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PubMed1995

Molecular epidemiology of Staphylococcus epidermidis isolates in a hematological unit during a 4-month survey.

In order to study the strain variety, clonal stability and epidemiology of Staphylococcus epidermidis, isolates from all bacterial cultures taken when clinically indicated in 2 wards of the hematological unit of Helsinki University Hospital, during a 4-month period, were characterized by 3 typing methods: antibiogram, plasmid profile and ribotype. A total of 141 distinct S. epidermidis colonies, from 28 blood cultures and 37 cultures from other sources in 32 patients were studied. Plasmid profiles and ribopatterns revealed 47 different strains of which 16 were bacteremic. One of these strains caused bacteremia in 4 different patients over a 3-month period and it was isolated from blood on 7 different sampling occasions. The occurrence of this clone was constant; it was usually found in both of 2 blood culture bottles inoculated (6/7 pairs) and dominated among the 17 distinct S. epidermidis colonies studied from the positive bottles (94% of the total). The clones causing bacteremias in the 2 wards were distinct. These findings indicate that certain clones of S. epidermidis can predominate in hematological wards and that nosocomial transmission of S. epidermidis strains may occur among patients, particularly within the same ward.

Anti-Bacterial Agents↗
PubMed1997

Enteropathogenic bacteria in migrating birds arriving in Sweden.

Birds have been thought to play a role in transmitting infectious agents like influenza, Borrelia and Salmonella. To investigate the role of migrating birds in the dispersal of enteropathogenic bacteria, stool samples from 151 wild birds (50 gulls and 101 passerines) just entering Sweden from their winter grounds were analysed for Salmonella spp., Campylobacter spp. and EHEC O157:H7. The thermophilic isolated enteropathogens found were further analysed by antibiograms. Among the 50 gulls examined, we found 2 isolates of Salmonella typhimurium with multiple antibiotic resistance. Three isolates of C. jejuni were found in the 101 stool samples from passerines. We did not isolate EHEC O157:H7 in any of the bird stools examined.

Animals↗
PubMed1982

Epidemiology of campylobacter enteritis.

Campylobacter jejuni/coli (CJC) was isolated from 386 patients (6.9%) of 5571 with a history of acute diarrhoea between December 1977 and June 1980. In the same study population Salmonella was found in 4.1%, Shigella in 1.7% and Yersinia enterocolitica in 2.1%. Only 5 (0.25%) of 2000 health controls had CJC in their stools. 53% of the patients had acquired their infection in Sweden. The peak incidence for CJC was from July to September. More than 50% of the patients were between 16-35 years. Within 1 month of the acute enteritis 80% had negative stool cultures for CJC. In general, campylobacter enteritis is not a severe disease and only 11% were admitted to hospital. The most common signs were high fever in 35%, frequent watery diarrhoea in 37%, colics or abdominal pains in 84%, and fresh blood in stools in 12%. Antibiotic treatment was given in 13% and was erythromycin in 56% and doxycycline in 26% of these patients. If chemotherapy was given and the strain was sensitive, no relapse occurred within 2 weeks of the treatment. The antibiograms for 435 strains showed that the aminoglycosides, erythromycin, doxycycline, chloramphenicol and nalidixic acid were the most effective drugs. This study implies that CJC is a common cause of bacterial diarrhoea also in patients with domestic enteritis.

Adolescent↗
PubMed1992

Plasmid pattern analysis of Staphylococcus species isolated from bovine mammary secretions.

Plasmid profiles of staphylococci isolated from bovine mammary secretions were heterogeneous as shown by the study of 94 isolates representing six species. Plasmids were identified in 19 of 94 staphylococcal isolates. Number of plasmids per isolate varied from 1 to 4. Size of plasmids ranged from 1.2 to 45 MDa; however, most were between 1.8 and 4.8 MDa. Some isolates with identical plasmid profiles were observed within and between species. Plasmid profiles observed in this study suggest that no specific plasmid pattern occurs within a species. Ability to differentiate isolates was not enhanced when antibiograms were used in conjunction with plasmid profiles. Plasmid pattern analysis does not appear to be an adequate method for discriminating between isolates of a species and would likely provide limited epidemiological information regarding staphylococci of bovine origin.

Ampicillin↗
PubMed2005

Pseudomonas aeruginosa, Staphylococcus aureus, and fluoroquinolone use.

Few long-term multicenter investigations have evaluated the relationships between aggregate antimicrobial drug use in hospitals and bacterial resistance. We measured fluoroquinolone use from 1999 through 2003 in a network of US hospitals. The percentages of fluoroquinolone-resistant Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA) were obtained from yearly antibiograms at each hospital. Univariate linear regression showed significant associations between a hospital's volume of fluoroquinolone use and percent resistance in most individual study years (1999-2001 for P. aeruginosa, 1999-2002 for S. aureus). When the method of generalized estimating equations was used, a population-averaged longitudinal model incorporating total fluoroquinolone use and the previous year's resistance (to account for autocorrelation) did not show a significant effect of fluoroquinolone use on percent resistance for most drug-organism combinations, except for the relationship between levofloxacin use and percent MRSA. The ecologic relationship between fluoroquinolone use and resistance is complex and requires further study.

Cross Infection↗
PubMed1984

Use of a laser-Doppler electrophoresis method in bacteriology (preliminary results).

A new electrophoresis system using Laser Doppler velocimetry has been developed. This technic allows fast measurements, (1 minute) over a large number of particles (several thousand or more). Furthermore, the small size of the particles is no longer a limitation of the measurement. These qualities made it possible to study the electrokinetic properties of cells. In this paper the authors present the first application obtained on different types of bacteria (Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, Proteus vulgaris) submitted to five antibiotics (gentamycin, minocyclin, cephalotin, spiramycin, sobramycin). After four hours of incubation at 37 degrees C, important decreases of electrophoretic mobility were observed on bacteria treated with antibiotics to which they were sensitive. On the other hand, no significant modification appeared on bacteria treated with antibiotics to which they were not sensitive. In conclusion, the electrophoretic mobility test seems to be useful to study the response of bacteria to antibiotics and perhaps could be used to set antibiograms.

Anti-Bacterial Agents↗
PubMed1998

Emergence and epidemiology of vancomycin-resistant enterococci in Australia.

Enterococci with acquired resistance to vancomycin and other glycopeptides (VRE) have emerged and spread rapidly through Europe and the United States since 1988. The first isolate of VRE in Australia occurred in 1994. Only one case was noted in 1995. Since March 1996 there has been a steady increase in the number of reports of VRE throughout the country. To August 1998 there have been 69 documented strains or clusters of strains detected in patients with documented infection, and about 3 times as many strains have been detected through screening procedures of contacts or in risk groups. 19% of strains whose source was known were blood isolates, while 34% came from urine and 47% came from other specimens. The strains have been found in 26 institutions in 10 widely separated cities or regions of the country (in 6/8 states or territories), without any obvious temporal associations in their appearance. All strains appear to have arisen locally except for one strain imported from the United Kingdom. Furthermore there was no direct evidence of interhospital transfer of strains. All clinical strains were examined by PCR to confirm species and to test for the presence of known vancomycin-resistance genes. Of the 69 strains, 42 were vanB E. faecium, 12 were vanA E. faecium, 9 were vanB E. faecalis, 3 were vanA E. faecalis. Three were negative for vanA, vanB, vanC1, vanC2/C3 and vanD. PGFE profiles on 38 strains have revealed at least 8 types of vanB E. faecium, 6 of vanA E. faecium, 4 of vanB E. faecalis and 2 of vanA E. faecalis. Isolates containing vanA always had different profiles from those containing vanB. Clinical clustering was confirmed by PFGE, and supported by extended antibiogram. 14 of 15 E. faecalis were ampicillin susceptible compared to only 2 of 54 E. faecium. One E. faecalis strain was beta-lactamase positive. The epidemiology of VRE in Australia appears to be different from that of Europe or the United States, since vanB E. faecium predominates and strains have appeared in diverse locations independently and are highly polyclonal.

Anti-Bacterial Agents↗
PubMed1976

Effect of dietary oxytetracycline on microorganisms in turkey feces.

Thirty-six two-day old male turkey poults were divided into three groups and fed three levels of oxytetracycline; 0, 110 or 440 mg. per kg. of ration, respectively, for nine weeks. The poults were given an oral spectinomycin plus vitamin treatment at the hatchery but were not fed before the start of the experiment. Defecated feces from each group were sampled at weekly intervals and analyzed for bacteriological content, especially for members of the Enterobacteriaceae. Total aerobic counts of 3 x 10(8) and total anaerobic counts of 2 x 10(9) were obtained. The majority of the Enterobacteriaceae were Escherichia coli but some Klebsiella sp., the Bethesda-Ballerup group of paracolon bacteria and Arizona sp. were also isolated. Antibiograms of the enteric isolates indicated that an increase in multiple antibiotic resistance occurred when increased amounts of antibiotic were fed.

Ampicillin↗
PubMed1981

Influence of salinomycin on incidence, shedding, and antimicrobial resistance of Salmonella typhimurium in experimentally infected broiler chicks.

Twenty broiler chickens were fed 80 g/T salinomycin, an antibiotic produced by Streptomyces albus, and 20 birds were fed a control, unmedicated feed. The birds were experimentally infected with Salmonella typhimurium. The study evaluated the effects of salinomycin on Salmonella incidence, shedding, and antimicrobial resistance. Salinomycin had no effect on body weights, length of time salmonellae were shed, number of salmonellae shed on postdosing day 3, salmonellae tissue recoverability, or on the total number of resistance patterns. Salinomycin caused the decline of salmonellae to be more gradual; however, both treatments were comparable at the end of the study. The majority of isolated from birds receiving salinomycin maintained the original S. typhimurium antibiogram of streptomycin, sulfadiazine, and nalidixic acid. The salinomycin salmonellae were more susceptible to tetracycline, amikacin, carbenicillin, gentamicin, and cephalothin. The multiple resistance patterns of eight and nine drugs tended to be more prevalent among salmonellae from control birds than salinomycin treated birds. The antibiotic salinomycin appears to be an acceptable feed additive in broilers at the level of 80 g/T based on these results of its effects on salmonellae shedding and antimicrobial resistance.

Animals↗
PubMed2005

Helicobacter pylori antibiotic resistance in Iran.

AIM: To examine the frequency of antibiotic resistance in Iranian Helicobacter pylori (H pylori) strains isolated from two major hospitals in Tehran. METHODS: Examination of antibiotic resistance was performed on 120 strains by modified disc diffusion test and PCR-RFLP methods. In addition, in order to identify the possible causes of the therapeutic failure in Iran, we also determined the resistance of these strains to the most commonly used antibiotics (metronidazole, amoxicillin, and tetracycline) by modified disc diffusion test. RESULTS: According to modified disc diffusion test, 1.6% of the studied strains were resistant to amoxicillin, 16.7% to clarithromycin, 57.5% to metronidazole, and there was no resistance to tetracycline. Of the clarithromycin resistant strains, 73.68% had the A2143G mutation in the 23S rRNA gene, 21.05% A2142C, and 5.26% A2142G. None of the sensitive strains were positive for any of the three point mutations. Of the metronidazole resistant strains, deletion in rdxA gene was studied and detected in only 6 (5%) of the antibiogram-based resistant strains. None of the metronidazole sensitive strains possessed rdxA gene deletion. CONCLUSION: These data show that despite the fact that clarithromycin has not yet been introduced to the Iranian drug market as a generic drug, nearly 20% rate of resistance alerts toward the frequency of macrolide resistance strains, which may be due to the widespread prescription of erythromycin in Iran. rdxA gene inactivation, if present in Iranian H pylori strains, may be due to other genetic defects rather than gene deletion.

Adult↗
PubMed2006

Organisms causing spontaneous bacterial peritonitis in children with liver disease and ascites in Southern Iran.

AIM: To determine the causative agents of spontaneous bacterial peritonitis (SBP) in children with liver disease and ascites in our center. METHODS: During a 2.5 year period, from September 2003 to March 2006, 12 patients with 13 episodes of SBP were studied. In all cases at the time of admission serum albumin and glucose, urinalysis and urine culture was performed. Analysis [white blood cell (WBC) count with differential, albumin, glucose], gram stain, culture by BACTEC method and antibiogram was done on ascitic fluids. Abdominal paracentesis was repeated after 48 h of antibiotic therapy for bacteriologic assay. The patients were followed for at least three months in a gastroenterology clinic. RESULTS: There were 7 girls (58%) and 5 boys (42%) with a median age of 5.2 years (range, 6 mo to 16 years). All cases had positive ascitic fluid culture. Gram stain was positive in 5 (38.5%) of them. The isolated organisms were S. pneumoniae in 5 (38.5%), E. coli in 2 (15.3%), S. viridans in 2 (15.3%), and K. pneumoniae, H. influenza, Enterococci, and nontypable Streptococcus each in one (7.7%). All of them except Enterococci were sensitive to ciprofloxacin and ceftriaxone. All ascitic fluid cultures were negative after 48 h of antibiotic therapy. CONCLUSION: S. pneumoniae is the most common cause of SBP in the pediatric age group and we recommend a third generation cephalosporine (e.g., Ceftriaxione or Cefotaxime) for empirical therapy in children with SBP.

Adolescent↗
PubMed1986

Plaster-associated Bacillus cereus wound infection. A case report.

Plaster of Paris and nonsterile cast padding have previously been implicated in wound infections. The observation of three pin site infections with Bacillus cereus following pin placement and plaster fixation of an open forearm fracture led to an epidemiologic investigation. Two hundred sixty-one bacterial cultures were taken from materials in the Steinmann pin application and plaster fixation procedures. B. cereus with a similar antibiogram and biotype as was identified in the pin site cultures was recovered from three of the 22 (14%) plaster-impregnated gauze rolls and six of seven (81%) tapwater samples. The Bacillus sp contamination rate of plaster when dry or wetted with sterile water or tapwater was 58%, 25% and 40% respectively. All cultures of plaster samples were negative after steam or gas sterilization. These results suggest that the patient may have acquired the infection from the plaster-impregnated gauze wetted in tapwater. In this case, the Steinmann pins may have facilitated infection by guiding the plaster-associated bacteria to the pin insertion site. The use of gas sterilized plaster materials should be considered in certain circumstances.

Adult↗
PubMed2001

The first reported case of equine nocardioform placentitis in South Africa.

Since the late 1980s a distinct form of focally-extensive mucoid to mucopurulent uterine body chronic placentitis,caused by nocardioform organisms, hasbeen recognised in horses in the USA state of Kentucky and possibly in other areas. This disease has led to increasing numbers of foal losses from late abortions, still-births, prematurity, or early neonatal deaths. The foals are usually not infected, but may be small or emaciated. Modes of infection and transmission are as yet unknown. Nocardia spp. and related nocardioform bacteria as causes of equine infertility, endometritis and foal death are briefly reviewed. A case of near full-term abortion involving a Friesian mare in the Pretoria district of Gauteng Province in South Africa during February 2000, with the same placental lesion as described in the Kentucky cases, is presented. Nocardioform organisms were visualised on impression smears and histological sections of affected foetal membranes, and were also cultured. The organism has been identified at the Livestock Disease Diagnostic Center of the University of Kentucky as an Amycolatopsis sp. of the less-commonly diagnosed group of nocardioforms causing placentitis in the USA. The organism was cultured from the uterus of the mare 18 days post-foaling, but after a 2-week course of oral trimethoprim and sulphamethoxazole, based on antibiogram sensitivity testing, a uterine flush yielded no growth. A semen sample from the sire of the aborted foal did not yield any Gram-positive filamentous branching bacteria. The mare subsequently conceived to a single insemination.

Abortion, Veterinary↗
PubMed2003

Enterotoxigenicity and drug sensitivity of staphylococci from children aged five years and below with sporadic diarrhoea.

OBJECTIVE: To investigate the incidence of enterotoxigenic strains of staphylococci in children aged five years and below suffering from sporadic diarrhoea and their antibiotic susceptibility pattern. DESIGN: Collection of stool samples from children with sporadic diarrhoea and laboratory based microbiological analysis. SETTING: Microbiology Research Laboratory, Department of Veterinary Microbiology and Parasitology, University of Ibadan, Ibadan, Nigeria. RESULTS: Out of one thousand seven hundred and sixty one diarhoeic faecal specimens collected, one hundred and seven strains of staphylococci were isolated as pure culture. Seventy two of these 107 staphylococci were coagulase positive S. aureus, 33 strains were S. epidermidis and two strains were S. saprophyticus. Sixty one (84.7%) of 72 isolates of S. aureus produced enterotoxins. Staphylococcal enterotoxins A was produced singly by 37(60.7%) of the toxigenic strain, while 12(19.7%) produced enterotoxin D alone. Two strains produced both enterotoxins A and C, six strains produced both enterotoxins A and D, one strain produced enterotoxins A, C and D while two strains produced enterotoxins A, B, and D. Most strains were resistant to pennicilin, with minimum inhibitory concentrations (MIC) within the range of 1-16 microg/ml. CONCLUSION: Enterotoxigenic strains of S. aureus were recovered from children aged five years and below suffering from sporadic diarhoea. The incidence rate was 3.5% of the samples investigated. Results of their antibiogram revealed that chloramphenicol, gentamicin, cephalothin and clindamycin would be appropriate for treatment of such diarrhoea after the clinical value of the antibiotics in young children has been evaluated.

Anti-Bacterial Agents↗
PubMed2005

Indications, diagnostic tests and Helicobacter pylori eradication therapy. Recommendations by the 2nd Spanish Consensus Conference.

The results of the 2nd Spanish Consensus Conference for appropriate practice regarding indications for eradication, diagnostic tests, and therapy regimens for Helicobacter pylori infection are summarized. The Conference was based on literature searches in Medline, abstracts from three international meetings, and abstracts from national meetings. Results were agreed upon and approved by the whole group. Results are supplemented by evidence grades and recommendation levels according to the classification used in the Clinical Practice Guidelines issued by Cochrane Collaboration. Convincing indications (peptic ulcer, duodenal erosions with no history of ASA or NSAIDs, MALT lymphoma), and not so convincing indications (functional dyspepsia, patients receiving low-dose ASA for platelet aggregation, gastrectomy stump in patients operated on for gastric cancer, first-degree relatives of patients with gastric cancer, lymphocytic gastritis, and Ménétrier s disease) for H. pylori eradication are discussed. Diagnostic recommendations for various clinical conditions (peptic ulcer, digestive hemorrhage secondary to ulcer, eradication control, patients currently or recently receiving antibiotic or antisecretory therapy), as well as diagnostic tests requiring biopsy collection (histology, urease fast test, and culture) when endoscopy is needed for clinical diagnosis, and non-invasive tests requiring no biopsy collection (13C-urea breath test, serologic tests, and fecal antigen tests) when endoscopy is not needed are also discussed. As regards treatment, first-choice therapies (triple therapy using a PPI and two antibiotics), therapy length, quadruple therapy, and a number of novel antibiotic options as "rescue" therapy are prioritized, the fact that prolonging PPI therapy following effective eradication is unnecessary for patients with duodenal ulcer but not for all gastric ulcers is documented, the fact that cultures and antibiograms are not needed for all eradicating therapies is indicated, and finally the test and treat strategy is considered adequate, however only under certain circumstances.

Helicobacter Infections↗
PubMed2000

Comparison of two antibiotic regimens in the treatment of perforated appendicitis in pediatric patients.

BACKGROUND AND PURPOSE: An increased incidence of post-surgical infectious complications in children admitted with a diagnosis of perforated appendicitis led to development of a disease-specific antibiogram and modification of our post-operative antibiotic regimen. METHODS: A historical control group comprised of 32 pediatric patients receiving ampicillin, gentamicin, and clindamycin (group AGC) was compared to a cohort of 32 children receiving ticarcillin/clavulanate plus gentamicin (group TG). The surgical procedure, peri-operative management, and inclusion, exclusion and discharge criteria were the same for each group. Outcome measures including length of stay, time to defervesce, incidence of infectious complications, and clinical failures to the antibiotic regimen were compared. RESULTS: The groups were similar with respect to gender, age, weight, surgical time, pre-operative leukocytes, and number of intra-operative bacterial isolates cultured per patient. Length of stay was 10.1 days in group TG and 12.5 days for group AGC (p = 0.0197). The number of clinical failures was reduced from 9 (28.1%) to 2 (6.3%) in group TG (p = 0.02). The time to defervesce was decreased by 1.4 days, and the number of infectious complications was reduced to 2.5-fold in group TG patients. CONCLUSIONS: Ticarcillin/clavulanate plus gentamicin was clinically more effective than ampicillin, gentamicin, and clindamycin combination therapy in the management of perforated appendicitis in our pediatric population.

Adolescent↗
PubMed2004

Urinary tract infection in men.

OBJECTIVE: To explore the prevalence and microbiology of urinary tract infection (UTI) in symptomatic men in a primary care setting and to determine the appropriateness of patient management of these conditions by the general practitioners. METHODS: A cross-sectional survey was carried out matching documentation of symptoms and management with urine culture and results of susceptibility tests. All patients presenting with symptoms typical for a UTI in 36 teaching general practices in the area of Göttingen, Germany, were eligible for enrolment in the study. 15% (n = 90) of all patients were adult men. General practitioners (GPs) were instructed to manage patients as usual. Patient characteristics, dipstick tests and treatment were matched with results of urine cultures and susceptibility testing. RESULTS: Men presenting with symptoms indicative of UTI were predominantly elderly (median age 61 years) and 41% had additional risk factors. Antibiotics were prescribed for 36%, but these were not well-targeted. Urine culture revealed UTI in 60%, of which half had low colony counts (23% of all patients) or multiple bacterial growth (7%); 40% had sterile urine. Dipstick tests proved unhelpful: leukocytes and nitrite had sensitivities of 54% and 38%, specificities of 55% and 84%, positive predictive values of 65% and 78% and negative predictive values of 44% and 46%, respectively. Resistance levels were 53% for amoxicillin and cefaclor, 28% for cefixim, 22% for ciprofloxacin, 34% for both trimethoprim as individual substance and the combination with sulfamethoxazole (cotrimoxazole) and 25% for nitrofurantoin. CONCLUSION: Men with symptoms indicative of a UTI should not be treated empirically. A urine culture and antibiogram should be obtained before a treatment decision is made. A low-count UTI was common and should not be considered normal.

Adult↗
PubMed1979

New aid to management of septicaemia: rapid direct antibiotic susceptibility testing.

A rapid and reliable method of performing direct antibiotic susceptibility tests on positive blood cultures has been developed. A result is now available five hours after laboratory confirmation of septicaemia. An evaluation involving 55 blood-culture isolates demonstrated an over-all correlation of 97.8% when results obtained by the rapid direct Autobac l method were compared to those obtained by definitive testing procedures. The method is particularly applicable to isolates of Staphyloccus aureus, Pseudomonas aeruginosa, and the Enterobacteriaceae. It is especially significant because of the recent emergence of multiple antibiotic resistance amongst hospital strains of these bacteria with many isolates showing resistance to antibiotics frequently used in the empirical treatment of septicaemia. The rapid availability of a reliable antibiogram is important in allowing early appropriate chemotherapy and, hence, in the reduction of septicaemia-associated morbidity and mortality, and the length of stay in hospital.

Anti-Bacterial Agents↗