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1.
Antibiotics (Basel) ; 9(1)2020 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-31963167

RESUMO

Antimicrobial resistance is one of the most important public health issues. Besides classical multidrug resistance species associated with medical care involved in superficial or invasive infections, there are strains less commonly associated with hospital or outpatient setting's infections. Non-diphtheria Corynebacterium spp. could produce infections in patients with or without immune-compromised status. The aim of our study was to determine the susceptibility to antimicrobial agents to Corynebacterium spp. from clinical samples collected from Romanian hospitalized individuals and outpatients. Twenty Corynebacterium strains were isolated and identified as Corynebacterium striatum (n = 7), Corynebacterium amycolatum (n = 7), C. urealyticum (n = 3), Corynebacterium afermentans (n = 2), and Corynebacterium pseudodiphtheriticum (n = 1). All isolates have been tested for antibiotic susceptibility by standardized disc diffusion method and minimal inhibitory concentration (MIC) tests. Seventeen isolates demonstrated multidrug resistance phenotypes. The molecular support responsible for high resistance to quinolones for ten of these strains was determined by the detection of point mutation in the gene sequence gyrA.

2.
J Infect ; 79(6): 528-541, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31682877

RESUMO

The Global Meningococcal Initiative (GMI) aims to prevent invasive meningococcal disease (IMD) worldwide through education, research and cooperation. In March 2019, a GMI meeting was held with a multidisciplinary group of experts and representatives from countries within Eastern Europe. Across the countries represented, IMD surveillance is largely in place, with incidence declining in recent decades and now generally at <1 case per 100,000 persons per year. Predominating serogroups are B and C, followed by A, and cases attributable to serogroups W, X and Y are emerging. Available vaccines differ between countries, are generally not included in immunization programs and provided to high-risk groups only. Available vaccines include both conjugate and polysaccharide vaccines; however, current data and GMI recommendations advocate the use of conjugate vaccines, where possible, due to the ability to interrupt the acquisition of carriage. Ongoing carriage studies are expected to inform vaccine effectiveness and immunization schedules. Additionally, IMD prevention and control should be guided by monitoring outbreak progression and the emergence and international spread of strains and antibiotic resistance through use of genomic analyses and implementation of World Health Organization initiatives. Protection of high-risk groups (such as those with complement deficiencies, laboratory workers, migrants and refugees) is recommended.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Surtos de Doenças , Transmissão de Doença Infecciosa/prevenção & controle , Infecções Meningocócicas/epidemiologia , Infecções Meningocócicas/prevenção & controle , Portador Sadio/epidemiologia , Portador Sadio/microbiologia , Portador Sadio/prevenção & controle , Europa Oriental/epidemiologia , Humanos , Incidência , Infecções Meningocócicas/microbiologia , Vacinas Meningocócicas/administração & dosagem , Vacinas Meningocócicas/imunologia , Neisseria meningitidis/classificação , Neisseria meningitidis/isolamento & purificação , Sorogrupo
3.
Euro Surveill ; 23(20)2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29790460

RESUMO

Invasive meningococcal disease surveillance in Europe combines isolate characterisation and epidemiological data to support public health intervention. A representative European Meningococcal Strain Collection (EMSC) of IMD isolates was obtained, and whole genome sequenced to characterise 799 EMSC isolates from the epidemiological year July 2011-June 2012. To establish a genome library (GL), the isolate information was deposited in the pubMLST.org/neisseria database. Genomes were curated and annotated at 2,429 meningococcal loci, including those defining clonal complex, capsule, antigens, and antimicrobial resistance. Most genomes contained genes encoding B (n = 525; 65.7%) or C (n = 163; 20.4%) capsules; isolates were genetically highly diverse, with >20 genomic lineages, five of which comprising 60.7% (n = 485) of isolates. There were >350 antigenic fine-types: 307 were present once, the most frequent (P1.7-2,4:F5-1) comprised 8% (n = 64) of isolates. Each genome was characterised for Bexsero Antigen Sequence Typing (BAST): 25.5% (n = 204) of isolates contained alleles encoding the fHbp and/or the PorA VR1 vaccine component, but most genomes (n = 513; 64.2%) did not contain the NadA component. EMSC-GL will support an integrated surveillance of disease-associated genotypes in Europe, enabling the monitoring of hyperinvasive lineages, outbreak identification, and supporting vaccine programme implementation.


Assuntos
Genes Bacterianos/genética , Biblioteca Genômica , Meningite Meningocócica/microbiologia , Infecções Meningocócicas/microbiologia , Neisseria meningitidis Sorogrupo B/genética , Neisseria meningitidis/classificação , Neisseria meningitidis/genética , Sequenciamento Completo do Genoma , Europa (Continente) , Loci Gênicos , Variação Genética , Genoma Bacteriano , Genômica , Genótipo , Humanos , Meningite Meningocócica/genética , Infecções Meningocócicas/genética , Epidemiologia Molecular , Neisseria meningitidis/isolamento & purificação , Vigilância da População , Sorogrupo
4.
Artigo em Inglês | MEDLINE | ID: mdl-28971878

RESUMO

Penicillin-resistant Streptococcus pneumoniae strains are found at high rates in Romania and Iran. The mosaic structure of PBP2x was investigated in 9 strains from Iran and in 15 strains from Romania to understand their evolutionary history. Mutations potentially important for ß-lactam resistance were identified by comparison of the PBP2x sequences with the sequence of the related PBP2x of reference penicillin-sensitive S. mitis strains. Two main PBP2x mosaic gene families were recognized. Eight Iranian strains expressed PBP2x variants in group 1, which had a mosaic block highly related to PBP2x of the Spain23F-1 clone, which is widespread among international penicillin-resistant S. pneumoniae clones. A second unique PBP2x group was observed in Romanian strains; furthermore, three PBP2x single mosaic variants were found. Sequence blocks of penicillin-sensitive strain S. mitis 658 were common among PBP2x variants from strains from both countries. Each PBP2x group contained specific signature mutations within the transpeptidase domain, documenting the existence of distinct mutational pathways for the development of penicillin resistance.


Assuntos
Antibacterianos/farmacologia , Mosaicismo , Resistência às Penicilinas/genética , Proteínas de Ligação às Penicilinas/genética , Penicilinas/farmacologia , Streptococcus pneumoniae/genética , Idoso , Sequência de Aminoácidos , Criança , Pré-Escolar , Células Clonais , Feminino , Expressão Gênica , Humanos , Lactente , Irã (Geográfico) , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Modelos Moleculares , Proteínas de Ligação às Penicilinas/química , Proteínas de Ligação às Penicilinas/metabolismo , Polimorfismo Genético , Romênia , Alinhamento de Sequência , Homologia de Sequência de Aminoácidos , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/patologia , Streptococcus mitis/efeitos dos fármacos , Streptococcus mitis/genética , Streptococcus mitis/isolamento & purificação , Streptococcus mitis/metabolismo , Streptococcus pneumoniae/efeitos dos fármacos , Streptococcus pneumoniae/isolamento & purificação , Streptococcus pneumoniae/metabolismo , Adulto Jovem
5.
Roum Arch Microbiol Immunol ; 70(4): 168-73, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22568264

RESUMO

Animal models of infection and protection on the topic of the Streptococcus pneumoniae (S. pneumoniae) have encountered many difficulties generated by low immunogenicity, a characteristic of polysaccharide capsular bacteria and difference of virulence between serotypes and strains. We have explored the immune response after immunization with heat inactivated S. pneumoniae serotype 1, 3 and 6B in C57BL/6 mice by IgM and IgG detection, and by splenocyte in vitro 5-ethynyl-2'-deoxyuridine (EdU) incorporation after antigen specific stimulation, as a proposed method of cellular immune response evaluation. Antibody titer persistence after immunization was not lengthy while antigen specific proliferation response detected by EdU assay was remnant. Intraperitoneal (i.p.) challenge with serotype 6B S. pneumoniae proved that antibody titers and the detected specific cellular immune response do not cover seroprotective necessity and do not confer improved immunologic memory in comparison to non-immunized mice, which show natural resistance.


Assuntos
Anticorpos Antibacterianos/sangue , Ativação Linfocitária , Streptococcus pneumoniae/imunologia , Animais , Antígenos de Bactérias/imunologia , Desoxiuridina/análogos & derivados , Desoxiuridina/metabolismo , Feminino , Imunização , Camundongos , Camundongos Endogâmicos C57BL , Sorotipagem , Baço/imunologia , Streptococcus pneumoniae/classificação
6.
Antimicrob Agents Chemother ; 54(9): 3651-8, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20606072

RESUMO

Identification of clinical isolates of Neisseria meningitidis that are resistant to rifampin is important to avoid prophylaxis failure in contacts of patients, but it is hindered by the absence of a breakpoint for resistance, despite many efforts toward standardization. We examined a large number (n = 392) of clinical meningococcal isolates, spanning 25 years (1984 to 2009), that were collected in 11 European countries, Argentina, and the Central African Republic. The collection comprises all clinical isolates with MICs of > or = 0.25 mg/liter (n = 161) received by the national reference laboratories for meningococci in the participating countries. Representative isolates displaying rifampin MICs of < 0.25 mg/liter were also examined (n = 231). Typing of isolates was performed, and a 660-bp DNA fragment of the rpoB gene was sequenced. Sequences differing by at least one nucleotide were defined as unique rpoB alleles. The geometric mean of the MICs was calculated for isolates displaying the same allele. The clinical isolates displaying rifampin MICs of > 1 mg/liter possessed rpoB alleles with nonsynonymous mutations at four critical amino acid residues, D542, H552, S548, and S557, that were absent in the alleles found in all isolates with MICs of < or = 1 mg/liter. Rifampin-susceptible isolates could be defined as those with MICs of < or = 1 mg/liter. The rpoB allele sequence and isolate data have been incorporated into the PubMLST Neisseria database (http://pubmlst.org/neisseria/). The rifampin-resistant isolates belonged to diverse genetic lineages and were associated with lower levels of bacteremia and inflammatory cytokines in mice. This biological cost may explain the lack of clonal expansion of these isolates.


Assuntos
Proteínas de Bactérias/genética , Farmacorresistência Bacteriana/genética , Neisseria meningitidis/genética , Rifampina/farmacologia , Sequência de Aminoácidos , Animais , Antibacterianos/farmacologia , Feminino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Transgênicos , Testes de Sensibilidade Microbiana , Dados de Sequência Molecular , Neisseria meningitidis/efeitos dos fármacos , Filogenia
7.
Artigo em Romano | MEDLINE | ID: mdl-21553474

RESUMO

OBJECTIVE: The aim of the this study was the analysis of the resistance to antibiotics of Streptococcus pneumoniae isolated in last years. METHODS: 328 S. pneumoniae strains, coming from blood, CSF tracheal aspirate (TA), or sputum, pleural fluid (PL) and other samples (ear and sinus fluid) isolated in 2006-2008, were analyzed at INCDMI "Cantacuzino", National Reference Center for Streptococcus pneumoniae. Strains were tested for susceptibility to by agar diution method (minimal inhibitory concentration-MIC) to the following antibiotics: penicillin (Pc), erythromycin (Em), cephalothin (Kf). cefuroxim (Cxm), cefotaxim (Ctx), trimethoprim/sulfamethoxazol (Sxt), ofloxacin (Ojx), amoxicillin (Amx). tetracycline (Te), cloramphenicol (Cm), vancomycin (Va). RESULTS: The analysis of the results was done according to CLSI 2009. Pneumococci strains isolated from blood, CSF, TA or sputum and PL showed lower resistance level to antibiotics (38.8% Pc, 9.3% Cxm. 4.1% Ctx, 2.7% Amx. 24% Em, 2.4% Ofx, 68% Sxt) against those isolated from ear ans sinus fluid which revealed high levels of resistance (70% Pc, 11.2 % Cxm, 5.9 % Ctx, 3.4% Amx, 58.4 % Em. 3.8% Ofx, 73% Sxt). Strains resistant to penicillin, isolated from blood and CSF revealed the following aspects: 17% low level of resistance and 11 % high level of resistance. CONCLUSIONS. The most efficient antibiotics were Ctx, Amx and Oft. A continuous surveillance of pneumococci strains resistant to antibiotics is needed, as well as the use of an pneumococcal efficient vaccine.


Assuntos
Academias e Institutos , Antibacterianos/farmacologia , Testes de Sensibilidade Microbiana , Streptococcus pneumoniae/isolamento & purificação , Amoxicilina/farmacologia , Antibacterianos/uso terapêutico , Pesquisa Biomédica , Cefotaxima/farmacologia , Cefuroxima/farmacologia , Cefalotina/farmacologia , Cloranfenicol/farmacologia , Eritromicina/farmacologia , Humanos , Testes de Sensibilidade Microbiana/métodos , Ofloxacino/farmacologia , Penicilinas/farmacologia , Estudos Retrospectivos , Romênia , Streptococcus pneumoniae/classificação , Streptococcus pneumoniae/efeitos dos fármacos , Tetraciclina/farmacologia , Combinação Trimetoprima e Sulfametoxazol/farmacologia , Vancomicina/farmacologia
8.
Artigo em Romano | MEDLINE | ID: mdl-21553480

RESUMO

EARSS (European Antimicrobial Resistance Surveillance System) is the biggest antimicrobial resistance surveillance project in the world financed from public finds, aiming to provide validated and comparable official data on antimicrobial resistance of invasive microbial strains (isolated from blood and CSF), belonging to 6 indicator bacterial species, i.e.: S. aureus, E. coli, E. faecium/faecalis, Str. pneumoniae, Ps. aeruginosa, K. pneumoniae. Romania reported data to EARSS since 2002 so far. Though the number of participating laboratories increased progressively from 12 to 35, the number of hospitals which reported for EARSS. as the number of strains included in the data base remained steady and relatively low. This issue is related to the particular position of Romania in the European context, in respect of the very low number of blood cultures performed in hospitals. Our paper is presenting the trends of antimicrobial resistance in the indicator strains in the 2002-2008 interval. During the 2002-2008 interval, Romania reported to EARSS a total number of 1276 bacterial strains, distributed by species as follows: 513 S aureus, 369 E. coli, 128 Streptococcus pneumoniae, 127 Enterococcus spp.. 71 Klebsiella pneumoniae, 68 Pseudomonas aeruginosa. Klebsiella pneumoniae and Pseudomonas aeruginosa were reported, according to the EARSS protocol, only for the 2005-2008 interval. It is difficult to describe trends, specially in Enterococcus, Streptococcus pneumonaie and the 2 species collected only since 2005, because of the low number of isolates, but there are several results that are supporting us to claim that antimicrobial resistance in invasive isolates is a real problem in Romanian hospitals, like in other Central, Southern and South Eastern European countries: more than 25% of S. aureus strains resistant to methicilline, with more than 50% in some years, high aminoglycozides resistance in more than 70-80% of Enterococcus faecium invasive strains, more than 80% of strains resistant to 3rd generation cephalosporines etc.


Assuntos
Antibacterianos/farmacologia , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/microbiologia , Farmacorresistência Bacteriana , Hospitais/tendências , Vigilância de Evento Sentinela , Aminoglicosídeos/farmacologia , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/prevenção & controle , Resistência às Cefalosporinas , Enterococcus/isolamento & purificação , Escherichia coli/isolamento & purificação , Europa (Continente)/epidemiologia , Hospitais/estatística & dados numéricos , Humanos , Klebsiella pneumoniae/isolamento & purificação , Resistência a Meticilina , Testes de Sensibilidade Microbiana , Pseudomonas aeruginosa/isolamento & purificação , Estudos Retrospectivos , Romênia/epidemiologia , Staphylococcus aureus/isolamento & purificação , Streptococcus pneumoniae/isolamento & purificação
9.
Roum Arch Microbiol Immunol ; 68(1): 38-43, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19507626

RESUMO

Thirty-one strains of Neisseria meningitidis strains coming from CSF, collected at the National Reference Center for Meningococci between January 2007-March 2008 were serogrouped and analysed for the susceptibility to 7 antibiotics: penicillin (Pc), erythromycin (Em), ceftriaxone (Cro), cefotaxime (Ctx), ciprofloxacin (Cip), rifampin (Rif), sulfonamides (Sm). Results revealed that serogroup B accounted to the highest number of strains (51.7%), followed by serogroup C (35.5%), serogroup W 135 (6.4%) and serogroup X (6.4%). The data analysed according to EMGM revealed the following aspects: 100% susceptibility to Cro and Ctx., 96.7% susceptibility to Rif (MIC 50 and MIC 90 =0.03 mg/l) and 96.7% susceptibility to Cip (MIC 50 and MIC 90=0.0015 mg/l). Concerning Pc, it was revealed 58% susceptible strains, 38.7% intermediate and 3.3% resistant strains with MIC 50=0.06 mg/l and MIC 90=0.12 mg/l. A high proportion (100%) of isolates were fully resistant to Sm, while 22.6% of strains were resistant to Em. In conclusion, this study showed that Cro, Ctx, Cip and Rif were the most efficient drugs. Sulfonamides must be used neither for treatment nor for prophylaxis, as they would be ineffective. Serogroups B and C were predominant in this period in Romania. The need for new antimicrobial agents and vaccines is being felt in today's society.


Assuntos
Antibacterianos/farmacologia , Infecções Meningocócicas/microbiologia , Neisseria meningitidis/efeitos dos fármacos , Cefotaxima/farmacologia , Ceftriaxona/farmacologia , Ciprofloxacina/farmacologia , Farmacorresistência Bacteriana Múltipla , Eritromicina/farmacologia , Humanos , Infecções Meningocócicas/líquido cefalorraquidiano , Testes de Sensibilidade Microbiana , Neisseria meningitidis/classificação , Neisseria meningitidis/isolamento & purificação , Penicilinas/farmacologia , Rifampina/farmacologia , Romênia , Sorotipagem , Sulfonamidas/farmacologia
10.
J Antimicrob Chemother ; 62(6): 1234-40, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18799472

RESUMO

OBJECTIVES: To phenotypically and genotypically characterize 11 strains (isolated in four different centres) exhibiting penicillin MIC of 8-32 mg/L among isolates of the SPICE project. Nine isolates were from Romania (9/162; 5.56%) and two from Poland (2/305; 0.66%). METHODS: In vitro susceptibility was determined in triplicate by microdilution (CLSI guidelines), and additionally, MICs of penicillin, cefotaxime and amoxicillin were confirmed in triplicate by agar dilution. Multilocus sequence typing (MLST), PFGE and gene amplification and sequencing were performed. RESULTS: For the nine Romanian isolates, MICs were >/=16 mg/L for penicillin, cefotaxime and amoxicillin, >/=32 mg/L for cefuroxime and cefpodoxime, 4-8 mg/L for cefditoren and >/=128 mg/L for erythromycin and gentamicin. All isolates were non-susceptible to imipenem (MIC = 0.5-1 mg/L) and susceptible to levofloxacin (MIC = 0.5-1 mg/L) and vancomycin (MIC = 0.25-0.5 mg/L). These Romanian strains presented a new cluster in the 595-600 region of PBP2X (YSGIQL-->LSTPWF) conferring 98% homology with Streptococcus mitis PBP2X, with a new MurM allele (seven strains) with eight amino acid changes versus R6. PBP nucleotide sequences were highly conserved suggesting a common origin. Allelic profiles of two strains gave sequence type 321, three strains exhibited a single- and four a double-locus variance. MLST-predicted serotype was 23F in all but one strain (19F), but three strains were 19A by Quellung. CONCLUSIONS: The multidrug high resistance (precluding adequate oral therapy in children), its origin, the prevalence found in Romania and the presence of non-vaccine (7-valent) serotypes should worry the medical community because of a possible clonal diffusion that would limit therapeutic alternatives.


Assuntos
Antibacterianos/farmacologia , Cefotaxima/farmacologia , Resistência às Penicilinas , Penicilinas/farmacologia , Infecções Pneumocócicas/microbiologia , Streptococcus pneumoniae/classificação , Streptococcus pneumoniae/efeitos dos fármacos , Sequência de Aminoácidos , Proteínas de Bactérias/genética , Técnicas de Tipagem Bacteriana , Criança , Análise por Conglomerados , Impressões Digitais de DNA , Eletroforese em Gel de Campo Pulsado , Genótipo , Humanos , Testes de Sensibilidade Microbiana , Epidemiologia Molecular , Dados de Sequência Molecular , Proteínas de Ligação às Penicilinas/genética , Polônia , Romênia , Análise de Sequência de DNA , Homologia de Sequência de Aminoácidos , Streptococcus pneumoniae/isolamento & purificação
11.
Rev Med Chir Soc Med Nat Iasi ; 110(4): 1012-5, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17438917

RESUMO

The aim of this study was to identify at species level and to investigate the antibiotic susceptibility of oral streptococcal strains isolated from 100 pus samples collected from Romanian patients with different odontogenic infections. The isolates were identified at species level using the Rapid ID 32 STREP system and their susceptibility was testing by the Etest, against: penicillin G, ampicillin, erythromycin, clindamycin and tetracycline. For the investigation of erythromycin resistance phenotype the disk diffusion test was used. The isolates belonged to several species, with Streptococcus anginosus and Streptococcus oralis predominating. Reduced susceptibility to beta-lactam antibiotics was found only among the isolates belonging to S. mitis and S. sanguinis groups. Resistance to erythromycin was detected among all species, except for: S. constellatus, S. intermedius and S. gordonii, and the M phenotype was established, while resistance to tetracycline was detected within all species but S. gordonii. In contrast, clindamycin was fully active. As most odontogenic infections are mixed infections, often involving strictly anaerobic bacteria, which are frequently beta-lactamase producers, the association of a penicillin and a beta-lactamase inhibitor, like Amoxiclav, is recommended when the antimicrobial treatment is necessary.


Assuntos
Antibacterianos/farmacologia , Doenças Periodontais/microbiologia , Infecções Estreptocócicas/microbiologia , Streptococcus/isolamento & purificação , Clindamicina/farmacologia , Resistência Microbiana a Medicamentos , Eritromicina/farmacologia , Humanos , Testes de Sensibilidade Microbiana , Penicilina G/farmacologia , Doenças Periodontais/tratamento farmacológico , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus/classificação , Streptococcus/efeitos dos fármacos , Tetraciclina/farmacologia
13.
Artigo em Romano | MEDLINE | ID: mdl-16938936

RESUMO

The aim of the present study was to identify at species level and to characterize the strains of streptococci belonging to anginosus group isolated from 30 pus samples collected from patients with abscesses of fascial spaces of the face or neck. The identification of facultatively anaerobic Gram-positive cocci in chains at genus level was made by conventional diagnosis methods and at species level by the help of Rapid ID 32 STREP system. The cultural, biochemical and antigenic (limited at Lancefield Group identification by Slidex Strepto-Kit) characterization was performed in the mean time with the species identification. The anginosus streptococcal strains were isolated either in association with other bacteria or in pure culture and S. anginosus isolates clearly predominated. As expected, the anginosus streptococcal strains were found to be heterogeneous regarding the cultural, biochemical and antigenic features.


Assuntos
Abscesso/microbiologia , Infecções Estreptocócicas/microbiologia , Streptococcus anginosus/isolamento & purificação , Adolescente , Adulto , Idoso , Técnicas de Tipagem Bacteriana , Criança , Face , Humanos , Pessoa de Meia-Idade , Pescoço , Fenótipo , Sorotipagem , Streptococcus anginosus/classificação , Streptococcus anginosus/patogenicidade
14.
Infect Control Hosp Epidemiol ; 24(5): 334-41, 2003 May.
Artigo em Inglês | MEDLINE | ID: mdl-12785406

RESUMO

OBJECTIVE: To assess the way healthcare facilities (HCFs) diagnose, survey, and control methicillin-resistant Staphylococcus aureus (MRSA). DESIGN: Questionnaire. SETTING: Ninety HCFs in 30 countries. RESULTS: Evaluation of susceptibility testing methods showed that 8 laboratories (9%) used oxacillin disks with antimicrobial content different from the one recommended, 12 (13%) did not determine MRSA susceptibility to vancomycin, and 4 (4.5%) reported instances of isolation of vancomycin-resistant S. aureus but neither confirmed this resistance nor alerted public health authorities. A MRSA control program was reported by 55 (61.1%) of the HCFs. The following isolation precautions were routinely used: hospitalization in a private room (34.4%), wearing of gloves (62.2%), wearing of gowns (44.4%), hand washing by healthcare workers (53.3%), use of an isolation sign on the patient's door (43%), or all four. When the characteristics of HCFs with low incidence rates (< 0.4 per 1,000 patient-days) were compared with those of HCFs with high incidence rates (> or = 0.4 per 1,000 patient-days), having a higher mean number of beds per infection control nurse was the only factor significantly associated with HCFs with high incidence rates (834 vs 318 beds; P = .02). CONCLUSION: Our results emphasize the urgent need to strengthen the microbiologic and epidemiologic capacities of HCFs worldwide to prevent MRSA transmission and to prepare them to address the possible emergence of vancomycin-resistant S. aureus.


Assuntos
Infecção Hospitalar/diagnóstico , Controle de Infecções/métodos , Resistência a Meticilina , Vigilância de Evento Sentinela , Infecções Estafilocócicas/diagnóstico , Staphylococcus aureus/isolamento & purificação , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Infecção Hospitalar/prevenção & controle , Saúde Global , Hospitais Públicos , Hospitais de Ensino , Humanos , Testes de Sensibilidade Microbiana , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/prevenção & controle , Staphylococcus aureus/efeitos dos fármacos , Resistência a Vancomicina
15.
Antimicrob Agents Chemother ; 46(2): 371-7, 2002 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-11796344

RESUMO

The macrolide and levofloxacin susceptibilities of 992 isolates of Streptococcus pneumoniae from clinical specimens collected in 1999 and 2000 were determined in 10 centers in Central and Eastern European countries. The prevalences of penicillin G-intermediate (MICs, 0.125 to 1 microg/ml) and penicillin-resistant (MICs, < or =2 microg/ml) Streptococcus pneumoniae isolates were 14.3 and 16.6%, respectively. The MICs at which 50% of isolates are inhibited (MIC(50)s) and the MIC(90)s of telithromycin were 0.016 and 0.06 microg/ml, respectively; those of erythromycin were 0.06 and >64 microg/ml, respectively; those of azithromycin were 0.125 and >64 microg/ml, respectively; those of clarithromycin were 0.03 and >64 microg/ml, respectively; and those of clindamycin were 0.06 and >64 microg/ml, respectively. Erythromycin resistance was found in 180 S. pneumoniae isolates (18.1%); the highest prevalence of erythromycin-resistant S. pneumoniae was observed in Hungary (35.5%). Among erythromycin-resistant S. pneumoniae isolates, strains harboring erm(B) genes (125 strains [69.4%]) were found to be predominant over strains with mef(E) genes (25 strains [13.4%]), L4 protein mutations (28 strains [15.6%]), and erm(A) genes (2 strains [1.1%]). Similar pulsed-field gel electrophoresis patterns suggested that some strains containing L4 mutations from the Slovak Republic, Bulgaria, and Latvia were clonally related. Of nine strains highly resistant to levofloxacin (MICs, >8 microg/ml) six were isolated from Zagreb, Croatia. Telithromycin at < or =0.5 microg/ml was active against 99.8% of S. pneumoniae isolates tested and may be useful for the treatment of respiratory tract infections caused by macrolide-resistant S. pneumoniae isolates.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana/genética , Cetolídeos , Macrolídeos , Proteínas Ribossômicas/genética , Streptococcus pneumoniae/efeitos dos fármacos , Fatores Etários , Anti-Infecciosos/farmacologia , Europa (Continente) , Frequência do Gene , Humanos , Levofloxacino , Testes de Sensibilidade Microbiana , Ofloxacino/farmacologia , Proteínas Ribossômicas/fisiologia , Sorotipagem , Streptococcus pneumoniae/genética , Streptococcus pneumoniae/isolamento & purificação
16.
Antimicrob Agents Chemother ; 46(2): 546-9, 2002 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-11796375

RESUMO

Among 1,011 recently isolated Streptococcus pyogenes isolates from 10 Central and Eastern European centers, the MICs at which 50% of isolates are inhibited (MIC(50)s) and the MIC(90)s were as follows: for telithromycin, 0.03 and 0.06 microg/ml, respectively; for erythromycin, azithromycin, and clarithromycin, 0.06 to 0.125 and 1 to 8 microg/ml, respectively; and for clindamycin, 0.125 and 0.125 microg/ml, respectively. Erythromycin resistance occurred in 12.3% of strains. Erm(A) [subclass erm(TR)] was most commonly encountered (60.5%), followed by mef(A) (23.4%) and erm(B) (14.5%). At <0.5 microg/ml, telithromycin was active against 98.5% of the strains tested.


Assuntos
Antibacterianos/farmacologia , Cetolídeos , Macrolídeos , Streptococcus pyogenes/efeitos dos fármacos , Azitromicina/farmacologia , Farmacorresistência Bacteriana/genética , Eritromicina/farmacologia , Europa Oriental , Genes Bacterianos , Humanos , Testes de Sensibilidade Microbiana , Streptococcus pyogenes/genética , Streptococcus pyogenes/isolamento & purificação
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