PubMed · 460882
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R H Winterbauer. 1979. Comments on current antibiotic therapy.. https://pubmed.ncbi.nlm.nih.gov/460882/
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OBJECTIVE: This study aims to assess the in vitro drug susceptibility of various Carbapenemase-Producing Enterobacteriaceae (CPE) genotypes and elucidate the underlying mechanisms of amikacin resistance. METHODS: A total of 72 unique CPE strains were collected from the Second Hospital of Jiaxing between 2019 and 2022, including 51 strains of Klebsiella pneumoniae, 11 strains of Escherichia coli, 6 strains of Enterobacter cloacae, 2 strains of Klebsiella aerogenes, 1 strain of Citrobacter freundii, and 1strain of Citrobacter werkmanii. Among these strains, 24 carried blaKPC gene, 20 carried blaNDM gene, 23 carried blaOXA-48-like gene, and 5 carried both blaKPC and blaNDM. We measured the in vitro activity of amikacin and other common antibiotics. Strains carrying blaOXA-48-like gene were selected for whole genome sequencing (WGS) via next-generation sequencing to identify genes related to antimicrobial resistance (AMR) and virulence factor (VF). RESULTS: Out of the 72 CPE strains tested, 41.7% exhibited resistance to amikacin. The drug resistance rates for K. pneumoniae, E. coli, and Enterobacter spp. were 51.0%, 27.3%, and 10.0%, respectively. The majority of the CPE strains (> 90%) displayed resistance to cephalosporins and carbapenems, while most of them were sensitive to polymyxin B and tigecycline (97.2% and 94.4%). The amikacin resistance rate was 100% for strains carrying blaOXA-48, 20.8% for those with blaKPC, 5.0% for those with blaNDM, and 20.0% for those with both blaKPC and blaNDM. These differences were statistically significant (P < 0.05). Through sequencing, we detected aminoglycoside resistance genes rmtF and aac(6')-Ib, VF genes iucABCD and rmpA2 in OXA-48-producing multidrug resistance and highly virulent strains. These genes were located on a IncFIB- and IncHI1B-type plasmid, respectively. Both plasmids were highly homologous to the plasmid from OXA-232 strains in Zhejiang province and Shanghai province. Integration of these resistance genes into the IncFIB plasmid, facilitated by the IS6 and/or Tn3 transposons, resulted in OXA232-producing K. pneumoniae with amikacin resistance. CONCLUSION: This study identified significant amikacin resistance in CPE strains, particularly in those carrying the blaOXA-48 gene. Resistance genes rmtF and aac(6')-Ib were identified on plasmids. These results highlight the need for careful monitoring of amikacin resistance.
Since 1981 we monitored all the bacteria strains isolated from patients bearing a surgical infection and hospitalized in our department. We also tested the susceptibility of the isolated strains to different antibiotics. The observed results at three different intervals (1981, 1984, 1987-1988) reveal an increase in Gram+strains. Among the tested antibiotics Imipenem and Amikacin showed the highest antibacterial activity in recent years (1987-1988).
Between February 1983 and February 1991, 471 blood cultures from newborns with neonatal infection, aged from 0 to 30 days, admitted to the Pediatric Hospital Albert Royer, Dakar, were performed. In 141 (30.3 percent) cases, one bacterium was isolated. Three major causative organisms were identified: Klebsiella spp (28.6 percent), E. coli (19.5 percent) and S. aureus (17.4 percent). Altogether, we isolated 99 (69.2 percent) enterobacteria, 7 (4.8 percent) other Gram negative bacilli and 37 (25.8 percent) Gram positive cocci among which 25 S. aureus, 10 streptococci (7 group B, 2 group D, 1 group A and 2 pneumococci). The most efficient antibiotics were amikacin and third generation cephalosporins.