Respiratory infections caused by Haemophilus influenzae β-lactamase positive carrying blaTEM gene

2020 ◽  
Vol 30 (Supplement_2) ◽  
Author(s):  
J Valério ◽  
H Ferreira ◽  
C Chaves ◽  
F Rodrigues ◽  
N Osório
Keyword(s):  
Antibiotic Therapy ◽  
Respiratory Infections ◽  
Clinical Pathology ◽  
Resistance Mechanisms ◽  
Important Data ◽  
Ampicillin Resistance ◽  
Phenotypic Profile ◽  
Antimicrobial Susceptibility Profile ◽  
Activity Screening ◽  
Etiological Agents

Abstract Introduction One of the main etiological agents of respiratory infections is H. Influenzae. The group of antibiotics most used to the treatment of H. influenzae infections is β-lactams. The most common β-lactam resistance is to ampicillin, characterized by the production of TEM (95%) and ROB (5%) β-lactamases, designated enzymatic resistance. Objectives Characterize the susceptibility profile of H. influenzae to β-lactam antibiotics, to evaluate the enzymatic resistance by the β-lactamase production and to correlate the phenotypic profile with the presence of the blaTEM. Methodology Total of 152 isolates of H. influenzae from respiratory infections were evaluated: 88 from expectorations, 56 from bronchial aspirates and 8 from bronchoalveolar lavage, collected in Clinical Pathology Service of Centro Hospitalar e Universitário de Coimbra. The results of the antimicrobial susceptibility profile and the β-lactamase screening were also provided. In order to investigate the blaTEM, DNA was extracted from the isolates and the detection was performed using the PCR technique. Results The prevalence of the blaTEM in the isolates was 31.6%, of these 33.3% showed resistance to ampicillin and 57.9% were positive in β-lactamase activity screening and blaTEM carriers. There was a statistically significance between the presence of the gene with ampicillin resistance and β-lactamase activity screening. Conclusion β-lactamase TEM production was the main mechanism of enzymatic resistance which demonstrates the high spread of the blaTEM among isolates of H. influenzae. The results found suggest that the negative strains for this β-lactamase but that presented β-lactamases with activity and resistance to β-lactams should have other β-lactamases as ROB or others. However strains with β-lactamase negative should have other mechanisms promoting the resistance as PBP3. This study provides important data on the antibiotic therapy, to minimize the expression of resistance mechanisms and problems associated with treatment.

Persistent Apical Periodontitis: Bacterial Taxonomic Analysis and Treatment Through Intentional Replantation

2020 ◽  
Author(s):  
Fernando Eduardo Coria-Valdiosera
Keyword(s):  
Antibiotic Therapy ◽  
Root Canal ◽  
Resistance Mechanisms ◽  
Apical Periodontitis ◽  
Infectious Process ◽  
Identification Of Bacteria ◽  
The Right ◽  
Apical Lesions ◽  
Endodontic Retreatment

Introduction: The microorganisms own different resistance mechanisms that allow them to resist the chemo-mechanical cleanliness of root canal and antibiotic therapies causing the persistence of apical lesions. Methods: This clinical case describes a male patient diagnosed with pulp necrosis in the right lower central incisor due to trauma, which developed apical periodontitis manifesting itself extra orally. Root canal treatment along with antibiotic therapy was performed, but because the infectious process persisted, endodontic retreatment and a new antibiotic therapy were carried out, however, the clinical evolution was not favorable. For this reason, the intentional replantation was chosen as the outright treatment, performing apicectomy and curettage of the periapical lesion, from which the isolation and taxonomic study of microorganisms were carried out, with the respective antibiogram. Results: In the 10-day clinical follow-up, the extraoral infectious process disappeared almost completely and 6 months later, a complete repair of the bone tissue was observed on the tomography. Conclusion: A better understanding of the persistence of apical periodontitis was achieved by taxonomic identification of bacteria and the intentional replantation allowed to remove the apical biofilm gaining an excellent wound healing.

scholarly journals Topical issues of inhaled antibacterial therapy of respiratory diseases in children

2018 ◽  
pp. 128-131 ◽  
Author(s):  
N. G. Kolosova ◽  
A. B. Kolosova
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Therapy ◽  
Respiratory Diseases ◽  
Respiratory Infections ◽  
Infectious Agents ◽  
Antibiotic Resistant ◽  
Restriction Policy ◽  
Resistant Strains ◽  
Outpatient Practice ◽  
Systemic Antibiotics

Despite the fact that acute respiratory infections have viral etiology, the frequency of antibiotic prescriptions accounts for more than 70% in outpatient practice. However, the preventive administration of systemic antibiotics does not reduce the duration of the disease and the incidence of bacterial complications. In addition, the irrational use of antibiotic therapy can lead to the development of antibiotic resistance of infectious disease pathogens. The global problem of antibiotic resistance is seen as a serious threat to public health, and therefore the systemic antibiotic restriction policy is crucial, which helps to reduce the formation of antibiotic-resistant strains of infectious agents. The possibility of using local antibacterial drugs enables optimization of antibiotic therapy and reduces the risk of the development of antibiotic resistance. The article discusses the issues of use of thiamphenicol glycinate acetylcysteinate in various diseases in children.

Procalcitonin-guided antibiotic therapy algorithms for different types of acute respiratory infections based on previous trials

2018 ◽  
Vol 16 (7) ◽  
pp. 555-564 ◽  
Author(s):  
Philipp Schuetz ◽  
Rebekka Bolliger ◽  
Meret Merker ◽  
Mirjam Christ-Crain ◽  
Daiana Stolz ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Respiratory Infections ◽  
Acute Respiratory Infections ◽  
Different Types

Parental Knowledge About Common Respiratory Infections and Antibiotic Therapy in Children

1999 ◽  
Vol 92 (10) ◽  
pp. 971-976 ◽  
Author(s):  
C APRIL COLLETT ◽  
DIANE E. PAPPAS ◽  
BRENT A. EVANS ◽  
GREGORY F. HAYDEN
Keyword(s):  
Antibiotic Therapy ◽  
Respiratory Infections ◽  
Parental Knowledge

scholarly journals The efficiency of sodC gene / N. meningitidis detection in comparison with the classical methods for the diagnosis of meningococcal infection / Evaluarea eficienţei Real Time PCR TaqMan utilizând gena sodC / N. meningitidis în comparaţie cu metodele clasice utilizate în diagnosticul infecţiei meningococice

2015 ◽  
Vol 23 (1) ◽  
Author(s):  
Roxana Elena Nemescu ◽  
Ramona Gabriela Ursu ◽  
Carmen Mihaela Dorobăț ◽  
Luminița Smaranda Iancu
Keyword(s):  
Antibiotic Therapy ◽  
Real Time ◽  
Real Time Pcr ◽  
Latex Agglutination ◽  
Blood Analysis ◽  
Meningococcal Infection ◽  
Specific Method ◽  
Rt Pcr ◽  
Highly Sensitive ◽  
Etiological Agents

AbstractMeningococcal infection requires a fast and accurate diagnostic method in order to correctly initiate the antibiotic therapy. The aim of our study was to assess the efficiency of Real Time PCR -Taq Man using sod C gene / N. meningitidis in comparison with the classical methods for the diagnosis of meningococcal infection - direct microscopy, cultivation, latex agglutination and blood culture. We have detected 24/44 (54.54%) patients with meningococcal infection. In both cases of patients with / without previous antibiotic therapy before admission, the AUC (area under curve) had the highest values for RT PCR in CSF and blood analysis. This sod C RT-PCR assay is a highly sensitive and specific method for detection of Neisseria meningitis and it would be useful to include this method like a multiplex in routine testing of patients with clinical meningococcal infection for other etiological agents also.

Antibiotic therapy of acute upper respiratory tract infections and otitis media in adults

2018 ◽  
Vol 7 (1) ◽  
pp. 1-7
Author(s):  
Aleksandra Paź ◽  
Magdalena Arimowicz
Keyword(s):  
Respiratory Tract ◽  
Antibiotic Therapy ◽  
Respiratory Tract Infections ◽  
Viral Infections ◽  
Respiratory Infections ◽  
Symptomatic Treatment ◽  
Upper Respiratory Tract Infections ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections

An estimated 50% of antibiotic prescriptions may be unjustified in the outpatient setting. Viruses are responsible for most acute respiratory tract infections. The viral infections are often self-limiting and only symptomatic treatment remains effective. Bacteria are involved in a small percentage of infections etiology in this area. In the case of a justified or documented suspicion of a bacterial infection, antibiotic therapy may be indicated. Based on the Polish „Recommendations for the management of non-hospital respiratory infections 2016”, the indications, the rules of choice, the appropriate dosing schedules and the therapy duration, in the most frequent upper respiratory tract infections in adults, have been presented. Implementation of the presented recommendations regarding our Polish epidemiological situation, will significantly reduce the tendency to abuse antibiotics, and thus will limit the spread of drug-resistant microorganisms.

scholarly journals Genetic and Molecular Characterization of β-Lactamase-Negative Ampicillin-Resistant Haemophilus influenzae with Unusually High Resistance to Ampicillin

2004 ◽  
Vol 48 (5) ◽  
pp. 1630-1639 ◽  
Author(s):  
Frank S. Kaczmarek ◽  
Thomas D. Gootz ◽  
Fadia Dib-Hajj ◽  
Wenchi Shang ◽  
Shawn Hallowell ◽  
...  
Keyword(s):  
North America ◽  
Haemophilus Influenzae ◽  
Efflux Pump ◽  
Geometric Mean ◽  
Resistance Mechanisms ◽  
Clinical Isolates ◽  
Ampicillin Resistance ◽  
Group I ◽  
Acrab Efflux Pump ◽  
High Level

ABSTRACT Previous studies with beta-lactamase-negative, ampicillin-resistant (BLNAR) Haemophilus influenzae from Japan, France, and North America indicate that mutations in ftsI encoding PBP3 confer ampicillin MICs of 1 to 4 μg/ml. Several BLNAR strains with ampicillin MICs of 4 to 16 μg/ml recently isolated from North America were studied. Pulsed-field gel electrophoresis identified 12 unique BLNAR strains; sequencing of their ftsI transpeptidase domains identified 1 group I and 11 group II mutants, as designated previously (K. Ubukata, Y. Shibasaki, K. Yamamoto, N. Chiba, K. Hasegawa, Y. Takeuchi, K. Sunakawa, M. Inoue, and M. Konno, Antimicrob. Agents Chemother. 45:1693-1699, 2001). Geometric mean ampicillin MICs for several clinical isolates were 8 to 10.56 μg/ml. Replacement of the ftsI gene in H. influenzae Rd with the intact ftsI from several clinical isolates resulted in integrants with typical BLNAR geometric mean ampicillin MICs of 1.7 to 2.2 μg/ml. Cloning and purification of His-tagged PBP3 from three clinical BLNAR strains showed significantly reduced Bocillin binding compared to that of PBP3 from strain Rd. Based on these data, changes in PBP3 alone could not account for the high ampicillin MICs observed for these BLNAR isolates. In an effort to determine the presence of additional mechanism(s) of ampicillin resistance, sequencing of the transpeptidase regions of pbp1a, -1b, and -2 was performed. While numerous changes were observed compared to the sequences from Rd, no consistent pattern correlating with high-level ampicillin resistance was apparent. Additional analysis of the resistant BLNAR strains revealed frame shift insertions in acrR for all four high-level, ampicillin-resistant isolates. acrR was intact for all eight low-level ampicillin-resistant and four ampicillin-susceptible strains tested. A knockout of acrB made in one clinical isolate (initial mean ampicillin MIC of 10.3 μg/ml) lowered the ampicillin MIC to 3.67 μg/ml, typical for BLNAR strains. These studies illustrate that BLNAR strains with high ampicillin MICs exist that have combined resistance mechanisms in PBP3 and in the AcrAB efflux pump.

scholarly journals Serum Procalcitonin Guided Antibiotic Therapy in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

2015 ◽  
Vol 3 (2) ◽  
pp. 67-70
Author(s):  
Rawshan Arra Khanam ◽  
Md Ashraful Haque ◽  
Mohammad Omar Faruq
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Antibiotic Therapy ◽  
Pulmonary Disease ◽  
Hospital Admissions ◽  
Respiratory Infections ◽  
Chronic Obstructive ◽  
Acute Phase Reactants ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Exacerbation Of Copd

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable, but progressive disease. Hospital admissions of patients with COPD are frequently due to acute exacerbations of COPD (AECOPD). AECOPD are very common, affecting about 20% of COPD patients. The bacterial infection plays an important role in the exacerbation of COPD patients. In addition, recent studies using molecular diagnostics indicate that a substantial proportion of AECOPD are associated with viral infection. Accurate methods to differentiate viral and bacterial respiratory infections to allow targeted antibiotic therapy would be beneficial. Acute phase reactants are capable of demonstrating the inflammation; however, they cannot be employed to make a difference between bacterial and nonbacterial causes of the inflammation. Recently, measurement of procalcitonin (PCT) levels appears to be useful in order to minimize this problem.Bangladesh Crit Care J September 2015; 3 (2): 67-70

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