Rates Of Multiple Drug Resistance Research Articles

Reduced susceptibility to carbapenems in Enterobacteriaceae and antimicrobial resistance profile of Escherichia coli strains isolated from clinical and zoonotic sources in the Bamenda Municipality, Cameroon.

food-producing animals harbour pathogenic and antibiotic resistant bacteria which can be transmitted to humans. Resistance to carbapenems may complicate treatment resulting to debilitating consequences. This study aimed at determining the susceptibility of Enterobacteriaceae to carbapenems and to compare the resistant patterns of E. coli strains isolated from clinical and zoonotic sources. this was a cross-sectional study involving patients presenting at the Bamenda Regional Hospital and abattoir samples. Clinical samples (faeces and urine) and zoonotic samples (cattle faeces) were cultured and isolates identified using API-20E. Enterobacteriaceae isolates were tested for their susceptibility to Carbapenems. The susceptibility of E. coli was tested against eight antibiotics on Mueller Hinton agar. Data was analysed using SPSS version 20. Enterobacteriaceae isolates from clinical specimen showed susceptibility of 93.3% to carbapenems. Out of 208 isolates 14 (6.7%) were Carbapenem-resistant Enterobacteriaceae (CRE) while 30 (14.4%) showed intermediate resistance and 164 (78.9%) were susceptible. The predominant CRE were Proteus (7/16, 43.8%), Providencia (3/15, 20.0%) and E. coli (4/60, 6.7%) with E. coli being the most clinically significant CRE. Multiple drug resistance (MDR) was observed in 83% of E. coli isolates, with the highest resistance being against vancomycin (90, 81.8%), azithromycin (69, 62.7%) and doxycycline (68, 61.8%). Clinical isolates were significantly (P<0.05) more resistant to azithromycin, trimethoprim-suphamethoxazole and gentamicin than zoonotic isolates. CRE were detected among isolates and a high rate of multiple drug resistance was observed among E. coli isolates. Proper antibiotic policies and good hygiene/sanitation measures may curb the development/spread of CRE and MDR E. coli.

Bacterial Species and Antimicrobial Resistance of Clinical Isolates from Pediatric Patients in Yangon, Myanmar, 2020.

Antimicrobial resistance (AMR) is a concern in medical care for children who have high burden of infectious diseases. We investigated the prevalence of bacterial species and their susceptibility to antimicrobials of 1019 clinical isolates from pediatric patients in a tertiary-care hospital in Yangon, Myanmar for one-year period (2020). The most frequently recovered species was Escherichia coli, followed by Klebsiella pneumoniae and Staphylococcus aureus, all of which accounted for 43% of clinical isolates, while 25% of isolates comprised non-fermenter, including Pseudomonas sp. and Acinetobacter sp. Phenotypically determined ESBL (extended-spectrum beta-lactamase)-positive rates in E. coli, K. pneumoniae, and Enterobacter sp. were 82%, 88%, and 65%, respectively. High rates of multiple drug resistance were noted for E. coli (84%), K. pneumoniae (81%), and Acinetobacter sp. (65%), associated with carbapenem resistance in 48%, 42%, and 59% of isolates, respectively. In contrast, S. aureus isolates exhibited low resistance rates (<30%) to most of antimicrobials, with 22% being resistant to oxacillin/cefoxitin. Fluoroquinolone resistance was found in most of bacterial species with different prevalence rates. The present study revealed the current status on prevalence of bacterial species causing infections in pediatric patients in Myanmar, highlighting the significance to monitor AMR among children.

Bacterial biofilm or biofouling networks with numerous resilience factors from real water supplies of Chennai and their enhanced susceptibility to biocompatible nanoparticles

In the present investigation, enhanced susceptibility of bacterial biofilm networks associated with water repositories of Chennai to silver and silica nanoparticles has been proposed. A total of 120 water samples were collected amid four seasons according to the standard methods and the collected samples were investigated for heterotrophic microorganisms, fecal coliforms and biofilm or biofouling. Bacterial strains segregated from the separate lake were assessed for biofilm or biofouling forming efficacy and their resilience to substantial metal, salt, various antibiotics. Dominant part of the bacterial strains confined from the respective reservoir showed biofilm development and high rate of biofilm framing adequacy was seen in Poondi Lake. E.coli (30–40%),Proteus sp (20–25%), Salmonella sp (10–20%) Pseudomonas aeruginosa (5–10%) and Lactobacillus (5%) sp were the major bacterial strains associated with biofilm of all the tested reservoirs. Bacterial strains related with biofilm of particular tried supplies demonstrated high resilience to heavy metal, salt and various antibiotics. High rate of multiple drug resistance was recorded in Poondi lake isolates (90%) followed by Porur (85%) and Chembarambakkam (81%).Vulnerability of the biofilm networks to nanoparticles like silver and silica was studied. Silver nanoparticles were orchestrated from leaf extrcat of Vitex negundo and silica from block powder separately which yield high stable, monodispersed particles.Both the nanoparticles realized viable restraint of the biofilm as concentration dependent manner. Be that as it may, noteworthy impact was recorded in silver nanoparticles treatment. Nanoparticles susceptibility testing against E.coli- Predominant member (65%) of the biofilm of all the reservior suggest that silver nanoparticles brought about distinct effect on biofilm networks which exhibited 99.0% of biofilm inhibition and improved spillage of protein, nucleic acid content.The study will give awareness about the sanitation and safety of water in the respective reservoirs and the enhanced susceptibility of the biofouling to the nanoparticles would suggest the possible utilization of nanotechnology principles as an effective green strategy in water treatment process

ХАРАКТЕРИСТИКА ПАЦИЕНТОВ СПЕЦИАЛИЗИРОВАННОГО ОТДЕЛЕНИЯ ДЛЯ ЛЕЧЕНИЯ БОЛЬНЫХ ТУБЕРКУЛЕЗОМ В СОЧЕТАНИИ С ВИЧ-ИНФЕКЦИЕЙ

The objective of the study: to analyze clinical data of patients staying in a specialized unit for tuberculosis patients with concurrent HIV infection. Subjects and methods. The case histories of all patients staying in the unit for T B / H IV c o-i nfection of Surgut Clinical TB Dispensary discharged in 2016 were retrospectively analyzed, totally there were 231 such patients. Results. Tuberculous lesions in the HIV infected patients were more disseminated (pulmonary disseminated tuberculosis was in 51.1% of patients and generalized forms with lesions in the lungs and other organs were in 17.9% of patients additionally). Cavities were diagnosed in 45.5% of pulmonary tuberculosis patients, and bacillary excretion was detected in 60.4% (among HIV negative patients, registered in the city, those rates made 38.3 and 42.3% respectively). The rate of multiple drug resistance made 9.9% in all pulmonary tuberculosis patients or 44% among the patients with drug resistance, and extensive drug resistance made 1.4 and 6.1% respectively. Along with ant i-t uberculosis chemotherapy, 45.9% of patients received antiretroviral therapy, and 10.0% of them rejected it. Only 36.7% of patients completed the intensive phase of treatment, 29.7% defaulted from treatment and left hospital at their will, 17.5% died, and the remaining patients were transferred to some other medical units (for surgery or to manage some concurrent condition) or they were discharged from the hospital due to violations of the discipline. While on treatment, 57.5% of the patients with bacillary excretion had their sputum converted (by culture).

The Bacteriological Quality, Safety, and Antibiogram of Salmonella Isolates from Fresh Meat in Retail Shops of Bahir Dar City, Ethiopia.

The habit of raw meat consumption in addition to the poor hygienic standards and lack of knowledge contribute to food-borne diseases outbreaks. The objective of this research was to assess the bacterial quality and safety of fresh meat from retail Bahir Dar City, Ethiopia. A total of 30 fresh meat samples were collected from butcher shops. Standard bacteriological methods were used to isolate and enumerate bacteria. Kirby-Bauer disk diffusion method was used for antimicrobial susceptibility testing of Salmonella isolates. The mean counts of AMB, TC, and S. aureus were log104.53, 3.97, and 3.88 log10cfu/g, respectively. Salmonella was isolated from 21 (70%) of the samples. Salmonella isolates in this study were highly susceptible to ciprofloxacin, gentamycin, and norfloxacin while they were resistant to erythromycin and tetracycline. High rate of multiple drug resistance was also noticed in Salmonella isolates. The microbial loads of meat were above the recommended microbial safety limits. Besides this, the isolation rate of Salmonella was high and high levels of drug resistance were documented for Salmonella isolates. Measures on handling and appropriate personal hygiene practices of workers in the retail shops are recommended to reduce the change of forborne disease outbreaks.

Antimicrobial Susceptibility-Guided Therapy Versus Empirical Concomitant Therapy for Eradication of Helicobacter pylori in a Region with High Rate of Clarithromycin Resistance.

Nonbismuth quadruple (concomitant) regimen is recommended for first-line empirical Helicobacter pylori (HP) eradication treatment when clarithromycin resistance is more than 15-20%. Our objective was to evaluate the efficacy and tolerability of concomitant versus antimicrobial susceptibility-guided treatment in an area with high rates of clarithromycin resistance. Three hundred consecutive HP-infected patients received antimicrobial susceptibility-guided therapy or empirical concomitant therapy for 10 days. The concomitant regimen was omeprazole (20 mg/12 hour), amoxicillin (1 g/12 hour), clarithromycin (500 mg/12 hour), and metronidazole (500 mg/12 hour) (OACM). Patients diagnosed by culture received one of three combinations of antibiotics based on susceptibility results: omeprazole, amoxicillin, and clarithromycin (OAC); omeprazole, amoxicillin, and levofloxacin (OAL); or omeprazole, amoxicillin, and metronidazole (OAM), at the aforementioned doses (and 500 mg/12 hour in the case of levofloxacin). Eradication was confirmed with a (13)C urea breath test, 6 weeks after treatment. Adverse events and adherence were assessed with questionnaires and reviewing medication sachets. The mean age was 50 years, 59% were women, and 14% had peptic ulcers. Concomitant and antimicrobial susceptibility-guided eradication rates were, respectively, 87% and 94% by intention-to-treat (p = .08) and 89% and 95% (p = .08) per protocol per-protocol analysis. Adverse effects were reported in 31% of patients on OACM and 15% of those on susceptibility-guided therapy (p < .05). For HP eradication in a region with high rates of multiple drug resistance, antimicrobial susceptibility-guided therapy is more effective than empirical concomitant therapy.

Prevalence, characterisation and antimicrobial resistance of Campylobacter and Salmonella in raw poultrymeat in the UK, 2003–2005

This study was conducted to determine the prevalence and antimicrobial resistance of Campylobacter and Salmonella isolates from retail poultrymeat in the UK during 2003–2005. Poultrymeat (n = 2104) were more frequently contaminated with Campylobacter (57.3%) than with Salmonella (6.6%). Chicken exhibited the highest contamination from Campylobacter (60.9%), followed by duck (50.7%), turkey (33.7%) and other poultrymeat (34.2%). Duck had the highest contamination from Salmonella (29.9%), compared with chicken (5.6%), turkey (5.6%), and other poultrymeat (8.6%). C. jejuni predominated in raw chicken, whereas C. coli predominated in turkey and duck. C. coli isolates were more likely to exhibit antimicrobial drug resistance, including quinolones, than C. jejuni. Salmonella Enteritidis was the most frequent Salmonella serotype isolated. Salmonella isolates from turkey exhibited higher rates of multiple drug resistance (55.6%) than isolates from chicken (20.9%) and duck (13.6%). The findings reinforce the importance of thorough cooking of poultrymeat and good hygiene to avoid cross-contamination.

Campylobacter and Salmonella in raw red meats in the United Kingdom: Prevalence, characterization and antimicrobial resistance pattern, 2003–2005

The prevalence of Campylobacter and Salmonella was assessed in 3959 raw red meats in the UK during 2003–2005. Meats were more frequently contaminated with Campylobacter (7.2%) than with Salmonella (2.4%). Lamb and other meats (e.g. mutton, rabbit) exhibited the highest contamination from Campylobacter (12.6% and 19.8%, respectively), compared with pork (6.3%) and beef (4.9%). Pork however had the highest contamination from Salmonella (3.9%), followed by lamb (2.0%), other meats (2.0%) and beef (1.3%). Offal samples (36.6%) were more frequently contaminated with Campylobacter or Salmonella than muscle tissue (7.0%). C. jejuni predominated in all meat types. C. coli isolates were more likely to exhibit antimicrobial drug resistance, including quinolones, than C. jejuni. Salmonella typhimurium was the most frequent Salmonella serotype isolated from meats; S. typhimurium DT104/104b isolates exhibited higher rates of multiple drug resistance than other serotypes. The findings reinforce the importance of adequate cooking of meat and good hygiene to avoid cross-contamination.

Antibiothérapie des pneumonies aiguës communautaires à Streptococcus pneumoniae : impact clinique de la résistance bactérienne

The emergence of Streptococcus pneumoniae strains with reduced susceptibility to β-lactams and with multiple drug resistance has not led to major changes in recommendations for antibiotic therapy in patients with acute community-acquired pneumococcal pneumonia. Numerous factors explain the limited clinical impact of this major microbiological change. The frequency of intermediate strains is high but the frequency of resistant strains to β-lactams is very low. There is a complex relation between the acquisition of resistance to β-lactams and the decreased virulence of S. pneumoniae strains. The only finding in studies of humanized experimental animal models of lethal bacteremic pneumonia caused by resistance and tolerant strains was a slowing in the kinetics of β-lactams bactericidal activity, especially for amoxicillin. Taken together, this preclinical data shows that microbiological resistance of pneumococci to β-lactams has very little influence on a possible failure of recommanded treatment regimens for pneumococcal pneumonia. The high rate of multiple drug resistance, particularly among β-lactam resistant strains, rules out the probabilistic use of macrolides. Conversely, fluoroquinolone (FQ) resistance remains low, inferior to 3%, and the same is true for ketolides (< 1%). Only a global strategy of patient management in the use of these new drugs could ensure their long-term activity. The high mortality rate of hospitalized S. pneumoniae pneumonia will only be improved with a better understanding of the complex host–bacteria interactions.

Multiple drug resistance in urinary pathogens at Gondar College of Medical Sciences Hospital, Ethiopia.

To determine multiple drug resistance and its associated factors of urinary pathogens. Cross-sectional study. Gondar College of Medical Sciences teaching and Referral Hospital, Northwest Ethiopia, between January and October 2000. Mid stream urine samples from 420 subjects were studied by quantitative culture method. Designed Questionnaires were used for data collection on the previous use of antimicrobials, catheterisation and hospitalisation. Rates of multiple drug resistance and the associated factors. Multiple drug resistance was common in the isolates tested against ten antibiotics showing more than 68% of the isolates being resistant to two or more antimicrobials. Significant variables associated with this were found to be urinary catheterisation, hospitalisation and previous use of antibiotics for urinary tract infection. The rate of multiple drug resistance was very high in this study. Probable contributing factors were found to be previous antibiotic exposure, urinary catheterisation and hospitalisation. Reduction of hospital stays and catheterisation, aseptic care of catheterised patients and selective use of antibiotics and strict follow up of hospital disease controls are recommended.

La résistance doit-elle modifier la prise en charge des pneumopathies et des bactériémies ?

The emergence and spread of S. pneumoniae strains with reduced susceptibility to beta-lactams and with multiple drug resistance have not led to major changes in recommendations for antibiotic therapy in patients with acute community-acquired pneumococcal pneumonia. Multiple factors explain the limited clinical impact of this major microbiological change : decreased susceptibility is common for penicillin (> 40 %) but less common for antipneumococcal amino-penicillins or cephalosporins ; few S. pneumoniae strains are resistant to beta-lactams ; there is a complex relation between acquisition of resistance to beta-lactams and decreased virulence of S. pneumoniae strains ; in studies of experimental animal models of lethal bacteremic pneumonia caused by strains with a high level of resistance, the only finding was a slowing in the killing kinetics of beta-lactams, particularly amoxicillin. Because the behavior of amoxicillin is both time-dependent and concentration-dependent, the unit dose should be increased commensurately with the level of resistance of the strain. Taken in concert, preclinical data show that microbiological resistance of pneumococci to betalactams has very little influence on the risk of failure of conventional treatment regimens for pneumococcal pneumonia. The high rate of multiple drug resistance, particularly among beta-lactam-resistant strains, rules out probabilistic use of macrolides, cyclines, and cotrimoxazole ; conversely, all S. pneumoniae strains remain susceptible to pristinamycin, rifampin, and glycopeptides, and less than 1 % of strains are resistant to the new fluoroquinolones with antipneumococcal activity or to ketolides. Only improved understanding of host-bacteria interactions will bring about a decrease in mortality related to this very common condition.

Drug susceptibility pattern of bacterial isolates from children with chronic suppurative otitis media

Background: In Ethiopia, as most developing countries, there is little information on chronic suppurative otitis media (CSOM) in children. Awareness about the seriousness of the condition is limited among the caretakers. Treatment is largely empirical owing to lack of microbiological data. Objectives: The study was conducted to identify bacterial isolates associated with the chronic suppurative otitis media in children and determine their antibiotic susceptibility pattern. Methods: Children consecutively seen for chronic otitis media at Department of Pediatrics and Child Health of the Tikur Anbessa Hospital during January - May 2000 were included in the study. Clinical/demographic data were collected using in a pre-formed questionnaire. Ear swabs were collected, transported, and cultured using standards methods. Biochemical tests were used in identifying Gram-negative bacteria. All isolates were tested for their susceptibility to different antibiotics. Results: A total of 158 bacterial agents were isolated from 120 ear swabs collected from 112 patients aged between 3 months and 12 years. The most frequent isolates were Proteus species (31%), Staphylococcus aureus (18%), Escherichia coli (16%), Klebsiella species (12%), and Pseudomonas species (6%). Most of the isolates were resistant to commonly used antibiotics but sensitive to kanamycin (72%), augmentin (84%) and gentamycin (88%). Triple antibiotics resistance was most common resistance pattern. Conclusions: The high rate of multiple drug resistance, particularly to cheap and frequently used antibiotics, raises serious concern. More comprehensive studies are required to define the true magnitude of CSOM, to determine the microbiological profile of isolates and produce data for policy decision on optimal intervention modalities. (Ethiopian Journal of Health Development, 2001, 15(2): 89-96)