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Eur J Clin Microbiol Infect Dis. 2008 Oct 2;
Szabó J, Dombrádi Z, Dobay O, Orosi P, Kónya J, Nagy K, Rozgonyi F
The purpose of this study was to characterise methicillin-resistant Staphylococcus aureus (MRSA) strains isolated in 2005 at the university hospitals of Debrecen, Hungary. Three hundred and thirty-nine MRSA strains were isolated from 102 patients at 18 different clinics. Their sensitivity to oxacillin and ten other antibiotics was determined. For genotypic analysis, phage typing and pulsed-field gel electrophoresis (PFGE) was performed. The rate of MRSA strains increased to 7.2% in 2005, especially at the clinics of surgery, pulmonology and paediatrics. No vancomycin- or teicoplanin-resistant strains were found. The resistance to erythromycin, clindamycin and ciprofloxacin was nearly 100% and multi-resistance was very frequent. Fifty-eight percent of the isolates belonged to mixed phage types and 8% was non-typable. One PFGE clone contained 58.2% of all strains and two further major clones were found at a separately located clinical block, indicating intra-hospital spread. We can conclude that MRSA exhibits an increasing nosocomial problem also in Hungary.
Mupirocin resistance among Iranian isolates of Staphylococcus aureus.
Med Sci Monit. 2008 Oct; 14(10): BR210-3
Saderi H, Owlia P, Habibi M
BACKGROUND: The topical agent mupirocin plays a crucial role in strategies designed to control outbreaks of methicillin-resistant Staphylococcus aureus. The rate of high- and low-level mupirocin resistance among S. aureus strains from Iranian hospitals is not known. MATERIAL/METHODS: Two hundred twenty-two nonduplicate S. aureus strains consecutively isolated in four university hospitals in Tehran, Iran, were tested for mupirocin susceptibility by disc diffusion agar method and minimum inhibitory concentration (MIC) determination by the E-test. Susceptibility to 16 other antimicrobial agents was also determined. RESULTS: With the disc diffusion agar method, the majority of strains (97.3%) were susceptible to mupirocin and only 2.7% were resistant. The S. aureus strains showed high resistance (>50%) to most antibiotics, including penicillin G, ampicillin-sulbactam, oxacillin, cefoxitin, ciprofloxacin, erythromycin, tetracycline, clindamycin, gentamicin, and rifampicin, but resistance to linezolid, chloramphenicol, cotrimoxazole, and quinupristin/dalfopristin was low and no isolate was resistant to vancomycin. In the E-test, six strains had MICs of >4 mg/l, i.e. five strains had MICs of 8-256 mg/l (low-level mupirocin resistance) and one strain had 1024 mg/l (high-level mupirocin resistance). One strain was resistant to mupirocin in the disc diffusion agar method but showed sensitivity in the E-test (MIC: 0.94 mg/l). The mupirocin-resistant S. aureus isolates were all methicillin resistant and more resistant to the other antimicrobial agents compared with the mupirocin-susceptible strains. CONCLUSIONS: This study is the first report about mupirocin resistance of S. aureus in Iranian hospitals.
J Chromatogr A. 2008 Sep 13;
Rodriguez E, Moreno-Bondi MC, Marazuela MD
This paper describes a new method for the effective extraction, clean-up and chromatographic analysis of residues of four fluoroquinolones (ciprofloxacin, enrofloxacin, danofloxacin and sarafloxacin) in powdered infant formulae and follow-on preparations. Samples were reconstituted following the manufacturer's recommendations and treated with trichloroacetic acid in methanol 10% (w/v) for deproteinization. Two solid-phase extraction cartridges have been evaluated for sample clean-up and preconcentration, Strata Screen A and Strata X and the later provided the best recoveries for all the analytes tested. Chromatographic analysis has been carried out using a polar endcapped column (AQUA C(18)) and fluorescence detection, with lomefloxacin (LOME) as internal standard. Method validation has been performed according to European Commission Decision 2002/657/EC criteria, in terms of linearity, recovery, precision, specificity, decision limit (CC(alpha)) and detection capability (CC(beta)). Typical recoveries ranged between 70 and 110% at levels below and above the maximum residue limits of the target analytes in bovine milk, with an excellent intralab reproducibility (RSDs
Clin Microbiol Infect. 2008 Oct; 14(10): 949-54
Starnino S, Suligoi B, Regine V, Bilek N, Stefanelli P, , Dal Conte I, Fianchino B, Delmonte S, Robbiano F, D'Antuono A, Mirone E, Matteelli A, De Francesco MA, Cusini M, Scioccati L, Di Carlo A, Prignano G, Salfa MC
Data concerning Neisseria gonorrhoeae infections in Italy are scarce, and there is little information on the phenotypic and genotypic characteristics of the circulating strains. In this study, 326 isolates collected from 397 patients, with or without concurrent human immunodeficiency virus (HIV) infection, were cultured and characterized by serovar and antimicrobial susceptibility to five antimicrobials. N. gonorrhoeae multi-antigen sequence typing (NG-MAST) was also performed for strain characterization and to identify a transmission network. Gonococcal infection was diagnosed in 364 males and 33 females, 296 of whom were Italian and 96 of whom were foreigners (nationality was unknown in five cases). Among the 364 males, 197 were heterosexual, and the median age was 31 years. Approximately 8.3% of all the investigated patients were HIV-1-positive. The isolates were assigned to three different serovars (IA, IB, IA/IB), IB being the most frequently encountered. A significant rate of resistant gonococci was also observed; 34%, 25.5% and 19.1% of ciprofloxacin-resistant, penicillin-resistant and tetracycline-resistant phenotypes, respectively, were detected, and 10.2% of strains were multidrug-resistant. Together with the presence of different sequence types (STs), identified by NG-MAST, a multidrug-resistant cluster, ST661, was detected in a heterosexual network in a precise geographical area of the country. In particular, all strains belonging to ST661 showed identical profiles according to pulsed-field gel electrophoresis (PFGE), all were serotype IB, and all were resistant to penicillin, ciprofloxacin and tetracycline.
Antimicrobial Effects of Drugs against Multidrug-Resistant Pseudomonas aeruginosa.
Biol Pharm Bull. 2008 Oct; 31(10): 1898-901
Maeda K, Kobayashi Y, Oie S, Ishida S, Okano Y, Kobayashi T, Shikichi K, Mizuno H, Kamiya A
We evaluated the effects of antimicrobial drugs on four strains of Pseudomonas aeruginosa that are resistant to eight widely used antipseudomonal drugs (piperacillin, piperacillin-tazobactam, imipenem, meropenem, ceftazidime, aztreonam, amikacin, ciprofloxacin) and colistin. In the killing test, colistin (2 mug/ml) was the most effective, followed by aztreonam (48 mug/ml), piperacillin-tazobactam (192-4 mug/ml), piperacillin (192 mug/ml), and a three drug combination of azetreonam (16 mug/ml), ceftazidime (16 mug/ml), and amikacin (4 mug/ml). Six hours after drug addition, colistin (2 mug/ml), aztreonam (48 mug/ml), piperacillin-tazobactam (192-4 mug/ml), piperacillin (192 mug/ml), and the above three drug combination had bacteriostatic effects on all four strains. Colistin, three time breakpoint of aztreonam, piperacillin, or piperacillin-tazobactam, and the three drug combination of aztreonam, ceftazidime, and amikacin were effective in vitro.
J Antimicrob Chemother. 2008 Sep 30;
Jones GL, Warren RE, Skidmore SJ, Davies VA, Gibreel T, Upton M
Objectives The aac(6')-Ib-cr gene has been described in plasmids from CTX-M-15-producing Escherichia coli in the worldwide ST131 lineage, but has not been systematically sought in other quinolone-resistant strains in the UK. A rise in quinolone resistance in bacteraemia isolates in the UK preceded the increased prevalence of CTX-M-producing strains. This study aimed to describe the presence of plasmid-encoded quinolone resistance genes in historical and current strains of E. coli not producing extended-spectrum beta-lactamases (ESBLs). Methods Ciprofloxacin-resistant, non-ESBL-producing E. coli isolates included nationally distributed isolates from the BSAC UK bacteraemia surveillance programme between 2001 and 2005, urinary isolates from a regional project in 2000 and local strains in 2006. The aac(6')-Ib-cr gene was detected using PCR followed by restriction fragment length polymorphism analysis. Multiplex PCR was used to detect qnr genes. Isolates with aac(6')-Ib-cr were assessed for aminoglycoside susceptibilities and were serotyped. Results The prevalence of the aac(6')-Ib-cr gene was 3% and 9% in current local urinary and historic national bacteraemia quinolone-resistant non-ESBL-producing E. coli, respectively. Of 521 regional urinary E. coli isolates from 2000, 14 were norfloxacin-resistant, none of which carried the aac(6')-Ib-cr gene. National positive bacteraemia isolates from 2001/2 were type O102-ST405 and, in 2004/5, types O1-ST645 and O25-ST131. Positive local urinary isolates from 2006 included serotypes O1 and O25. Conclusions In the UK, aac(6')-Ib-cr occurs in E. coli in the absence of CTX-M-15, but with a restricted serotype distribution. Its presence in widespread bacteraemia isolates of a single type from 2001 to 2002, prior to the spread of CTX-M-15 in Britain, might suggest a lineage from which plasmid recombination occurred in man or other species.
Neisseria gonorrhoeae meningitis in pregnant adolescent.
Emerg Infect Dis. 2008 Oct; 14(10): 1672-4
Martín MC, Pérez F, Moreno A, Moral A, Alvarez MA, Méndez FJ, Vázquez F
Serogroup A Neisseria meningitidis with reduced susceptibility to ciprofloxacin.
Emerg Infect Dis. 2008 Oct; 14(10): 1667-9
Strahilevitz J, Adler A, Smollan G, Temper V, Keller N, Block C
Antimicrob Agents Chemother. 2008 Sep 29;
Breidenstein EB, Khaira BK, Wiegand I, Hancock RE
Pseudomonas aeruginosa offers substantial therapeutic challenges due to its high intrinsic resistance to many antibiotics and propensity to develop mutational and/or adaptive resistance. The PA14 comprehensive mutant library was screened for mutants exhibiting either 2-8-fold increased susceptibility (revealing genes involved in intrinsic resistance) or decreased susceptibility (mutational resistance) to the fluoroquinolone ciprofloxacin, identifying 35 and 79 mutants respectively as confirmed by broth dilution.
Similar cefoxitin-resistance plasmids circulating in Escherichia coli from human and animal sources.
Vet Microbiol. 2008 Aug 23;
Mulvey MR, Susky E, McCracken M, Morck DW, Read RR
The aim of this study was to determine the molecular epidemiology of cefoxitin-resistance Escherichia coli identified in cattle entering feedlots and determine if there were any similarities to E. coli causing human infections in Canadian hospitals. A total of 51 E. coli were isolated from a total of 2483 cattle entering four feedlots in southern Alberta, Canada. DNA fingerprinting using pulsed-field gel electrophoresis revealed thirty-two unique patterns with two major clusters observed comprised of Cluster A (11 strains) and Cluster B (7 strains). PCR and sequence analysis revealed 38 isolates (74.5%) harboured bla(CMY-2), whereas the remainder were found to contain mutations in the promoter region of the chromosomal ampC gene, which has been previously associated with cefoxitin resistance. No resistance to nalidixic acid, ciprofloxacin, or amikacin was observed in the clinical isolates. bla(CMY-2) harbouring plasmids were transferred to E. coli DH10B. All of the plasmids carrying bla(CMY-2) contained the A/C replicon and also harboured other resistance genes. Plasmid fingerprinting using BglII revealed 17 unique patterns with all but one clustering within 70% similarity. Comparison of the plasmid fingerprints to those isolated from human clinically significant E. coli in Canada during a similar time period [Mulvey, M.R., Bryce, E., Boyd, D.A., Ofner-Agostini, M., Land, A.M., Simor, A.E, Paton, S., 2005. The Canadian Hospital Epidemiology Committee, and The Canadian Nosocomial Infection Surveillance Program, Health Canada. Molecular characterization of cefoxitin resistant Escherichia coli from Canadian hospitals. Antimicrob. Agents Chemother. 49, 358-365] revealed four strains that harboured bla(CMY-2) A/C replicon type plasmid with fingerprint similarities of greater than 90% to the ones identified in E. coli from the cattle in this study. These findings highlight the potential linkage of multidrug resistant organisms in food producing animals and human infections in Canadian hospitals. The plasmids conferred resistance to multiple antibiotics which could limit options for the treatment of infections caused by these strains.