Pilot Study on non-tuberculous mycobacteria infections in Italy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Fattorini ◽  
A Iacobino ◽  
F Giannoni ◽  
Keyword(s):  
Cystic Fibrosis ◽  
Minimum Inhibitory Concentration ◽  
Pilot Study ◽  
Inhibitory Concentration ◽  
Strategic Plan ◽  
Foreign Born ◽  
Old Patients ◽  
National Strategic Plan ◽  
Reported Data ◽  
Resistance Rates

Abstract Background The rise in non-tuberculous mycobacteria (NTM) diseases has been reported worldwide, but no major information is known for Italy. The purpose of this pilot study is to release nationwide data on distribution of NTM in our country. Methods In 2016, the Istituto Superiore di Sanità (National Institute of Health) began to collect microbiological, clinical and minimum inhibitory concentration (MIC) data on NTM infections, in collaboration with hospital laboratories located in 15 out of 20 regions (Studio Multicentrico Italiano NTM, SMI-NTM), which routinely isolate and characterize NTM by commercial identification (Genotype) and MIC (Sensititre) assays. Results In 2016-2018, 32 labs reported data on 4169 NTM strains, including 644 rapid growers (15%) and 3525 slow growers (85%). The most frequent species were Mycobacterium avium (MA) (29.2%), M. intracellulare (MI) (21.5%), M. xenopi (MX) (10.6%), M. gordonae (10.6%), M. abscessus (5.9%), M. chimaera (MC) (5.1%). Overall, 88% NTM strains were isolated from pulmonary sites, 84% from Italians, 51% from men. NTM infections in Italians occurred in 75-84 years old patients, while in foreign-born people were observed in 15-44 years old patients. Strains from cystic fibrosis were 11.9%. The MICs of clarithromycin (CLA) for MA or MI peaked at 2 µg/ml, while for amikacin (AK) peaked at 16 µg/ml. When MICs were interpreted according to the 2018 Clinical and Laboratory Institute Standards (CLSI) breakpoints, MA or MI resistances for CLA were 2.6% and 2.6% respectively, while for AK they were 7.2% and 4.5%, respectively. Higher resistance rates for MA and MI were observed for moxifloxacin and linezolid. MICs of MC, MX, M. kansasii, M. marinum and rapid grower NTM were also determined and interpreted on the basis of CLSI breakpoints. Conclusions This 3-years pilot study is the basis for a future multiannual national strategic plan for surveillance of NTM infections in Italy (collection of 2019 data is in progress). Key messages This 3-years pilot study is the basis for a future multiannual national strategic plan for surveillance of NTM infections in Italy. The purpose of this pilot study is to release nationwide data on distribution of NTM in our country.

scholarly journals Current situation of tuberculosis and National Strategic Plan for Tuberculosis Control in Korea

2021 ◽  
Vol 64 (4) ◽  
pp. 316-323
Author(s):  
Eunjeong Son ◽  
Doosoo Jeon
Keyword(s):  
Insurance Coverage ◽  
Public Health Problem ◽  
Strategic Plan ◽  
Multidrug Resistant ◽  
High Rate ◽  
Foreign Born ◽  
Tuberculosis Control ◽  
Notification Rate ◽  
Tb Control ◽  
National Strategic Plan

Tuberculosis (TB) remains a serious public health problem in Korea. Korea has the highest incidence rate (59 per 100,000 population) and the second-highest TB mortality rate (four per 100,000 population) among Organisation for Economic Cooperation and Development member countries. However, some progress has been made in TB control over the past decade. The notification rate of new TB cases has been gradually decreasing since reaching its highest rate in 2011 (78.9 per 100,000 population). In 2019, the notification rate of new TB cases was 46.4 per 100,000 population, with a reduction of 9.9% from the 2018 rate. Additionally, the number of multidrug-resistant TB cases decreased from 618 in 2018 to 580 in 2019. This progress is thought the result of various TB control programs including a TB public–private mix model, insurance coverage for TB management, and a contact investigation program. Despite the progress made, new challenges have also emerged. The predominant challenges lie in the relatively increasing burden of TB in the vulnerable population (aging, socio-economically vulnerable, and foreign-born population), the implementation of latent TB infection management, and the high rate of multidrug-resistant TB. Since 2019, the Korean government has been implementing the “Midterm strategies to strengthen TB prevention and management” based on the 2nd National Strategic Plan for Tuberculosis Control (2018-2022). This program will be a turning point of TB control in Korea. The results produced in 2023 is expected to be favorable.

scholarly journals Susceptibility in vitro of clinical Candida albicans isolates to the selected azoles

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Bartlomiej Pawlicki ◽  
Anna Biernasiuk ◽  
Monika Jonczyk ◽  
Anna Malm
Keyword(s):  
Candida Albicans ◽  
Minimum Inhibitory Concentration ◽  
Fungal Infection ◽  
Inhibitory Concentration ◽  
Invasive Disease ◽  
Yeast Strains ◽  
Resistance Rates ◽  
Anti Fungal ◽  
Mic Minimum Inhibitory Concentration

Abstract Candida spp. is the most prevalent cause of fungal infection worldwide, and their increasing resistance to anti-fungal agents, especially to azoles, has become problematic. The aim of this work was to establish the susceptibility to fluconazole, itraconazole, voriconazole and posaconazole of 50 clinical C. albicans isolates from hematooncological patients. This has been evaluated using the following parameters: MIC (Minimum Inhibitory Concentration), MIC50 (MIC required to inhibit the growth of 50% of organisms), as well as MIC90 (MIC required to inhibit the growth of 90% of organisms). Susceptibility of the studied clinical isolates to all azoles was high, being 86% for itraconazole, 90% for fluconazole and posaconazole and 92% for voriconazole. The resistance rates ranged from 8% (voriconazole), to 12% (itraconazole). The emergence of azole-resistant yeast strains creates a necessity to determine and monitor the sensitivity of the isolated Candida spp., including C. albicans, especially in patients predisposed to life-threating fungal invasive disease.

Ceftazidime, gentamicin, and rifampicin, in combination, kill biofilms of mucoidPseudomonas aeruginosa

1997 ◽  
Vol 43 (11) ◽  
pp. 999-1004 ◽  
Author(s):  
M. Ghani ◽  
J. S. Soothill
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Minimum Inhibitory Concentration ◽  
Continuous Flow ◽  
Inhibitory Concentration ◽  
Bronchial Secretions ◽  
High Concentrations

In continuous flow biofilm cultures in medium resembling cystic fibrosis bronchial secretions, Pseudomonas aeruginosa was not eradicated from biofilms by 1 week of treatment with high concentrations of ceftazidime and gentamicin, to which the strains were sensitive on conventional testing. The addition of rifampicin, which has little activity against the strains as measured by the minimum inhibitory concentration, led to the apparent elimination of the bacteria from the biofilms. The effect was not strain specific.Key words: Pseudomonas aeruginosa, biofilm, rifampicin.

scholarly journals Comparison between conventional dosing versus personalized pharmacokinetic dosing of vancomycin: a pilot study from a Malaysian private hospital

2021 ◽  
Vol 12 (2) ◽  
pp. 1020-1029
Author(s):  
Tsuey Li Yong ◽  
Chee Ping Chong
Keyword(s):  
Minimum Inhibitory Concentration ◽  
Pilot Study ◽  
Private Hospital ◽  
Inhibitory Concentration ◽  
Hospital Setting ◽  
Total Daily Dose ◽  
Pharmacokinetic Parameters ◽  
Efficacy And Safety ◽  
Daily Dose ◽  
Dosing Method

Pharmacist led vancomycin dosing is not a common practice in private hospital settings of the Malaysian healthcare system. The lack of this pharmacist led system has led to conventional vancomycin dosing without considering the differences in patients pharmacokinetic parameters. This study aims to compare the differences in vancomycin doses between conventional dosing and pharmacist-led personalized pharmacokinetic dosing. A retrospective pilot study was conducted on inpatient adults who were prescribed with intravenous vancomycin in a private hospital. Personalized vancomycin doses were retrospectively calculated by using the pharmacokinetic parameters and was then compared with the actual conventional doses used in the patients. The area under concentration curve over 24 hours/minimum inhibitory concentration (AUC24/MIC) ratio achieved by the doses was also compared. The targeted AUC24/MIC ratio was 400-600 to ensure efficacy and safety of the therapy. A total of 24 patients with a median age of 55.50 years were conveniently sampled. The patients were mostly male (58.3%) and were admitted to the neurosurgical ward (33.3%). Vancomycin was mainly prescribed as empirical treatment (58.3%) for a median treatment period of 5.00 days (IQR 4.00 – 7.00 days). The conventional doses had significant (p < 0.001) lower median total daily dose (2000 mg versus 2500 mg) and lower AUC24/MIC ratio (385 versus 495) as compared to personalized doses. In conclusion, the personalized pharmacokinetic dosing method was significantly more able to achieve the targeted AUC24/MIC ratio. Vancomycin personalized dosing should be considered in the Malaysian private hospital setting.

scholarly journals 133. The Changing Phenotypes and Genotypes of Invasive Pneumococcal Isolates From Children in Shenzhen During 2013–2017

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S95-S95
Author(s):  
Yanmin Bao ◽  
Yuejie Zheng
Keyword(s):  
Antibiotic Resistance ◽  
Streptococcus Pneumoniae ◽  
Minimum Inhibitory Concentration ◽  
Inhibitory Concentration ◽  
The Other ◽  
Significant Difference ◽  
Ermb Gene ◽  
Resistance To Penicillin ◽  
Resistance Rates ◽  
Sequence Types

Abstract Background The phenotypes and genotypes of Streptococcus pneumoniae (Spn.) isolated from children with invasive pneumococcal diseases (IPDs) were changed in these years. The purpose of this study was to monitor this mutation trends before the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) in China. Methods Strains were isolated from children less than 14 years old between January 2013 and May 2017 in Shenzhen Children’s Hospital. Serotypes, antibiotic resistance, and genotypes of these isolates were determined using capsular swelling, E-test, and multi-locus sequence typing, respectively. Results A total of 94 Spn. strains were isolated, which belonged to 15 serotypes. The five most prevalent serotypes were 19F (25.5%), 19A (19%), 14 (17%), 23F (7.5%), and 6B (9.6%). The other two serotypes (19C and 15) were non-vaccine types. We found 42 sequence types (STs) for these isolates. The most abundant STs were ST271 (24.4%), ST876 (17%), and ST320 (10.6%), mainly related to 19F, 14, and 19A, respectively. The potential coverage of PCV13 was 87.2%. Among non-meningitis isolates, the resistance rates to penicillin and ceftriaxone were 0% and 2%. However, the meningitis isolates showed universal resistance to penicillin (80%) and ceftriaxone (20%). Most of these isolates (95.7%) were resistant to erythromycin, and 66 (70.2%) strains carried the ermB gene and 24 (25.5%) strains carried both the ermB and mefA/E genes. Serotype 19A showed the highest minimum inhibitory concentration (MIC) for penicillin than the other serotypes, but no significant difference in penicillin MIC among the three main STs (ST271, ST320, and ST876). Conclusion The phenotypes and genotypes of invasive pneumococcal isolates from children in Shenzhen have changed with the passage of time. Compared with PCV7, PCV13 can more effectively protect Chinese children from IPDs. To some extent, these changes are possibly related to the usage of antibiotics and vaccines. Disclosures All authors: No reported disclosures.

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