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1.
Arch Esp Urol ; 74(7): 645-651, 2021 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-34472432

RESUMO

INTRODUCTION: Urinary tract infections (Uti) are one of the most common infections that affec thumans throughout their lives and are a common healthproblem both at the community and at the nosocomial level. Knowing microbiological characteristics, sensitivity profile and risk factors allow to optimize the management of Utis minimizing the increase of antibiotic resistance (AR) and establishing early treatments to reduce the morbidity and severity of infection. This study aims to establish which microorganisms are responsible for urinary tract infections in our community and determine their AR. PATIENTS AND METHODS: An observational, descriptive, cross-sectional, retrospective study of all patients with the first episode of UTI recorded at the Sanatorio Allende in the city of Cordoba, Argentina, who were requested to under go urine culture (URC), from January 2016 to December 2017. RESULTS: 3636 positive URC were analyzed, of which1740 met the inclusion criteria. Of the total analyzed 90.2 % (n=1570) were female. The average age was 37.8 years (SD=15.2). Escherichia coli was the microorganism most frequently isolated in 80.3% followed by S. saprophyticus in 8.0%. The age group of 18-30 years (40.1%) showed the highest proportion of microorganisms, where we observed the highest prevalence of E. coli and S. saprophyticus. The following acquired resistances were obtained from the total isolations: 47.6% of the microorganisms were resistant to ampicillin, 29.6% to cotrimoxazole, 15.2% to ciprofloxacin, 4.6% to first generation of cephalosporins, 3.4% to cefixime, 2.3% to amoxicillin-clavulanic, 1,2% to gentamicin and 1% to nitrofurantoin. CONCLUSION: E. Coli was the most prevalent pathogenin our environment, with high rates of resistance to ampicillin, fluoroquinolones and trimethoprim-sulfamethoxazole, confirming the need for periodic studiesto determine the most optimal empirical antibiotic treatment.


Assuntos
Infecções por Escherichia coli , Infecções Urinárias , Adolescente , Adulto , Antibacterianos/uso terapêutico , Argentina/epidemiologia , Estudos Transversais , Farmacorresistência Bacteriana , Escherichia coli , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/epidemiologia , Feminino , Humanos , Estudos Retrospectivos , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/epidemiologia , Adulto Jovem
2.
Ethiop J Health Sci ; 31(3): 663-672, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34483624

RESUMO

Background: This cross-sectional study was performed on isolates of Klebsiella pneumoniae, and E.coli from clinical specimens of patients admitted to Sayyad Shirazi Hospital by census sampling method in 2019. Antibiogram testing was performed using the disk diffusion method as defined by the Clinical and Laboratory Standards Organization for performing this test. Finally, the abundance of genes was evaluated by PCR using specific primers. Frequency, percentage, mean±SD were used to describe the data. Chi-square and Fisher's exact tests were used to compare the presence and absence of the studied genes alone and in the presence of each other. Result: This study was performed on 130 positive samples, isolated from 32 (24.6%) males and 98 (65.4%) females with a mean age of 43.78 ± 21.72. From the total number of 130 isolates, 84 (64.6%) consisted of E.coli, and 46 (35.4%) were Klebsiella. Most of the cultures were urine and vaginal (61.5%). The highest antibiotic resistance in isolates was cephalexin and cefazolin (67.9% in E.coli & 63% in Klebsiella). Colistin was identified as the most effective antibiotic (100%) in both. AMPC extendedspectrum ß-lactamase genes were present in 40 (30.8%) isolates. The highest frequency about the gene pattern of AMPC positive ß-lactamase bacteria was correlated to DHA, FOX, and CIT genes, while none of the samples contained the MOX ß-lactamase gene. E.coli and Klebsiella beta-lactamase-producing AMPC isolates were also significantly correlated with antibiotic resistance to the cephalosporin class (P <0.05). Conclusion: This study indicated a high percentage of resistance to third and fourth generation cephalosporins. Hence, careful antibiogram tests and prevention of antibiotic overuse in infections caused by AMPC-producing organisms and screening of clinical samples for the resistance mentioned above genes and providing effective strategies to help diagnose and apply appropriate treatments and change antibiotic usage strategies can partially prevent the transmission of this resistance.


Assuntos
Farmacorresistência Bacteriana/genética , Escherichia coli , Klebsiella pneumoniae , Antibacterianos/farmacologia , Estudos Transversais , Escherichia coli/efeitos dos fármacos , Escherichia coli/genética , Infecções por Escherichia coli/tratamento farmacológico , Feminino , Humanos , Infecções por Klebsiella/tratamento farmacológico , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/genética , Masculino , Testes de Sensibilidade Microbiana , beta-Lactamases/genética
3.
Malawi Med J ; 33(1): 59-64, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-34422235

RESUMO

Background: Non-susceptibility of bacteria to antiseptic agents used for preoperative skin preparations threaten the effectiveness of prevention of surgical site infections. Data concerning susceptibility of multidrug resistant bacteria strains to antiseptic agents was limited at our setting. This study presents the susceptibility of extended spectrum ß-lactamases producing Klebsiella pneumoniae and Escherichia coli (with and without biofilm formation) to antiseptic agents used for preoperative skin preparations at zonal referral hospital in Mwanza, Tanzania. Methods: This cross-sectional descriptive study was conducted through July 2020. Presumptive extended spectrum beta-lactamase producing Klebsiella pneumoniae and Escherichia coli were recovered for this study. Disc combination method was used to confirm production of ESBL while tube method was used to detect biofilms formation. Then, isolates were tested for susceptibility towards 10% povidone iodine, 70% methylated spirit, 50% hydrogen peroxide (6% of industrial H2O2 diluted in equal volume with sterile distilled water) and 2% chlorhexidine. STATA software version 13.0 was used for data analysis. Results: A total of 31 presumptive ESBL producers were recovered and phenotypically confirmed, whereas 54.8% (n=17) were K. pneumoniae and 45.2% (n=14) were E. coli. Five (35.7%) E. coli and seven (41.2%) K. pneumoniae had positive biofilms test results. Four (12.9%) bacteria were non-susceptible to antiseptic agents used for preoperative skin preparations. However, none exhibited resistance towards 10% PVP-I. Conclusion: In this study we highlight the existence of multidrug resistant Gram-negative bacteria with resistance to antiseptic agents used for preoperative skin preparation at a zonal referral hospital in Mwanza, Tanzania.


Assuntos
Anti-Infecciosos Locais/farmacologia , Resistência a Múltiplos Medicamentos/efeitos dos fármacos , Escherichia coli/efeitos dos fármacos , Klebsiella pneumoniae/efeitos dos fármacos , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Anti-Infecciosos Locais/uso terapêutico , Bactérias/classificação , Bactérias/efeitos dos fármacos , Bactérias/genética , Bactérias/isolamento & purificação , Biofilmes , Estudos Transversais , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/microbiologia , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Negativas/isolamento & purificação , Humanos , Infecções por Klebsiella/tratamento farmacológico , Klebsiella pneumoniae/isolamento & purificação , Testes de Sensibilidade Microbiana , Tanzânia
4.
J Infect Chemother ; 27(11): 1602-1606, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34348852

RESUMO

INTRODUCTION: The frequency of urinary tract infections (UTIs) caused by extended-spectrum ß-lactamase (ESBL)-producing Enterobacterales is steadily increasing worldwide. Therefore, we aimed to evaluate the efficacy and appropriate dosing of cefmetazole (CMZ) in invasive urinary tract infection (iUTI) caused by ESBL-producing Escherichia coli (ESBLEC). METHODS: Patients who developed ESBLEC iUTI and received CMZ between January 2007 and December 2018 were identified, and their medical records were reviewed. The time above minimum inhibitory concentration (MIC) (TAM) was calculated using the MIC value obtained from each patient and its simulated CMZ concentration. RESULTS: Thirty-nine patients were included in the study. The median TAM was 92.6% (interquartile range [IQR], 67.6-100). CMZ was clinically efficacious in 38 (97.4%) patients overall and in 11 out of 12 (91.7%) patients with normal renal function who received CMZ at 1 g every 8 h. CONCLUSIONS: In normal renal function, 1 g CMZ infused for over 1 h every 8 h is an efficacious treatment for iUTI caused by ESBLEC with MIC =< 4 mg/L.


Assuntos
Infecções por Escherichia coli , Infecções Urinárias , Antibacterianos/uso terapêutico , Cefmetazol/uso terapêutico , Escherichia coli , Infecções por Escherichia coli/tratamento farmacológico , Humanos , Estudos Retrospectivos , Infecções Urinárias/tratamento farmacológico , beta-Lactamases
5.
Front Cell Infect Microbiol ; 11: 614963, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34268129

RESUMO

Shiga toxin-producing Escherichia coli (STEC) is a global foodborne bacterial pathogen that is often accountable for colon disorder or distress. STEC commonly induces severe diarrhea in hosts but can cause critical illnesses due to the Shiga toxin virulence factors. To date, there have been a significant number of STEC serotypes have been evolved. STECs vary from nausea and hemorrhoid (HC) to possible lethal hemolytic-based uremic syndrome (HUS), thrombotic thrombocytopenic purpura (TTP). Inflammation-based STEC is usually a foodborne illness with Shiga toxins (Stx 1 and 2) thought to be pathogenesis. The STEC's pathogenicity depends significantly on developing one or more Shiga toxins, which can constrain host cell protein synthesis leading to cytotoxicity. In managing STEC infections, antimicrobial agents are generally avoided, as bacterial damage and discharge of accumulated toxins are thought the body. It has also been documented that certain antibiotics improve toxin production and the development of these species. Many different groups have attempted various therapies, including toxin-focused antibodies, toxin-based polymers, synbiotic agents, and secondary metabolites remedies. Besides, in recent years, antibiotics' efficacy in treating STEC infections has been reassessed with some encouraging methods. Nevertheless, the primary role of synbiotic effectiveness (probiotic and prebiotic) against pathogenic STEC and other enteropathogens is less recognized. Additional studies are required to understand the mechanisms of action of probiotic bacteria and yeast against STEC infection. Because of the consensus contraindication of antimicrobials for these bacterial pathogens, the examination was focused on alternative remedy strategies for STEC infections. The rise of novel STEC serotypes and approaches employed in its treatment are highlighted.


Assuntos
Infecções por Escherichia coli , Síndrome Hemolítico-Urêmica , Escherichia coli Shiga Toxigênica , Infecções por Escherichia coli/tratamento farmacológico , Humanos , Toxina Shiga , Toxinas Shiga
6.
Front Cell Infect Microbiol ; 11: 690377, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34222051

RESUMO

Mastitis caused by Escherichia coli (E. coli) remains a threat to dairy animals and impacts animal welfare and causes great economic loss. Furthermore, antibiotic resistance and the lagged development of novel antibacterial drugs greatly challenge the livestock industry. Phage therapy has regained attention. In this study, three lytic phages, termed vB_EcoM_SYGD1 (SYGD1), vB_EcoP_SYGE1 (SYGE1), and vB_EcoM_SYGMH1 (SYGMH1), were isolated from sewage of dairy farm. The three phages showed a broad host range and high bacteriolytic efficiency against E. coli from different sources. Genome sequence and transmission electron microscope analysis revealed that SYGD1 and SYGMH1 belong to the Myoviridae, and SYGE1 belong to the Autographiviridae of the order Caudovirales. All three phages remained stable under a wide range of temperatures or pH and were almost unaffected in chloroform. Specially, a mastitis infected cow model, which challenged by a drug resistant E. coli, was used to evaluate the efficacy of phages. The results showed that the cocktails consists of three phages significantly reduced the number of bacteria, somatic cells, and inflammatory factors, alleviated the symptoms of mastitis in cattle, and achieved the same effect as antibiotic treatment. Overall, our study demonstrated that phage cocktail may be a promising alternative therapy against mastitis caused by drug resistant E. coli.


Assuntos
Bacteriófagos , Infecções por Escherichia coli , Mastite Bovina , Mastite , Preparações Farmacêuticas , Animais , Bovinos , Escherichia coli , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/veterinária , Feminino , Humanos , Mastite/tratamento farmacológico , Mastite/veterinária , Mastite Bovina/tratamento farmacológico
7.
Front Cell Infect Microbiol ; 11: 560622, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34249771

RESUMO

AmpC ß-lactamases hydrolyze all ß-lactams except cefepime and carbapenems. The study of AmpC-producing E. coli has high priority for the infection control committee. This research is aimed to investigate the resistant urinary AmpC-generating E. coli isolates and identify their genetic variety. Some 230 E. coli isolates from patients suffering urinary tract infection symptoms were studied in 2017-2018 to assess their susceptibility toward antimicrobial agents. AmpC gene was evaluated by PCR and molecular typing using the 10-loci MLVA method. MLVA images were examined by BioNumerics 6.6 software through the use of the UPGMA algorithms. Thirty-eight AmpC-generating E. coli isolates were detected. The most abundant determinant was blaCIT and blaEBC , blaFOX , and blaDHA had the next ranks, respectively. Six major clusters and a singleton were identified by MLVA. AmpC beta-lactamases in urinary isolates of E. coli in the hospital under study and high rate of additional resistance to gentamicin, cotrimoxazole and ciprofloxacin. The most frequent gene determinant of AmpC beta-lactamase was blaCIT and vary depending on time and geographical location.


Assuntos
Infecções por Escherichia coli , Infecções Urinárias , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Proteínas de Bactérias/genética , Escherichia coli/genética , Infecções por Escherichia coli/tratamento farmacológico , Humanos , Testes de Sensibilidade Microbiana , beta-Lactamases/genética
8.
Can Vet J ; 62(6): 608-610, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34219768

RESUMO

Antimicrobial resistance surveillance targeting agricultural animals is practiced in many countries but does not often include media selective for cephalosporin resistance. Here, we compared the frequency of recovery of resistant Escherichia coli using selective and non-selective media from the cecal contents of 116 chickens collected by the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS). Third generation cephalosporin resistance was detected in 24 samples including 12, 10, and 2 on selective, non-selective, and both media, respectively. Isolates producing the CTX-M-1 ESBL were grown from 11 samples, 10 on selective medium only. Our results suggest that current surveillance approaches underestimate the true prevalence of resistance to critically important antimicrobials.


Assuntos
Farmacorresistência Bacteriana , Infecções por Escherichia coli , Doenças das Aves Domésticas , Animais , Antibacterianos/farmacologia , Anti-Infecciosos , Canadá , Galinhas , Escherichia coli , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/veterinária , Doenças das Aves Domésticas/tratamento farmacológico , Doenças das Aves Domésticas/microbiologia , beta-Lactamases
9.
Am J Clin Oncol ; 44(8): 402-408, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34107499

RESUMO

BACKGROUND AND OBJECTIVE: Immune-mediated diarrhea and colitis (IMDC) is a common adverse event in cancer patients receiving immune checkpoint inhibitors (ICIs). Gastrointestinal (GI) infections can co-occur with IMDC, and its impact on the course and outcome of IMDC remains unclear. PATIENTS AND METHODS: We retrospectively reviewed cancer patients who received ICIs and developed IMDC between January 2015 and September 2019. GI multiplex panel is used to assess GI infection. The study group included patients with positive infection except those who are only positive for Clostridioides difficile or cytomegalovirus. The control group is IMDC patients with negative infection using frequency matching. Patients' disease course and outcome were compared between groups. RESULTS: A total of 72 patients with IMDC were included: 22 in the study group and 50 as control. Escherichia coli of different pathotypes was observed in 17 patients. Five patients had viral infections, for example, adenovirus, norovirus, and sapovirus. Patients with GI infections more frequently had grade 3 or 4 colitis (43% vs. 18%, P=0.041). Overall, GI infections were not associated with different risks of IMDC recurrence or overall survival. Antibiotics treatment did not affect the requirement for infliximab or vedolizumab but relate to a higher risk of IMDC recurrence (50.0% vs. 0.0%, P=0.015). CONCLUSIONS: In our study, concomitant GI infections are associated with more severe symptoms in IMDC patients. Antimicrobial treatment did not circumvent the need for immunosuppressive therapy for IMDC or improve the clinical outcome. Concomitant GI infection was not associated with a higher risk of IMDC recurrence or poor overall survival.


Assuntos
Colite/induzido quimicamente , Diarreia/induzido quimicamente , Gastroenteropatias/microbiologia , Gastroenteropatias/virologia , Inibidores de Checkpoint Imunológico/efeitos adversos , Idoso , Antibacterianos/efeitos adversos , Antibacterianos/uso terapêutico , Infecções por Clostridium/induzido quimicamente , Colite/mortalidade , Colite/terapia , Diarreia/mortalidade , Diarreia/terapia , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/etiologia , Feminino , Gastroenteropatias/tratamento farmacológico , Humanos , Inibidores de Checkpoint Imunológico/uso terapêutico , Masculino , Pessoa de Meia-Idade , Neoplasias/tratamento farmacológico , Neoplasias/microbiologia , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Viroses/etiologia , Viroses/virologia
10.
Int J Clin Pract ; 75(10): e14475, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34107556

RESUMO

AIM OF STUDY: Urinary tract infections (UTIs) are among the most common infections affecting individuals of different ages worldwide. Antimicrobial agents are usually the first-line treatment for UTIs, and the use of the prescribed antibiotic is escalating, resulting in increased rates of bacterial resistance and UTI recurrence. The current study aimed to identify the causative bacteria in Jordan, to explore their resistance pattern to antibiotics and to describe drug-related problems (DRPs) associated with UTI management. METHODS: This prospective, descriptive study was conducted in two major health institutions in two cities in Jordan over a period of six months. The study population included inpatients and outpatients diagnosed with UTIs. Patients' data were collected directly from patients using data collection sheet and from patients' charts. RESULTS: A total of 273 patients were included, of whom 56.4% were women. Urine cultures were obtained from 81% of the patients. Escherichia coli was the most common causative pathogen (50.6%), followed by Klebsiella pneumonia (10.8%). Extended spectrum beta-lactamase (ESBL) producing E. coli was the most commonly detected organism across all types of UTIs. Ceftriaxone and imipenem/cilastatin were most commonly administered to hospitalised patients, whilst ciprofloxacin and co-triamzaxole were the most commonly prescribed in outpatient clinics. The susceptibility results for parenteral antibiotics showed high rates of resistance to cefazolin and ticarcillin. Additionally, high rates of resistance to fluoroquinolones were identified. Further, several DRPs were identified. High rates of resistance to commonly prescribed antibiotics were detected. DRPs (ie, inappropriate antibiotic dosage, unnecessary antibiotic prescribing, inappropriate duration of therapy and prescribing of ineffective antibiotics) were relatively common. CONCLUSION: The present study highlights the need for clinical pharmacists to manage the high level of drug related problems by providing updated information about proper drug selection, rational drug use and patient education and counselling.


Assuntos
Infecções por Escherichia coli , Infecções Urinárias , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana , Escherichia coli , Infecções por Escherichia coli/tratamento farmacológico , Feminino , Humanos , Testes de Sensibilidade Microbiana , Estudos Prospectivos , Infecções Urinárias/tratamento farmacológico , beta-Lactamases
11.
J Mater Chem B ; 9(23): 4735-4745, 2021 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-34095948

RESUMO

Large bone defects face a high risk of infection, which can also lead to bone homeostasis disorders. This seriously hinders the bone healing process; therefore, the help of a dual-functional scaffold that has both anti-infection and bone-homeostasis-regulating capacities is needed in the treatment of infected bone defects. In this study, a 3D printed dual-functional scaffold composed of poly-ε-caprolactone (PCL), mesoporous bioactive glasses (MBG), and gallium (Ga) was produced. In vitro experiments demonstrated the excellent antibacterial ability of the PCL/MBG/Ga scaffold against methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli (E. coli). The scaffold also significantly inhibited osteoclastic activity and promoted osteogenic differentiation. Furthermore, a rabbit model with an infected bone defect in the radius was used to evaluate the in vivo bone healing capability of PCL/MBG/Ga. The results demonstrate that the PCL/MBG/Ga scaffold can significantly accelerate bone healing and prevent bone resorption, suggesting its potential for application in repairing infected bone defects.


Assuntos
Anti-Infecciosos/uso terapêutico , Osso e Ossos/patologia , Infecções por Escherichia coli/tratamento farmacológico , Gálio/química , Homeostase , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Impressão Tridimensional , Infecções Estafilocócicas/tratamento farmacológico , Animais , Regeneração Óssea , Osso e Ossos/microbiologia , Coelhos , Infecções Estafilocócicas/microbiologia , Tecidos Suporte , Cicatrização
12.
ACS Appl Mater Interfaces ; 13(23): 26800-26807, 2021 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-34096255

RESUMO

Catalytic conversion of hydrogen peroxide (H2O2) to more toxic hydroxyl radicals (•OH) is a good choice for sterilization and anti-infection, but endogenous H2O2 is insufficient to achieve satisfactory sterilization efficacy. Despite great efforts, designing and developing antimicrobial materials that specifically and effectively self-supply H2O2 at the wound site remain as tremendous challenges. Here, we report a pH-responsive copper peroxide-loaded wound dressing made from copper hydroxide and gelatin sponge and then reacted with H2O2. In vitro experiments show that the prepared wound dressing has good bactericidal properties against Escherichia coli (E. coli), Staphylococcus aureus (S. aureus), and Pseudomonas aeruginosa (P. aeruginosa). Moreover, the as-prepared wound dressing can release •OH specifically in the bacterial-infected skin wound, rather than in normal tissues, and in vivo skin wound-healing experiments proved that the synthesized copper peroxide-loaded gelatin sponge could combat E. coli effectively; in addition, Cu2+ released from the gelatin sponge could stimulate angiogenesis and collagen deposition simultaneously. The study provides a strategy to improve antibacterial efficacy and reduce the toxic side effects through the release of •OH by bacterial self-activation.


Assuntos
Antibacterianos/farmacologia , Cobre/farmacologia , Infecções por Escherichia coli/tratamento farmacológico , Gelatina/química , Peróxidos/farmacologia , Pele/efeitos dos fármacos , Cicatrização/efeitos dos fármacos , Infecção dos Ferimentos/tratamento farmacológico , Animais , Antibacterianos/química , Bandagens , Cobre/química , Escherichia coli/efeitos dos fármacos , Infecções por Escherichia coli/microbiologia , Camundongos , Camundongos Endogâmicos BALB C , Peróxidos/química , Infecção dos Ferimentos/microbiologia
13.
Tidsskr Nor Laegeforen ; 141(10)2021 06 29.
Artigo em Inglês, Norueguês | MEDLINE | ID: mdl-34182746

RESUMO

BACKGROUND: Urinary tract infections are common in children. The purpose of this study was to describe national resistance data from urinary isolates from children with a view to informing antibiotic use. METHOD: We conducted an observational study based on culture responses with resistance determination in urine from the Norwegian Surveillance System for Antimicrobial Drug Resistance (NORM). All urinary isolates from children (0-17 years) in the period 2013-17 were included and compared with urinary isolates from adults. For cephalexin resistance, we used data from two Norwegian hospitals covering the period 2015-19. RESULTS: Of 13 211 urinary isolates included in the NORM register, 589 (4.5 %) were from children. Weighted by the number of data collection days, Escherichia coli accounted for 85.2 % of the isolates from children. For E. coli, there was a higher proportion of trimethoprim resistance in urine samples from children (27.0 %) compared to adults (22.9 %), p = 0.02. For ciprofloxacin, we found a lower resistance rate in E. coli in urine samples from children (5.7 %) compared to adults (8.7 %), p = 0.03. For other selected antibiotics, we found the following resistance rates in E. coli in children: nitrofurantoin (0.5 %), mecillinam (4.0 %), cephalexin (4.3 %), amoxicillin-clavulanic acid (7.2 %) and trimethoprim-sulfamethoxazole (24.1 %). INTERPRETATION: Pivmecillinam, cephalexin and amoxicillin-clavulanic acid are relevant choices in the empirical treatment of upper urinary tract infections. Nitrofurantoin and pivmecillinam are relevant for lower urinary tract infections. Trimethoprim and trimethoprim-sulfamethoxazole should only be used after resistance determination.


Assuntos
Infecções por Escherichia coli , Infecções Urinárias , Adulto , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Criança , Farmacorresistência Bacteriana , Resistência Microbiana a Medicamentos , Escherichia coli , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/epidemiologia , Humanos , Noruega/epidemiologia , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/epidemiologia
14.
Rev Peru Med Exp Salud Publica ; 38(1): 119-123, 2021.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-34190903

RESUMO

We characterized the antimicrobial resistance of 70 Escherichia coli isolates obtained from patients with a urinary tract infection (UTI) from 8 public hospitals in Peru. Resistance profiles were identified using the automated MicroScan® system. A standard polymerase chain reaction was used for the detection of the bla TEM, bla CTX-M, bla SHV and bla PER genes. The 65.7% (46/70) of the isolates presented a multidrug-resistant phenotype and 55.7% (39/70) were extended-spectrum beta-lactamases producers. High levels of resistance were detected for ampicillin (77,1%), ciprofloxacin (74,3%), trimethoprim/sulfamethoxazole (62,9%), cefepime (57,1%), and cefuroxime (57,1%). The bla TEM gene was the most frequent (31,4%), followed by bla CTX-M (18,6%) and bla SHV (2,9%) genes. These results show high resistance levels to antimicrobials of clinical use in E. coli isolates from hospital UTI patients in Peru.


Assuntos
Infecções por Escherichia coli , Escherichia coli Uropatogênica , Antibacterianos/farmacologia , Farmacorresistência Bacteriana/genética , Infecções por Escherichia coli/tratamento farmacológico , Hospitais Públicos , Humanos , Testes de Sensibilidade Microbiana , Peru , Escherichia coli Uropatogênica/genética , beta-Lactamases/genética
15.
Int J Mol Sci ; 22(10)2021 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-34069756

RESUMO

Hybrid nanostructures can be developed with inorganic nanoparticles (NPs) such as zinc oxide (ZnO) and natural antibacterials. ZnO NPs can also exert antibacterial effects, and we used them here to examine their dual action in combination with a natural antibacterial agent, protocatechuic acid (PCA). To produce hybrid nanoformulations, we functionalized ZnO NPs with four types of silane organic molecules and successfully linked them to PCA. Physicochemical assessment confirmed PCA content up to ~18% in hybrid nanoformulations, with a PCA entrapment efficiency of ~72%, indicating successful connection. We then investigated the in vitro release kinetics and antibacterial effects of the hybrid against Staphylococcus aureus. PCA release from hybrid nanoformulations varied with silane surface modification. Within 98 h, only 8% of the total encapsulated PCA was released, suggesting sustained long-term release. We used nanoformulation solutions collected at days 3, 5, and 7 by disc diffusion or log reduction to evaluate their antibacterial effect against S. aureus. The hybrid nanoformulation showed efficient antibacterial and bactericidal effects that also depended on the surface modification and at a lower minimum inhibition concentration compared with the separate components. A hybrid nanoformulation of the PCA prodrug and ZnO NPs offers effective sustained-release inhibition of S. aureus growth.


Assuntos
Hidroxibenzoatos/administração & dosagem , Hidroxibenzoatos/farmacologia , Óxido de Zinco/farmacologia , Antibacterianos/administração & dosagem , Antibacterianos/farmacologia , Anti-Infecciosos/farmacologia , Preparações de Ação Retardada/farmacologia , Sistemas de Liberação de Medicamentos/métodos , Escherichia coli/efeitos dos fármacos , Infecções por Escherichia coli/tratamento farmacológico , Nanopartículas Metálicas/química , Testes de Sensibilidade Microbiana , Nanopartículas/química , Nanopartículas/metabolismo , Nanoestruturas/química , Infecções Estafilocócicas/tratamento farmacológico , Staphylococcus aureus/efeitos dos fármacos , Óxido de Zinco/química , Óxido de Zinco/metabolismo
16.
Antimicrob Agents Chemother ; 65(7): e0082521, 2021 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-33972240

RESUMO

Infections caused by extended-spectrum-ß-lactamase (ESBL)-producing Escherichia coli are a significant cause of morbidity and health care costs. Globally, the prevailing clonal type is ST131 in association with the blaCTX-M-15 ß-lactamase gene. However, other ESBLs, such as blaCTX-M-14 and blaCTX-M-27, can also be prevalent in some regions. We identified ST38 ESBL-producing E. coli from different regions in the United States which carry blaCTX-M-27 embedded on two distinct plasmid types, suggesting the potential emergence of new ESBL lineages.


Assuntos
Infecções por Escherichia coli , Proteínas de Escherichia coli , Escherichia coli/genética , Infecções por Escherichia coli/tratamento farmacológico , Proteínas de Escherichia coli/genética , Humanos , Plasmídeos/genética , Estados Unidos , beta-Lactamases/genética
18.
J Hosp Infect ; 114: 104-110, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34052283

RESUMO

BACKGROUND: Monitoring the use of antimicrobials in hospitalized patients is critical owing to the risk of resistance selection. This study aimed to describe the patterns of antimicrobial prescription for the most frequent healthcare-associated infections (HAIs) in France, relating drugs and microbiological data. METHODS: We used data from the 2017 point-prevalence survey of HAI and antimicrobial use in France, a large nationally representative sample survey of inpatients. We sought unambiguous correspondence between individual indications of antibiotic regimen and HAI sites to determine which molecules were directed towards which pathogen, considering its resistance profile. RESULTS: Among 75,698 adult patients from 401 hospitals, 5.1% had an active HAI and 4.3% were being treated for an HAI. The two most frequent antibiotic indications were lower respiratory tract (LRTI, 27.7%) and urinary tract infections (UTI, 18.4%). For LRTI, the most prescribed antibiotic was amoxicillin-clavulanic acid (27.6%) and most frequently isolated pathogens (each accounting for around 17% of isolates) were Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli. Meticillin-resistant S. aureus LRTI was more likely to be treated with linezolid. For UTI, ofloxacin, ceftriaxone, amoxicillin/co-amoxiclav were most-prescribed (∼13% each) and E. coli predominantly isolated (52.0%). Extended-spectrum beta-lactamase-producing E. coli UTI were more likely treated by fosfomycin, pivmecillinam or ertapenem. CONCLUSIONS: This study provides a baseline of antimicrobial use in relation to microbiological information in patients with the most common HAIs. These results can serve to direct future efforts in antimicrobial stewardship. Our work could be extended to a broader population, notably in Europe where similar surveys have been conducted.


Assuntos
Infecção Hospitalar , Infecções por Escherichia coli , Infecções Urinárias , Adulto , Antibacterianos/uso terapêutico , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/epidemiologia , Infecções por Escherichia coli/tratamento farmacológico , Hospitais , Humanos , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/epidemiologia
19.
Commun Biol ; 4(1): 542, 2021 05 10.
Artigo em Inglês | MEDLINE | ID: mdl-33972678

RESUMO

The increasing prevalence of antimicrobial resistance has become a global health problem. Acinetobacter baumannii is an important nosocomial pathogen due to its capacity to persist in the hospital environment. It has a high mortality rate and few treatment options. Antibiotic combinations can help to fight multi-drug resistant (MDR) bacterial infections, but they are rarely used in the clinics and mostly unexplored. The interaction between bacteriostatic and bactericidal antibiotics are mostly reported as antagonism based on the results obtained in the susceptible model laboratory strain Escherichia coli. However, in the present study, we report a synergistic interaction between nalidixic acid and tetracycline against clinical multi-drug resistant A. baumannii and E. coli. Here we provide mechanistic insight into this dichotomy. The synergistic combination was studied by checkerboard assay and time-kill curve analysis. We also elucidate the mechanism behind this synergy using several techniques such as fluorescence spectroscopy, flow cytometry, fluorescence microscopy, morphometric analysis, and real-time polymerase chain reaction. Nalidixic acid and tetracycline combination displayed synergy against most of the MDR clinical isolates of A. baumannii and E. coli but not against susceptible isolates. Finally, we demonstrate that this combination is also effective in vivo in an A. baumannii/Caenorhabditis elegans infection model (p < 0.001).


Assuntos
Infecções por Acinetobacter/tratamento farmacológico , Acinetobacter baumannii/isolamento & purificação , Caenorhabditis elegans/crescimento & desenvolvimento , Sinergismo Farmacológico , Infecções por Escherichia coli/tratamento farmacológico , Escherichia coli/isolamento & purificação , Ácido Nalidíxico/farmacologia , Tetraciclinas/farmacologia , Infecções por Acinetobacter/microbiologia , Animais , Antibacterianos/farmacologia , Caenorhabditis elegans/efeitos dos fármacos , Caenorhabditis elegans/microbiologia , Infecções por Escherichia coli/microbiologia , Humanos , Testes de Sensibilidade Microbiana
20.
ACS Biomater Sci Eng ; 7(5): 1827-1835, 2021 05 10.
Artigo em Inglês | MEDLINE | ID: mdl-33966376

RESUMO

The progressively increasing degree of multiple antibiotic resistance in Gram-negative bacteria challenges the treatment of severe bacterial infection-induced chronic skin wounds. To address this problem, we developed a straightforward strategy to prepare a composite film consisting of antibacterial nanoparticles (4,6-diamino-2-pyrimidinethiol-functionalized gold nanoparticles, DAPT-Au NPs) and a silk fibroin (SF) mixed-matrix membrane (DAPT-Au-SF MMM) as a wound dressing for treating multidrug-resistant (MDR) E. coli- induced infection. The good hydrophilicity of SF allows the highly effective release of DAPT-Au NPs from the composite film to combat pathogens within minutes. The antibacterial activity of the composite film is maintained regardless of antimicrobial susceptibility. DAPT-Au-SF MMMs also promote healing in rat wounds infected by clinically isolated MDR E. coli. Our findings provide a new strategy to extend the use of gold nanomaterials and SF-based wound dressings, especially against drug-resistant bacterial infections.


Assuntos
Antibacterianos/uso terapêutico , Infecções por Escherichia coli/tratamento farmacológico , Fibroínas , Nanopartículas Metálicas , Ferimentos e Lesões/tratamento farmacológico , Ferimentos e Lesões/microbiologia , Animais , Escherichia coli , Ouro , Ratos
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