ABSTRACT
Objectives: Our objective was to evaluate the in vitro activity of ceftolozane-tazobactam against multidrug resistant (MDR) and extensively drug-resistant (XDR) non metallo-ß-lactamase producing Pseudomonas aeruginosa clinical isolates at Hospital Universitario Miguel Servet (Zaragoza, Spain) from February 2016 to October 2017. Material and methods: We evaluated the in vitro activity of ceftolozane-tazobactam and other antipseudomonal antibiotics against 12 MDR and 117 XDR non metallo-ß-lactamase producing P. aeruginosa isolates. Ceftolozane-tazobactam minimal inhibitory concentrations (MICs) were determined by MIC gradient diffusion test strip. Results: Among the 129 MDR/XDR isolates included, 119 (92.2%) were susceptible to ceftolozane-tazobactam, and ten (7.8%) were resistant. MIC50 was 2 mg/L, and MIC90 4 mg/L. Ceftolozane-tazobactam was the second most active antibiotic after colistin, overtaking amikacin. Conclusions: Ceftolozane-tazobactam is a valuable treatment option for MDR and XDR P. aeruginosa infections in our setting
Objetivos: Nuestro objetivo fue evaluar la sensibilidad in vitro de ceftolozano-tazobactam en aislados clínicos de P. aeruginosa multirresistente (MDR) y extremadamente resistente (XDR) desde Febrero de 2016 a Octubre de 2017 en el Hospital Universitario Miguel Servet, Zaragoza (España). Material y métodos: Evaluamos la actividad in vitro de ceftolozano-tazobactam y otros antibióticos anti-pseudomónicos en 12 aislados de P. aeruginosa MDR y en 117 aislados XDR, no productores de metalo-ß-lactamasas. Se determinó la concentración mínima inhibitoria (CMI) de ceftolozano-tazobactam mediante tiras de difusión en gradiente. Resultados: Entre los 129 aislados MDR/XDR incluidos, 119 (92,2%) fueron sensibles a ceftolozano-tazobactam, y diez (7,8%) presentaron resistencia. La CMI50 fue de 2 mg/L, y la CMI90 de 4 mg/L. Ceftolozano-tazobactam fue el segundo antibiótico más activo después de colistina, superando a amikacina. Conclusiones: Ceftolozano-tazobactam es una opción de tratamiento válida para infecciones causadas por P. aeruginosa MDR y XDR en nuestro entorno
Subject(s)
Humans , Tazobactam/pharmacokinetics , Cephalosporins/pharmacokinetics , Pseudomonas aeruginosa/pathogenicity , Pseudomonas Infections/drug therapy , In Vitro Techniques/methods , Drug Resistance, Multiple , Drug Therapy, Combination/methods , Treatment OutcomeABSTRACT
INTRODUCTION: Our objective was to characterize the enzymatic Beta-lactam resistance in clinical Enterobacteriaceae isolates with diminished susceptibility to carbapenems from 2013 to 2014 at Hospital Universitario Miguel Servet. Material/methods: A total of 63 clinical isolates were analyzed for the presence of carbapenemases (KPC, OXA-48 and MBL), ESBLs and AmpC enzymes by combined disk methods and PCR detection of carbapenemase-encoding and beta-lactamase-encoding genes. RESULTS: Fifteen isolates had a phenotypic test compatible with carbapenemase production; two of these were confirmed by PCR as OXA-48 producers. ESBL detection was positive in 27 isolates (43%); plasmid-mediated AmpC was detected in nine isolates (14.2%) and derepressed AmpC β-lactamase was present in 18 isolates (28%). CONCLUSION: During the study period, the decreased susceptibility to carbapenems in Enterobacteriaceae in our area was not due to true carbapenemases but rather to Beta-lactamase activity (82.5% were ESBL or AmpC producers), probably in combination with decreased permeability of the outer membrane
INTRODUCCIÓN: Nuestro objetivo fue caracterizar la resistencia enzimática a Beta-lactámicos en aislados clínicos de Enterobacteriaceae con sensibilidad disminuida a carbapenems desde 2013 a 2014 en el Hospital Universitario Miguel Servet. Material/métodos: Se analizaron un total de 63 aislados clínicos para presencia de carbapenemasas (KPC, OXA-48 y MBL), BLEE y AmpC por método de discos combinados y detección de genes codificantes de carbapenemasas y betalactamasas por PCR. RESULTADOS: Quince aislados tuvieron un test fenotípico compatible con producción de carbapenemasas; dos de ellos confirmados por PCR como productores de OXA-48. La detección BLEE fue positiva en 27 aislados (43%); se detectó AmpC plasmídica en 9 aislados (14,2%) y se observó β-lactamasa AmpC desreprimida en 18 aislados (28%). CONCLUSIÓN: Durante el período de estudio, la sensibilidad disminuida a carbapenems en Enterobacteriaceae en nuestra área no se debió a verdaderas carbapenemasas sino a actividad Beta-lactamasa (82,5% eran productores de BLEE o AmpC) probablemente en combinación con permeabilidad disminuida de la membrana externa
Subject(s)
Humans , Carbapenems/pharmacology , Enterobacteriaceae , Enterobacteriaceae/enzymology , Drug Resistance, Microbial , Microbial Sensitivity Tests , PhenotypeABSTRACT
A hexanuclear molybdenum cluster [Mo6I8Ac6]2- (1) has been ionically bound onto macroporous (Pmp) and gel-type (Pgel) resins and their performance as materials for the photodynamic inactivation of microorganisms has been studied. It has been found that 1@Pmp in combination with light is able to reduce 99.999999% of the population of Gram-positive Staphylococcus aureus whereas the activity of 1@Pgel is limited to a 99.99% reduction at the same light dose. The same trend is observed with Gram-negative Pseudomonas aeruginosa. A comprehensive study of both materials has been performed using confocal laser scanning microscopy, thermogravimetric analysis, nitrogen porosimetry, steady state and time resolved fluorometries and diffuse reflectance spectroscopy. The photochemical generation of singlet oxygen (1O2) has been assessed using 9,10-dimethylanthracene as a trap for this reactive oxygen species. It can be concluded that the nature of the polymeric support is of paramount importance for the development of surfaces with bactericidal properties.
ABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Candida/pathogenicity , Amphotericin B/administration & dosage , Sepsis/drug therapy , Candidemia/drug therapy , Administration, Intravesical , Fluconazole/administration & dosageABSTRACT
MALDI-TOF (matrix-assisted laser desorption ionization time-of-flight) mass spectrometry (MS) is becoming an essential tool in most microbiology laboratories. At present, by using a characteristic fungal profile obtained from whole cells or through simple extraction protocols, MALDI-TOF MS allows the identification of pathogenic fungi with a high performance potential. This methodology decreases the laboratory turnaround time, optimizing the detection of mycoses. This article describes the state-of-the-art of the use of MALDI-TOF MS for the detection of human clinical fungal pathogens in the laboratory and discusses the future applications of this technology, which will further improve routine mycological diagnosis.
Subject(s)
Fungi/isolation & purification , Mycology/methods , Mycoses/diagnosis , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization/methods , Diagnostic Tests, Routine , Forecasting , Fungemia/diagnosis , Fungemia/microbiology , Humans , Mycological Typing Techniques , Mycology/trends , Mycoses/microbiology , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization/trendsABSTRACT
La espectrometría de masas (EM) MALDI-TOF (matrix-assisted laser desorption ionization time-of-flight) se está convirtiendo en esencial en la mayoría de los laboratorios de micología clínica. En la actualidad, según un "perfil fúngico" característico, ya sea obtenido a partir de células intactas o mediante unos protocolos de extracción rápidos y reproducibles, la EM MALDI-TOF permite identificar hongos patógenos con un alto poder discriminatorio. Este hecho acorta enormemente los tiempos de respuesta y mejora el diagnóstico del laboratorio de micología clínica, optimizando la detección de las micosis. Esta revisión describe el estado actual del uso de EM MALDI-TOF para la detección en el laboratorio clínico de hongos patógenos humanos y presenta una perspectiva de las futuras aplicaciones de esta tecnología relativamente reciente, que está destinada a mejorar todavía más el diagnóstico micológico de rutina
MALDI-TOF (matrix-assisted laser desorption ionization time-of-flight) mass spectrometry (MS) is becoming an essential tool in most microbiology laboratories. At present, by using a characteristic fungal profile obtained from whole cells or through simple extraction protocols, MALDI-TOF MS allows the identification of pathogenic fungi with a high performance potential. This methodology decreases the laboratory turnaround time, optimizing the detection of mycoses. This article describes the state-of-the-art of the use of MALDI-TOF MS for the detection of human clinical fungal pathogens in the laboratory and discusses the future applications of this technology, which will further improve routine mycological diagnosis
