scholarly journals Correlation between Antibiotic Resistance of Main Gram-Negative Pathogens and Antibiotic Consumption in a General Hospital of China

2019 ◽  
Author(s):  
Shaoqing Shen ◽  
Rui Wang ◽  
Jin Wang ◽  
Yun Cai
Keyword(s):  
Antibiotic Resistance ◽  
Bacterial Resistance ◽  
Mainland China ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Multidrug Resistant ◽  
Resistance Rate ◽  
Gram Negative ◽  
Positive Effects ◽  
Resistance Rates

Abstract Purpose Our hospital is a newly established hospital in China, which is located in the tropics. Better depicting antibiotic consumption and antibiotic resistance may help better develop and implement an antibiotic stewardship with regional characteristics.Methods Total antibiotic prescriptions, patient days and microbiological data from January 2014 to December 2017 were collected. Antibiotic use density (AUD) was expressed as daily defined dose (DDD) and normalized per 100 patient-days. The resistance rates of Gram-negative pathogens against commonly used antibiotics were calculated. The relationship between antibiotic consumption and bacterial resistance rate was described by Pearson’s correlation coefficient.Results Different from mainland China, A. baumannii was the leading Gram-negative pathogen, followed by K. pneumoniae , E. coli and P. aeruginosa . The AUD was gradually increased from 2014 to 2016, while it was slowly decreased in 2017. Ceftazidime/tazobactam, levofloxacin and meropenem were the top three consumed antibiotics. The proportion of multidrug resistant (MDR) Gram-negative bacteria was increased (>40%) before 2016, and it was decreased in 2017. The prevalence of MDR A. baumannii and MDR P. aeruginosa was correlated with the AUD of β-lactam/lactamase inhibitors, fluoroquinolones and carbapenems. The increased AUD of meropenem had positive effects on the incidence of carbapenem-resistant A. baumannii and P. aeruginosa .Conclusions Our study showed that there was an association between the resistance density of Gram-negative pathogens and the consumption of β-lactam/lactamase inhibitors, carbapenems and fluoroquinolones. Collectively, a multifaceted antimicrobial stewardship is necessary to decrease resistance density of available antibiotics.

scholarly journals Microbiologic characteristics and antibiotic resistance rates of diabetic foot infections

2020 ◽  
Vol 47 ◽  
Author(s):  
DÊNISSON GUEDES PONTES ◽  
IVAN TRAMUJAS DA COSTA E SILVA ◽  
JESSICA JANSEN FERNANDES ◽  
AMANDA DE FÁTIMA GURGEL MONTEIRO ◽  
PEDRO HENRIQUE DA SILVA GOMES ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Resistance ◽  
Diabetic Foot ◽  
Educational Level ◽  
Bacterial Resistance ◽  
Positive Culture ◽  
Gram Negative ◽  
Diabetic Foot Infections ◽  
Foot Lesions ◽  
Resistance Rates

ABSTRACT Purpose: the purpose of this research was to identify the sociodemographic and microbiological characteristics and antibiotic resistance rates of patients with diabetic foot infections, hospitalized in an emergency reference center. Methods: it was an observational and transversal study. The sociodemographic data were collected by direct interview with the patients. During the surgical procedures, specimens of tissue of the infected foot lesions were biopsied to be cultured, and for bacterial resistance analysis. Results: the sample consisted of 105 patients. The majority of patierns were men, over 50 years of age, married and with low educational level. There was bacterial growth in 95 of the 105 tissue cultures. In each positive culture only one germ was isolated. There was a high prevalence of germs of the Enterobacteriaceae family (51,5%). Gram-negative germs were isolated in 60% of cultures and the most individually isolated germs were the Gram-positive cocci, Staphylococcus aureus (20%) and Enterococcus faecalis (17,9%). Regarding antibiotic resistance rates, a high frequency of Staphylococcus aureus resistant to methicillin (63,0%) and to ciprofloxacin (55,5%) was found; additionally, 43,5% of the Gram-negative isolated germs were resistant to ciprofloxacin. Conclusions: the majority of patients were men, over 50 years of age, married and with low educational level. The most prevalent isolated germs from the infected foot lesions were Gram-negative bacteria, resistant to ciprofloxacin, and the individually most isolated germ was the methicillin resistant Staphylococcus aureus.

scholarly journals Gram-Negative Bacterial Lysins

Antibiotics ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. 74 ◽  
Author(s):  
Chandrabali Ghose ◽  
Chad W. Euler
Keyword(s):  
Cell Wall ◽  
Antibiotic Resistance ◽  
Standard Of Care ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Lytic Cycle ◽  
Human Society ◽  
Gram Negative ◽  
Critical Components ◽  
Conventional Antibiotics

Antibiotics have had a profound impact on human society by enabling the eradication of otherwise deadly infections. Unfortunately, antibiotic use and overuse has led to the rapid spread of acquired antibiotic resistance, creating a major threat to public health. Novel therapeutic agents called bacteriophage endolysins (lysins) provide a solution to the worldwide epidemic of antibiotic resistance. Lysins are a class of enzymes produced by bacteriophages during the lytic cycle, which are capable of cleaving bonds in the bacterial cell wall, resulting in the death of the bacteria within seconds after contact. Through evolutionary selection of the phage progeny to be released and spread, these lysins target different critical components in the cell wall, making resistance to these molecules orders of magnitude less likely than conventional antibiotics. Such properties make lysins uniquely suitable for the treatment of multidrug resistant bacterial pathogens. Lysins, either naturally occurring or engineered, have the potential of being developed into fast-acting, narrow-spectrum, biofilm-disrupting antimicrobials that act synergistically with standard of care antibiotics. This review focuses on newly discovered classes of Gram-negative lysins with emphasis on prototypical enzymes that have been evaluated for efficacy against the major antibiotic resistant organisms causing nosocomial infections.

scholarly journals Cefiderocol: An Overview of Its in-vitro and in-vivo Activity and Underlying Resistant Mechanisms

2021 ◽  
Vol 8 ◽  
Author(s):  
Jiahui Yao ◽  
Jin Wang ◽  
Mengli Chen ◽  
Yun Cai
Keyword(s):  
Bacterial Resistance ◽  
Resistance Mechanism ◽  
Multidrug Resistant ◽  
Resistance Rate ◽  
New Delhi ◽  
Global Public Health ◽  
Gram Negative ◽  
First Line Therapy

Treatment of multidrug-resistant (MDR) Gram-negative bacteria (GNB) infections has led to a global public health challenging due to the bacterial resistance and limited choices of antibiotics. Cefiderocol (CFDC), a novel siderophore cephalosporin possessed unique drug delivery systems and stability to β-lactamases, has the potential to become first-line therapy for most aggressive MDR Gram-negative pathogens infection. However, there have been reports of drug resistance in the course of using CFDC. This study provides an overview of the in-vitro and in-vivo activity of CFDC and potential resistance mechanism was also summarized. In general, CFDC shows excellent activity against a broad range of MDR GNB pathogens including Enterobacteriaceae, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Stenotrophomonas maltophilia. The expressions of metallo-β-lactamases such as inosine 5'-monophosphate (IMP), Verona integron-mediated metallo-β-lactamase (VIM), and New Delhi metallo-β-lactamase (NDM) are associated with a higher resistance rate of CFDC. Carbapenem-resistant phenotype has little effect on the resistance rate, although the acquisition of a particular carbapenemase may affect the susceptibility of the pathogens to CFDC. For potential resistance mechanism, mutations in β-lactamases and TonB-dependent receptors, which assist CFDC entering bacteria, would increase a minimum inhibitory concentration (MIC)90 value of CFDC against MDR pathogens. Since the development of CFDC, resistance during its utilization has been reported thus, prudent clinical applications are still necessary to preserve the activity of CFDC.

scholarly journals The Analysis Of Antibiotic Consumption And Bacterial Resistance As An Indicator Of Their Proper Use At The Urology Department In The Health Centre “Studenica” Kraljevo

2015 ◽  
Vol 16 (2) ◽  
pp. 135-141
Author(s):  
Andriana Bukonjić ◽  
Srđan Stefanović
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Klebsiella Pneumoniae ◽  
Bacterial Resistance ◽  
Health Centre ◽  
Antibiotic Consumption ◽  
Resistance Rate ◽  
Gram Negative Bacteria ◽  
Financial Assets ◽  
Bacterial Strains ◽  
Gram Negative

Abstract The objective of the study was to analyze antibiotic consumption and determine bacterial resistance rates as an indicator of the rational utilization of this drug group at the urology department in the Health Centre “Studenica” Kraljevo. Over a two-year period, the average antibiotic consumption was 104.55 DDD/100BD. Of the total financial assets used for medical treatment, the antibiotic group JO1 had a share of 49.52% in 2011 and 47.53% in 2012. Antibacterial drugs from a group of β-lactamic antibiotics were consumed most commonly, at 54.02% (2011) and 43.44% (2012). First-generation cephalosporins, quinolones and aminoglycosides were the most frequently used drug groups, while cephalexin was the antibiotic with the highest individual consumption. E. coli was the most frequently isolated bacterium in 2011, while in 2012, Klebsiella pneumoniae was the most frequently isolated bacterium. The total bacterial resistance both in 2011 and 2012 was above 50%. Gram-negative bacteria showed a higher resistance rate (2011, 59.3%; 2012, 58.9%) than Gram-positive bacteria (2011, 44.4%; 2012, 40.6%). Klebsiella pneumoniae was the bacterium with the highest resistance (75.3%) in 2011, while in 2012, there was a resistance increase in Pseudomonas aeruginosa (71.4%), especially to carbapenems. A correlation was determined between the consumption of individual antibiotics and bacterial strain resistance in 2011 (r=0.433, p=0.044) and in 2012 (r=0.478, p=0.024). The high resistance rate shown in the bacterial strains, which was correlated with antibiotic consumption, as well as the great financial assets used for this group of drugs suggest the necessity for the rationalization of their utilization. Empirical therapy with Gram-negative bacteria should be based on carbapenems utilization, except with Pseudomonas aeruginosa, where piperacillin/tazobactam should be used.

scholarly journals Resistensi Antibiotik pada Escherichia coli yang Diisolasi dari Daging Ayam pada Pasar Tradisional di Kota Bogor (ANTIBIOTIC RESISTANCE IN ESCHERICHIA COLI ISOLATED FROM CHICKEN MEAT OF TRADITIONAL MARKETS IN THE CITY OF BOGOR)

2019 ◽  
Vol 20 (1) ◽  
pp. 125
Author(s):  
Connie Januari ◽  
Mirnawati Bachrum Sudarwanto ◽  
Trioso Purnawarman
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Bacterial Resistance ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Chicken Meat ◽  
Diffusion Method ◽  
Negative Effects ◽  
Disk Diffusion Method ◽  
E Coli

Antibiotic use in farm is spread widely to treat of poultry disease including therapy, supportive or preventive use and as afeed additive to improve chicken performance. The negative effects of antibiotic use can increase the level of bacterial resistance to antibiotics. This study aimed to investigate on antibiotic resistance in Escherichia coli isolated from chicken meat that were sold in Traditional Market of Bogor City. A total of 175 samples of chicken meat were taken by purposive sampling method, out of 175 found 50 positive samples of E. coli. The samples were subjected to E. coli examination and the isolated E. coli were tested for the antibiotic resistance using eight antibiotics, i.e., amoxicillin, cefotaxime, colistin, nalidixid acid, streptomycin, erythromycin, oxytetracillin, and tetracycline. The study was conducted by using the disk diffusion method on Muller-Hinton agar according to the Clinical and Laboratory Standards Institute guidelines. The study showed E. coli isolated from chicken meat were resistance towards amoxicilin (90%), colistin (94%), nalidixid acid (86%), streptomycin (98%), erythromycin (98%), oxytetracillin (84%), tetracycline (86%), and cefotaxime antibiotics (12%). The proportion of multidrugresistant was 99%. The higher of multidrug-resistant indicated the E. coli would be a threat to public and environmental health. 

scholarly journals Antibiotic Resistance Patterns and Distribution of Ampc β-Lactamases Genes Among Acinetobacter Baumannii Clinical Isolates from Hospitals of Tehran, Iran

2021 ◽  
Author(s):  
Sajad Alizadeh ◽  
Majid Baserisalehi ◽  
Nima Bahador
Keyword(s):  
Antibiotic Resistance ◽  
Acinetobacter Baumannii ◽  
Resistance Rate ◽  
Clinical Samples ◽  
Common Cause ◽  
Gram Negative ◽  
High Prevalence ◽  
Resistance Patterns ◽  
Resistance Rates ◽  
Antibiotic Resistance Patterns

Abstract Background Acinetobacter is a Gram-negative coccobacilli bacterium that can produce severe and different infections. Among the species of these bacteria, Acinetobacter baumannii is the most common cause of nosocomial infections. Due to the high prevalence of antibiotic resistance in this bacterium and the significant increase in antibiotic resistance, this study was conducted to investigate the antibiotic susceptibility of A. baumannii isolates from Iran. A total of 60 A. baumannii bacteria were isolated from the different clinical samples in hospitals of Tehran, Iran. The isolates susceptibility to 13 commonly used antibiotics was examined according to the Clinical & Laboratory Standards Institute (CLSI) guidelines. Using PCR, three important AmpC β-lactamases relayed genes (DHA, CIT and MOX) were detected. Results The highest and lowest resistance rate was related to ampicillin (98.3%) colistin (35%), respectively. Of 60 isolates, 59 isolates (98.34%) were resistant to more than 8 antibiotics. The frequencies of DHA, CIT and MOX genes were 1 (2%), 7 (12%), 27 (46%), respectively. Based on definition, 59 (88.33%), 44 (73.33%) and 13 (21.66%) isolates were MDR, XDR and PDR, respectively. Twenty-four isolates (40%) were negative for all three genes. There was a significant relationship between the presence of MOX gene and antibiotic resistance. Conclusions The high resistance rates of the A. baumannii isolates reported in the present study is alarming and need the management of treatment such as performing of antibiogram test before antibiotic therapy for select the appropriate antibiotic and also completes the course of treatment period.

scholarly journals Characterization of Neonatal Infections by Gram-Negative Bacilli and Associated Risk Factors, Havana, Cuba

2021 ◽  
Vol 13 (1) ◽  
pp. 219-229
Author(s):  
Arlenis Oliva ◽  
Yenisel Carmona ◽  
Elizabeth de La C. López ◽  
Roberto Álvarez ◽  
Meiji Soe Aung ◽  
...  
Keyword(s):  
Risk Factors ◽  
Late Onset ◽  
Empirical Therapy ◽  
Antibiotic Use ◽  
Neonatal Infections ◽  
Cross Sectional ◽  
Prolonged Stay ◽  
Gram Negative ◽  
Associated Risk Factors ◽  
Resistance Rates

Infections represent an important problem in neonates because of the high mortality. An increase in neonatal infections has been found in Cuban hospitals in recent years. The aim of this study was to provide evidence on the clinical and microbiological behavior of Gram-negative bacilli that cause neonatal infections in hospitals of Havana, Cuba. It was carried out as a descriptive cross-sectional investigation from September 2017 to July 2018 in The Tropical Medicine Institute “Pedro Kouri” (IPK). Sixty-one Gram-negative bacilli isolated from neonates with infections in six Gyneco-Obstetric and Pediatric Hospitals of Havana were analyzed for their species and antimicrobial susceptibility. Late-onset infections were more common than early-onset ones and included urinary tract infection in the community (87%) and sepsis in hospitals (63.3%). Catheter use (47%) and prolonged stay (38%) were the most frequent risk factors. Species of major pathogens were Escherichia coli (47%) and Klebsiella spp. (26%). The isolated Gram-negative bacilli showed high resistance rates to third-generation cephalosporins, ciprofloxacin and gentamicin, while being more susceptible to carbapenems, fosfomycin, colistin and amikacin. The present study revealed the clinical impact of Gram-negative bacilli in neonatology units in hospitals of Havana. Evaluation of antimicrobial susceptibilities to the isolates from neonates is necessary for selection of appropriate empirical therapy and promotion of the rational antibiotic use.

scholarly journals Animal and Human Multidrug-Resistant, Cephalosporin-ResistantSalmonella Isolates Expressing a Plasmid-Mediated CMY-2 AmpC β-Lactamase

2000 ◽  
Vol 44 (10) ◽  
pp. 2777-2783 ◽  
Author(s):  
P. L. Winokur ◽  
A. Brueggemann ◽  
D. L. DeSalvo ◽  
L. Hoffmann ◽  
M. D. Apley ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Plasmid Dna ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Geographic Region ◽  
Chromosomal Dna ◽  
Important Food ◽  
Food Borne ◽  
Clonal Spread ◽  
Resistance Rates

ABSTRACT Salmonella spp. are important food-borne pathogens that are demonstrating increasing antimicrobial resistance rates in isolates obtained from food animals and humans. In this study, 10 multidrug-resistant, cephalosporin-resistant Salmonellaisolates from bovine, porcine, and human sources from a single geographic region were identified. All isolates demonstrated resistance to cephamycins and extended-spectrum cephalosporins as well as tetracycline, chloramphenicol, streptomycin, and sulfisoxazole. Molecular epidemiological analyses revealed eight distinct chromosomal DNA patterns, suggesting that clonal spread could not entirely explain the distribution of this antimicrobial resistance phenotype. However, all isolates encoded an AmpC-like β-lactamase, CMY-2. Eight isolates contained a large nonconjugative plasmid that could transformEscherichia coli. Transformants coexpressed cephalosporin, tetracycline, chloramphenicol, streptomycin, and sulfisoxazole resistances. Plasmid DNA revealed highly related restriction fragments though plasmids appeared to have undergone some evolution over time. Multidrug-resistant, cephalosporin-resistant Salmonellaspp. present significant therapeutic problems in animal and human health care and raise further questions about the association between antimicrobial resistance, antibiotic use in animals, and transfer of multidrug-resistant Salmonella spp. between animals and man.

scholarly journals Methicillin-resistant Staphylococcus aureus of the clonal lineage ST5-SCCmecII-t2460 was associated with high mortality in a Wuhan hospital

2021 ◽  
Author(s):  
Xuehan Li ◽  
Jing Zhang ◽  
Yifan Zhang ◽  
Junying Zhou ◽  
Xinwei Li ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Resistance ◽  
White Blood Cells ◽  
Resistance Rate ◽  
Molecular Characteristics ◽  
Invasive Procedures ◽  
Methicillin Resistant ◽  
Small Colony Variant ◽  
Recent Emergence ◽  
Resistance Rates

AbstractMethicillin-resistant Staphylococcus aureus (MRSA) is an important human pathogen that can cause serious infectious diseases. An emerging MRSA strain, ST5-SCCmecII spa-type-t2460 (SMRSA), has spread rapidly since its recent emergence in China, but little information is available about this lineage. In this study, 91 MRSA isolates were collected from patients treated in the Zhongnan Hospital, Wuhan University, from 2018 to 2019, and investigated for their molecular characteristics, antibiotic resistance profiles, and clinical characteristics. The predominant lineage, SMRSA, accounted for 37.4% (34/91) of the isolates, followed by ST239-SCCmecIII-t030 (19.8%, 18/91) and ST59-SCCmecIV-t437 (8.8%, 8/91). In contrast to the latter two non-SMRSA (nSMRSA) lineages, which are among the main MRSA found in Chinese settings, SMRSA exhibited small colony variant (SCV) phenotype and had extremely high resistance rates to erythromycin (100.0%), clindamycin (100.0%), levofloxacin (100.0%), tetracycline (97.1%), moxifloxacin (97.1%), and ciprofloxacin (100%), but was more susceptible to rifampicin (resistance rate 3%). The levels of white blood cells (WBC) and procalcitonin (PCT) and the 30-day mortality in patients infected with SMRSA were (12.54 ± 6.61) × 109/L, 0.66 ng/mL, and 52.9%, respectively, which were much higher than those in patients infected with nSMRSA. In addition, patients infected with SMRSA were more frequently admitted to the intensive care unit (ICU) and submitted to invasive procedures than those infected with nSMRSA. In conclusion, SMRSA showed SCV phenotype and exhibited multiple antibiotic-resistance profiles. In this study, SMRSA was associated with serious infections and poor prognosis. Compared with ST239, ST59, or other nSMRSA strains, patients infected with SMRSA strains have higher 30-day mortality, increased levels of inflammatory biomarkers, and more frequent ICU hospitalization and invasive procedures.

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