AbstractBackground: Infection is an important cause of death in burns. The emergence of antimicrobial resistant pathogens like ESBL producers is leading to inappropriate/or treatment failure and increased morbidity and mortality.Objective: the purpose of this study was to determine the antimicrobial susceptibility pattern with the identification of Extended spectrum Beta-lactamase (ESBL) producers among pathogens isolated from burn patients at Al-Shifa burn unit in Gaza, Palestine.Methods: A total of 40 gram-negative bacterial isolates were obtained from burn wound patients at Al-Shifa Hospital burn unit from August 2012 to December 2012. Antibiotic susceptibility profiles were determined by the standard disc diffusion method according to CLSI guidelines. The ESBL detection was screened by using double disc diffusion method.Results: Pseudomonas aeruginosa was the predominant isolate 15 (37.5%) followed by Klebsiella pneumoniae 10 (25%), Escherichia coli 9 (22.5%), Enterobacter cloacae 4 (10%) and Acinetobacter baumannii 2 (5%). ESBL was detected in 37.5% of isolates. Most of ESBL-producing isolates were susceptible to meropenem and imipenem (80% and 73% respectively). However, ESBL producing isolates showed 100% resistance against cefotaxime, followed by ampicillin with 93.3% resistance. The resistance rate towards sulfamethoxazole/trimethoprim, tetracycline, cefepime, tobramycin and aztreonam was 80%, 73.3%, 66.7%, 60% and 60% respectively. A. baumannii isolates were resistance to all tested antibiotics.Conclusion: P. aeruginosa is the most common bacteria isolated from burn wound patients. The frequency of ESBL among gram-negative bacteria is high. Carbapenems including imipenem and meropenem remain the most effective treatment options against gram-negative producing ESBL isolated from Al-Shifa burn unit.
{"title":"Occurrence and antimicrobial susceptibility pattern of ESBL among Gram-negative bacteria isolated from burn unit of Al Shifa hospital in Gaza, Palestine","authors":"G. Tayh, N. A. Laham, A. Elmanama, K. B. Slama","doi":"10.3823/775","DOIUrl":"https://doi.org/10.3823/775","url":null,"abstract":"AbstractBackground: Infection is an important cause of death in burns. The emergence of antimicrobial resistant pathogens like ESBL producers is leading to inappropriate/or treatment failure and increased morbidity and mortality.Objective: the purpose of this study was to determine the antimicrobial susceptibility pattern with the identification of Extended spectrum Beta-lactamase (ESBL) producers among pathogens isolated from burn patients at Al-Shifa burn unit in Gaza, Palestine.Methods: A total of 40 gram-negative bacterial isolates were obtained from burn wound patients at Al-Shifa Hospital burn unit from August 2012 to December 2012. Antibiotic susceptibility profiles were determined by the standard disc diffusion method according to CLSI guidelines. The ESBL detection was screened by using double disc diffusion method.Results: Pseudomonas aeruginosa was the predominant isolate 15 (37.5%) followed by Klebsiella pneumoniae 10 (25%), Escherichia coli 9 (22.5%), Enterobacter cloacae 4 (10%) and Acinetobacter baumannii 2 (5%). ESBL was detected in 37.5% of isolates. Most of ESBL-producing isolates were susceptible to meropenem and imipenem (80% and 73% respectively). However, ESBL producing isolates showed 100% resistance against cefotaxime, followed by ampicillin with 93.3% resistance. The resistance rate towards sulfamethoxazole/trimethoprim, tetracycline, cefepime, tobramycin and aztreonam was 80%, 73.3%, 66.7%, 60% and 60% respectively. A. baumannii isolates were resistance to all tested antibiotics.Conclusion: P. aeruginosa is the most common bacteria isolated from burn wound patients. The frequency of ESBL among gram-negative bacteria is high. Carbapenems including imipenem and meropenem remain the most effective treatment options against gram-negative producing ESBL isolated from Al-Shifa burn unit.","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84837550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Jiman-Fatani, D. El-Hossary, Rehab A. Eltahlawi
Tuberculosis (TB) remains a major cause of morbidity and mortality worldwide. Continued surveillance of drug susceptibility help determining treatment regimen by anti-tuberculous drugs. Gene Xpert PCR sensitivity was compared to the liquid culture media by Versa TREK for detecting Mycobacterium tuberculosis complex(MTBC). Rates, patterns and types of anti-tuberculosis drug- resistance atKing Abdulaziz University Hospital (KAUH), Jeddah, KSA were determined from January 2013 to June 2014.A total of 101 tuberculous patients were included, 43 Saudi tuberculous patients and 58 non-Saudi tuberculous patients. All resistances detected were primary resistances. PCR Sensitivities for detection of MTBC were 29.4%, 80%, 87.5%, 77.8% and 100% in AFB-negative samples and AFB +1,+2,+3 and +4 positive samples respectively. MTBC percentage detected by PCR was 88.1% in AFB-positive samples and 29.9% in AFB-negative ones. Versa Trek detection time was 15.01±7.32 days in AFB-positive samples and 26.63±6.7 days in AFB-negative ones. MTBC pyrazinamide resistance was (13.86%), followed by streptomycin (7.9%), rifampicin (3.96%) and isoniazid (3.96%). Mono-resistance percentages to pyrazinamide, rifampicin and isoniazid were 11.88%, 1.98% and 0.99% respectively. MDR-TB were 1.98% and anti-TB resistance percentage was 24.75%. There was no significant difference between Saudi and non-Saudi tuberculous patients regarding anti- tuberculous drugs resistance.
{"title":"Mycobacterium tuberculosis complex: Detection and patterns of resistance to the first line anti-TB drugs at the King Abdulaziz University Hospital, Saudi Arabia","authors":"A. Jiman-Fatani, D. El-Hossary, Rehab A. Eltahlawi","doi":"10.3823/774","DOIUrl":"https://doi.org/10.3823/774","url":null,"abstract":"Tuberculosis (TB) remains a major cause of morbidity and mortality worldwide. Continued surveillance of drug susceptibility help determining treatment regimen by anti-tuberculous drugs. Gene Xpert PCR sensitivity was compared to the liquid culture media by Versa TREK for detecting Mycobacterium tuberculosis complex(MTBC). Rates, patterns and types of anti-tuberculosis drug- resistance atKing Abdulaziz University Hospital (KAUH), Jeddah, KSA were determined from January 2013 to June 2014.A total of 101 tuberculous patients were included, 43 Saudi tuberculous patients and 58 non-Saudi tuberculous patients. All resistances detected were primary resistances. PCR Sensitivities for detection of MTBC were 29.4%, 80%, 87.5%, 77.8% and 100% in AFB-negative samples and AFB +1,+2,+3 and +4 positive samples respectively. MTBC percentage detected by PCR was 88.1% in AFB-positive samples and 29.9% in AFB-negative ones. Versa Trek detection time was 15.01±7.32 days in AFB-positive samples and 26.63±6.7 days in AFB-negative ones. MTBC pyrazinamide resistance was (13.86%), followed by streptomycin (7.9%), rifampicin (3.96%) and isoniazid (3.96%). Mono-resistance percentages to pyrazinamide, rifampicin and isoniazid were 11.88%, 1.98% and 0.99% respectively. MDR-TB were 1.98% and anti-TB resistance percentage was 24.75%. There was no significant difference between Saudi and non-Saudi tuberculous patients regarding anti- tuberculous drugs resistance.","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84020959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Abu-Qatouseh, Mohammad Abu-Sini, Amal Mayyas, R. Darwish, T. Aburjai, Qusai abdoh Qusai abdoh, I. Sabri
Introduction: Helicobacter pylori is a major cause of more than 80% of chronic active gastritis and other gastrodeudonal diseases worldwide. Successful treatment of H. pylori routinely requires the use of multiple agents with different mechanisms including compounds inhibiting acid secretion in conjunction with antibiotics. However, recent data showed the emergence of resistant clinical strains particularly against metronidazole and clarithromycin. The aim of this study is to determine the prevalence of and the susceptibility of H. pylori isolates recovered from patients with gastrodeudonal diseases to several antimicrobial agents. Materials and Methods: A prospective study has been conducting on Jordanian patients attended the gastrointestinal unit of the Jordan university hospital starting from 2014-2015 with gastroduodenal diseases. Antral and corpus mucosal biopsies from the stomach of each patient were used for the isolation of H. pylori on selective culture media. Presumptive H. pylori colonies were subsequently confirmed by biochemical tests and standard 16S rDNA PCR assay. The antimicrobial susceptibility testing was performed by standard agar diffusion methods according to CLSI. Subsequently, MICs were determined by E test and standard agar dilution method. Molecular typing of the clinical strains was performed using multiplex PCR for the detection of vacA and cagA genotypes. Metronidazole resistance was characterized by molecular methods for the detection of rdxA gene mutations. Results: Among 72 symptomatic patients, 13 (23%) patients showed positive H. pylori infection by both rapid urease test and culture. The antibiotic susceptibility profile showed that all of the isolates were sensitive to amoxicillin. Resistance to, clarithromycin, ciprofloxacin and levofloxacin were observed in 15%, 23% and 8% of the isolates respectively while 92% of the strains were resistant to metronidazole (MIC ≥ 32 ug/ml). Metronidazole resistance due to mutations in rdxA gene was only observed in one strain (8%) suggesting other resistance mechanisms. Correlation between antibiotic resistance and virulence factors was statistically not significant (p > 0.05). Conclusion: The present study showed that the prevalence of metronidazole resistance among clinical isolates of H. pylori is very high. Lower resistance to other antibiotics are reported. Concern should be taken into consideration when triple therapy is used for the treatment of H. pylori in our region.
{"title":"Molecular characterization and antibiotic susceptibility profiles of Helicobacter pylori isolated from patients with Gastrodeudenal diseases in Jordan","authors":"L. Abu-Qatouseh, Mohammad Abu-Sini, Amal Mayyas, R. Darwish, T. Aburjai, Qusai abdoh Qusai abdoh, I. Sabri","doi":"10.3823/794","DOIUrl":"https://doi.org/10.3823/794","url":null,"abstract":"Introduction: Helicobacter pylori is a major cause of more than 80% of chronic active gastritis and other gastrodeudonal diseases worldwide. Successful treatment of H. pylori routinely requires the use of multiple agents with different mechanisms including compounds inhibiting acid secretion in conjunction with antibiotics. However, recent data showed the emergence of resistant clinical strains particularly against metronidazole and clarithromycin. The aim of this study is to determine the prevalence of and the susceptibility of H. pylori isolates recovered from patients with gastrodeudonal diseases to several antimicrobial agents. Materials and Methods: A prospective study has been conducting on Jordanian patients attended the gastrointestinal unit of the Jordan university hospital starting from 2014-2015 with gastroduodenal diseases. Antral and corpus mucosal biopsies from the stomach of each patient were used for the isolation of H. pylori on selective culture media. Presumptive H. pylori colonies were subsequently confirmed by biochemical tests and standard 16S rDNA PCR assay. The antimicrobial susceptibility testing was performed by standard agar diffusion methods according to CLSI. Subsequently, MICs were determined by E test and standard agar dilution method. Molecular typing of the clinical strains was performed using multiplex PCR for the detection of vacA and cagA genotypes. Metronidazole resistance was characterized by molecular methods for the detection of rdxA gene mutations. Results: Among 72 symptomatic patients, 13 (23%) patients showed positive H. pylori infection by both rapid urease test and culture. The antibiotic susceptibility profile showed that all of the isolates were sensitive to amoxicillin. Resistance to, clarithromycin, ciprofloxacin and levofloxacin were observed in 15%, 23% and 8% of the isolates respectively while 92% of the strains were resistant to metronidazole (MIC ≥ 32 ug/ml). Metronidazole resistance due to mutations in rdxA gene was only observed in one strain (8%) suggesting other resistance mechanisms. Correlation between antibiotic resistance and virulence factors was statistically not significant (p > 0.05). Conclusion: The present study showed that the prevalence of metronidazole resistance among clinical isolates of H. pylori is very high. Lower resistance to other antibiotics are reported. Concern should be taken into consideration when triple therapy is used for the treatment of H. pylori in our region.","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"211 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87914141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. M. H. R. Alfola, Zeinat Kamel, M. Nada, L. Rashed, Basma A. El-Awady
Introduction: Extended-spectrum β-lactamases (ESBL)-producing Enterobacteriaceae are a clinical threat that may cause nosocomial as well as community-acquired infections. E.coli and Klebsiella are among the most common Gram-negative bacilli causing urinary tract infections. Aim of the study: Molecular confirmation of ESBL production among phenotypically proved ESBL-producing E.coli and Klebsiella. Materials and Methods: A total of 64 community and hospital-acquired Enterobacteriaceae suspected to produce ESBLs by routine antimicrobial susceptibility test. Identification of species of Enterobacteriacea was done by the API 20E identification system. ESBL production was detected by double disc synergy test (DDST) followed by detection of the encoding genes by PCR using primers for bla-TEM, bla-CTX-M1, bla-CTX-M2, bla-SHV and bla-PER genes. Results: E.coli (n=40) and Klebsiella pneumonie (n=24) were identified by API 20E. Fourty nine isolates were positive for ESBL-production by DDST. Fifty seven isolates proved to produce ESBLs by PCR. The bla-TEM, bla-CTX-M1 and bla-PER were the most prevalent ESBL genes detected by PCR. Conclusion: The double disc synergy test showed sensitivity of 82.5% in relation to PCR. The study showed high prevalence of ESBLs in E.coli and Klebsiella pneumonie with bla-TEM, bla-CTX-M1 and bla-PER as the predominant ESBL genes. Key words: E.coli, Klebsiella pneumonie, ESBL, DDST, PCR.
{"title":"Phenotypic and Genotypic Characterization of ESBL-Producing Escherichia coli and Klebsiella pneumonia isolates from Patient’s Urine specimens","authors":"M. M. H. R. Alfola, Zeinat Kamel, M. Nada, L. Rashed, Basma A. El-Awady","doi":"10.3823/798","DOIUrl":"https://doi.org/10.3823/798","url":null,"abstract":"Introduction: Extended-spectrum β-lactamases (ESBL)-producing Enterobacteriaceae are a clinical threat that may cause nosocomial as well as community-acquired infections. E.coli and Klebsiella are among the most common Gram-negative bacilli causing urinary tract infections. Aim of the study: Molecular confirmation of ESBL production among phenotypically proved ESBL-producing E.coli and Klebsiella. Materials and Methods: A total of 64 community and hospital-acquired Enterobacteriaceae suspected to produce ESBLs by routine antimicrobial susceptibility test. Identification of species of Enterobacteriacea was done by the API 20E identification system. ESBL production was detected by double disc synergy test (DDST) followed by detection of the encoding genes by PCR using primers for bla-TEM, bla-CTX-M1, bla-CTX-M2, bla-SHV and bla-PER genes. Results: E.coli (n=40) and Klebsiella pneumonie (n=24) were identified by API 20E. Fourty nine isolates were positive for ESBL-production by DDST. Fifty seven isolates proved to produce ESBLs by PCR. The bla-TEM, bla-CTX-M1 and bla-PER were the most prevalent ESBL genes detected by PCR. Conclusion: The double disc synergy test showed sensitivity of 82.5% in relation to PCR. The study showed high prevalence of ESBLs in E.coli and Klebsiella pneumonie with bla-TEM, bla-CTX-M1 and bla-PER as the predominant ESBL genes. Key words: E.coli, Klebsiella pneumonie, ESBL, DDST, PCR.","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90478189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective One of the properties of an ideal root canal irrigant is the ability to eradicate Enterococcus faecalis which is one of the most resistant microorganisms encountered in persistent peri-radicular lesions. The aim of this study was to test the in vitro antibacterial effectiveness of a naturally occurring agent called phytic acid (IP6) against E. faecalis and compare it to the antibacterial activities of clinically used irrigants: sodium hypochlorite (NaOCl), ethylenediaminetetraacetic (EDTA), phosphoric acid (PA) and chlorhexidine (CHX). Design The antimicrobial activities of 5% IP6, 5% NaOCl, 18% EDTA, 37% PA and 2% CHX against E. faecalis were determined using disk diffusion test. Minimum inhibitory concentration (MIC) was calculated by broth macrodilution method. The minimal bactericidal concentration (MBC) was determined for the used agents by culturing the clear broth of MIC tests. Results The results of agar diffusion test showed statistically significant differences between the groups. PA showed a larger zone when compared to other tested materials (p< 0.05). There was no statistical significant difference between NaOCl, EDTA and CHX (p=0.098). IP6 showed the smallest zone of inhibition when compared to all groups (p< 0.05).The recorded MIC and MBC values for IP6 were 0.156% and 0.625%; respectively. The MIC and MBC values for PA were 0.578% and 4.6% and for NaOCl 0.093% and 0.375%, respectively. EDTA MIC value was 0.14 % but it showed no bactericidal activity. CHX was excluded from MIC test as immediate precipitation and turbidity occurred after mixing CHX with Mueller Hinton Broth. Conclusions Within the limitation of this study and despite that IP6 showed the smallest zone of inhibition in agar diffusion test, the results of MIC and MBC indicated that IP6 exhibits in vitro antibacterial effect against E. faecalis at low concentrations.
{"title":"Antimicrobial effect of phytic acid on Enterococcus faecalis","authors":"Rania Nassar, M. Nassar","doi":"10.3823/796","DOIUrl":"https://doi.org/10.3823/796","url":null,"abstract":"Objective One of the properties of an ideal root canal irrigant is the ability to eradicate Enterococcus faecalis which is one of the most resistant microorganisms encountered in persistent peri-radicular lesions. The aim of this study was to test the in vitro antibacterial effectiveness of a naturally occurring agent called phytic acid (IP6) against E. faecalis and compare it to the antibacterial activities of clinically used irrigants: sodium hypochlorite (NaOCl), ethylenediaminetetraacetic (EDTA), phosphoric acid (PA) and chlorhexidine (CHX). Design The antimicrobial activities of 5% IP6, 5% NaOCl, 18% EDTA, 37% PA and 2% CHX against E. faecalis were determined using disk diffusion test. Minimum inhibitory concentration (MIC) was calculated by broth macrodilution method. The minimal bactericidal concentration (MBC) was determined for the used agents by culturing the clear broth of MIC tests. Results The results of agar diffusion test showed statistically significant differences between the groups. PA showed a larger zone when compared to other tested materials (p< 0.05). There was no statistical significant difference between NaOCl, EDTA and CHX (p=0.098). IP6 showed the smallest zone of inhibition when compared to all groups (p< 0.05).The recorded MIC and MBC values for IP6 were 0.156% and 0.625%; respectively. The MIC and MBC values for PA were 0.578% and 4.6% and for NaOCl 0.093% and 0.375%, respectively. EDTA MIC value was 0.14 % but it showed no bactericidal activity. CHX was excluded from MIC test as immediate precipitation and turbidity occurred after mixing CHX with Mueller Hinton Broth. Conclusions Within the limitation of this study and despite that IP6 showed the smallest zone of inhibition in agar diffusion test, the results of MIC and MBC indicated that IP6 exhibits in vitro antibacterial effect against E. faecalis at low concentrations.","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74956192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. A. Salman, R. Agha, Amani Al Arrayedh, D. Radhi, M. A. Alawi, A. Khalaf, Z. Ebrahim
{"title":"Infection among renal transplant patients in the Kingdom of Bahrain: A ten year retrospective study ( 2004-2014)","authors":"J. A. Salman, R. Agha, Amani Al Arrayedh, D. Radhi, M. A. Alawi, A. Khalaf, Z. Ebrahim","doi":"10.3823/797","DOIUrl":"https://doi.org/10.3823/797","url":null,"abstract":"","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86041839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Plasmid mediated quinolone resistant determinants (PMQR) are found to be of clinical relevance because it causes decreased quinolones sensitivity. Quinolones are valuable antibiotics against intrinsically resistant Serratia marcescens. Purpose: To determine the occurrence of PMQR determinants qnr, aac(6′)-Ib-cr and qep and their relation with extended-spectrum β-lactamase (ESBL) and / or Amp C- producing Serratia marcescens. Material and Method: One hundred and eleven Serratia marcescens were tested for resistance to five quinolones by disc diffusion method. Testing for qnr, aac(6′)-Ib-cr and qep was carried by multiplex PCR. Whereas ESBL and Amp C production were evaluated by double disc synergy test and cefoxitin Hodge test respectively. Results: Out of 111 Serratia marcescens , 51 (45.9%) were resistant to one or more of the used quinolones. Among Serratia marcescens isolates, 13 (11.7%) were ESBL producers while 5 (4.5%) were Amp C producers. Multiplex PCR confirmed the presence of PMQR determinant in 14 (12.6%) isolates of Serratia marcescens. Serratia marcescens positive for qnr determinants were detected as qnrA and qnr B in 3 and 10 isolates respectively whereas one isolate co harbored aac(6')-Ib-cr and qnrA. Among 13 ESBL producers, 3 and 5 isolates were positive for qnrA and qnr B respectively (8/13, 61.5%). Whereas one isolate co- expressed aac(6')-Ib-cr and qnrA was associated with Amp C production (1/5, 20%). Conclusion: This study indicated that PMQR play significant role in the occurrence and expansion of fluoroquinolone resistance in Serratia macrscens. Moreover they are closely associated with ESBL and Amp C producers.
{"title":"PMQR determinants among clinical isolates of ESBL and Amp C producing Serratia marcescens in Mansoura University Hospitals: A 6-year study","authors":"E. Hammad, R. Helal","doi":"10.3823/773","DOIUrl":"https://doi.org/10.3823/773","url":null,"abstract":"Background: Plasmid mediated quinolone resistant determinants (PMQR) are found to be of clinical relevance because it causes decreased quinolones sensitivity. Quinolones are valuable antibiotics against intrinsically resistant Serratia marcescens. Purpose: To determine the occurrence of PMQR determinants qnr, aac(6′)-Ib-cr and qep and their relation with extended-spectrum β-lactamase (ESBL) and / or Amp C- producing Serratia marcescens. Material and Method: One hundred and eleven Serratia marcescens were tested for resistance to five quinolones by disc diffusion method. Testing for qnr, aac(6′)-Ib-cr and qep was carried by multiplex PCR. Whereas ESBL and Amp C production were evaluated by double disc synergy test and cefoxitin Hodge test respectively. Results: Out of 111 Serratia marcescens , 51 (45.9%) were resistant to one or more of the used quinolones. Among Serratia marcescens isolates, 13 (11.7%) were ESBL producers while 5 (4.5%) were Amp C producers. Multiplex PCR confirmed the presence of PMQR determinant in 14 (12.6%) isolates of Serratia marcescens. Serratia marcescens positive for qnr determinants were detected as qnrA and qnr B in 3 and 10 isolates respectively whereas one isolate co harbored aac(6')-Ib-cr and qnrA. Among 13 ESBL producers, 3 and 5 isolates were positive for qnrA and qnr B respectively (8/13, 61.5%). Whereas one isolate co- expressed aac(6')-Ib-cr and qnrA was associated with Amp C production (1/5, 20%). Conclusion: This study indicated that PMQR play significant role in the occurrence and expansion of fluoroquinolone resistance in Serratia macrscens. Moreover they are closely associated with ESBL and Amp C producers.","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83690891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Cucunawangsih, V. Wiwing, Nata Ph Lugito, V. Puspitasari
Central nervous system (CNS) infections have become serious problems that contribute to morbidity and mortality in developing countries. In the recent years, antimicrobial resistance has arisen parallel with the changing trend of infectious pathogens, which resulted in the unavailability of an ideal antimicrobial agent. This study was designed to evaluate the central nervous system pathogens and their susceptibility profile using routine microbiological data. The data of CSF culture and susceptibility testing were collected from January 2010 to August 2015. The majority of eligible sample 68/99 (68.7%) had history of neurosurgical procedures. The most common pathogens isolated were coagulase negative staphylococci (CoNS) 39/99 (39.4%) followed by Acinetobacter baumanii 10/99 (10.1%), Pseudomonas aeruginosa 7/99 (7.1%), Sphingomonas paucimobilis 5/99 (5.0%), and Aeromonas salmonocida 4/99 (4.0%). Almost of all Gram positive cocci were susceptible to tigecycline, linezolide, vancomycin, and trimethoprim/sulfamethoxazole. Most Gram negative bacilli (GNB) in this study were multi-drug resistant with high susceptibility level to amikacin, tigecycline, and trimethoprim/sulfamethoxazole. The overall susceptibility testing to cephalosporins was low, ranging 34.2% to 58.5%. The susceptibility to several antifungal remained high for Candida spp. and Cryptococcus neoformans. The present study notifies the changing pathogens trend of CNS infections along with their antimicrobial susceptibility level in our hospital. There is a need of local antimicrobial recommendation and surveillance system to control the usage of antimicrobial and selection of empirical antimicrobial therapy.
{"title":"The changing microbiological and antimicrobial susceptibility profile of cerebrospinal fluid organism isolates in a teaching hospital, Tangerang, Indonesia","authors":"C. Cucunawangsih, V. Wiwing, Nata Ph Lugito, V. Puspitasari","doi":"10.3823/772","DOIUrl":"https://doi.org/10.3823/772","url":null,"abstract":"Central nervous system (CNS) infections have become serious problems that contribute to morbidity and mortality in developing countries. In the recent years, antimicrobial resistance has arisen parallel with the changing trend of infectious pathogens, which resulted in the unavailability of an ideal antimicrobial agent. This study was designed to evaluate the central nervous system pathogens and their susceptibility profile using routine microbiological data. The data of CSF culture and susceptibility testing were collected from January 2010 to August 2015. The majority of eligible sample 68/99 (68.7%) had history of neurosurgical procedures. The most common pathogens isolated were coagulase negative staphylococci (CoNS) 39/99 (39.4%) followed by Acinetobacter baumanii 10/99 (10.1%), Pseudomonas aeruginosa 7/99 (7.1%), Sphingomonas paucimobilis 5/99 (5.0%), and Aeromonas salmonocida 4/99 (4.0%). Almost of all Gram positive cocci were susceptible to tigecycline, linezolide, vancomycin, and trimethoprim/sulfamethoxazole. Most Gram negative bacilli (GNB) in this study were multi-drug resistant with high susceptibility level to amikacin, tigecycline, and trimethoprim/sulfamethoxazole. The overall susceptibility testing to cephalosporins was low, ranging 34.2% to 58.5%. The susceptibility to several antifungal remained high for Candida spp. and Cryptococcus neoformans. The present study notifies the changing pathogens trend of CNS infections along with their antimicrobial susceptibility level in our hospital. There is a need of local antimicrobial recommendation and surveillance system to control the usage of antimicrobial and selection of empirical antimicrobial therapy.","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90056801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Klebsiella species are widely present in the environment and colonize mucosal surfaces of humans. The organism is responsible for various community and hospital-acquired infections. Increased incidence of isolates producing K .pneumoniae carbapenemases (KPCs) in infected patients has become a significant problem in many countries, especially those new hypervirulent clinical variant (hvKP). This prospective study was intended to detect the incidence, virulence factors and carbapenems resistant gene (blakpc2) in K. pneumoniae isolates among Jordanian patients.Methods: A total of 104 klebsiella species isolates were collected randomly from three major hospitals in Amman, Jordan, over the period from September 2012 to October 2013. These isolates were investigated for incidence of K.pneumoniae , antimicrobial susceptibility and detection of virulence factors and kpc gene using PCR .Results: A total of 75 (72%) of the collected isolates were confirmed as K. pneumoniae using PCR, and 74% of these were MDR to at least 3 antibiotic classes. The percentage of the virulence factors K1, K2, K5, rmpA and aerobactin were 0%, 4%, 0%, 5.3% and 10.7%, respectively. Resistant to cabapenems was detected in 18/75 (24% ) of K . pneumoniae isolates, and 10 (13.3%) of these have the kpc genes .Conclusion: This study confirms the high incidence rate of MDR K. pneumoniae and low incidence of (KPCs) isolates in Jordanian patients. There were few isolates associated with virulence factor genes causing hvKP, and no significant correlation demonstrated between the presence of virulence factors and kpc gene in these isolates.
{"title":"Low incidence of hypervirulent clinical klebsiella pneumoniae producing carbapenemases among Jordanian hospitalized patients","authors":"A. Mahasneh, A. Mahafzah, A. Shehabi","doi":"10.3823/771","DOIUrl":"https://doi.org/10.3823/771","url":null,"abstract":"Background: Klebsiella species are widely present in the environment and colonize mucosal surfaces of humans. The organism is responsible for various community and hospital-acquired infections. Increased incidence of isolates producing K .pneumoniae carbapenemases (KPCs) in infected patients has become a significant problem in many countries, especially those new hypervirulent clinical variant (hvKP). This prospective study was intended to detect the incidence, virulence factors and carbapenems resistant gene (blakpc2) in K. pneumoniae isolates among Jordanian patients.Methods: A total of 104 klebsiella species isolates were collected randomly from three major hospitals in Amman, Jordan, over the period from September 2012 to October 2013. These isolates were investigated for incidence of K.pneumoniae , antimicrobial susceptibility and detection of virulence factors and kpc gene using PCR .Results: A total of 75 (72%) of the collected isolates were confirmed as K. pneumoniae using PCR, and 74% of these were MDR to at least 3 antibiotic classes. The percentage of the virulence factors K1, K2, K5, rmpA and aerobactin were 0%, 4%, 0%, 5.3% and 10.7%, respectively. Resistant to cabapenems was detected in 18/75 (24% ) of K . pneumoniae isolates, and 10 (13.3%) of these have the kpc genes .Conclusion: This study confirms the high incidence rate of MDR K. pneumoniae and low incidence of (KPCs) isolates in Jordanian patients. There were few isolates associated with virulence factor genes causing hvKP, and no significant correlation demonstrated between the presence of virulence factors and kpc gene in these isolates.","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85004877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Candidemia is a major cause of morbidity and mortality in hospitalized patients. The spectrum of candidemia has been changed especially among critically ill patients due to emergence of non-albicans Candida (NAC) species. The increasing use of azole agents is suggested to be responsible for this epidemiological shift. NAC species are of special concern because of their high drug-resistance and increasing prevalence.The aim of this study was to detect antifungal-susceptibility patterns, treatment outcomes and associated risk factors in patients with candidemia who were admitted to King Abdulaziz University Hospital (KAUH), Jeddah, Kingdom of Saudi Arabia (KSA) . Methods: This work represents a cross sectional study done in the Clinical and Microbiology Laboratory at KAUH, during the period from March 2012 till February 2014 on a total of 141 patients with candidemia. They were 31(22%) Saudi and 110(87%) non-Saudi patients with age ranged from 1 day - 102 years. Blood cultures were collected for suspected cases of candidemia, followed by subculture on SDA. Identifiation was done by VITEK MS (MALDI-TOF MS), and confimation of Candida isolates and antifungal-susceptibility testing were performed by using VITEK ®2 system. Results: C.albicans isolates accounted for 39.7%, followed by C. tropicalis (21.3%), C. galabrata (18.4%) and C. parapsiliosis (14.9%). Additionally, C. dublinsis, C. krusei and C. famata were representing 2.1%, 2.1% and 1.4%, respectively. All Candida isolates were 100% susceptible to amphotericin B. The best susceptibility to flconazole was detected among each C. dubliensis and C. famata (100%). All C. krusei isolates were resistant to flconazole, while they were susceptible to other antifungal agents. All isolates were susceptible to flcytosine,except C. albicans and C. dubliensis which were susceptible 92.9%and 66.7%, respectively. All isolates were susceptible to itraconazol,except C. albicans and C. tropicalis which were susceptible 94.6% and 96.7%, respectively. The percentage of deceased patients with candidemia was signifiantly higher than the survivors among age group >64 years, particularly those who were mechanically ventilated and those understeroid therapy. The percentage of deceased patients was signifiantly higher than survivors among those admitted to adult ICUs (73.78%vs 26.23%) . Conclusion: This study shows an epidemiological shift to higher NAC species isolation rates, with 100% susceptibility to amphotericin B in all isolates either C. albicans or NAC species, and 100% susceptibility to flconazole among C. dubliensis and C. famata. Patients aged > 64 years, admission to adult ICUs, mechanical ventilation and steroid therapy were signifiant risk factors for increased mortality due to candidemia.
背景:念珠菌是住院患者发病和死亡的主要原因。由于非白色念珠菌(NAC)物种的出现，念珠菌的谱已经发生了变化，特别是在危重患者中。越来越多地使用唑类药物被认为是造成这种流行病学转变的原因。由于耐药程度高且流行率不断上升，NAC物种受到特别关注。本研究的目的是检测沙特阿拉伯王国(KSA)吉达阿卜杜勒阿齐兹国王大学医院(KAUH)收治的念珠菌病患者的抗真菌药敏模式、治疗结果和相关危险因素。方法:本研究是在2012年3月至2014年2月期间，在kah临床和微生物实验室对141例念珠菌患者进行的横断面研究。31例沙特患者(22%)和110例非沙特患者(87%)，年龄从1天到102岁不等。对疑似念珠菌采集血培养，然后进行SDA传代培养。鉴定采用VITEK MS (MALDI-TOF MS)，假丝酵母菌分离株鉴定及药敏试验采用VITEK®2系统。结果:白色念珠菌占39.7%，其次是热带念珠菌(21.3%)、半蓝念珠菌(18.4%)和副肺念珠菌(14.9%)。另外，C. dublinsis、C. krusei和C. famata分别占2.1%、2.1%和1.4%。所有念珠菌对两性霉素b的敏感性均为100%，其中dubliensis和famata对氟康唑的敏感性最高(100%)。所有菌株对氟康唑耐药，对其他抗真菌药物敏感。除白色念珠菌和dubliensis对氟胞嘧啶敏感92.9%和66.7%外，其余菌株均对氟胞嘧啶敏感。除白色假丝酵母菌和热带假丝酵母菌对伊曲康唑敏感外，其余菌株均对伊曲康唑敏感，敏感性分别为94.6%和96.7%。在>64岁年龄组中，念珠菌菌死亡患者的百分比明显高于幸存者，特别是那些机械通气和类固醇治疗的患者。成人重症监护病房中死亡患者的比例明显高于存活患者(73.78%vs 26.23%)。结论:本研究显示出流行病学向较高NAC种分离率的转变，白色念珠菌和NAC种分离株对两性霉素B的敏感性均为100%，对氟康唑的敏感性为100%。年龄> 64岁、入住成人icu、机械通气和类固醇治疗是念珠菌病死亡率增加的重要危险因素。
{"title":"Antifungal susceptibility, risk factors and treatment outcomes of patients with candidemia at a university hospital in Saudi Arabia","authors":"A. Jiman-Fatani, T. Meawed, D. El-Hossary","doi":"10.3823/770","DOIUrl":"https://doi.org/10.3823/770","url":null,"abstract":"Background: Candidemia is a major cause of morbidity and mortality in hospitalized patients. The spectrum of candidemia has been changed especially among critically ill patients due to emergence of non-albicans Candida (NAC) species. The increasing use of azole agents is suggested to be responsible for this epidemiological shift. NAC species are of special concern because of their high drug-resistance and increasing prevalence.The aim of this study was to detect antifungal-susceptibility patterns, treatment outcomes and associated risk factors in patients with candidemia who were admitted to King Abdulaziz University Hospital (KAUH), Jeddah, Kingdom of Saudi Arabia (KSA) . Methods: This work represents a cross sectional study done in the Clinical and Microbiology Laboratory at KAUH, during the period from March 2012 till February 2014 on a total of 141 patients with candidemia. They were 31(22%) Saudi and 110(87%) non-Saudi patients with age ranged from 1 day - 102 years. Blood cultures were collected for suspected cases of candidemia, followed by subculture on SDA. Identifiation was done by VITEK MS (MALDI-TOF MS), and confimation of Candida isolates and antifungal-susceptibility testing were performed by using VITEK ®2 system. Results: C.albicans isolates accounted for 39.7%, followed by C. tropicalis (21.3%), C. galabrata (18.4%) and C. parapsiliosis (14.9%). Additionally, C. dublinsis, C. krusei and C. famata were representing 2.1%, 2.1% and 1.4%, respectively. All Candida isolates were 100% susceptible to amphotericin B. The best susceptibility to flconazole was detected among each C. dubliensis and C. famata (100%). All C. krusei isolates were resistant to flconazole, while they were susceptible to other antifungal agents. All isolates were susceptible to flcytosine,except C. albicans and C. dubliensis which were susceptible 92.9%and 66.7%, respectively. All isolates were susceptible to itraconazol,except C. albicans and C. tropicalis which were susceptible 94.6% and 96.7%, respectively. The percentage of deceased patients with candidemia was signifiantly higher than the survivors among age group >64 years, particularly those who were mechanically ventilated and those understeroid therapy. The percentage of deceased patients was signifiantly higher than survivors among those admitted to adult ICUs (73.78%vs 26.23%) . Conclusion: This study shows an epidemiological shift to higher NAC species isolation rates, with 100% susceptibility to amphotericin B in all isolates either C. albicans or NAC species, and 100% susceptibility to flconazole among C. dubliensis and C. famata. Patients aged > 64 years, admission to adult ICUs, mechanical ventilation and steroid therapy were signifiant risk factors for increased mortality due to candidemia.","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76056874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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