MedWorm: Antimicrobial Resistance

Cefpodoxime vs Ciprofloxacin for Short-Course Treatment of Acute Uncomplicated Cystitis: A Randomized Trial [Original Contribution]

JAMA — Tue, 07 Feb 2012 05:00:00 +0100

Conclusions Among women with uncomplicated cystitis, a 3-day regimen of cefpodoxime compared with ciprofloxacin did not meet criteria for noninferiority for achieving clinical cure. These findings, along with concerns about possible adverse ecological effects associated with other broad-spectrum β-lactams, do not support the use of cefpodoxime as a first-line fluoroquinolone-sparing antimicrobial for acute uncomplicated cystitis. Trial Registration clinicaltrials.gov Identifier: NCT00194532 (Source: JAMA)

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[Correspondence] Treatment of Helicobacter pylori in Latin America

LANCET — Sat, 04 Feb 2012 05:00:00 +0100

In their multisite study, Robert Greenberg and colleagues attempted to identify a reliably effective treatment for Helicobacter pylori for use in Latin America. Each study site used locally available drugs and the regimens all contained clarithromycin or clarithromycin–metronidazole, despite the unacceptably low success of triple therapies elsewhere and a high expected prevalence of metronidazole resistance. The success of treatments for infectious diseases is mainly related to the absence of antimicrobial resistance and is predictable if one knows the pattern of resistance and the effect of resistance on the regimens tested. (Source: LANCET)

Correlation Between Carbapenem Consumption and Antimicrobial Resistance Rates of Acinetobacter baumannii in a University-Affiliated Hospital in China.

The Journal of Clinical Pharmacology — Thu, 02 Feb 2012 05:00:00 +0100

Authors: Cao J, Song W, Gu B, Mei YN, Tang JP, Meng L, Yang CQ, Wang H, Zhou H Abstract To investigate the correlation between carbapenem consumption and rates of antimicrobial resistance in Acinetobacter baumannii, carbapenem consumption was expressed as defined daily dose based on the World Health Organization (WHO) anatomical therapeutic chemical classification index. Clinical isolates from 2001-2009 were collected and analyzed using WHONET 5.4 software. Results show that the consumption of imipenem/cilastatin, meropenem, and total carbapenem is significantly correlated with imipenem resistance in A baumannii (r = 0.818, P = .007; r = 0.817, P = .007; r = 0.827, P = .006). Furthermore, total carbapenem consumption is significantly correlated with meropenem resistance in A bauman...

Antibiotic susceptibility profiles and first report of TEM extended-spectrum β-lactamase in Pseudomonas fluorescens from coastal waters of the Kaštela Bay, Croatia

World Journal of Microbiology and Biotechnology — Wed, 01 Feb 2012 17:10:11 +0100

Abstract The aim of this study was to investigate the antibiotic susceptibility profiles and the presence of extended-spectrum-β-lactamases (ESBLs) in Pseudomonas fluorescens isolates from coastal waters of the Kaštela Bay, Croatia. Twenty-two water samples were collected during 2009. Isolates were tested for susceptibilities to 13 antibiotics by Etest. ESBL production was confirmed by double-disk synergy test carried out on Mueller–Hinton agar plates containing efflux pump inhibitor Phe-Arg-β-naphthylamide dihydrochloride. PCR and DNA sequencing analysis were used to identify ESBL-encoding genes. The transferability of cephalosporin resistance was tested by conjugation experiments. Genetic relatedness of ESBL-producing isolates was determined by random amplified polym...

Prevalence, Distribution and Antibiotic Resistance of Emergent Arcobacter spp. from Clinically Healthy Cattle and Goats

Transboundary and Emerging Diseases — Sat, 28 Jan 2012 05:39:55 +0100

SummaryPrevalence, distribution and antibiotic resistance of Arcobacter spp. were investigated in cattle, goats, floor and treated water samples in this study. The prevalence of Arcobacter in adult and young was recorded as 8/110 (7.27%) and 4/83 (4.81%), respectively, which showed insignificant difference (P = 0.3503) in detection rates between adult and young cattle. A total of 33.33% of the floor samples and 11.11% of the treated water samples analysed were determined as positive for Arcobacter. Among the species isolated, over all, A. butzleri (45%) was the most frequently detected species, followed by A. skirrowii (5%). A. butzleri was isolated from adult cattle, floor and water samples at the rates of 75.0%, 33.4% and 50%, respectively. Co‐colonization of species was not unc...

Molecular Characterization of Salmonella enterica Serotype Enteritidis Isolates from Humans by Antimicrobial Resistance, Virulence Genes, and Pulsed-Field Gel Electrophoresis

Foodborne Pathogens and Disease — Fri, 27 Jan 2012 15:19:55 +0100

Foodborne Pathogens and Disease , Vol. 0, No. 0. (Source: Foodborne Pathogens and Disease)

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Use of aminoglycosides for peritoneal dialysis-associated peritonitis does not affect residual renal function

Nephrology Dialysis Transplantation — Fri, 27 Jan 2012 05:00:00 +0100

Conclusions. Empiric treatment with aminoglycoside for peritonitis was not associated with an adverse effect on RRF in PD patients. (Source: Nephrology Dialysis Transplantation)

Antimicrobial Resistance and Virulence Factors in Escherichia coli from Swedish Dairy Calves

Acta Veterinaria Scandinavica — Thu, 26 Jan 2012 05:00:00 +0100

Conclusions: Antimicrobial resistance was common in E. coli from pre-weaned dairy calves, occurring particularly in calves from herds experiencing calf diarrhea problems. The results indicate that more factors than use of antimicrobials influence the epidemiology of resistant E. coli.Enteropathogenic E. coli seems to be an uncommon cause of neonatal calf diarrhea in Swedish dairy herds. In practice, calf diarrhea should be regarded holistically in a context of infectious agents, calf immunity, management practices etc. We therefore advice against routine antimicrobial treatment and recommend that bacteriological cultures, followed by testing for antimicrobial susceptibility and for virulence factors, are used to guide decisions on such treatment. (Source: Acta Veterinaria Scandinavica)

Molecular characterization of β-lactam-resistant Escherichia coli isolated from Fu River, China

World Journal of Microbiology and Biotechnology — Wed, 25 Jan 2012 18:07:41 +0100

Abstract The present study aims to demonstrate the β-lactam resistance phenotypes and genotypes of Escherichia coli isolates from the Fu River in Chengdu, southwestern China. We obtained 108 E. coli isolates from nine sampling sites during May and December 2010. The total bacterial count varied from 79 colony-forming units (CFU)/ml to 14,550 CFU/ml, and coliform group number from 13 to 1,435 MPN/ml. Among the 108 isolates, 0–31.48% were resistant to β-lactams and β-lactam inhibitors, 1.85–7.40% to aminoglycoside, 1–20% to fluoroquinolone, and 50% to trimethoprim- sulfamethoxazole. The total bacterial count and antimicrobial resistance of different sites were significantly correlated (P < 0.05). Among the 34 ampicillin-resistant isolates, polymerase ...

Genetic analysis of multiple antimicrobial resistance in Salmonella isolated from diseased broilers in Egypt

Microbiology and Immunology — Wed, 25 Jan 2012 05:00:00 +0100

ABSTRACTTo date, no information is available on the molecular bases of antimicrobial resistance in Salmonella spp. from poultry in Egypt or even in Africa. Therefore, the objective of this study was to analyze, at the molecular level, the mechanism of multidrug‐resistance in isolates of Salmonella recovered from diseased broilers in Egypt. A total of 21 Salmonella isolates were identified; 13 isolates were Salmonella enterica serovar Enteritidis and eight isolates were Salmonella enterica serovar Typhimurium. 17 (81%) Salmonella isolates displayed multidrug resistance phenotypes, particularly against ampicillin, streptomycin, spectinomycin, kanamycin, tetracycline, chloramphenicol, and trimethoprim/sulfamethoxazole. PCR and DNA sequencing identified class 1 integrons in nine (42.9%) isol...

Antimicrobial Resistance in Campylobacter spp. Isolated from Ontario Sheep Flocks and Associations between Antimicrobial use and Antimicrobial Resistance

Zoonoses and Public Health — Tue, 24 Jan 2012 05:00:00 +0100

The objectives of this study were to determine the prevalence of antimicrobial resistance (AMR) in faecal Campylobacter spp. from lambs and adult sheep and associations between antimicrobial use (AMU) and AMR. A total of 275 faecal samples collected during initial and final visits from 51 sheep flocks, including one feedlot, across southern Ontario were tested for the presence of Campylobacter spp. Campylobacter jejuni was detected in 52% (143/275) of the faecal samples, Campylobacter coli in 7% (19/275), Campylobacter lari in 1% (2/275) and 2% (4/275) were non‐speciated Campylobacter. Broth microdilution was used to test antimicrobial susceptibility of 162 isolates to nine antimicrobials. Campylobacter jejuni isolates (n = 142) were resistant to tetracycline (39%), ciprofloxacin (4%...

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Heavy metals in liquid pig manure in light of bacterial antimicrobial resistance.

Environmental Research — Tue, 24 Jan 2012 05:00:00 +0100

Authors: Hölzel CS, Müller C, Harms KS, Mikolajewski S, Schäfer S, Schwaiger K, Bauer J Abstract Heavy metals are regularly found in liquid pig manure, and might interact with bacterial antimicrobial resistance. Concentrations of heavy metals were determined by atomic spectroscopic methods in 305 pig manure samples and were connected to the phenotypic resistance of Escherichia coli (n=613) against 29 antimicrobial drugs. Concentrations of heavy metals (/kg dry matter) were 0.08-5.30mg cadmium, 1.1-32.0mg chrome, 22.4-3387.6mg copper, <2.0-26.7mg lead, <0.01-0.11mg mercury, 3.1-97.3mg nickel and 93.0-8239.0mg zinc. Associated with the detection of copper and zinc, resistance rates against β-lactams were significantly elevated. By contrast, the presence of mercury was signi...

Inhaled antibiotics for nosocomial pneumonia.

Inflammation and Allergy Drug Targets — Fri, 20 Jan 2012 05:00:00 +0100

In this report, we reviewed available evidence from animal and human clinical studies in respect of the role of inhaled antibiotic therapy in pneumonia. In most studies, pneumonia cure rates were found to be comparable to that of systemic antibiotic only therapy and occasionally better. Inhaled antibiotic therapy was found to have an acceptable safety profile by avoiding systemic toxicity; despite previous concerns regarding the emergence of antimicrobial resistance, recent studies did not support such concerns. However, in respect of the sparity of data larger randomized trial are needed to shed more light in this promising form of treatment. PMID: 22280234 [PubMed - as supplied by publisher] (Source: Inflammation and Allergy Drug Targets)

Detection of Methicillin Resistant Staphylococcus aureus in Iberian pigs

Letters in Applied Microbiology — Thu, 19 Jan 2012 02:49:00 +0100

Conclusions: Despite limited contact with humans, pigs raised outdoors are colonized by an MRSA population that genetically overlaps with that of intensively farmed pigs, though antimicrobial resistance is lower.Significance and impact of the study: To our knowledge, this is the first detection of MRSA in food animals raised in free‐range conditions.© 2012 The Authors Letters in Applied Microbiology © 2012 The Society for Applied Microbiology (Source: Letters in Applied Microbiology)

In vitro antimicrobial resistance of urinary E. coli among U.S. outpatients from 2000 to 2010.

Antimicrobial Agents and Chemotherapy — Tue, 17 Jan 2012 05:00:00 +0100

This study examines in-vitro antimicrobial resistance data from E. coli urine isolates from U.S. outpatients between 2000 and 2010 using The Surveillance Network (TSN). Antimicrobial susceptibility results (n=12,253,679) showed the greatest increases in E. coli resistance from 2000 to 2010 for ciprofloxacin (3% to 17.1%) and TMP/SMX (17.9% to 24.2%), whereas nitrofurantoin (0.8% to 1.6%) and ceftriaxone (0.2% to 2.3%) showed minimal change. From 2000 to 2010, outpatient urinary E. coli antimicrobial resistance to ciprofloxacin and TMP/SMX increased substantially. PMID: 22252813 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

The natural antimicrobial peptide subtilosin acts synergistically with glycerol monolaurate, lauric arginate and {varepsilon}-poly-L-lysine against bacterial vaginosis-associated pathogens but not human lactobacilli.

Antimicrobial Agents and Chemotherapy — Tue, 17 Jan 2012 05:00:00 +0100

Authors: Sutyak Noll K, Prichard MN, Khaykin A, Sinko PJ, Chikindas ML Abstract Subtilosin is a cyclical antimicrobial peptide produced by Bacillus amyloliquefaciens that has antimicrobial activity against the bacterial vaginosis-associated human pathogen Gardnerella vaginalis. The ability of subtilosin to inhibit G. vaginalis alone and in combination with the natural antimicrobials glycerol monolaurate (Lauricidin®), lauric arginate and ε-poly-L-lysine was tested using a checkerboard approach. Subtilosin was found to synergize with all of the chosen antimicrobials. These promising results indicate that lower concentrations of subtilosin in combination with other compounds could effectively be used to inhibit growth of the pathogen, thereby decreasing the risk of developed antimi...

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Cephalosporin resistant Neisseria gonorrhoeae: time to consider gentamicin?

Sexually Transmitted Infections — Sun, 15 Jan 2012 05:00:00 +0100

The pattern of antimicrobial resistance in Neisseria gonorrhoeae is depressingly predictable. An antibiotic is chosen and used for a few years but resistance develops, so the dose is increased to maintain efficacy before the drug finally fails irrevocably. For penicillin, this process took a number of decades but with the subsequent use of tetracyclines, macrolides and fluoroquinolones, the cycle has shortened, and the utility of oral cephalosporins is now threatened within a few short years of their introduction as preferred therapy in many countries.1 Following the emergence of N gonorrhoeae strains with decreased susceptibility to oral cephalosporins, clinical treatment failures soon appeared in Japan and Hong Kong;2–4 more recently, similar outcomes have reported from other regio...

Comparative performance of culture using swabs transported in Amies medium and the Aptima Combo 2 nucleic acid amplification test in detection of Neisseria gonorrhoeae from genital and extra-genital sites: a retrospective study

Sexually Transmitted Infections — Sun, 15 Jan 2012 05:00:00 +0100

Conclusions The AC2 with AGC confirmation performs well at genital and extra-genital sites for detecting GC. Culture for GC using transport swabs performs poorly in asymptomatic men, symptomatic and asymptomatic women and at extra-genital sites. With the improved performance of nucleic acid amplification tests and the increase in GC antimicrobial resistance, research is needed into how best to optimise GC culture in settings where direct plating is not feasible. (Source: Sexually Transmitted Infections)

Antimicrobial resistance, virulence profiles, and phylogenetic groups of fecal Escherichia coli isolates: A comparative analysis between dogs and their owners in Japan.

Comparative immunology, microbiology and infectious diseases. — Sun, 15 Jan 2012 05:00:00 +0100

In this study, fecal Escherichia coli isolates (n=188) from 34 dog-owner pairs and 26 healthy control humans (2 isolates per individual) were tested for susceptibility to 6 antimicrobials and screened for virulence genes. Genetic diversity between canine and owner isolates was evaluated by pulsed-field gel electrophoresis (PFGE). Canine isolates exhibited significantly different rates of resistance to four and two antimicrobials, compared to control and owner isolates, respectively. Of the genes examined, the prevalence of sfa, hly, and cnf genes in canine isolates were higher than in control isolates, but not than in owner isolates. These results suggest that characteristics of owner isolates are somewhat similar to canine isolates, compared to isolates from non-dog owners. In addition, P...

Development of carbapenem resistance while on therapy for nontyphoid Salmonella infection

Clinical Microbiology and Infection — Fri, 13 Jan 2012 05:00:00 +0100

We report a case of infection caused by ceftriaxone‐ and ciprofloxacin‐resistant Salmonella enterica serotype Typhimurium. A blaCMY‐2‐containing Tn6092, located on a self‐transferable IncI1 plasmid, was found in all isolates derived from the patient. While on ertapenem treatment, the strain developed carbapenem resistance. Apart from the OmpD deficiency found in all isolates, the strain further developed OmpC deficiency through a single gene mutation and became carbapenem‐resistant. Salmonella appears very plastic in developing antimicrobial resistance. Caution must be taken by physicians when treating multidrug‐resistant Salmonella infection. (Source: Clinical Microbiology and Infection)

A Comparison of the Prevalence and Antimicrobial Resistance of Escherichia coli from Different Retail Meats in the United States: 2002-2008.

Applied and Environmental Microbiology — Fri, 13 Jan 2012 05:00:00 +0100

Authors: Zhao S, Blickenstaff K, Bodeis-Jones S, Gaines SA, Tong E, McDermott PF Abstract Escherichia coli were recovered from the National Antimicrobial Resistance Monitoring System retail meat program and examined for antimicrobial susceptibility. Retail meat samples (N= 11,921) from four U.S. states collected during 2002-2008 were analyzed, consisting of 2,988 chicken breast, 2,942 ground turkey, 2,991 ground beef and 3,000 pork chops. A total of 8,286 E. coli were recovered. Most chicken (83.5%) and turkey (82.0%) were contaminated with the organism, followed by beef (68.9%) and pork (44.0%). Resistance to tetracycline was most common (50.3%), followed by streptomycin (34.6%), sulfamethoxazole/sulfisoxazole (31.6%), ampicillin (22.5%), gentamicin (18.6%), kanamycin (8.4%), amox...

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Prevalence, characterization and antimicrobial resistance of Listeria monocytogenes isolated from bovine hides and carcasses.

Applied and Environmental Microbiology — Fri, 13 Jan 2012 05:00:00 +0100

Authors: Wieczorek K, Dmowska K, Osek J Abstract L. monocytogenes isolated from bovine hides and carcasses (n = 812) were mainly of serogroup 1/2a. All strains were positive for internalin genes. Several isolates (72.2%) were resistant to oxacillin or clindamycin (37.0%). These findings indicate that L. monocytogenes of beef origin can be considered as a public health concern. PMID: 22247138 [PubMed - as supplied by publisher] (Source: Applied and Environmental Microbiology)

Role of moxifloxacin for the treatment of commmunity-acquired complicated intra-abdominal infections in Taiwan.

Journal of Microbiology, Immunology, and Infection — Wed, 11 Jan 2012 05:00:00 +0100

Authors: Lau YJ, Chen YH, Huang CT, Lee WS, Liu CY, Liu JW, Liu HD, Lee YJ, Chen CW, Ko WC, Hsueh PR Abstract Complicated intra-abdominal infections (cIAIs) are common yet serious infections that can potentially lead to substantial morbidity and morbidity. As an essential adjunct to source control, the goals of antimicrobial therapy are to promote patient recovery, reduce recurrence risk, and prevent antimicrobial resistance. The current international guidelines on the empirical treatment of community-acquired complicated IAIs were published by the Infectious Diseases Society of America (IDSA) and Surgical Infections Society (SIS) in 2010. These guidelines all recommend the use of a fluoroquinolone (ciprofloxacin or levofloxacin) plus metronidazole for mild-to-moderate- and high-se...

New treatments for emerging cystic fibrosis pathogens other than Pseudomonas.

Current Pharmaceutical Design — Tue, 10 Jan 2012 05:00:00 +0100

Authors: Waters V Abstract The development of antimicrobial treatments for respiratory pathogens in cystic fibrosis (CF) has been an integral component to the increased survival of CF patients over the past fifty years. Despite significant treatment advances, however, respiratory failure secondary to chronic bacterial pulmonary infection remains the primary cause of death in CF patients. The purpose of this review is to discuss emerging pathogens (other than Pseudomonas) in CF by describing the characteristics of the organism, their clinical significance in CF, their mechanisms of antimicrobial resistance and the current treatment approaches including newer pharmaceutical modalities. This review will focus on the following pathogens: Burkholderia cepacia complex, Stenotrophomonas m...

Fosfomycin: evaluation of the published evidence on the emergence of antimicrobial resistance in Gram-negative pathogens

Journal of Antimicrobial Chemotherapy — Tue, 10 Jan 2012 05:00:00 +0100

Fosfomycin has attracted renewed interest for the treatment of lower urinary tract and even systemic infections caused by Gram-negative pathogens with resistance to traditionally used agents. The main concern regarding the clinical utility of fosfomycin refers to the potential for the emergence of resistance during therapy. In this review, we evaluate the available published evidence regarding the mechanisms and the frequency of in vitro mutational resistance to fosfomycin in Gram-negative pathogens. We also review data regarding the emergence of resistance in clinical studies of fosfomycin therapy in various infectious syndromes and data from studies that evaluate the evolution of fosfomycin resistance over time. There appears to be discordance between the high frequency of mutational res...

Trimethoprim-sulfamethoxazole Prophylaxis and Antibiotic Non-susceptibility in Invasive Pneumococcal Disease.

Antimicrobial Agents and Chemotherapy — Mon, 09 Jan 2012 05:00:00 +0100

This study informs empirical treatment of suspected IPD in patients with a history of TMP-SMX use. PMID: 22232291 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

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Changing trend of antimicrobial resistance and serotypes in Streptococcus pneumoniae in Asian countries: an ANSORP study.

Antimicrobial Agents and Chemotherapy — Mon, 09 Jan 2012 05:00:00 +0100

Authors: Kim SH, Song JH, Chung DR, Thamlikitkul V, Yang Y, Wang H, Lu M, So TM, Hsueh PR, Yasin RM, Carlos CC, Pham HV, Lalitha MK, Shimono N, Perera J, Shibl AM, Baek JY, Kang CI, Ko KS, Peck KR, Abstract Antimicrobial resistance in Streptococcus pneumoniae remains a serious concern worldwide, particularly in Asian countries, despite the introduction of heptavalent pneumococcal conjugate vaccine (PCV7). The Asian Network for Surveillance of Resistant Pathogens (ANSORP) performed a prospective surveillance study of 2,184 S. pneumoniae isolates collected from patients with pneumococcal infections from 60 hospitals in 11 Asian countries from 2008 to 2009. Among non-meningeal isolates, prevalence rate of penicillin non-susceptible pneumococci (MIC ≥ 4 μg/ml) was 4.6% and penicill...

FDA Limits Use of Cephalosporins in AnimalsFDA Limits Use of Cephalosporins in Animals

Medscape Today Headlines — Thu, 05 Jan 2012 20:56:09 +0100

The FDA is restricting the use of cephalosporins in cattle, swine, chickens, and turkeys in an effort to reduce antimicrobial resistance in humans. Medscape Medical News (Source: Medscape Today Headlines)

Structure and function of OprD protein in Pseudomonas aeruginosa: From antibiotic resistance to novel therapies.

International Journal of Medical Microbiology — Thu, 05 Jan 2012 05:00:00 +0100

Authors: Li H, Luo YF, Williams BJ, Blackwell TS, Xie CM Abstract Pseudomonas aeruginosa (P. aeruginosa) is a common pathogen isolated from patients with nosocomial infections. Due to its intrinsic and acquired antimicrobial resistance, limited classes of antibiotics can be used for the treatment of infection with P. aeruginosa. Of these, the carbapenems are very important; however, the occurrence of carbapenem-resistant strains is gradually increasing over time. Deficiency of the outer membrane protein OprD confers P. aeruginosa a basal level of resistance to carbapenems, especially to imipenem. Functional studies have revealed that loops 2 and 3 in the OprD protein contain the entrance and/or binding sites for imipenem. Therefore, any mutation in loop 2 and/or loop 3 that causes ...

After genomics, what proteomics tools could help us understand the antimicrobial resistance of Escherichia coli?

Journal of Proteomics — Thu, 05 Jan 2012 05:00:00 +0100

This article is part of a Special Issue entitled: Photosynthesis Research for Sustainability: from Natural to Artificial Photosynthesis. PMID: 22245553 [PubMed - as supplied by publisher] (Source: Journal of Proteomics)

MpeR regulates the mtr efflux locus in Neisseria gonorrhoeae and modulates antimicrobial resistance by an iron-responsive mechanism.

Antimicrobial Agents and Chemotherapy — Tue, 03 Jan 2012 05:00:00 +0100

Authors: Mercante AD, Jackson L, Johnson PJ, Stringer VA, Dyer DW, Shafer WM Abstract Previous studies have shown that the MpeR transcriptional regulator produced by Neisseria gonorrhoeae represses expression of mtrF, which encodes a putative inner membrane protein (MtrF). MtrF works as an accessory protein with the Mtr efflux pump helping gonococci to resist high levels of diverse hydrophobic antimicrobials. Regulation of mpeR has been reported to occur by an iron-dependent mechanism involving Fur (Ferric uptake regulator). Collectively, these observations suggest the presence of an interconnected regulatory system in gonococci that modulates expression of efflux pump protein-encoding genes in an iron-responsive manner. Herein, we describe this connection and report that levels of...

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Prevalence of Antimicrobial Resistance among Clinical Isolates of Bacteroides fragilis group in Canada in 2010-2011: CANWARD Surveillance Study.

Antimicrobial Agents and Chemotherapy — Tue, 27 Dec 2011 05:00:00 +0100

Authors: Karlowsky JA, Walkty AJ, Adam HJ, Baxter MR, Hoban DJ, Zhanel GG Abstract Clinical isolates of Bacteroides fragilis group (n = 387) were collected from patients attending nine Canadian hospitals in 2010-2011 and tested for susceptibility to 10 antimicrobial agents using the Clinical and Laboratory Standards Institute (CLSI) broth microdilution method. B. fragilis (59.9%), Bacteroides ovatus (16.3%), and Bacteroides thetaiotamicron (12.7%) accounted for ∼90% of isolates collected. Overall rates of percent susceptibility were: 99.7%, metronidazole; 99.5%, piperacillin-tazobactam; 99.2% imipenem; 97.7%, ertapenem; 92.0%, doripenem; 87.3%, amoxicillin-clavulanate; 80.9%, tigecycline; 65.9%, cefoxitin; 55.6%, moxifloxacin; and 52.2%, clindamycin. Percent susceptibility to cef...

Increasing antibiotic activity against a multidrug-resistant Acinetobacter spp by essential oils of Citrus limon and Cinnamomum zeylanicum.

Natural Product Research — Fri, 23 Dec 2011 05:00:00 +0100

Authors: Guerra FQ, Mendes JM, Sousa JP, Morais-Braga MF, Santos BH, Melo Coutinho HD, Lima ED Abstract The genus Acinetobacter has gained importance in recent years due to involvement in serious infections and antimicrobial resistance. Many plants have been evaluated not only for direct antimicrobial activity, but also as resistance modifying agents. The Essential oil of Citrus limon (EOCL) addition at 156.25 µgmL(-1) (MIC/8) sub-inhibitory concentration in the growth medium led to MIC decrease for amikacin, imipenem and meropenem. The Essential oil of Cinnamomum zeylanicum (EOCZ) addition at 78.125 µg mL(-1) (MIC/8) sub-inhibitory concentrations in the growth medium caused drastic MIC reduction of amikacin. Results of combining antibiotics and essential oils had shown us ...

Increasing the duration of dual amoxicillin plus omeprazole Helicobacter pylori eradication to 6 weeks: A pilot study

Journal of Gastroenterology and Hepatology — Thu, 22 Dec 2011 09:16:04 +0100

Conclusion: Despite the theory and pre‐existing data from Japan, in the USA, prolonging the duration of dual amoxicillin‐PPI therapy did not improve treatment outcome in 90% or more of our patients. (Source: Journal of Gastroenterology and Hepatology)

In vitro activity of tigecycline and comparators against Gram-negative pathogens isolated from blood in Europe (2004–2009)

International Journal of Antimicrobial Agents — Wed, 21 Dec 2011 05:00:00 +0100

Abstract: Here we report on the antimicrobial resistance amongst Gram-negative isolates (excluding Acinetobacter spp.) collected from blood culture sources at European study sites as part of the global Tigecycline Evaluation and Surveillance Trial (T.E.S.T.) from the study start in 2004 until August 2009. All isolates were collected and tested for minimum inhibitory concentrations using Clinical and Laboratory Standards Institute methodology. Over the collection period, extended-spectrum β-lactamase (ESBL) production was recorded in 21.1% of Klebsiella pneumoniae, 2.6% of Klebsiella oxytoca and 11.3% of Escherichia coli, primarily in Croatia, Greece, Hungary, Italy, Poland, Romania and the Slovak Republic. ESBL rates stabilised amongst K. pneumoniae over 2006–2009, but doubled amongst E...

Characterization of Pseudomonas aeruginosa isolates from dogs and cats in Japan: current status of antimicrobial resistance and prevailing resistance mechanisms

Microbiology and Immunology — Tue, 20 Dec 2011 05:00:00 +0100

ABSTRACTSeventy‐three Pseudomonas aeruginosa isolates were collected from dogs and cats to investigate antimicrobial susceptibility and resistance mechanisms to anti‐pseudomonal agents. Resistance rates against orbifloxacin, enrofloxacin, ciprofloxacin, cefotaxime, aztreonam and gentamicin were 34.2, 31.5, 20.5, 17.8, 12.3 and 11.0%, respectively. The level of resistance to cefotaxime, orbifloxacin, and enrofloxacin was greatly affected by efflux pump inhibitors, indicating overexpression of efflux pump contributes to these resistances. Notably, orbifloxacin and enrofloxacin resistance was observed even in isolates without mutations in the target sites. This is the first report on cephalosporin‐ and fluoroquinolone‐resistant isolates of P. aeruginosa from Japanese companion animals...

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Increasing prevalence of antimicrobial resistance among gram-negative isolates in patients with pemphigus vulgaris

Journal of the American Academy of Dermatology — Mon, 19 Dec 2011 05:52:16 +0100

To the Editor: Recent data have suggested an association between the overuse of antibiotics for the acquisition of antibiotic resistance. It has been observed that in hospitalized patients there is increased emergence and spread of antibiotic-resistant pathogens, particularly multi-resistant gram-negative bacteria (GNB). We observed the same trend in patients with pemphigus vulgaris (PV), in whom infection remains the major cause of death. Delay in treating these infections and the increasing resistance to several antibiotics have been associated with poor outcomes. Extended-spectrum β-lactamases (ESBL) are often found in GNB, particularly Klebsiella spp, Escherichia coli, and Pseudomonas aeruginosa. Usually, this process occurs as the result of cross-infection with resistant organisms du...

Whole-genome sequencing of rifampicin-resistant Mycobacterium tuberculosis strains identifies compensatory mutations in RNA polymerase genes

Nature Genetics — Sun, 18 Dec 2011 05:00:00 +0100

Authors: Iñaki Comas, Sonia Borrell, Andreas Roetzer, Graham Rose, Bijaya Malla, Midori Kato-Maeda, James Galagan, Stefan Niemann & Sebastien Gagneux Epidemics of drug-resistant bacteria emerge worldwide, even as resistant strains frequently have reduced fitness compared to their drug-susceptible counterparts. Data from model systems suggest that the fitness cost of antimicrobial resistance can be reduced by compensatory mutations; however, there is limited evidence that compensatory evolution has any significant role in the success of drug-resistant bacteria in human populations. Here we describe a set of compensatory mutations in the RNA polymerase genes of rifampicin-resistant M. tuberculosis, the etiologic agent of human tuberculosis (TB). M. tuberculosis strains harboring the...

Re: Antimicrobial Resistance in More Than 100,000 Escherichia coli Isolates According to Culture Site and Patient Age, Gender, and Location

The Journal of Urology — Thu, 15 Dec 2011 05:00:00 +0100

J. M. Sahuquillo-Arce, M. Selva, H. Perpiñán, M. Gobernado, C. Armero, López-A. Quílez, F. González and H. Vanaclocha Hospital La Fe, Valencia, Spain (Source: The Journal of Urology)

ICEPmu1, an integrative conjugative element (ICE) of Pasteurella multocida: analysis of the regions that comprise 12 antimicrobial resistance genes

Journal of Antimicrobial Chemotherapy — Mon, 12 Dec 2011 05:00:00 +0100

Conclusions The observation that 12 resistance genes, organized in two resistance gene regions, represent part of an ICE in P. multocida underlines the risk of simultaneous acquisition of multiple resistance genes via a single horizontal gene transfer event. (Source: Journal of Antimicrobial Chemotherapy)

Comparison of antimicrobial resistance patterns of Salmonella spp. and Escherichia coli recovered from pet dogs from volunteer households in Ontario (2005-06)

Journal of Antimicrobial Chemotherapy — Mon, 12 Dec 2011 05:00:00 +0100

Conclusions Pet dogs are a potential household source of antimicrobial-resistant Salmonella spp. and E. coli. However, extrapolating the epidemiology of antimicrobial resistance in pathogens, like Salmonella, from E. coli should be done with caution. (Source: Journal of Antimicrobial Chemotherapy)

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Impact of Carbapenem Resistance on Mortality in Pseudomonas aeruginosa Bloodstream Infections. A Prospective Multicenter Study.

Antimicrobial Agents and Chemotherapy — Mon, 12 Dec 2011 05:00:00 +0100

This study clarifies the relationship between carbapenem resistance and mortality of patients with P. aeruginosa bacteremia. Although resistance was associated with a higher risk of mortality, the study suggested that this deleterious effect may be not as great during the first days of the bacteremia or in the presence of comorbidities. PMID: 22155832 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

High-level cefixime- and ceftriaxone-resistant N. gonorrhoeae in Europe (France): novel penA mosaic allele in a successful international clone causes treatment failure.

Antimicrobial Agents and Chemotherapy — Mon, 12 Dec 2011 05:00:00 +0100

Authors: Unemo M, Golparian D, Nicholas R, Ohnishi M, Gallay A, Sednaoui P Abstract Recently, the first Neisseria gonorrhoeae strain (H041) highly resistant to the extended-spectrum cephalosporins (ESC) ceftriaxone and cefixime, which are the last remaining options for first-line gonorrhoea treatment, was isolated in Japan. Here, we confirm and characterize a second strain (F89) with high-level cefixime and ceftriaxone resistance, which was isolated in France and most likely caused a treatment failure with cefixime. F89 was examined using six species-confirmatory tests, antibiograms (33 antimicrobials), porB sequencing, N. gonorrhoeae multiantigen sequence typing (NG-MAST), multilocus sequence typing (MLST), and sequencing of known gonococcal resistance determinants (penA, mtrR, pe...

A multicenter surveillance of antimicrobial resistance on Stenotrophomonas maltophilia in Taiwan.

Journal of Microbiology, Immunology, and Infection — Sat, 10 Dec 2011 05:00:00 +0100

CONCLUSION: In this 10-year study, minocycline and TMP-SMX remained the two antimicrobials with better in vitro activities against S. maltophilia than ceftazidime, levofloxacin, and ticarcillin-clavulanic acid. The activity of levofloxacin against S. maltophilia in Taiwan declined during the past 10 years. PMID: 22154599 [PubMed - as supplied by publisher] (Source: Journal of Microbiology, Immunology, and Infection)

Antimicrobial resistance of Moraxella catarrhalis isolates in Taiwan.

Journal of Microbiology, Immunology, and Infection — Thu, 08 Dec 2011 05:00:00 +0100

CONCLUSION: The rates of resistance to cefaclor, cefuroxime, tetracycline and SXT are now increasing in Taiwan. Molecular typing showed that at least two closely related BRO-1 clones are circulating. Although amoxicillin + clavulanate remains the antimicrobial therapy of choice for M. catarrhalis infections, continued surveillance of antimicrobial susceptibility and application of control measures against further transmission are required to inhibit the emergence of the resistant strains. PMID: 22154675 [PubMed - as supplied by publisher] (Source: Journal of Microbiology, Immunology, and Infection)

Antimicrobial Susceptibility Among Gram-Negative Isolates Collected From Intensive Care Units in North America, Europe, the Asia-Pacific Rim, Latin America, the Middle East, and Africa Between 2004 and 2009 as Part of the Tigecycline Evaluation and Surveillance Trial.

Clinical Therapeutics — Wed, 07 Dec 2011 05:00:00 +0100

CONCLUSIONS: Antimicrobial resistance among gram-negative intensive care unit isolates was highly variable between geographic regions. The carbapenems were active in vitro against Enterobacteriaceae, A baumannii and P aeruginosa, and tigecycline continued to be active in vitro against members of the Enterobacteriaceae and A baumannii collected from intensive care units in North America, Europe, the Asia-Pacific Rim, Latin America, the Middle East, and Africa. PMID: 22154196 [PubMed - as supplied by publisher] (Source: Clinical Therapeutics)

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Prevalence and antimicrobial resistance of Salmonella isolated from fish, shrimp, lobster, and crab in Iran

Comparative Clinical Pathology — Tue, 06 Dec 2011 07:01:32 +0100

The objective of this study was to determine the Salmonella prevalence, the serotypes involved, and antimicrobial susceptibility patterns of Salmonella isolates recovered from fish, shrimp, lobster, and crab in Iran. A total of 384 samples of fish, shrimp, lobster, and crab were collected in three provinces along the Persian Gulf in the south coast of Iran. Samples were collected at the end of each month from September 2009 to May 2011. All samples were evaluated for the presence of Salmonella, stereotyped and tested for antimicrobial susceptibility. There was an overall Salmonella prevalence of 5%. Salmonella was isolated from a significantly larger number of fish (10.4%) than shrimp (1.8%; P ≤ 0.05). No Salmonella was isolated from lobster and crab samples. Salmonella isolates re...

[Spontaneous and Secondary Bacterial Peritonitis in Cirrhotic Patients with Ascites.]

Zentralblatt fur Chirurgie — Mon, 05 Dec 2011 05:00:00 +0100

Authors: Bruns T, Stallmach A Abstract Peritonitis is one of the most frequent infectious complications in patients with liver cirrhosis and ascites. In more than 95 % it occurs as spontaneous bacterial peritonitis (SBP) as a result of bacterial translocation from intestinal bacteria and bacterial products into mesenteric lymph nodes and subsequent systemic circulation. Identified risk factors that justify antibiotic prophylaxis for SBP include a prior episode of SBP, gastrointestinal haemorrhage and low ascitic fluid protein in combination with renal or advanced liver failure. SBP requires conservative therapy, which should be empirically performed using third-generation cephalosporins and adjunctive albumin therapy under consideration of individual and nosocomial risk factors f...

The Importance of Sample Size in the Determination of a Flock-Level Antimicrobial Resistance Profile for Escherichia coli in Broilers

Microbial Drug Resistance — Thu, 01 Dec 2011 15:53:27 +0100

Microbial Drug Resistance Dec 2011, Vol. 17, No. 4: 513-519. (Source: Microbial Drug Resistance)

Benefits of a Pediatric Antimicrobial Stewardship Program at a Children's Hospital

PEDIATRICS — Thu, 01 Dec 2011 05:00:00 +0100

CONCLUSIONS: The successful implementation of antimicrobial stewardship strategies had a significant impact on reducing targeted- and nontargeted-antimicrobial use, improving quality of care of hospitalized children and preventing emergence of resistance. (Source: PEDIATRICS)

Antimicrobial susceptibility of Gram-negative organisms from intraabdominal infections and evolution of isolates with extended spectrum β-lactamases in the SMART study in Spain (2002-2010).

Revista Espanola de Quimioterapia — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions. Antimicrobial susceptibility data from the SMART-Spain study reinforce current therapeutic guidelines of intraabdominal infections that include ertapenem as the empirical choice for treatment. This is also supported by the high frequency of ESBL-producers in our geographic area. PMID: 22173194 [PubMed - in process] (Source: Revista Espanola de Quimioterapia)

Phenotypes, genotypes, serotypes and molecular epidemiology of erythromycin-resistant Streptococcus agalactiae in Italy

European Journal of Clinical Microbiology and Infectious Diseases — Fri, 25 Nov 2011 17:59:50 +0100

Abstract The purpose of this investigation was to analyse Streptococcus agalactiae (group B Streptococcus, GBS) isolates collected in Italy from vaginal and urine samples in respect to their clonality, distribution of virulence factors and antimicrobial resistance determinants. Three hundred and eighty-eight GBS were recovered from clinical samples. They were analysed for antibiotic resistance profiling. Erythromycin-resistant strains were further characterised by multilocus sequence typing (MLST), serotyping and the detection of alp genes of the alpha-like protein (Alp) family. GBS isolates represented 40 different sequence types (STs), grouped in five clonal complexes (CCs) and belonged to seven serotypes. Most serotype V strains (81%) possessed alp2-3; serotype Ia carried...

Quality Improvement Service: Multidisciplinary Antimicrobial Ward Rounds: Impact on prescribing in medical and elderly care wards in West Glasgow hospitals: Category: Clinical lesson

Journal of Infection — Fri, 25 Nov 2011 11:05:46 +0100

Prudent antimicrobial prescribing is fundamental to reducing antimicrobial resistance, preventing the development of hospital acquired infections, preventing adverse effects related to antimicrobials and reducing antimicrobial costs. In May 2009, antimicrobial ward rounds consisting of an infectious disease (ID) consultant and an antimicrobial pharmacist were commenced in 2 hospitals within NHS Greater Glasgow and Clyde: Gartnavel General Hospital and the Western Infirmary. The ward rounds aim to promote prudent antimicrobial prescribing, promote adherence to the Greater Glasgow and Clyde Infection Management Guidelines whilst also providing support and advice to prescribers, nurses and pharmacists. The antimicrobial ward rounds were started in two hospital sites; twice weekly on one site ...

Development of national prescribing indicators for antimicrobials to support reduction in Clostridium difficile infection: Category: Scientific free paper

Journal of Infection — Fri, 25 Nov 2011 11:05:46 +0100

The Scottish Antimicrobial Prescribing Group (SAPG) is a national multi-disciplinary clinical forum formed by the Scottish Government and hosted by the Scottish Medicines Consortium to implement the recommendations of Scottish Management of Antimicrobial Resistance Action Plan (ScotMARAP). SAPG directs national improvement initiatives via a network of NHS Board Antimicrobial Management Teams (AMTs). (Source: Journal of Infection)

Audit of adherence to NICE Clinical Guideline 64 - "Prophylaxis against infective endocarditis" in adult gastroscopy in Sheffield: Category: Lesson in Microbiology & Infection Control

Journal of Infection — Fri, 25 Nov 2011 11:05:46 +0100

For many years, antibiotic prophylaxis was given routinely to those with congenital or acquired valvular heart disease undergoing invasive procedures such as endoscopy. The evidence base for such prophylaxis was weak and antibiotic use is associated with increased cost, a risk of adverse drug reactions and may drive the development of antimicrobial resistance. As a result, national guidelines gradually reduced the clinical circumstances in which prophylaxis was recommended. In March 2008, the National Institute for Health and Clinical Excellence (NICE) took this further and published Clinical Guideline 64, recommending against antibiotic prophylaxis for dental work or endoscopic procedures unless the procedure involves an infected site or the patient elects to receive prophylaxis after a f...

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Retrospective review of The Management of Gram Negative Prosthetic Joint Infections at a Large UK Centre: Category: Clinical lesson

Journal of Infection — Fri, 25 Nov 2011 11:05:46 +0100

Prosthetic Joint infection (PJI) complicates around 1% of all joint replacements per year. The most commonly implicated aetiological organisms are Gram positive, with coagulase negative staphylococci predominating. Management usually involves debridement or removal of prosthesis combined with insertion of antimicrobial cement or prolonged systemic antibiotics. Gram negative bacilli are an uncommon cause of prosthetic joint infection and are of particular concern given the increasing prevalence of antimicrobial resistance and the attendant risks of prolonged broad-spectrum antibacterials in an elderly patient group. (Source: Journal of Infection)

Antibiotic susceptibility monitoring using a Microsoft Access database: Category: Lesson in Microbiology & Infection Control

Journal of Infection — Fri, 25 Nov 2011 11:05:45 +0100

The clinical effectiveness of antimicrobial therapy is constantly being undermined by the development of antimicrobial resistance. Appropriate antibiotic prescribing is critical to good patient outcomes and a significant factor in the battle against emerging resistance. As resistance is a constantly evolving problem active, real time surveillance of susceptibility rates is necessary to optimise empirical treatment and prophylactic regimens. We aimed to develop a local surveillance system for monitoring our susceptibility rates and present here the tool and some initial findings. (Source: Journal of Infection)

Antibiotic prescribing on an Elderly Care ward: closing the audit loop: Category: Scientific free paper

Journal of Infection — Fri, 25 Nov 2011 11:05:45 +0100

Antibiotic stewardship is an important tool in preventing development of antimicrobial resistance and reducing the prevalence of health-care associated infections such as MRSA (Methicillin-resistant Staphylococcus aureus) and CDAD (Clostridium-associated diarrhoea). Following on from an earlier antibiotic audit conducted in December 2008, we re-evaluated the quality of antibiotic prescribing on all patients on the elderly care wards that were on antibiotics over a period of 8 weeks from January-March 2010 at Addenbrooke's Hospital. (Source: Journal of Infection)

Mecillinam as a potential therapy for lower urinary tract infections caused by organisms resistant to first line antibiotics: Category: Scientific free paper

Journal of Infection — Fri, 25 Nov 2011 11:05:45 +0100

Background: Significant numbers of urinary pathogens are now resistant to first line antibiotics such as trimethoprim and amoxicillin. Many second line antibiotics either have a broad spectrum of activity, carrying the risk of increasing antimicrobial resistance and Clostridium difficile infection (CDI), or are not available as oral formulations. Mecillinam is an orally administered beta-lactam antibiotic which has a low propensity for inducing CDI and, despite widespread use in Scandinavian countries for more than three decades, for which resistance has remained low. The aim of this study was to investigate the sensitivities of local urinary isolates to mecillinam, specifically those isolates resistant to first line antimicrobials. (Source: Journal of Infection)

The impact upon mortality due to sepsis following the introduction of a restrictive empirical antibiotic policy in NHS Lanarkshire: Category: Lesson in Microbiology & Infection Control

Journal of Infection — Fri, 25 Nov 2011 11:05:45 +0100

The objective was to tackle the threat of antimicrobial resistance and rise in Clostridium difficile infection (CDI) [2]. This led NHS Lanarkshire (NHSL) to implement a restrictive empirical antibiotic policy across 3 acute hospitals in August 2008. (Source: Journal of Infection)

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An investigation into antimicrobial properties of protein extractions from native fungal and plant species: Category: Scientific free paper

Journal of Infection — Fri, 25 Nov 2011 11:05:45 +0100

Since the discovery and exploitation of antibiotic agents in the 20th century, the targeted selective toxicity of such agents has ensured their widespread and largely effective use to combat infection, however it has paradoxically resulted in the emergence and dissemination of multi drug resistant pathogens. Antimicrobial resistance in both medicine and agriculture is now recognized by the World Health Organisation (WHO), along with other various national authorities, as a major emerging problem of public health importance. It represents a significant challenge of global dimensions to human and veterinary medicine with the prospect of therapeutic failure for life-saving treatments now a reality. In order to minimise the potential development of further antimicrobial resistance "The Copenha...

Comparison of S1 nuclease pulsed field gel electrophoresis and alkaline lysis for isolation of plasmid DNA: Category: Scientific free paper

Journal of Infection — Fri, 25 Nov 2011 11:05:45 +0100

Plasmids are key elements in the horizontal transfer of genes that code for virulence and antimicrobial resistance. Plasmid profile analysis is also useful for epidemiological investigations. A variety of methods have been described for the isolation of plasmid DNA. One of the most commonly used methods, the alkaline lysis (AL) method was developed by Birnholm and Doly in 1979. AL relies on the manipulation of pH to selectively precipitate chromosomal DNA and other high molecular weight cell components resulting in a suspension of plasmid DNA which can be precipitated by isopropanol. The S1 nuclease pulsed field gel electrophoresis (S1PFGE) method was first described by Barton et al. in 1995. This method is based on the ability of S1 nuclease to convert plasmid DNA to linear forms which ca...

Opt out as an acceptable method of obtaining consent in a prospective study on antimicrobial resistance and prescribing: Category: Scientific free paper

Journal of Infection — Fri, 25 Nov 2011 11:05:45 +0100

A prospective cohort study was set up to investigate a possible association between antibiotic prescribing and antibiotic resistance of E.coli urinary tract infection in the community. A direct link between prescribing and resistance was analysed by searching the records for previous prescription of antibiotics for patients with a suspected urinary tract infection. (Source: Journal of Infection)

Emergence of resistance to carbapenems in Acinetobacter baumannii in Europe: clinical impact and therapeutic options

International Journal of Antimicrobial Agents — Wed, 23 Nov 2011 05:00:00 +0100

Abstract: Despite having a reputation of low virulence, Acinetobacter baumannii is an emerging multidrug-resistant (MDR) pathogen responsible for community- and hospital-acquired infections that are difficult to control and treat. Interest in this pathogen emerged about one decade ago because of its natural MDR phenotype, its capability of acquiring new mechanisms of resistance and the existence of nosocomial outbreaks. Recent advances in molecular biology, including full genome sequencing of several A. baumannii isolates, has led to the discovery of the extraordinary plasticity of their genomes, which is linked to their great propensity to adapt to any environment, including hospitals. In this context, as well as the increasing antimicrobial resistance amongst A. baumannii isolates to the...

Activity of tigecycline and comparators against skin and skin structure pathogens: global results of the Tigecycline Evaluation and Surveillance Trial, 2004–2009

International Journal of Infectious Diseases — Tue, 22 Nov 2011 05:00:00 +0100

Conclusions: The problem of antimicrobial resistance is demonstrated by the data presented. T.E.S.T. continues to provide valuable information on antimicrobial resistance globally. (Source: International Journal of Infectious Diseases)

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Identification of shiga toxin and intimin coding genes in Escherichia coli isolates from pigeons (Columba livia) in relation to phylotypes and antibiotic resistance patterns

Tropical Animal Health and Production — Mon, 21 Nov 2011 18:04:34 +0100

Abstract Shiga toxin-producing Escherichia coli (STEC) strains are responsible for outbreaks of human intestinal diseases worldwide. Pigeons are distributed in public areas and are potential reservoirs for pathogenic bacteria. One hundred fifty-four fresh fecal samples were obtained from trapped pigeons in southeast of Iran and were cultured for isolation of E. coli. The isolates were examined to determine the prevalence of stx1, stx2, and eae genes, antimicrobial resistance, and their phylotypes. The confirmed E. coli isolates (138) belong to four phylogenetic groups: A (54.34%), B1 (34.05%), B2 (3.62%), and D (7.79%). Thirteen (9.42%) isolates were positive for one of the examined genes. Eight isolates (5.79%) were positive for eae, four (2.89%) for stx2, and one isolate (1...

Synergistic activity of sulbactam combined with colistin against colistin-resistant Acinetobacter baumannii

International Journal of Antimicrobial Agents — Mon, 21 Nov 2011 05:00:00 +0100

In this study, we report the in vitro synergistic activity of a combination of colistin with sulbactam against colistin-resistant A. baumannii strains. (Source: International Journal of Antimicrobial Agents)

Characteristics related to antimicrobial resistance and biofilm formation of widespread methicillin-resistant Staphylococcus epidermidis ST2 and ST23 lineages in Rio de Janeiro hospitals, Brazil

Diagnostic Microbiology and Infectious Disease — Fri, 18 Nov 2011 05:00:00 +0100

In this study, staphylococcal chromosomal cassette mec (SCCmec) types, antimicrobial susceptibility profiles, biofilm formation genes, and multilocus sequence types (MLST) were investigated in 35 MRSE clinical isolates. The collection of isolates was previously well characterized by pulsed-field gel electrophoresis (PFGE) into 2 main genotypes (A and B, 22 isolates) and 10 sporadic genotypes (13 isolates). MLST revealed a total of 8 different sequence types (STs), but ST2 and ST23, which were icaAB-positive, represented the majority (71.4%) of MRSE isolates tested. Almost all isolates (91.4%) belonged to clonal complex 2. SCCmec types III and IV were identified among 71.4% of the isolates, while the remaining was nontypeable. The predominant MRSE genotypes were defined as SCCmec type III/S...

bioMérieux Initiative to Support European Antibiotic Awareness Day

bioMerieux Press Releases — Thu, 17 Nov 2011 23:00:00 +0100

As the world leader in microbiology and a pioneer in diagnostics for antimicrobial resistance detection and susceptibility testing (AST), bioMérieux actively supports the annual European Antibiotic Awareness Day, organized today by the ECDC.1 bioMérieux subsidiaries throughout the world are providing educational tools for healthcare professionals to help increase public awareness about this serious issue. (Source: bioMerieux Press Releases)

Antimicrobial resistance a global concern

Reactions — Wed, 16 Nov 2011 21:59:42 +0100

(Source: Reactions)

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Antimicrobial resistance to Citrobacter spp. and Salmonella spp. isolated from goose eggs

Comparative Clinical Pathology — Wed, 16 Nov 2011 06:47:37 +0100

Abstract Infections with bacteria of the genus Salmonella are responsible for a variety of acute and chronic diseases in poultry. Infected poultry flocks are also among the most important reservoirs of salmonellae that can be transmitted through the food chain to humans. Citrobacter belongs to the Enterobacteriaceae family which is closely related to Salmonella. The aim of this study was to examine goose eggs contaminated with Citrobacter spp. and Salmonella spp. and determine the drug resistance pattern of the isolated organisms. Two hundred and forty goose eggs were collected in Zabol region and were transferred to the microbiology laboratory of Zabol University. The egg shells were thoroughly disinfected and the interior contents of individual eggs were pooled into a steri...

Get Smart About Antibiotics

Blogged_Arteries — Tue, 15 Nov 2011 06:00:00 +0100

Earlier this year, TMA's Committee on Infectious Diseases highlighted the growing problem of antimicrobial resistance. The committee encourages you to be familiar with information prepared by the Centers for Disease Control and Prevention for this year's national Get Smart About Antibiotics Week, Nov. 14-20. (Source: Blogged_Arteries)

Knowledge, attitudes and practice survey about antimicrobial resistance and prescribing among physicians in a hospital setting in Lima, Peru

BMC Clinical Pharmacology — Tue, 15 Nov 2011 05:00:00 +0100

Conclusions: This survey revealed topics to address during future AM prescribing interventions such as dissemination of information about local AMR rates, promoting confidence in the quality of locally available AMs, redaction and dissemination of local AM guidelines and addressing the general public, and exploring the possibilities of internet-based training. (Source: BMC Clinical Pharmacology)

Nosocomial Infections in Burned Patients in Motahari Hospital, Tehran, Iran

Advances in Bioinformatics — Mon, 14 Nov 2011 14:34:28 +0100

The objective of the present study was to identify the causative bacterial of nosocomial infection and to determine the incidence of nosocomial infection and their changing during hospitalization in burned patients admitted to in the Motahari Hospital, Tehran, Iran. During the second part of 2010, 164 patients were included in this study. Samples were taken the first 48 hours and the fourth week after admission to Motahari Burn hospital. Isolation and identification of microorganisms was performed using the standard procedure. Of the 164 patients, 717 samples were taken and 812 bacteria were identified, 610 patients were culture positive on day 7 while 24 (17.2%) on 14 days after admission. The bacteria causing infections were 325 Pseudomonas, 140 Acinetobacter, 132 Staphylococcus aure...

Effects of Melaleuca alternifolia (tea tree) essential oil and the major monoterpene component terpinen-4-ol on the development of single- and multi-step antibiotic resistance and antimicrobial susceptibility.

Antimicrobial Agents and Chemotherapy — Mon, 14 Nov 2011 05:00:00 +0100

This study examined the impact of sub-inhibitory Melaleuca alternifolia essential (tea tree) oil on the development of antibiotic resistance in Staphylococcus aureus and Escherichia coli. Frequencies of single-step antibiotic resistant mutants were determined by inoculating bacteria cultured with or without sub-inhibitory tea tree oil onto agar containing 2 - 8 × MIC of each antibiotic, also with or without tea tree oil. Whereas most differences in resistance frequencies were relatively minor, the combination of kanamycin and tea tree oil yielded approximately 10-fold fewer resistant E. coli mutants than kanamycin alone. The development of multi-step antibiotic resistance in the presence of tea tree oil or terpinen-4-ol was examined by culturing S. aureus and E. coli isolates daily with a...

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Yersinia enterocolitica strains associated with human infections in Switzerland 2001–2010

European Journal of Clinical Microbiology and Infectious Diseases — Thu, 10 Nov 2011 06:46:17 +0100

Abstract Yersinia enterocolitica infections are common in humans. However, very scarce data are available on the different biotypes and virulence factors of human strains, which has proved to be problematic to assess the clinical significance of the isolated strains. In this study, the presence of the ail gene and distribution of different bio- and serotypes among human Y. enterocolitica strains and their possible relation to the genotype and antimicrobial resistance were studied. In total, 128 Y. enterocolitica strains isolated from human clinical samples in Switzerland during 2001–2010 were characterised. Most (75 out of 128) of the Y. enterocolitica strains belonged to biotypes 2, 3 or 4 and carried the ail gene. One of the 51 strains that belonged to biotype 1A was al...

Prophylactic Medicine European Ban Might Undermine Animal Welfare

Health News from Medical News Today — Mon, 07 Nov 2011 14:00:00 +0100

The British Veterinary Association (BVA) voices its deep concern regarding the European Parliament resolution to call on the Commission to legislate against the prophylactic (preventive) use of antibiotics (antimicrobials) in livestock farming. The move, passed by MEPs (Members of the European Parliament) on October 27, 2011, is part of a larger motion that draws attention to the antimicrobial resistance problem, and calls for European-wide measures to reduce the increase in resistance... (Source: Health News from Medical News Today)

Rapid evolution of fluoroquinolone-resistant Escherichia coli in Nigeria is temporally associated with fluoroquinolone use

BMC Infectious Diseases — Mon, 07 Nov 2011 05:00:00 +0100

Conclusions: Fluoroquinolones, and not chloroquine, appear to be the selective force for fluoroquinolone-resistant fecal E. coli in this setting. Rapid evolution to resistance following fluoroquinolone introduction points the need to implement resistant containment strategies when new antibacterials are introduced into resource-poor settings with high infectious disease burdens. (Source: BMC Infectious Diseases)

The Oligo-acyl Lysyl Anti-Microbial Peptide, C12K-2β12, Exhibits a Dual Mechanism of Action and Demonstrates Strong In Vivo Efficacy against Helicobacter pylori.

Antimicrobial Agents and Chemotherapy — Mon, 07 Nov 2011 05:00:00 +0100

Authors: Makobongo MO, Gancz H, Carpenter BM, McDaniel DP, Merrell DS Abstract Helicobacter pylori has developed antimicrobial resistance to virtually all current antibiotics. Thus, there is a pressing need to develop new anti-H. pylori therapies. We recently described a novel oligo-acyl-lysyl (OAK) antimicrobial peptidomimetic, C(12)K-2β(12), that shows potent in vitro bactericidal activity against H. pylori. Herein, we define the mechanism of action as well as evaluate the in vivo efficacy of C(12)K-2β(12) against H. pylori after experimental infection of Mongolian gerbils. We demonstrate using a 1-N-phenyl-naphthylamine (fluorescent probe) uptake assay and electron microscopy that C(12)K-2β(12) rapidly permeabilizes the bacterial membrane and creates pores that cause bacteria...

C4-Alkylthiols with activity against Moraxella catarrhalis and Mycobacterium tuberculosis.

Bioorganic and Medicinal Chemistry — Sat, 05 Nov 2011 07:24:41 +0100

Authors: Kostova MB, Myers CJ, Beck TN, Plotkin BJ, Green JM, Boshoff HI, Barry CE, Deschamps JR, Konaklieva MI Abstract Antimicrobial resistance represents a global threat to healthcare. The ability to adequately treat infectious diseases is increasingly under siege due to the emergence of drug-resistant microorganisms. New approaches to drug development are especially needed to target organisms that exhibit broad antibiotic resistance due to expression of β-lactamases which is the most common mechanism by which bacteria become resistant to β-lactam antibiotics. We designed and synthesized 20 novel monocyclic β-lactams with alkyl- and aryl-thio moieties at C4, and subsequently tested these for antibacterial activity. These compounds demonstrated intrinsic activity against serin...

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Acute bacterial skin and skin structure infections: current perspective

Indian Journal of Dermatology — Fri, 04 Nov 2011 04:00:00 +0100

Megha Shah, Hetal D ShahIndian Journal of Dermatology 2011 56(5):510-512A skin and skin structure infection is a bacterial infection of skin and associated tissues. It may be complicated skin and skin structure infection or uncomplicated skin and skin structure infection. Recently, the Food and Drug Administration has called them acute bacterial skin and skin structure infections (ABSSSI). ABSSSI are common and encompass a variety of disease presentations and severity. Increased antimicrobial resistance among both Gram-positive and Gram-negative bacteria with methicillin-resistant Staphylococcus aureus is the main problem in treatment. So, development of newer agents to fight against resistant microbes is the need of the hour. Ceftaroline, a newer cephalosporin, is one promising agent. (So...

Antimicrobial resistance: the threat to public health

The Journal of the Royal Society for the Promotion of Health — Thu, 03 Nov 2011 04:00:00 +0100

(Source: The Journal of the Royal Society for the Promotion of Health)

Update on acute otitis media in children younger than 2 years of age.

Canadian Family Physician Medecin de Famille Canadien — Tue, 01 Nov 2011 04:00:00 +0100

Authors: McWilliams CJ, Goldman RD Abstract Question As concern about antimicrobial resistance grows, I am aware of the need to reduce unnecessary antibiotic treatment; however, in my practice I see many children with acute otitis media (AOM) and this is the most common reason I prescribe antibiotics. Most of these children are young and otherwise healthy, and I am uncertain about when to prescribe antibiotics and when to endorse "watchful waiting." Which children will benefit from antibiotic treatment? Answer Current Canadian guidelines recommend all children younger than 2 years of age with otalgia due to AOM and fever greater than 39°C be considered for treatment with amoxicillin. Watchful waiting is indicated only for children older than 6 months with mild-to-moderate AOM. Rec...

Characterization of class I integrons among Salmonella enterica serovar Enteritidis isolated from human and poultry

FEMS Immunology and Medical Microbiology — Mon, 31 Oct 2011 04:00:00 +0100

In conclusion, the high rates of multidrug‐resistance and class I integrons found among Salmonella Enteritidis isolates in human and poultry population in our area, suggest that efforts are needed to confine the prevalence of multidrug‐resistant Salmonella isolates. (Source: FEMS Immunology and Medical Microbiology)

Characterization of class I integrons among Salmonella enterica serovar Enteritidis isolated from humans and poultry

FEMS Immunology and Medical Microbiology — Mon, 31 Oct 2011 04:00:00 +0100

In conclusion, the high rates of multidrug‐resistance and class I integrons found among S. Enteritidis isolates in humans and poultry in Tehran suggest that efforts are needed to confine the prevalence of MDR Salmonella isolates. (Source: FEMS Immunology and Medical Microbiology)

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Exploring the contribution of efflux on the resistance to fluoroquinolones in clinical isolates of Staphylococcus aureus

BMC Microbiology - Latest articles — Thu, 27 Oct 2011 04:00:00 +0100

Conclusions: The results obtained in this work do not exclude the importance of mutations in resistance to fluoroquinolones in S. aureus, yet they underline the contribution of efflux systems for the emergence of high-level resistance. All together, the results presented in this study show the potential role played by efflux systems in the development of resistance to fluoroquinolones in clinical isolates of S. aureus. (Source: BMC Microbiology - Latest articles)

Antimicrobial Stewardship

Mayo Clinic Proceedings — Thu, 27 Oct 2011 04:00:00 +0100

Antimicrobial resistance is increasing; however, antimicrobial drug development is slowing. Now more than ever before, antimicrobial stewardship is of the utmost importance as a way to optimize the use of antimicrobials to prevent the development of resistance and improve patient outcomes. This review describes the why, what, who, how, when, and where of antimicrobial stewardship. Techniques of stewardship are summarized, and a plan for implementation of a stewardship program is outlined. (Source: Mayo Clinic Proceedings)

Quantification and antibiotic susceptibility profiles of staphylococcus aureus and bacillus cereus strains isolated from biltong

Journal of Food Safety — Mon, 24 Oct 2011 16:27:19 +0100

This study contributes new knowledge to food processors in the central region of S.A. relating to the production of safe dried meat products. (Source: Journal of Food Safety)

Lack of Antimicrobial Resistance in Yersinia pestis Isolates from 17 Countries in the Americas, Africa, and Asia.

Antimicrobial Agents and Chemotherapy — Mon, 24 Oct 2011 04:00:00 +0100

Authors: Urich SK, Chalcraft L, Schriefer ME, Yockey BM, Petersen JM Abstract Yersinia pestis is the causative agent of plague, a fulminant disease often fatal without antimicrobial treatment. Plasmid (IncA/C) mediated multi-drug resistance in Y. pestis was reported in 1995 in Madagascar and has generated considerable public health concern, most recently because of the identification of IncA/C multi-drug resistant plasmids in other zoonotic pathogens. Here, we demonstrate no resistance in 392 Y. pestis isolates from 17 countries to eight antimicrobials used for treatment or prophylaxis of plague. PMID: 22024826 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

Preview: Hot Topics of Clinical Interest at IDSA 2011Preview: Hot Topics of Clinical Interest at IDSA 2011

Medscape PublicHealth Headlines — Thu, 20 Oct 2011 16:00:00 +0100

Paul G. Auwaerter, MD, reviews what he considers the hot topics at this year’s IDSA meeting: HPV, HCV/HIV coinfection, and the continuing big story of antimicrobial resistance. Medscape Infectious Diseases (Source: Medscape PublicHealth Headlines)

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Data Mining Derived Treatment Algorithms From the Electronic Medical Record Improve Theoretical Empirical Therapy for Outpatient Urinary Tract Infections

The Journal of Urology — Wed, 19 Oct 2011 04:00:00 +0100

Conclusions: Antimicrobial resistance patterns in outpatient urinary tract infections are time dependent, and drug and site specific. Data mining directed therapy significantly improved theoretical outcomes compared to conventional therapy for Department of Urology outpatients and for female patients in the Emergency Department. (Source: The Journal of Urology)

Heterogeneity and Phylogenetic Relationships of Community‐Associated Methicillin‐Sensitive/Resistant Staphylococcus aureus Isolates in Healthy Dogs, Cats and Their Owners

Journal of Applied Microbiology — Tue, 18 Oct 2011 04:00:00 +0100

Conclusion: The CA‐MRSA clone of se‐carrying‐MDR‐ST‐59‐IV/V‐SC VII was identified predominantly in the present study, and this clone might play a significant role in staphylococcal food poisoning in community settings.Significance and Impact of the Study: To our knowledge, this is the first study focussing on enterotoxin‐carrying CA‐MRSA/MSSA in pets and their owners, and the results support the future warnings in animal‐human bond caused by community‐associated staphylococci in the commonwealth and need to take cautions worldwide. (Source: Journal of Applied Microbiology)

Identification of hopanoid biosynthesis genes involved in polymyxin resistance in Burkholderia multivorans.

Antimicrobial Agents and Chemotherapy — Mon, 17 Oct 2011 04:00:00 +0100

Authors: Malott RJ, Steen-Kinnaird BR, Lee TD, Speert DP Abstract A major challenge to clinical therapy of Burkholderia cepacia complex (Bcc) pulmonary infections is their innate resistance to a broad range of antimicrobials including polycationic agents such as aminoglycosides, polymyxins and cationic peptides. To identify genetic loci associated with this phenotype, a transposon mutant library was constructed in B. multivorans ATCC 17616 and screened for increased susceptibility to polymyxin B. Compared to the parent strain, mutant 26D7 exhibited an eight- and sixteen-fold increase in susceptibility to polymyxin B and colistin, respectively. Genetic analysis of mutant 26D7 indicated that the transposon inserted into ORF Bmul_2133, part of a putative hopanoid biosynthesis gene clu...

Mortality and hospital stay associated with resistant Staphylococcus aureus and Escherichia coli bacteremia: Estimating the burden of antibiotic resistance in Europe

NeLM - News — Fri, 14 Oct 2011 04:00:00 +0100

This study aimed to establish the excess number of deaths, bed-days, and hospital costs associated with blood stream infections (BSIs) caused by methicillin-resistant Staphylococcus aureus (MRSA) and third-generation cephalosporin-resistant Escherichia coli (G3CREC) in 31 countries participating in the European Antimicrobial Resistance Surveillance System (EARSS). Prevalence data for 2007 from the EARSS and data on the clinical impact of antimicrobial resistance throughout Europe was used to calculate the number of BSIs caused by MRSA and G3CREC. This was expressed as excess number of deaths, excess number of days in hospital, and excess costs. Statistical methods were used to predict the trajectories for MRSA and G3CREC prevalence until 2015 for the 31 participating countries i...

Re: Consensus review of the epidemiology and appropriate antimicrobial therapy for complicated urinary tract infections in Asia-Pacific region

Journal of Infection — Fri, 14 Oct 2011 04:00:00 +0100

We endorse the benefits of local data on isolates originating from complicated urinary tract infections (cUTI) and stress the necessity of monitoring antimicrobial susceptibility of multidrug-resistant isolates in local circulation. Data on antimicrobial resistance of isolates responsible for cUTI should incorporate information about strains that are resistant to several categories of antibiotics since the management of cUTI patients infected with strains resistant to carbapenem, fourth-generation cephalosporin, aminoglycoside and ß-lactam- ß-lactamase inhibitors would be tough. (Source: Journal of Infection)

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Imipenem: a potent inducer of multidrug resistance in Acinetobacter baumannii

International Journal of Antimicrobial Agents — Thu, 13 Oct 2011 04:00:00 +0100

This study investigated the progression of multidrug resistance upon exposure to imipenem in Acinetobacter baumannii. Eighteen A. baumannii strains, including two reference strains (ATCC 19606 and ATCC 17978), four clinical strains (AB56, AB242, AB273 and AB279) and 12 antibiotic-selected mutant strains, were used in this study. Imipenem-selected mutants were generated from imipenem-susceptible strains (ATCC 19606, ATCC 17978 and AB242) by multistep selection resistance. Amikacin-, ciprofloxacin-, colistin-, meropenem- and ceftazidime-selected mutants were also generated from the two reference strains and were used for comparison. Antibiotic susceptibilities in the absence and presence of the efflux pump inhibitors carbonyl cyanide m-chlorophenylhydrazone (CCCP) and 1-(1-naphthylmethyl)-pi...

Characteristics of carbapenem-resistant Acinetobacter spp. other than Acinetobacter baumannii in South Korea

International Journal of Antimicrobial Agents — Thu, 13 Oct 2011 04:00:00 +0100

Abstract: Although many studies have been performed on carbapenem-resistant Acinetobacter baumannii, only a few studies have addressed carbapenem resistance in Acinetobacter spp. other than A. baumannii (non-baumannii Acinetobacter). Amongst 287 Acinetobacter spp. isolates from patients with bacteraemia in a South Korean hospital collected between 2003 and 2010, 160 (55.7%) were non-baumannii Acinetobacter spp. Antimicrobial susceptibility testing was performed and the effect of efflux pump inhibitors was examined. Antimicrobial resistance genes were identified and pulsed-field gel electrophoresis (PFGE) analysis was performed. OprD expression was also evaluated by quantitative real-time polymerase chain reaction (qRT-PCR), and CarO disruption was investigated by PCR. Seventeen non-baumann...

Bacteriophages as vehicles of the resistome in cystic fibrosis

Journal of Antimicrobial Chemotherapy — Wed, 12 Oct 2011 04:00:00 +0100

Environmental microbial communities and human microbiota represent a huge reservoir of mobilizable genes, the ‘mobilome’, including a pool of genes encoding antimicrobial resistance, the ‘resistome’. Whole-genome sequencing of bacterial genomes from cystic fibrosis (CF) patients has demonstrated that bacteriophages contribute significantly to bacterial genome alterations, and metagenomic analysis of respiratory tract DNA viral communities has revealed the presence of genes encoding antimicrobial resistance in bacteriophages of CF patients. CF airways should now be considered as the site of complex microbiota, where bacteriophages are vehicles for the adaptation of bacteria to this specific environment and for the emergence and selection of multidrug-resistant bacter...

Bacteriophages and diffusion of genes encoding antimicrobial resistance in cystic fibrosis sputum microbiota

Journal of Antimicrobial Chemotherapy — Wed, 12 Oct 2011 04:00:00 +0100

Conclusions Our results suggest that phages in the CF sputum microbiota represent a reservoir of mobilizable genes associated with antimicrobial resistance that may spread in this specific niche. This phenomenon could explain the fantastic adaptation of CF strains to their niche and may represent a new potential therapeutic target to prevent the emergence of multidrug-resistant bacteria, which are responsible for most of the deaths in CF. (Source: Journal of Antimicrobial Chemotherapy)

Molecular epidemiology of extraintestinal pathogenic Escherichia coli isolates from a regional cohort of elderly patients highlights the prevalence of ST131 strains with increased antimicrobial resistance in both community and hospital care settings

Journal of Antimicrobial Chemotherapy — Wed, 12 Oct 2011 04:00:00 +0100

Conclusions The level of antibiotic resistance or virulence gene possession in uropathogenic E. coli is not directly associated with the healthcare setting of the patient, but there is a variation in antibiotic resistance and virulence gene possession depending on clonal group. ST131 is highly virulent and demonstrates high levels of antibiotic resistance, but its virulence does not appear to be attributable to the possession of a specific virulence-associated gene set or the possession of any virulence-associated gene in significantly higher levels than in any other ST. (Source: Journal of Antimicrobial Chemotherapy)

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Wide dissemination of multidrug-resistant Shigella isolates in China

Journal of Antimicrobial Chemotherapy — Wed, 12 Oct 2011 04:00:00 +0100

Conclusions ESBL-producing or fluoroquinolone-resistant Shigella is no longer an unusual phenomenon in the local community. The monitoring programme in China should stay vigilant to the dissemination of these isolates and the health agencies must take appropriate measures to restrict the abuse of antimicrobials, especially in the community. (Source: Journal of Antimicrobial Chemotherapy)

DNA sequence analysis of the composite plasmid pTC conferring virulence and antimicrobial resistance for porcine enterotoxigenic Escherichia coli.

International Journal of Medical Microbiology — Wed, 12 Oct 2011 04:00:00 +0100

In this study the plasmid pTC, a 90kb self-conjugative virulence plasmid of the porcine enterotoxigenic Escherichia coli (ETEC) strain EC2173 encoding the STa and STb heat-stable enterotoxins and tetracycline resistance, has been sequenced in two steps. As a result we identified five main distinct regions of pTC: (i) the maintenance region responsible for the extreme stability of the plasmid, (ii) the TSL (toxin-specific locus comprising the estA and estB genes) which is unique and characteristic for pTC, (iii) a Tn10 transposon, encoding tetracycline resistance, (iv) the tra (plasmid transfer) region, and (v) the colE1-like origin of replication. It is concluded that pTC is a self-transmissible composite plasmid harbouring antibiotic resistance and virulence genes. pTC belongs to a group ...

Mortality and Hospital Stay Associated with Resistant Staphylococcus aureus and Escherichia coli Bacteremia: Estimating the Burden of Antibiotic Resistance in Europe

PLoS Medicine — Tue, 11 Oct 2011 04:00:00 +0100

Conclusions Excess mortality associated with BSIs caused by MRSA and G3CREC is significant, and the prolongation of hospital stay imposes a considerable burden on health care systems. A foreseeable shift in the burden of antibiotic resistance from Gram-positive to Gram-negative infections will exacerbate this situation and is reason for concern. Please see later in the article for the Editors' Summary (Source: PLoS Medicine)

Antimicrobial resistance to ceftazidime involving loss of penicillin-binding protein 3 in Burkholderia pseudomallei [Microbiology]

Proceedings of the National Academy of Sciences — Tue, 11 Oct 2011 04:00:00 +0100

Known mechanisms of resistance to β-lactam antibiotics include β-lactamase expression, altered drug target, decreased bacterial permeability, and increased drug efflux. Here, we describe a unique mechanism of β-lactam resistance in the biothreat organism Burkholderia pseudomallei (the cause of melioidosis), associated with treatment failure during prolonged ceftazidime therapy of natural infection. Detailed comparisons of the initial ceftazidime-susceptible infecting isolate and subsequent ceftazidime-resistant variants from six patients led us to identify a common, large-scale genomic loss involving a minimum of 49 genes in all six resistant strains. Mutational analysis of wild-type B. pseudomallei demonstrated that ceftazidime resistance was due to deletion of a gene encoding a penici...

Resistance gene transfer during treatments of experimental avian colibacillosis.

Antimicrobial Agents and Chemotherapy — Mon, 10 Oct 2011 04:00:00 +0100

In conclusion, this study clearly illustrates how, in E. coli, "old" antimicrobials may co-select antimicrobial resistance to recent and critical molecules. PMID: 21986830 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

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Plasmids in Gram negatives: Molecular typing of resistance plasmids.

International Journal of Medical Microbiology — Mon, 10 Oct 2011 04:00:00 +0100

Authors: Carattoli A Abstract A plasmid is defined as a double stranded, circular DNA molecule capable of autonomous replication. By definition, plasmids do not carry genes essential for the growth of host cells under non-stressed conditions but they have systems which guarantee their autonomous replication also controlling the copy number and ensuring stable inheritance during cell division. Most of the plasmids confer positively selectable phenotypes by the presence of antimicrobial resistance genes. Plasmids evolve as an integral part of the bacterial genome, providing resistance genes that can be easily exchanged among bacteria of different origin and source by conjugation. A multidisciplinary approach is currently applied to study the acquisition and spread of antimicrobial re...

Clinical characteristics and antibiotic resistance of Shigella gastroenteritis in Ankara, Turkey between 2003 and 2009, and comparison with previous reports

International Journal of Infectious Diseases — Mon, 10 Oct 2011 04:00:00 +0100

Summary: Objectives: The aim of this study was to define the epidemiological, clinical, and antibiotic susceptibility patterns of Shigella gastroenteritis cases occurring during the years 2003–2009 and to compare results with those of the years 1987–2002.Methods: A hospital-based study was conducted over a 22-year period. All 238 Shigella strains isolated between 2003 and 2009 were compared to 618 isolates from the period 1987–1994 and 218 Shigella strains isolated during 1995–2002 with regard to antimicrobial resistance patterns and patient clinical characteristics.Results: The predominant species during all periods was Shigella sonnei, with an increasing predominance across the periods (64.0%, 71.5%, and 87.8%, respectively; p (Source: International Journal of Infectious Diseases...

Trend of antibiotic resistance in children with first acute pyelonephritis.

Indian Pediatrics — Sat, 08 Oct 2011 04:00:00 +0100

In this study, we reviewed medical records of children (<18 yr age) with first acute pyelonephritis admitted to our Institution between January 2005 to December 2009. 411 children (189 girls) were studied and increasing trend in bacterial resistance toward co-trimoxazole, 2nd and 3rd generation cephalosporins and gentamicin were observed. PMID: 22080687 [PubMed - in process] (Source: Indian Pediatrics)

Impact of healthcare-associated acquisition on community-onset Gram-negative bloodstream infection: a population-based study

European Journal of Clinical Microbiology and Infectious Diseases — Fri, 07 Oct 2011 16:00:00 +0100

Abstract We performed a population-based study to examine the influence of healthcare-associated acquisition on pathogen distribution, antimicrobial resistance, short- and long-term mortality of community-onset Gram-negative bloodstream infections (BSI). We identified 733 unique patients with community-onset Gram-negative BSI (306 healthcare-associated and 427 community-acquired) among Olmsted County, Minnesota, residents from 1 January 1998 to 31 December 2007. Multivariate logistic regression was used to examine the association between healthcare-associated acquisition and microbiological etiology and antimicrobial resistance. Multivariate Cox proportional hazards regression was used to evaluate the influence of the site of acquisition on mortality. Healthcare-associated...

Methicillin Resistant S. aureus in Human and Bovine Mastitis

Journal of Mammary Gland Biology and Neoplasia — Fri, 07 Oct 2011 15:59:17 +0100

Abstract Staphylococcus aureus is a ubiquitous organism that causes a variety of diseases including mastitis in cattle and humans. High-level resistance of S. aureus to β-lactams conferred by a mecA gene encoding a modified penicillin binding protein (PBP2a) was first observed in the early 1960’s. These methicillin resistant S. aureus (MRSA) have been responsible for both hospital acquired infections (HA-MRSA) and, more recently, community acquired MRSA (CA-MRSA). A small number of human MRSA mastitis cases and outbreaks in maternity or neonatal units have been reported which are generally the result of CA-MRSA. The establishment of the sequence type 398 (ST398) in farm animals, primarily pigs, in the early 2000’s has provided a reservoir of infection for humans and ...

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Implementation and outcomes of a hospital-wide computerised antimicrobial stewardship programme in a large medical centre in Taiwan

International Journal of Antimicrobial Agents — Fri, 07 Oct 2011 04:00:00 +0100

The objective of this study was to evaluate the impacts of HCAAS on the hospital from 2003 to 2009. Following HCAAS deployment, the gradients of consumption over time during the study period of third- and fourth-generation cephalosporins, fluoroquinolones and glycopeptides fell significantly, whilst that of carbapenems increased. The amount and expenditure of antimicrobial use did not increase with the overall healthcare-associated infection rate, and inpatient mortality rate remained stable with a slight decreasing trend. The rate of meticillin-resistant Staphylococcus aureus started to decline in 2002 and continued after HCAAS deployment. There was an increasing isolation of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae, presumably leading to the inc...

Parenteral versus oral administration of systemic antimicrobials in European nursing homes: a point-prevalence survey

NeLM - Care of Older People — Thu, 06 Oct 2011 04:00:00 +0100

Source: Drugs and Aging Area: Evidence > Medicines Management > References Background: Residents in long-term care facilities are predisposed to healthcare-associated infections that are likely to be caused by antimicrobial-resistant micro-organisms. Long-term care facilities are increasingly able to offer parenteral antimicrobial treatment but there are few data on the use and appropriateness of such treatment in this setting. Information on the use of parenteral antimicrobials and associated factors in long-term care facilities is necessary to assess the risks and benefits of this treatment and to support the development of antimicrobial policies aimed at minimising the emergence and spread of antimicrobial resistance. Objective: The aim of this study was to describe the e...

Antimicrobial management and appropriateness of treatment of urinary tract infection in general practice in Ireland

BMC Family Practice — Mon, 03 Oct 2011 04:00:00 +0100

Conclusions: There appears to be considerable scope to reduce the frequency and increase the quality of antimicrobial prescribing for patients with suspected UTI. (Source: BMC Family Practice)

The First NDM-Positive Salmonella spp. Identified in the United States.

Antimicrobial Agents and Chemotherapy — Mon, 03 Oct 2011 04:00:00 +0100

Authors: Savard P, Gopinath R, Zhu W, Kitchel B, Rasheed JK, Tekle T, Roberts A, Ross T, Razeq J, Landrum BM, Wilson LE, Limbago B, Perl TM, Carroll KC Abstract Antimicrobial resistance among Enterobacteriaceae is growing, largely due to β-lactamase production.… PMID: 21968356 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

Food animals and antimicrobials: impacts on human health.

Clinical Microbiology Reviews — Sat, 01 Oct 2011 04:00:00 +0100

Authors: Marshall BM, Levy SB Abstract Summary: Antimicrobials are valuable therapeutics whose efficacy is seriously compromised by the emergence and spread of antimicrobial resistance. The provision of antibiotics to food animals encompasses a wide variety of nontherapeutic purposes that include growth promotion. The concern over resistance emergence and spread to people by nontherapeutic use of antimicrobials has led to conflicted practices and opinions. Considerable evidence supported the removal of nontherapeutic antimicrobials (NTAs) in Europe, based on the "precautionary principle." Still, concrete scientific evidence of the favorable versus unfavorable consequences of NTAs is not clear to all stakeholders. Substantial data show elevated antibiotic resistance in bacteria asso...

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Molecular Characterization of Multidrug-Resistant Escherichia coli Isolates from Irish Cattle Farms.

Applied and Environmental Microbiology — Sat, 01 Oct 2011 04:00:00 +0100

This study describes the genotypic characteristics of a collection of 100 multidrug-resistant (MDR) Escherichia coli strains recovered from cattle and the farm environment in Ireland in 2007. The most prevalent antimicrobial resistance identified was to streptomycin (100%), followed by tetracycline (99%), sulfonamides (98%), ampicillin (82%), and neomycin (62%). Resistance was mediated predominantly by strA-strB (92%), tetA (67%), sul2 (90%), bla(TEM) (79%), and aphA1 (63%) gene markers, respectively. Twenty-seven isolates harbored a class 1 integrase (intI1), while qacEΔ1 and sul1 markers were identified in 25 and 26 isolates, respectively. The variable regions of these integrons contained aminoglycoside, trimethoprim, and β-lactam resistance determinants (aadA12, aadB-aadA1, bla(OXA-30...

Comparison of Bacteria Isolated From Urinary Tract Infections in Patients on Transplant Versus Urologic Wards

Transplantation Proceedings — Sat, 01 Oct 2011 04:00:00 +0100

Conclusions: The high level of antimicrobial resistance of microorganisms isolated from the urine of transplant patients and the relatively high incidence of fungal infections, demand an especially quick, accurate microbiological diagnosis for this group of patients. (Source: Transplantation Proceedings)

Antimicrobial Resistance Determinants in Imipenem-nonsusceptible Acinetobacter calcoaceticus-baumannii Complex Isolated in Daejeon, Korea.

The Korean Journal of Laboratory Medicine — Sat, 01 Oct 2011 04:00:00 +0100

CONCLUSIONS: Several differences in carbapenem, aminoglycoside, and fluoroquinolone resistance gene content were detected among Acb complex isolates. However, most Acb complex isolates (87.5%) possessed integrons, carbapenemases, AMEs, and mutations in gyrA. The co-occurrence of several resistance determinants may present a significant threat. PMID: 22016680 [PubMed - in process] (Source: The Korean Journal of Laboratory Medicine)

Prevalence of Plasmid-mediated Quinolone Resistance and Its Association with Extended-spectrum Beta-lactamase and AmpC Beta-lactamase in Enterobacteriaceae.

The Korean Journal of Laboratory Medicine — Sat, 01 Oct 2011 04:00:00 +0100

CONCLUSIONS: The qnr genes were highly prevalent in Enterobacteriaceae, primarily the qnrB subtypes. They were closely associated with EBSL and AmpC beta-lactamase. PMID: 22016679 [PubMed - in process] (Source: The Korean Journal of Laboratory Medicine)

An insight into the drug resistance profile & mechanism of drug resistance in Neisseria gonorrhoeae.

Indian J Med Res — Sat, 01 Oct 2011 04:00:00 +0100

Authors: Patel AL, Chaudhry U, Sachdev D, Sachdeva PN, Bala M, Saluja D Abstract Among the aetiological agents of treatable sexually transmitted diseases (STDs), Neissseria gonorrhoeae is considered to be most important because of emerging antibiotic resistant strains that compromise the effectiveness of treatment of the disease - gonorrhoea. In most of the developing countries, treatment of gonorrhoea relies mainly on syndromic management rather than the aetiological based therapy. Gonococcal infections are usually treated with single-dose therapy with an agent found to cure > 95 per cent of cases. Unfortunately during the last few decades, N. gonorrhoeae has developed resistance not only to less expensive antimicrobials such as sulphonamides, penicillin and tetracyclines but a...

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Multidrug-resistant intestinal Staphylococcus aureus among self-medicated healthy adults in Amassoma, South-South, Nigeria.

Journal of Health, Population, and Nutrition — Sat, 01 Oct 2011 04:00:00 +0100

This study assessed the previous usage of antibiotics by healthy adults (university students and villagers) in Amassoma, Nigeria, and investigated the antimicrobial resistance patterns of their intestinal S. aureus isolates. A questionnaire was used for evaluating the previous usage of antibiotics by the volunteers. Stool samples were collected and cultured, and S. aureus isolates were confirmed using standard microbiological protocols. Their antimicrobial resistance patterns were determined using disc-diffusion and agar dilution techniques. In total, 54 (45.0%) volunteers used antibiotics on self-medications, and the practice was significantly higher (p=0.01) among the villagers than among the students. The level of judicious use of prescribed antibiotics was significantly higher (p=0.003...

Inhibitory and bactericidal potential of crude acetone extracts of Combretum molle (Combretaceae) on drug-resistant strains of Helicobacter pylori.

Journal of Health, Population, and Nutrition — Sat, 01 Oct 2011 04:00:00 +0100

Authors: Njume C, Afolayan AJ, Samie A, Ndip RN Abstract Infection with Helicobacter pylori is strongly associated with a number of gastroduodenal pathologies. Antimicrobial resistance to commonly-used drugs has generated a considerable interest in the search for novel therapeutic compounds from medicinal plants. As an ongoing effort of this search, the susceptibility of 32 clinical strains of H. pylori and a reference strain-NCTC 11,638-was evaluated against five solvent extracts of Combretum molle, a plant widely used for the treatment of gastric ulcers and other stomach-related morbidities in South Africa. The extracts were screened for activity by the agar-well diffusion method, and the most active one of them was tested against the same strains by micro-broth dilution and time...

Phenotypic and genotypic properties of Neisseria gonorrhoeae isolates in Norway in 2009: antimicrobial resistance warrants an immediate change in national management guidelines

European Journal of Clinical Microbiology and Infectious Diseases — Fri, 30 Sep 2011 06:24:43 +0100

Abstract Despite rapidly diminishing treatment options for Neisseria gonorrhoeae and high levels of ciprofloxacin resistance worldwide, Norwegian guidelines still recommend ciprofloxacin as empirical treatment for gonorrhea. The present study aimed to characterize phenotypical and genotypical properties of N. gonorrhoeae isolates in Norway in 2009. All viable N. gonorrhoeae isolates (n = 114) from six university hospitals in Norway (2009) were collected, representing 42% of all notified gonorrhea cases. Epidemiological data were collected from the Norwegian Surveillance System for Communicable Diseases and linked to phenotypical and genotypical characteristics for each N. gonorrhoeae isolate. Resistance levels to the antimicrobials examined were: ciprofloxacin 78%, azithr...

Materials available to support European Antibiotic Awareness Day on 18th November 2011 in England

NeLM - News — Fri, 30 Sep 2011 04:00:00 +0100

Source: Department of Health (DH) Area: News To support European Antibiotic Awareness Day (EAAD) and the promotion of prudent antibiotic use, the European Centre for Disease Prevention and Control (ECDC) has created information and educational materials for use in hospitals and primary care settings and these have been adapted for use in England. EAAD will be held on 18th November 2011 and is a Europe-wide public health initiative aimed at encouraging responsible use of antibiotics. The initiative is supported in England by the Department of Health, its advisory committee on antimicrobial resistance and health care associated infections. Please see link below for access to the support materials available. (Source: NeLM - News)

Alternative methods for the detection of extended-spectrum-beta-lactamase in Escherichia coli and Klebsiella pneumoniae

Jornal Brasileiro de Patologia e Medicina Laboratorial — Thu, 29 Sep 2011 18:16:28 +0100

CONCLUSION: Both methods yielded satisfactory results with higher sensitivity (90%) and lower costs in comparison with the reference one (CLSI disk diffusion method), which corroborates its use in ESBL investigation. (Source: Jornal Brasileiro de Patologia e Medicina Laboratorial)

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The Prevalence and Incidence of Helicobacter pylori–Associated Peptic Ulcer Disease and Upper Gastrointestinal Bleeding Throughout the World

Gastrointestinal Endoscopy Clinics of North America — Thu, 29 Sep 2011 08:28:07 +0100

Due to heightened awareness regarding testing for and eradication of infection, the prevalence and incidence of H pylori infection (and by extension the prevalence and incidence of peptic ulcer disease) appear to have declined in recent years. However, antimicrobial resistance is mounting and traditional clarithromycin- or metronidazole-containing triple therapies may no longer be highly effective at eradicating the infection. Combined bismuth- and metronidazole-containing quadruple therapy or sequential 4-drug therapy may be better choices for first-line treatment against this unique pathogen that is ideally suited to survive in the human stomach. (Source: Gastrointestinal Endoscopy Clinics of North America)

Hospital Sewage a Breeding Ground for Bacterial ResistanceHospital Sewage a Breeding Ground for Bacterial Resistance

Medscape Today Headlines — Tue, 27 Sep 2011 15:28:34 +0100

Nosocomial pathogens and environmental bacteria swap genes in hospital sewage, potentially spreading antimicrobial resistance across a wide range of hosts. Medscape Medical News (Source: Medscape Today Headlines)

Resistance rises to antibiotics in E.coli infections

The Irish Times - Health — Mon, 26 Sep 2011 23:42:37 +0100

A STUDY AT Tallaght Hospital, which included more than 42,000 samples, found that antimicrobial resistance in E.coli urinary tract infections has risen in recent years. (Source: The Irish Times - Health)

Overview of Biologic Response Modifiers in Infectious Disease

Infectious Diseases Clinics of North America — Mon, 26 Sep 2011 04:00:00 +0100

The conventional treatment of infectious agents is increasingly encountering antimicrobial resistance. This resistance has led to an intense search for novel treatment modalities for infectious diseases. Elucidation of the mechanisms underlying the inhibitory activity of chemokines has been instrumental in the rational design of anti–human immunodeficiency virus chemokine drugs. The immune-based therapies, in combination with antimicrobial drugs, for viral hepatitis have attracted much attention. Recognition of toll-like receptors by synthetic immunomodulators is used for certain viral infections. New methodologies have the potential to identify novel targets and foster the development of individually tailored immunomodulatory drug treatments. (Source: Infectious Diseases Clinics of Nort...

Antimicrobial susceptibility of Salmonella isolates recovered from calves with diarrhoea in Australia

Australian Veterinary Journal — Fri, 23 Sep 2011 16:32:00 +0100

Conclusion The prevalence of antimicrobial resistance in Salmonella isolates from dairy calves in Australia is low compared with that reported overseas. From a human health perspective, resistance to antimicrobials used in the treatment of human salmonellosis was infrequent. (Source: Australian Veterinary Journal)

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Resistance patterns and occurrence of virulence determinants among GRE strains in southwestern Poland.

Advances in Medical Sciences — Thu, 22 Sep 2011 04:00:00 +0100

Conclusions: Linezolid seems to be the optimal option in empirical therapy of infections caused by GRE strains because of the relationship between its activity (MIC value) and susceptibility breakpoint. There was no correlation between the prevalence of different virulence genes and resistance to the antibiotics tested. PMID: 21940270 [PubMed - as supplied by publisher] (Source: Advances in Medical Sciences)

A new look at anti-Helicobacter pylori therapy.

World Journal of Gastroenterology : WJG — Wed, 21 Sep 2011 04:00:00 +0100

Authors: Chuah SK, Tsay FW, Hsu PI, Wu DC Abstract With the rising prevalence of antimicrobial resistance, the treatment success of standard triple therapy has recently declined to unacceptable levels (i.e., 80% or less) in most countries. Therefore, several treatment regimens have emerged to cure Helicobacter pylori (H. pylori) infection. Novel first-line anti-H. pylori therapies in 2011 include sequential therapy, concomitant quadruple therapy, hybrid (dual-concomitant) therapy and bismuth-containing quadruple therapy. After the failure of standard triple therapy, a bismuth-containing quadruple therapy comprising a proton pump inhibitor (PPI), bismuth, tetracycline and metronidazole can be employed as rescue treatment. Recently, triple therapy combining a PPI, levofloxacin and am...

The characteristics of NDM-producing Klebsiella pneumoniae from Canada

Diagnostic Microbiology and Infectious Disease — Tue, 20 Sep 2011 05:23:23 +0100

Abstract: After recent hospitalization in India (New Delhi and Mumbai), 2 patients, on their return to Canada, presented with lower urinary tract infections due to multiresistant Klebsiella pneumoniae that produced New Delhi metallo-β-lactamase and CTX-M-15. The organisms belonged to clones ST147 and ST340, and were positive for aac(6′)-Ib-cr, as well as for the ccdAB and vagCD addiction systems. The blaNDM plasmid was located on the IncFIIA and IncA/C replicon groups of plasmids. Clones ST147 and ST340 are also responsible for harbouring blaKPC, and it is possible that they played an important role in the intercontinental spread of antimicrobial resistance. (Source: Diagnostic Microbiology and Infectious Disease)

Shortening the Antibiotic Course for the Treatment of Neonatal Coagulase-Negative Staphylococcal Sepsis: Fine with Three Days?

Neonatology — Sat, 17 Sep 2011 04:00:00 +0100

Conclusions: Antibiotic treatment for CoNS sepsis may be shortened to 3 days when clinical improvement is rapid and central lines are not present. Prospective randomized studies are needed to confirm the results of this single-center study. Future studies may reveal the effects on the development of antimicrobial resistance. PMID: 21934336 [PubMed - as supplied by publisher] (Source: Neonatology)

Common Treatments Can Lead To Antibiotic Resistance

Health News from Medical News Today — Fri, 16 Sep 2011 09:00:00 +0100

Overexposure to antibiotics has long been a concern in the medical community most specifically the development of antibiotic resistant infections as a result of repeated use. According to a study released this week in the Archives of Ophthalmology, ophthalmologic antibiotics promote antimicrobial resistance too, prompting a call from Vanderbilt Eye Institute physicians to be more judicial in the administration of certain classes of antibiotics. "The use of topical antibiotics is promoting antimicrobial resistance, prompting an emergence of resistant strains," said Stephen Kim, M.D... (Source: Health News from Medical News Today)

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Changing pattern of antimicrobial resistance within E coli isolates from nosocomial, community and urology patient-specific UTIs, Dublin 1999 to 2009

NeLM - News — Fri, 16 Sep 2011 04:00:00 +0100

Source: BJU International Area: News The authors of this report suggest that empirical therapy to treat urinary tract infection (UTI) should be tailored to the surveillance data on the epidemiology and resistance patterns of common uropathogens to reduce treatment failures and emergence of bacterial resistance strains. They conducted a retrospective analysis of the 42,033 E. coli urine isolates from 1999-2009 in a single Dublin teaching hospital, to examine the changing pattern of antimicrobial resistance in Escherichia coli (E.coli) UTI over an 11 year period, and to determine whether E.coli antibiotic resistance rates vary depending on whether the UTI represents a nosocomial, community acquired or urology patient specific infection. The following findings were reported: &nb...

Increasing Trend of Resistance to Penicillin, Tetracycline, and Fluoroquinolone Resistance in Neisseria gonorrhoeae from Pakistan (1992–2009)

Computational Intelligence and Neuroscience — Thu, 15 Sep 2011 15:32:33 +0100

Emergence and spread of drug resistant Neisseria gonorrhoeae is global concern. We evaluated trends of antimicrobial resistance in Neisseria gonorrhoeae over years 1992–2009 in Pakistan. Resistance rates were compared between years (2007–2009) and (1992–2006). Antimicrobial susceptibility testing was performed and interpreted according to Clinical Laboratory Standards Institute (CLSI) criteria using the disk diffusion methodology against penicillin, ceftriaxone, tetracycline and ofloxacin. Additional antibiotics tested in 100 strains isolated during 2007–2009, included cefotaxime, cefoxitin, cefuroxime, cefipime, ceftazidime, ceftizoxime, cefixime, cefpodoxime, spectinomycin and azithromycin. Neisseria gonorrhoeae ATCC 49226 was used as control. Chi-square for trend...

High Prevalence of Multidrug-Resistant Non-Fermenters in Hospital-Acquired Pneumonia in Asia.

American Journal of Respiratory and Critical Care Medicine — Thu, 15 Sep 2011 04:00:00 +0100

CONCLUSIONS: Acinetobacter spp., P. aeruginosa, S. aureus, and K. pneumoniae are the most frequent isolates from adults with HAP or VAP in Asian countries. These isolates are highly resistant to major antimicrobial agents, which could limit the therapeutic options in the clinical practice. Discordant initial empirical antimicrobial therapy significantly increases the likelihood of pneumonia-related mortality. PMID: 21920919 [PubMed - as supplied by publisher] (Source: American Journal of Respiratory and Critical Care Medicine)

Changing trend of antimicrobial resistance among gram-negative bacilli isolated from lower respiratory tract of ICU patients: A 5-year study

Indian Journal of Critical Care Medicine — Wed, 14 Sep 2011 04:00:00 +0100

Conclusions: Gram-negative organisms are the predominant pathogens causing LRTI in ICU. The increasing trend of resistance to cephalosporins and carbapenems in gram-negative organisms is very disturbing. Judicious use of antimicrobial agents is essential to prevent the emergence of multidrug-resistant bacteria in the ICU. (Source: Indian Journal of Critical Care Medicine)

Antimicrobial Resistance and Ophthalmic Antibiotics: 1-Year Results of a Longitudinal Controlled Study of Patients Undergoing Intravitreal Injections [Clinical Sciences]

Archives of Opthalmology — Mon, 12 Sep 2011 04:00:00 +0100

Conclusion Repeated exposure of conjunctival flora to ophthalmic antibiotics selects for resistant strains. Application to Clinical Practice Repeated use of ophthalmic antibiotics after intraocular injection promotes the emergence of antimicrobial resistance. Trial Registration clinicaltrials.gov Identifier: NCT00831961 (Source: Archives of Opthalmology)

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The effect of a whole-system approach in an antimicrobial stewardship programme at the Singapore General Hospital

European Journal of Clinical Microbiology and Infectious Diseases — Fri, 09 Sep 2011 05:47:31 +0100

Abstract Inappropriate antibiotic use contributes to antimicrobial resistance. Multi-faceted antimicrobial stewardship programmes (ASPs) are recommended for sustainable changes in prescribing practices. A multi-disciplinary ASP was established in October 2008 and piloted in the Departments of General Surgery, Renal Medicine and Endocrinology sequentially. To improve the quality of patient care via optimising the (1) choice, (2) dose, (3) route and (4) duration of antibiotics, a “whole-system” approach incorporating prospective review with immediate concurrent feedback (ICF), prescriber education (public or individualised), de-escalation of therapy, dose optimisation and parenteral-to-oral conversion, while recognising the autonomy of primary prescribers, was adopted. T...

Detection and characterization of methicillin-resistant Staphylococcus pseudintermedius in healthy dogs in La Rioja, Spain.

Comparative immunology, microbiology and infectious diseases. — Tue, 06 Sep 2011 04:00:00 +0100

The objective was to identify the methicillin-resistant coagulase-positive staphylococci (MRCoPS) nasal carriage rate of healthy dogs in La Rioja (Spain) and to characterize the recovered isolates by different molecular techniques. Nasal samples from 196 dogs were obtained (98 household-dogs, 98 pound-dogs). Isolates were identified and characterized by spa-, SCCmec- and MLST-typing, SmaI-PFGE, antimicrobial susceptibility, determination of antimicrobial resistance and toxin genes profiling. S. pseudintermedius was the only species recovered. Nine methicillin-resistant S. pseudintermedius (MRSP) were obtained from 9 of 196 sampled dogs (8% pound-dogs, 1% household-dogs). MRSP isolates were typed (MLST/PFGE/spa/SCCmec) as: ST71/A/t02/II-III (7 isolates), ST92/C/t06/V (1 isolate), and ST26/B...

Update in Adult Urinary Tract Infection

Current Infectious Disease Reports — Mon, 05 Sep 2011 16:14:59 +0100

Abstract Urinary tract infection remains a common problem for many populations. Recent studies have expanded our understanding of the host innate immune response and its role in the familial association observed for recurrent uncomplicated urinary tract infection in healthy women. Therapeutic management for uncomplicated infection has been compromised by increasing antimicrobial resistance, particularly global dissemination of the CTXM-15 extended spectrum β-lactamase (ESBL) producing Escherichia coli ST-131 strain. Prevention strategies exploring non-antimicrobial approaches continue to show limited promise, and approaches to limit empiric antimicrobials are now being explored. For complicated urinary tract infection, increasing antimicrobial resistance limits therapeutic...

Combination therapies for combating antimicrobial resistance.

Current Opinion in Microbiology — Mon, 05 Sep 2011 04:00:00 +0100

Authors: Fischbach MA Abstract New drug development strategies are needed to combat antimicrobial resistance. The object of this perspective is to highlight one such strategy: treating infections with sets of drugs rather than individual drugs. We will highlight three categories of combination therapy: those that inhibit targets in different pathways; those that inhibit distinct nodes in the same pathway; and those that inhibit the very same target in different ways. We will then consider examples of naturally occurring combination therapies produced by micro-organisms, and conclude by discussing key opportunities and challenges for making more widespread use of drug combinations. PMID: 21900036 [PubMed - as supplied by publisher] (Source: Current Opinion in Microbiology)

Silver resistance: an alarming public health concern?

International Journal of Antimicrobial Agents — Mon, 05 Sep 2011 04:00:00 +0100

Increasing antimicrobial resistance, e.g. as seen with the spread of meticillin-resistant Staphylococcus aureus (MRSA), has complicated the treatment of infectious diseases and has led to an increasing use of ionic silver as a biocide. The number of available silver-based products has also increased outside clinical settings, e.g. in households for water purification, personal care applications and clothes . Due to the extensive and uncontrolled use of silver, it is of increasing public interest to address and monitor the clinical risk related to silver resistance and in an environmental context to study the sources, fate, transport routes and toxicity of environmentally relevant forms of silver . Despite long-term use, there are few reports of silver resistance amongst clinical isolates, ...

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[Helicobacter pylori Eradication Therapy in Korea].

Korean J Gastroenter... — Fri, 02 Sep 2011 01:25:34 +0100

Authors: Kim SY, Jung SW Abstract Helicobacter pylori (H. pylori) is known to be associated with many gastrointestinal diseases including peptic ulcer. In Korea, eradication of H. pylori is recommended for peptic ulcer disease, low grade gastric mucosa-associated lymphoid tissue lymphoma, and early gastric cancer. Standard triple therapy using proton pump inhibitor, clarithromycin, and amoxicillin and bismuth-containing quadruple therapy have been the main first-line and second-line therapy for H. pylori in Korea. Although eradication rate of second-line quadruple therapy remains similar to that of the past, the success rate of eradication with triple therapy has decreased with increasing antimicrobial resistance to H. pylori. There is no standard third-line therapy, and some regim...

Association Between Antimicrobial Resistance in Escherichia coli Isolates from Food Animals and Blood Stream Isolates from Humans in Europe: An Ecological Study

Foodborne Pathogens and Disease — Thu, 01 Sep 2011 19:51:23 +0100

Foodborne Pathogens and Disease , Vol. 0, No. 0. (Source: Foodborne Pathogens and Disease)

Prevalence, Characterization, and Antimicrobial Resistance of Aeromonas Strains from Various Retail Food Products in Mumbai, India

Journal of Food Science — Thu, 01 Sep 2011 04:00:00 +0100

Abstract: A total of 154 food samples (chicken, fish, and ready‐to‐eat sprouts) from various retail outlets in Mumbai, India, were analyzed for the presence of Aeromonas spp. over a period of 2 y (January 2006 to March 2008). Twenty‐two Aeromonas isolates belonging to 7 different species were isolated from 18 (11.7%) food samples. The highest percentages of isolation were from chicken (28.6%) followed by fish (20%) and sprout (2.5%) samples. Aeromonas caviae, A. veronii bv. sobria, and A. salmonicida were the most frequently isolated species from sprouts, chicken, and fish samples, respectively. The genes encoding for putative virulence factors, cytotoxic enterotoxin (act), hemolysin (hly), aerolysin (aer), elastase (ahyB), and lipase (lip) were detected using ...

Mortality risk factors in patients with Acinetobacter baumannii ventilator-associated pneumonia.

J Formos Med Assoc — Thu, 01 Sep 2011 04:00:00 +0100

CONCLUSION: Inadequate initial empiric antimicrobial therapy and higher disease severity scores, including CURB ≥ 3 and C-reactive protein ≥ 120 mg/L, were independent risk factors associated with higher mortality rates for A baumannii pneumonia. Length of stay before VAP and white blood cell count <4/μL or >1.1 × 10(4)/μL were independent risk factors for carbapenem resistance. PMID: 21930066 [PubMed - in process] (Source: J Formos Med Assoc)