partir de entrevistas semi-estructuradas con jóvenes residentes en colonias populares y estigmatizadas de la Ciudad de México.What does urban segregation mean in México and what are its implications for this particular context? This article poses these two questions. Our response is based on the hypothesis of the "co-existence of isolated worlds." In order to support and develop this hypothesis, the author analyses the relationship between the objective and symbolic dimensions of urban segregation. The analysis is based on secondary data and semi-structured interviews with young people from poor and stigmatized neighborhoods in México City.

Efecto in vitro de aceites esenciales de tres especies de Lippia sobre Moniliophthora roreri (Cif. y Par. Evans et al., agente causante de la moniliasis del cacao (Theobroma cacao L.

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Lozada Betty Stefany

2012-11-01

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Se evaluó el efecto antifúngico in vitro de cinco aceites esenciales (AEs (AE1, AE2, AE3, AE4 y AE5 extraídos de Lippia origanoides, L. citriodora y L. alba sobre aislados de monilia (Moniliophthora roreri obtenidos de frutos de cacao infectados provenientes de San Vicente de Chucurí, Santander, Colombia. Las plantas de Lippia fueron colectadas en cinco localidades colombianas. Los aislados de monilia (M1, M2, M3, M4 y M5 fueron caracterizados por su morfología, germinación y crecimiento en medios de cultivo. La actividad antifúngica de diferentes concentraciones de los AEs fue evaluada contra el aisla- do M2 y la cepa de M. roreri (ATCC 64239, para determinar su efecto sobre la germinación y la inhibi- ción del crecimiento micelial. Los AEs estudiados inhibieron 100% de la germinación y del crecimiento micelial cuando fueron utilizados en concentraciones de 800 - 1000 µg/ml. Concentraciones de 200 µg/ml también mostraron efecto sobre los aislamientos fúngicos, siendo los AEs obtenidos de L. ori- ganoides (AE2 y AE3 los más activos. Estos estaban compuestos principalmente por timol, p-cimeno,

y-terpineno, acetato de timilo, carvacrol, 1-mirceno, trans-1ccariofileno. Diferencias significativas (P <

MICROORGANISMOS ASOCIADOS A FRUTOS EMBOLSADOS DE GUAYABA TAIWANESA VARIEDAD TAI KUO

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Rossy Morera-Montoya

2009-01-01

Durante la época lluviosa también se encontraron diferencias altamente significativas (X2= 0,04773 en la incidencia de microorganismos, teniendo como resultado: cuando control > bolsa de tergal > bolsa Taiwanesa. Los resultados sugieren que los microorganismos aislados de frutos enfermos podrían ser agentes responsables de la pérdida de frutas comercia les en las plantaciones tropicales de guayaba.

Infección urinaria intrahospitalaria en los servicios de hospitalización de Medicina de un Hospital General.

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Marjorie Katherine Flores Siccha

2008-04-01

Full Text Available Las infecciones intrahospitalarias (IIH constituyen un gran problema de salud pública, no solo por su alta frecuencia, sino por sus consecuencias que se traducen en términos de morbi-mortalidad, aumento de costos y prolongación de estancia hospitalaria. Objetivo: El objetivo del estudio fue determinar la frecuencia de ITU-IH en los servicios de hospitalización de medicina, así como las características demográficas, factores asociados, gérmenes más frecuentemente aislados y la resistencia antibiótica de los mismos. Materiales y Métodos: Se realizó un estudio de corte transversal durante 48 horas en el Hospital Nacional Cayetano Heredia. Los pacientes con ITU IH: sintomática y bacteriuria asintomática, fueron seleccionados de acuerdo los criterios clínicos y laboratoriales del Centro de Control de Enfermedades (CDC. Resultados: La frecuencia de casos de ITU-IH, sintomática y bacteriurias asintomaticas, fue de 12%. Solo Tuberculosis y de enfermedad nefrourológica estuvieron relacionados en forma independiente a la presencia de ITU-IH. El germen más frecuente fue E. coli seguido de Klebsiella pneumoniae. De las E.coli aisladas fueron resistentes a ciprofloxacina 5/5, ceftriaxona 3/5, amikacina y gentamicina 1/5. Conclusiones: La frecuencia de ITU-IH fue 12%. Las cepas de E. coli aisladas mostraron resistencia alta para antibióticos de primera línea como ciprofloxacina y ceftriaxona, sin embargo alta sensibilidad para aminoglicosidos.

Comparative effectiveness of flomoxef versus carbapenems in the treatment of bacteraemia due to extended-spectrum β-lactamase-producing Escherichia coli or Klebsiella pneumoniae with emphasis on minimum inhibitory concentration of flomoxef: a retrospective study.

Science.gov (United States)

Lee, Chen-Hsiang; Su, Lin-Hui; Chen, Fang-Ju; Tang, Ya-Feng; Li, Chia-Chin; Chien, Chun-Chih; Liu, Jien-Wei

2015-12-01

This study compared treatment outcomes of adult patients with bacteraemia due to extended-spectrum β-lactamase-producing Escherichia coli or Klebsiella pneumoniae (ESBL-EK) receiving flomoxef versus those receiving a carbapenem as definitive therapy. In propensity score matching (PSM) analysis, case patients receiving flomoxef shown to be active in vitro against ESBL-EK were matched with controls who received a carbapenem. The primary endpoint was 30-day crude mortality. The flomoxef group had statistically significantly higher sepsis-related mortality (27.3% vs. 10.5%) and 30-day mortality (28.8% vs. 12.8%) than the carbapenem group. Of the bacteraemic episodes caused by isolates with a MICflomoxef of ≤1 mg/L, sepsis-related mortality rates were similar between the two treatment groups (8.7% vs. 6.4%; P=0.73). The sepsis-related mortality rate of the flomoxef group increased to 29.6% and 50.0% of episodes caused by isolates with a MICflomoxef of 2-4 mg/L and 8 mg/L, respectively, which was significantly higher than the carbapenem group (12.3%). In the PSM analysis of 86 case-control pairs infected with strains with a MICflomoxef of 2-8 mg/L, case patients had a significantly higher 30-day mortality rate (38.4% vs. 18.6%). Multivariate regression analysis revealed that flomoxef therapy for isolates with a MICflomoxef of 2-8 mg/L, concurrent pneumonia or urosepsis, and a Pitt bacteraemia score ≥4 were independently associated with 30-day mortality. Definitive flomoxef therapy appears to be inferior to carbapenems in treating ESBL-EK bacteraemia, particularly for isolates with a MICflomoxef of 2-8 mg/L, even though the currently suggested MIC breakpoint of flomoxef is ≤8 mg/L. Copyright © 2015 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

Changing the epidemiology of carbapenem-resistant Pseudomonas aeruginosa in a Brazilian teaching hospital: the replacement of São Paulo metallo-β-lactamase-producing isolates

Directory of Open Access Journals (Sweden)

Felipe Lira de Sá Cavalcanti

2012-05-01

Full Text Available In Brazil, carbapenem-resistant Pseudomonas aeruginosa isolates are closely related to the São Paulo metallo-β-lactamase (SPM Brazilian clone. In this study, imipenem-resistant isolates were divided in two sets, 2002/2003 and 2008/2009, analysed by pulsed field gel electrophoresis and tested for the Ambler class B metallo-β-lactamase (MBL genes blaSPM-1, blaIMP and blaVIM. The results show a prevalence of one clone related to the SPM Brazilian clone in 2002/2003. In 2008/2009, P. aeruginosa isolates were mostly MBL negative, genetically diverse and unrelated to those that had been detected earlier. These findings suggest that the resistance to carbapenems by these recent P. aeruginosa isolates was not due to the spread of MBL-positive SPM-related clones, as often observed in Brazilian hospitals.

Molecular epidemiology of bla OXA-23 -producing carbapenem-resistant Acinetobacter baumannii in a single institution over a 65-month period in north China.

Science.gov (United States)

Ning, Nian-Zhi; Liu, Xiong; Bao, Chun-Mei; Chen, Su-Ming; Cui, En-Bo; Zhang, Ju-Ling; Huang, Jie; Chen, Fang-Hong; Li, Tao; Qu, Fen; Wang, Hui

2017-01-05

Carbapenem-resistant Acinetobacter baumannii poses a significant threat to hospitalized patients, as few therapeutic options remain. Thus, we investigated the molecular epidemiology and mechanism of resistance of carbapenem-resistant A.baumannii isolates in Beijing, China. Carbapenem-resistant A.baumannii isolates (n = 101) obtained between June 2009 and November 2014 were used. Multilocus sequence typing (MLST) and PCR assays for class C and D β-lactamase were performed on all isolates. S1 nuclease pulsed-field gel electrophoresis (PFGE) and Southern blot hybridization were performed to identify the resistance gene location. All 101 A.baumannii isolates were highly resistant to frequently used antimicrobials, and were considered multidrug resistant. A total of 12 sequence types (STs) were identified, including 10 reported STs and 2 novel STs. Eighty-seven isolates were classified to clonal complex 92 (CC92), among which ST191 and ST195 were the most common STs. The bla OXA-23 gene was positive in most (n = 95) of the A.baumannii isolates. Using S1-nuclease digestion PFGE and Southern blot hybridization, 3 patterns of plasmids carrying bla OXA-23 were confirmed. ST191 and ST195 (both harboring bla OXA-23 ) caused outbreaks during the study period, and this is the first report of outbreaks caused by ST191 and ST195 in north China. bla OXA-23 -producing A.baumannii ST191 and ST 195 isolates can disseminate in a hospital and are potential nosocomial outbreak strains. Surveillance of imipenem-resistant A.baumannii and antimicrobial stewardship should be strengthened.

Evaluation of meat, fruit and vegetables from retail stores in five United Kingdom regions as sources of extended-spectrum beta-lactamase (ESBL)-producing and carbapenem-resistant Escherichia coli.

Science.gov (United States)

Randall, L P; Lodge, M P; Elviss, N C; Lemma, F L; Hopkins, K L; Teale, C J; Woodford, N

2017-01-16

We determined the prevalence and types of extended-spectrum β-lactamase (ESBL)-producing and carbapenem-resistant Escherichia coli in raw retail beef, chicken, pork, fruit and vegetables in five UK regions in 2013-14. Raw meat (n=397), and fruit and vegetable samples (n=400) were purchased from retail stores in London, East Anglia, North West England, Scotland and Wales. Samples were tested for the presence of ESBL-producing E. coli by plating enriched samples on CHROMagar CTX and CHROMagar ESBL, for AmpC-type E. coli by plating on "CHROMagar FOX" (CHROMagar ECC+16mg/L cefoxitin), and for carbapenem-resistant E. coli by plating on CHROMagar KPC. Additionally, pre-enrichment counts were performed on the above agars, and on CHROMagar ECC. Isolates of interest were characterised by MALDI-ToF to confirm identification, by PCR for bla CIT, bla CTX-M, bla OXA , bla SHV and bla TEM genes; ESBL or bla CIT genes were sequenced. Only 1.9% and 2.5% of beef and pork samples, respectively were positive for ESBL-producing E. coli after enrichment compared with 65.4% of chicken samples. 85.6% positive samples from chicken meat carried bla CTX-M-1 ; bla CTX-M-15 was not detected. None of the fruits or vegetables yielded ESBL-producing E. coli and none of the meat, fruit or vegetable samples yielded carbapenem-resistant E. coli. Retail chicken was more frequently a source of ESBL-producing E. coli than were beef, pork, fruit or vegetables. None of the foodstuffs yielded E. coli with CTX-M-15 ESBL, which dominates in human clinical isolates in the UK, and none yielded carbapenem-resistant E. coli. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

Arquitectura hospitalaria

OpenAIRE

Insua Cabanas, Mercedes

2011-01-01

[Resumen] Estudio análisis e investigación de los hospitales de pabellones aislados gallegos, su evolución y comparación con la missma tipología en Europa y en España, así como su estudio pormenorizado.

Nuevas aplicaciones de polisacáridos de bacterias lácticas: geles de kefiran y su aplicación como vehículo de microorganismos probióticos

OpenAIRE

Zavala, Lucía

2015-01-01

Teniendo en cuenta la capacidad del polisacárido kefiran de formar geles, se pretende profundizar el conocimiento del comportamiento de este polisacárido en sistemas complejos y utilizar los mismos como vehículo de sustancias bioactivas o microorganismos. Se han propuesto los siguientes objetivos específicos: A. Seleccionar microorganismos aislados de kefir con potencialidad probiótica. B. Utilizar los geles de kefiran como vehículos para la inclusión de componen...

EVALUACIÓN DEL ANTAGONISMO Y MULTIPLICACIÓN DE Trichoderma sp. EN SUSTRATO DE PLÁTANO EN MEDIO LÍQUIDO ESTÁTICO

Directory of Open Access Journals (Sweden)

Elkin Agamez Ramos

2009-09-01

Full Text Available Se evaluó la capacidad antagónica de nueve aislados del hongo Trichoderma sp. proveniente de la colección de cepas del Laboratorio de Fitopatología de la Universidad de Córdoba, Colombia y su producción de esporas en medios de cultivo líquido estático, a través de pruebas in vitro de antagonismo, utilizando dos hongos fitopatógenos: Fusarium sp. y Rhizoctonia sp.; esta prueba permitió seleccionar el aislado con la mayor actividad antagónica, para así ajustar la producción de esporas mediante un proceso de fermentación en estado líquido en condición estática mediante procesos de buferización y sin buferización con fosfato 0,2N, utilizándose como sustrato principal harina de plátano (HP 5%, además de complementos nutricionales que constituyeron los tratamientos: HPM (solución de melaza 5%, HPL (solución de levadura granulada al 2%, HPU (solución de urea 0,1%, y como testigo PGL (papa glucosa líquida. En los ensayos de antagonismo se seleccionó el aislado C2 de Trichoderma sp. por presentar la mayor capacidad antagónica frente al hongo Fusarium sp., con un porcentaje de inhibición del 78,30% y reportando un índice 4 de antagonismo, en los procesos de producción de esporas el tratamiento HPL (harina de plátano más levadura sin buffer se destacó por su favorable producción de conidias, con una concentración de 1,1 x 109 conidias/mL. Los procesos de buferización se diferenciaron significativamente, demostrando que la variable buffer influyó en la producción de conidias, los medios que se amortiguaron mostraron una producción de 1,01 x 109 conidias/mL, con respecto a los que no se amortiguaron 6,3 x 108 conidias/mL.

Community-acquired carbapenem-resistant Acinetobacter baumannii urinary tract infection just after marriage in a renal transplant recipient.

Science.gov (United States)

Solak, Y; Atalay, H; Turkmen, K; Biyik, Z; Genc, N; Yeksan, M

2011-12-01

Urinary tract infection (UTI) is common in renal transplant recipients and may worsen allograft and patient survival. Many risk factors such as age, female gender, immunosuppression, comorbidity, deceased-donor kidney transplantation, and uretheral catheterization are involved in development of UTI. Acinetobacter baumannii has rarely been reported as a causative agent for development of UTI. Here, we present an unusual case of a renal transplant recipient who developed community-acquired carbapenem-resistent A. baumannii UTI. © 2011 John Wiley & Sons A/S.

Los hallazgos de armas en los campamentos romanos alrededor de Numancia

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Luik, Martin

2010-12-01

Full Text Available This paper provides an overview of the finds of arms and armour from the Roman camps around Numantia, i.e. the circumvallation surrounding the oppidum of Renieblas. Virtually all of the material presented was recovered during the 1906-1912 excavations led by Adolf Schulten. Since the conclusion of these research campaigns, there have only been isolated surface finds. The entire corpus of finds was drawn and - in part - photographed. The material was furher analysed and published as a monograph (Luik 2002. A particularly interesting result of this analysis is that there are relatively few defensive items such as body-armour or shield bosses. Offensive weaponry, and ranged weapons in particular, on the other hand, are frequent and include spearheads, socketed as well as tanged pila and various types of arrow and bolt heads. Interestingly, there are few swords or daggers, and little associated equipment parts. All in all, the presented fi nds provide a unique insight into the equipment and arms of the Roman Army during the Late Republic. At the same time, the corpus of material discussed and presented provides new information regarding the internal structure of the Roman Army at the time.

Este artículo pretende ofrecer un panorama general de los hallazgos de armas en los campamentos romanos alrededor de Numancia (línea de circunvalación en torno al oppidum, Renieblas. Los descubrimientos proceden casi en su totalidad de las excavaciones que se realizaron en los años 1906 a 1912 bajo la dirección de Adolf Schulten. Desde entonces, sólo hay que sumar algunos hallazgos aislados. La totalidad de los objetos ha sido documentada y sometida a un nuevo estudio científico y, finalmente, se presentó en forma de monografía en el año 2002 (Luik, 2002 con resumen español: 173-sq. En general, llama la atención la reducida proporción de armas defensivas (corazas de discos, cotas de malla, umbo de escudos. Por el contrario, las armas

New chiral phosphinephosphinite ligands: Application to stereoselective synthesis of a key intermediate of 1{beta}-methyl carbapenems by Rh(I)-catalyzed asymmetric hydroformylation

Energy Technology Data Exchange (ETDEWEB)

Saito, Takao; Yoshida, Akifumi; Matsumura, Kazuhiko [Takasago International Corp., Kanagawa (Japan)] [and others

1995-12-31

Transition metal catalyzed asymmetric hydroformylation is an attractive and highly useful homologation process for organic synthesis. Recently, the authors reported that the Rh(I) complexes of phosphinephosphite BINAPHOS are highly efficient catalysts for enantioselective hydroformylation of a variety of olefins. This time, the authors have designed and synthesized new chiral phosphinephosphinite ligands having binaphthyl backbone, (R)-2-diarylphosphino-2{prime}-diarylphosphinoxy-1,1{prime}-binaphthy1 (hereafter abbreviated (R)-BIPNITE). The Rh(I) complexes of these ligands are effective catalysts for the asymmetric hydroformylation of 4-vinylazetidin-2-one to give the corresponding oxo-aldehyde 3{beta} as the major product in very high diastereoselectivities and in good regioselectivities. Interestingly, modifications of the aryl substituents in phosphine and phosphinite moieties afforded higher selectivities. Aldehyde 3{beta} was easily oxidized with NaClO{sub 2} to 4, a key intermediate of 1{beta}-methyl carbapenems. Thus, the present method provides a new practical route to a versatile key intermediate for the synthesis of carbapenem antibiotics.

Germinación simbiótica y asimbiótica en semillas de orquídeas epifitas

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Joel Tupac Otero Ospina

2009-10-01

Full Text Available Se compara el crecimiento de plántulas de la orquídeas epifita Tolumnia variegata en medios de agar con y sin hongos micorrízicos. Los métodos de germinación simbiótica produjeron embriones de T. variegata más desarrollados que los métodos de germinación asimbiótica y las diferencias fueron estadísticamente significativas. Las semillas en los controles en medio de celulosa sin hongos micorrízicos no germinaron. Las semillas de Epidendrum ramosum, Lepanthes rupestris y Psychilis monensis no mostraron diferencias significativas en germinación entre métodos simbiótica y asimbiótica utilizando hongos aislados de raíces de T. variegata, incluso algunos aislados del grupo Rhizoctonia parasitaron las semillas. Los resultados sugieren que las semillas de orquídeas epifitas y sus hongos micorrízicos son más específicos de lo que anteriormente se había creído y por tanto es necesario utilizar los hongos específicos para cada especie de orquídea. Además, se sugiere que los cultivadores de orquídeas podrían obtener mejores resultados en la propagación de orquídeas epifitas si utilizan metodologías de germinación simbiótica apropiados.

Germinación simbiótica y asimbiótica en semillas de orquídeas epifitas

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Bayman Paul

2009-12-01

Full Text Available Se compara el crecimiento de plántulas de la orquídeas epifita Tolumnia variegata en medios de agar con y sin hongos micorrízicos. Los métodos de germinación simbiótica produjeron embriones de T. variegata más desarrollados que los métodos de germinación asimbiótica y las diferencias fueron estadísticamente significativas. Las semillas en los controles en medio de celulosa sin hongos micorrízicos no germinaron. Las semillas de Epidendrum ramosum, Lepanthes rupestris y Psychilis monensis no mostraron diferencias significativas en germinación entre métodos simbiótica y asimbiótica utilizando hongos aislados de raíces de T. variegata, incluso algunos aislados del grupo Rhizoctonia parasitaron las semillas. Los resultados sugieren que las semillas de orquídeas epifitas y sus hongos micorrízicos son más específicos de lo que anteriormente se había creído y por tanto es necesario utilizar los hongos específicos para cada especie de orquídea. Además, se sugiere que los cultivadores de orquídeas podrían obtener mejores resultados en la propagación de orquídeas epifitas si utilizan metodologías de germinación simbiótica apropiados.

New Delhi Metallo-Β-Lactamase-Producing Carbapenem-Resistant Enterobacteriacae Isolated From Bronchial Washings.

LENUS (Irish Health Repository)

Cullivan, S

2017-11-01

The prevalence of Carbapenem resistance among Enterobacteriacae species is increasing and poses a potential major public health risk. In recent years, several new carbapenemases have been identified, including New Delhi metallo-β-lactamase (NDM). A 78-year-old non-smoking female with prior medical history of type 2 diabetes mellitus, gastroesophageal reflux disease (GERD) and prior coronary artery bypass grafting was referred to our respiratory outpatient service for evaluation of a chronic cough and dyspnoea in 2013. Clinical examination revealed bibasal pulmonary crepitations but was otherwise unremarkable. Computed tomography of the chest demonstrated atelectasis of the lingula and right middle lobe. She underwent bronchoscopy, which demonstrated laryngeal mucosa inflammation, consistent with her GERD. There was no growth on bacterial, fungal or mycobacterial bronchial washings cultures.

Algunos elementos para interpretar la presencia de los varones en los procesos de salud reproductiva Some elements for interpreting men's presence in reproductive health processes

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Juan Guillermo Figueroa-Perea

1998-01-01

Full Text Available El objetivo del trabajo es identificar vertientes analíticas para ubicar a los varones en los procesos de salud reproductiva. Se propone cuestionar la interpretación que los identifica solamente como actores que pueden apoyar mejorías en la salud de las mujeres y de los hijos. Es reciente la inquietud por redimensionar su papel, como seres que se reproducen y enfrentan riesgos en su aparato, comportamiento y proceso reproductivos. Una posibilidad para explicitar la presencia de los varones en dichos procesos es identificar cuáles son sus ausencias y presencias que condicionan las consecuencias favorables o no para las mujeres y los hijos. Se trata de ver de qué manera dificultan o contribuyen a mejorar las condiciones de la morbimortalidad materna. Una segunda posibilidad es incursionar en el carácter relacional, social y potencialmente conflictivo de la reproducción "sexualizada". Implica replantear el análisis de la reproducción como un proceso relacional y no como eventos aislados de hombres y mujeres, al mismo tiempo que recuperar la especificidad de unos y de otras. Se utiliza la perspectiva de género con el fin de imaginar los procesos sin negar la dimensión del poder. Así, se replantean la sexualidad, la reproducción y la salud en términos de interacción, con el fin de construir referencias más claras respecto a la población masculina.This study aims to identify analytical approaches to situate men in processes pertaining to reproductive health. We challenge the position that identifies them only as actors that can support improvements in the health of women and children. More recently there has been a concern over reshaping their role, as individuals who both reproduce and face risks to their reproductive organs, behaviors, and processes. One possibility for explaining men's presence in such processes is to identify their absence or presence as conditioning the consequences for women and children. The issue is to

Multicenter Clinical and Molecular Epidemiological Analysis of Bacteremia Due to Carbapenem-Resistant Enterobacteriaceae (CRE) in the CRE Epicenter of the United States

Science.gov (United States)

Chen, Liang; Patel, Gopi; Gomez-Simmonds, Angela; Weston, Gregory; Kim, Angela C.; Seo, Susan K.; Rosenthal, Marnie E.; Sperber, Steven J.; Jenkins, Stephen G.; Hamula, Camille L.; Uhlemann, Anne-Catrin; Levi, Michael H.; Fries, Bettina C.; Juretschko, Stefan; Rojtman, Albert D.; Hong, Tao; Mathema, Barun; Jacobs, Michael R.; Walsh, Thomas J.; Bonomo, Robert A.; Kreiswirth, Barry N.

2017-01-01

ABSTRACT Although the New York/New Jersey (NY/NJ) area is an epicenter for carbapenem-resistant Enterobacteriaceae (CRE), there are few multicenter studies of CRE from this region. We characterized patients with CRE bacteremia in 2013 at eight NY/NJ medical centers and determined the prevalence of carbapenem resistance among Enterobacteriaceae bloodstream isolates and CRE resistance mechanisms, genetic backgrounds, capsular types (cps), and antimicrobial susceptibilities. Of 121 patients with CRE bacteremia, 50% had cancer or had undergone transplantation. The prevalences of carbapenem resistance among Klebsiella pneumoniae, Enterobacter spp., and Escherichia coli bacteremias were 9.7%, 2.2%, and 0.1%, respectively. Ninety percent of CRE were K. pneumoniae and 92% produced K. pneumoniae carbapenemase (KPC-3, 48%; KPC-2, 44%). Two CRE produced NDM-1 and OXA-48 carbapenemases. Sequence type 258 (ST258) predominated among KPC-producing K. pneumoniae (KPC-Kp). The wzi154 allele, corresponding to cps-2, was present in 93% of KPC-3-Kp, whereas KPC-2-Kp had greater cps diversity. Ninety-nine percent of CRE were ceftazidime-avibactam (CAZ-AVI)-susceptible, although 42% of KPC-3-Kp had an CAZ-AVI MIC of ≥4/4 μg/ml. There was a median of 47 h from bacteremia onset until active antimicrobial therapy, 38% of patients had septic shock, and 49% died within 30 days. KPC-3-Kp bacteremia (adjusted odds ratio [aOR], 2.58; P = 0.045), cancer (aOR, 3.61, P = 0.01), and bacteremia onset in the intensive care unit (aOR, 3.79; P = 0.03) were independently associated with mortality. Active empirical therapy and combination therapy were not associated with survival. Despite a decade of experience with CRE, patients with CRE bacteremia have protracted delays in appropriate therapies and high mortality rates, highlighting the need for rapid diagnostics and evaluation of new therapeutics. PMID:28167547

Molecular epidemiological survey of the quinolone- and carbapenem-resistant genotype and its association with the type III secretion system in Pseudomonas aeruginosa.

Science.gov (United States)

Ferreira, Melina Lorraine; Dantas, Raquel Cavalcanti; Faria, Ana Luiza Souza; Gonçalves, Iara Rossi; Silveira de Brito, Cristiane; Queiroz, Lícia Ludendorff; Gontijo-Filho, Paulo P; Ribas, Rosineide Marques

2015-03-01

This study evaluated the predictors of mortality and the impact of inappropriate therapy on the outcomes of patients with bacteraemia and ventilator-associated pneumonia (VAP). Additionally, we evaluated the correlation of the type III secretion system (TTSS) effector genotype with resistance to carbapenems and fluoroquinolones, mutations in the quinolone resistance-determining regions (QRDRs), metallo-β-lactamase and virulence factors. A retrospective cohort was conducted at a tertiary hospital in patients with multidrug-resistant (MDR) P. aeruginosa bacteraemia (157 patients) and VAP (60 patients). The genes for blaIMP, blaVIM, blaSIM, blaGIM and blaSPM and virulence genes (exoT, exoS, exoY, exoU, lasB, algD and toxA) were detected; sequencing was conducted for QRDR genes on fluoroquinolone-resistant strains. The multivariate analyses showed that the predictors independently associated with death in patients with bacteraemia were cancer and inappropriate therapy. Carbapenem resistance was more frequent among strains causing VAP (53.3 %), and in blood we observed the blaSPM genotype (66.6 %) and blaVIM genotype (33.3 %). The exoS gene was found in all isolates, whilst the frequency was low for exoU (9.4 %). Substitution of threonine to isoleucine at position 83 in gyrA was the most frequent mutation among fluoroquinolone-resistant strains. Our study showed a mutation at position 91 in the parC gene (Glu91Lys) associated with a mutation in gyrA (Thre83Ile) in a strain of extensively drug-resistant P. aeruginosa, with the exoT(+)exoS(+)exoU(+) genotype, that has not yet been described in Brazil to the best of our knowledge. This comprehensive analysis of resistance mechanisms to carbapenem and fluoroquinolones and their association with TTSS virulence genes, covering MDR P. aeruginosa in Brazil, is the largest reported to date. © 2015 The Authors.

Angioma de iris: a propósito de un caso

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José L. Torres-Peña

2017-07-01

Discusión: Sintomáticamente lo más frecuente en los angiomas de iris es el hifema transitorio como pudo presentar nuestro paciente, aunque también se ha descrito aumentos de la presión intraocular producto de los hifemas de repetición en algún caso aislado. El manejo habitual es la observación aunque algunos casos requieren resección quirúrgica.

Phenotypic Detection of Metallo-Beta-Lactamases in Carbapenem Resistant Acinetobacter baumannii Isolated from Pediatric Patients in Pakistan

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Muneeza Anwar

2016-01-01

Full Text Available Multidrug resistant A. baumannii has emerged as an important and problematic human pathogen as it is the causative agent of several types of infections especially in neonates and immunocompromised patients because they have least capacity to fight against infections. Carbapenems are used as last resort antibiotics for treating these infections but currently resistance against carbapenems due to MBL production is on the rise. The objective of this study was to determine the frequency of antibiotic resistance in A. baumannii and also to compare the efficacy of combined disk test and double disk synergy test for detection of metallo-beta-lactamases. A total of 112 A. baumannii were identified from various clinical samples and antibiotic susceptibility profile was determined by Kirby-Bauer Disk Diffusion method. Out of 112, 66 (58.9% isolates were resistant to both imipenem and meropenem (OXOID. These resistant isolates were tested for carbapenemase production, and 55 (83.3% were carbapenemase producers by Modified Hodge Test. These isolates were further tested for MBL production by combined disk test and double disk synergy test. Out of 66, 49 isolates were positive by both methods, CDT and DDST, and only one isolate was detected as negative (with kappa value = 0.038. All MBL producing strains showed remarkable resistance to cephalosporins, fluoroquinolones, aminoglycosides, and piperacillin/tazobactam (OXOID. The antibiotic resistance was very high in A. baumannii which were isolated from children in Pakistan specially attending a nephrology unit.

Novel Aminoglycoside Resistance Transposons and Transposon-Derived Circular Forms Detected in Carbapenem-Resistant Acinetobacter baumannii Clinical Isolates

Science.gov (United States)

Dwibedi, Chinmay Kumar; Sjöström, Karin; Edquist, Petra; Wai, Sun Nyunt; Uhlin, Bernt Eric

2016-01-01

Acinetobacter baumannii has emerged as an important opportunistic pathogen equipped with a growing number of antibiotic resistance genes. Our study investigated the molecular epidemiology and antibiotic resistance features of 28 consecutive carbapenem-resistant clinical isolates of A. baumannii collected throughout Sweden in 2012 and 2013. The isolates mainly belonged to clonal complexes (CCs) with an extensive international distribution, such as CC2 (n = 16) and CC25 (n = 7). Resistance to carbapenems was related to blaOXA-23 (20 isolates), blaOXA-24/40-like (6 isolates), blaOXA-467 (1 isolate), and ISAba1-blaOXA-69 (1 isolate). Ceftazidime resistance was associated with blaPER-7 in the CC25 isolates. Two classical point mutations were responsible for resistance to quinolones in all the isolates. Isolates with high levels of resistance to aminoglycosides carried the 16S rRNA methylase armA gene. The isolates also carried a variety of genes encoding aminoglycoside-modifying enzymes. Several novel structures involved in aminoglycoside resistance were identified, including Tn6279, ΔTn6279, Ab-ST3-aadB, and different assemblies of Tn6020 and TnaphA6. Importantly, a number of circular forms related to the IS26 or ISAba125 composite transposons were detected. The frequent occurrence of these circular forms in the populations of several isolates indicates a potential role of these circular forms in the dissemination of antibiotic resistance genes. PMID:26824943

Carbapenem susceptibilities and non-susceptibility concordance to different carbapenems amongst clinically important Gram-negative bacteria isolated from intensive care units in Taiwan: results from the Surveillance of Multicentre Antimicrobial Resistance in Taiwan (SMART) in 2009.

Science.gov (United States)

Jean, Shio-Shin; Hsueh, Po-Ren; Lee, Wen-Sen; Yu, Kwok-Woon; Liao, Chun-Hsing; Chang, Feng-Yi; Ko, Wen-Chien; Wu, Jiunn-Jong; Chen, Yen-Hsu; Chen, Yao-Shen; Liu, Jien-Wei; Lu, Min-Chi; Liu, Cheng-Yi; Lam, Carlos; Chen, Ray-Jade

2013-05-01

To investigate the in vitro susceptibilities to various carbapenems amongst clinical Gram-negative bacteria isolated from patients in intensive care units of ten major teaching hospitals in Taiwan in 2009, a survey was conducted to determine the minimum inhibitory concentrations (MICs) of ertapenem, imipenem, meropenem and doripenem against isolates of Enterobacteriaceae (n = 594), Pseudomonas aeruginosa (n = 185), Acinetobacter baumannii (n = 192) and Burkholderia cepacia (n = 23) using the agar dilution method. Susceptibilities were determined according to 2009, 2011 and 2012 MIC breakpoints recommended by the CLSI as well as 2012 MIC breakpoints recommended by EUCAST. Based on CLSI 2012 criteria, the ertapenem susceptible rate was 93%, 81%, 68% and 92% for Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae and Serratia marcescens, respectively. All Proteus mirabilis and Morganella morganii isolates were susceptible to ertapenem; however, 64% of P. mirabilis and all M. morganii isolates were non-susceptible to imipenem. Meropenem and doripenem had better activities than imipenem against ertapenem-non-susceptible Enterobacteriaceae isolates. E. coli, K. pneumoniae and E. cloacae with ertapenem MICs≥4 mg/L were synchronously not susceptible to imipenem, meropenem and doripenem. Imipenem susceptibility was 65% and 29% for P. aeruginosa and A. baumannii, respectively. Additionally, P. aeruginosa and A. baumannii isolates with imipenem MICs≥8 mg/L were also not susceptible to meropenem and doripenem. These data provide a better understanding of choosing appropriate carbapenem agents to treat infections caused by ertapenem-non-susceptible Enterobacteriaceae as well as P. aeruginosa and A. baumannii isolates with imipenem MICs≥4 mg/L. Copyright © 2013 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

Evaluación de la opinión de estudiantes de farmacia sobre la implementación de alternativas basadas en computador para el proceso enseñanza-aprendizaje de la farmacología experimental.

Directory of Open Access Journals (Sweden)

María Cristina González Guevara

2008-01-01

Full Text Available Antecedentes. Actualmente el uso del animal de laboratorio en educación está siendo eliminado a nivel mundial y se buscan otras estrategias que permitan sustituirlo, pues no hay evidencia de que los estudiantes formados con métodos alternativos sean menos calificados. Objetivo. Contrastar la opinión de los estudiantes de farmacología, carrera de Farmacia Universidad Nacional de Colombia, sobre la implementación de un software interactivo en comparación con el montaje de órgano aislado. Material y métodos. Se comparó un recurso pedagógico usando animales en el laboratorio, con otro recurso basado en un software interactivo, para la práctica de “órgano aislado en intestino de roedor” por medio de la aplicación de una encuesta a estudiantes de séptimo semestre. Resultados. La opinión de los estudiantes, en una escala de uno a cinco, es que existen ventajas del montaje de órgano aislado sobre el software interactivo (p menor que 0,05 en cuanto al aporte de información (mediana 5:4 respectivamente, la integración de conocimientos (mediana 5:4 y la interpretación de datos inesperados (mediana 4:3. En cuanto a la claridad de la información obtenida la apreciación de los estudiantes muestra que no existen diferencias entre las dos alternativas (mediana 4. La utilización del animal involucra un costo ético (67% que no se da con el empleo del software (27%. Finalmente es muy alta la aceptación del software interactivo como una ayuda eficaz para el aprendizaje de la farmacología (77% y es notorio el interés de los estudiantes en que éstas alternativas sean implementadas en otras asignaturas (79%. Conclusión. Los estudiantes opinan que, aun cuando pueden perderse algunos componentes de la práctica con la implementación del software interactivo (conocimiento del montaje real, enfrentamiento a las dificultades propias de la experimentación con seres vivos y acercamiento al proceso dinámico de la vida, no hay diferencias

Carbapenems and SHV-1 β-Lactamase Form Different Acyl-Enzyme Populations in Crystals and Solution

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Kalp, Matthew; Carey, Paul R.

2009-01-01

The reactions between single crystals of the SHV-1 β-lactamase enzyme and the carbapenems, meropenem, imipenem and ertapenem, have been studied by Raman microscopy. Aided by quantum mechanical calculations, major populations of two acyl-enzyme species, a labile Δ2-pyrroline and a more tightly bound Δ1-pyrroline, have been identified for all three compounds. These isomers differ only in the position of the double bond about the carbapenem nucleus. This discovery is consonant with X-ray crystallographic findings that also identified two populations for meropenem bound in SHV-1: one with the acyl C=O group in the oxyanion hole and the second with the acyl group rotated 180 degrees compared to its expected position [Nukaga, M., Bethel, C. R., Thomson, J. M., Hujer, A. M., Distler, A. M., Anderson, V. E., Knox, J. R., and Bonomo, R. A. (2008) Journal of the American Chemical Society]. When crystals of the Δ1 and Δ2 containing acyl-enzymes were exposed to solutions with no carbapenem, rapid deacylation of the Δ2 species was observed by kinetic Raman experiments. However, no change in the Δ1 population was observed over 1 hour, the effective lifetime of the crystal. These observations lead to the hypothesis that the stable Δ1 species is due to the form seen by X-ray with the acyl carbonyl outside the oxyanion hole, while the Δ2 species corresponds to the form with the carbonyl inside the oxyanion hole. Soak-in and soak-out Raman experiments also demonstrated that tautomeric exchange between the Δ1 and Δ2 forms does not occur on the crystalline enzyme. When meropenem or ertapenem were reacted with SHV-1 in solution, the Raman difference spectra demonstrated that only a major population corresponding to the Δ1 acyl-enzyme could be detected. The 1003 cm-1 mode of the phenyl ring positioned on the C3 side chain of ertapenem acts as an effective internal Raman intensity standard and the ratio of its intensity to that of the 1600 cm-1 feature of Δ1 provides an

Arbuscular mycorrhizal fungi and Zn accumulation in the metallophytic plant Viola calaminaria (Gingins. Lej.

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O. Fernández-Fernández

2008-01-01

Full Text Available Los hongos micorrízico arbusculares (HMA incrementan la tolerancia a metales en la mayoría de sus plantas hospederas, sin embargo, se conoce poco de su efecto en plantas metalófitas. Los objetivos de esta investigación fueron: 1 determinar la respuesta a la inoculación con dos HMA de Viola calaminaria (Gingins. Lej., una planta endémica de suelos contaminados con metales pesados, y 2 investigar el efecto de la inoculación con HMA en la acumulación de zinc. Se establecieron dos experimentos: El primero duró tres meses y consistió en la inoculación de plantas de V. calaminaria con dos HMA utilizando arena de río como sustrato de crecimiento. El segundo experimento duró dos semanas y consideró el efecto de la inoculación de las plantas procedentes del primer experimento y que se transfirieron a condiciones de hidroponia con diferentes niveles de Zn+2 (50, 200, 300 y 400 mg.litro-1. Los HMA que se estudiaron fueron dos aislados de Glomus mosseae (Nicol. & Gerd. Gerd. & Trappe: BEG-132- y BEG-25, los cuales se aislaron, respectivamente, de suelos contaminados o no con metales pesados. El experimento 1 mostró que las raíces de V. calaminaria se colonizaron por ambos aislados micorrízicos; sin embargo las plantas no presentaron beneficios en relación a crecimiento, desarrollo y nutrición. El segundo experimento mostró que la inoculación incrementó el contenido total de Zn por planta y que el aislado BEG 25 fue el que mayor influencia tuvo. La colonización micorrízica en las raíces de V. calaminaria no se afectó por las concentraciones de Zn. Resulta relevante continuar experimentos de este tipo para conocer si los HMA adaptados a altos contenidos de metales pesados confieren ventajas sobre crecimiento y supervivencia en campo en estas y otras plantas metalíferas.

Performance evaluation of three automated identification systems in detecting carbapenem-resistant Enterobacteriaceae.

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He, Qingwen; Chen, Weiyuan; Huang, Liya; Lin, Qili; Zhang, Jingling; Liu, Rui; Li, Bin

2016-06-21

Carbapenem-resistant Enterobacteriaceae (CRE) is prevalent around the world. Rapid and accurate detection of CRE is urgently needed to provide effective treatment. Automated identification systems have been widely used in clinical microbiology laboratories for rapid and high-efficient identification of pathogenic bacteria. However, critical evaluation and comparison are needed to determine the specificity and accuracy of different systems. The aim of this study was to evaluate the performance of three commonly used automated identification systems on the detection of CRE. A total of 81 non-repetitive clinical CRE isolates were collected from August 2011 to August 2012 in a Chinese university hospital, and all the isolates were confirmed to be resistant to carbapenems by the agar dilution method. The potential presence of carbapenemase genotypes of the 81 isolates was detected by PCR and sequencing. Using 81 clinical CRE isolates, we evaluated and compared the performance of three automated identification systems, MicroScan WalkAway 96 Plus, Phoenix 100, and Vitek 2 Compact, which are commonly used in China. To identify CRE, the comparator methodology was agar dilution method, while the PCR and sequencing was the comparator one to identify CPE. PCR and sequencing analysis showed that 48 of the 81 CRE isolates carried carbapenemase genes, including 23 (28.4 %) IMP-4, 14 (17.3 %) IMP-8, 5 (6.2 %) NDM-1, and 8 (9.9 %) KPC-2. Notably, one Klebsiella pneumoniae isolate produced both IMP-4 and NDM-1. One Klebsiella oxytoca isolate produced both KPC-2 and IMP-8. Of the 81 clinical CRE isolates, 56 (69.1 %), 33 (40.7 %) and 77 (95.1 %) were identified as CRE by MicroScan WalkAway 96 Plus, Phoenix 100, and Vitek 2 Compact, respectively. The sensitivities/specificities of MicroScan WalkAway, Phoenix 100 and Vitek 2 were 93.8/42.4 %, 54.2/66.7 %, and 75.0/36.4 %, respectively. The MicroScan WalkAway and Viteck2 systems are more reliable in clinical identification of

Un modelo de ti basado en la arquitectura empresarial para la gestión administrativa de una universidad pública

OpenAIRE

Alfaro Bernedo, Juan Oswaldo; Alfaro Bernedo, Juan Oswaldo

2004-01-01

Cada vez son más complejos los escenarios en los que las organizaciones se desenvuelven, demandando mayor capacidad de gestión para alcanzar o mantener adecuados niveles de competitividad. Al respecto, son evidentes los avances científicos y tecnológicos orientados a la generación de nuevos conocimientos, herramientas de gestión y herramientas tecnológicas; Sin embargo, tales esfuerzos no están articulados de manera sistémica, logrando en consecuencia, resultados aislados y, en muchos casos, ...

Sepsis y muertes neonatales asociadas a estreptococo β hemolítico en caninos

OpenAIRE

Guerrero López, Ana Elizabeth

2016-01-01

Los porcentajes de mortalidad neonatal en caninos oscilan entre en el 5 y 35% siendo causales de importantes pérdidas económicas en los criaderos. Las enfermedades infecciosas bacterianas son la segunda causa de muertes neonatales caninas después de los problemas de manejo. Las bacterias implicadas pueden habitar en la vagina de la perra. El estreptococo β hemolítico es frecuentemente aislado de las vaginas de perras. En humanos, el estreptococo β hemolítico causa muertes neonatales infectánd...

The stationary phase sigma factor, RpoS, regulates the production of a carbapenem antibiotic, a bioactive prodigiosin and virulence in the enterobacterial pathogen Serratia sp. ATCC 39006.

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Wilf, Nabil M; Salmond, George P C

2012-03-01

Serratia sp. ATCC 39006 (S39006) is a Gram-negative bacterium that is virulent in plant (potato) and invertebrate animal (Caenorhabditis elegans) models. It produces two secondary metabolite antibiotics, a prodigiosin and a carbapenem, and the exoenzymes pectate lyase and cellulase. We showed previously that deletion of the RNA chaperone Hfq abolished antibiotic production and attenuated virulence in both animal and plant hosts. Hfq and dependent small RNAs (sRNAs) are known to regulate the post-transcriptional expression of rpoS, which encodes σ(S), the stationary phase sigma factor subunit of RNA polymerase. An S39006 hfq deletion mutant showed decreased transcript levels of rpoS. Therefore, in this study we investigated whether the phenotypes regulated by Hfq were mediated through its control of rpoS. Whereas loss of Hfq abolished prodigiosin and carbapenem production and attenuated virulence in both C. elegans and potato, characterization of an S39006 rpoS mutant showed unexpectedly elevated prodigiosin and carbapenem production. Furthermore, the rpoS mutant exhibited attenuated animal pathogenesis, but not plant pathogenesis. Additionally, a homologue of the Hfq-dependent sRNA, RprA, was identified and shown to regulate prodigiosin production in a manner consistent with its role in positively regulating translation of rpoS mRNA. Combined, these results demonstrate that Hfq regulation of secondary metabolism and plant pathogenesis is independent of RpoS and establishes RpoS and RprA as regulators of antibiotic production.

The Carbapenem Inactivation Method (CIM), a Simple and Low-Cost Alternative for the Carba NP Test to Assess Phenotypic Carbapenemase Activity in Gram-Negative Rods

NARCIS (Netherlands)

Zwaluw, K. van der; Haan, A. de; Pluister, G.N.; Bootsma, H.J.; Neeling, A.J. de; Schouls, L.M.

2015-01-01

A new phenotypic test, called the Carbapenem Inactivation Method (CIM), was developed to detect carbapenemase activity in Gram-negative rods within eight hours. This method showed high concordance with results obtained by PCR to detect genes coding for the carbapenemases KPC, NDM, OXA-48, VIM, IMP

In vitro activity of tigecycline and comparators against carbapenem-resistant Enterobacteriaceae in Africa-Middle East countries: TEST 2007-2012.

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Renteria, M I; Biedenbach, D J; Bouchillon, S K; Hoban, D J; Raghubir, N; Sajben, P

2014-09-01

Multidrug-resistant (MDR) Enterobacteriaceae are an emerging concern for healthcare providers. Infections caused by MDR pathogens are associated with increased costs, length of hospital stay, and morbidity and mortality rates. Carbapenem-resistant Enterobacteriaceae (CRE) continue to increase, and infections with these organisms are observed worldwide not only as hospital-acquired infections but also as community-acquired infections. Increasing antimicrobial resistance dictates the need for continued surveillance studies of common and MDR pathogens. The Tigecycline Evaluation Surveillance Trial (TEST) examined the susceptibility of pathogens isolated in Africa and the Middle East from 2007 to 2012. A total of 4155 Enterobacteriaceae isolates were evaluated to determine the in vitro activity and changes in resistance patterns for tigecycline and comparators. Carbapenem resistance was found in 191 (4.6%) of the isolates tested. Klebsiella pneumoniae was the most common CRE (64.9%), followed by Enterobacter cloacae (14.1%) and Escherichia coli (9.9%). Tigecycline MIC 90 values (minimum inhibitory concentration required to inhibit 90% of the isolates) were 2μg/mL against all of these enteric species, with susceptibility rates of 96.8%, 92.6% and 100%, respectively. Tigecycline had in vitro activity against CRE, with a 95.3% susceptibility rate. Copyright © 2014 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.

Aminoglycoside Concentrations Required for Synergy with Carbapenems against Pseudomonas aeruginosa Determined via Mechanistic Studies and Modeling.

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Yadav, Rajbharan; Bulitta, Jürgen B; Schneider, Elena K; Shin, Beom Soo; Velkov, Tony; Nation, Roger L; Landersdorfer, Cornelia B

2017-12-01

This study aimed to systematically identify the aminoglycoside concentrations required for synergy with a carbapenem and characterize the permeabilizing effect of aminoglycosides on the outer membrane of Pseudomonas aeruginosa Monotherapies and combinations of four aminoglycosides and three carbapenems were studied for activity against P. aeruginosa strain AH298-GFP in 48-h static-concentration time-kill studies (SCTK) (inoculum: 10 7.6 CFU/ml). The outer membrane-permeabilizing effect of tobramycin alone and in combination with imipenem was characterized via electron microscopy, confocal imaging, and the nitrocefin assay. A mechanism-based model (MBM) was developed to simultaneously describe the time course of bacterial killing and prevention of regrowth by imipenem combined with each of the four aminoglycosides. Notably, 0.25 mg/liter of tobramycin, which was inactive in monotherapy, achieved synergy (i.e., ≥2-log 10 more killing than the most active monotherapy at 24 h) combined with imipenem. Electron micrographs, confocal image analyses, and the nitrocefin uptake data showed distinct outer membrane damage by tobramycin, which was more extensive for the combination with imipenem. The MBM indicated that aminoglycosides enhanced the imipenem target site concentration up to 4.27-fold. Tobramycin was the most potent aminoglycoside to permeabilize the outer membrane; tobramycin (0.216 mg/liter), gentamicin (0.739 mg/liter), amikacin (1.70 mg/liter), or streptomycin (5.19 mg/liter) was required for half-maximal permeabilization. In summary, our SCTK, mechanistic studies and MBM indicated that tobramycin was highly synergistic and displayed the maximum outer membrane disruption potential among the tested aminoglycosides. These findings support the optimization of highly promising antibiotic combination dosage regimens for critically ill patients. Copyright © 2017 American Society for Microbiology.

Screening for synergistic activity of antimicrobial combinations against carbapenem-resistant Enterobacteriaceae using inkjet printer-based technology.

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Brennan-Krohn, Thea; Truelson, Katherine A; Smith, Kenneth P; Kirby, James E

2017-10-01

Synergistic combination antimicrobial therapy may provide new options for treatment of MDR infections. However, comprehensive in vitro synergy data are limited and facile methods to perform synergy testing in a clinically actionable time frame are unavailable. To systematically investigate a broad range of antibiotic combinations for evidence of synergistic activity against a collection of carbapenem-resistant Enterobacteriaceae (CRE) isolates. We made use of an automated method for chequerboard array synergy testing based on inkjet printer technology in the HP D300 digital dispenser to test 56 pairwise antimicrobial combinations of meropenem, aztreonam, cefepime, colistin, gentamicin, levofloxacin, chloramphenicol, fosfomycin, trimethoprim/sulfamethoxazole, minocycline and rifampicin, as well as the double carbapenem combination of meropenem and ertapenem. In a screening procedure, we tested these combinations against four CRE strains and identified nine antibiotic combinations that showed potential clinically relevant synergy. In confirmatory testing using 10 CRE strains, six combinations demonstrated clinically relevant synergy with both antimicrobials at the minimum fractional inhibitory concentration (FICI-MIN) in the susceptible or intermediate range in at least one trial. These included two novel combinations: minocycline plus colistin and minocycline plus meropenem. In 80% of strains at least one combination demonstrated clinically relevant synergy, but the combinations that demonstrated synergy varied from strain to strain. This work establishes the foundation for future systematic, broad-range investigations into antibiotic synergy for CRE, emphasizes the need for individualized synergy testing and demonstrates the utility of inkjet printer-based technology for the performance of automated antimicrobial synergy assays. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights

Treatment Options for Infections Caused by Carbapenem-resistant Enterobacteriaceae: Can We Apply “Precision Medicine” to Antimicrobial Chemotherapy?

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Perez, Federico; El Chakhtoura, Nadim G.; Papp-Wallace, Krisztina; Wilson, Brigid M; Bonomo, Robert A.

2016-01-01

Introduction For the past three decades, carbapenems played a central role in our antibiotic armamentarium, trusted to effectively treat infections caused by drug-resistant bacteria. The utility of this class of antibiotics has been compromised by the emergence of resistance especially among Enterobacteriaceae. Areas covered We review the current mainstays of pharmacotherapy against infections caused by carbapenem-resistant Enterobacteriaceae (CRE) including tigecycline, aminoglycosides, and rediscovered 'old' antibiotics such as fosfomycin and polymyxins, and discuss their efficacy and potential toxicity. We also summarize the clinical experience treating CRE infections with antibiotic combination therapy. Finally, we review ceftazidime/avibactam and imipenem/relebactam, a new generation of beta-lactamase inhibitors, which may offer alternatives to treat CRE infections. We critically evaluate the published literature, identify relevant clinical trials and review documents submitted to the United States Food and Drug Administration. Expert Opinion It is essential to define the molecular mechanisms of resistance and to apply insights about pharmacodynamic and pharmacokinetic properties of antibiotics, in order to maximize the impact of old and new therapeutic approaches against infections caused by CRE. A concerted effort is needed to carry out high-quality clinical trials that: i) establish the superiority of combination therapy vs. monotherapy; ii) confirm the role of novel beta-lactam/beta-lactamase inhibitor combinations as therapy against KPC- and OXA-48 producing Enterobacteriaceae; and, iii) evaluate new antibiotics active against CRE as they are introduced into the clinic. PMID:26799840

Outbreak of carbapenem-resistant Klebsiella pneumoniae: two-year epidemiologic follow-up in a tertiary hospital

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Graziella Hanna Pereira

2013-02-01

Full Text Available This study describes a carbapenem-resistant Klebsiella pneumoniae (CRKP outbreak that occurred from October 2008-December 2010. Polymerase chain reaction assays were performed to detect the blaKPC gene and molecular typing was performed using pulsed-field gel electrophoresis (PFGE. There were 33 CRKP infections; PFGE revealed five genotypes: genotype A in five (15%, B in 18 (55%, C in eight (24% and two unique profiles. Genotype B was disseminated in all hospital units and belonged to the same clone identified in 11 different hospitals in the state of São Paulo. Sixteen (48% patients died. Seven isolates (21% were resistant to polymyxin B and 45% were resistant to tigecycline and amikacin.

In Vitro Activity of the Siderophore Cephalosporin, Cefiderocol, against Carbapenem-Nonsusceptible and Multidrug-Resistant Isolates of Gram-Negative Bacilli Collected Worldwide in 2014 to 2016.

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Hackel, Meredith A; Tsuji, Masakatsu; Yamano, Yoshinori; Echols, Roger; Karlowsky, James A; Sahm, Daniel F

2018-02-01

The in vitro activity of the investigational siderophore cephalosporin, cefiderocol (formerly S-649266), was determined against a 2014-2016, 52-country, worldwide collection of clinical isolates of carbapenem-nonsusceptible Enterobacteriaceae ( n = 1,022), multidrug-resistant (MDR) Acinetobacter baumannii ( n = 368), MDR Pseudomonas aeruginosa ( n = 262), Stenotrophomonas maltophilia ( n = 217), and Burkholderia cepacia ( n = 4) using the Clinical and Laboratory Standards Institute (CLSI) standard broth microdilution method. Iron-depleted cation-adjusted Mueller-Hinton broth (ID-CAMHB), prepared according to a recently approved (2017), but not yet published, CLSI protocol, was used to test cefiderocol; all other antimicrobial agents were tested using CAMHB. The concentration of cefiderocol inhibiting 90% (MIC 90 ) of isolates of carbapenem-nonsusceptible Enterobacteriaceae was 4 μg/ml; cefiderocol MICs ranged from 0.004 to 32 μg/ml, and 97.0% (991/1,022) of isolates demonstrated cefiderocol MICs of ≤4 μg/ml. The MIC 90 s for cefiderocol for MDR A. baumannii , MDR P. aeruginosa , and S. maltophilia were 8, 1, and 0.25 μg/ml, respectively, with 89.7% (330/368), 99.2% (260/262), and 100% (217/217) of isolates demonstrating cefiderocol MICs of ≤4 μg/ml. Cefiderocol MICs for B. cepacia ranged from 0.004 to 8 μg/ml. We conclude that cefiderocol demonstrated potent in vitro activity against a 2014-2016, worldwide collection of clinical isolates of carbapenem-nonsusceptible Enterobacteriaceae , MDR A. baumannii , MDR P. aeruginosa , S. maltophilia , and B. cepacia isolates as 96.2% of all (1,801/1,873) isolates tested had cefiderocol MICs of ≤4 μg/ml. Copyright © 2018 Hackel et al.

SINOPSIS DE LOS ESCARABAJOS COPRÓFAGOS (COLEOPTERA: SCARABAEINAE DEL CARIBE COLOMBIANO

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JORGE ARI NORIEGA

2013-12-01

Full Text Available La subfamilia Scarabaeinae (Coleoptera: Scarabaeidae es un grupo de gran importancia en los ecosistemas por su significativa participación en el proceso de reciclaje de nutrientes. Para Colombia existen algunos acercamientos al análisis de su diversidad en ciertas regiones biogeográficas. Sin embargo, existen zonas que necesitan un mayor estudio, como es el caso de la región Caribe. Con el fin de llenar el vacío de información se realizó una revisión de la información depositada en 16 colecciones a nivel nacional y de la literatura en esta zona. Se registran 90 especies pertenecientes a 24 géneros, agrupadas en seis tribus. Se reportan 20 nuevas especies para el departamento de La Guajira, 18 para Sucre, once para Magdalena, nueve para Bolívar, nueve para Córdoba, tres para Atlántico y dos para Cesar. El departamento con la mayor riqueza es Magdalena ya que es el mejor muestreado incluyendo su rango altitudinal. Al analizar la composición de especies, la región Caribe presenta pocos endemismos, exceptuando las zonas altas del Macizo de la Sierra Nevada de Santa Marta. El género Onthophagus es el más diverso en la región y la especie que presenta el mayor rango altitudinal es Ontherus sanctaemartae (700 hasta 2500 m . La región es homogénea en las zonas bajas, presentándose una mayor afinidad con el Chocó biogeográfico. Se establecen en la región cuatro grandes franjas altitudinales: planicies (0- 500 m , colinas altas (>500- 900 m , zona subandina-andina (> 900 a 2500 m y alta montaña (> 2500 m . Es posible que con el incremento de muestreos en zonas poco estudiadas la homogeneidad específica aumente. Finalmente, es necesario ampliar e intensificar los estudios en esta región, especialmente en los sistemas montañosos aislados.

Outbreak by Hypermucoviscous Klebsiella pneumoniae ST11 Isolates with Carbapenem Resistance in a Tertiary Hospital in China

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Lingling Zhan

2017-05-01

Full Text Available Hypervirulent and multidrug resistant Klebsiella pneumoniae strains pose a significant threat to the public health. In the present study, 21 carbapenem-resistant K. pneumoniae isolates (CRKP were determined by the string test as hypermucoviscous K. pneumoniae (HMKP, with the prevalence of 15.0% (21/140 among CRKP, and 1.1% (21/1838 among all K. pneumoniae isolates. Among them, 7 (33.3%, and 1 (4.76% isolate belonged to capsular serotype K20 and K2 respectively, while 13 (61.9%, 13/21 weren't successfully typed by capsular serotyping. All the 21 isolates were carbapenemase-producers and were positive for blaKPC-2. In addition to blaKPC-2, all the 21 isolates except one harbor blaSHV-11, and 15 carry extended-spectrum β-lactamase gene blaCTX-M-65. The virulence-associated genes with more than 90% of positive rates among 21 isolates included ureA (100%, 21/21, wabG (100%, 21/21, fimH (95.2%, 20/21, entB (95.2%, 20/21, ycf (95.2%, 20/21, ybtS (95.2%, 20/21, and iutA (90.5%, 19/21. rmpA and aerobactin were found in 57.1% (12/21 isolates. Five sequence types (STs were identified by multilocus sequence typing (MLST, including ST11 (11 K-non capsule typable and 5 K20 isolates, ST268 (1 K20 isolate and 1 K-non capsule typable isolate, ST65 (1 K2 isolate, ST692 (1 K-non capsule typable isolate, and ST595, a novel sequence type (1 K-non capsule typable isolate. Pulsed-field gel electrophoresis (PFGE results showed two major PFGE clusters, of which cluster A accounts for 6 ST11 isolates (28.6% and cluster B includes 8 ST11 isolates (38.1%, 8/21. Ten and six ST11 isolates were isolated from 2014 and 2015, respectively, while 8 were isolated from the same month of December in 2014. Ten isolates were collected from the intensive care unit (ICU, and all except one belonged to ST11. Additional 4 ST11 isolates were collected from patients in non-ICU wards, who had more than 10 days of ICU stay history in 2014 prior to transfer to their current wards where the

Multicenter Clinical and Molecular Epidemiological Analysis of Bacteremia Due to Carbapenem-Resistant Enterobacteriaceae (CRE) in the CRE Epicenter of the United States.

Science.gov (United States)

Satlin, Michael J; Chen, Liang; Patel, Gopi; Gomez-Simmonds, Angela; Weston, Gregory; Kim, Angela C; Seo, Susan K; Rosenthal, Marnie E; Sperber, Steven J; Jenkins, Stephen G; Hamula, Camille L; Uhlemann, Anne-Catrin; Levi, Michael H; Fries, Bettina C; Tang, Yi-Wei; Juretschko, Stefan; Rojtman, Albert D; Hong, Tao; Mathema, Barun; Jacobs, Michael R; Walsh, Thomas J; Bonomo, Robert A; Kreiswirth, Barry N

2017-04-01

Although the New York/New Jersey (NY/NJ) area is an epicenter for carbapenem-resistant Enterobacteriaceae (CRE), there are few multicenter studies of CRE from this region. We characterized patients with CRE bacteremia in 2013 at eight NY/NJ medical centers and determined the prevalence of carbapenem resistance among Enterobacteriaceae bloodstream isolates and CRE resistance mechanisms, genetic backgrounds, capsular types ( cps ), and antimicrobial susceptibilities. Of 121 patients with CRE bacteremia, 50% had cancer or had undergone transplantation. The prevalences of carbapenem resistance among Klebsiella pneumoniae , Enterobacter spp., and Escherichia coli bacteremias were 9.7%, 2.2%, and 0.1%, respectively. Ninety percent of CRE were K. pneumoniae and 92% produced K. pneumoniae carbapenemase (KPC-3, 48%; KPC-2, 44%). Two CRE produced NDM-1 and OXA-48 carbapenemases. Sequence type 258 (ST258) predominated among KPC-producing K. pneumoniae (KPC- Kp ). The wzi154 allele, corresponding to cps-2 , was present in 93% of KPC-3- Kp , whereas KPC-2- Kp had greater cps diversity. Ninety-nine percent of CRE were ceftazidime-avibactam (CAZ-AVI)-susceptible, although 42% of KPC-3- Kp had an CAZ-AVI MIC of ≥4/4 μg/ml. There was a median of 47 h from bacteremia onset until active antimicrobial therapy, 38% of patients had septic shock, and 49% died within 30 days. KPC-3- Kp bacteremia (adjusted odds ratio [aOR], 2.58; P = 0.045), cancer (aOR, 3.61, P = 0.01), and bacteremia onset in the intensive care unit (aOR, 3.79; P = 0.03) were independently associated with mortality. Active empirical therapy and combination therapy were not associated with survival. Despite a decade of experience with CRE, patients with CRE bacteremia have protracted delays in appropriate therapies and high mortality rates, highlighting the need for rapid diagnostics and evaluation of new therapeutics. Copyright © 2017 American Society for Microbiology.

Inmunogenicidad, inocuidad y eficacia de una vacuna tetravalente obtenida por recombinación genética de rotavirus aislados de monos rhesus y seres humanos en Belém, Brasil Immunogenicity, safety and efficacy of tetravalent rhesus-human, reassortant rotavirus vaccine in Belém, Brazil

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A. C. Linhares

1998-05-01

Full Text Available Se evaluó la inocuidad, inmunogenicidad y eficacia de una vacuna tetravalente obtenida por recombinación genética de rotavirus aislados de monos rhesus y seres humanos (RRV-TV (4 x 10(4 unidades formadoras de placas por dosis en un ensayo prospectivo, aleatorio, a doble ciego y controlado con placebo que se efectuó con 540 lactantes brasileños. Se administraron dosis de vacuna o de placebo a la edad de 1, 3 y 5 meses. No se observaron diferencias significativas en la frecuencia de diarrea o vómito en los bebés de ninguno de los dos grupos después de administrar la dosis correspondiente. De 2 a 3% de los vacunados tuvieron fiebre baja los días tercero a quinto después de recibir la primera dosis, pero no después de las dosis segunda o tercera. Se observó una respuesta de anticuerpos del tipo IgA al rotavirus aislado de monos rhesus (RRV en 58% de los vacunados y en 33% de quienes recibieron placebo. La respuesta de anticuerpos neutralizantes a cada serotipo no pasó de 20% cuando se determinó con la prueba de reducción de focos de fluorescencia, pero fue superior a 40% al medirse con la prueba de neutralización a base de reducción de placas. Se presentaron 91 casos de diarrea causada por rotavirus entre los niños que recibieron las tres dosis (de vacuna o de placebo durante un seguimiento de 2 años, 36 de ellos en los niños vacunados. La eficacia general de la vacuna fue de 8% (P = 0,005 contra toda clase de diarrea y de 35% (P = 0,03 contra la diarrea causada por rotavirus. La protección durante el primer año de seguimiento, cuando predominó el rotavirus G del serotipo 1, fue de 57% (P = 0,008, pero se redujo a 12% en el segundo año. Se obtuvieron resultados similares al restringir el análisis a episodios en que el rotavirus fue el único agente patógeno identificado. Se observó en la vacuna una mayor tendencia a proteger contra casos de enfermedad con un promedio de seis o más deposiciones diarias. Estos resultados

Judíos, indios y el mito del crimen ritual. El caso de Chamula, Chiapas, 1868

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Misgav Har Peled

2015-01-01

Full Text Available Entre 1867 y 1869 se vivió en Los Altos de Chiapas la rebelión de los indios chamulas contra los ladinos de San Cristóbal de Las Casas conocida como Guerra de Castas. Según la historia oficial, los indígenas crucificaron el Viernes Santo de 1868 a un niño de dicha comunidad tsotsil. Este hecho puede compararse con la “leyenda de sangre” imputada a los judíos, y su transferencia a los indios suscita preguntarse si se trata de un suceso aislado, o si responde a una lógica que vincula al indio salvaje con el judío como el asesino del Hijo de Dios.

Cirugía de reemplazo valvular aórtico aislado en pacientes octogenarios: evaluación, riesgo operatorio y resultados a mediano plazo

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Fernando Piccinini

2010-01-01

Full Text Available RESUMENIntroducciónLas indicaciones y los beneficios del reemplazo valvular aórtico han sido claramente establecidos, aun para poblaciones añosas, de aumentada comorbilidad. Aun así, la manipulación de ateromas aórticos, el uso de circulación extracorpórea y de clampeo aórtico, el paro cardíaco y la descalcificación ligadas a esta técnica y sus eventuales consecuencias generan dudas acerca de su indicación en este grupo de pacientes.ObjetivosComunicar la morbimortalidad del procedimiento en octogenarios y validar la utilidad de los puntajes de predicción de riesgo utilizados más frecuentemente.Material y métodosSe estudiaron 87 pacientes octogenarios sometidos a reemplazo aórtico aislado; se analizaron variables preoperatorias, intraoperatorias y posoperatorias y se aplicó el Euroscore; para facilitar el subanálisis del Euroscore logístico, la población se dividió en tres grupos: riesgo bajo, moderado y alto. Se utilizó técnica quirúrgica convencional. Para el seguimiento, se analizó la historia clínica y/o se realizó encuesta telefónica.ResultadosLa mediana de edad fue de 83 ± 2,5 años, con un rango de 80 a 89 años. El 60% de la población en estudio era de sexo femenino. La indicación quirúrgica fue estenosis 92%, endocarditis activa 4,6% y enfermedad valvular 3,4%. Antecedentes: hipertensión 71%, tabaquismo 31%, dislipidemia 39%, diabetes 11,5%, EPOC 10%, IRC-diálisis 2,3%, ACV 11,5%, IAM previo 8%, fibrilación auricular 16%, reoperación 15%. Cuadro clínico: asintomático 3,45%, angina crónica estable 10,3%, angina inestable 11%, ICC 13,8%, disnea CF III-IV 60%. Disfunción ventricular izquierda moderada-grave 18,3%. Riesgo por Euroscore logístico 12,4% ± 15%. El tiempo operatorio promedio fue de 200 ± 61,7 min, el de CEC de 86 ± 32,5 min y el de clampeo aórtico de 65 ± 18,2 min. Complicaciones: sangrado médico 17,2%, reoperación sangrado 5,7%, bajo gasto cardíaco 13,8%, inotrópicos > 48 horas

Eficiencia isoterma de los modelos de ventilación exterior en patios de edificios residenciales. Estudio de casos

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Padilla-Marcos, M. A.

2015-12-01

Full Text Available Many buildings have been designed and built with courtyards to supply the light and healthy air demands to the dwellings. However, confined air quality in many of them is unhealthy for human use due to the diminished ability to renew the air. The purpose of the study is to catalog different models of isolated building courtyards under isothermal conditions, according to their dimensions. The goal is to quantify the efficiency of air exchange in each model and analyze the influence of size in controlled external conditions. In addition, current regulations in Spain are compared with the obtained results. In conclusion, the efficiency of ventilation ratio for courtyards in buildings depends on its design.Muchos edificios han sido diseñados y construidos con patios interiores para satisfacer exigencias de habitabilidad, ya que estos espacios surten de luz y aire a los locales interiores. Sin embargo, la calidad del aire confinado en muchos de ellos es insalubre para el uso humano debido a la mermada capacidad que tienen para renovar su aire. El propósito del estudio es catalogar diferentes modelos de patio interior en edificios aislados, en condiciones isotermas, según sus dimensiones. El objetivo consiste en cuantificar la eficiencia en la renovación del aire en cada modelo y analizar la influencia de sus dimensiones en unas condiciones externas controladas. Adicionalmente, se comparan las normativas vigentes en España con los resultados así obtenidos. Como conclusión se determina la razón de cómo dicha eficiencia de la ventilación de patios interiores de los edificios desciende en función de su diseño.

Act Fast as Time Is Less: High Faecal Carriage of Carbapenem-Resistant Enterobacteriaceae in Critical Care Patients.

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Saseedharan, Sanjith; Sahu, Manisa; Pathrose, Edwin Joseph; Shivdas, Sarita

2016-09-01

Carbapenem-resistant Enterobacteriaceae (CRE) are drug-resistant Gram-negative bacteria that are present in the community as well as in hospitals. Their infection and colonisation puts critically ill patients at high risk due to the drug-resistant nature of the strains and possible spreading of these organisms, even in a hospital environment. To examine the presence and types of Enterobacteriaceae species in patients admitted directly from the community. The present study was a one-month pilot conducted in the ICU of a tertiary care hospital in Mumbai, India in 2015. Faecal samples of patients admitted from the community directly to the ICU were analysed using tests like MHT (Modified Hodge) and EDTA for the presence of IMP (action on Imipenem) and KPC ( Klebsiella Test Pneumoniae Carbapenemase) producing strains of Enterobacteriaceae . Polymerase Chain Reaction (PCR) was performed to look for VIM , IMP , NDM 1, OXA , and KPC genes. Antibiotic Sensitivity Test was carried out as per CLSI guidelines. The results showed an alarming level of faecal carriage rates in adult ICU patients. Klebsiella pneumonia was the most common carbapenem-resistant isolate, closely followed by Escherichia coli . PCR results revealed nine strains were positive for bla (KPC) gene, from which 7 were Klebsiella pneumoniae and one each of Escherichia coli and Klebsiella oxytoca was observed. Antibiotic Sensitivity Test results showed that the isolates had maximum sensitivity to Colistin (100%) and Tigecycline (95%). These levels indicate that in the absence of CRE screenings, proper isolation of carrier patients is not possible, leading to possible spreading of these resistant bacteria strains in ICUs. A longer period of study is required to obtain more substantial data to validate the results of this pilot.

Comparación de concentración mínima inhibitoria y concentración plasmática de cefalotina mediante un modelo matemático

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Julian Javier Martínez Zambrano

Full Text Available Introducción: el uso de fármacos fuera de rangos terapéuticos es un problema hospitalario, pues pocas veces se tienen en cuenta parámetros antropométricos del paciente, determinantes en las concentraciones del medicamento. Objetivo: aplicar un modelo matemático basado en parámetros del paciente, para determinar las posibles concentraciones plasmáticas de cefalotina y compárarlas con las concentraciones mínimas inhibitorias de los microrganismos aislados. Métodos: se seleccionó un grupo de pacientes del sexo masculino entre 18 y 50 años de edad con tratamiento profiláctico posquirúrgico con cefalotina. Se recopiló la información: dosis de cefalotina, peso, talla, edad, hematócrito. Se calcularon volumen extracelular, plasmático y sanguíneo según el modelo informado por Hedin. Luego se calculó la concentración plasmática de cefalotina usando el modelo propuesto en el presente estudio y se comparó con la concentración mínima inhibitoria de los microorganismos aislados. Resultados: se analizaron 24 pacientes con promedio de edad 32,6 años ± 8, peso de 69 kg ± 7,51, talla de 168,87 cm ± 7,10. El 56,3 % de los microorganismos presentó resistencia a concentraciones ³ 32 µg/mL. El agente más común fue Escherichia coli de 18 cepas aisladas. La comparación del volumen de distribución y la concentración plasmática de cefalotina calculada con el modelo informado por Hedin y el desarrollado en presente trabajo, no presentó diferencia significativa después de aplicar la prueba t de Student, con p< 0,05. Conclusiones: al comparar las concentraciones teóricas de cefalotina para uso profiláctico posquirúrgico intrahospitalario, calculadas con el modelo planteado, se encontró que estas no permitieron superar la concentración mínima inhibitoria de los microorganismos aislados.

Resistencia a drogas de segunda línea en cepas peruanas de Mycobacterium tuberculosis multidrogorresistentes

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Francesca Barletta

Full Text Available Objetivos. Determinar los perfiles de resistencia de las quinolonas; ciprofloxacina (Cpx, ofloxacina (Ofx, gatifloxacina (Gfx y moxifloxacina (Mfx, y de los inyectables; kanamicina (Km, amikacina (Am y capreomicina (Cm en cepas multidrogorresistente (MDR. Se buscó la presencia de mutaciones en los genes rrs,tlyA y gyrA/B, y su posible asociación con la resistencia a inyectables y quinolonas. Materiales y métodos. En este estudio piloto descriptivo se seleccionaron cepas MDR aisladas durante junio a diciembre de 2004, que fueron criopreservadas en el banco de muestras del Instituto de Medicina Tropical "Alexander von Humboldt" en Lima, Perú. Se determinó la concentración mínima inhibitoria (CMI para Cpx, Ofx, Gfx, Mfx, Km, Am y Cm. Se investigó las mutaciones presentes en los genes rrs, tlyA y gyrA/B a través de un PCR convencional y posterior secuenciamiento de los productos obtenidos. Resultados. Cuatro de los once aislados presentaron resistencia contra los inyectables y en todas se observó una alta CMI; >120 μg/mL para Km y >160 μg/mL para Am y Cm. Solo dos aislados presentaron resistencia a Ofx con un CMI = 4 μg/mL. Los resultados de secuenciamiento sugirieron que la mutación A1401T en rrs podría ser la causa molecular de resistencia a los inyectables; mientras que en este estudio no se halló ninguna mutación en tlyA ni en gyrA/B asociada a resistencia. Conclusiones. Este estudio sugiere una posible asociación entre la mutación en A1401G y la resistencia a los antibióticos inyectables.

Reconocimiento de antígenos lipopolisacarídicos de Pseudomonas aeruginosa por sueros humanos

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Jacquelin Alfonso

2004-04-01

Full Text Available En este trabajo se procedió al reconocimiento de lipopolisacáridos de diferentes serotipos de Pseusodomas aeruginosa por sueros humanos. Los lipopolisacáridos fueron aislados por el método Wespthal y Jann. Se utilizaron un total de 104 sueros de pacientes infectados y donantes voluntarios, provenientes de instalaciones hospitalarias y del Banco de Sangre, para el reconocimiento de antígenos lipopolisacarídicos, mediante el ensayo de Dott Blot. Los resultados mostraron que los serotipos de mayor reconocimiento, por los sueros testados, fueron el O11, O13, O16 y el O15, existiendo diferencias significativas entre ellos (p< 0,05.

Aislamiento de microorganismos productores de biosurfactantes y lipasas a partir de efluentes residuales de camales y suelos contaminados con hidrocarburos

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Lizzie Karen Becerra Gutiérrez; María Valeria Horna Acevedo

2016-01-01

Los biosurfactantes son moléculas anfipáticas que reducen la tensión en la interfase, incrementando así la solubilidad en agua y disponibilidad de compuestos orgánicos, son producidos por bacterias, hongos, y levaduras. Para el aislamiento de bacterias productoras de biosurfactante y lipasas, se sembró en medios inductores 10% de efluentes residuales procedentes de camales y suelos de grifos contaminados con hidrocarburos de la Provincia de Trujillo - Perú. Los cultivos aislados se sembraron ...

Evaluación ambiental de la arquitectura urbana moderna en Cali: análisis multidimensional de la arquitectura de Borrero, Zamorano y Giovanelli

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Cruz Velásquez, Carolina

2013-01-01

Con este trabajo queremos poner en valor los criterios espaciales, formales, urbanos y ambientales que tuvo la arquitectura moderna tanto en la elaboración de los proyectos como en el proceso de construcción de ciudad, dando como resultado una unidad urbana. De esta manera contribuir al desmantelamiento de la idea errónea que versa sobre como la arquitectura moderna negó su entorno y sus condicionantes ambientales y urbanas, insertándose en el territorio como un objeto aislado....

The Impact of a Carbapenem-Resistant Enterobacteriaceae Outbreak on Facilitating Development of a National Infrastructure for Infection Control in Israel.

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Schwaber, Mitchell J; Carmeli, Yehuda

2017-11-29

In 2006 the Israeli healthcare system faced an unprecedented outbreak of carbapenem-resistant Enterobacteriaceae, primarily involving KPC-producing Klebsiella pneumoniae clonal complex CC258. This public health crisis exposed major gaps in infection control. In response, Israel established a national infection control infrastructure. The steps taken to build this infrastructure and benefits realized from its creation are described here. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Biochemical and Structural Characterization of Mycobacterium tuberculosis beta-Lactamase with the Carbapenems Ertapenem and Doripenem

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L Tremblay; F Fan; J Blanchard

2011-12-31

Despite the enormous success of {beta}-lactams as broad-spectrum antibacterials, they have never been widely used for the treatment of tuberculosis (TB) due to intrinsic resistance that is caused by the presence of a chromosomally encoded gene (blaC) in Mycobacterium tuberculosis. Our previous studies of TB BlaC revealed that this enzyme is an extremely broad-spectrum {beta}-lactamase hydrolyzing all {beta}-lactam classes. Carbapenems are slow substrates that acylate the enzyme but are only slowly deacylated and can therefore act also as potent inhibitors of BlaC. We conducted the in vitro characterization of doripenem and ertapenem with BlaC. A steady-state kinetic burst was observed with both compounds with magnitudes proportional to the concentration of BlaC used. The results provide apparent K{sub m} and k{sub cat} values of 0.18 {micro}M and 0.016 min{sup -1} for doripenem and 0.18 {micro}M and 0.017 min{sup -1} for ertapenem, respectively. FTICR mass spectrometry demonstrated that the doripenem and ertapenem acyl-enzyme complexes remain stable over a time period of 90 min. The BlaC-doripenem covalent complex obtained after a 90 min soak was determined to 2.2 {angstrom}, while the BlaC-ertapenem complex obtained after a 90 min soak was determined to 2.0 {angstrom}. The 1.3 {angstrom} diffraction data from a 10 min ertapenem-soaked crystal revealed an isomerization occurring in the BlaC-ertapenem adduct in which the original {Delta}2-pyrroline ring was tautomerized to generate the {Delta}1-pyrroline ring. The isomerization leads to the flipping of the carbapenem hydroxyethyl group to hydrogen bond to carboxyl O2 of Glu166. The hydroxyethyl flip results in both the decreased basicity of Glu166 and a significant increase in the distance between carboxyl O2 of Glu166 and the catalytic water molecule, slowing hydrolysis.

Emergence of Oxacillinases in Environmental Carbapenem-Resistant Acinetobacter baumannii Associated with Clinical Isolates.

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Goic-Barisic, Ivana; Hrenovic, Jasna; Kovacic, Ana; Musić, Martina Šeruga

2016-10-01

Six carbapenem-resistant isolates of Acinetobacter baumannii were recovered from untreated and treated municipal wastewater of the capital city of Zagreb, Croatia. Molecular identification of environmental isolates of A. baumannii was performed by amplification, sequencing, and phylogenetic analyses of rpoB gene. The presence of bla OXA genes encoding OXA-type carbapenemases (OXA-51-like, OXA-23, and OXA-40-like) was confirmed by multiplex PCR and sequencing. Phylogenetic analyses corroborated the affiliation of detected bla OXA genes to three different clusters and showed association of environmental OXAs with those described from clinical isolates. This result suggests that isolates recovered from municipal wastewater are most probably of clinical origin. Furthermore, the presence of OXA-40-like (OXA-72) in an environmental A. baumannii isolate is reported for the first time. Persistence of A. baumannii harboring the clinically important OXAs in the wastewater treatment process poses a potentially significant source for horizontal gene transfer and implications for wider spread of antibiotic resistance genes.

Fibrosis pulmonar asociada a vasculitis con anticuerpos anticitoplasmáticos positivos

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Marcelo Fernández Casares; Alejandra González; Flavia Caputo; Yanina Bottinelli; Patricia Nastavi; Marcelo Zamboni

2012-01-01

Las complicaciones pulmonares más conocidas de las vasculitis con anticuerpos anticitoplasmáticos de los neutrófilos (ANCA) positivos (VAA), son la hemorragia alveolar, los granulomas y la estenosis de la vía aérea. En los últimos años han aparecido algunos informes aislados que muestran la asociación con fibrosis pulmonar (FP), sugiriendo que ésta sería otra complicación de las VAA. En este trabajo informamos dos casos con dicha asociación describiendo sus características clínicas, tomográfi...

Carbapenem-resistant Enterobacteriaceae colonization and infection in critically ill patients: a retrospective matched cohort comparison with non-carriers.

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Dickstein, Y; Edelman, R; Dror, T; Hussein, K; Bar-Lavie, Y; Paul, M

2016-09-01

To examine whether carbapenem-resistant Enterobacteriaceae (CRE) carriage is associated with incidence of clinical infection as a means of assessing whether the morbidity and mortality associated with these bacteria are mediated by underlying conditions or intrinsic properties of CRE. This retrospective matched cohort study compared the incidence of invasive infections in CRE-colonized patients and matched non-carriers in the intensive care unit (ICU). The primary outcome was infection caused by CRE of the same species as the colonizing strain among CRE carriers, and infections caused by carbapenem-sensitive strains of the same organism in non-carriers. Hospital discharge and death were considered as competing events. Competing-risks hazard analysis was performed for the entire cohort and for a nested cohort matched by Acute Physiology and Chronic Health Evaluation (APACHE) II scores, stratified by matching. In total, 146 CRE carriers were compared with 292 non-carriers. Patients were well matched for most risk factors for Enterobacteriaceae infection, including age, renal failure, previous invasive infection, previous hospitalization, APACHE II score, length of mechanical ventilation, length of hospitalization and CRE carriage. On regression analysis, colonization with CRE was independently associated with Enterobacteriaceae infection {cause-specific hazard ratio (CSHR) 2.06 [95% confidence interval (CI) 1.03-4.09]}. On regression analysis of the APACHE-II-matched cohort (N=284), colonization with CRE remained significantly associated with Enterobacteriaceae infection [CSHR 3.32 (95% CI 1.31-8.43)]. Colonization with CRE was associated with at least a two-fold increased risk of infection by the colonizing strain amongst ICU patients. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Informe científico de investigador: Aphalo, Paula (2013)

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Aphalo, Paula

2013-01-01

Como punto de partida, se preparon aislados de amaranto por extracción acuosa en medio alcalino (pH 9) y posterior precipitación isoeléctrica (pH 5), según el procedimiento utilizado comúnmente en nuestro laboratorio (Martínez y Añón, 1996). Se determinó la solubilidad de los aislados, en dos buffers: a) con elevada fuerza iónica (K2HPO4 32,5 mM, KH2PO4 2,6 mM con NaCl 0,4M pH 7,5) y b) de baja fuerza iónica (K2HPO4 33,3 mM, KH2PO4 1,7 mM pH 8,5), en ambos la solubilidad fue cercana al 80%. L...

Outbreak of carbapenem-resistant Acinetobacter baumannii in the intensive care unit: a multi-level strategic management approach.

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Molter, G; Seifert, H; Mandraka, F; Kasper, G; Weidmann, B; Hornei, B; Öhler, M; Schwimmbeck, P; Kröschel, P; Higgins, P G; Reuter, S

2016-02-01

An outbreak of carbapenem-resistant Acinetobacter baumannii (CRAb) occurred in an interdisciplinary intensive care unit, affecting 10 patients. Within hours of recognition of the spread of CRAb an intervention team was instituted for collection of available data, decision-making, communication and monitoring of all interventions performed, including cohorting, temporary stop of admissions, staff education, and enforcement of infection control measures. An area was defined for cohortation of patients colonized with CRAb, with a separate nursing team and a second set of mobile equipment. New transmissions were no longer observed after only four days into the institution of enhanced infection control measures. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Is This the Carbapenemase Test We've Been Waiting for? A Multicenter Evaluation of the Modified Carbapenem Inactivation Method.

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Butler-Wu, Susan M; Abbott, April N

2017-08-01

A plethora of phenotypic methods exist for the detection of carbapenemases; however, clinical laboratories have struggled for years with accurate, objective phenotypic detection of carbapenemase activity in Enterobacteriaceae In this issue of the Journal of Clinical Microbiology , V. M. Pierce et al. (J Clin Microbiol 55:2321-2333, 2017, https://doi.org/10.1128/JCM.00193-17) report on a multicenter evaluation of the modified carbapenem inactivation method (mCIM). The high sensitivity, specificity, reproducibility, and ease of interpretation associated with the mCIM for Enterobacteriaceae will likely lead to its adoption by clinical laboratories. Copyright © 2017 American Society for Microbiology.

In vitro activity of doripenem and other carbapenems against contemporary Gram-negative pathogens isolated from hospitalised patients in the Asia-Pacific region: results of the COMPACT Asia-Pacific Study.

Science.gov (United States)

Christiansen, K J; Ip, M; Ker, H B; Mendoza, M; Hsu, L; Kiratisin, P; Chongthaleong, A; Redjeki, I S; Quintana, A; Flamm, R; Garcia, J; Cassettari, M; Cooper, D; Okolo, P; Morrissey, I

2010-12-01

The Comparative Activity of Carbapenems Testing (COMPACT) Study was designed to determine the in vitro potency of doripenem compared with imipenem and meropenem against a large number of contemporary Gram-negative pathogens from more than 100 centres across Europe and the Asia-Pacific region and to assess the reliability of Etest methodology for doripenem minimum inhibitory concentration (MIC) determination against these pathogens. Data from eight countries within the Asia-Pacific region, which collected 1612 bacterial isolates, are presented here. Etest methodology was found to be a reliable method for MIC determination. Doripenem showed in vitro activity similar to or better than meropenem and at least four-fold better than imipenem against Enterobacteriaceae. Against Pseudomonas aeruginosa, doripenem was also the most active of the three carbapenems in vitro. However, in vitro results do not necessarily correlate with clinical outcome. Copyright © 2010 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

Determinación de sexo en restos prehistóricos aislados del este uruguayo

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Figueiro, Gonzalo

2001-01-01

Full Text Available El frecuente hallazgo de restos humanos desarticulados y dispersos en sitios de la región Este del territorio uruguayo da lugar a la necesidad de recurrir en muchos casos a métodos alternativos de determinación de sexo, basados en análisis discriminantes. Las muestras de las que se parte en estos análisis son ya de poblaciones actuales, ya de poblaciones prehistóricas distintas a las representadas en el registro arqueológico uruguayo. Al determinar el número mínimo de individuos de un conjunto disperso, la edad y el sexo de los individuos representados cobran gran utilidad, y la precisión de los métodos de determinación de sexo basados en piezas aisladas se vuelve crucial. Este trabajo presenta la evaluación de 24 ecuaciones discriminantes canónicas sobre medidas de 7 huesos, en una muestra arqueológica de 15 individuos de dos sitios con estructuras monticulares ("cerritos de indios" del Este Uruguayo. El sexo de los esqueletos fue determinado anteriormente mediante métodos basados en la pelvis, el cráneo, o ambos. Los métodos evaluados presentaron grados de exactitud general de entre el 30 y el 100 por ciento, sin una dirección particular en los errores de clasificación. Esto pone de relieve la necesidad de revisar las ecuaciones utilizadas, recurriendo ya sea a una reelaboración de los coeficientes utilizados, o a un desplazamiento de los puntos de corte.

Las autopistas urbanas concesionadas: Una nueva forma de segregación

OpenAIRE

Greene,Margarita; Mora,Rodrigo

2005-01-01

Si es que existiera el modelo de ciudad automovilística, sin duda sería el referente que ha determinado las intervenciones urbanas en Santiago durante los últimos treinta años: aparte del caso relativamente aislado del ferrocarril subterráneo, son incontables los kilómetros entregados al tráfico vehicular. Las concesiones viales inauguran la formalización de un sistema de clases dentro del parque automotriz; un sistema que lamentablemente informará la manera en que entendemos y experimentamos...

Diversidad genética y persistencia ambiental de "Listeria Monocytogenes" en dos plantas de procesado de carne de cerdo ibérico: influencia de la resistencia a desinfectantes de amonio cuaternario

OpenAIRE

Ortiz Jareño, María del Sagrario

2016-01-01

La clasificación en subtipos moleculares de los aislados de L. monocytogenes procedentes de productos cárnicos y del ambiente de las plantas de procesado donde se elaboran, habitualmente muestra la presencia de un reducido número de cepas y la persistencia durante largos periodos de tiempo de cepas específicas que sobreviven a la limpieza y la desinfección. Entre los mecanismos que facilitan la supervivencia de L. monocytogenes en el ambiente de las plantas de procesado de alimentos se incluy...

La vegetación como indicador de la Geomorfología Fluvial

OpenAIRE

Juan José Neiff; Silvina Lorena Casco; Nora Indiana Basterra de Chiozzi

2005-01-01

Aguas abajo de la confluencia con el río Paraguay, el Paraná se expande en una ancha planicie lateral que, durante las inundaciones extraordinarias completa un área 2-10 veces mayor que el área ocupada por las aguas en los períodos de bajantes extraordinarias, en los que el curso queda aislado de la planicie inundable. El propósito de esta contribución es presentar las características más salientes de este tramo entrelazado del r&...

Informe científico de investigador: Cabello, Marta Noemí (2011-2012)

OpenAIRE

Cabello, Marta Noemí

2012-01-01

La investigación del período informado (2011-2012) se centró en el análisis de las comunidades de hongos biótrofos (simbiontes micorrícicos y patógenos de insectos) y saprótrofos, aislados de agrosistemas y ecosistemas naturales. Estos estudios se relacionan a los roles que estos microorganismos juegan en los diferentes sistemas, su participación como agentes de control biológico y su aplicabilidad en evaluaciones de sustentabilidad. Relacionado a hongos biotrofos formadores de mico...

Síntesis de Protoberberinas y Ciclopentil-isoquinoleínas Dopaminérgicas, y Síntesis de Indenopiridinas Melatoninérgicas

OpenAIRE

Párraga Vidal, Javier

2015-01-01

Resumen – Discusión de los resultados. En la presente Tesis Doctoral se han desarrollado diversas rutas de síntesis para la obtención de alcaloides isoquinoleínicos, con diferentes esqueletos, y de hexahidroindenopiridinas. Además se han realizado sus correspondientes ensayos farmacológicos, sobre distintas dianas biológicas basándonos en los resultados obtenidos previamente con este tipo de alcaloides de síntesis y/o aislados de la naturaleza, y de moléculas estructuralmente similares. Se...

Clinical and Molecular Epidemiology of Carbapenem-Resistant Enterobacteriaceae Among Adult Inpatients in Singapore.

Science.gov (United States)

Marimuthu, Kalisvar; Venkatachalam, Indumathi; Khong, Wei Xin; Koh, Tse Hsien; Cherng, Benjamin Pei Zhi; Van La, My; De, Partha Pratim; Krishnan, Prabha Unny; Tan, Thean Yen; Choon, Raymond Fong Kok; Pada, Surinder Kaur; Lam, Choong Weng; Ooi, Say Tat; Deepak, Rama Narayana; Smitasin, Nares; Tan, Eng Lee; Lee, Jia Jun; Kurup, Asok; Young, Barnaby; Sim, Nancy Tee Wen; Thoon, Koh Cheng; Fisher, Dale; Ling, Moi Lin; Peng, Brenda Ang Sze; Teo, Yik-Ying; Hsu, Li Yang; Lin, Raymond Tzer Pin; Ong, Rick Twee-Hee; Teo, Jeanette; Ng, Oon Tek

2017-05-15

Since 2010, the incidence of carbapenem-resistant Enterobacteriaceae (CRE) has been increasing in Singapore. We analyzed the clinical and molecular epidemiology of CRE among adult inpatients in Singapore. Quarterly incidence of unique subjects (per 100000 patient-days) with positive clinical and surveillance cultures for CRE were estimated based on mandatory data submitted to the National Public Health Laboratory by public hospitals between 2010 and 2015. CRE-positive adult inpatients were prospectively recruited from 6 public sector hospitals between December 2013 and April 2015. Subjects answered a standardized epidemiologic questionnaire and provided samples for this study. Further clinical information was extracted from subjects' electronic medical records. Whole-genome sequencing was performed on study isolates to determine transmission clusters. Incidence of CRE clinical cultures among adult inpatients plateaued from 2013 (range: 7.73 to 10.32 per 100000 patient-days) following an initial increase between 2010 and end-2012. We prospectively recruited 249 subjects. Their median age was 65 years, 108 (43%) were female, and 161 (64.7%) had carbapenemase-producing Enterobacteriaceae (CPE). On multivariate analysis, prior carbapenem exposure (OR: 3.23; 95% CI: 1.67-6.25) and hematological malignancies (OR: 2.85; 95% CI: 1.10-7.41) were associated with non-carbapenemase-producing CRE (NCPE) (n = 88) compared with CPE (n = 161) subjects. Among 430 CRE isolates from the 249 subjects, 307(71.3%) were CPE, of which 154(50.2%) were blaKPC-positive, 97(31.6%) blaNDM-positive, and 42 (13.7%) blaOXA-positive. Klebsiella pneumoniae (n = 180, 41.9%), Escherichia coli (n = 129, 30.0%) and Enterobacter cloacae (n = 62, 14.4%) were the main Enterobacteriaceae species. WGS (n = 206) revealed diverse bacterial strain type (STs). The predominant blaKPC-positive plasmid was pHS102707 (n = 62, 55.4%) and the predominant blaNDM-positive plasmid was pNDM-ECS01 (n = 46, 48.9%). Five

Vital Signs – Cómo hacer el cuidado de salud más seguro (Making Health Care Safer)

Centers for Disease Control (CDC) Podcasts

2013-03-05

Este podcast se basa en el informe de los CDC Vital Signs de marzo del 2013, que trata sobre las infecciones mortales por enterobacterias resistentes a los carbapenemes o ERC y formas en que los proveedores de atención médica pueden detener dichas infecciones.  Created: 3/5/2013 by Centers for Disease Control and Prevention (CDC).   Date Released: 3/5/2013.

Identificación y caracterización de especies de Neosartorya aisladas de frutillas (Fragaria spp. frescas y tratadas térmicamente

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Laura Frisón

2012-12-01

Full Text Available El género Aspergillus es uno de los géneros fúngicos más estudiados y de gran impacto a nivel industrial. La sección Fumigati incluye unas pocas especies anamorfas del género Aspergillus. Las especies que son teleomorfas se encuentran dentro del género Neosartorya. Este es un moho resistente al calor que causan problemas en las industrias alimentarias o enfermedades en los seres humanos. Sus ascosporas han sido aisladas a partir de frutas, pulpas y jugos, ya que pueden sobrevivir a los tratamientos de térmicos industriales pudiendo aparecer la contaminación post-pasteurización. El objetivo fue caracterizar aislados de Neosartorya de frutillas frescas recién cosechadas y tratadas térmicamente, analizando la ornamentación de las ascosporas, toxicidad y resistencia térmica. Se aislaron las colonias, y se identificaron macro y microscópicamente siguiendo la metodología de Pitt y Hocking (2009, de 60 muestras. Se caracterizaron las ascosporas por microscopía electrónica de barrido. Se determinó la capacidad toxicogénica de los extractos por cromatografía líquida de alta eficiencia. Se evaluó la resistencia térmica a diferentes temperaturas. Se aislaron 18 cepas de Neosartorya de frutillas recién cosechadas, y otros mohos termorresistentes como Arthrinium phaeospermum, Byssochlamys nivea y Talaromyces macrosporus. En las frutillas tratadas térmicamente no se aislaron mohos termorresistentes. Trece aislados mostraron ascosporascoincidentes con N. fischeri, el resto con N. spinosa. Los aislados de N. fischeri produjeron fumitremorgina A y B y verruculógeno en arroz, pero no lo hicieron en frutillas frescas. Los parámetros de resistencia térmica fueron: D80 ºC: 20 - 22 minutos, D85 ºC: 9 - 11 minutos, D90 ºC: 2 - 3 minutos y z: 10 - 11 ºC para N. fischeri y D80 ºC: > 120 minutos, D85 ºC: 11 - 94 minutos, D90 ºC: 3 - 15 minutos y z: 6 - 9 ºC para N. spinosa. Es indispensable aplicar buenas prácticas agrícolas y

Identificación y caracterización de especies de Neosartorya aisladas de frutillas (Fragaria spp. frescas y tratadas térmicamente

Directory of Open Access Journals (Sweden)

Laura Frisón

2012-01-01

Full Text Available El género Aspergillus es uno de los géneros fúngicos más estudiados y de gran impacto a nivel industrial. La sección Fumigati incluye unas pocas especies anamorfas del género Aspergillus. Las especies que son teleomorfas se encuentran dentro del género Neosartorya. Este es un moho resistente al calor que causan problemas en las industrias alimentarias o enfermedades en los seres humanos. Sus ascosporas han sido aisladas a partir de frutas, pulpas y jugos, ya que pueden sobrevivir a los tratamientos de térmicos industriales pudiendo aparecer la contaminación post-pasteurización. El objetivo fue caracterizar aislados de Neosartorya de frutillas frescas recién cosechadas y tratadas térmicamente, analizando la ornamentación de las ascosporas, toxicidad y resistencia térmica. Se aislaron las colonias, y se identificaron macro y microscópicamente siguiendo la metodología de Pitt y Hocking (2009, de 60 muestras. Se caracterizaron las ascosporas por microscopía electrónica de barrido. Se determinó la capacidad toxicogénica de los extractos por cromatografía líquida de alta eficiencia. Se evaluó la resistencia térmica a diferentes temperaturas. Se aislaron 18 cepas de Neosartorya de frutillas recién cosechadas, y otros mohos termorresistentes como Arthrinium phaeospermum, Byssochlamys nivea y Talaromyces macrosporus. En las frutillas tratadas térmicamente no se aislaron mohos termorresistentes. Trece aislados mostraron ascosporas coincidentes con N. fischeri, el resto con N. spinosa. Los aislados de N. fischeri produjeron fumitremorgina A y B y verruculógeno en arroz, pero no lo hicieron en frutillas frescas. Los parámetros de resistencia térmica fueron: D80 ºC: 20 - 22 minutos, D85 ºC: 9 - 11 minutos, D90 ºC: 2 - 3 minutos y z: 10 - 11 ºC para N. fischeri y D80 ºC: > 120 minutos, D85 ºC: 11 - 94 minutos, D90 ºC: 3 - 15 minutos y z: 6 - 9 ºC para N. spinosa. Es indispensable aplicar buenas prácticas agrícolas y

High prevalence of the PER-1 gene among carbapenem-resistant Acinetobacter baumannii in Riyadh, Saudi Arabia.

Science.gov (United States)

Aly, M M; Abu Alsoud, N M; Elrobh, M S; Al Johani, S M; Balkhy, H H

2016-11-01

The prevalence of carbapenem-resistant Acinetobacter baumannii in Saudi Arabia and their resistance genetic mechanisms are yet to be identified. We studied the prevalence and genetic diversity of extended-spectrum beta-lactamase genes, particularly the PER-1 gene, among carbapenem-resistant A. baumannii strains from patients at a tertiary care hospital in Riyadh, Saudi Arabia between 2006 and 2014. Fresh subcultured samples were tested for antimicrobial susceptibility minimum inhibitory concentration (MIC). Total genomic DNA was extracted from each isolate and further used for polymerase chain reaction (PCR) genotyping, sequence-based typing (SBT) of PER-1 and OXA-51-like gene, and multilocus sequence typing (MLST) of positive isolates. Randomly selected clinical isolates (n = 100) were subjected to MLST. A total of 503 isolates were characterized as multidrug-resistant (MDR) using the MIC. Isolates were further PCR tested for bla -TEM and bla -PER-1 resistance genes (n = 503). The genotyping results showed that 68/503 (14 %) isolates were positive to bla TEM. The genotyping results of PER-1-like genes showed that 384/503 (76.3 %) were positive among MDR Acinetobacter isolates. Based on SBT, the majority of these isolates were clustered into three main groups including isolates harboring PER-1: AB11 (bla -PER-1 ), isolate AB16 (bla -PER-1 ), and, finally, the plasmid pAB154 (bla -PER-7 ). Remarkably, many isolates were concealing the PER-1 gene and harboring the TEM resistance genes as well. MLST results for selected isolates (n = 100) identified four main sequence types (STs: 2, 19, 20, and 25) and four novel isolates (ST 486-489). We report 76.3 % prevalence of the PER-1 resistance gene among Acinetobacter clinical isolates from Riyadh, Saudi Arabia. Further work is needed to explore the clinical risks and patient outcome with such resistance related to healthcare-associated infections and investigate the genetic and molecular mechanisms that confer the MDR

Leishmania mexicana: aspectos taxonómicos y rareza de la infección humana en Três Braços, Bahia, Brasil

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César Augusto Cuba Cuba

1984-09-01

Full Text Available Del estúdio de 51 stocks de Leishmania aislados de pacientes humanos de leishmaniasis cutaneomucosa en Três Braços, Bahia, Brasil, los autores describen, en detalle, el análisis de los dos únicos stocks de L. mexicana, identificando uno de ellos como L. mexicana amazonensis. El otro aislado permanece en posición taxonómica no definida pues considerándosele como un miembro de L. mexicana, encuéntranse dificultades para su identificación subespecífica. Evaluan también los parâmetros biológicos e isoenzimáticos y discuten el papel de los anticuerpos monoclonales en la tipificación de éstos stocks. Los autores remarcan la rareza de la transmisión de parásitos del complejo L. mexicana en esta región, aun cuando estudien epidemiológicamente por mais de 8 anos la infección humana.In a study of 51 stocks of Leishmania isolated from patients with cutaneous leishmaniasis in Três Braços, Bahia, Brazil 49 were characterized as L. braziliensis braziliensis. Only two L. mexicana stocks were identified. One was subspeciated as L. mexicana amazonensis. The other differed from this species and to date remains unspeciated. The biological parameters, isoenzyme analysis and monoclonal antibody findings relating to these two strains are discussed. Transmission of parasites of the mexicana complex to man have been rare in this region during the 8 years of study of the human infection.

Posición de los araucanos en un contexto asiático-europeo

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Luis, María Antonia

1999-01-01

Full Text Available Según el modelo clásico de poblamiento americano, los amerindios poseen un ancestro básico de tipo mongoloide, con diferenciaciones secundarias originadas por procesos microevolutivos locales. Toda comparación basada en distancias o en componentes funcionales, debería sostener entonces, la hipótesis: "las distribuciones amerindias se aproximan en mayor grado a las de las poblaciones asiáticas y en menor grado a las de las poblaciones europeas". Por componer los araucanos una población típicamente amerindia, debe esperarse que presenten mayor similitud morfológica con grupos asiáticos mongolizados y secundariamente, afinidades con grupos de extracción no mongoloide, dadas estas últimas por procesos evolutivos de adaptación convergente o mestizaje. El objeto del presente trabajo es corroborar el rechazo de dicha hipótesis (Pucciarelli et al.,1999, a través de un conjunto de nuevas comparaciones. Se procedió a medir 17 cráneos araucanos masculinos mediante 46 variables de las propuestas por Howells (1973 y compararlos con muestras de europeos (norse, zalavar, berg, asiáticos (chinos, japoneses, ainu, buriat, coreanos, filipinos y esquimales, cuyos datos fueron extraídos de los archivos proporcionados por Howells (1996. La estadística realizada consistió en análisis canónico, análisis discriminante, y "clusters" jerárquicos, mediante el programa Systat 7.0. Se halló que: (ala elipse de distribución de los araucanos fue casi equidistante respecto de norse y sudjaponeses, siendo la distancia entre éstos menor que la de cada uno de ellos respecto de araucanos; (ben el primer "cluster" con europeos, filipinos, sudjaponeses y ainu, los araucanos se separaron en un "subcluster" aislado y a la mayor distancia, le siguieron los ainu en un segundo "subcluster", mientras que los filipinos ocuparon un tercero, junto con europeos y japoneses; (cen el segundo "cluster", los araucanos se agruparon en forma intermedia entre chinos

Física y química: 1 Bachillerato. Calor y principio de conservación de la energía

OpenAIRE

Carrascosa Alís, Jaime; Martínez Sala, Salvador; Martínez-Torregrosa, Joaquín

1998-01-01

Cuando la energía mecánica disminuye, los objetos se calientan. ¿Hay alguna relación entre los cambios en propiedades mecánicas y térmicas?. La termología (con su hipótesis del "calórico") y sus límites con la mecánica: ¿cómo explicar que aumente la temperatura de todos los cuerpos cuando hay rozamiento?. Los trabajos de Joule. Generalización de la conservación de la energía. ¿Si la energía siempre se conserva en un sistema aislado, por qué hablamos de "crisis energética"?. Análisis de las ca...

Arquitectura contemporánea en rollizo en las regiones del Bío-Bío y La Araucanía

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Rodrigo Villalobos P.

1997-05-01

Full Text Available En la regiones del Bío-Bío y de la Araucanía se ha observado en el transcurso de los últimos años, un notorio desarrollo de arquitectura en rollizo de pino. Hasta ahora la historia arquitectónica del sur del país no había mostrado un masivo empleo del rollizo y los ejemplos existentes eran más bien aislados, como el caso del Fuerte Bulnes en la Patagonia Austral o la arquitectura tradicional mapuche en que los troncos de madera fueron utilizados como estructura. A diferencia de los Estados Unidos y Canadá, en que apareció arquitectura en rollizo desde los tiempos de la conquista del Oeste.

SISTEMA FIBRINOLÍTICO: MÉTODOS DE ESTUDIO Y HALLAZGOS EN VENENOS DE SERPIENTES DE LOS GENEROS Bothrops, Crotalus, Micrurus EN VENEZUELA | FIBRINOLYTIC SYSTEM: METHODS OF STUDY AND FINDINGS IN Bothrops, Crotalus, Micrurus SNAKE VENOMS IN VENEZUELA

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Alexis Rodríguez-Acosta,

2016-10-01

Full Text Available En la presente revisión se muestran resultados relevantes de actividades hemostáticas, con especial énfasis a las relacionadas con la fibrinólisis, presentes en venenos de serpientes venezolanas de los géneros Bothrops, Crotalus y Micrurus, que existen en diversas localidades geográficas. Con esta descripción, se presenta además una revisión de diversos ensayos que se utilizan en investigación para estos estudios. Se han evidenciado importantes diferencias inter e intra-especies, e incluso entre ejemplares de distintos espacios geográficos, lo que debe influir en los mecanismos de acción de sus venenos y la sintomatología clínica. Estas diferencias en composición y concentración de componentes activos, deben estar asociadas a variaciones estacionales o geográficas, dieta, sexo, hábitat, edad, e inclusive variabilidades genéticas. Ello podría explicar las discrepancias en los cuadros clínicos de las víctimas y también ayudar a determinar mecanismos de acción que faciliten una mejor orientación a los médicos tratantes. Estas variables ayudarían al seguimiento y tratamiento de los pacientes, orientando a los especialistas en antivenenos, en la escogencia del inóculo, con una mezcla amplia de venenos de diferentes especies, géneros, edad, sexo y procedencia, así como con toxinas de relevancia, para la preparación y obtención de estos antivenenos con valores de gran eficacia y amplio espectro. Los componentes bioactivos aislados, como las colombienasas y la tenerplasminina-1, por sus características biológicas, representan asimismo moléculas con un uso potencial como trombolíticos y antifibrinolíticos, respectivamente.

Apuntes sobre control de costos en la construcción

OpenAIRE

Gómez Posada, Gustavo Cayetano

2000-01-01

Resumen: ha sido una permanente y vieja aspiración de un grupo de profesores de la Facultad, entre los cuales me incluyo, dar el primer paso para abordar el tema de los controles de costos en la construcción, puesto que todo el acervo existente con respecto a dicho tema, giraba alrededor de una cantidad de conceptos aislados, de puntos de vista muy personales o particulares de una entidad o empresa, pero siempre con el común denominador de que "algo" faltaba, de que lo que se manejaba como co...

27. Tratamiento endovascular de los aneurismas postraumáticos del cayado aórtico

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M.T. González López

2012-04-01

Conclusiones: Es necesario un alto índice de sospecha de esta patología en pacientes con antecedentes de traumatismo de alta energía. Debido a la localización anatómica secundaria al origen traumático, el estudio de troncos supraaórticos y polígono de Willis es fundamental en la planificación quirúrgica de un tratamiento híbrido o endovascular aislado.

Emergence of carbapenem non-susceptible multidrug resistant Acinetobacter baumannii strains of clonal complexes 103(B) and 92(B) harboring OXA-type carbapenemases and metallo-β-lactamases in Southern India.

Science.gov (United States)

Saranathan, Rajagopalan; Vasanth, Vaidyanathan; Vasanth, Thamodharan; Shabareesh, Pidathala Raghavendra Venkata; Shashikala, P; Devi, Chandrakesan Sheela; Kalaivani, Ramakrishnan; Asir, Johny; Sudhakar, Pagal; Prashanth, K

2015-05-01

The molecular epidemiology and carbapenem resistance mechanisms of clinical isolates of Acinetobacter baumannii obtained from a south Indian tertiary care hospital were investigated by repetitive extragenic palindromic sequence PCR (REP-PCR) and multi-locus sequence typing (MLST). Analysis of resistant determinants was achieved by PCR screening for the presence of genes encoding OXA-carbapenemases, metallo-β-lactamases (MBLs) and efflux pumps. REP-PCR generated around eight clusters of high heterogeneity; of these, two major clusters (I and V) appeared to be clonal in origin. Analysis of representative isolates from different clusters by MLST revealed that most of the isolates belonged to sequence type 103 of CC103(B) . Second most prevalent ST belonged to clonal complex (CC) 92(B) which is also referred to as international clone II. Most of the isolates were multi-drug resistant, being susceptible only to polymyxin-B and newer quinolones. Class D β-lactamases such as blaOXA-51-like (100%), blaOXA-23-like (56.8%) and blaOXA-24-like (14.8%) were found to be predominant, followed by a class B β-lactamase, namely blaIMP-1 (40.7%); none of the isolates had blaOXA-58 like, blaNDM-1 or blaSIM-1 . Genes of efflux-pump adeABC were predominant, most of isolates being biofilm producers that were PCR-positive for autoinducer synthase gene (>94%). Carbapenem non-susceptible isolates were highly diverse and present throughout the hospital irrespective of type of ward or intensive care unit. Although previous reports have documented diverse resistant mechanisms in A. baumannii, production of MBL and OXA-type of carbapenamases were found to be the predominant mechanism(s) of carbapenem resistance identified in strains isolated from Southern India. © 2015 The Societies and Wiley Publishing Asia Pty Ltd.

Community-onset carbapenem-resistant Klebsiella pneumoniae urinary tract infections in infancy following NICU hospitalisation.

Science.gov (United States)

Vergadi, Eleni; Bitsori, Maria; Maraki, Sofia; Galanakis, Emmanouil

2017-10-01

Urinary tract infection (UTI) is a common bacterial infection in childhood with favourable outcome. However, the recent emergence of UTI caused by multidrug-resistant pathogens, such as carbapenem-resistant Enterobacteriaceae (CRE), has become a great concern worldwide. CRE are mainly responsible for nosocomial infections and community-onset CRE infections in healthy individuals are rare. In this study, we report a series of infants without substantial genitourinary abnormalities that were admitted with community-onset urinary tract infections (UTIs) caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) and we discuss their aetiology. We retrospectively reviewed the medical records of nine infants who presented from community to the paediatric ward with CRKP urinary tract infections, as well as all affected neonates of a concomitant CRKP outbreak that occurred in the neonatal intensive care unit (NICU) in a tertiary hospital (period from April 2009 to July 2012). We further retrieved all culture-proven CRKP infections of any site from 2007 to 2015 in our paediatric department. Over a 33-month period, nine infants, all males, aged 0.9-19.3 (median 4.0) months, were admitted to the Department of Paediatrics with UTI caused by CRKP. Three of them were diagnosed with urinary tract abnormalities but only one had vesicoureteral reflux (VUR), which was a UTI-associated one. History revealed that they had all been hospitalised in the same NICU during a concurrent long-lasting CRKP outbreak for a median of 17 (2-275) days and thereafter presented with CRKP UTI 15 to 207 (median 41) days after NICU discharge. The antibiotic susceptibility and phenotypic characteristics were identical among all isolates in NICU and the paediatric ward. The summary Figure shows a timeline of NICU hospitalisation indicative of its duration and subsequent CRKP UTI of study participants is presented. These cases illustrate that UTI caused by multidrug-resistant pathogens does not

¿Son los errores congénitos del metabolismo causa prevenible de muerte súbita?

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Roberto Álvarez Fumero

2004-03-01

Full Text Available El síndrome de muerte súbita del lactante (SMSL no es un proceso aislado, sino un hecho multifactorial y multicausal, del cual cada día se restan alteraciones potencialmente diagnosticables, para pasar a ser un diagnóstico de exclusión. Algunos errores congénitos del metabolismo (ECM han sido asociados al SMSL y/o a episodios aparentemente letales EAL, aunque la mayoría de ellos suelen tener alguna expresión clínica que los hace potencialmente diagnosticables antes de la muerte, lo que permite ser descartados de entre las causas del SMSL. De ellos, los más estrechamente relacionados con el SMSL son los trastornos de la betaoxidación mitocondrial de ácidos grasos. Solo del 3 al 5 % de los SMSL pueden guardar relación con ECM. El mayor impacto que representa el conocimiento de la asociación de SMSL y estos trastornos, es precisamente la posibilidad de su prevención. El personal médico debe conocer que la más eficiente forma de prevenir el SMSL relacionado con los ECM, es la búsqueda activa de lactantes de riesgo al realizar una exhaustiva anamnesis. Estos casos deben ser objeto de estudios metabólicos especializados, para lo cual es imprescindible conocer los requisitos de obtención, conservación y traslado de muestras al Laboratorio de Referencia.The sudden infant death syndrome (SIDS is not an isolated process, but a multifactorial and multicausal event, of which there are less potentially diagnosable alterations every day, turning into an exclusion diagnosis. Some congenital errors of metabolism have been associated with SDSI and/or with apparently lethal episodes, although most of them may have some clinical expression that makes them potentially diagnosable before death, allowing to eliminate them from the causes of SIDS. Of them, the most closely related to SIDS are the disorders of mitochondrial betaoxidation of fatty acids. Only from 3 to 5 % of the SIDS may be related to CEM. The greatest impact of knowing about the

Caracterización del riesgo familiar total de las familias con adulto mayor ubicadas en la Comuna Seis del municipio de Ibagué

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Elizabeth Fajardo Ramos

2008-01-01

Conclusiones: Los factores que más aportaron al riesgo familiar fueron familias monoparentales, con mujeres cabeza de familia. La tendencia respecto a morbilidad fue encontrar más de un enfermo en la familia; la mortalidad fue baja. Las prácticas de salud mostraron ausencia de actividades recreativas, poco gratificantes, uso indiscriminado de tratamientos, prácticas perinatales inadecuadas en gestantes, ancianos inactivos y aislados.

Investigation of a possible outbreak of carbapenem-resistant Acinetobacter baumannii in Odense, Denmark using PFGE, MLST and whole-genome-based SNPs

DEFF Research Database (Denmark)

Hammerum, Anette M; Hansen, Frank; Skov, Marianne N

2015-01-01

carbapenem-resistant A. baumannii were detected at Odense University Hospital, Odense, Denmark. These isolates were typed by PFGE, with ApaI and SmaI, respectively, and subjected to WGS. The WGS data were used for in silico extraction of MLST types using two different schemes, resistance genes and SNPs......, to which 31 publicly available A. baumannii genomes were added. RESULTS: Using ApaI, the eight isolates had four different PFGE profiles, which were further differentiated using SmaI, separating one of the profiles into two distinct PFGE types. Five ST2 (Pasteur MLST) OXA-23-producing isolates, two ST1 OXA...

Complete nucleotide sequence of pGA45, a 140,698-bp incFIIY plasmid encoding blaIMI-3-mediated carbapenem resistance, from river sediment

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Bingjun eDang

2016-02-01

Full Text Available Plasmid pGA45 was isolated from the sediment of Haihe River using E. coli CV601 (gfp-tagged as recipients and indigenous bacteria from sediment as donors. This plasmid confers reduced susceptibility to imipenem which belongs to carbapenem group. Plasmid pGA45 was fully sequenced on an Illumina HiSeq 2000 sequencing system. The complete sequence of plasmid pGA45 was 140,698 bp in length with an average G+C content of 52.03%. Sequence analysis shows that pGA45 belongs to incFIIY group and harbors a backbone region shares high homology and gene synteny to several other incF plasmids including pNDM1_EC14653, pYDC644, pNDM-Ec1GN574, pRJF866, pKOX_NDM1 and pP10164-NDM. In addition to the backbone region, plasmid pGA45 harbors two notable features including one blaIMI-3-containing region and one type VI secretion system region. The blaIMI-3-containing region is responsible for bacteria carbapenem resistance and the type VI secretion system region is probably involved in bacteria virulence, respectively. Plasmid pGA45 represents the first complete nucleotide sequence of the blaIMI-harboring plasmid from environment sample and the sequencing of this plasmid provided insight into the architecture used for the dissemination of blaIMI carbapenemase genes.

Utilidad de los índices de memoria verbal para detectar simulación en población española

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Raquel Vilar López

2013-01-01

Full Text Available Introducción. A pesar de que la literatura internacional ha demostrado la utilidad de diversos índices de las pruebas neuropsicológicas tradicionales de memoria verbal para ayudar en la detección de la simulación de problemas cognitivos, ningún estudio similar ha sido realizado todavía en nuestro contexto. Metodología. Este estudio ha incluido a 84 participantes divididos en 4 grupos: tres grupos de pacientes con traumatismo craneoencefálico leve (30 participantes que no buscan compensación económica, 14 participantes que buscan compensación económica pero no son sospechosos de simulación y un grupo de 10 participantes que busca una compensación económica y es sospechoso de simulación atendiendo a diversas pruebas específicas de simulación, además de un grupo de 30 análogos. Todos los participantes realizaron una extensa batería neuropsicológica en la que estaba incluido el Test de Aprendizaje Verbal España Complutense (TAVEC además de distintas pruebas específicas de simulación (Victoria Symptom Validity Test, Test of Memory Malingering, Dot Counting Test, el Test de la b y el Test de los 15 ítems de Rey. Resultados. Se han encontrado diferencias estadísticamente significativas entre los grupos para todos los índices del TAVEC propuestos como indicativos de simulación y tamaño del efecto elevado. Con una especificidad superior al 90%, algunos índices del TAVEC han mostrado una sensibilidad adecuada para detectar simulación: 50% el total de palabras recordadas en los cinco ensayos, el recuerdo a largo plazo y el reconocimiento, 40% el recuerdo libre a corto plazo y 60% la discriminabilidad Conclusiones. Algunos índices del TAVEC han mostrado su utilidad para ser empleados como un apoyo más en el complejo proceso de toma de decisiones que supone el diagnóstico de simulación, si bien nunca deberían interpretarse de modo aislado

Whole genome sequencing for the molecular characterization of carbapenem-resistant Klebsiella pneumoniae strains isolated at the Italian ASST Fatebenefratelli Sacco Hospital, 2012-2014.

Science.gov (United States)

Rimoldi, Sara Giordana; Gentile, Bernardina; Pagani, Cristina; Di Gregorio, Annamaria; Anselmo, Anna; Palozzi, Anna Maria; Fortunato, Antonella; Pittiglio, Valentina; Ridolfo, Anna Lisa; Gismondo, Maria Rita; Rizzardini, Giuliano; Lista, Florigio

2017-10-10

The emergence of carbapenem-resistant Klebsiella pneumoniae strains is threatening antimicrobial treatment. Sixty-eight carbapenemase-producing K. pneumoniae strains isolated at Luigi Sacco University Hospital-ASST Fatebenefratelli Sacco (Milan, Italy) between 2012 and 2014 were characterised microbiologically and molecularly. They were tested for drug susceptibility and carbapenemase phenotypes, investigated by means of repetitive extra-genic palindromic polymerase chain reaction (REP-PCR), and fully sequenced by means of next-generation sequencing for the in silico analysis of multi-locus sequence typing (MLST), their resistome, virulome and plasmid content, and their core single nucleotide polymorphism (SNP) genotypes. All of the samples were resistant to carbapenems, other β-lactams and ciprofloxacin; many were resistant to aminoglycosides and tigecycline; and seven were resistant to colistin. Resistome analysis revealed the presence of blaKPC genes and, less frequently blaSHV, blaTEM, blaCTX-M and blaOXA, which are related to resistance to carbapenem and other β-lactams. Other genes conferring resistance to aminoglycoside, fluoroquinolone, phenicol, sulphonamide, tetracycline, trimethoprim and macrolide-lincosamide-streptogramin were also detected. Genes related to AcrAB-TolC efflux pump-dependent and pump-independent tigecycline resistance mechanisms were investigated, but it was not possible to clearly correlate the genomic features with tigecycline resistance because of the presence of a common mutation in susceptible, intermediate and resistant strains. Concerning colistin resistance, the mgrB gene was disrupted by an IS5-like element, and the mobile mcr-1 and mcr-2 genes were not detected in two cases. The virulome profile revealed type-3 fimbriae and iron uptake system genes, which are important during the colonisation stage in the mammalian host environment. The in silico detected plasmid replicons were classified as IncFIB(pQil), IncFIB(K), Col

Interconnection of industrial centers with the electric network of the public service; Interconexion de centros industriales con la red electrica del servicio publico

Energy Technology Data Exchange (ETDEWEB)

Rosales Sedano, Inocente; Lopez Velazquez, Juan Jose; Garcia Paredes, Job; Robles Pimentel, Edgar [Instituto de Investigaciones Electricas, Temixco, Morelos (Mexico); Garcia Alvarez, David; Guzman Camacho, Benigno [Petroleos Mexicanos (Mexico)

2000-07-01

The large industrial centers that have continuous production processes and consume high amounts of electrical energy, generally have their own power generation. The petrochemical complexes, the paper and steel factories and the sugar mills are examples of this type of centers. On the other hand, the new regulation for the generation of electrical energy that allows to the electrical energy interchange between private companies and the public network, has originated the necessity of connecting systems that formerly operated isolated. Since the original design of the isolated electrical systems was to operate in an independent form, making the interconnection can generate technical problems that must be analyzed and solved. In this paper, some experiences related with the behavior of electrical equipment when connected to operate with the public network, are presented. [Spanish] Los grandes centros industriales que tienen procesos de produccion continua y consumen altas cantidades de energia electrica, generalmente cuentan con generacion propia. Los complejos petroquimicos, las fabricas de papel y acero y los ingenios azucareros son ejemplos de este tipo de centros. Por otro lado, la nueva reglamentacion de generacion de energia electrica que permite el intercambio de energia electrica entre las companias privadas y la red publica, ha originado la necesidad de conectar sistemas que antes operaban aislados. Debido a que el diseno original de los sistemas electricos aislados fue trabajar en forma independiente, el realizar la interconexion puede generar problemas tecnicos que tienen que analizarse y resolverse. En este articulo, se presentan algunas experiencias relacionadas con el comportamiento del equipo electrico al operar conectado con la red publica.

Risk factors for infections due to carbapenem-resistant Klebsiella pneumoniae after open heart surgery.

Science.gov (United States)

Salsano, Antonio; Giacobbe, Daniele Roberto; Sportelli, Elena; Olivieri, Guido Maria; Brega, Carlotta; Di Biase, Carlo; Coppo, Erika; Marchese, Anna; Del Bono, Valerio; Viscoli, Claudio; Santini, Francesco

2016-11-01

Patients undergoing major surgery are at increased risk of developing infections due to resistant organisms, including carbapenem-resistant Klebsiella pneumoniae (CR-Kp). In this study, we assessed risk factors for CR-Kp infections after open heart surgery in a teaching hospital in northern Italy. A retrospective study was conducted from January to December 2014. The primary outcome measure was postoperative CR-Kp infection, defined as a time-to-event end-point. The effect of potentially related variables was assessed by univariable and multivariable analyses. Secondary end-points were in-hospital mortality and 180-day postoperative mortality. Among 553 patients undergoing open heart surgery, 32 developed CR-Kp infections (6%). In the final multivariable model, CR-Kp colonization [hazard ratio (HR) 227.45, 95% confidence intervals (CI) 67.13-1225.20, P open heart surgery. CR-Kp infection after surgery significantly affected survival. Preventing colonization is conceivably the most effective current strategy to reduce the impact of CR-Kp. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

High-dose Sulbactam Treatment for Ventilator-Associated Pneumonia Caused by Carbapenem-Resistant

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In Beom Jeong

2016-11-01

Full Text Available Background Several antibiotics can be used to treat ventilator-associated pneumonia caused by carbapenem-resistant A. baumannii (CRAB-VAP including high-dose sulbactam. However, the effectiveness of high-dose sulbactam therapy is not well known. We report our experience with high-dose sulbactam for treatment of CRAB-VAP. Methods Medical records of patients with CRAB-VAP who were given high-dose sulbactam between May 2013 and June 2015 were reviewed. Results Fifty-eight patients with CRAB-VAP were treated with high-dose sulbactam. The mean age was 72.0 ± 15.2 years, and the acute physiology and chronic health evaluation II (APACHE II score was 15.1 ± 5.10 at the time of CRAB-VAP diagnosis. Early clinical improvement was observed in 65.5% of patients, and 30-day mortality was 29.3%. Early clinical failure (odds ratio [OR]: 8.720, confidence interval [CI]: 1.346-56.484; p = 0.023 and APACHE II score ≥ 14 at CRAB-VAP diagnosis (OR: 10.934, CI: 1.047-114.148; p = 0.046 were associated with 30-day mortality. Conclusions High-dose sulbactam therapy may be effective for the treatment of CRAB-VAP. However, early clinical failure was observed in 35% of patients and was associated with poor outcome.

El locus de distribución en el medio organizacional: de la valorización/ desvalorización de las explicaciones internas vs. externas utilizadas para justificar las recompensas y sanciones distribuidas por los superioresjerárquicos

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Luisa Mayoral

2011-01-01

Full Text Available A lo largo de los años, diferentes investigadores han aislado distintas creencias o sistemas de creencias que han tratado de describir y evaluar. Una de ellas es la variable o dimensión de control percibido (en inglés: LOC, que alude a las creencias sobre el control interno o externo de los reforzamientos (o refuerzos recibidos. Más precisamente, se observa que los beneficiarios de estos refuerzos se atribuyen voluntariamente la responsabilidad. El corolario del LOC, en lo que hace a la distribución de refuerzos, remite al concepto -mucho menos explorado- de atribución de la distribución de los refuerzos (en inglés: LOD. En este sentido, y de acuerdo a lo anteriormente expresado, se esperaría que los distribuidores de los refuerzos consideraran a los receptores como la fuente de los refuerzos recibidos (realizando este modo atribuciones internas en materia de refuerzos recibidos visualizándose a sí mismos como no responsables por los refuerzos que distribuyen (realizando este modo atribuciónes externas en materia de sus comportamientos distributivos de refuerzos. Si estos resultados se confirman, los agentes distribuidores se "des-responsabilizarían" de los refuerzos que ellos distribuyen, quedando de algún modo, fuera del alcance de posibles cuestionamientos y disputas, lo cual sería funcional al mantenimiento de su status como agentes de poder. Tal es la hipótesis que intentaremos verificar situándonos dentro del campo de los refuerzos distribuidos por los responsables jerárquicos a sus subordinados. Para responder a este interrogante, hemos utilizado el paradigma de la autopresentación sobrenormativa vs. contranormativa para los responsables jerárquicos y el paradigma de los juicios para los subordinados. En lo que concierne a los responsables jerárquicos, hemos verificado que para dar una buena imagen de ellos mismos, estos atribuyen los refuerzos que distribuyen a sus subordinados (y sólo después a ellos mismos o al

Discrepancy between effects of carbapenems and flomoxef in treating nosocomial hemodialysis access-related bacteremia secondary to extended spectrum beta-lactamase producing Klebsiella pneumoniae in patients on maintenance hemodialysis.

Science.gov (United States)

Yang, Chih-Chao; Li, Shau-Hsuan; Chuang, Feng-Rong; Chen, Chih-Hung; Lee, Chih-Hsiung; Chen, Jin-Bor; Wu, Chien-Hsing; Lee, Chien-Te

2012-09-05

Hemodialysis (HD) patients are susceptible to extended spectrum beta-lactamase (ESBL)-producing bacterial infections. Because the optimal treatment and clinical significance of ESBL-producing Klebsiella pneumoniae (ESBL-Kp) HD access-related bacteremia remain unclear, we conducted this retrospective study to determine the clinical outcomes of patients treated with either flomoxef or a carbapenem. The eligibility criterion was fistula or graft- or catheter- related ESBL-Kp bacteremia in patients on maintenance HD. The clinical characteristics and antibiotic management were analyzed. Outcome was determined by mortality resulting from bacteremia during the 14-day period after the first positive blood culture for flomoxef-susceptible ESBL-Kp. The 57 patients studied were predominantly elderly, malnourished, with a history of severe illnesses and broad-spectrum antibiotic use before the onset of bacteremia, and with severe septicemia as determined by the Pitt bacteremia score (PBS). The study population comprised 7 fistula, 8 graft, and 42 HD catheter-related bacteremia (CRB) cases, and the mortality rate was high (36/57, 63.2%) in these 57 patients. Of 42 patients with CRB, those in the deceased group (27/42, 64.3%) had significantly lower levels of serum albumin, longer prior hospital stay and duration of catheter-dependent HD, and higher PBS than patients in the survived group. Failure to receive effective antibiotics (flomoxef or a carbapenem) within 5 days after onset of bacteremia and treatment with flomoxef both significantly contributed to higher mortality. Multivariate analyses revealed that flomoxef use, PBS, and catheter-dependent HD >30 days were independently associated with increased mortality (OR, 3.52; 95% CI, 1.19-58.17, OR, 2.92; 95% CI, 1.36-6.26 and OR, 5.73; 95% CI, 1.21-63.2, respectively). Considering the high mortality rate, ESBL-Kp should be recognized as a possible pathogen in patients on maintenance HD at high risk of acquiring HD access

Discrepancy between effects of carbapenems and flomoxef in treating nosocomial hemodialysis access-related bacteremia secondary to extended spectrum beta-lactamase producing klebsiella pneumoniae in patients on maintenance hemodialysis

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Yang Chih-Chao

2012-09-01

Full Text Available Abstract Background Hemodialysis (HD patients are susceptible to extended spectrum beta-lactamase (ESBL-producing bacterial infections. Because the optimal treatment and clinical significance of ESBL-producing Klebsiella pneumoniae (ESBL-Kp HD access-related bacteremia remain unclear, we conducted this retrospective study to determine the clinical outcomes of patients treated with either flomoxef or a carbapenem. Methods The eligibility criterion was fistula or graft- or catheter- related ESBL-Kp bacteremia in patients on maintenance HD. The clinical characteristics and antibiotic management were analyzed. Outcome was determined by mortality resulting from bacteremia during the 14‐day period after the first positive blood culture for flomoxef-susceptible ESBL-Kp. Results The 57 patients studied were predominantly elderly, malnourished, with a history of severe illnesses and broad-spectrum antibiotic use before the onset of bacteremia, and with severe septicemia as determined by the Pitt bacteremia score (PBS. The study population comprised 7 fistula, 8 graft, and 42 HD catheter-related bacteremia (CRB cases, and the mortality rate was high (36/57, 63.2% in these 57 patients. Of 42 patients with CRB, those in the deceased group (27/42, 64.3% had significantly lower levels of serum albumin, longer prior hospital stay and duration of catheter-dependent HD, and higher PBS than patients in the survived group. Failure to receive effective antibiotics (flomoxef or a carbapenem within 5 days after onset of bacteremia and treatment with flomoxef both significantly contributed to higher mortality. Multivariate analyses revealed that flomoxef use, PBS, and catheter-dependent HD >30 days were independently associated with increased mortality (OR, 3.52; 95% CI, 1.19–58.17, OR, 2.92; 95% CI, 1.36–6.26 and OR, 5.73; 95% CI, 1.21–63.2, respectively. Conclusions Considering the high mortality rate, ESBL-Kp should be recognized as a possible pathogen in

PRUEBAS DE CARGA NO DESTRUCTIVAS EN PILOTES

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LUIS IBAÑEZ MORA

2008-01-01

Full Text Available En el presente trabajo se abordan las experiencias en la utilización de la modelación matemática y la realización de pruebas de carga no destructivas en cimentaciones sobre pilotes para evaluar su capacidad de carga. Para ello se exponen los resultados obtenidos en pruebas de carga de más de 200 Toneladas, y la distribución de cargas en una estructura portuaria, evaluando su capacidad resistente. Se establecen comparaciones entre los métodos teóricos de calculo de la capacidad de carga del pilote aislado y modelos matemáticos, así como los resultados de la pruebas de carga a escala real.

Detección del virus de la tristeza de los cítricos por serología, microscopía e hibridación in situ

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Patricia Rodríguez

2009-01-01

Full Text Available El virus de la tristeza de los cítricos (CTV es perjudicial para la citricultura y causa la enfermedad llamada tristeza de los cítricos. Infecta las especies del género Citrus ocasionando la muerte de millones de árboles. Los síntomas son decaimiento rápido (QD y acanalamiento de tallo (SP. En el trabajo se diagnosticó molecular y serológicamente al CTV en aislados provenientes de Citrus aurantifolia o Lima Tahití (LT y Citrus madurensis (Lour o Calamondino (Ca, y se realizaron estudios preliminares de detección viral por medio de microscopía óptica e hibridación in situ. Se utilizó IC-RT-PCR e inmunoimpresión de tejido (IMI expuesto a los anticuerpos monoclonales 3DF1+3CA5, y con el anticuerpo discriminante MCA 13 con técnica de Enzyme Linked Inmunossorbent Assay Doble Sándwich (Elisa-DAS. La detección por microscopía se realizó sobre secciones de pecíolo de LT y C que se tiñeron con Azure A, y con acetato de uranilo y citrato de plomo. Para la hibridación in situ se empleó una sonda marcada con digoxigenina dirigida hacia el gen de la proteína mayor de la cápside. Los resultados de IC-RT-PCR, IMI y Elisa fueron positivos para LT y C, indicando la presencia de variantes virales de tipo severo. Con microscopía de luz se detectaron inclusiones citoplasmáticas en las células acompañantes y del floema, confirmado con IMI y por hibridación in situ. Se visualizaron inclusiones de partículas virales en el tejido vegetal con microscopía electrónica con cambios en la ultraestructura celular como presencia de grandes vacuolas propias de la infección viral. Este trabajo integra distintas técnicas diagnósticas sobre dos especies cítricas exóticas.

Aislamiento e identificaci?n de diez cepas bacterianas desnitrificantes a partir de un suelo agr?cola contaminado con abonos nitrogenados proveniente de una finca productora de cebolla en la Laguna de Tota, Boyac?, Colombia

OpenAIRE

Ostos Ortiz, Olga Lucia; Benavides L?pez de Mesa, Joaqu?n; Quintero, Gladys

2006-01-01

Este articulo presenta los resultados de la versatilidad adaptativa y tolerancia de una consorcio bacteriano constituido por 10 cepas bacterianas end?micas de un suelo agr?cola contaminado, proveniente de una finca productora de cebolla ubicada en la laguna de Tota en Aquitania, Boyac?, Colombia, expuesto al uso incontrolado de fertilizantes nitrogenados. La consorcio bacteriano aislado del suelo est? conformado por: Bacillus megaterium, Bacillus licheniformis, Pseudomonas stutzeri, Acinetoba...

Antioxidant effect of melanoidins after induction of oxidative stress in isolated rat hepatocytes

OpenAIRE

Torres Rodríguez, Mª Carmen; Codoñer Franch, Pilar; Muñiz, Pilar; González, Maria Luisa; Boix, Laura; Valls Bellés, Victoria

2002-01-01

Se estudia el efecto de las melanoidinas en el estrés oxidativo inducido por adriamicina en hepatocitos aislados de rata. Las melanoidinas presentan un efecto protector, incrementando la viabilidad celular y protegiendo a los lípidos y a las proteínas del estrés oxidativo Melanoidins have a protective effect over macromolecules. They increase cellular viability and protect lipids and proteins from oxidative stress

Columnata y memoria

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Eduardo Meissner Grebe

1986-12-01

Full Text Available La arquitectura le imprime memoria a la ciudad. Esta impronta que remonta los tiempos se ha tildado en llamar memoria urbana. Se constituye a partir de la manera por la cual los diferentes estilos y tendencias han dejado su huella en el recuerdo e imagen de las gentes y así en la cultura de una sociedad. Pero también la forma y las configuraciones espaciales en la ciudad van contribuyendo a crear un substrato de referencias históricas que quizás son mucho más importantes que un objeto arquitectónico aislado.

Psicología, psicología social y asuntos económicos

OpenAIRE

Julio Eduardo Cruz

1994-01-01

La comprensión, desde una perspectiva psicológica, de los fenómenos económicos es un propósito que han perseguido varios e importantes investigadores de diferentes disciplinas científicas. Al interior de la psicología, sin embargo, tales esfuerzos han sido por varios años muy aislados, y sólo recientemente han permitido la configuración de nuevas especialidades como la Psicología Económica (PE) y la Psicología Social de los Asuntos Económicos (PSE). El presente artículo mues...

Informe científico de investigador: Balatti, Pedro Alberto (2012)

OpenAIRE

Balatti, Pedro Alberto

2012-01-01

Se analizó la diversidad genética existente en los rizobios de crecimiento rápido que nodulan la soja. Por medio de la reacción en cadena de la polimerasa y con diversos primers se generaron marcadores ERIC, REP y RAPD. Además, se amplificó el RNA de 16S el que restringión con endonucleasas. Por medio de estos marcadores se estableció, entre los representantes de Sinorhizobium fredii aislados de la China y Vietnam y Rhizobium sp. NGR234, la diversidad genética existente entre ellos. Además se...

Caída abrupta del tono muscular al entrar a sueño MOR en el ser humano

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Rosales-Lagarde, Alejandra; del Río-Portilla, Irma Yolanda; Guevara, Miguel Ángel; Corsi-Cabrera, María

2009-01-01

De acuerdo con el manual estandarizado para la clasificación del sueño en el ser humano, tres variables fisiológicas marcan el inicio del sueño con movimientos oculares rápidos (MOR): la desincronización electroencefalográfica (EEG), los movimientos oculares rápidos y la pérdida de tono muscular. De estos tres indicadores, uno de ellos, los movimientos oculares rápidos, es una manifestación intermitente o fásica que consiste en movimientos que pueden ser aislados o emitirse en salvas de vario...

Síntesis enantioselectiva de alcaloides oxindólicos a partir de lactamas bicíclicas quirales

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Ramos Bosch, Carlos Martín

2016-01-01

Los alcaloides oxindólicos de origen monoterpénico se caracterizan por poseer un núcleo 2- oxindólico con fusión espiránica 3,3' con un anillo de pirrolidina que, a su vez, forma parte de un sistema policíclico. Estos alcaloides se han aislado de plantas de las familias Apocynaceae y Rubiaceae, algunas de cuyas especies poseen gran relevancia en la medicina tradicional china. La actividad biológica de algunos miembros pertenecientes a este grupo de los alcaloides oxindólicos es de interés par...

Activity of Simulated Human Dosage Regimens of Meropenem and Vaborbactam against Carbapenem-Resistant Enterobacteriaceae in an In Vitro Hollow-Fiber Model.

Science.gov (United States)

Sabet, Mojgan; Tarazi, Ziad; Rubio-Aparicio, Debora; Nolan, Thomas G; Parkinson, Jonathan; Lomovskaya, Olga; Dudley, Michael N; Griffith, David C

2018-02-01

The objective of these studies was to evaluate the exposures of meropenem and vaborbactam that would produce antibacterial activity and prevent resistance development in carbapenem-resistant Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae strains when tested at an inoculum of 10 8 CFU/ml. Thirteen K. pneumoniae isolates, three Enterobacter cloacae isolates, and one Escherichia coli isolate were examined in an in vitro hollow-fiber model over 32 h. Simulated dosage regimens of 1 to 2 g of meropenem with 1 to 2 g of vaborbactam, with meropenem administered every 8 h by a 3-h infusion based on phase 1 or phase 3 patient pharmacokinetic data, were studied in the model. A dosage of 2 g of meropenem in combination with 2 g of vaborbactam was bactericidal against K. pneumoniae , E. cloacae , and E. coli strains, with meropenem-vaborbactam MICs of up to 8 mg/liter. When the vaborbactam exposure was adjusted to the levels observed in patients enrolled in phase 3 trials (24-h free AUC, ∼550 mg · h/liter, versus 320 mg · h/liter in the phase 1 studies), 2 g of meropenem with 2 g of vaborbactam was also bactericidal against strains with meropenem-vaborbactam MICs of 16 mg/liter. In addition, this level of vaborbactam also suppressed the development of resistance observed using phase 1 exposures. In this pharmacodynamic model, exposures similar to 2 g of meropenem in combination with 2 g of vaborbactam administered every 8 h by a 3-h infusion in phase 3 trials produced antibacterial activity and suppressed the development of resistance against carbapenem-resistant KPC-producing strains of Enterobacteriaceae . Copyright © 2018 American Society for Microbiology.

Insertional inactivation of oprD in carbapenem-resistant Pseudomonas aeruginosa strains isolated from burn patients in Tehran, Iran.

Science.gov (United States)

Shariati, A; Azimi, T; Ardebili, A; Chirani, A S; Bahramian, A; Pormohammad, A; Sadredinamin, M; Erfanimanesh, S; Bostanghadiri, N; Shams, S; Hashemi, A

2018-01-01

In this study, we report the insertion sequence IS Ppu 21 in the opr D porin gene of carbapenem-resistant Pseudomonas aeruginosa isolates from burn patients in Tehran, Iran. Antibiotic susceptibility tests for P. aeruginosa isolates were determined. Production of metallo-β-lactamases (MBLs) and carbapenemase was evaluated and the β-lactamase-encoding and aminoglycoside-modifying enzyme genes were investigated by PCR and sequencing methods. The mRNA transcription level of oprD and mex efflux pump genes were evaluated by real-time PCR. The outer membrane protein profile was determined by SDS-PAGE. The genetic relationship between the P. aeruginosa isolates was assessed by random amplified polymorphic DNA PCR. In all, 10.52% (10/95) of clinical isolates of P. aeruginosa harboured the IS Ppu 21 insertion element in the opr D gene. The extended-spectrum β-lactamase-encoding gene in IS Ppu 21-carrying isolates was bla TEM . PCR assays targeting MBL and carbapenemase-encoding genes were also negative in all ten isolates. The rmt A, aad A, aad B and arm A genes were positive in all IS Ppu 21 harbouring isolates. The relative expression levels of the mex X, mex B, mex T and mex D genes in ten isolates ranged from 0.1- to 1.4-fold, 1.1- to 3.68-fold, 0.3- to 8.22-fold and 1.7- to 35.17-fold, respectively. The relative expression levels of the oprD in ten isolates ranged from 0.57- to 35.01-fold, which was much higher than those in the control strain P. aeruginosa PAO1. Evaluation of the outer membrane protein by SDS-PAGE suggested that opr D was produced at very low levels by all isolates. Using random amplified polymorphic DNA PCR genotyping, eight of the ten isolates containing IS Ppu 21 were shown to be clonally related. The present study describes a novel molecular mechanism, IS Ppu 21 insertion of the opr D gene, associated with carbapenem resistance in clinical P. aeruginosa isolates.

Prevalencia de bacterias causantes de mastitis en fincas lecheras de Toca (Boyacá, Colombia

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Roy José Andrade-Becerra

2015-04-01

Full Text Available El presente trabajo tuvo como objetivo aislar las diferentes bacterias causantes de mastitis subclínica, de cuartos positivos a CMT (2+ o mayores a 300,000 cel/mL de vacas procedentes de fincas lecheras del municipio de Toca (Boyacá. Mediante un muestreo probabilístico de conveniencia y por medio de un estudio descriptivo longitudinal retrospectivo durante el año 2013, se estudiaron 130 fincas  especializadas en la producción de leche con promedios de 20 animales en lactancia por finca, ubicadas entre los 2300 y los 2800 msnm, con temperaturas anuales promedios de 13 °C y pluviosidades entre 800 y 1200 mm/año. Durante el año de estudio se encontró un 3.14% de cuartos positivos al CMT con grados superiores a 2 +. Streptococcus agalactiae se aisló en el 9,73%, y se convirtió en el principal patógeno aislado. Staphylococcus aureus fue aislado, en promedio, en el 6,00%. Corynebacterium bovis se aisló en el 0,30% de los casos. E. coli no se aisló. Mycoplasma bovis no se encontró en ninguna muestra. M. californicum se recuperó en el 0,50%. Levaduras, en el 0,20%, y Acholeplasma spp. se aisló en el 0,40%.

CLONACIÓN Y FILOGENIA MOLECULAR DE UN SEGMENTO DEL GEN CODANTE DE LA ACTINA DE MYRCIARIA DUBIA “CAMU-CAMU”: UN CANDIDATO PARA GEN DE REFERENCIA

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Juan Carlos Castro Gómez

2012-12-01

Full Text Available Myrciaria dubia “camu-camu” es un frutal amazónico caracterizado por su amplia variación de vitamina C. Pero los estudios genético moleculares que puedan explicar esta variación son limitados. Por ello nuestro objetivo fue realizar la clonación y filogenia molecular de un segmento del gen codante de la actina de M. dubia. Las muestras fueron obtenidas de la colección de germoplasma del INIA. Luego, el ARN fue purificado y mediante RT-PCR con cebadores degenerados se amplificó un segmento del gen. En base a la secuencia obtenida se diseñaron cebadores específicos para PCR en tiempo real. Los resultados muestran que se ha aislado, clonado y secuenciado un segmento del gen codante de actina de M. dubia y detectado su expresión en hojas, pulpa y cáscara de M. dubia. Así, con el soporte de herramientas bioinformáticas y uso de técnicas de biología molecular hemos aislado, clonado y secuenciado un segmento del gen codante de la actina de M. dubia. Asimismo, los análisis realizados muestran que el gen se expresa y presenta niveles similares de expresión en hojas, pulpa y cáscara de M. dubia. Sin embargo, es necesario realizar más experimentos a fin de verificar su estabilidad de expresión.

Diversidad de levaduras asociadas a chichas tradicionales de Colombia

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William Andrés López-Arboleda

2010-07-01

Full Text Available Título en inglés: Yeast diversity associated to Colombian traditional “chichas” Resumen En Colombia el conocimiento de la comunidad levaduriforme ha sido limitado, ya que los estudios se han enfocado principalmente en especies de interés clínico. Las fermentaciones espontáneas a partir de diversos sustratos representan hábitats de gran importancia para el estudio de la dinámica de las poblaciones de levaduras nativas, por esta razón, en el presente estudio se aislaron e identificaron las levaduras asociadas a las chichas de maíz, piña y arracacha, que son bebidas fermentadas de manera artesanal en Colombia. Se realizó el aislamiento de las levaduras más representativas de la chicha durante sus tres fases de fermentación: inicial, tumultuosa y final. Inicialmente, se hizo una caracterización parcial de los aislados, que incluyó pruebas fisiológicas, y medición de su capacidad para producir filamentos y esporas. Sin embargo, debido a que estas técnicas no fueron suficientes para identificar los aislados hasta el nivel taxonómico de género o de especie, se complementó el estudio de cada aislado empleando técnicas moleculares basadas en el análisis de restricción del gen rRNA 5.8S y los espaciadores transcritos internos (ITS1 e ITS2. Cuando el empleo de esta técnica no permitió obtener resultados definitivos y para confirmar las asignaciones realizadas usando PCR-RFLPs, se secuenció el dominio D1/D2 del gen 26S rRNA de los aislados más representativos. Mediante estas técnicas se lograron identificar las especies más representativas de los tres tipos de chicha: Candida tropicalis, Pichia kluyveri, Pichia guilliermondii, Hanseniapora guilliermondii, Pichia fermentans, Saccharomyces cerevisiae, Candida maltosa, Rhodotorula glutinis, Torulaspora delbrueckii, Hanseniaspora uvarum, Kazachstania exigua, Kluyveromyces marxianus, Yarrowia lypolitica, Candida parapsilosis, Debaromyces hansenii, Cryptococcus arboriformis

Diversidad de levaduras asociadas a chichas tradicionales de Colombia

Directory of Open Access Journals (Sweden)

William Andrés López-Arboleda

2011-01-01

Full Text Available Título en inglés: Yeast diversity associated to Colombian traditional “chichas” Resumen En Colombia el conocimiento de la comunidad levaduriforme ha sido limitado, ya que los estudios se han enfocado principalmente en especies de interés clínico. Las fermentaciones espontáneas a partir de diversos sustratos representan hábitats de gran importancia para el estudio de la dinámica de las poblaciones de levaduras nativas, por esta razón, en el presente estudio se aislaron e identificaron las levaduras asociadas a las chichas de maíz, piña y arracacha, que son bebidas fermentadas de manera artesanal en Colombia. Se realizó el aislamiento de las levaduras más representativas de la chicha durante sus tres fases de fermentación: inicial, tumultuosa y final. Inicialmente, se hizo una caracterización parcial de los aislados, que incluyó pruebas fisiológicas, y medición de su capacidad para producir filamentos y esporas. Sin embargo, debido a que estas técnicas no fueron suficientes para identificar los aislados hasta el nivel taxonómico de género o de especie, se complementó el estudio de cada aislado empleando técnicas moleculares basadas en el análisis de restricción del gen rRNA 5.8S y los espaciadores transcritos internos (ITS1 e ITS2. Cuando el empleo de esta técnica no permitió obtener resultados definitivos y para confirmar las asignaciones realizadas usando PCR-RFLPs, se secuenció el dominio D1/D2 del gen 26S rRNA de los aislados más representativos. Mediante estas técnicas se lograron identificar las especies más representativas de los tres tipos de chicha: Candida tropicalis, Pichia kluyveri, Pichia guilliermondii, Hanseniapora guilliermondii, Pichia fermentans, Saccharomyces cerevisiae, Candida maltosa, Rhodotorula glutinis, Torulaspora delbrueckii, Hanseniaspora uvarum, Kazachstania exigua, Kluyveromyces marxianus, Yarrowia lypolitica, Candida parapsilosis, Debaromyces hansenii, Cryptococcus arboriformis

Phosphate Solubilizers from the Rhizosphere of Piper nigrum L. in Karnataka, India Solubilizadores de Fosfatos desde la Rizósfera de Piper nigrum L. en Karnataka, India

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Usha Seshachala

2012-09-01

Full Text Available Black pepper (Piper nigrum L. is a climbing vine known for its pungent fruit used as a spice worldwide. The aim of this study was to evaluate the available P content in the native soils where pepper is grown as a crop plant. The native population of phosphate solubilising microbes (PSM was studied from the rhizosphere of P. nigrum plants grown in the Western Ghats of Karnataka, India. A variety of phosphate solubilising bacteria and fungi were isolated from the rhizosphere soil samples. Phosphate solubilising capacity of different isolates was studied on Pikovskaya's medium. The isolates were tested for their phosphate solubilising capacity in vitro with three different phosphate sources, tricalcium phosphate (TCP, potassium dihydrogen phosphate (KHP, and rock phosphate (RP in the concentrations 2.5, 5.0 and 7.5 g L-1. The three phosphate sources were solubilised by the isolates in varying proportions. The dominant PSM flora obtained from the samples included Bacillus and Aspergillus. The study showed that PSM utilised the three phosphate sources TCP, KHP, and RP with considerable variability. The phosphatase activity of the isolates showed that the predominant microorganisms were Bacillus subtilis (5.33 U mL-1 and Aspergillus (11.5 U mL¹. The predominant organisms were identified up to molecular level.La pimienta negra (Piper nigrum L. es una planta trepadora conocida por su fruto utilizado como especia en todo el mundo. El objetivo de este estudio fue evaluar el contenido de P disponible en los suelos nativos donde se cultiva. La población nativa de microbios solubilizantes de fosfato (PSM fue estudiada en la rizósfera de plantas de P. nigrum cultivadas en los Ghats occidentales de Karnataka, India. Una variedad de hongos y bacterias solubilizantes de fosfato fueron aislados de muestras de suelo de la rizósfera. La capacidad solubilizadora de fosfato de diferentes aislamientos fue estudiada en medio de Pikovskaya. Los aislados fueron

Informe de personal de apoyo: Bosch, María Alejandra (2011-2012)

OpenAIRE

Bosch, María Alejandra Nieves

2012-01-01

Proyectos de investigación en los cuales colabora: a) “Caracterización e identificación de aislados clínicos de Burkholderia cepacia de pacientes fibroquísticos mediante técnicas moleculares y espectroscópicas vibracionales.” Proyecto de la Secretaría de Extensión de la Facultad de Ciencias Exactas de la Universidad Nacional de La Plata (Participación: Co-dirección). b) Biofilms microb...

Bacillus sp. G3 un microorganismo promisorio en la biorremediación de aguas industriales contaminadas con cromo hexavalente

OpenAIRE

Alexander Mora Collazos

2016-01-01

Introducción: El presente trabajo tuvo como objetivo identificar y caracterizar microorganismos provenientes de un agua residual industrial potencialmente útiles en biorremediación de aguas contaminadas con cromo hexavalente. Metodología: Se realizó el aislamiento de tres microorganismos partiendo de un agua residual industrial proveniente de una empresa de galvanoplastia. Se evaluó el potencial de los microorganismos aislados en su capacidad para reducir cromo hexavalente; escogiéndose al ai...

Comparative Genomics of Two ST 195 Carbapenem-Resistant Acinetobacter baumannii with Different Susceptibility to Polymyxin Revealed Underlying Resistance Mechanism

Science.gov (United States)

Lean, Soo-Sum; Yeo, Chew Chieng; Suhaili, Zarizal; Thong, Kwai-Lin

2016-01-01

Acinetobacter baumannii is a Gram-negative nosocomial pathogen of importance due to its uncanny ability to acquire resistance to most antimicrobials. These include carbapenems, which are the drugs of choice for treating A. baumannii infections, and polymyxins, the drugs of last resort. Whole genome sequencing was performed on two clinical carbapenem-resistant A. baumannii AC29 and AC30 strains which had an indistinguishable ApaI pulsotype but different susceptibilities to polymyxin. Both genomes consisted of an approximately 3.8 Mbp circular chromosome each and several plasmids. AC29 (susceptible to polymyxin) and AC30 (resistant to polymyxin) belonged to the ST195 lineage and are phylogenetically clustered under the International Clone II (IC-II) group. An AbaR4-type resistance island (RI) interrupted the comM gene in the chromosomes of both strains and contained the blaOXA−23 carbapenemase gene and determinants for tetracycline and streptomycin resistance. AC29 harbored another copy of blaOXA−23 in a large (~74 kb) conjugative plasmid, pAC29b, but this gene was absent in a similar plasmid (pAC30c) found in AC30. A 7 kb Tn1548::armA RI which encodes determinants for aminoglycoside and macrolide resistance, is chromosomally-located in AC29 but found in a 16 kb plasmid in AC30, pAC30b. Analysis of known determinants for polymyxin resistance in AC30 showed mutations in the pmrA gene encoding the response regulator of the two-component pmrAB signal transduction system as well as in the lpxD, lpxC, and lpsB genes that encode enzymes involved in the biosynthesis of lipopolysaccharide (LPS). Experimental evidence indicated that impairment of LPS along with overexpression of pmrAB may have contributed to the development of polymyxin resistance in AC30. Cloning of a novel variant of the blaAmpC gene from AC29 and AC30, and its subsequent expression in E. coli also indicated its likely function as an extended-spectrum cephalosporinase. PMID:26779129

ESTUDIO TEÓRICO DE LA MOLÉCULA DE HIDROGENO CALCULO AB-INITIO

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N. Quitián

2010-09-01

Full Text Available Utilizando la técnica LCGO-SCF-MO (Combinación Lineal de los Orbitales Moleculares en Orbitales Gausianos, en el método del Campo Auto-Coherente, se determinaron las energías de orbital, la energía electrónica total, la energía de repulsión nuclear y la energía de Hartree-Fock de la molécula de hidrógeno en su estado fundamental, mediante un cálculo ab initio y utilizando una base de funciones gausianas. Los orbitales moleculares fueron desarrollados en términos de una función Is contraída por átomo de hidrógeno, obtenida por la minimización de los coeficientes y de los exponentes de los orbitales gausianos para el átomo aislado. Los resultados obtenidos nos permiten afirmar que la base molecular mejora sensiblemente los resultados, acercándose más al límite de Hartree-Fock.

Emergence of carbapenem resistant Escherichia coli isolates producing blaNDM and blaOXA-48-like carried on IncA/C and IncL/M plasmids at two Iranian university hospitals.

Science.gov (United States)

Solgi, Hamid; Giske, Christian G; Badmasti, Farzad; Aghamohammad, Shadi; Havaei, Seyed Asghar; Sabeti, Shahram; Mostafavizadeh, Kamyar; Shahcheraghi, Fereshteh

2017-11-01

The emergence of carbapenem resistance among Escherichia coli is a serious threat to public health. The objective of this study was to investigate resistance genes and clonality of carbapenem resistant E. coli in Iran. Between February 2015 and July 2016, a total of 32 non-duplicate E. coli isolates that were ertapenem resistant or intermediate (R/I-ETP) were collected from patient clinical or surveillance cultures (rectal swabs) at two university hospitals. Resistance genes were identified by PCR and sequencing. Conjugation experiments, PCR-based replicon typing, PFGE and multilocus sequence typing (MLST) were performed. PCR assays showed, among the 32 isolates, twenty-nine strains produced carbapenemase genes. The predominant carbapenemase was bla OXA-48 (82.8%), followed by bla NDM-1 (31%), bla NDM-7 (6.9%) and bla OXA-181 (3.4%). Seven of the bla NDM positive isolates co-harbored bla OXA-48 carbapenemases. The bla NDM and bla OXA-48 were found in IncA/C and IncL/M conjugative plasmids, respectively. The bla CTX-M-15 , qnrA and intI1 genes were also present in most isolates. The PFGE revealed genetic diversity among the 28 E. coli isolates, which belonged to six minor PFGE clusters and 14 isolates were singletons. The 26 isolates were distributed into 18 STs, of which two were dominant (ST648 and ST167). We identified one bla NDM-1 -positive ST131 E. coli isolates that harbor the bla CTX-M-15 and bla TEM genes. Horizontal transfer of IncA/C and IncL/M plasmids has likely facilitated the spread of the bla OXA-48 and bla NDM genes among E. coli. Their clonal diversity and the presence of faecal carriers in isolates suggest an endemic spread of OXA-48 and NDM. Therefore, it emphasizes the critical importance of monitoring and controlling the spread of carbapenem resistant E. coli. Copyright © 2017. Published by Elsevier B.V.

ESTUDIO QUÍMICO DE LA CORTEZA DE Remijia peruviana “Cascarilla”

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Gabriel Vargas Arana

2011-07-01

Full Text Available En el presente trabajo se realizó el análisis cualitativo de los metabolitos secundarios  y la cuantificación e identificación de los alcaloides presentes en la corteza de Remijia peruviana, la cual forma parte de la familia Rubiaceae, caracterizada por sintetizar  mayoritariamente alcaloides. Se ha aislado y determinado la estructura química de cinco alcaloides quinolínicos: tres nuevos derivados, Quinina acetato (1, Quinina alcohol (2 y N-Etil Quinina (3; y dos reportados anteriormente en la literatura: Quinina (4 y Cinchonina (5. La estructura de los nuevos alcaloides fueron elucidados por análisis básicos de espectroscopía RMN, incluyendo correlaciones homonuclear y heteronuclear (COSY, NOESY, HMBC y HSQC.

Desderivación Urinaria

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Carlos de Vivero Amador

1986-04-01

Full Text Available

Preocupación de los urólogos de todos los tiempos ha sido el desarrollo de un procedimiento operatorio que permita sustituir total o parcialmente la vejiga urinaria cuando ésta, por lesiones congénitas o adquiridas, haya cesado sus funciones o no pueda ser utilizada como órgano colector y excretor de la orina. Lesiones congénitas o adquiridas de uretra han sido motivo para derivar la orina por encima de la vejiga. Es así como numerosos métodos de derivaciones urinarias han sido ideados, siendo los primeros en su orden la nefrostomía y ureterostomía cutánea, con los inconvenientes de cambios de tubos, infección, formación de cálculos y daño progresivo renal. (1

La implantación de los uréteres al intestino fue utilizada con el fin de evitar el uso de tubos y bolsas colectoras; pero la absorción de electrolitos, las infecciones renales, la estenosis de las anastomosis y la insuficiencia renal progresiva, llevaron a muchos urólogos a no practicar más estos procedimientos y buscar otras soluciones al problema.

La implantación de los uréteres al sigmoides (Ureterosigmoidostomía se realiza en Colombia por primera vez por el Profesor Jorge E. Cavelier en 1932, cuando usa la técnica submucosa de Coffey, y en trabajo para ingresar a la Academia Nacional de Medicina informa sobre sus resultados.

Era necesario separar las materias fecales de la orina, por razones obvias; esto llevó al uso de segmentos aislados de intestino en los cuales se implantaron los uréteres, esperando en esta forma reducir la incidencia de insuficiencia renal progresiva; se acepta hoy, que los segmentos intestinales aislados constituyen los mejores órganos para sustituir, en todo o en parte, alguna porción del tracto urinario. (2

En 1944 el Profesor Santiago Triana Cortés usa el segmento ileocecal y apendicostomía en 5 pacientes y presenta este importante trabajo con carácter de comunicación preliminar a la Academia Nacional

Prevalencia de anticuerpos neutralizantes contra los serotipos del virus dengue en universitarios de Tabasco, México Prevalence of neutralizing antibodies to dengue virus serotypes in university students from Tabasco, Mexico

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Gilma Guadalupe Sánchez-Burgos

2008-10-01

Full Text Available OBJETIVO: Determinar la seroprevalencia de anticuerpos neutralizantes de los serotipos del virus dengue en estudiantes universitarios de Tabasco, México, durante los meses de septiembre a noviembre del año 2005. MATERIAL Y MÉTODOS: Se determinó la presencia de IgG contra el virus en el suero de estudiantes que acudieron al centro clínico de la universidad; en los sueros positivos se determinaron los anticuerpos neutralizantes mediante el ensayo de reducción de placa lítica. RESULTADOS: La prevalencia de IgG contra el dengue fue de 9.1%; de esta proporción, los anticuerpos neutralizantes fueron DENV-1 (20%, DENV-2 (100%, DENV-3 (4% y DENV-4 (68%. CONCLUSIONES: Este estudio muestra que el serotipo transmitido con mayor frecuencia en el estado de Tabasco es el DENV-2, aunque no ha sido el aislado con más frecuencia. La elevada prevalencia de anticuerpos neutralizantes contra el DENV-4, al parecer de reacción cruzada, podría explicar la baja circulación de este serotipo en Tabasco.OBJECTIVE: Determine the seroprevalence of neutralizing antibodies to dengue virus in students from the state university of Tabasco, Mexico. MATERIAL AND METHODS: A transversal study was conducted of serum collected from students between September and November, 2005. The sera were screened for anti-dengue IgG and those that had evidence of dengue antibodies were analyzed by a plaque reduction neutralization test. RESULTS: Prevalence of anti-dengue IgG was 9.1%. The frequency of neutralizing antibodies was 100% for DENV-2, 68% for DENV-4, 20% for DENV-1, and 4 % for DENV-3. CONCLUSIONS: We found that in this population, DENV-2 circulates more than DENV-3 despite the fact that DENV-3 is more frequently isolated. Unexpectedly, neutralizing antibodies against DENV-4 were frequently found even though this serotype is almost extinct; thus, it is probable that cross-immunity could suppress DEN-4 transmission, as has been suggested.

Aplicación de rizobacterias que promueven el crecimiento en plantas (PGPR del género Pseudomonas spp como controladores biológicos de insectos y nematodos-plagas

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Fabricio Canchignia Martínez

2015-10-01

Full Text Available Las rizobacterias son una alternativa que ha demostrado no generar resistencia en los fitopatógenos. Cepas de Pseudomonas cumplen un rol importante en el biocontrol, por su amplia diversidad de compuestos bioactivos hacia el control de patógenos de plantas. La información obtenida se enfocó al estudio de aislados de Pseudomonas spp que tienen la capacidad de disminuir la viabilidad de agentes patógenos como: hongos, bacterias, nematodos, mediante un mecanismo antagonista y de inducir los sistemas de defensa de plantas por la resistencia sistémica adquirida (RSA y resistencia sistémica inducida (RSI.

Efecto del Propóleos Chileno sobre el Metabolismo de Glucosa en Ratones Diabéticos

OpenAIRE

Pacheco, Alejandro; Daleprane, Julio B; Freitas, Vanessa S; Ferderbar, Simone; Hirabara, Sandro; Cuevas, Alejandro; Saavedra, Nicolás; Curi, Rui; Abdalla, Dulcineia S. P; Salazar, Luis A

2011-01-01

En el presente estudio se evaluó el efecto del propóleos sobre el metabolismo de la glucosa en ratones C57/BL-6 con diabetes mellitus tipo 2 inducida por dieta alta en grasa. Se midieron los cambios en las concentraciones séricas de lípidos, glucosa e insulina, y el efecto sobre la captación de 2-deoxi-[2,6-3H]-D-glucosa, síntesis de [14C]-glicógeno y descarboxilación de [U-14C]-D-glucosa inducida por insulina en músculo aislado. Los resultados muestran que en ratones diabéticos, el tratamien...

Biopsia por aspiración con aguja fina (BAAF) para el diagnóstico de linfoma no hodking cutáneo asociado a HTLV I-II. Presentación de caso.

OpenAIRE

Núñez Carrión., Ericka Cecilia

2010-01-01

INTRODUCCIÓN: El HTLV-1 es el primer retrovirus oncógeno humano que fue aislado por vez primera. Más tarde se demostró que el virus del linfoma leucemia de células T humanas (HTLV-1) era el agente causal de la Leucemia/linfoma de células T del adulto (ATL). EL HTLV-1 es más común en Japón y en el Caribe que en los Estados Unidos. También se ha descrito posteriormente en varios países latinoamericanos incluyendo Perú. El HTLV-1 pertenece a la familia de los retrovirus humanos, con tropismo pos...

Combinations of mutations in envZ, ftsI, mrdA, acrB and acrR can cause high-level carbapenem resistance in Escherichia coli

DEFF Research Database (Denmark)

Adler, Marlen; Anjum, Mehreen; Andersson, Dan I.

2016-01-01

of meropenem or ertapenem for similar to 60 generations. Isolated clones were whole-genome sequenced, and the order in which the identified mutations arose was determined in the passaged populations. Key mutations were reconstructed, and bacterial growth rates of populations and isolated clones and resistance...... levels to 23 antibiotics were measured. High-level resistance to carbapenems resulted from a combination of downstream effects of envZ mutation and target mutations in AcrAB-TolC-mediated drug export, together with PBP genes [mrdA (PBP2) after meropenem exposure or ftsI (PBP3) after ertapenem exposure...

Genotypic and Antimicrobial Susceptibility of Carbapenem-Resistant Acinetobacter baumannii: Analysis of ISAba Elements and blaOXA-23-like Genes Including A New Variant

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Abbas eBahador

2015-11-01

Full Text Available Carbapenem-resistant Acinetobacter baumannii (CR-AB causes serious nosocomial infections, especially in ICU wards of hospitals, worldwide. Expression of blaOXA genes is the chief mechanism of conferring carbapenem resistance among CR-AB. Although some blaOXA genes have been studied among CR-AB isolates from Iran, their blaOXA-23-like genes have not been investigated. We used a multiplex-PCR to detect Ambler class A, B, and D carbapenemases of 85 isolates, and determined that 34 harbored blaOXA-23-like genes. Amplified fragment length polymorphism (AFLP genotyping, followed by DNA sequencing of blaOXA-23-like amplicons of CR-AB from each AFLP group was used to characterize their blaOXA-23-like genes. We also assessed the antimicrobial susceptibility pattern of CR-AB isolates, and tested whether they harbored insertion sequences ISAba1 and ISAba4. Sequence comparison with reference strain A. baumannii (NCTC12156 revealed five types of mutations in blaOXA-23-like genes; including one novel variant and four mutants that were already reported from China and the USA. All of the blaOXA-23-like genes mutations were associated with increased minimum inhibitory concentrations (MICs against imipenem. ISAba1 and ISAba4 sequences were detected upstream of blaOXA-23 genes in 19% and 7% of isolates, respectively. The isolation of CR-AB with new blaOXA-23 mutations including some that have been reported from the USA and China highlights CR-AB pervasive distribution, which underscores the importance of concerted national and global efforts to control the spread of CR-AB isolates worldwide.

Evaluation of carriage and environmental contamination by carbapenem-resistant Acinetobacter baumannii.

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Nutman, A; Lerner, A; Schwartz, D; Carmeli, Y

2016-11-01

We evaluated the sensitivity of surveillance cultures for carbapenem-resistant Acinetobacter baumannii (CRAB) in patients and in their environment. Patients with a CRAB-positive clinical culture were sampled within 7 days; the buccal mucosa and rectum were sampled using swabs, and skin was sampled using pre-moistened sterile sponges. Sponges were also used to sample the surrounding environment. Specimens were inoculated onto CHROMagar MDR Acinetobacter plates both directly and after overnight enrichment. CRAB load was scored semi-quantitatively and composite scores for patient colonization and environmental contamination were calculated. Thirty-four patients were included. Screening sensitivity was 28/34 (82%) for buccal mucosa, 30/34 (88%) for skin, and 25/34 (74%) for rectum. Combined sensitivity was 32/34 (94%). Among patients with CRAB-positive respiratory cultures, sensitivity for buccal mucosa was 20/20 (100%). Direct inoculation had excellent sensitivity: 25/28 (89%) for all three sites combined. In the subgroup of patients who did not have a respiratory source for CRAB, direct inoculation sensitivity was lower than among patients with CRAB-positive respiratory cultures: 5/8 (63%) versus 20/20 (100%). The environment of all patients was contaminated with CRAB. There was a positive correlation between the patient colonization score and the environmental contamination score (r = 0.63, p Environmental contamination is common and can be monitored. Implementing screening may facilitate infection control efforts to limit the spread of CRAB. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Molecular epidemiology and drug resistant mechanism in carbapenem-resistant Klebsiella pneumoniae isolated from pediatric patients in Shanghai, China.

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Zhang, Xingyu; Chen, Di; Xu, Guifeng; Huang, Weichun; Wang, Xing

2018-01-01

Infection by carbapenem-resistant Klebsiella pneumoniae (CR-KP) is a public health challenge worldwide, in particular among children, which was associated with high morbidity and mortality rates. There was limited data in pediatric populations, thus this study aimed to investigate molecular epidemiology and drug resistant mechanism of CR-KP strains from pediatric patients in Shanghai, China. A total of 41 clinical CR-KP isolates from sputum, urine, blood or drainage fluid were collected between July 2014 and May 2015 in Shanghai Children's Medical Center. Multilocus sequence typing (MLST), antibiotic susceptibility testing, PCR amplification and sequencing of the drug resistance associated genes were applied to all these isolates. MLST analysis revealed 16 distinct STs identified within the 41 isolates, among which the most frequently represented were ST11(19.5%),ST25(14.6%),ST76(14.6%),ST37(9.8%).One new ST was first identified. All CR-KP isolates showed MDR phenotypes and were resistance to ceftazidime, imipenem, piperacillin / tazobactam, ceftriaxone, ampicillin /sulbactam, aztreonam. They were confirmed as carbapenemase producer, NDM-1 (56.1%, 23/41), IMP (26.8%, 11/41), KPC-2 (22.0%, 9/41) were detected. Of note, two isolates carried simultaneously both NDM-1 and IMP-4. All CR-KP strains contained at least one of extended spectrum β-lactamase genes tested(TEM, SHV, OXA-1, CTX-M group) and six isolates carried both ESBL and AmpC genes(DHA-1). Among the penicllinase and β-lactamase genes, the most frequently one is SHV(92.7%,38/41), followed by TEM-1(68.3%,28/41), CTX-M-14(43.9%,18/41), CTX-M-15(43.9%,14/41), OXA-1(14.6%,6/41). In the present study, NDM-1-producing isolates was the predominant CR-KP strains in children, follow by IMP and KPC-producing strains. NDM-1and IMP-4 were more frequent than KPC-2 and showed a multiclonal background. Those suggested carbapenem-resistant in children is diverse, and certain resistance mechanisms differ from prevalent

Trends in Resistance to Extended-Spectrum Cephalosporins and Carbapenems among Escherichia coli and Klebsiella spp. Isolates in a District in Western India during 2004–2014

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Ingvild Odsbu

2018-01-01

Full Text Available Surveillance data on the level of resistant bacteria is needed to inform strategies to reduce the development and spread of antibiotic resistance. The aim of this study was to determine the non-susceptibility trends to extended-spectrum cephalosporins and carbapenems among Escherichia coli and Klebsiella spp. isolates from the district of Nashik in Western India during the period 2004–2014. Antibacterial susceptibility testing of clinical isolates was performed using Kirby-Bauer disc diffusion method to determine inhibitory zone diameters. The change in proportions of non-susceptible bacteria over calendar time was investigated with spline transformations in a logistic regression model. For the extended-spectrum cephalosporins, the proportions of non-susceptible E. coli and Klebsiella spp. isolates were above 78.4% and 84.9% throughout the study period, respectively. E. coli and Klebsiella spp. isolates exhibited carbapenem non-susceptibility levels as high as 76.9% and 84.1% respectively. The proportions of extended-spectrum betalactamase (ESBL-producing isolates ranged from 38.3–85.9% in E. coli and from 45.1–93.1% in Klebsiella spp. Significantly higher proportions of non-susceptible and ESBL-producing isolates were found among isolates from inpatients compared to isolates from outpatients for both E. coli and Klebsiella spp. (p < 0.050. The high proportions of non-susceptible isolates observed show that there is great need to focus on optimal use of antibiotics to reduce the development of antibiotic resistance.

Los niños y los videojuegos

OpenAIRE

Orrego Gaviria, Jaime; Fundación Valle de Lili

2007-01-01

Los niños y los videojuegos / Efectos perjudiciales de la utilización de los videojuegos por los niños y adolescentes/ Efectos benéficos de la de la utilización de los videojuegos por los niños y adolescentes/ Recomendaciones para favorecer el uso adecuado/ Sistema de clasificación de los videojuegos

Control del desarrollo de hongos contaminantes de alimentos mediante iones dosificados por materiales microporosos.

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Chiericatti, Carolina Andrea Antonia; Chiericatti, Carolina Andrea Antonia

2014-01-01

Se estudió el efecto inhibitorio de Ag y Cu incorporado en matrices microporosas sobre el crecimiento de diferentes hongos, que son problemáticos en las industrias alimenticias de nuestra zona. Se estudiaron las especies fúngicas: Rhizopus oryzae, Mucor circinelloides, Geotrichum candidum, Saccharomyces cerevisiae, Debaryomyces hansenii y Zygosaccharomyces rouxii. Los Hongos filamentosos fueron aislados de productos lácteos que provocaron alteración a baja tensión de oxígeno y las levaduras f...

Actividad antimicrobiana de Illicium verum Hook. f.

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De, M.; De, A.K.; Mukhopadhyay, R.; Mir??, M.A.; Anerjee, A.B.

2001-01-01

Entre las diferentes especies de Illicium, Illicium verum Hook.f., conocido vulgarmente como an??s estrellado, posee potentes propiedades antimicrobianas. Los estudios qu??micos realizados indican que la mayor parte de esta actividad antimicrobiana se debe al anetol [1-metoxi-4-(1-propenil)-benceno] presente en el fruto desecado de esta planta. Ensayos de concentraci??n m??nima inhibitoria (CMI) con el anetol aislado, en comparaci??n con un patr??n de anetol, indicaron que es efec...

Wide Distribution of Carbapenem Resistant Acinetobacter baumannii in Burns Patients in Iran

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zahra eFarshadzadeh

2015-10-01

Full Text Available Antimicrobial resistance in carbapenem non-susceptible Acinetobacter baumannii (CNSAb is a major public health concern globally. This study determined the antibiotic resistance and molecular epidemiology of CNSAb isolates from a referral burn center in Tehran, Iran.Sixty-nine CNSAb isolates were tested for susceptibility to antimicrobial agents using the E-test methodology. Multiple locus variable number tandem repeat analysis (MLVA, Multilocus sequence typing and multiplex PCR were performed. PCR assays tested for ambler classes A, B, and D β-lactamases. Detection of ISAba1, characterization of integrons, and biofilm formation were investigated.Fifty-three (77% isolates revealed XDR phenotypes. High prevalence of blaOXA-23-like (88% and blaPER-1 (54% were detected. ISAba1 was detected upstream of blaADC, blaOXA-23-like and blaOXA51-like genes in, 97, 42 and 26% of isolates, respectively. Thirty-one (45% isolates were assigned to International Clone (IC variants. MLVA identified 56 distinct types with 6 clusters and 53 singleton genotypes. Forty previously known MLST sequence types forming 5 clonal complexes were identified. The Class 1 integron (class 1 integrons gene was identified in 84% of the isolates. The most prevalent (33% cassette combination was aacA4-catB8-aadA1. The IC variants were predominant in the A. baumannii lineage with the ability to form strong biofilms.The XDR-CNSAb from burned patients

Diversidad genética de la región variable de los genes msp1a y msp4 en cepas de Anaplasma marginale de México

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Rafael Jiménez Ocampo

2012-01-01

Full Text Available La anaplasmosis es de difícil control debido a la diversidad genética de la rickettsia. La proteína Msp1a, compuesta de repetidos variables de entre 23 y 31 aminoácidos en su región variable y la proteína Msp4, son dos de las proteínas de superficie más estudiadas en A. marginale y han sido ampliamente usadas como marcadores genéticos en la caracterización de cepas de A. marginale de diferentes orígenes geográficos. En este trabajo se analizaron, la región variable de la proteína Msp1a y la proteína Msp4 de 10 cepas mexicanas. En el caso de Msp1a, se observó un patrón de segregación que contiene los repetidos (alpha, beta, beta, gama en diferentes modalidades a lo largo de aislamientos del Golfo de México, principalmente en zonas de estabilidad enzoótica, mientras que la máxima variabilidad se presentó en Tamaulipas, en aislamientos de un brote de la enfermedad, es decir en zonas de inestabilidad. La diversidad observada no es tan extensa como se esperaba y, misma que se puede explicar por la presión que el sistema inmune del hospedero ejerce contra la rickettsia y los mecanismos de esta última para evadirla. En el caso de la proteína Msp4, la secuencia fue altamente conservada tanto en nucleótidos como en aminoácidos para los aislados en estudio, aunque, se observan diferencias con lo previamente reportado en México para este marcador.

Trabectedina (Yondelis): un agente antitumoral aislado de la ascidia Ecteinascidia turbinata

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González-Gallego Rivera, Isabel

2016-01-01

A lo largo del tiempo, innumerables formas de vida marina han evolucionado para producir una inmensa variedad de sustancias químicas. Entre éstas se encuentran moléculas que manifiestan una potente actividad biológica, desarrolladas como una forma de defensa bioquímica para sobrevivir en un entorno extremadamente competitivo. Este arsenal de moléculas (metabolitos) constituye una fuente constante de nuevos agentes terapéuticos con los cuales combatir todo tipo de enfermedades. La trabectedina...

A Rapid Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry-Based Method for Single-Plasmid Tracking in an Outbreak of Carbapenem-Resistant Enterobacteriaceae

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Lau, Anna F.; Wang, Honghui; Weingarten, Rebecca A.; Drake, Steven K.; Suffredini, Anthony F.; Garfield, Mark K.; Chen, Yong; Gucek, Marjan; Youn, Jung-Ho; Stock, Frida; Tso, Hanna; DeLeo, Jim; Cimino, James J.; Frank, Karen M.

2014-01-01

Carbapenem-resistant Enterobacteriaceae (CRE) have spread globally and represent a serious and growing threat to public health. Rapid methods for tracking plasmids carrying carbapenemase genes could greatly benefit infection control efforts. Here, we demonstrate that real-time, direct tracking of a single plasmid in a bacterial strain responsible for an outbreak is possible using a commercial matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) system. In this case, we retrospectively tracked the blaKPC carbapenemase gene-bearing pKpQIL plasmid responsible for a CRE outbreak that occurred at the NIH Clinical Center in 2011. An ∼11,109-Da MS peak corresponding to a gene product of the blaKPC pKpQIL plasmid was identified and characterized using a combination of proteomics and molecular techniques. This plasmid peak was present in spectra from retrospectively analyzed K. pneumoniae outbreak isolates, concordant with results from whole-genome sequencing, and absent from a diverse control set of blaKPC-negative clinical Enterobacteriaceae isolates. Notably, the gene characterized here is located adjacent to the blaKPC Tn4401 transposon on the pKpQIL plasmid. Sequence analysis demonstrates the presence of this gene in other blaKPC Tn4401-containing plasmids and suggests that this signature MS peak may be useful in tracking other plasmids conferring carbapenem resistance. Plasmid identification using this MALDI-TOF MS method was accomplished in as little as 10 min from isolated colonies and 30 min from positive (spiked) blood cultures, demonstrating the potential clinical utility for real-time plasmid tracking in an outbreak. PMID:24850353

Efecto in vitro de aceites esenciales de tres especies de Lippia sobre Moniliophthora roreri (Cif. y Par. Evans et al., agente causante de la moniliasis del cacao (Theobroma cacao L. In vitro effect of essential oils of three Lippia species on Moniliophthora roreri (Cif. and Par. Evans et al., causative agent of moniliasis of cocoa (Theobroma cacao L.

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Betty Stefany Lozada

2012-04-01

Full Text Available Se evaluó el efecto antifúngico in vitro de cinco aceites esenciales (AEs (AE1, AE2, AE3, AE4 y AE5 extraídos de Lippia origanoides, L. citriodora y L. alba sobre aislados de monilia (Moniliophthora roreri obtenidos de frutos de cacao infectados provenientes de San Vicente de Chucurí, Santander, Colombia. Las plantas de Lippia fueron colectadas en cinco localidades colombianas. Los aislados de monilia (M1, M2, M3, M4 y M5 fueron caracterizados por su morfología, germinación y crecimiento en medios de cultivo. La actividad antifúngica de diferentes concentraciones de los AEs fue evaluada contra el aislado M2 y la cepa de M. roreri (ATCC 64239, para determinar su efecto sobre la germinación y la inhibición del crecimiento micelial. Los AEs estudiados inhibieron 100% de la germinación y del crecimiento micelial cuando fueron utilizados en concentraciones de 800 - 1000 µg/ml. Concentraciones de 200 µg/ml también mostraron efecto sobre los aislamientos fúngicos, siendo los AEs obtenidos de L. origanoides (AE2 y AE3 los más activos. Estos estaban compuestos principalmente por timol, p-cimeno, g-terpineno, acetato de timilo, carvacrol, b-mirceno, trans-b-cariofileno. Diferencias significativas (P The in vitro antifungal effect of five essential oils (EOs (EO1, EO2, EO3, EO4 and EO5 extracted from Lippia origanoides, L. citriodora and L. alba on isolates of Monilia (Moniliophthora roreri was evaluated. Lippia plants were collected at five locations in Colombia, and monilia isolates were obtained from infected cocoa fruits collected in San Vicente de Chucurí, Santander, Colombia. The fungi strains (M1, M2, M3, M4 and M5 were characterized by morphology, germination and growth in culture media. Antifungal activity of different concentrations of EOs was evaluated against the M2 and the isolated strain of M. roreri (ATCC 64239 determining their effect on germination and mycelial growth inhibition. The five essential oils studied inhibited

Comparison among three methods for mycobacteria identification Comparación entre tres métodos para identificar micobacterias

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Misael Mondragón-Barreto