scholarly journals A patient presenting with cholangitis due to Stenotrophomonas maltophilia and Pseudomonas aeruginosa successfully treated with intrabiliary colistine

2014 ◽  
Vol 6 (2) ◽  
Author(s):  
Pablo N. Pérez ◽  
María A. Ramírez ◽  
José A. Fernández ◽  
Laura Ladrón de Guevara
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Stenotrophomonas Maltophilia ◽  
Percutaneous Transhepatic Biliary Drainage ◽  
Multiple Drug Resistance ◽  
Multiple Drug ◽  
New Approach ◽  
Adequate Response ◽  
First Case ◽  
Transhepatic Biliary Drainage

Anatomical barriers for antibiotic penetration can pose a particular challenge in the clinical setting. <em>Stenotrophomonas maltophilia</em> (SM) and <em>Pseudomonas aeruginosa</em> (PA) are two pathogens capable of developing multiple drug-resistance (MDR) mechanisms. We report the case of a 56-year-old female patient with a permanent percutaneous transhepatic biliary drainage (PTBD), who was admitted to our hospital with a cholangitis due to a MDR <em>Escherichia coli</em> strain. Upon admission, culture-guided antimicrobial therapy was conducted and the biliary catheter was replaced, with poor clinical response. Subsequently, SM and PA were detected. Treatment with fosfomycin and colistine was initiated, again without adequate response. Systemic colistine and tigecycline along with an intrabiliary infusion of colistine for 5 days was then used, followed by parenteral fosfomycin and tigecycline for 7 days. The patient was then successfully discharged. This is the first case report we are aware of on the use of intrabiliary colistine. It describes a new approach to treating cholangitis by MDR bacteria in patients with a PTBD.

scholarly journals First Report ofblaIMP-14on a Plasmid Harboring Multiple Drug Resistance Genes in Escherichia coli Sequence Type 131

2016 ◽  
Vol 60 (8) ◽  
pp. 5068-5071 ◽  
Author(s):  
Nicole Stoesser ◽  
Anna E. Sheppard ◽  
Gisele Peirano ◽  
Robert P. Sebra ◽  
Tarah Lynch ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Multiple Drug Resistance ◽  
Carbapenem Resistance ◽  
Sequence Type ◽  
Multiple Drug ◽  
Class 1 Integron ◽  
Content Type ◽  
Carbapenem Resistant ◽  
Class 1

ABSTRACTTheblaIMP-14carbapenem resistance gene has largely previously been observed inPseudomonas aeruginosaandAcinetobacterspp. As part of global surveillance and sequencing of carbapenem-resistantEscherichia coli, we identified a sequence type 131 strain harboringblaIMP-14within a class 1 integron, itself nested within an ∼54-kb multidrug resistance region on an epidemic IncA/C2plasmid. The emergence ofblaIMP-14in this context in the ST131 lineage is of potential clinical concern.

Detection of Metalo-Beta-Lactamase Gene in Carbapenem Resistant Pseudomonas Aeruginosa Isolated From Lahore, Pakistan

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Humera Kausar ◽  
Shabbir Hussain ◽  
Afia Muhammad Akram
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Multiple Drug Resistance ◽  
Diffusion Method ◽  
Multiple Drug ◽  
Carbapenem Resistant ◽  
Routine Laboratory Examination ◽  
Polymerase Chain ◽  
Biochemical Testing ◽  
Resistance Rates ◽  
Lactamase Gene

Pseudomonas aeruginosa is a widespread organism, caused severe nosocomial infection in human andassociated with multiple drug resistance (MDR) Objective: The present study was carried out to observecurrent antimicrobial resistant pattern of Pseudomonas aeruginosa in Lahore and to detect the Metallobeta-lactamase (MBL) gene in carbapenem resistant Pseudomonas aeruginosa Methods: By screening360 samples total 123 Pseudomonas aeruginosa was identified by standard microbiology techniques suchas microscopy and biochemical testing. The isolated Pseudomonas aeruginosa was evaluated for drugresistance by disc diffusion method and polymerase chain reaction (PCR) was used to identify thecarbapenem resistance causing gene (bla-VIM and bla-IMP) Results: Following antibiotic resistantpattern was observed, Gentamycin (59.00%), Ceftazidime (58.7%), Ceftriaxone (58.00%), Cefotazime(57.0%) and Ciprofloxacin (55.00%). Resistance rates to carbapenem group of antibiotics is Doripenem(30.5%) Meropenem (31.0%) and Imipenem (28.0%). Out of 123 samples of Pseudomonas aeruginosa, 28isolates were found resistant to carbapenem group of antibiotic which was supposed to be highlysensitive for this bacterium. Molecular based identification of resistance genes showed that bla-IMP genewas present in 32.1% (09) and bla-VIM was found positive in 17.8% (04) samples. Metallo-beta-lactamasesproducing genes (bla-VIM and bla-IMP), among carbapenem resistant Pseudomonas aeruginosa weredetected in 28.1% of samples. If other carbapenem resistant gene were also included this number mightbe higher Conclusions: PCR based test should be included in routine laboratory examination for quickdetection of the resistance causing genes.

Characterization of novel ybjG and dacC variants in Escherichia coli

2013 ◽  
Vol 62 (11) ◽  
pp. 1728-1734 ◽  
Author(s):  
Dongguo Wang ◽  
Enping Hu ◽  
Jiayu Chen ◽  
Xiulin Tao ◽  
Katelyn Gutierrez ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Multiple Drug Resistance ◽  
Multiple Drug ◽  
The Novel ◽  
Conventional Pcr ◽  
E Coli ◽  
Novel Variants ◽  
Restriction Sites ◽  
Genetic Structures

A total of 69 strains of Escherichia coli from patients in the Taizhou Municipal Hospital, China, were isolated, and 11 strains were identified that were resistant to bacitracin, chloramphenicol, tetracycline and erythromycin. These strains were PCR positive for at least two out of three genes, ybjG, dacC and mdfA, by gene mapping with conventional PCR detection. Conjugation experiments demonstrated that these genes existed in plasmids that conferred resistance. Novel ybjG and dacC variants were isolated from E. coli strains EC2163 and EC2347, which were obtained from the sputum of intensive care unit patients. Genetic mapping showed that the genes were located on 8200 kb plasmid regions flanked by EcoRI restriction sites. Three distinct genetic structures were identified among the 11 PCR-positive strains of E. coli, and two contained the novel ybjG and dacC variants. The putative amino acid differences in the ybjG and dacC gene variants were characterized. These results provide evidence for novel variants of ybjG and dacC, and suggest that multiple drug resistance in hospital strains of E. coli depends on the synergistic function of ybjG, dacC and mdfA within three distinct genetic structures in conjugative plasmids.

scholarly journals Detection of VIM and NDM-1 metallo-beta-lactamase genes in carbapenem-resistant Pseudomonas aeruginosa clinical strains in Bahrain

2019 ◽  
Vol 11 (02) ◽  
pp. 138-143 ◽  
Author(s):  
Ronni Mol Joji ◽  
Nouf Al-Rashed ◽  
Nermin Kamal Saeed ◽  
Khalid Mubarak Bindayna
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Multiple Drug Resistance ◽  
Infectious Agent ◽  
Carbapenem Resistance ◽  
Conventional Polymerase Chain Reaction ◽  
Control Measures ◽  
Multiple Drug ◽  
Beta Lactamase ◽  
Infection Control Measures ◽  
Carbapenem Resistant

Abstract INTRODUCTION: Carbapenem-resistant Pseudomonas aeruginosa has emerged as a life-threatening infectious agent worldwide. Carbapenemase genes are reported to be some of the most common mechanisms for carbapenem resistance in P. aeruginosa. No reports are available from the Kingdom of Bahrain about carbapenem resistance and the underlying cause. In this study, we determined to study the presence of the metallo-beta-lactamase (M β L) genes of VIM family and NDM-1 in carbapenem-resistant P. aeruginosa strains. METHODOLOGY: Fifty carbapenem-resistant P. aeruginosa isolates were obtained from three main hospitals of Bahrain. They were subjected to antimicrobial susceptibility testing by disc diffusion test. Subsequently, MβL was detected by imipenem-ethylene diamine tetraacetic acid (EDTA) combined disc test and conventional polymerase chain reaction. RESULTS: Among 50 P. aeruginosa strains, 40 (80%) were imipenem resistant. Among the 40 imipenem-resistant strains, 35 (87.5%) strains were positive for the imipenem-EDTA combined disc test, and 21 (52%) were carrying MβL genes. Nineteen (47.5%) strains were positive for the VIM gene; one (2.5%) strain was carrying the NDM-1 gene, while one strain was carrying both the VIM and NDM-1 genes. None of the imipenem sensitive strains carried the VIM or NDM-1 gene. CONCLUSION: This is the first study to report the presence of the VIM family gene and NDM-1 genes in imipenem-resistant P. aeruginosa isolates in the Kingdom of Bahrain. The study also confirms the multiple drug resistance by the MβL strains, attention should therefore from now on, be focused on prevention of further spread of such isolates by firm infection control measures, and to reduce its threat to public health.

scholarly journals Enhanced Survival of Rifampin- and Streptomycin-Resistant Escherichia coli Inside Macrophages

2016 ◽  
Vol 60 (7) ◽  
pp. 4324-4332 ◽  
Author(s):  
Paulo Durão ◽  
Daniela Gülereşi ◽  
João Proença ◽  
Isabel Gordo
Keyword(s):  
Gene Expression ◽  
Escherichia Coli ◽  
Multiple Drug Resistance ◽  
Host Cells ◽  
Resistant Bacteria ◽  
Multiple Drug ◽  
Bacterial Survival ◽  
Phagocytic Cells ◽  
Content Type ◽  
Multiple Paths

ABSTRACTThe evolution of multiple-antibiotic-resistant bacteria is an increasing global problem. Even though mutations causing resistance usually incur a fitness cost in the absence of antibiotics, the magnitude of such costs varies across environments and genomic backgrounds. We studied how the combination of mutations that confer resistance to rifampin (Rifr) and streptomycin (Strr) affects the fitness ofEscherichia coliwhen it interacts with cells from the immune system, i.e., macrophages (Mϕs). We found that 13 RifrStrrdoubly resistant genotypes, of the 16 tested, show a survival advantage inside Mϕs, indicating that double resistance can be highly beneficial in this environment. Our results suggest that there are multiple paths to acquire multiple-drug resistance in this context, i.e., if a clone carrying Rifrallele H526 or S531 acquires a second mutation conferring Strr, the resulting double mutant has a high probability of showing increased survival inside Mϕs. On the other hand, we found two cases of sign epistasis between mutations, leading to a significant decrease in bacterial survival. Remarkably, infection of Mϕs with one of these combinations, K88R+H526Y, resulted in an altered pattern of gene expression in the infected Mϕs. This indicates that the fitness effects of resistance may depend on the pattern of gene expression of infected host cells. Notwithstanding the benefits of resistance found inside Mϕs, the RifrStrrmutants have massive fitness costs when the bacteria divide outside Mϕs, indicating that the maintenance of double resistance may depend on the time spent within and outside phagocytic cells.

scholarly journals R plasmids conferring multiple drug resistance from shigella isolated in Korea

1984 ◽  
Vol 92 (2) ◽  
pp. 153-160 ◽  
Author(s):  
Doki Chun ◽  
Dong Taek Cho ◽  
Sung Yong Seol ◽  
Min Ho Suh ◽  
Yoo Chul Lee
Keyword(s):  
Escherichia Coli ◽  
Multiple Drug Resistance ◽  
Shigella Flexneri ◽  
Multiple Drug ◽  
Drug Resistant ◽  
R Plasmids ◽  
Resistance Markers ◽  
Resistant Strains ◽  
Almost All ◽  
Drug Resistant Strains

SUMMARYThe majority (85%) of shigella isolated in 1980 and 1981 in Korea wereShigella flexneri, the others wereSh. sonnei(14%) with only a small number ofSh. dysenteriae. Only 14 of the 459 strains of shigella isolated were susceptible to all 12 drugs tested, and 445 were resistant to three or more drugs. Strains multiply resistant to the six drugs, chloramphenicol (Cm), tetracycline (Tc), streptomycin (Sm), sulfisomidine (Su), ampicillin (Ap) and trimethoprim (Tp) were most frequently encountered, followed by those resistant to Cm, Tc, Sm, Su and Tp. The complete patterns of resistance to drugs except nalidixic acid and rifampin in approximately 73% of drug-resistant strains were co-transferred toEscherichia coliby conjugation, indicating that the resistance was R plasmid-mediated. Randomly selected R plasmids conferring various patterns of resistance markers were tested for the incompatibility groups, and almost all of them were classified intoIncFII. Two of three R plasmids conferring resistance to Cm, Tc, Sm and Su were classified intoIncB and one toIncFII. Two R types with resistance markers of Cm, Tc, Sm and Ap were not classified with our standard plasmids used.

scholarly journals Pola Kuman Penyebab Ventilator Associated Pneumonia(VAP) dan Sensitivitas Terhadap Antibiotik di RSAB Harapan Kita

Sari Pediatri ◽  
2016 ◽  
Vol 13 (6) ◽  
pp. 384
Author(s):  
Retno Widyaningsih ◽  
Latre Buntaran
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Stenotrophomonas Maltophilia ◽  
Clinical Laboratory ◽  
Enterobacter Aerogenes ◽  
National Committee ◽  
Klebsiella Pneumonia ◽  
Ventilator Associated Pneumonia ◽  
Pseudomonas Sp ◽  
Bacillus Sp

Latar belakang. Peningkatan resistensi antibiotik di antara bakteri penyebab pneumonia nosokomial yang didapat di rumah sakit telah banyak dilaporkan. Jika kita tidak mengenal pola kepekaan kuman di suatu rumah sakit akan menyulitkan pemberian terapi empiris awal. Tujuan. Mengetahui profil kuman penyebab pneumonia yang didapat di rumah sakit pada anak serta uji sensitivitas terhadap beberapa antibiotik.Metode. Studi deskriptif retrospektif dengan sumber data yang berasal dari rekam medis Laboratorium Mikrobiologi RSAB Harapan Kita periode Januari hingga Juni 2010. Spesimen adalah semua spesimen saluran respiratorik dari pasien dengan diagnosis pneumonia yang dirawat. Biakan dan uji resistensi dilakukan menurut standar National Committee for Clinical Laboratory Standards(NCCLS).Hasil. Didapatkan 116 spesimen biakan dan di antaranya 4 (3,4%) steril. Dari 112 biakan positif, 79.5% di antaranya adalah bakteri gram negatif berturut-turut dari yang paling dominan adalah Pseudomonas sp.(22,4%), Pseudomonas aeruginosa(18,1%), Stenotrophomonas maltophilia(9.5%), Serratia marcescens(8,6%),Enterobacter aerogenes(7,8%), Klebsiella pneumonia, Bacillus sp., dan Escherichia coli(masing-masing 5,2%). Golongan Pseudomonasmemiliki sensitivitas terhadap ceftazidime, amikacin serta netilmicin.Kesimpulan. Basil gram negatif aerob (79,5%) merupakan mikroorganisme penyebab yang paling dominan. Ceftazidime, diikuti terhadap amikacin serta netilmicin masih mempunyai sensitivitas yang tinggi sehingga dapat dipakai sebagai terapi awal VAP.

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