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- A case of wound infection caused by Shewanella algae in the south of Iran. [Journal Article]
- New Microbes New Infect 2014 Jan; 2(1):29-30.
Shewanella algae was isolated from the purulent discharge in the navel area of a young male with a history of swimming in the Persian Gulf. A routine laboratory diagnosis procedure, followed by 16S rRNA gene sequence analyses, was used to avoid misidentification with other species of Shewanella. The bacterium was suscetible to ceftazidime, ciprofloxacin, nalidixic acid, nitrophorantion, amikacin, ceftriaxone, cefotaxime, gentamicin and co-trimoxazole but was resistant to amoxicillin, vancomycin, doxycycline, cephalexin, ampicillin, tetracycline, cephalothin and ceftizoxime. The patient successfully recovered after treatment with antibiotics.
- Dermabacter hominis: a usually daptomycin-resistant gram-positive organism infrequently isolated from human clinical samples. [Journal Article]
- New Microbes New Infect 2013 Dec; 1(3):35-40.
During a 12-year period, Dermabacter hominis was isolated from 21 clinical samples belonging to 14 patients attending a tertiary hospital in León, Spain. Samples included blood cultures (14), peritoneal dialysis catheter exit sites (three), cutaneous abscesses (two), an infected vascular catheter (one) and a wound swab (one). Identification was made by API Coryne™ V2.0, Biolog™ GP2 and 16S rRNA gene amplification. Six febrile patients had positive blood cultures (one, two or three sets) and all of them were treated with teicoplanin (two patients), vancomycin, ampicillin plus gentamicin, amoxicillin/clavulanic acid and ciprofloxacin (one each). An additional patient with a single positive blood culture was not treated, the finding being considered non-significant. In the remaining seven patients the organism was isolated from a single specimen and three of them received antimicrobial treatment (ciprofloxacin, ceftriaxone plus vancomycin and amoxicillin/clavulanic acid). At least ten patients had several underlying diseases and conditions, and no direct mortality was observed in relation to the isolated organism. All isolates were susceptible to vancomycin, rifampin and linezolid. Resistance to other antibiotics varied: erythromycin (100%), clindamycin (78.5%), ciprofloxacin (21.4%) and gentamicin, quinupristin-dalfopristin, benzylpenicillin and imipenem 7.1% each. Thirteen isolates were highly resistant to daptomycin with MICs ranging from 8 to 48 (MIC90 = 32 mg/L); only one was daptomycin-sensitive (MIC = 0.19 mg/L).
- Standard triple therapy for Helicobacter pylori infection in China: A meta-analysis. [Journal Article]
- World J Gastroenterol 2014 Oct 28; 20(40):14973-85.
To assess the efficacy and safety of standard triple therapy compared with other pre-existing and new therapies in China.Literature searches were conducted in the following databases: PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, the VIP database, the China National Knowledge Infrastructure database, and the Chinese Biomedical Database. A meta-analysis of all randomized controlled trials (RCTs) comparing standard triple therapy for the eradication of Helicobacter pylori with pre-existing and new therapies in China was performed using Comprehensive Meta-Analysis 2.0. There were 49 studies that met our criteria and the qualities of these studies were assessed using the Jadad scale. The Mantel-Haenszel method was used for pooling dichotomous data. We also conducted subgroup analyses according to age, duration of treatment and drug type. Sensitivity analyses and a cumulative meta-analysis were also performed with CMA 2.0. Publication bias was evaluated using Egger's test, Begg's test or a funnel plot.A total of 49 RCTs including 8332 patients were assessed. This meta-analysis showed that standard triple therapy with proton pump inhibitors (PPIs), amoxicillin (AMO) and clarithromycin (CLA) was inferior to sequential therapy [relative risk (RR) = 0.863; 95% confidence interval (CI): 0.824-0.904], but was not superior to quadruple therapy (RR = 1.073; 95%CI: 0.849-1.357) or other triple therapies (RR = 1.01; 95%CI: 0.936-1.089). The meta-analysis also suggested that standard triple therapy is slightly more effective than dual therapy (RR = 1.14; 95%CI: 0.99-1.31). However, the differences were not statistically significant. We removed the only trial with a regimen lasting 14 d by sensitivity analysis and found that 7-d standard triple therapy was superior to 7-d dual therapy (RR = 1.222; 95%CI: 1.021-1.461). Moreover, a sub-analysis based on the duration of quadruple therapy indicated that the 7-d and 10-d standard triple therapies were inferior to sequential therapy (RR = 0.790; 95%CI: 0.718-0.868; RR = 0.917; 95%CI: 0.839-1.002, respectively). Additionally, there were no significant differences in cure rate or adverse events among standard triple therapy, quadruple therapy, and other triple therapies (RR = 0.940; 95%CI: 0.825-1.072; RR = 1.081; 95%CI: 0.848-1.378, respectively). Standard triple therapy had a higher occurrence of side effects than sequential therapy (RR = 1.283; 95%CI: 1.066-1.544).The eradication rates with a standard triple therapy consisting of PPI, AMO, and CLA are suboptimal in China, and new treatment agents need to be developed.
- Antimicrobial resistance of Escherichia coli isolates from canine urinary tract infections. [JOURNAL ARTICLE]
- J Vet Med Sci 2014 Oct 28.
This study determined the antimicrobial resistance profiles of Escherichia coli isolates from dogs with a presumptive diagnosis of urinary tract infection (UTI). Urine samples from 201 dogs with UTI diagnosed through clinical examination and urinalysis were processed for isolation of Escherichia coli. Colonies from pure cultures were identified by biochemical reactions (n=114) and were tested for susceptibility to 18 antimicrobials. The two most frequent antimicrobials showing resistance in Urinary E. coli isolates were oxytetracycline and ampicillin. Among the resistant isolates, 17 resistance patterns were observed, with 12 patterns involving multidrug resistance (MDR). Of the 69 tetracycline-resistant E. coli isolates, tet(B) was the predominant resistance determinant and was detected in 50.9% of the isolates, whereas the remaining 25.5% isolates carried the tet(A) determinant. Most ampicillin and/or amoxicillin-resistant E. coli isolates carried blaTEM-1 genes. Class 1 integrons were prevalent (28.9%) and contained previously described gene cassettes that are implicated primarily in resistance to aminoglycosides and trimethoprim (dfrA1, dfrA17-aadA5). Of the 44 quinolone-resistant E. coli isolates, 38 were resistant to nalidixic acid, and 6 were resistant to nalidixic acid, ciprofloxacin and enrofloxacin. Chromosomal point mutations were found in the GyrA (Ser83Leu) and ParC (Ser80Ile) genes. Furthermore, the aminoglycoside resistance gene aacC2, the chloramphenicol resistant gene cmlA and the florfenicol resistant gene floR were also identified. This study revealed an alarming rate of antimicrobial resistance among E. coli isolates from dogs with UTIs.
- Occurrence of virulence factors and antimicrobial resistance in Pasteurella multocida strains isolated from slaughter cattle in Iran. [Journal Article]
- Front Microbiol 2014.:536.
A total of 30 Pasteurella multocida strains isolated from 333 pneumonic and apparently health slaughter cattle were examined for capsule biosynthesis genes and 23 virulence-associated genes by polymerase chain reaction (PCR). The disc diffusion technique was used to determine antimicrobial resistance profiles among the isolates. Of the isolates, 23 belonged to capsular type A, 5 to capsular type D and two isolates were untypeable. The distribution of the capsular types in pneumonic lungs and in apparently health lungs was statistically similar. All virulence genes tested were detected among the isolates derived from pneumonic lungs; whereas isolates derived from apparently health lungs carried 16 of the 23 genes. The frequently detected genes among isolates from pneumonic lungs were exbD, hgbA, hgbB, ompA, ompH, oma87, and sodC; whereas tadD, toxA, and pmHAS genes occurred less frequently. Most of the adhesins and superoxide dismutases; and all of the iron acquisition and protectin proteins occurred at significantly (p ≤ 0.05) higher frequencies in isolates from pneumonic lungs. Isolates from apparently healthy lungs didn't carry the following genes; hsf-1, hsf-2, tadD, toxA, nanB, nanH, and pmHAS. One adhesion (hsf-1) and two iron acquisition (exbD and tonB) genes occurred at significantly (p ≤ 0.05) higher frequencies among capA isolates. All the P. multocida isolates were susceptible to ciprofloxacin, co-trimoxazole, doxycycline, enrofloxacin, nitrofurantoin, and tetracyclines. Different proportions of the isolates were however resistant to ampicillin, amoxicillin, erythromycin, lincomycin, penicillin, rifampin, streptomycin, and florfenicol. Our results reveal presence of virulence factors (VFs) in P. multocida strains isolated from symptomatic and asymptomatic bovids. A higher frequency of the factors among isolates from symptomatic study animals may suggest their role in pathogenesis of P. multocida-associated bovine respiratory disease (BRD). The results further reveal occurrence of antimicrobial resistance among some isolates. Control strategies for this pathogen, which could include development of an effective vaccine, are warranted so as to mitigate the social and economic consequences attributable to natural infections with this bacterium.
- Feline urinary tract pathogens: prevalence of bacterial species and antimicrobial resistance over a 10-year period. [JOURNAL ARTICLE]
- Vet Rec 2014 Oct 28.
The purpose of this retrospective study was to identify bacterial species in cats with bacterial urinary tract infections (UTIs) and to investigate their antimicrobial susceptibilities over a 10-year period. Three hundred and thirty cultures from 280 cats were included in the study. The mean age of affected cats was 9.9 years; female cats with bacterial UTIs were significantly older than male cats with UTIs. The most common pathogen identified was Escherichia coli (42.3 per cent), followed by Streptococcus species (19.3 per cent), Staphylococcus species (15.6 per cent), Enterococcus species (6.6 per cent) and Micrococcaceae (5.8 per cent). Forty specimens (12.1 per cent) yielded growth of more than one isolate. Streptococcus and Enterococcus isolates were resistant to a significantly higher number of antimicrobial agents than E coli and Staphylococcus species isolates. Applying the formula to select rational antimicrobial therapy, bacterial isolates were most likely to be susceptible to nitrofurantoin, amoxicillin clavulanic acid, enrofloxacin and gentamicin. The antimicrobial impact factor for nitrofurantoin increased significantly over the 10-year period, whereas there was no significant change in antimicrobial impact factors for doxycycline, trimethoprim-sulfamethoxazole, gentamicin, enrofloxacin, cephalothin and amoxicillin clavulanic acid. The detected changes in in vitro antimicrobial efficacy could help to develop hospital-specific guidelines for antimicrobial use to prevent the further development of resistance in feline uropathogens.
- A Comparison between Moderate- and High-dose Furazolidone in Triple Regimens for Helicobacterpylori Eradication in Iran. [Journal Article]
- Middle East J Dig Dis 2014 Oct; 6(4):195-202.
BACKGROUNDFurazolidone has been used as an alternative for clarithromycin or metronidazole in Helicobacterpylori (H.pylori) eradication regimens. In Iran, 14-day Furazolidone-containing quadruple regimens have shown promising eradication rates, but short-course, low dose therapies are always attractive. Therefore, we designed a study to compare the efficacy of two 10-day triple regimens containing moderate and high dose furazolidone for H.pylori eradication.
METHODSTwo hundred and ten patients with peptic ulcer disease who were naïve to H.pylori treatment were included. They were randomized into 2 groups: 105 patients received omeprazole 20mg, amoxicillin 1000mg, and furazolidone 200mg(OAF-400), all twice a day for ten days.And the remaining 105 patients received omeprazole 20mg twice a day, amoxicillin 1000mg twice a day and furazolidone 200mg three times a day for ten days(OAF-600). Urease breath test was performed 8 weeks after the treatment to confirm H. pylori eradication.
RESULTSThe intention-to-treat eradication rate was 76.19% in group OAF-400 and 80.95% in group OAF-600 (pp=0.38). Per protocol eradication rates were 81.63% and 89.47%, respectively (p= 0.11).Severe adverse effects were reported by 8.6% of the patients in group OAF-400 and 5.7% of the patient in group OAF-600 (p=0.1). However, the total side effects (including mild, moderate, and severe ones) were significantly more prevalent in the OAF-600 group (p=0.001).
CONCLUSIONNone of our triple furazolidone-based regimens (moderate- and high-dose) could achieve the standard eradication rate, and therefore, cannot be considered as a suitable option for first-line treatment.
- [Clinical features of inhaled and blood-borne Staphylococcus aureus pneumonia and analysis of antibiotic resistance of the pathogen in children]. [English Abstract, Journal Article]
- Zhongguo Dang Dai Er Ke Za Zhi 2014 Oct; 16(10):979-83.
To compare the clinical manifestations between inhaled and blood-borne Staphylococcus aureus pneumonia (SAP) and the antibiotic resistance between the isolates of inhaled and blood-borne Staphylococcus aureus.The clinical data of 44 pediatric SAP cases in the Children′s Hospital, Chongqing Medical University from January 2008 to December 2013 were retrospectively analyzed. Twenty-four cases were identified as inhaled SAP, and 20 cases as blood-borne SAP.Inhaled SAP was more common in children younger than 3 years of age, while blood-borne SAP was more prevalent in children older than 6 years of age. Patients with inhaled SAP had significantly higher incidence rates of cough, wheeze, moist rales, dyspnea and empyema than those with blood-borne SAP (P<0.05). The patients with blood-borne SAP were more vulnerable to severe fever, unconsciousness, dysfunction of liver and kidney, pyogenic osteomyelitis, septic arthritis, sepsis, and abscess of skin and soft tissues (P<0.05). Inhaled SAP isolates had significantly higher rates of resistance to amoxicillin/clavulanic acid, oxacillin, and cefoxitin than blood-borne SAP isolates (P<0.05), while the latter had a higher rate of resistance to cotrimoxazole (P<0.05).Inhaled SAP often occurs in children younger than 3 years of age, and the respiratory manifestations are commonly seen. Blood-borne SAP often occurs in children older than 6 years of age, with the infectious-toxic symptoms that result in multiple organ infection and dysfunction. The isolates of inhaled and blood-borne SAP have different antibiograms.
- Genotypes and phenotypes of Shiga toxin-producing Escherichia coli (STEC) in Abeokuta, Southwestern Nigeria. [Journal Article]
- Infect Drug Resist 2014.:253-9.
To characterize the prevalence of hemolytic Shiga toxin-producing Escherichia coli (STEC) with a multidrug-resistant pattern in different age groups in Abeokuta, Nigeria.Nonrepetitive E. coli isolates were collected from 202 subjects with or without evidence of diarrhea. Each isolate was biochemically identified and antimicrobial susceptibility testing was performed using the disk diffusion method. A sorbitol fermentation test of all the E. coli isolates was done and the minimum inhibitory concentration of suspected STEC was measured by the standard broth microdilution method to determine antibiotic resistance. The genotypes of stx1, stx2, and hlyA were determined by polymerase chain reaction assay.The majority of subjects were aged ≥40 years (41.6%) and were female (61.9%). Of the 202 subjects, 86.1% had STEC isolates (P<0.05). A high rate of STEC isolates resistant to amoxicillin (90.6%), cefotaxime (77.7%), and cefuroxime (75.7%) was observed. Resistance to amoxicillin, gentamicin, and cefotaxime was demonstrated with a minimum inhibitory concentration >16 μg/mL in 13.9%, 11.4%, and 10.4% of the isolates, respectively. The prevalence of stx1, stx2, and hlyA was 13.9%, 6.9%, and 2.0%, respectively; 5.5% of stx1 were in the 0-10-year-old age group, 3.5% of stx2 were aged ≥40 and above, and 1.0% of the hlyA isolates were in the 0-10-year-old age group.The prevalence of virulent STEC is a public health concern. The use of polymerase chain reaction assay should aid quick detection of this virulent serotype and help curb the severe epidemic of human diseases associated with STEC infections.
- Cellular and Transcriptional Responses in Microcystis aeruginosa Exposed to Two Antibiotic Contaminants. [JOURNAL ARTICLE]
- Microb Ecol 2014 Oct 24.
The responses of Microcystis aeruginosa under exposure to spiramycin and amoxicillin were investigated on both cellular and genetic levels through a 7-day exposure test. Algal growth was inhibited by spiramycin while promoted by amoxicillin at test concentrations of 0.6-1.8 μg L(-1), indicating a higher toxicity of spiramycin than amoxicillin. During the whole exposure period, the chlorophyll a content and expression levels of psbA, psaB, and rbcL were significantly inhibited by spiramycin at test concentrations of 1.2 and 1.8 μg L(-1) (p < 0.05) and stimulated by 0.6-1.8 μg L(-1) of amoxicillin (p < 0.05), with respective decreases of up to 26, 75, 72, and 82 % compared to the control and respective increases of 20, 70, 135, and 55 %. During the 4 to 7 days of exposure, the microcystin-LR content and expression levels of mcyB and grpE were reduced by up to 66, 47, and 72 % in spiramycin-treated algal cells, respectively, and stimulated by up to 1.3-, 1.4-, and 1.5-folds in amoxicillin-treated algal cells, respectively. Elevated recA expression was only observed in 1.2 and 1.8 μg L(-1) of spiramycin-treated algal cells, indicating severe DNA damage due to the high toxicity. Target antibiotics were suspected to regulate the growth and microcystin-production in M. aeruginosa via the photosynthesis system.