- Time required to achieve maximum concentration of amikacin in synovial fluid of the distal interphalangeal joint after intravenous regional limb perfusion in horses. [Journal Article]
- AJAm J Vet Res 2018; 79(3):282-286
- CONCLUSIONS: AND CLINICAL RELEVANCE Tmax of amikacin was 15 minutes after IVRLP in horses and Cmax did not increase > 15 minutes after IVRLP despite maintenance of the tourniquet. Application of a tourniquet for 15 minutes should be sufficient for completion of IVRLP when attempting to achieve an adequate concentration of amikacin in the synovial fluid of the DIP joint.
- Antibiotic resistance and frequency of class 1 integrons among Pseudomonas aeruginosa isolates obtained from wastewaters of a burn center in Northern Iran. [Journal Article]
- AIAnn Ig 2018 Mar-Apr; 30(2):112-119
- CONCLUSIONS: The results highlight the importance of class 1 integrons in multiple antibiotic resistance among P. aeruginosa isolates. Moreover, the spread of hospital derived wastewaters in the environment can be regarded as the origin of significant reservoirs for antibiotic-resistant pathogens.
- Strategy to reduceE. colibacteraemia based on cohort data from a London teaching hospital. [Journal Article]
- PMPostgrad Med J 2018 Feb 20
- CONCLUSIONS: E. coli bacteraemias related to urosepsis could have been prevented by better empirical treatment and targeted prophylaxis. Urinary catheter quality improvement programmes should contribute to a further reduction. For patients undergoing high-risk urinary or biliary tract procedures or device manipulation, we advocate single-dose amikacin prophylaxis.
- Complete genome sequencing ofAcinetobacter baumanniistr. K50 disclosed the large conjugative plasmid pK50a encoding the carbapenemase OXA-23 and the extended-spectrum β-lactamase GES-11. [Journal Article]
- AAAntimicrob Agents Chemother 2018 Feb 20
- Multidrug-resistant (MDR)Acinetobacter baumanniistrains appeared as serious emerging nosocomial pathogens in clinical environments and especially in intensive care units (ICUs).A. baumanniistrain K50...
Multidrug-resistant (MDR)Acinetobacter baumanniistrains appeared as serious emerging nosocomial pathogens in clinical environments and especially in intensive care units (ICUs).A. baumanniistrain K50 recovered from a hospitalized patient in Kuwait exhibited resistance to carbapenems, and additionally to ciprofloxacin, chloramphenicol, sulfonamides, amikacin and gentamicin. Genome sequencing revealed that the strain possesses two plasmids, pK50a (79.6 kb) and pK50b (9.5 kb) and a 3.75 Mb chromosome.A. baumanniiK50 exhibits an Average Nucleotide Identity (ANI) value of 99.98% to the previously reported Iraqi clinical isolate AA-014, even though that the latter strain lacked plasmid pK50a. Strain K50 belongs to the Sequence Type ST158 (Pasteur scheme) and ST499 according to the Oxford scheme. Plasmid pK50a is a member of the Aci6 (RG6) group ofAcinetobacterplasmids, and encodes a conjugative transfer module and two antibiotic resistance gene regions comprising the transposon Tn2008.The transposon carries the carbapenemase geneblaOXA-23and a class 1 integron harboring the resistance genesblaGES-11,aacA4,dfrA7,qacEΔ1andsul1conferring resistance to all β-lactams and reduced susceptibility to carbapenems, resistance to aminoglycosides, trimethoprim, quaternary ammonium compounds and sulfamethoxazole, respectively. The class 1 integron is flanked by MITEs (Miniature Inverted repeat Transposable Element) delimiting the element at its insertion site.
- Prevalence of Metallo-β-lactamase Producing Non-fermentative Pseudomonas Species from Clinical Isolates in Dhaka, Bangladesh. [Journal Article]
- MMMymensingh Med J 2018; 27(1):89-94
- Antimicrobial drug resistance, a global concern, has been increasing unpredictably in microorganism causing human infections specially among Gram negative non-fermenting Pseudomonas spp. Carbapenems,...
Antimicrobial drug resistance, a global concern, has been increasing unpredictably in microorganism causing human infections specially among Gram negative non-fermenting Pseudomonas spp. Carbapenems, a beta lactam antibiotics, are the most potent and effective drug usually kept reserved for treating the multi-drug resistant Psedomonas spp and other infections caused by organisms producing Extended Spectrum Beta Lactamase (ESBL) and AmpC. Clinical utility of carbapenem will reduce when resistant bacteria evolve due to production of carbapenem hydrolyzing Metallo-β-lactamase (MBL) which confers high-level resistance to all beta-lactam antibiotics except aztreonam. The various reports on the prevalence of MBLs are available from many countries but few from Bangladesh. We investigated the prevalence of MBL production in these Pseudomonads obtained from clinical sources in an uraban setting in Dhaka, Bangladesh. A total of 29,136 specimens were processed for culture from January 2011 and December 2015 from non duplicated patients attending diagnostic unit of icddr,b from different settings of Bangladesh. The specimens included urine 14,323; blood 11,378; other body fluid 2,487; sputum 535 and tracheal aspirate 413. All specimens were processed for culture following standard bacteriological methods and the Pseudomonas spp were identified following defined standard biochemical procedures. Metallo-β-lactamase (MBL) was determined by EDTA disk synergy (EDS) test. Antimicrobial susceptibility test was performed by disk diffusion method and susceptibility pattern was interpreted and reported following Clinical Laboratory Standard Institute (CLSI) guideline. From 29,136 specimens a total of 2,340(8%) were isolated and identified as Pseudomonas spp. Of the identified Pseudomonas spp, 238(57.6%) were from tracheal aspirate, 216(40.4%) from sputum, 902(36.7%) from other body fluids, 463(4.1%) from blood and 521(3.6%) from urine samples. From 2,340 Pseudomonas spp, by selective sampling, imipenem-meropenem resistant and intermediate susceptible 100 strains were tested for MBL production and 92 were found positive. Tracheal aspirate showed 38%, other body fluids 30%, Urine 17%, sputum 4% and blood 3% MBL production respectively. Irrespective of the sources of specimens, Pseudomonas spp showed 71% resistance to cefixime, 70% to ceftriaxone, 64% to gentamicin, 56% to piperecillin+tazobactam, 50% to ciprofloxacin, 49% to amikacin, 46% to netilmicin, 45% to ceftazidime, 30% to meropenem, 26% to imipenem and 19% to polymyxin B. As multi-drug resistant Pseudomonas showed high level of (92%) MBL production, so MBL detection testing facility may be a useful battery to determine MDR producing Pseudomonas from clinical isolates.
- Evaluation of greater wax moth larvae, Galleria mellonella, as a novel in vivo model for non-tuberculosis Mycobacteria infections and antibiotic treatments. [Journal Article]
- JMJ Med Microbiol 2018 Feb 13
- CONCLUSIONS: This report demonstrates the potential of employing a wax moth larvae model for studying fast-growing mycobacteria infections, and as a cheap, effective system for initial screening of novel treatments.
- Antimicrobial activity against Mycobacterium tuberculosis under in vitro lipid-rich dormancy conditions. [Journal Article]
- JMJ Med Microbiol 2018 Jan 15
- Although tuberculosis treatment is dependent on drug-susceptibility testing (DST) and molecular drug-resistance detection, treatment failure and relapse remain a challenge. This could be partially du...
Although tuberculosis treatment is dependent on drug-susceptibility testing (DST) and molecular drug-resistance detection, treatment failure and relapse remain a challenge. This could be partially due to the emergence of antibiotic-tolerant dormant mycobacteria, where host lipids have been shown to play an important role. This study evaluated the susceptibility of Mycobacterium tuberculosis to two antibiotic combinations - rifampicin, moxifloxacin, amikacin and metronidazole (RIF-MXF-AMK-MTZ), and rifampicin, moxifloxacin, amikacin and pretomanid (RIF-MXF-AMK-PA) - in a lipid-rich dormancy model. Although their effectiveness in in vitro cultures with dextrose as a carbon source has been proved, we observed that none of the antibiotic mixtures were bactericidal in the presence of lipids. The presence of lipids may confer tolerance to M. tuberculosis against the mixture of antibiotics tested and such tolerance could be even higher during the dormant stages. The implementation of lipids in DST on clinical isolates could potentially lead to a better treatment strategy.
- Mycobacterium abscessus Complex Infections: A Retrospective Cohort Study. [Journal Article]
- OFOpen Forum Infect Dis 2018; 5(2):ofy022
- CONCLUSIONS: Our cohort of 108M. abscessuscomplex isolates in Miami, Florida, showed an in-hospital mortality of 15.7%. Most infections were respiratory. Clarithromycin and amikacin were the most likely agents to be susceptible in vitro. Resistance to fluoroquinolone and trimethoprim/sulfamethoxazole was highly common. Macrolide resistance, immunosuppression, and renal disease were significantly associated with early treatment failure.
- Establishment and validation ofGalleria mellonellaas a novel model organism to studyMycobacterium abscessusinfection, pathogenesis and treatment. [Journal Article]
- AAAntimicrob Agents Chemother 2018 Feb 05
- Introduction: Treatment ofMycobacterium abscessusinfections is extremely challenging due to its intrinsic resistance to most antibiotics, and research of pathogenesis is limited d...
Introduction: Treatment ofMycobacterium abscessusinfections is extremely challenging due to its intrinsic resistance to most antibiotics, and research of pathogenesis is limited due to a lack of a practicalin vivomodel of infection.Objectives: To establish a simplein-vivomodel forM. abscessusinfection, virulence, and drug testing inG. mellonellalarvae.Methods: We inoculated larvae withM. abscessus, and followed histopathology, CFU count and mortality with and without antibiotic treatment. We also constructed a luminescent, recombinantM. abscesssus, mDB158, and imaged infected larvae using IVIS®.Results:M. abscessusproliferated and induced granulomatous-like responses in infected larvae leading to larval mortality. TheG. mellonellamodel was further successfully validated by demonstration of the expected favorable antimicrobial effect of treatment with meropenem, and the superiority of combination treatment (meropenem and tigecycline) over single agents. We then used IVIS® imaging of larvae infected with luminescentM. abscessus, allowing live real-time assessment of bacterial load. We used this method to compare the antimicrobial effect of various antibiotics (meropemen, amikacin, linezolid, levofloxacin, etc.) on bacterial proliferation and larval survival. Meropenem and amikacin had the most favorable effect, correlating well with common clinical practice guidelines.Conclusions: These findings suggestG. mellonellato be an excellentin vivomodel for research ofM. abscessusinfection, pathogenesis and treatment. LuminescentM. abscessusand IVIS® imaging further facilitates this model. Results obtained in this model clearly substantiated common clinical practice, thus validating the model as a predictor of treatment efficacy and outcome.
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- Drug susceptibility profiling and genetic determinants of drug resistance inMycobacterium kansasii. [Journal Article]
- AAAntimicrob Agents Chemother 2018 Feb 05
- Studies on drug susceptibility ofMycobacterium kansasiiare very few and involve limited number of strains. The purpose of this study was to determine drug susceptibility profiles ofM. kansasiiisolate...
Studies on drug susceptibility ofMycobacterium kansasiiare very few and involve limited number of strains. The purpose of this study was to determine drug susceptibility profiles ofM. kansasiiisolates representing a spectrum of species genotypes (subtypes) with two different methodologies, i.e. broth microdilution and E-test assays. To confirm drug resistance, drug target genes were sequenced.A collection of 85M. kansasiiisolates, including representatives of eight different subtypes (I-VI, I/II, IIB) from eight countries was used. Drug susceptibility against 13 and 8 anti-mycobacterial agents was tested by using broth microdilution and E-test method, respectively. For drug-resistant or high-MIC isolates, eight structural genes (rrl,katG,inhA,embB,rrs,rpsL,gyrA, andgyrB) and one regulatory region (embCA) were PCR-amplified and sequenced in the search for resistance-associated mutations.All isolates tested were susceptible to rifampicin (RIF), amikacin (AMK), co-trimoxazole (SXT), rifabutin (RFB), moxifloxacin (MXF), and linezolid (LZD), when using microdilution method. Resistance to ethambutol (EMB), ciprofloxacin (CIP), and clarithromycin (CLR) was found in 83 (97.7%), 17 (20%), and 1 (1.2%) isolate, respectively. The calculated concordance between the E-test and dilution method was 22.6% for AMK, 4.8% for streptomycin (STR), 3.2% for CLR, and 1.6% for RIF. For EMB, INH, and SXT, not even a single MIC value determined by one method equaled that by the second method. The only mutations disclosed were A2266C transversion atrrlgene (CLR-resistant strain) and A128G transition atrpsLgene (strain with STR MIC >64 mg/L).In conclusion, eight drugs, including RIF, CLR, AMK, SXT, RFB, MXF, LZD, and ethionamide (ETO) showed highin vitroactivity againstM. kansasiiisolates. Discrepancies of the results between the reference microdilution method and E-test precludes the use of the latter for drug susceptibility determination inM. kansasiiDrug resistance inM. kansasiimay have different genetic determinants than resistance to the same drugs inM. tuberculosis.