Paradoxical effect of 1-(1-naphthylmethyl)-piperazine on resistance to tetracyclines in multidrug-resistant Acinetobacter baumannii.

OBJECTIVES: The efflux inhibitor 1-(1-naphthylmethyl)-piperazine (NMP) has been demonstrated to reverse multidrug resistance in Acinetobacter baumannii. We investigated the interaction of NMP with tigecycline and three other tetracyclines on clinical isolates of A. baumannii. METHODS: One hundred and four clinical isolates of Acinetobacter were tested for susceptibility to tigecycline, minocycline, doxycycline and tetracycline by disc diffusion, and tigecycline MICs were determined by Etest, both in the presence and absence of NMP. Tigecycline MICs and zones of inhibition were interpreted using the BSAC guidelines. An OXA carbapenemase multiplex PCR was also performed on each isolate. RESULTS: Mean zones of inhibition for tetracycline, doxycycline and minocycline increased by 11.3%, 22.9% and 11.2%, respectively, in the presence of NMP. In contrast, tigecycline susceptibility was decreased in the presence of NMP, with mean zones of inhibition decreasing by 8.4%. Based on PCR results, all but six isolates belonged to the OXA-23 clone 1. CONCLUSIONS: Susceptibility to tigecycline of the A. baumannii OXA-23 clone 1 prevalent in the UK is reduced (approximately 2-fold) by the presence of the efflux inhibitor NMP. NMP does not have the same effect on susceptibility to other tetracyclines.

Carriage rate and antibiotic susceptibility of coagulase-positive staphylococci isolated from healthy dogs in Victoria, Australia.

BACKGROUND: Studies in Australia and elsewhere have shown high levels of antibiotic resistance in coagulase-positive staphylococci in dogs visiting veterinary clinics with pyoderma and related conditions. Although important, such studies tend to overestimate the burden of resistance. The aim of the current study was to investigate the prevalence of coagulase-positive staphylococci in healthy dogs in Central Victoria to assess the level of antibiotic resistance among these isolates. METHODS: We recruited 117 healthy dogs into the study. Swabs were taken at four sites (ear, mouth, nose, perineum) and staphylococcal species identified and isolated using culture and biochemical techniques. RESULTS: Staphylococcus pseudintermedius and S. aureus were recovered from 100 and 17 dogs, respectively; 15 dogs were simultaneously co-colonised with both organisms. The mouth and perineum were the most sensitive sites for recovery of these organisms. The most commonly encountered resistances were penicillin (95.2% and 72.4% in S. aureus and S. pseudintermedius, respectively) and doxycycline/tetracycline (19.7% in S. pseudintermedius). No methicillin-resistant S. aureus were recovered, but two phenotypically methicillin-resistant S. pseudintermedius (MRSP) isolates were recovered, although only one was PCR-positive for the mecA gene. Notably the MRSP isolate was multidrug resistant, as it also exhibited resistance to mupirocin and erythromycin. CONCLUSION: With the exception of penicillin, doxycycline and tetracycline, the level of resistance to the antimicrobial agents tested was minimal. Prudent antibiotic use in treating companion animals with skin infections will reduce the selection of MRSP and other multidrug-resistant bacteria.

Bloodstream infection due to Acinetobacter spp: epidemiology, risk factors and impact of multi-drug resistance.

Acinetobacter spp. are increasingly reported as important causes of human infection. Many isolates exhibit multi-drug resistance, raising concerns over our ability to treat serious infections with these organisms. The impact of infection on clinical outcome as well as the importance of multi-drug resistance is poorly defined. A descriptive retrospective observational study was undertaken of all episodes of Acinetobacter bacteremia occurring in a UK tertiary care centre from 1998-2006. Demographics of infected patients, characteristics and antimicrobial susceptibility of infecting strains were recorded and the impact of antimicrobial therapy on all causes of 30-day mortality assessed. Three hundred ninety-nine episodes of Acinetobacter bacteremia were identified, with A. baumannii being the most frequently isolated species. Most episodes occurred in critical care and were associated with multidrug resistance, with carbapenem resistance rising from 0% in 1998 to 55% in 2006. Although bacteremia due to carbapenem-resistant Acinetobacter and a requirement for critical care were associated with a higher mortality, mortality was not reduced by the administration of appropriate empirical antimicrobial therapy. A prospective study is required to identify both the most effective intervention and those most likely to benefit from treatment.

Listeriosis due to infection with a catalase-negative strain of Listeria monocytogenes.

A strain of Listeria monocytogenes recovered from blood and cerebrospinal fluid had no detectable catalase activity, a characteristic used for primary identification. The sporadic occurrence of pathogenic catalase-negative strains highlights the need for a reconsideration of diagnostic criteria and questions the role of catalase in the pathogenesis of listeria infection.