Beta-lactamases in Enterobacteriaceae--an ever-present threat.
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Outer membrane proteins (OMP) isolated from Shigella flexneri, Escherichia coli, Proteus vulgaris and Salmonella typhimurium were tested for their protective activity. Each OMP preparate given to mice intraperitoneally in a single injection (5 micrograms/per mouse) protected the animals not only in homologous but also in varying intensity in heterologous systems. Evidence was obtained that this nonspecific protection is cell mediated.
Sulfonamide (Su) and trimethoprim (Tp) resistance are known to caused by the production of drug resistant dihydropteroate synthase (DHPS) and dihydrofolate reductase (DHFR), respectively. Sulfonamide and trimethoprim are often used in combination under the name cotrimoxazole. Cotrimoxazole resistance in various enteric bacteria isolated at Ramathibodi Hospital was studied. The rate of resistance from 1984-1989 of many genera was rather constant at 40%-60% except in Shigella spp in which the rate increased rapidly in 1987 till 1989. Seventy-five percent of Su-Tp resistant (Sur-Tpr) bacteria were also found to be resistant to other drugs such as ampicillin, aminoglycosides, tetracycline and chloramphenicol in addition to cotrimoxazole. Two hundred and forty Su-Tp resistant strains were analysed for the presence of type I and II dihydropteroate synthase as well as type I and V dihydrofolate reductase genes by hybridization with the corresponding gene probes. Type I DHPS gene predominated in Su-Tp resistant bacteria at 60.8% whereas type II DHPS was found in only 25%. Some strains (11.7%) had both genotypes but 2.5% did not have any. In the trimethoprim resistance study, the DHFR type I gene was also found more frequently (30%) whereas type V DHFR was only 19%. The remaining of Tp resistance (51%) was unclassified. The coexistence of Su and Tp resistance genes of each type was investigated among 118 Su and Tp resistant strains. It was found that type I DHPS gene was found together with either type I or V DHFR gene and type II DHPS was found with type I DHFR gene at about the same rate (28.9%, 27.1% and 26.3%, respectively). However, the presence of type II DHPS together with type V DHFR was rather low, only 5.9% of isolates were found to have both types of genes.
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A new diagnostic two-steps scheme for the species identification of enterobacteria was employed with 703 strains. The diagnoses were compared with those obtained by employing Api 20 E and Enterotube II. On the basis of the reported results this new scheme is shown to be reliable (99.71% right diagnosis) and easy to perform.
An in vitro study of the sensitivity of three cephalosporins of the third generation was performed on 119 wild strains of enterobacteriae selected because of their resistance to cefalotine and cefoxitine. Cefotaxime, latamoxef and cetriaxone remain very active on such strains since almost all of the strains were inhibited by a dose of 4 micrograms/ml and CI 50 p. cent was below 0.20 micrograms/ml. The activity of these three cephalosporins was comparable on groups E. coli, Klebsiella-Enterobacter-Serratia and C. freudii. Ceftriaxone appeared clearly more active than latamoxef and cefotaxime on Proteus stains.
Strains of K. pneumoniae belonging to serowars K10, K3, K16 and K62 and two strains of E. coli with multiple drug resistance including newly detected resistance to gentamicin were isolated in succession within the 2-year period of microbiological survey of a hospital department for premature infants. Resistance to gentamicin in the first isolate of K. pneumoniae was due to the non-conjugated plasmid pP12140 with a molecular weight of 15 MD. This plasmid also controlled resistance to streptomycin and sulfanilamides and was physically independent of the other large (about 80 MD) conjugative R plasmid controlling resistance to kanamycin, tetracycline, chloramphenicol and ampicillin. In the strains of K. pneumoniae and E. coli isolated within the following 2 years the marker of gentamicin resistance was included into large (80-120 MD) conjugative R plasmids controlling 6-7 resistance types. DNA of such plasmids was used for transformation of the recipient strain C600 of E. coli. In addition to the transformants with the acquired R plasmids possessing all the resistance markers there were isolated transformants carrying plasmids with the molecular weight of 15 MD controlling resistance to gentamicin, streptomycin and sulfanilamides and capable of self-replication. Analysis of the plasmids with the help of endonucleases EcoR1 and Pst1 revealed complete identity of plasmid pP12140 and similar plasmids of the transformants isolated with the use of DNA of the plasmids of the other K. pneumoniae strains. Marked relation with the plasmids of the transformants isolated with the use of the plasmid DNA of E. coli was also revealed.(ABSTRACT TRUNCATED AT 250 WORDS)
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Enterobacteria, potentially capable of causing infections, were isolated from the feces of 88.7% of young children in the intestinal department of an infectious disease hospital. Opportunistic bacteria were considered to be the causative agents of infections only in cases of their high concentration in the material under test. In about a half of the cases the etiological role of the suspected microorganisms was confirmed by the detection of antibodies in low titers. The presence of maternal antibodies did not interfere with diagnostic procedures. The detection of antibodies to autocultures, even in a single case, is of diagnostic importance in the examination of young children. Autoserologically confirmed mixed infection was found to take a more prolonged course than autoserologically confirmed monoinfection.
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