Etiological Trends and Patterns of Antimicrobial Resistance in Respiratory Infections

Background:Respiratory infections are one of the commonest causes of morbidity and mortality related to infectious diseases worldwide. The emergence of antimicrobial resistance is a major global health problem which is well established in developing countries. Good clinical suspicion and correct laboratory identification of respiratory infection causing organisms followed by the appropriate management are needed to compact both community-acquired and nosocomial infection respiratory infections.Objectives:A retrospective study was carried out to elucidate the etiology of respiratory infections in Sudan, as well as to guide the physician to the best antimicrobial alternatives used in the treatment of respiratory infection.Method:Respiratory isolates that have been morphologically identified and biologically characterized were subjected to antibiotic susceptibility testing.Results:A total of 1481 respiratory specimens were examined, recovering 377 organisms from 350 culture positive samples [225(59.7%) sputum, 94(24.9%) broncho-alveolar lavage (BAL), 58(15.4%) Pleural fluid], the commonest organisms wereKlebsiella ssp. (25.20%) andmycobacterium tuberculosis(25.20%), followed byStaphylococcus aureus(19.89%) andPseudomonas aeruginosa(8.49%). High rate of resistance of bacterial isolates was observed to Co-trimoxazole (BA), Ampicillin sulbactam (AS), Cefotaxime (CF) and Tetracycline (TE), being 80%, 72.3%, 68.8% and 66.9% respectively; on the other hand, very low resistance rate was found to Amikacin (AK) and Levofloxacin (LE), being 4.6% and 8.5%, respectively.Conclusion:Guided prescription of antimicrobial agents must be implemented and controlled to limit further spread of antimicrobial resistance.

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Molecular Characteristics and Antimicrobial Susceptibility Profile of Pseudomonas aeruginosa isolated from patients attending Healthcare Facilities in Mthatha, South Africa

10.21203/rs.3.rs-16668/v1 ◽

2020 ◽

Author(s):

Mojisola C. Hosu ◽

Sandeep D. Vasaikar ◽

Grace E. Okuthe ◽

teke apalata

Keyword(s):

Pseudomonas Aeruginosa ◽

Antibiotic Resistance ◽

Antimicrobial Resistance ◽

Antimicrobial Agents ◽

Resistance Mechanisms ◽

High Rate ◽

Infection Prevention And Control ◽

Molecular Characteristics ◽

Mortality And Morbidity ◽

Resistance Patterns

Abstract Background: Pseudomonas aeruginosa is a common pathogen causing healthcare-associated infections most especially in critically ill and immunocompromised patients. This pathogen poses a public health threat due to its innate resistance to many antimicrobial agents and its ability to acquire new resistance mechanisms under pressure. Infections with Extended spectrum β-lactamases (ESBL)‑producing isolates result into outbreaks that lead to serious antibiotic management concerns with higher mortality and morbidity and significant economic causatives. In this study, we evaluated the antimicrobial resistance patterns and characterized genetically the ESBLs and Metallo- β-lactamases (MBL) produced by this pathogen. Methods: Isolates of P. aeruginosa cultured from patients who attended Nelson Mandela Academic Hospital and other clinics in the four district municipalities of the Eastern Cape between August 2017 and May 2019 were identified; and their antibiotic resistance patterns were tested against amikacin, aztreonam, cefepime, ceftazidime, ciprofloxacin, doripenem, gentamicin, imipenem, levofloxacin, meropenem, piperacillin, piperacillin/tazobactam and tobramycin using the bioMérieux VITEK® 2 and confirmed by Beckman autoSCAN-4 System. Real-time PCR was done using Roche Light Cycler 2.0 to detect the presence of ESBLs; blaSHV, blaTEM and blaCTX-M genes; and MBLs; blaIMP, blaVIM. Results: High antibiotic resistance in decreasing order was observed in piperacillin (64.2%), aztreonam (57.8%), cefepime (51.5%), ceftazidime (51.0%), piperacillin/tazobactam (50.5%), and imipenem (46.6%). A total of 75 (36.8%) multidrug resistant (MDR) isolates were observed of the total pool of isolates. The blaTEM, blaSHV and blaCTX-M was detected in 79.3%, 69.5% and 31.7% isolates (n=82), respectively. The blaIMP was detected in 1.25% while no blaVIM was detected in any of the isolates tested. Conclusions: The study showed a high rate of MDR P. aeruginosa in our setting. The vast majority of these resistant isolates carried blaTEM and blaSHV genes. Continuous monitoring of antimicrobial resistance and strict compliance towards infection prevention and control practices are the best defence against spread of MDR P. aeruginosa.

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Prevalence and Antimicrobial Resistance of DiarrheagenicEscherichia coliandShigellaSpecies Associated with Acute Diarrhea in Tehran, Iran

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2009/341275 ◽

2009 ◽

Vol 20 (3) ◽

pp. e56-e62 ◽

Cited By ~ 31

Author(s):

Fereshteh Jafari ◽

Mohammad Hamidian ◽

Maryam Rezadehbashi ◽

Michael Doyle ◽

Siavosh Salmanzadeh-ahrabi ◽

...

Keyword(s):

Escherichia Coli ◽

Antibiotic Resistance ◽

Antimicrobial Resistance ◽

Shiga Toxin ◽

Acute Diarrhea ◽

Antimicrobial Agents ◽

High Rate ◽

Appropriate Use ◽

E Coli ◽

Etiological Agents

A study was performed to determine the prevalence and antimicrobial resistance ofShigellaspecies and diarrheagenicEscherichia coliisolates cultured from patients with acute diarrhea in Tehran, Iran. Between May 2003 and May 2005, 1120 diarrheal specimens were collected and assayed for bacterial enteropathogens by conventional and molecular methods. Etiological agents were isolated from 564 (50.3%) specimens, and included 305 (54%)E coli, 157 (27.8%)Shigellaspecies, and 102 (18%) from other genera of bacteria. The predominantE coliwas Shiga toxin-producingE coli(105 isolates [34.5%]) and the predominantShigellaserotype wasShigella sonnei(88 isolates [56.1%]). A high rate of antibiotic resistance was observed amongE coli,with 40 of 53 (75.5%) Shiga toxin-producingE coliisolates resistant to amoxicillin and tetra-cycline, and eight (5.2%)E coliisolates resistant to more than six antibiotics. MostShigellaisolates were resistant to tetracycline (95%) and trimethoprim-sulfamethoxazole (91.7%), with greatest antibiotic resistance observed amongS sonnei(53 of 88 [60.2%] isolates). Antibiotic resistance is widespread in diarrheagenicE coliandShigellain children with acute diarrhea in Tehran, Iran; hence, updated strategies for appropriate use of antimicrobial agents in Iran are needed.

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Combating Antimicrobial Resistance in Foodborne Microorganisms

Journal of Food Protection ◽

10.4315/0362-028x.jfp-15-023 ◽

2016 ◽

Vol 79 (2) ◽

pp. 321-336 ◽

Cited By ~ 11

Author(s):

EDWARD P. C. LAI ◽

ZAFAR IQBAL ◽

TYLER J. AVIS

Keyword(s):

Public Health ◽

Escherichia Coli ◽

Food Safety ◽

Antimicrobial Resistance ◽

Antimicrobial Agents ◽

Susceptibility Testing ◽

Health Hazard ◽

Important Public Health ◽

Killing Action ◽

Campylobacter Spp

ABSTRACT This review addresses an important public health hazard affecting food safety. Antimicrobial agents are used in foods to reduce or eliminate microorganisms that cause disease. Many traditional organic compounds, novel synthetic organic agents, natural products, peptides, and proteins have been extensively studied for their effectiveness as antimicrobial agents against foodborne Campylobacter spp., Escherichia coli, Listeria spp. and Salmonella. However, antimicrobial resistance can develop in microorganisms, enhancing their ability to withstand the inhibiting or killing action of antimicrobial agents. Knowledge gaps still exist with regard to the actual chemical and microbiological mechanisms that must be identified to facilitate the search for new antimicrobial agents. Technical implementation of antimicrobial active packing films and coatings against target microorganisms must also be improved for extended product shelf life. Recent advances in antimicrobial susceptibility testing can provide researchers with new momentum to pursue their quest for a resistance panacea.

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Organization of antibiotic stewardship in Europe: the way to go

Wiener Medizinische Wochenschrift ◽

10.1007/s10354-020-00796-5 ◽

2021 ◽

Vol 171 (S1) ◽

pp. 4-8

Author(s):

Winfried V. Kern

Keyword(s):

Antimicrobial Resistance ◽

Antimicrobial Agents ◽

Susceptibility Testing ◽

Good Practice ◽

Inappropriate Prescribing ◽

Antibiotic Consumption ◽

Surveillance Systems ◽

Educational Activities ◽

Essential Components ◽

The Way

SummaryIt is more than two decades ago that a European Union conference on “The Microbial Threat” hosted by the Danish Government in Copenhagen in September 1998 issued recommendations to encourage good practice in the use of antimicrobial agents and reduce inappropriate prescribing. Essential components of those recommendations were antimicrobial teams in hospitals and the use of feedback to prescribers as well as educational activities. Two decades later, important surveillance systems on both antimicrobial resistance as well as on antibiotic consumption are functioning at the European level and in most European countries; European Committee on Antimicrobial Susceptibility Testing (EUCAST) has thoroughly re-evaluated, standardized and harmonized antibiotic susceptibility testing and breakpoints; there have been educational activities in many countries; and stewardship teams are now included in many guidelines and policy papers and recommendations. Yet, antimicrobial resistance problems in Europe have shifted from methicillin-resistant Staphylococus aureus (MRSA) to vancomycin-resistent Enterococcus faecium (VRE) and to multidrug-resistant gramnegative bacteria, while antibiotic consumption volumes, trends and patterns across countries do not show major and highly significant improvements. The way to go further is to recognize that better prescribing comes at a cost and requires investment in expert personnel, practice guideline drafting, and implementation aids, and, secondly, the setting of clear goals and quantitative targets for prescribing quality.

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Antimicrobial resistance in coagulase-negative staphylococci isolated from subclinical mastitis in Ettawa Crossbred goat (PE) in Yogyakarta, Indonesia

Biodiversitas Journal of Biological Diversity ◽

10.13057/biodiv/d220650 ◽

2021 ◽

Vol 22 (6) ◽

Author(s):

Widodo Suwito ◽

WIDAGDO SRI NUGROHO ◽

AGNESIA ENDANG TRI HASTUTI WAHYUNI ◽

BAMBANG SUMIARTO

Keyword(s):

Antimicrobial Resistance ◽

Susceptibility Testing ◽

Clinical Laboratory ◽

Subclinical Mastitis ◽

Multidrug Resistant ◽

Resistance Rate ◽

Diffusion Method ◽

Disc Diffusion Method ◽

Coagulase Negative Staphylococci ◽

Resistance Patterns

Abstract. Suwito W, Nugroho WS, Wahyuni AETH, Sumiarto B. 2021. Antimicrobial resistance in coagulase-negative staphylococci isolated from subclinical mastitis in Ettawa Crossbred goat (PE) in Yogyakarta, Indonesia. Biodiversitas 22: 3418-3422. Subclinical mastitis (SCM) in Ettawa Crossbred Goat (PE) is most frequently caused by staphylococci with a significant reduction in milk yield. The aim of this study is to determine antimicrobial resistance patterns of coagulase-negative staphylococci (CoNS) from PE goat SCM. A total of 36 CoNS isolates originating from PE goat SCM were collected in semisolid tube use in this study. All CoNS isolates were further examined for antimicrobial susceptibility testing by the Kirby-Bauer disc diffusion method. Antibiotic susceptibility of CoNS isolated samples according to Clinical Laboratory Standards Institute (CLSI). The CoNS isolates showed the highest resistance rate against sulfamethoxazole (65%), ampicillin (55.56%), penicillin (45%), cefoxitin (33.33%), erythromycin (25%), oxytetracycline (20%), tetracycline (15%), gentamicin and neomycin (11.11%), while oxacillin was sensitive. The highest of multiple antimicrobials resistance observed 15% in ampicillin, penicillin and tetracycline, then 5-10% in ampicillin, penicillin, erythromycin, tetracycline and oxytetracycline. The majority of CoNS in this study were resistant to sulfamethoxazole and then, followed by ampicillin, penicillin, cefoxitin, erythromycin, oxytetracycline, tetracycline, gentamicin and neomycin. In addition, most isolates were penicillin-resistant and multidrug-resistant (MDR).

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Determination of Antimicrobial Resistance Patterns in Bloodstream Infections-Isolated Bacteria From a University Tertiary Hospital Patients

International Journal of Enteric Pathogens ◽

10.15171/ijep.2019.12 ◽

2019 ◽

Vol 7 (2) ◽

pp. 49-54

Author(s):

Alka Hasani ◽

Nasim Asadi Faezi ◽

Mohammad Ahangarzadeh Rezaee ◽

Elham Sheykhsaran ◽

Narges Darabi ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Antimicrobial Agents ◽

Bloodstream Infections ◽

Tertiary Hospital ◽

Resistance Rate ◽

High Morbidity ◽

Hospital Patients ◽

Resistance Patterns ◽

Susceptibility Patterns

Background: Bloodstream infections are considered a significant medical concern associated with high morbidity and mortality rates. Therefore, physicians should be guided to use antimicrobial susceptibility patterns in order to select appropriate empiric antimicrobial agents to treat the patients who suffer from bacteremia. Objective: The present study aimed to determine antimicrobial resistance and susceptibility patterns in isolates collected from bloodstream infections. Materials and Methods: To achieve this, a total of 710 bacterial blood culture isolates were collected from Sina hospital, and then susceptibility patterns to a number of antibiotics were analyzed according to Clinical and Laboratory Standards Institute guidelines. Results: The identified isolates included Staphylococcus aureus 14 (20.6%), Escherichia coli 14 (20.6%), Acinetobacter baumannii 12 (17.6%), Pseudomonas aeruginosa 11 (16.2%), Coagulasenegative Staphylococcus 8 (11.8%), Klebsiella pneumoniae 6 (8.8%), and Enterobacter spp. 3 (4.4%). The total resistance rate to co-trimoxazole, ceftriaxone, ceftazidime, cefotaxime, ofloxacin, gentamicin, ciprofloxacin, levofloxacin, amikacin, and imipenem was 44 (64.7%), 42 (61.8%), 39 (57.4%), 38 (55.9%), 35 (51.51%), 32 (47.1%), 31 (45.6%), 25 (36.8%), and 27 (39.7%), respectively. Finally, the susceptibility rate to amikacin and imipenem was 43 (63.2%) and 41 (60.3%), respectively. Conclusion: In general, A. baumannii strains isolated from blood cultures were resistant to most antibiotics and the greatest sensitivity was observed to gentamicin (58.3%) compared to other antibiotics. Therefore, gentamicin was found as the most effective antibiotic for treating bloodstream infections caused by A. baumannii.

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Prevalence and Antimicrobial Resistance of Campylobacter coli and Campylobacter jejuni in the Animals, Food Products, and Human Clinical Specimens in Iran During 2004 - 2017: A Review Study

Jundishapur Journal of Health Sciences ◽

10.5812/jjhs.108609 ◽

2021 ◽

Vol 12 (4) ◽

Author(s):

Farhad Moradi ◽

Maryam Akbari ◽

Hengameh Zandi ◽

Reyhaneh Rouhi Jahromi

Keyword(s):

Antimicrobial Resistance ◽

Campylobacter Jejuni ◽

Treatment Guidelines ◽

Treatment Strategies ◽

Food Products ◽

Resistance Rate ◽

High Rate ◽

Campylobacter Coli ◽

Human Society ◽

Antibiotic Resistant

Context: Several studies reported that the prevalence and antibiotic-resistant of Campylobacter coli (C. coli) and Campylobacter jejuni (C. jejuni) are on the rise in Iran. To explain the prevalence and antibiotic-resistant of Campylobacter coli and Campylobacter jejuni, we reviewed related studies published from 2004 to 2017 in Iran. Methods: We systematically searched biomedical databases (PubMed, Scopus, Google Scholar, and Web of sciences) to identify relevant studies from 2004 to 2017, either in English or in Persian. Out of 65 identified articles, 47 were published during 2004 - 2017. Results: We found an increase in the prevalence of C. coli and C. jejuni in the animals (34.71%, 68.73%), food products (42.18%, 72%), and different clinical human samples (7.77%, 25.84%), respectively. This comprehensive review showed that C. jejuni is the foremost species in Iran. Accordingly, antimicrobial resistance studies performed during 2004 - 2017 reported a high rate of resistance to several antibiotics like ciprofloxacin, nalidixic acid, and tetracycline, with the exception of gentamicin, neomycin, and chloramphenicol that had a low resistance rate. Conclusions: According to the results, novel prevention and treatment strategies against C. coli and C. jejuni infections are recommended, and these data may help in revising treatment guidelines in aviculture, stockyard and decreasing the antimicrobial resistance in human society.

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Surveillance for Antimicrobial Resistance in Gonorrhea: The Alberta Model, 2012–2016

Antibiotics ◽

10.3390/antibiotics7030063 ◽

2018 ◽

Vol 7 (3) ◽

pp. 63 ◽

Cited By ~ 4

Author(s):

Jennifer Gratrix ◽

Anmmd Kamruzzaman ◽

Irene Martin ◽

Petra Smyczek ◽

Ron Read ◽

...

Keyword(s):

Public Health ◽

Antimicrobial Resistance ◽

Surveillance System ◽

Susceptibility Testing ◽

Treatment Guidelines ◽

Nucleic Acid Amplification ◽

Microbiology Laboratory ◽

Testing Laboratories ◽

Culture Positive ◽

Multiple Antibiotics

Alberta established a surveillance system in 2001 to monitor resistance to antibiotics used for the treatment of gonorrhea. A retrospective review of gonorrhea cases during the last five years was conducted. All cases of gonorrhea were reportable to public health by testing laboratories and clinicians. Specimens were primarily submitted for nucleic acid amplification testing (NAAT); three sentinel sites obtained specimens for culture and NAAT. The Provincial Laboratory for Public Health conducted E-tests on isolates for multiple antibiotics. A proportion of isolates and NAAT specimens were submitted to the National Microbiology Laboratory for sequence typing (ST). Data were combined and analyzed using SAS version 9.4. Between 2012 and 2016, 13,132 gonorrhea cases were reported; 22.0% (n = 2891) had isolates available for susceptibility testing. All culture positive isolates were susceptible to ceftriaxone. Decreased susceptibility (0.5 ug/mL) to cefixime was reported in four cases in 2014. Resistance to azithromycin (≥2 ug/mL) ranged between 0.4% and 1.8%. Many (n = 509) unique STs were identified; the most prevalent sequence groups (SG) were SG-7638 (n = 367), SG-5985 (n = 145), and SG-11299 (n = 127). The Alberta model for maintaining surveillance for antimicrobial resistance in gonorrhea employs culture and NAAT specimens, providing information crucial to informing provincial treatment guidelines.

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Antimicrobial resistance surveillance of Salmonella isolates from the First People’s Hospital of Yunnan Province, China

The Journal of Infection in Developing Countries ◽

10.3855/jidc.5420 ◽

2015 ◽

Vol 9 (04) ◽

pp. 333-337 ◽

Cited By ~ 3

Author(s):

Jiang Yaxian ◽

Zuo Hui ◽

Niu Hua ◽

Mao Xiaoqin ◽

Li Fengliang ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Antimicrobial Susceptibility ◽

Yunnan Province ◽

Antimicrobial Agents ◽

Susceptibility Testing ◽

Common Disease ◽

First Line ◽

Salmonella Spp ◽

Resistant Phenotype ◽

Resistance Rates

Introduction: Typhoid fever is a common disease in Yunnan province; however, the resistant phenotype and epidemic characteristics of Salmonella in this area are still unclear. In this study, a 15-year surveillance of antimicrobial susceptibility of Salmonella is reported. Methodology: From January 1999 to December 2013, Salmonella isolates were recovered from patients in the First People's Hospital of Yunnan Province. Antimicrobial susceptibility was detected and data were analyzed using WHONET5.6. Results: A total of 845 Salmonella isolates were recovered between 1999 and 2013. The most frequently isolated Salmonella serovar was S. Paratyphi A (93%), and 75.1% (635/845) of the isolates were from the young and middle-aged population. The resistance rates of Salmonella spp. to ciprofloxacin, ampicillin, and ceftriaxone increased dramatically during the 15 years. Carbapenems retained the highest and most stable activity against isolates. The resistance rates of all Salmonella isolates to chloramphenicol and sulfamethoxazole were 0.4% (3/845) and 1.8% (15/845), respectively. Conclusions: As Salmonella isolates have been observed to be resistant to first-line antibiotics, antimicrobial agents should be used rationally and prescriptions should be based on case-by-case susceptibility testing.

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Identification, Genotyping and Antimicrobial Susceptibility Testing of Brucella spp. Isolated from Livestock in Egypt

Microorganisms ◽

10.3390/microorganisms7120603 ◽

2019 ◽

Vol 7 (12) ◽

pp. 603 ◽

Cited By ~ 3

Author(s):

Aman Ullah Khan ◽

Waleed S. Shell ◽

Falk Melzer ◽

Ashraf E. Sayour ◽

Eman Shawkat Ramadan ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Antimicrobial Susceptibility ◽

Molecular Mechanisms ◽

Antimicrobial Agents ◽

Susceptibility Testing ◽

Brucella Melitensis ◽

Rpob Gene ◽

Antimicrobial Susceptibility Testing ◽

Animal Populations ◽

Microbiological Methods

Brucellosis is a highly contagious zoonosis worldwide with economic and public health impacts. The aim of the present study was to identify Brucella (B.) spp. isolated from animal populations located in different districts of Egypt and to determine their antimicrobial resistance. In total, 34-suspected Brucella isolates were recovered from lymph nodes, milk, and fetal abomasal contents of infected cattle, buffaloes, sheep, and goats from nine districts in Egypt. The isolates were identified by microbiological methods and matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). Differentiation and genotyping were confirmed using multiplex PCR for B. abortus, Brucella melitensis, Brucella ovis, and Brucella suis (AMOS) and Bruce-ladder PCR. Antimicrobial susceptibility testing against clinically used antimicrobial agents (chloramphenicol, ciprofloxacin, erythromycin, gentamicin, imipenem, rifampicin, streptomycin, and tetracycline) was performed using E-Test. The antimicrobial resistance-associated genes and mutations in Brucella isolates were confirmed using molecular tools. In total, 29 Brucella isolates (eight B. abortus biovar 1 and 21 B. melitensis biovar 3) were identified and typed. The resistance of B. melitensis to ciprofloxacin, erythromycin, imipenem, rifampicin, and streptomycin were 76.2%, 19.0%, 76.2%, 66.7%, and 4.8%, respectively. Whereas, 25.0%, 87.5%, 25.0%, and 37.5% of B. abortus were resistant to ciprofloxacin, erythromycin, imipenem, and rifampicin, respectively. Mutations in the rpoB gene associated with rifampicin resistance were identified in all phenotypically resistant isolates. Mutations in gyrA and gyrB genes associated with ciprofloxacin resistance were identified in four phenotypically resistant isolates of B. melitensis. This is the first study highlighting the antimicrobial resistance in Brucella isolated from different animal species in Egypt. Mutations detected in genes associated with antimicrobial resistance unravel the molecular mechanisms of resistance in Brucella isolates from Egypt. The mutations in the rpoB gene in phenotypically resistant B. abortus isolates in this study were reported for the first time in Egypt.

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