Prevalence of Colonization with Antibiotic Resistant Gram-Negative Bacilli in a Nursing Home Care Unit: The Importance of Cross-Colonization as Documented by Plasmid Analysis

1986 ◽  
Vol 7 (11) ◽  
pp. 538-545 ◽  
Author(s):  
David M. Shlaes ◽  
Mary-Helen Lehman ◽  
Charlotte A. Currie-McCumber ◽  
C.H. Kim ◽  
Rachel Floyd
Keyword(s):  
Nursing Home ◽  
Plasmid Dna ◽  
Nursing Home Care ◽  
Restriction Endonuclease Digestion ◽  
Gram Negative ◽  
E Coli ◽  
Plasmid Analysis ◽  
Gentamicin Resistance ◽  
R Plasmids ◽  
Endonuclease Digestion

AbstractA prevalence study was carried out on a 100-bed Veterans Administration nursing home care unit to determine the extent of colonization with gentamicin-resistant gram-negative bacilli (GRGNB). Hand cultures of 12 employees and 17 environmental cultures were negative. Twenty-six of 86 (30%) patients were colonized with 49 GRGNB. Sixteen patients (19%) had urinary colonization. Multivariate analysis revealed significant associations between rectal or perineal colonization (P<0.01), and the presence of a urinary device (82% condom catheters) (P<0.05), with urinary colonization. The most common isolates were Providencia stuartii (20), Escherichia coli (nine) and Klebsiella pneumoniae (nine). Twenty-six of 49 isolates carried plasmids. Restriction endonuclease digestion of plasmid DNA was performed for 21. Cross-colonization, as defined by the presence of the identical species with the identical restriction endonuclease digestion profile of purified plasmid DNA found in different patients, was observed for eight of 21 (38%) strains. All were geographically clustered. No strains could transfer gentamicin-resistance by conjugation and only two plasmids could transform our E coli recipient to gentamicin resistance. One E coli plasmid was identical to two Citrobacter freundii plasmids and a P stuartii plasmid isolated from three different patients. This 105 kb plasmid is conjugative and encodes resistance to ampicillin, carbenicillin, tetracycline, and sulfonamides. Thus, 57% of strains were cross-colonizing or contained identical R-plasmids. Southern hybridization using a 1 kb TEM-1 gene probe demonstrated sequences homologous to this probe in five of five nursing home plasmids examined. These data demonstrate the utility of plasmid analysis in epidemiologic typing of multiple species of Enterobacteriaceae, and suggest wide dissemination of R-plasmids bearing the TEM-1β-lactamase gene among gram-negative bacilli colonizing patients residing in our nursing home.

Commentary: Dissemination of a Plasmid Determining Multiple Antibiotic Resistance Between Two Veterans Administration Medical Centers

1986 ◽  
Vol 7 (7) ◽  
pp. 362-364 ◽  
Author(s):  
David M. Shlaes ◽  
Charlotte Currie-McCumber
Keyword(s):  
Antibiotic Resistance ◽  
Restriction Endonuclease ◽  
Veterans Administration ◽  
Restriction Endonuclease Digestion ◽  
Multiple Antibiotic Resistance ◽  
Administration Medical ◽  
E Coli ◽  
Medical Centers ◽  
R Plasmids ◽  
Endonuclease Digestion

AbstractThe endemic R-plasmids mediating resistance to gentamicin and multiple other antibiotics among many species of Enterobacteriaceae from the Minneapolis and Cleveland Veterans Administration Medical Centers were compared by restriction endonuclease digestion profiling and by phenotype expressed in sensitive E. coli recipients. Southern hybridizations were also performed. Our data indicate that these plasmids demonstrate some microheterogeneity, but are very closely related. Both are self-transferable and mediate resistance to ampicillin, carbenicillin, chloramphenicol, gentamicin, tobramycin, neomycin and kanamycin. These results suggest the dissemination of a conjugal R-plasmid or of Enterobacteriaceae bearing the plasmid between two midwestern Veterans Administration Medical Centers. The most likely mechanism of transmission may be the frequent transfer of patients between midwestern Veterans Administration Medical Centers.

scholarly journals Gram-negative Organisms from Patients with Community-Acquired Urinary Tract Infections and Associated Risk Factors for Antimicrobial Resistance: A Single-Center Retrospective Observational Study in Japan

Antibiotics ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 438 ◽  
Author(s):  
Naoki Kanda ◽  
Hideki Hashimoto ◽  
Tomohiro Sonoo ◽  
Hiromu Naraba ◽  
Yuji Takahashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nursing Home ◽  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Urinary Tract Infections ◽  
Strong Impact ◽  
Care Hospital ◽  
Gram Negative ◽  
E Coli ◽  
Tract Infections

A specific antibiogram is necessary for the empiric antibiotic treatment of community-acquired urinary tract infections (UTI) because of the global spread of antimicrobial resistance. This study aimed to develop an antibiogram specific for community-acquired UTI and assess the risk factors associated with community-acquired UTI caused by antimicrobial-resistant organisms. This cross-sectional observational retrospective study included patients with community-acquired UTI caused by Gram-negative rods (GNR) who were admitted to the emergency department at a tertiary care hospital in Ibaraki, Japan, in 2017–2018. A total of 172 patients were enrolled (including 38 nursing home residents). Of the 181 GNR strains considered as causative agents, 135 (75%) were Escherichia coli, and 40 (22%) exhibited third-generation cephalosporin resistance. Extended-spectrum β-lactamase (ESBL)-producing E. coli accounted for 25/40 (63%) of resistant GNR. Overall susceptibility rate of Enterobacterales was 92%, 81%, 100%, 75%, and 89% for cefmetazole, ceftriaxone, meropenem, levofloxacin, and trimethoprim–sulfamethoxazole, respectively. Residence in a nursing home (odds ratio (OR), 2.83; 95% confidence interval (CI), 1.18–6.79) and recent antibiotic use (OR, 4.52; 95% CI, 1.02–19.97) were independent risk factors for UTI with resistant GNR. ESBL-producing E. coli was revealed to have a strong impact on antimicrobial resistance pattern. Therefore, an antibiotic strategy based on a disease-specific antibiogram is required.

Gentamicin-Resistance Plasmids in an Intensive Care Unit

1986 ◽  
Vol 7 (7) ◽  
pp. 355-361 ◽  
Author(s):  
David M. Shlaes ◽  
Charlotte Currie-McCumber ◽  
Mabel Eanes ◽  
Grace Rotter ◽  
Rachel Floyd
Keyword(s):  
Antibiotic Resistance ◽  
Intensive Care ◽  
E Coli ◽  
Prospective Sampling ◽  
Initial Culture ◽  
Gentamicin Resistance ◽  
R Plasmids ◽  
A Prospective Study ◽  
Time Of Admission

AbstractTo better understand the role of plasmids and their importance in the endemic antibiotic resistance of Enterobacteriaceae, we began a prospective study of our combined medical intensive care/coronary care unit. An initial culture survey of the patients, ward staff, and environment was followed by a prospective sampling of 139 consecutive new admissions at the time of admission to the unit, and at regular intervals thereafter for the remainder of their stay. All cultures were planted on agar-containing gentamicin. Of the 147 patients studied, 12 (8.2%) were colonized with 20 strains of gentamicin-resistant gram-negative bacilli (GRGNB) at 29 sites. An additional four GRGNB were isolated from the environment. Of the 24 GRGNB strains, 7 (29%) Enterobacteriaceae carried plasmids shown to carry the gentamicin-resistance determinant. Plasmids were further characterized by restriction endonuclease digestion profiles of plasmid DNA purified from E. coli C600 transconjugants or transformants. A 93 kb plasmid introduced to the unit by a Serratia liquefaciens colonizing a patient transferred from another area in the hospital was identical to 93 kb plasmids carried by a C. amalonaticus and an E. aerogenes subsequently colonizing another patient on the unit. A 60 kb plasmid, first isolated from a S. marcescens colonizing a sink drain was later isolated from an E. cloacae colonizing a patient. Our results indicate that spread of specific R-plasmids may be one mechanism for dissemination of antibiotic resistance on our MICU/CCU.

Nursing Home Care

1986 ◽  
Vol 2 (3) ◽  
pp. 601-615 ◽  
Author(s):  
James S. Wood
Keyword(s):  
Nursing Home ◽  
Home Care ◽  
Nursing Home Care

SYNTHESIS, CHARACTERIZATION AND BIOLOGICAL EVALUATION OF 3-FORMYL INDOLE BASED SCHIFF BASES

2018 ◽  
Vol 7 (6) ◽  
Author(s):  
Singh Gurvinder ◽  
Singh Prabhsimran ◽  
Dhawan R. K.
Keyword(s):  
Antimicrobial Activity ◽  
Spectral Analysis ◽  
Schiff Bases ◽  
Antimicrobial Agents ◽  
Biological Evaluation ◽  
Fungal Strain ◽  
Bacterial Strains ◽  
Standard Drug ◽  
Gram Negative ◽  
E Coli

In order to develop new antimicrobial agents, a series of 3-formyl indole based Schiff bases were synthesized by reacting 3-formyl indole(indole-3-carboxaldehyde) with substituted aniline taking ethanol as solvent. The reaction was carried in the presence of small amount of p-toluene sulphonic acid as catalyst.All the synthesized compounds were characterized by IR, 1H-NMR spectral analysis. All the synthesized compounds were evaluated for antimicrobial activity against two gram positive bacterial strains (B. subtilisand S. aureus) and two gram negative bacterial strains (P. aeruginosaand E. coli) and one fungal strain (C. albicans). All the synthesized compounds were found to have moderate to good antimicrobial activity. The  standard drug amoxicillin, fluconazole were used for antimicrobial activity. Among the synthesized compounds, the maximum antimicrobial activity was shown by compounds GS04, GS07, GS08 and GS10.

Disinfection of Fruits with Activated Water

2019 ◽  
Vol 10 ◽  
pp. 1864-1872
Author(s):  
Prof. Teodora P. Popova
Keyword(s):  
Antimicrobial Activity ◽  
Aqueous Solutions ◽  
Antimicrobial Properties ◽  
The Other ◽  
Gram Negative Bacteria ◽  
High Antimicrobial Activity ◽  
Gram Negative ◽  
E Coli ◽  
Number Of Microorganisms ◽  
Lower Effect

The effect of ionized aqueous solutions (anolytes and catholyte) in the processing of fruits (cherries, morellos, and strawberries) for decontamination has been tested. Freshly prepared analytes and catholyte without the addition of salts were used, as well as stored for 7 months anolytes, prepared with 0.5% NaCl and a combination of 0.5% NaCl and 0.5% Na2CO3. The anolyte prepared with a combination of 0.5% NaCl and 0.5% Na2CO3, as well as the anolyte obtained with 0.5% NaCl, exhibit high antimicrobial activity against the surface microflora of strawberries, cherries, and sour cherries. They inactivate E. coli for 15 minutes. The other species of the fam. Enterobacteriaceae were also affected to the maximum extent, as is the total number of microorganisms, especially in cherries and sour cherries. Even stored for 7 months, they largely retain their antimicrobial properties. Anolyte and catholyte, obtained without the addition of salts, showed a lower effect on the total number of microorganisms, but had a significant effect on Gram-negative bacteria, and especially with regard to the sanitary indicative E. coli.

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