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PubMed2003

An investigation of the bactericidal effect of certain antiseptics and disinfectants on some hospital isolates of gram-negative bacteria.

The effect of widely used antiseptics and disinfectants on some hospital isolates of gram-negative bacteria was assessed by the quantitative suspension test Chlorhexidine gluconate (4%), savlon (1:100), and 5.25% sodium hypochlorite were tested. Savlon and chlorhexidine gluconate were effective at in-use concentrations and sodium hypochlorite was effective at 1:50 dilution.

Anti-Infective Agents, Local↗
PubMed1991

[In vitro antibacterial activity of piperacillin-tazobactam combination on hospital isolates and regression curve].

Minimal inhibitory concentrations (MICs) of piperacillin (P) in combination with 4 micrograms/ml of tazobactam (T) were evaluated by agar dilution for 1,245 strains isolated in 4 hospitals. In addition antibiograms by agar diffusion were performed with disks loaded of 75 micrograms of P + 10 micrograms of T. For naturally non beta-lactamase producing Enterobacteriaceae (E), MIC 50 and 90% of P + T were (microgram/ml): E. coli 1-2; P. mirabilis: 0.5-1; activity was practically identical on plasmid mediated penicillinase (Pase) producing strains. Strains of K. pneumoniae only resistant (R) to amino- and carboxypenicillins (C) had MICs less than or equal to 4 (mode MIC 2); MICs of strains R to cephalothin and/or cefotaxime were 2 to 16 (mode MIC 4). For chromosomal cephalosporinase (Case) producing species, MICs of P + T were less than or equal to 8, including for acquired Pase producing strains, but were greater than or equal to 16 for Case hyperproducing strains. Strains of P. aeruginosa susceptible (S) to C were inhibited by 1 to 16 (with MIC 4) and strains R to C by 8 to greater than 128. MICs were generally 2 to 32 for A. baumannii S to C at 0.12 to greater than 128 for strains R to C. Haemophilus, S or R to ampicillin, were inhibited by 0.008 to 2 (MIC 50 and 90: 0.016-0.12). S. aureus S to methicillin (M), Pase producing on not, were inhibited by 0.5 to 2 (mode MIC 1) and strains R to M by 8 to greater than 128. Activity of P + T for coagulase-Staphylococci was similar.(ABSTRACT TRUNCATED AT 250 WORDS)

Acinetobacter↗
PubMed1999

In-vitro antibacterial activity of levofloxacin against hospital isolates: a multicentre study.

The objective of this study was to evaluate the activity of the fluoroquinolone, levofloxacin, against hospital isolates of bacteria. MICs of levofloxacin were determined for 2154 strains by agar dilution. Breakpoints for susceptibility testing were calculated using the agar diffusion technique with 5 micrograms discs. The activity of levofloxacin against nalidixic acid- and pefloxacin-susceptible Enterobacteriaceae (n = 668) was higher (MIC50/90 0.06-0.12 mg/L) than previously reported for ofloxacin. As seen with other fluoroquinolones, this activity was reduced against nalidixic acid-resistant and pefloxacin-intermediate and -resistant strains (MIC 1-8 mg/L). MICs for Pseudomonas aeruginosa (n = 104) were between 0.12 and 128 mg/L. Levofloxacin had good activity against nalidixic acid- and pefloxacin-susceptible Acinetobacter baumannii (n = 12; MIC 0.06-0.25 mg/L), but the activity was reduced against nalidixic acid- and pefloxacin-resistant strains (n = 80; MIC 1-32 mg/L). Haemophilus influenzae (n = 70), Haemophilus parainfluenzae (n = 47) and Moraxella catarrhalis (n = 64) were inhibited by low concentrations of levofloxacin (MICs 0.016-0.03 mg/L, 0.03-0.12 mg/L) and 0.03-0.12 mg/L, respectively). Clostridium perfringens (n = 23; MIC 0.25-1 mg/L) was more susceptible than Bacteroides fragilis (n = 60; MIC 0.5-4 mg/L). Levofloxacin showed superior activity compared with ofloxacin against methicillin-susceptible staphylococci (n = 107; MIC 0.03-0.5 mg/L); the resistant strains (MICs 2-32 mg/L) were usually also resistant to methicillin. Levofloxacin was less effective against enterococci (n = 105; MIC 1-32 mg/L), but streptococci (n = 192) and pneumococci (n = 129), including 58 penicillin-non-susceptible strains, were inhibited by low concentrations (MICs 0.5-2 mg/L). According to the regression curve, zone diameters were usually 20-22 mm, 17-19 mm and 15-16 mm for MICs of 1, 2 and 4 mg/L, respectively. In conclusion, this study, performed on a large number of strains, confirms the superior anti-bacterial activity of levofloxacin compared with ofloxacin, especially against pathogens isolated from respiratory tract infections.

Acinetobacter↗
PubMed2005

Activity of medicinal plant extracts against hospital isolates of methicillin-resistant Staphylococcus aureus.

Aqueous and ethanolic extracts of ten traditional Thai medicinal plants were investigated for their ability to inhibit 35 hospital isolates of methicillin-resistant Staphylococcus aureus (MRSA). Nine medicinal plants displayed activity against all isolates tested. Ethanolic extracts of Garcinia mangostana, Punica granatum and Quercus infectoria were most effective, with MICs for MRSA isolates of 0.05-0.4, 0.2-0.4 and 0.2-0.4 mg/mL, respectively, and for S. aureus ATCC 25923 of 0.1, 0.2 and 0.1 mg/mL, respectively. MBCs for MRSA isolates were 0.1-0.4, 1.6-3.2 and 0.4-1.6 mg/mL, and for S. aureus ATCC 25923 were 0.4, 3.2 and 1.6 mg/mL, respectively.

Ethanol↗
PubMed1983

Conjugal transfer of multiple antibiotic resistance from hospital isolates of Klebsiella to Escherichia coli.

Six independent isolates of Klebsiella from hospital environmental sources in Malaysia were found to be resistant to at least ampicillin, carbenicillin, cefoperazone, chloramphenicol, gentamicin and tetracycline. On the basis of their antibiograms, they were divided into four antibiogroups. They transferred all or part of their multiple antibiotic resistance traits to E. coli by conjugation. The results suggest that these Klebsiella strains harbour self-transmissible R plasmids. The significance of these findings are discussed.

Anti-Bacterial Agents↗
PubMed2006

Comparison of UV C light and chemicals for disinfection of surfaces in hospital isolation units.

OBJECTIVE: To determine the bactericidal effect on surfaces of ceiling- and wall-mounted UV C (UVC) light (wavelength, 254 nm) in isolation units, compared with standard hospital environmental cleaning and chemical disinfection during final disinfection after patients are treated for infections. DESIGN: Microbial samples were obtained from surfaces in isolation units (patient room, anteroom, and bathroom) before and after irradiation with UVC, chloramine disinfection, and standard hospital environmental cleaning. Samples were tested using standard contact plates. SETTING: Four identical, negative air-pressure isolation units (patient room, anteroom, and bathroom) with a defined number of ceiling- and wall-mounted UVC light units. The UVC distribution was monitored in one isolation unit after irradiation for approximately 40 minutes, corresponding to doses ranging from 160 J/m2 in a shadowed area to 19,230 J/m2 at the mostly highly exposed site (which is high enough to inactivate most bacterial organisms, including spores). RESULTS: UVC disinfection significantly reduced the number of bacteria on surfaces directly or indirectly exposed to UVC to a very low number, as did 5% chloramine disinfection alone (P<.001 for both). Completely shadowed areas in the isolation unit (eg, the bed rail, lockers, and mattresses) still required disinfection by chemicals. CONCLUSION: Disinfection with UVC light may significantly reduce environmental bacterial contamination and thereby protect the next patient housed in an isolation room. UVC disinfection may not be used alone but is a good addition to chemical disinfection.

Bacteria↗
PubMed2005

Restructuring isolation: hospital architecture, medicine, and disease prevention.

This paper examines changing strategies of isolation in the New York Hospital between 1771 and 1930 by correlating the facilities available for isolation with changing reactions to internal disease incidence, changing medical rules and regulations, and shifting ward categories. To prevent internal "epidemics" of telltale diseases such as erysipelas, pyemia, and "hospital gangrene," what (or who) was isolated from what, and how that isolation was achieved, altered drastically. Traditional strategies of increasing the air space and flow around each patient gave way to Florence Nightingale's sanitary nursing, Joseph Lister's antisepsis, Joseph Grancher's barrier system of nursing, D. L. Richardson's aseptic nursing, and Charles Chapin's advocacy of individual cubicles. The larger social and medical transformations of the hospital colored all of these shifts. But the changing isolation strategies also reveal a transformation of the underlying understanding of the role that hospital architecture played in disease incidence.

Cellulitis↗
PubMed2000

Activity pattern of natural and synthetic antibacterial agents among hospital isolates.

The antibacterial pattern of tetracycline and bactrim was compared with that of the chloroform extract of two Pseudomonas strains using ten hospital strains each of Staphylococcus aureus and Escherichia coli. There was no perfect correlation between isolate source, antibiotic type and sensitivity. Both the synthetic and natural antibiotic agent exhibited antibacterial activities against resistant hospital isolates at high concentrations.

Anti-Bacterial Agents↗
PubMed1992

Tetracycline resistance genes in Kenyan hospital isolates of Salmonella typhimurium.

All 97 strains of Salmonella typhimurium isolated from patients at a hospital in Nairobi, Kenya, during 1988-90 were resistant to tetracycline. The minimum inhibitory concentration (MIC) showed a large distribution range from 1 microgram/ml to 128 micrograms/ml. The strains were heterogeneous with respect to plasmid content, but initially all strains possessed, in addition to other plasmids, a large 60-, 63- or 65-MDa plasmid. The tetracycline resistance genes were characterized using oligonucleotide probes, and 20% of the resistant strains possessed tetracycline type A (tetr A), 6% tetr B, and 4% tetrC genes. Three strains possessed both type A and B tetracycline resistance determinants, which were shown to be located on the large 65-MDa plasmid. There was no correlation between strains isolated from stools, blood, cerebrospinal or epidural fluids, pus, or urine, with respect to the tetracycline genotypes, MIC values or plasmid content.

Base Sequence↗
PubMed2004

[Efficacy of biocides against hospital isolates of Staphylococcus sensitive and resistant to methicillin, in the province of Buenos Aires, Argentina].

OBJECTIVE: To assess the response to the action of different antiseptics and disinfectants usually used in Argentinian hospitals of hospital staphylococci sensitive and resistant to methicillin. To test the effectiveness of the biocides by measuring their effective bactericidal concentrations, and to determine whether there is any correlation between biocide resistance and methicillin resistance in this bacterial population. METHODS: The action of seven biocides was tested against 25 strains of nosocomial Staphylococcus spp. sensitive and resistant to methicillin, and in Staphylococcus aureus ATCC 6538. Hospital strains were obtained from April, 2000 to May, 2002, from clinical samples (blood culture, urine culture, catheter tip or abscess) from male and female inpatients and outpatients at two tertiary hospitals. After isolation, antibiotic sensitivity was tested with the agar diffusion method of Kirby and Bauer. The action of hospital biocides on the strains was studied with the Kelsey-Sykes test, which establishes the effective bactericide concentrations of these compounds. RESULTS: The results showed that the response of strains sensitive and resistant to methicillin varied in comparison to the collection strain. Chlorhexidine digluconate, povidone iodine, weak tincture of iodine and alkaline glutaraldehyde were effective against most strains, regardless of whether they were sensitive or resistant to methicillin. CONCLUSIONS: We found no indication of a relationship between resistance to methicillin and resistance to biocides. Our study shows that further research is needed to evaluate the efficacy of chemical agents against microorganisms that have been exposed to antibiotic therapies.

Adolescent↗
PubMed1983

The in-vitro activity of mezlocillin against community hospital isolates in comparison to other penicillins and cephalosporins.

The in-vitro activity of mezlocillin was evaluated against 1795 fresh clinical isolates at a 320-bed community hospital and compared with that of ticarcillin, piperacillin, cefoxitin, cefamandole, moxalactam, cefotaxime and cefoperazone. Only 25 isolates (1.4%) were highly resistant to mezlocillin (greater than 128 mg/l). The MIC 90 values were less than or equal to 32 mg/l for all species studied, including Klebsiella, but excluding Acinetobacter and Pseudomonas where the MIC 90 values were 64 mg/l. The anti-pseudomonal activity of mezlocillin was equivalent to that of ticarcillin but less than that of piperacillin, particularly at low MIC values. Against most members of the Enterobacteriaceae mezlocillin was more active than cefoxitin or cefamandole but was less active than moxalactam, cefotaxime or cefoperazone. Its activity against enterococci exceeded that of all other agents tested, inhibiting 82% of strains at an MIC value less than or equal to 1 mg/l. Because of its exceptionally broad spectrum, mezlocillin promises to be of value for the treatment of infections due to a wide variety of micro-organisms, and particularly for mixed infections due to Gram-negative bacilli and enterococci.

Bacteria↗
PubMed1984

Cryptic plasmids in hospital isolates of Providencia stuarti.

The distribution of cryptic plasmids among 123 isolates of Providencia stuarti from a hospital ward during a prospective epidemiological study is reported. Two closely related stable plasmids (34 Kb and 36 Kb) were identified by restriction endonuclease digest analysis of plasmid DNA. One or other of these cryptic plasmids was carried by 40 isolates, the remainder were plasmid-free. A higher proportion of one cryptic plasmid (CPT-A) was found in environmental isolates than in isolates from patients. The serotype of all isolates of P. stuarti was O63 and they were epidemiologically related. Two of the eight patients colonised by P. stuarti carried all three possible variants: plasmid-free (PFI) strains or strains containing cryptic plasmid A (CPT-A) or cryptic plasmid B (CPT-B). The epidemiological significance of these results is discussed.

Aged↗
PubMed2006

Prospective evaluation of hospital isolation room capacity.

Risk assessment is used to determine the need for isolation in single rooms. Limited availability of isolation rooms and/or operational needs may compromise this process. This article reports the results of a 12-month prospective observational study of every infection control request for isolation in a 1100-bed teaching hospital. In addition, four point-prevalence surveys of the usage of single rooms were carried out. Data were collected on the incidence of new clinical meticillin-resistant Staphylococcus aureus (MRSA) isolates per ward and these were correlated with rates of isolation failures for MRSA cases. There were 845 requirements for patient isolation, of which 185 (22%) could not be met (isolation failures). Three-quarters of the requirements for isolation were due to MRSA or Clostridium difficile. The proportion of isolation failures was consistent for most organisms and conditions but varied markedly between clinical specialities (0-57%). Reasons for failure to isolate included no single rooms available, all single/isolation rooms occupied (for both isolation and non-infection-control reasons), limitations on the use of single rooms in mixed-sex wards and patient-specific reasons. Only a minority of the available single rooms were occupied for infection control reasons (12-19%). There was a statistically significant correlation between isolation failures and MRSA incidence (Spearman's rho 0.596, P<0.001). In only one case where a ward had >or=30% of its beds provided in single rooms was there an instance of failure to isolate. In conclusion, insufficient capacity to isolate patients with potentially transmissible pathogens is common and may compromise infection control requirements. Either isolation capacity must be increased or evidence-based risk assessment must be applied to situations where demand for isolation exceeds availability. Further information is needed on the consequences of isolation failure.

Cross Infection↗
PubMed1979

Hospital isolates of Serratia marcescens transferring ampicillin, carbenicillin, and gentamicin resistance to other gram-negative bacteria including Pseudomonas aeruginosa.

Thirteen independent isolates of Serratia marcescens associated with nosocomial urinary tract infections were obtained from the clinical microbiology laboratory at Hines Veterans Administration Hospital. The isolates were resistant to at least ampicillin, carbenicillin, gentamicin, and tobramycin. They could be divided into two groups on the basis of their antibiotypes. Group I (9 strains) showed resistance to 13 antibiotics, including 3 beta-lactams, 6 aminoglycosides, tetracycline, sulfonamide, trimethoprim, and polymyxin B. Group II (4 strains) was resistant to 11 antibiotics, including 3 beta-lactams, 5 aminoglycosides, sulfonamide, trimethoprim, and polymyxin B. Donors from both groups transferred resistance traits to Escherichia coli. Transconjugants from matings with group II donors all acquired resistance to nine antibiotics, including the three beta-lactams, five aminoglycosides, and sulfonamide. Transconjugants from matings with group I donors were of varied antibiotypes, inheriting resistance to up to 11 of the 13 antibiotics. Resistances to trimethoprim and polymyxin B were never observed to transfer. E. coli transconjugants of each group were capable of transferring multiple-antibiotic resistance to several other members of the family Enterobacteriaceae. All group II S. marcescens and E. coli donors and all group I S. marcescens donors transferred carbenicillin, streptomycin, kanamycin, gentamicin, tobramycin, and sisomicin resistance to Pseudomonas aeruginosa. The results suggest that these S. marcescens strains harbor R factors of a broader host range than previously reported.

Ampicillin↗
PubMed1991

[In vitro antibacterial activity of a new fluoroquinolone, temafloxacin, against hospital isolates. Results of a multicenter study].

Minimal inhibitory concentrations (MICs) of temafloxacin (TMF) was determined by agar dilution for 2,510 bacterial strains isolated in 1989 in 9 university hospitals. Activity of TMF against nalidixic acid (NAL) susceptible (S) Enterobacteriaceae was close to that of other fluoroquinolones (FQ) (mode MIC: 0.06 micrograms/l); like for other FQ, this activity was reduced against NAL intermediate (mode 1) and resistant (R) (mode 4) Enterobacteriaceae. MICs of TMF against P. aeruginosa were between 0.12 and 128 (mode 0.5-1). TMF had also a good activity against NAL S A. baumannii (mode MIC: 0.06-0.12) but this activity is reduced against NAL R Acinetobacter (mode MIC: 16). TMF was highly active against Haemophilus mode MIC: less than or equal to 0.008), Gonococci (mode MIC: 0.008-0.032), Meningococci (mode MIC: 0.08) and B. catarrhalis (mode MIC: 0.016). TMF showed better activity to other fluoroquinolones against methicillin susceptible Staphylococci (mode MIC: 0.06); the resistant strains (mode MIC: 8) are usually methicillin resistant. Comparatively to the currently available FQ, TMF is so more effective against Enterococci (mode MIC: 1), Streptococci (mode MIC: 0.5-1) and Pneumococci (mode MIC: 0.5). Finally, for the anaerobic bacteria, TMF is more active against C. perfringens (mode MIC: 0.5) than against B. fragilis (mode MIC: 2).

4-Quinolones↗