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PubMed2003

[Clinical and microbiological characteristics of nosocomial infections according to material of the IIIrd Surgical Clinic, UMBAL "St. George"--Plovdiv, over a 10-year period].

UNLABELLED: As a nosocomial (NI) infection we describe this one acquired in hospital due to proper conditions for spreading of virulent microbes. This is old problem with new vision in the field of use of powerful antibiotics and fast growth microbial resistance. AIM OF THE STUDY: To make an retrospective clinical investigation about the rate, type and etiology of NI as well as duration and outcome of treatment in our clinic and to compare the data with these quoted in literature. MATERIAL AND METHODS: We use hospital charts about the period of 1990-1999. Distribution of NI types was according to CDC criteria. RESULTS: For the period were operated on 14 932 patients. In 918 (6.15%) of them a NI was diagnosed. Sex ratio was 56% (514) man and 44% (404) women with a mean age of 56 years. After the treatment of patients with NI 86.48% (805) of them got better. 13.52% (102) were with unsuccessful treatment and got lethal exit. In 78 (76.47%) of death patients a pneumonia NI was developed. 633 antibiograms were received with 63.03% monoinfections and 22.59% polyinfections. In 91 cases smears were sterile. CONCLUSIONS: NI are one of the reasons for prolonged hospital stay and death of patients although fast development of pharmacy and new antimicrobial agents. It was centered on their prophylaxis.

Anti-Bacterial Agents↗

PubMed2004

Early onset neonatal sepsis due to Morganella morganii.

Two neonates, both 32-weekers, developed Morganella morganii sepsis on the first day of life. They presented within a day of each other, primarily with respiratory signs. In both cases there was a history of spontaneous premature rupture of membranes, exposure to a single dose of ampicillin ante-partum, and similar antibiograms. No common source could be identified.

Ampicillin Resistance↗

PubMedDate not supplied

[PCR genotyping of Acinetobacter hospital isolates].

A total of 13 Acinetobacter baumannii-13TU isolates obtained from patients of the Perm regional clinical hospital during the period of 1 year, were genotyped in the polymerase chain reaction (PCR) with universal primers. Acinetobacter cultures could not be distinguished by phenotypic tests and antibiogram and were resistant to B-lactams and gentamicin. According to the results of amplification the obtained isolates could be subdivided into two groups (with 6 and 7 respectively). The detection of "epidemic" strains, including those capable of prolonged (for more than 5 months) persistence in hospital environment, may be indicative of the growing role of Acinetobacter as the causative agent in nosocomial infection.

Acinetobacter Infections↗

PubMed2003

Mycoplasma pneumoniae infection in Yemen: incidence, presentation and antibiotic susceptibility.

To determine the incidence, clinical presentation and antibiotic susceptibility of Mycoplasma pneumoniae at the main hospitals in Sana'a, we studied 405 patients clinically and radiographically diagnosed with lower respiratory tract infections aged 10-60 years. M. pneumoniae was identified by 3 different methods: culture, antigen detection and IgM serology. Antibiotic susceptibility testing was performed for confirmed isolates by macro-broth dilution technique. There were 125 patients (30.9%) with current infection, mostly among younger age groups, with bronchopneumonia the most common underlying clinical condition. All tested isolates were susceptible to all antibiotics in the in vitro antibiogram, with erythromycin the most active. The results indicate the need for different approaches in the diagnosis of M. pneumoniae infection in Yemen.

Adolescent↗

PubMed2004

[Epidemiological, clinical and biological profile of resistant or recurrent pulmonary tuberculosis in Abidjan].

From August to December 1998, over a period of 5 months, a cross-sectional study had been carried out in Abidjan in order to analyze the epidemiological and microbiological features of BAAR+ TB patients in situation of failure or relapse after specific treatment. We investigated 79 patients enrolled in the departments of pulmonary disease of two general hospitals in Abidjan (CHU of Cocody and Treichville) and a TB outpatients' clinic. From 45 strains of Mycobacterium obtained by culture, 33 antibiograms were performed. The rate of multi-drug-resistance (MDR-TB) was 79%. Among MDR--TB patients, those aged of 20-40 years were the most concerned age group (72%) with a clear male predominant rate (sex ratio: 3). Among them 49/79 (62%) had an educational level lower or equal to primary school standarts and most of them lived in dwellings with common yard (67%). In their medical history only 40% had tuberculosis and 2 cases of self-medication were reported. MDR--TB prevailed among patients having at first a positive bacilloscopy. No link between HIV infection and MDR--TB was found.

Adult↗

PubMedDate not supplied

[Evaluation of bacterial resistance to pefloxacine after prolonged use in resuscitation].

In an overall of the value of an antibiotic it is important to take into account the onset of bacterial resistance in addition to its immediate clinical effects since the former can render an otherwise efficacious antibiotic obsolete within a short space of time. We studied two groups of intubated patients with pneumonia infections during two different periods in 1990: January-June and October-December; each patient was treated with pefloxacin 400 mg twice a day i.v. for 6 days on the basis of an antibiogram carried out on tracheobronchial secretion; at the end of that period patients were clinically evaluated and a second bacteriological test was performed. It was found that the percentage of pefloxacin-resistant bacterial strains did not increase significantly after this antibiotic had been used for a year for pneumonia infections (from 27.5% to 33%). The appearance of bacterial resistance at the six-day treatment cycle was similar in both groups (19% and 22%). Of all the bacterial strains, Pseudomonas aeruginosa showed the greatest tendency to become resistant.

Adult↗

PubMed2005

[Sensitivity to penicillin G of isolates of pneumococci meningitis and therapeutic implication in CHU of Treichville, Abidjan].

To determine the frequency of pneumococci meningitis with reduced sensitivity to penicillin G isolated from cerebrospinal fluid, 539 strains were studied between 1996 to 2000. All strains were analysed with oxacilline containing 5 mcg / standard antibiogram for determination of minimal inhibitory concentration (MIC) for penicillin G by E-test. Our results do not show any significant variation from 1996 to 2000. Generally as regard the penicillin G sensitivity we observed that strains were classified as: sensitive strains (CMI < or = 0.06 mg/l): 22.5%, less sensitive strains (0.6 mg/l < CMI < or = 2 mg/l): 58.2%, resistance (CMI > 2 mg/l): 19.2%. The pneumococci rate with reduced sensitivity observed in our study is high and should be taken into consideration in the therapeutic choices.

Anti-Bacterial Agents↗

PubMed2004

[Microbiological external quality assurance program (MEQAP)--evaluation of results obtained in sanitary epidemiological laboratories in 2002].

The aim of this study was to evaluate reliability of identification and determination of sensitivity to antibiotics and chemotherapeutics of some Gram positive cocci strains in 34 sanitary-epidemiological stations. All laboratories engaged in this study received 3 strains: S. aureus (S. aureus SC+ CF+, resistant to methicillin., or S. aureus SC - CF+, sensitive to methicillin), coagulase-negative staphylococci (S. epidermidis or S. haemolyticus or S. saprophyticus) and Enterococcus sp. (E. faecalis HLAR-positive or E. faecalis HLAR-negative or E. faecium or E. gallinarum). All these strains previously were identified in Department of Bacteriology of National Institute of Hygiene. Of the 68 staphylococci strains tested, 66 isolates were correctly identified. Among the 34 enterococcal strains studied the greatest difficulty in identification was caused by E. gallinarum strain--(8 out of 13 strains were incorrectly recognised). The determination of the sensitivity of the control strains to antibiotics and chemotherapeutic agents, generally was performed correctly in accordance with to the NCCLS and national recommendations. Some incorrect results of the antibiograms were caused by an erroneous interpretation of the zones of inhibition.

Enterococcus↗

PubMed1992

[Tuberculous meningitis with atypical presentation in a patient with human immunodeficiency virus infection].

A 32 years old male patient is described with infection by the human immunodeficiency virus (HIV) on stage IV C1 and with positive Ag p24 who developed tuberculous meningitis of atypical presentation. A persistent liquoral neutrophilia and low adenosindeaminase values were observed in cerebrospinal fluid of purulent appearance. The patient responded badly to tuberculostatic treatment and died. In the antibiogram carried out resistance to Mycobacterium tuberculosis was observed to rifampicine and isoniazide, two of the five drugs the patient had received. The peculiarities of the clinical form of presentation similar to purulent bacterian meningitis are discussed, and the possible influence of HIV infection and the antibiotic multiresistance observed in the bad evolution of the tuberculous meningitis which the patient developed.

Acquired Immunodeficiency Syndrome↗

PubMed2005

Some virulence characteristics of uropathogenic Escherichia coli in different patient groups.

BACKGROUND & OBJECTIVE: Uropathogenic Escherichia coli have virulence properties, that are absent in non pathogenic E. coli. The distribution of these markers can vary according to patient populations. Hence, a study was undertaken to describe the presence of virulence factors like Pfimbriae, type 1 fimbriae and haemolysin in E.coli causing urinary infections in three groups of patients. Antibiogram was also recorded to determine differences, if any, between the groups. METHODS: E. coli isolated from three groups of subjects, in counts of >10(5) CFU/ml and in pure growth were tested for mannose resistant haemagglutination (MRHA) to indicate P fimbriae and mannose sensitive haemagglutination (MSHA) to indicate type 1 fimbriae. Haemolysin production and antimicrobial susceptibility patterns were also recorded. RESULTS: Significantly more isolates from antenatal and postnatal women possessed P fimbriae compared to groups with urologic abnormalities (P=0.05). Haemolysin production was also significantly higher (P<0.001) in this group. Greater proportions of isolates from pregnant women were susceptible to commonly used antimicrobials. However, resistance to third generation cephalosporins was present even in these isolates from community infections. INTERPRETATION & CONCLUSION: In patients with urological abnormality, E. coli with lower virulence can cause infections. Isolates from these patients exhibited greater drug resistance. In pregnant women and in community acquired infections, simple antimicrobial drugs like nitrofurantoin might still be useful. However, urgent and stringent policies for antimicrobial use and infection control in hospitals are required in India.

Animals↗

PubMed2005

Effectiveness of steam pasteurization in controlling microbiological hazards of cull cow carcasses in a commercial plant.

The purpose of the study, carried out in a beef processing plant, was to evaluate the effectiveness of a new prototype for steam pasteurization treatment in controlling microbiological hazards. Samples were taken by swabbing randomly selected sites before and after pasteurization and again after chilling to obtain total aerobic counts (TAC), total coliform counts (TCC), and generic Escherichia coli counts (ECC) on Petrifilm plates and to determine the prevalence of Salmonella spp., Listeria monocytogenes, and E. coli O157:H7 using standard enrichment techniques. Escherichia coli and L. monocytogenes strains were tested for various factors associated with their virulence by using colony hybridization and polymerase chain reaction (PCR), respectively. Antimicrobial susceptibility was determined for each isolate that was potentially pathogenic to humans by using the disk-diffusion method. Mean values for TAC, TCC, and ECC were 2.18, 0.16, and 0.06 log10 CFU/cm2, respectively, before pasteurization; 1.17, 0.03, and 0.01 log10 CFU/cm2 after pasteurization; and 0.89, 0.02, and 0.01 log10 CFU/cm2 after chilling. Prevalence of L. monocytogenes, Salmonella spp., and E. coli O157:H7 on carcasses was 0.8%, 0.0%, and 0.0%, respectively, before pasteurization; 2.6%, 0.0%, and 0.0% after pasteurization; and 3.1%, 0.1%, and 0.0% after chilling. The prevalence of E. coli containing > or = 1 virulence gene was 14.7%. More specifically, 11.88% of the isolates obtained before pasteurization, 22.2% obtained after pasteurization, and 31.2% obtained after chilling had virulence genes. All L. monocytogenes isolates tested positive for the presence of 3 major virulence factors (hlyA, inlB, and plcB). Antibiograms showed that certain isolates were susceptible to all antibiotics, some showed an intermediate sensitivity, and others were multiresistant. Overall, these results suggest that steam pasteurization is an effective means of improving safety quality of beef carcasses. However, pasteurization may indirectly contribute to the growth of some pathogenic microorganisms, such as L. monocytogenes.

Abattoirs↗

PubMed1992

[A Staphylococcus haemolyticus study in urinary infections. An analysis of 8 cases].

Urinary infections caused by Staphylococcus are attributed usually to Staphylococcus epidermidis or Staphylococcus saprophyticus. 8 cases of urinary infection due to S. haemolyticus are discussed: 5 adults all of them over 66 years, diagnosed respectively of diabetes, cancer and stroke. Three children diagnosed of febrile syndrome, encephalopathy and enterocolitis associated with urinary infection. S. haemolyticus was identified through the determination of 19 biochemical parameters. The antibiograms performed showed that all S. haemolyticus isolated were sensible to vancomycin, nitrofurantoin and trimethoprim/sulfamethoxazole. It is concluded that S. haemolyticus is an opportunistic pathogen that is present on immunodepressed hosts, that is why is advisable to perform a more in-depth characterization of the S. epidermidis isolated in urine, especially in persistent pathologic processes.

Aged↗

PubMedDate not supplied

Primary antibiotic resistance and effectiveness of Helicobacter pylori triple therapy in ulcero-inflammatory pathologies of the upper digestive tract.

OBJECTIVES: To determine firstly, the rates of primary antimicrobial resistance for Helicobacter pylori-associated upper-digestive lesions in relation to the success rate of triple therapy; and secondly, the performance of HpSA stool antigen detection test for control of eradication after treatment. METHODS: Prospective open study of 436 patients who underwent upper-digestive tract endoscopy with biopsies for histological examination and culture between January 1 and July 31, 2002 at a University hospital in Brussels, Belgium. The primary resistance to antibiotics of H. pylori isolates was determined by disc diffusion method. Seventy of 164 infected patients agreed to be included in the treatment study with standard triple therapy with amoxicillin + clarithromycin + omeprazole adjusted on the basis of antibiogram results. Control of eradication was tested by 14C-Urea breath test and H. pylori Stool Antigen test (HpSA test). RESULTS: Primary resistance to clarithromycin and metronidazole was observed in 3% and 31% of the isolates, respectively. No primary resistance to amoxicillin and tetracycline was observed. By intention to treat analysis, H. pylori was eradicated in 56 (80%) patients included in the therapeutic study. Three (4%) patients were lost to follow-up. The rate of eradication failure was 20% (14/70), included 11 cases documented by a positive control test (14C-Urea breath test). In comparison with 14C-Urea breath test, the H. pylori Stool Antigen test showed a sensitivity of 100%, a specificity of 91%, PPV of 69%, and NPV of 100%. CONCLUSION: Standard triple therapy achieved 80% bacterial eradication in this patient population with a low prevalence of H. pylori primary antibiotic resistance. Our data confirm that the H. pylori Stool Antigen test displays a diagnostic performance similar to the breath test for control of eradication.

Adolescent↗

PubMed2005

Finding the sources of Korean Salmonella enterica serovar Enteritidis PT 4 isolates by pulsed-field gel electrophoresis.

In previous studies, it has been reported that both S. enteritidis, the most common serotype, and S. enteritidis Phage Type 4 (SEPT 4) isolates were identified as the most prevalent PT in domestic poultry and also in humans in Korea until 2002. The aim of this study was to analyze the genetic diversity and epidemiological properties of both PT isolates, and also to trace the source of SEPT 4 isolates from domestic poultry and humans by Pulsed-field gel electrophoresis (PFGE). In order to understand the molecular epidemiologic properties of SEPT 4 isolates, which have very similar phenotypic properties to our preliminary investigations (serotyping, phage typing, large plasmids and antibiograms), PFGE analysis with XbaI enzyme was performed on the representative SEPT 4 isolates. Thirty-six SEPT 4 isolates were analyzed and differentiated with 10 pulsed-field profiles (PFP) expressing very high discriminative ability (SID: 0.921). In PFP, SEPT 4 isolates from human patients showed a perfect genetic match with those from broiler chickens and meats. Therefore, this study was able to successfully trace the major source of SEPT 4 isolates and also to determine the usefulness of the PFGE method for genetic analysis of epidemic strains.

Animals↗

PubMed2005

[Cefprozil in the treatment of chronic maxillary sinusitis. Clinical and microbiological effectiveness and penetration into sinuses examination].

UNLABELLED: 40 patients with exacerbation of a chronic maxillary sinusitis were examined. Sinus puncture was performed (sinoject) in all of the patients. Before the treatment (500 mg cefprozil orally twice a day, the recommended duration of therapy was ten days) and on the fifth day, the microorganisms from sinus were isolated (the bacteriological culture, antibiogram and MIC were determined). On the second and the fifth day, blood cefprozil level and the presence of cefprozil in the washings from maxillary sinuses were investigated. RESULTS: 17 pathogens were isolated from maxillary sinuses, only two of them were anaerobic. The bacterial strains: Staphylococcus (55%), E.coli (15%), Klebsiella (10%) and 20% of others, were found. Four of them (23.5%) were resistant to cefprozil. In all patients cefprozil was identified in maxillary sinuses (0.87-2.52 ug/ml). The value of MIC were from 0.094 to 2.0 ug/ml. A satisfactory clinical response was observed in 92.5% persons but the eradication of pathogens was obtained in 70%. The adverse clinical events (diarrhea) were observed only in one patient (2.5%). CONCLUSIONS: cefprozil well penetrates into inflammable mucous membrane of maxillary sinuses. Cefprozil obtains efficient bactericidal concentration in relation to sensitive bacteria on the fifth day of therapy. It is also well tolerated by the patients.

Adolescent↗

PubMed2006

[Treatment of Pseudomonas aeruginosa in cystic fibrosis in a child].

The report deals with the case of a 10-year-old girl with chronic cystic fibrosis. She has been repeatedly treated at the hospital. She has been hospitalized due to respiratory deterioration. Cystic fibrosis is a rare disease, inherited autosomaly recessively, but is very complex in terms of diagnostic and treatment. Fibrosis is the formation of scar tissue due to injury or long term inflammation. The diagnosis is confirmed based on a clinical picture of the child, measure of Chloride in the sweat, chest X-ray, CT thorax, laboratory findings--genetic confirmation CFTR genes. The diagnosis is originally set when she was 4 years old. She is now admitted due to a deterioration of the main disease. Five days before the admission, the girl had a higher bodily temperature, cough and difficult breathing. Due to the deteriorated general condition and the respiratory insufficiency and respiratory acidosis in blood gas analysis, the girl was intubated and put on the complete mechanical ventilation (IPPV). Since the girl is a chronic patient with bronchiectasie chronic walls of bronchi changes full of the mucus, who is not responding to conservative treatment (antibiotics), therapeutic and diagnostic flexible bronchoscopy had to be performed, resulting in a gram-negative bacteri Pseudomonas aeruginosa--a typical bacteri for chronically sick C. F. patient. Pseudomonas aeruginosa is typically acquired in early childhood. This bacteria is giving progressive lung disease and often aggravates morbidity and mortality. So the main thing as a respiratory management is prevention of lung infection with this bacteria. A Pseudomonas therapy was prescribed according to the sensitive antibiogram, (Garamycin). Antibiotics are crucial to treating cystic fibrosis lung infections. Therapy with an amynoglicoside in combination with a B-lactam or a quinolone antibiotic is standard. It is a difficult to deliver a high doses at these antibiotics via the iv. route without significant systemic adverse events (otoxicity and nephrotoxicity). A reformulation of the aminoglycoside antibiotic tobramicin or garamycin therapy is solution for inhalation. To be well established infections the suppression of Pseudomonas aeruginosa has been shown to lead to decreasing same bacteria and benefits lung function from antibiotic therapy in a way that can be maintained over extended period. During bronchoscopy was given locally on changes mucous pulmozyme (to destroy a very hard mucous) and garamycin. So, after taking out a lot of mucus, it was later continued spontaneously. Control chest x ray and blood gas analysis are now very improved.

Child↗

PubMed2005

[Drug susceptibility of Pseudomonas aeruginosa strains isolated from patients of a hospital and specialistic outpatients clinics of the SP ZOZ in Nidzica].

The aim of this study was to evaluate a frequency of isolation and antimicrobial susceptibility testing (AST) of Pseudomonas aeruginosa strains cultured from clinical specimens collected from patients hospitalized in wards and specialistic outpatients clinics of a hospital in Nidzica (01. 09. 2000 -31. 12. 2003). During over three years 392 Pseudomonas aeruginosa strains were cultured from 16346 clinical samples provided to bacteriological laboratory. P. aeruginosa strains were isolated from 2.5% of examined specimens. Susceptibility of Pseudomonas aeruginosa strains to antimicrobial agents was tested. The highest in vitro activity against clinical P. aeruginosa strains demonstrated imipenem. One strain was resistant to imipenem. This strain was isolated from a patient of a surgical department. Metalo-beta-lactamase was not detected (MBL-negative strain). Twenty nine strains were ESBL producer (7.4% of all strains). The contribution of Pseudomonas aeruginosa strains to the etiology of nosoconial and ambulatory infections increases. In vitro activity of antibacterial agents against P. aeruginosa strains should be monitored during therapy of infections. Resistance to antibiotics/chemothe-rapeutics may be acquired during treatment with antibacterial agent to which P. aeruginosa strain was susceptible according to the antibiogram.

Adult↗

PubMed2006

Characterization of Salmonella isolated in Okinawa, Japan.

Salmonella enterica strains isolated in Okinawa between 1995 and 2005 were analyzed with respect to their serovars and antimicrobial susceptibility, and pulsed-field gel electrophoresis (PFGE) was used to examine their digestion patterns. A total of 1,071 isolates, including 610 from humans, 358 from animal rectal swabs and 103 from meat obtained at grocery stores, were examined. The first 3 most frequent serovars in human isolates were Enteritidis, Weltevreden and Bareilly, together accounting for 65% of the isolates. In isolates from the rectal swabs of laying hens, the predominant serovars were Albany, Saintpaul and Aarhus, accounting for 82% of the isolates. In broilers, 123 of 124 isolates belonged to serovar Infantis, which reflected the high ratio of this serovar in the chicken sold at grocery stores. An antibiogram of human isolates was different from that of broilers and chicken. Chromosomal DNAs of S. Infantis isolated from humans and from the rectal swab of broilers and chickens were examined by PFGE using the restriction enzymes XbaI and BlnI. The digestion patterns of human isolates were not coincident with those of the isolates from the rectal swab of broilers and chicken-meat samples.

Animals↗