Microbial profile, antimicrobial resistance, and molecular characterization of diabetic foot infections in a university hospital. - Related Documents




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219101.0000Microbial profile, antimicrobial resistance, and molecular characterization of diabetic foot infections in a university hospital. INTRODUCTION: Diabetic foot infections (DFIs) are among the most severe complications of diabetes. The aim of this study was to determine the etiological pathogens of DFIs in different Wagner's and IDSA/IWGDF grades, and to assess their antimicrobial susceptibility pattern together with molecular characterization of antibiotic resistance genes. METHODS: A prospective study was conducted on 120 DFI patients at Main Alexandria University Hospital, Egypt. The aerobic and anaerobic etiological pathogens were determined using semi-quantitative culture and PCR respectively. The antimicrobial susceptibility pattern was done according to Clinical Laboratory Standards Institute guidelines. Detection of carbapenemases and class-1 integron genes was carried out by polymerase chain reaction (PCR). RESULTS: A total of 178 (124 aerobic, 54 anaerobic) pathogens were identified from patients with DFI, with an average of 1.82 isolates/subject. Among aerobic pathogens, Gram-negative predominated (98/124; 79%), of which Pseudomonas spp. and Proteus spp. were the most common. MRSA constituted more than 50% of Gram-positive isolates. Polymicrobial infection was found in 42 (42.9%) subjects. The proportion of Gram-negative bacteria and anaerobes increased with increased DFI grades and severity. Multidrug and extensively drug resistant isolates were observed in 86 patients (87.7%). PCR identified carbapenemases genes in 14 (11.7%) and class 1 integron in 28 (23.3%) DFI cases. Vancomycin, teicoplanin, linezolid were the most effective antimicrobial agents against Gram-positive pathogens, while colistin, imipenem, meropenem, and piperacillin-tazobactam were effective against Gram-negative pathogens. CONCLUSIONS: Multidrug and extensively drug resistant Gram-negative bacteria were the dominant pathogens among all DFI severity grades. However, the proportion of Gram-positive bacteria decreased with the severity of infection. The clinical role of our relatively high rate of anaerobes should be investigated. The results found in this study could be beneficial for designing future empiric antimicrobial protocols in relation to the severity of DFIs.202133898340
219010.9998Microbial Profile and Antibiotic Susceptibility Pattern in Diabetic Patients with Mild, Moderate, and Severe Foot Infections in Tehran. It is estimated that 10-25% of diabetic patients will encounter diabetic foot ulcers (DFU) during their lifetime. This study evaluated the microbiology of DFUs and determined the antibiotic resistance pattern of bacterial isolates based on the severity of wounds and infections in different grades of ulcer. The specimens were collected from115 diabetic foot infections (DFI) deep tissue by needle aspiration and biopsy. The aerobic and anaerobic cultures and antimicrobial susceptibility testing were carried out. The presence of resistance genes including metallo-beta-lactamases (MBL), extended-spectrum β-lactamase (ESBL), ermA, ermC, and mecA was also determined. A total of 222 microorganisms were isolated. The prevalence of poly-microbial infections was 69.6%. Bacterial isolates comprised 64.2% Gram-positive bacteria (GPB), 33.5% Gram-negative bacteria (GNB), and five isolates of anaerobic bacteria were also detected. The most prevalent GPB and GNB were Staphylococcus spp. (52.2%) and Escherichia coli (33.3%), respectively. The prevalence of poly-microbial infections and GNB was positively associated with increased grades of Wagner and IDSA classifications. Among Staphylococcus aureus isolates, resistance to clindamycin (73.5%), ciprofloxacin (70.6%), and erythromycin (70.6%) were noticeable. GNB was also highly resistant to cephalosporins and ciprofloxacin. ESBL genes were detected in approximately 40% of isolates of Enterobacteriaceae. The prevalence of ermA, ermC, and mecA genes in S. aureus isolates were 8.8%, 32.3%, and 14.7%, respectively. In conclusion, our data suggest that GPBs are the most common isolates from DFIs. Furthermore, with the development of wounds and infection, the prevalence of GNB in DFIs are increased.202237123144
220420.9998Multidrug resistance pattern of bacterial agents isolated from patient with chronic sinusitis. BACKGROUND: Treatment of chronic sinusitis is complicated due to increase of antibiotic-resistant bacteria. The aim of this study was to determine the multidrug resistance (MDR) pattern of the bacteria causing chronic sinusitis in north of Iran. METHODS: This cross-sectional study was carried out on patients with chronic sinusitis. Bacterial susceptibility to antimicrobial agents was determined according to the CLSI 2013 standards. Double-disk synergy (DDS) test was performed for the detection of extended-spectrum beta-lactamase (ESBL) producing bacteria; also methicillin-resistant Staphylococcus (MRSA) strains were identified by MRSA screen agar. The MDR isolates were defined as resistant to 3 or more antibiotics. Data were analyzed using SPSS 17 software. Descriptive statistics was used to describe the features of the data in this study. RESULTS: The rate of ESBL-producing bacteria was 28.75-37.03% among enterobacteriaceae and the rate of MRSA was 42.75%-60% among Staphylococcus strains. The most detectable rate of the MDR bacterial isolates was Gram-negative bacteria 39 (76.47%) and Enterobacter spp. 19(70.37%) was the most multidrug resistant isolate among Gram negative bacteria. Also 36 (73.46%) of the gram positive bacterial isolated were multidrug resistance and Staphylococcus aureus 9(90%) was the most MDR among Gram positive bacteria. CONCLUSION: Antimicrobial resistance is increasing in chronic bacterial sinusitis. The emergence of MRSA and ESBL bacteria causing chronic sinusitis is increasing.201627386063
231130.9998Serious antimicrobial resistance status of pathogens causing hospital-acquired lower respiratory tract infections in North China. Antimicrobial resistance patterns of pathogens causing hospital-acquired lower respiratory tract infections (LRTIs) in Shandong Province, China were investigated using data collected from January 2002 to December 2006. A total of 10 337 isolates were characterized in sputum samples from 39 920 LRTI patients: 68.72% were Gram-negative bacteria, 20.65% were Gram-positive bacteria, and 10.62% were fungi. Organisms most frequently isolated were: Pseudomonas aeruginosa (16.88%), Klebsiella pneumoniae (10.80%), Escherichia coli (10.71%), fungi (10.62%), Staphylococcus aureus (9.68%) and Acinetobacter baumannii (9.03%). Imipenem was the most effective antibiotic against Gram-negative bacteria. Most Gram-positive bacteria were susceptible to vancomycin. Susceptibility to cephalosporins was not optimal and resistance to fluoroquinolones was high. Resistance of Gram-negative bacteria showed a rapid increase over the study period, while resistance of Gram-positive bacteria remained relatively stable. The emergence of resistance to commonly prescribed antimicrobial agents used against LRTI pathogens has compounded the problem of using empirical therapy and created selective pressure on physicians to use certain antibiotics.200919589276
235540.9998Causative bacteria and antibiotic resistance in neonatal sepsis. BACKGROUND: Neonatal sepsis is characterised by bacteraemia and clinical symptoms caused by microorganisms and their toxic products. Gram negative bacteria are the commonest causes of neonatal Sepsis. The resistance to the commonly used antibiotics is alarmingly high. The major reason for emerging resistance against antibiotics is that doctors often do not take blood cultures before starting antibiotics. We have carried out this study to find out various bacteria causing neonatal sepsis and their susceptibility to antibiotics for better management of neonatal sepsis. METHODS: A total of 130 neonates with sepsis who were found to be blood culture positive were taken in this study. Culture/sensitivity was done, isolated organisms identified and their sensitivity/resistance was noted against different antibiotics. Data were arranged in terms of frequencies and percentage. RESULTS: Out of 130 culture proven cases of neonatal sepsis, gram negative bacteria were found in 71 (54.6%) cases and gram positive bacteria in 59 (45.4%) cases. Staphylococcus aureus was the most common bacteria found in 35 (26.9%) cases followed by Escherichia coli in 30 (23.1%) cases. Acinetobacter species, Staphylococcus epidermidis, Klebseila, Streptococci, Enterobacter cloacae and Morexella species were found in 17 (13.1%), 17 (13.1%), 13 (10%), 7 (5.4%), 6 (4.6%), and 5 (3.8%) cases respectively. In most of the cases causative organisms were found to be resistant to commonly used antibiotics like ampicillin, amoxicillin, cefotaxime, and ceftriaxone (77.7%, 81.5%, 63.1%, and 66.9% respectively). There was comparatively less (56.9%) resistance to ceftazidime. Gentamicin had resistance in 55.1% cases, while amikacin and tobramycin had relatively less resistance (17.4% and 34.8% cases respectively). Quinolones and imipenem had relatively less resistance. Vancomycin was found to be effective in 100% cases of Staphylococcus group. CONCLUSION: Staphylococcus aureus are the most common gram positive bacteria and Escherichia coli are the most common gram negative bacteria causing neonatal sepsis. Resistance to commonly used antibiotics is alarmingly increasing. Continued surveillance is mandatory to assess the resistance pattern at a certain level.201224669633
235650.9998Occurrence of Multiple-Drug Resistance Bacteria and Their Antimicrobial Resistance Patterns in Burn Infections from Southwest of Iran. Burn infection continues to be a major issue of concern globally and causes more harm to developing countries. This study aimed to identify the aerobic bacteriological profiles and antimicrobial resistance patterns of burn infections in three hospitals in Abadan, southwest Iran. The cultures of various clinical samples obtained from 325 burn patients were investigated from January to December 2019. All bacterial isolates were identified based on the standard microbiological procedures. Antibiotic susceptibility tests were performed according to the CLSI. A total of 287 bacterial species were isolated from burn patients. Pseudomonas aeruginosa was the most frequent bacterial isolate in Gram-negative bacteria and S. epidermidis was the most frequent species isolated in Gram-positive bacteria. The maximum resistance was found to ampicillin, gentamicin, ciprofloxacin, while in Gram-negative bacteria, the maximum resistance was found to imipenem, gentamicin, ciprofloxacin, ceftazidime, and amikacin. The occurrence of multidrug resistance phenotype was as follows: P. aeruginosa (30.3%), Enterobacter spp (11.1%), Escherichia coli (10.5%), Citrobacter spp (2.1%), S. epidermidis (2.8%), S. aureus, and S. saprophyticus (0.7%). Owing to the diverse range of bacteria that cause burn wound infection, regular investigation, and diagnosis of common bacteria and their resistance patterns is recommended to determine the proper antibiotic regimen for appropriate therapy.202234236077
216560.9997Distribution and analysis of the resistance profiles of bacteria isolated from blood cultures in the intensive care unit. PURPOSE: To investigate the distribution characteristics and drug resistance of pathogenic bacteria in bloodstream infections, providing a basis for rational clinical treatment. PATIENTS AND METHODS: Retrospective analysis of 1,282 pathogenic strains isolated from blood cultures in the intensive care unit (ICU) of the Second Affiliated Hospital of Xi'an Jiaotong University from January 1, 2019, to December 31, 2022. RESULTS: Gram-positive bacteria (52.0%) slightly predominated over gram-negative bacteria (48.0%). The top three gram-positive bacteria were Coagulase-negative Staphylococcus (28.0%), Enterococcus faecium (7.4%), and Staphylococcus aureus (6.6%). Staphylococci exhibited a high resistance rate to penicillin, oxacillin, and erythromycin; no strains resistant to vancomycin or linezolid were found. Among the Enterococci, Enterococcus faecium had a high resistance rate to penicillin, ampicillin, and erythromycin. Two strains of Enterococcus faecalis were resistant to linezolid, but none to vancomycin. The top three gram-negative bacteria were Escherichia coli (14.7%), Klebsiella pneumoniae (14.0%), and Acinetobacter baumannii (4.8%). The resistance rate of Escherichia coli to carbapenems increased from 0.0 to 2.3%. Acinetobacter baumannii reached 100% carbapenem resistance (up from 75.0%), while Klebsiella pneumoniae demonstrated 21.1-80.4% resistance to various carbapenems. CONCLUSION: The isolation rate of gram-positive bacteria in patients with bloodstream infection in the ICU of the Second Affiliated Hospital of Xi'an Jiaotong University was slightly higher than that of gram-negative bacteria. The alarming carbapenem resistance among gram-negative pathogens and emerging linezolid resistance in Enterococci demand urgent clinical interventions, including enhanced surveillance, antimicrobial stewardship, and novel therapeutic strategies.202540727562
235470.9997Resistance profiles of Staphylococcus aureus isolates against frequently used antibiotics at private sector laboratories in Jordan. BACKGROUND AND OBJECTIVES: Staphylococcus aureus (S. aureus) is one of the most important pathogens, responsible for a range of infections. This study aimed to assess resistance patterns in S. aureus isolates obtained from certain private-sector laboratories against commonly used antimicrobial agents. MATERIALS AND METHODS: The process involved collecting various samples from several private laboratories and then identifying S. aureus isolates using biochemical characterization. The antibiotic susceptibility of these isolates was determined by disc diffusion method. Furthermore, Rt-PCR was employed to identify two genes namely the methicillin/oxacillin resistance genes (mecA), and (SCCmec). RESULTS: The findings of the current study exhibited that females constituted a larger proportion of the participants (59.1%) compared to males (40.9%), with a mean participant age of 40.82 years. Gram-positive bacteria were more prevalent (71.3%) than Gram-negative bacteria (18.3%), with S. aureus being the most frequent isolate (60.9%). Urine samples represented the highest collected sample type (47.8%). Out of the 115 bacterial isolates, 85.2% exhibited multidrug resistance to antibiotics such as cefazolin, gentamicin, vancomycin, and ceftazidime. Clindamycin was the most effective antibiotic, with a sensitivity rate of 62.9%, followed by teicoplanin and meropenem, each with a sensitivity rate of 52.9%. Methicillin-resistant Staphylococcus aureus (MRSA) strains were susceptabile to vancomycin and teicoplanin. The methicillin/oxacillin resistant isolates showed significant association with mecA and SCCA genes. CONCLUSION: This study highlighted the multi-drug resistance in S. aureus isolates, stressing the need for stringent antibiotic stewardship, continuous surveillance, and further research into alternative treatments, including novel antibiotics and combination therapy, to combat resistant strains.202540337673
215380.9997Molecular Characterization and Epidemiology of Antibiotic Resistance Genes of β-Lactamase Producing Bacterial Pathogens Causing Septicemia from Tertiary Care Hospitals. Septicemia is a systematic inflammatory response and can be a consequence of abdominal, urinary tract and lung infections. Keeping in view the importance of Gram-negative bacteria as one of the leading causes of septicemia, the current study was designed with the aim to determine the antibiotic susceptibility pattern, the molecular basis for antibiotic resistance and the mutations in selected genes of bacterial isolates. In this study, clinical samples (n = 3389) were collected from potentially infected male (n = 1898) and female (n = 1491) patients. A total of 443 (13.07%) patients were found to be positive for bacterial growth, of whom 181 (40.8%) were Gram-positive and 262 (59.1%) were Gram-negative. The infected patients included 238 males, who made up 12.5% of the total number tested, and 205 females, who made up 13.7%. The identification of bacterial isolates revealed that 184 patients (41.5%) were infected with Escherichia coli and 78 (17.6%) with Pseudomonas aeruginosa. The clinical isolates were identified using Gram staining biochemical tests and were confirmed using polymerase chain reaction (PCR), with specific primers for E. coli (USP) and P. aeruginosa (oprL). Most of the isolates were resistant to aztreonam (ATM), cefotaxime (CTX), ampicillin (AMP) and trimethoprim/sulfamethoxazole (SXT), and were sensitive to tigecycline (TGC), meropenem (MEM) and imipenem (IPM), as revealed by high minimum inhibitory concentration (MIC) values. Among the antibiotic-resistant bacteria, 126 (28.4%) samples were positive for ESBL, 105 (23.7%) for AmpC β-lactamases and 45 (10.1%) for MBL. The sequencing and mutational analysis of antibiotic resistance genes revealed mutations in TEM, SHV and AAC genes. We conclude that antibiotic resistance is increasing; this requires the attention of health authorities and clinicians for proper management of the disease burden.202336978484
219590.9997Detection of Biocide Resistance Genes (qacE and qacΔE1) in Pseudomonas spp Isolated from Patients with CSOM at Mymensingh Medical College Hospital, Bangladesh. Biocides, including disinfectants and antiseptics, are used for a variety of topical and hard surface applications in health care facilities. Biocides play a significant role for preventing and controlling nosocomial infections. However, failures in the antimicrobial activities of biocides have been reported. The resistance mechanism to disinfectants is usually determined by genes which are related to resistance to quaternary ammonium compounds, namely, qacE, qacΔE1 that are found in Gram-negative bacteria. The aim of this study is to detect the prevalence of Biocides resistance genes, qacE and qacΔE1, in clinical isolates of Pseudomonas spp. It was carried out from March 2017 to July 2018 in the department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh. Samples were collected from Outpatient of ENT department, MMCH. In this study, 300 clinical samples of CSOM cases were tested by the PCR method. The present study shows detection of biocide resistance genes (qacE, qacΔE1) among 87 isolated Pseudomonas spp by uniplex PCR. Among 72 clinical isolates of Pseudomonas aeruginosa 67(93.05%) had the gene qacEΔ1 and 25(34.72%) had the gene qacE. In addition other 15 Pseudomonas spp 3(20%) isolates had the qacEΔ1 gene and 2(13.33%) isolates had the qacE gene. In this study there is a marked difference in detection of the qacEΔ1 gene between the MDR and non MDR P. aeruginosa isolates. The qacEΔ1 was identified in 50 of 54(92.59%) MDR isolates and 7 of 18(38.89%) non MDR strains respectively. While gene qacE was detect 25(46.29%) MDR isolates and did not show any qacEΔ1gene in non MDR isolates. This study shows that the genes, qacE, qacΔE1 are widespread among Pseudomonas aeruginosa, they are higher in MDR strains than non MDR strains.202134605462
2167100.9997In and Outpatients Bacteria Antibiotic Resistances in Positive Urine Cultures from a Tertiary Care Hospital in the Western Part of Romania-A Cross-Sectional Study. BACKGROUND/OBJECTIVES: Urinary tract infections (UTI) represent a global problem with implications for mortality and morbidity. Published data present different bacterial incidences and different antibiotic resistance. The objective of our study is to evaluate the bacteria distribution in positive urine cultures in a mixed adult population and evaluate the differences in antibiotic resistance in in- and outpatients. METHODS: We analyzed 1186 positive urine cultures in 2021 from the Emergency County Hospital "Pius Brinzeu" from Timisoara, Romania. We evaluated the bacteria distribution and antibiotic resistance stratified by in and outpatients from a mixed adult population. RESULTS: The median age was 67, with 65.7% females and 28.5% were outpatients. In inpatients, the most commonly identified bacteria was E. coli, followed by Enterococcus spp., and Klebsiella spp., while in outpatients, E. coli, Enterococcus spp., and Klebsiella spp. were the leading ones. Overall, E. coli presented the highest resistance rate to ampicillin, Enterococcus spp. to ciprofloxacin, Klebsiella spp. to cephalosporins, and Proteus spp. to trimethoprim/sulfamethoxazole. Inpatients presented higher resistance rates for E. coli to ceftazidime, cefuroxime, gentamycin, ciprofloxacin, and trimethoprim/sulfamethoxazole, Klebsiella spp. to most cephalosporin, gentamycin and levofloxacin, Proteus spp. to gentamycin and Enterococcus spp. to gentamycin and quinolones when compared to outpatients. The highest incidence of extensively drug-resistant (XDR) bacteria was among Acinetobacter baumanii, followed by Pseudomonas spp., and Serratia spp. CONCLUSIONS: susceptibility. Bacteria identified in inpatients' positive urine cultures present higher resistance rates to several antibiotics. Our study could be a foundation for a local or even national guideline for the antibiotic treatment of urinary tract infections.202540136614
935110.9997Evaluating the Saliva of Burn ICU Patients for Resistant Infections Harbor Metallo-β-Lactamase Genes. Pseudomonas aeruginosa and Acinetobacter baumannii are the bacteria which increasingly account for nosocomial infections. Due to high virulence, the rate of Multi-Drug Resistance (MDR) and limited availability of new agents, these infections create significant clinical burdens, making it important to identify the possible sources of their occurrence. The aim of this study was to assess non-lactose fermenting bacteria and their metallo-β-lactamase (MBLs) genes expression in the Burn Intensive Care Unit (BICU) patients' saliva samples. This cross-sectional study was conducted from 2017 to 2018 on 124 saliva samples of BICU patients. Identified isolates were evaluated for drug susceptibility by disc diffusion method. MBLs production isolates were detected by Modified Hodge test and Imipenem-EDTA Combined disk. MBLs related genes were evaluated by polymerase chain reaction (PCR). A total of 86 Gram negative non-lactose fermenting bacteria (38; A. baumannii) and (48; P. aeruginosa), were detected. All of the A. baumannii isolates were resistant to Carbapenems, while more than 90% of them were sensitive to Colistin. However, the highest sensitivity in P. aeruginosa isolates was related to Carbapenems and Colistin. More than 95% of A. baumannii and 32% of P. aeruginosa were detected MDR. MBLs production was confirmed in 9 (33.33%) P. aeruginosa and 18 (66.67%) A. baumannii isolates. The blaVIM was the most prevalent gene, while this gene was detected in all of MBLs positive strains. This study confirmed the prevalence of carbapenemase producer Gram-negative bacilli in the saliva of BICU patients. The results of the present study provide a new data set about saliva infection source that could lead to the proper antibiotic regimen and better control of drug resistance.202031930340
2157120.9997Prevalence and antibiotic resistance pattern of bacteria isolated from urinary tract infections in Northern Iran. BACKGROUND: This study aimed to investigate the bacteria associated with urinary tract infection (UTI) and antibiotic susceptibility pattern of the isolates during 2013-2015 in Northern Iran. MATERIALS AND METHODS: Overall 3798 patients with clinical symptoms of UTI were subjected as samples, and they were cultured and pure isolated bacteria were identified using biochemical tests and subjected to antibiogram assessment using disc diffusion method. RESULTS: Totally, 568 (14.96%) from 3798 patients had positive UTI. Four hundred and ninety-seven (87.5%) from 568 isolated bacteria were resistant to at least one antibiotic. Escherichia coli, Staphylococcus spp., and Pseudomonas spp. were the most prevalent bacteria. Isolated bacteria indicated the highest antibiotic resistance to methicillin (76.06%) and ampicillin (89.29%) and also revealed the most sensitivity to imipenem (99.1%) and amikacin (91.57%). Statistical analysis of the resistance pattern trend during 3 years indicated the insignificant increase (P > 0.05) in antibiotic resistance of the isolates. CONCLUSION: The results of this study revealed a great concern for emerging UTI-related multidrug-resistant strains of bacteria causing UTI in Iran.201729026424
1128130.9997Molecular detection of ESBLs production and antibiotic resistance patterns in Gram negative bacilli isolated from urinary tract infections. BACKGROUND: β-lactam resistance is more prevalent in Gram negative bacterial isolates worldwide, particularly in developing countries. In order to provide data relating to antibiotic therapy and resistance control, routine monitoring of corresponding antibiotic resistance genes is necessary. AIMS: The aim of this study was the characterization of β-lactam resistance genes and its plasmid profile in bacteria isolated from urinary tract infection samples. MATERIALS AND METHODS: In this study, 298 Gram negative bacteria isolated from 6739 urine specimens were identified by biochemical standard tests. Antimicrobial susceptibility testing was performed by the disk diffusion method. Extended-spectrum β-lactamase (ESBL)-producing strains were also detected by the double-disk synergy test. The presence of blaTEM and blaSHV genes in the strains studied was ascertained by polymerase chain reaction. RESULTS: Of all Gram negative bacteria, Escherichia coli (69.1%) was the most common strain, followed by Klebsiella sp. (12.1%), Enterobacter sp. (8.4%), Proteus sp. (4.4%), Citrobacter (4%) and Pseudomonas sp. (2%). The most antibiotic resistance was shown to tetracycline (95.16%), nalidixic acid (89.78%) and gentamycin (73.20%) antibiotics. Among all the strains tested, 35 isolates (11.75%) expressed ESBL activity. The prevalence of TEM and SHV positivity among these isolates was 34.29%, followed by TEM (31.43%), TEM and SHV negativity (20.0%) and SHV (14.29%), respectively. CONCLUSIONS: Regular monitoring of antimicrobial drug resistance seems necessary to improve our guidelines in the use of the empirical antibiotic therapy.201424943757
2220140.9997Rapid detection and molecular survey of blaVIM, blaIMP and blaNDM genes among clinical isolates of Acinetobacter baumannii using new multiplex real-time PCR and melting curve analysis. BACKGROUND: Acinetobacter baumannii is a cosmopolitan bacterium that is frequently reported from hospitalized patients, especially those patients who admitted in the intensive care unit. Recently, multiplex real-time PCR has been introduced for rapid detection of the resistance genes in clinical isolates of bacteria. The current study aimed to develop and evaluate multiplex real-time PCR to detect common resistance genes among clinical isolates of A. baumannii. RESULTS: Multiplex real-time PCR based on melting curve analysis showed different T(m) corresponding to the amplified fragment consisted of 83.5 °C, 93.3 °C and 89.3 °C for blaIMP, blaVIM and blaNDM, respectively. Results of multiplex real-time PCR showed that the prevalence of blaIMP, blaVIM and blaNDM among the clinical isolates of A. baumannii were 5/128(3.9%), 9/128(7.03%) and 0/128(0%), respectively. Multiplex real-time PCR was able to simultaneously identify the resistance genes, while showed 100% concordance with the results of conventional PCR. CONCLUSIONS: The current study showed that blaVIM, was the most prevalent MBL gene among the clinical isolates of A. baumannii while no amplification of blaNDM was seen. Multiplex real-time PCR can be sensitive and reliable technique for rapid detection of resistance genes in clinical isolates.201931182026
2149150.9997Cross-Resistance and the Mechanisms of Cephalosporin-Resistant Bacteria in Urinary Tract Infections Isolated in Indonesia. Urinary tract infection (UTI) by antibiotic-resistant strains has become increasingly problematic, with trends that differ from country to country. This study examined cross-resistance and the mechanisms of cephalosporin resistance in UTI-causative bacteria isolated in Indonesia. Antibiotic susceptibility tests based on Clinical Laboratory Standards Institute (CLSI) standards were done for UTI-causative strains (n = 50) isolated from patients in Indonesia in 2015-2016 and showed resistance against the third-generation cephalosporin. Mechanistic studies were carried out to confirm the presence of extended-spectrum β-lactamase (ESBL) genes, carbapenemase-related genes, the fosA3 gene related to fosfomycin resistance, and mutations of quinolone-resistance-related genes. Isolated UTI-causative bacteria included Escherichia coli (64.0%), Pseudomonas aeruginosa (16.0%), Klebsiella pneumoniae (10.0%), and others (10.0%). These strains showed 96.0% susceptibility to amikacin, 76.0% to fosfomycin, 90.0% to imipenem, 28.0% to levofloxacin, 92.0% to meropenem, and 74.0% to tazobactam/piperacillin. ESBL was produced by 68.0% of these strains. Mechanistic studies found no strains with carbapenemase genes but 6.0% of strains had the fosA3 gene. Seventy-two % of the strains had mutations in the gyrA gene and 74.0% in the parC gene. Most E. coli strains (87.5%) had Ser-83 → Leu and Asp-87 → Asn in gyrA and 93.8% of E. coli had Ser-80 → Ile in parC. There were significant correlations among mutations in gyrA and parC, and fosA3 gene detection (P < 0.05), respectively. To our knowledge, this is the first mechanistic study of antibiotic-cross-resistant UTI-causative bacteria in Indonesia. Further studies with a longer period of observation are necessary, especially for changes in carbapenem resistance without carbapenemase-related genes.202133713209
923160.9997Prevalence of Oxacillinase Genes in Clinical Multidrug-Resistant Gram-Negative Bacteria. BACKGROUND: The emergence of OXA-type beta-lactamases has become a significant threat to public healthcare systems and may lead to prolonged hospital stays and increased mortality rates among affected patients. This study aimed to determine the prevalence of oxacillinase resistance (OXA) genes in multidrug-resistant (MDR) Gram-negative bacteria. METHODS: One hundred and six clinical isolates were collected from a stock of Gram-negative isolates and were identified and tested for antibiotic susceptibility and presence of OXA genes using polymerase chain reaction (PCR). RESULTS: The most common detected isolate was Klebsiella pneumoniae (36.8%), followed by Escherichia coli (33%), Pseudomonas aeruginosa (16%), and Acinetobacter baumannii (14.2%). Out of these isolates, 97.4%, 87.2%, 84.6%, and 79.5% were resistant to ampicillin/sulbactam, cefotaxime, ceftazidime, and aztreonam, respectively. PCR results confirmed the presence of one or more OXA genes in 34% of the samples studied. The blaOXA-1 and blaOXA-10 genes were the most highly detected genes, followed by blaOXA-4 and blaOXA-51. The total number of Pseudomonas aeruginosa isolates was confirmed to carry at least one OXA gene (70.6%), whereas Acinetobacter baumannii, Klebsiella pneumoniae, and Escherichia coli were confirmed to carry at least one OXA gene (53.3, 28.2, and 22.9%, respectively). There was a significant association (p < 0.05) between the resistance genes and the type of isolate. CONCLUSIONS: Pseudomonas aeruginosa and Acinetobacter baumannii are the most common MDR Gram-negative strains carrying OXA-type beta-lactamase genes. Monitoring of MDR pathogens in Gram-negative bacteria must be continuously undertaken to implement effective measures for infection control and prevention.202540066541
2203170.9997What about Urinary Tract Infections and its Antibiotic Resistance Bacteria in Ilam, Iran? BACKGROUND: Because of the unknown situation of antibiotic resistance pattern in the main hospital in Ilam, Iran, we aimed to evaluate the antibiotic resistance pattern of uropathogenic bacteria obtained from referred patients to Imam Khomaini Hospital, Ilam, Iran. So, 114 bacteria were collected during 9-month period and evaluated for their antibiotic resistance patterns. RESULTS: Our results demonstrated that Escherichia coli as the dominant responsible for urinary tract infection. Our results demonstrated that 61.4 % (n = 70) of isolates were positive for E.coli, while lowest prevalence was observed for Staphylococcus aureus and Acinetobacter baumannii. The results also showed that 6.4% (n = 7) were metallo beta lactamase (MBL) producers. Our findings showed only 4 gram positive bacteria were obtained from patients with urinary tract infections including one methicillin resistant S. aureus (MRSA) and 2 vancomycin resistant Enterococcus faecalis (VRE). CONCLUSION: In conclusion, we strongly recommended to perform a perfect study among all hospitals in Iran to evaluate the situation of antibiotic resistance and make a real panel to control this issue.201829932037
2357180.9997Prevalence of Methicillin and β-Lactamase Resistant Pathogens Associated with Oral and Periodontal Disease of Children in Mymensingh, Bangladesh. Oral and periodontal diseases (OPD) is considered one of the main problems of dentistry worldwide. This study aimed to estimate the prevalence of oral and periodontal pathogenic bacteria along with their antimicrobial resistance pattern in 131 children patients aged between 4-10 years who attended in Mymensingh Medical College Hospital during October 2019 to March 2020. OPD pathogens were identified through isolation, cultural and biochemical properties, and nucleic acid detection. The isolates were subjected to antimicrobial susceptibility to 12 antibiotics commonly used in dentistry. In addition, the isolates were analyzed molecularly for the presence of six virulence and three antibacterial resistance genes. Five pathogens were identified, of which Staphylococcus aureus (S. aureus) (49%) and S. salivarius (46%) were noticed frequently; other bacteria included S. mutans (16.8%), S. sobrinus (0.8%) and L. fermentum (13.7%). The virulence genes-clumping factor A (clfA) was detected in 62.5% isolates of S. aureus, and gelatinase enzyme E (gelE) gene was detected in 5% isolates of S. salivarius, while other virulence genes were not detected. All the tested isolates were multidrug-resistant. The overall prevalence of MDR S. aureus, Streptococcus spp. and L. fermentum was 92.2%, 95.1% and 100%, respectively. It was observed that a high proportion of isolates were found resistant to 5-8 antibiotics. A majority of S. aureus, Streptococcus spp., and L. fermentum isolates tested positive for the β-lactamase resistance genes blaTEM and cfxA, as well as the methicillin resistance gene mecA. Phylogenetically, the resistance genes showed variable genetic character among Bangladeshi bacterial pathogens. In conclusion, S. aureus and S. salivarius were major OPD pathogens in patients attended in Mymensingh Medical College Hospital of Bangladesh, and most were Beta-lactam and methicillin resistant.202236015011
2156190.9997Antimicrobial resistance in urinary pathogens and culture-independent detection of trimethoprim resistance in urine from patients with urinary tract infection. BACKGROUND: Although urinary tract infections (UTIs) are extremely common, isolation of causative uropathogens is not always routinely performed, with antibiotics frequently prescribed empirically. This study determined the susceptibility of urinary isolates from two Health and Social Care Trusts (HSCTs) in Northern Ireland to a range of antibiotics commonly used in the treatment of UTIs. Furthermore, we determined if detection of trimethoprim resistance genes (dfrA) could be used as a potential biomarker for rapid detection of phenotypic trimethoprim resistance in urinary pathogens and from urine without culture. METHODS: Susceptibility of E. coli and Klebsiella spp. isolates (n = 124) to trimethoprim, amoxicillin, ceftazidime, ciprofloxacin, co-amoxiclav and nitrofurantoin in addition to susceptibility of Proteus mirabilis (n = 61) and Staphylococcus saprophyticus (n = 17) to trimethoprim was determined by ETEST® and interpreted according to EUCAST breakpoints. PCR was used to detect dfrA genes in bacterial isolates (n = 202) and urine samples(n = 94). RESULTS: Resistance to trimethoprim was observed in 37/124 (29.8%) E. coli and Klebsiella spp. isolates with an MIC(90) > 32 mg/L. DfrA genes were detected in 29/37 (78.4%) trimethoprim-resistant isolates. Detection of dfrA was highly sensitive (93.6%) and specific (91.4%) in predicting phenotypic trimethoprim resistance among E. coli and Klebsiella spp. isolates. The dfrA genes analysed were detected using a culture-independent PCR method in 16/94 (17%) urine samples. Phenotypic trimethoprim resistance was apparent in isolates cultured from 15/16 (94%) dfrA-positive urine samples. There was a significant association (P < 0.0001) between the presence of dfrA and trimethoprim resistance in urine samples containing Gram-negative bacteria (Sensitivity = 75%; Specificity = 96.9%; PPV = 93.8%; NPV = 86.1%). CONCLUSIONS: This study demonstrates that molecular detection of dfrA genes is a good indicator of trimethoprim resistance without the need for culture and susceptibility testing.202235610571