scholarly journals Resistome in gram-negative bacteria from soft cheese in Brazil

2020 ◽  
Vol 19 (3) ◽  
pp. 430
Author(s):  
Cristiane Rodrigues Silva ◽  
Newton Takeshi Okuno ◽  
Victor Hugo Lima de Medeiros Macedo ◽  
Isabela Da Rocha Freire ◽  
Rafael Monção Miller ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
High Rate ◽  
Fourth Generation ◽  
Specific Method ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Pcr Screening ◽  
Soft Cheese ◽  
Class 1 ◽  
Phenotypic Susceptibility

<p class="SemEspaamento11"><strong>ABSTRACT</strong></p><p class="SemEspaamento11"><strong> </strong></p><p class="SemEspaamento11"><strong>Objectives:</strong> evaluation of antibiotic resistance in Gram-negative microbiota from ready-to-eat cheese samples.</p><p><strong>Methodology: </strong>this research applied a specific method to evaluate the phenotypic susceptibility to antibiotics in a viable Gram-negative microbiota. The selected food was a cheese that is commonly consumed without thermal processing, the Minas Frescal cheese. The evaluation was followed by a PCR screening in this resistant microbiota, for genes that provide resistance to antibiotics and also to the quaternary ammonium.</p><p><strong>Results: </strong>all cheese samples demonstrated a resistant microbiota. In 13.3% of the cheese samples analyzed, the resistance reached all ten different antibiotics tested and, in 80%, 8 to 10 different antibiotics. In antibiotics considered critics as the carbapenems: ertapenem presented resistant microbiota in 86.7% of the samples. In cephalosporins, the resistance reached 100% in the third generation (ceftazidime) and almost half of the samples (46.7%) in the fourth generation (cefepime). In genotypic research, seven different resistance genes were found in 69.2% of the bacterial pools, including the beta-lactamase-producing genes ctx, tem, shv, tetracycline resistant genes and a high rate of integrons class 1 and 2.</p><strong>Conclusions: </strong>the results indicate phenotypically and genotypically that the Minas frescal cheese can present potential resistant microbiota. Therefore, the methodology used is a viable possibility and with a broader answer about the food microbiota role in resistance. This research corroborates the food area as an important sector to be managed to reduce the process of antibiotic resistance.

Extended Spectrum Beta Lactamase (ESBL), bla TEM,bla SHVand bla CTX-M,resistance genes in Community and Healthcare Associated Gram Negative Bacteria from Osun State, Nigeria

2020 ◽  
Vol 20 ◽  
Author(s):  
Ganiyat Shitta ◽  
Olufunmilola Makanjuola ◽  
Olusolabomi Adefioye ◽  
Olugbenga Adekunle Olowe
Keyword(s):  
Antibiotic Resistance ◽  
Resistance Genes ◽  
Gram Negative Bacteria ◽  
Beta Lactamase ◽  
Multiple Antibiotic Resistance ◽  
Esbl Production ◽  
Gram Negative ◽  
Extended Spectrum Beta Lactamase ◽  
Healthcare Associated ◽  
Esbl Producers

Background: Extended Spectrum Beta Lactamase (ESBL) production in gram negative bacteria confers multiple antibiotic resistance, adversely affecting antimicrobial therapy in infected individuals. ESBLs result from mutations in β-lactamases encoded mainly by the bla TEM,bla SHVand bla CTX-Mgenes. The prevalence of ESBL producing bacteria has been on the increase globally especially its upsurge among isolates from community-acquired infections. Aim: To determine ESBL prevalence and identify ESBL genes among clinical isolates in Osun State, Nigeria. Material and Methods: A cross-sectional study was carried out from August 2016 –July 2017 in Osun State, Nigeria. Three hundred and sixty Gram negative bacteria recovered from clinical samples obtained from both community and healthcare associated infections were tested. They included147 Escherichia coli(40.8%), 116 Klebsiella spp(32.2%), 44 Pseudomo-nas aeruginosa(12.2%) and23 Proteus vulgaris (6.4%) isolates. Others were Acinetobacter baumannii, Serratia rubidae, Citrobacter spp, Enterobacter spp and Salmonella typhi. Disk diffusion antibiotic susceptibility testing was carried out, isolates were screened for ESBL production and confirmed using standard laboratory procedures. ESBLs resistance genes were identified by Polymerase Chain Reaction (PCR). Results: All isolates demonstrated multiple antibiotic resistance. Resistance to ampicillin, amoxicillin with clavulanate and erythromycin was 100%, whereas resistance to Imipenem was very low (5.0%). : Overall prevalence of ESBL producers was 41.4% with Klebsiellaspp as the highest ESBL producing Enterobacteriacaea. ESBL producers were more prevalent among the hospital pathogens than community pathogens, 58% vs 29.5% (p=0.003). ESBL genes were detected in all ESBL producers with the blaCTX-Mgene predominating (47.0%) followed by blaTEM(30.9%) and blaSHVgene was the least, 22.1%. The blaCTX-Mgene was also the most prevalent in the healthcare pathogens (62%) but it accounted for only 25% in those of community origin. Conclusion: A high prevalence of ESBL producing gram negative organisms occurs both in healthcare and in the community in our environment with the CTX-M variant predominating. Efforts to control spread of these pathogens should be addressed.

#43: Monotherapy Experience in Pediatric Patients with High-risk Febrile Neutropenia

2021 ◽  
Vol 10 (Supplement_1) ◽  
pp. S19-S19
Author(s):  
Valentina Gutiérrez ◽  
Ximena Claverie
Keyword(s):  
High Risk ◽  
Febrile Neutropenia ◽  
Fungal Infections ◽  
Clinical Signs ◽  
Empiric Therapy ◽  
Fourth Generation ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Third Line ◽  
Clinical Worsening

Abstract Background Fever during neutropenia is a common occurrence in children with cancer. In a systematic review of RCTs of pediatric febrile neutropenia, compared monotherapy with aminoglycoside-containing combination therapy found no significant differences in failure rates, infection-related mortality, or overall mortality. The updated pediatric-specific guidelines recommend initiation of empirical antibiotic monotherapy using an antipseudomonal β-lactam, a fourth-generation cephalosporin, or a carbapenem for pediatric high-risk febrile neutropenia. However, local epidemiology and resistance patterns should be evaluated regularly. Our local hospital epidemiology does not have Pseudomonas aeruginosa isolates, therefore, we used ceftriaxone as monotherapy in patients with high-risk febrile neutropenia without other risk factors. The goal of our investigation is to describe the experience of using third-generation cephalosporins in these patients. Methods Descriptive study of high-risk febrile neutropenia episodes in patients admitted to the Pediatric Oncology Unit of Hospital Dr. Sótero del Río, Santiago, Chile. We included patients ≤15 years from June 2016 until November 2019. Results We found a total of 133 high-risk febrile neutropenia episodes corresponding to 50 patients, 78% were leukemia and 22% were solid tumor patients. Of the 133 episodes, 92 (69%) had clinical signs at admission, mostly respiratory in 46 (50%) of the cases, 18 (29%) had mucositis and 13 (14%) had diarrhea. Of 133 episodes, 41 (31%) did not have any source at clinical examination. Eighty-six (65%) cases started ceftriaxone at admission, 28 (33%) maintained ceftriaxone for 7 days of treatment with good clinical response. Of this group 58 (67%) patients changed treatment: 32 (37%) cases started second-line antibiotics for clinical worsening, 19 (22%) cases required second- and third-line antibiotics for persistent fever and clinical worsening, and 7 (8%) received third-line antibiotics from the start for past microbiological history. Sixteen (12%) cases of total evolved with sepsis requiring intensive care unit management. We had 30 (23%) episodes with positive blood culture, 11 (37%) due to gram-positive bacteria, 16 (53%) gram-negative bacteria, and 3 (10%) cases of fungal infections. Of the gram-negative bacteria, 7 (44%) were ESBL producers, without P. aeruginosa isolates. One case died (0.7%) for refractory sepsis due to gram-negative bacteria. Conclusion Although we did not have P. aeruginosa isolates, due to the spread of ESBL strains, monotherapy with ceftriaxone is not a good option as initial therapy for high-risk febrile neutropenia patients. The empiric therapy has to be evaluated regularly and should always be based on local epidemiology.

How fluoroquinolone preauthorization affects third- and fourth-generation cephalosporin use and resistance in a large academic hospital

2021 ◽  
pp. 1-12
Author(s):  
Adeniyi J. Idigo ◽  
Matthew L. Brown ◽  
Howard W. Wiener ◽  
Russell L. Griffin ◽  
Yuanfan Ye ◽  
...  
Keyword(s):  
Regression Models ◽  
Interrupted Time Series ◽  
Generation Cephalosporin ◽  
Fourth Generation ◽  
Gram Negative Bacteria ◽  
Academic Hospital ◽  
Gram Negative ◽  
Hospital Acquired Infections ◽  
Quasi Experimental ◽  
Hospital Acquired

Abstract Objective: We observed an overall increase in the use of third- and fourth-generation cephalosporins after fluoroquinolone preauthorization was implemented. We examined the change in specific third- and fourth-generation cephalosporin use, and we sought to determine whether there was a consequent change in non-susceptibility of select Gram-negative bacterial isolates to these antibiotics. Design: Retrospective quasi-experimental study. Setting: Academic hospital. Intervention: Fluoroquinolone preauthorization was implemented in the hospital in October 2005. We used interrupted time series (ITS) Poisson regression models to examine trends in monthly rates of ceftriaxone, ceftazidime, and cefepime use and trends in yearly rates of nonsusceptible isolates (NSIs) of select Gram-negative bacteria before (1998–2004) and after (2006–2016) fluoroquinolone preauthorization was implemented. Results: Rates of use of ceftriaxone and cefepime increased after fluoroquinolone preauthorization was implemented (ceftriaxone RR, 1.002; 95% CI, 1.002–1.003; P < .0001; cefepime RR, 1.003; 95% CI, 1.001–1.004; P = .0006), but ceftazidime use continued to decline (RR, 0.991, 95% CI, 0.990–0.992; P < .0001). Rates of ceftazidime and cefepime NSIs of Pseudomonas aeruginosa (ceftazidime RR, 0.937; 95% CI, 0.910–0.965, P < .0001; cefepime RR, 0.937; 95% CI, 0.912–0.963; P < .0001) declined after fluoroquinolone preauthorization was implemented. Rates of ceftazidime and cefepime NSIs of Enterobacter cloacae (ceftazidime RR, 1.116; 95% CI, 1.078–1.154; P < .0001; cefepime RR, 1.198; 95% CI, 1.112–1.291; P < .0001) and cefepime NSI of Acinetobacter baumannii (RR, 1.169; 95% CI, 1.081–1.263; P < .0001) were increasing before fluoroquinolone preauthorization was implemented but became stable thereafter: E. cloacae (ceftazidime RR, 0.987; 95% CI, 0.948–1.028; P = .531; cefepime RR, 0.990; 95% CI, 0.962–1.018; P = .461) and A. baumannii (cefepime RR, 0.972; 95% CI, 0.939–1.006; P = .100). Conclusions: Fluoroquinolone preauthorization may increase use of unrestricted third- and fourth-generation cephalosporins; however, we did not observe increased antimicrobial resistance to these agents, especially among clinically important Gram-negative bacteria known for hospital-acquired infections.

scholarly journals Utilization of Vector Autoregressive and Linear Transfer Models to Follow Up the Antibiotic Resistance Spiral in Gram-negative Bacteria From Cephalosporin Consumption to Colistin Resistance

2018 ◽  
Vol 69 (8) ◽  
pp. 1410-1421 ◽  
Author(s):  
Hajnalka Tóth ◽  
Adina Fésűs ◽  
Orsolya Kungler-Gorácz ◽  
Bence Balázs ◽  
László Majoros ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Carbapenem Resistance ◽  
Gram Negative Bacteria ◽  
Vicious Cycle ◽  
Var Models ◽  
Gram Negative ◽  
Vector Autoregressive ◽  
E Coli ◽  
Cephalosporin Resistance ◽  
Klebsiella Spp

Abstract Background Increasing antibiotic resistance may reciprocally affect consumption and lead to use of broader-spectrum alternatives; a vicious cycle that may gradually limit therapeutic options. Our aim in this study was to demonstrate this vicious cycle in gram-negative bacteria and show the utility of vector autoregressive (VAR) models for time-series analysis in explanatory and dependent roles simultaneously. Methods Monthly drug consumption data in defined daily doses per 100 bed-days and incidence densities of gram-negative bacteria (Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, and Acinetobacter baumannii) resistant to cephalosporins or to carbapenems were analyzed using VAR models. These were compared to linear transfer models used earlier. Results In case of all gram-negative bacteria, cephalosporin consumption led to increasing cephalosporin resistance, which provoked carbapenem use and consequent carbapenem resistance and finally increased colistin consumption, exemplifying the vicious cycle. Different species were involved in different ways. For example, cephalosporin-resistant Klebsiella spp. provoked carbapenem use less than E. coli, and the association between carbapenem resistance of P. aeruginosa and colistin use was weaker than that of A. baumannii. Colistin use led to decreased carbapenem use and decreased carbapenem resistance of P. aeruginosa but not of A. baumannii. Conclusions VAR models allow analysis of consumption and resistance series in a bidirectional manner. The reconstructed resistance spiral involved cephalosporin use augmenting cephalosporin resistance primarily in E. coli. This led to increased carbapenem use, provoking spread of carbapenem-resistant A. baumannii and consequent colistin use. Emergence of panresistance is fueled by such antibiotic-resistance spirals.

scholarly journals Bloodstream infections in patients with hematologic malignancies and febrile neutropenia - a single center experience

2021 ◽  
Vol 74 (3-4) ◽  
pp. 83-89
Author(s):  
Marina Dragicevic-Jojkic ◽  
Ivana Urosevic ◽  
Amir El Farra ◽  
Borivoj Sekulic ◽  
Ivanka Percic ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Fatal Outcome ◽  
Antibiotic Sensitivity ◽  
Bloodstream Infections ◽  
Hematologic Malignancies ◽  
High Rate ◽  
Antibiotics Resistance ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Acinetobacter Spp

Introduction. Bacterial blood infections during febrile neutropenia episodes are urgent medical conditions which were and still are the main cause of morbidity and mortality among patients with hematologic malignancies. The aim of this study was to determine the incidence and clinical characteristics of bacteremia, infectious agents, presence and incidence of antibiotic resistance, as well as the treatment outcome of bloodstream infections in patients with hematologic malignancies. Material and Methods. A three-year retrospective study included 107 patients with hematologic malignancies and positive blood culture results during febrile neutropenia. Results. The most common isolates were Gram-negative bacteria (58.5%), with Escherichia coli being the most frequent pathogen. The Gram-negative microorganisms were mostly sensitive to carbapenems in 70.7%, whereas sensitivity to other antibiotics was as follows: piperacillin/ tazobactam 62%, amikacin 58.5%, and third-generation cephalosporins 50.5%. Acinetobacter spp. was sensitive only to colistin (94.1%). The antibiotic sensitivity among Gram-positive bacteria was highest to linezolid (97.1%), followed by teicoplanin (81.4%) and vancomycin (81.4%). In our patients, the mortality rate during the first 28 days from the moment of positive isolates was high (37.4%). Most patients died within the first seven days. Bacterial blood infections caused by Gram-negative bacteria were associated with significantly higher mortality (?2 = 4.92, p = 0.026). Acinetobacter spp. was isolated in almost half of the patients with fatal outcome, of whom 62.5% died in the first 24 hours. Conclusion. Bacterial bloodstream infections are severe complications with a high rate of mortality in febrile neutropenic hematological patients. Gram-negative bacteria were the most common isolates in our Clinic, with high mortality. It is of utmost importance to constantly monitor the resistance of bacteria to antibiotics, as well as to prevent and control the spread of resistant strains. Antibiotics resistance patterns should regularly be followed.

scholarly journals CHARACTERISTICS OF ANTIBIOTIC RESISTANCE OF BACTERIA ISOLATED FROM INFANTS – PATIENTS OF NATIONAL HOSPITAL PEDIATRICS HANOI, VIETNAM

2017 ◽  
pp. 51-53
Author(s):  
T.F. Stepanova ◽  
L.V. Kataeva ◽  
A.P. Rebeshchenko ◽  
Le Thanh Hai ◽  
Khu Thi Khanh Dung ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Antibiotic Resistance ◽  
Intensive Care ◽  
High Resistance ◽  
Gram Negative Bacteria ◽  
National Hospital ◽  
Gram Negative ◽  
Resistance To Antibiotics ◽  
Pure Block ◽  
Carbapenem Antibiotic

The results of studies of resistance to antibiotics microflora isolated from mucous pharynx and rectum of patients intensive care unit newborns of National Hospital of Pediatrics, Hanoi are presented. It is shown that gram-negative bacteria isolated from children have a high resistance to penicillins, cephalosporins and carbapenem. Antibiotic resistance of bacteria isolated from children receiving treatment in «pure» block did not differ from sustainability of the strains, selected from children in «dirty» block.

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