Comparative analysis of resistance of main etiological agents of chronic osteomyelitis isolated from association and in monoculture

2022 ◽  
pp. 30-33
Author(s):  
I. V. Shipitsyna ◽  
E. V. Osipova

Introduction. To date, a significant number of works have been published devoted to the analysis of the sensitivity of the leading causative agents of osteomyelitis to modern drugs, however, in the available literature there are no data on a comparative analysis of the antibiotic resistance of bacteria isolated from the osteomyelitis focus from the association and in monoculture. Purpose of the work: to compare the resistance profiles of the leading causative agents of osteomyelitis, depending on the bacterial composition of the focus of infection.Materials and methods. The study included 216 clinical isolates, of which 114 were isolated as part of two-component associations, 102 – in a monoculture from pathological material in patients with chronic osteomyelitis who were treated in the purulent department of National Medical Scientific Centre of Traumatology and Orthopedics n.a. academician G.E. Ilizarov (Kurgan, Russia) from 2018 to 2020. To analyze the resistance profiles, depending on the type of microorganism, modern drugs used in the clinic for the treatment of osteomyelitis were taken into account.Results and its discussion. Effective drugs against P. aeruginosa strains isolated from the association were polymyxin and meropenem, and in monoculture–polymyxin, piperacillin/tazobactam, tobramycin; in relation to strains of K. pneumoniae isolated from the association, it was imipenem, in monoculture – amikacin. S. aureus strains isolated both from the association and in monoculture were highly susceptible to antibacterial drugs.Conclusion. The analysis of the sensitivity of the leading causative agents of osteomyelitis, isolated in monoculture and from the association, to the antibacterial drugs used in the clinic, showed significant differences in the resistance profiles between the groups: for S. aureus strains, 4 antibiotics tested out of 13, for P. aeruginosa strains – 7 out of 13, for K. pneumoniae strains – 12 out of 16. The tested antibacterial drugs were less active against P. aeruginosa and S. aureus strains isolated from associations. In contrast, the percentage of resistant strains of K. pneumoniae was higher among monocultures.

Author(s):  
Tayebwa Edson ◽  
Kisitu Kyengera ◽  
Baguma Andrew ◽  
Bazira Joel

Background: This cross-sectional study was conducted to determine prevalence, causative agents and their drug susceptibility patterns of chronic osteomyelitis children among 766 children attending orthopedic services at Mbarara Regional Referral Hospital between October 2016 and June 2017. Methods: Seventy-four consented patients were consecutively enrolled and their demographic characteristics, clinical and radiological data collected. Superficial and deep bone pus swabs were collected and processed as per standard operative procedures. Susceptibility testing was done using the Kirby Bauer disc diffusion technique. Data was analyzed using Stata version 13.0. Results: The prevalence of children with COM was 9.7%.  The female: Male ratio was 1:1.2 with a mean age of 11 years. The most infected bone was the tibia followed by the femur. The common clinical presentations were chronic bone pain and discharging sinus tracts whereas the most imminent radiological features were sequestrum and involcrum. Pus swabs were taken off from both the discharging sinuses and the deep intra osseous abscesses for culture and sensitivity studies. The concordance rate of the microorganisms between the superficial and the deep swabs was 62.5%. Staphylococcus aureus was the most predominant microorganism isolated (85%). All the microorganism isolates were sensitive to gentamycin. However, all Staphylococcus aureus isolated were resistant to penicillin. Conclusion: Prevalence of Chronic osteomyelitis among children with orthopedic conditions presenting to MRRH is high. The isolated microorganisms are resistant to antibiotics we commonly use in our settings.


2018 ◽  
Vol 8 (3) ◽  
pp. 316-324
Author(s):  
N. E. Bondareva ◽  
E. Yu. Morgunova ◽  
N. A. Zigangirova ◽  
Yu. G. Shapkin ◽  
Yu. V. Chalyk ◽  
...  

 To date, clinical data have convincingly shown that C. trachomatis and C. pneumoniae infectious can cause serious diseases with severe complications and consequences. There are assumptions that the developed chronic chlamydial infection can become an important factor in the pathogenesis of the gastrointestinal tract diseases, which are manifested in the so-called post-infectious period. It is commonly known that chlamydial infection has a tropism to the cylindrical epithelium, which covers the human mucous membrane of the urethra, cervix, rectum, conjunctiva of the eyes and the throat. However, the role of the causative agents of chlamydial infections, such as C. trachomatis and C. pneumoniae, in the occurrence of the gastrointestinal tract diseases has not been studied. In order to study the possible relationship between the gastrointestinal diseases and the presence of chlamydial infection markers, we have selected a group of patients with the gastrointestinal diseases and detected antibodies to C. trachomatis and C. pneumoniae and DNA of these pathogens in blood serum, liver biopsy and bile ducts. As a result, C. trachomatis DNA in blood serum was detected in 50% of cases, and in liver biopsies — in 59.3%. A new approach has been developed in the serological diagnosis of chlamydial infection caused by C. trachomatis, which allowed for revealing diagnostic antibody titers in 51.9% of cases in this group of patients, and in the comparison group — in 11.6% of cases. Among 50% of patients, in whom DNA was revealed in blood serum, it was also revealed in 64.3% of cases in biopsy samples of gastrointestinal organs. Upon detection of C. trachomatis DNA in blood serum, antibodies to the “cultural” antigen were detected in 60.1% of cases, and with the simultaneous detection of C. trachomatis DNA in blood serum and gastrointestinal organs, they were found in 72.2% of cases. Simultaneous detection of C. trachomatis, both in blood serum and in the gastrointestinal tract, may indicate the ability of C. trachomatis to spread hematogenously and infect organs away from the primary focus of infection. The obtained data absolutely require further study in light of the identification of the relationship between the detection of the pathogen and the development of the gastrointestinal pathology. But in general, the results are not yet studied evidence of the possible gastrointestinal organs infection by C. trachomatis.


2011 ◽  
Vol 152 (42) ◽  
pp. 1698-1702 ◽  
Author(s):  
Balázs Farkas ◽  
Eszter Ostorházi ◽  
Katinka Pónyai ◽  
Béla Tóth ◽  
Elmardi Adlan ◽  
...  

Ureaplasma urealyticum and Mycoplasma hominis have important role among the causative agents of sexually transmitted diseases. Aim: The aim of the study was to determine the frequency and antibiotic resistance of Ureaplasma urealyticum and Mycoplasma hominis in genital samples obtained from patients examined in the Sexually Transmitted Diseases Centre of the Department of Dermatology, Venerology and Dermatooncology, Semmelweis University, Budapest between May 1, 2008 and July 31, 2010. Patients and methods: Samples were taken from the urethra in men and from the cervix and urethra in women by universal swab (Biolab®) into Urea-Myco DUO kit (Bio-Rad®) and were incubated for 48 hours at 37 C°. Antibiotic sensitivity of positive samples was determined in U9 bouillon using SIR Mycoplasma kit (Bio-Rad®). Results: Samples for 4154 patients aged 16-60 years were examined. In 247/4154 samples (6%) U. urealyticum and in 26/4154 samples (0.63%) M. hominis was isolated from the genital tract. Most U. urealyticum and M. hominis strains (75% and 77%, respectively) were cultured from cervix, while the remaining 25%, and 23% from the male and female urethra, respectively. U. urealyticum and M. hominis were most commonly detected in patients aged between 21 and 40 years. The majority of U. urealyticum strains were sensitive to tetracycline (94%), doxycycline (95%), azithromycin (88%) and josamycin (90%), but were resistant to ofloxacin (21%), erythromycin (85%) and clindamycin (79%). Seventy-seven percent of the U. urealyticum strains were simultaneously resistant to erythromycin and clindamycin, suggesting that ex iuvantibus therapies may select cross-resistant strains to both antibiotics. The resistance of M. hominis to clindamycin, doxycycline, ofloxacin and tetracycline varied between 4% and 12 %. Conclusions: Because none of the strains was sensitive to all examined antibiotics, the antibiotic sensitivity of U. urealyticum and M. hominis strains should be determined. The high rate of ofloxacin, erythromycin and clindamycin resistance should be considered in the therapy of U. urealyticum infections in Hungary. This is the firstsuch a clinical microbiological study in this topic in Hungary. Orv. Hetil., 2011, 152, 1698–1702.


Molecules ◽  
2019 ◽  
Vol 24 (11) ◽  
pp. 2072 ◽  
Author(s):  
Mohammad Reza Youssefi ◽  
Elham Moghaddas ◽  
Mohaddeseh Abouhosseini Tabari ◽  
Ali Akbar Moghadamnia ◽  
Seyed Mohammad Hosseini ◽  
...  

Background: One of the most important causative agents of visceral leishmaniasis (VL) is Leishmania infantum, which is mainly spread by Phlebotomus and Lutzomyia sandflies in the Old and New World, respectively. Novel and effective drugs to manage this neglected vector-borne disease are urgently required. In this study, we evaluated the toxicity of carvacrol, thymol and linalool, three common essential oil constituents, on amastigotes and promastigotes of L. infantum. Methods: in vitro experiments were performed by 24 h MTT assay. Carvacrol, thymol and linalool at concentrations ranging from 1.3 to 10 μg/mL were tested on promastigotes of L. infantum. For in vivo test, two groups of hamsters (Mesocricetus auratus) received 100 mg/kg of body weight/day of carvacrol and thymol as intraperitoneal injection on day 7 post-infection, followed by a 48 h later injection. The third group was treated with the glucantime as standard drug (500 mg/kg) and the last group (control) just received normal saline. On the 16th day, the number of parasites and histopathological changes in liver and spleen were investigated. Results: 24 h MTT assay showed promising antileishmanial activity of thymol and carvacrol, with IC50 values of 7.2 (48 μM) and 9.8 μg/mL (65 μM), respectively. Linalool at all concentrations did not affect L. infantum promastigote viability. In vivo toxicity data of carvacrol and thymol showed that the former at 100 mg/kg was the safest and most effective treatment with little side effects on the liver. Conclusions: Overall, thymol and carvacrol are highly promising candidates for the development of effective and safe drugs in the fight against VL.


2020 ◽  
Vol 6 (4) ◽  
pp. 325
Author(s):  
Cristina Isabel Ferrer Villena ◽  
Renata Rodrigues Gomes ◽  
Larissa Fernandes ◽  
Camille Silva Florencio ◽  
Amanda Bombassaro ◽  
...  

The fungal genus Fonsecaea contains etiological agents of human chromoblastomycosis, a (sub)tropical, (sub)cutaneous implantation disease caused by plant contact. The invasive potential differs significantly between species. Infections by Fonsecaea monophora are believed to originate from the environment and the species has been reported as one of the main causative agents of the disease, but also of cases of primary brain infection. The epidemiology of the disease has not been fully elucidated and questions related to its infection route and virulence are still to be clarified. The environmental species Fonsecaea erecta was isolated from organic material and living plants in endemic areas for chromoblastomycosis in Brazil. The present paper describes Agrobacteriumtumefaciens-mediated transformation (AMT) of the environmental species F. erecta and the pathogenic species F. monophora. We propose the use of Agrobacterium transformation for future gene function studies related to Fonsecaea virulence and pathogenicity. We evaluated the co-cultivation ratios 1:1, 10:1 and 100:1 (Agrobacterium:conidia) at 28 °C during 72 h. pAD1625 and pCAMDsRed plasmids were inserted into both species. Confirmation of transformation was realized by hph gene amplification and Southern blot determined the amount of foreign DNA integrated into the genome. In order to evaluate a potential link between environmental and clinical strains, we obtained red fluorescent transformants after pCAMDsRed insertion. We observed by confocal fluorescence microscopy that both F. monophora and F. erecta were able to colonize the palm Bactris gasipaes, penetrating the epidermis. These results contribute to understanding the ability of Fonsecaea species to adapt to different environmental and host conditions.


2019 ◽  
Vol 64 (10) ◽  
pp. 627-631
Author(s):  
S. I. Burnashov ◽  
I. V. Shipitsyna ◽  
E. V. Osipova

Relevance of microbiological monitoring in chronic osteomyelitis of the tibia developed during treatment of fractures with a plate is associated with a noticeable increase of various kinds of the microflora. A microbiological study was conducted of pathological material taken from wounds, fistulas and from the focus of inflammation in 49 patients with chronic tibial osteomyelitis, developed during treatment of fractures with a plate. The patients underwent sequestrectomy of the tibia and subsequent application of bilocal consecutive compression-distraction osteosynthesis or monolocal compression osteosynthesis. Microbiological study of smears taken before the reconstructive treatment from fistulas and wounds of patients showed that in mono-culture there were 30 strains, the remaining 30 - as a part of 14 two - and three-component associations. The frequency of S. aureus strains was 55.3%, followed by coagulase-negative staphylococcus - 13.6% and representatives of the family Enterobacteriacae - 10.2%. There were methicillin-resistant strains of S. aureus in 11.8%, strains of coagulase-negative staphylococcus (MRCoNS) - 6.8%. Recurrence of the disease was observed in 7 patients. The microflora of the discharge from the fistula was represented by monocultures of S. aureus and associations of bacteria in which one of the components was methicillin-resistant strains of S. aureus. We observed differences in the contents of the microflora before reconstructive treatment of patients and in recurrence of infection. In case of recurrence of infection, the qualitative contents of the microflora changed: in 2 patients in the association of microorganisms and in 3 - in monocultures, S. aureus strains acquired resistance to ß-lactam antibiotics, new associations appeared, which were not present in primary cultures before reconstructive treatment. The study showed that the spectrum of micro-organisms in chronic osteomyelitis of the tibia, developed after osteosynthesis with a plate, varied and is subject to change and that dictates the need for microbiological monitoring to detect the etiological structure of pathogens, monitoring of antibiotic resistance of the isolated strains and rational approach to treatment of patients.


2019 ◽  
pp. 24-29
Author(s):  
A. N. Tsatsulin

In the report the authors analyze the complex problems associated with the formation of regional industrial clusters, initially announced as an innovative structure. The main objectives of the planned is the introduction of the real economy scheme of public-private partnership and in the revival of national medical industry of innovative type, in particular, the sector of pharmaceuticals. Solution of these problems, according to the author, provide a procedure for import of foreign drugs quality Russian pharmaceuticals, which is currently the most important task, which stood in front of society and the state. Expounded material evidence of the relevance of the issues raised by the report. The author examines the pharmaceutical cluster of St. Petersburg, activities, participants, members of these relatively new shape territorial entities, analyzes the innovation activity of a number of existing enterprises producing both generic and original commercial products with innovative features. The latter feature is not always obvious. However, to identify the innovative leaders in the cluster author of the report offers a comparative analysis of multi-dimensional methodology. The report draws conclusions, makes recommendations.


2020 ◽  
Vol 30 (2) ◽  
pp. 219-226
Author(s):  
S. S. Sobina ◽  
M. O. Zolotov ◽  
A. V. Lyamin ◽  
D. D. Ismatullin ◽  
A. V. Zhestkov

According to the World Health Organization (WHO), diseases caused by Streptococcus pneumoniae are one of the most dangerous diseases, that can be completely prevented by vaccination. Studies conducted in various regions of the Russian Federation and other countries have revealed certain features in the prevalence of pneumococcus strains, resistant to different antibacterial drugs, which requires local studies among patients of different age groups.The aim of the study was to determine the level of sensitivity of S. pneumoniae, isolated from adult patients, to antibacterial drugs (ABD) and the dynamics of resistance to ABD in Samara for the period of 2015–2019.Methods. A retrospective analysis of data from the microbiological department of clinical diagnostic laboratories of the Clinics of Samara State Medical University, Healthcare Ministry of Russia for 2015–2019 was carried out. The microorganism resistance to several groups of ABD was studied – macrolides (erythromycin, azithromycin, clarithro mycin), cephalosporins (ceftriaxone, cefotaxime), fluoroquinolones (levofloxacin) and penicillin. The sensitivity was determined by the disk diffusion method. Statistical processing was performed using the SPSS Statistic 22.0 program. When comparing groups, the χ2 criterion was used; to compare small groups (n < 5), the exact Fisher test was used.Results. Since 2017, there has been a tendency to increase the frequency of pneumococcus isolation in the carrier group. At the same time, a 3-fold decrease in S. pneumoniae excretion from patients with ENT pathology occurred. The highest sensitivity was detected for cephalosporins – 100% sensitivity of all S. pneumoniae strains, detected from ENT organs and during carriage. There is a low level of pneumococcus resistance to levofloxacin. The general sensitivity to ABD from penicillin group is 96.4–98.8%, while the most common resistant strains were found in patients with respiratory tract damage. The highest resistance of S. pneumoniae was revealed to ABD from the macrolide group with a tendency to increase from 4.6% in 2016 to 14.0% in 2019.Conclusion. According to the study results, a rather low level of resistance of S. pneumoniae to most ABD groups, with the exception of macrolides, was demonstrated in Samara. The greatest number of ABD-insensitive pathogens was isolated in patients with pathology of the bronchopulmonary system. A mandatory microbiological examination of the sputum of such patients is necessary with a determination of the sensitivity of the isolated microorganisms to ABD and subsequent correction of therapy upon the identification of resistant strains. Given the increasing resistance of S. pneumoniae in carriers, it is necessary to vaccinate patients in this group. 


Author(s):  
П. В. Сімонов

<p><strong>ACUTE ORAL TOXICITY TESTING OF THE COPPER NANOPARTICLE-CEFTRIAXONE CONJUGATE IN MICE</strong></p><p><strong>P.V. Simonov</strong></p><p>Bogomolets National Medical University, Kyiv</p><p><strong>Summary:</strong> The antimicrobial resistance of causative agents of infectious diseases problem may be solved by an introduction of medications based on metal nanoparticles and their combinations with other antimicrobial drugs into medical practice. The results on a determination of the copper nanoparticle-ceftriaxone conjugate acute toxicity parameters in an experiment of oral administration in BALB/с mice were presented in the article. It had been found out that the studied substance belonged to the 5<sup>th</sup> toxicity class (practically non-toxic). Central and autonomous nervous systems, gastro-intestinal tract and kidneys were the biological targets of action of the copper nanoparticle-ceftriaxone conjugate after oral administration in mice. A reversibility of the studied substance’s negative influence on animals was confirmed by an absence of significant influence on a dynamics of body mass changes. It seems advisable to continue studies on the copper nanoparticle-ceftriaxone conjugate in order to introduce it into medical practice for a treatment of infections, particularly those caused by antimicrobial resistant strains.</p><p><strong>Key words (MeSH Terms):</strong> Metal Nanoparticles; Copper; Ceftriaxone; Safety; Toxicity Tests, Acute; Administration, Oral; Mice.</p><p><strong>Introduction.</strong> The antimicrobial resistance of causative agents of community- and hospital-acquired infections is a global healthcare problem nowadays. It may be solved by an introduction of new antimicrobial medications, which are effective against resistant strains of bacteria and fungi, into medical practice. Copper-based nanoparticles may become such novel drugs.</p><p>It seems advisable to develop a medication based on the copper nanoparticle-ceftriaxone conjugate. It would comprise a composition of a safe and efficient cephalosporin antibiotic with copper, which is an essential trace element for a human organism and possesses wide spectrum of antimicrobial action, especially in a nanostructured form.</p><p>The purpose of this study was to determine acute oral toxicity parameters of the copper nanoparticle-ceftriaxone conjugate in laboratory female BALB/с mice.</p><p><strong>Methods.</strong> Pharmacological, toxicological, pathomorphological, and statistical methods were used to achieve the goals and objectives of the study.</p><p><strong>Results and discussion</strong>. The conjugate consisting of 20 nm chemically stable spherical zerovalent copper nanoparticles, obtained by original protocol of chemical condensation in aqueous solution method, and ceftriaxone, a third generation cephalosporin, belongs to the 5<sup>th</sup> toxicity class (practically non-toxic) according to K. K. Sidorov classification in an experiment of single oral administration in laboratory female BALB/с mice.</p><p>Central and autonomous nervous systems, gastro-intestinal tract and kidneys are the biological targets of action of the copper nanoparticle-ceftriaxone conjugate after oral administration in mice.</p><p>A reversibility of the copper nanoparticle-ceftriaxone conjugate’s toxic influence on animals after single oral administration is confirmed by an absence of significant influence on a dynamics of body mass changes.</p><p><strong>Conclusions.</strong> The copper nanoparticle-ceftriaxone conjugate appears to be a safe substance after single oral administration in laboratory female BALB/с mice, according to results obtained. It seems advisable to continue studies on the substance in order to introduce it into medical practice for a treatment of infections, particularly those caused by antimicrobial resistant strains.</p>


2019 ◽  
Vol 1 (2) ◽  
pp. 18-22
Author(s):  
O A Nazarchuk ◽  
V I Nahaichuk

Introduction. Non-fermenting Gram-negative bacilli are known as one of the most frequent causative agents of hospital-acquired infections. Acinetobacter baumannii, as causative agent of infection complications of different localization, has obtained recently high resistance to anti-biotics and has belonged to ESKAPE group of pathogens. Antimicrobials, recommended for the prophylaxis and therapy of hospital-acquired infections, have been failing in their effectiveness and lead to selection of antibiotic resistant strains of A. baumannii. The aim of this research was to substantiate the way of overcoming of resistance in clinical strains of A. baumannii, by means of synergic antimicrobial activity of antibiotics and antiseptic decamethoxinum®. Material and methods. The research was carried out on 190 clinical strains of A. baumannii, isolated from patients with burn disease during the period 2011–2015. The sensitivity of clinical strains of A. baumannii was determined to such antibiotics as ampicillin/sulbactam, cefoperazone, cefoperazone/sulbactam, meropenem, imipenem, amikacin, ciprofloxacin, gatifloxacin and antiseptic decamethoxinum® (DCM; Registration certificate No UA/14444/01/01 since 24.06.2015. Order of the Ministry of Health of Ukraine No 373). The sensitivity of A. baumannii to antibiotics and DCM was determined by means of disk diffusion test and serial dilution (Order of the Ministry of Health of Ukraine No167 since 05.04.2007; EUCAST expert rules).The study of the influence of antiseptic DCM on the sensitivity of acinetobacteria to antibiotics was studied on 35 clinical strains of A. baumannii, drafted from the general number of isolates enrolled in the research. For this, the sensitivity of A. baumannii to antibiotics in the presence of sub-minimal inhibitory concentrations (subMIC) of DCM was identified. The received experimental data were analyzed by “Statistica 6.0”. Results and discussion. The changes of antibiotic sensitivity profile of A. baumannii for five years were shown. It was found that the sensitivity of A. baumannii to majority of antibiotics, selected for study, decreased significantly. But the only ampicillin/sulbactam was found to have vice versa tendency. We found the rising quantity of antibiotic resistant strains of A. baumannii. At the same time, high resistance of acinetobacteria to fluoroquinolones (ciprofloxacin– 96,1%; gatifloxacin– 95,8%) was found in 2015. The in vitro research of combined activity of DCM antiseptic remedy and early mentioned antibiotics against clinical strains of A. baumannii demonstrated the reveal antibiotic effectiveness. As follows, minimal inhibitory concentrations of antibiotics decreased in 1.5–4 times in the mediums which contained subMIC of DCM. Especially this tendency was found in resistant clinical strains. Conclusion. Under selective influence of antibiotics protected by β-lactamase inhibitors, carbapenems, fluoroquinolones aminoglycosides increase the antibiotic resistance in A. baumannii, causative agents of infectious complications in patients with burn disease. The antiseptic remedy decamethoxinum® helps to improve antibiotic sensitivity in resistant A. baumannii.


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