scholarly journals Current Antibiotic Resistance Trends of Uropathogens in Central Europe: Survey from a Tertiary Hospital Urology Department 2011–2019

Antibiotics ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 630 ◽  
Author(s):  
Jan Hrbacek ◽  
Pavel Cermak ◽  
Roman Zachoval

Monitoring of pathogen resistance profiles is necessary to guide empirical antibiotic therapy before culture and sensitivity results become available. The aim of this study was to describe current antibiotic resistance patterns of five most frequent causative uropathogens in a Department of Urology of a tertiary referral centre in Central Europe over a period of nine years. The Hospital Department of Clinical Microbiology database was used to extract data on all positive urine samples from inpatients in the Department of Urology between 2011 and 2019. Numbers of susceptible and resistant isolates per year were calculated for five most frequent uropathogens: Escherichia coli, Enterococcus spp., Klebsiella spp., Pseudomonas aeruginosa, and Proteus spp. Antimicrobial agents selected for the survey included: ampicillin, amoxicillin/clavulanic acid, piperacillin/tazobactam; cefuroxime, cefotaxime, ceftazidime and cefepime; ciprofloxacin and ofloxacin; gentamicin and amikacin; ertapenem, meropenem and imipenem; trimethoprim-sulfamethoxazole (co-trimoxazole), nitrofurantoin, colistin, and vancomycin. High resistance rates of Gram-negative uropathogens were demonstrated to most common antimicrobials, with statistically significant increasing or decreasing trends in some cases. No carbapenem-resistant Enterobacteriaceae were isolated. Vancomycin-resistant Enterococcus spp. strains were rare in our population.

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jan Hrbacek ◽  
Pavel Cermak ◽  
Roman Zachoval

Abstract Background While the resistance rates of commonly detected uropathogens are well described, those of less frequent Gram-negative uropathogenic bacteria have seldom been reported. The aim of this study was to examine the resistance rates of less frequent uropathogenic Gram-negatives in a population of patients treated in a Department of Urology of a tertiary referral centre in Central Europe over a period of 9 years. Methods Data on all positive urine samples from urological in- and out-patients were extracted form the Department of Clinical Microbiology database from 2011 to 2019. Numbers of susceptible and resistant isolates per year were calculated for these uropathogens: Acinetobacter spp. (n = 74), Citrobacter spp. (n = 60), Enterobacter spp. (n = 250), Morganella morganii (n = 194), Providencia spp. (n = 53), Serratia spp. (n = 82) and Stenotrophomonas maltophilia (n = 27). Antimicrobial agents selected for the survey included: ampicillin, amoxicillin/clavulanic acid, piperacillin/tazobactam; cefuroxime, cefotaxime, ceftazidime and cefepime; ciprofloxacin and ofloxacin; gentamicin and amikacin; ertapenem, meropenem and imipenem; trimethoprim-sulfamethoxazole (co-trimoxazole), nitrofurantoin and colistin. Results Penicillin derivatives have generally poor effect except piperacillin/tazobactam. Cefuroxime is not efficient unlike cefotaxime (except against Acinetobacter spp. and S. maltophilia). Susceptibility to fluoroquinolones is limited. Amikacin is somewhat more efficient than gentamicine but susceptibilities for both safely exceed 80%. Nitrofurantoin shows virtually no efficiency. Cotrimoxazole acts well against Citrobacter spp., Serratia spp. and it is the treatment of choice for S. maltophilia UTIs. Among carbapenems, ertapenem was less efficient than meropenem and imipenem except for S. maltophilia whose isolates were mostly not suceptible to any carbapenems. Conclusions Uropathogenic microorganisms covered in this report are noteworthy for their frequently multi-drug resistant phenotypes. Knowledge of resistance patterns helps clinicians choose the right empirical antibiotic treatment when the taxonomical assignment of the isolate is known but sensitivity results are pending.


2005 ◽  
Vol 71 (6) ◽  
pp. 2840-2847 ◽  
Author(s):  
M. Wittwer ◽  
J. Keller ◽  
T. M. Wassenaar ◽  
R. Stephan ◽  
D. Howald ◽  
...  

ABSTRACT The diversity and genetic interrelation of Campylobacter jejuni and C. coli isolated from Swiss poultry were assessed by three independent typing methods. Samples were derived prior to slaughter from 100 randomly selected flocks (five birds per flock) raised on three different farm types. The observed flock prevalence was 54% in total, with 50% for conventional and 69% for free-range farms. Birds held on farms with a confined roaming area had the lowest prevalence of 37%. Campylobacter isolates were characterized by amplified fragment length polymorphism (AFLP), restriction fragment length polymorphism of flaA PCR fragments (flaA-RFLP), and disk diffusion testing for eight antimicrobial agents that are commonly used in veterinary or human medicine in Switzerland. Analysis of the genotypic results indicates that the Campylobacter population in Swiss poultry is genetically highly diverse. Nevertheless, occasionally, isolates with identical or nearly identical characteristics were isolated from different farms or farm types in different locations. Genetic typing by AFLP and flaA-RFLP was found to be complementary. The majority of isolates (67%) were susceptible to all tested antibiotics; however, single, double, and triple resistances were observed in 7%, 23%, and 2% of the strains, respectively. There was no correlation between genotype and antibiotic resistance. Surprisingly, sulfonamide resistance was frequently found together with streptomycin resistance. Our findings illustrate the results of common genetic exchange in the studied bacterial population.


PRILOZI ◽  
2014 ◽  
Vol 35 (2) ◽  
pp. 31-38
Author(s):  
Ana Kaftandzieva ◽  
Elena Trajkovska-Dokic ◽  
Vesna Kotevska ◽  
Zaklina Cekovska ◽  
Gordana Jankoska

Abstract The aim of the study was to evaluate the association of drug resistance with β-lactamase gene types in ESBL positive E. coli and Klebsiella pneumoniae-Kp. Material and methods: A total of 251 ESBL-positive E. coli and Kp isolates obtained from urine, tracheal aspirate, wound swab and blood from patients hospitalised at the University Clinics in Skopje were detected using the ESBL set and automated Vitek 2 system. Vitek was also used for susceptibility testing (determination of MIC of 17 antimicrobial agents). Multiplex PCR was used to identify genes for different types of ESBLs in a 100 randomly selected, ESBL positive strains. Results: More of the 87 ESBL typeable isolates (61%) harbour two or more bla genes and the frequency of antibiotic resistance was high in these isolates, compared to those with a single gene. Isolates with ≥ 3 genes were highly resistant to beta-lactams and non-beta lactams used. The degree of resistance to 3rd generation cephalosporins was also high in these isolates (MIC ≥ 64). More of the ESBL-positive isolates showed higher resistance to cefotaxime than to ceftazidime. Conclusion: Identification of the genes is necessary for the surveillance of their transmission in hospitals. Surveillance of antibiotic resistance patterns are crucial to overcome the problems associated with ESBLs.


2021 ◽  
Vol 9 ◽  
Author(s):  
Xiao-Yu Zheng ◽  
Bonnie Nga Kwan Choy ◽  
Ming-Ming Zhou ◽  
Zheng-Yan Zhao

Staphylococcus aureus (S. aureus) is an important pathogen of ocular infections in pediatrics. The study aimed to identify the prevalence and resistance pattern of S. aureus, especially methicillin-resistant S. aureus (MRSA), in Chinese children with ocular infections. All patients with S. aureus infections were reviewed at a tertiary children's hospital during 2015–2020, and those with ocular infections were investigated for susceptibility results. Of 1,668 S. aureus strains, there were 177 unique isolates from ocular infection. Among them, 45 (25.4%) were MRSA and 132 (74.6%) were methicillin-sensitive S. aureus (MSSA). The proportion of MRSA did not change over time. Most of the strains were obtained from the neonate ward and ophthalmology department (n = 88, 49.7%, and n = 85, 48.0%, respectively), while eye secretion and pus were the main specimen types (n = 128, 72.3%, and n = 37, 20.9%, respectively). MRSA was significantly resistant against penicillin class (97.8%), erythromycin (71.1%), clindamycin (71.1%), and tetracycline (32.1%), with a high multidrug resistance (MDR) rate of 71.1%. However, MRSA was highly sensitive to levofloxacin. Resistance rates against erythromycin and ciprofloxacin as well as MDR percentage all increased among MSSA in children above 1 year of age, ophthalmology department, and outpatient population and decreased in eye secretion specimen. The mean resistance percentage remained stable for MRSA and MSSA during the study period. The survey of ocular S. aureus pathogens in pediatrics and their antibiotic resistance patterns helps in clinical treatment. MRSA with many strains demonstrating MDR is highly prevalent in children with ocular infections in Southeast China. Levofloxacin is an effective topical antibiotic for ocular MRSA infection, while erythromycin has a high resistance rate. The antibiotic resistance patterns of MRSA and MSSA differs and varies by different stratifications. A cautious use of antibiotics should be considered.


2017 ◽  
Vol 5 (4) ◽  
pp. 106-110 ◽  
Author(s):  
Farzaneh Firoozeh ◽  
Ehsan Dadgostar ◽  
Hussein Akbari ◽  
Mohammad Zibaei ◽  
Seyed Mohammad Sadjjad Sadjjadian ◽  
...  

Background: Paper banknotes would be a vector for transmission of pathogenic microorganisms through handling. Objective: This study aimed to determine bacterial contamination of Iranian paper currencies in circulation and their antibiotic resistance patterns. Materials and Methods: In this study, 337 currency notes of different value were collected from markets, shops, restaurants, bus stations and banks in Kashan, Iran during April 2015 to March 2016. The currency notes transferred to microbiology laboratory and were tested for bacterial contamination using standard microbiological methods. Antibiotic resistance patterns of isolated bacteria were determined by disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) standards. The results and data were analyzed using descriptive statistics. Results: Of 337 currency notes, 262 (77.7%) were identified with bacterial contamination. Bacteria isolated from currency notes were as follows: Bacillus spp 113 (43.1%), coagulase-negative staphylococci 99 (37.7%), Escherichia coli 20 (7.6%), Enterococci species 14 (5.3%), Staphylococcus aureus 8 (3.1%), Klebsiella spp 4 (1.5%), Shigella species 2 (0.8%), and Pseudomonas species 2 (0.8%). The most and least contaminated currency notes were 50000 and 500 Rials, respectively. The highest resistance rates in gram-negative rods were against nalidixic acid, and ampicillin. However, the highest resistance rates in S. aureus, coagulase-negative staphylococci and Enterococci species were against ampicillin, erythromycin and tetracycline. Conclusion: Our study revealed that the bacterial contamination among Iranian paper currency in circulation especially those obtained from certain sources including shops and bus stations is high and in most cases these bacterial isolates are antibiotic-resistant strains.


2018 ◽  
pp. 35-42

Serotipos y resistencia antibiótica en Shigella spp aisladas de infecciones intestinales, Lima, 2012 Serotypes and antibiotic resistance in Shigella spp. isolated from intestinal infections, Lima, 2012 César E. Guerrero Barrantes1, Alfredo Guillén O.1, Roberto Rojas L1, Nora Bravo2 & Paola Muñoz1 1 Universidad Nacional Federico Villarreal, Facultad de Tecnología Médica, Lima 10 2 Universidad Nacional Federico Villarreal, Facultad de Ciencias Naturales, Lima 10 DOI: https://doi.org/10.33017/RevECIPeru2013.0005/ Resumen Se ha descrito que la distribución mundial de los serogrupos de Shigella no es igual en las distintas regiones. El objetivo es determinar los serotipos, la frecuencia de éstos y el patrón de resistencia a los antimicrobianos de los cultivos de Shigella  spp. aislados de infecciones intestinales.  Se evaluaron 75 cultivos   de  Shigella spp., identificados bioquímicamente y serológicamente, tanto su serogrupo como su serotipo, por aglutinación en lámina.  Los patrones de resistencia antibiótica se determinaron mediante el método de difusión de disco en agar. De los 75 cultivos de Shigella, 54 fueron Shigella flexneri (72%) y 21 Shigella sonnei (28%). De los 54 cultivos de Shigella flexneri, el 48,15% resultó ser del serotipo 2a, seguidos por los serotipos 1b y 6 con el 12,96% cada uno, luego el serotipo 3a con 11,11% y por último los serotipos 1a, 4b y 2b, con 5,56%, 5,56% y 3,70%, respectivamente. La resistencia antibiótica observada en los cultivos de Shigella, independientemente del serogrupo, fue muy frecuente para Sulfametoxazol Trimetoprim, ampicilina, cloranfenicol y tetraciclina; además, algunos cultivos fueron resistentes a Aztreonam, Furazolidona y Amoxicilina-Acido Clavulánico. Los serotipos de Shigella flexneri desde infecciones intestinales, en Lima, son 2a – 1b – 6 –3a – 1a – 4b – 2b; el más frecuente es el 2a, seguido por el 1b y 6 y el patrón de resistencia observado en Shigella spp, fue elevado para sulfametoxazol-Trimetoprim, Tetraciclina, Cloranfenicol y Ampicilina. Descriptores: Shigella, serotypes, resistance. Abstract The global distribution of serogroups in Shigella is not equal across regions. The objective is to determine  serotypes, the frequency and pattern of resistance to antimicrobial agents of cultures of Shigella spp. isolated from intestinal infections.  The  75 cultures of Shigella spp., identified biochemically and serologically, were evaluated for serogroup and serotype, by agglutination on slide.  Antibiotic resistance patterns were determined by disk agar diffusion method. Of the 75 strains of Shigella, 54 were Shigella flexneri (72%) and 21 Shigella sonnei (28%). Of the 54 strains of Shigella flexneri, 48,15% proved serotype 2a, while 12,96% corresponded  to the 1b and 6 serotypes  one each,  than the serotype 3a with 11,11%, and finally the serotypes 1a, 4b and 2b, with 5.56%, 5,56 and  3,70%, respectively.  Antibiotic resistance observed in cultures of Shigella, regardless of the serogroup, was very frequent for Sulfametoxazol Trimetoprim, ampicillin, chloramphenicol, and tetracycline; in addition, some strains were resistant for Aztreonam, furazolidone and amoxicillin-Clavulanic acid. The serotypes of Shigella flexneri from intestinal infections, in Lima, are 2a - 1b - 6- 3a - 1a - 4b -2b; the most frequent is the 2a, followed by 1b and 6 serotypes, and the resistance pattern observed in Shigella spp., was elevated to trimethoprim-sulfamethoxazole, tetracycline, chloramphenicol and ampicillin. Keywords: Shigella, serotypes, resistance.


2001 ◽  
Vol 45 (5) ◽  
pp. 1374-1378 ◽  
Author(s):  
Patrick Butaye ◽  
Luc A. Devriese ◽  
Freddy Haesebrouck

ABSTRACT The prevalence of acquired resistance in 146 Enterococcus faecium and 166 Enterococcus faecalis strains from farm and pet animals, isolated in 1998 and 1999 in Belgium, against antibiotics used for growth promotion and for therapy was determined. Acquired resistance against flavomycin and monensin, two antibiotics used solely for growth promotion, was not detected. Avoparcin (glycopeptide) resistance was found sporadically in E. faecium only. Avilamycin resistance was almost exclusively seen in strains from farm animals. Resistance rates were higher in E. faecium strains from broiler chickens than in strains from other animal groups with tylosin and virginiamycin and in E. faecalis as well as in E. faecium strains with narasin and bacitracin. Resistance against ampicillin was mainly found among E. faecium strains from pets and was absent inE. faecalis. Tetracycline resistance occurred most often in strains from farm animals, while enrofloxacin resistance, only found inE. faecalis, occurred equally among strains from all origins. Resistance against gentamicin was very rare in broiler strains, whereas resistance rates were high in strains from other origins. It can be concluded that resistance against antibiotics used solely for growth promotion was more prevalent in E. faecium strains than in E. faecalis strains. With few exceptions, resistance against the different categories of antibiotics was more prevalent in strains from farm animals than in those from pets.


2014 ◽  
Vol 60 (4) ◽  
pp. 237-242 ◽  
Author(s):  
Haifei Yang ◽  
Yachao Pan ◽  
Lifen Hu ◽  
Yanyan Liu ◽  
Ying Ye ◽  
...  

One hundred fifty-three Shigella isolates were examined for multiple antibiotic resistance phenotypes and prevalence of class 1 and class 2 integron sequences. The gene cassettes dfrA17-aadA5, dfrA12-orfF-aadA2, and arr-3-aacA4 were found in typical class 1 integrons. The gene cassettes blaOXA-1-aadA1 and dfrA1-sat1-aadA1 were detected in atypical class 1 integrons and in class 2 integrons, respectively. This is the first report of arr-3-aacA4 cassette detected in typical class 1 integrons among Shigella isolates. Rates of antibiotic resistance were different between integron-positive and integron-negative strains (P < 0.05), and all integron-positive isolates were resistant to at least 3 different antimicrobial agents. Typical class 1 integron-positive isolates showed higher resistance rates to cefotaxime and ciprofloxacin than did integron-negative ones (P < 0.05). Typical class 1 integrons and β-lactamase genes were found in conjugative plasmids, otherwise class 2 and atypical class 1 integrons were located on chromosome. This study demonstrated the wide distribution of class 1 integrons in Shigella spp., which may lead resistance to cefotaxime and ciprofloxacin in China.


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