首页 > 最新文献

Indian Journal of Medical Microbiology最新文献

英文 中文
Characterization of clinical infection and drug resistance of group B streptococcus in Chengdu, China 中国成都 B 群链球菌的临床感染特征和耐药性。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2024-10-09 DOI: 10.1016/j.ijmmb.2024.100742
Qin Wang , Yuxia Huang , Xiaoli Liu , Lin Deng , Jingruo Xia , Feng Wen , Chenggui Liu , Xuan Zhu , Jiajia Zhang

Objective

To investigate the clinical infection characteristics and antibiotic resistance of Group B Streptococcus (Streptococcus agalactiae, GBS) in Chengdu, China, from 2019 to 2021, as well as to provide data to support rational clinical drug use.

Methods

This was a retrospective study to collect 203 culture-positive GBS strains isolated from January 2019 to December 2021 in Chengdu, China, all of which were identified by the VITEK 2 Compact automated microbial Bacterial identification instrument. Data were derived using WHONET 5.6 software. The sample type and ward distribution were counted. Pregnant women and newborns were screened from the original data and their pregnancy outcomes were calculated respectively.

Results

GBS strains were mainly concentrated in obstetrics and neonatology departments, accounting for 40.9 % and 33.5 %. The types of specimens were mainly vaginal secretions, amniotic fluid and sputum, accounting for 25.6 %, 26.1 % and 18.7 %, respectively. Chorioamnionitis, premature rupture of membranes and preterm delivery occurred mainly in pregnant women after infection, accounting for 44.4 %, 31.5 % and 24.1 %. Neonates, on the other hand, were mainly diagnosed with neonatal pneumonia, neonatal sepsis, respiratory failure and septic meningitis, accounting for 91.8 %, 61.2 %, 44.9 % and 16.3 % of all positive neonates. 840 pregnant women were screened for GBS colonization from 2019 to 2021, and a total of 108 GBS positive pregnant women were identified, with a GBS colonization rate of 12.9 %. A total of 9 neonates from 108 GBS positive pregnant women developed early-onset disease. The morbidity in neonates was 8.3 %. No strains resistant to penicillin and ampicillin were found, while the resistance rates of tetracycline and clindamycin were higher than 50 %, respectively 60.1 % and 53.2 %.

Conclusion

GBS infection mainly affected pregnant women and newborns in Chengdu, China, which can lead to adverse maternal and infant outcomes. Attention should be paid to strengthening general screening of GBS in perinatal urogenital secretions and the prevention strategy of IAP (intrapartum antibiotic prophylaxis). Antimicrobial therapy should be administered with appropriate antibiotics. Penicillin was still the first line drug for the treatment of GBS. These initiatives were important to reduce mother-to-child transmission and neonatal infections.
目的调查2019年至2021年中国成都地区B群链球菌(无乳链球菌,GBS)的临床感染特征和抗生素耐药性,并为临床合理用药提供数据支持:这是一项回顾性研究,收集了2019年1月至2021年12月在中国成都分离的203株培养阳性GBS菌株,所有菌株均由VITEK 2 Compact全自动微生物细菌鉴定仪鉴定。数据使用 WHONET 5.6 软件得出。对样本类型和病房分布进行了统计。从原始数据中筛选出孕妇和新生儿,并分别计算其妊娠结局:GBS菌株主要集中在产科和新生儿科,分别占40.9%和33.5%。标本类型主要为阴道分泌物、羊水和痰液,分别占 25.6%、26.1% 和 18.7%。绒毛膜羊膜炎、胎膜早破和早产主要发生在感染后的孕妇身上,分别占 44.4%、31.5% 和 24.1%。新生儿则主要被诊断为新生儿肺炎、新生儿败血症、呼吸衰竭和化脓性脑膜炎,分别占所有阳性新生儿的 91.8%、61.2%、44.9% 和 16.3%。2019-2021年对840名孕妇进行了GBS定植筛查,共发现108名GBS阳性孕妇,GBS定植率为12.9%。108 名 GBS 阳性孕妇中共有 9 名新生儿出现早发性疾病。新生儿的发病率为 8.3%。没有发现对青霉素和氨苄西林耐药的菌株,而对四环素和林可霉素的耐药率高于50%,分别为60.1%和53.2%:结论:GBS 感染主要影响成都地区的孕妇和新生儿,可导致不良的母婴结局。应注意加强对围产期泌尿生殖道分泌物中 GBS 的普遍筛查和 IAP(产前抗生素预防)预防策略。应使用适当的抗生素进行抗菌治疗。青霉素仍是治疗 GBS 的一线药物。这些举措对于减少母婴传播和新生儿感染非常重要。
{"title":"Characterization of clinical infection and drug resistance of group B streptococcus in Chengdu, China","authors":"Qin Wang ,&nbsp;Yuxia Huang ,&nbsp;Xiaoli Liu ,&nbsp;Lin Deng ,&nbsp;Jingruo Xia ,&nbsp;Feng Wen ,&nbsp;Chenggui Liu ,&nbsp;Xuan Zhu ,&nbsp;Jiajia Zhang","doi":"10.1016/j.ijmmb.2024.100742","DOIUrl":"10.1016/j.ijmmb.2024.100742","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the clinical infection characteristics and antibiotic resistance of Group B Streptococcus (<em>Streptococcus agalactiae</em>, GBS) in Chengdu, China, from 2019 to 2021, as well as to provide data to support rational clinical drug use.</div></div><div><h3>Methods</h3><div>This was a retrospective study to collect 203 culture-positive GBS strains isolated from January 2019 to December 2021 in Chengdu, China, all of which were identified by the VITEK 2 Compact automated microbial Bacterial identification instrument. Data were derived using WHONET 5.6 software. The sample type and ward distribution were counted. Pregnant women and newborns were screened from the original data and their pregnancy outcomes were calculated respectively.</div></div><div><h3>Results</h3><div>GBS strains were mainly concentrated in obstetrics and neonatology departments, accounting for 40.9 % and 33.5 %. The types of specimens were mainly vaginal secretions, amniotic fluid and sputum, accounting for 25.6 %, 26.1 % and 18.7 %, respectively. Chorioamnionitis, premature rupture of membranes and preterm delivery occurred mainly in pregnant women after infection, accounting for 44.4 %, 31.5 % and 24.1 %. Neonates, on the other hand, were mainly diagnosed with neonatal pneumonia, neonatal sepsis, respiratory failure and septic meningitis, accounting for 91.8 %, 61.2 %, 44.9 % and 16.3 % of all positive neonates. 840 pregnant women were screened for GBS colonization from 2019 to 2021, and a total of 108 GBS positive pregnant women were identified, with a GBS colonization rate of 12.9 %. A total of 9 neonates from 108 GBS positive pregnant women developed early-onset disease. The morbidity in neonates was 8.3 %. No strains resistant to penicillin and ampicillin were found, while the resistance rates of tetracycline and clindamycin were higher than 50 %, respectively 60.1 % and 53.2 %.</div></div><div><h3>Conclusion</h3><div>GBS infection mainly affected pregnant women and newborns in Chengdu, China, which can lead to adverse maternal and infant outcomes. Attention should be paid to strengthening general screening of GBS in perinatal urogenital secretions and the prevention strategy of IAP (intrapartum antibiotic prophylaxis). Antimicrobial therapy should be administered with appropriate antibiotics. Penicillin was still the first line drug for the treatment of GBS. These initiatives were important to reduce mother-to-child transmission and neonatal infections.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100742"},"PeriodicalIF":1.4,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Klebsiella pneumoniae infections and phage therapy 肺炎克雷伯菌感染与噬菌体疗法
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2024-10-05 DOI: 10.1016/j.ijmmb.2024.100736
Alakh Narayan Singh, Aprajita Singh, Sudhir Kumar Singh, Gopal Nath

Objective

Carbapenem-colistin-resistant Klebsiella pneumoniae has emerged as a serious global problem. Klebsiella pneumoniae is a major culprit in healthcare settings and is responsible for septicemia, urinary tract infections, pneumonia, meningitis, burn wound and surgical site infections, and liver abscesses even in younger and healthier population worldwide. The formation of biofilm prevents antibiotics from reaching the bacteria and exerting their effector mechanism. The non-availability of therapeutic alternatives (antibiotic therapy) further complicates the scenario. However, in the era of antibiotic resistance, bacteriophage therapy emerges as a ray of hope against antibiotic-resistant bacteria.

Method

The present review focuses on the therapeutic potential of bacteriophages as an antimicrobial agent with special reference to safety, specificity, efficacy, dosage, and dosage frequency against Pan-Drug Resistant (PDR) K. pneumoniae, both in-vitro and in-vivo (animals and human) studies.

Result

This review highlights the perspectives therapeutic potential of bacteriophages, their impact on the host immune system, combination therapy, and bacteriophage-encoded gene product endolysin, artificial lysins (Artilysins), polysaccharide depolymerase, and peptidoglycan hydrolases.

Conclusion

This review briefly describes the application of bacteriophage and its encoded gene products in clinical trials.
目的:对碳青霉烯类-科利斯丁耐药的肺炎克雷伯氏菌已成为一个严重的全球性问题。肺炎克雷伯氏菌是医疗机构中的主要罪魁祸首,即使在全球较年轻和健康的人群中,它也是导致脓毒血症、尿路感染、肺炎、脑膜炎、烧伤伤口和手术部位感染以及肝脓肿的罪魁祸首。生物膜的形成阻碍了抗生素进入细菌体内并发挥其作用机制。由于没有替代疗法(抗生素疗法),情况变得更加复杂。然而,在抗生素耐药性时代,噬菌体疗法的出现为抗击耐抗生素细菌带来了一线希望:方法:本综述侧重于噬菌体作为抗菌剂的治疗潜力,特别是在体外和体内(动物和人体)研究中,针对泛耐药(PDR)肺炎克氏菌的安全性、特异性、疗效、剂量和用药频率:本综述重点介绍了噬菌体的治疗潜力、噬菌体对宿主免疫系统的影响、联合疗法以及噬菌体编码的基因产物内溶菌酶、人工溶菌酶(Artilysins)、多糖解聚酶和肽聚糖水解酶:本综述简要介绍了噬菌体及其编码基因产品在临床试验中的应用。
{"title":"Klebsiella pneumoniae infections and phage therapy","authors":"Alakh Narayan Singh,&nbsp;Aprajita Singh,&nbsp;Sudhir Kumar Singh,&nbsp;Gopal Nath","doi":"10.1016/j.ijmmb.2024.100736","DOIUrl":"10.1016/j.ijmmb.2024.100736","url":null,"abstract":"<div><h3>Objective</h3><div>Carbapenem-colistin-resistant <em>Klebsiella pneumoniae</em> has emerged as a serious global problem. <em>Klebsiella pneumoniae</em> is a major culprit in healthcare settings and is responsible for septicemia, urinary tract infections, pneumonia, meningitis, burn wound and surgical site infections, and liver abscesses even in younger and healthier population worldwide. The formation of biofilm prevents antibiotics from reaching the bacteria and exerting their effector mechanism. The non-availability of therapeutic alternatives (antibiotic therapy) further complicates the scenario. However, in the era of antibiotic resistance, bacteriophage therapy emerges as a ray of hope against antibiotic-resistant bacteria.</div></div><div><h3>Method</h3><div>The present review focuses on the therapeutic potential of bacteriophages as an antimicrobial agent with special reference to safety, specificity, efficacy, dosage, and dosage frequency against Pan-Drug Resistant (PDR) <em>K. pneumoniae,</em> both <em>in-vitro</em> and <em>in-vivo</em> (animals and human) studies.</div></div><div><h3>Result</h3><div>This review highlights the perspectives therapeutic potential of bacteriophages, their impact on the host immune system, combination therapy, and bacteriophage-encoded gene product endolysin, artificial lysins (Artilysins), polysaccharide depolymerase, and peptidoglycan hydrolases.</div></div><div><h3>Conclusion</h3><div>This review briefly describes the application of bacteriophage and its encoded gene products in clinical trials.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100736"},"PeriodicalIF":1.4,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Vulvovaginal candidiasis in pregnant women attending a tertiary care centre in North-Eastern India 在印度东北部一家三级医疗中心就诊的孕妇患有外阴阴道念珠菌病。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2024-10-04 DOI: 10.1016/j.ijmmb.2024.100738
Mahuya Roy , Tapan Majumdar , Jayanta Ray

Background

Candida colonisation in vagina was found to be 20 %, rising to 30 % during pregnancy. According to studies, the prevalence of VVC during pregnancy is higher than healthy women. During pregnancy, candidal colonisation increases, both symptomatic and asymptomatic. However, the difference between strains causing symptomatic infection and those that cause asymptomatic infection is unknown.

Objective

This study aimed to compare the virulence factors of Candida VVC isolates from symptomatic and asymptomatic pregnant women.

Methods

The study included 120 pregnant women- 60 symptomatic and 60 asymptomatic, who presented to the Obstetrics and Gynaecology Outpatient Department with vaginitis symptoms. High vaginal swabs from the patient and used for gram stain, direct wet mount, pH detection and fungal culture in SDA with and without antibiotics. Germ tube tests, growth in CMA, and HiCrome Candida Differential Agar were used to identify yeast colonies grown in culture. The isolates were then examined for virulence factors like biofilm formation, phospholipase, coagulase, and hemolysin. Antifungal susceptibility was determined using E-test.

Results

The current study reveals a high prevalence of Vulvovaginal Candidiasis in pregnant women(35 %). Asymptomatic patients had lower proportion of VVC than symptomatic patients. Non albicans Candida(NAC) outnumbered Candida albicans. Although Candida albicans growth was predominant in asymptomatic patients. Virulence studies revealed that Candida spp. isolated from symptomatic patients expressed a higher proportion of virulence factors. Besides NAC has higher proportion of expressing virulence factors than Candida albicans and has higher propensity to cause infection especially in symptomatic pregnant women. Antifungal susceptibility testing shows Itraconazole to be most sensitive for VVC treatment but Candida albicans was most susceptible to fluconazole while NAC had the least.

Conclusions

The study emphasizes the importance of routine screening of symptomatic pregnant women for VVC, as syndromic treatment will increase antifungal resistance, particularly in NAC.
背景:研究发现,念珠菌在阴道中的定植率为 20%,而在怀孕期间则上升至 30%。研究表明,孕期阴道念珠菌感染率高于健康妇女。在怀孕期间,念珠菌的定植率会增加,无论是有症状还是无症状。然而,引起无症状感染的菌株与引起无症状感染的菌株之间的差异尚不清楚:本研究旨在比较从有症状和无症状孕妇中分离出的 VVC 念珠菌的毒力因子:研究对象包括 120 名因阴道炎症状到妇产科门诊就诊的孕妇--60 名有症状和 60 名无症状。取患者阴道高位拭子进行革兰氏染色、直接湿装片、pH 值检测,并在使用或不使用抗生素的情况下在 SDA 中进行真菌培养。菌管试验、CMA 生长和 HiCrome 念珠菌差异琼脂用于鉴定培养物中生长的酵母菌菌落。然后检测分离物的毒力因子,如生物膜形成、磷脂酶、凝固酶和溶血素。抗真菌药敏性采用 E 测试法确定:本次研究显示,孕妇外阴阴道念珠菌病的发病率很高(35%)。无症状患者患外阴阴道念珠菌病的比例低于有症状的患者。非白色念珠菌(NAC)多于白色念珠菌。尽管在无症状患者中白念珠菌的生长占主导地位。毒力研究显示,从无症状患者体内分离出的念珠菌属表达毒力因子的比例较高。此外,南美念珠菌属表达毒力因子的比例高于白念珠菌属,尤其在有症状的孕妇中更易引起感染。抗真菌药敏试验显示,伊曲康唑对治疗 VVC 最为敏感,但白念珠菌对氟康唑的敏感性最高,而 NAC 的敏感性最低:本研究强调了对有症状的孕妇进行 VVC 常规筛查的重要性,因为综合治疗会增加抗真菌耐药性,尤其是对 NAC 的耐药性。
{"title":"Vulvovaginal candidiasis in pregnant women attending a tertiary care centre in North-Eastern India","authors":"Mahuya Roy ,&nbsp;Tapan Majumdar ,&nbsp;Jayanta Ray","doi":"10.1016/j.ijmmb.2024.100738","DOIUrl":"10.1016/j.ijmmb.2024.100738","url":null,"abstract":"<div><h3>Background</h3><div><em>Candida</em> colonisation in vagina was found to be 20 %, rising to 30 % during pregnancy. According to studies, the prevalence of VVC during pregnancy is higher than healthy women. During pregnancy, candidal colonisation increases, both symptomatic and asymptomatic. However, the difference between strains causing symptomatic infection and those that cause asymptomatic infection is unknown.</div></div><div><h3>Objective</h3><div>This study aimed to compare the virulence factors of Candida VVC isolates from symptomatic and asymptomatic pregnant women.</div></div><div><h3>Methods</h3><div>The study included 120 pregnant women- 60 symptomatic and 60 asymptomatic, who presented to the Obstetrics and Gynaecology Outpatient Department with vaginitis symptoms. High vaginal swabs from the patient and used for gram stain, direct wet mount, pH detection and fungal culture in SDA with and without antibiotics. Germ tube tests, growth in CMA, and HiCrome <em>Candida</em> Differential Agar were used to identify yeast colonies grown in culture. The isolates were then examined for virulence factors like biofilm formation, phospholipase, coagulase, and hemolysin. Antifungal susceptibility was determined using E-test.</div></div><div><h3>Results</h3><div>The current study reveals a high prevalence of Vulvovaginal Candidiasis in pregnant women(35 %). Asymptomatic patients had lower proportion of VVC than symptomatic patients. Non albicans <em>Candida</em>(NAC) outnumbered <em>Candida albicans</em>. Although <em>Candida albicans</em> growth was predominant in asymptomatic patients. Virulence studies revealed that Candida spp. isolated from symptomatic patients expressed a higher proportion of virulence factors. Besides NAC has higher proportion of expressing virulence factors than <em>Candida albicans</em> and has higher propensity to cause infection especially in symptomatic pregnant women. Antifungal susceptibility testing shows Itraconazole to be most sensitive for VVC treatment but <em>Candida albicans</em> was most susceptible to fluconazole while NAC had the least.</div></div><div><h3>Conclusions</h3><div>The study emphasizes the importance of routine screening of symptomatic pregnant women for VVC, as syndromic treatment will increase antifungal resistance, particularly in NAC.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100738"},"PeriodicalIF":1.4,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Utilization of MALDI-TOF MS in the etiological diagnosis of deep-seated anaerobic bacterial infections 利用 MALDI-TOF MS 对深层厌氧菌感染进行病原学诊断。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2024-10-04 DOI: 10.1016/j.ijmmb.2024.100739
Ashish William, Srestha Mitra, Oves Siddiqui, Prabhav Aggarwal, Sonal Saxena

Purpose

Deep-seated abscesses can be caused by a wide array of bacteria in various anatomical sites, the precise identification of which is crucial for implementing organism-specific treatments which can reduce morbidity and mortality. MALDI-TOF MS is a powerful proteomic method for the swift and accurate identification of anaerobic organisms. The aim of this study was to investigate deep-seated infections by MALDI-TOF MS (in comparison to VITEK®2 ANC ID card and phenotypic biochemical tests) and to determine the susceptibility pattern of identified microorganisms.

Materials and methods

A total of 104 samples from patients suspected of deep-seated infections were aseptically collected and subjected to microscopy, aerobic/anaerobic cultures and subsequent identification via MALDI-TOF MS followed by antimicrobial susceptibility testing. Anaerobic bacteria were also identified using the VITEK-2 system and phenotypic biochemical tests.

Results

Out of the 104 samples tested, 41.3 % (43/104) showed positive results, predominantly in pus specimens (88 %). Mixed infections were found in 21 % of the positive cases. Of the 52 organisms identified from positive specimens, 19.2 % (10/52) were obligate anaerobes, with Bacteroides fragilis group being the most prevalent, followed by both Clostridium perfringens and Clostridium sporogenes respectively. Escherichia coli was observed to be the most common facultative anaerobic isolate. All obligate anaerobes were successfully identified to the species level via MALDI-TOF MS. In contrast, the VITEK®2 ANC ID card identified only 40 % (4/10) anaerobic bacteria to the species level. All obligate anaerobic organisms showed 100 % susceptibility to metronidazole, vancomycin and ertapenem. 25 % of the Bacteroides spp. and 50 % of Clostridium perfringens isolates were found to be resistant to clindamycin.

Conclusion

MALDI-TOF MS proves as a beneficial diagnostic tool for bacterial identification, eliminating the labour-intensive and time consuming conventional microbiological methods. Its accuracy of bacterial detection further helps in combating antibiotic resistance and improving patient outcomes in deep-seated infections.
目的:深部脓肿可由不同解剖部位的多种细菌引起,准确识别这些细菌对于实施针对特定生物的治疗至关重要,可降低发病率和死亡率。MALDI-TOF MS 是一种强大的蛋白质组学方法,可快速准确地鉴定厌氧菌。本研究的目的是通过 MALDI-TOF MS(与 VITEK®2 ANC ID 卡和表型生化检验进行比较)研究深部感染,并确定已鉴定微生物的敏感性模式:无菌采集疑似深部感染患者的 104 份样本,进行显微镜检查、需氧/厌氧菌培养、MALDI-TOF MS 鉴定和抗菌药物药敏试验。厌氧菌也通过 VITEK-2 系统和表型生化测试进行鉴定:在检测的 104 份样本中,41.3%(43/104)呈阳性结果,主要是脓液样本(88%)。在 21% 的阳性病例中发现了混合感染。从阳性标本中鉴定出的 52 种微生物中,19.2%(10/52)为强制性厌氧菌,其中以脆弱拟杆菌属最为普遍,其次分别为产气荚膜梭菌和产气荚膜梭菌。大肠杆菌是最常见的兼性厌氧菌。通过 MALDI-TOF MS,成功地鉴定出了所有厌氧菌的种类。相比之下,VITEK®2 ANC ID 卡只能鉴定出 40% 的厌氧菌(4/10)达到物种水平。所有厌氧菌对甲硝唑、万古霉素和厄他培南的敏感性均为 100%。25%的乳杆菌属和 50%的产气荚膜梭菌分离物对克林霉素有耐药性:结论:MALDI-TOF MS 是一种有益的细菌鉴定诊断工具,省去了耗费大量人力和时间的传统微生物学方法。MALDI-TOF MS 鉴定的准确性还有助于抗击抗生素耐药性,改善深部感染患者的治疗效果。
{"title":"Utilization of MALDI-TOF MS in the etiological diagnosis of deep-seated anaerobic bacterial infections","authors":"Ashish William,&nbsp;Srestha Mitra,&nbsp;Oves Siddiqui,&nbsp;Prabhav Aggarwal,&nbsp;Sonal Saxena","doi":"10.1016/j.ijmmb.2024.100739","DOIUrl":"10.1016/j.ijmmb.2024.100739","url":null,"abstract":"<div><h3>Purpose</h3><div>Deep-seated abscesses can be caused by a wide array of bacteria in various anatomical sites, the precise identification of which is crucial for implementing organism-specific treatments which can reduce morbidity and mortality. MALDI-TOF MS is a powerful proteomic method for the swift and accurate identification of anaerobic organisms. The aim of this study was to investigate deep-seated infections by MALDI-TOF MS (in comparison to VITEK<strong>®</strong>2 ANC ID card and phenotypic biochemical tests) and to determine the susceptibility pattern of identified microorganisms.</div></div><div><h3>Materials and methods</h3><div>A total of 104 samples from patients suspected of deep-seated infections were aseptically collected and subjected to microscopy, aerobic/anaerobic cultures and subsequent identification via MALDI-TOF MS followed by antimicrobial susceptibility testing. Anaerobic bacteria were also identified using the VITEK-2 system and phenotypic biochemical tests.</div></div><div><h3>Results</h3><div>Out of the 104 samples tested, 41.3 % (43/104) showed positive results, predominantly in pus specimens (88 %). Mixed infections were found in 21 % of the positive cases. Of the 52 organisms identified from positive specimens, 19.2 % (10/52) were obligate anaerobes, with <em>Bacteroides fragilis</em> group being the most prevalent, followed by both <em>Clostridium perfringens</em> and <em>Clostridium sporogenes</em> respectively. <em>Escherichia coli</em> was observed to be the most common facultative anaerobic isolate. All obligate anaerobes were successfully identified to the species level via MALDI-TOF MS. In contrast, the VITEK<strong>®</strong>2 ANC ID card identified only 40 % (4/10) anaerobic bacteria to the species level. All obligate anaerobic organisms showed 100 % susceptibility to metronidazole, vancomycin and ertapenem. 25 % of the <em>Bacteroides</em> spp. and 50 % of <em>Clostridium perfringens</em> isolates were found to be resistant to clindamycin.</div></div><div><h3>Conclusion</h3><div>MALDI-TOF MS proves as a beneficial diagnostic tool for bacterial identification, eliminating the labour-intensive and time consuming conventional microbiological methods. Its accuracy of bacterial detection further helps in combating antibiotic resistance and improving patient outcomes in deep-seated infections.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100739"},"PeriodicalIF":1.4,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
‘Effectiveness of various sulbactam-based combination antibiotic therapy in the management of ventilator-associated pneumonia caused by carbapenem-resistant Acinetobacter baumannii in a tertiary care Health centre’ 在一家三级医疗保健中心治疗由耐碳青霉烯类鲍曼不动杆菌引起的呼吸机相关性肺炎时,基于舒巴坦类药物的多种联合抗生素疗法的效果"。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2024-10-03 DOI: 10.1016/j.ijmmb.2024.100737
Monika Chaudhary , Deepak Kumar , Durga Shankar Meena , Naresh Kumar Midha , Gopal Krishana Bohra , Vibhor Tak , Subhashree Samantaray , Navneet Kaur , T.R. Neetha , Sadik Mohammed , Ankur Sharma , Nikhil Kothari , Pradeep Kumar Bhatia , M.K. Garg

Objective

Carbapenem-resistant Acinetobacter baumannii (CRAB) is a common cause of ventilator-associated pneumonia (VAP). Some in vitro data favour various combination antibiotic therapy. However, there is a need for more in vivo studies for the management of VAP caused by CRAB. This retrospective study was done to evaluate the effectiveness of various combination antibiotic therapy including sulbactam on outcomes of VAP caused by CRAB.

Methods

Adult patients (age ≥18 years) diagnosed with VAP caused by CRAB were included. Patients with polymicrobial infections were excluded from the study. Patients with CRAB associated VAP who were given sulbactam based antibiotic combinations were observed for outcomes. The primary outcome was 28-day mortality after diagnosis of VAP caused by CRAB. Reduction in serum HsCRP (High sensitivity C-reactive protein) during treatment and requirement of inotropes were the secondary outcomes. Outcomes were compared between various sulbactam based antibiotic combination therapies.

Results

A total of 103 patients were included. A total of 44 (42.7 %) patients received sulbactam and minocycline or sulbactam and polymyxin B dual antibiotic combination, and 59 (57.3 %) patients received sulbactam, polymyxin B and minocycline triple antibiotic combination. The percentage difference in 28 days mortality was 27.51 % (95 % CI 8.03 %–44.06 %; p = 0.005) in dual vs triple sulbactam based antibiotic combination therapy. The percentage difference in requirement of inotropes during therapy and HsCRP reduction after 7 days of therapy was 23.65 % (95 % CI 6.43 %–38.3 %; p = 0.007) and 25.1 % (95%CI 10.1 %–38.2 %; p < 0.001) respectively when compared between dual vs triple sulbactam based antibiotic combination therapy.

Conclusion

Treatment with sulbactam, polymyxin B and minocycline combination antibiotic therapy was associated with significantly lower 28-day mortality. Moreover, the lower requirement of inotropes during treatment and a significant reduction in HsCRP level favours this combination antibiotic therapy in VAP caused by CRAB.
目的:耐碳青霉烯类鲍曼不动杆菌(CRAB耐碳青霉烯类鲍曼不动杆菌(CRAB)是呼吸机相关性肺炎(VAP)的常见病因。一些体外数据支持各种联合抗生素疗法。然而,在治疗由 CRAB 引起的 VAP 方面还需要更多的体内研究。这项回顾性研究旨在评估包括舒巴坦在内的各种抗生素联合疗法对 CRAB 引起的 VAP 的疗效:纳入诊断为 CRAB 引起的 VAP 的成人患者(年龄≥ 18 岁)。研究排除了多微生物感染患者。对接受舒巴坦类抗生素联合治疗的 CRAB 相关 VAP 患者进行疗效观察。主要结果是确诊 CRAB 引起的 VAP 后 28 天的死亡率。治疗期间血清 HsCRP(高敏 C 反应蛋白)的降低和肌注的需求是次要结果。对不同舒巴坦类抗生素联合疗法的疗效进行了比较:结果:共纳入 103 名患者。结果:共纳入 103 例患者,其中 44 例(42.7%)患者接受了舒巴坦和米诺环素或舒巴坦和多粘菌素 B 双抗生素联合疗法,59 例(57.3%)患者接受了舒巴坦、多粘菌素 B 和米诺环素三抗生素联合疗法。舒巴坦双联疗法与舒巴坦三联疗法的 28 天死亡率差异为 27.51%(95% CI 为 8.03% 至 44.06%;P=0.005)。治疗期间肌注需求的百分比差异为 23.65%(95% CI 6.43% 至 38.3%;P=0.007),治疗 7 天后 HsCRP 降低的百分比差异为 25.1%(95%CI 10.1% 至 38.2%;P=0.007),治疗 7 天后 HsCRP 降低的百分比差异为 25.1%(95%CI 10.1% 至 38.2%;P=0.007):舒巴坦、多粘菌素 B 和米诺环素联合抗生素疗法可显著降低 28 天死亡率。此外,治疗期间对肌注药物的需求较低,HsCRP水平显著降低,这有利于对CRAB引起的VAP采用联合抗生素疗法。
{"title":"‘Effectiveness of various sulbactam-based combination antibiotic therapy in the management of ventilator-associated pneumonia caused by carbapenem-resistant Acinetobacter baumannii in a tertiary care Health centre’","authors":"Monika Chaudhary ,&nbsp;Deepak Kumar ,&nbsp;Durga Shankar Meena ,&nbsp;Naresh Kumar Midha ,&nbsp;Gopal Krishana Bohra ,&nbsp;Vibhor Tak ,&nbsp;Subhashree Samantaray ,&nbsp;Navneet Kaur ,&nbsp;T.R. Neetha ,&nbsp;Sadik Mohammed ,&nbsp;Ankur Sharma ,&nbsp;Nikhil Kothari ,&nbsp;Pradeep Kumar Bhatia ,&nbsp;M.K. Garg","doi":"10.1016/j.ijmmb.2024.100737","DOIUrl":"10.1016/j.ijmmb.2024.100737","url":null,"abstract":"<div><h3>Objective</h3><div>Carbapenem-resistant <em>Acinetobacter baumannii</em> (CRAB) is a common cause of ventilator-associated pneumonia (VAP). Some in vitro data favour various combination antibiotic therapy. However, there is a need for more in vivo studies for the management of VAP caused by CRAB. This retrospective study was done to evaluate the effectiveness of various combination antibiotic therapy including sulbactam on outcomes of VAP caused by CRAB.</div></div><div><h3>Methods</h3><div>Adult patients (age ≥18 years) diagnosed with VAP caused by CRAB were included. Patients with polymicrobial infections were excluded from the study. Patients with CRAB associated VAP who were given sulbactam based antibiotic combinations were observed for outcomes. The primary outcome was 28-day mortality after diagnosis of VAP caused by CRAB. Reduction in serum HsCRP (High sensitivity C-reactive protein) during treatment and requirement of inotropes were the secondary outcomes. Outcomes were compared between various sulbactam based antibiotic combination therapies.</div></div><div><h3>Results</h3><div>A total of 103 patients were included. A total of 44 (42.7 %) patients received sulbactam and minocycline or sulbactam and polymyxin B dual antibiotic combination, and 59 (57.3 %) patients received sulbactam, polymyxin B and minocycline triple antibiotic combination. The percentage difference in 28 days mortality was 27.51 % (95 % CI 8.03 %–44.06 %; p = 0.005) in dual vs triple sulbactam based antibiotic combination therapy. The percentage difference in requirement of inotropes during therapy and HsCRP reduction after 7 days of therapy was 23.65 % (95 % CI 6.43 %–38.3 %; p = 0.007) and 25.1 % (95%CI 10.1 %–38.2 %; p &lt; 0.001) respectively when compared between dual vs triple sulbactam based antibiotic combination therapy.</div></div><div><h3>Conclusion</h3><div>Treatment with sulbactam, polymyxin B and minocycline combination antibiotic therapy was associated with significantly lower 28-day mortality. Moreover, the lower requirement of inotropes during treatment and a significant reduction in HsCRP level favours this combination antibiotic therapy in VAP caused by CRAB.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100737"},"PeriodicalIF":1.4,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A novel case of Vibrio bacteremia in an immune-competent patient 免疫功能正常患者的弧菌菌血症新病例
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2024-10-03 DOI: 10.1016/j.ijmmb.2024.100740
Muzeer Ahmed , Abdul Nafey Kazi , Muhammad Ateeb Sheikh , Fareeha Adnan , Fivzia Farooq Herekar
Vibrio Cholera, a gram negative bacterium, is notoriously known to cause diarrheal epidemics. The serotypes O1 and O139 are mainly responsible for the diarrheal outbreaks due to the enterotoxin they produce. This enterotoxin however seems to be protective against bacteremia and hence bacteremia is rarely encountered. We report a case of an immune-competent young female who initially presented with hypokalemic periodic paralysis secondary to acute on chronic diarrhea. She was discharged after rehydration and bounced back in septic shock and her blood cultures grew Vibrio Cholera identified on Vitek. She succumbed to this organism within 24 hours of re-admission.
霍乱弧菌是一种革兰氏阴性细菌,以引起腹泻流行而闻名。血清型为 O1 和 O139 的霍乱弧菌因其产生的肠毒素而对腹泻疫情负有主要责任。然而,这种肠毒素似乎对菌血症有保护作用,因此很少发生菌血症。我们报告了一例免疫功能正常的年轻女性病例,她最初因急性和慢性腹泻继发低钾周期性麻痹。她在补液后出院,又因脓毒性休克而反弹,血液培养出了经 Vitek 鉴定的霍乱弧菌。她在再次入院的 24 小时内死于霍乱弧菌。
{"title":"A novel case of Vibrio bacteremia in an immune-competent patient","authors":"Muzeer Ahmed ,&nbsp;Abdul Nafey Kazi ,&nbsp;Muhammad Ateeb Sheikh ,&nbsp;Fareeha Adnan ,&nbsp;Fivzia Farooq Herekar","doi":"10.1016/j.ijmmb.2024.100740","DOIUrl":"10.1016/j.ijmmb.2024.100740","url":null,"abstract":"<div><div>Vibrio Cholera, a gram negative bacterium, is notoriously known to cause diarrheal epidemics. The serotypes O1 and O139 are mainly responsible for the diarrheal outbreaks due to the enterotoxin they produce. This enterotoxin however seems to be protective against bacteremia and hence bacteremia is rarely encountered. We report a case of an immune-competent young female who initially presented with hypokalemic periodic paralysis secondary to acute on chronic diarrhea. She was discharged after rehydration and bounced back in septic shock and her blood cultures grew <em>Vibrio Cholera</em> identified on Vitek. She succumbed to this organism within 24 hours of re-admission.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100740"},"PeriodicalIF":1.4,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enhancing infection control in dialysis at a resource limited public healthcare institute: A cross-sectional study on microbiological quality assessment of dialysis water and dialysate 在资源有限的公立医疗机构加强透析感染控制:透析水和透析液微生物质量评估横断面研究。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.ijmmb.2024.100734
Swathi Suravaram , Shreya Sri Gopikonda , Imran Ahmed Siddiqui , Harika Kanugula , Dhanalakshmi Gorakanti , Lakshmi Vaddanapu

Purpose

To evaluate the microbiological quality of dialysis water and dialysate samples from hemodialysis units at a tertiary care government hospital and to assess the use of culture, endotoxin and periodicity of testing these assays to guide the actions of monitoring the quality of hemodialysis fluids, implement preventive and corrective actions, and improve the safety and outcomes of the dialysis process.

Methods

A cross-sectional study was conducted at a 250-bedded super-specialty government hospital with a 24/7 hemodialysis unit equipped with 40 dialysis machines. Dialysis water and dialysate samples were collected monthly and analysed for microbial contamination and endotoxin levels as per AAMI guidelines. Bacterial cultures were done using Reasoner's Agar plates, and endotoxin analysis was performed using gel clot assay. Interpretation of results was based on predefined thresholds.

Results

Among the 740 samples processed for microbial culture 19.6 % and 80.4% were unacceptable and acceptable respectively.Among the acceptable samples 10.5 % were at action level. At the end of 2 days of incubation, 15.2%dialysis water samples and 5.1%dialysate samples had unacceptable levels of bacterial colonies and at 5days additional 10.6 % dialysis water samples and 7.7%dialysate samples were unacceptable. 21.5 % of the samples tested for endotoxin had unacceptable levels.

Conclusions

Regular monitoring of water quality in government healthcare hemodialysis units is crucial for quality of care, timely preventive and corrective actions for mitigating adverse outcomes. Processing cultures for 5–7 days is essential for detecting all contaminated specimens. While there might be a link between endotoxin levels and bacterial contamination, both endotoxin testing and bacterial culture independently are vital for evaluating water quality in dialysis settings. A comprehensive approach integrating various testing methods is necessary to uphold patient safety and enable necessary improvements.
目的:评估一家三级护理政府医院血液透析室透析水和透析液样本的微生物质量,并评估培养、内毒素和检测周期的使用情况,以指导监测血液透析液质量的行动,实施预防和纠正措施,提高透析过程的安全性和效果:在一家拥有 250 张床位的政府超级专科医院开展了一项横断面研究,该医院的血液透析室全天候配备了 40 台透析机。每月收集透析用水和透析液样本,并根据美国血液透析学会(AAMI)指南分析微生物污染和内毒素水平。细菌培养采用 Reasoner's 琼脂平板,内毒素分析采用凝胶凝块测定法。结果根据预先确定的阈值进行解释:在 740 个微生物培养样本中,分别有 19.6% 和 80.4% 的样本不合格和合格。在培养 2 天后,15.2% 的透析水样本和 5.1%的透析液样本中的细菌菌落数量达到了不可接受的水平;在培养 5 天后,又有 10.6% 的透析水样本和 7.7% 的透析液样本中的细菌菌落数量达到了不可接受的水平。21.5%的内毒素检测样本达到不可接受的水平:结论:定期监测政府医疗机构血液透析室的水质对提高医疗质量、及时采取预防和纠正措施以减轻不良后果至关重要。将培养物处理 5-7 天对于检测所有受污染标本至关重要。虽然内毒素水平与细菌污染之间可能存在联系,但独立的内毒素检测和细菌培养对于评估透析环境中的水质至关重要。要维护患者安全并进行必要的改进,就必须采用综合各种检测方法的综合方法。
{"title":"Enhancing infection control in dialysis at a resource limited public healthcare institute: A cross-sectional study on microbiological quality assessment of dialysis water and dialysate","authors":"Swathi Suravaram ,&nbsp;Shreya Sri Gopikonda ,&nbsp;Imran Ahmed Siddiqui ,&nbsp;Harika Kanugula ,&nbsp;Dhanalakshmi Gorakanti ,&nbsp;Lakshmi Vaddanapu","doi":"10.1016/j.ijmmb.2024.100734","DOIUrl":"10.1016/j.ijmmb.2024.100734","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the microbiological quality of dialysis water and dialysate samples from hemodialysis units at a tertiary care government hospital and to assess the use of culture, endotoxin and periodicity of testing these assays to guide the actions of monitoring the quality of hemodialysis fluids, implement preventive and corrective actions, and improve the safety and outcomes of the dialysis process.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted at a 250-bedded super-specialty government hospital with a 24/7 hemodialysis unit equipped with 40 dialysis machines. Dialysis water and dialysate samples were collected monthly and analysed for microbial contamination and endotoxin levels as per AAMI guidelines. Bacterial cultures were done using Reasoner's Agar plates, and endotoxin analysis was performed using gel clot assay. Interpretation of results was based on predefined thresholds.</div></div><div><h3>Results</h3><div>Among the 740 samples processed for microbial culture 19.6 % and 80.4% were unacceptable and acceptable respectively.Among the acceptable samples 10.5 % were at action level. At the end of 2 days of incubation, 15.2%dialysis water samples and 5.1%dialysate samples had unacceptable levels of bacterial colonies and at 5days additional 10.6 % dialysis water samples and 7.7%dialysate samples were unacceptable. 21.5 % of the samples tested for endotoxin had unacceptable levels.</div></div><div><h3>Conclusions</h3><div>Regular monitoring of water quality in government healthcare hemodialysis units is crucial for quality of care, timely preventive and corrective actions for mitigating adverse outcomes. Processing cultures for 5–7 days is essential for detecting all contaminated specimens. While there might be a link between endotoxin levels and bacterial contamination, both endotoxin testing and bacterial culture independently are vital for evaluating water quality in dialysis settings. A comprehensive approach integrating various testing methods is necessary to uphold patient safety and enable necessary improvements.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100734"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Microbial profiling, antimicrobial resistance surveillance, and molecular detection of MecA gene in Staphylococcal strains from donor human milk: Insights from a milk bank investigation 捐赠人乳中葡萄球菌菌株的微生物谱分析、抗菌药耐药性监测和 MecA 基因的分子检测:牛奶银行调查的启示。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2024-09-30 DOI: 10.1016/j.ijmmb.2024.100733
Astha Yadav , Sheetal Verma , Vimala Venkatesh , Amita Jain , Mala Kumar , Saurabh Kashyap , Shalini Tripathi

Purpose

Donor human milk (DHM) from milk banks provides vital nutrition to vulnerable infants. Understanding its microbial profile and antimicrobial resistance patterns is crucial for ensuring its safety and efficacy. This study aimed to profile the microbial composition, detect antibiotic resistance, and identify the presence of mecA gene in Staphylococcal strains from DHM samples.

Materials and method

A total of 151 DHM samples were collected from a regional human milk bank in North India. Microbial identification was performed using MALDI TOF MS, and antimicrobial susceptibility testing was conducted using the disc diffusion method. Molecular methods, including PCR, were employed for mecA gene detection.

Results

The study revealed a diverse microbial profile, with Staphylococcus species being predominant. Acinetobacter and Pseudomonas species were also prevalent, raising concerns due to their association with healthcare-associated outbreaks. High rates of antibiotic resistance were observed across both Gram-positive and Gram-negative bacteria, with resistance to commonly used antibiotics such as penicillin, clindamycin, erythromycin, and ceftriaxone. The mecA gene, associated with methicillin resistance, was detected in a significant proportion of Staphylococcal isolates.

Conclusion

The study underscores the importance of rigorous microbial analysis and antimicrobial susceptibility testing in assessing the safety of DHM. The presence of diverse microbial species, including antibiotic-resistant strains and the mecA gene in Staphylococcal strains, emphasizes the need for stringent hygiene practices and continuous surveillance in milk banks. Implementing comprehensive screening protocols and adhering to best practices in milk handling and pasteurization are crucial for safeguarding the health of vulnerable infants reliant on donor milk.
目的:来自母乳库的捐赠人乳(DHM)为脆弱婴儿提供了重要的营养。了解其微生物特征和抗菌药耐药性模式对确保其安全性和有效性至关重要。本研究旨在分析 DHM 样品中的微生物组成、检测抗生素耐药性并确定葡萄球菌菌株中是否存在 mecA 基因:从北印度的一个地区母乳库中共收集了 151 份母乳样本。使用 MALDI TOF MS 进行微生物鉴定,并使用碟片扩散法进行抗菌药敏感性测试。在检测 mecA 基因时采用了包括 PCR 在内的分子方法:结果:研究显示微生物种类繁多,以葡萄球菌为主。不动杆菌和假单胞菌也很普遍,由于它们与医疗相关疾病的爆发有关,因此引起了人们的关注。革兰氏阳性和革兰氏阴性细菌的抗生素耐药率都很高,对青霉素、克林霉素、红霉素和头孢曲松等常用抗生素都有耐药性。在相当大比例的葡萄球菌分离物中检测到了与甲氧西林耐药性相关的 mecA 基因:本研究强调了严格的微生物分析和抗菌药敏感性测试对评估 DHM 安全性的重要性。牛奶中存在多种微生物,包括抗生素耐药菌株和葡萄球菌菌株中的 mecA 基因,这强调了在奶库中实施严格的卫生规范和持续监控的必要性。实施全面的筛查方案并坚持牛奶处理和巴氏杀菌的最佳做法,对于保障依赖捐献牛奶的脆弱婴儿的健康至关重要。
{"title":"Microbial profiling, antimicrobial resistance surveillance, and molecular detection of MecA gene in Staphylococcal strains from donor human milk: Insights from a milk bank investigation","authors":"Astha Yadav ,&nbsp;Sheetal Verma ,&nbsp;Vimala Venkatesh ,&nbsp;Amita Jain ,&nbsp;Mala Kumar ,&nbsp;Saurabh Kashyap ,&nbsp;Shalini Tripathi","doi":"10.1016/j.ijmmb.2024.100733","DOIUrl":"10.1016/j.ijmmb.2024.100733","url":null,"abstract":"<div><h3>Purpose</h3><div>Donor human milk (DHM) from milk banks provides vital nutrition to vulnerable infants. Understanding its microbial profile and antimicrobial resistance patterns is crucial for ensuring its safety and efficacy. This study aimed to profile the microbial composition, detect antibiotic resistance, and identify the presence of mecA gene in <em>Staphylococcal</em> strains from DHM samples.</div></div><div><h3>Materials and method</h3><div>A total of 151 DHM samples were collected from a regional human milk bank in North India. Microbial identification was performed using MALDI TOF MS, and antimicrobial susceptibility testing was conducted using the disc diffusion method. Molecular methods, including PCR, were employed for mecA gene detection.</div></div><div><h3>Results</h3><div>The study revealed a diverse microbial profile, with <em>Staphylococcus</em> species being predominant. <em>Acinetobacter</em> and <em>Pseudomonas</em> species were also prevalent, raising concerns due to their association with healthcare-associated outbreaks. High rates of antibiotic resistance were observed across both Gram-positive and Gram-negative bacteria, with resistance to commonly used antibiotics such as penicillin, clindamycin, erythromycin, and ceftriaxone. The mecA gene, associated with methicillin resistance, was detected in a significant proportion of <em>Staphylococcal</em> isolates.</div></div><div><h3>Conclusion</h3><div>The study underscores the importance of rigorous microbial analysis and antimicrobial susceptibility testing in assessing the safety of DHM. The presence of diverse microbial species, including antibiotic-resistant strains and the mecA gene in <em>Staphylococcal</em> strains, emphasizes the need for stringent hygiene practices and continuous surveillance in milk banks. Implementing comprehensive screening protocols and adhering to best practices in milk handling and pasteurization are crucial for safeguarding the health of vulnerable infants reliant on donor milk.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100733"},"PeriodicalIF":1.4,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A systematic review and meta-analysis to develop a landscape map of antibiotic resistance for six WHO priority pathogens in east and north-east India from 2011 to 2022 为绘制 2011 年至 2022 年印度东部和东北部六种世界卫生组织重点病原体的抗生素耐药性分布图而进行的系统回顾和元分析。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2024-09-25 DOI: 10.1016/j.ijmmb.2024.100732
Simran Malik , Chetan Mahadev Shirvankar , Rahul Kurian Jacob , Debashree Guha Adhya , Subir Sinha , Sanjay Bhattacharya , Kamini Walia , Sangeeta Das Bhattacharya

Background

Determining regional patterns of antimicrobial resistance in bacterial infections in the healthcare setting (AMR) identifies surveillance gaps and informs policies for mitigation. We estimated the prevalence of AMR for six WHO priority pathogens in diagnostic and surveillance samples in the twelve east and north-east Indian states from 2011 to 2022 (PROSPERO ID: CRD42021278961).

Methods

Studies were searched on Medline, Scopus, and Web of Science. Observational, descriptive, and cross-sectional studies, reporting AMR based on laboratory diagnostics, in individuals from east and north-east India from 2011 to 2022 were included. Four reviewers in pairs conducted abstract, full-text screening, and data extraction. We estimated the prevalence of resistance in fifty-four pathogen-antibiotic combinations, and six antibiotic resistance patterns. Pooled estimates of prevalence (Ɵ), heterogeneity (I2), and 95 % confidence intervals were calculated using the random effects model.

Results

Fifty-five studies were included. Information was available for nine states, none from Arunachal Pradesh, Mizoram, and Nagaland. E. coli was most frequently isolated (59.2 %, 95 % CI: 48.8–69.6 %), followed by S. aureus (36.2 %, 95 % CI: 20.2–52.2 %), Enterococcus (27.5 %, 95 % CI: 11.2–43.7 %), Klebsiella (25 %, 95 % CI: 15–35 %), Acinetobacter (15.7 %, 95 % CI: 2.3–29.1 %), and Pseudomonas aeruginosa (15.7 %, 95 % CI: 4.1–27.3 %). There was high prevalence of ESBL (45 %, 95 % CI: 35–55 %) and carbapenem resistance (30 %, 95 % CI: 22–38 %). AmpC (23 %, 95 % CI: 9–37 %) and colistin resistance was lower (10 %, 95 % CI: 0–22 %) but supporting data was limited. Overall prevalence of MRSA was 26 % (95 % CI: 14–39 %), and VRE was 9 % (95 % CI: 0–17 %).

Conclusion

High prevalence of resistance was seen to all first-line antibiotics. Gram positive bacteria had high resistance to penicillins, and Gram negatives to third-generation cephalosporins, beta-lactam/beta-lactamase inhibitors, and carbapenems. Aminoglycoside, fluoroquinolone, and trimethoprim-sulphamethoxazole resistance was common across all genera. Critical regional AMR information gaps exist.
背景:确定医疗环境中细菌感染的抗菌药耐药性(AMR)的区域模式可以发现监测差距,并为缓解政策提供信息。我们估计了 2011 年至 2022 年印度东部和东北部十二个邦的诊断和监测样本中六种世界卫生组织优先病原体的 AMR 流行率(PROSPERO ID:CRD42021278961):方法:在 Medline、Scopus 和 Web of Science 上搜索相关研究。方法:在 Medline、Scopus 和 Web Science 上检索了 2011 年至 2022 年期间根据实验室诊断报告印度东部和东北部个人 AMR 的观察性、描述性和横断面研究。四名审稿人结对进行摘要、全文筛选和数据提取。我们估算了 54 种病原体-抗生素组合和 6 种抗生素耐药性模式的耐药性流行率。使用随机效应模型计算了流行率的汇总估计值(Ɵ)、异质性(I2)和95%置信区间:结果:共纳入 55 项研究。结果:共纳入 55 项研究,其中 9 个州有相关资料,阿鲁纳恰尔邦、米佐拉姆邦和那加兰邦没有相关资料。大肠杆菌最常被分离出来(59.2%,95% CI:48.8-69.6%),其次是金黄色葡萄球菌(36.2%,95% CI:20.2-52.2%)、肠球菌(27.5%,95% CI:11.2-43.7%)、克雷伯氏菌(25%,95% CI:15-35%)、醋杆菌(15.7%,95% CI:2.3-29.1%)和铜绿假单胞菌(15.7%,95% CI:4.1-27.3%)。ESBL(45%,95% CI:35-55%)和碳青霉烯耐药率较高(30%,95% CI:22-38%)。AmpC(23%,95% CI:9-37%)和可乐定耐药率较低(10%,95% CI:0-22%),但支持数据有限。MRSA 的总体流行率为 26%(95% CI:14-39%),VRE 为 9%(95% CI:0-17%):结论:所有一线抗生素的耐药率都很高。革兰氏阳性菌对青霉素类耐药率高,革兰氏阴性菌对第三代头孢菌素、β-内酰胺/β-内酰胺酶抑制剂和碳青霉烯类耐药率高。氨基糖苷类、氟喹诺酮类和三甲氧苄氨嘧啶-磺胺甲噁唑的耐药性在所有菌属中都很常见。地区 AMR 信息存在严重缺口。
{"title":"A systematic review and meta-analysis to develop a landscape map of antibiotic resistance for six WHO priority pathogens in east and north-east India from 2011 to 2022","authors":"Simran Malik ,&nbsp;Chetan Mahadev Shirvankar ,&nbsp;Rahul Kurian Jacob ,&nbsp;Debashree Guha Adhya ,&nbsp;Subir Sinha ,&nbsp;Sanjay Bhattacharya ,&nbsp;Kamini Walia ,&nbsp;Sangeeta Das Bhattacharya","doi":"10.1016/j.ijmmb.2024.100732","DOIUrl":"10.1016/j.ijmmb.2024.100732","url":null,"abstract":"<div><h3>Background</h3><div>Determining regional patterns of antimicrobial resistance in bacterial infections in the healthcare setting (AMR) identifies surveillance gaps and informs policies for mitigation. We estimated the prevalence of AMR for six WHO priority pathogens in diagnostic and surveillance samples in the twelve east and north-east Indian states from 2011 to 2022 (PROSPERO ID: CRD42021278961).</div></div><div><h3>Methods</h3><div>Studies were searched on Medline, Scopus, and Web of Science. Observational, descriptive, and cross-sectional studies, reporting AMR based on laboratory diagnostics, in individuals from east and north-east India from 2011 to 2022 were included. Four reviewers in pairs conducted abstract, full-text screening, and data extraction. We estimated the prevalence of resistance in fifty-four pathogen-antibiotic combinations, and six antibiotic resistance patterns. Pooled estimates of prevalence (Ɵ), heterogeneity (I<sup>2</sup>), and 95 % confidence intervals were calculated using the random effects model.</div></div><div><h3>Results</h3><div>Fifty-five studies were included. Information was available for nine states, none from Arunachal Pradesh, Mizoram, and Nagaland<em>. E. coli</em> was most frequently isolated (59.2 %, 95 % CI: 48.8–69.6 %), followed by <em>S. aureus</em> (36.2 %, 95 % CI: 20.2–52.2 %)<em>, Enterococcus</em> (27.5 %, 95 % CI: 11.2–43.7 %)<em>, Klebsiella</em> (25 %, 95 % CI: 15–35 %)<em>, Acinetobacter</em> (15.7 %, 95 % CI: 2.3–29.1 %), and <em>Pseudomona</em>s <em>aeruginosa</em> (15.7 %, 95 % CI: 4.1–27.3 %). There was high prevalence of ESBL (45 %, 95 % CI: 35–55 %) and carbapenem resistance (30 %, 95 % CI: 22–38 %). AmpC (23 %, 95 % CI: 9–37 %) and colistin resistance was lower (10 %, 95 % CI: 0–22 %) but supporting data was limited. Overall prevalence of MRSA was 26 % (95 % CI: 14–39 %), and VRE was 9 % (95 % CI: 0–17 %).</div></div><div><h3>Conclusion</h3><div>High prevalence of resistance was seen to all first-line antibiotics. Gram positive bacteria had high resistance to penicillins, and Gram negatives to third-generation cephalosporins, beta-lactam/beta-lactamase inhibitors, and carbapenems. Aminoglycoside, fluoroquinolone, and trimethoprim-sulphamethoxazole resistance was common across all genera. Critical regional AMR information gaps exist.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100732"},"PeriodicalIF":1.4,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A case report and literature review of nontuberculous mycobacterial disease caused by Mycolicibacter kumamotonensis 由库马莫托分枝杆菌引起的非结核分枝杆菌病病例报告和文献综述
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2024-09-12 DOI: 10.1016/j.ijmmb.2024.100731
Ayano Watanabe , Takehisa Sano , Kenta Murayama , Ryota Miyamoto , Junya Kamei , Toshihiro Masuda , Suguru Kojima , Kyoko Hijiya , Masato Fujii

Herein, we report a rare case of pulmonary nontuberculous mycobacterial (NTM) infection caused by Mycolicibacter kumamotonensis in a 73-year-old man successfully treated with clarithromycin, rifampicin, and ethambutol. Seven cases of NTM disease caused by M. kumamotonensis have been previously described, with characteristics differing from those of more common NTM diseases.

在此,我们报告了一例罕见的由库马莫托分枝杆菌(Mycolicibacter kumamotonensis)引起的肺部非结核分枝杆菌(NTM)感染病例,该患者 73 岁,接受克拉霉素、利福平和乙胺丁醇治疗后获得成功。以前曾描述过七例由库马莫托分枝杆菌引起的非结核分枝杆菌病,其特征与更常见的非结核分枝杆菌病不同。
{"title":"A case report and literature review of nontuberculous mycobacterial disease caused by Mycolicibacter kumamotonensis","authors":"Ayano Watanabe ,&nbsp;Takehisa Sano ,&nbsp;Kenta Murayama ,&nbsp;Ryota Miyamoto ,&nbsp;Junya Kamei ,&nbsp;Toshihiro Masuda ,&nbsp;Suguru Kojima ,&nbsp;Kyoko Hijiya ,&nbsp;Masato Fujii","doi":"10.1016/j.ijmmb.2024.100731","DOIUrl":"10.1016/j.ijmmb.2024.100731","url":null,"abstract":"<div><p>Herein, we report a rare case of pulmonary nontuberculous mycobacterial (NTM) infection caused by <em>Mycolicibacter kumamotonensis</em> in a 73-year-old man successfully treated with clarithromycin, rifampicin, and ethambutol. Seven cases of NTM disease caused by <em>M. kumamotonensis</em> have been previously described, with characteristics differing from those of more common NTM diseases.</p></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100731"},"PeriodicalIF":1.4,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Indian Journal of Medical Microbiology
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1