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Background: High incidences of dysentery and diarrhea were reported in a pediatric hospital in Ahvaz, Iran during March to April, 2013. Objectives: A cross-sectional study was therefore undertaken to identify the causative agents....
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Background: High incidences of dysentery and diarrhea were reported in a pediatric hospital in Ahvaz, Iran during March to April, 2013. Objectives: A cross-sectional study was therefore undertaken to identify the causative agents. Patients and Methods: A total of 230 diarrhea samples were collected from the patients and analyzed by routine bacteriological methods. Bacterial identification, serological assay, antimicrobial susceptibility testing, extended spectrum β-lactamases (ESBLs) screening and plasmid profile analysis were performed according to the standard guidelines. Results: A total of 70 Shigella strains including %70 (n = 49) S. sonnei and 30% (n = 21) S. flexneri were isolated from diarrhea samples. Most of the Shigella isolates showed high degrees of resistance to ampicillin, ulafamethoxazole- trimethoprime and cefexim. Concurrent resistance to sulafametoxazole- trimethoprime and ampicillin was the most common resistance pattern. Overall, 11.4% of Shigella isolates showed the ESBL producer criteria. The plasmid profile patterns of all the strains were determined by a modified alkaline lysis method. By plasmid profile analysis 23 genotypes were identified among all the isolates, 14 and 9 genotypes among the S. sonnei and S. flexneri respectively. S. sonnei and S. flexneri isolates demonstrated unique plasmid profiles. Conclusions: These data demonstrated that S. sonnei strains are the main cause of shigellosis as the prevalent Shigella serotype in Iran. We also found that the antibiotic resistance rates are increasing among Shigella strains. Plasmid profile analysis is more reliable than antibiotic susceptibility patterns in epidemiologic studies.
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Objectives. To characterize healthcare-associated infections due to extended-spectrum β-lactamase (ESBL)–producing strains of Escherichia coli and Klebsiella pneumoniae that harbor multiple ESBL genes, as opposed to a single ES...
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Objectives. To characterize healthcare-associated infections due to extended-spectrum β-lactamase (ESBL)–producing strains of Escherichia coli and Klebsiella pneumoniae that harbor multiple ESBL genes, as opposed to a single ESBL gene.
Methods. All patients with a confirmed healthcare-associated infection due to an ESBL-producing strain of E. coli or K. pneumoniae were enrolled in the study. Molecular typing of isolates was performed, and the comparative risks and outcomes of patients were analyzed.
Results. Among 71 patients with healthcare-associated infection due to an ESBL-producing strain of E. coli or K. pneumoniae, the gene for CTX-M, with or without other ESBL genes, was identified in all 51 (100%) of the patients infected with an E. coli strain and in 18 (90%) of the 20 patients infected with a K. pneumoniae strain. Of these 71 patients, 17 (24%) met the definition of healthcare-associated infection due to an ESBL-producing strain that harbored multiple genes; in multivariate analysis, previous exposure to 3 or more classes of antibiotics (adjusted odds ratio, 4.5 [95% confidence interval, 1.7–75.2]) was the sole risk factor for healthcare-associated infection due to an ESBL-producing strain that harbored multiple ESBL genes. Isolates recovered from patients with healthcare-associated infection due to an ESBL-producing strain that harbored multiple ESBL genes were more resistant to various antibiotic classes, and, compared with patients with healthcare-associated infection due to an ESBL-producing strain that harbored a single ESBL gene, they were more likely to have ineffective initial empirical antimicrobial therapy (52% vs 94%; odds ratio, 5.1 [95% confidence interval, 1.04–14.5]).
Conclusions. CTX-M ESBL is highly prevalent in Thailand. Patients with healthcare-associated infection due to an ESBL-producing strain that harbored multiple ESBL genes were more likely to have had ineffective initial empirical antimicrobial therapy, and, given that antibiotic selection pressure was the only associated risk, we suggest focused antimicrobial stewardship programs to limit the emergence and spread of healthcare-associated infection due to ESBL-producing strains in this middle-income country.
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Morbidity and mortality of infant infections caused by contaminated?powdered infant formula (PIF) have been reported worldwide, and pathogens like?Enterobacter sakazakii?andKlebsiella pneumoniae?are important causative agents. To ...
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Morbidity and mortality of infant infections caused by contaminated?powdered infant formula (PIF) have been reported worldwide, and pathogens like?Enterobacter sakazakii?andKlebsiella pneumoniae?are important causative agents. To evaluate the prevalence of antibiotic resistance in?E. sakazakii?and?K. pneumoniae?that caused PIF contamination in Chinese market, all the isolates from PIF were analyzed for detecting resistance to antibiotics. 30 PIF samples were randomly purchased in Chinese market in 2009 and 7?E. sakazakii?and 6?K. pneumoniae?isolates were obtained from 8 samples (26.7%), the isolates were evaluated for antibiotics susceptibility by disk diffusion technique as recommended by the Clinical Laboratory Standards Institute (CLSI). Susceptibility results showed that each isolate had different levels of resistance to β-lactam antibiotics, while sensitive to fluoroquinolones and aminoglycosides. One?K. pneumoniae?and one?E. sakazakii?isolate almost resisted all Cephalosporins chosen; the double-disk synergy test (DDST) showed these two isolates producing extended spectrum β-lactamase (ESBL). This is the first report of ESBL-produing in?E. sakazakii?from powdered infant formula in China.
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This study was undertaken to evaluate the comparison among three different assays: extended-spectrum beta-lactamases (ESBL) Nordmann/ Dortet/ Poirel (NDP) test, flow cytometric assay and disc diffusion method for the detection of ...
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This study was undertaken to evaluate the comparison among three different assays: extended-spectrum beta-lactamases (ESBL) Nordmann/ Dortet/ Poirel (NDP) test, flow cytometric assay and disc diffusion method for the detection of ESBL production. Sixty clinical isolates of Klebsiella pneumoniae were isolated from patients’ clinical samples admitted to Suez-Canal University Hospital, Ismailia Governorate. The percentages of ESBLs producing Klebsiella pneumoniae ranged from 70 to 80% by ESBL NDP and flow cytometric assays, respectively in comparison to 76.6% by disc diffusion method. The sensitivity and specificity of the three assays were evaluated and the sensitivity by ESBL NDP and disc diffusion method was 100%, while by the flow cytometric assay, it was 91.3%. The specificity of disc diffusion method in detection of ESBLs was 100%, followed by the ESBL NDP test (85.7%) and flow cytometric assay (77.8%). Kappa testing showed perfect agreement between the ESBL NDP test and disc diffusion method (kappa=0.9), while flow cytometric assay showed substantial agreement (kappa= 0.7). The ESBL NDP test offers an applicable tool for rapid detection of ESBL-production. Although, flow cytometric assay is a promising method that might be used in the clinical microbiology laboratory but there is a need for the experienced personnel along with the device.
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摘要 :
This study was undertaken to evaluate the comparison among three different assays: extended-spectrum beta-lactamases (ESBL) Nordmann/ Dortet/ Poirel (NDP) test, flow cytometric assay and disc diffusion method for the detection of ...
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This study was undertaken to evaluate the comparison among three different assays: extended-spectrum beta-lactamases (ESBL) Nordmann/ Dortet/ Poirel (NDP) test, flow cytometric assay and disc diffusion method for the detection of ESBL production. Sixty clinical isolates of Klebsiella pneumoniae were isolated from patients’ clinical samples admitted to Suez-Canal University Hospital, Ismailia Governorate. The percentages of ESBLs producing Klebsiella pneumoniae ranged from 70 to 80% by ESBL NDP and flow cytometric assays, respectively in comparison to 76.6% by disc diffusion method. The sensitivity and specificity of the three assays were evaluated and the sensitivity by ESBL NDP and disc diffusion method was 100%, while by the flow cytometric assay, it was 91.3%. The specificity of disc diffusion method in detection of ESBLs was 100%, followed by the ESBL NDP test (85.7%) and flow cytometric assay (77.8%). Kappa testing showed perfect agreement between the ESBL NDP test and disc diffusion method (kappa=0.9), while flow cytometric assay showed substantial agreement (kappa= 0.7). The ESBL NDP test offers an applicable tool for rapid detection of ESBL-production. Although, flow cytometric assay is a promising method that might be used in the clinical microbiology laboratory but there is a need for the experienced personnel along with the device.
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Aim/Objectives: This study was aimed to detect extended-spectrum beta-lactamase (ESBL) producing Pseudomonas species isolated from various clinical samples by phenotypic methods with their susceptibility testing. Materials and Met...
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Aim/Objectives: This study was aimed to detect extended-spectrum beta-lactamase (ESBL) producing Pseudomonas species isolated from various clinical samples by phenotypic methods with their susceptibility testing. Materials and Methods: Hundred Pseudomonas isolates were taken from various clinical samples of patients attending outpatient department (OPD) and inpatient department (IPD). Antimicrobial susceptibility test and ESBL detection were assessed using CLSI guidelines on Mueller Hinton agar. Results: Out of 100 Pseudomonas isolates, 46 isolates were from female and 54 were from male patients. More cases of pseudomonal infection were in the age group between 46 and 60 years (34%), and 59% of Pseudomonas species were isolated from patients belongs to urban areas and the rest 41% were from rural. The isolates collected from OPD were 61% and rest 39% from IPD. Pseudomonas species showed maximum resistance to cephalosporin group of antibiotics and showed least resistance to imipenem, and showed 100% susceptibility to colistin. ESBL production was detected in 42% of total isolates. Conclusion: The present study highlights that the Pseudomonas species remains an important cause of nosocomial infections. ESBL producing Pseudomonas species continue to be an important organism causing life-threatening infections. Multidrug resistance was seen in most of the strains. Resistance is developing even to combination of ceftazidime clavulanic acid. Resistance is developing to last resort of antibiotic, i.e. imipenem also. This gives the alarming signal for the future, making the therapeutic options more difficult. Strict infection control measures are to be taken to contain this so-called water and soil organisms as Pseudomonas.
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This study determines the antibiotic resistance pattern of extended spectrum beta-lactamase (ESBL) producing pathogens responsible for catheter associated urinary tract infection (CAUTI) and the genes associated with the resistanc...
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This study determines the antibiotic resistance pattern of extended spectrum beta-lactamase (ESBL) producing pathogens responsible for catheter associated urinary tract infection (CAUTI) and the genes associated with the resistance. The study used 35 ESBL-producing pathogens isolated from urine and biofilm found in CAUTI from June 2018 to November 2018. Pathogens were confirmed phenotypically for ESBL production with cefpodoxime combination disc kits. Antibiotic resistance was tested using the Kirby-Baurer disc diffusion method on Muller Hinton Agar. ESBL genotypes were identified with PCR. Urine isolates showed higher frequency of resistance against ciprofloxacin (94.11%), cefuroxime and ceftazidime (82.35%) and with no recorded resistance against Eertepenem (0.0%). The average resistance of the biofilm isolates ranged from 0.0% (Ertepenem) to 88.89% (Cefuroxime, Cefpodoxime, Ciprofloxacin and Trimethoprim). All the targeted genes were identified with CTX-M (40%) being the most dominant among them. The ESBL-producing pathogens showed zero resistance against Ertepenem. Ciprofloxacin and other Cephems commonly used in CAUTI treatment were shown to be less effective. The high resistance is as a result of the bacterial cells present in the biofilm with Klebsiella pneumonia exhibiting more resistance than the ESBL-producing E. coli and CTX-M-1 was identified as the most prevalent gene among the identified genotypes. Ertepenem should therefore be recommended for treatment of Catheter associated urinary tract infection.
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The aim of this study was to characterize the beta lactamases genes of bacteria isolated from urinary tract infection (UTI) in Assiut, Egypt. Results revealed that one hundred fifty nine [31.8%] out from 500 urine samples were cul...
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The aim of this study was to characterize the beta lactamases genes of bacteria isolated from urinary tract infection (UTI) in Assiut, Egypt. Results revealed that one hundred fifty nine [31.8%] out from 500 urine samples were culture-positive. Escherichia coli was the most common UTI pathogen [61%] followed by Klebsiella pneumoniae [23.3%], Proteus mirabilis [8.2%] and Pseudomonas aeruginosa [7.5%]. Sensitivity of isolates to ampicillin was [15%], amoxicillin/clavulanic acid [43.5%], ceftriaxone [24%], imipenem [95.6%], amikacin [75%], ciprofloxacin [21.4%] and trimethoprim /sulfamethoxazole [37%]. Confirmatory phenotypic detection of extended-spectrum β-lactamases [ESBLs] by ESBL E-test method resulted in [42.7%] isolates were ESBLs producers. Genotypic characterization of ESBLs genes in phenotypically positive isolates resulted in [91.2%] were ESBL producers. The presence of CTX-M type ESBL was [75%] followed by TEM [37%], OXA [24%] and SHV [21%]. Sequencing of ESBLs genes showed that CTX-M-15, OXA [1,116], TEM-1 and SHV [1, 11,111,115] as new ESBL types. Multiple sequence alignment of sequenced genes showed mutation in L31R in SHV-11[Novel SHV-115], E29Q in SHV-1[Novel SHV-111], and P65R in TEM-1 and I97M in OXA-1 [Novel OXA-116]. This study is one from first studies in Egypt that highlights the presence of multiple mutations in ESBLs.
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Several studies have been reported on the blaTEM, blaCTX-M and blaSHV genes in Extended-spectrum β-lactamase (ESBL) producing Enterobacteria, however very few studies reported in the literature are related to blaBES in ESBL produ...
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Several studies have been reported on the blaTEM, blaCTX-M and blaSHV genes in Extended-spectrum β-lactamase (ESBL) producing Enterobacteria, however very few studies reported in the literature are related to blaBES in ESBL producing Enterobacteria. This study concerns the molecular epidemiology of the blaBES gene in Enterobacteria identified from in-patients and out-patients at Saint Camille hospital of Ouagadougou (Burkina Faso). The study was first involved microbiological identification of Enterobacteria that are implicated in antibiotic resistance using API 20 E system; the antibiotics susceptibility test was secondly performed by the diffusion method and the molecular characterization was finally made by PCR to detect the blaBES gene. Data were entered and analyzed using Excel 2013 and EPI Info version 6.0 software. A p-value?收起
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Francis media was developed for the differential screening of Burkholderia pseudomallei. It was later found to have additional function of selecting extended spectrum beta lactamase (ESBL) from Enterobacteriaceae. A total of 305 E...
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Francis media was developed for the differential screening of Burkholderia pseudomallei. It was later found to have additional function of selecting extended spectrum beta lactamase (ESBL) from Enterobacteriaceae. A total of 305 Enterobacteriaceae isolates from clinical specimens (Klebsiella spp. [191], Escherichia coli [96], Enterobacter spp. [9], Citrobacter spp. [3] and others [6]) were tested for the presence of ESBL.Out of 305, 135 were ESBL producing Enterobacteriaceae tested on Francis media for the presence of yellow colonies and haze after 24 h of incubation. Francis media revealed sensitivity and specificity of 89 and 99%, respectively in detecting ESBL producing Enterobactericeae.
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