ABSTRACT
The incidence of Candida species causing bloodstream infections in the University Hospital of Szeged, Hungary, between 1996 and 2009, and the susceptibilities of these isolates to antifungal agents were evaluated.Automated blood culture systems (Vital, bioMérieux, Marcy-l'Etoile, France; and BACTEC 9120, Becton-Dickinson Diagnostic Systems, Sparks, USA) were used. The in vitro susceptibilities of the yeast isolates to antifungal agents were determined by the Etest method (AB Biodisk, Solna, Sweden).Bloodstream infections were caused by yeast strains in 231 cases during this period, and 226 Candida strains were cultured from 216 candidaemia patients. Bloodstream infections caused by multiple Candida spp. were diagnosed almost every year. Of the 216 patients, 67 were children; and 55 infants needed intensive care. In 2005, C. glabrata caused an increase in the incidence of invasive fungal infections in the Neonatal Intensive Care Unit. The PFGE analysis of 12 isolates distinguished 4 different karyotypes. The incidence of bloodstream infections caused by fungi did not change during the 14-year study period. The most frequent species cultured from blood samples were C. albicans and C. glabrata. The incidence of resistant isolates remained constant. The local trends of fungaemia must be monitored and compared with global reports.
Subject(s)
Candidemia/epidemiology , Adult , Aged , Aged, 80 and over , Candida/drug effects , Candidemia/microbiology , Child , Drug Resistance, Fungal , Female , Hospitals, University , Humans , Hungary/epidemiology , Incidence , Male , Microbial Sensitivity Tests , Time FactorsABSTRACT
The applicability of the repetitive-sequence-based PCR (rep-PCR)-based DiversiLab system was tested compared with the pulsed field gel electrophoresis (PFGE) to type a phenotypically similar subset of a large collection of multiresistant Pseudomonas aeruginosa strains isolated during a 17-month period from patients treated in different wards including 4 intensive care units (ICUs). Five environmental P. aeruginosa isolates obtained from one of the ICUs were also included. The DiversiLab system and the PFGE demonstrated the genetic relationship among the isolates with the same efficacy. One of the environmental isolates had the same rep-PCR type as the circulating clone. Multilocus sequence typing of one of the clinical isolates of the circulating clone proved that it is a member of a clonal complex of P. aeruginosa that has not been previously described in clinical samples.
Subject(s)
Bacterial Typing Techniques , Cross Infection/microbiology , DNA Fingerprinting , Polymerase Chain Reaction/methods , Pseudomonas Infections/microbiology , Pseudomonas aeruginosa/classification , Repetitive Sequences, Nucleic Acid , Cluster Analysis , Cross Infection/epidemiology , Electrophoresis, Gel, Pulsed-Field , Environmental Microbiology , Genotype , Hospitals , Humans , Molecular Epidemiology , Pseudomonas Infections/epidemiology , Pseudomonas aeruginosa/genetics , Pseudomonas aeruginosa/isolation & purificationABSTRACT
Our aim was to estimate the frequency and characteristics ofmethicillin-resistant Staphylococcus aureus (MRSA) strains occurring in a Romanian teaching hospital. We retrospectively studied isolates from infected or colonized patients treated at the intensive care and surgical units during January 2004-December 2005. The antibiotic susceptibility of MRSA strains and the presence of mecA gene were determined. Consecutively occurring strains isolated through a three-month period were typed using pulsed field gel electrophoresis. A total of 423 S. aureus strains were identified, methicillin-resistance was detected in 211 (49.9%) strains. Most of them were multiresistant. One of the MRSA genotypes identified by PFGE was commonly recovered from patients treated in the intensive care unit. According to our results, MRSA strains were frequently isolated pathogens in our hospital and there is an urgent need to enhance infection control efforts.
Subject(s)
Drug Resistance, Bacterial , Methicillin Resistance , Staphylococcal Infections/microbiology , Staphylococcus aureus/classification , Staphylococcus aureus/drug effects , Bacterial Proteins/genetics , Cross Infection/epidemiology , Cross Infection/microbiology , DNA Fingerprinting , DNA, Bacterial/genetics , Drug Resistance, Multiple, Bacterial , Electrophoresis, Gel, Pulsed-Field , Genotype , Hospitals, University , Humans , Incidence , Microbial Sensitivity Tests , Penicillin-Binding Proteins , Retrospective Studies , Romania , Staphylococcal Infections/epidemiology , Staphylococcus aureus/genetics , Staphylococcus aureus/isolation & purificationABSTRACT
Isolates from faecal samples (n = 224) from the UK and Hungary were screened for carbapenem-resistant Bacteroides strains and were consecutively investigated for the resistance mechanisms through detection of cfiA genes, the presence or lack of insertion sequence insertions in their upstream regions and the production of carbapenemase activities. In this way, a significant number of strains (n = 7, 3.1%) were recovered. They included 2 Bacteroides fragilis strains (one in each country) which harboured cfiA genes, but which were not activated by insertion sequence elements; this is reminiscent of some novel clinical B. fragilis strains. The cfiA-negative strains exhibited lower levels of carbapenem resistance and varying levels of carbapenemase activity, suggesting that other resistance mechanisms may also exist.
Subject(s)
Bacterial Proteins/genetics , Bacteroides/drug effects , Carbapenems/pharmacology , DNA Transposable Elements , Drug Resistance, Bacterial/physiology , Feces/microbiology , beta-Lactamases/genetics , Bacterial Proteins/metabolism , Bacteroides/classification , Bacteroides/genetics , Bacteroides Infections/microbiology , Humans , beta-Lactamases/metabolismABSTRACT
Fifteen Bacteroides fragilis isolates from the USA, Hungary and Kuwait were examined for carbapenem resistance, for carbapenemase activity and, with the use of various PCR-based methods and nucleotide sequencing, for cfiA genes and activating insertion sequence (IS) elements. All the B. fragilis isolates were cfiA-positive, 10 of the cfiA genes being upregulated by IS elements that are already known. Of these 10, one was of a novel type (designated IS943) and two further ones (IS614B and IS614C) were suspected hybrids of IS612, IS614 and IS942. There were five cfiA-positive imipenem-resistant B. fragilis isolates with elevated imipenem MICs (minimal inhibitory concentration) that harboured no IS insertion upstream of the cfiA gene, but produced carbapenemase; these isolates might possess a novel activation mechanism. On the basis of the available phenotypic and genotypic evidence, the present data suggest that there are at least two cfiA activation mechanisms among B. fragilis isolates.
Subject(s)
Anti-Bacterial Agents/pharmacology , Bacterial Proteins/genetics , Bacteroides fragilis/genetics , DNA Transposable Elements , Drug Resistance, Bacterial , Imipenem/pharmacology , beta-Lactamases/genetics , Amino Acid Sequence , Bacterial Proteins/metabolism , Bacteroides Infections/microbiology , Bacteroides fragilis/classification , Bacteroides fragilis/drug effects , Base Sequence , Humans , Hungary , Kuwait , Microbial Sensitivity Tests , Molecular Sequence Data , Sequence Analysis, DNA , United States , beta-Lactamases/metabolismABSTRACT
In the present study, 16 women with recurrent vulvovaginal candidiasis (RVVC) due to Candida albicans and Candida (Torulopsis) glabrata were followed for a period of 4 to 12 months, and 36 vaginal isolates were evaluated by pulsed-field gel electrophoresis (PFGE). Eleven women were infected by C. albicans and 5 by C. glabrata. Three electrophoretic karyotypes of C. albicans and 3 of C. glabrata were identified throughout the follow-up. All patients but one was infected with the same karyotype of C. albicans or C. glabrata during the follow-up period. Two different karyotypes of C. glabrata were identified in one patient in the course of 12 months. The results confirmed the diversity of the karyotypes of C. albicans and C. glabrata causing vulvovaginitis, and demonstrated the persistence of colonization with the same strain over different periods of time despite therapy (15/16 women).
