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1.
Urol Int ; 106(3): 298-303, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34175852

RESUMO

BACKGROUND: Increasing life expectancy and demographic change result in a rising number of geriatric patients, but knowledge about geriatric treatment options and adapted diagnostic pathways is low. Simultaneously, urinary tract infections (UTIs) are common in older people and often difficult to treat. METHODS: Patients with a UTI at a urological outpatient department between January 01, 2016, and December 31, 2017, were retrospectively identified in the data system. One thousand one hundred fifteen patients with "N30" and "N39" diagnosis were included in this study, 965 of which were under the age of 75 (group 1) and 150 of which 75 years or older (group 2). RESULTS: Of 150 patients in group 2, 41.6% had nitrite-positive urine (vs. 20.9% in group 1, p < 0.05 in χ2 testing). Patients in group 2 often had indwelling devices (30.3 vs. 6.0%, p < 0.05) and presented a sterile urine culture in only 20.7% (vs. 40.1% in group 1). Regarding calculated antibiotic therapy, there were significant differences concerning prescription of ciprofloxacin (34.9 vs. 25%, p < 0.05) and fosfomycin (12.7 vs. 40.7%, p < 0.05). CONCLUSION: UTI in geriatric patients should be treated differently than in younger patients because antibiotic resistance is high. The group with indwelling devices is complex. Individual strategies for geriatric patients should be considered.


Assuntos
Fosfomicina , Infecções Urinárias , Idoso , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana , Hospitais , Humanos , Estudos Retrospectivos , Infecções Urinárias/diagnóstico , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/epidemiologia
2.
Med Mycol ; 59(4): 350-354, 2021 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-32634233

RESUMO

The aim of this work was to study the epidemiology of candidemia in our hospital in order to determine whether the T2MR system might be a useful tool for early diagnosis of candidemia in selected units. We perform a retrospective review of all candidemia episodes registered in the last 12 years in selected units of our hospital in adult and pediatric patients. Candida species and antifungal susceptibility patterns were registered. A total of 686 isolates were registered, of which 625 were infections due to the five most common species of Candida. C. albicans (45.6%) and C. parapsilosis (33.1%) were the predominant species found in our institution. In adults these species were closely followed by C. glabrata (12-21%) in all units. While in pediatric medical and intensive care units (PICU), these species were followed by other uncommon yeasts. Resistance rates to triazoles were low in C. albicans and C. parapsilosis. In C. glabrata and C. tropicalis the resistance rates to fluconazole ranged from 10.86 to 6.67%. Resistance rates for echinocandins were very low and all strains were susceptible to amphotericin B. T2Candida® might be useful to guide antifungal targeted treatment and discontinuation of antifungal empirical treatment in those units where the five most common Candida species represent more than the ninety percent of the isolates. The selection of medical and surgical units should be based on local epidemiology and antifungal susceptibility patterns. Incidence should be taken into account in order to make clinical decisions based on negative results. LAY ABSTRACT: T2Candida® might be useful selectively in clinical units according to their local epidemiology, antifungal resistance patterns, and incidence of candidemia. It optimizes the clinical value of positive results supporting decisions about targeted therapies or discontinuations based on negative results.


Assuntos
Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Candidemia/diagnóstico , Candidemia/epidemiologia , Técnicas de Laboratório Clínico/métodos , Farmacorresistência Fúngica , Centros de Atenção Terciária/estatística & dados numéricos , Adulto , Antifúngicos/classificação , Candida/classificação , Candidemia/microbiologia , Criança , Técnicas de Laboratório Clínico/instrumentação , Implementação de Plano de Saúde , Unidades Hospitalares/estatística & dados numéricos , Humanos , Incidência , Testes de Sensibilidade Microbiana , Estudos Retrospectivos , Espanha/epidemiologia
3.
Ann Ig ; 33(3): 289-296, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33300944

RESUMO

Conclusion: The results of the present study highlight the need for comprehensive strategies targeting the appropriate use of antibiotics and infection control measures. Background: In the last decades, multidrug-resistant gram-negative bacteria have been increasing and they are involved in severe healthcare associated infections. In treating drug-resistant gram-negative bacterial infections, carbapenems are generally administered as a last choice. However, the rate of carbapenemresistant bacteria is constantly increasing the last years. The aim of the present study is to describe the relationship between the rate of carbapenem-resistant gram-negative bacteria and antibiotic consumption intensity. Study design: In 2017, the Sicilian Region implemented a regional surveillance system to describe and analyze consumption of antibiotics in hospital settings, as well as prevalence of antibiotic resistant microorganisms. Methods: Resistance data were retrospectively collected from routinary clinical antimicrobial susceptibility tests. Resistance rates (RRs) of carbapenems were calculated and Spearman's correlation analysis was performed to investigate the relationship between annual antibiotic consumption and rate of carbapenem resistance. Results: In 2015, the overall prevalence of carbapenem-resistant Klebsiella pneumoniae isolates was 43.9 %, and was positively correlated with beta-lactam consumption (R=0.529, p<0.01), and with carbapenem consumption (R=0.364, p<0.05). In 2016, the overall prevalence of carbapenem-resistant Klebsiella pneumoniae isolates was 53.8 %, and was positively correlated with carbapenem antibiotic consumption (R=0.364, p<0.05). In 2017, the overall prevalence of carbapenem-resistant Klebsiella pneumoniae isolates was 58.7 %, and was significantly positively correlated with carbapenem antibiotic consumption (R=0.427, p<0.05). In 2015, the overall prevalence of carbapenem-resistant Escherichia coli isolates was 6.5 %, and was significantly positively correlated with antibiotic consumption for the ATC class J01 (i.e., antibacterial for systemic use) (R=0.402, p<0.05).


Assuntos
Carbapenêmicos , Infecções por Bactérias Gram-Negativas , Antibacterianos/uso terapêutico , Carbapenêmicos/farmacologia , Bactérias Gram-Negativas , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/epidemiologia , Humanos , Klebsiella pneumoniae , Testes de Sensibilidade Microbiana , Estudos Retrospectivos
4.
Infection ; 47(6): 1027-1035, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31595436

RESUMO

PURPOSE: Urinary tract infections (UTI) are one of the most common reasons for prescribing antibiotics in primary care. In Switzerland, the Swiss Center for Antibiotic Resistances (ANRESIS) provides resistance data by passive surveillance, which overestimates the true resistance rates. The aim of this study was to provide actual data of the antimicrobial resistance patterns in patients with UTI in Swiss primary care. METHODS: From June 2017 to August 2018, we conducted a cross-sectional study in 163 practices in Switzerland. We determined the resistance patterns of uropathogens in patients with a diagnosis of a lower UTI and analyzed risk factors for resistance. Patients with age < 18 years, pregnancy or a pyelonephritis were excluded. RESULTS: 1352 patients (mean age 53.8, 94.9% female) were included in the study. 1210 cases (89.5%) were classified as uncomplicated UTI. Escherichia coli (E. coli) was the most frequent pathogen (74.6%). Susceptibility proportions of E. coli to ciprofloxacin (88.9%) and trimethoprim-sulfamethoxazol (TMP/SMX) (85.7%) were significantly higher than the proportions reported by ANRESIS. We found high susceptibility to the recommended first-line antibiotics nitrofurantoin (99.5%) and fosfomycin (99.4%). Increasing age, antimicrobial exposure and a recent travel history were independently associated with resistance. DISCUSSION: In this study, we report actual data on the resistance patterns of uropathogens in primary care in Switzerland. Escherichia coli showed low resistance rates to the recommended first-line antibiotics. Resistance to TMP/SMX was significantly lower than reported by ANRESIS, making TMP/SMX a suitable and cheap alternative for the empirical treatment.


Assuntos
Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana , Infecções Urinárias/epidemiologia , Conduta Expectante , Adulto , Idoso , Idoso de 80 Anos ou mais , Bactérias/isolamento & purificação , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Atenção Primária à Saúde/estatística & dados numéricos , Suíça/epidemiologia , Infecções Urinárias/tratamento farmacológico , Adulto Jovem
5.
Acta Paediatr ; 108(12): 2192-2198, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31168848

RESUMO

AIM: Early-onset neonatal sepsis (EOS) may lead to significant morbidity and mortality, yet the recommended antimicrobials have not changed for many years. We aimed to optimise EOS treatment by examining EOS pathogens, resistance rates and resistance risk factors. METHODS: A retrospective, nationwide cohort study analysing 2010-2015 EOS data in Israel. RESULTS: The 21 participating centres constitute 92% of the total birth cohort (around 180 000 live births/year). Of 549 EOS neonates (0.57/1000 live births), 306 (56%) and 243 (44%) were full-term and preterm, respectively (0.35 vs. 2.94 per/1000 live births). Gram-negative pathogens predominated, especially in preterms. Escherichia coli and Streptococcus agalactiae were most common pathogens (0.2 and 0.19 per 1000 live births, respectively). In 277 Gram-negatives, 16%, 14%, 8% and 3% were gentamicin-resistant, extended-spectrum beta-lactamase (ESBL)-positive, gentamicin-resistant and ESBL-positive, and amikacin-resistant, respectively; preterms had higher resistance rates. No risk factors for antimicrobial resistance were identified. Mortality was reported in 21% of Gram-negative EOS versus 7% of Gram-positive EOS [OR 3.4 (95% CI 1.8-6.2), p < 0.01]. CONCLUSION: In this nationwide study, EOS was caused predominantly by Gram-negatives, with high gentamicin resistance and ESBL phenotype rates, without identifiable resistance risk factors. As EOS is life-threatening, modification of empiric therapy for amikacin-based regimens should be considered, mainly in preterms.


Assuntos
Antibacterianos/uso terapêutico , Resistência Microbiana a Medicamentos , Sepse Neonatal/epidemiologia , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Israel/epidemiologia , Sepse Neonatal/tratamento farmacológico , Sepse Neonatal/microbiologia
6.
Infection ; 46(3): 325-331, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29368165

RESUMO

PURPOSE: Escherichia coli urine isolates from patients presenting to the emergency department at a German tertiary care hospital were retrospectively analyzed from January 2015-March 2017 to determine antibiotic resistance patterns and patient risk factors for resistance. METHODS: Uncomplicated urinary tract infection (UTI) was defined as UTI in the otherwise healthy patient without relevant co-morbidities and complications. Patients were assumed to have UTI if diagnosis was made by the attending physician with conclusive dipstick results. For subgroup analysis, only patients with symptoms suggestive for UTI documented in their records were included. RESULTS: 228 patients with a UTI diagnosed by the attending physician with E. coli isolated in urine culture were included. 154/228 patients had documented symptomatic UTI, 57/154 had uncomplicated infection, 76/154 patients had cystitis, and 124/154 were female. Resistance rates of uncomplicated UTI in symptomatic patients were: ciprofloxacin 10.5%, cotrimoxazole 15.8%, amoxicillin/clavulanic acid 5.3%, nitrofurantoin 0% (CLSI MICs). Previous hospitalization in the last 3 months (including patients living in a long-term care facility) was significantly correlated with resistance to ciprofloxacin, cotrimoxazole and amoxicillin/clav. Previous hospitalization was a strong predictor of resistance to ciprofloxacin and cotrimoxazole in multivariate analysis also. Other risk factors correlated with resistance were hematological malignancy (for cotrimoxazole) and renal transplantation (for ciprofloxacin). CONCLUSIONS: Cotrimoxazole is still an alternative for treating uncomplicated cystitis. Previous hospitalization in the last 3 months was a strong predictor of resistance to cotrimoxazole and ciprofloxacin. Other risk factors which might help guide empirical therapy are hematological malignancy and renal transplantation.


Assuntos
Farmacorresistência Bacteriana , Serviço Hospitalar de Emergência/estatística & dados numéricos , Infecções por Escherichia coli/microbiologia , Escherichia coli/efeitos dos fármacos , Infecções Urinárias/microbiologia , Idoso , Feminino , Alemanha , Humanos , Masculino , Estudos Retrospectivos
7.
Antibiotics (Basel) ; 11(12)2022 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-36551465

RESUMO

Little is known about the antimicrobial resistance (AMR) status of uropathogens in Western Africa. We performed a retrospective evaluation of urine cultures collected from the rural Margret Marquart Catholic Hospital, Kpando, Ghana during the time period from October 2019−December 2021. Urine samples from 348 patients (median age 40 years, 52.6% male) were examined. Of these, 125 (35.9%) showed either fungal or bacterial growth, including Escherichia coli in 48 (38.4%), Candida species (spp.) in 29 (23.2%), Klebsiella spp. in 27 (21.6%), Proteus spp. in 12 (9.6%), Citrobacter spp. in 10 (8.0%), Salmonella spp. in 4 (3.2%), Staphylococcus spp. in 3 (2.4%), and Pseudomonas spp. in 2 (1.6%) cases. Two bacterial spp. were detected in 7 samples (5.6%). Antibiotic susceptibility testing showed resistance to a mean 8.6 out of 11 tested antibiotics per patient. Significant predictors (p < 0.05) of bacterial growth were age (OR 1.03), female sex (OR 3.84), and the number of pus cells (OR 1.05) and epithelial cells (OR 1.07) in urine microscopy. We observed an alarmingly high AMR rate among the uropathogens detected, even to reserve antibiotics. A similar resistance profile can be expected in West African patients living in high-income countries. These observations warrant the implementation of restrictive antibiotic protocols, together with the expansion of urine culture testing capacities, improvement of documentation and reporting of AMR rates, and continued research and development of new antibiotic therapies in order to stem the progression of AMR in this West African region.

9.
Artigo em Inglês | MEDLINE | ID: mdl-31247907

RESUMO

Antimicrobial resistance (AMR) is one of the biggest issues facing global public health. In 2017, Italy adopted its first National Action Plan on Antimicrobial Resistance 2017-2020, which works through the synergy between national, regional, and local levels. In the framework of a Regional Action Plan on healthcare-associated infections and AMR prevention, the Sicilian Health Authority of the Sicilian Region, Southern Italy, has implemented a surveillance system of antibiotic consumption in hospitals, in the community, and of resistance rates (RRs) in hospital settings. Data on antibiotic consumption and on antibiotic RRs have been collected from 2015 to 2017 from pharmacies and laboratories of participating hospitals and from community, respectively. Data on antibiotic consumption showed that the most consumed antibiotics in hospitals were fluoroquinolones in 2015, penicillin in 2016, and beta-lactams in 2017. From 2015 to 2017, data on Klebsiella pneumoniae showed significant increasing RRs to all antibiotic classes, except to carbapenems. RRs of third-generation cephalosporins and carbapenems Escherichia coli showed significant decreasing trends. RRs of the other microorganisms did not change significantly during the study period. The results from the present study show that in Sicily, the use of antibiotics and RRs for selected microorganisms are at a high level. Immediate strategies are needed to decrease the inappropriate usage of antibiotics and control the spread of AMR.


Assuntos
Antibacterianos/administração & dosagem , Antibacterianos/farmacologia , Resistência Microbiana a Medicamentos/efeitos dos fármacos , Uso de Medicamentos/estatística & dados numéricos , Carbapenêmicos/administração & dosagem , Carbapenêmicos/farmacologia , Escherichia coli/efeitos dos fármacos , Fluoroquinolonas/administração & dosagem , Fluoroquinolonas/farmacologia , Humanos , Klebsiella pneumoniae/efeitos dos fármacos , Vigilância em Saúde Pública , Sicília
10.
J Med Microbiol ; 67(4): 496-498, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29504930

RESUMO

In recent years, hospitals in southeastern Europe have faced dramatically high rates of antibiotic-resistant Acinetobacter baumannii. We analysed the evolution of resistance among clinical isolates of A. baumannii group obtained from nine tertiary hospitals throughout Greece over 6 years (2010-2015). Identification and antimicrobial susceptibility testing were performed using Vitek 2 or Microscan walkaway automated systems. Between 2010 and 2015, resistance to ampicillin/sulbactam increased from 46.2 to 88.2 % (P=0.021), resistance to gentamicin increased from 69.3 to 86.4 % (P=0.014) and resistance to tobramycin increased from 59.8 to 76.8 % (P=0.011). Imipenem resistance rates were consistently very high, ranging from 90.3 % in 2010 to 94.5 % in 2015 (P=0.198), while meropenem resistance rates increased from 82.6 % in 2010 to 94.8 % in 2015 (P=0.006). Resistance rates to trimethoprim/sulfamethoxazole showed a remarkable decreasing trend, declining from 90.2 % in 2010 to 69.1 % in 2015 (P=0.035). These evolutions render the treatment of A. baumannii infections particularly challenging and underline the need for enhanced infection control measures.


Assuntos
Infecções por Acinetobacter/microbiologia , Acinetobacter baumannii/efeitos dos fármacos , Antibacterianos/farmacologia , Farmacorresistência Bacteriana , Infecções por Acinetobacter/tratamento farmacológico , Acinetobacter baumannii/classificação , Acinetobacter baumannii/genética , Acinetobacter baumannii/isolamento & purificação , Ampicilina/farmacologia , Grécia , Humanos , Imipenem/farmacologia , Testes de Sensibilidade Microbiana , Centros de Atenção Terciária , Tobramicina/farmacologia
11.
Curr Eye Res ; 41(5): 581-9, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-26200173

RESUMO

PURPOSE/AIM: Bacterial infections of the ocular surface are commonly treated empirically with broad spectrum antibiotics. Due to concerns over increasing antibiotic resistance, we evaluated current susceptibility patterns of the ocular bacterial pathogens in Europe. MATERIALS AND METHODS: Non-consecutive ocular isolates of Staphylococcus aureus, coagulase-negative staphylococci (CoNS), Streptococcus pneumoniae, Haemophilus influenzae, and Pseudomonas aeruginosa were collected in 2011 from centers in France, Germany, Italy, Poland, Slovak Republic, Spain, and the United Kingdom. Centers were asked to provide similar numbers of methicillin-susceptible and -resistant staphylococcal isolates. Minimum inhibitory concentrations were determined for fluoroquinolones (besifloxacin, ciprofloxacin, moxifloxacin), aminoglycosides (tobramycin, gentamicin, netilmicin), oxacillin, chloramphenicol and erythromycin. Isolates were categorized as susceptible, intermediate, or resistant according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria. RESULTS: A total of 741 ocular isolates were obtained. Antibiotic resistance rates depended not only on the antibiotic and species, but also varied greatly by the country of origin. Resistance to ciprofloxacin, tobramycin, erythromycin, and to a lesser extent, chloramphenicol, was a concern for all staphylococci. Multidrug resistance was common among methicillin-resistant S. aureus (MRSA) and MRCoNS and isolates of S. pneumoniae, H. influenzae, and P. aeruginosa were frequently non-susceptible to erythromycin, beta-lactams, and ciprofloxacin/tobramycin, respectively. Resistance rates showed substantial differences among the seven countries tested. Fluoroquinolones and aminoglycosides showed differences in antibacterial potency and resilience toward the antibiotic resistance mechanisms. CONCLUSIONS: Methicillin-resistant staphylococcal isolates were frequently non-susceptible to a multitude of other antibiotics, making MRSA and MRCoNS a potentially significant concern. The broad range of resistance rates observed across Europe in this study confirms the importance of considering current local resistance patterns when antibacterial agents are chosen for empiric management of ocular infections.


Assuntos
Aminoglicosídeos/farmacologia , Bactérias/isolamento & purificação , Farmacorresistência Bacteriana Múltipla , Infecções Oculares Bacterianas/tratamento farmacológico , Fluoroquinolonas/farmacologia , Vigilância da População , Fatores de Tempo , Antibacterianos/farmacologia , Bactérias/efeitos dos fármacos , Europa (Continente) , Infecções Oculares Bacterianas/microbiologia , Seguimentos , Humanos , Testes de Sensibilidade Microbiana , Estudos Retrospectivos
12.
Artigo em Inglês | MEDLINE | ID: mdl-26539294

RESUMO

BACKGROUND: The overuse of antimicrobials is one of the main factors responsible for the development and spread of antimicrobial resistance, together with other causes, such as intra- and inter-hospital spread of resistant microorganisms and infection control policies and practices. The objective of the present study is to report the trends of Klebsiella pneumoniae and Acinetobacter baumannii antimicrobial resistance indicators in an Italian intensive care unit (ICU) during a six-year period, from 2008 to 2013. METHODS: Susceptibility data and annual antibiotic consumptions in the ICU were retrospectively obtained from the clinical laboratory and the pharmacy. Trends over time of resistance rates (RRs) and of incidence densities of resistant isolates were determined by linear regression. RESULTS: Isolation density of A. baumannii increased significantly from 2008 (20.4 per 1,000 patient-days) to 2013 (58.1 per 1,000 patient-days) and of K. pneumoniae from 2010 (22.3 per 1,000 patient-days) to 2013 (55.9 per 1,000 patient-days). RRs of third-generation cephalosporins (3GCs)-resistant K. pneumoniae (from 2010: 41.9 %, to 2012: 87.0 %), of carbapenem-resistant K. pneumoniae (from 2008: 0 %, to 2013: 59.2 %), and of carbapenem-resistant A. baumannii (from 2008: 87.5 %, to 2013: 96.6 %) showed significant increasing trends. Carbapenems was the main antibiotic class consumed (24.9 % of the total antimicrobial usage density), followed by 3GCs (21.0 %), fluoroquinolones (20.6 %), aminoglycosides (17.3 %), penicillins (15.1 %) and glycopeptides (1.1 %). Carbapenems consumption decreased from 2008 to 2012 and then increased in 2013. Glycopeptides consumption decreased from 2008 to 2011 and then increased in 2013. Aminoglycosides consumption decreased from 2008 to 2010 and increased from 2012 to 2013. Finally, 3GC, penicillins and fluoroquinolones consumptions decreased from 2012 to 2013. CONCLUSIONS: RRs of carbapenem-resistant A. baumannii and of carbapenem- and 3GC-resistant K. pneumoniae were higher than those for Europe. Our findings highlight the necessity to implement an integrated system for monitoring not only consumption of antibiotics and resistance profiles but also the clonality of alert microorganisms in the ICU for effective infection control.

13.
Artigo em Zh | WPRIM | ID: wpr-861891

RESUMO

The resistance rate of Helicobacter pylori (Hp) to antimicrobial drugs increases year by year, which is the key factor for the decreased Hp eradication rate. Formulating an empirical regimen for Hp eradication based on an understanding of the dynamic epidemiology of antimicrobial resistance of Hp in the region will improve the eradication rate of Hp efficiently. The resistance rates of Hp to antimicrobial drugs are diversified in different geographic regions, population and time. This article reviewed the resistance rates of Hp to seven currently most frequently used antimicrobial drugs.

14.
J Glob Antimicrob Resist ; 2(3): 179-182, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27873726

RESUMO

Multidrug-resistant (MDR) Enterobacteriaceae are an emerging concern for healthcare providers. Infections caused by MDR pathogens are associated with increased costs, length of hospital stay, and morbidity and mortality rates. Carbapenem-resistant Enterobacteriaceae (CRE) continue to increase, and infections with these organisms are observed worldwide not only as hospital-acquired infections but also as community-acquired infections. Increasing antimicrobial resistance dictates the need for continued surveillance studies of common and MDR pathogens. The Tigecycline Evaluation Surveillance Trial (TEST) examined the susceptibility of pathogens isolated in Africa and the Middle East from 2007 to 2012. A total of 4155 Enterobacteriaceae isolates were evaluated to determine the in vitro activity and changes in resistance patterns for tigecycline and comparators. Carbapenem resistance was found in 191 (4.6%) of the isolates tested. Klebsiella pneumoniae was the most common CRE (64.9%), followed by Enterobacter cloacae (14.1%) and Escherichia coli (9.9%). Tigecycline MIC90 values (minimum inhibitory concentration required to inhibit 90% of the isolates) were 2µg/mL against all of these enteric species, with susceptibility rates of 96.8%, 92.6% and 100%, respectively. Tigecycline had in vitro activity against CRE, with a 95.3% susceptibility rate.

15.
Artigo em Zh | WPRIM | ID: wpr-672923

RESUMO

Objective: To determine the prevalence and antimicrobial resistance rates of nosocomial pathogens isolated from cancer patients and hospital environments. Methods: A descriptive cross-sectional study was conducted between December 2010 to May 2013 at Radiation and Isotopes Centre of Khartoum, Sudan. A total of 1 503 samples (505 clinical and 998 environmental) were examined. Isolates were identified, and their antimicrobial susceptibility was determined using standard laboratory procedures. Results: Out of 505 clinical samples, nosocomial pathogens were found as 48.1%. Among hospital environment samples, bacterial contaminants were detected in 29.7%of samples. The main microorganisms recovered from cancer patients were Proteus spp. (23.5%), Escherichia coli (22.2%), Pseudomonas aeruginosa (P. aeruginosa) (21.0%) and Staphylococcus aureus (20.2%). The most frequent isolates from hospital environ-ments were Bacillus spp. (50.0%), Staphylococcus aureus (14.2%) and P. aeruginosa (11.5%). The proportions of resistance among Gram-negative pathogens from cancer patients were high for ampicillin, cefotaxime, ceftazidime and ceftriaxone. Moderate resistance rates were recorded to ciprofloxacin, such as 51.0%for P. aeruginosa, 21.7%for Klebsiella pneumoniae and 55.5%for Escherichia coli. Except Klebsiella, there were no significant differences (P ? 0.05) of resistance rates between Gram-negative isolates from cancer patients to those from the hospital environments. The proportions of extended-spectrum b-lactamase producing isolates from cancer patients were not differ significantly (P=0.763) from those collected from the hospital environments (49.2%;91/185 vs. 47%;32/68). Conclusions: The prevalence of nosocomial infection among cancer patients was high (48.1%) with the increasing of antimicrobial resistance rates. Hospital environments are potential reservoirs for nosocomial infections, which calls for intervention program to reduce environmental transmission of pathogens.

16.
Artigo em Zh | WPRIM | ID: wpr-950851

RESUMO

Objective: To determine the prevalence and antimicrobial resistance rates of nosocomial pathogens isolated from cancer patients and hospital environments. Methods: A descriptive cross-sectional study was conducted between December 2010 to May 2013 at Radiation and Isotopes Centre of Khartoum, Sudan. A total of 1. 503 samples (505 clinical and 998 environmental) were examined. Isolates were identified, and their antimicrobial susceptibility was determined using standard laboratory procedures. Results: Out of 505 clinical samples, nosocomial pathogens were found as 48.1%. Among hospital environment samples, bacterial contaminants were detected in 29.7% of samples. The main microorganisms recovered from cancer patients were Proteus spp. (23.5%), Escherichia coli (22.2%), Pseudomonas aeruginosa (P. aeruginosa) (21.0%) and Staphylococcus aureus (20.2%). The most frequent isolates from hospital environments were Bacillus spp. (50.0%), Staphylococcus aureus (14.2%) and P. aeruginosa (11.5%). The proportions of resistance among Gram-negative pathogens from cancer patients were high for ampicillin, cefotaxime, ceftazidime and ceftriaxone. Moderate resistance rates were recorded to ciprofloxacin, such as 51.0% for P. aeruginosa, 21.7% for Klebsiella pneumoniae and 55.5% for Escherichia coli. Except Klebsiella, there were no significant differences (P ≥ 0.05) of resistance rates between Gram-negative isolates from cancer patients to those from the hospital environments. The proportions of extended-spectrum β-lactamase producing isolates from cancer patients were not differ significantly (P = 0.763) from those collected from the hospital environments (49.2%; 91/185 vs. 47%; 32/68). Conclusions: The prevalence of nosocomial infection among cancer patients was high (48.1%) with the increasing of antimicrobial resistance rates. Hospital environments are potential reservoirs for nosocomial infections, which calls for intervention program to reduce environmental transmission of pathogens.

17.
Artigo em Zh | WPRIM | ID: wpr-485458

RESUMO

Objective To explore the distribution and drug resistance of pathogen in hospitalized tumor patients and to provide reference for the clinical reasonable use of antibiotics and strengthening the hospital infection control. Methods 6 500 clinical speciments were tested in hospitalized tumor patients from January to December,2013.The drug susceptibilities were tested by automated microbiology system or Kirby-Bauer disk dilution method.Drug susceptibility tests were evaluated according to CLSI standard 2012.WHONET5.6 software data were used to analyze the data.The clinical distribution and the resistance results of bacterial were analyzed retrospectively. Results A total of 2 093 strains of pathogens were isolated from 6 500 clinical speciments,among these strains, the gram-negative bacteria accounted for 55.23%,the gram-positive bacteria accounted for 11.08%,and the fungi accounted for 33.68%.Klebsiella pneumoniae,Escherichia coli,Pseudomonas aeruginosa ranked the top three species of pathogens, accounting for 16.63%, 9.60%, and 7.98%, respectively. Staphylococcus aureus, Candidaalbicans ranked the first place of gram-positive bacteria and fungi,respectively.The antibiotic resistance of Escherichia coli was strong in Enterobacteriaceae, and its resistance rates to penicillins,cephalosporins, and quinolones were more than 60%.Of the Staphylococcus,the methicillin-resistant Staphylococcus aureus(MRSA) accounted for 10.00% and the coagulase-negative Staphylococcus (MRCNS)accounted for 87.10%.There was no vancomycin resistant Staphylococcus aureus and coagulase-negative Staphylococcus detected. Enterobacteriaceae strains were found most sensitive to imipenem;gram-positive bacteria were found most sensitive to vancomycin. Conclusion The hospitalized tumor patients are susceptible to pathogens, and the gram-negative bacteria are the predominant isolated pathogen.Etiology inspection and monitoring of antibiotics sensitivity provide experimental basis for clinical infection control and prevention.

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