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1.
Prensa méd. argent ; 107(8): 418-422, 20210000. fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1358673

ABSTRACT

Las betalactamasas de espectro extendido (BLEE) son enzimas producidas por bacilos gram negativos capaces de hidrolizar las cefalosporinas de amplio espectro y los monobactámicos. La mayoría pertenece a la familia de Enterobacteriae, tales como Klebsiella pneumoniae y Escherichia coli: Sin embargo, se asocian también con otras bacterias como Proteus, Serratia, Salmonella, Pseudomonas aeruginosa y Acinetobacter. Las enterobacterias productoras de carbapenemasas no sólo han sido aisladas en el ambiente hospitalario, sino que también provienen de la comunidad. Se presenta una paciente de sexo femenino con antecedentes de sida y osteomielitis secundaria a artritis séptica producida por una Klebsiella pneumoniae BLEE de la comunidad. Un tratamiento oportuno y eficaz puede evitar la opción quirúrgica, disminuyendo la morbimortalidad asociada con esta afección


Extended-spectrum beta-lactamases (ESBL) are enzymes produced by gram-negative rods capable of hydrolyzing broad-spectrum cephalosporins and monobactams. Most belong to the Enterobacteriae family, such as Klebsiella pneumoniae and Escherichia coli. However, they are also associated with other bacteria such as Proteus, Serratia, Salmonella, Pseudomonas aeruginosa and Acinetobacter. Carbapenemase-producing Enterobacteriaceae have not only been isolated from the hospital environment, but also from the community. We present a female patient with a history of AIDS and secondary osteomyelitis to septic arthritis caused by a community Klebsiella pneumoniae ESBL. It is concluded that a timely and effective treatment can avoids the surgical option, reducing the morbidity and mortality of this condition.


Subject(s)
Humans , Female , Adult , Osteomyelitis/immunology , Klebsiella Infections/therapy , Arthritis, Infectious/therapy , Imipenem/therapeutic use , AIDS-Related Opportunistic Infections/immunology , Arthrocentesis , Knee Injuries/therapy
2.
Arq. bras. oftalmol ; 84(3): 279-281, May-June 2021. graf
Article in English | LILACS | ID: biblio-1248970

ABSTRACT

ABSTRACT The aim of this study was to discuss a case of late-onset Klebsiella oxytoca keratitis after deep anterior lamellar keratoplasty and its treatment. A 21-year-old female patient presented with redness and effluence in the left eye at 5 months after uncomplicated deep anterior lamellar keratoplasty surgery. In the examination, a single suture was loosened in the superior nasal region and there was an infiltration area and epithelial defect in the graft and recipient bed junction in the area of the loose suture. Topical fortified vancomycin and fortified ceftazidime treatment was started empirically hourly, but there was insufficient response. After K. Oxytoca growth in a swab and suture culture taken from the patient, fortified vancomycin was replaced with fortified imipenem. It was observed that the infiltration area rapidly regressed and the epithelial defect was closed after fortified imipenem treatment. Fortified imipenem may be considered as an alternative treatment, especially in cases in which there is no response to treatment and culture growth is detected.(AU)


RESUMO O objetivo deste estudo é discutir um caso de ceratite tardia por Klebsiella oxytoca, após ceratoplastia lamelar anterior profunda, bem como seu tratamento. Uma paciente de 21 anos apresentou vermelhidão e efluxo no olho esquerdo 5 meses após cirurgia de ceratoplastia lamelar anterior profunda sem complicações. Ao exame, havia uma única sutura solta na região nasal superior e uma área de infiltração com defeito epitelial no enxerto e na junção com o leito receptor na área da sutura solta. Iniciou-se empiricamente um tratamento tópico com vancomicina e ceftazidima fortificada de hora em hora, porém com resposta insuficiente. Após o crescimento de K. oxytoca a partir de cultura de swab e sutura retirados da paciente, a vancomicina fortificada foi substituída por imipenem fortificado. Observou-se que a área de infiltração regrediu rapidamente e que o defeito epitelial foi fechado com o tratamento com imipenem fortificado. O imipenem fortificado pode ser considerado um tratamento alternativo, especialmente nos casos sem resposta ao tratamento e detecção de crescimento na cultura.(AU)


Subject(s)
Humans , Male , Adult , Imipenem/therapeutic use , Corneal Transplantation , Klebsiella oxytoca/isolation & purification , Keratitis/diagnosis
3.
Rev. Hosp. Ital. B. Aires (2004) ; 41(1): 26-30, mar. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1178336

ABSTRACT

El pioderma gangrenoso ampollar es una variedad infrecuente de pioderma gangrenoso, que se asocia en el 50-70% de los casos con trastornos oncohematológicos. Se comunica el caso de una paciente de 59 años, que consultó por fiebre y ampollas purpúricas de rápida progresión, con compromiso cutáneo mucoso. Con sospecha de una enfermedad neutrofílica, ampollar, o infección por gérmenes oportunistas, se realizó biopsia de piel para estudio histopatológico, inmunofluorescencia directa y cultivo. Los cultivos y la inmunofluorescencia directa fueron negativos, y la anatomía patológica reveló un denso infiltrado inflamatorio con predominio neutrofílico en dermis. Ante el diagnóstico de pioderma gangrenoso ampollar, se realizó una punción-aspiración de médula ósea cuyo resultado fue compatible con leucemia mieloide aguda. Se instauró tratamiento con corticosteroides sistémicos, a pesar de lo cual la paciente evolucionó desfavorablemente y falleció a los 15 días de su ingreso hospitalario. Este caso ilustra la asociación de esta enfermedad cutánea con trastornos oncohematológicos y el mal pronóstico que esto implica a corto plazo. (AU)


Bullous pyoderma gangrenosum is an infrequent type of pyoderma gangrenosum, associated with onco hematological diseases in 50-70% of cases. We present the case of a 59-year-old patient with fever and mucocutaneous hemorrhagic bullous of rapid progression. A biopsy for histopathology, direct immunofluorescence (DIF) and skin culture was made, considering the possibility of neutrophilic dermatoses, bullous dermatosis or an opportunistic infection. The results of both the culture and the DIF were negative. The histopathological examination of the specimen revealed a dense dermal polymorphic infiltrate composed primarily of neutrophils. Considering bullous pyoderma gangrenosum as a potential diagnosis, a bone-marrow biopsy was performed. This study revealed an acute myeloid leukemia. Although systemic corticosteroid therapy was begun, the patient presented an unfavorable evolution that led to her death 15 days after her admission at the hospital. This case shows the association between bullous pyoderma gangrenosum and onco hematological diseases. In addition, it highlights the poor prognosis related to these diseases in the short term. (AU)


Subject(s)
Humans , Female , Middle Aged , Leukemia, Myeloid, Acute/pathology , Pyoderma Gangrenosum/diagnosis , Paraneoplastic Syndromes/pathology , Respiration, Artificial , Azacitidine/therapeutic use , Myelodysplastic Syndromes/pathology , Acyclovir/administration & dosage , Methylprednisolone/administration & dosage , Vancomycin/administration & dosage , Cardiotonic Agents/therapeutic use , Ceftazidime/administration & dosage , Amphotericin B/administration & dosage , Imipenem/administration & dosage , Sweet Syndrome/etiology , Pyoderma Gangrenosum/etiology , Pyoderma Gangrenosum/pathology , Pyoderma Gangrenosum/drug therapy , Adrenal Cortex Hormones/therapeutic use , Meropenem/administration & dosage
4.
Braz. J. Pharm. Sci. (Online) ; 57: e19048, 2021. tab, graf
Article in English | LILACS | ID: biblio-1345460

ABSTRACT

Drug-resistant Acinetobacter baumannii is a frightening reality. The aim of this study is to examine the expression profiles of blaOXA-51 gene in carbapenemases producing A. baumannii treated with imipenem/sulbactam combination. Carbapenemases producing A. baumannii was identified among clinical isolates of A. baumannii obtained from patients at Shahid Rajaee hospital, Gachsaran, Iran, from January to June 2018. Synergism testing of imipenem/sulbactam on carbapenemases producing A. baumannii was carried out by broth microdilution method. Eventually, the expression of blaOXA-51 gene was carried out to investigate the inhibitory properties of imipenem/sulbactam combination against carbapenemases producing A. baumannii using quantitative real time RT-PCR. Among A. baumannii isolates, 24% were carbapenemases producing A. baumannii. Imipenem/sulbactam combination revealed synergistic and partial synergistic effect for all tested isolates (FIC= 0.313-0.75). Finally, imipenem/sulbactam combination displayed significant down-regulation of blaOXA-51 gene in carbapenemases producing A. baumannii. Imipenem synergizes with sulbactam against carbapenemases producing A. baumannii by targeting of the blaOXA-51 gene.


Subject(s)
Sulbactam/agonists , Imipenem/agonists , Acinetobacter baumannii/drug effects , Patients/classification , In Vitro Techniques/instrumentation , Pharmaceutical Preparations/analysis , Hospitals/classification , Methods
5.
Article in Korean | WPRIM | ID: wpr-816603

ABSTRACT

BACKGROUND: The emergence of multidrug-resistant Acinetobacter baumannii as a nosocomial pathogen is one of the major public health problems. The aim of this study was to evaluate the role of an efflux pump gene adeJ for the multidrug resistance of A. baumannii clinical isolates.METHODS: Two groups (MDRAB and SAB) of A. baumannii clinical isolates were studied. The SAB group consisted of strains that did not meet the criteria of MDRAB and were susceptible to more categories of antibiotics than MDRAB. Antimicrobial susceptibility results obtained by VITEKII system were used in data analysis and bacterial group allocation. We performed real-time reverse transcription PCR to determine relative expression of adeJ. We compared relative expression of adeJ in comparison groups by considering two viewpoints: i) MDRAB and SAB groups and ii) susceptible and non-susceptible groups for each antibiotic used in this study.RESULTS: The mean value of relative expression of adeJ of MDRAB and SAB groups was 1.4 and 0.92, respectively, and showed significant difference (P=0.002). The mean values of relative expression of adeJ of susceptible and non-susceptible groups to the antibiotics cefepime, ceftazidime, ciprofloxacin, imipenem, meropenem, tigecycline, piperacillin/tazobactam, ticarcillin/clavulanic acid, trimethoprim/sulfamethoxazole, piperacillin, and gentamicin showed statistically significant differences.CONCLUSION: The overexpression of adeIJK might contribute to the multi-drug resistance in A. baumannii clinical isolates. Further, the overexpression of adeIJK might be one of the factors contributing to the resistance to numerous antibiotics.


Subject(s)
Acinetobacter baumannii , Acinetobacter , Anti-Bacterial Agents , Ceftazidime , Ciprofloxacin , Drug Resistance, Multiple , Gentamicins , Imipenem , Piperacillin , Polymerase Chain Reaction , Public Health , Reverse Transcription , Statistics as Topic
6.
Article in English | WPRIM | ID: wpr-765057

ABSTRACT

The susceptibility of Escherichia coli from community onset urinary tract infection (UTI) was evaluated by dividing community onset UTI into the simple community acquired-UTI (CA-UTI) and healthcare associated UTI (HCA-UTI) groups for a period of 10 years. The susceptibility of E. coli to most antibiotics, except amikacin and imipenem, continued to decrease. In the CA-UTI group, the susceptibility to cefotaxime was 88% in 2015, but rapidly decreased to 79.3% in 2017. The susceptibility to cefepime and piperacillin-tazobactam were 88.8% and 90.5% in 2017, respectively. In the HCA-UTI group, the susceptibility to most antibiotics markedly decreased to less than 60% by 2017. The incidence of ESBL-producing E. coli increased to 23.3% in the CA-UTI group in 2017.


Subject(s)
Amikacin , Anti-Bacterial Agents , Cefotaxime , Delivery of Health Care , Escherichia coli , Escherichia , Imipenem , Incidence , Korea , Tertiary Healthcare , Urinary Tract Infections , Urinary Tract
7.
Korean Journal of Medicine ; : 343-352, 2019.
Article in Korean | WPRIM | ID: wpr-759949

ABSTRACT

Mycobacterium abscessus is the second most important pathogen in pulmonary disease caused by nontuberculous mycobacteria (NTM), following Mycobacterium avium. Mycobacterium abscessus is classified into three subspecies: M. abscessus subsp. abscessus, M. abscessus subsp. massiliense, and M. abscessus subsp. bolletii. Mycobacterium abscessus is the most difficult to treat NTM due to its resistance to many antibiotics. Treatment should include an initial regimen of 2–3 injectable and oral antibiotics for several weeks or months, followed by inhaled amikacin and 1–3 oral antibiotics, depending on the subspecies and drug susceptibility patterns, including macrolide susceptibility. The continuation phase should be continued for a minimum of 12 months after culture conversion. Suitable injectable antibiotics include amikacin, imipenem, cefoxitin, and tigecycline, while oral antibiotics include macrolides (azithromycin or clarithromycin), clofazimine, linezolid, and moxifloxacin. Surgery can be a useful adjunctive therapy for some patients with refractory disease. However, the overall treatment prognosis is still unsatisfactory. Therefore, novel and more effective interventions are required for the treatment of M. abscessus pulmonary disease.


Subject(s)
Amikacin , Anti-Bacterial Agents , Cefoxitin , Clofazimine , Humans , Imipenem , Linezolid , Lung Diseases , Macrolides , Mycobacterium avium , Mycobacterium , Nontuberculous Mycobacteria , Prognosis
8.
Article in English | WPRIM | ID: wpr-739143

ABSTRACT

BACKGROUND: The emergence of carbapenem resistance among gram-negative bacilli (GNB), mediated by carbapenemase production, has necessitated the development of a simple and accurate device for detecting minimum inhibitory concentrations (MICs) and resistance mechanisms, especially carbapenemase production. We evaluated the performance of the BD Phoenix NMIC-500 panel (BD Diagnostic Systems, Sparks, MD, USA) for antimicrobial susceptibility testing (AST) and carbapenemase-producing organism (CPO) detection. METHODS: We used 450 non-duplicate clinical GNB isolates from six general hospitals in Korea (409 Enterobacteriaceae and 41 glucose non-fermenting bacilli [GNFB] isolates). AST for meropenem, imipenem, ertapenem, ceftazidime, and ceftazidime/avibactam, and CPO detection were performed using the Phoenix NMIC-500 panel. Broth microdilution was used as the reference method for AST. The rates of categorical agreement (CA), essential agreement (EA), minor error (mE), major error (ME), and very major error (VME) were calculated in each antimicrobial. In addition, PCR and sequencing were performed to evaluate the accuracy of CPO detection by the BD Phoenix NMIC-500 panel, and the rate of correct identification was calculated. RESULTS: The CA rates were >90% for all antimicrobials tested with the Enterobacteriaceae isolates, except for imipenem (87.2%). The GNFB CA rates ranged from 92.7% to 100% for all antimicrobials. The ME rates were 1.7% for Enterobacteriaceae and 0% for GNFB. The panel identified 97.2% (243/250) of the carbapenemase-producing isolates. CONCLUSIONS: The BD Phoenix NMIC-500 panel shows promise for AST and CPO detection.


Subject(s)
Ceftazidime , Drug Resistance, Bacterial , Enterobacteriaceae , Glucose , Hospitals, General , Imipenem , Korea , Methods , Microbial Sensitivity Tests , Polymerase Chain Reaction
10.
Rev. méd. Chile ; 146(4): 523-527, abr. 2018. graf
Article in Spanish | LILACS | ID: biblio-961424

ABSTRACT

Toxic epidermal necrolysis (TEN) is a lethal entity, characterized by extensive epidermal necrosis and multiorgan failure. Hemophagocytic syndrome (HFS) is also a rare and lethal syndrome characterized by hyperinflammation that leads to the appearance of fever, pancytopenia, organomegaly and hemophagocytosis. The concomitance of these diseases is extremely uncommon. We report a 38 years old female, who during the course of a HFS secondary to Hodgkin Lymphoma (HL), presented a TEN secondary to antibiotics. She was admitted due to a consumptive syndrome, lymphadenopathy, visceromegaly and severe pancytopenia. Laboratory and bone marrow tests confirmed HFS. Due to constant fever, imipenem was indicated. On the third day she started with pain and skin rash. She evolved with positive Nikolsky sign. Cutaneous biopsy was concordant with extensive TEN, which was managed with intravenous immunoglobulin and dexamethasone. A complete response and normalization of the blood count were achieved. Finally, the lymph node biopsy showed HL of mixed cellularity type, which was managed with 8 cycles of ABVD chemotherapy, achieving complete remission.


Subject(s)
Humans , Female , Adult , Hodgkin Disease/complications , Stevens-Johnson Syndrome/etiology , Lymphohistiocytosis, Hemophagocytic/etiology , Vinblastine , Bleomycin , Hodgkin Disease/pathology , Hodgkin Disease/drug therapy , Antineoplastic Combined Chemotherapy Protocols , Doxorubicin , Imipenem/adverse effects , Stevens-Johnson Syndrome/pathology , Stevens-Johnson Syndrome/drug therapy , Treatment Outcome , Dacarbazine , Lymphohistiocytosis, Hemophagocytic/pathology , Lymphohistiocytosis, Hemophagocytic/drug therapy , Anti-Bacterial Agents/adverse effects
11.
Article in English | WPRIM | ID: wpr-716936

ABSTRACT

BACKGROUND: This study was conducted to evaluate the impact of the media type used for direct identification of colonies on the surveillance culture of carbapenem-resistant Enterobacteriaceae (CRE) by matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). METHODS: CRE surveillance culture isolates were subjected to species identification using the MALDI Biotyper (Bruker Daltonics, Germany) for 2 months starting in March 2017. Four types of media were evaluated: blood agar (BA), Mueller Hinton agar (MH), MacConkey agar (Mac), and MacConkey agar containing imipenem of 1 µg/mL (IMP-Mac). CRE-like colonies on IMP-Mac and their subculture colonies on the other media were tested after overnight incubation and extended incubation for one additional day. The percent identification and score value were analyzed for each media types and incubation time when the identification was correct at the genus level. RESULTS: A total of 117 isolates were identified as 84 Klebsiella pneumoniae, 12 Escherichia coli, 9 Enterobacter cloacae, 5 Klebsiella oxytoca, 4 Enterobacter aerogenes, and 2 Raoultella ornithinolytica. The successful identification rates (SIR) for BA and MH were 98.3% and 97.4% (P=0.9), respectively, while those for Mac and IMP-Mac were 82.1% (P < 0.001) and 70.9% (P < 0.001), respectively. After extended incubation, SIRs were decreased to 96.6%, 96.6% (P=1.0), 61.5% (P < 0.001), and 58.1% (P < 0.001) on BA, MH, Mac, and IMP-Mac, respectively. The average score values were significantly lower for Mac (2.017±0.22) and IMP-Mac (1.978±0.24) than for BA (2.213±0.16) (P < 0.001). CONCLUSIONS: The low performance of the MALDI Biotyper applied directly to the colonies grown on Mac or IMP-Mac indicates that subculture on BA or MH is preferable before identification by MALDI-TOF MS.


Subject(s)
Agar , Enterobacter aerogenes , Enterobacter cloacae , Enterobacteriaceae , Escherichia coli , Imipenem , Klebsiella oxytoca , Klebsiella pneumoniae , Mass Spectrometry , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
12.
Article in English | WPRIM | ID: wpr-758817

ABSTRACT

Clostridium perfringens causes diarrhea and other diseases in animals and humans. We investigated the prevalence, toxin gene profiles, and antibiotic resistance of C. perfringens isolated from diarrheic dogs (DD) and non-diarrheic dogs (ND) in two animal hospitals in Seoul, Korea. Fecal samples were collected from clinically DD (n = 49) and ND (n = 34). C. perfringens was isolated from 31 of 49 DD (63.3%) and 21 of 34 ND dogs (61.8%). All C. perfringens strains were positive for the α toxin gene, but not for the β, ε, or ι toxin genes; therefore, all strains were identified as type A C. perfringens. All isolates were cpe-negative, whereas the β2 toxin gene was identified in 83.9% and 61.9% of isolates from DD and ND, respectively. Most isolates were susceptible to ampicillin (94%), chloramphenicol (92%), metronidazole (100%), moxifloxacin (96%), and imipenem (100%). However, 25.0% and 21.2% of isolates were resistant to tetracycline and clindamycin, respectively. Molecular subtyping of the isolated strains was performed by using pulsed-field gel electrophoresis. Fifty-two isolates were classified into 48 pulsotypes based on more than 90% similarity of banding patterns. No notable differences were observed among the isolates from DD and ND.


Subject(s)
Ampicillin , Animals , Bacterial Toxins , Chloramphenicol , Clindamycin , Clostridium perfringens , Clostridium , Diarrhea , Dogs , Drug Resistance , Drug Resistance, Microbial , Electrophoresis, Gel, Pulsed-Field , Hospitals, Animal , Humans , Imipenem , Korea , Metronidazole , Prevalence , Seoul , Tetracycline
13.
Article in English | WPRIM | ID: wpr-713549

ABSTRACT

Antimicrobial resistance is becoming one of the greatest challenges to public health worldwide. Infections by antimicrobial-resistant organisms could result in the failure of treatment, increased medical costs, prolonged hospital stays, and an increased socioeconomic burden. Antimicrobial usage in Korea remains heavy, even after much effort to reduce their use. According to the Korean antimicrobial resistance surveillance system, the resistance rates of many bacteria are increasing. The resistance rate of Acinetobacter baumannii to imipenem in Korea increased to 85% in 2015, representing a major public threat. The reports of increased carbapenem resistance in Enterobacteriaceae are worrisome. More importantly, some carbapenem-resistant Enterobacteriaceae may result from the production of carbapenemases, which break down carbapenems. There are relatively few treatment options for extensively drug-resistant A. baumannii and carbapenem-resistant Enterobacteriaceae. Most reports are retrospective observational studies. Because there are little published data from randomized controlled trials, more data assessing antimicrobial treatment for extensively drug-resistant A. baumannii and carbapenem-resistant Enterobacteriaceae are needed to make treatment recommendations.


Subject(s)
Acinetobacter baumannii , Bacteria , Carbapenems , Drug Resistance , Drug Resistance, Bacterial , Enterobacteriaceae , Epidemiology , Gram-Negative Bacteria , Imipenem , Korea , Length of Stay , Public Health , Retrospective Studies
15.
Kosin Medical Journal ; : 29-40, 2018.
Article in English | WPRIM | ID: wpr-715039

ABSTRACT

OBJECTIVES: Blood culture is a one of the most important procedure for diagnosis and treatment of infectious disease, but distribution of pathogenic species and the antimicrobial susceptibility can be vary from pathogen, individual trait, regional or environmental features. In this study, we investigated the changes in frequency of occurrence and antimicrobial susceptibility pattern of blood isolates from 2005 to 2014. METHODS: Data of blood isolates from Kosin Gospel Hospital during 2005 to 2014 were analyzed retrospectively. Blood isolates were cultured for 5 days using BACTEC Plus Aerobic/F and BACTEC lytic/10 Anaerobic/F. Identification and antimicrobial susceptibility test was performed using VITEK 1 system, VITEK 2 XL, PHOENIX 100 and conventional method. RESULTS: 9,847 isolates were identified during 10 years. Among the isolates aerobic or falcutative anaerobic bacteria were isolated in 99.5% specimens, anaerobic were 0.1%, and fugi were 0.4%. Most commonly isolated bacteria were coagulase-negative Staphylococcus (CoNS) followed by Escherichia coli, Staphylococcus aureus and Klebsiella pneumoniae. Candida parapsilosis were most frequently isolated among fungi. The proportion of S. aureus, A. baumannii and E. faecium were increased, while Pseudomonas aeruginosa and Streptococcus pneumoniae decreased over decennium. Imipenem resistant K. pneumoniae were identified. Vancomycin resistant E. faecium and imipenem resistant A. baumannii were increased (7.1% in 2005 to 12.3% in 2014, 0% in 2005 to 55.6% in 2014, respectively). CONCLUSIONS: Over the last 10 year, CoNS were the most frequently isolated pathogen. Imipenem resistant K. pneumoniae was emerged. Vancomycin resistant E. faecium and imipenem resistant A. baumannii increased during this period.


Subject(s)
Bacteremia , Bacteria , Bacteria, Anaerobic , Candida , Communicable Diseases , Diagnosis , Escherichia coli , Fungi , Imipenem , Klebsiella pneumoniae , Methods , Pneumonia , Pseudomonas aeruginosa , Retrospective Studies , Staphylococcus , Staphylococcus aureus , Streptococcus pneumoniae , Vancomycin
16.
Rev. med. Risaralda ; 23(2): 38-42, jul.-dic. 2017. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-902079

ABSTRACT

La amplia distribución de los bacilos gram negativos no fermentadores en medios ambientales como el agua y especies vegetales cobra importancia al ser reconocidos como agentes causales de enfermedades en pacientes inmunocomprometidos, de allí la relevancia del porque debemos conocer la prevalencia y perfil de susceptibilidad de estos microorganismos en ambientes no hospitalarios. Materiales y Métodos: Estudio transversal, realizado en muestras hídricas de fuentes naturales y artificiales de almacenamiento para el consumo humano en la ciudad de Bogotá y municipios aledaños. La identificación se realizó a través de pruebas IMVIC y el perfil de resistencia a través del método de kirby bauer o E-TEST®. Resultados: Se obtuvieron 42 muestras, 7 (16,6%) con aislamientos de interés: 3 (60%) Pseudomonas spp, 2 (20%) Acinetobacter spp, 1 (10%) Sphingomonas paucimobilis y 1 (10%) Pantoea spp. El 70% presento resistencia a la ceftriaxona, el 30% a cefoxitina, 20% a gentamicina, 10% a ciprofloxacina y 10% a piperacilina-tazobactam. No se presentó resistencia a imipenem. Conclusión: 5 de 7 aislamientos revelaron un BGNNF de importancia en infección en humanos, siendo importante la resistencia encontrada a la ceftriaxona.


The wide distribution of non-fermenting gram negative bacilli in environmental media such as water and plants becomes important as they are recognized a cause of diseases in immunocompromised patients, that’s the reason why we should to know the prevalence and the susceptibility profile of these microorganisms in non-hospital environments. Materials and Methods: Cross-sectional study done with samples of natural and artificial water storage for human consumption in the city of Bogotá and surrounding municipalities. The identification was made through IMVIC tests and the resistance profile through the kirby bauer or E-TEST® method. Results: 42 samples were obtained, 7 (16.6%) with isolates of interest: 3 (60%) Pseudomonas spp, 2 (20%) Acinetobacter spp, 1 (10%) Sphingomonas paucimobilis and 1 (10%) Pantoea spp. The 70% had resistance to ceftriaxone, 30% to cefoxitin, 20% to gentamicin, 10% to ciprofloxacin and 10% to piperacillin-tazobactam. No resistance to imipenem was shown. Conclusion: 5 of 7 isolates revealed a BGNNF of importance in infection in humans, with an important resistance to ceftriaxone.


Subject(s)
Humans , Pseudomonas , Acinetobacter , Drug Resistance, Microbial , Water Storage , Environment , Gram-Negative Bacteria , Piperacillin , Ceftriaxone , Gentamicins , Ciprofloxacin , Cefoxitin , Imipenem , Cross-Sectional Studies , Immunocompromised Host , Elapidae , Sphingomonas , Pantoea , Orlistat , Piperacillin, Tazobactam Drug Combination , Tazobactam , Hospitals
17.
Rev. cuba. plantas med ; 22(1)ene.-mar. 2017. tab
Article in Portuguese | LILACS, CUMED | ID: biblio-901507

ABSTRACT

Introdução: Piper tuberculatum Jacq., popularmente conhecida como pimenta-longaou pimenta-d'Arda, é utilizada empiricamente no tratamento de doenças respiratórias (asma, bronquite e tosse) e digestivas (dores abdominais e diarreias). Na literatura é descrita com importantes atividades anti-inflamatória, antimicrobiana, antileucêmico e anti-helmíntica. Objetivos: avaliar a atividade moduladora do óleo essencial dos frutos de P. tuberculatum (OEPT) em associação com diferentes antibióticos frente à Staphylococcus aureus, Escherichia coli e Pseudomona aeruginosa. Metodos: Os frutos (frescos) de P. tuberculatum foram coletados em Barbalha/CE e submetidos à hidrodestilação em aparelho tipo Clevenger para ser extraído o óleo essencial, após a extração o óleo essencial foi tratado com sulfato de sódio anidro para eliminação da umidade residual. A avaliação da atividade antibacteriana e modulação (em resistência bacteriana) frente às cepas de S. aureus (SA358), E. coli (EC27) e P. aeruginosa (PA03) foram determinadas pelo método de microdiluição para identificar a concentração inibitória mínima (CIM), realizada em triplicata. CIM de ≤ 256 µg/mL foi considerado clinicamente relevante. Resultados: a atividade antibacteriana do OEPT exibiu um CIM de ≥ 1024 µg/mL contra as cepas de bactérias de padrão resistente a múltiplas drogas. Na avaliação da atividade moduladora, o OEPT antagonizou o efeito da amicacina contra E. coli e S. aureus, mas teve efeito sinérgico contra P. aeruginosa. Combinado com a getamicina o óleo exibiu antagonismo frente a E. coli, no entanto não apresentou resultado relevante contra S. aureas e P. aeruginosa. A associação do OEPT com o antibiótico imipenem resultou efeito mais relevante, apresentando sinergismo para todas as bactérias avaliadas, por outro lado, em associação com ciprofloxacino não apresentou efeito significante em relação ao controle. Conclusão: O OEPT apresentou uma melhor atividade quando associado ao imipenem frente todas as bactérias avaliadas, mostrando ser uma possível alternativa no desenvolvimento de novos fármacos com atividade antibacteriana advindos de produtos fitoterápicos(AU)


Introducción: Piper tuberculatum Jacq. popularmente conocida como pimenta-longa o pimenta-d'Arda, se utiliza empíricamente en el tratamiento de enfermedades respiratorias (asma, bronquitis y tos) y digestivas (dolor abdominal y diarrea). En la literatura es describe con importantes actividades antiinflamatorias, antimicrobianas, antileucémicas y antihelmínticas. Objetivo: evaluar la actividad moduladora de los aceites esenciales de frutos de P. tuberculatum (AEPT) en asociación con diferentes antibióticos contra Staphylococcus aureus, Escherichia coli y Pseudomona aeruginosa. Metodología: los frutos (frescos) de P. tuberculatum fueron recolectados en Barbalha/CE y sometidos a hidrodestilación en un equipo Clevenger, para extraer el aceite essencial (AEPT), el cual, una vez extraído, fue tratado con sulfato de sodio anhidro para eliminar la humedad residual. Se evaluó su actividad antibacteriana contra las cepas de S. aureus (SA358), E. coli (EC27) y P. aeruginosas (PA03). Empleando el método de microdilución se determinó la concentración inhibitoria mínima (CIM), con tres réplicas por cada tratamiento. Un valor de CIM ≤ 256 µg/mL se considera clínicamente relevante. Resultados: la actividad antibacteriana del AEPT exhibió una CIM ≥ 1024 µg/mL contra las cepas estándar de bacterias resistentes a múltiples fármacos. En efecto, la actividad AEPT antagoniza el efecto de amikacina contra E. coli y S. aureus, pero tenía un efecto sinérgico contra P. aeruginosa. Combinado con la getamicina el aceite exhibió antagonismo contra E. coli, sin embargo no presentó resultado relevante ante S. aureus y P. aeruginosa. La asociación de AEPT con el antibiótico imipenem resultó el efecto más relevante, mostrando sinergismo frente a todas las bacterias evaluadas. Por el contrario, en asociación con ciprofloxacina no mostró ningún efecto significativo con respecto al control. Conclusión: el AEPT presentó una mejor actividad cuando se asoció a imipenem, frente todas las bacterias evaluadas, demostrando ser una posible alternativa en el desarrollo de nuevos fármacos con actividad antimicrobiana, a partir de productos herbarios(AU)


Introduction: Piper tuberculatum Jacq., commonly known as pimenta-longa or pimenta-d'Arda, is empirically used to treat respiratory conditions (asthma, bronchitis and coughing) and digestive disorders (abdominal pain and diarrhea). Reference may be found in the literature to outstanding antiinflammatory, antimicrobial, antileukemic and antihelmintic activity. Objective: Evaluate the modulatory activity of essential oils from fruits of P. tuberculatum (AEPT) combined with various antibiotics againstStaphylococcus aureus, Escherichia coli and Pseudomona aeruginosa. Methods: Fresh fruits of P. tuberculatum were collected in Barbalha, CE, and subjected to hydrodistillation in a Clevenger set to extract the essential oil (AEPT). The oil extracted was then treated with anhydrous sodium sulfate to eliminate residual humidity. Antibacterial activity was evaluated against strains of S. aureus (SA358), E. coli (EC27) and P. aeruginosas (PA03). Minimum inhibitory concentration (MIC) was determined by the microdilution method, with three replications for each treatment. A MIC ≤ 256 µg/mL was considered to be clinically relevant. Results: Antibacterial activity of AEPT displayed a MIC of ≥1024 µg/mL against standard strains of multi-drug resistant bacteria. In fact, activity of AEPT antagonized the effect of amikacin against E. coli and S. aureus, but had a synergic effect against P. aeruginosa. Combined with gentamicin, the oil exhibited antagonism against E. coli, but no relevant result was obtained against S. aureus and P. aeruginosa. Combination of AEPT with the antibiotic imipenem had the most relevant effect, displaying synergism against all the bacteria evaluated. However, in combination with ciprofloxacin it did not show any significant effect with respect to the control. Conclusion: AEPT displayed better activity against all the bacteria evaluated when combined with imipenem, proving to be a possible alternative for the development of new herbal drugs with antimicrobial activity(AU)


Subject(s)
Humans , Oils, Volatile/therapeutic use , Imipenem/therapeutic use , Piper nigrum/drug effects , Anti-Infective Agents/therapeutic use
18.
Infection and Chemotherapy ; : 184-193, 2017.
Article in English | WPRIM | ID: wpr-201460

ABSTRACT

BACKGROUND: Through investigating antimicrobial susceptibility patterns of Enterobacteriaceae in community-acquired urinary tract infection (CA-UTI), we provide basic evidence for the use of empirical antibiotics in CA-UTI. MATERIALS AND METHODS: We retrospectively reviewed the medical records of patients over the age of 19 years who visited a hospital in Seoul between January 2012 and December 2016 for a CA-UTI. Urine cultures were used to identify causative organisms. We investigated extended-spectrum β-lactamase (ESBL) production and the antimicrobial susceptibility of Enterobactereiaceae. We evaluated recommended empirical antibiotics numerically by calculating the syndrome-specific likelihood of inadequate therapy (LIT) for the last 2 years (interpretation of the LIT A value: 1 out of A people is likely to receive inadequate empirical antibiotics). RESULTS: Urine cultures were performed in 1,605 out of 2,208 patients who were diagnosed with CA-UTI, and causative pathogens were identified in 1,134 (70.7%) cases. There were 998 (88.0%) cases of Enterobacteriaceae and Escherichia coli was the most common pathogen, accounting for 80.3% of cases (911 cases). The overall resistance rates to trimethoprim-sulfamethoxazole, fluoroquinolones, and cefotaxime were 31.7%, 23.2%, and 13.5%, respectively. There were 128 (10.8%) cases of ESBL-producing Entererobacteriaceae with an increasing but non-significant trend (P = 0.255). The LIT for CA-UTI in the past two years was highest for ertapenem and imipenem. Fluoroquinolones ranked 11th, with a LIT of 8.2, and cefotaxime ranked higher, at 10.5. In ESBL-producing Enterobacteriaceae, except for carbapenems, amikacin and piperacillin-tazobactam showed the highest susceptibility rates at 99.2% and 94.3%, respectively. CONCLUSION: Empiric treatment with fluoroquinolones in CA-UTI should be carefully considered, given the high resistance rate. The proportion of ESBL-producing Entererobacteriaceae in CA-UTI has increased to a high level in Korea. Amikacin and piperacillin-tazobactam could be considered for empiric treatment in patients at risk for ESBL-producing Entererobacteriaceae when considering alternatives to carbapenems.


Subject(s)
Amikacin , Anti-Bacterial Agents , Carbapenems , Cefotaxime , Community-Acquired Infections , Enterobacteriaceae , Escherichia coli , Fluoroquinolones , Humans , Imipenem , Korea , Medical Records , Retrospective Studies , Seoul , Trimethoprim, Sulfamethoxazole Drug Combination , Urinary Tract Infections , Urinary Tract
19.
Article in English | WPRIM | ID: wpr-109775

ABSTRACT

Enterococcus spp. are normally present in the gastrointestinal tracts of animals and humans, but can cause opportunistic infections that can be transmitted to other animals or humans with integrated antibiotic resistance. To investigate if this is a potential risk in military working dogs (MWDs), we analyzed antibiotic resistance patterns and genetic relatedness of Enterococcus spp. isolated from fecal samples of MWDs of four different age groups. Isolation rates of Enterococcus spp., Enterococcus (E.) faecalis, and E. faecium, were 87.7% (57/65), 59.6% (34/57), and 56.1% (32/57), respectively, as determined by bacterial culture and multiplex PCR. The isolation rate of E. faecalis gradually decreased with age (puppy, 100%; adolescent, 91.7%; adult, 36.4%; and senior, 14.3%). Rates of resistance to the antibiotics ciprofloxacin, gentamicin, streptomycin, sulfamethoxazole/trimethoprim, imipenem, and kanamycin among Enterococcus spp. increased in adolescents and adults and decreased in senior dogs, with some isolates having three different antibiotic resistance patterns. There were indistinguishable pulsed-field gel electrophoresis patterns among the age groups. The results suggest that Enterococcus is horizontally transferred, regardless of age. As such, periodic surveillance studies should be undertaken to monitor changes in antibiotic resistance, which may necessitate modification of antibiotic regimens to manage antibiotic resistance transmission.


Subject(s)
Adolescent , Adult , Animals , Anti-Bacterial Agents , Ciprofloxacin , Dogs , Drug Resistance, Microbial , Electrophoresis, Gel, Pulsed-Field , Enterococcus faecalis , Enterococcus faecium , Enterococcus , Gastrointestinal Tract , Gentamicins , Humans , Imipenem , Kanamycin , Korea , Military Personnel , Multiplex Polymerase Chain Reaction , Opportunistic Infections , Streptomycin
20.
Article in Korean | WPRIM | ID: wpr-100910

ABSTRACT

Blood culture is important to detecting bacteremia and fungemia in patients with suspected sepsis. We observed a four-year trend of blood culture isolates in the frequency by age group and in vitro antimicrobial susceptibility patterns obtained at VHS Medical Center, the largest veterans hospital in Korea. Blood cultures collected between 2012 and 2015 were analysed retrospectively. Of 68,352 blood specimens, 7,901 isolates were identified during the study period. Seventy-two percent of the isolates were gram-positive cocci, 18% were gram-negative rods, and 6% were fungi. The frequency of bacteremia/fungemia in patients who were 80–89 years old was 43.8%, the highest rate among all age groups, and the mean age of patients diagnosed by blood culture was 77 years old. Coagulase-negative staphylococcus (52.3%), Staphylococcus aureus (8.3%), enterococci (7.5%), Escherichia coli (6.4%), and Klebsiella pneumoniae (3.9%) were the bacteria most commonly isolated. The percentage of methicillin-resistant S . aureus increased in 2015 (76%) relative to that in 2012–2014 (63%–65%), and that of vancomycin-resistant Enterococcus faecium was 17%–22% with no significant changes through time. Among the gram-negative isolates, the ciprofloxacin resistance rate increased to 51.4% (E. coli ) and 31.1% (K. pneumoniae ) in 2015, but imipenem or ertapenem resistance was still very rare, with resistance rates of less than 0.5%. Acinetobacter baumannii showed a high rate of resistance (over 70%) to imipenem and ciprofloxacin throughout the study. In Pseudomonas aeruginosa , the resistance rates of imipenem and ciprofloxacin increased dramatically over time. This analysis confirmed a decrease in antimicrobial susceptibility of gram-negative rods isolated by blood culture.


Subject(s)
Acinetobacter baumannii , Bacteremia , Bacteria , Ciprofloxacin , Enterococcus faecium , Escherichia coli , Fungemia , Fungi , Gram-Positive Cocci , Hospitals, Veterans , Humans , Imipenem , In Vitro Techniques , Klebsiella pneumoniae , Korea , Methicillin Resistance , Pneumonia , Pseudomonas aeruginosa , Retrospective Studies , Sepsis , Staphylococcus , Staphylococcus aureus , Veterans
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