GERMS最新文献

Introduction: Integrons are genetic systems that may confer antibiotic resistance to Pseudomonas aeruginosa. Biofilm formation can facilitate gene exchange and can accelerate the development of antibiotic resistance. The aim of this work was to assess the distribution of resistance integrons including class 1, 2 and 3 among biofilm- and non-biofilm producing clinical strains of P. aeruginosa. We also aimed to investigate the relationship between the existence of these integrons and the isolates' resistance patterns.

Methods: Specimens were obtained from patients showing evidence of infection. P. aeruginosa isolates were identified using conventional techniques, while disk diffusion test was used to detect their antimicrobial susceptibilities. Biofilm formation was detected by the tissue culture plate technique, while classes of integrons were detected by polymerase chain reaction.

Results: Out of 106 P. aeruginosa isolates, 55.7% were class 1 integron-positive while 19.8% were class 2 integron-positive. However, class 3 integrons were not detected. Significant associations were found between class 1 integrons and resistance toward amikacin, gentamicin, cefepime, ceftazidime and ciprofloxacin. Class 2 integrons were associated with amikacin, ceftazidime and cefepime resistance. Of pseudomonal isolates, 61.3% were biofilm producing. Biofilm production was associated significantly with the existence of class 1 integrons (p<0.001) and class 2 integrons (p=0.039).

Conclusions: About two thirds of isolated strains harbored resistance integrons, which emphasized their significance in our locality. The frequencies of class 1 and 2 integrons were significantly higher among biofilm forming isolates. Ongoing surveillance and infection control strategies are necessary to limit spread of integrons.

Pseudomonas aeruginosa is one of the most common causes of diabetic foot infection globally. This study aimed to determine the global distribution of P. aeruginosa isolated from diabetic foot ulcer infection. PRISMA procedure was used to perform the current systematic review and meta-analysis. The Web of Science, MEDLINE/PubMed, Scopus, and other databases were searched for studies published in English from 2000 to 2022. Data was analyzed using the Comprehensive Meta-Analysis software (CMA). Keywords and MESH phrases included Pseudomonas aeruginosa, diabetic foot ulcer, P. aeruginosa, and diabetic foot infection. As a result of this review, 16.6% of diabetic foot wound infections were caused by P. aeruginosa. About 37.9% of strains were multidrug resistant (MDR). P. aeruginosa infection rates in diabetic foot ulcers ranged from 0.5 to 100% globally. In total, the prevalence rates of P. aeruginosa in diabetic foot ulcer infection from Asia, Africa, and Western countries were reported at 18.5%, 16.3%, and 11.1%, respectively. Data have shown that the prevalence of P. aeruginosa, particularly MDR strains, isolated from diabetic foot ulcer infection was relatively high; inherent resistance to antibiotics is also high; the wound either does not heal or if it does, it will be delayed. Therefore, timely treatment is essential.

Introduction: Hydropneumothorax with a bronchopleural fistula is an infrequent but severe complication of necrotizing pneumonia associated with high morbidity and mortality. Few cases in the adult population have been reported.

Case report: This is a case of a 76-year-old male patient who developed pneumonia caused by Pseudomonas aeruginosa and Klebsiella pneumoniae complicated by hydropneumothorax. He was managed conservatively with chest tube placement but denied surgical management and eventually died despite initial improvement.

Conclusions: Early recognition and appropriate management of pneumonia complications, such as hydropneumothorax, including thoracic surgeon interventions, are crucial as this complication can be fatal. Factors like the patient's overall status, preferences, and comorbidities may have a crucial effect on clinical decisions and outcomes.

Introduction: This study aimed to examine the effect of commonly used non-antibiotic drugs (dexamethasone and tenoxicam), on treatment of Pseudomonas aeruginosa infections, antibiotic resistance and virulence in this pathogen.

Methods: Four antibiotics (gentamicin, cefepime, ciprofloxacin and meropenem) were investigated. The proteolysis and hemolysis were selected as virulence factors for investigation. In this work, we selected the following final concentrations: dexamethasone (0.0052 μg/mL) and tenoxicam (2.7 μg/mL) to be used in combination with antibiotics or alone for investigation of their effects on antibiotic resistance and virulence in P. aeruginosa isolates.

Results: The drugs either increased or decreased antibiotic resistance in only 0-3 isolates, which indicates that the investigated drugs did not significantly affect the antibiotic resistance. Interestingly, our study demonstrated that both dexamethasone and tenoxicam increased the hemolytic activity of the investigated isolates. On the other hand, our results indicated that no overall final increasing or decreasing effect could be observed for dexamethasone on the proteolytic activity, while tenoxicam increased the proteolytic activity of the investigated isolates. Interestingly, by real-time PCR dexamethasone has shown significant down-regulation of virulence genes namely algD, plcH and toxA, apparently, in case of combination with ciprofloxacin and with gentamicin in one isolate. However, a negative influence was observed in another isolate. Unfortunately, in the case of tenoxicam the only positive effect was observed in the combination with gentamicin in one isolate.

Conclusions: Resistance of P. aeruginosa against gentamicin and ciprofloxacin may be affected by combining these antibiotics with dexamethasone or tenoxicam.

Introduction: Fosfomycin is an effective treatment for urinary tract infections (UTIs). It is not currently used in Sri Lanka to treat UTIs. Hence, this study was conducted to assess the fosfomycin susceptibility for E. coli in urinary isolates, with an aim to find the usability of fosfomycin in the context of high antibiotic resistance.

Methods: E. coli isolates were identified by the colony appearance and by performing biochemical tests for the urinary coliform isolates collected from two different hospitals in Western Province Sri Lanka, during the period of November 2021 to February 2022. Susceptibility to fosfomycin 200 μg disc was performed following the Clinical Laboratory Standard Institute (CLSI) disc diffusion method.

Results: A total of 101 E. coli isolates from both oncology patients (52.5%) and non-oncology patients (47.5%) were identified and included in the study. The study sample showed majority of females (63.3%). Ampicillin showed the highest resistance rate (72.2%) while fosfomycin was the only antibiotic that showed 100% in vitro susceptibility to all the tested clinical isolates. The overall presence of multidrug-resistant (MDR) and carbapenem-resistant (CR) E. coli were 47.5% and 9.9% respectively.

Conclusions: Fosfomycin is a potential antibiotic option especially for MDR and CR organisms, with 100% in vitro susceptibility. Further studies involving multiple centers, with larger sample size and clinical efficacy studies would be important to assess the potential use of fosfomycin especially for the treatment of UTI-causing MDR and CR organisms.

Peri-implantitis is a pathological condition in dental medicine that manifests as an inflammatory process affecting the tissues surrounding dental implants. Peri-implantitis occurs when the soft and hard tissues surrounding these implants become inflamed, leading to progressive destruction of the supporting bone. The etiology of peri-implantitis is multifactorial, involving microbial, host-related, and environmental factors. Microbial involvement in peri-implantitis can be explained either by direct in-situ virulence activation leading to pathogenicity, or by induction of low-grade chronic immune activation, leading to long-term persistence of a pro-inflammatory status. Understanding peri-implantitis is pivotal in maintaining the long-term success of dental implants and improving patient outcomes in implant-supported restorations. Recognizing the etiological factors, including particular bacterial species, genetic predispositions, and environmental influences, is very important for devising effective preventive strategies and targeted interventions.