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Thermomonas hydrothermalis sp. nov., a new slightly thermophilic gamma-proteobacterium isolated from a hot spring in central Portugal.

Several non-pigmented bacterial isolates, with an optimum growth temperature of about 50 degrees C, were recovered from the hot spring at São Gemil in Central Portugal. Phylogenetic analyses of the 16S rRNA gene sequence of strain SGM-6T indicated that this organism represents a new species of the gamma-subclass of the Proteobacteria that is closely related to the newly described slightly thermophilic species Thermomonas haemolytica. The major fatty acids of strains SGM-6T and SGM-7 are C15:0 iso, C16:0 iso, C11:0 iso and C11:0 iso 3OH. Ubiquinone 8 is the major respiratory quinone. The new isolates are strictly organotrophic and aerobic. Strain SGM-6T only assimilated D-glucose, D-maltose, D-cellobiose, D-furanose, L-glutamate, L-glutamine, L-lysine, L-proline, L-ornithine, acetate, L-glutamic acid and pyruvate of sixty-five carbon sources tested. Strain SGM-7 also assimilates L-serine, but does not assimilate L-ornithine. On the basis of the phylogenetic analyses, physiological and biochemical characteristics, we propose that strains SGM-6T and SGM-7 represent a new species most closely related to Thermomonas haemolytica for which we propose the name Thermomonas hydrothermalis.

Culture Media↗

Diagnostic use of 3 techniques for identification of microsporidian spores among AIDS patients in Portugal.

The calcofluor stain (CF), the monoclonal antibody (MAb) 3B6 indirect immunofluorescence assay (IFA) and the modified trichrome blue stain (MT) were compared in terms of their reproducibility in a routine laboratory and in order to evaluate the percentage of cases of microsporidiosis in Portuguese HIV patients. A total of 166 faeces samples, 71 pulmonary specimens and 43 urine samples were studied using the 3 techniques. CF had a high sensitivity and a moderate specificity when applied to faeces samples. The sensitivity was lower with pulmonary specimens. The method is easy and quick to perform but readings take a long time to obtain. The MAb 3B6 IFA had a good to excellent sensitivity when applied to faeces and urine samples, but moderate sensitivity in pulmonary specimens. Readings were quick and easy to obtain, but the assay took longer to perform than the other 2 techniques. There was a greater correlation between the results obtained with the MT and MAb 3B6 IFA techniques than between those obtained with the MT and CF techniques. In conclusion, the MT performed better than the MAb 3B6 IFA and CF and continues to have an important place in a routine laboratory for the diagnosis of microsporidiosis. This work also confirms the existence of a relatively high proportion (30%) of cases of infection with Microsporidia, especially intestinal microsporidiosis, in HIV patients in Portugal.

AIDS-Related Opportunistic Infections↗

Aflatoxin M1 in raw and ultra high temperature-treated milk commercialized in Portugal.

During June to September 1999, 31 samples of raw milk were obtained from individual farms and 70 samples of ultrahigh-temperature-treated (UHT) milk (18 samples of whole milk, 22 of semi-skimmed and 30 samples of skimmed milk) were collected in supermarkets in Lisbon, Portugal. The total number of samples analysed was 101. The incidence of aflatoxin M1 (AFM1) contamination in the milk samples analysed was very high (83.2%). AFM1 was detected in 80.6% of raw milk and 84.2% of UHT milk. Concerning raw milk, 17 samples (54.8%) contained low levels (0.005-0.010 microgram/l), two samples (6.5%) had levels ranging from 0.011 to 0.020 microgram/l and six samples (19.3%) had levels between 0.021 and 0.050 microgram/l. Of 70 samples of UHT milk analysed, 10 samples had levels below 0.005 microgram/l (one whole milk, two semi-skimmed milk and seven skimmed milk). Nine samples--two whole milk (11.1%) and seven skimmed milk (23.3%)--were contaminated with levels between 0.005 and 0.010 microgram/l. Twenty-five samples (eight whole milk, 44.4%; one semi-skimmed milk, 4.5%; and 16 skimmed milk, 53.4%) had AFM1 contamination levels of 0.011-0.020 microgram/l. Six samples of whole milk (33.3%) and 18 samples of semi-skimmed milk (81.9%) had levels of 0.021-0.050 microgram/l. Only two samples were contaminated at levels above the legal limit for AFM1 (one whole milk and one semi-skimmed milk, 0.059 and 0.061 microgram/l, respectively). At the moment, the contamination of milk with AFM1 does not appear to be a risk to public health, although the presence of this toxin was detected in 83.2% of the samples analysed.

Aflatoxin M1↗

Aflatoxins in spices marketed in Portugal.

Seventy-nine prepackaged samples of 12 different types of spice powders (five cardamom, five cayenne pepper, eight chilli, five cloves, seven cumin, five curry) powder, five ginger, five mustard, 10 nutmeg, 12 paprika, five saffron and seven white pepper) were selected from supermarkets and ethnic shops in Lisbon (Portugal) for estimation of aflatoxins by immunoaffinity column clean-up followed by HPLC. Aflatoxin B1 (AFB1) was detected in 34 samples of prepackaged spices (43.0%). All of the cayenne pepper samples were contaminated with levels ranging from 2 to 32 microg AFB1/kg. Three nutmeg samples contained levels ranging from 1 to 5 microg/kg, three samples had levels ranging from 6 to 20 microg/kg, and there were two with 54 microg/kg and 58 microg/ kg. Paprika contained levels of aflatoxin B1 ranging from 1 to 20 microg/kg. Chilli, cumin, curry powder, saffron and white pepper samples had levels ranging from 1 to 5 microg/kg. Aflotoxins were not detected in cardamon, cloves, ginger and mustard. None of the samples analysed contained aflatoxins B2, G1 and G2.

Aflatoxins↗

Antibiotic residues in edible tissues and antibiotic resistance of faecal Escherichia coli in pigs from Portugal.

The aims were to provide data on antibiotic residues in pig tissues and the trends in the occurrence of antibiotic resistance in Escherichia coli (a commensal bacteria that can colonize the intestinal tract of humans and animals) isolated from the animals studied. Muscle and kidney samples collected from freshly slaughtered pigs were tested for the presence of antibiotic residues using rapid screening tests. Ninety muscle and 90 kidney samples from the same animals, collected in the slaughterhouse of the central region of Portugal, were screened by microbial tests and only six samples did not fulfil the European Community regulations concerning maximum residue limits. When a more sensitive method was used for the detection of sulphamethazine, 36% of the animals contained residues of the antibiotic. This indication of a larger antibiotic occurrence than anticipated was confirmed by studying the susceptibility of their enteric E. coli. In all the animal faeces studied (n = 60), E. coli isolates resistant to amoxycillin, tetracyclines and sulphonamides were found. The majority of the faecal samples demonstrated a high degree of E. coli resistant to sulphonamides and tetracyclines, respectively 88% and 85%. These data raise important questions about the relevance of the detection of antibiotic residues as the only method to establish the quality and safety of animal products for human consumption.

Amoxicillin↗

Survey of caffeine levels in retail beverages in Portugal.

The caffeine content of 85 retail beverage samples purchased from local supermarkets between 1995 and 2004 was determined. The potential intake of caffeine through the consumption of these beverages (but excluding coffee) was estimated for students of the University of Coimbra, Portugal. The caffeine content of the beverages ranged from 47.5 to 282.5 mg l(-1) for teas, from 20.1 to 47.2 mg l(-1) for tea extracts samples, and from 80.7 to 168.7 mg l(-1) for cola soft drinks. Caffeine was not completely absent from caffeine-free colas, and energy drinks had a far greater caffeine content than regular drinks, ranging from 21 to 2175 mg l(-1). Soft drinks were consumed by 72% of the individuals, although 14% of the survey participants did not drink any of the different types of the beverages studied. Contrary to expectations for this age group, no consumptions of energy drinks was reported. Daily caffeine intake was estimated to range from 4.7 to 200 mg day(-1), but with only 5% reporting a daily intake around 200 mg caffeine. Cola-type beverages were an important dietary source of caffeine for the population studied. Statistical differences in the caffeine intake between the male and female populations were found, with p = 0.014, being higher for the male population. Of the beverages studied, cola-type drinks showed statistical differences for the male population, p = 0.03, and tea showed statistical differences for female population p = 0.013, respectively.

Adult↗

Secular trends in male adult height 1904-1996 in relation to place of residence and parent's educational level in Portugal.

The records of height of 22841 18-year-old Portuguese males were analysed as well as their parents educational level and localities of subject's residence (districts). The sample includes all the Portuguese 18-year-old males, born in 1978 and examined in 1996, in central and southern Portugal, representing all the social strata. Statistically significant differences (p < or = 0.001) among the districts were found: males from Setúbal (172.75 cm) and Lisboa (172.64 cm), the most developed districts, are the tallest, and those from C. Branco (170.79cm) and Coimbra (171.19 cm) are the shortest. Comparing to published data from 1904, a positive secular trend in height was found. The average increase was 8.99 cm, which yields a rate of 0.99 cm per decade. This positive trend must be related to the general improvement in the population's standard living conditions, as the striking drop of post-neonatal mortality rate shows after the 1960s and 1970s. Despite this positive trend, great social difference still exists: the gap between the two extremes of parents' educational level is almost 4 cm for height. Analysis of variance (ANOVA) showed significant effects of father's and mother's educational level as well as subject's locality of residence, but the influence of parents' educational level was stronger than that of geographic residence. These results suggest that the secular trend in height will continue for the Portuguese population in the future decade.

Adolescent↗

Evaluation of compliance with national legislation on emissions in Portugal.

More than 13 years after publication of the first air quality laws in Portugal and more than 10 years after the publication of the respective emission limits, it seems appropriate to analyze the degree of compliance by the Portuguese manufacturing industry. Using the data from emission measurements made regularly by the Instituto de Soldadura e Qualidade, the only officially accredited laboratory according to standard ISO 17025, I analyzed a set of approximately 400 sources in terms of compliance with the emission limits regarding total suspended particulates, sulfur dioxide, nitrogen oxides, and volatile organic compounds. I evaluated compliance through a nondimensional parameter and plotted it versus the emission flow rate to derive conclusions: the results indicate that emission limits are generally met regarding sulfur dioxide and nitrogen oxides but not for the other pollutants considered in this study. However, noncompliance occurs mainly for very low emission flow rates, which suggests some alterations in the emission limits, which are being revised at the moment. These alterations will include the exemption of measurements in minor sources.

Air Movements↗

Whole blood glutathione peroxidase and erythrocyte superoxide dismutase activities, serum trace elements (Se, Cu, Zn) and cardiovascular risk factors in subjects from the city of Ponta Delgada, Island of San Miguel, The Azores Archipelago, Portugal.

Activities of whole blood glutathione peroxidase (GSH-Px) and erythrocyte superoxide dismutase (SOD) and serum levels of selenium (Se), copper (Cu) and zinc (Zn) were measured in 118 apparently healthy subjects aged 20-60 years from the city of Ponta Delgada, Island of San Miguel, The Azores Archipelago, Portugal. Data were analysed by age/gender, lipid profile and blood pressure as cardiovascular risk factors searching for their relevance when assessing reference values for antioxidant biomarkers. GSH-Px was in the same range, but SOD was significantly lower than in other Portuguese populations. Neither activity differed with gender. GSH-Px activity increased with age, namely in normolipidemic men versus the hyperlipidemic group in which a decrease was observed. This suggests a progressive impairment of GSH-Px with age caused by an enhanced production of oxidant species in hyperlipidemia. GSH-Px was 30% lower in male hypertensives versus normotensives. SOD activity did not relate to age or blood pressure but was 17% higher in the hyperlipidemic men versus the normolipidemic group, suggesting a better antioxidant protection by SOD than by GSH-Px in hyperlipidemia and hypertension. Se was higher in men versus women, particularly in the older subjects, and partly related to hyperlipidemia. Zn levels showed a similar dependency on gender, not related to age or lipid profile. Cu levels were much higher in women than in men in all age or lipid profile classes and decreased in hyperlipidemia. They were lowered with age in both genders, particularly in normolipidemic women. The present research therefore suggests that hyperlipidemia and hypertension do affect antioxidant status and should be considered when assessing antioxidant biomarkers in blood.

Adult↗

Spreading of HIV-1 subtype G and envB/gagG recombinant strains among injecting drug users in Lisbon, Portugal.

We have evaluated the genetic diversity of HIV-1 strains infecting injecting drug users (IDUs) in Lisbon, Portugal. Heteroduplex mobility assay and/or phylogenetic analysis revealed that env (C2V3C3 or gp41) subtype B is present in 63.7% of the 135 viral samples studied, followed by subtypes G (23.7%), A (6.7%), F (5.2%), and D (0.7%). Similar analysis of gag (p24/p7) performed on 91 of the specimens demonstrated that 49.5% of the infections were caused by subtype G viruses; other gag subtypes identified were B (39.5%), F (3.3%), A and D (1.1.% each), and the recombinant circulating form CRF02_AG (5.5%). Discordant env/gag sub-types were detected in 34.1% of the strains and may reflect the presence of dual infections and/or recombinant viruses. The presumptive B/G recombinant form was highly predominant (21 of 31). The genetic pattern of HIV-1 subtype B and G strains is suggestive of multiple introductions and recombination episodes and of a longstanding presence of both subtypes in the country. C2V3C3 amino acid sequences from IDU-derived subtype G viruses presented highly significant signatures, which distinguish the variants from this transmission group. The unusually high prevalence of subtype G sequences (34.1%), independent of the geographic origin of the infected individuals, makes this IDU HIV-1 epidemic unique.

Adolescent↗

Antibiotic susceptibility of Streptococcus pneumoniae isolates in Portugal. A multicenter study between 1989 and 1993.

A total of 1,104 strains of Streptococcus pneumoniae were isolated from hospitalized patients (75.5%) and from colonization sites at the Public Health Institute (24.5%) during the last 4 years (1989-1993). Penicillin resistance (defined as MIC > or = 0.1 microgram/liter) was found to increase in time: 4.6% in 1989, 4.9% in 1990, 6.4% in 1991, 11.3% in 1992, and 17% in 1993. In 1992, 0.8% of the strains had penicillin MIC = 2 mg/liter. Increase in penicillin resistance was also evident among invasive strains [blood, cerebrospinal fluid (CSF), pleura]: 2/92 isolates from 1989-1992 (2.3%) were penicillin resistant as compared to 7/101 isolates from 1992 (6.9%). Multiresistance (resistance to three or more antibiotics) was 4.4% with penicillin, tetracycline, chloramphenicol being the predominant resistant phenotype at the end of 1992. In 1993, strains with resistance to penicillin plus chloramphenicol plus tetracycline increased further. Erythromycin resistance was usually associated with clindamycin resistance, but the majority of such strains remained susceptible to penicillin. Drift in the direction of increasing MIC values was also noted during this 3-year period among "susceptible" isolates: bacteria with MIC of 6-10 ng/ml representing the majority of isolates in 1990-1991 decreased and were replaced by cells with MIC of 20 ng/ml. The most frequent pneumococcal serotypes were 23, 19, 3, 6, 14, 9, and 8, with the frequency of type 9 increasing from 2.9% (in 1989) through 3.2% (1990) to 6.4% (1992). Among all antibiotic resistant strains, the prevalent serotypes were 23, 9, 14, and 6. The chromosomal backgrounds of resistant isolates tested by pulsed-field gel electrophoresis showed close resemblance to the background of the serotype 23F multiresistant clone first identified in Spain. The data suggest that the recent large increase in the frequency of penicillin-resistant pneumococci represents the import of this clone into Portugal during the early 1990s. The increased frequency of drug-resistant pneumococci highlights the importance of continued surveillance of these dangerous pathogens.

Drug Resistance, Microbial↗

Carriage of respiratory tract pathogens and molecular epidemiology of Streptococcus pneumoniae colonization in healthy children attending day care centers in Lisbon, Portugal.

In an effort to establish the rate of carriage of antibiotic resistant respiratory pathogens in children attending urban day care centers (DCC) in Portugal, seven DCC in Lisbon were selected for determining the rate of nasopharyngeal colonization of children between the ages of 6 months to 6 years by Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Of the 586 children studied between January and March 1996, 47% carried S. pneumoniae, 72% H. influenzae, and 54% M. catarrhalis. Twenty-four percent of the pneumococci had reduced susceptibility to penicillin, and most of these belonged to serogroups 19, 23, 14, and 6. An additional 19% were fully susceptible to penicillin but showed decreased susceptibility to other antimicrobials. These isolates expressed serogroups 6, 11, 14, 18, 19, and 34. The majority (96%) of M. catarrhalis and 20% of H. influenzae were penicillin resistant due to the production of beta-lactamases. Recent antimicrobial use was associated with carriage of penicillin non-susceptible pneumococci and beta-lactamase producing H. influenzae (p < 0.05). Individual DCC differed substantially from one another in their rates of carriage of antibiotic resistant H. influenzae and S. pneumoniae. Characterization of antibiotic resistant S. pneumoniae isolates by molecular fingerprinting techniques showed that each DCC had a unique microbiological profile, suggesting little, if any, exchange of the resistant microbial flora among them. An exception to this was the presence of isolates belonging to two internationally spread epidemic clones: the multiresistant Spanish/USA clone expressing serotype 23F, and the penicillin and sulfamethoxazole-trimethoprim resistant French/Spanish clone (serotype 14) which were detected in four and three DCC, respectively.

Anti-Bacterial Agents↗

Natural history of drug-resistant clones of Streptococcus pneumoniae colonizing healthy children in Portugal.

A total of 3,539 Streptococcus pneumoniae (Pn) were recovered from 4,969 nasopharyngeal samples of children attending 13 day-care centers (DCCs) located in Lisbon, Portugal, during a surveillance study from January, 2001, through March, 2003, integrated in the European intervention project (EURIS, European Resistance Intervention Study). All Pn isolates were tested for anti-biotyping and drug-resistant pneumococci (DRPn) were further tested by serotyping and pulsed-field gel electrophoresis (PFGE). Overall carriage of Pn was very high (71.2%) and 39.9% of the isolates were resistant to antimicrobials (22.5% with decreased susceptibility to penicillin and 17.4% susceptible to penicillin and resistant to other antimicrobials). Serotypes 6B, 14, 23 F, 19F, and 19 A were prevalent among the 1,287 DRPn and 5.8% of the isolates were non-typeable. Eighty PFGE patterns were identified among 1,285 DRPn, and 93.1% of the DRPn belonged to 26 major clonal types that comprised: Pneumococcal Molecular Epidemiology Network (PMEN) clones (76.3%), Portuguese (PT)-DCC clones, previously detected in 1996-1999 (14.3%), and EURIS PT-DCC new clones, identified for the first time in the EURIS study, during 2001-2003 (9.4%). Comparing with previous Portuguese surveillance studies carried out since 1996, we observed that carriage increased from 47% to 71%, but no major changes were detected on the prevalence of pneumococcal serotypes. Moreover, although PMEN clones were predominant in all DCCs, in the present study the majority of them were gradually decreasing in time whereas several PT-DCC and new clones seemed to be increasing.

Anti-Bacterial Agents↗

Group A Streptococci from carriage and disease in Portugal: evolution of antimicrobial resistance and T antigenic types during 2000-2002.

In this study, we analyzed the antimicrobial resistance properties and T antigenic types of 511 isolates collected in Lisbon district, Portugal, from throat swabs of healthy subjects (n=341), during 2000-2002 and from diverse infection sites (n=170) of outpatients and inpatients, during 1999-2002. Erythromycin resistance was higher in tonsillitis/pharyngitis (27.4%) and skin infection isolates (21.1%), than in carriage and invasive isolates (<or=10%). Differences in erythromycin resistance among children and adults were noticed only for carriage isolates (9.3% in children and 21.1% in adults). Most erythromycin-resistant isolates from carriage (82.4%) and tonsillitis/pharyngitis (71.9%) showed the M phenotype. All M phenotype isolates (n=53) carried mef(A), whereas all MLS(B) phenotype isolates (n=19) carried erm(B) and not erm(A). Resistance to tetracycline [mediated by tet(M) in most isolates] was <or=6% in tonsillitis/pharyngitis and carriage isolates, 36.8% in skin infection isolates, and 44.1% in invasive isolates. The M phenotype increased since 2000, linked to a decrease of tetracycline resistance, and was predominantly associated with T1 in 2000-2001 and T12 in 2002 among carriage isolates, and with T8/25/Imp19 through 2000-2002 among tonsillitis/pharyngitis isolates. The majority (53%) of the tetracycline-resistant invasive isolates were nontypable. All isolates were susceptible to penicillin and chloramphenicol. This study showed that tetracycline and macrolide resistance frequency and phenotypes differ among GAS from various origins and changed over time. Moreover, T typing suggested that most drug-resistant isolates causing oropharyngeal carriage are distinct from the majority of isolates causing noninvasive and invasive infection.

Adolescent↗

Emergence of optochin resistance among Streptococcus pneumoniae in Portugal.

In most clinical microbiology laboratories optochin susceptibility is used in the screening and identification of Streptococcus pneumoniae. We report the characterization of 32 optochin-resistant S. pneumoniae strains from 10 laboratories that constituted 3.2% of all isolates recovered in 2005 in 30 laboratories in Portugal. Resistant isolates consisted of bile-soluble optochin-susceptible and optochin-resistant subpopulations with identical antimicrobial susceptibility patterns, capsular types and pulsed-field gel electrophoresis (PFGE) profiles. The most frequent serotypes--1, 19A, 11A, 3, 8, and 15A--were all common serotypes present in infection and colonization isolates in the country. The PFGE profiles of the 32 isolates corresponded to those of previously identified clones and confirmed that the emergence of these strains could not be attributed to clonal expansion. Clinical laboratories must be aware that optochin-resistant pneumococci are presently circulating in the community. Because accurate identification of S. pneumoniae is essential for correct diagnosis and adequate therapy of patients, we recommend that at least the bile solubility test should be routinely performed in cases of suspected pneumococcal etiology, even if the isolates are optochin-resistant.

Anti-Bacterial Agents↗

Persistent geographical disparities in infant mortality rates in Italy (1999-2001): comparison with France, England, Germany, and Portugal.

BACKGROUND: Infant mortality rate (IMR) is used as a population health indicator. We provide an updated description of temporal and geographical trends of IMR in Italy. METHODS: Regional data on infant deaths and live births were available for France, Germany, England, Portugal (1999-2000), and Italy (1990-2001). Mortality rates including 95% CIs and time-trends were computed. RESULTS: IMR was 4.5 per 1000 live births in 1999-2001. Between 1999-2001 and 1990-1992 both neonatal and post-neonatal mortality rates declined (P < 0.05) but not the North/South ratio. In 1999-2000 the regional variability in IMR was higher in Italy than in other European countries. CONCLUSION: Despite progresses in reducing IMR, geographical disparities persist within Italy.

England↗

Estimation of gene diversity at the b locus of the constant region of the immunoglobulin light chain in natural populations of European rabbit (Oryctolagus cuniculus) in Portugal, Andalusia and on the Azorean Islands.

The minimal gene diversity at a locus of the antibody constant region, as estimated in natural populations of rabbit, revealed levels of heterozygosity similar to those reported for the major histocompatibility complex in human and murine populations. Sera of 416 wild rabbits were collected on the Iberian peninsula and on three islands of the Azorean archipelago and analyzed for the occurrence of the serological markers of the b locus of the immunoglobulin light chain. All four serotypes present in domestic rabbits were found in Portugal. They represented less than 50% of the gene pool. In Andalusia this was less than 15% and on the Azorean islands less than 10%. The pronounced and systematic hierarchy in allele frequencies, previously found in populations from the more recent distribution area of the species, was not observed. On the peninsula, the frequencies of the "domestic" alleles were similar, averaging 10%. The Portuguese sample revealed a total heterozygosity of at least 87%. This high value was supported by at least 11 serologically different alleles, none of them occurring at frequencies above 20%. These data are in agreement with an Iberian origin of the European rabbit and strongly suggest the coalescence of b locus allelic lines drawn from Iberian and western populations. The role of balancing selection in the evolution of the b locus polymorphism was further emphasized.

Alleles↗

Characterization of beta-lactamases encoded by pathogenic strains of Escherichia coli from Portugal.

A survey of 2036 strains of Escherichia coli was conducted in Oporto, Portugal, to establish the prevalence of resistance to beta-lactam antibiotics. Isolates were from hospital and clinical practice patients, and were further divided into urinary and non-urinary pathogens. A high level of resistance to aminopenicillins (55.3%) was observed. Further examination of the resistant strains showed that the frequencies of occurrence of known beta-lactamases were as follows: TEM-1 (78.2% of resistant strains); SHV-1 (7.9%); TEM-2 (0.45%); OXA-1 (1.5%); HMS-1 (0.18%); TEM-1 + SHV-1 (4.2%). Other pairs of beta-lactamases were also identified in less than 2% of the resistant strains. In addition, 4.7% of the resistant strains produced elevated levels of a presumed chromosomal cephalosporinase, while 0.9% produced a ceftazimidase of pI 5.8-5.9 which was similar to TEM-6.

Anti-Bacterial Agents↗