SEARCH · PubMed Health

Results for “Meropenem”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,495 records · Page 83Linked to original sources

PubMed2004

[Isolation-frequency and antibiotic susceptibility of Streptococcus pneumoniae, Haemophilus influenzae, and Pseudomonas aeruginosa isolated in regional core hospitals in the Nagaoka district of Niigata Prefecture (changes for 3 years)].

We measured MICs of various antimicrobial agents against Streptococcus pneumoniae, Haemophilus influenzae, and Pseudomonas aeruginosa isolated in the Nagaoka district of Niigata Prefecture in 2000 (March-May), 2001 (January-May), and 2002 (March-May). S. pneumoniae: Fifty-six strains were isolated in 2000, 119 strains in 2001, and 88 strains in 2002. In 2000, 2001, and 2002, 24 strains (42.9%), 58 strains (48.7%), and 40 strains (45.5%), respectively, were penicillin-intermediate S. pneumoniae (PISP), and 4 strains (7.1%), 12 strains (10.1%), and 7 strains (8.0%), respectively, were penicillin-resistant S. pneumoniae (PRSP). Carbapenems had the most excellent antimicrobial activity, followed by penicillin G, against penicillin-susceptible S. pneumoniae (PSSP), PISP, and PRSP. H. influenzae: Seventy-six strains were isolated in 2000, 154 strains in 2001, and 91 strains in 2002. In 2000, 2001, and 2002, 6 strains (7.9%), 8 strains (5.2%), and 7 strains (7.7%), respectively, were beta-lactamase-producing ampicillin (ABPC)-resistant strains (MIC > or = 2 micrograms/ml), showing no increase, and 14 strains (18.4%), 70 strains (45.5%), and 31 strains (34.1%), respectively, were beta-lactamase-non-producing ABPC-resistant strains (MIC > or = 2 micrograms/ml), showing a slight increase. Ceftriaxon, meropenem (MEPM), and levofloxacin had excellent antimicrobial activity against these resistant strains. P. aeruginosa: In 2000, 2001, and 2002, 135, 74, and 91 strains, respectively, were isolated, and 14 strains (10.4%), 17 strains (23.0%), and 24 strains (26.4%), respectively, were imipenem-resistant (MIC > or = 16 micrograms/ml), showing a slight increase. MEPM, biapenem, and ciprofloxacin had excellent antimicrobial activity against P. aeruginosa.

Anti-Infective Agents↗

PubMed2004

[Human intestinal spirochetosis].

A characteristic feature of human intestinal spirochetosis (IS) is the colonization of the mucosa of the large intestine with intestinal spirochetes of the genus Brachyspira. The joining of the brachyspirae with the apical cellular membrane of enterocytes resembles in histological slides a false brush border of the intestinal mucosa. Various symptoms related to the involvement of the large gut were found with invasive IS. From the cultures of these cases were isolated Brachyspira aalborgii and B. pilosicoli. The frequency of the incidence of brachyspirae depended on the socio-economic living conditions of people. Colonization of the mucosa of the large gut was found more often in human populations in the developing countries; it was fairly rare in countries with high hygienic standards. An exception were men of homosexual orienation and patients presenting with a HIV infection. Isolation of brachyspirae from the faeces and biopsy of the mucosa of the large gut are fairly demanding jobs, especially with B. aalborgii. Most documented IS cases of this aetiology were diagnosed using immunohistochemical methods and amplification of the genus-specific region of the gene 16S rRNA. Isolation of B. pilosicoli tends to be simpler, it requires anaerobic incubation on selective blood agars for a period of 3-6 days at 37 degrees C. When manual haemoculture systems were used, patients in a critical state presented a translocation of brachyspirae into blood circulation, while automatic systems don't necessarily diagnose spirochetaemia. In the management of described cases of invasive IS particularly successful proved metronidazole and beta-lactam antibiotics. In isolated B. pilosicoli, in vitro tests confirmed sensitivity to metronidazole, ceftriaxone, meropenem, tetracycline, moxifloxacine and chloramphenicol. A varying frequency of resistance was found with clindamycin and amoxicillin, which how ever was efficacious in combination with clavulanic acid.

Feces↗

PubMed2004

[A case of M. fortuitum lung disease with small-cell lung cancer].

A 58-year-old man was admitted to our hospital because of an abnormal shadow found on chest radiography. Chest radiographs and chest CT on admission showed a bulla with a niveau and infiltration in the right upper lobe. Smear of sputum and bronchial lavage were negative for acid-fast bacilli. Despite treatment with meropenem and clindamycin, the infiltrating shadow worsened. Since bronchial lavage and sputum culture were positive for M. fortuitum, these drugs were replaced with minocycline and imipenem. Thereafter, the shadow on the chest radiograph improved. After discharge, outpatient treatment with clarithromycin and levofloxacin was continued. After 4 months, the residual tumor shadow in the right upper lobe gradually grew. When a CT-guided transcutaneous needle lung biopsy was undertaken, malignant cells were found. Right upper lobectomy was performed. Pathological examination of the lesion demonstrated small-cell lung cancer. If a lesion does not change after nontuberculous mycobacteria treatment, the physician should consider other lesions such as lung cancer.

Anti-Bacterial Agents↗

PubMed2004

Antimicrobial susceptibility pattern of clinical isolates of Pseudomonas aeruginosa.

OBJECTIVE: To determine the level of resistance to the widely used antipseudomonal antibiotics in clinical isolates of Pseudomonas aeruginosa (P. aeruginosa). METHODS: The microbiology database of all clinical isolates of P. aeruginosa at the Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia, from January 1999 to December 1999 was reviewed. The antimicrobial susceptibilities were determined by a standardized method. RESULTS: Seven hundred and four P. aeruginosa isolates were tested. These strains were commonly isolated from surgical patients followed by intensive care units. Respiratory tract was the most common source of isolation. The antibiotic susceptibility rates were as follows: ciprofloxacin 92.2%, meropenem 91.6%, imipenem 90.2%, amikacin 85.8%, ceftazidime 81.8% piperacillin/tazobactam 81.3% and gentamicin 77.7%. Among 704 strains 6.4% were designated as being multidrug resistant. These were commonly isolated from respiratory tract specimens of patients in intensive care units. CONCLUSION: The clinical significance of these findings is important in the selection of appropriate empiric treatment of serious P. aeruginosa infections. It emphasizes the importance of a conservative approach to antibiotic therapy and continued antimicrobial susceptibility testing surveillance programs to curtail the problem of antibiotic resistance.

Anti-Bacterial Agents↗

PubMed2004

[Epidemiology of Streptococcus pneumoniae isolates in Gifu Prefecture].

We analyzed Streptococcus pneumoniae isolates confirmed by direct PCR in Gifu prefecture between May 2002 and August 2002. We analyzed isolates of 254 strains from 6 hospitals to determine antibiotic susceptibility, genotype of penicillin-binding protein (PBP) genes and macrolide resistant genes, and the serotypes distribution of isolates from Matsubara Otorhinolaryngology Clinic. Isolates in which abnormal PBP genes of pbp1a, pbp2x, and pbp2b were identified by PCR were classified based on PCR results as follows; (i) penicillin-susceptible (PSSP) with 3 normal PBP genes, (ii) penicillin-intermediate (PISP) with an abnormal pbp2x, (iii) PISP with an abnormal php2b, (iv) PISP with abnormal pbp2x and pbp2b, (v) PISP with abnormal pbpla and pbp2x, (vi) penicillin-resistant (PRSP) with 3 abnormal PBP genes. The overall incidence of PRSP, PISP and PSSP was 121 (49%), 109 (42%) and 24 (9%), respectively, and there was a significant difference among some hospitals (p<0.05). However, there was no significant difference among the hospitals for the incidence of abnormal macrolide-resistant genes (mefA, ermB). Panipenem showed an excellent antimicrobial activity for injectable carbapenems against PRSP, following biapenem, imipenem, and meropenem. Cefditoren (CDTR) showed an excellent antimicrobial activity for oral cephalosporins against PRSP, following cefteram and cefcapene. Interestingly, there were 2 and 3 strains on MIC of CDTR for 8 and 4 microg/mL, respectively. The prevalent pneumococcal serotypes of isolates in Matsubara Clinic were 6 (17/55), following by 40 (8/55), 9 (6/5) and 15 (5/55). The endemic strains were observed in this study using pulsed field gel electrophoresis. These findings suggest the needs to continue the surveillance of bacterial resistance not only in the nationwide but also in the distict.

Drug Resistance, Bacterial↗

PubMedDate not supplied

[Molecular epidemiology of Stenotrophomonas maltophilia strains isolated from paediatric patients].

As alternative regimens in therapy of Stenotrophomonas maltophilia infections are limited, epidemiological investigation of S. maltophilia is necessary for developing new strategies in prophylaxis of these infections. "Enterobacterial repetetive intergenic consensus-polymerase chain reaction (ERIC-PCR)", is a simple and rapid method to detect the genomic polymorphism at the strain level in nosocomial outbreaks due to S. maltophilia. The aim of this study was to investigate the molecular epidemiology of S. maltophilia strains isolated from paediatric patients in a university hospital. A total of 40 clinical isolates one from each of 35 patients, two pairs from two patients and one from an environmental source, were collected between 1998-2001 period. Susceptibility to eleven antimicrobials was studied by agar dilution test according to NCCLS criteria. Resistance rates of the tested isolates against piperacillin, piperacillin-tazobactam, ceftriaxone, ceftazidime, cefepime, ciprofloxacin, imipenem, meropenem, amikacin, gentamicin and trimethoprim-sulfamethoxazole were 57.5%, 25%, 85%, 37.5%, 47.5%, 20%, 100%, 95%, 62.5%, 62.5% and 5%, respectively. Trimethoprim-sulfamethoxazole was the most active agent against the tested isolates. The isolates were analyzed by ERIC-PCR by using each of ERIC-I and ERIC-II primers. Genotypic analysis by ERIC-PCR identified 24 different major and 4 minor profiles. Three isolates from each of four different groups, two isolates from each of other four different groups were unique. The results of this study, revealing a great genomic diversity and low clonality within the strains of S. maltophilia strains suggest that patients may be colonized with the naturally occuring isolates in the hospital environment and then get infected with these strains under the selective antibiotic pressure, thus supporting the view that clonal spread of S. maltophilia strains between patients is of rather low possibility.

Anti-Infective Agents↗

PubMed2004

[Molecular mechanisms of cephalosporin resistance in Gram-negative bacteria of the Enterobacteriaceae family].

Extended spectrum beta lactamase genes were detected by the PCR in 87.6% of 231 Enterobacteriaceae strains isolated in medical institutions of Moscow, St. Petersburg, Tomsk and Nazran that showed a decrease in their susceptibility to 3rd generation cephalosporins. Alone or in various combinations TEM type beta lactamases were detected in 43.3% of the isolates, 46.8 and 51.2% of the isolates produced SHV type and CTX type beta lactamases respectively. Combinations of 2 and 3 different determinants were detected in 40 and 14% of the isolates respectively. Production of class C beta lactamases was suspected in 28% of the isolates by their resistance to cefoxitin. The gene of ACT type beta lactamase was detected in 1 strain of Klebsiella pneumoniae and the gene of CMY type beta lactamase was detected in 1 strain of Proteus mirabilis. By the NCCLS 100% of the isolates was susceptible to meropenem, 14% was susceptible to cefotaxime, 64% was susceptible to cefepime, 81% was susceptible to cefoperazone/sulbactam, 47% was susceptible to gentamicin, 57% was susceptible to amikacin and 36% was susceptible to ciprofloxacin.

Anti-Bacterial Agents↗

PubMed2004

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (2002). I. Susceptibility distribution].

The bacterial strains isolated from 491 patients diagnosed as having urinary tract infections (UTIs) in 13 institutions in Japan were supplied between August 2002 and July 2003. The susceptibilities of them to many kinds of antimicrobial agents were investigated. Of them, 578 strains were estimated as causative bacteria and used for the investigation. The number of them was 578 strains consisting of 177 gram-positive bacterial strains (30.6%) and 401 gram-negative bacterial strains (69.4%). Against Staphylococcus aureus, vancomycin (VCM) showed a strong activity and prevented the growth of all strains with 1 microg/mL. The susceptibility of Staphylococcus epidermidis to cephems including cefotiam (CTM) was relatively good. Against Enterococcus faecalis, ampicillin (ABPC), imipenem (IPM), and VCM showed the strongest antibacterial activity (MIC90: 2-4 microg/mL). In addition, the low sensitive strains (MIC: > or = 256 microg/mL) to clarithromycin (CAM) were detected at 48.3% but none to cefozopran (CZOP). The antibacterial activity of cephems to Escherichia coli was generally good, and especially CZOP and cefpirome (CPR) showed the highest activity (MIC90: < or = 0.125 microg/mL). Quinolone resistant E. coli was detected at frequency of 13.5%, which was higher than that in the last year. The antibacterial activity of cephems to Citrobacter freundii was generally low but CZOP and CPR had a strong acitivity (MIC90: 0.25 and 0.5 microg/mL, respectively). The antibacterial activity of cephems to Klebsiella pneumoniae was good and especially cefmenoxime (CMX), cefixime (CFIX), flomoxef (FMOX), CPR, and CZOP showed stronger activity (MIC90: < or = 0.125 microg/mL). Against Serratia marcescens, meropenem (MEPM) had the highest antibacterial activity followed by CPR and CZOP. Against Proteus mirabilis, CMX, ceftazidime (CAZ), CPR, MEPM, carumonam (CRMN), and levofloxacin (LVFX) showed the strongest activity (MC90: < or = 0.125 microg/mL). Among other cephems, CZOP and CFIX were also strong (MIC90: 0.25 microg/mL). The antibacterial activity of the drugs to Pseudomonas aeruginosa was generally low, and MIC90 of all the drugs were ranged from 64 to > or = 256 microg/mL except IPM and amikacin (AMK) having 16 microg/mL. The antibacterial activity of CZOP was relatively good (MIC50: 8 microg/mL).

Anti-Bacterial Agents↗

PubMed2004

[Surviving case of Legionella pneumonia showing a high level of serum KL-6 and complicated with rhabdomyolysis].

A 66-year-old man was admitted to our hospital with pyrexia up to 40 degrees C since one day after taking a public bath. Since multiple infiltrations on the lung were shown by chest radiography, severe pneumonia was diagnosed. Administration of antibiotics meropenem and erythromycin yielded no detected effect. Furthermore, rifampicin induced severe liver dysfunction. Improvement of clinical symptoms was seen after ciprofloxacine (CPFX) was given. Interstitial pneumonia, increases in KL-6 up to a level of 3545 U/ml and acute respiratory failure were improved by taking methylprednisolone. Since Legionella antigen was found in the urine, the use of CPFX was continued. Rhabdomyolysis and acute renal failure were successfully treated by transfusion, diuretic therapy, and glucocorticoid therapy. This was a very rare case of survival after Legionella pneumonia complicated with acute respiratory failure, acute renal failure, rhabdomyolysis, and interstitial pneumonia accompanied with a high KL-6 level, and successfully treated with steroids and CPFX.

Acute Kidney Injury↗

PubMed2004

Use of quinupristin/dalfopristin in a critical patient with a methicillin-resistant Staphilococcus aureus infection.

The growing incidence of infections due to Gram-positive multiresistant germs has stimulated research into new drugs endowed with broader activity, that are useful in case of infections unresponsive to common antibiotics. The case of a 28-year-old man infected with a methicillin resistant Staphylococcus aureus non responder to therapy with glycopeptide antibiotics is reported. At admission the patient presented a septic condition and required mechanical ventilation. Antibiotic therapy was immediately started with teicoplanin+meropenem. Blood culture and bronchial aspirate evidenced a methicillin resistant Staphylococcus aureus with high sensibility to glycopeptide antibiotics. Although this therapy produced a slight improvement in clinical condition and the patient was extubated, fever and leucocytosis associated with a BAL positive to methicillin resistant Staphylococcus aureus, in vitro susceptible to glycopeptides, persisted. Considering the possibility of a non-responder condition of the patient to glycopeptide antibiotics, quinupristin/dalfopristin was added. The streptogramin produced a quick improvement in clinical condition with resolution of sepsis and culture sterilization. The patient improved progressively and was discharged. In conclusion, in our experience the association quinupristin/dalfopristin was effective in the resolution of a critical methicillin resistant Staphylococcus aureus infection non responder to classical treatment with glycopeptide antibiotics that showed a high sensibility in vitro.

Adult↗

PubMed2004

[Septic shock following intracavitary Bacillus Calmette-Guerin therapy for postcystectomy ureteral cancer].

A 72-year-old female patient was diagnosed as having a tumor in her bladder at the department of obstetrics and gynecology. Transurethral resection of bladder tumor was performed in November, 2002. Pathology showed transitional cell carcinoma (TCC), G2>G3, pT1. Chemotherapy consisting of methotrexate, adriamycin and cisplatin and bladder instillation of Bacillus Calmette-Guerin (BCG) was performed. Re-biopsy revealed transitional cell carcinoma, G2, carcinoma in situ of the bladder and she received radical cystectomy with ureterocutaneostomy in June, 2003. After the cystectomy, the left ureter showed signs of cancer so BCG was administered through the left ureterocutaneostomy. During the second instillation, she had a high temperature and also exhibited signs of chills with frequent shivering followed by dyspnea, severe hypotension and tachycardia. We started the patient on dopamine and norepinephrine drips to maintain blood pressure and then started isoniazide and meropenem for presumed septic shock. The next day, the patient continued to be febrile and her condition deteriorated. After she was given endotoxin absorption therapy, she regained normal blood pressure and her heart rate, but was still febrile. After 13 days, rifampicin, ethambutol, and pyrazinamide were administered and after 18 days predonisolone was begun. From that point the patient's general condition gradually improved.

Administration, Intravesical↗

PubMed2004

[Study of administration times and clinical efficacy of carbapenems in the treatment of moderate community-acquired bacterial pneumonia].

The half-lives of carbapenems are about 1 hour. It was expected that increasing the daily frequency of administration would improve the clinical effects. We therefore studied the clinical effects of increasing the daily administration frequency of meropenem in the treatment of community-acquired bacterial pneumonia. The subjects were patients with moderate community-acquired bacterial pneumonia who were aged less than 75 years. They were divided into a BID group (28 patients receiving 0.5 g morning and evening) and a TID group (27 patients receiving 0.25 g in the morning and about midday, and 0.5 g in the evening), and the clinical effects were reviewed prospectively. Clinical efficacy on the third day was 78.6% in the BID group and 85.2% in the TID group, and over-all clinical efficacy was 89.3% in the BID group and 88.9% in the TID group. Administration periods were 12.8 +/- 4.2 days in the BID group and 10.9 +/- 3.4 days in the TID group. These results show no statistically significant difference, and suggest that the excellent clinical effect of administration of MEPM 0.5 g twice a day on moderate community-acquired bacterial pneumonia is not improved by administration three times a day.

Adult↗

PubMed2004

Metallo-beta-lactamase inhibitors: promise for the future?

Carbapenem resistance continues to erode the effectiveness of antibiotics such as imipenem and meropenem in the clinic. Resistance mechanisms can include interplay between porin loss (membrane permeability), mutation of penicillin binding proteins necessary for cell division, and expression of class A, B and D beta-lactamases. Bacterial resistance to beta-lactams such as penicillin or amoxicillin has been overcome in the clinic using several strategies, including development of antibiotics not susceptible to hydrolysis by beta-lactamases, or co-administration of the antibiotic with beta-lactamase inhibitors. This overview will focus on progress since 2000 in identifying inhibitors of class B, or metallo-beta-lactamases with the aim of reversing carbapenem resistance.

Anti-Bacterial Agents↗

PubMed2004

[A new member of CMY type cephalosporinase prevailing in Escherichia coli].

OBJECTIVE: To study the resistant phenotype and molecular biology character of plasmid mediated high AmpC-producing clinical isolates of Escherichia coli and to find new AmpC genotype. METHODS: The cefoxitin highly resistant clinical isolates of Escherichia coli were studied by K-B method, three-dimensional method, Isoelectric Focusing (IEF) and the MIC of these strains were examined by micro-dilution method. The conjugation experiment, multiplex PCR and DNA sequencing methods were used in further study. RESULTS: Above 719 strains studied, there are 6 isolates were showed as high AmpC-producing by three-dimensional method and IEF found they could produce a beta-Lactamase which PI was 8.9 and could be inhibited by cloxacillin but not by clavulnate. The strains were resistant to most of third generation cephalosporins, but were susceptible to cefepime, meropenem and imipenem. The experiment also showed that the gene which express this AmpC like beta-Lactamase could be transferable. Multiplex PCR indicated they belong to Citrobacter freundii family. Sequencing of corresponding DNA revealed 99% identities of the deduced amino acid sequence with CMY-2 and CMY-7 respectively. It is a new CMY type cephalosporinase. CONCLUSION: A new CMY type cephalosporinase has been found in clinical strains of Escherichia coli in our hospital. It was resistant to many antibiotics and its resistance could be transferred horizontally.

Bacterial Proteins↗

PubMed2005

Relationship between antimicrobial resistance and aminoglycoside-modifying enzyme gene expressions in Acinetobacter baumannii.

BACKGROUND: Acinetobacter baumannii is one of the main gram-negative bacilli in clinical practice. Nosocomial infections caused by multi-drug resistance Acinetobacter baumannii is very difficult to treat. This study was designed to investigate the antimicrobial resistance characteristics and four resistant gene expressions of aminoglycoside-modifying enzymes including N-acetyltransferases and O-phosphotransferases in Acinetobacter baumannii. METHODS: Bacterial identification and antimicrobial susceptibility test were performed by Phoenix system in 247 strains of Acinetobacter baumannii. Minimal inhibitory concentrations (MICs) of seven aminoglycosides including gentamicin, amikacin, kanamycin, tobramycin, netilmicin, neomycin and streptomycin in 15 strains of multi-drug resistant Acinetobacter baumannii were detected by agar dilution. Four aminoglycoside-modifying enzyme genes were amplified by polymerase chain reaction (PCR) and verified by DNA sequencer. RESULTS: The resistance rates of 247 strains of Acinetobacter baumannii against cefotaxime, levofloxacin, piperacillin, aztreonam, tetracycline, ciprofloxacin and chloramphenicol were more than 50%. Imipenem and meropenem showed high antibacterial activities with resistance rates of 3.2% and 4.1%. MIC50 and MIC90 of gentamicin, amikacin, streptomycin and kanamycin in 15 strains of multi-drug resistant Acinetobacter baumanii were all more than 1024 mg/L, and the resistance rates were 100%, 100%, 100% and 93.3%, respectively. But their resistance rates to tobramycin, netilmicin and neomycin were 86.7%, 93.3% and 46.7%, respectively. Three modifying enzyme genes, including aacC1, aacC2 and aacA4 genes, were found in 15 strains, but aphA6 had not been detected. Their positive rates were 93.3%, 20.0% and 20.0%, respectively. These three genes existed simultaneously in No.19 strain. Nucleotide sequences of aacC1, aacC2 and aacA4 genes shared 100%, 97.9% and 99.7% identities with GenBank genes (AY307113, S68058 and AY307114). CONCLUSION: Multi-drug resistant Acinetobacter baumannii strains are rapidly spreading in our hospital, and their resistance to aminoglycosides may be associated with aminoglycoside-modifying enzyme gene expressions.

Acinetobacter baumannii↗

PubMed2004

[Carbapenem resistance determined by metalloenzymes in clinical isolates of Pseudomonas aeruginosa].

Carbapenem resistance in clinical isolates of P. aeruginosa has risen notably in recent years. P. aeruginosa has different mechanisms for carbapenem resistance, such as decreased levels of OprD or overexpression of the MexAB-OprM efflux system. Also, the emergence of metallo-beta-lactamases (MBL)-producing bacteria is becoming a severe therapeutic problem. The aim of this study was to determine MBL presence in clinical isolates of P. aeruginosa: 133 with MIC > or =4 mg/l for imipenem and/or meropenem were selected. We studied the sensitivity to different antibiotics in these strains. Tobramycin (26.3%) and colistin (17.3%) were the most active antibiotics. To determine the presence of MBL, we used the E-test with imipenem/imipenem plus EDTA and disk-agar diffusion, also using EDTA as an MBL inhibitor. As a result of the screening test to evaluate the presence of MBL, we obtained four out of 133 strains as probable producers of metalloenzyme. These four strains were positive for the VIM-like gene as determined by a polymerase chain reaction method.

Carbapenems↗

PubMed2005

[Susceptibility of ESBL-producing Escherichia coli and Klebsiella pneumoniae to various antibacterial agents].

With the increasing use of broad-spectrum antibacterial agents, the increase in various drug-resistant bacterial strains has become a concern in recent years. Especially, the development of drug-resistance by Enterobacteriaceae which significantly affects therapy and prognosis in sepsis and lower gastrointestinal post-operative infection. The extended spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae strains isolated in the Surveillance Program of Bacterial Resistance in Kinki region of Japan (SBRK) were supplied between November 2000 and March 2003. The susceptibilities of them to 16 kinds of antimicrobial agents were investigated. The number of them was 48 strains consisting of 36 Escherichia coli strains (75%) and 12 Klebsiella pneumoniae strains (25%). Our focus was on carbapenem and the new quinolone antibacterial agents. Among the 16 major antibacterial agents examined, carbapenem had low MIC50/90 values. Meropenem had a MIC50/90 of 0.03/0.06microg/ml, followed by biapenem (0.12/0.5), imipenem (0.25/0.5) and panipenem (0.25/0.5). Among cephem, ceftazidime had the lowest MIC50 at 4 microg/ml. All four of the cephem agents had a MIC90 of greater than 128microg/ml. Among beta-lactamase inhibitors, tazobactam/piperacillin had the lowest MIC50 at 4 microg/ml, and sulbactam/cefoperazone had a MIC50 of 32 microg/ml. Among the new quinolones, prulifloxacin had the lowest MIC50 at 1 microg/ml, and the other drugs had a MIC50 of 2 microg/ml. The resistance rate of ciprofloxacin was 61.1% in E. coli and 16.6% in K. pneumoniae. Comparison of drug-sensitivity to cephem by ESBL-gene type revealed that cefpirome, cefepime and cefozopran had higher MIC50/90 values against the CTX-M group with a MIC50 of greater than 128microg/ml. Ceftazidime and aztreonam had higher MIC50/90 values against the TEM/SHV group than those against the CTX-M group. In the CTX-M group, the MIC50 was 4 and 16microg/ml, respectively.

Anti-Bacterial Agents↗

PubMed2005

[Study on the drug resistance and beta-lactamases of Pseudomonas aeruginosa].

OBJECTIVE: To analyze the resistance and beta-lactamases of 93 strains of Pseudomonas aeruginosa. METHODS: Antimicrobial activity to 93 strains of Pseudomonas aeruginosa were determined by K-B test, and the beta-lactamases produced by these strains were characterized by isoelectric focusing, three-dimensional test, 2-mercaptopropanoic acid inhibited assays, and polymerase chain reaction (PCR). RESULTS: The resistance of amikacin, cefepime, cefoperazone/sulbactam, ceftazidime, meropenem were 82.8%, 81.7%, 81.7%, 80.6%, 77.4%, respectively. The susceptibility of rate imipenem was 71.0%. Three-dimensional test showed that 14 strains produced carbapenemases, only and 2 strain produced metallo-beta-lactamase, which was in agreement with the result of 2-mercaptopropanoic acid inhibited assays, 13 strains produced AmpC enzymes, and 2 strains produced AmpC enzymes and ESBLs. The 15 strains and other two (Number 19, 54) had 1 band on IEF electrophoresis, and the isoelectric points were 9.0 and 6.3 respectively. The 2 metallo-beta-lactamases were revealed by amplified PCR products with VIM-2 specific PCR, the production was sequenced and revealed that the found to match with the known sequences of VIM-2. CONCLUSION: The production of carbapenemases and AmpC enzymes was the main cause for multi-drug resistance in Pseudomonas aeruginosa in our hospital.

Anti-Bacterial Agents↗