Antibiotic resistance pattern among biofilm producing and non producing Proteus strains isolated from hospitalized patients; matter of hospital hygiene and antimicrobial stewardship.

A retrospective study on antimicrobial susceptibility and biofilm production were carried out for eighty eight strains of Proteus strains isolated from UTI and other hospital samples during April 2011-April 2012. The antibiotic susceptibility was carried out by Kirby-Bauer disk diffusion and MIC by E-test. Biofilm production was measured by microtiter method and confirmed by Scanning electron microscopy. Plasmids from biofilm producing isolates were detected by alkaline lysis technique. From 88 patients infected by proteus species, 58% were female and 42% were mail. The most frequent age range was 20-29 (77.39%) and the least were 60-69 years old (3.4%) (p = 0.05). Eighty one isolates were identified as P. mirabilis while, 7 identified as P. vulgaris. 67.04% [n = 59] of the isolates showed MIC range (16-32 +/- 0.05 microg mL(-1)) to ceftriaxone, 46.59% [n = 41] exhibited least MIC range to chloramphenicol (8-64 +/- 0.08 microg mL(-1)). 31% [n = 28] of the isolates also exhibited MIC range 1-4 microg mL(-1) to ciprofloxacin. 17% [n = 15] of the isolates exhibited strong biofilm while, 6% [n = 6] did not show any biofilm (p < or = 0.05). Plasmid isolation from biofilm producing isolates revealed that stains number 19, 24 and 87' that produced strong biofilm carried similar high M. Wt. plasmid. From above results it can be concluded that the majority of Proteus isolated from UTI patients were belong to P. mirabilis. Ciprofloxacin was the most effective antibiotic for treatment of the infected patients. Limited number of the isolates could produce strong biofilm that were bearing plasmids. Majority of the biofilm producing isolates were also resistance at least to 4 antibiotics routinely prescribed in our hospital.

Ulcer infection by ESbetaL-producing Proteus mirabilis: a case report.

In this article, a case of decubitus ulcer infection caused by an extended-spectrum beta-lactamase-producing Proteus mirabilis strain, successfully treated with oral amoxicillin-clavulanate (1-month therapy) is described. This article focuses on diffusion and clinical effect of extended-spectrum beta-lactamases-producing Proteus mirabilis on treatment of gram negative lower extremity infections.

Infección del tracto urinario en Pediatría Etiología y tratamiento / Urinary tract infection in pediatrics: etiology and treatment

La infección urinaria (ITU) en pediatria es frecuente y el tratamiento antibiotico inicial es empirico, basada en la sensibilidad conocida de las bacterias del medio. Para averiguar dicha sensibilidad, se seleccionaron 61 pacientes entre 4 meses y 13 años, que acudieron al Servicio de Emergencia Pediátrica del Hospital Nacional Cayetano Heredia, con cuadro clínico de ITU y urocultivo positivo. Las bacterias aisladas fueron: E. coli, en 49 cultivos(80.3 por ciento), Klebsiella sp. en 10 cultivos (16.4 por ciento) y Proteus mirabilis en 2 casos (3.3 por ciento). La sensibilidad in vitro fue de un 100 por ciento a la Gentamicina, ceftriaxone, ceftazidime, y norfloxacina; 95.9 por ciento a amikacina, 94.1 por ciento a nitrofurantoina, 91.4 por ciento a acido nalidixico, 81.7 por ciento a cefalotina, 46.6 por ciento a cotrimoxazole y 18.8 por ciento a ampicilina

Nonclostridial gas gangrene.

Although nonclostridial gas gangrene is not an unusual occurrence, relatively few cases including the distal lower extremity have been reported. Due to the serious nature of some of these infections, it is important for physicians to familiarize themselves with these nonclostridial crepitant infections, which are often confused with clostridial myonecrosis. Etiology, evaluation, and treatment is described by the authors. Also, a case study is presented.