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1.
Artigo em Chinês | WPRIM | ID: wpr-971136

RESUMO

OBJECTIVE@#To analyze the distribution and drug resistance of pathogens in oral mucositis associated with chemotherapy in hospitalized patients with malignant hematopathy, so as to provide scientific evidences for rational selection of antibiotics and infection prevention and control.@*METHODS@#From July 2020 to June 2022, 167 patients with malignant hematopathy were treated with chemical drugs in the Department of Hematology, Hainan Hospital, and secretions from oral mucosal infected wounds were collected. VITEK2 COMPECT automatic microbial identification system (BioMerieux, France) and bacterial susceptibility card (BioMerieux) were used for bacterial identification and drug susceptibility tests.@*RESULTS@#A total of 352 strains of pathogens were isolated from 167 patients, among which 220 strains of Gram-positive bacteria, 118 strains of Gram-negative bacteria and 14 strains of fungi, accounted for 62.50%, 33.52% and 3.98%, respectively. The Gram-positive bacteria was mainly Staphylococcus and Streptococcus, while Gram-negative bacteria was mainly Klebsiella and Proteus. The resistance of main Gram-positive bacteria to vancomycin, ciprofloxacin and gentamicin was low, and the resistance to penicillin, cefuroxime, ampicillin, cefotaxime, erythromycin and levofloxacin was high. The main Gram-negative bacteria had low resistance to gentamicin, imipenem and penicillin, but high resistance to levofloxacin, cefotaxime, cefuroxime, ampicillin and vancomycin. The clinical data of oral mucositis patients with oral ulcer (severe) and without oral ulcer (mild) were compared, and it was found that there were statistically significant differences in poor oral hygiene, diabetes, sleep duration less than 8 hours per night between two groups (P<0.05).@*CONCLUSION@#Gram-positive bacteria is the main pathogen of oral mucositis in patients with malignant hematopathy after chemotherapy. It is sensitive to glycopeptide antibiotics and aminoglycosides antibiotics. Poor oral hygiene, diabetes and sleep duration less than 8 hours per night are risk factors for oral mucositis with oral ulcer (severe).


Assuntos
Humanos , Vancomicina/uso terapêutico , Cefuroxima , Levofloxacino , Úlceras Orais/tratamento farmacológico , Farmacorresistência Bacteriana , Antibacterianos/efeitos adversos , Ampicilina , Penicilinas , Cefotaxima , Bactérias Gram-Positivas , Bactérias Gram-Negativas , Gentamicinas , Estomatite/tratamento farmacológico
2.
Rev. otorrinolaringol. cir. cabeza cuello ; 82(4): 466-469, dic. 2022. ilus
Artigo em Espanhol | LILACS | ID: biblio-1431937

RESUMO

La mastoiditis enmascarada es una forma poco frecuente dentro de las complicaciones de las otitis medias, ya sean aguda o crónicas. Su principal característica es presentar poca o mínima sintomatología ótica y tener un curso larvado en el tiempo. Este diagnóstico debe ser correctamente sospechado, ya que eventualmente puede generar consecuencias otológicas graves y presentar complicaciones mayores a nivel intra o extratemporal. En este trabajo se presenta el caso clínico de una paciente pediátrica sana, a la cual se diagnostica mastoiditis enmascarada de tres meses de evolución complicada con absceso de Bezold. Se inicia desde el ingreso hospitalario esquema antibiótico bi-asociado y se realiza mastoidectomía simple, evolucionando de forma satisfactoria.


Masked mastoiditis is a rare complication of acute or chronic otitis media. Its main characteristic is to present little or minimal otic symptoms and has a slowly progressive course over time. This diagnosis must be suspected correctly because it can eventually generate serious otological consequences and present major complications at intra or extratemporal levels. We report the clinical case of a healthy pediatric patient, who was diagnosed with masked mastoiditis complicated with a Bezold's abscess. A bi-associated antibiotic scheme was started from admission and a timpanomastoidectomy was performed, with a satisfactory outcome.


Assuntos
Humanos , Feminino , Criança , Otite Média/complicações , Mastoidite/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Clindamicina/uso terapêutico , Tomografia Computadorizada por Raios X/métodos , Cefotaxima/uso terapêutico , Mastoidite/tratamento farmacológico , Antibacterianos/uso terapêutico
3.
Artigo em Inglês | WPRIM | ID: wpr-739013

RESUMO

BACKGROUND: Escherichia coli and Klebsiella pneumoniae clinical isolates producing CTX-M extendedspectrum β-lactamases (ESBLs) were assessed for antimicrobial resistance phenotypes varied by group of enzymes. METHODS: A total of 1,338 blood isolates, including 959 E. coli and 379 K. pneumoniae, were studied. All the strains were collected between January and July 2017 from eight general hospitals in South Korea. The species were identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Antimicrobial susceptibilities were determined by disk diffusion methods and ESBL phenotypes by double-disk synergy tests using disks containing cefotaxime, ceftazidime, cefepime, aztreonam, and clavulanic acid (CA). The genes for β-lactamases were identified by PCR and sequencing. RESULTS: Of total microbes, 31.6% (303/959) E. coli and 24.0% (91/379) K. pneumoniae were resistant to cefotaxime and 28.1% (269/959) E. coli and 20.1% (76/379) K. pneumoniae were CTX-M-type ESBL producers. Among the detected CTX-M ESBLs, 58.0% (156/269) in E. coli and 86.8% (66/76) in K. pneumoniae belonged to group 1, 46.8% (126/269) in E. coli and 14.5% (11/76) in K. pneumoniae were group 9. Ten E. coli and one K. pneumoniae isolates co-produced both groups of CTX-M ESBL. The group 1 CTX-M producers had a higher level of resistance to cefotaxime, ceftazidime, cefepime, and aztreonam and exhibited stronger synergistic activities when combined with CA compared to group 9. CONCLUSION: ESBL phenotypes differ by CTX-M ESBL group and phenotype testing with drugs including 4th generation cephalosporins and monobactams is critical for screening CTX-M-producers with better sensitivity.


Assuntos
Aztreonam , Cefotaxima , Ceftazidima , Cefalosporinas , Ácido Clavulânico , Difusão , Escherichia coli , Hospitais Gerais , Klebsiella pneumoniae , Coreia (Geográfico) , Programas de Rastreamento , Espectrometria de Massas , Monobactamas , Fenótipo , Pneumonia , Reação em Cadeia da Polimerase
4.
Artigo em Coreano | WPRIM | ID: wpr-741875

RESUMO

PURPOSE: We investigated the distribution and antimicrobial resistance of pneumococcal isolates from hospitalized children at Asan Medical Center for recent 4 years, and aimed to recommend proper choice of empirical antibiotics for pneumococcal infection. METHODS: From March 2014 to May 2018, children admitted to Asan Medical Center Childrens' Hospital with pneumococcal infection were subjected for evaluation of minimal inhibitory concentration (MIC) for β-lactams and macrolide antibiotics. Patient's age, underlying disease, gender were retrospectively collected. Using Monte Carlo simulation model and MIC from our study, we predicted the rate of treatment success with amoxicillin treatment. RESULTS: Sixty-three isolates were analyzed including 20.6% (n=13) of invasive isolates, and 79.4% (n=50) of non-invasive isolates; median age were 3.3 years old, and 87.3% of the pneumococcal infections occurred to children with underlying disease. Overall susceptibility rate was 49.2%, 68.2%, and 74.6% for amoxicillin, parenteral penicillin, and cefotaxime respectively. 23.8% and 9.5% of the isolates showed high resistance for amoxicillin, and cefotaxime. Only 4.8% (n=3) were susceptible to erythromycin. Monte Carlo simulation model revealed the likelihood of treatment success was 46.0% at the dosage of 90 mg/kg/day of amoxicillin. CONCLUSIONS: Recent pneumococcal isolates from pediatric patients with underlying disease revealed high resistance for amoxicillin and cefotaxime, and high resistance for erythromycin. Prudent choice of antibiotics based on the local data of resistance cannot be emphasized enough, especially in high risk patients with underlying disease, and timely vaccination should be implemented for prevention of the spread of resistant strains.


Assuntos
Criança , Humanos , Amoxicilina , Antibacterianos , Cefotaxima , Criança Hospitalizada , Eritromicina , Penicilinas , Infecções Pneumocócicas , Estudos Retrospectivos , Streptococcus pneumoniae , Streptococcus , Vacinação
5.
Artigo em Inglês | WPRIM | ID: wpr-760895

RESUMO

Eikenella corrodens rarely causes invasive head and neck infections in immunocompetent children. We report a case of epidural abscess caused by E. corrodens in a previously healthy 13-year-old boy who presented with fever, headache, and vomiting. On physical examination upon admission, there was no neck stiffness, but discharge from the right ear was observed. Brain magnetic resonance imaging (MRI) revealed approximately 4.5-cm-sized epidural empyema on the right temporal lobe as well as bilateral ethmoid and sphenoid sinusitis, right mastoiditis, and right otitis media. During treatment with vancomycin and cefotaxime, purulent ear discharge aggravated, and on follow-up brain MRI, the empyema size increased to 5.6×3.4 cm with interval development of an abscess at the right sphenoid sinus. Burr hole trephination was performed, and foul-smelling pus was aspirated from the epidural abscess near the right temporal lobe. Pus culture yielded E. corrodens. Endoscopic sphenoidotomy was also performed with massive pus drainage, and the same organism was grown. The patient was treated with intravenous cefotaxime for 3 weeks and recovered well with no other complications. Therefore, E. corrodens can cause serious complications in children with untreated sinusitis.


Assuntos
Adolescente , Criança , Humanos , Masculino , Abscesso , Encéfalo , Cefotaxima , Drenagem , Orelha , Eikenella corrodens , Eikenella , Empiema , Abscesso Epidural , Febre , Seguimentos , Cabeça , Cefaleia , Imageamento por Ressonância Magnética , Processo Mastoide , Mastoidite , Pescoço , Otite Média , Exame Físico , Sinusite , Seio Esfenoidal , Sinusite Esfenoidal , Supuração , Lobo Temporal , Trepanação , Vancomicina , Vômito
6.
Artigo em Inglês | WPRIM | ID: wpr-765057

RESUMO

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.


Assuntos
Amicacina , Antibacterianos , Cefotaxima , Atenção à Saúde , Escherichia coli , Escherichia , Imipenem , Incidência , Coreia (Geográfico) , Atenção Terciária à Saúde , Infecções Urinárias , Sistema Urinário
7.
Artigo em Inglês | WPRIM | ID: wpr-762441

RESUMO

BACKGROUND: Several factors contribute to differences in Streptococcus pneumoniae serotype distribution. We investigated the serotype distribution and antimicrobial resistance of S. pneumoniae isolated between 2014 and 2016 in Korea. METHODS: We collected a total of 1,855 S. pneumoniae isolates from 44 hospitals between May 2014 and May 2016, and analyzed the serotypes by sequential multiplex PCR. We investigated the distribution of each serotype by patient age, source of the clinical specimen, and antimicrobial resistance pattern. RESULTS: The most common serotypes were 11A (10.1%), followed by 19A (8.8%), 3 (8.5%), 34 (8.1%), 23A (7.3%), and 35B (6.2%). The major invasive serotypes were 3 (12.6%), 19A (7.8%), 34 (7.8%), 10A (6.8%), and 11A (6.8%). Serotypes 10A, 15B, 19A, and 12F were more common in patients ≤5 years old, while serotype 3 was more common in patients ≥65 years old compared with the other age groups. The coverage rates of pneumococcal conjugate vaccine (PCV)7, PCV10, PCV13, and pneumococcal polysaccharide vaccine 23 were 11.8%, 12.12%, 33.3%, and 53.6%, respectively. Of the 1,855 isolates, 857 (46.2%) were multi-drug resistant (MDR), with serotypes 11A and 19A predominant among the MDR strains. The resistance rates against penicillin, cefotaxime, and levofloxacin were 22.8%, 12.5%, and 9.4%, respectively. CONCLUSIONS: There were significant changes in the major S. pneumoniae serotypes in the community. Non-PCV13 serotypes increased in patients ≤5 years old following the introduction of national immunization programs with the 10- and 13-polyvalent vaccines.


Assuntos
Humanos , Cefotaxima , Programas de Imunização , Coreia (Geográfico) , Levofloxacino , Reação em Cadeia da Polimerase Multiplex , Penicilinas , Vacinas Pneumocócicas , Pneumonia , Sorogrupo , Streptococcus pneumoniae , Streptococcus , Vacinas
8.
J. vet. sci ; J. vet. sci;: 58-62, 2019.
Artigo em Inglês | WPRIM | ID: wpr-758883

RESUMO

Anthrax, caused by Bacillus anthracis, is a non-contagious infectious disease that affects a wide range of animal species (primarily ruminants) including humans. Due to the often-fatal outcome in humans, quick administration of definitely effective antimicrobials is crucial either as prophylaxis or as a clinical case therapy. In this study, 110 B. anthracis strains, temporally, geographically, and genetically different, isolated during anthrax outbreaks in Italy from 1984 to 2017, were screened using a broth microdilution method to determine their susceptibility to 16 clinically relevant antimicrobial agents. The strains were isolated from various matrices (human, animal, and environmental samples) and were representative of thirty distinct genotypes previously identified by 15-loci multiple-locus variable-number of tandem repeats analysis. The antimicrobials tested were gentamicin, ceftriaxone, streptomycin, penicillin G, clindamycin, chloramphenicol, vancomycin, linezolid, cefotaxime, tetracycline, erythromycin, rifampin, amoxicillin, ciprofloxacin, doxycycline, and trimethoprim. All isolates were susceptible to most of the tested antimicrobials, with the exception of trimethoprim for which all of them showed high minimal inhibitory concentration values. An intermediate level of susceptibility was recorded for ceftriaxone and cefotaxime. Although the Centers for Disease Control and Prevention recommend the use of doxycycline, ciprofloxacin, penicillin G, and amoxicillin for treatment of human cases and for post-exposure prophylaxis to anthrax spores, this study shows a high degree of in vitro susceptibility of B. anthracis to many other antimicrobials, suggesting the possibility of an alternative choice for prophylaxis and therapy.


Assuntos
Animais , Humanos , Amoxicilina , Antraz , Anti-Infecciosos , Bacillus anthracis , Bacillus , Cefotaxima , Ceftriaxona , Cloranfenicol , Ciprofloxacina , Clindamicina , Doenças Transmissíveis , Surtos de Doenças , Doxiciclina , Eritromicina , Genótipo , Gentamicinas , Técnicas In Vitro , Itália , Linezolida , Métodos , Testes de Sensibilidade Microbiana , Penicilina G , Profilaxia Pós-Exposição , Rifampina , Esporos , Estreptomicina , Sequências de Repetição em Tandem , Tetraciclina , Trimetoprima , Vancomicina
10.
Artigo em Inglês | WPRIM | ID: wpr-717230

RESUMO

We describe a cutaneous abscess caused by Nocardia abscessus in a previously healthy woman. A 74-year-old woman presented with recurrent bullae on her left forearm that developed 1 week prior and was initially suspected to be a cutaneous infection with Mycobacteria or Tinea corporis. Histopathologically, the skin lesion formed an abscess. A smear revealed a few branched Gram-positive filamentous microorganisms that formed a creamy white colony on a blood agar plate after incubation for 3 days. The colony tested negative on acid-fast bacilli (AFB) staining, but was positive on modified AFB staining. The isolate was confirmed to be N. abscessus by 16S rRNA sequencing analysis. The isolate was susceptible to trimethoprim-sulfamethoxazole, amikacin, cefotaxime and erythromycin but resistant to penicillin. The patient was treated with clarithromycin but subsequently lost to follow-up. To the best of our knowledge, this is the first report of a human cutaneous infection with N. abscessus in Korea.


Assuntos
Idoso , Feminino , Humanos , Abscesso , Ágar , Amicacina , Cefotaxima , Claritromicina , Eritromicina , Antebraço , Coreia (Geográfico) , Perda de Seguimento , Nocardia , Penicilinas , Pele , Tinha , Combinação Trimetoprima e Sulfametoxazol
11.
Artigo em Inglês | WPRIM | ID: wpr-741357

RESUMO

We report the case of a 12-year-old girl who had mild encephalopathy with a reversible splenial lesion (MERS) associated with acutepyelonephritis caused by Escherichia coli. The patient was admitted with a high fever, and she was diagnosed with acute pyelonephritis based on pyuria and the results of urine culture, which detected cefotaxime-sensitive E. coli. Although intravenous cefotaxime and tobramycin were administered, her fever persisted and her C-reactive protein level increased to 307 mg/L. On day 3 of admission, she demonstrated abnormal neuropsychiatric symptoms, such as delirium, ataxia, and word salad. Magnetic resonance imaging (MRI) of the brain performed on day 4 showed marked hyperintensities in the bilateral corpus callosum and deep white matter on diffusion-weighted images, with corresponding diffusion restriction on apparent diffusion coefficient mapping. No abnormalities or pathogens were detected in the cerebrospinal fluid; however, lipopolysaccharides (LPS, endotoxin) were detected in plasma (41.6 pg/mL), associated with acute neurological deterioration. Her clinical condition gradually improved, and no neurological abnormalities were observed on day 6. Follow-up brain MRI performed 2 weeks later showed near-disappearance of the previously noted hyperintense lesions. In this patient, we first proved endotoxemia in a setting of MERS. The release of LPS following antibiotic administration might be related to the development of MERS in this patient. The possibility of MERS should be considered in patients who present with acute pyelonephritis and demonstrate delirious behavior.


Assuntos
Criança , Feminino , Humanos , Ataxia , Encéfalo , Encefalopatias , Proteína C-Reativa , Cefotaxima , Líquido Cefalorraquidiano , Corpo Caloso , Delírio , Difusão , Endotoxemia , Escherichia coli , Febre , Seguimentos , Lipopolissacarídeos , Imageamento por Ressonância Magnética , Plasma , Pielonefrite , Piúria , Tobramicina , Substância Branca
12.
Artigo em Inglês | WPRIM | ID: wpr-741760

RESUMO

OBJECTIVES: Antimicrobial resistant extended-spectrum-β-lactamase-producing Enterobacteriaceae (ESBL-PE) have been shown to be present in healthy communities. This study examined healthy children from the rural Andean village of Llano del Hato, Mérida, Venezuela, who have had little or no antibiotic exposure to determine the prevalence of fecal carriage of ESBL-producing Escherichia coli (ESBL-EC). METHODS: A total of 78 fecal samples were collected in healthy children aged from 1 to 5 years. ESBL-EC were selected in MacConkey agar plates with cefotaxime and further confirmed by the VITEK 2 system. ESBL were phenotypically detected and presence of bla genes and their variants were confirmed by molecular assays. Determination of phylogenetic groups was performed by PCR amplification. Risk factors associated with fecal carriage of ESBL-EC-positive isolates were analyzed using standard statistical methods. RESULTS: Of the 78 children studied, 27 (34.6%) carried ESBL-EC. All strains harbored the bla(CTX-M-15) allele. Of these, 8 were co-producers of bla(TEM-1), bla(TEM-5), bla(SHV-5) or bla(SHV-12). Co-resistance to aminoglycosides and/or fluoroquinolones was observed in 9 strains. 51.9% of ESBL-EC isolates were classified within phylogroup A. A significant, positive correlation was found between age (≥2.5 – ≤5 years), food consumption patterns and ESBL-EC fecal carriage. CONCLUSION: This is the first study describing the high prevalence of fecal carriage of ESBL-EC expressing CTX-M-15- among very young, healthy children from a rural Andean village in Venezuela with scarce antibiotic exposure, underlining the importance of this population as a reservoir.


Assuntos
Criança , Humanos , Ágar , Alelos , Aminoglicosídeos , Cefotaxima , Enterobacteriaceae , Escherichia coli , Escherichia , Fluoroquinolonas , Reação em Cadeia da Polimerase , Prevalência , Fatores de Risco , Venezuela
13.
Artigo em Inglês | WPRIM | ID: wpr-717794

RESUMO

OBJECTIVES: Uropathogenic Escherichia coli (UPEC) are the major cause of urinary tract infections (UTIs). Here, we determined whether sensitivity to antibiotics was related to the prevalence of iron scavenging genes, or to biofilm and hemolysis formation. METHODS: A total of 110 UPEC and 30 E coli isolates were collected from the urine of UTI patients and feces of healthy individuals without UTI, respectively. The presence of iron receptor genes and phenotypic properties were evaluated by polymerase chain reaction and phenotypic methods, respectively. Susceptibility to routine antibiotics was evaluated using the disc diffusion method. RESULTS: The prevalence of iron scavenging genes ranged from 21.8% (ireA) to 84.5% (chuA) in the UPEC. Resistance to ceftazidime and cefotaxime was significantly correlated with the presence of fyuA and iutA iron genes. Biofilm production was significantly associated with the prevalence of fyuA and hma iron genes. A higher degree of antibiotic resistance was exhibited by isolates that produced biofilms than by their non-biofilm producing counterparts. CONCLUSION: Our study clearly indicates that biofilm production is associated with antibiotic resistance, and that iron receptors and hemolysin production also contribute to reduced antibiotic sensitivity. These results further our understanding of the role that these virulence factors play during UPEC pathogenesis, which in turn may be valuable for the development of novel treatment strategies against UTIs.


Assuntos
Humanos , Antibacterianos , Biofilmes , Cefotaxima , Ceftazidima , Difusão , Resistência Microbiana a Medicamentos , Escherichia coli , Escherichia , Fezes , Hemólise , Irã (Geográfico) , Ferro , Métodos , Reação em Cadeia da Polimerase , Prevalência , Infecções Urinárias , Sistema Urinário , Escherichia coli Uropatogênica , Fatores de Virulência , Virulência
14.
Kosin Medical Journal ; : 159-170, 2018.
Artigo em Inglês | WPRIM | ID: wpr-718470

RESUMO

OBJECTIVES: The purpose of this study was to compare antibiotic resistance patterns between first urinary tract infection (UTI) and recurrent UTI groups and to obtain information regarding empirical antibiotic selection for treating recurrent UTI. METHODS: We retrospectively reviewed 148 children treated for UTIs from January 2009 to June 2016. The patients were divided into two groups: first UTI (N = 148) and recurrent UTI (17 patients and 20 episodes). RESULTS: In both groups, Escherichia coli was the most frequent causative organism, accounting for 89.9% and 75.0% in the first and recurrent UTI groups, respectively. When E. coli or Klebsiella pneumoniae was the causative organism, extended-spectrum β-lactamase (ESBL)-producing organisms were more frequent in the recurrent UTI group (17.6%) than in the first UTI group (14.0%); however, this difference was not statistically significant (P = 0.684). Cefotaxime was the most frequently used first-line empirical antibiotic in both groups. In the first UTI and recurrent UTI groups, 7.4% and 15.0% of patients were treated with intravenous antibiotics as definitive therapy, respectively (P = 0.250). Fifteen out of 17 patients having a second UTI had different causative organisms or antibiotic susceptibility patterns compared to their previous episode. CONCLUSIONS: Escherichia coli was the most frequent causative organism in the recurrent UTI group. There were no differences in the proportion of ESBL-producing organisms between the first UTI and recurrent UTI groups. Therefore, when a UTI recurs in children, the antibiotics effective on the most common causative organism might be administered as empirical antibiotics.


Assuntos
Criança , Humanos , Antibacterianos , Cefotaxima , Resistência Microbiana a Medicamentos , Escherichia coli , Klebsiella pneumoniae , Recidiva , Estudos Retrospectivos , Infecções Urinárias , Sistema Urinário
15.
Artigo em Inglês | WPRIM | ID: wpr-718596

RESUMO

OBJECTIVES: The purpose of this study was to determine the presence of IMP and OXA genes in clinical strains of Pseudomonas aeruginosa (P. aeruginosa) that are carriers of the ampC gene. METHODS: In this study, 105 clinical isolates of P. aeruginosa were collected. Antibiotic resistance patterns were determined using the disk diffusion method. The strains carrying AmpC enzymes were characterized by a combination disk method. Multiplex-PCR was used to identify resistance and virulence genes, chi-square test was used to determine the relationship between variables. RESULTS: Among 105 isolates of P. aeruginosa, the highest antibiotic resistance was to cefotaxime and aztreonam, and the least resistance was to colictin and ceftazidime. There were 49 isolates (46.66%) that showed an AmpC phenotype. In addition, the frequencies of the resistance genes were; OXA48 gene 85.2%, OXA199, 139 3.8%, OXA23 3.8%, OXA2 66.6%, OXA10 3.8%, OXA51 85.2% and OXA58 3.8%. The IMP27 gene was detected in 9 isolates (8.57%) and the IMP3.34 was detected in 11 isolates (10.47%). Other genes detected included; lasR (17.1%), lasB (18%) and lasA (26.6%). There was a significant relationship between virulence factors and the OX and IMP genes (p ≤ 0.05). CONCLUSION: The relationship between antibiotic resistance and virulence factors observed in this study could play an important role in outbreaks associated with P. aeruginosa infections.


Assuntos
Aztreonam , beta-Lactamases , Cefotaxima , Ceftazidima , Difusão , Surtos de Doenças , Resistência Microbiana a Medicamentos , Métodos , Fenótipo , Pseudomonas aeruginosa , Fatores de Virulência , Virulência
16.
Artigo em Inglês | WPRIM | ID: wpr-715910

RESUMO

BACKGROUND: From January 2014 to December 2015, 69 clones of Enterobacter cloacae showing multidrug resistance to six classes of antimicrobial agents were collected from two medical centers in Korea. METHODS: Minimum inhibitory concentrations were determined using the E-test method, and 17 genes were detected using polymerase chain reaction (PCR). The epidemiological relatedness of the strains was identified using repetitive element sequence-based PCR and multilocus sequence typing. RESULTS: The 69 E. cloacae clones produced extended spectrum β lactamase (ESBL) and AmpC and showed multidrug resistance to cefotaxime, ceftazidime, and aztreonam. We identified the following sequence types: ST56 of type VI for ESBL SHV (N=12, 17.4%); ST53, ST114, ST113, and ST550 of types I, IV, VI, and VII, respectively, for CTX-M (N=11, 15.9%); and ST668 of type III for the carbapenemase NDM gene (N=1, 1.5%). The AmpC DHA gene (N=2, 2.89%) was confirmed as ST134, although its type was not identified, whereas EBC (MIR/ACT; N=18, 26.1%) was identified as ST53, ST24, ST41, ST114, ST442, ST446, ST484, and ST550 of types V, I, III, IV, VII, and VI, respectively. The formed subclasses were bla CTX-M-3 and bla CTX-M-22 by CTX-M-1, bla CTX-M-9 and bla CTX-M-125 by CTX-M-9, bla DHA-1 by DHA, and bla MIR-7 and bla ACT-15,17,18,25,27,28 by EBC (MIR/ACT). CONCLUSIONS: There were no epidemiological relationships between the gene products and the occurrence of resistance among the strains.


Assuntos
Anti-Infecciosos , Aztreonam , Cefotaxima , Ceftazidima , Cloaca , Células Clonais , Resistência a Múltiplos Medicamentos , Enterobacter cloacae , Enterobacter , Coreia (Geográfico) , Métodos , Testes de Sensibilidade Microbiana , Tipagem de Sequências Multilocus , Reação em Cadeia da Polimerase
17.
Artigo em Inglês | WPRIM | ID: wpr-714632

RESUMO

BACKGROUND/AIMS: Klebsiella pneumoniae is second most common organism of gram-negative bacteremia in Korea and one of the most common cause of urinary tract infection, and intra-abdominal infection. METHODS: We compared clinical and microbiological characteristics about K. pneumoniae bacteremia in a tertiary hospital between 10 years. Group A is who had K. pneumoniae bacteremia at least one time from January 2004 to December 2005. Group B is from January 2012 to December 2013. We also analyzed antibiotic resistance, clinical manifestation of the K. pneumoniae bacteremia divided into community-acquired infections, healthcare associated infections, and nosocomial infections. RESULTS: The resistance for ampicillin, aztreonam, cefazolin, and cefotaxime significantly increased compared to 10 years ago. Extended spectrum β-lactamase positivity surged from 4.3% to 19.6%. Ten years ago, 1st, 2nd cephalosporin, and aminoglycoside were used more as empirical antibiotics. But these days, empirical antibiotics were broad spectrum such as 3rd and 4th cephalosporin. In treatment outcome, acute kidney injury decreased from 47.5% to 28.7%, and mortality decreased from 48.9% to 33.2%. In community-acquired infections, there was similar in antimicrobial resistance and mortality. In healthcare-associated and nosocomial infections, there was significantly increasing in antibiotic resistance, decreasing in mortality, and acute kidney injury. CONCLUSIONS: In community-acquired infections, broader antibiotics were more used than 10 years ago despite of similar antimicrobial resistance. When K. pneumoniae bacteremia is suspected, we recommend to use the narrow spectrum antibiotics as initial therapy if there are no healthcare-associated risk factors, because the antibiotic resistance is similar to 10 years ago in community-acquired infections.


Assuntos
Injúria Renal Aguda , Ampicilina , Antibacterianos , Aztreonam , Bacteriemia , Cefazolina , Cefotaxima , Infecções Comunitárias Adquiridas , Infecção Hospitalar , Resistência a Medicamentos , Resistência Microbiana a Medicamentos , Infecções Intra-Abdominais , Klebsiella pneumoniae , Klebsiella , Coreia (Geográfico) , Mortalidade , Pneumonia , Fatores de Risco , Centros de Atenção Terciária , Resultado do Tratamento , Infecções Urinárias
18.
Braz. J. Pharm. Sci. (Online) ; 54(3): e17565, 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-974411

RESUMO

The aim of this work is to evaluate simple, sensitive, effective and validated procedures for the determination of cefotaxime, cefoperazone, ceftazidime and cefadroxil. In this study, the methods based on the ability of the cited drugs to reduce Ag+ ions to silver nanoparticles (Ag-NPs) in the presence of Polyvinyl Pyrrolidone (PVP) as a stabilizing agent producing very intense surface plasmon resonance peak of Ag-NPs (λmax. = 410-430 nm). The plasmon absorbance of the Ag-NPs allows the quantitative spectrophotometric determination of the cited drugs. The calibration curves are linear with concentration ranges of 0.4-3.2, 1-8, 0.5-4.0 and 1.5-9.0 µg/mL for cefotaxime, cefoperazone, ceftazidime and cefadroxil, respectively. Apparent molar absorptivity, detection and quantitative limits are calculated. Applications of the proposed methods to representative pharmaceutical formulations are successfully presented. The extracellular synthesis of nanoparticles is fast, and the method doesn't require various elaborate treatments and tedious extraction procedures.


Assuntos
Cefadroxila/análise , Cefoperazona/análise , Cefotaxima/análise , Ceftazidima/análise , Nanopartículas Metálicas/estatística & dados numéricos , Ressonância de Plasmônio de Superfície/métodos , Estudo de Validação
19.
Artigo em Coreano | WPRIM | ID: wpr-201472

RESUMO

Recurrent aphthous stomatitis (RAS) is a common oral mucosal disorder for which no curative treatment is available. We previously reported that decreased Streptococcus salivarius and increased Acinetobacter johnsonii on the oral mucosa are associated with RAS risk. The purpose of this study was to identify antibiotics that selectively inhibit A. johnsonii but minimally inhibit oral mucosal commensals. S. salivarius KCTC 5512, S. salivarius KCTC 3960, A. johnsonii KCTC 12405, Rothia mucilaginosa KCTC 19862, and Veillonella dispar KCOM 1864 were subjected to antibiotic susceptibility test using amoxicillin, cefotaxime, gentamicin, clindamycin, and metronidazole in liquid culture. The minimal inhibitory concentration (MIC) was defined as the concentration that inhibits 90% of growth. Only gentamicin presented a higher MIC for A. johnsonii than MICs for S. salivarius and several oral mucosal commensals. Interestingly, the growth of S. salivarius increased 10~200% in the presence of sub-MIC concentrations of gentamicin, which was independent of development of resistance to gentamicin. In conclusion, gentamicin may be useful to restore RAS-associated imbalance in oral microbiota by selectively inhibiting the growth of A. johnsonii but enhancing the growth of S. salivarius.


Assuntos
Acinetobacter , Amoxicilina , Antibacterianos , Cefotaxima , Clindamicina , Gentamicinas , Programas de Rastreamento , Metronidazol , Microbiota , Mucosa Bucal , Estomatite Aftosa , Streptococcus , Veillonella
20.
Artigo em Inglês | WPRIM | ID: wpr-200240

RESUMO

This study investigated the serotype distribution and antimicrobial resistance of 3,820 nasopharyngeal Streptococcus pneumoniae isolates from infants and children who presented with respiratory symptoms at Seoul National University Children's Hospital from July 2010 to June 2015 after the introduction of the extended-valency pneumococcal conjugate vaccines (PCVs). Serotypes and antimicrobial susceptibility were determined using the Quellung reaction and E-test, respectively. S. pneumoniae was isolated from 397 (10.4%) specimens. The most common serotypes were 19A (14.0%), 23A (12.8%), 15B/C (10.7%), 11A (10.1%), 6C (7.8%), and 6A (6.3%) among the typeable pneumococci (n = 335). The PCV serotype proportions significantly decreased (59.1% in 2010/11 to 17.0% in 2014/15, P < 0.001), whereas the non-PCV serotype proportions significantly increased (40.9% in 2010/11 to 83.0% in 2014/15, P < 0.001). The non-susceptibility rates for penicillin (oral), penicillin (parenteral, non-meningitis), cefotaxime, and erythromycin were 97.8%, 22.8%, 27.7%, and 95.5%, respectively. The proportions of PCV serotypes responsible for non-susceptibility to penicillin (parenteral, non-meningitis) and multidrug resistance significantly decreased (80.8% to 21.1%, P < 0.001 and 64.3% to 12.3%, P < 0.001, respectively), whereas the non-PCV serotype proportions significantly increased (19.2% to 78.9%, P < 0.001 and 35.7% to 87.7%, P < 0.001, respectively). Serotypes 23A and 15B/C demonstrated significant proportional increase among the antibiotics resistant strains. Thus, the PCV serotype proportions decreased and the non-PCV serotype proportions increased among nasopharyngeal carriage pneumococci after the introduction of extended-valency PCVs in Korea. Antimicrobial non-susceptibility rates for penicillin and erythromycin remain high despite the decrease in the proportion of PCV serotypes responsible for antimicrobial resistance over time.


Assuntos
Criança , Humanos , Lactente , Antibacterianos , Cefotaxima , Resistência a Múltiplos Medicamentos , Eritromicina , Coreia (Geográfico) , Penicilinas , Pneumonia , Seul , Sorogrupo , Streptococcus pneumoniae , Streptococcus , Vacinas Conjugadas
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