ABSTRACT
Para evaluar la susceptibilidad antimicrobiana in vitro de enterobacterias nosocomiales productoras de BLEE en pacientes recluidos en el Servicio Autónomo Hospital Universitario Antonio Patricio de Alcalá, se recolectaron 27 cepas bacterianas procedentes de las salas de UCI, retén, medicina y pediatría, en el periodo septiembre-noviembre de 2005. La susceptibilidad antimicrobiana se determinó por el método de difusión del disco. El mayor número de infecciones nosocomiales se presentó en UCI y retén con 10 (37,03 por ciento) y 7 (25,93 por ciento) casos; 44,44 por ciento de cultivos positivos fueron aislados en secreciones. K. pneumoniae resultó la especie mayormente aislada (51,85 por ciento), seguida de Enterobacter aerogenes con 18,52 por ciento. La mayor resistencia antimicrobiana en el grupo de los ß-lactámicos, se obtuvo para ceftazidima (77,77 por ciento), cefotaxima (70,37 por ciento) y cefepima (40,74 por ciento); en el grupo de los aminoglucósidos, a tobramicina y gentamicina (44,44 por ciento y 40,74 por ciento); asimismo, cloranfenicol (70,37 por ciento), tetraciclinas (51,85 por ciento) y trimetoprim-sulfametoxazol (44,44 por ciento). Estos resultados pudieran ser útiles a la comunidad médica, al tomar en cuenta las pautas de tratamiento y modificar las conductas de riesgo, las cuales facilitan la inducción de resistencia, como el abuso al prescribir antimicrobianos y las hospitalizaciones innecesarias
In order to assess in vitro antimicrobial susceptibility for nosocomial enterobacteria ESBL producers for patients in the Autonomous University Hospital Service Antonio Patricio de Alcalá, 27 bacterial strains were collected in the ICU, neonatology, medicine and pediatric facilities during September-November 2005. Antimicrobial susceptibility was determined by the disk diffusion method. The highest number of nosocomial infections was found in ICU and neonatology with 10 (37.03 percent) and 7 (25.93 percent) cases, respectively; 44.44 percent of the positive cultures were isolated from secretions. K. pneumoniae was the most frequently isolated species (51.85 percent), followed by Enterobacter aerogenes with 18.52 percent. The greatest antimicrobial resistance in the betalactam group was obtained for ceftazidime (77.77 percent), cefotaxime (70.37 percent) and cefepime (40.74 percent); in the aminoglycosides group, for tobramycin and gentamycin, (44.44 percent and 40.74 percent, respectively); also, chloramphenicol (70.37 percent), tetracycline (51.85 percent) and trimethoprim-sulfamethoxazole (44.44 percent). These results could be useful to the medical community when taking into account guidelines for treatment and risk behavior modification, which facilitate the induction of resistance, such as abuse in prescribing antibiotics and unnecessary hospitalizations
Subject(s)
Humans , Enterobacteriaceae , Enterobacteriaceae/isolation & purification , Cross Infection/diagnosis , Cross Infection/microbiology , Disk Diffusion Antimicrobial Tests/methods , Disease Susceptibility/virology , beta-LactamasesABSTRACT
One hundred and seventy-two ampicillin-resistant E. coli strains isolated from commercial chickens in Enugu State, Nigeria, were screened for beta-lactamase production using the broth method with nitrocefin® as the chromogenic cephalosporin to detect enzyme production. Beta-lactamase producing strains were further examined for extended-spectrum beta-lactamase (ESBL) production using the Oxoid combination discs method. One hundred and seventy (98.8 percent) of the 172 ampicillin-resistant E. coli strains produced beta-lactamase enzyme. Sixteen (9.4 percent) beta-lactamase producers were phenotypically confirmed to produce ESBLs. Six of the ESBL producing strains were only detected with ceftazidime versus ceftazidime/clavulanate combination while ten of the ESBL producers were detected with cefotaxime versus cefotaxime/clavulanate combination. Chicken may serve as a reservoir of ESBL-producing E. coli strains which could be transferred to man and other animals.
Cento e setenta e duas cepas de Escherichia coli resistentes a ampicilina isoladas de frangos em Enugu State, Nigéria, foram avaliadas quanto à produção de beta-lactamase através do uso de método em caldo com nitrocefin® como indicador cromogênico da produção da enzima. Em seguida, as cepas produtoras de beta-lactamase foram examinadas quanto à produção de beta-lactamase de espectro expandido (ESBL) através do método de discos combinados Oxoid. Entre as cepas de Escherichia coli resistentes a ampicilina, cento e setenta (98,8 por cento) produziram beta-lactamase. Testes fenotípicos indicaram que dezesseis (9,4 por cento) das cepas produtoras de beta-lactamase produziram ESBL. Seis cepas produtoras de ESBL foram detectadas apenas com a combinação ceftazidima versus cefotaxime/clavulanato, enquanto dez cepas produtoras de ESBL foram detectadas com a combinação cefotaxime versus cefotaxime/clavulanato. Frangos podem ser reservatório de cepas de E.coli produtoras de ESBL, que podem ser transferidos para o homem e outros animais.
ABSTRACT
Betalactamases de espectro estendido são mediadas por plasmídios. Essas enzimas possuem a habilidade de hidrolizar antibióticos beta-lactâmicos. Nesse estudo, avaliamos a atividade in vitro do meropenem contra cepas de Klebsiella pneumoniae produtoras de ESBLs. Foram estudadas 14 cepas. A susceptibilidade dessas cepas para o meropenem foi de 100 por cento.
Extended-spectrum beta-lactamases are plasmid-mediated. These enzymes have the ability to hydrolyze beta-lactam antibiotics. In this study, we evaluated the in vitro activity of meropenem against ESBL-producing Klebsiella pneumoniae strains. Fourteen strains were studied. The susceptibility of these strains to meropenem was 100 percent.
Subject(s)
Humans , Anti-Bacterial Agents/pharmacology , Klebsiella pneumoniae/drug effects , Thienamycins/pharmacology , beta-Lactamases/metabolism , Klebsiella pneumoniae/enzymology , Microbial Sensitivity TestsABSTRACT
Dentro de los mecanismos de resistencia bacteriana encontrados en los miembros de las Enterobacteriaceae, las Beta Lactamasas de Espectro Expandido (BLEE), juegan un papel importante ya que debido a su naturaleza plasmídica pueden diseminarse a otros géneros diferentes a E. coli, K. pneumoniae y K. oxytoca, de donde principalmente se han descrito y confieren resistencia a cefalosporinas de tercera y cuarta generación y a aztreonam. Dado que en la Maternidad Concepción Palacios (MCP) la mayor parte de los pacientes constituyen neonatos y el tratamiento empleado principalmente son cefalosporinas, se evaluó la frecuencia en este centro de Enterobacterias productoras de BLEE aislados en áreas críticas de muestras de hemocultivos, puntas de catéter, orina y secreciones en el período comprendido de Enero a Junio de 2006. La identificación y sensibilidad se realizaron con las galerías ID32GN y ATBGN-5 respectivamente, utilizando el equipo semiautomatizado Mini API (BioMérieux). Para la detección fenotípica de producción de BLEE se empleó el método de doble difusión con discos y el método recomendado por el Clínical and Laboratory Standard Institute (CLSI) (1). La mayor frecuencia se obtuvo para Pantoea agglomerans, seguida de Klebsiella pneumoniae, y Enterobacter cloacae. El 80 % de las enterobacterias aisladas, fueron productoras de BLEE.
Inside the mechanisms of bacterial resistance found in members of the Enterobacteriaceae family, the Expanded Spectrum Beta Lactamasas (ESBL), play an important role due to its plasmid nature it can be spread to other different genera to E. coli, K.pneumoniae, and K. oxytoca, wherefrom principally they have been described, and award resistance to cephalosporin of third and fourth generation and to aztreonam. In view of the Maternity Concepción Palacios (MCP) most of the patients constitutes newborn, and the principally used treatment are cephalosporin, the frequency of ESBL producting enterobacteria was evaluated in this center, isolated in critical areas from samples of blood cultures, tops of catheter, urine and secretions from January to June, 2006. The identification and sensibility were realized by the galleries ID32GN and ATBGN-5 respectively, using the semi automated Mini API (BioMérieux) equipment. For the phenotypical detection of ESBL production there were used the double diffusion of disc method and the method recommended by the Clinical and Laboratory Standard Institute (CLSI) (1). The major frequency was to Pantoea agglomerans followed by Klebsiella pneumoniae, and Enterobacter cloacae. 80% of the isolated enterobacteria, were producer of ESBL.