Treating osteoarticular infections in a Role 2 in Chad: a bacterial epidemiological study

2021 ◽  
pp. bmjmilitary-2020-001604
Author(s):  
Thomas Demoures ◽  
C Choufani ◽  
C Contargyris ◽  
A Caubere ◽  
L Mathieu ◽  
...  
Keyword(s):  
First Generation ◽  
Multidrug Resistant ◽  
Bacterial Strains ◽  
Tissue Samples ◽  
Beta Lactamases ◽  
Medical Treatment Facility ◽  
Osteoarticular Infections ◽  
Extended Spectrum Beta Lactamases ◽  
Staphylococcus Infections ◽  
Third Generation Cephalosporins

IntroductionThe treatment of osteoarticular infections in Africa is a medical and surgical challenge due to the difficulties in managing antibiotic therapy after the surgical procedure. The objectives of this study were to identify the types of bacteria in osteoarticular lesions in patients treated in Chad and to determine the spectrum of resistance encountered and the efficacy of available antibiotics.Material and methodsThis is a retrospective study of all intraoperative osteoarticular and soft tissue samples taken in a French Role 2 Medical Treatment Facility of N'Djamena during surgery for chronic osteoarticular infections, in Chad, for 1 year.ResultsA total of 160 bacterial strains were identified, with a predominance of Gram-negative bacillus (GNB) and staphylococcus infections. Among staphylococci, 80% were methicillin-sensitive streptococci which were generally multidrug-sensitive. Enterococci were resistant to third-generation cephalosporins, first-generation fluoroquinolones and gentamycin. Among GNB, there was a predominance of enterobacteria compared with non-fermenting GNB, of which 52% were multidrug-resistant and produced extended spectrum beta-lactamases (ESBL).ConclusionStaphylococcus aureus infections are most often sensitive to available antibiotics and therefore have better prognoses than infections caused by other bacteria. In contrast, in half of the cases of GNB, infections were caused by bacteria producing ESBL, thus posing the problem of multidrug-resistance, the risks of which are increased in precarious situations. Therefore, the type of bacteria appears to be a major prognostic factor in the treatment of osteoarticular infections in a Role 2 in Chad. This criterion will need to be considered before any treatment decisions are made.

Multidrug resistant and ESBL producing Salmonella enterica serotype Heidelberg is widespread in a poultry processing facility from Southern Brazil

2021 ◽  
Author(s):  
Luciano Bersot ◽  
Neila Carbonera ◽  
Carolina Dias Rodrigues ◽  
Cibeli Viana ◽  
Luis Augusto Nero
Keyword(s):  
Antibiotic Resistance ◽  
Multidrug Resistant ◽  
Salmonella Spp ◽  
Proper Understanding ◽  
Beta Lactamases ◽  
High Frequencies ◽  
Processing Facility ◽  
Extended Spectrum Beta Lactamases ◽  
Poultry Processing ◽  
Third Generation Cephalosporins

This study aimed to characterize the Salmonella spp. distribution in a poultry processing facility, and to identify their antibiotic resistance profiles. S. enterica was detected in 146 samples (66.7%), and 125 isolates were identified as S. Heidelberg (n = 123), S. Abony (n = 1) and S. O:4,5 (n = 1). S. Heidelberg isolates were subjected to XbaI macrorestriction and PFGE, resulting in 66 pulsotypes grouped in 4 major clusters and demonstrating the cross contamination and persistence of this serotype in the processing facility. Also, S. enterica selected isolates were subjected to antibiotic resistance characterization, with most being categorized as multidrug resistant (n = 122, 97.6%). The resistance to third generation cephalosporins was particularly high: ceftazidime (n = 84, 67.2%) and cefotaxime and ceftriaxone (n = 91, 72.8%). Production of extended-spectrum beta-lactamases (ESBL) was identified in 24 isolates (19.2%) and ESBL-producing isolates were resistant to at least eight different antibiotics. The study highlighted the occurrence and the distribution of S. Heidelberg in the poultry chain, allowing proper understanding of the ecology of this pathogen in the studied facility. Also, the presence of multidrug resistant S. enterica at high frequencies is a concern due to the potential consequences for public health.

scholarly journals Antibiotic Resistance of Uropathogens Isolated from Patients Hospitalized in District Hospital in Central Poland in 2020

Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 447
Author(s):  
Barbara Kot ◽  
Agata Grużewska ◽  
Piotr Szweda ◽  
Jolanta Wicha ◽  
Urszula Parulska
Keyword(s):  
Antibiotic Resistance ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Beta Lactamases ◽  
E Coli ◽  
Central Poland ◽  
Resistance Patterns ◽  
Extended Spectrum Beta Lactamases ◽  
Tract Infections

The aim of this study was to determine antibiotic resistance patterns and the prevalence of uropathogenes causing urinary tract infections (UTIs) in patients hospitalized in January–June 2020 in central Poland. Antimicrobial susceptibility testing was performed using the disk-diffusion method. Escherichia coli (52.2%), Klebsiella pneumoniae (13.7%), Enterococcus faecalis (9.3%), E. faecium (6.2%), and Proteus mirabilis (4,3%) were most commonly isolated from urine samples. E. coli was significantly more frequent in women (58.6%) (p = 0.0089) and in the age group 0–18, while K. pneumoniae was more frequent in men (24.4%) (p = 0.0119) and in individuals aged 40–60 and >60. Gram-negative species showed resistance to ampicillin. K. pneumoniae were resistant to amoxicillin plus clavulanic acid (75.0%), piperacillin plus tazobactam (76.2%), cefotaxime (76.2%), cefuroxime (81.0%), ciprofloxacin (81.0%), and trimethoprim plus sulphamethoxazole (81.0%). Carbapenems were effective against all E. coli and P. mirabilis. Some K. pneumoniae (13.6%) produced metallo-β-lactamases (MBLs). E. coli (22.6%), K. pneumoniae (81.8%), and all E. faecium were multidrug-resistant (MDR). Some E. coli (26.2%), K. pneumoniae (63.6%), and P. mirabilis (14.3%) isolates produced extended-spectrum beta-lactamases (ESBL). Vancomycin-resistant E. faecium was also found. This study showed that the possibilities of UTIs therapy using available antibiotics become limited due to the increasing number of antibiotic-resistant uropathogens.

scholarly journals Multidrug-resistant bacteria in unaccompanied refugee minors arriving in Frankfurt am Main, Germany, October to November 2015

2016 ◽  
Vol 21 (2) ◽  
Author(s):  
Ursel Heudorf ◽  
Bernhard Krackhardt ◽  
Maria Karathana ◽  
Niels Kleinkauf ◽  
Christian Zinn
Keyword(s):  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
German Population ◽  
Unaccompanied Refugee Minors ◽  
Frankfurt Am Main ◽  
Beta Lactamases ◽  
Extended Spectrum Beta Lactamases ◽  
Additional Resistance ◽  
Gram Negative Organisms ◽  
Refugee Minors

Many refugees arriving in Germany originate or have travelled through countries with high prevalence of multidrug-resistant Gram-negative organisms. Therefore, all unaccompanied refugee minors (<18 years-old) arriving in Frankfurt am Main between 12 October and 6 November 2015, were screened for multidrug-resistant Enterobacteriaceae in stool samples. Enterobacteriaceae with extended spectrum beta-lactamases (ESBL) were detected in 42 of 119 (35%) individuals, including nine with additional resistance to fluoroquinolones (8% of total screened), thus exceeding the prevalences in the German population by far.

scholarly journals Antimicrobial Resistance Factors of Extended-Spectrum Beta-Lactamases Producing Escherichia coli and Klebsiella pneumoniae Isolated from Cattle Farms and Raw Beef in North-West Province, South Africa

2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Kotsoana Peter Montso ◽  
Sicelo Beauty Dlamini ◽  
Ajay Kumar ◽  
Collins Njie Ateba
Keyword(s):  
Antimicrobial Susceptibility ◽  
Multidrug Resistant ◽  
Health Concern ◽  
Beta Lactamases ◽  
North West ◽  
E Coli ◽  
Esbl Gene ◽  
Extended Spectrum ◽  
North West Province ◽  
Extended Spectrum Beta Lactamases

Background. Extended spectrum beta-lactamases (ESBLs) producing Enterobacteriaceae cause severe infections in humans which leads to complicated diseases. There is increasing evidence that cattle contribute to the development and spread of multidrug resistant pathogens and this raises public health concern. Despite this, data on the concurrence of ESBL producing pathogens in cattle, especially in the North-West province are rare. Therefore, the aim of the present study was to isolate, identify and characterise ESBL producing E. coli and K. pneumoniae species from cattle faeces and raw beef samples. Results. A total of 151 samples comprising 55 faeces samples and 96 raw beef samples were collected and 259 nonreplicative potential isolates of Enterobacteriaceae were obtained. One hundred and ninety-six isolates were confirmed as E. coli (114; 44%) and K. pneumoniae (82; 32%) species through amplification of uspA and uidA and ntrA gene fragments, respectively. Antimicrobial susceptibility test revealed that large proportions (66.7–100%) of the isolates were resistant to Amoxicillin, Aztreonam, Ceftazidime, Cefotaxime, and Piperacillin and were multidrug resistant isolates. Cluster analysis of antibiotic inhibition zone diameter data revealed close similarities between isolates from different sources or species thus suggested a link in antibiotic exposures. The isolates showing phenotypic resistance against ESBL antimicrobial susceptibility tests were screened for the presence of ESBL gene determinants. It was observed that 53.1% of the isolates harboured ESBL gene determinants. The blaTEM, blaSHV and blaCTX-M genes were detected in E. coli isolates (85.5%, 69.6%, and 58%, respectively) while blaCTX-M and blaOXA were detected in K. pneumoniae (40% and 42.9%, respectively). All the genetically confirmed ESBL producing E. coli and K. pneumoniae isolates were subjected to Enterobacterial Repetitive Intergenic Consensus (ERIC) PCR analysis. Fingerprinting data revealed great similarities between isolates from different areas and sources which indicates cross-contamination between cattle and beef. Conclusion. This study revealed that cattle and its associated food products, beef in particular, harbour ESBL producing pathogens. And this warrants a need to enforce hygiene measures and to develop other mitigation strategies to minimise the spread of antibiotic resistant pathogens from animals to human.

scholarly journals Extended spectrum beta-lactamase and fluoroquinolone resistance genes among Escherichia coli and Salmonella isolates from children with diarrhea, Burkina Faso

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
René Dembélé ◽  
Ali Konaté ◽  
Oumar Traoré ◽  
Wendpoulomdé A. D. Kaboré ◽  
Issiaka Soulama ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Multidrug Resistant ◽  
Quinolone Resistance ◽  
Health Concern ◽  
Cross Resistance ◽  
Beta Lactamases ◽  
Resistance Phenotype ◽  
Resistant Genes ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases

Abstract Background The emergence and spread of multidrug-resistant gram-negative bacteria (MDR) has become a major public health concern worldwide. This resistance is caused by enzymes-mediated genes (i.e., extended spectrum beta-lactamases) that are common in certain Enterobacterioceae species. However, the distribution of these genes is poorly documented in Burkina Faso. This study aims to determine the prevalence and distribution of the resistant genes coding for broad spectrum beta-lactamases and quinolones in rural Burkina Faso. Methods Multiplex PCR assays were carried out to detect ESBL-encoding genes, including blaOXA, blaTEM, blaCTX-M, blaSHV. The assays also assessed the presence of quinolone resistance gene namely qnrA, qnrB and qnrS in the quinolone-resistance DEC and Salmonella strains. Results The Extended-Spectrum Beta-Lactamases (ESBL) resistance phenotype was reported in all the E. coli isolates (5/5). Cross-resistance phenotype to quinolones (CRQ) was shown by one Salmonella strain (1/9) and three E. coli (3/5). Cross-resistance phenotypes to fluoroquinolones (CRFQ) were harboured by one Salmonella (1/9) and carbapenemase phenotypes were detected in two E. coli strains (2/5). Whilst the blaOXA genes were detected in 100% (5/5) of E. coli isolates and in 33.33% (3/9) Salmonella isolates. One strain of E. coli (1/5) harbored the blaCTX−M gene and the qnrB gene simultaneously. Conclusions This study identified β-lactam (bla) and quinolone resistance (qnr) genes in multidrug-resistant E. coli and Salmonella spp. in rural Burkina Faso. Our finding which highlighted the enterobacteriaceae strains resistance to β-lactams and quinolones are of high interest for adequate management of antimicrobial resistant genes outbreak in Burkina Faso.

scholarly journals Mechanisms of Resistance in Gram-Negative Urinary Pathogens: From Country-Specific Molecular Insights to Global Clinical Relevance

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 800
Author(s):  
Branka Bedenić ◽  
Tomislav Meštrović
Keyword(s):  
Clinical Importance ◽  
Resistance Mechanisms ◽  
Bacterial Strains ◽  
Mechanisms Of Resistance ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Resistance Determinants ◽  
Genes Encoding ◽  
Extended Spectrum Beta Lactamases ◽  
Tract Infections

Urinary tract infections (UTIs) are the most frequent hospital infections and among the most commonly observed community acquired infections. Alongside their clinical importance, they are notorious because the pathogens that cause them are prone to acquiring various resistance determinants, including extended-spectrum beta-lactamases (ESBL); plasmid-encoded AmpC β-lactamases (p-AmpC); carbapenemases belonging to class A, B, and D; qnr genes encoding reduced susceptibility to fluoroquinolones; as well as genes encoding enzymes that hydrolyse aminoglycosides. In Escherichia coli and Klebsiella pneumoniae, the dominant resistance mechanisms are ESBLs belonging to the CTX-M, TEM, and SHV families; p-AmpC; and (more recently) carbapenemases belonging to classes A, B, and D. Urinary Pseudomonas aeruginosa isolates harbour metallo-beta-lactamases (MBLs) and ESBLs belonging to PER and GES families, while carbapenemases of class D are found in urinary Acinetobacter baumannii isolates. The identification of resistance mechanisms in routine diagnostic practice is primarily based on phenotypic tests for the detection of beta-lactamases, such as the double-disk synergy test or Hodge test, while polymerase chain reaction (PCR) for the detection of resistance genes is mostly pursued in reference laboratories for research purposes. As the emergence of drug-resistant bacterial strains poses serious challenges in the management of UTIs, this review aimed to appraise mechanisms of resistance in relevant Gram-negative urinary pathogens, to provide a detailed map of resistance determinants in Croatia and the world, and to discuss the implications of these resistance traits on diagnostic approaches. We summarized a sundry of different resistance mechanisms among urinary isolates and showed how their prevalence highly depends on the local epidemiological context, highlighting the need for tailored interventions in the field of antimicrobial stewardship.

scholarly journals Detection, identification and characterization of extended-spectrum beta-lactamases producing Enterobacteriaceae in wastewater and salads marketed in Ouagadougou, Burkina Faso

2020 ◽  
Vol 14 (8) ◽  
pp. 2746-2757
Author(s):  
Souleymane Soré ◽  
Yacouba Sawadogo ◽  
Juste Isidore Bonkoungou ◽  
Sephora P. Kaboré ◽  
Saidou Béogo ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
Diffusion Method ◽  
Beta Lactamases ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases ◽  
Amoxicillin Clavulanic Acid ◽  
Synergy Test ◽  
Identification And Characterization

Extended spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE) represent a threat for failure of empirical antibiotic therapy and are associated with high mortality, morbidity and expenses. The aims of this study was to determine the prevalence of ESBL-PE and multidrug resistant enterobacteria (MDR), enterobacteria profil, investigate the associated resistance in wastewater and salads. After wastewater and salad sampling, enterobacteria was isoled on (EMB + 4μg / L cefotaxim). The stains of Enterobacteriaceae were identified by using biochemical methods and confirmed as ESBL by double-disc synergy test (amoxicillin/clavulanic acid with cefotaxime 30 μg, ceftazidime 30 μg and ceftriaxone 30 μg). Finally, the associated resistance was investigated by testing the susceptibility of the strains by the disc diffusion method. Global prevalence of ESBL-PE was 53.92% (95% CI: 48,2-59,5) (153/293), 61.11% from wastewater and 42.47% from salads. Major ESBL-E was Escherichia coli (73.44%), followed by Klebsiella pneumoniae (21.88%). Resistance to the aminoglycoside , fluroquinolonones and sulfonamides classes were dominant, observed in 53,83%, 93,86% and 98,95% of the isolates, respectively. The frequence of MDR was hight to channel1 (32,40%) and channel2 (26,26%). This study reports very worrying results. There is an urgent need to develop measures to monitor the spread of these multidrug-resistant strains.Keywords: Wastewater, ESBL-PE, Salads, Ouagadougou.

scholarly journals Co-occurrence of colistin-resistance genes mcr-1 and mcr-3 among multidrug-resistant Escherichia coli isolated from cattle, Spain, September 2015

2017 ◽  
Vol 22 (31) ◽  
Author(s):  
Marta Hernández ◽  
M Rocío Iglesias ◽  
David Rodríguez-Lázaro ◽  
Alejandro Gallardo ◽  
Narciso Quijada ◽  
...  
Keyword(s):  
United States ◽  
Escherichia Coli ◽  
Resistance Genes ◽  
The United States ◽  
Multidrug Resistant ◽  
Sequence Type ◽  
Colistin Resistance ◽  
Beta Lactamases ◽  
Extended Spectrum Beta Lactamases ◽  
Cattle Faeces

Colistin resistance genes mcr-3 and mcr-1 have been detected in an Escherichia coli isolate from cattle faeces in a Spanish slaughterhouse in 2015. The sequences of both genes hybridised to same plasmid band of ca 250 kb, although colistin resistance was non-mobilisable. The isolate was producing extended-spectrum beta-lactamases and belonged to serotype O9:H10 and sequence type ST533. Here we report an mcr-3 gene detected in Europe following earlier reports from Asia and the United States.

scholarly journals Community Origin and Previous Use of Antimicrobials Increase the Risk of Nosocomial Multidrug-resistant Bacteria Colonisation in the Intensive Care Unit in a Brazilian Hospital

2019 ◽  
Vol 12 (1) ◽  
pp. 449-454
Author(s):  
Debora Vandresen ◽  
Maria Helena B. Werlang ◽  
Mirian Carla B. Silva ◽  
Juliana S. Link ◽  
Paulo Cezar N. Fortes
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Antibiotic Resistant ◽  
Beta Lactamases ◽  
Hospitalised Patients ◽  
Extended Spectrum Beta Lactamases ◽  
Hospital Acquired

Background: Hospitalised patients are often surrounded by microorganisms, and antibiotic-resistant pathogens are a major and growing threat to public health. Objective: This study aimed to investigate the epidemiology and the risk factors for colonisation by multidrug-resistant organisms (MDROs) in a Brazilian hospital. Methods: Patients in the Intensive Care Unit (ICU) who underwent nasal and rectal swab cultures for the surveillance of colonisation by MDROs were evaluated in a retrospective study. MDROs were determined by routine microbiological cultures. Results: Of the 785 patients included in this study, 86 presented positive results for MDRO colonisation. Overall, the most frequently isolated organism was Klebsiella pneumoniae (41.9%), followed by Escherichia coli (33.7%). The main type of resistance was the production of extended-spectrum beta-lactamases (ESBL). The prevalence of MDRO infections was significantly associated with the patient's origin (community or hospital-acquired). Having been submitted to previous antimicrobial drug therapy was significantly associated with MDRO infection (relative risk [RR]: 4.02 [2.60 - 6.23]). Conclusion: MDRO ICU colonisation was variable, with similar frequencies as other centres, and important factors, including previous hospital stay and antibiotic use, were closely related to MDRO colonisation. Therefore, control interventions should reduce their rates, especially considering the particularities of each geographic centre.

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