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Esbl And

Matti Uhari
Enterobacteriaceae can produce β-lactamases that are capable of hydrolysing extended-spectrum cephalosporins, namely cefotaxime, ceftriaxone, ceftizoxime and ceftatzidime. Today there are more than 1,600 different known β-lactamases (1) and, although the first reports of extended spectrum beta-lactamases (ESBL) were from Germany and England, ESBL producing bacteria have been particularly common in France (2). This article is protected by copyright. All rights reserved.
October 20, 2016: Acta Paediatrica
C O'Connor, M G Kiernan, C Finnegan, J Powell, L Power, N H O'Connell, C P Dunne
BACKGROUND: The Mid-West of Ireland has higher than average national rates of invasive extended-spectrum beta-lactamase (ESBL) bloodstream infections and carbapenemase-producing Enterobacteriaceae (CPE), with increasing numbers of ESBL isolates detected in community-dwelling patients. AIMS: To conduct a point prevalence study in a convenience sample of the Mid-West population with the aim of determining the extent of ESBL colonisation. METHODS: Utilising anonymised community stool samples that had completed routine analysis, we conducted a point prevalence study over a 4-week period on all samples that met defined inclusion and exclusion criteria...
September 24, 2016: Irish Journal of Medical Science
Michael M Petrov, Atanaska Petrova, Irina Stanimirova, Marina Mircheva-Topalova, Lalka Koycheva, Rayna Velcheva, Mariana Stoycheva-Vartigova, Ralitsa Raycheva, Galina Asseva, Petar Petrov, Velichka Kardjeva, Marianna Murdjeva
The aim of this work is to study the epidemiology and antimicrobial resistance to the most commonly used antibiotics for the treatment of acute gastroenteritis caused by Salmonella and Shigella at the largest Bulgarian hospital-University Hospital "St. George," Plovdiv-for the period 2009-2013. Two hundred ninety strains were in vitro tested for resistance to 15 antimicrobial agents. The presence of extended-spectrum beta-lactamases (ESBLs) was demonstrated by a variety of specialized tests. For comparison, a collection of 28 strains submitted by the National Reference Laboratory (NRL) "Enteric Infections" at the National Center of Infectious and Parasitic Diseases (NCIPD), Sofia, was also tested for the production of ESBLs...
October 19, 2016: Folia Microbiologica
James Knox, Claire Gregory, Louise Prendergast, Chandrika Perera, Jennifer Robson, Lynette Waring
Stool specimens spiked with a panel of 46 carbapenemase-producing Enterobacteriaceae (CPE) and 59 non-carbapenemase producers were used to compare the diagnostic accuracy of 4 testing algorithms for the detection of intestinal carriage of CPE: (1) culture on Brilliance ESBL agar followed by the Carba NP test; (2) Brilliance ESBL followed by the Carba NP test, plus chromID OXA-48 agar with no Carba NP test; (3) chromID CARBA agar followed by the Carba NP test; (4) chromID CARBA followed by the Carba NP test, plus chromID OXA-48 with no Carba NP test...
September 30, 2016: Diagnostic Microbiology and Infectious Disease
Hemlata Hemlata, Arif Tasleem Jan, Archana Tiwari
Antibiotic resistance is a global problem exacerbated due to selective pressure of antimicrobial agents, spontaneous mutation, recombination and horizontal gene transfer. Of the different mechanisms that led to spread of resistance, one notorious phenomenon is the generation of Extended Spectrum β-lactamases (ESBLs) preferably TEM, SHV, OXA and CTX-M. Their production and frequent mobilization through horizontal gene transfer, made bacteria to exhibit resistance against a broad range of antibiotics. Resilient development of resistance among bacteria hampers available treatment options against different infections in the health care system...
October 14, 2016: Current Drug Metabolism
Yuji Watanabe, Nozomi Oikawa, Maya Hariu, Ryota Fuke, Masafumi Seki
Procalcitonin (PCT) and C-reactive protein serve as biomarkers of infection in patients with sepsis/bacteremia. The present study assessed the clinical characteristics of 280 patients with suspected sepsis who were admitted to Tohoku Medical and Pharmaceutical University Hospital between January 2012 and December 2013. Among the patients, 133 and 147 were positive and negative for PCT, respectively. Patients who were PCT positive were older and more frequently male, had reduced levels of platelets and albumin, and increased levels of aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen, creatinine, and C-reactive protein...
2016: International Journal of General Medicine
Maris S Arcilla, Jarne M van Hattem, Manon R Haverkate, Martin C J Bootsma, Perry J J van Genderen, Abraham Goorhuis, Martin P Grobusch, Astrid M Oude Lashof, Nicky Molhoek, Constance Schultsz, Ellen E Stobberingh, Henri A Verbrugh, Menno D de Jong, Damian C Melles, John Penders
BACKGROUND: International travel contributes to the dissemination of antimicrobial resistance. We investigated the acquisition of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) during international travel, with a focus on predictive factors for acquisition, duration of colonisation, and probability of onward transmission. METHODS: Within the prospective, multicentre COMBAT study, 2001 Dutch travellers and 215 non-travelling household members were enrolled...
October 14, 2016: Lancet Infectious Diseases
Heloise Buys, Rudzani Muloiwa, Colleen Bamford, Brian Eley
BACKGROUND: Klebsiella pneumoniae (KP) is a significant paediatric bloodstream pathogen in children. There is little data from Africa. In this study we describe the epidemiology of multi-drug resistant Klebsiella pneumoniae bloodstream infection (KPBSI) at Red Cross War Memorial Children's Hospital, Cape Town, South Africa. METHODS: We conducted a retrospective cross-sectional study of KPBSI from 1 January 2006 to 31 December 2011 using conventional descriptive and inferential statistical methods...
October 17, 2016: BMC Infectious Diseases
Ana Flores-Carrero, Indira Labrador, Alberto Paniz-Mondolfi, David R Peaper, Dana Towle, María Araque
Enterobacter spp. have emerged as an important group of pathogens linked to outbreaks in neonatal intensive care units (NICUs), usually involving strains expressing extended-spectrum β-lactamases (ESBLs). The aim of this study was to describe the first nosocomial bloodstream infection outbreak caused by Enterobacter ludwigii co-harbouring CTX-M-8, SHV-12 and TEM-15 in a NICU in a Venezuelan hospital. Initial bacterial identification was achieved by VITEK(®)2 system and matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (VITEK(®) MS) and was subsequently confirmed by nucleotide sequencing of the 16S rDNA gene and hsp60 genotyping...
October 7, 2016: Journal of Global Antimicrobial Resistance
Huimin Lin, Samuel T H Chew
An 85-year-old female with chronic kidney disease and newly acquired seizures on oral phenytoin received intravenous ertapenem 500 mg once daily for a urinary tract infection and bacteraemia involving extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli. After three ertapenem doses, she developed seizures which self-aborted. Corrected phenytoin level was sub-therapeutic initially, but became therapeutic following a phenytoin dose increase. On Day 14 of ertapenem, the patient suffered another episode of seizure...
December 2015: Drug Saf Case Rep
Michail Alevizakos, Styliani Karanika, Marios Detsis, Eleftherios Mylonakis
Cancer patients are vulnerable to infections, including those with extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE), and most of these infections are associated with colonisation of the gastrointestinal tract. The aim of this study was to estimate the prevalence of gastrointestinal colonisation with ESBL-PE cancer populations and to determine the risk for subsequent bloodstream infection (BSI) with these pathogens. PubMed and EMBASE databases were searched from 1 January 1991 to 1 March 2016 to identify studies regarding ESBL-PE colonisation among patients with malignancies...
October 6, 2016: International Journal of Antimicrobial Agents
Sara Tedeschi, Filippo Trapani, Maddalena Giannella, Francesco Cristini, Fabio Tumietto, Michele Bartoletti, Annalisa Liverani, Salvatore Pignanelli, Luisa Toni, Roberto Pederzini, Augusto Cavina, Pierluigi Viale
OBJECTIVE To assess the impact of an antimicrobial stewardship program (ASP) on antibiotic consumption, Clostridium difficile infections (CDI), and antimicrobial resistance patterns in a rehabilitation hospital. DESIGN Quasi-experimental study of the periods before (from January 2011 to June 2012) and after (from July 2012 to December 2014) ASP implementation. SETTING 150-bed rehabilitation hospital dedicated to patients with spinal-cord injuries. INTERVENTION Beginning in July 2012, an ASP was implemented based on systematic bedside infectious disease (ID) consultation and structural interventions (ie, revision of protocols for antibiotic prophylaxis and education focused on the appropriateness of antibiotic prescriptions)...
October 17, 2016: Infection Control and Hospital Epidemiology
Stefan Erb, Reno Frei, Marc Dangel, Andreas F Widmer
BACKGROUND Infections and colonization with multidrug-resistant organisms (MDROs) identified >48 hours after hospital admission are considered healthcare-acquired according to the definition of the Centers for Disease Control and Prevention (CDC). Some may originate from delayed diagnosis rather than true acquisition in the hospital, potentially diluting the impact of infection control programs. In addition, such infections are not necessarily reimbursed in a healthcare system based on the diagnosis-related groups (DRGs)...
October 17, 2016: Infection Control and Hospital Epidemiology
Robert A Bonomo
β-Lactamases, the enzymes that hydrolyze β-lactam antibiotics, remain the greatest threat to the usage of these agents. In this review, the mechanism of hydrolysis is discussed for both those enzymes that use serine at the active site and those that require divalent zinc ions for hydrolysis. The β-lactamases now include >2000 unique, naturally occurring amino acid sequences. Some of the clinically most important of these are the class A penicillinases, the extended-spectrum β-lactamases (ESBLs), the AmpC cephalosporinases, and the carbapenem-hydrolyzing enzymes in both the serine and metalloenzyme groups...
October 14, 2016: Cold Spring Harbor Perspectives in Medicine
A Guzek, Krzysztof Korzeniewski, D Tomaszewski, Z Rybicki, E Zwolińska
The article presents the results of 11-year study (2005-2015) of Gram-negative bacteria responsible for pneumonia in 2033 mechanically ventilated patients hospitalized in Intensive Care Unit. Of 8796 biological samples, consisting mainly of bronchial aspirate (97.9 %), 2056 bacterial strains were isolated and subjected to identification. VITEK 2 was used to determine drug susceptibility (classified according to the EUCAST criteria). ESBL, MBL and KPC-producing strains were identified by means of phenotypic methods using appropriate discs...
October 14, 2016: Advances in Experimental Medicine and Biology
Bhoomika, Sanjay Shakya, Anil Patyal, Nitin Eknath Gade
AIM: To assess the prevalence of antimicrobial resistance producing extended-spectrum β-lactamases (ESBL) (blaTEM, blaSHV, and blaCTX-M) genes in Escherichia coli isolated from chicken meat, chevon meat, raw milk, and human urine and stool samples collected from tribal districts of Chhattisgarh, viz., Jagdalpur, Dantewada, Kondagaon, and Kanker. MATERIALS AND METHODS: A total of 330 samples, comprising 98 chicken meat, 82 chevon meat, 90 raw milk, and 60 human urine and stool samples, were processed for isolation of E...
September 2016: Veterinary World
Tadashi Ishida, Akihiro Ito, Yasuyoshi Washio, Akio Yamazaki, Maki Noyama, Fumiaki Tokioka, Machiko Arita
RATIONALE: The new acronym, PES pathogens (Pseudomonas aeruginosa, Enterobacteriaceae extended-spectrum beta-lactamase-positive, and methicillin-resistant Staphylococcus aureus), was recently proposed to identify drug-resistant pathogens associated with community-acquired pneumonia. OBJECTIVES: To evaluate the risk factors for antimicrobial-resistant pathogens in immunocompetent patients with pneumonia and to validate the role of PES pathogens. METHODS: A retrospective analysis of a prospective observational study of immunocompetent patients with pneumonia between March 2009 and June 2015 was conducted...
October 8, 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Philippa C Matthews, Lucinda K Barrett, Stephanie Warren, Nicole Stoesser, Mel Snelling, Matthew Scarborough, Nicola Jones
BACKGROUND: Fosfomycin is increasingly called upon for the treatment of multi drug-resistant (MDR) organisms causing urinary tract infection (UTI). We reviewed oral fosfomycin use for UTI treatment in a large UK hospital. The primary goal was to audit our clinical practice against current national guidelines. Secondary aims were to identify factors associated with treatment failure, and to investigate the potential for using fosfomycin in patients with co-morbidities. METHODS: We retrospectively studied 75 adult patients with UTI who received 151 episodes of treatment with fosfomycin from March 2013 to June 2015...
October 11, 2016: BMC Infectious Diseases
G P Senadheera, S Sri Ranganathan, G Patabendige, G H Fernando, D Gamage, R M Maneke, B M Fernandopulle
OBJECTIVES: Antibacterial resistance (ABR) is a public threat. Sri Lanka is a country with limited surveillance of ABR in the community. The WHO methodology was adapted to identify ABR in outpatient settings (nonhospitalised patients) and its link to consumption of antibiotics. METHODS: It was a cross-sectional descriptive community based study to collect ABR data from Out Patient Department (OPD) of two leading Teaching Hospitals in Colombo district. The indicator organism Escherichia coli (E...
2016: Ceylon Medical Journal
Pablo C Sandoval, J'Neka S Claxton, Jae Wook Lee, Fahad Saeed, Jason D Hoffert, Mark A Knepper
Vasopressin-mediated regulation of renal water excretion is defective in a variety of water balance disorders in humans. It occurs in part through long-term mechanisms that regulate the abundance of the aquaporin-2 water channel in renal collecting duct cells. Here, we use deep DNA sequencing in mouse collecting duct cells to ask whether vasopressin signaling selectively increases Aqp2 gene transcription or whether it triggers a broadly targeted transcriptional network. ChIP-Seq quantification of binding sites for RNA polymerase II was combined with RNA-Seq quantification of transcript abundances to identify genes whose transcription is regulated by vasopressin...
October 11, 2016: Scientific Reports
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