- In-house rapid colorimetric method for detection of colistin resistance in Enterobacterales: A significant impact on resistance rates. [Journal Article]
- JCJ Chemother 2019 Jul 17; :1-4
- A rapid colorimetric method, the Andrade Screening Antimicrobial Test (ASAT) was evaluated to detect colistin resistance in Enterobacteriales clinical isolates. The sensitivity and specificity were 9…
A rapid colorimetric method, the Andrade Screening Antimicrobial Test (ASAT) was evaluated to detect colistin resistance in Enterobacteriales clinical isolates. The sensitivity and specificity were 90.7% and 100%, respectively. In 10/26 E. coli isolates the automatized method failed to detect the resistance, whereas the ASAT detected it accurately. Most of these isolates showed COL MIC values in the range 4-8 µg mL-1 and carried mcr-1. As regards K. pneumoniae COL- resistant isolates, discrepancies between the Phoenix system and the ASAT were observed only in 3/44 isolates, most of them carried the blaKPC gene and showed COL MIC values >16 µg mL-1.
- Rapid Identification of New Delhi Metallo-β-Lactamase (NDM) Using Tryptic Peptides and LC-MS/MS. [Journal Article]
- AAAntimicrob Agents Chemother 2019 Jul 15
- There is significant interest in the development of mass spectrometry (MS) methods for antimicrobial resistance protein detection, given the ability of these methods to confirm protein expression. In…
There is significant interest in the development of mass spectrometry (MS) methods for antimicrobial resistance protein detection, given the ability of these methods to confirm protein expression. In this work, we studied the performance of a liquid chromatography, tandem MS multiple reaction monitoring (LC-MS/MS MRM) method for the direct detection of the New Delhi Metallo-β-Lactamase (NDM) carbapenemase in clinical isolates. Using a genoproteomic approach, we selected three unique peptides (SLGNLGDADTEHYAASAR, AFGAAFPK and ASMIVMSHSAPDSR) specific to NDM that were efficiently ionized and spectrally well-defined. These three peptides were used to build an assay with turnaround time of 90 minutes. In a blinded set, the assay detected 21/24 blaNDM -containing and 76/76 negative isolates, corresponding to a sensitivity of 87.5% (95% CI 67.6%-97.3%) and a specificity of 100% (95% CI; 95.3-100%). One of the missed identifications was determined by protein fractionation to be due to low NDM protein expression (∼0.1fm/μg), below the assay limit of detection. Parallel disk diffusion susceptibility testing demonstrated this isolate to be meropenem susceptible, consistent with low NDM expression. Total proteomic analysis of the other two missed identifications did not detect NDM peptides, but detected other proteins expressed from the blaNDM -containing plasmids, confirming plasmids were not lost. The measurement of relative NDM concentrations over the entire isolate test set demonstrated variability spanning four orders of magnitude, further confirming the remarkable range that may be seen in NDM expression. This study highlights the sensitivity of LC-MS/MS to variations in NDM protein expression with implications for how this technology may be used.
- Pertussis detection in children with cough of any duration. [Journal Article]
- BPedBMC Pediatr 2019 Jul 12; 19(1):236
- CONCLUSIONS: The "one-size-fits-all" clinical pertussis case definition is no longer optimal to recognize this disease. A large comprehensive study of children with all types of cough is required to make substantial inroads into increasing both the sensitivity and specificity in pertussis diagnosis, which will have a beneficial impact on public health. Amoxicillin maybe an alternative for children with marolide-resistant B.pertussis infection; however, local sensitivities are required to inform clinical practice.
- [Evaluation of a rapid assay for detection of PBP2a Staphylococcus aureus]. [Journal Article]
- RERev Esp Quimioter 2019 Jul 10
- CONCLUSIONS: ICPBP2a Culture Colony Test (AlereTM) is fast, efficient and economical technique for detection of penicillin binding protein 2a (PBP2a) from isolates. This assay is a useful tool for the management of hospital outbreaks.
- Biological responses following one-stage full-mouth scaling and root planing with and without azithromycin: Multicenter randomized trial. [Journal Article]
- JPJ Periodontal Res 2019 Jul 10
- CONCLUSIONS: FM-SRP resulted in similar improvements in clinical parameters with and without the use of AZM. Inflammatory mediators showed no difference between the two groups after FM-SRP treatment. The use of AZM was effective in preventing the elevation of body temperature after FM-SRP.
- Pathogens distribution and drug resistance in patients with acute cerebral infarction complicated with diabetes and nosocomial pulmonary infection. [Journal Article]
- BIBMC Infect Dis 2019 Jul 10; 19(1):603
- CONCLUSIONS: In patients with acute cerebral infarction complicated with diabetes mellitus and nosocomial pulmonary infection, the majority of pathogens are multidrug-resistant gram negative bacilli. Pathogen culture should be conducted as soon as possible before using antibiotics, and antimicrobial agents should be reasonably used according to drug sensitivity test results.
- Quadruple versus triple combination antiretroviral therapies for treatment naive people with HIV: systematic review and meta-analysis of randomised controlled trials. [Meta-Analysis]
- BMJBMJ 2019 Jul 08; 366:l4179
- CONCLUSIONS: In this study, effects of quadruple combination antiretroviral therapy were not better than triple combination antiretroviral therapy in treatment naive people with HIV. This finding lends support to current guidelines recommending the triple regimen as first line treatment. Further trials on this topic should be conducted only when new research is justified by adequate systematic reviews of the existing evidence. However, this study cannot exclude the possibility that quadruple cART would be better than triple cART when new classes of antiretroviral drugs are made available.
- Antibiotic-loaded tantalum may serve as an antimicrobial delivery agent. [Journal Article]
- BJBone Joint J 2019; 101-B(7):848-851
- CONCLUSIONS: Compared with cement, tantalum could release antibiotics for longer. Further studies should assess the advantages of using antibiotic-loaded porous tantalum implants at revision arthroplasty. Cite this article: Bone Joint J 2019;101-B:848-851.
- Detection of "Hidden" Antimicrobial Drug Resistance. [Journal Article]
- AIACS Infect Dis 2019 Jul 12; 5(7):1252-1263
- Antimicrobial drug resistance has become a serious public health problem. The current clinical diagnostic methods are turbidity-based assays that have been used for years to track bacterial growth; h…
Antimicrobial drug resistance has become a serious public health problem. The current clinical diagnostic methods are turbidity-based assays that have been used for years to track bacterial growth; however, the method is relatively insensitive. To eliminate the new occurrence of drug resistance in infectious bacteria, we developed a highly sensitive EZMTT method for the antibiotic susceptibility test (AST) that magnified the cell growth signal and revealed partial drug resistance (showing 2-20% weak cell growth) that was not detected by the current turbidity assay within 24 h. By simply mixing the EZMTT dye with the bacterial culture and then following the growth by absorbance measurement at 450 nm, the drug-induced proliferation (DIP) rate can be obtained in a high-throughput-screening (HTS) mode with greater than 10-fold better sensitivity than the turbidity assay. The EZMTT-based DIP rate assay of 5 clinically isolated E. coli strains found approximately 30% more partial drug resistance than what was detected in the traditional turbidity-based assay. The observed partial drug resistance was further confirmed by mechanistic analyses. Therefore, a combination of the EZMTT dye and the current clinically used VITEK-type technology has great potential to help understand antimicrobial drug resistance and ultimately provide patients with precise medical care to prevent the occurrence of multidrug resistant bacteria.
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- Multidrug-resistant Klebsiella pneumoniae: genetic diversity, mechanisms of resistance to polymyxins and clinical outcomes in a tertiary teaching hospital in Brazil. [Journal Article]
- RIRev Inst Med Trop Sao Paulo 2019 Jun 19; 61:e29
- Increased resistance to polymyxin in Klebsiella pneumoniae (ColRKP) has been observed. Molecular epidemiology, as well as the clinical impact of these difficult to treat pathogens need to be better c…
Increased resistance to polymyxin in Klebsiella pneumoniae (ColRKP) has been observed. Molecular epidemiology, as well as the clinical impact of these difficult to treat pathogens need to be better characterized. We present the clinical outcomes of 28 patients infected by ColRKP in a tertiary hospital. Isolates with MIC >2 by Vitek 2 were confirmed by the microdilution broth test. Polymerase chain reaction (PCR) was performed for blaKPC, blaNDM, blaOXA-48 and blamcr-1 genes in the isolates, and Whole Genome Sequencing (WGS) was performed in six isolates. Seventeen (61%) patients were female and the mean age was 50 years old. In-hospital and 30-day mortality were 64% (18/28) and 53% (15/28), respectively. Central line-associated bloodstream infection in addition to bacteremia episodes due to other sources were the most frequent (61%). Mean APACHE and Charlson comorbidity index were 16 and 5, respectively. Twenty patients (71%) received at least one active drug and ten (35%) received two drugs: tigecycline 46% (13/28); amikacin 21% (6/28) and fosfomycin 3% (1 case). Twenty-six out of 28 tested cases were positive for blaKPC. Eight different clusters were identified. Four STs were detected (ST11, ST23, ST340, and ST437). Mutations on pmrA, arnB, udg, and yciM genes were present in all six isolates submitted to WGS; lpxMand mgrB mutations were also detected in all but one isolate. In conclusion, we observed resistance to polymyxin in severely ill patients mostly from intensive care units and/or immunosuppressed patients with high mortality rates in whom a diversity of ColRKP clusters was identified and might indicate selective pressure.