scholarly journals Prevalence of Ciprofloxacin Resistance Among Gram-Negative Bacilli at a Specialist Hospital in Saudi Arabia

2012 ◽  
Vol 11 (4) ◽  
pp. 317-321
Author(s):  
Shamweel Ahmad
Keyword(s):  
Bacterial Species ◽  
Treatment Options ◽  
Medical Science ◽  
Surrogate Marker ◽  
Quinolone Resistance ◽  
Cross Resistance ◽  
Multi Drug Resistance ◽  
Gram Negative ◽  
Ciprofloxacin Resistance ◽  
Tract Infections

Background: Resistance to antimicrobials of different structural classes including fluoroquinolones has arisen in a multitude of bacterial species both in the community and the hospitals. This may complicate the therapeutic management of infections. Decreased susceptibility to fluoroquinolones arises mainly by singlestep mutations in the gyrA and parC genes, which encode the fluoroquinolones targets, the topoisomerase enzymes, conferring cross resistance to all fluoroquinolones. Accumulation of multiple mutations in several genes confers increasing level of resistance associated with clinical failure. However, even low level resistance can generate therapeutic failure. In 1998, some mobile elements with a potential for the horizontal transfer of the quinolone resistance genes were described. The loci which are responsible for this plasmid-mediated quinolone resistance, which have been designated as qnrA, qnrB and qnrS, have been identified in the Enterobacteriaceae species. Aim: To evaluate the susceptibility pattern of the isolates to various antibiotics and to know the prevalence rate of ciprofloxacin resistance in our hospital. Materials & Methods: A total of 916 gram-negative bacilli (GNB) were isolated from different clinical specimens over a period of nine months, were subjected to antibiotic susceptibility testing. Isolates with resistance or with a decreased susceptibility to ciprofloxacin (£20 mm) were then screened for their minimum inhibitory concentration(MIC) by using the E-test. Results: Out of 916 GNB, 321 (35%) isolates were resistant to ciprofloxacin. The MIC of these isolates ranged from 4 to >32?g/ml.Conclusion: The resistance rate to ciprofloxacin was 35% in our study. Most of the ciprofloxacin resistant isolates were from urinary tract infections (UTI). The ciprofloxacin resistance was also closely associated with multi-drug resistance, thus limiting the treatment options. Ciprofloxacin resistance can be used as a general surrogate marker of multidrug resistance, thus limiting the already restricted treatment options. The considerably high MIC values for ciprofloxacin in this study reflected the extent of the treatment problems for these resistant isolates and a need for the continuous evaluation of the commonly used antibiotics. DOI: http://dx.doi.org/10.3329/bjms.v11i4.12604 Bangladesh Journal of Medical Science Vol. 11 No. 04 Oct’12

scholarly journals Dissemination of NDM Metallo-β-Lactamase Genes among Clinical Isolates of Enterobacteriaceae Collected during the SMART Global Surveillance Study from 2008 to 2012

2014 ◽  
Vol 59 (2) ◽  
pp. 826-830 ◽  
Author(s):  
D. Biedenbach ◽  
S. Bouchillon ◽  
M. Hackel ◽  
D. Hoban ◽  
K. Kazmierczak ◽  
...  
Keyword(s):  
Antimicrobial Agents ◽  
Bacterial Species ◽  
Treatment Options ◽  
Surveillance Study ◽  
Cross Resistance ◽  
New Delhi ◽  
Content Type ◽  
Class B ◽  
Tract Infections ◽  
Inhibitor Combination

ABSTRACTThe prevalence of carbapenemase enzymes continues to increase. Among the Ambler class B enzymes is the New Delhi metallo-β-lactamase (NDM). This particular enzyme is capable of hydrolyzing nearly all β-lactam antimicrobial agents and has spread rapidly, becoming a global problem. Therapeutic treatment options for patients infected with isolates which produce this enzyme are difficult to manage, as cross-resistance to other antimicrobial classes is common. The Study for Monitoring Antimicrobial Resistance Trends (SMART) is a global surveillance study evaluating the antimicrobial susceptibilities of numerous Gram-negative bacterial species recovered from people with intra-abdominal and urinary tract infections. The Clinical and Laboratory Standards Institute methods and a molecular analysis identified 134 isolates ofEnterobacteriaceae(nine species) and oneAcinetobactersp. withblaNDMgenes. These isolates were collected in nine countries, and >95% of the isolates possessed the NDM-1 variant. The MIC90values were >4 mg/liter and >8 mg/liter for ertapenem and imipenem, respectively. No tested β-lactam or β-lactamase inhibitor combination had activity against these isolates. Resistance to amikacin (79.9%) and levofloxacin (82.8%) was common. Nearly all the isolates encoded additional enzymes, including AmpC cephalosporinases and extended-spectrum β-lactamases. There is an urgent need for infection control and continued global monitoring of isolates which harbor the NDM enzyme, as evidenced by recent outbreaks.

scholarly journals Prevalence of Ciprofloxacin Resistance among Gram-Negative Bacilli Isolated From Different Specimens at a General Hospital in Riyadh, Saudi Arabia

2013 ◽  
Vol 5 (1) ◽  
pp. 7-10
Author(s):  
Mohammad Afzal Hossain ◽  
Shirin Mohal ◽  
Md Abdullah Yusuf ◽  
Md Saiful Islam ◽  
Md Rafiqul Islam ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
General Hospital ◽  
Inhibitory Concentration ◽  
Bacterial Species ◽  
Cross Sectional Study ◽  
Test Results ◽  
Cross Sectional ◽  
Gram Negative ◽  
Ciprofloxacin Resistance ◽  
Tract Infections

Background: Resistance among the different classes of antimicrobials including fluoroquinolones has arisen in a multitude of bacterial species in the hospitals and in the community. Objective: The purpose of the present study was to measure the prevalence of ciprofloxacin resistance as well as to evaluate the susceptibility pattern of the isolates to various antibiotics. Methodology: This cross sectional study was carried out in the Department of Microbiology at a General Hospital in Riyadh, Saudi Arabia from July'2009 to December'2009. Different clinical specimens were collected and culture was done in the appropriate media. Antibiotic susceptibility testing was performed. Gram negative bacterial isolates with decreased susceptibility to ciprofloxacin were tested for minimum inhibitory concentration (MIC) by using the E-test. Results: A total of 1246 gram-negative bacilli (GNB) were isolated from different specimens of which 486(39.0%) isolates were resistant to ciprofloxacin. The MIC of these isolates ranged from 4 to 32 ?g/ml. Most of the Ciprofloxacin resistant isolates were from urinary tract infections. Conclusion: The prevalence of ciprofloxacin resistance in different specimens is high. DOI: http://dx.doi.org/10.3329/jssmc.v5i1.16197 J Shaheed Suhrawardy Med Coll, 2013;5(1):7-10

scholarly journals Evolution and Dissemination of OqxAB-Like Efflux Pumps, an Emerging Quinolone Resistance Determinant among Members of Enterobacteriaceae

2015 ◽  
Vol 59 (6) ◽  
pp. 3290-3297 ◽  
Author(s):  
Marcus Ho Yin Wong ◽  
Edward Wai Chi Chan ◽  
Sheng Chen
Keyword(s):  
Efflux Pump ◽  
Phylogenetic Analyses ◽  
Bacterial Species ◽  
Fold Increase ◽  
Quinolone Resistance ◽  
Cross Resistance ◽  
Phenotypic Characteristics ◽  
Gram Negative ◽  
Content Type ◽  
Elevated Expression

ABSTRACTThe OqxAB efflux pump, a plasmid-mediated quinolone resistance (PMQR) determinant, has become increasingly prevalent among members ofEnterobacteriaceaeover the past decade. To investigate the evolution and dissemination routes of theoqxABoperon, we assessed the prevalence ofoqxAB-like elements among various Gram-negative bacterial species and analyzed the genotypic and phenotypic characteristics of organisms harboring such elements. With a comprehensive genotyping approach, a chromosome-basedoqxABoperon was detectable in allKlebsiella pneumoniaestrains tested, including organisms isolated before the year 1984. Sequence and phylogenetic analyses confirmed that theoqxABoperon inK. pneumoniaeisolates was genetically closest to their plasmid-borne counterparts recoverable only fromEscherichia coliandSalmonellaisolates collected from the year 2003 onward. Chromosomal elements with much lower sequence homology were also found among theEnterobacterspp. but not other Gram-negative species. Contrary to the quinolone resistance phenotypes which were consistently observable among organisms withoqxAB-harboring plasmids, chromosomaloqxABelements generally did not confer quinolone resistance, except forK. pneumoniaestrains, which exhibited a typicaloqxAB-mediated phenotype characterized by cross-resistance to olaquindox, chloramphenicol, and the quinolones. Gene expression analysis illustrated that such phenotypes were due to elevated expression of the chromosomaloqxABoperon. Furthermore, transposition of theoqxABoperon from the bacterial chromosome to plasmids was found to result in a >80-fold increase in the level of expression of the OqxAB pump, confirming its status as the first constitutively expressed efflux system located in bacterial mobile elements.

scholarly journals Prevalence of Ciprofloxacin Resistance among Gram-Negative Bacilli Isolated From Urinary Tract Infection Specimens at a Specialist Hospital in Riyadh, Saudi Arabia

2013 ◽  
Vol 11 (1) ◽  
pp. 11-16
Author(s):  
Md. Afzal Hossain ◽  
Shirin Mohal ◽  
Md. Saiful Islam ◽  
Mohammad Abdullah Yusuf
Keyword(s):  
Urinary Tract Infection ◽  
Saudi Arabia ◽  
Urinary Tract ◽  
Tract Infection ◽  
Multi Drug Resistance ◽  
Cross Sectional ◽  
Gram Negative ◽  
Sensitivity Pattern ◽  
Ciprofloxacin Resistance ◽  
Tract Infections

Background: Susceptibility to fluoroquinolones is very important information before prescribing to the urinary tract infection (UTI) patients. Objective: The purpose of the present study was to see the sensitivity pattern of the Gram-Negative bacilli isolated from urinary tract infection to various antibiotics as well as to know the prevalence rate of Ciprofloxacin resistance. Methodology: This cross sectional study was conducted in a specialized hospital in Riyadh, Saudi Arabia from January’2006 to June’2006 for over a period of six months. The Gram-negative bacilli (GNB) were isolated from clinical specimens of UTIs and antibiotic susceptibility testing was performed. Isolates with resistance or with a decreased susceptibility to Ciprofloxacin (20 mm) were than screened for their minimum inhibitory concentration (MIC) by using the E-test. Results: Out of 510 GNB, 97(19%) isolates were resistant to Ciprofloxacin. The MIC of these isolates ranged from 4 to 32µg/ml. Most of the Ciprofloxacin resistant isolates were from urinary tract infections (UTI) of hospital patients both (indoor & outdoor). The Ciprofloxacin resistance was also closely associated with multi-drug resistance, thus limiting the treatment options. Conclusion: The considerably high MIC values for Ciprofloxacin in this study reflected the extent of the treatment problems for these resistant isolates.DOI: http://dx.doi.org/10.3329/jsf.v11i1.19395

scholarly journals Integrons as surrogate marker for multi drug resistance in gram negative bacilli

2012 ◽  
Vol 12 (S1) ◽  
Author(s):  
Gopalakrishnan Kaushik ◽  
K Arunkumar ◽  
G Sivakumar ◽  
R Rajasomasundharam ◽  
Padma Krishnan
Keyword(s):  
Drug Resistance ◽  
Surrogate Marker ◽  
Multi Drug Resistance ◽  
Gram Negative

scholarly journals In VitroAntibacterial Activity of AZD0914, a New Spiropyrimidinetrione DNA Gyrase/Topoisomerase Inhibitor with Potent Activity against Gram-Positive, Fastidious Gram-Negative, and Atypical Bacteria

2014 ◽  
Vol 59 (1) ◽  
pp. 467-474 ◽  
Author(s):  
Michael D. Huband ◽  
Patricia A. Bradford ◽  
Linda G. Otterson ◽  
Gregory S. Basarab ◽  
Amy C. Kutschke ◽  
...  
Keyword(s):  
Antibacterial Activity ◽  
Legionella Pneumophila ◽  
Bacterial Species ◽  
Dna Gyrase ◽  
Cross Resistance ◽  
Gram Positive ◽  
Gram Negative ◽  
Content Type ◽  
Topoisomerase Inhibitor

ABSTRACTAZD0914 is a new spiropyrimidinetrione bacterial DNA gyrase/topoisomerase inhibitor with potentin vitroantibacterial activity against key Gram-positive (Staphylococcus aureus,Staphylococcus epidermidis,Streptococcus pneumoniae,Streptococcus pyogenes, andStreptococcus agalactiae), fastidious Gram-negative (Haemophilus influenzaeandNeisseria gonorrhoeae), atypical (Legionella pneumophila), and anaerobic (Clostridium difficile) bacterial species, including isolates with known resistance to fluoroquinolones. AZD0914 works via inhibition of DNA biosynthesis and accumulation of double-strand cleavages; this mechanism of inhibition differs from those of other marketed antibacterial compounds. AZD0914 stabilizes and arrests the cleaved covalent complex of gyrase with double-strand broken DNA under permissive conditions and thus blocks religation of the double-strand cleaved DNA to form fused circular DNA. Whereas this mechanism is similar to that seen with fluoroquinolones, it is mechanistically distinct. AZD0914 exhibited low frequencies of spontaneous resistance inS. aureus, and if mutants were obtained, the mutations mapped togyrB. Additionally, no cross-resistance was observed for AZD0914 against recent bacterial clinical isolates demonstrating resistance to fluoroquinolones or other drug classes, including macrolides, β-lactams, glycopeptides, and oxazolidinones. AZD0914 was bactericidal in both minimum bactericidal concentration andin vitrotime-kill studies. Inin vitrocheckerboard/synergy testing with 17 comparator antibacterials, only additivity/indifference was observed. The potentin vitroantibacterial activity (including activity against fluoroquinolone-resistant isolates), low frequency of resistance, lack of cross-resistance, and bactericidal activity of AZD0914 support its continued development.

scholarly journals ANTIBACTERIAL SURVEILLANCE: AN APPROACH TO MITIGATING MULTI-DRUG RESISTANCE MENACE AMONG CLINICAL UROPATHOGENS IN EKITI STATE, NIGERIA

2020 ◽  
Vol 3 (2) ◽  
pp. 10
Author(s):  
Seye Julius Oladeji ◽  
Gbenga Victor Kayejo
Keyword(s):  
Antibiotic Resistance ◽  
Tertiary Care ◽  
Multi Drug Resistance ◽  
Care Hospital ◽  
Gram Negative ◽  
Microbiological Methods ◽  
Resistance Patterns ◽  
Etiological Agents ◽  
Tract Infections ◽  
Urine Specimens

Urinary tract infections (UTIs) are among the most common human infections with the distribution of etiological agents and antibiotic resistance patterns varying from region to region and from time to time. The aims of this study were to ascertain the prevalence and antibiotic resistance profiles of common Gram-negative uropathogens among patients attending a Tertiary Care Hospital in Ekiti State, Nigeria. One hundred and fifty clean-catch midstream urine specimens were obtained and cultured within 2 hours of collection for the detection of Gram-negative uropathogens. The isolated organisms were identified by standard microbiological methods. Of the total 150 urine specimens analyzed, 82 (54.67%) specimens were positive for Gram-negative uropathogen with significant bacteriuria of which 34 (41.46%) were males and 48 (58.54%) were females. Klebsiella spp. 38 (46.34%) and Escherichia coli 32 (39.02%) were the most frequently isolated Gram-negative uropathogens, followed by Proteus mirabilis 10 (12.20%) while the least occurring uropathogen was observed to be Pseudomonas aeruginosa 2 (2.44%). All the isolated uropathogens were observed to be highly resistant to the commonly prescribed antibiotics. Emerging resistance to carbapenems was also observed. Nevertheless, carbapenems showed highest susceptibility compared to other tested antibiotics. Conclusively, high levels of resistance of uropathogens to antibiotics exist in our setting. This therefore calls for continuous antibiotic surveillance and improved antibiotic stewardship.  

scholarly journals OXA-48 Carbapenemase-Encoding Transferable Plasmids of Klebsiella pneumoniae Recovered from Egyptian Patients Suffering from Complicated Urinary Tract Infections

Biology ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 889
Author(s):  
Ann A. Elshamy ◽  
Sarra E. Saleh ◽  
Mohammad Y. Alshahrani ◽  
Khaled M. Aboshanab ◽  
Mohammad M. Aboulwafa ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antimicrobial Agents ◽  
Bacterial Species ◽  
Tertiary Care ◽  
Carbapenem Resistance ◽  
Clinical Isolates ◽  
Gram Negative ◽  
E Coli ◽  
Tract Infections

Gram-negative bacteria are common causes of urinary tract infections (UTIs). Such pathogens can acquire genes encoding multiple mechanisms of antimicrobial resistance, including carbapenem resistance. The aim of this study was to detect the carbapenemase-producing ability of some Gram-negative bacterial isolates from urine specimens of patients suffering from complicated UTIs at two vital tertiary care hospitals in Cairo, Egypt; to determine the prevalence of carbapenemase genes among plasmid-bearing isolates; and explore the possibility of horizontal gene transfer to other bacterial species. The collected isolates were subjected to antimicrobial susceptibility testing, phenotypic analysis of carbapenemase production, and molecular detection of plasmid-borne carbapenemase genes, then the extracted plasmids were transformed into competent E. coli DH5α. A total of 256 Gram-negative bacterial clinical isolates were collected, 65 (25.4%) isolates showed carbapenem resistance of which 36 (55.4%) were carbapenemase-producers, and of these 31 (47.7%) harbored plasmids. The extracted plasmids were used as templates for PCR amplification of blaKPC, blaNDM, blaVIM, blaOXA-48, and blaIMP carbapenemase genes. The blaOXA-48 gene was detected in 24 (77.4%) of the tested isolates while blaVIM gene was detected in 8 (25.8%), both blaKPC and blaNDM genes were co-present in 1 (3.2%) isolate. Plasmids carrying the blaOXA-48 gene from 4 K. pneumoniae clinical isolates were successfully transformed into competent E. coli DH5α. The transformants were carbapenemase-producers and acquired resistance to some of the tested antimicrobial agents as compared to untransformed E. coli DH5α. The study concluded that the rate of carbapenem resistance among Gram-negative bacterial uropathogens in Cairo, Egypt is relatively high and can be transferred horizontally to other bacterial host(s).

scholarly journals Cefiderocol, a new antibiotic against multidrug-resistant Gram-negative bacteria

2021 ◽  
Vol 34 (Suppl 1) ◽  
pp. 41-43
Author(s):  
José Tiago Silva ◽  
Francisco López-Medrano
Keyword(s):  
Bacterial Pneumonia ◽  
Treatment Options ◽  
Multidrug Resistant ◽  
Resistance Mechanisms ◽  
Phase Iii ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Tract Infections ◽  
Transport Channels ◽  
Hospital Acquired

Cefiderocol is a novel catechol-substituted siderophore cephalosporin that binds to the extracellular free iron, and uses the bacterial active iron transport channels to penetrate in the periplasmic space of Gram-negative bacteria (GNB). Cefiderocol overcomes many resistance mechanisms of these bacteria. Cefiderocol is approved for the treatment of complicated urinary tract infections, hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia in the case of adults with limited treatment options, based on the clinical data from the APEKS-cUTI, APEKS-NP and CREDIBLE-CR trials. In the CREDIBLE-CR trial, a higher all-cause mortality was observed in the group of patients who received cefiderocol, especially those with severe infections due to Acinetobacter spp. Further phase III clinical studies are necessary in order to evaluate cefiderocol´s efficacy in the treatment of serious infections.

scholarly journals Prevalence and Expression of the Plasmid-Mediated Quinolone Resistance Determinant qnrA1

2007 ◽  
Vol 51 (11) ◽  
pp. 4105-4110 ◽  
Author(s):  
Xiaogang Xu ◽  
Shi Wu ◽  
Xinyu Ye ◽  
Yang Liu ◽  
Wanliang Shi ◽  
...  
Keyword(s):  
Enterobacter Cloacae ◽  
Quinolone Resistance ◽  
Gram Negative ◽  
Clinical Strains ◽  
E Coli ◽  
Reverse Transcription Pcr ◽  
Single Plasmid ◽  
Ciprofloxacin Resistance ◽  
Different Levels ◽  
High Expression Level

ABSTRACT Since its discovery, qnrA has been found in most common Enterobacteriaceae. Ciprofloxacin MICs conferred by different qnrA-positive plasmids could range from 0.1 μg/ml to 2 μg/ml in Escherichia coli J53. The reasons for different ciprofloxacin MICs conferred by qnrA have not been fully clarified. Five hundred forty-one consecutive gram-negative clinical strains that were resistant or intermediate to ciprofloxacin and that were isolated in Shanghai in 2005 were screened for qnrA by PCR. For qnrA-positive isolates, the transferability of quinolone resistance was determined by conjugation and mutations within the quinolone resistance-determining region (QRDR) of gyrA and parC. aac(6′)-Ib-cr was detected and qnrA RNA expression was determined using real-time reverse transcription-PCR for transconjugants with different ciprofloxacin MICs. The qnrA gene was detected in 7 of the 541 clinical isolates. Quinolone resistance was transferred in four strains by conjugation. Mutations in the QRDR of gyrA and parC were detected in five qnrA-positive clinical strains with higher ciprofloxacin MICs. Of four qnrA-bearing plasmids in E. coli J53, pHS4 and pHS5 conferred ciprofloxacin MICs of 0.094 to 0.125 μg/ml; pHS3, which harbored the aac(6′)-Ib-cr gene as well, conferred a ciprofloxacin MIC of 0.25 μg/ml, and pHS6, which had both the aac(6′)-Ib-cr gene and a high expression level of qnrA, had a ciprofloxacin MIC of 1.0 μg/ml. The prevalence of qnrA appeared to be higher in Enterobacter cloacae than in other Enterobacteriaceae. The coexistence of qnrA and aac(6′)-Ib-cr in a single plasmid and increased qnrA expression can account for the different levels of ciprofloxacin resistance seen in transconjugants.

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