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PubMed2003

Relationship between semen cultures, leukospermia, and semen analysis in men undergoing fertility evaluation.

OBJECTIVE: To determine the correlation between semen cultures, semen Gram stains, leukospermia, and semen analysis parameters in asymptomatic men undergoing fertility evaluation. DESIGN: Prospective clinical study. SETTINGS: Infertility clinic at a university teaching hospital. PATIENT(S): Two hundred ninety-nine asymptomatic men undergoing fertility evaluation. INTERVENTION(S): After an antibacterial skin preparation, all men gave semen specimens for culture, Gram stains, semen analysis, and assessment for leukospermia. MAIN OUTCOME MEASURE(S): A comparison of the presence or absence of bacteriospermia, the specific bacterial isolate, the quantity of bacteriospermia, the presence or absence of leukospermia, and semen analysis parameters. RESULT(S): The presence or absence of bacteriospermia or leukospermia did not correlate with each other. Leukospermia did not correlate with semen parameters. Staphylococcus species was the most common isolate (25.4% of all patients) and did not correlate with semen parameters or leukospermia. Streptococcus viridans (15.4% of all patients) and Enterococcus faecalis (7.4% of all patients) were the next most common isolates and were associated with statistically significantly poorer semen quality. CONCLUSION(S): Leukospermia is a poor marker for either bacteriospermia or impaired semen quality. Staphylococcus species are commonly isolated but appear to be innocuous. Streptococcus viridans and Enterococcus faecalis are associated with poorer semen quality and may warrant treatment.

Adult↗

PubMed1995

Comparison of pigment production and motility tests with PCR for reliable identification of intrinsically vancomycin-resistant enterococci.

Forty-eight clinical isolates identified as either Enterococcus faecium or Enterococcus faecalis with the MicroScan system (Dade International, MicroScan Inc., West Sacramento, Calif.) were further characterized by two supplementary biochemical tests (pigment production and motility). Twenty isolates (42%), all initially identified as E. faecium, were motile. Of these 20, 8 isolates (17%) produced yellow pigment and were identified as Enterococcus casseliflavus and the remaining 12 (25%) were nonpigmented and were identified as Enterococcus gallinarum. Identical identification results were obtained when PCR amplification of regions of the vanC gene was used as a technique for differentiating these organisms. The results of this study indicate that motility and pigment production tests together with commercial test systems are sufficient for reliable identifications of E. faecium, E. casseliflavus, and E. gallinarum.

Bacteriological Techniques↗

PubMed1999

In-vitro activity of fosfomycin against vancomycin-resistant enterococci.

The effect of fosfomycin against 69 vancomycin-resistant isolates of Enterococcus faecium (VanA), five of E. faecium (VanB), 11 of Enterococcus faecalis (VanA), three of E. faecalis (VanB), 10 of Enterococcus gallinarum (VanC1) and two of Enterococcus casseliflavus (VanC2) and glycopeptide-sensitive E. faecium (n = 8) and E. faecalis (n = 10) was tested in vitro. Fosfomycin inhibited 97%, 94% and 96% of the vancomycin-resistant strains, according to results of agar dilution, broth microdilution, and a disc diffusion method (DIN 58940). The disc diffusion test by the NCCLS method does not include fosfomycin; using breakpoints suggested by Andrews et al. (< or = 11 mm, resistant; > or = 18 mm, susceptible), 5% of the vancomycin-resistant strains tested would have been considered fosfomycin resistant. Minimal inhibitory concentrations of most vancomycin-resistant isolates were in the intermediate sensitivity range, yielding an MIC50 of 32 mg/L and an MIC90 of 64 mg/L. Moreover the majority of inhibitory zone sizes by the disc diffusion method (DIN 58940) corresponded to intermediate susceptibility. These results suggest that fosfomycin at a high dosage and possibly used in combination with other drugs could be a potentially useful drug for the treatment of infections caused by vancomycin-resistant enterococci.

Anti-Bacterial Agents↗

PubMed2004

Changing face of septicaemia and increasing drug resistance in blood isolates.

In a retrospective study conducted between January, 2000 and December 2000, 7157 adults and children were studied. Amongst these, 1071 patients had positive blood cultures. Of these, 575 (53.6%) cases were community acquired septicaemia and 486 (46.4%) cases had developed septicaemia of nosocomial origin. Gram negative aerobes accounted for 708 (66.1%) isolates. Amongst them, Klebsiella pneumoniae predominated (23%), followed by Escherichia coli (14%). Acinetobacter spp. emerged as the next common pathogen (9%), followed by Salmonella typhi (5.4%). Staphylococcus aureus (9%) and coagulase negative staphylococci (9%) were the most common gram positive isolates followed by Enterococcus faecalis (4.7%). Antibiotic susceptibility of all these isolates was performed by the modified Stokes' method. Both Klebsiella pneumoniae and Escherichia coli showed alarmingly high resistance to all groups of antibiotics with 70-80% resistance to amoxicillin and cephalexin. Minimum resistance was observed against cefotaxime (23%) and ciprofloxacin (12%). Majority of Enterococcus faecalis were multidrug resistant. Streptococcus pneumoniae exhibited 26% resistance to penicillin. Thus, the study clearly highlights the rising level of drug resistance amongst the bacterial isolates from blood and hence the need to update and formulate newer drug policies.

Adult↗

PubMed2003

[Analysis of antimicrobial resistance of clinical isolates of enterococci from Beijing and other areas in China].

OBJECTIVE: To analyze the antimicrobial resistance of enterococci in Beijing and other areas in China. METHODS: Disk diffusion method was used to test the antimicrobial resistance of 1978 enterococcal isolates from 4 teaching hospitals in Beijing and 53 grade 3 A hospitals in other areas of China The laboratory data were analyzed by WHONET5 statistic software. RESULTS: Enterococcus. faecalis isolates and E. facium isolates accounted for 80.7% and 17.1% of the enterococcus isolates in Beijing and 79.4% and 15.2% in other areas respectively. The enterococcus isolates from urine, sputum, secretion with pus, blood, and bile accounted for 33.7%, 22.9%, 9.8%, 4.4%, and 3.0% of the enterococcus isolates in Beijing and 28.4%, 16.3%, 14.6%, 5.0%, and 4.5% in other areas respectively. The resistance rates of E. faecalis to vancomycin, teicoplanin, ampicillin, and high -level gentamicin were 2.0%, 1.4%, 17.7%, and 47.4% in Beijing, and 5.1%, 3.7%, 24%, and 49.2% in other areas; The resistance rates of E. faecium to vancomycin, teicoplanin, ampicillin, and high -level gentamicin were 1.5%, 2.6%, 64.2%, and 64.9% in Beijing, and 2.1%, 3.1%, 68.5%, and 62.3% in other areas respectively. The vancomycin-resistant rate of the total isolates of enterococci was 3.2%. CONCLUSION: Enterococcus faecalis is the main species in the enterococcus isolates from clinical samples. E. facium, as compared with E. faecalis resists many antimicrobial agents more strongly. Both of E. faecalis and E. facium show the least resistance to vancomycin and teicoplanin.

Drug Resistance, Bacterial↗

PubMed2003

Susceptibility of Gram-positive bacteria from ICU patients in UK hospitals to antimicrobial agents.

Microbiologists in 25 sentinel laboratories were each asked to refer up to 100 clinically-significant Gram-positive bacteria isolated from consecutive intensive care unit (ICU) patients. A total of 1595 isolates were collected from patients in 23 hospitals; these included Staphylococcus aureus (47.6%), coagulase-negative staphylococci (CNS) (30.6%), enterococci (14.3%), pneumococci (2.8%) and other streptococci (3.5%). A few coryneforms, other bacilli and a Nocardia sp. were also collected. Rates of oxacillin resistance among S. aureus and CNS isolates were 59.3 and 78.5%, respectively. Vancomycin-resistant S. aureus were not detected, although two isolates (0.3%) were resistant to teicoplanin [minimum inhibitory concentrations (MICs) 8 mg/L]. In contrast, 13.7% of CNS were teicoplanin resistant (MICs 8-32 mg/L) and 1.2% were resistant to vancomycin. Among the enterococci, 72.5% were Enterococcus faecalis and 24.5% were Enterococcus faecium, the remainder including isolates of Enterococcus casseliflavus or Enterococcus gallinarum. Eighteen percent of E. faecium isolates were vancomycin-resistant, compared with only 3% of E. faecalis isolates. Rates of high-level gentamicin resistance in E. faecalis and E. faecium were 40 and 25%, respectively. Nine percent of pneumococci and streptococci were resistant to penicillin, with 7 and 11%, respectively, resistant to erythromycin. None of the isolates showed resistance to linezolid, with the MICs for the entire study population falling in the range of 0.5-4 mg/L.

Coagulase↗

PubMed1989

In vitro activity of CP-65,207, a new penem antimicrobial agent, in comparison with those of other agents.

CP-65,207 is a new parenteral penem antibiotic with a broad spectrum that includes gram-positive, gram-negative, and anaerobic microorganisms, with MICs for 90% (MIC90s) of the majority of 1,101 clinical pathogens tested being less than or equal to 1 microgram/ml. The compound was from 10- to 100-fold more active than cefoxitin and broad-spectrum cephalosporins against gram-positive bacteria and anaerobes. CP-65,207 was less active than imipenem for staphylococci, group A streptococci, and Enterococcus faecalis. Against members of the family Enterobacteriaceae, CP-65,207 was in general 100-fold more active than cefoxitin, 5- to 10-fold more active than broad-spectrum cephalosporins, and 2-fold more active than imipenem. Fresh clinical isolates that were resistant to broad-spectrum cephalosporins were highly susceptible to CP-65,207 and imipenem (MIC90, 1 microgram/ml). Isolates of Enterococcus faecalis, Serratia marcescens, and anaerobic Peptococcus spp. had MIC90s of 8, 2, and 3.12 micrograms/ml, respectively. CP-65,207 was not very active against methicillin-resistant staphylococci or Pseudomonas aeruginosa. Killing kinetics showed that against some strains CP-65,207 is rapidly bactericidal at concentrations well below those required to achieve a similar degree of killing with cefotaxime, ceftazidime, and ceftriaxone. CP-65,207 was only slightly susceptible to hydrolysis by type I cephalosporinases and TEM-1, SHV-1, and PSE-2 plasmid-encoded enzymes. It had the highest affinity for penicillin-binding proteins 2, 1A, 1B, and 3 in cell-free preparations of Escherichia coli W-7.

Anti-Bacterial Agents↗

PubMed1997

Synthesis and antimicrobial activity of 1-dialkylaminomethyl- 2-(p-substituted phenyl)-5-substituted benzimidazole derivatives.

1-(Dialkylaminomethyl)-2-(p-substituted phenyl)-5-substituted benzimidazole derivatives 1 have been synthesized by reacting 2-phenylbenzimidazole derivatives with formaldehyde and a secondary amine. The derivatives of 2-phenylbenzimidazole were obtained by reacting the bisulfide addition product of substituted benzaldehydes with 4-substituted-o-phenylenediamines. Their structures were confirmed by microanalysis, IR and NMR spectral analysis. Antimicrobial activity of the compounds was investigated by the microdilution susceptibility test in Mueller-Hinton Broth and Sabouraud Dextrose Broth was used for the determination of antibacterial and antifungal activities. Test organisms: Staphylococcus aureus ATCC 29213 and Enterococcus faecalis ATCC 29212 as Gram-positive bacteria, Escherichia coli ATCC 25922 and Pseudomonas aeruginosa ATCC 27853 as Gram-negative bacteria, and Candida albicans, C. parapsilosis, C. stellatoidea as yeast-like fungi. Compounds 1a, 1b, 1c, 1e and 1i showed slight to moderate activity against all microorganisms. Compound 1g showed the highest activity. It was found more potent than streptomycin against Enterococcus faecalis and Pseudomonas aeruginosa.

Anti-Bacterial Agents↗

PubMed1998

Antimicrobial resistance in enterococci isolated from Turkey flocks fed virginiamycin.

From 125 separate cloacal cultures from three turkey flocks fed virginiamycin, 104 Enterococcus faecium and 186 Enterococcus faecalis isolates were obtained. As the turkeys aged, there was a higher percentage of quinupristin-dalfopristin-resistant E. faecium isolates, with isolates from the oldest flock being 100% resistant. There were no vancomycin-resistant enterococci. Results of pulsed-field gel electrophoresis (PFGE) indicated there were 11 PFGE types of E. faecalis and 7 PFGE types of E. faecium that were in more than one group of flock cultures.

Animals↗

PubMed2002

[Survey on drug resistance to ciprofloxacin in common pathogenic bacteria].

OBJECTIVE: To obtain primary knowledge of drug resistance to ciprofloxacin in the common pathogenic bacteria in this hospital thereby to bring the situation under control. METHODS: A total of 3 800 strains of pathogenic bacteria were isolated from in-patients from 1997 to 2000, and drug resistance of these strains to ciprofloxacin was examined. RESULTS: During the past 4 years, Staphylococcus aureus, Staphylococcus epidermidis and Enterococcus faecalis were found to be highly resistant to ciprofloxacin with the rates still on the rise from 50%, 25.6% and 40.3% in 1997 to 62.2%, 53.4% and 63.6% respectively in 2000. Over 40% of Escherichia coli, Klebsiella pneumoniae and Enterobacter were resistant to ciprofloxacin and the percentages for Pseudomonas aeruginosa and Acinetobacter reached 31.1% to 34.0% in 2000. Among the 189 strains of the pathogenic bacteria isolated from patients with sustained infection in our hospital in 2000, over 70% of Staphylococcus aureus, Staphylococcus epidermidis and Enterococcus faecalis were identified as having resistance to ciprofloxacin. CONCLUSION: The percentages of common pathogenic bacteria that are resistant to ciprofloxacin have been considerably high and tend to increase further. Ciprofloxacin abuse needs to be given appropriate attention.

Anti-Infective Agents↗

PubMed2000

Comparison of phenotypic methods to identify enterococci intrinsically resistant to vancomycin (VanC VRE).

Clinical laboratories must be able to differentiate between enterococci possessing acquired resistance to vancomycin (vanA and vanB genotypes) from those that are inherently resistant (vanC1 and vanC2/C3 genotypes). We compared several routine phenotypic tests to determine the species identity of clinical isolates of enterococci and a PCR assay for the van ligase genes was used to confirm identification of VanC VRE. The Vitek Gram Positive Identification card identified 53/60 (88%) Enterococcus faecalis and E. faecium isolates and 81/141 (57%) VanC VRE without additional testing. Another 32 of the VanC VRE required additional testing (e.g., motility and pigmentation) for correct identification. However, 7 of these 32 VanC VRE were nonmotile. The rapid ID 32 STREP strips identified 50/60 (83%) E. faecalis and E. faecium isolates and 102/141 (72%) VanC VRE. All E. faecalis and E. faecium isolates were nonmotile and did not acidify 1% methyl-alpha-D-glucopyranoside (MGP). Only 93/115 (81%) E. gallinarum and 21/26 (81%) E. casseliflavus/E. flavescens were motile but all 141 VanC VRE acidified MGP. MGP acidification can accurately differentiate VanC VRE from E. faecalis and E. faecium. Because some VanC VRE isolates are nonmotile, MGP acidification is preferred as a simple and less costly test for identification of these isolates.

Bacterial Proteins↗

PubMed2006

Characterisation and transfer of antibiotic resistance genes from enterococci isolated from food.

The genetic determinants responsible for the resistances against the antibiotics tetracycline [tet(M), tet(O), tet(S), tet(K) and tet(L)], erythromycin (ermA,B,C; mefA,E; msrA/B; and ereA,B) and chloramphenicol (cat) of 38 antibiotic-resistant Enterococcus faecium and Enterococcus faecalis strains from food were characterised. In addition, the transferability of resistance genes was also assessed using filter mating assays. The tet(L) determinant was the most commonly detected among tetracycline-resistant enterococci (94% of the strains), followed by the tet(M) gene, which occurred in 63.0% of the strains. Tet(K) occurred in 56.0% of the resistant strains, while genes for tet(O) and tet(S) could not be detected. The integrase gene of the Tn916-1545 family of transposons was present in 81.3% of the tetracycline resistant strains, indicating that resistance genes might be transferable by transposons. All chloramphenicol-resistant strains carried a cat gene. 81.8% of the erythromycin-resistant strains carried the ermB gene. Two (9.5%) of the 21 erythromycin-resistant strains, which did not contain ermA,B,C, ereA,B and mphA genes harboured the msrC gene encoding an erythromycin efflux pump, which was confirmed by sequencing the PCR amplicon. In addition, all E. faecium strains contained the msrC gene, but none of the E. faecalis strains. Transfer of the genetic determinants for antibiotic resistance could only be demonstrated in one filter mating experiment, where both the tet(M) and tet(L) genes were transferred from E. faecalis FAIR-E 315 to the E. faecalis OG1X recipient strain. Our results show the presence of various types of resistance genes as well as transposon integrase genes associated with transferable resistances in enterococci, indicating a potential for gene transfer in the food environment.

Drug Resistance, Bacterial↗

PubMed2001

Incidence of virulence factors and antibiotic resistance among Enterococci isolated from food.

The incidence of virulence factors among 48 Enterococcus faecium and 47 Enterococcus faecalis strains from foods and their antibiotic susceptibility were investigated. No strain was resistant to all antibiotics, and for some strains, multiple resistances were observed. Of E. faecium strains, 10.4% were positive for one or more virulence determinants, compared to 78.7% of E. faecalis strains. Strains exhibiting virulence traits were not necessarily positive for all traits; thus, the incidence of virulence factors may be considered to be strain specific.

Anti-Bacterial Agents↗

PubMedDate not supplied

The comparative in vitro activity of clinafloxacin and other antimicrobials against vancomycin-susceptible and vancomycin-resistant enterococci.

The susceptibilities of 50 unique vancomycin-susceptible (n = 15) and vancomycin-resistant (n = 35) enterococci to 6 antimicrobials were compared. Teicoplanin was consistently the most active agent for all strains. Ampicillin and imipenem were active primarily for vancomycin-sensitive Enterococcus faecalis. Clinafloxacin and ciprofloxacin showed poorer activity compared to prior studies, suggesting that the emergence of quinolone resistance is now occurring in enterococci.

Ampicillin↗

PubMed2001

Infectious complications and antibiotic use in renal transplant recipients during a 1-year follow-up.

OBJECTIVE: To evaluate infectious complications and antibiotic use in 192 renal transplant recipients. METHODS: Infectious complications and antibiotic use were monitored in all patients receiving renal transplantation at our center from 1992 to 1997. Risk factors for infectious complications were evaluated. Transplants and patient survival were monitored. The follow-up period was 1 year. RESULTS: One-hundred and ninety-two patients received renal transplants during the study period. The mean duration of urethral catheterisation after transplantation was 10.5 days (SD = 5). Seventy-one per cent (n = 137) of patients had at least one infectious episode. In all, 284 infectious episodes were monitored. The most frequent infections were: urinary tract infections 61%, respiratory tract infections 8%, intra-abdominal infections 7%, and cytomegalovirus infection 8%. Escherichia coli and Enterococcus faecalis were the most frequently isolated microorganisms. Seventy-four per cent (n = 142) of patients received 314 antimicrobial courses (284 for therapy, and 30 for prophylaxis). Female gender and duration of urethral catheterisation were risk factors for urinary tract infection. Cytomegalovirus reactivation was associated with acute graft rejection and additional immunosuppressive therapy. Overall mortality was 4%. Infection-related mortality was 2.6%. Mortality was associated with Enterobacteriaceae in three patients, with Pseudomonas aeroginosa in one patient and with Enterococcus faecalis in one patient. CONCLUSIONS: The incidence of infectious complications remains high in renal transplant recipients. Most cases of mortality were associated with infections. Early removal of the urethral catheter to reduce the risk of urinary tract infections is recommended.

Adolescent↗

PubMed1999

Occurrence of vancomycin-resistant enterococci in relation to the administration of glycopeptide antibiotics.

Occurrence of vancomycin-resistant enterococci and its relationship to the administration of glycopeptide antibiotics (vancomycin, teicoplanin) was described. A total number of 628 strains of the genus Enterococcus was isolated in the Hemato-oncologic Department of the University Hospital in Olomouc in 1997. Seven strains (1.1%) were found to be resistant to vancomycin. Five of them were identified as Enterococcus faecalis of phenotype VanB, and two strains as E. faecium of phenotype VanA. The administration of vancomycin and teicoplanin in the Hemato-oncologic Department amounted to 85.7% and 89.2%, respectively, of the total consumption of these drugs at the University Hospital.

Anti-Bacterial Agents↗

PubMed1999

Antimicrobial susceptibilities of clinical isolates of vancomycin-resistant enterococci in Taiwan.

To understand the antimicrobial resistance patterns of vancomycin-resistant enterococci in Taiwan, we tested the in vitro activities of 10 antimicrobial agents against 71 clinical isolates (39 of Enterococcus faecalis and 32 of Enterococcus faecium) by means of the agar dilution method. Resistance was determined on the basis of the minimum inhibitory concentration (MIC) of each antimicrobial agent--MIC50 and MIC90 (minimum concentrations required to inhibit growth of 50% and 90% of isolates, respectively) were determined. No beta-lactamase producers were identified with the cefinase test. All E. faecalis isolates were susceptible to penicillin and ampicillin, and 97% of these isolates were resistant to teicoplanin (vanA phenotype). Of the E. faecium isolates, 75% were susceptible to teicoplanin (vanB phenotype) and most were resistant to penicillin (94%) and ampicillin (94%). Quinupristin/dalfopristin was markedly less active against E. faecalis than E. faecium isolates (MIC50, 64 vs 2 micrograms/mL; MIC90, 128 vs 8 micrograms/mL; susceptibility rates, 3% vs 81%). Five of the eight vanA phenotype E. faecium isolates and one of the 24 vanB phenotype E. faecium isolates were resistant to quinupristin/dalfopristin. The activity of rifampin was also species-specific, with E. faecium being markedly less susceptible to this agent than E. faecalis (MIC50, 16 vs 1 microgram/mL; MIC90, 64 vs 4 micrograms/mL). Our data suggest the potential of teicoplanin and quinupristin/dalfopristin as appropriate antimicrobial agents in the treatment of infections caused by vanB phenotype E. faecium. Penicillin, ampicillin, and rifampin alone, or preferably in combination with other agents, appear to be the most appropriate agents for the treatment of vancomycin-resistant E. faecalis infections in Taiwan.

Drug Resistance, Microbial↗

PubMed1997

Activity of a new glycopeptide antibiotic (LY333328) against enterococci and other resistant gram-positive organisms.

A new semi-synthetic glycopeptide, LY333328, was tested for in-vitro activity against 197 strains of enterococci including strains resistant to other glycopeptides. Activity was also assessed against species with intrinsic resistance to glycopeptides. For strains of enterococci tested the LY333328 MIC90s were < or = 0.5 mg/L. Enterococcus faecalis was less susceptible to LY333328 than other enterococci with a maximum MIC of 2.0 mg/L. Glycopeptide-resistant strains of enterococci were not more resistant to LY333328 than glycopeptide-susceptible strains but intrinsically resistant species had MICs between 4 and 8 mg/L.

Ampicillin↗