Perfil de farmacorresistencia microbiana en adultos con infección del tracto urinario en una población de Pichincha-Ecuador / Microbial drug resistance profile in adults with urinary tract infection in a population of Pichincha-Ecuador

INTRODUCCIÓN. Las infecciones del tracto urinario son causa de mayor morbilidad en la población adulta y afectan con frecuencia a la mujer. Al ser un problema prevalente, fue fundamental realizar estudios sobre perfiles de susceptibilidad locales para establecer medidas de vigilancia y control de uso de antibióticos. OBJETIVO. Determinar el perfil de farmacorresistencia microbiana en adultos con infección del tracto urinario. MATERIALES Y MÉTODOS. Estudio descriptivo, transversal. La población fue de 437 urocultivos y una muestra de 176 positivos con su antibiograma, realizados en el laboratorio del Hospital Básico de Sangolquí entre enero de 2017 hasta abril de 2018. Los criterios de inclusión fueron: pacientes mayores de 15 años de edad de ambos sexos, ambulatorios y hospitalizados, que presentaron urocultivos positivos definidos por una cuenta mayor a 100 000 Unidades Formadoras de Colonia. RESULTADOS. Del 40,27% (176; 437) de urocultivos positivos, la bacteria aislada con frecuencia fue Escherichia coli. 69,31% (122; 176), con resistencia a ampicilina 77,97% (92; 118), trimetropim-sulfametoxazole 62,26% (66; 106), norfloxacino 37,50% (42; 112), ciprofloxacino 35,65 % (41; 115), ampicilina/sulbactam 32,20% (38; 118) y con susceptibilidad a: fosfomicina, ceftriaxona, amikacina y nitrofurantoina. CONCLUSIÓN. Se determinó el perfil de farmacorresistencia microbiana en adultos con infección del tracto urinario; donde Escherichia coli. fue aislada con frecuencia, con susceptibilidad favorable para nitrofurantoína y fosfomicina.

INTRODUCTION. Urinary tract infections are the cause of greater morbidity in the adult population and it often affects women. As it is a prevalent problem, it was essential to carry out studies on local susceptibility profiles to establish surveillance measures and control of antibiotic use. OBJECTIVE. To determine the microbial drug resistance profile in adults with urinary tract infection. MATERIALS AND METHODS. Descriptive, cross-sectional study. The population was 437 urine cultures and a sample of 176 positive with their antibiogram, carried out in the laboratory of the Hospital Básico de Sangolquí between january 2017 and april 2018. Inclusion criteria were: patients older than 15 years of age of both sexes, ambulatory and hospitalized, who presented positive urine cultures defined by a count greater than 100 000 Colony Forming Units. RESULTS. Of the 40,27% (176; 437) of positive urine cultures, the bacterium frequently isolated was Escherichia coli. 69,31% (122; 176), with resistance to ampicillin 77,97% (92; 118), trimethoprim-sulfamethoxazole 62,26% (66; 106), norfloxacin 37,50% (42; 112), ciprofloxacin 35,65% (41; 115), ampicillin / sulbactam 32,20% (38; 118) and with susceptibility to: fosfomycin, ceftriaxone, amikacin and nitrofurantoin. CONCLUSION. The microbial drug resistance profile was determined in adults with urinary tract infection; where Escherichia coli. was frequently isolated, with favorable susceptibility to nitrofurantoin and fosfomycin.

Resistencia a los β -lactámicos en enterococos / Resistance to β-lactams in enterococci

Enterococci are intrinsically resistant to several antimicrobial classes and show a great ability to acquire new mechanisms of resistance. Resistance to β-lactam antibiotics is a major concern because these drugs either alone or in combination are commonly used for the treatment of enterococcal infections. Ampicillin resistance, which is rare in Enterococcus faecium occurs in most of the hospital-associated Enterococcus faecium isolates. High-level resistance to ampicillin in E. faecium is mainly due to the enhanced production of PBP5 and/or by polymorphisms in the beta subunit of this protein. The dissemination of high-level ampicillin resistance can be the result of both clonal spread of strains with mutated pbp5 genes and resistance horizontal gene transfer.

Los enterococos son intrínsecamente resistentes a varias clases de antimicrobianos y presentan una gran capacidad para adquirir mecanismos de resistencia. La resistencia a los antibióticos p-lactámicos es preocupante porque estos fármacos solos o combinados se usan comúnmente para el tratamiento de las infecciones enterocócicas. La mayoría de los aislamientos hospitalarios de Enterococcus faecium presentan resistencia a la ampicilina, la cual es rara en Enterococcus faecalis. El alto nivel de resistencia a la ampicilina en E. faecium se debe principalmente a la hiperproducción de PBP5 y/o a polimorfismos en la subunidad beta de esta proteína. La propagación de esta resistencia puede deberse tanto a la diseminación clonal de cepas con genes pbp5 mutados como a la transferencia horizontal de genes.

Comparison of Enterococcus faecium Bacteremic Isolates from Hematologic and Non-hematologic Patients: Differences in Antimicrobial Resistance and Molecular Characteristics

BACKGROUND: Enterococcus faecium, especially vancomycin-resistant E. faecium (VREfm), is a major concern for patients with hematologic diseases. Exposure to antibiotics including fluoroquinolone, which is used as a routine prophylaxis for patients with hematologic (MH) diseases, has been reported to be a risk factor for infection with vancomycin-resistant eneterocci. We compared the characteristics of E. faecium isolates according to their vancomycin susceptibility and patient group (MH vs non-MH patients). METHODS: A total of 120 E. faecium bacteremic isolates (84 from MH and 36 from non-MH patients) were collected consecutively, and their characteristics (susceptibility, multilocus sequence type [MLST], Tn1546 type, and the presence of virulence genes and plasmids) were determined. RESULTS: Among the vancomycin-susceptible E. faecium (VSEfm) isolates, resistance to ampicillin (97.6% vs 61.1%) and high-level gentamicin (71.4% vs 38.9%) was significantly higher in isolates from MH patients than in those from non-MH patients. Notably, hyl, esp, and pEF1071 were present only in isolates with ampicillin resistance. Among the VREfm isolates, ST230 (33.3%) and ST17 (26.2%) were predominant in MH patients, while ST17 (61.1%) was predominant in non-MH patients. Plasmid pLG1 was more prevalent in E. faecium isolates from MH patients than in those from non-MH patients, regardless of vancomycin resistance. Transposon analysis revealed five types across all VREfm isolates. CONCLUSIONS: The antimicrobial resistance profiles and molecular characteristics of E. faecium isolates differed according to the underlying diseases of patients within the same hospital. We hypothesize that the prophylactic use of fluoroquinolone might have an effect on these differences.

Mastites em ruminantes no Brasil / Mastitis in ruminants in Brazil

A mastite é uma doença complexa e considerada uma das principais causas de perdas à indústria leiteira mundial. Objetivou-se com esta revisão compilar informações dos últimos dez anos sobre a mastite em ruminantes no Brasil. A prevalência da mastite subclínica chega a 48,64% na espécie bovina, 30,7% na espécie caprina, 31,45% na espécie ovina e 42,2% na espécie bubalina, destacando-se a etiologia por Staphylococcus spp. Os fatores de risco associados à ocorrência de mastite estão relacionados a problemas no saneamento ambiental e ao manejo dos animais. As bactérias isoladas do leite mastítico apresentam maior percentual de resistência a penicilina, ampicilina, amoxicilina e neomicina e a utilização de técnicas moleculares no diagnóstico dos agentes causadores de mastites no país, ainda é escassa o que dificulta a obtenção de um diagnóstico mais rápido, sensível e específico.(AU)

Mastitis is a complex disease and is considered one of the main causes of losses to the global dairy industry. The objective of this review was to compile information for the last ten years of mastitis in ruminants in Brazil. The prevalence of subclinical mastitis was 48.64% in cattle, 30.7% in goats, 31.45% in sheep and 42.2% in the buffalo species, with especial participation of Staphylococcus spp. in the etiology. Risk factors associated with the occurrence of mastitis were related to problems in environmental sanitation and handling of animals. The largest percentage of resistance of microorganisms to antimicrobials was for penicillin, ampicillin, amoxicillin and neomycin. The use of molecular tools for diagnosis of mastitis-causing agents in the country is still scarce, making it difficult to obtain a faster, sensitive and specific diagnosis.(AU)

Evaluation of Haemophilus influenzae type b carrier status among children 10 years after the introduction of Hib vaccine in Brazil

The aim of the present study was to assess the prevalence of Haemophilus influenzaetype b (Hib) nasopharyngeal (NP) colonisation among healthy children where Hib vaccination using a 3p+0 dosing schedule has been routinely administered for 10 years with sustained coverage (> 90%). NP swabs were collected from 2,558 children who had received the Hib vaccine, of whom 1,379 were 12-< 24 months (m) old and 1,179 were 48-< 60 m old. Hi strains were identified by molecular methods. Hi carriage prevalence was 45.1% (1,153/2,558) and the prevalence in the 12-< 24 m and 48-< 60 m age groups were 37.5% (517/1,379) and 53.9% (636/1,179), respectively. Hib was identified in 0.6% (16/2,558) of all children in the study, being 0.8% (11/1,379) and 0.4% (5/1,179) among the 12-< 24 m and 48-< 60 m age groups, respectively. The nonencapsulate Hi colonisation was 43% (n = 1,099) and was significantly more frequent at 48-< 60 m of age (51.6%, n = 608) compared with that at 12-< 24 m of age (35.6%, n = 491). The overall resistance rates to ampicillin and chloramphenicol were 16.5% and 3.7%, respectively; the co-resistance was detected in 2.6%. Our findings showed that the Hib carrier rate in healthy children under five years was very low after 10 years of the introduction of the Hib vaccine.

Tipagem molecular e resistência aos antimicrobianos em isolados de Escherichia coli de frangos de corte e de tratadores na região metropolitana de Curitiba, Paraná / Molecular typing and antimicrobial resistance in isolates of Escherichia coli from poultry and farmers in the metropolitan region of Curitiba, Paraná

Este estudo verificou o perfil de resistência aos antimicrobianos entre isolados de Escherichia coli de frangos de corte de criação intensiva e de subsistência e dos respectivos tratadores e a similaridade genotípica entre isolados de E.coli de frangos de corte de criação intensiva e isolados de E. coli de tratadores de frangos de criação intensiva pela técnica de Eletroforese em Gel de Campo Pulsado (PFGE). 60 amostras de fezes de frangos de criação intensiva, 60 de frangos de corte de criação de subsistência (caipira) e 20 amostras dos tratadores de frangos de criação intensiva e 20 de tratadores de frangos de criação de subsistência. E. coli foram isoladas, identificadas e submetidas ao teste de suscetibilidade a 12 antimicrobianos. Pela PFGE foram analisados 24 isolados de E. coli de frangos de corte de criação intensiva e oito de tratadores. Em isolados E. coli de frangos de criação intensiva a resistência para a ampicilina foi de 100%, cefotaxima 43%, ceftriaxona 48%, ácido nalidíxico 62%, enrofloxacina 23%, ciprofloxacina 23%, tetraciclina 83% e 45% para trimetoprim-sulfametoxazol. Nos isolados de frangos de criação de subsistência foi de 20%, 0%, 0%, 5%, 2%, 4%, 33% e 8%, respectivamente...

This study examined the profile of antimicrobial resistance among isolates of Escherichia coli from poultry intensive farming and free-range systems and their farmers. For technique of Gel Electrophoresis Pulsed Field (PFGE) examined the similarity between isolates from poultry intensive farming and their farmers. From 60 samples of poultry feces from intensive farming systems, 60 of free-range extensive systems and 20 of farmers of each segment, the E. coli was isolated and submitted to the test of susceptability to 12 antimicrobials. 24 isolates of E. coli of poultry from intensive farming systems and eight E. coli isolates from farmers poultry intensive farming were analyzed via technique of PFGE. In intensive farming systems poultry, 100% resistence to ampicillin was verified, 43% to cefotaxime, 48% to ceftriaxone, 62% to nalidixic acid, 23% to enrofloxacin, 23% to ciprofloxacin, 83% to tetracycline and 45% to trimetroprim-sulfametoxazol. In the strains of free-range extensive systems, resistance was 20%, 0%, 0%, 5%, 2%, 4%, 33% and 8%, respectively...

Chromobacterium violaceum: um caso fatal no nordeste do Brasil / Chromobacterium violaceum: a fatal case in the northeast of the Brazil

Chromobacterium violaceum is a rare pathogen that can potentially cause fatal infections in humans. An 8-year-old child from Natal, northeast of Brazil, presented history of fever, sore throat, and abdominal pain, during 5 days before admission, and died 4 hours after hospitalization. Chromobacterium violaceum was isolated from oropharynx scrapings and was resistant to ampicillin, cefotaxime, cefalotin, ceftazidime, and ceftriaxone...

Chromobacterium violaceum é um patógeno raro que potencialmente pode causar infecções fatais em humanos. Relatamos o caso de uma criança de 8 anos de idade, moradora da cidade de Natal, nordeste do Brasil, que apresentou história de febre, dor na garganta e no abdome durante os cinco dias anteriores à internação, e veio a falecer após 4 horas de hospitalização. A bactéria Chromobacterium violaceum foi isolada da orofaringe e apresentou resistência a ampicilina, cefotaxima, cefalotina, ceftazidima e ceftriaxona...

Sistemas de efluxo multidrogas em Escherichia coli e uso de inibidores como possíveis adjuvantes na terapia da mastite bovina / Multidrug efflux systems in Escherichia coli and the use of inhibitors as possible adjuvant therapy in bovine mastitis

Vinte e sete isolados de Escherichia coli provenientes de leite de bovinos com mastite clínica foram submetidos a teste de sensibilidade aos principais antimicrobianos usados no tratamento desta doença. Avaliou-se também a efetividade in vitro de dois inibidores de sistemas de efluxo multidrogas, fenilalanina arginyl ß naftilamida (PAβN) e 1-(1-Naphthylmethyl)-piperazine (NMP), utilizando-se a concentração inibitória mínima (CIM) como referência. A CIM e o sistema de efluxo foram detectados com base nas curvas de crescimento, utilizando-se a densidade óptica (D.O550), em diferentes concentrações da droga e na presença e ausência dos inibidores. Apenas quatro isolados apresentaram resistência à ampicilina e ao sulfametoxazol∕trimetoprim, simultaneamente, enquanto todos os 27 foram sensíveis aos demais antimicrobianos. Observaram-se valores para ampicilina variando de 6µg/mL a 250µg/mL e para sulfametoxazol∕trimetoprim de 12µg/mL a 1500µg/mL. Houve redução das CIMs desses antimicrobianos em todos os isolados na presença dos inibidores, exceto para sulfametoxazol∕trimetoprim na presença de NMP. Conclui-se que esses isolados possuem um estreito perfil de resistência e que PAßN apresentou melhor efeito inibitório em relação à ampicilina e ao sulfametoxazol∕trimetoprim, apresentando-se como um candidato a adjuvante no tratamento da mastite...

Twenty-seven isolates of Escherichia coli from cattle with clinical mastitis were subjected to sensitivity tests regarding main antimicrobials used in the treatment of this disease. We also evaluated in vitro effectiveness of two inhibitors of multidrug efflux systems, fenilalanina arginyl ß naftilamida (PAβN) and 1-(1-Naphthylmethyl)-piperazine (NMP), using the minimum inhibitory concentration (MIC) as a reference. MIC and multidrug efflux systems were detected in the growth curves, using optical density (D.O550) at different drug concentrations and the presence and absence of inhibitors. Only four isolates of E. coli were resistant to ampicillin and trimethoprim/sulfamethoxazole, simultaneously. However, all isolates were sensitive to the other antimicrobials. Were observed values ranging from 6mg to 250mg ampicillin/mL, and 12mg to 1500mg/mL trimethoprim/sulfamethoxazole. There was a reduction of the MIC of antimicrobials for all isolates in the presence of inhibitors, except for trimethoprim/sulfamethoxazole in the presence of NMP. In conclusion, these isolates have a narrow resistance profile and PAßN showed better inhibitory effect against ampicillin and trimethoprim/sulfamethoxazole, and is a candidate for the adjuvant treatment of mastitis...

Perfil de sensibilidade aos antimicrobianos e eficácia de sanitizantes frente aos isolados de Salmonella spp: oriundos de carcaças suínas no Rio Grande do Sul / Antimicrobial sensitivity and efficacy of sanitizers against the Salmonella spp: isolated from swine slaughterhouse in southern Brazil

Os objetivos do trabalho foram avaliar o perfil de sensibilidade a antimicrobianos e a eficácia de três sanitizantes frente a isolados de Salmonella spp. oriundos de carcaças na tecnologia de abate de suínos. Avaliaram-se 120 amostras, das quais 39 foram positivas para Salmonella spp. Os princípios ativos testados foram penicilina G 10 U, amoxicilina + ácido clavulânico 30mcg, ampicilina 10mcg, cloranfenicol 30mcg, tetraciclina 30mcg, estreptomicina 10mcg, neomicina 30mcg, gentamicina 10mcg, enrofloxacina 5mcg, sulfazotrim 25mcg, sulfonamida 300mcg e trimetropima 5mcg. Nos testes com sanitizantes utilizaram-se clorexidina, amônia quaternária e ácido peracético com tempos de contato de um, cinco, 10 e 15 minutos. Os índices de resistência aos antimicrobianos foram de 100 por cento para penicilina, 94,9 por cento para tetraciclina, 89,7 por cento para trimetropima e 87,2 por cento para ampicilina. Nenhum dos princípios ativos foi 100 por cento eficaz frente aos isolados testados, observando-se melhor ação para amoxicilina+ácido clavulânico (86,7 por cento), neomicina (86,7 por cento) e cloranfenicol (64,1 por cento). Nos testes de eficácia dos sanitizantes, o ácido peracético a 0.5 por cento foi efetivo a partir de 10 minutos (94,6 por cento) e 15 minutos (97,3 por cento) de contato; amônia quaternária a 1 por cento por 10 minutos (89,2 por cento) e 15 minutos (97,3 por cento) e clorexidina a 0.5 por cento por 10 minutos (70,3 por cento) e 15 minutos de contato (72,8 por cento). Todas as amostras testadas apresentaram multirresistência e seis [...] O sanitizante mais efetivo frente aos isolados testados foi o ácido peracético a 0.5 por cento por 15 minutos, reforçando a necessidade de monitorar também a efetividade de produtos sanitizantes frente aos isolados de Salmonella spp.

The aim of this study was to evaluate the antimicrobial sensitivity and efficacy of three sanitizers against Salmonella spp. isolated from carcasses in swine slaughterhouse. Thirty nine of 120 samples were positive for Salmonella spp. The antimicrobials tested included: penicillin G 10 U, amoxicillin + clavulanic acid 30mcg, ampicillin 10mcg, chloramphenicol 30mcg, tetracycline 30mcg, streptomycin 10mcg, gentamicin 10mcg, neomycin 30mcg, enrofloxacin 5mcg, sulfazotrim 25mcg, sulfonamide 300mcg and trimetropim 5mcg. In the tests with sanitizers were used chlorhexidine, quaternary ammonia and peracetic acid, which were put in contact intervals of 1, 5, 10 and 15 minutes. Antimicrobial resistance was observed using penicillin (100 percent), tetracycline (94.9 percent), trimetropim (89.7 percent), and ampicillin (87.2 percent). None of the antimicrobials was 100 percent effective against the samples tested. Amoxicillin + clavulanic acid (86.7 percent), neomycin (86.7 percent) and chloramphenicol (64.1 percent) showed better antimicrobial action. In tests of efficacy of sanitizers, 0.5 percent peracetic acid was effective at 10 minutes (94.6 percent) and 15 minutes (97.3 percent) of contact; 1 percent quaternary ammonia at 10 minutes (89.2 percent) and 15 minutes (97.3 percent) and 0.5 percent chlorhexidine at 10 minutes (70.3 percent) and 15 minutes (72.8 percent). All samples tested were multidrug resistance and six (15.3 percent) showed resistance to ampicillin, chloramphenicol, streptomycin, sulfonamide and tetracycline (ACSSuT group) indicating the need to monitor the spread of antimicrobial resistance of Salmonella spp. isolated from swine. The most effective sanitizing against the bacteria tested was 0.5 percent peracetic acid per 15 minutes, reinforcing the need to monitor the effectiveness of products sanitizers against Salmonella spp.

A prospective study on Aeromonas in outpatients with diarrhea in the central region of Rio Grande do Sul State

Aeromonas spp. were identified in five (2,7%) of 182 diarrheal stool cultures, A. caviae was predominant, resistant mainly to ampicillin and cephalotin. This is the first study showing the presence of Aeromonas spp. in diarrheal stools of outpatients in the central region of Rio Grande do Sul State, Brazil.

Antimicrobial resistance; comparison of Escherichia coli in different areas of Lahore

Since the development of antibiotics there is a growing concern about the increasing incidence of antibiotic resistance. As a result the therapeutic value of originally effective antibiotics become significantly reduced overtimes. Extensive data is available on antibiotic susceptibilities of hospital isolates but very little information is available about the susceptibilities of community strains. Descriptive. July 2004 to June 2005. Department of Microbiology, Shaikh Zayed Hospital Lahore. Hence the present study was design to assess the environmental load of the antibiotic resistance using fecal flora as an indicator of overall problem. It will also provide guidance in antibiotic protocol for antibiotic policy. Objective of the present study was to determine the developing resistance to beta - Lactam Antibiotics which is the commensal microbe of enteric tract. One hundred samples were collected from ten different areas of Lahore city [10 samples from each area] and were inoculated on Mac Conkey's agar. Five morphologically distinct lactose fermenting colonies were selected and identified using standard laboratory methods. Five hundred different colonies of E.coli were identified and analyzed for their susceptibility to b-lactam antibiotic. Out of 500 isolates, the resistant isolates with ampicillin [48%], coamoxiclav [40%] and cephradine [37%] were detected, with cheaper oral agents high prevalence of resistance was detected. Ampicillin, co-amoxiclav and cephradine are not much useful for the treatment of urinary tract infection and septicemia caused by E-coli and other Members of fecal flora

Perfil antimicrobiano de cepas de Escherichia coli isolados de pessoas com suspeita de infecção do trato urinário / Antimicrobial profile of Escherichia coli strains isolated of peoples withsuspect of urinary tract infections

A infecção do trato urinário (ITU), situa-se entre as mais frequentes doenças bacterianas, sendo Escherichia coli um dos principais microrganismos causadores de ITU. Assim, o objetivo desse estudo foi verificar a incidência de cepas de E. coli na urina de indivíduos com suspeita de infecção urinária e avaliar o perfil de suscetibilidade a antimicrobiano dessas cepas. Foram analisadas 280 uroculturas, sendo 140 hospitalares e 140 de pessoas da comunidade, em três cidades do extremo oeste de Santa Catarina, Brasil. As urinas foram semeadas em ágar Macconkey, incubadas por 48 horas a 36 ± 1ºC. Colônias características foram identificadas por coloração de Gram e testes bioquímicos. O perfil desuscetibilidade a antimicrobianos foi realizada através da técnica de Kirby-Bauer conforme recomendações do CLSI 2005. Das 280 uroculturas analisadas, 79 (28,2%) foram positivas para Escherichia coli, destas 32 (40,5%) foram provenientes de amostras hospitalares e 47 (59,5%) de origem comunitária. O antimicrobiano de maior eficiência foi o imipenem e osantimicrobianos ampicilina, cefalotina e amicacina apresentaram maior índice de ineficácia para ambos os ambientes decoleta, demonstrando que o uso continuo e errôneo dos antimicrobianos favorecem o desenvolvimento de cepasresistentes, porque normalmente esses são drogas de primeira escolha e já não são mais eficientes nos tratamentos deITUs.

The urinary tract infection (UTI) is among the most frequent of all bacterial diseases and Escherichia coli is oneof the main microorganisms which causes the infection. Thus, the objective of this study was to verify the incidence of strains of E. coli in the individual's urine when urinary infection is suspected and to evaluate the susceptibility profile of the antimicrobials of these strains. A total of 280 urine cultures were analyzed. Half the cultures were taken from hospital patients and half were taken from people in communities located in three cities of the extreme west of Santa Catarina, Brazil. Theurine had been sown in Macconkey agar and incubated for 48 hours at 36± 1 ºC. Characteristic colonies had been identified by Gram coloration and biochemists tests. The susceptibility profile of the antimicrobials was carried through the technique in agreement with the Kirby-Bauer recommendations of CLSI 2005. Of the 280 analyzed urine cultures, 79 (28.2%) were positive for E. coli. Of these, 32 (40.5%) had come from hospital samples and 47 (59.5%) were of community-acquired origin.The antimicrobial with the most efficiency was imipenem. The ones with the worst efficiency were ampicillin, cephalothin and amikacin. This was true for cultures taken from both environments. It demonstrated that the continued and erroneous use of the antimicrobials contributed to the resistance development of strains, because these are normally drugs of first choice and already are less efficient in the treatment of ITUs.

Occurrence of multidrug resistant and ESBL producing E. coli causing urinary tract infections

Urinary tract infection [UTI] forms the largest single group of hospital-acquired infection and account for about 40-50% of the total nosocomial infections. Present study indicates that there is a high prevalence of multidrug resistant E. coli in UTI. Purpose of this study was to find out the occurrence of multidrug resistance among the Escherichia coli, which is the causative agent in more than 80% of urinary tract infection. In this study, 100 isolates were taken from UTI patients and their susceptibility pattern was studied. Minimum inhibitory concentration [MIC] of 11 antibiotics was studied using agar dilution method. The isolates were highly susceptible against imipenem i.e. 91% and were least susceptible to ampicillin and tetracycline. The resistance against ciprofloxacin was also very high i.e. 85%. ESBL production among these E.coli isolates was checked by combination disc method and about 54% isolates were found to be ESBL producers. So our result indicates the fact that the physicians should be aware of this increasing resistance among our local clinical isolates and should change their therapy regime accordingly

Clinical Features and Prognostic Factors of Neurologic Outcome in Group B Streptococcal Meningitis

PURPOSE: Group B streptococcal (GBS) meningitis is the leading cause of mortality and morbidity in neonates. There are limited current data regarding outcomes from GBS meningitis and factors that predict an adverse outcome. METHODS: Twenty-three cases of GBS meningitis that were proven by cerebrospinal fluid culture from 2000 to 2010 were retrospectively reviewed. RESULTS: All GBS meningitis cases occurred in young infants less than 3 months and were late-onset (> or =7 days). Four infants (17.4%) died, and three (13.0%) were neurologically impaired at hospital discharge. Compared to the 16 infants with normal neurologic examinations, the 7 infants who died or had adverse outcomes at hospital discharge were more likely to present with seizures within hours of admission, have coma, require pressor support or ventilator support, have an initial peripheral blood leukocyte count less than 4,000/mm3 or neutrophil count less than 1,000/mm3, and have ampicillin resistance on culture. CONCLUSION: Despite advances in intensive care, 30.4% of infants with GBS meningitis die or have neurologic impairment at hospital discharge. Poor outcome can be predicted in cases that have seizures, coma, peripheral leukopenia, or require ventilator or pressor support on initial presentation. These cases show a tendency toward resistance to ampicillin, so vancomycin can be tried initially.

Infecções do trato urinário diagnosticada no laboratório universitário - Campus Erechim/RS / Urinary tract infections diagnosed at the laboratory of the university - Campus of Erechim/RS

As infecções do trato urinário (ITU) são definidas como a presença de microrganismos no trato urinário, podendo se localizar desde a uretra até os rins. Dentre as doenças infecciosas, as ITU estão entre as mais comuns na prática clínica e acometem homens e mulheres em qualquer idade. O presente trabalho objetivou avaliar a ocorrência de ITU diagnosticadas no Laboratório da Universitário da URI - Campus Erechim/RS. Durante o período de outubro de 2006 a outubro de 2007 foram analisados os resultados de 195 uroculturas, onde foram identificados 36 casos de ITU. A identificação das bactérias foi realizada por métodos bioquímicos tradicionais e o antibiograma pelo método de disco-difusão. Pacientes do sexo feminino foram os mais acometidos (97,22%) Observou-se um predomínio de ITU em indivíduos com idade superior a 40 anos, totalizando 47,22% dos casos. A Escherichia coli foi o microrganismo mais frequente (80,55%). Os uropatógenos apresentaram maiores índices de susceptibilidade à Ofloxacina (94,11%) e maiores índices de resistência à Ampicilina (69,44%). O diagnóstico correto das ITU é extremamente importante, pois permite a aplicação de um tratamento adequado e uso prudente e racional dos antimicrobianos.

Survey study on the sensitivity and resistance of urine specimen pathogens to the therapeutically used antibiotics in Aden city

Resistance to antibiotics refers to unresponsiveness of microorganism to antimicrobial agent related to tolerance observed in higher organism. In Aden, there is still a lack of studies related to the identification of antibiotics-resistance in spite of the opening market for the spread of mostly all types of antibiotics. To perform this study, fifteen medical laboratories were selected. Most of them implicated the diffusion sensitivity method. Computer data base, using Excel-program, was [instructed for the information collected in the period from December 2007 to the end of April 2008. The total number of antibiotics standards used in these laboratories were 60. The highest number if antibiotics standard is available in Aden-diagnostic centre. Most of the collected specimens are of urine [31%].92% of them were adult and most of them were female [67%]. The most frequent pathogens of urinary infection were of gram [-] microorganisms [69%], and the most pathogen was E-coli [48%]. The most sensitive antibiotic against E-coli was Cefotaxim, while the most resistant was Ampicillin

Serotypes and ampicillin resistance of Haemophilus influenzae isolates from children with respiratory infection in Hangzhou / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the serotypes distribution and ampicillin resistance of Haemophilus influenzae isolates from children with respiratory infection in Hangzhou.</p><p><b>METHODS</b>Haemophilus influenzae strains were identified with V factor and X factor tests. Serotypes were determined with the slide agglutination method. Nitrocefin test was used to detect beta-lactamase. The sensitivities of ampicillin to Haemophilus influenzae were determined with the Kirby-Bauer diffusion method and the E-test method.</p><p><b>RESULTS</b>One hundred and fifty-two Haemophilus influenzae isolates, 108 from boys and 44 from girls, were identified between December 2006 and July 2007. Of the 152 isolates, 148 (97.4%) were untypable, only 4 (2.6%) were typable, including type a, type d, type e and type f (n=1 each type). Haemophilus influenzae type b and c strain was not found. Thirty-four isolates (22.4%) were beta-lactamase-positive. One hundred and thirteen isolates (74.3%) were susceptible to ampicillin, while 34 isolates (22.4%) were resistant to ampicillin.</p><p><b>CONCLUSIONS</b>Untypable strains were the most common in Haemophilus influenzae isolates from children with respiratory infection in Hangzhou. The isolates of Haemophilus influenzae kept susceptibity to ampicillin to a certain extent.</p>

Antibacterial susceptibility of uropathogens in 3 hospitals, Sari, Islamic Republic of Iran, 2002-2003

To determine the frequency and pattern of antibiotic susceptibility of uropathogens in urinary tract infection [UTI] from 3 university hospitals we carried out a retrospective review of urine culture and antibiotic sensitivity testing from symptomatic outpatients and inpatients during 2002-2003. Of 5600 samples, 703 [12.6%] were culture positive, 38.7% of which were from hospitalized patients. Escherichia coli was the leading cause of UTI in both groups of patients. The rates and roles of other pathogens, including Pseudomonas spp. [5.3%-10.4%], Enterobacter spp. [0%-5.7%], Staphylococcus spp.] 5.4%-26.4%], differed in each hospital. Differences in antibacterial susceptibility patterns were observed. Ampicillin [82%-100%] and co-trimoxazole [50%-90%] resistance were the most frequent. Methicillin resistance in Staphylococcus spp. ranged from 17% to 60%

Shigella and Salmonella serogroups and their antibiotic susceptibility patterns in Ethiopia

In this study, the serogroup and susceptibility patterns of Shigella and Salmonella spp. isolated from stool cultures were determined using standard laboratory procedures. Among the 76 Shigella isolates serogroup B [Sh. flexeneri] was the most prevalent species [54.0%] and among the 37 Salmonella strains serogroup B was also the most prevalent [81.1%]. Antibiograms of Shigella and Salmonella spp. showed 100% resistance to erythromycin and high resistance rates [>/= 75%] to ampicillin, cephalothin, chloramphenicol and tetracycline. Salmonella spp. Also had high resistance to gentamicin, sulphonamide, and trimethoprim- sulfamethoxazole. Shigella were susceptible to gentamicin [100%] and nalidixic acid [97.3%] and Shigella and Salmonella were 100.0% susceptible to norfloxacin

Molecular detection and antimicrobial resistance of diarrheagenic Escherichia coli strains isolated from diarrheal cases

To identify and classify Iranian isolates of diarrheagenic Escherichia coli E. coli on the basis of presence of virulence genes and to determine antibiotic susceptibility of isolated strains. The current cross-sectional study was conducted in 2005 at the Pasteur Institute, Tehran, Iran. One hundred and ninety-three diarrheagenic E. coli isolated from diarrheal patients in different regions of Iran were included in current study. Virulence factor genes for diarrheagenic E. coli were detected by polymerase chain reaction. Of the 193 diarrheagenic E. coli detected by PCR, 86 44.5% were Shiga toxin-producing E. coli STEC, 74 38.4% enteropathogenic E. coli EPEC, 19 9.8% enteroaggregative E. coli, and 14 7.3% enterotoxigenic E. coli isolates. Susceptibility to 12 clinically important antimicrobial agents was determined for 193 strains of diarrheagenic E. coli. A high incidence of resistance to tetracycline 63%, ampicillin 62%, streptomycin 56%, amoxicillin/clavulanic acid 44.5%, trimethoprim/sulfamethoxazole 39.5%, and cephalothin 37% was observed. The STEC and EPEC strains with high resistance to tetracycline and ampicillin, but highly susceptible to quinolones are among the most important causative agent of diarrhea in Iran. This study suggests that antimicrobial resistance is widespread among E. coli strains colonizing Iranian patients. Guidelines for appropriate use of antibiotics in developing countries require updating