High Frequency Of Resistance Research Articles

Resistance to different generations of quinolones in Streptococcus pneumoniae strains isolated from hospitals in Shiraz

Streptococcus pneumoniae is a leading cause of respiratory tract infections, including pneumonia. In recent years, due to the incidence of resistance to commonly used antibiotics, quinolones have been taken into consideration in treatment of S. pneumoniae. The present study aimed to investigate the quinolone resistance rate among pneumococcus isolates from Shiraz. This cross-sectional-descriptive study was performed on 45 strains of S. pneumoniae isolated from clinical samples. Initially, using biochemical tests and PCR technique with specific primers of lytA gene, S. pneumoniae strains were identified. Subsequently, antibiotic resistance to quinolones was evaluated by CLSI criteria. Among 45 strains isolated from clinical specimen, resistance to nalidixic acid, ciprofloxacin, ofloxacin, norfloxacin and levofloxacin were estimated 88.22, 73.43, 53.33, 48.88 and 42.22 %, respectively. The highest frequency of resistance corresponded to the people with pneumonia. Besides, the greatest resistance to all antibiotics related to the age group of 31–40. Statistical analysis indicated no significant association between antibiotic resistance and disease type or age groups. In concurrence with other investigations, our results showed that the level of resistance to quinolones is increasing in Shiraz. Hence, the quinolone resistance in this region is a serious issue; therefore, the regional pattern of antimicrobial resistance on therapeutic regimes must be taken into consideration.

The gull (Chroicocephalus brunnicephalus) as an environmental bioindicator and reservoir for antibiotic resistance on the coastlines of the Bay of Bengal.

The presence and frequency of multiresistant bacteria in wild birds act as indicators of the environmental contamination of antibiotic resistance. To explore the rate of contamination mediated by Escherichia coli, 150 fecal samples from the brown-headed gull (Chroicocephalus brunnicephalus) and 8 water samples from the Bay of Bengal area were collected, cultured, and tested for antibiotic susceptibility. Special attention was paid to extended-spectrum beta-lactamase (ESBL)-producing isolates, which were further characterized genetically. Antibiotic resistance was found in 42.3% (36/85) of the E. coli isolates and multidrug resistance in 11.8%. Isolates from the area with a higher human activity were more resistant than those from an area with a lower level of activity. Most frequent was resistance to ampicillin (29.4%), followed by trimethoprim-sulfamethoxazole (24.7%) and quinolones (22.4%). Carriage of ESBL-producing E. coli was relatively high (17.3%) in the gulls, whereas no ESBL producers were found in the water. All ESBL-producing E. coli isolates, but one, carried bla(CTX-M-15) or bla(CTX-M-15)-like genes. A bla(CTX-M-14)-like enzyme was found as an exception. Gulls from two different colonies shared E. coli clones and harbored the clinically relevant sequence types ST10, ST48, and ST131. The high frequency of antibiotic resistance and ESBL production among E. coli isolates from gulls indicates that the environmental contamination of antibiotic resistance has already gone far on the coastlines of the Bay of Bengal. Considering the limited control over the antibiotic consumption and waste from human activities in Bangladesh, there is no easy solution in sight.

Investigation of antimicrobial resistance in Escherichia coli and enterococci isolated from Tibetan pigs.

ObjectivesThis study investigated the antimicrobial resistance of Escherichia coli and enterococci isolated from free-ranging Tibetan pigs in Tibet, China, and analyzed the influence of free-ranging husbandry on antimicrobial resistance.MethodsA total of 232 fecal samples were collected from Tibetan pigs, and the disk diffusion method was used to examine their antimicrobial resistance. Broth microdilution and agar dilution methods were used to determine minimum inhibitory concentrations for antimicrobial agents for which disks were not commercially available.ResultsA total of 129 E. coli isolates and 84 Enterococcus isolates were recovered from the fecal samples. All E. coli isolates were susceptible to amoxicillin/clavulanic acid, and 40.4% were resistant to tetracycline. A small number of isolates were resistant to florfenicol (27.9%), ampicillin (27.9%), sulfamethoxazole/trimethoprim (19.4%), nalidixic acid (19.4%), streptomycin (16.2%) and ceftiofur (10.9%), and very low resistance rates to ciprofloxacin (7.8%), gentamicin (6.9%), and spectinomycin (2.3%) were observed in E. coli. All Enterococcus isolates, including E. faecium, E. faecalis, E. hirae, and E. mundtii, were susceptible to amoxicillin/clavulanic acid and vancomycin, but showed high frequencies of resistance to oxacillin (92.8%), clindamycin (82.1%), tetracycline (64.3%), and erythromycin (48.8%). Resistance rates to florfenicol (17.9%), penicillin (6.0%), ciprofloxacin (3.6%), levofloxacin (1.2%), and ampicillin (1.2%) were low. Only one high-level streptomycin resistant E. faecium isolate and one high-level gentamicin resistant E. faecium isolate were observed. Approximately 20% and 70% of E. coli and Enterococcus isolates, respectively, were defined as multidrug-resistant.ConclusionsIn this study, E. coli and Enterococcus isolated from free-ranging Tibetan pigs showed relatively lower resistance rates than those in other areas of China, where more intensive farming practices are used. These results also revealed that free-range husbandry and absence of antibiotic use could decrease the occurrence of antimicrobial resistance to some extent.

Antiretroviral drug resistance among antiretroviral-naïve and treatment experienced patients infected with HIV in Iran.

Resistance to antiretroviral therapy (ART) threatens the success of programs to reduce HIV morbidity and mortality, particularly in countries with few treatment options. In the present study, genotype and phenotype data from ART-naïve and experienced hospitalized patients infected with HIV in Tehran, Iran were used to assess the prevalence and types of transmitted (TDR) and acquired drug resistance (ADR) mutations. All 30 participants naïve to ART and 62 of 70 (88.6%) participants receiving ART had detectable viral loads. Among participants receiving ART with sequencing data available (n = 62), 36 (58.1%) had at least one drug resistance mutation; the most common mutations were K103N (21.0%), M184V (19.4%), and the thymidine analogue mutations. Seven (11.3%), 27 (43.5%), and two (3.2%) of these participants had resistance to one, two, and three drug classes, respectively. High-level resistance to efavirenz (EFV) was more common among participants on EFV-based regimens than high-level lopinavir/ritonivar (LPV/r) resistance among those on LPV/r-based regimens (55.3% vs. 6.7%, P < 0.0001). Two (6.7%) antiretroviral-naïve participants had K103N mutations. These findings document an alarmingly high frequency of multiple HIV drug class resistance in Iran, confirm the presence of TDR, and highlight the need for systematic viral load monitoring and drug resistance testing, including at diagnosis. Expanded access to new antiretroviral medications from additional drug classes is needed.

Antimicrobial susceptibility pattern of bacterial isolates from wound infection and their sensitivity to alternative topical agents at Jimma University Specialized Hospital, South-West Ethiopia.

BackgroundWound infection is one of the health problems that are caused and aggravated by the invasion of pathogenic organisms. Information on local pathogens and sensitivity to antimicrobial agents, and topical agents like acetic acid is crucial for successful treatment of wounds.ObjectivesTo determine antimicrobial susceptibility pattern of bacterial isolates from wound infection and their sensitivity to alternative topical agents at Jimma University Specialized Hospital.MethodsA cross sectional study was conducted among patients with wound infection visiting Jimma University Specialized Hospital, from May to September 2013. Wound swab was collected using sterile cotton swabs and processed for bacterial isolation and susceptibility testing to antimicrobial agents, acetic acid, hydrogen peroxide and dabkin solution following standard bacteriological techniques. Biochemical tests were done to identify the species of the organisms. Sensitivity testing was done using Kirby- Baur disk diffusion method. Minimum inhibitory and bactericidal concentration was done using tube dilution method.ResultsIn this study 145 bacterial isolates were recovered from 150 specimens showing an isolation rate of 87.3%. The predominant bacteria isolated from the infected wounds were Staphylococcus aureus 47 (32.4%) followed by Escherichia coli 29 (20%), Proteus species 23 (16%), Coagulase negative Staphylococci 21 (14.5%), Klebsiella pneumoniae 14 (10%) and Pseudomonas aeruginosa 11 (8%). All isolates showed high frequency of resistance to ampicillin, penicillin, cephalothin and tetracycline. The overall multiple drug resistance patterns were found to be 85%. Acetic acid (0.5%), Dabkin solution (1%) and 3% hydrogen peroxide were bactericidal to all isolated bacteria and lethal effect observed when applied for 10 minutes.ConclusionsOn in vitro sensitivity testing, ampicillin, penicillin, cephalothin and tetracycline were the least effective. Gentamicin, norfloxacin, ciprofloxacin, vancomycin and amikacin were the most effective antibiotics. Acetic acid (0.5%), dabkin solution (1%) and H2O2 (3%) were bactericidal to all isolates.

The identification, typing, and antimicrobial susceptibility of Pseudomonas aeruginosa isolated from mink with hemorrhagic pneumonia

The biological characteristics and molecular epidemiology of Pseudomonas aeruginosa associated with mink hemorrhagic pneumonia from Shandong province of eastern China were determined in this study. From 2010 to 2011, 30 mink P. aeruginosa isolates were identified from lung, fecal and feed samples of clinical cases and subjected to serotyping, antimicrobial susceptibility testing and pulsed-field gel electrophoresis (PFGE) using SpeI. The P. aeruginosa isolates belonged to four serotypes—21 of type G, four of type I, three of type M, one of type B, and one non-typable strain. The strains were divided into four large groups as determined by PFGE. Isolates from the group 2 were highly homologous and were obtained from the same region as an epidemic. All of the isolates were sensitive to piperacillin, piperacillin/tazobactam, ceftazidime, cefepime, imipenem, amikacin, gentamicin and tobramycin and resistant to ampicillin, cefuroxime and cefuroxime axetil. A high frequency of resistance was found to ampicillin/sulbactam, cefazolin, cefotetan, ceftriaxone, nitrofurantoin, and trimethoprim/sulfamethoxazole (96.7%). Resistance to ticarcillin/clavulanic acid, ciprofloxacin and levofloxacin was less common (13.3%). There was no relationship between antibiotic resistance and serotype distribution of the isolates. The epidemic serotype of P. aeruginosa from the mink hemorrhagic pneumonia in Shandong province was type G, which was a clone of commonly found in this province. These findings reveal the genetic similarities and antimicrobial susceptibility profiles of P. aeruginosa from clinical cases of mink hemorrhagic pneumonia and will facilitate the prevention and control of the disease in Shandong province of China.

The association between occurrence of plasmid-mediated quinolone resistance and ciprofloxacin resistance in Escherichia coli isolates of different origins

This study was performed to determine the prevalence of plasmid-mediated quinolone resistance (PMQR) determinants and characterize the ciprofloxacin resistance in Escherichia coli isolated from different sources in China. PMQR determinants were detected by PCR amplification and sequencing in 2297 E. coli isolates randomly collected from animals, food and humans during 2004 to 2011. MICs of ciprofloxacin were determined by agar dilution method. Of the 2297 E. coli isolates, 43.6% harbored at least one PMQR gene. The most common PMQR gene was oqxAB (29.3%), followed by qnr (13.6%), aac(6′)-Ib-cr (11.6%), and qepA (3.3%). 12.0% isolates carried two or more PMQR genes. The prevalence of PMQR genes in food animal isolates increased over time, from 38.7% in 2004 to 69.8% in 2011. The prevalence of PMQR/ciprofloxacin resistance among isolates from pig, chicken, duck, companion animals, animal food and human volunteers were 65.2%/69.6%, 42.4%/60.0%, 59.4%/65.0%, 28.6%/57.5%, 29.3%/25.6%, and 14.0/8.7%, respectively. Most isolates carrying qnr along showed susceptible to ciprofloxacin, and only 21.6% the isolates exhibited resistance to ciprofloxacin, which was significantly lower than those carrying other PMQR genes (65.2–89.9%) and those that do not (43.1%) (p<0.01). In conclusion, high frequency of ciprofloxacin resistance and PMQR genes was observed among E. coli isolates of different origins in China, with oqxAB being the most frequent. qnr-positive E. coli isolates have relatively low ciprofloxacin resistance rate compared with other PMQR determinants-carrying isolates and PMQR-negative isolates.

Identification of a novel plasmid-associated spectinomycin adenyltransferase gene spd in methicillin-resistant Staphylococcus aureus ST398 isolated from animal and human sources

Previously described methicillin-resistant Staphylococcus aureus (MRSA) ST398 strains revealed a high frequency of phenotypic resistance to spectinomycin. However, only a few were found to carry the spc resistance determinant. The aim of this study was to identify the genetic mechanism of spectinomycin resistance among spc-negative MRSA ST398 strains. Nine spectinomycin-resistant, but spc-negative, MRSA ST398 strains were analysed. The strains were screened for carriage of the spw gene and tested for the presence of transferrable spectinomycin resistance. Plasmid DNA was isolated from all strains and used in transformation assays. The plasmid identified as mediating resistance to spectinomycin was fully sequenced. The function of the novel spectinomycin resistance gene was confirmed by restriction digest inactivation and its distribution was determined using a PCR assay. A single MRSA ST398 strain was spw positive. The remaining strains carried a plasmid that mediated resistance to spectinomycin. Sequence analysis of a single plasmid, termed pDJ91S, revealed that it was 3928 bp in size and contained three open reading frames: a novel spectinomycin resistance gene, designated spd, as well as a repN gene and a rec gene. The XmnI digest inactivation of the spd gene resulted in a 4-fold decrease in spectinomycin MIC. The spd gene was detected in seven other spectinomycin-resistant MRSA ST398 strains that carried a plasmid comparable in size to pDJ91S. A novel gene, designated spd, that confers resistance to spectinomycin has been identified on a small plasmid in MRSA ST398.

Frequency of resistance to methicillin and other antimicrobial agents among Staphylococcus aureus strains isolated from pigs and their human handlers in Trinidad

BackgroundMethicillin-resistant Staphylococcus aureus (MRSA) has emerged recently worldwide in production animals, particularly pigs and veal calves, which act as reservoirs for MRSA strains for human infection. The study determined the prevalence of MRSA and other resistant strains of S. aureus isolated from the anterior nares of pigs and human handlers on pig farms in Trinidad.MethodsIsolation of S. aureus was done by concurrently inoculating Baird-Parker agar (BPA) and Chromagar MRSA (CHROM) with swab samples and isolates were identified using standard methods. Suspect MRSA isolates from Chromagar and BPA were subjected to confirmatory test using Oxoid PBP2 latex agglutination test. The disc diffusion method was used to determine resistance to antimicrobial agents.ResultsThe frequency of isolation of MRSA was 2.1% (15 of 723) for pigs but 0.0% (0 of 72) for humans. Generally, for isolates of S. aureus from humans there was a high frequency of resistance compared with those from pigs, which had moderate resistance to the following antimicrobials: penicillin G (54.5%, 51.5%), ampicillin (59.1%, 49.5%), and streptomycin (59.1%, 37.1%), respectively. There was moderate resistance to tetracycline (36.4%, 41.2%) and gentamycin (27.2%, 23.7%) for human and pig S. aureus isolates, respectively, and low resistance to sulfamethoxazole-trimethoprim (4.5%, 6.2%) and norfloxacin (9.1%, 12.4%), respectively. The frequency of resistance to oxacillin by the disc method was 36.4 and 34.0% from S. aureus isolates from humans and pigs, respectively. Out of a total of 78 isolates of S. aureus from both human and pig sources that were resistant to oxacillin by the disc diffusion method, only 15 (19.2%) were confirmed as MRSA by the PBP'2 latex test kit.ConclusionsThe detection of MRSA strains in pigs, albeit at a low frequency, coupled with a high frequency of resistance to commonly used antimicrobial agents in pig and humans could have zoonotic and therapeutic implications. Finally, the diagnostic limitation of using CHROMagar and testing for oxacillin resistance by the disc diffusion method alone to determine MRSA strains without performing confirmatory tests cannot be overemphasized because the possibility of overdiagnosis of MRSA infections cannot be ignored.

The role of microRNAs in the regulation of apoptosis in lung cancer and its application in cancer treatment.

Lung cancer remains to be one of the most common and serious types of cancer worldwide. While treatment is available, the survival rate of this cancer is still critically low due to late stage diagnosis and high frequency of drug resistance, thus highlighting the pressing need for a greater understanding of the molecular mechanisms involved in lung carcinogenesis. Studies in the past years have evidenced that microRNAs (miRNAs) are critical players in the regulation of various biological functions, including apoptosis, which is a process frequently evaded in cancer progression. Recently, miRNAs were demonstrated to possess proapoptotic or antiapoptotic abilities through the targeting of oncogenes or tumor suppressor genes. This review examines the involvement of miRNAs in the apoptotic process of lung cancer and will also touch on the promising evidence supporting the role of miRNAs in regulating sensitivity to anticancer treatment.

Frequency of bacterial isolates and pattern of antimicrobial resistance in patients with hematological malignancies: A snapshot from tertiary cancer center.

Infections are the most important cause of mortality in patients with high-risk febrile neutropenia. Emergence of multi-drug resistant organisms (MDROs) has become a major challenge for hemato-oncologists. Knowledge of the prevalent organisms and their antimicrobial sensitivity can help deciding the empirical therapy at individual centers and allows timely measures to reduce the risk of antimicrobial resistance. To evaluate the frequency of bacterial isolates from all the samples and the pattern of bacterial bloodstream infections and incidence of MDROs. This is a retrospective analysis from a tertiary care cancer center. From January to June 2014 information on all the samples received in Department of Microbiology was collected retrospectively. The data from samples collected from patients with hematological cancers were analyzed for types of bacterial isolates and antimicrobial sensitivity. A total of 739 isolates were identified with 67.9% of isolates being Gram-negative. The predominant Gram-negative organisms were Escherichia coli, Psuedomonas spp. and Klebsiella spp. Among the bacterial bloodstream infections, 66% were Gram-negative isolates. MDROs constituted 22% of all isolates in blood cultures. Incidence of resistant Gram-positive organisms was low in the present dataset (methicillin resistant Staphylococcus aureus and vancomycin-resistant enterococci-1.3%). The analysis reconfirms the Gram-negative organisms as the predominant pathogens in bacteremia seen in patients with hematological cancers. The high frequency of multi-drug resistance in the dataset calls for the need of emergency measures to curtail further development and propagation of resistant organisms.

Abstract A35: Evaluation of MEK inhibitor chemosensitivity in human tumor explants using the Mosaic Blue Assay and relationship to biomarkers by immunohistochemistry.

Abstract The MEK pathway is activated in most cancers. Several chemotherapeutic agents target this pathway through inhibition of MEK, ERK or upstream receptor tyrosine kinases and are in clinical trials to treat patients with solid tumors. The use of chemosensitivity testing using human cancer explants is very useful in identifying biomarkers that relate to the intrinsic sensitivity of the tumor to a chemotherapeutic agent. The Mosaic Blue assay is a soft agar, ex vivo tumor response assay that utilizes non-expanded patient cancer cells. Viable colorectal and non-small cell lung cancer tissues with matched formalin-fixed, paraffin embedded (FFPE) tissue were used for this study. Fresh tissues were disaggregated into single cells and exposed to various inhibitors of the MEK pathway, specifically AZD6244 and GSK1120212. Samples were classified as resistant or sensitive. The inhibitors demonstrated different resistance and sensitivity profiles in the human tumors and samples demonstrated a higher frequency of resistance to AZD6244 than to GSK1120212 at similar concentrations. The corresponding FFPE tissue block was stained by immunohistochemistry for phosphorylated AKT, PRAS40, 4EBP1, S6 kinase, S6 ribosomal protein as well as PTEN, EGFR, cMET, HER3, and Ki-67 in accordance with validated protocols. In addition to analysis of primary cancer samples, the MDA-MB-468, MKN45, and T47D cell lines were also treated with AZD6244 and GSK1120212, harvested, and phosphorylated proteins were evaluated in the pre and post-dose tumor cells. Immunohistochemistry results were compared to chemosensitivity results and 2 relationships were identified. First, biomarker status of the archival tissue was evaluated in order to understand the intrinsic chemosensitivity. Resistant tissues demonstrated higher expression of EGFR, cMET, and HER3 and lower expression of phosphorylated S6 ribosomal protein (S240/244 and S235/236) and phosphorylated PRAS40 compared to sensitive tissues. Second, biomarker status upon treatment in cell lines was evaluated to understand modulation of proteins due to therapy. In summary, use of soft agar ex vivo tumor response assays such as the Mosaic Blue assay is a useful tool to predict relative sensitivity across tumor types and allow investigation of potential biomarkers. Citation Information: Mol Cancer Ther 2013;12(11 Suppl):A35. Citation Format: Lisa M. Dauffenbach, Patricia A. Cash, Gela C. Sia, Sherif K. Girees, Ryan S. Lim, Jianping Zheng, Eric P. Olsen, Christopher A. Kerfoot. Evaluation of MEK inhibitor chemosensitivity in human tumor explants using the Mosaic Blue Assay and relationship to biomarkers by immunohistochemistry. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2013 Oct 19-23; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2013;12(11 Suppl):Abstract nr A35.

Clinically relevant multidrug resistant Salmonella enterica in swine and meat handlers at the abattoir

The presence of multidrug resistant (MDR) Salmonella serotypes in slaughtered swine, carcasses, meat and meat handlers is scarcely evaluated. Recently we demonstrated that diverse Salmonella serotypes are frequently present in swine, pork meat and carcasses, and meat handlers at Portuguese abattoirs. Here we have characterized their antibiotic resistance phenotypes and genotypes, helping elucidate the flow of MDR Salmonella in the food chain. Testing 60 Salmonella isolates from different serotypes, the highest frequencies of resistance were observed for tetracycline (T) [70% (n=42/60), tet(A)/tet(B)/tet(G)], streptomycin (S) [63% (n=38/60), aadA2/strA/strB], sulfamethoxazole (Sul) [62% (n=37/60), sul1/sul2/sul3] and ampicillin (A) [57% (n=34/60), blaPSE-1/blaTEM]. Thirty-seven percent (n=22/60) carried class 1 integrons and multidrug resistance was frequently observed (63% n=38/60), including those serotypes common to human infections [S. Typhimurium 78% n=25/32; S. 4,[5],12:i:- 67% n=2/3; S. Rissen 75% (n=3/4); S. London 67% n=2/3; S. Derby 55%; n=6/11)]. The emergent S. 4,[5],12:i:- isolates were mostly characterized by ASSuT phenotype [blaTEM/strA-strB/sul2/tet(B)], typical of the European clone, while for the first time the ST phenotype [strA-strB-tet(A)-tet(B)] was also observed. Moreover, we report a first finding of a MDR phenotype in S. London [ANSSuT; blaTEM-strA-strB-sul2-tet(A)]. Our findings suggest that the abattoir environment and the slaughter operations seem not only to harbor MDR serotypes that originated in the pig reservoir, but also propagate them through cross-contamination processes, involving meat handlers. The present study suggests a probable relationship between swine and human salmonellosis throughout the food chain, which is of interest for epidemiological, animal health and public health purposes.

Vigilancia de infecciones asociadas a la atención en salud, resistencia bacteriana y consumo de antibióticos en hospitales de alta complejidad, Colombia, 2011

Introduction: Preventing healthcare associated infections, especially for resistant microorganisms, is a priority. In Colombia, the surveillance of such events was started through a national pilot study.Objective: To describe the epidemiology of device-associated infections, bacterial resistance and antibiotic consumption patterns in institutions with intensive care units (ICU), 2011.Materials and methods: Descriptive observational study in 10 health institutions from three Colombian provinces: Antioquia, Valle del Cauca, and Bogotá. Surveillance protocols were designed and implemented by trained health professionals in each hospital. A web tool was designed for data reporting and analysis. Infection rates, device-use percentages and antibiotics defined daily dose (DDD) were calculated. Bacterial resistance phenotypes and profiles were reported and analyzed using Whonet 5.6.Results: The most common event was bloodstream infection (rate &gt; 4.8/1000 catheter-days) followed by ventilator-associated pneumonia (VAP) and catheter-related urinary tract infection, showing a wide variability among institutions. A high consumption of meropenem in the ICU (DDD 22.5/100 beds-day) was observed, as well as a high carbapenem resistance (&gt; 11.6%) and a high frequency of third generation cephalosporins resistance (&gt; 25.6%) in Enterobacteriaceae in ICUs and hospitalization wards. The percentage of methicillin-resistant Staphylococcus aureus was higher in hospitalization wards (34.3%).Conclusions: This is the first experience in measuring these events in Colombia. It is necessary to implement a national surveillance system aimed at guiding governmental and institutional actions oriented to infection prevention and control, to resistance management and to the promotion of antibiotics rational use, along with a follow-up and monitoring process.

Surveillance of healthcare associated infections, bacterial resistance and antibiotic consumption in high-complexity hospitals in Colombia, 2011

Preventing healthcare associated infections, especially for resistant microorganisms, is a priority. In Colombia, the surveillance of such events was started through a national pilot study. To describe the epidemiology of device-associated infections, bacterial resistance and antibiotic consumption patterns in institutions with intensive care units (ICU), 2011. Descriptive observational study in 10 health institutions from three Colombian provinces: Antioquia, Valle del Cauca, and Bogotá. Surveillance protocols were designed and implemented by trained health professionals in each hospital. A web tool was designed for data reporting and analysis. Infection rates, device-use percentages and antibiotics defined daily dose (DDD) were calculated. Bacterial resistance phenotypes and profiles were reported and analyzed using Whonet 5.6. The most common event was bloodstream infection (rate > 4.8/1000 catheter-days) followed by ventilator-associated pneumonia (VAP) and catheter-related urinary tract infection, showing a wide variability among institutions. A high consumption of meropenem in the ICU (DDD 22.5/100 beds-day) was observed, as well as a high carbapenem resistance (> 11.6%) and a high frequency of third generation cephalosporins resistance (> 25.6%) in Enterobacteriaceae in ICUs and hospitalization wards. The percentage of methicillin-resistant Staphylococcus aureus was higher in hospitalization wards (34.3%). This is the first experience in measuring these events in Colombia. It is necessary to implement a national surveillance system aimed at guiding governmental and institutional actions oriented to infection prevention and control, to resistance management and to the promotion of antibiotics rational use, along with a follow-up and monitoring process.

Multiple Resistance to Herbicides from Four Site-of-Action Groups in Waterhemp (Amaranthus tuberculatus)

In 2006 and 2007, farmers from two counties in Illinois reported failure to control waterhemp with glyphosate. Subsequent onsite field experiments revealed that the populations might be resistant to multiple herbicides. Greenhouse experiments therefore were conducted to confirm glyphosate resistance, and to test for multiple resistance to other herbicides, including atrazine, acifluorfen, lactofen, and imazamox. In glyphosate dose-response experiments, both populations responded similarly to a previously characterized glyphosate-resistant population (MO1). Both Illinois populations also demonstrated high frequencies of resistance to the acetolactate synthase (ALS) inhibitor, imazamox. Additionally, one of the populations demonstrated high frequencies of resistance to both atrazine and the protoporphyrinogen oxidase (PPO) inhibitor, lactofen. Furthermore, using combinations of sequential and tank-mix herbicide applications, individual plants resistant to herbicides spanning all four site-of-action groups were identified from one population. Molecular experiments were performed to provide an initial characterization of the resistance mechanisms and to provide confirmation of the presence of multiple resistance traits within the two populations. Both populations contained the W574L ALS mutation and the ΔG210 PPO mutation, previously shown to confer resistance to ALS and PPO inhibitors, respectively. Atrazine resistance in both populations is suspected to be metabolism-based, because a triazine target-site mutation was not identified. A P106S EPSPS mutation, previously reported to confer glyphosate resistance, was identified in one population. This mutation was identified in both resistant and sensitive plants from the population; however, and so more research is needed to determine the glyphosate-resistance mechanism(s). This is the first known case of a weed population in the United States possessing multiple resistance to herbicides from four site-of-action groups.

Antimicrobial susceptibility of Salmonella strains isolated from retail meat products in Poland between 2008 and 2012

A total of 106 Salmonella strains were isolated in the years 2008–2012 from retail meat products sampled in Poland. Strains from poultry meat (n = 81), pork (n = 7), beef (n = 3) and mixed meat (n = 15) were serotyped and subjected to antimicrobial susceptibility testing by the disk diffusion method (19 antibiotics). Twenty-one Salmonella serotypes were identified, with the three most common being Salmonella Enteritidis (34.9%), Salmonella Infantis (14.2%) and Salmonella Typhimurium (10.4%).The majority of the Salmonella strains (68.9%; n = 73) were resistant to one or more antimicrobial compound. Among the resistant isolates, 31 were resistant to one antibiotic, 4 to two, 10 to three, 13 to four, and 15 to five or more antibiotics.Of the Salmonella Enteritidis isolates, 54% were resistant to at least one antibiotic, while much higher frequencies of resistance were found in Salmonella Newport (100%), Salmonella Typhimurium (91%), Salmonella Hadar (85.7%), Salmonella Virchow (80%) and Salmonella Infantis (80%).The most common resistance observed among the Salmonella isolates was to nalidixic acid (52.8%). The isolates were also frequently resistant to tetracycline (32.1%), ampicillin (28.3%), streptomycin (28.3%) and sulphonamides (26.4%). All of the tested strains were susceptible to cefepime, cefotaxime, ceftazidime, ceftriaxone, ciprofloxacin, ertapenem and imipenem.Salmonella strains isolated from poultry meat showed the widest spectrum of resistance (to 12 of the 19 tested antimicrobials) compared with isolates from the other meat sources.The level of resistance among Salmonella strains isolated between 2008 and 2012 was consistently high: 59.1% in 2010, 84.6% in 2011 and 64.7% in 2012. In addition, there was an increase in the number of multiresistant strains over this period, from 23.1% in 2010 to 81.8% in 2012. The demonstration that meat products are a source of antibiotic resistant Salmonella strains is a serious concern for public health and food safety.

Amblyomma cajennense (Acari: Ixodidae) tick populations susceptible or resistant to acaricides in the Mexican Tropics

The objectives of the present study were: (i) to identify the frequency of cattle farms with a cohabitation of Amblyomma cajennense and Rhipicephalus microplus, (ii) to determine the status of susceptibility or resistance to acaricides used in Veracruz, Mexico, on A. cajennense populations and (iii) to identify factors associated with A. cajennense resistant to acaricides. Fifty farms were visited to determine the presence of ticks (A. cajennense and R. microplus) and to collect engorged A. cajennense individuals. From these, 24 A. cajennense populations were evaluated in resistance bioassays using discriminating doses of acaricides. The acaricides tested were organophosphates (chlorpiriphos, coumaphos and diazinon), pyrethroids (flumethrin, deltamethrin and cypermethrin), amidines (amitraz) and fipronil (a broad spectrum N-phenylpyrazole insecticide). A. cajennense infesting bovines were identified in 86% (43/50) of the farms visited, and 100% of the farms sampled (43/43) had cohabitation between R. microplus and A. cajennense. Of the farm owners or managers surveyed, 87.5% could not distinguish the morphological difference between tick genera. Populations of A. cajennense were 100%, 91.7% and 12.5% resistant to diazinon, coumaphos and chlorpyriphos (organophosphates), respectively, and 12.5% to amitraz, as were those susceptible to flumethrin and fipronil. In conclusions, populations of A. cajennense showed a high frequency of resistance to the organophosphates tested and to amitraz. Factors associated with the resistance to acaricides in A. cajennense were not identified.

Heavy metal and associated antibiotic resistance of fecal coliforms, fecal streptococci and pathogens isolated from wastewaters of abattoirs in Nairobi, Kenya

Objective: The pollution of the environment with toxic heavy metals is increasing globally with industrial progress. Microorganisms can be good bio-accumulators of particulate and soluble forms of heavy metals and subsequently resist antibiotics. The present study aimed at assessing the resistance pattern to multiple heavy metals by wastewater bacteria and associated antibiotic resistance. Methodology and results: Standard microbiological methods were used to isolate fecal streptococci, fecal coliforms, Vibrio and Salmonella species from raw animal wastewaters and sludge samples obtained from three abattoirs around Nairobi city. A total of 30 samples were collected. Agar diffusion and tube dilution methods were used to assess the heavy metal resistance while sensitivity to antibiotics was determined by the agar diffusion method. From the 40 isolates obtained, 27 showed multiple resistance to heavy metals. Resistance pattern was as follows; Hg 9 (33.3%), Co 11 (40.7%), Cu 18 (66.7%), Zn 19 (70.4%), Pb 21 (77.8%), and Ni 24 (88.9%). Out of the 27 resistant strains, 5 (18.5%) showed resistance to 5 different metal ions and only 1 (3.7%) showed resistance to two different metal ions. With each of the six metals tested, there was a tendency towards a high frequency of resistance among the isolates to lincomycin (77.8%), tetracycline (70.4%) and ampicillin (66.7%). Conclusion and application of findings: In the present study, heavy metal resistance associated with multiple drug resistance was detected in the bacterial isolates from the wastewater and sludge of the cattle, sheep and goat abattoirs. The high degree of resistance to common antibiotics could be attributed to the contamination of the wastewaters and sludge with heavy metals possibly from animal feeds or drinking waters, leading to co-selection of both metal tolerant and antibiotic resistant microbial species. This requires intervention measures to curb the potential health hazard that heavy metal pollution pose in the environment. The identified heavy metal resistant bacteria could be useful for bioremediation of heavy metals contaminated sewage and wastewaters, but the coupled antibiotic resistance is a worrying phenomenon. Keywords: Heavy metal resistant bacteria, antibiotic resistance, wastewaters, sludge, animals

Chlorfenapyr resistance in the spider mite Tetranychus urticae: stability, cross-resistance and monitoring of resistance

The two-spotted spider mite, Tetranychus urticae Koch, is a key pest of many agricultural crops. Studies of stability of resistance, cross-resistance relationships and monitoring of chlorfenapyr resistance were carried out with T. urticae to provide basic information necessary to define effective acaricide resistance management strategies for this pest. Chlorfenapyr resistance was shown to be stable in the absence of selection pressure under laboratory conditions. The activities of seven different acaricides against chlorfenapyr-resistant and -susceptible strains of T. urticae were evaluated. The results indicated possible positive cross-resistance between chlorfenapyr and the acaricides abamectin, propargite and etoxazole. No cross-resistance was detected for the acaricides milbemectin, fenpyroximate and diafenthiuron. A possible negatively correlated cross-resistance was observed between chlorfenapyr and spiromesifen. The evaluation of 21 T. urticae populations from several crops in the States of Sao Paulo, Mato Grosso, Goias, and Bahia, in Brazil, indicated that the susceptibility of mites to chlorfenapyr was variable, with percentages of resistant mites ranging from 0.0 to 86.5%. The highest resistance frequencies were observed in ornamental plants in the State of Sao Paulo. Some populations from cotton and papaya also presented high frequencies of chlorfenapyr resistance. This is the first report on chlorfenapyr resistance in T. urticae on cotton and papaya in Brazil. Strategies for the management of acaricide resistance are discussed.