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PubMed2004

[Mechanisms of resistance in Enterobacteriaceae towards beta-lactamase antibiotics].

Except for Salmonella spp., all Enterobacteriaceae produce intrinsic chromosomal encoded beta-lactamases which, beside their physiologic role in cell-wall synthesis and natural beta-lactam protection, are responsible for intrinsic resistance of individual species among Enterobacteriaceae. E. coli and Shigella spp. produce a small amount of AmpC beta-lactamases and are susceptible to ampicillin and other beta-lactam antibiotic agents. Enterobacter spp, C. freundii, Serratia spp., M. morganii, P. stuarti and P. rettgeri produce small amounts of inducible AmpC beta-lactamases which are not inhibited by beta-lactamases inhibitor, causing intrinsic resistance to ampicillin, co-amoxiclav and first-generation cephalosporins. K. pneumoniae produces small amounts of SHV-1 beta-lactamases, and K. oxytoca chromosomal K1 beta-lactamase, causing resistance to ampicillin, carbencillin, ticarcillin and attenuated zone of inhibition to piperacillin, compared to piperacillin with tazobactam. They are susceptible to beta-lactamase inhibitors. Whereas P. mirabilis shows a minor chromosomal expression of beta-lactamases, P. vulgaris produces chromosomal beta-lactamases of class A (cefuroximases), causing resistance to ampicillin, ticarcillin, and first- and second-generation cephalosporins. Antibiotics have caused the appearance of acquired or secondary beta-lactamases, with the sole function of protecting bacteria from antibiotics. The production of broad-spectrum beta-lactamases (TEM-1, TEM-2, SHV-1, OXA-1) results in resistance to ampicillin, ticarcillin, first-generation cephalosporins and piperacillin. A high level of beta-lactamases leads to resistance to their inhibitors. The plasmid-mediated extended-spectrum beta-lactamases (ESBLs) are of increasing concern. Most are mutants of classic TEM- and SHV-beta-lactamases types. Unlike these parent enzymes, ESBLs hydrolyze oxymino-cephalosporins such as cefuroxime, cefotaxime, ceftriaxone, ceftizoxime, ceftazidime, cefpirome and cefepime, aztreonam, as well as penicillins and other cephalosporins, except for cephamycin (cefoxitin and cefotetan). They are inhibited by beta-lactamase inhibitors. AmpC beta-lactamases are chromosomal and inducible in most Enterobacter spp., C. freundii, Serratia spp., M. morganii and Providentia spp. They are resistant to almost all penicillins and cephalosporins, to beta-lactamase inhibitors and aztreonam, and are susceptible to cefepime and carbapenems as well. Plasmid-mediated AmpC beta-lactamases have arisen through the transfer of chromosomal genes for the inducible AmpC beta-lactamase onto plasmids. All plasmid-mediated AmpC beta-lactamases have similar substrate profiles to the parental enzymes from which they appear to be derived. With one exception, plasmid-mediated AmpCs differ from chromosomal AmpCs in being uninducible. The National Committee for Clinical Laboratory Standards (NCCLS) has issued recommendations for ESBL screening and confirmation for isolates of E. coli, K. pneumoniae and K. oxytoca. No NCCLS recommendations exist for ESBLs detection and reporting for other organisms or for detecting plasmid-mediated AmpC beta-lactamases. High-level expression of AmpC may prevent recognition of an ESBL in species that produce a chromosomally encoded inducible AmpC beta-lactamase. AmpC-inducible species (e. g. Enterobacter spp. and C. freundii) can be recognized by cefoxitin/cefotaxime disk antagonism tests. Since clinical laboratories are first to encounter bacteria with new forms of antibiotic resistance, they need appropriate tools to recognize these bacteria, including trained staff with sufficient time and equipment to follow up important observations. Because bacterial pathogenes are constantly changing, training must be an ongoing process.

Enterobacteriaceae↗
PubMed2005

[Comparison of frequency and susceptibility to antimicrobials of bacterial strains of the family Enterobacteriaceae isolated from patients hospitalised in intensive care units].

UNLABELLED: The aim of the study was estimation of frequency and susceptibility to antimicrobial agents of gram-negative rods isolated from clinical specimens obtained from patients requiring intensive care, with emphasis on profile of the unit. The analysis comprised strains of gram-negative rods isolated from patients of two intensive care units (ICUs) of a tertiary care hospital (1200 beds). Identification of cultured isolates was done using automated VITEK and API systems (bioMerieux, France). Susceptibility to antimicrobial agents was tested by a disk-diffusion method according to the NCCLS recommendations. In total the analysis comprised 722 strains of gram-negative rods. In blood cultures predominated strains of Enterobacter spp. (42.5%) and Klebsiella pneumoniae (37.5%). In cultures of clinical specimens other than blood 41.6% comprised strains of Klebsiella pneumoniae, 14.8% Escherichia coli and 14.4% Proteus mirabilis. Frequency of multi-drug resistant strains of bacteria of the family Enterobacteriaceae was much higher among blood isolates in comparison to strains cultured from other clinical specimens. There was a relatively high percentage of strains of Enterobacteriaceae susceptible to piperacillin and tazobactam (69.0%) and ceftazidime (54.6%). CONCLUSIONS: 1. All strains were susceptible to carbapenems. 2. There was a relatively high percentage of strains of gram-negative rods susceptible to piperacillin/tazobactam and ceftazidime. 3. Bacteria isolated from blood cultures were characterised by a much higher percentage of resistant strains in comparison to other specimens. 4. Longer stay in ICU promoted selection of strains resistant to antimicrobials.

Anti-Bacterial Agents↗
PubMed2006

[Conjugative transfer frequency of resistance genes from ESBL-producing Enterobacteriaceae strains isolated from patients hospitalized in pediatric wards].

The aim of this study was to evaluate the transfer frequency of plasmids encoding extended-spectrum beta-lactamases (ESBLs) from clinical isolates of Enterobacteriaceae to E. coli K12 C600 recipient strain. Additionally, resistance patterns to antimicrobial drugs of the isolates as well as transconjugants were analyzed. Fifty-four clinical strains belonging to the Enterobacteriaceae family were isolated from children hospitalized in Medical University Hospital in Wrocław. All the strains studied were identified in automatic ATB system using ID32E tests. Besides, they were ESBL-positive as was confirmed by the double-disc synergy test (DDST). The minimal inhibitory concentration (MIC) was determined for twelve selected antibiotics and chemotherapeutics. The majority of the strains (87%) were able to transfer plasmid-mediated ESBL to E. coli K12 C600 recipient strain with a frequencies ranged from 10(-5) to 10(-1) per donor cell. All the isolates studied as well as their transconjugants were susceptible to imipenem, meropenem and norfloxacin (MIC <1mg/L). On the other hand, these strains displayed high level of resistance (MIC 512 - >1024 mg/L) to cefotaxime, ceftriaxone, gentamycin, amikacin and cotrimoxazole. Genetic markers conferring resistance to aminoglycosides and cotrimoxazole were often co-transferred to recipient strain in conjugation process.

Anti-Bacterial Agents↗
PubMed1991

Species incidence and antimicrobial-agent resistance patterns of Enterobacteriaceae in Charles Nicolle Hospital, Tunis, from 1983 to 1987.

Between July 1983 and December 1987, 13,108 strains of enterobacteriaceae were isolated at Charles Nicolle Hospital in Tunis. This study reports the prevalence of different species isolated, their resistance and the evolution of bacterial resistance during that period. There appeared to be a great stability in the distribution of bacterial groups. Among the commonly sensitive species, Proteus mirabilis showed a high proportion of strains resistant to ampicillin (79.3%), carbenicillin (75.9%), cefalotin (73.8%) and gentamicin (46%). The proportions of resistant strains in P. mirabilis were much the same for each successive year from 1983 to 1987, and the percentages of resistant strains in the majority of the bacterial species were similarly stable. Amikacin and cefotaxime remained the most active antibiotics against enterobacteriaceae.

Drug Resistance, Microbial↗
PubMed1990

[Reactions of different Enterobacteriaceae and Vibrionaceae species in BRILA-MUG (Fluorocult) bouillion].

In order to test the usefulness of BRILA-MUG (= Fluorocult) medium (Merck) for isolation and identification of total coliforms and faecal coliforms in surface water according to the EC guidelines for bathing waters a total of 969 strains of different Enterobacteriaceae and Vibrionaceae species was examined under different culture conditions. These included 486 E. coli (reference strains of O-groups 1-170, enterotoxin and Verotoxin-producing strains), 149 Salmonella (subspecies I-VI), 92 Yersinia, 44 Shigella, 64 Vibrio, 16 Aeromonas, and 118 strains of other Enterobacteriaceae species. After 48 h incubation at 36 degrees C 372 (82.0%) of 486 E. coli showed the typical reactions of gas formation, fluorescence (beta-glucuronidase activity), and indole production. Examination of fluorescence after addition of 1 N NaOH (0.5 ml), or testing of indole production after subculture in tryptophane containing broth improved the amount of typical reactions to 434 (95.4%). Incubation at 44 degrees C for 48 h gave less favourable results as compared with that at 36 degrees C. Out of 483 strains of other species 3.9% Salmonella strains of subspecies II-IV, 6.25% Citrobacter freundii, and 50% Edwardsiella tarda strains yielded reactions typical of E. coli. Shigella and Yersinia strains occasionally produced indole or fluorescence, but never visible gas.

Culture Media↗
PubMed1989

Gas liquid chromatography of amines produced by the Enterobacteriaceae.

1. Gas liquid chromatography (GLC) was used to test the production of amines by 85 strains of Enterobacteriaceae. 2. The strains tested produced cadaverine, beta-phenylethylamine, putrescine, iso-amylamine, 2-methylbutylamine and iso-butylamine. 3. Although the overlap in amine production between obviously different genera and species limits the general applicability of this methodology in clinical microbiology, the results obtained demonstrate the possibility of differentiating Proteus rettgeri from other Proteus species, Escherichia coli from Proteus species and Salmonella species from Shigella species on the basis of their amine composition. 4. In general, members of the Enterobacteriaceae family produce qualitatively similar amine profiles, though differing quantitatively in the amounts of individual amines produced. GLC proved to be useful for separating amines and for providing tentative peak identification.

Amines↗
PubMed1989

Evaluation of the resistance of Enterobacteriaceae strains to antibiotics--comparison of strains from clinical material versus environment.

The authors analyzed resistance to antibiotics of bacterial strains from the family of enterobacteriaceae comparing the resistance of two sets of strains, one set being strains isolated from clinical material of patients, the other being those isolated from municipal waste water of the 4th district of Bratislava. Referring to higher index of resistance in strains isolated from outer environment, they draw attention to high number of strains resistant to ampicillin and tetracyclin in clinical material and that of gentamicin-resistant ones from outer environment. Some views on standardization of empirical antibiotic therapy of infections due to strains from clinical material and outer environment are formulated and changes in the antibiotic spectrum effectivity as compared with past results as well as possible unsatisfactory success in treatment by means of currently applied broad spectrum antibiotics in cases of empiric therapy of infections are pointed to. Information on incidence of polyresistant strains of Enterobacteriaceae in outer environment and municipal waste water is presented.

Drug Resistance, Microbial↗
PubMedDate not supplied

Multitest system for biochemical identification of Salmonella, Escherichia coli, and other Enterobacteriaceae isolated from foods: collaborative study.

Nine laboratories evaluated the ability of the MICRO-ID test system to correctly identify members of the Enterobacteriaceae. A total of 78 isolates representing 11 genera of enterics that had been previously isolated from foods were used in the collaborative study. The collaborators streaked each isolate on plate count agar and incubated the plates overnight at 35 degrees C to check purity of the isolates. Then they proceeded with the method in which an isolated colony is transferred to a plate count agar slant and is incubated 18-24 h at 35 degrees C. Growth from the slant is emulsified in 3.5 mL physiological saline to a density comparable to a McFarland No. 2 tube and is then used to inoculate the test (MICRO-ID) strip. The strip is incubated 4 h at 35 degrees C and the reactions are read and recorded. Isolates are identified by using an octal code and the test kit manual. The system correctly identified 98.8% of the Salmonella isolates, 97.7% of the E. coli isolates, and 84.6% of the other 9 enteric genera tested. The system has been approved interim official first action as an alternative to conventional biochemical tests (1) for presumptive generic identification of food-borne Salmonella and for screening and elimination of non-Salmonella isolates; (2) for identification of E. coli from foods; and (3) for presumptive generic identification of other Enterobacteriaceae isolated from foods.

Culture Media↗
PubMed1987

[Bacteriologic quality of water from the Rhine and its tributaries in the Rhine-Neckar region. I. Bacterial count and Enterobacteriaceae of the current status of pollution].

During the period of May 1982 to January 1983 and March 1986 to May 1986, 164 water-specimens had been collected along the river Rhine and its affluxes in the overcrowded Rhine-Neckar-Region from 34 collecting-sites on 8 different days. The specimens were tested for the total-germ-count and the titers of different Enterobacteriaceae-species. The total-germ-count examined concentrations of several hundreds up to 1.8 million germ in 1 ml river-water. Extremely high concentrations were found along the waste-water-influxes (purification-plants) and the overloaded Rhine-affluences (Leimbach, Kraichbach, Speyerbach, Rehbach, Neckar). The waste-water-samples from the central flow of the Rhine-river showed germ-concentrations of less than 10.000/ml, due to the mix-up of the waste water with the Rhine-water. Enterobacteriaceae--549 isolates together--could be found mainly in specimens from all collected sites in low titers. E. coli, Klebsiella pneumoniae, Enterobacter cloacae, Serratia liquefaciens and Citrobacter freundii had been the highest recovery rate. The isolation of Salmonellae was examined because of specific methods in a separate study (2. Communication). Based on these data, it has to be concluded, that the water of the Rhine-river and its affluxes in the Rhine-Neckar-Region is an uncontrolled germ-reservoir. The use of this water for bathing, unprocessed drinking-water or for agriculture purpose has to be refused from the hygienic point of view.

Bacteriological Techniques↗
PubMed1988

[Enterobacteriaceae: genera and species in 1988].

Numerical taxonomy, G + C content determination, DNA-DNA reassociation studies and divergence values delta tm) elicit considerable proliferation in the number of genera and species in recent years. Until 1988 Enterobacteriaceae contain 30 genera and 99 species which can be identified by biochemical tests. Only 20-25 species of Enterobacteriaceae family are of real importance in medical microbiology.

Animals↗
PubMed1988

Acute interstitial nephritis following enterobacteriaceae sepsis.

A 52-year-old male developed acute renal failure (ARF) following enterobacteriaceae sepsis. The cause of renal failure was remarkable for prolonged, slow, and incomplete recovery. Recurrence of enterobacteriaceae infection was associated with fever, cutaneous rash, eosinophilia, and elevated IgE level. Renal biopsy and gallium scan studies confirmed the diagnosis of acute interstitial nephritis. The temporal relationship between the first episode of sepsis and the precipitation of ARF and the development of rash, eosinophilia, and elevated IgE level in association with recurrence of infection indicated the role of bacterial antigen in the induction of immune-mediated injury.

Dermatitis, Atopic↗
PubMed1986

Evaluation of Minibact, a new system for rapid identification of Enterobacteriaceae. Comparison of Minibact, Micro-ID and API 20E with a conventional method as reference.

Minibact, a new system for four-hour identification of Enterobacteriaceae, combined with a computer identification system, was compared with Micro-ID and API 20E in testing 110 strains of Enterobacteriaceae. Minibact gave identification rates of 96.4% at species level and 96.4% at genus level; the corresponding values for Micro-ID were 87.3% and 91.8%, and for API 20E 91.8% and 94.5%. In conclusion, Minibact combined with a computer identification program gave high identification rates fully comparable to those of Micro-ID and API 20E, and the system might be an alternative to conventional identification systems in clinical microbiological departments.

Bacteriological Techniques↗
PubMed1978

[A new method for evaluation of beta-lactamase production of resistant enterobacteriaceae strains (author's transl)].

Resistant strains of Enterobacteriaceae were investigated with a chemical and microbiological test on beta-lactamase activity. The chemical method was needed as screening-test basing on the enzymatic hydrolysis of the chromogenic cephalosporin compound 87/312. The microbiological test is a modified cup plate method using Staph. aureus SG 511 as sensitive test strain for penicillins and cephalosporins. In one of the two cups of the blood agar plate 20 microliter of the beta-lactam antibiotic, in the other cup 20 microliter of the supernatant of the 24 h broth of the bacterial strain was pipettet. If the lactamase in the supernatant neutralises the antibiotic, a halfemoonlike blank is forming on the left site of the inhibition zone. An unchangeable inhibition zone demonstrates stability of the antibiotic to the enzyme. Each of 10 ampicillin- and/or cephalothin-resistant strains of E. coli, Klebsiella, Enterobacter and Serratia were investigated against 6 penicillins (penicillin G, ampicillin, ticarcillin, mezlocillin, azlocillin, bay k 4999) and 6 cephalosporins (cefoxitin, cefuroxime, cefamandol, cephalothin, cefazolin, cefradine). The microbiological method allows the statement, against which beta-lactam antibiotic the enzyme is effective. A correlation between the beta-lactamase activity and the MIC values in Enterobacteriaceae was not found.

DNA, Bacterial↗
PubMedDate not supplied

[Differentiation of "Pasteurella" and "Actinobacillus" from Enterobacteriaceae" by use of the O/129 vibriostatic agent (author's transl)].

Out of 134 Pasteurella and Actinobacillus strains studied, 132 are found to be susceptible to the O/129 vibriostatic agent with growth inhibition diameter ranging from 10 to 42 mm (86% in the range 25 to 32 mm); 46 reference strains of Enterobacteriaceae including Yersinia are resistant to the O/129 vibriostatic agent. This test can quickly differentiate between typical or atypical Enterobacteriaceae and the genus Pasteurella or Actinobacillus.

Actinobacillus↗
PubMed1979

[On the contamination of the citric acid fermentation. I. The contamination by representatives of Enterobacteriaceae (author's transl)].

Among the most dangerous bacterial contaminations of the citric acid fermentation is the so-called brown contamination, which is called forth by non pathogenic representatives of Enterobacteriaceae like Escherichia coli, Aerobacter aerogenes, Enterobacter cloacae and Proteus vulgaris, while other bacteria do not produce the mentioned contamination. There is given a comprehensive characterization of the brown contamination. Enterobacteriaceae interrupt the growth of the mycelium of the mold Aspergillus niger and stop the production of citric acid, produce a characteristic repugnant smell and reduce nitrate to nitrite. In a case of weak contamination the phenomena of the brown contamination do not appear, but the yield of citric acid is rather low. The contamination may be transferred successfully within the first 24 hrs. of incubation. The effect of the bacteria is determined by their virulence and some other factors.

Aspergillus niger↗
PubMed1983

[Apalcillin: in vitro activity compared with that of carbenicillin, ticarcillin, mezlocillin, piperacillin against Enterobacteriaceae and Acinetobacter].

The in vitro activity of apalcillin was compared with that of carbenicillin, ticarcillin, mezlocillin and piperacillin against clinical isolates of Enterobacteriaceae and Acinetobacter. 1 168 strains were tested by a routine disk diffusion method. They were grouped into different patterns of resistance by results to ampicillin, carbenicillin and cephalotin. The MICs were determined for 300 of these strains. Apalcillin, mezlocillin and piperacillin are active against most strains of E. coli, P. mirabilis, Klebsiella and C. diversus resistant to carbenicillin and ticarcillin. Apalcillin is the most active penicillin against Acinetobacter; it is almost as active as piperacillin, the best drug against Enterobacteriaceae.

Acinetobacter↗
PubMed1981

[In vitro activity of cefotaxime against enterobacteriaceae. Comparison with cephalothin, cefazolin, cefamandole, cefoxitin and cefuroxime on 117 strains isolated from neutropenic patients (author's transl)].

The considerable activity of cefotaxime on enterobacteriaceae is especially useful in neutropenic patients who are particularly at risk of septicaemia complications. The rapidly fatal development of this type of infections necessitates the use of a presumably efficacious therapy even before the result of blood cultures are obtained. The in vitro activity of cefotaxime in enterobacteriaceae has been compared to that of cephalothin, cefazolin, cefamandole, cefoxitin and cefuroxime.

Cefotaxime↗
PubMed1983

[In vitro activity of combinations of cefotaxime and moxalactam with aminoglycosides on beta-lactamase-producing Enterobacteriaceae].

The in vitro synergistic activities of cefotaxime (Ctx) or moxalactam (Mox) in combination with gentamicin, amikacin, dibekacin or netilmicin were compared against 15 beta-lactamases non-producing or producing isolates of Enterobacteriaceae. The strains were classified according to their resistance to ampicillin (Am), carbenicillin (Cb) and cephalotin (Ce), but all were sensitive to the antibiotics tested in combination. In vitro checkerboard studies were performed using a microtiter technique for the selected strains. The FIC index was less than or equal to 0.62 for AmR CbR CeR strains (E. coli, E. cloacae, Serratia), for AmR CbS CeR strains (E. cloacae, Serratia, P. vulgaris) and for AmS CbS CeR strains (Serratia, P. morganii). These combinations were frequently additive (FIC = 0.75 - 1.0) against the AmS CbS CeS or AmR CbR CeS strains. Thus, the synergistic activities of Ctx and Mox in combination with an aminoglycoside seem to be correlated with beta-lactamase type produced by the Enterobacteriaceae.

Aminoglycosides↗