Microbial drug resistance : MDR : mechanisms, epidemiology, and disease
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Microb. Drug Resist. · Feb 2013
Characterization of PVL/ACME-positive methicillin-resistant Staphylococcus aureus (genotypes ST8-MRSA-IV and ST5-MRSA-II) isolated from a university hospital in Japan.
The ST8 methicillin-resistant Staphylococcus aureus (MRSA) with Staphylococcal cassette chromosome mec (SCCmec) type IVa, known as USA300, is a prevalent community-acquired MRSA (CA-MRSA) clone in the United States and has been spreading worldwide. The USA300 characteristically harbors Panton-Valentine Leukocidin (PVL) genes and the arginine catabolic mobile element (ACME, type I). Prevalence and molecular characteristics of PVL(+) and/or ACME(+) S. aureus were investigated in a university hospital located in northern Japan, for 1,366 S. aureus isolates, including 601 MRSA strains derived from clinical specimens collected from 2008 to 2010. ⋯ Besides the two PVL(+) MRSA strains, ACME (type-ΔII) was identified into seven MRSA strains with SCCmec II belonging to ST5, one of the three spa types (t002, t067, and t071), coagulase type II, and agr type II. These PVL(-)/ACME(+) MRSA strains showed multiple drug resistance and harbored various toxin genes as observed for ST5 PVL(-)/ACME(-) MRSA-II. The present study suggested the spread of ST8-MRSA-IV in northern Japan, and a potential significance of ACME-positive ST5-MRSA-II as an emerging MRSA clone in a hospital.
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Microb. Drug Resist. · Dec 2012
Multicenter StudyClinical experience of tigecycline treatment in infections caused by extensively drug-resistant Acinetobacter spp.
Tigecycline has broad spectrum antimicrobial activity and is approved for complicated intra-abdominal infections, complicated skin and soft tissue infections, and community-acquired pneumonia. There are few data on clinical experience of tigecycline in hospital-acquired pneumonia (HAP) and Acinetobacter spp. infection. ⋯ Tigecycline can be considered as an alternative therapy in patients with HAP or infections caused by Acinetobacter spp., especially extensively drug-resistant A. baumannii.
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Microb. Drug Resist. · Dec 2011
Comparative StudyIn vitro activity of tigecycline and comparators against gram-negative bacteria isolated from a tertiary hospital in Alexandria, Egypt.
The emergence of infections caused by multidrug-resistant Gram-negative bacteria, in particular Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae, has necessitated the search for alternative therapy by either introducing new agents or renewing interest in old agents. This study compares the in vitro activity of tigecycline (TIG), recently introduced to Egyptian market, to other potentially active antimicrobials as Colistin (COL), imipenem (IPM), levofloxacin (LEV), and piperacillin/tazobactam (PIP/TAZ) against 67 Gram-negative clinical isolates obtained from El- Meery Hospital in Alexandria, Egypt. El-Meery Hospital is a 1,500-bed tertiary teaching hospital where TIG has not been previously used. ⋯ TIG demonstrated variable ability to suppress biofilm formation affecting mainly E. coli and A. baumannii isolates. These results point TIG to be a promising agent in treatment of infections caused by strains for which adequate therapy has been limited. As far as we know, this is the first report evaluating the in vitro activity of TIG against Egyptian clinical isolates.
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Microb. Drug Resist. · Dec 2011
Virulence factors and genetic characteristics of methicillin-resistant and -susceptible Staphylococcus aureus isolates in Myanmar.
Staphylococcus aureus produces virulence factors, including various exotoxins and adhesins, which are associated with a variety of symptoms caused by its infections. In the present study, the prevalence of these virulence factors was analyzed for 23 S. aureus strains isolated from wound infections in hospitals, nasal swabs, or vomit from patients and cooks in a food poisoning case and from healthy adults in Yangon, Myanmar. Among these strains, five were methicillin-resistant S. aureus (MRSA) derived from pus (four strains, SCCmec III, ST239) and a healthy adult (one strain, SCCmec-IVa, ST5). ⋯ Adhesin genes, which are associated with binding to fibronectin, fibrinogen, and elastin, were detected in all the MRSA and most of the MSSA strains examined. However, the bone sialoprotein-binding protein gene (bbp) and the variant form of the elastin-binding protein gene (ebpS-v) with an internal 180 bp deletion were identified only in the MSSA strains harboring the PVL gene. These findings suggest that those genetic traits are characteristic of PVL-positive ST121 S. aureus strains in Myanmar.
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Microb. Drug Resist. · Jun 2011
Risk factors for mortality in patients with Pseudomonas aeruginosa bacteremia: clinical impact of antimicrobial resistance on outcome.
Despite the high prevalence of antimicrobial resistance among Pseudomonas aeruginosa bacteremia, the clinical consequence of resistance remains unclear. The purpose of this study was to identify predictors of mortality and evaluate the clinical impact of antimicrobial resistance on outcome in P. aeruginosa bacteremia. A retrospective cohort study including patients with P. aeruginosa bacteremia was performed. ⋯ As compared with the susceptible group, ceftazidime-, piperacillin-, or imipenem-resistant groups had a higher mortality (p < 0.05). A multivariate analysis showed that resistance to ceftazidime or imipenem remained a significant factor associated with mortality (odds ratio, 2.96; 95% confidential interval, 1.20-7.31; and odds ratio, 2.74; 95% confidential interval, 1.02-7.31, respectively). Antimicrobial resistance, especially to ceftazidime or imipenem, adversely affected outcome in patients with P. aeruginosa bacteremia.