scholarly journals Clinical characteristics and drug sensitivity analysis of bloodstream infection caused by Klebsiella pneumoniae in the north of Henan province

2021 ◽  
Author(s):  
Yanchao Wang ◽  
Shanmei Wang ◽  
Wenjuan Wang ◽  
Youhua Yuan ◽  
Junzheng Yang
Keyword(s):  
Drug Resistance ◽  
Antibiotic Resistance ◽  
Klebsiella Pneumoniae ◽  
Bloodstream Infection ◽  
Clinical Characteristics ◽  
Drug Sensitivity ◽  
Resistance Rate ◽  
Henan Province ◽  
The North ◽  
Drug Sensitivity Test

Objectives To analyze clinical characteristics of bloodstream infection caused by Klebsiella pneumoniae and antibiotic resistance of Klebsiella pneumoniae in the north of Henan province, provide the basis for rational selection of antimicrobial drugs. Methods Klebsiella pneumoniae was isolated from 195 patients with bloodstream infection caused by Klebsiella pneumoniae in 2017 in the north of Henan Province, Phoenix100 blood culture and identification system were used for bacterial identification and drug sensitivity test was used for antibiotic resistance detection, and WHONET 5.6 software was used for data analysis of antibiotic resistance and antibiotic sensitivity; the medical history of patients, antibiotic use and laboratory examination results of 195 cases of patients with bloodstream infection caused by Klebsiella pneumoniae were also retrospectively analyzed. Results The patients with bloodstream infection caused by Klebsiella pneumoniae were mainly distributed in ICU, surgical department and Internal medicine department. There were 110 patients with bloodstream infection caused by Klebsiella pneumoniae accompanied with underlying diseases, accounting for 56.41% in 195 patients with bloodstream infection caused by Klebsiella pneumoniae, and 87 (87/110, 77.3%) patients accompanied with hypertension and diabetes. Drug sensitivity test showed that in 195 patients with bloodstream infection caused by Klebsiella pneumoniae, the top three antibiotics of the drug resistance rate of Klebsiella pneumoniae were cefazolin (74%), amoxicillin/clavulanic acid (70.1%), ampicillin /sulbactam (68.5%); the lower three antibiotics of drug resistance rate were imipenem (52%), cefepime (53%) and amikacin (33%); there were 81 strains of Klebsiella pneumoniae produced ESBLs, accounting for 41.53% in 195 strains of Klebsiella pneumoniae. The drug resistance rate of ESBLs positive strains was significantly higher than that of ESBL negative strains. It should be pointed out that the resistance of ESBLs positive strains of Klebsiella pneumoniae to cefazole reached 100%, followed by gentamicin (71.4%), ciprofloxacin (70.4%) and levofloxacin (69.1%); The resistance of ESBLs negative strains to cefazole was 18.2%, followed by gentamicin (3.5%), ciprofloxacin (3.0%) and levofloxacin (19.3%). Conclusions The number of total bacteria isolated from departments with large number of patients is relatively large, and the number of pneumonia patients caused by Klebsiella is also increased; ESBLs positive strains in this hospital are still the main reasons for the drug resistance of Klebsiella pneumoniae, reducing the antibiotics use of cefazol, gentamycin, ciprofloxacin and levofloxacin can effectively reduce the resistance of Klebsiella pneumoniae in the hospital. At the same time, we should pay attention to some contraindications for treating hypertension, diabetes drugs and antibiotics; the clinical staff should pay attention to the timely blood culture test, rational drug use can reduce the emergence of drug-resistant strains and prevent the outbreak of nosocomial infection.

scholarly journals Molecular and phenotypic characterization of clinical isolates belonging to a KPC-2-producing strain of ST15 Klebsiella pneumoniae from a Vietnamese pediatric hospital

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Björn Berglund ◽  
Ngoc Thi Bich Hoang ◽  
Maria Tärnberg ◽  
Ngai Kien Le ◽  
Maud Nilsson ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Klebsiella Pneumoniae ◽  
Resistance Genes ◽  
Resistance Rate ◽  
Clinical Isolates ◽  
Phenotypic Characterization ◽  
Polymorphism Analysis ◽  
Pediatric Hospital ◽  
Carbapenem Resistant ◽  
Global Epidemiology

Abstract Background Carbapenem-resistant Klebsiella pneumoniae are becoming increasingly common in hospital settings worldwide and are a source of increased morbidity, mortality and health care costs. The global epidemiology of carbapenem-resistant K. pneumoniae is characterized by different strains distributed geographically, with the strain ST258 being predominant in Europe and USA, and ST11 being most common in East Asia. ST15 is a less frequently occurring strain but has nevertheless been reported worldwide as a source of hospital outbreaks of carbapenem-resistant K. pneumoniae. Methods In this study, whole-genome sequencing and antimicrobial susceptibility testing was used to characterize 57 clinical isolates of carbapenem-resistant K. pneumoniae belonging to a strain of ST15, which were collected at a Vietnamese pediatric hospital from February throughout September 2015. Results Aside from the carbapenem resistance gene blaKPC-2, which was carried by all isolates, prevalence of resistance genes to other antibiotics including aminoglycosides, macrolides, quinolones, fosfomycin and trimethoprim, was also high. All isolates were multidrug-resistant. Susceptibility was highest to ceftazidime/avibactam (96%), gentamicin (91%) and tigecycline (82%). Notably, the colistin resistance rate was very high (42%). Single-nucleotide polymorphism analysis indicated that most isolates belonged to a single clone. Conclusions The diverse variety of antibiotic resistance genes and the high antibiotic resistance rates to last-resort antibiotics such as carbapenems and colistin, is indicative of a highly adaptable strain. This emphasizes the importance of implementation of infection controls measures, continued monitoring of antibiotic resistance and prudent use of antibiotics to prevent further selection of resistant strains and the emergence of pan-resistant clones.

scholarly journals Multiple-Antibiotic Resistance Mediated by Plasmids and Integrons in Uropathogenic Escherichia coli and Klebsiella pneumoniae

1970 ◽  
Vol 24 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Taslima Taher Lina ◽  
Sabita Rezwana Rahman ◽  
Donald James Gomes
Keyword(s):  
Escherichia Coli ◽  
Drug Resistance ◽  
Urinary Tract Infection ◽  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Tract Infection ◽  
Klebsiella Pneumoniae ◽  
High Rate ◽  
E Coli ◽  
Class 1

Antibiotic resistance in urinary tract infection (UTI) is a growing public health problem in the world. In this study, a total of 182 uropathogens were isolated from patients with symptoms of urinary tract infection (UTI). Escherichia coli (88%) was the most prevalent isolate, while Klebsiella pneumoniae was recovered from 12% cases. The male/female ratio was 1:3. About 56% female and 51% male patients belonged to the age group >40 years. The antibiotic resistance rates of the isolates to fifteen different drugs were investigated. E. coli and K. pneumoniae showed variable pattern of susceptibility. The percentage of resistance to different drugs was higher in E. coli isolates compared to that of K. pneumoniae. Among the total number of isolates about 87% were resistant to at least three commonly used antibiotics. All the isolates were sensitive to imipenem. Analysis of the plasmid DNA had shown that the plasmid pattern was very diverse in both E. coli and K. pneumoniae. All the isolates contained multiple numbers of plasmid ranging from 1.0 to >140 MDa. Middleranged plasmids (30 to 80 MDa), the transferable resistance plasmids, were found to be present in 86% E. coli and 85% K. pneumoniae isolates. The strong association observed between plasmid profiles and drug resistance patterns suggest that plasmids other than the common plasmids may have epidemiological significance. The presence of class 1 and class 2 integrons were also investigated. A relatively high occurrence of class 1 integrons, that are associated with lateral transfer of antibacterial resistance genes, was observed in K. pneumoniae (88%) than in E. coli isolates (54%). Class 2 integrons were not found in any of the E. coli and K. pneumoniae isolates. These results show the high rate of drug resistance and the presence of high rate of transferable elements in these MDR isolates. Keywords: Uropathogens, Escherichia coli, Klebsiella pneumoniae, Multidrug-resistant (MDR) bacteria, Plasmid profiles, IntegronsDOI: http://dx.doi.org/10.3329/bjm.v24i1.1231 Bangladesh J Microbiol, Volume 24, Number 1, June 2007, pp 19-23

scholarly journals Epidemiological, Clinical characteristics and Drug resistance situation of Culture-confirmed Children TBM in Southwest of China: A 6-Year Retrospective Study

2020 ◽  
Author(s):  
Dong-Mei Wang ◽  
Qing-Feng Li ◽  
Ma Zhu ◽  
Gui-Hui Wu ◽  
Xi Li ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Retrospective Study ◽  
Clinical Characteristics ◽  
Clinical Laboratory ◽  
Resistance Rate ◽  
X Rays ◽  
Sensitivity Testing ◽  
Neck Stiffness ◽  
Western Sichuan ◽  
Bcg Vaccination

Abstract Background : Sichuan is a province located in southwestern China, which have a higher incidence of tuberculosis (TB).This study aimed to analyze the epidemiological and clinical characteristics, as well as drug resistance in culture-confirmed children with Tuberculosis meningitis (TBM) in Southwest of China. Materials and Methods: We performed a retrospective study on children (<14 years old) with cerebrospinal fluid (CSF) culture-confirmed TBM between January 2013 and December 2018 at Public Health Clinical Center of Chengdu (PHCCC). Mycobacterium tuberculosis (MTB) drug sensitivity testing (DST) was performed using the MicroDST TM method. The age, gender, family history of tuberculosis, status of Bacillus Calmette–Guérin (BCG) vaccination, residential areas information, clinical, laboratory, and radiological features were recorded. Data were analyzed using SPSS Statistics Client 25.0, and the change in drug resistance rate was examined using the Cruskal-Wallis test. Results: Among 319 patients clinically diagnosed with TBM, 42 cases were Mycobacterial culture-positive, with a positive rate of 13.2 per 100 patients. Their median age was nine years, and the distribution was equal among female and male patients. Among 42 patients who were enrolled in the study, 1/42 (2.38%) passed away. Children with TBM were concentrated in the minority areas of western Sichuan, where 34/42 (81.0%) patients with TBM were ethnic minorities, and only 2/42 (4.76%) received BCG vaccination in the past. Chest X-rays changes were observed in all patients. Fever and headache were the most common presenting symptom. Thirty-five (83.3%) patients suffered from neck stiffness, and 30/42 (71.4%) had high CSF pressure. DST results showed that the resistance rate was high; resistance to any anti-tuberculosis drug (ATD) was observed in 13 (31.0%) patient isolates, while multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) were found in 2 (4.8%) and 1 (2.4%) patients, respectively. Conclusions : TBM among children in Southwest China was mainly concentrated in the minority areas of western Sichuan. The most common symptoms were fever, headache, and neck stiffness and all patients had positive chest X-ray findings. In addition, high rates of drug resistance were found; and more than 95% of patients did not receive BCG vaccination at birth.ΦΦΦ

scholarly journals A Case of Disseminated Extensively Drug Resistant Extrapulmonary Tuberculosis

2020 ◽  
Author(s):  
Diti V Gandhasiri ◽  
Tilak M Dhamgaye ◽  
Ulhas Jadhav ◽  
Babaji Ghewade
Keyword(s):  
Drug Resistance ◽  
Drug Sensitivity ◽  
Extrapulmonary Tuberculosis ◽  
World Health ◽  
Drug Resistant ◽  
Immunocompetent Adult ◽  
Tb Treatment ◽  
Extensively Drug Resistant ◽  
Drug Sensitivity Test ◽  
Hiv Negative

Tuberculosis (TB) strains with drug resistance are more difficult to treat than drug susceptible ones and jeopardise global progress towards the targets set by the World Health Organisation’s End TB Strategy. Although disseminated TB is well known as an opportunistic infection in HIV infected individuals, it is uncommon in HIV negative individuals. The present case is a rare case of Extensively Drug Resistant (XDR)-TB in disseminated TB involving the extrapulmonary sites in an immunocompetent adult. We report a case of a young man who has disseminated TB involving pleura and peritoneum. Prior to this, he had taken category II anti-TB treatment with no satisfactory response. Drug sensitivity test of pleural fluid revealed resistance to quinolones, kanamycin, isoniazid and rifampicin. Patient was administered second line anti-TB therapy with remarkable response. Therefore, this case highlights the importance of investigating aggressively for Drug Resistance (DR) in suspected cases of extrapulmonary TB

scholarly journals Epidemiological, Clinical characteristics and Drug resistance situation of Culture-confirmed Children TBM in Southwest of China: A 6-Year Retrospective Study

2020 ◽  
Author(s):  
Dong-Mei Wang ◽  
Qing-Feng Li ◽  
Ma Zhu ◽  
Gui-Hui Wu ◽  
Xi Li ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Retrospective Study ◽  
Clinical Characteristics ◽  
Clinical Laboratory ◽  
Resistance Rate ◽  
X Rays ◽  
Sensitivity Testing ◽  
Neck Stiffness ◽  
Western Sichuan ◽  
Bcg Vaccination

Abstract Background : Sichuan is a province located in southwestern China, which have a higher incidence of tuberculosis (TB).This study aimed to analyze the epidemiological and clinical characteristics, as well as drug resistance in culture-confirmed children with Tuberculosis meningitis (TBM) in Southwest of China. Materials and Methods: We performed a retrospective study on children (<14 years old) with cerebrospinal fluid (CSF) culture-confirmed TBM between January 2013 and December 2018 at Public Health Clinical Center of Chengdu (PHCCC). Mycobacterium tuberculosis (MTB) drug sensitivity testing (DST) was performed using the MicroDST TM method. The age, gender, family history of tuberculosis, status of Bacillus Calmette–Guérin (BCG) vaccination, residential areas information, clinical, laboratory, and radiological features were recorded. Data were analyzed using SPSS Statistics Client 25.0, and the change in drug resistance rate was examined using the Cruskal-Wallis test. Results: Among 319 patients clinically diagnosed with TBM, 42 cases were Mycobacterial culture-positive, with a positive rate of 13.2 per 100 patients. Their median age was nine years, and the distribution was equal among female and male patients. Among 42 patients who were enrolled in the study, 1/42 (2.38%) passed away. Children with TBM were concentrated in the minority areas of western Sichuan, where 34/42 (81.0%) patients with TBM were ethnic minorities, and only 2/42 (4.76%) received BCG vaccination in the past. Chest X-rays changes were observed in all patients. Fever and headache were the most common presenting symptom. Thirty-five (83.3%) patients suffered from neck stiffness, and 30/42 (71.4%) had high CSF pressure. DST results showed that the resistance rate was high; resistance to any anti-tuberculosis drug (ATD) was observed in 13 (31.0%) patient isolates, while multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) were found in 2 (4.8%) and 1 (2.4%) patients, respectively. Conclusions : TBM among children in Southwest China was mainly concentrated in the minority areas of western Sichuan. The most common symptoms were fever, headache, and neck stiffness and all patients had positive chest X-ray findings. In addition, high rates of drug resistance were found; and more than 95% of patients did not receive BCG vaccination at birth.ΦΦΦ

scholarly journals Epidemiological, Clinical characteristics and Drug resistance situation of Culture-confirmed Children TBM in Southwest of China: A 6-Year Retrospective Study

2019 ◽  
Author(s):  
meidong Wang ◽  
Yi Liao ◽  
Feng-Qing Li ◽  
Ma Zhu ◽  
Hui-Gui Wu ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Retrospective Study ◽  
Clinical Characteristics ◽  
Clinical Laboratory ◽  
Resistance Rate ◽  
X Rays ◽  
Sensitivity Testing ◽  
Neck Stiffness ◽  
Western Sichuan ◽  
Bcg Vaccination

Abstract Background: There are little data on the disease in children. This study aimed to analyze the epidemiological, clinical characteristics and drug resistance situation of culture-confirmed children TBM in Southwest of China，and hope this study will provide some recommendations to readers in clinical or related fields. Methods: We performed a retrospective study including children <14 years of age with cerebrospinal fluid (CSF) culture-confirmed TBM between January 2013 and December 2018 at Public Health Clinical Center of Chengdu (PHCCC). Nontuberculosis Mycobacteria (NTM) were excluded. Mycobacterium tuberculosis (MTB) drug sensitivity testing (DST) was performed using the MicroDSTTM method. The age, gender, family history of tuberculosis, status of Bacillus Calmette–Guérin (BCG) vaccination, residential areas information, clinical, laboratory and radiological features were recorded. Data were analyzed using SPSS Statistics Client 19.0, and the change in drug resistance rate was analyzed using the chi-square (2) test. Results: From 3467 probable TBM patients recruited, 295 cases were Mycobacterial culture-positive, the positive rate of 8.5 per 100 patients, included 253 adults and 42 children. We included all the 42 children <14 years of age for this study, the median age was 9 years, sex distribution was equal, of which 1/42 (2.38%) died. The geographical distribution of children's TBM in southwest of China is mainly concentrated in the minority areas of western Sichuan. Thirty-four (81.0%) children TBM patients is the population of China's ethnic minorities, only 2/42 (4.76%) had BCG vaccination histories. All the 42 patients had varying degrees of Chest X-rays changes and 18/42(42.9%) merger of extracranial TB. Fever and headache are the most common presenting symptom. Thirty-five (83.3%) with neck stiffness and 30/42(71.4%) with high CSF pressure. DST results showed that the resistance rate was high, to any anti-tuberculosis drug (ATD) resistance was 18 (42.9%), to multidrug-resistant tuberculosis (MDR-TB) and pre-XDR rate were 1 (2.4%) respectively. Conclusions: TBM in Children in Southwest China were mainly concentrated in the minority areas of western Sichuan, presents with nonspecific clinical features and all with positive chest X-ray findings. High rates of drug resistance were founded. More than 95% of patients were lack of BCG vaccination at birth.

scholarly journals Epidemiological, Clinical characteristics and Drug resistance situation of Culture-confirmed Children TBM in Southwest of China: A 6-Year Retrospective Study

2019 ◽  
Author(s):  
Dong-Mei Wang ◽  
Qing-Feng Li ◽  
Ma Zhu ◽  
Gui-Hui Wu ◽  
Xi Li ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Retrospective Study ◽  
Clinical Characteristics ◽  
Clinical Laboratory ◽  
Resistance Rate ◽  
X Rays ◽  
Sensitivity Testing ◽  
Neck Stiffness ◽  
Western Sichuan ◽  
Bcg Vaccination

Abstract Background : Sichuan is a province located in southwestern China, which have a higher incidence of tuberculosis (TB).This study aimed to analyze the epidemiological, clinical characteristics, and drug resistance in culture-confirmed children with Tuberculosis meningitis (TBM) in Southwest of China. Materials and Methods: We performed a retrospective study of children with cerebrospinal fluid (CSF) culture-confirmed TBM who were <14 years of age between January 2013 and December 2018 at Public Health Clinical Center of Chengdu (PHCCC). Mycobacterium tuberculosis (MTB) drug sensitivity testing (DST) was performed using the MicroDST TM method. The age, gender, family history of tuberculosis, status of Bacillus Calmette–Guérin (BCG) vaccination, residential areas information, clinical, laboratory and radiological features were recorded. Data were analyzed using SPSS Statistics Client 25.0, and the change in drug resistance rate was analyzed using the Cruskal-Wallis test. Results: From 319 TBM initially recruited patients,42 cases were Mycobacterialculture-positive, with the positive rate of 13.2 per 100 patients. Theirmedian age was nine years, sex distribution was equal. Among 42 patients who were enrolled in the study, 1/42 (2.38%) died. Children with TBM in the southwest of China were mainly concentrated in the minority areas of western Sichuan. In fact, 34/42 (81.0%) patients with TBM belonged to ethnic minorities, and only 2/42 (4.76%) had BCG vaccination histories.All the 42 patients had varying degrees of chest X-rays changes and 18/42 (42.9%) merger of extracranial TB. Fever and headache were the most common presenting symptom. Thirty-five (83.3%) patients suffered from neck stiffness and 30/42 (71.4%) had high CSF pressure. DST results showed that the resistance rate was high; resistance to any anti-tuberculosis drug (ATD) was 13 (31.0%), and to multidrug-resistant tuberculosis (MDR-TB) and XDR it was 2 (4.8%) and 1 (2.4%), respectively. Conclusions : TBM in children in Southwest China was mainly concentrated in the minority areas of western Sichuan. The most common symptoms were fever, headache and neck stiffness and all patients had positive chest X-ray findings. High rates of drug resistance were founded. In addition, more than 95% of patients did not receive BCG vaccination at birth.

scholarly journals Antimicrobial Resistance of Shigella spp. isolated in the State of Pará, Brazil

2011 ◽  
Vol 44 (5) ◽  
pp. 607-610 ◽  
Author(s):  
Flávia Corrêa Bastos ◽  
Edvaldo Carlos Brito Loureiro
Keyword(s):  
Antibiotic Resistance ◽  
Resistance Rate ◽  
The State ◽  
Control Measures ◽  
Health Concern ◽  
The North ◽  
The Family ◽  
Shigella Spp ◽  
And Control ◽  
Disk Method

INTRODUCTION: Shigella spp. are Gram-negative, nonsporulating, rod-shaped bacteria that belong to the family Enterobacteriaceae and are responsible for shigellosis or bacillary dysentery, an important cause of worldwide morbidity and mortality. METHODS: We studied the antibiotic resistance profiles of 122 Shigella spp. strains (81 S. flexneri, 41 S. sonnei, 1 S. boydii) isolated from patients (female and male from 0 to 80 years of age) presenting diarrhea in different districts of the State of Pará, in the North of Brazil. The antibiotic resistance of the strains, isolated from human fecal samples, was determined by the diffusion disk method and by using the VITEK-2 system. RESULTS: The highest resistance rate found was the resistance rate to tetracycline (93.8%), followed by the resistance rate to chloramphenicol (63.9%) and to trimethoprim/sulfamethoxazole (63.1%). Resistance to at least three drugs was more common among S. flexneri than S. sonnei (39.5% vs. 10%). Six (4.9%) strains were susceptible to all the antibiotics tested. All strains were susceptible to cefotaxime, ceftazidime, ciprofloxacin, nalidixic acid and nitrofurantoin. CONCLUSIONS: High rates of multidrug resistance in Shigella spp. are a serious public health concern in Brazil. It is extremely important to continuously monitor the antimicrobial resistances of Shigella spp. for effective therapy and control measures against shigellosis.

Sign in / Sign up

Export Citation Format

Share Document