scholarly journals Emergence of Third-Generation Cephalosporin-Resistant Morganella morganii in a Captive Breeding Dolphin in South Korea

Animals ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 2052
Author(s):  
Seon Young Park ◽  
Kyunglee Lee ◽  
Yuna Cho ◽  
Se Ra Lim ◽  
Hyemin Kwon ◽  
...  
Keyword(s):  
South Korea ◽  
Bottlenose Dolphin ◽  
Captive Breeding ◽  
Antibiotic Use ◽  
Generation Cephalosporin ◽  
Third Generation ◽  
Morganella Morganii ◽  
Human Sepsis ◽  
Zoonotic Infections ◽  
Third Generation Cephalosporins

The emergence of antimicrobial resistant (AMR) strains of Morganella morganii is increasingly being recognized. Recently, we reported a fatal M. morganii infection in a captive bottlenose dolphin (Tursiops truncatus) bred at a dolphinarium in South Korea. According to our subsequent investigations, the isolated M. morganii strain KC-Tt-01 exhibited extensive resistance to third-generation cephalosporins which have not been reported in animals. Therefore, in the present study, the genome of strain KC-Tt-01 was sequenced, and putative virulence and AMR genes were investigated. The strain had virulence and AMR genes similar to those of other M. morganii strains, including a strain that causes human sepsis. An amino-acid substitution detected at the 86th residue (Arg to Cys) of the protein encoded by ampR might explain the extended resistance to third-generation cephalosporins. These results indicate that the AMR M. morganii strain isolated from the captive dolphin has the potential to cause fatal zoonotic infections with antibiotic treatment failure due to extended drug resistance, and therefore, the management of antibiotic use and monitoring of the emergence of AMR bacteria are urgently needed in captive cetaceans for their health and conservation.

scholarly journals Oral Microbiota of the Snake Bothrops lanceolatus in Martinique

2018 ◽  
Vol 15 (10) ◽  
pp. 2122 ◽  
Author(s):  
Dabor Résière ◽  
Claude Olive ◽  
Hatem Kallel ◽  
André Cabié ◽  
Rémi Névière ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Generation Cephalosporin ◽  
Oral Microbiota ◽  
Third Generation ◽  
Beta Lactams ◽  
Morganella Morganii ◽  
Enterococcus Spp ◽  
Bacillus Spp ◽  
Amoxicillin Clavulanate ◽  
Third Generation Cephalosporins

In Martinique, Bothrops lanceolatus snakebite, although relatively uncommon (~30 cases/year), may result in serious complications such as systemic thrombosis and local infections. Infections have been hypothesized to be related to bacteria present in the snake’s oral cavity. In this investigation, we isolated, identified, and studied the susceptibility to beta-lactams of bacteria sampled from the oral cavity of twenty-six B. lanceolatus specimens collected from various areas in Martinique. Microbiota from B. lanceolatus oral cavity was polymicrobial. Isolated bacteria belonged to fifteen different taxa; the most frequent being Aeromonas hydrophyla (present in 50% of the samples), Morganella morganii, Klebsiella pneumoniae, Bacillus spp., and Enterococcus spp. Analysis of antibiotic susceptibility revealed that 66.7% of the isolated bacteria were resistant to amoxicillin/clavulanate. In contrast, the majority of isolated bacteria were susceptible to the third-generation cephalosporins (i.e., 73.3% with cefotaxime and 80.0% with ceftazidime). Microbiota from B. lanceolatus oral cavity is polymicrobial with bacteria mostly susceptible to third-generation cephalosporins but rarely to amoxicillin/clavulanate. In conclusion, our findings clearly support that first-line antibiotic therapy in the B. lanceolatus-bitten patients, when there is evidence of infection, should include a third-generation cephalosporin rather than amoxicillin/clavulanate.

scholarly journals Detecting the dual presence of AmpC and ESBL enzymes

2009 ◽  
Vol 30 (5) ◽  
pp. 208
Author(s):  
John Sfakinos
Keyword(s):  
Generation Cephalosporin ◽  
Third Generation ◽  
Proteus Vulgaris ◽  
First Line ◽  
Morganella Morganii ◽  
Gram Negative ◽  
E Coli ◽  
Acinetobacter Spp ◽  
Gram Negative Organisms ◽  
Third Generation Cephalosporins

Inducible-chromosomal AmpC cephalosporinase enzymes have been recognised for several years in the ESCAPPM (Enterobacter spp., Serratia spp., Citrobacter freundii, Acinetobacter spp., Proteus vulgaris, Providencia spp. and Morganella morganii) group of gram-negative organisms, which result in the potential resistance to third-generation cephalosporin drugs. More recently several non-ESCAPPM Enterobacteriaceae (particularly E coli, Klebsiella and Proteus mirabilis) have been found to harbour a non-inducible-plasmid form of AmpC. This is particularly important when found in bacteremic patients where third-generation cephalosporins are often the first line drugs of choice.

scholarly journals Effect of educational intervention on the appropriate use of oral antimicrobials in oral and maxillofacial surgery: a retrospective secondary data analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Junya Kusumoto ◽  
Atsushi Uda ◽  
Takeshi Kimura ◽  
Shungo Furudoi ◽  
Ryosuke Yoshii ◽  
...  
Keyword(s):  
Educational Intervention ◽  
Oral Surgery ◽  
Maxillofacial Surgery ◽  
Antibiotic Use ◽  
Oral And Maxillofacial Surgery ◽  
Third Generation ◽  
Oral Antibiotics ◽  
Appropriate Use ◽  
Before And After ◽  
Third Generation Cephalosporins

Abstract Background In Japan, oral third-generation cephalosporins with broad-spectrum activity are commonly prescribed in the practices of dentistry and oral surgery. However, there are few reports on the appropriate use of antibiotics in the field of oral surgery. This study aimed to evaluate the appropriateness of antibiotic use before and after an educational intervention in the Department of Oral and Maxillofacial Surgery, Kobe University Hospital. Methods The use of oral antibiotics was investigated among inpatients and outpatients before and after an educational intervention conducted by the antimicrobial stewardship team. Additionally, the frequency of surgical site infection after the surgical removal of an impacted third mandibular molar under general anesthesia and the prevalence of adverse effects of the prescribed antibiotics were comparatively evaluated between 2013 and 2018. Results After the educational intervention, a remarkable reduction was noted in the prescription of oral third-generation cephalosporins, but increased use of penicillins was noted among outpatients. There was reduced use of macrolides and quinolones in outpatients. Although a similar trend was seen for inpatients, the use of quinolones increased in this population. Despite the change in the pattern of antibiotic prescription, inpatients who underwent mandibular third molar extraction between 2013 and 2018 did not show a significant increase in the prevalence of surgical site infections (6.2% vs. 1.8%, p = .336) and adverse effects of drugs (2.1% vs. 0%, p = .466). Conclusions This study suggests that the judicious use of oral antibiotics is possible through conscious and habitual practice of appropriate antibiotic use. However, further investigation is required to develop measures for appropriate use of oral antibiotics.

scholarly journals Acute kidney injury as the presenting complaint of ceftazidime-induced immune-mediated haemolysis

2019 ◽  
Vol 12 (11) ◽  
pp. e232884 ◽  
Author(s):  
Ashley Ferro ◽  
Meryl Griffiths ◽  
Rona Smith ◽  
Andrew Fry
Keyword(s):  
Cystic Fibrosis ◽  
Acute Kidney Injury ◽  
Renal Function ◽  
Kidney Injury ◽  
Generation Cephalosporin ◽  
Third Generation ◽  
Tubular Necrosis ◽  
Immune Mediated ◽  
Cystic Fibrosis Centre ◽  
Third Generation Cephalosporins

We present the case of ceftazidime-induced immune-mediated haemolysis with associated acute kidney injury in a 43-year-old woman. The patient initially presented to the regional cystic fibrosis centre for treatment of an infective exacerbation of cystic fibrosis. After initiation of ceftazidime (a third-generation cephalosporin), renal function rapidly deteriorated and a fall in haemoglobin was noted. On transfer to our care, a haemolysis screen identified immune-mediated haemolysis, and renal biopsy confirmed the finding of acute tubular necrosis secondary to haem pigment. The patient’s renal function deteriorated such that she required haemodialysis, although she subsequently recovered and is now dialysis-independent. Although acute haemolytic reactions are recognised with third-generation cephalosporins, this is the first reported case of ceftazidime-induced immune-mediated haemolysis with acute kidney injury. Given the increased frequency of cephalosporin usage, it is important for both nephrologists and general physicians to be aware of this rare but very serious complication.

scholarly journals National Prevalence of Resistance to Third-Generation Cephalosporins in Escherichia coli Isolates from Layer Flocks in France

2013 ◽  
Vol 57 (12) ◽  
pp. 6351-6353 ◽  
Author(s):  
Claire Chauvin ◽  
Laetitia Le Devendec ◽  
Eric Jouy ◽  
Maena Le Cornec ◽  
Sylvie Francart ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Confidence Interval ◽  
Egg Production ◽  
Generation Cephalosporin ◽  
Gene Control ◽  
Third Generation ◽  
Content Type ◽  
E Coli ◽  
National Prevalence ◽  
Third Generation Cephalosporins

ABSTRACTResistance ofEscherichia colito third-generation cephalosporin (3GC) in fecal samples representative of French egg production was studied. The susceptibility to cefotaxime ofE. coliisolates obtained by culture on nonselective media was determined. Twenty-two nonsusceptible isolates were obtained (7.51%; 95% confidence interval, 4.49 to 10.54%), the majority of which came from young birds. Most isolates carried ablaCTX-M-1group gene, and a few carried ablaCMY-2-like gene. Control of 3GC resistance in laying hens is needed.

Impact of simplified therapeutic guidelines on antibiotic prescriptions: a prospective multicentre comparative study

2019 ◽  
Vol 75 (3) ◽  
pp. 747-755
Author(s):  
Pierre-Marie Roger ◽  
Ingrid Peyraud ◽  
Michel Vitris ◽  
Valérie Romain ◽  
Laura Bestman ◽  
...  
Keyword(s):  
Clavulanic Acid ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Third Generation ◽  
Therapeutic Guidelines ◽  
Amoxicillin Clavulanic Acid ◽  
The Impact ◽  
Third Generation Cephalosporins

Abstract Objectives We studied the impact of simplified therapeutic guidelines (STGs) associated with accompanied self-antibiotic reassessment (ASAR) on antibiotic use. Methods Prospective antibiotic audits and feedback took place at 15 hospitals for 12 months, allowing STGs with ≤15 drugs to be devised. STGs were explained to prescribers through sessions referred to as ASAR. Optimal therapy was defined by the conjunction of a diagnosis and the drug specified in the STGs. Analysis of consumption focused on critical drugs: amoxicillin/clavulanic acid, third-generation cephalosporins and fluoroquinolones. Results We compared prescriptions in five hospitals before (n = 179) and after (n = 168) the implementation of STGs + ASAR. These tools were associated with optimal therapies and amoxicillin/clavulanic acid prescriptions [adjusted odds ratio (AOR) 3.28, 95% CI 1.82–5.92 and 2.18, 95% CI 1.38–3.44, respectively] and fewer prescriptions for urine colonization [AOR 0.20 (95% CI 0.06–0.61)]. Comparison of prescriptions (n = 1221) from 10 departments of three clinics with STGs + ASAR for the first quarters of 2018 and 2019 revealed that the prescriptions by 23 ASAR participants more often complied with STGs than those by 28 other doctors (71% versus 60%, P = 0.003). STGs alone were adopted by 10 clinics; comparing the prescriptions (n = 311) with the 5 clinics with both tools, we observed fewer unnecessary therapies in the latter [AOR 0.52 (95% CI 0.34–0.80)]. The variation in critical antibiotic consumption between 2017 and 2018 was −16% for the 5 clinics with both tools and +20% for the other 10 (P = 0.020). Conclusions STGs + ASAR promote optimal antibiotic therapy and reduce antibiotic use.

scholarly journals Subacute Bacterial Endocarditis Caused byCardiobacterium hominis: A Case Report

2015 ◽  
Vol 26 (1) ◽  
pp. 41-43 ◽  
Author(s):  
Davie Wong ◽  
Julie Carson ◽  
Andrew Johnson
Keyword(s):  
Susceptibility Testing ◽  
Medical Literature ◽  
Generation Cephalosporin ◽  
Bacterial Endocarditis ◽  
Clinical Microbiology Laboratory ◽  
Third Generation ◽  
First Line ◽  
Subacute Bacterial Endocarditis ◽  
First Line Therapy ◽  
Third Generation Cephalosporins

Cardiobacterium hominis, a member of the HACEK group of organisms, is an uncommon but important cause of subacute bacterial endocarditis. First-line therapy is a third-generation cephalosporin due to rare beta-lactamase production. The authors report a case involving endovascular infection due toC hoministhat initially tested resistant to third-generation cephalosporins using an antibiotic gradient strip susceptibility method (nitrocephin negative), but later proved to be susceptible using broth microdilution reference methods (a ‘major’ error). There are limited studies to guide susceptibility testing and interpretive breakpoints forC hominisin the medical literature, and the present case illustrates some of the issues that may arise when performing susceptibility testing for fastidious organisms in the clinical microbiology laboratory.

Impact of restriction of third generation cephalosporins on the burden of third generation cephalosporin resistant K. pneumoniae and E. coli in an ICU

2008 ◽  
Vol 35 (5) ◽  
pp. 862-870 ◽  
Author(s):  
Elisabeth Meyer ◽  
Matthias Lapatschek ◽  
Andreas Bechtold ◽  
Gerhard Schwarzkopf ◽  
Petra Gastmeier ◽  
...  
Keyword(s):  
Generation Cephalosporin ◽  
Third Generation ◽  
E Coli ◽  
Third Generation Cephalosporins

scholarly journals Characterization of Third-Generation-Cephalosporin-Resistant Shiga Toxin-Producing Strains of Escherichia coli O157:H7 in Japan

2015 ◽  
Vol 53 (9) ◽  
pp. 3035-3038 ◽  
Author(s):  
Ryuji Kawahara ◽  
Kazuko Seto ◽  
Masumi Taguchi ◽  
Chie Nakajima ◽  
Yuko Kumeda ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Shiga Toxin ◽  
Generation Cephalosporin ◽  
Escherichia Coli O157 ◽  
Third Generation ◽  
Content Type ◽  
Resistant Strains ◽  
Third Generation Cephalosporins

We isolated Shiga toxin-producingEscherichia coliO157:H7 strains resistant to third-generation cephalosporins. The resistant strains harboredblaCMY-2, a plasmid-mediated AmpC β-lactamase. Genotyping of isolates revealed the possible spread of this problematic bacterium. Results suggested the importance of the investigation and surveillance of enterobacteria with plasmids harboringblaCMY-2.

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