Assuntos
Antibacterianos/uso terapêutico , Proteínas de Bactérias/genética , Carbapenêmicos/uso terapêutico , Infecções por Klebsiella/epidemiologia , Klebsiella pneumoniae/genética , beta-Lactamases/genética , Idoso , Idoso de 80 Anos ou mais , Surtos de Doenças , Humanos , Infecções por Klebsiella/tratamento farmacológico , Infecções por Klebsiella/transmissão , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/isolamento & purificação , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Nova ZelândiaRESUMO
AIM: The aim of this study was to provide baseline information on the molecular epidemiology and the antimicrobial susceptibility of Clostridium difficile (C. difficile) clinical isolates from patients throughout New Zealand. METHODS: Faecal specimens that were C. difficile-toxin positive by EIA assay were cultured for C. difficile. Antimicrobial susceptibility testing was carried out using the agar dilution minimum inhibitory concentration method. The following antibiotics were tested: penicillin, piperacillin/tazobactam, vancomycin, ciprofloxacin, moxifloxacin, clindamycin, clarithromycin, meropenem and metronidazole. Molecular typing by PCR-ribotyping was performed on all isolates. RESULTS: C. difficile was isolated from 108 of 159 submitted faecal specimens. After excluding the repeats, there were 101 isolates from 97 patients. Most isolates were fully susceptible to the range of antibiotics tested. Thirty-two PCR-ribotypes were identified among the 101 isolates. The most common ribotypes were 014 (18 isolates), 002 (11) and 005 (10). No PCR-ribotype 027 isolates were identified, but one isolate of another hypervirulent strain, PCR-ribotype 078, was identified. CONCLUSION: There is a wide range of C. difficile PCR-ribotypes circulating in New Zealand and antimicrobial resistance is uncommon. Ongoing surveillance for hypervirulent strains of C. difficile is essential to prevent the dissemination of these strains within New Zealand hospitals.
Assuntos
Antibacterianos/uso terapêutico , Clostridioides difficile/efeitos dos fármacos , Clostridioides difficile/genética , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Enterocolite Pseudomembranosa/tratamento farmacológico , Enterocolite Pseudomembranosa/microbiologia , Testes de Sensibilidade Microbiana , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecção Hospitalar/epidemiologia , Enterocolite Pseudomembranosa/epidemiologia , Fezes/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Reação em Cadeia da Polimerase , Vigilância da População , Ribotipagem , Virulência/efeitos dos fármacos , Virulência/genéticaRESUMO
AIM: To estimate the prevalence of antimicrobial resistance among Neisseria gonorrhoeae, and to determine whether the increase in ciprofloxacin resistance observed in Auckland in 2001 had occurred in other parts of the country. METHODS: The antimicrobial susceptibility of N. gonorrhoeae (isolated in New Zealand over a 4-month period between April and August 2002) was tested at either LabPlus, Auckland District Health Board, or at ESR, using the same agar dilution method. RESULTS: The prevalence of resistance to the antimicrobials tested was: ceftriaxone, 0%; ciprofloxacin, 6.8%; penicillin, 9.0%; spectinomycin, 0%; and tetracycline, 27.8%. There were few statistically significant geographical differences in resistance within New Zealand. Gonococcal infections acquired in Asia were more likely to be ciprofloxacin and penicillin resistant than infections acquired in New Zealand. CONCLUSIONS: Ciprofloxacin resistance among N. gonorrhoeae in New Zealand has reached a level where this antibiotic is no longer the most appropriate first-line treatment. In fact, ceftriaxone should now be considered the most reliable option for the treatment and control of gonorrhoea in New Zealand, particularly in the Northland/Auckland region.