Antimicrobial Susceptibility of Neisseria gonorrhoeae in Adult Patients Seeking Care at Military Hospitals in Thailand From 2014 to 2020

2022 ◽  
Author(s):  
Maneerat Somsri ◽  
Wilawan Oransathid ◽  
Brian Vesely ◽  
Mariusz Wojnarski ◽  
Samandra Demons ◽  
...  
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Antimicrobial Susceptibility ◽  
Generation Cephalosporin ◽  
Multidrug Resistant ◽  
Fourth Generation ◽  
Walter Reed Army Institute ◽  
Medical Department ◽  
Military Hospitals ◽  
Silver Spring ◽  
Susceptibility Profiles

ABSTRACT Introduction The effective dual antibiotics ceftriaxone (CRO) and azithromycin (AZM) have successfully treated Neisseria gonorrhoeae (GC) infection, however, the CRO- and AZM-resistant strains have been sporadically detected globally and in Thailand. Furthermore, there are no currently antimicrobial susceptibility profiles of the GC isolates obtained from soldiers reported in Thailand. Hence, this is the first study to describe the antimicrobial susceptibility profiles of GC isolates obtained from predominately soldiers who seeking care at Military Camp Hospitals, in Thailand from 2014 to 2020. Materials and Methods A total of 624 symptomatic gonococcal samples were received from 10 military hospitals during 2014-2020. They were collected from urethral swabs and inoculated into selective media. The suspected GC isolates were subcultured and presumptively identified using conventional microbiology techniques. Antimicrobial susceptibility test was performed by Etest to determine minimal inhibitory concentration (μg/mL) against AZM, benzylpenicillin, cefepime, cefixime, ceftriaxone (CRO), ciprofloxacin, spectinomycin, and tetracycline using the criteria outlined in the Clinical and Laboratory Standards Institute guidelines. This study was approved by Institutional Review Board, Royal Thai Army Medical Department under protocol number S036b/56 and Walter Reed Army Institute of Research, and Silver Spring, MD under protocol number WR #2039. Results A total of 624 samples were collected from symptomatic gonococcal infectious patients with 91.5% (571/624) of samples obtained from soldiers. Of those, 78% (488/624) were identified as GC and 92% (449/488) of them were isolated from soldiers. All GC samples collected were susceptible to CRO (first-line treatment) with only one GC isolate identified as non-susceptible to cefepime and three isolates identified as non-susceptible to AZM. Conclusion The recommended dual treatment of GC infections with CRO and AZM is currently an effective empirical treatment for patients who are seeking care at military hospitals in Thailand. Nevertheless, cefepime is a fourth-generation cephalosporin with documented high activity against GC strains equal to other “third-generation” cephalosporins such as CRO. Due to the active duty of military personnel, they concerned about the confidentiality and frequently seek treatment at civilian clinics. Additionally, due to the availability of antibiotics over the counter in Thailand, many choose the option to self-medicate without a physician’s prescription. These could be subsequently driven the gradual increase of multidrug-resistant gonococcal strains throughout the country. Thus, the GC surveillance would be needed for further Force Health Protection and public health authorities in response to the drug-resistant GC threats.

scholarly journals Gram-Negative Taxa and Antimicrobial Susceptibility after Fecal Microbiota Transplantation for Recurrent Clostridioides difficile Infection

mSphere ◽  
2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Danielle Barrios Steed ◽  
Tiffany Wang ◽  
Divyanshu Raheja ◽  
Alex D. Waldman ◽  
Ahmed Babiker ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Susceptibility ◽  
Fecal Microbiota Transplantation ◽  
Antibiotic Prescription ◽  
Multidrug Resistant ◽  
Fecal Microbiota ◽  
Gram Negative ◽  
Content Type ◽  
Clostridioides Difficile ◽  
Susceptibility Profiles

ABSTRACT Fecal microbiota transplantation (FMT) has promising applications in reducing multidrug-resistant organism (MDRO) colonization and antibiotic resistance (AR) gene abundance. However, data on clinical microbiology results after FMT are limited. We examined the changes in antimicrobial susceptibility profiles in patients with Gram-negative infections in the year before and the year after treatment with FMT for recurrent Clostridioides difficile infection (RCDI). We also examined whether a history of FMT changed health care provider behavior with respect to culture ordering and antibiotic prescription. Medical records for RCDI patients who underwent FMT at Emory University between July 2012 and March 2017 were reviewed retrospectively. FMT-treated patients with Gram-negative culture data in the 1-year period preceding and the 1-year period following FMT were included. Demographic and clinical data were abstracted, including CDI history, frequency of Gram-negative cultures, microbiological results, and antibiotic prescription in response to positive cultures in the period following FMT. Twelve patients were included in this case series. We pooled data from infections at all body sites and found a decrease in the number of total and Gram-negative cultures post-FMT. We compared susceptibility profiles across taxa given the potential for horizontal transmission of AR elements and observed increased susceptibility to nitrofurantoin, trimethoprim-sulfamethoxazole, and the aminoglycosides. FMT did not drastically influence health care provider ordering of bacterial cultures or antibiotic prescribing practices. We observed a reduction in Gram-negative cultures and a trend toward increased antimicrobial susceptibility. This study supports further investigation of FMT as a means of improving antimicrobial susceptibility. IMPORTANCE Fecal microbiota transplantation (FMT), which is highly efficacious in treating recurrent C. difficile infection (RCDI), has a promising application in decolonization of multidrug-resistant organisms, reduction of antibiotic resistance gene abundance, and restoration of healthy intestinal microbiota. However, data representing clinical microbiology results after FMT are limited. We sought to characterize the differences in culture positivity and antimicrobial susceptibility profiles in patients with Gram-negative infections in the year before and the year after FMT for RCDI. Drawing on prior studies that had demonstrated the success of FMT in eradicating extraintestinal infections and the occurrence of patient-level interspecies transfer of resistance elements, we employed an agnostic analytic approach of reviewing the data irrespective of body site or species. In a small RCDI population, we observed an improvement in the antimicrobial susceptibility profile of Gram-negative bacteria following FMT, which supports further study of FMT as a strategy to combat antibiotic resistance.

scholarly journals NG-STAR genotypes are associated with MDR in Neisseria gonorrhoeae isolates collected in 2017 in Shanghai

2019 ◽  
Vol 75 (3) ◽  
pp. 566-570 ◽  
Author(s):  
Yijing Yang ◽  
Yang Yang ◽  
Irene Martin ◽  
Yuan Dong ◽  
Nannan Diao ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Antimicrobial Susceptibility ◽  
Mlst Analysis ◽  
High Prevalence ◽  
Star Database ◽  
Susceptibility Profiles

Abstract Objectives To determine the association of Neisseria gonorrhoeae antimicrobial resistance and genotypes using N. gonorrhoeae sequence typing for antimicrobial resistance (NG-STAR). Methods We characterized 124 N. gonorrhoeae isolates for their antimicrobial susceptibility profiles and NG-STAR ST characteristics using the guidelines of CLSI and EUCAST. The NG-STAR STs of seven loci were analysed. N. gonorrhoeae multiantigen sequence typing (NG-MAST) and MLST analysis was conducted in isolates with specific NG-STAR STs. Results NG-STAR differentiated 124 N. gonorrhoeae isolates into 84 STs, of which 66 STs were novel to the NG-STAR database. NG-STAR ST-199, ST-348, ST-428, ST-497 and ST-1138 were the predominant STs. Three N. gonorrhoeae isolates with ceftriaxone and cefixime MICs ≥1.0 mg/L were grouped as NG-STAR ST-233. NG-STAR ST-202 isolates (n=4) were associated with high azithromycin MICs and had an identical NG-MAST ST. The NG-STAR ST-348 group (n=5) comprised more isolates with reduced susceptibility to cefixime (n=4) than cefixime-susceptible isolates (n=1). Conclusions NG-STAR analysis differentiated N. gonorrhoeae isolates in settings with a high prevalence of antimicrobial resistance. Specific NG-STAR STs are associated with reduced susceptibility to ceftriaxone or cefixime and resistance to azithromycin in N. gonorrhoeae.

scholarly journals Community Acquired Multi-drug Resistant Clinical Strains from Tracheal Aspirates of Patients in Hospital Settings in Dhaka, Bangladesh

2019 ◽  
Author(s):  
Md Murshed Hasan Sarkar ◽  
Jinia Afroz ◽  
Fatema Tuz Jubyda ◽  
Sanzida Sharmin ◽  
Md. Jobaid Faruq ◽  
...  
Keyword(s):  
Generation Cephalosporin ◽  
Multidrug Resistant ◽  
Clinical Isolates ◽  
Drug Resistant ◽  
Hospital Data ◽  
Old Adults ◽  
Patients Âgés ◽  
Vitek 2 ◽  
Susceptibility Profiles ◽  
Tracheal Aspirates

Abstract Background: Antimicrobial resistance is a multi-sectoral problem which poses a major threat in the treatment of infectious diseases especially in developing countries like Bangladesh. Multidrug-resistant (MDR) bacteria along with extremely drug resistant (XDR) bacteria have emerged as major clinical and therapeutic dilemma in the treatment of tracheal infections in hospitals here. Thus the aim of this study was to document the incidence of MDR and XDR producing β-lactamases in clinical isolates from tracheal aspirates of patients in Dhaka, Bangladesh. Methods: Two hundred clinical isolates from tracheal aspirates were identified and their antibiotic susceptibility profiles were evaluated by using the VITEK 2 system following the Clinical and Laboratory Standards Institute guidelines. Patient information on diagnosis, sex, age was obtained from hospital data. Results: Of 200 clinical, non-duplicate bacterial isolates obtained, Pseudomonas aeruginosa was the most frequent pathogens (N=61/200, 30.5%) followed by Acinetobacter baumannii (N=58/200, 29%), Klebsiella pneumoniae (N=45/200, 22.5%), Streptococcus pneumoniae (N = 15/200, 7.5%), Escherichia coli (N=10/200, 5%), Staphylococcus aureus (N=4/200, 2%), Proteus spp (N=3/200, 1.5%), Enterobacter spp (N=2/100, 1%), Citrobacter spp (1/200, 0.5%), Providencia spp (N=1/200, 0.5%). Of 20 different antibiotics tested, highest number of isolates (N=172/200, 86%) showed resistance to third generation cephalosporin cefixime, however least number of isolates showed resistance to polymixin antibiotics- colistin (N=25/200, 12.5%) and polymixinB (N=12/200, 6%) . The patients’ ages ranged between 1 month to 95 years with the gender distribution of 133 (66.5%) males and 67 (33.5%) females. The prevalence of infections was highest among the patients of age-group (old adults) ≥60 years (N=123/200, 61.5%). Of 200 clinical isolates, 43 (21.5%) were XDR and 125 (62.5%) were MDR bacteria. Of 200 clinical isolates, the synthesis of extended spectrum β-lactamases (ESBL) and carbepenemase were detected in 59 (29.5%) and 98 (49%) strains respectively. Conclusion: Tracheal infections caused by MDR and XDR pathogens among patients are high at hospital settings in Bangladesh. Therefore, there is an urgent need for constant surveillance and interventions in Bangladesh in order to prevent further spreading of those resistant organisms.

scholarly journals Antimicrobial susceptibility profiles of Staphylococcus spp. from domestic and wild animals

2016 ◽  
Vol 46 (12) ◽  
pp. 2148-2151 ◽  
Author(s):  
Isabela de Godoy ◽  
Danny Franciele da Silva Dias Moraes ◽  
Letícia Camara Pitchenin ◽  
Janaina Marcela Assunção Rosa ◽  
Francielle Cristina Kagueyama ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Multidrug Resistant ◽  
Clinical Isolates ◽  
Rrna Gene ◽  
Wild Animals ◽  
Species Determination ◽  
Disk Diffusion Test ◽  
Susceptibility Profiles ◽  
Staphylococcus Spp ◽  
The 16S Rrna Gene

ABSTRACT: The aim of this study was to determine the prevalence and diversity of veterinary clinical isolates of Staphylococcus and analyze their antimicrobial susceptibility. One hundred Staphylococcus spp. clinical isolates from domestic and wild animals were subjected to partial sequencing of the 16S rRNA gene to species determination. Antimicrobial susceptibility was obtained by a disk diffusion test against six antibiotics: amoxicillin (AMX), cephalexin (LEX), ciprofloxacin (CIP), erythromycin (ERY), gentamicin (GEN) and trimethoprim-sulfamethoxazole (SXT). The most common specie was S. pseudintermedius (61%, 61/100) and resistance to ERY (57%, 57/100), SXT (50%, 50/100) and AMX (46%, 46/100) was detected most frequently. In total, 40% (40/100) of Staphylococcus spp. exhibited a multidrug-resistant (MDR) phenotype. Results of this study emphasize that animals are reservoir of MDR Staphylococcus spp.

scholarly journals Evaluation of a Biocide Used in the Biological Isolation and Containment Unit of a Veterinary Teaching Hospital

Antibiotics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 639
Author(s):  
Catarina Geraldes ◽  
Cláudia Verdial ◽  
Eva Cunha ◽  
Virgílio Almeida ◽  
Luís Tavares ◽  
...  
Keyword(s):  
Organic Matter ◽  
Teaching Hospital ◽  
Antimicrobial Susceptibility ◽  
Multidrug Resistant ◽  
Cross Resistance ◽  
Induced Response ◽  
Minimal Bactericidal Concentration ◽  
Surveillance Systems ◽  
Susceptibility Profiles ◽  
Hospital Acquired

Hospital-acquired infections (HAIs) are a rising problem worldwide, and the best way of coping with them is through infection tracking and surveillance systems, combined with prevention strategies, namely efficient disinfection protocols, that employ various biocides. However, increasing reports about reductions in biocide susceptibility and the development of cross-resistance to antimicrobials emphasize the need for identifying the factors influencing biocide efficiency. In this study, 29 bacterial isolates (n = 3 E. coli, n = 2 Pseudomonas spp., n = 23 Enterococcus spp., and n = 1 Staphylococcus pseudintermedius), obtained from environmental samples collected from the Biological Isolation and Containment Unit (BICU), of the Veterinary Teaching Hospital of the Faculty of Veterinary Medicine, University of Lisbon, were tested in order to determine their antimicrobial susceptibility to various antibiotics. Thirteen of these isolates were further selected in order to determine their antimicrobial susceptibility to Virkon™ S, with and without the presence of organic matter. Afterward, seven of these isolates were incubated in the presence of sub-lethal concentrations of this formulation and, subsequently, new susceptibility profiles were determined. Fourteen of the 29 isolates (48.3%) were classified as multidrug resistant, all previously identified as enterococci. Concerning Virkon™ S’s susceptibility, the Minimal Bactericidal Concentration (MBC) of this biocide regarding all isolates was at least eight times lower than the concentration regularly used, when no organic matter was present. However, when organic matter was added, MBC values rose up to 23 times. After exposure to sub-lethal concentrations of Virkon™ S, four enterococci presented a phenotypical change regarding antimicrobial susceptibility towards gentamicin. Virkon™ S also resulted in higher MBC values, up to 1.5 times, in the presence of low concentrations of organic matter, but no rise in these values was observed in assays without interfering substance. Virkon™ S seemed to be an efficient formulation in eliminating all bacteria isolates isolated from the BICU. However, organic matter could represent a hindrance to this ability, which emphasizes the importance of sanitization before disinfection procedures. The changes seen in antimicrobial susceptibility could be explained by a general stress-induced response promoted by the sub-lethal levels of Virkon™ S. Additionally, when no organic matter was present, a decrease in susceptibility to this biocide seemed to be non-existent.

scholarly journals Multidrug resistant clinical strains isolated from tracheal aspirates of patients in Dhaka, Bangladesh

2020 ◽  
Vol 8 (3) ◽  
pp. 1094
Author(s):  
Jinia Afroz ◽  
Fatema T. Jubyda ◽  
Sanzida Sharmin ◽  
Md. J. Faruq ◽  
Amit K. Dey ◽  
...  
Keyword(s):  
Generation Cephalosporin ◽  
Multidrug Resistant ◽  
Clinical Isolates ◽  
Drug Resistant ◽  
Age Group ◽  
Old Adults ◽  
Clinical Strains ◽  
Vitek 2 ◽  
Susceptibility Profiles ◽  
Tracheal Aspirates

Background: Antimicrobial resistance poses a major threat in the treatment of respiratory disease especially in developing countries like Bangladesh. Multidrug-resistant (MDR) bacteria along with extremely drug resistant (XDR) bacteria have emerged as major clinical and therapeutic dilemma in the treatment of tracheal infections here. Thus, the aim of this study is to assess multidrug resistance among clinical strains isolated from tracheal aspirates of patients in Dhaka, Bangladesh.Methods: Total 200 clinical isolates from tracheal aspirates were identified and their antibiotic susceptibility profiles were evaluated by using the VITEK 2 system following the Clinical and Laboratory Standards Institute guidelines. Patient information on diagnosis, sex, age was obtained from hospital data.Results: Of 200 clinical isolates obtained, Pseudomonas aeruginosa was the most frequent pathogens (30.5%) followed by Acinetobacter baumannii (29%), Klebsiella pneumoniae (22.5%), Streptococcus pneumoniae (7.5%), Escherichia coli (5%), Staphylococcus aureus (2%), Proteus spp (1.5%), Enterobacter spp (1%), Citrobacter spp (0.5%), Providencia spp (0.5%). Of 20 different antibiotics tested, highest number of isolates (86%) showed resistance to third generation cephalosporin cefixime, however least number of isolates showed resistance to polymixin antibiotics- colistin (12.5%) and polymixin B (6%). Tracheal infection was found to be more prevalent in males rather than in females although this difference was not statistically significant. The prevalence of infections was highest among the patients of age-group (old adults) ≥60 years (61.5%). Of 200 clinical isolates, 43 (21.5%) were XDR and 125 (62.5%) were MDR bacteria. Of 200 clinical isolates, the synthesis of extended spectrum β-lactamases (ESBL) and carbepenemase were detected in 59 (29.5%) and 98 (49%) strains respectively.Conclusions: Tracheal infections caused by β-lactamase producing MDR and XDR pathogens among patients are high in Dhaka, Bangladesh. Therefore, there is an urgent need for constant surveillance and interventions in Bangladesh in order to prevent further spreading of those resistant organisms.

scholarly journals Quinolone-resistant Neisseria gonorrhoeae: correlation of alterations in the GyrA subunit of DNA gyrase and the ParC subunit of topoisomerase IV with antimicrobial susceptibility profiles.

1996 ◽  
Vol 40 (4) ◽  
pp. 1020-1023 ◽  
Author(s):  
T Deguchi ◽  
M Yasuda ◽  
M Nakano ◽  
S Ozeki ◽  
T Ezaki ◽  
...  
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Antimicrobial Susceptibility ◽  
Dna Gyrase ◽  
Topoisomerase Iv ◽  
Clinical Strains ◽  
Susceptibility Profiles

Fifty-five clinical strains of Neisseria gonorrhoeae were examined for mutations in the gyrA and parC genes and for antimicrobial susceptibility profiles. The MICs of quinolones for 31 strains with alterations in GyrA were significantly higher than the MICs for 24 strains without such alterations. Eleven strains with alterations in both GyrA and ParC were significantly more resistant to fluoroquinolones than those with alterations in GyrA alone. The MICs of cephalosporins for these strains were also significantly higher than those for other strains.

scholarly journals Occurrence and Antimicrobial Susceptibility Profiles of Streptococcus equi subsp. zooepidemicus Strains Isolated from Mares with Fertility Problems

Antibiotics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 25
Author(s):  
Francesca Paola Nocera ◽  
Elena D’Eletto ◽  
Monica Ambrosio ◽  
Filomena Fiorito ◽  
Ugo Pagnini ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Flight Mass Spectrometry ◽  
Stewardship Program ◽  
First Choice ◽  
Streptococcus Equi ◽  
Resistance To Penicillin ◽  
Susceptibility Profiles

Streptococcus equi subsp. zooepidemicus (S. zooepidemicus), is a β-hemolytic Streptococcus belonging to the Lancefield group C; it is a rare human pathogen, but in horses, it is frequently associated with endometritis. This study aimed to isolate S. zooepidemicus strains, associated with bacterial endometritis in mares, and to define their antimicrobial resistance profile. Twenty-three isolates were recovered from one hundred ninety-six equine uterine swabs (11.7%). Bacterial identification was carried out by Api 20 Strep and confirmed by matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF-MS), while antimicrobial susceptibility testing was performed by disk diffusion method on Muller Hinton agar plates. The antibiotic resistance profiles of the isolates revealed a high percentage of resistance to amikacin (95.6%), ampicillin (73.9%) and tetracycline (69.6%), while ceftiofur and ceftriaxone were highly effective with 82.6% and 78.3% of the isolates inhibited, respectively. An intriguing value of resistance to penicillin (34.8%), which represents the first-choice antibiotic in equine S. zooepidemicus infections, was observed. Furthermore, a high prevalence of multidrug-resistant strains (82.6%) was recorded. Continuous surveillance of this potential zoonotic pathogen and an appropriate antimicrobial stewardship program with the promotion of correct use of antimicrobials, after a proper diagnosis, are needed to allow an effective therapy.

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