Genotypic Distribution and Antimicrobial Susceptibilities of Carbapenemase-Producing Enterobacteriaceae Isolated From Rectal and Clinical Samples in Korean University Hospitals Between 2016 and 2019

Introduction: For the best management of the zygomycosis in immunocompromised patients, the present study aims to detect and identify the etiologic agents by DNA sequencing method and their related factors in clinical samples of patients. Methodology: Clinical samples from 1,058 patients admitted in 11 university hospitals in Shiraz, Southern Iran were collected between July 2015 and July 2018. All samples (bronchoalveolar lavage, sputum, blood, tissue) were examined by routine microscopic and culture tests for zygomycetes. The etiologic agents were identified by the molecular method and sequencing. Results: Direct microscopic examinations or pathology smear, culture, and PCR were positive in 61 (5.8%), 15 (1.4%), and 103 (9.7%) patients, respectively. According to EORTC/MSG criteria, the rates of proven, probable, and possible zygomycosis were 59.2% (61/103), 14.6% (15/103), and 26.2% (27/103 patients), respectively. The most prevalent etiologic agents according to sequencing were Rhizopus oryzae (44 cases), Rhizopus microsporus (31 cases), Rhizopus stolonifer (15 cases). Twenty-two patients (21.4%) with positive PCR died. There were significant relations between zygomycosis and the underlying disease (p = 0.043) and prior antifungal therapy (p = 0.023). White blood cell count was in the normal range in 14.1% of patients, and the means of erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) were 65 mm/hour and 57 mg/L, respectively. Conclusions: Molecular methods and sequencing may have considered as suitable tools to diagnose zygomycosis. Identification of the etiologic agents may be considered as the future antifungal therapy and management of the respective patients.

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Phenotypic Description and Antimicrobial Susceptibilities of Aerococcus sanguinicola Isolates from Human Clinical Samples

Journal of Clinical Microbiology ◽

10.1128/jcm.41.6.2587-2592.2003 ◽

2003 ◽

Vol 41 (6) ◽

pp. 2587-2592 ◽

Cited By ~ 27

Author(s):

R. Facklam ◽

M. Lovgren ◽

P. L. Shewmaker ◽

G. Tyrrell

Keyword(s):

Clinical Samples ◽

Antimicrobial Susceptibilities

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Bicentric evaluation of stabilizing sampling tubes for assessment of monocyte HLA-DR expression in clinical samples

10.1101/2021.05.12.21256300 ◽

2021 ◽

Author(s):

guillaume monneret

Keyword(s):

Flow Cytometry ◽

Whole Blood ◽

Human Leukocyte ◽

Clinical Samples ◽

University Hospitals ◽

Short Delay ◽

Leukocyte Antigen ◽

Hla Dr ◽

Healthy Donors ◽

Flow Cytometry Staining

Background. Diminished expression of human leukocyte antigen DR on circulating monocytes (mHLA-DR), measured by standardized flow cytometry procedure, is a reliable indicator of immunosuppression in severely injured intensive care unit patients. As such, it is used as stratification criteria in clinical trials evaluating novel immunostimulating therapies. Pre-analytical constraints relative to the short delay between blood sampling and flow cytometry staining have nevertheless limited its use in multicentric studies. The objective of the present work was to compare mHLA-DR expression between whole blood samples simultaneously drawn in EDTA or Cyto-Chex BCT tubes. Methods. In 2 university hospitals, mHLA-DR was assessed in fresh whole blood from septic patients (n = 12) and healthy donors (n = 6) simultaneously sampled on EDTA and Cyto-Chex BCT tubes. Staining was performed immediately after sampling and after blood storage at room temperature. Results. We observed the remarkable stability of mHLA-DR results when blood was collected in Cyto-Chex BCT tubes (until 48-72 h). On baseline values, despite good correlation between tubes (r = 0.98, p< 0.001), mHLA-DR expression was systematically lower with Cyto-Chex BCT. Conclusion. The present reports confirms the great potential of Cyto-Chex BCT tubes to delay mHLA-DR staining in centers without rapid access to flow cytometry facilities. However, a 30 % gap exists between results obtained with EDTA and Cyto-Chex BCT tubes. As current thresholds for clinical decisions were obtained with EDTA samples, further studies are needed to confirm clinical thresholds with Cyto-Chex BCT tubes.

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SFO-1 and DHA-1 genes Detection in β-lactamases-producing Klebsiella pneumoniae Causing Blood Stream Infections Acquired in Intensive Care Units in Mansoura University Hospitals

10.51429/ejmm30306 ◽

2021 ◽

Vol 30 (3) ◽

pp. 43-51

Author(s):

Nermeen Nassar ◽

Mohammad Badr ◽

Nehad Nasef ◽

Ghada Barakat

Keyword(s):

Risk Factors ◽

Significant Risk ◽

Blood Stream ◽

Clinical Samples ◽

University Hospitals ◽

Blood Stream Infections ◽

Significant Difference ◽

Synergy Test ◽

A Prospective Study ◽

Low Prevalence

Objectives: The study aimed to detect SFO-1 and DHA-1 genes and to differentiate AmpC with overlapped ESBL isolates. Also, it identified the risk factors aiding in emergence the ESBL producing K.pneumoniae causing blood stream infections in ICUs of Mansoura University Hospitals (MUHs). Methodology: This is a prospective study that enrolled 520 blood samples. Double disk synergy test (DDST) and Modified threedimensional test were performed. Genotypic detection of SFO-1, Class A ESBL, and DHA-1, AmpC β-lactamase was done. Results: 520 septicemic patients were enrolled with significant correlation for adults’ acquisition of infection. The main bacteria isolates causing nosocomial infection in septicemic patients admitted to ICU were S. aureus, E. coli and K. pneumoniae. A significant difference in distribution of ESBL and AmpC β-lactamases was detected with significant association between impenem resistance and prevalence of ESBL in those patients. There was a low-occurrence of ESBL SFO-1 and DHA-1 detected in clinical samples. Surgical intervention and CVC were the significant risk factors for presence of ESBL but previous antibiotics and hospital stay were non-significant effectors for presence of ESBL. Conclusion: Though SFO-1 is a low-prevalence ESBL, it has been taken by a plasmid with many other multiple resistance determinants including many related genes, and go together with by a large DHA-1- plasmid.

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Species Identification andIn VitroAntifungal Susceptibility ofAspergillus terreusSpecies Complex Clinical Isolates from a French Multicenter Study

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.02315-17 ◽

2018 ◽

Vol 62 (5) ◽

pp. e02315-17 ◽

Cited By ~ 4

Author(s):

S. Imbert ◽

A. C. Normand ◽

S. Ranque ◽

J. M. Costa ◽

J. Guitard ◽

...

Keyword(s):

Amphotericin B ◽

Antifungal Susceptibility ◽

Sensu Stricto ◽

Antifungal Drugs ◽

Clinical Isolates ◽

Clinical Samples ◽

Azole Resistance ◽

University Hospitals ◽

Content Type ◽

Interesting Alternative

ABSTRACTAspergillussectionTerreiis a species complex currently comprised of 14 cryptic species whose prevalence in clinical samples as well as antifungal susceptibility are poorly known. The aims of this study were to investigateA. Terreiclinical isolates at the species level and to perform antifungal susceptibility analyses by reference and commercial methods. Eighty-two clinicalA. Terreiisolates were collected from 8 French university hospitals. Molecular identification was performed by sequencing parts of beta-tubulin and calmodulin genes. MICs or minimum effective concentrations (MECs) were determined for 8 antifungal drugs using both EUCAST broth microdilution (BMD) methods and concentration gradient strips (CGS). Among the 79A. Terreiisolates,A. terreus stricto sensu(n= 61),A. citrinoterreus(n= 13),A. hortai(n= 3), andA. alabamensis(n= 2) were identified. All strains had MICs of ≥1 mg/liter for amphotericin B, except for two isolates (bothA. hortai) that had MICs of 0.25 mg/liter. FourA. terreusisolates were resistant to at least one azole drug, including one with pan-azole resistance, yet no mutation in theCYP51Agene was found. All strains had low MECs for the three echinocandins. The essential agreements (EAs) between BMD and CGS were >90%, except for those of amphotericin B (79.7%) and itraconazole (73.4%). Isolates belonging to theA. sectionTerreiidentified in clinical samples show wider species diversity beyond the knownA. terreus sensu stricto. Azole resistance inside the sectionTerreiis uncommon and is not related to CYP51A mutations here. Finally, CGS is an interesting alternative for routine antifungal susceptibility testing.

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Antimicrobial Susceptibilities and Clinical Sources of Dialister Species

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00538-07 ◽

2007 ◽

Vol 51 (12) ◽

pp. 4498-4501 ◽

Cited By ~ 25

Author(s):

F. Morio ◽

H. Jean-Pierre ◽

L. Dubreuil ◽

E. Jumas-Bilak ◽

L. Calvet ◽

...

Keyword(s):

Antimicrobial Susceptibility ◽

Antimicrobial Agents ◽

Susceptibility Testing ◽

Clinical Impact ◽

Antimicrobial Susceptibility Testing ◽

Clinical Samples ◽

Antimicrobial Susceptibilities

ABSTRACT Seventy-four strains representing the four species of the genus Dialister were isolated from various clinical samples. Dialister pneumosintes and Dialister micraerophilus were the two mainly encountered species. Fifty-five isolates were tested against 14 antimicrobial agents. Decreased susceptibilities to piperacillin, metronidazole, macrolides, fluoroquinolones, and rifampin were demonstrated. The clinical impact of these decreased susceptibilities remains to be investigated but should prompt microbiologists to perform antimicrobial susceptibility testing for clinically important Dialister spp.

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MrkD Gene as a Regulator of Biofilm Formation with Correlation to Antibiotic Resistance among Clinical Klebsiella pneumoniae Isolates from Menoufia University Hospitals

10.51429/ejmm29318 ◽

2020 ◽

Vol 29 (3) ◽

pp. 137-144

Author(s):

Asmaa M. Elbrolosy ◽

Naira A. Eissa ◽

Nahed A. Al-Rajhy ◽

Esraa El-Sayed A. El-Mahdy ◽

Rasha G. Mostafa

Keyword(s):

Antibiotic Resistance ◽

Klebsiella Pneumoniae ◽

Biofilm Formation ◽

Diffusion Method ◽

Clinical Samples ◽

Resistance Pattern ◽

University Hospitals ◽

Pcr Assay ◽

Disk Diffusion Method ◽

Microbiological Methods

Background: Klebsiella pneumoniae (K. pneumoniae) is a common pathogen involved in a diverse array of life-threatening infections. Increasing frequent acquisition of antibiotic resistance by K. pneumoniae has given rise to multidrug-resistant pathogen mostly at the hospital level. Objectives: To assess the prevalence and antibiotic resistance pattern of the clinical K. pneumoniae isolates at Menoufia University Hospitals (MUHs) as well as to explore the role of mrkD gene as a regulator of biofilm formation. Methodology: A total of 340 different clinical samples were obtained from 270 patients who were admitted to MUHs and those from Outpatient clinics during the period from April 2018 to September 2019. 84 K. pneumoniae isolates were identified by the standard microbiological methods and vitek-2 system. The antimicrobial resistance pattern was determined by disk diffusion method. The biofilm-forming ability of all K. pneumoniae isolates was demonstrated phenotypically by the modified Congo red agar method (MCRA) and PCR assay verified the presence of mrkD gene as a genetic determinant of biofilm formation. Results: Klebsiella spp. represented 34.7% of the collected isolates and the predominant spp. was K. pneumoniae (91.3%). The highest resistance rates were for ceftriaxone (69%) followed by aztreonam (67.9%), 66.7% for each of piperacillin and ceftazidime, while the least resistance rate was for fosfomycin (8.3%). Biofilm production was detected among 83.3% of the isolates by MCRA method. A highly significant statistical difference was noted between biofilm- and non- biofilm - producing K. pneumoniae isolates regarding resistance to cefepieme and amikacin (P <0.001) and similarly regarding resistance to aztreonam, imipenem, meropenem, ertapenem and tobramycin (P<0.05). Conventional PCR assay showed that, 92% of the isolates harbored mrkD gene with a highly significant association with biofilm formation. Conclusion: The increasing prevalence and remarkable ability to acquire antibiotic resistance among K. pneumoniae isolates together with biofilm formation should alert even more regarding the hazard of this pathogen in hospital settings.

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Detection of class D carbapenemases (blaoxa23 and bla oxa48) genes among extended-spectrum β-lactamase-producing Escherichia coli in Menoufia University Hospitals

10.51429/ejmm29303 ◽

2020 ◽

Vol 29 (3) ◽

pp. 19-27

Author(s):

Mabrouk M Ghonaim ◽

Azza Z. Labeeb ◽

Asmaa K Amer ◽

Soma E Ajlan

Keyword(s):

Escherichia Coli ◽

High Rate ◽

Disk Diffusion ◽

Clinical Samples ◽

Resistance Pattern ◽

University Hospitals ◽

E Coli ◽

Extended Spectrum ◽

Stewardship Program ◽

Class D

Background: Carbapenemases production by extended-spectrum β-lactamases (ESβLs)- producing Escherichia coli (E. coli) has been increasingly found and may be considered as a major cause of morbidity and mortality in hospital-acquired infection. Objectives: To determine resistance pattern and frequency of carbapenem resistance and presence of class D carbapenemases among ESβLs-producing E. coli isolated from patients in Menoufia University Hospitals. Methodology: Different clinical samples were obtained from 270 patients who were admitted to Menoufia University Hospitals. E. coli were isolated and identified, and their antimicrobial resistance profiles were tested by the disk diffusion and agar dilution methods. Confirmed ESβLs producers (by cephalosporin/ clavulanate combination disks and ESβL NDP tests) were further tested for carbapenemase production by phenotypic and genotypic methods. Results: E. coli was the most common isolate (30.4%) from clinical samples. High rate of ESβLs-producing E. coli was detected by disk diffusion (87.5%), cephalosporin/clavulanate combination disk (62.5%) and ESβL NDP test (60%).About10%, 24% and 28% of the ESβLsproducing E. coli isolates were producers of class A, B and D carbapenemases respectively. The prevalence of blashv, blaoxa23 and blaoxa48 genes among ESβLsproducing E. coli isolates was 18%, 22% and 12% respectively. Conclusion: Carbapenemases production by EβSLs-producing E. coli is a major challenge. A great concern should be paid to provide alternative new therapeutic agents, continuous surveillance, and effective antibiotic stewardship program.

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In Vitro Activity of Plazomicin among Carbapenem-resistant Enterobacteriaceae

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.7579 ◽

2021 ◽

Vol 9 (A) ◽

pp. 1203-1207

Author(s):

Sara Essam ◽

Nada Nawar ◽

Mohamed ElBashaar ◽

May Soliman ◽

May Abdelfattah

Keyword(s):

Therapeutic Option ◽

Vitro Activity ◽

Clinical Samples ◽

In Vitro Activity ◽

University Hospitals ◽

Therapeutic Drugs ◽

Carbapenem Resistant ◽

Global Threat ◽

Carbapenem Resistant Enterobacteriaceae

Background: Carbapenem-resistant Enterobacteriaceae (CRE) have been disseminated worldwide and became a global threat. Due to limited therapeutic drugs plazomicin - a new semisynthetic aminoglycoside - have been suggested as an alternative option owing to its stability against aminoglycosides modifying enzymes (AMEs). This study aims to assess the in vitro activity of plazomicin against CRE isolates and to detect different types of carbapenemases among these isolates. Material and Methods: In this study, 102 CRE isolates were collected from different clinical samples at Cairo University hospitals and the presence of carbapenemases was detected by modified carbapenem inhibition method (mCIM) and multiplex PCR tests. Plazomicin susceptibility testing was done using E test. Results: The most frequently detected carbapenemase genes were blaNDM in 75 (73.5%) isolates, followed by blaOXA-48 in 57 (55.9%) and blaKPC in 16 (15.5%) isolates. Plazomicin was active against 32 (31.4%) isolates. Among the isolates carrying blaNDM gene only and those carrying blaOXA-48 gene only, 21% and 41% were sensitive to plazomicin, respectively. Plazomicin showed the highest sensitivity against CRE isolates compared to the other tested antibiotics. Conclusion: Plazomicin might be a good option for treatment of infections caused by CRE. In health care settings where blaNDM gene is prevalent, plazomicin may not be a good therapeutic option for CRE infections.

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