ABSTRACT
Surgical site infections (SSIs) and antimicrobial resistance among pathogens causing SSI are a growing concern in veterinary hospitals. One major reason, the widespread use of antimicrobials, has led to increased incidence of SSIs. This study identified bacteria and resistance profiles to antimicrobials in the SSI cases diagnosed at the Surgical Clinic of Small Animals in the Veterinary Hospital, Federal University of Viçosa, Brazil. The main genus identified was Staphylococcus, followed by Escherichia, Enterococcus, Bacillus, Shigella, Citrobacter, Proteus, Morganella, Serratia, Enterobacter, Pseudomonas and Klebsiella were also found, but in small number. The results indicated the predominance of Gram-negative bacteria among the collected samples. Most of isolates identified were resistant to more than one of the following antimicrobials: ampicillin, tetracycline, enrofloxacin, amoxicillin/clavulanic acid and cephalotin. Of the 17 Staphylococcus sp. isolates, two (11.8%) were methicillin-resistant Staphylococcus aureus (MRSA) and 11 (64.7%) of them were methicillin-resistant Staphylococcus pseudintermedius (MRSP). There were bacterial genera identified with resistance to all tested antimicrobials in different proportions. This should alert veterinary hospitals to the emergence of multidrug-resistant bacteria and to the requirement for the revision of surgical protocols with regard to antimicrobial prophylaxis and therapy.(AU)
As infecções em sítio cirúrgico (ISCs) e a resistência bacteriana entre os patógenos relacionados constituem uma preocupação crescente nos hospitais veterinários. O aumento na incidência de ISCs possui forte relação com o uso amplo e disseminado de antibióticos. O presente estudo identificou bactérias e perfis de resistência a antibióticos nos casos de ISCs diagnosticados na Clínica Cirúrgica de Pequenos Animais do Hospital Veterinário da Universidade Federal de Viçosa, Brasil. O principal gênero identificado foi Staphylococcus, seguido pelos gêneros Escherichia, Enterococcus, Bacillus, Shigella, Citrobacter, Proteus, Morganella, Serratia, Enterobacter, Pseudomonas e Klebsiella, porém, em menor quantidade. Os resultados demonstraram a predominância de bactérias Gram-negativas entre as amostras coletadas. A maioria dos isolados identificados eram resistentes a um ou a mais de um dos seguintes antibióticos: ampicilina, tetraciclina, enrofloxacina, amoxicilina/ácido clavulânico e cefalotina. Entre os 17 isolados de Staphylococcus sp., dois (11,8%) eram Staphylococcus aureus resistentes à meticilina (SARM) e 11 (64,7%) eram Staphylococcus pseudintermedius resistentes à meticilina (SPRM). Houve identificação de gêneros bacterianos com diferentes proporções de resistência para todos os antibióticos avaliados. Esses achados devem alertar os hospitais veterinários para a emergência de bactérias multirresistentes e para a necessidade de revisar a profilaxia e a terapia antimicrobiana referente aos protocolos cirúrgicos.(AU)
Subject(s)
Animals , Cats , Dogs , Drug Resistance, Microbial , Cross Infection/veterinary , Methicillin-Resistant Staphylococcus aureus , Microbial Sensitivity Tests/veterinaryABSTRACT
Bacterial keratitis is a common infectious keratitis.Patients often end up with severe vision loss even after the infection is completely eradicated.With the increasing resistance of pathogens to antibiotics,treatment of bacterial keratitis has become increasingly difficult.Facing such an emerging challenge,the present review outlined recent clinical experience in the diagnosis and treatment of bacterial keratitis.In addition to a summary on practice standards in specimen collection,selection of common culture media and antibiotics,a new simple and efficacious antibiotic delivery method is introduced using continuous subpalpebral lavage for the treatment of severe and recalcitrant bacterial keratitis.
ABSTRACT
BACKGROUND/AIMS: Healthcare-associated pneumonia (HCAP) was proposed asa new pneumonia category in 2005, and treatment recommendations includebroad-spectrum antibiotics directed at multidrug-resistant (MDR) pathogens.However, this concept continues to be controversial, and microbiological data arelacking for HCAP patients in the intensive care unit (ICU). This study was conductedto determine the rate and type of antibiotic-resistant organisms and theclinical outcomes in patients with HCAP in the ICU, compared to patients withcommunity-acquired pneumonia (CAP) or hospital-acquired pneumonia (HAP). METHODS: We conducted a retrospective cohort analysis of patients with pneumonia(n = 195) who admitted to medical ICU in tertiary teaching hospital fromMarch 2011 to February 2013. Clinical characteristics, microbiological distributions,treatment outcomes, and prognosis of HCAP (n = 74) were compared tothose of CAP (n = 75) and HAP (n = 46). RESULTS: MDR pathogens were significantly higher in HCAP patients (39.1%) thanin CAP (13.5%) and lower than in HAP (79.3%, p < 0.001). The initial use of inappropriateantibiotic treatment occurred more frequently in the HCAP (32.6%) andHAP (51.7%) groups than in the CAP group (11.8%, p = 0.006). There were no differencesin clinical outcomes. The significant prognostic factors were pneumoniaseverity and treatment response. CONCLUSIONS: MDR pathogens were isolated in HCAP patients requiring ICU admissionat intermediate rates between those of CAP and HAP.
Subject(s)
Humans , Anti-Bacterial Agents , Cohort Studies , Hospitals, Teaching , Intensive Care Units , Critical Care , Pneumonia , Prognosis , Retrospective StudiesABSTRACT
Objective To investigate the characteristics of department distribution and antibacterial resistance of multidrug‐re‐sistant(MDR) pathogens in hospital ,and take specific measures for the prevention ,treatment and infection cntrol .Methods Data of 1 816 MDR isolates detected in the hospital from January to December in 2014 were analyzed retrospectively .Results Among the 1 816 MDR strains ,extended‐spectrum β lactamases(ESBLs) producing Escherichia coli ranked first(665 strains ,36 .62% ) ,fol‐lowed by methicillin‐resistant Staphylococcus aureus(387 strains ,21 .31% ) ,MDR Acinetobacter baumannii(295 strains ,16 .22% ) , MDR Pseudomonas aeruginosa(195 strains ,10 .74% ) ,carbapenem‐resistant Enterobacteriaceae(144 strains ,7 .92% ) ,ESBLs pro‐ducing Klebsiella pneumoniae(130 strains ,7 .16% ) .MDR strains were mainly distributed in general department of urology surgery (384 strains ,21 .14% ) ,burn unit(325 strains ,17 .90% ) ,intensive care unit(ICU )(266 strains ,14 .52% ) and department neurosur‐gery(110 strains ,6 .04% ) .Vancomycin and linezolid resistance were not found in methicillin‐resistant Staphylococcus aureus ;less than 2 .9% of the ESBLs producing Escherichia coli and Klebsiella pneumonia strains were resistant to carbapenems .The resistance of carbapenem‐resistant Enterobacteriaceae to amikacin ,sulfamethoxazole‐trimethoprim ,meropenem and tetracycline were relatively low (39 .6% -60 .7% ) .The resistance of MDR Acinetobacter baumannii to levofloxacin ,tetracycline ,sulfamethoxazole‐trime‐thoprim and cefoperazone‐sulbactam were relatively low (48 .9% -76 .5% ) .The resistance of MDR Pseudomonas aeruginosa to amikacin ,ceftazidime ,gentamicin and ciprofloxacin were relatively low(45 .3% -66 .7% ) .Conclusion The MDR pathogens should be monitored in high‐risk department ,preventive measures should be taken ,and antibiotics should be used according to the results of drug susceptibility tests .
ABSTRACT
Methicillin-resistant Staphylococcus aureus (MRSA) stand out as one of the main agents causing nosocomial and community infections. This retrospective study aimed to analyze the MRSA predominance in a university hospital in the south of Brazil and it was carried out for five years (from 2007 to 2011). 616 MRSA (33,3% of the total) were isolated and an important reduction in the MRSA predominance was observed along the study. Although it was registered a reduction in the MRSA predominance, male adult patients (41-70 years old), who were in the Medical Clinic and Adult ICU, had the highest infection rates and concerning MRSA isolates rates, these were higher in blood and tracheal aspirates. In conclusion, studies of this type are becoming relevant to recognize pathogens like MRSA and to determine its predominance.
Staphylococcus aureus resistentes à meticilina (MRSA) destacam-se mundialmente como um dos mais frequentes patógenos nosocomiais e comunitários. Este estudo retrospectivo teve por objetivo analisar a prevalência de MRSA em um hospital universitário no sul do Brasil. Durante cinco anos (2007 a 2011), 616 MRSA (33,3% do total de S. aureus) foram isolados, sendo que sua frequência de isolamento apresentou considerável redução no decorrer do estudo. Nossos resultados demonstraram que as maiores taxas de isolamento dos MRSA ocorreram em amostras de sangue e secreção traqueal. As infecções prevaleceram em pacientes adultos (41 a 70 anos), do sexo masculino, internados na Clínica Médica e UTI adulto. Estudos como este se tornam importantes para o reconhecimento de patógenos resistentes, como o MRSA, e para a determinação da sua prevalência.
Subject(s)
Humans , Methicillin-Resistant Staphylococcus aureus , Hospitals, University/classification , Infections/diagnosis , Noxae/classificationABSTRACT
Background: Gram negative bacteria accounts for significant proportion of hospital and community associated infections responsible for significant proportion of hospital admission, and associated increased level of antibiotic resistance pattern. Based on this information, we retrospectively analyzed the prevalence and resistance pattern of gram negative bacteria isolated from clinical specimens submitted in a tertiary hospital in Maiduguri, Nigeria. Methodology: Bacteriological data of gram negative bacteria isolates recovered from clinical specimens submitted to medical microbiology laboratory of University of Maiduguri Teaching Hospital (UMTH) between 2007-2011were extracted and analyzed. A total of 36,800clinical specimens were examined. Results: The prevalence level of gram-negative bacteria isolates was 24.09% (8865/36,800), majority (29.16%, n=2585) of the isolates were recovered from wound specimens. Escherichia coli accounted for 31.8% (n=2823) of the total isolates. High susceptibility was observed with fluoroquinolones, aminoglycosides and cephalosporin tested, and resistance with cotrimoxazole and chloramphenicol. Overall, 7.6% (n=671) of the gram negative isolates exhibited multidrug resistance pattern, Escherichia coli accounted for 39.9% (268/671) of the multidrug resistant isolates. Conclusion: The study highlights epidemiological characteristics of the gram-negative bacteria isolated in our hospital, with prevalence level of 24.09% and diverse isolation pattern which affirmed gram-negative bacteria clinical implication in hospital and community associated infections. In addition, the multidrug resistance pattern level of 7.6% is an indication for laboratory personnel to be aware of possible emergence of multidrug resistant strain among gram-negative isolated in the hospital.
ABSTRACT
Severe sepsis and septic shock in the intensive care unit (ICU) needs emergent coverage with empirical broad-spectrum antibiotics, with a commitment to de-escalation once the organism and its susceptibility to a particular antibiotic becomes known. The dose and duration of antibiotic must be optimized according to standard guidelines to prevent emergence of resistant pathogens. Strategies of using Procalcitonin measurements in guiding the duration of antibiotic treatment and aerosolized antibiotics are helpful in optimizing antibiotic usage. Efforts are needed to prevent emergence of antibiotic resistance by pathogens, as the antibiotic pipeline is dwindling and the number of newly discovered multidrug-resistant (MDR) pathogens is increasing. Prevention of infection must be given top priority by strict adherence to asepsis measures.
ABSTRACT
The present investigation was focused to study the antagonistic potential of actinobacterial strain TK2 isolated from Thirukurungudi Hills (Western Ghats, Tamil Nadu), against selected drug resistant bacterial pathogens. Of the 9 clinical bacterial strains, S. aureus was found to be resistant against methicillin and vancomycin while the remaining 8 gram negative pathogens were confirmed as extended spectrum beta lactamase (ESBL) producers. Strain TK2 showed good antagonistic activity against all the bacterial pathogens, except the three isolates of P. aeruginosa. Strain TK2 produced the antimicrobial activity on 4th day of incubation when growing on ISP2 agar medium whereas the same strain showed activity only on 8th day of incubation when it was grown on ISP2 broth. Of the various solvents tested for extraction, bioactive compound was extracted only in ethyl acetate. The crude extract showed 14-18 mm inhibition zone in disc diffusion method. The crude extract produced two spots in thin layer chromatography (TLC) in chloroform: methanol (30:60) solvent system. In bioautography, the second spot (Rf value 0.685) showed activity. The active compound was purified by preparative TLC, which showed maximum activity (15-20 mm inhibition) against test pathogens. Based on the results of chemical screening, the active compound was identified as sugar containing substance. Strain TK2 showed good growth on various growth media and culture conditions. Based on the studied phenotypic characteristics strain TK2 was identified as the species of the genus Streptomyces. Of the various growth parameters tested, ISP2 medium, glucose, pH 7, 1% NaCl and temperature 300C was influenced the antagonistic activity of strain TK2. Strain TK2 will be a potential for the isolation of bioactive compound(s) which will be a candidate for the development of antibiotic against drug resistant bacterial pathogens.