scholarly journals Molecular Epidemiology, Antimicrobial Surveillance, and PK/PD Analysis to Guide the Treatment of Neisseria gonorrhoeae Infections

Pharmaceutics ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 1699
Author(s):  
Rodrigo Alonso ◽  
Ainara Rodríguez-Achaerandio ◽  
Amaia Aguirre-Quiñonero ◽  
Aitor Artetxe ◽  
Ilargi Martínez-Ballesteros ◽  
...  

The aim of this study was to apply molecular epidemiology, antimicrobial surveillance, and PK/PD analysis to guide the antimicrobial treatment of gonococci infections in a region of the north of Spain. Antibiotic susceptibility testing was performed on all isolates (2017 to 2019, n = 202). A subset of 35 isolates intermediate or resistant to at least two antimicrobials were selected to search for resistance genes and genotyping through WGS. By Monte Carlo simulation, we estimated the probability of target attainment (PTA) and the cumulative fraction of response (CFR) of the antimicrobials used to treat gonorrhea, both indicative of the probability of treatment success. In total, 2.0%, 6.4%, 5.4%, and 48.2% of the isolates were resistant to ceftriaxone, cefixime, azithromycin, and ciprofloxacin, respectively. Twenty sequence types were identified. Detected mutations were related to antibiotic resistance. PK/PD analysis showed high probability of treatment success of the cephalosporins. In conclusion, multiple populations of N. gonorrhoeae were identified. We can confirm that ceftriaxone (even at the lowest dose: 250 mg) and oral cefixime are good candidates to treat gonorrhea. For patients allergic to cephalosporins, ciprofloxacin should be only used if the MIC is known and ≤ 0.125 mg/L; this antimicrobial is not recommended for empirical treatment.

2004 ◽  
Vol 53 (11) ◽  
pp. 1101-1103 ◽  
Author(s):  
S C Clarke ◽  
K J Scott ◽  
S M McChlery

Sixty-seven serotype 14 pneumococci, isolated from invasive disease in Scotland during the first 6 months of 2003, were characterized. Serotype 14 pneumococci accounted for 18.2 % of the total number of cases. Serotyping, multilocus sequence typing and antibiotic susceptibility testing revealed 10 different sequence types (STs), predominantly ST 9 and ST 124; most ST 9 pneumococci were erythromycin-resistant whilst those of ST 124 were not.


2000 ◽  
Vol 38 (12) ◽  
pp. 4361-4366 ◽  
Author(s):  
Debby Bogaert ◽  
George A. Syrogiannopoulos ◽  
Ioanna N. Grivea ◽  
Ronald de Groot ◽  
Nicholas G. Beratis ◽  
...  

A total of 145 penicillin-nonsusceptible Streptococcus pneumoniae strains were isolated from young carriers in Greece and analyzed by antibiotic susceptibility testing, serotyping, restriction fragment end labeling (RFEL), and penicillin-binding protein (PBP) genotyping. The serotypes 23A and 23F (54%), 19A and 19F (25%), 9V (5%), 15A, 15B, and 15C (4%), 6A and 6B (4%), and 21 (4%) were most prevalent in this collection. Fifty-three distinct RFEL types were identified. Sixteen different RFEL clusters, harboring 2 to 32 strains each, accounted for 82% of all strains. Eight of these genetic clusters representing 60% of the strains were previously identified in other countries. A predominant lineage of 66 strains (46%) harboring five RFEL types and the serotypes 19F and 23F was closely related to the pandemic clone Spain23F-1 (genetic relatedness of ≥85%). Another lineage, representing 11 strains, showed close genetic relatedness to the pandemic clone France9V-3. Another lineage of 8 serotype 21 strains was Greece specific since the RFEL types were not observed in an international collection of 193 genotypes from 16 different countries. Characterization of the PBP genes pbp1a, pbp2b, and pbp2x revealed 20 distinct PBP genotypes of which PBP type 1-1-1, initially observed in the pandemic clones 23F and 9V, was predominantly present in 11 RFEL types in this Greek collection of penicillin-nonsusceptible strains (55%). Sixteen PBP types covering 52 strains (36%) were Greece specific. This study underlines the strong contribution of penicillin-resistant international clones to the prevalence and spread of penicillin-nonsusceptible pneumococci among young children in Greece.


2018 ◽  
Vol 62 (4) ◽  
Author(s):  
Alefiya Neemuchwala ◽  
Deidre Soares ◽  
Vithusha Ravirajan ◽  
Alex Marchand-Austin ◽  
Julianne V. Kus ◽  
...  

ABSTRACTNon-diphtheriae Corynebacterium-associated disease has been increasingly observed and often presents a conundrum to the treating physician. Analysis of antibiotic susceptibility testing data for 1,970 clinicalCorynebacteriumisolates received between 2011 and 2016 revealed that empirical drug treatment options are limited to vancomycin and linezolid.Corynebacterium striatumwas the most frequently observed species during this study period, along withC. amycolatumandC. pseudodiphtheriticum/C. propinquum. Low levels of susceptibility to penicillin (14.5%), erythromycin (15.1%), and clindamycin (8.7%) were observed for non-diphtheriae Corynebacteriumspecies, while 3.0% of isolates were not susceptible to daptomycin. Similarly, 26.9% and 38.1% ofCorynebacteriumisolates were susceptible to ciprofloxacin and trimethoprim-sulfamethoxazole, respectively. Our data show much lower susceptibility to penicillin than previously reported in the literature and an increasing number of isolates resistant to daptomycin, highlighting the need for continued antibiotic surveillance studies for appropriate patient management and treatment success.


ACS Omega ◽  
2021 ◽  
Author(s):  
Armelle Novelli Rousseau ◽  
Nicolas Faure ◽  
Fabian Rol ◽  
Zohreh Sedaghat ◽  
Joël Le Galudec ◽  
...  

Author(s):  
Jorge L. Villacís ◽  
Jesús de la Fuente ◽  
Concepción Naval

A renewed interest in the study of character and virtue has recently emerged in the fields of Education and Psychology. The latest research has confirmed the association between virtuous consistent behaviours and academic positive outcomes. However, the motivational dimension of character (the intentions underlying the patterns of observed behaviours) has received little attention. This research aims to extend the knowledge on this topic by examining the predictive relationships between the behavioural and motivational dimensions of character, with reference to academic engagement, career self-doubt and performance of Spanish university students. A total of 183 undergraduates aged 18–30 (142 of whom were women) from the north of Spain completed specific parts of self-report questionnaires, including the Values in Action VIA-72, a Spanish translated and validated version of the Moral Self-Relevance Measure MSR, and the Utrecht Work Engagement Student Scale UWES-S9. The collected data were analysed using Structural Equation Modelling. The behavioural dimension of character (character strength factors of caring, self-control and inquisitiveness) showed positive associations with academic engagement and performance. The motivational dimension of character (phronesis motivation), was negatively related to career self-doubt. For the first time, the present study has provided support for the contribution of both dimensions of character to undergraduate academic outcomes.


2020 ◽  
Vol 41 (S1) ◽  
pp. s42-s43
Author(s):  
Kimberley Sukhum ◽  
Candice Cass ◽  
Meghan Wallace ◽  
Caitlin Johnson ◽  
Steven Sax ◽  
...  

Background: Healthcare-associated infections caused by antibiotic-resistant organisms (AROs) are a major cause of significant morbidity and mortality. To create and optimize infection prevention strategies, it is crucial to delineate the role of the environment and clinical infections. Methods: Over a 14-month period, we collected environmental samples, patient feces, and patient bloodstream infection (BSI) isolates in a newly built bone marrow transplant (BMT) intensive care unit (ICU). Samples were collected from 13 high-touch areas in the patient room and 4 communal areas. Samples were collected from the old BMT ICU, in the new BMT ICU before patients moved in, and for 1 year after patients moved in. Selective microbiologic culture was used to isolate AROs, and whole-genome sequencing (WGS) was used to determine clonality. Antibiotic susceptibility testing was performed using Kirby-Bauer disk diffusion assays. Using linear mixed modeling, we compared ARO recovery across time and sample area. Results: AROs were collected and cultured from environmental samples, patient feces, and BSI isolates (Fig. 1a). AROs were found both before and after a patient entered the ICU (Fig. 1b). Sink drains had significantly more AROs recovered per sample than any other surface area (P < .001) (Fig. 1c). The most common ARO isolates were Pseudomonas aeruginosa and Stenotrophomonas maltophila (Fig. 1d). The new BMT ICU had fewer AROs recovered per sample than the old BMT ICU (P < .001) and no increase in AROs recovered over the first year of opening (P > .05). Furthermore, there was no difference before versus after patients moved into the hospital (P > .05). Antibiotic susceptibility testing reveal that P. aeruginosa isolates recovered from the old ICU were resistant to more antibiotics than isolates recovered from the new ICU (Fig. 2a). ANI and clonal analyses of P. aeruginosa revealed a large cluster of clonal isolates (34 of 76) (Fig. 2b). This clonal group included isolates found before patients moved into the BMT ICU and patient blood isolates. Furthermore, this clonal group was initially found in only 1 room in the BMT ICU, and over 26 weeks, it was found in sink drains in all 6 rooms sampled (Fig. 2b). Conclusions: AROs are present before patients move into a new BMT ICU, and sink drains act as a reservoir for AROs over time. Furthermore, sink-drain P. aeruginosa isolates are clonally related to isolates found in patient BSIs. Overall, these results provide insight into ARO transmission dynamics in the hospital environment.Funding: Research reported in this publication was supported by the Washington University Institute of Clinical and Translational Sciences grant UL1TR002345 from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official view of the NIH.Disclosures: None


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