ABSTRACT
Background and Aim: The emergence of nonfermenter bacteria that are resistant to multidrug resistant ESBL are nowadays a principal problem for hospitalized patients. The present study aimed at surveying the emergence of nonfermenter bacteria resistant to multi-drug ESBL producing isolated from patients blood samples using BACTEC 9240 automatic system in Shiraz
Materials and Methods: In this cross-sectional study, 4825 blood specimens were collected from hospitalized patients in Shiraz [Iran], and positive samples were detected by means of BACTEC 9240 automatic system. The isolates containing nonfermenter bacteria were identified based on biochemical tests embedded in the API-20E system. Antibiotic sensitivity test was performed and identification of ESBL producing strains were done using phenotypic detection of extended spectrum beta-lactamase producing isolates [DDST] according to CLSI [2013]guidelines
Results: Out of 4825 blood samples, 1145 [24%] specimen were gram-positive using BACTEC system
Among all isolated microorganisms, 206 isolates were non-fermenting gram- negative bacteria
The most common non-fermenter isolates were Pseudomonas spp. [48%], Acinetobacter spp. [41.7%] ,and Stenotrophomonas spp. [8.2%]. Seventy of them [81.4%] were Acinetobacter spp. which were ESBL positive. Among beta-lactam antibiotics, Pseudomonas spp. showed the best sensitivity to piperacillintazobactam [46.5%]
Conclusion: It was found that ?-lactam antibiotics are not effective against more than 40% of Pseudomonas spp. infections and 78% Acinetobacter infections. Emergence of multi-drug resistant strains that are resistant to most antibiotic classes is a major public health problem in Iran. To resolve this problem using of practical guidelines is critical
ABSTRACT
Background: Urinary tract infections [UTIs], including cystitis and pyelonephritis, are the most common infectious diseases in childhood. Escherichia coli [E. coli] accounts for as much as 90% of the community-acquired and 50% of nosocomial UTIs. Therefore, identification of E. coli strains is important for both clinical and epidemiological implications. Understanding antibiotic resistance patterns and molecular characterization of plasmids and other genetic elements is also epidemiologically useful
Methods: To characterize uropathogenic strains of E. coli, we studied 96 E. coli strains recovered from urine samples of children aged 1 month to 14 years with community-acquired UTIs in Jahrom, Iran. We assessed virulence factors [VFs], drug sensitivities, and plasmid profiles
Results: Drug sensitivities of the isolates were: 19.8% [ampicillin], 24% [trimethoprim-sulfamethoxazole], 29.2% [tetracycline], 75.5% [nalidixic acid], 80.4% [cefixime], 84.6% [gentamicin], 91.4% [ciproAoxacin], 96.8% [nitrofurantoin], 96.8% [amikacin] and 100% [imipenem]. Totally, 76 isolates harbored plasmids with an average of 5.5 plasmids [range: 1-10] in each strain. Plasmid profiling distinguished 22 different E. coli genotypes in all isolates that ranged in similarity from 50% to 100%. PCR showed that the prevalence of virulence genes ranged from 15.62% forhly to 30.2% for pap
Conclusion: These data mandate local monitoring of drug resistance and its consideration in empirical therapy of E. coli infections. Plasmid analysis of representative E. coli isolates also demonstrates the presence of a wide range of plasmid sizes, with no consistent relationship between plasmid profiles and resistance phenotypes. Plasmid profiles distinguished more strains than did the antimicrobial susceptibility pattern