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PubMed2004

[Urinary tract infections in children--etiologic agents and susceptibility to antibiotics].

Urinary tract infections (UTIs) are common clinical problem in pediatric hospitals. The aim of this study was to compare the incidence of UTIs during two different time periods (from February 1999 to March 2000, and from April 2000 to September 2001) in pediatric patients treated in ambulatory or hospitalized in new children hospital. The frequency of occurrence of ESBL--producing Gram-negative rods increased during second period study. The isolated ESBL--producing strains were resistant also to aminoglicosides and trimethoprim/sulfamethoxazol Gram-negative rods were predominant microorganisms. Isolated organisms from urine samples included Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Proteus mirabilis, Proteus penneri, Proteus vulgaris, Morganella morganii, Citrobacter freundi, Serratia spp., Enterobacter cloacae, Pseudomonas aeruginosa, Staphylococcus aureus, CNS, Enterococcus spp. Streptococcus spp, and Candida spp. Enterococcus spp. were isolated from urine samples in 20% of cases. Only 9.4% of isolated Enterococcus spp. were high-level aminoglicoside resistant (HLAR) strains. No vancomycin-resistant Enterococcus spp. were isolated. Among coagulase-negative Staphylococci (CNS) methicillin resistant strains (MRCNS) were isolated in 43.3%.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Surveillance of bacterial causes of hospital infections during periods of war and peace].

Surveillance based on laboratory findings of bacteria isolated from hospitalized patients is an important activity in epidemiologic surveillance of nosocomial infections. It provides the insight into the circulation and management of some causative agents of nosocomial infections in hospitals, which facilitates defining of proper measures for the prevention and suppression of nosocomial infections caused by these agents. The aim of this study was to analyze and compare surveillance data collected in Military Medical Academy (MMA) during June 1999 (the period of war), and June 2000 (the period of peace). Isolation frequency of bacteria that were the most common agents of nosocomial: Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus (MRSA), Escherichia coli, Acinetobacter spp. and Enterococcus spp., was monitored in patients from 5 various surgical wards of MMA. In the war period, the increase of number of isolates of all these bacteria was registered, but the increase of isolated Acinetobacter spp. was the most significant. The total number of isolates was greater in June 1999, in comparison to June 2000. Most isolates were recovered from wound cultures, when the increased number of Enterococcus spp. Methicillin-resistant Staphylococcus aureus isolated from the blood was registered. In the period of peace isolates of Pseudomonas aeruginosa manifested reduced resistance to quinolones, imipenem and 3rd generation cephalosporins. Barrier infection control measures are necessary in preventing nosocomial transmission, particularly in the wartime. Thus, preventive medicine is important for performing efficient surveillance, and suggesting the adequate measures for prevention and repression of nosocomial infections, particularly in the period of war.

Bacterial Infections↗
PubMed2002

Resistance to quaternary ammonium compounds in food-related bacteria.

Microbial resistance to antimicrobial agents continues to be a major problem. The frequent use and misuse of disinfectants based on quaternary ammonium compounds (QACs) in food-processing industries have imposed a selective pressure and may contribute to the emergence of disinfectant-resistant microorganisms. A total number of 1,325 Gram-negative isolates (Escherichia coli, other coliforms Vibrio spp., and Aeromonas spp.) and 500 Enterococcus spp. from food and food-processing industries and fish farming were screened for natural resistance to the QAC-based disinfectant benzalkonium chloride (BC). Of the 1,825 isolates, 16 strains, mainly from meat retail shops, showed low-level resistance to BC. None of the Enterococcus spp. from broiler, cattle, and pigs, the antibiotic-resistant E. coli from pig intestine and fish pathogens Vibrio spp. and Aeromonas spp. from the Norwegian fish farming industry were resistant to BC. The BC-resistant strains were examined for susceptibility to 15 different antibiotics, disinfectants, and dyes. No systematic cross-resistance between BC and any of the other antimicrobial agents tested was detected. Stable enhanced resistance in Enterobacter cloacae isolates was demonstrated by step-wise adaptation in increasing concentrations of BC. In conclusion, BC resistance among food-associated Gram-negative bacteria and Enterococcus spp. is not frequent, but resistance may develop to user concentrations after exposure to sublethal concentrations of BC.

Adaptation, Physiological↗
PubMed1988

Microbial Ecology of the Gut in Laboratory Stocks of the Migratory Grasshopper, Melanoplus sanguinipes (Fab.) (Orthoptera: Acrididae).

Mean pH values in pooled samples of foregut, midgut, and hindgut from adult Melanoplus sanguinipes, which had been raised in the laboratory on barley shoots and wheat bran, were 5.15, 6.39, and 5.98, respectively. Homogenates of midgut/hindgut sections and frass (feces) yielded colony counts of bacteria by the spread plate method of 5.7 to 5.9 and 5.3 to 5.5 log(10) colonies per mg, respectively; there were no significant differences (P > 0.05) between counts obtained on several media or on media incubated aerobically or anaerobically. There was no evidence of significant populations of protozoa, fungi, or obligately anaerobic bacteria associated with the gut. A total of 168 pure strains of bacteria isolated from the gut sections were characterized and assigned to 11 taxonomic groups, including Enterococcus spp., Serratia liquefaciens, Pseudomonas spp., and Enterobacter spp. Numbers of Enterococcus spp. in the gut were 2 to 3 orders of magnitude higher than those of the other genera. Strains representing only four of the groups were recovered from bran fed to the grasshoppers; the barley shoots, which were raised in sterile soil, appeared virtually sterile. Examination of the gut wall by scanning electron microscopy revealed the presence of epimural bacteria in the foregut and hindgut but not in the midgut. The distribution of epimural cocci and bacilli differed with the gut section examined. Numerous spherical to ovoid structures up to 10 mum in diameter, which were not identified, were associated with the microvillous surface of the midgut epithelium. Acetate was present in gut, hemolymph, and frass, and it was shown that representative isolates of Enterococcus spp. and Enterobacter agglomerans produced acetate when incubated in an aqueous suspension of bran. The egestion time of solid digesta, as measured with methylene blue-stained barley shoots, was 3.0 to 5.7 h. The results show that M. sanguinipes supported extensive indigenous populations of luminal and epimural bacteria in the gut which were composed predominantly of facultatively anaerobic species; the relatively short egestion time, indicating rapid passage of digesta through the gut, was consistent with the microscopic appearance of digesta residues in frass and could account, at least in part, for the absence of a significant population of obligately anaerobic bacteria from the gut.

Journal Article↗
PubMed2004

Acidified litter benefits the intestinal flora balance of broiler chickens.

The alterations in the balance of the normal intestinal bacterial flora of chickens exposed to acidified wood-derived litter were analyzed and compared to those of a control group exposed to nonacidified litter. A total of 1,728 broilers were divided into two groups, with six replicates in each. One group was exposed to dry wood-derived litter, and the other was exposed to dry wood-derived litter sprayed with a mixture of sodium lignosulfonate, formic acid, and propionic acid. At five different times, five chickens from each pen were killed and the intestinal contents from ileum and caeca were collected. The samples were diluted and plated onto selective media to identify coliforms, Lactobacillus spp., Clostridium perfringens, and Enterococcus spp. Covariance analysis of bacterial counts showed significantly lower counts for C. perfringens in the caeca and the ileum and for Enterococcus spp. and Lactobacillus spp. in the ileum in chickens exposed to the acidified litter. Lactobacillus spp. showed significantly higher counts in the caeca in chickens exposed to acidified litter. There was no difference between the two litters with regard to coliforms in the ileum and the caeca or to Enterococcus spp. in the caeca. The study shows that exposing the chickens to acidified litter lowers the intestinal bacterial number, especially in the ileum, without negative consequences for the chicken's health or performance. Of special interest are the lower counts of C. perfringens and Enterococcus spp. that might reduce the risk of developing clinical or subclinical necrotic enteritis and growth depression.

Animal Feed↗
PubMed2000

Alternative indicator bacteria analyses for evaluating the sanitary condition of beef carcasses.

Sponge samples were obtained from 47 (study 1) and 32 (study 2) beef carcasses in a small plant over 6 months. In study 2, slaughter equipment surfaces were also sampled. In study 1, the Petrifilm method was used to count presumptive Escherichia coli and spread plating on kanamycin esculin azide (KEA) agar with and without 40% added bile was used to count presumptive Enterococcus spp. Qualitative testing for presumptive E. coli and Enterococcus spp. in study 1 was done using lauryl sulfate tryptone broth (LST) + 4-methylumbelliferyl-beta-D-glucuronide (MUG) and KEA + 40% bile broth, respectively. In study 2, LST + MUG was used as a most probable number (MPN) method along with the Petrifilm method. In the two studies, 8 (17.0%) and 11 (34.4%) carcasses were contaminated with presumptive E. coli; all but one contaminated carcass contained <1 CFU/cm2. Presumptive Enterococcus spp. were recovered from 15 carcasses (31.9%) in study 1, but the KEA + 40% bile agar method lacked specificity (only 31.3% of isolates confirmed as Enterococcus spp.) The LST + MUG and Petrifilm methods were significantly (P < 0.05) related in terms of detecting presumptive E. coli, but the presence of presumptive Enterococcus spp. was not significantly related to the presence of presumptive E. coli. However, on slaughter plant equipment in Study 2 there was a statistically significant (P < 0.05) relationship between the presence of presumptive E. coli and presumptive Enterococcus spp. In study 2, there was no significant (P < 0.05) difference in numbers of presumptive E. coli (obtained using Petrifilm) on carcasses chilled 1 day (n = 16) and 7 days (n = 16), although more of the 7-day carcasses were contaminated (five and seven carcasses, respectively). For samples testing positive for presumptive E. coli, the 95% confidence intervals obtained using the LST + MUG MPN method included the Petrifilm value for all but one sample.

Animals↗
PubMed2002

Pathogen occurrence and antimicrobial resistance trends among urinary tract infection isolates in the Asia-Western Pacific Region: report from the SENTRY Antimicrobial Surveillance Program, 1998-1999.

Worldwide surveillance of antimicrobial resistance among urinary tract pathogens is useful to determine important trends and geographical variation for common Gram-positive and -negative species. The most common causative uropathogens often have intrinsic or acquired resistance mechanisms which include ESBL production among enteric bacilli, multi-drug resistant staphylococci and non-fermentative Gram-negative bacilli such as Pseudomonas aeruginosa and Acinetobacter spp. and vancomycin-resistant Enterococcus spp. This study evaluates pathogen frequency and the resistance rates among urinary tract infection (UTI) pathogens in 14 medical centres in the Asia-Pacific region between 1998 and 1999. The isolates were referred to a central monitor for reference NCCLS broth microdilution testing, identification confirmation and patient demographic analysis. Over 50% of the 958 pathogens were Escherichia coli and Klebsiella spp. followed by P. aeruginosa, Enterococcus spp. and Enterobacter spp. Susceptibility for the three enteric bacilli was high for carbapenems (100%), 'fourth-generation' cephalosporins (cefepime 94.9-98.6%) and amikacin (> or = 93.0%). Beta-lactamase inhibitor compounds were more active against E. coli (piperacillin/tazobactam; > 90% susceptible) than the other two enteric species and all other tested agents had a narrower spectra of activity. The rank order of anti-pseudomonal agents was amikacin (91.5% susceptible)> imipenem > piperacillin/tazobactam > tobramycin > ceftazidime and cefepime (77.4 and 76.4% susceptible, respectively). Susceptibility to quinolones for the P. aeruginosa isolates was only 63.2-67.0%. Only one vancomycin-intermediate Enterococcus spp. (van C phenotype) was detected among the 103 strains tested. Newer fluoroquinolones (gatifloxacin; MIC(50), mg/l) were more potent against enterococci than ciprofloxacin (MIC(50), 2 mg/l) and high-level resistance to aminoglycosides was common (41.7%). The data presented are compared to studies of similar design from other areas which are part of the SENTRY surveillance network.

Anti-Bacterial Agents↗
PubMed2003

[Enterococcal infections in critically ill patients admitted to ICU].

BACKGROUND AND OBJECTIVE: To determine the frequency of infections caused by Enterococcus spp. in critically ill patients admitted to ICUs in Spain and to describe the clinical features and outcome of those patients in whom this pathogen was isolated. PATIENTS AND METHOD: Prospective, observational, multicenter study. Patients admitted to the ICUs who participated in the National Surveillance Study of Nosocomial Infections (ENVIN) from 1997 to 2001 were included. Patients were classified as infected by Enterococcus spp., infected by other pathogens, and without nosocomial infection (non-infected). RESULTS: Of 21,972 patients, 2,177 (9.9%) had acquired 3,490 nosocomial infections during their stay in the ICU. In 223 patients (10.2%), 239 episodes of infections in which one of the causative pathogen was Enterococcus spp. were identified (cumulative incidence 1.1 episodes of Enterococcus spp. infection per 100 patients). Enterococcus spp. accounted for urinary infection in 14.3% of cases and secondary bacteremia in 12.2% especially those related with abdominal infection (20%) and soft tissue infection (21.4%). Predominant species was E. faecalis in 197 isolates (82.4%). After multivariate analysis, variables significantly associated with infection caused by Enterococcus spp. included: age (odds ratio [OR]=1.13; 95% confidence interval [CI], 1.01-1.25); APACHE II score (OR=1.19; CI 95%, 1.07-1.32); and length of ICU stay (OR=1.02; CI 95%, 1.01-1.03). There were no differences in the overall ICU mortality rate between patients with Enterococcus spp. infection (31.8%) and those with infection caused by other pathogens (31.8%), although in both cases the mortality rate was significantly higher than in non-infected patients (11.1%). CONCLUSIONS: Enterococcus spp. was present in 10.2% patients with ICU-acquired infection. Infection by Enterococcus spp. mainly occurred in the form of urinary tract infection and secondary bacteremia, mainly related to abdominal and soft tissue infections. E. faecalis predominated in all foci. There were no differences in mortality between patients with Enterococcus spp. infection and patients with infection caused by other pathogens.

Adult↗
PubMed2006

Increased resistance to first-line agents among bacterial pathogens isolated from urinary tract infections in Latin America: time for local guidelines?

Emerging resistance phenotypes and antimicrobial resistance rates among pathogens recovered from community-acquired urinary tract infections (CA-UTI) is an increasing problem in specific regions, limiting therapeutic options. As part of the SENTRY Antimicrobial Surveillance Program, a total of 611 isolates were collected in 2003 from patients with CA-UTI presenting at Latin American medical centers. Each strain was tested in a central laboratory using Clinical Laboratory Standard Institute (CLSI) broth microdilution methods with appropriate controls. Escherichia coli was the leading pathogen (66%), followed by Klebsiella spp. (7%), Proteus mirabilis (6.4%), Enterococcus spp. (5.6%), and Pseudomonas aeruginosa (4.6%). Surprisingly high resistance rates were recorded for E. coli against first-line orally administered agents for CA-UTI, such as ampicillin (53.6%), TMP/SMX (40.4%), ciprofloxacin (21.6%), and gatifloxacin (17.1%). Decreased susceptibility rates to TMP/SMX and ciprofloxacin were also documented for Klebsiella spp. (79.1 and 81.4%, respectively), and P. mirabilis (71.8 and 84.6%, respectively). For Enterococcus spp., susceptibility rates to ampicillin, chloramphenicol, ciprofloxacin, and vancomycin were 88.2, 85.3, 55.9, and 97.1%, respectively. High-level resistance to gentamicin was detected in 24% of Enterococcus spp. Bacteria isolated from patients with CA-UTI in Latin America showed limited susceptibility to orally administered antimicrobials, especially for TMP/SMX and fluoroquinolones. Our results highlight the need for developing specific CA-UTI guidelines in geographic regions where elevated resistance to new and old compounds may influence prescribing decisions.

Adult↗
PubMed1999

Intestinal protozoa and associated bacteria in captive houbara bustards (Chlamydotis undulata) in the United Arab Emirates.

A protozoal survey was carried out in 114 captive houbara bustards (Chlamydotis undulata) in the United Arab Emirates. Trichomonas gallinarum, Chilomastix gallinarum, Giardia spp. and Lophomonas spp. were detected from faecal samples of 49 (43%) captive houbara bustards. Culture and identification studies were carried out to assess associated bacteria. The bacteria isolated from birds negative to protozoa included Enterococcus spp., Aerococcus spp., Micrococci spp., Proteus spp., Enterobacter spp., Escherichia coli and Klebsiella spp., while Enterococcus spp., Micrococci kristinae, Aerococcus spp., Staphylococcus sciuri, Staphylococcus aureus, E. coli, Klebsiella spp. and Alcaligenes faecalis were isolated from protozoa positive birds. Proteus spp., Enterobacter spp., E. coli , Klebsiella spp., Aerococcus spp. and Enterococcus spp. are considered part of the normal intestinal bacterial flora of captive bustards and they were also isolated from the food items used to feed the captive bustards. S. sciuri possibly originated from ingested mice; Alcaligenes faecalis and Micrococcus spp. are contaminants from soil or water.

Journal Article↗
PubMed2006

Frequency and antimicrobial susceptibility of aerobic bacterial vaginal isolates.

OBJECTIVE: To determine the frequency and antimicrobial susceptibility of aerobic bacterial isolates from high vaginal swab cultures. DESIGN: Cross-sectional survey. PLACE AND DURATION OF STUDY: Shifa International Hospital, Islamabad, from January 2003 to February 2004. PATIENTS AND METHODS: The subjects included 136 symptomatic women attending Obstetrics and Gynecology Out-Patient Department. A proforma was filled to document the demographic details, presenting complaint and examination findings. High vaginal swabs were taken for gram staining, culture and antimicrobial sensitivity testing using standard microbiologic techniques. RESULTS: Normal flora was isolated in 30% of the cases, followed by Candida spp. (21.3%), Enterococcus spp. (14.7%), E.coli (10.2%), Beta hemolytic Streptococcus spp. (7.3%), Staphylococcus spp. (4.4%), Enterobacter spp. (4.4%), while Streptococcus pyogenes, Staphylococcus epidermidis and Klebsiella spp. were isolated 1.5% each. Enterococcus, Staphylococcus and Streptococcus were mostly sensitive to penicillin and amoxicillin while E.coli and Klebsiella were sensitive to (piperacillin-Tazobactum, Imipenem and vancomycin. Enterococci species showed significant resistance to aminoglycoside antibiotics (68.8% to 81.3%) resistance to vancomycin was 5%. CONCLUSION: Thirty percent of symptomatic patients had normal flora on culture. Candida spp was the most frequent pathogen isolated. Co-amoxiclav should be used as empiric therapy until culture-sensitivity report is available.

Adult↗
PubMed1988

[Antibiotic susceptibility of bacteria isolated from surgical infection (second report)].

Isolated bacteria from infections in general surgery in 1984 and 1985 have been investigated to find bacterial composition and their susceptibilities to antibiotics in a joint research in which 6 university hospitals in Japan participated. A summary of findings from the investigation is as follows. 1. One hundred and seventy-two (1984) and 211 (1985) cases were included in the study. Cases in which bacteria were detected were 147 and 174 in the respective years. The detection rate was higher than 80% in either year. 2. Total numbers of strains isolated in 1984 and 1985 were 267 and 293, respectively; major sources of these strains were intraperitoneal infection exudates in either year. 3. The most frequent isolate from primary infection cases in both years was Escherichia coli (15-21%), followed by Bacteroides spp. and Staphylococcus spp., in that order. The most frequently isolated from postoperative infection cases were Enterococcus spp. (16-22%), followed by Pseudomonas spp. The diversity of isolated species, as well as the similarity of incidences of different species were noted in cases of postoperative infections. It is suspected that a certain species, even if its pathogenicity is essentially low, may become to be a causative organism once its number increases due to its survival through a perioperative prophylactic use of antibiotics, and also due to the decreased host resistance to infections caused by underlying diseases or surgical stress. 4. Staphylococcus spp. was the most frequent isolate from postoperative infections occurring after clean operations, while Enterococcus spp. and Pseudomonas aeruginosa were major isolates from infections after clean-contaminated operations. Isolates from infections occurring after contaminated operations included Enterococcus spp. greater than E. coli greater than Klebsiella pneumoniae, P. aeruginosa, Bacteroides spp. (1985). 5. In cases without the presence of clinical factors cause by depressed host defense, E. coli and Bacteroides spp. were major isolates, while in cases with the factors, a wide variety of bacterial population tended to be found. 6. Before an administration of antibiotics in primary infections, E. coli, Staphylococcus spp. Bacteroides spp. and Klebsiella spp. were most commonly isolated, while after a chemotherapy, Enterococcus spp. were the most frequent isolates, followed by P. aeruginosa during 1985. These findings reflected the antibacterial spectrum of cephems usually used in surgical field.(ABSTRACT TRUNCATED AT 400 WORDS)

Anti-Bacterial Agents↗
PubMed2006

Comparison of composting, storage and urea treatment for sanitising of faecal matter and manure.

To close the loop of nutrients in a safe way, the loop of pathogens has to be broken. By sanitising organic fertilisers derived from faeces and manure, the first step in the disease transmission chain is broken. Two alternatives for this treatment, thermophilic composting and ammonia-based treatment, were evaluated and compared to storage treatment. Thermal composting of faecal matter and food waste resulted in a treatment temperature of over 65 degrees C in a 90 L reactor. By using insulation and turning the compost three times during the high temperature period, it is possible to ensure a 5 log(10) reduction of pathogens. Small scale composting of the same material indicated less efficient reduction of faecal bacteria at temperatures around 50 degrees C. In the chemical treatment tested, an addition of 3% N-NH(3) increased the pH to above 9 within 1h and resulted in a good reduction in the indicator organisms for bacteria (Salmonella spp. and faecal coliforms D(r)<0.7 days, Enterococcus spp. D(r)<3 days). Lower addition rates resulted in a longer treatment period needed. The storage period tested resulted in slow reduction of faecal coliforms, Salmonella spp. and Enterococcus spp.

Enterococcus faecalis↗
PubMed2005

Influence of solid dairy manure and compost with and without alum on survival of indicator bacteria in soil and on potato.

We measured Escherichia coli, Enterococcus spp. and fecal coliform numbers in soil and on fresh potato skins after addition of solid dairy manure and dairy compost with and without alum (Al(2)(SO(4))(3)) treatment 1, 7, 14, 28, 179 and 297 days after application. The addition of dairy compost or solid dairy manure at rates to meet crop phosphorus uptake did not consistently increase E. coli and Enterococcus spp. and fecal coliform bacteria in the soil. We did not detect E. coli in any soil sample after the first sampling day. Seven, 14, 28, 179 and 297 days after solid dairy waste and compost and alum were applied to soil, alum did not consistently affect Enterococcus spp. and fecal coliform bacteria in the soil. We did not detect E. coli in any soil, fresh potato skin or potato wash-water at 214 days after dairy manure or compost application regardless of alum treatment. Dairy compost or solid dairy manure application to soil at rates to meet crop phosphorus uptake did not consistently increase Enterococcus spp. and fecal coliform numbers in bulk soil. Solid dairy manure application to soil at rates to meet crop phosphorus uptake, increased Enterococcus spp. and fecal coliform numbers in potato rhizosphere soil. However, fresh potato skins had higher Enterococcus spp. and fecal coliform numbers when solid dairy manure was added to soil compared to compost, N and P inorganic fertilizer and N fertilizer treatments. We did not find any E. coli, Enterococcus or total coliform bacteria on the exterior of the tuber, within the peel or within a whole baked potato after microwave cooking for 5 min.

Agriculture↗
PubMedDate not supplied

Frequency and treatment of urinary tract infection in children subjected to urine culture, in Sana'a, Yemen.

BACKGROUND: This study was carried out to estimate the frequency of urinary tract infection among children subjected to urine culture presenting to Sam Hospital, Sana'a city, Yemen and to determine the susceptibility of the isolated bacteria to the antibiotics. METHODS: Record-based study was done in Sam hospital in Sana'a city Yemen during three years 1/1/1999-31/12/2001. Out of 70,500 patients seen for different causes through that period 820 (1.16%) having urinary symptoms (fever, rigor, vomiting, frequency or screams during the act of urination) were subjected to urine culture. Data about age and sex were also collected. RESULTS: Frequency of urinary tract infections among children examined by urine culture was 36.8% (n=302), with mean age of 7.6 years. 272 (90.1%) of them were females, and 30 (9.9%) were males. More than half 154 (51%) of infected patients were less than three years old. The isolated bacteria was Escherichia coli 201 (66.3%) followed by Staphylococcus suprofyticus 45 (14.9%), Proteus spp 15 (4.9%), Klebsiella 12 (3.9%) then Enterococcus spp 12 (3.9%). Sensitivity of E. coli to Nalidexic acid was 70%, to Amoxicillin/Clavulanic acid was 29.9%, to Co-trimoxasole was 16.4%, and to Nitrofurantoin was 15.9%. CONCLUSION: The majority of the infected patients were females and the highest frequency of the disease was in the first three years of age. The most common isolated microorganism was E. coli followed by Staphylococcus suprofyticus, Proteus spp, then Enterococcus spp. The highly active antibiotic for most organisms isolated was Nalidexic acid, then amoxicillin/clavulanic acid. Nalidexic acid can be used as a first line empiric treatment and/or prophylaxis of UTI in children.

Adolescent↗
PubMed2001

Uropathogens and their susceptibility pattern: a retrospective analysis.

OBJECTIVE: To determine the frequency and antibiotic susceptibility pattern of uro-pathogens. SETTING: Department of Pathalogy, Ziauddin Medical Hospital Laboratory, Karachi. METHOD: A retrospective analysis was done on all the urine samples sent for culture and sensitivity during a seven months period. Two thousand eight hundred and forty four urine samples were received and inoculated in cysteine lactose electrolyte deficient agar (CLED). Positive samples were identified, processed and antibiotic susceptibility was carried out. Data was analyzed using Microsoft Excel 97. RESULTS: E. coli (45.6%) was the leading uropathogen followed by candida spp. (10.5%), enterococcus spp. (10.2%). For E. coli ampicillin, ceftazidime, nitrofurantoin and gentamycin sensitivity was 26%, 20%, 79.5%, 65% respectively. Enterococcus isolates showed 60% resistance to ampicillin. CONCLUSION: The resistant pattern of uro-pathogens causing urinary tract infections to common antimicrobial agents is changing and must be taken into account when selecting treatment strategies. Therefore, antibiotic policy should be made according to local surveillance data.

Drug Resistance, Microbial↗
PubMed2001

In vitro activities of a new ketolide, ABT-773, against multidrug-resistant gram-positive cocci.

The in vitro activities of ABT-773 were evaluated against 324 strains of gram-positive bacteria, including multidrug-resistant Staphylococcus spp. and Enterococcus spp. ABT-773 had lower MIC ranges, MICs at which 50% of isolates are inhibited (MIC(50)s), and MIC(90)s than erythromycin or clindamycin for almost all isolates tested. The MICs of ABT-773 were also lower than those of quinupristin-dalfopristin (Q-D) for methicillin-susceptible Staphylococcus aureus, Rhodococcus spp., and Streptococcus spp., while the MICs of Q-D were lower than those of ABT-773 for methicillin-resistant S. aureus and Enterococcus faecium, including vancomycin-resistant isolates.

Anti-Bacterial Agents↗
PubMed1993

Erythromycin, clarithromycin, and azithromycin: use of frequency distribution curves, scattergrams, and regression analyses to compare in vitro activities and describe cross-resistance.

MICs of erythromycin, clarithromycin, and azithromycin for 852 recent clinical isolates were determined by broth microdilution methods. Frequency distribution curves, scattergrams, and regression analyses were used to compare in vitro activities and describe cross-resistance. Clarithromycin was the most active drug against Bacteroides spp. but the least active against Haemophilus influenzae. Azithromycin was most active against H. influenzae, Moraxella catarrhalis, Pasteurella multocida, and Fusobacterium spp. but the least active against Streptococcus spp. and Enterococcus spp. All three drugs had equivalent activities against Staphylococcus spp. and gram-positive anaerobes. None of the three drugs was particularly active against members of the family Enterobacteriaceae or nonfermentative gram-negative bacilli, although concentrations of 4 micrograms of azithromycin per ml inhibited some strains of the family Enterobacteriaceae (particularly Escherichia coli and Citrobacter diversus) and Acinetobacter baumannii. Although relative drug activities varied by organism, organisms relatively susceptible to one were relatively susceptible to all and organisms relatively resistant to one were relatively resistant to all; an exception was fusobacteria, which were usually susceptible only to azithromycin. Cross-susceptibility and cross-resistance were, therefore, the rule (except for Fusobacterium spp.), although the percentage of susceptible organisms could be varied considerably on the basis of the selection of breakpoints.

Azithromycin↗