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Multidrug Resistant (MDR), Extensively Drug Resistant (XDR) and Pan Drug Resistant (PDR) variants manifest a high level of intrinsic resistance to antimicrobial drugs by the help of efflux pump, biofilm formation and aminoglycosid...
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Multidrug Resistant (MDR), Extensively Drug Resistant (XDR) and Pan Drug Resistant (PDR) variants manifest a high level of intrinsic resistance to antimicrobial drugs by the help of efflux pump, biofilm formation and aminoglycoside modifying enzymes. The potentiality of Pseudomonas spp. to produce variety of drug resistance mechanism has led to evolution of drug resistant phenotypes this poses a challenge for clinicians in the treatment of severe infection among Intensive Care Unit (ICU) patients.Aim: To determine the phenotypic profiling of β-lactamases and burden of MDR, XDR and PDR Pseudomonas aeruginosa (P. aeruginosa) in ICU patients.Materials and Methods: The present cross-sectional prospective study was carried in the Department of Microbiology, Santosh Medical College and Hospital, Ghaziabad, Uttar Pradesh, India, after permission from Institutional Ethics Committee (IEC). A total of 115 isolates of P. aeruginosa were isolated from 502 human clinical samples from January 2019 to February 2021 and all the clinical samples were non duplicate. Antimicrobial Susceptibility Testing (AST) was performed for all isolates by standard KirbyBauer disc diffusion method on Mueller Hinton Agar (MHA). Phenotypic profiling of Extended Spectrum β-Lactamase (ESBL), Metallo β-Lactamase (MBL) and Ampicillinase C (AmpC) was performed by disc potentiation test; Imipenemase (IMP) - Ethylenediamine Tetraacetic Acid (EDTA) combined disc test and Cefoxitin Cloxacillin Double Disc Synergy Test (CC-DDST), respectively. The obtained results were statistically analysed in numbers and percentages using MS Excel 2013 version.Results: Out of 502 total human clinical samples, 115 isolates were P. aeruginosa giving the prevalence rate of 23%. Among 115 Pseudomonas isolates, 60 (52%) were MDR phenotypes, 8 (7%) were XDR phenotypes and there was no PDR phenotypes isolated in present study as all isolates were sensitive to Ticarcillin/Clavulanic acid, Colistin and Polymyxin B. Out of 115 isolates, 59 (51%) were ESBL producers, 26 (23%) were MBL producers, and 6 (5%) were AmpC producers.Conclusion: Strict antibiotic policies and regular surveillance programme of antimicrobial resistance must be tailored to fend off the emergence of drug resistant Pseudomonas aeruginosa.
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Aeromonas producing extended-spectrum ?-lactamases?(ESBLs) have been reported in many countries, but there is no?information on the prevalence of ESBL-producing clinical Aeromonas in South African. A total of 230 isolates of?Aerom...
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Aeromonas producing extended-spectrum ?-lactamases?(ESBLs) have been reported in many countries, but there is no?information on the prevalence of ESBL-producing clinical Aeromonas in South African. A total of 230 isolates of?Aeromonas hydrophila?were isolated from 660 stool samples and 709 water samples collected in different municipalities in Limpopo province, South Africa over a period of three month. Isolates were screened for the production of ESBLs by the double disk diffusion test and for AmpC production by assessing resistance to cefoxitin.?blaSHV,blaTEM?,?blaCTX-M?and?blaCMY-2?were isolated from all ESBL-positive and cefoxitin-resistant isolates. Only 21 isolates were found to be ESBL producers. All 21 isolates were screened for the production of?blaSHV,?blaTEM,?blaCTX-M?and?blaCMY-2?ESBLs. Only (1/21) was found to produce?blaTEM 63?and?blaCMY-2.?All transconjugants were resistant to amoxicillin,?piperacillin, the cephalosporins and aztreonam but remainedsusceptible to cefoxitin and imipenem. Crude extracts of ?-lactamase-producingtransconjugants were able to reduce the diameters of inhibition?zones around disks containing penicillin, but had no effect on such zones around cefoxitin,?imipenem and amoxicillin-clavulanate disks. In conclusion, the occurrence of ESBLs in?A .hydrophila?emphasizes the importance of constant surveillance of clinical isolates to determine the prevalence of antibiotic resistance genes.
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ABSTRACT Introduction: Cephalosporins are a major class of antibiotics, frequently used in children because of their remarkable antibacterial activity and excellent safety profile. Time above the minimal inhibitory concentration o...
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ABSTRACT Introduction: Cephalosporins are a major class of antibiotics, frequently used in children because of their remarkable antibacterial activity and excellent safety profile. Time above the minimal inhibitory concentration of the non-protein-bound fraction (fT>MIC) is the pharmacokinetic/pharmacodynamic parameter that correlates with the therapeutic efficacy. In the pediatric population, the inter-individual variability in cephalosporin pharmacokinetics is large because of maturational changes. However, the prescription of cephalosporins promotes emergence of Enterobacteriaceae producing broad-spectrum B-lactamases. Areas covered: Here we describe in vitro activities and the main pharmacokinetic characteristics of cephalosporins in children. On the basis of these characteristics, we propose an estimation of the fT>MIC for each molecule as a tool to help optimize the use of cephalosporins. We also provide an inventory of the clinical use of cephalosporins and present prospects for the development of new molecules or associations to address the emergence of resistant strains. Expert opinion: Cephalosporins represent a heterogeneous group of antibiotics with various pharmacokinetics and in vitro antimicrobial activity that the clinician needs to master to optimize their use. However, their broad use plays a role in the emergence of broad-spectrum B-lactamase-producing strains and must thus be restricted to probabilistic broad-spectrum therapy and situations without therapeutic alternatives.
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Background: Infections due to extended spectrum ?-lactamases (ESBL) producing Escherichia coli and Klebsiella pneumoniae have become an important clinical problem. These organisms are important regarding the infection control by the physicians.
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Klebsiella pneumoniae has long been a prominent causes of nosocomial infections and outbreak have been observed in the intensive care units and in the high risk groups. We present here a brief report on an outbreak of Klebsiella p...
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Klebsiella pneumoniae has long been a prominent causes of nosocomial infections and outbreak have been observed in the intensive care units and in the high risk groups. We present here a brief report on an outbreak of Klebsiella pneumoniae which occurred in a neonatal intensive care unit in our teaching hospital. As neonates are at highest risk for acquisition of Klebsiella pneumonia producing extended spectrum B-lactamase, infection control policies and procedure should be strictly followed to prevent such outbreaks.
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Background & aims : The microbiological characteristics of spontaneous bacterial peritonitis (SBP) are changing worldwide with a shift in patterns of SBP and increasing prevalence of antibiotic-resistant bacteria. We, therefore, conducted this retrospective study aiming to characterise the current patterns and microbiology of SBP in our region. Methods: We performed a retrospective chart review of patients presenting with their first episodes of SBP. The demographical, clinical and laboratory parameters of all patients at first paracentesis were recorded. Results : The study included 200 cirrhotic patients with SBP. Mean age was 60.4±13.5 years and 116 (58%) patients were males. Liver cirrhosis was predominantly viral in 138 (69%) patients. Ascitic fluid cultures were positive in 103 (51.5%) patients and negative in 97 (48.5%). Ninety-eight (95.1%) patients had monomicrobial bacterial growth. The most common variants of spontaneous ascitic fluid infection were culture negative neutrocytic ascites (CNNA) in 97(48.5%) patients and SBP in 65 (32.5%) patients. E.Coli was most frequently isolated microorganism in 41 (39.8%) patients followed by staphylococcus species in 19 (18.4%) patients, Klebsiella pneumonae in 14(13.6%) patients and streptococcus species in 13 (10.7%) patients. The prevalence of extended spectrum beta-lactamases (ESBL) resistant E.Coli was 29.3%. Antibiotic resistance rate for meropenem, piperacillin\ tazobactam, ceftriaxone and ciprofloxacin was 0%, 22.0%, 29.0%, and 28.6% respectively. Conclusions : Changes in the patterns and microbiology of SBP are evident in our region with increasing prevalence of culture negative SBP, extended spectrum beta-lactamases resistant E.Coli, and increased resistance rate to first line antibiotics. Our data argue for relying on periodic hospital based antibiotic susceptibility data whenever SBP is treated....
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Background & aims : The microbiological characteristics of spontaneous bacterial peritonitis (SBP) are changing worldwide with a shift in patterns of SBP and increasing prevalence of antibiotic-resistant bacteria. We, therefore, conducted this retrospective study aiming to characterise the current patterns and microbiology of SBP in our region. Methods: We performed a retrospective chart review of patients presenting with their first episodes of SBP. The demographical, clinical and laboratory parameters of all patients at first paracentesis were recorded. Results : The study included 200 cirrhotic patients with SBP. Mean age was 60.4±13.5 years and 116 (58%) patients were males. Liver cirrhosis was predominantly viral in 138 (69%) patients. Ascitic fluid cultures were positive in 103 (51.5%) patients and negative in 97 (48.5%). Ninety-eight (95.1%) patients had monomicrobial bacterial growth. The most common variants of spontaneous ascitic fluid infection were culture negative neutrocytic ascites (CNNA) in 97(48.5%) patients and SBP in 65 (32.5%) patients. E.Coli was most frequently isolated microorganism in 41 (39.8%) patients followed by staphylococcus species in 19 (18.4%) patients, Klebsiella pneumonae in 14(13.6%) patients and streptococcus species in 13 (10.7%) patients. The prevalence of extended spectrum beta-lactamases (ESBL) resistant E.Coli was 29.3%. Antibiotic resistance rate for meropenem, piperacillin\ tazobactam, ceftriaxone and ciprofloxacin was 0%, 22.0%, 29.0%, and 28.6% respectively. Conclusions : Changes in the patterns and microbiology of SBP are evident in our region with increasing prevalence of culture negative SBP, extended spectrum beta-lactamases resistant E.Coli, and increased resistance rate to first line antibiotics. Our data argue for relying on periodic hospital based antibiotic susceptibility data whenever SBP is treated.
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Reasons for performing study: The increasing prevalence of antimicrobial resistant bacteria such as antimicrobial-resistant and extended spectrum beta-lactamase (ESBL)-producing Escherichia coli represents a significant problem fo...
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Reasons for performing study: The increasing prevalence of antimicrobial resistant bacteria such as antimicrobial-resistant and extended spectrum beta-lactamase (ESBL)-producing Escherichia coli represents a significant problem for human and veterinary medicine. Despite this, the risk factors for faecal carriage of such bacteria by horses in the UK, particularly those in the wider community, have not been well described. Objectives: To characterise the risk factors for faecal carriage of antimicrobial-resistant E. coli amongst horses in the mainland UK. Methods: A cross-sectional study of horses recruited by 65 randomly selected equine veterinary practices was conducted, with a faecal sample collected and self-administered questionnaire completed by the horse owner. Faecal samples were cultured for antimicrobial-resistant E. coli, with isolates confirmed as E. coli having their antimicrobial resistance profile determined. Multilevel, multivariable logistic regression models were used to investigate risk factors for the carriage of antimicrobial-resistant E. coli in the sample population. Results: Faecal samples and completed questionnaires were obtained for 627 horses located on 475 premises. Recent hospitalisation, contact with specific types of nonequid animals, the type of premises, the surrounding land use, the reason for veterinary treatment received in the last 6 months and antimicrobial treatment in the previous 10 days were identified as risk factors for many of the antimicrobial-resistance outcomes considered. Being stabled on the same yard as a recently hospitalised horse was identified as a risk factor for increased risk of carriage of ESBL-producing E. coli. Conclusions and potential relevance: Increasing antimicrobial resistance may have significant health implications for the horse population of Great Britain. This form of epidemiological investigation highlights potential risk factors that may be controlled to limit the extent of the problem.
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Aims: To characterize the diversity of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli isolates recovered within the faecal microbiota of Iberian lynx. The identification of other associated resistance genes and...
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Aims: To characterize the diversity of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli isolates recovered within the faecal microbiota of Iberian lynx. The identification of other associated resistance genes and the analysis of clonal relationship were also focused in this study. Methods and Results: From 2008 to 2010, 128 faecal samples of Iberian lynx (wild and captive animals) were collected. Eleven tested samples contained cefotaxime-resistant E. coli isolates (all belonging to captive animals) and 10 ESBL-producing isolates were showed. CTX-M-14 and SHV-12 ESBL-types were detected and seven different patterns were identified by pulsed-field gel electrophoresis analysis. Conclusions: The occurrence of unrelated multiresistant E. coli in faecal flora of captive specimens of Iberian lynx, including the presence of ESBLs, resistant genes in integrons and virulence determinants was showed in this study. Significance and Impact of the Study: The results obtained in this study highlight the environmental problem as future reintroductions of Iberian lynx could lead to a spread of resistant bacteria. Additionally, ESBL-producing bacteria can represent a health problem for this endangered species.Digital Object Identifier http://dx.doi.org/10.1111/j.1472-765X.2011.03173.x
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A toide variety of microbial infections in the body (~ 80%) are caused by bacterial biofilm, which are hardly treated because of the development of resistance against antimicrobial agents through various mechanisms. Klebsiella pne...
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A toide variety of microbial infections in the body (~ 80%) are caused by bacterial biofilm, which are hardly treated because of the development of resistance against antimicrobial agents through various mechanisms. Klebsiella pneumoniae is the causative agent of ~ 14-20% of hospital-acquired urinary tract infections, respiratory tract infections and septicemia. It has been observed that the extended spectrum β-lactamases producing K pneumoniae strain is not susceptible to third-generation cephalosporins viz., ceftizoxime, cefotaxime, ceftriaxone and ceftazidime etc. Analysis performed in Europe with 5000 Enterobacteriaceae isolates showed a high degree of resistance to many antibiotics due to bacterial biofilm formation.
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