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PubMed2002

Antimicrobial susceptibility of Neisseria gonorrhoeae isolated in Bangladesh (1997 to 1999): rapid shift to fluoroquinolone resistance.

Periodic monitoring of antimicrobial susceptibility of Neisseria gonorrhoeae is essential for early detection of emergence of drug resistance. A total of 343 gonococcal strains isolated from high-risk and general populations in Bangladesh from 1997 to 1999 were studied. The MICs of penicillin, tetracycline, ciprofloxacin, ceftriaxone, and spectinomycin for the isolates were determined by the agar dilution method. Of the isolates from 1997, 9% were resistant (MIC >or= 1.0 microg/ml) to ciprofloxacin, while 41 and 49% of the isolates from 1998 and 1999, respectively, were resistant to ciprofloxacin. Of the N. gonorrhoeae isolates from 1998 and 1999, 1.2 and 3.6%, respectively, both were penicillinase producing and displayed plasmid-mediated tetracycline resistance.

Anti-Bacterial Agents↗
PubMed2004

Molecular epidemiology of sequential outbreaks of Acinetobacter baumannii in an intensive care unit shows the emergence of carbapenem resistance.

The molecular epidemiology of multidrug-resistant Acinetobacter baumannii was investigated in the medical-surgical intensive care unit (ICU) of a university hospital in Italy during two window periods in which two sequential A. baumannii epidemics occurred. Genotype analysis by pulsed-field gel electrophoresis (PFGE) of A. baumannii isolates from 131 patients identified nine distinct PFGE patterns. Of these, PFGE clones B and I predominated and occurred sequentially during the two epidemics. A. baumannii epidemic clones showed a multidrug-resistant antibiotype, being clone B resistant to all antimicrobials tested except the carbapenems and clone I resistant to all antimicrobials except ampicillin-sulbactam and gentamicin. Type 1 integrons of 2.5 and 2.2 kb were amplified from the chromosomal DNA of epidemic PFGE clones B and I, respectively, but not from the chromosomal DNA of the nonepidemic clones. Nucleotide analysis of clone B integron identified four gene cassettes: aacC1, which confers resistance to gentamicin; two open reading frames (ORFs) coding for unknown products; and aadA1a, which confers resistance to spectinomycin and streptomycin. The integron of clone I contained three gene cassettes: aacA4, which confers resistance to amikacin, netilmicin, and tobramycin; an unknown ORF; and bla(OXA-20), which codes for a class D beta-lactamase that confers resistance to amoxicillin, ticarcillin, oxacillin, and cloxacillin. Also, the bla(IMP) allele was amplified from chromosomal DNA of A. baumannii strains of PFGE type I. Class 1 integrons carrying antimicrobial resistance genes and bla(IMP) allele in A. baumannii epidemic strains correlated with the high use rates of broad-spectrum cephalosporins, carbapenems, and aminoglycosides in the ICU during the study period.

Acinetobacter Infections↗
PubMed2006

Multidrug resistance in Salmonella enterica serotype Typhimurium from humans in France (1993 to 2003).

The aim of this study was to determine the distribution of the antimicrobial resistance phenotypes (R types), the phage types and XbaI-pulsed-field gel electrophoresis (PFGE) types, the genes coding for resistance to beta-lactams and to quinolones, and the class 1 integrons among a representative sample of Salmonella enterica serotype Typhimurium isolates collected from humans in 2002 through the French National Reference Center for Salmonella (NRC-Salm) network. The trends in the evolution of antimicrobial resistance of serotype Typhimurium were reviewed by using NRC-Salm data from 1993, 1997, 2000, and 2003. In 2002, 3,998 isolates of serotype Typhimurium were registered at the NRC-Salm among 11,775 serotyped S. enterica isolates (34%). The most common multiple antibiotic resistance pattern was resistance to amoxicillin, chloramphenicol, streptomycin and spectinomycin, sulfonamides, and tetracycline (ACSSpSuTe R type), with 156 isolates (48.8%). One isolate resistant to extended-spectrum cephalosporins due to the production of TEM-52 extended-spectrum beta-lactamase was detected (0.3%), and one multidrug-resistant isolate was highly resistant to ciprofloxacin (MIC > 32 mg/liter). We found that 57.2% of the isolates tested belonged to the DT104 clone. The main resistance pattern of DT104 isolates was R type ACSSpSuTe (83.2%). However, evolutionary changes have occurred within DT104, involving both loss (variants of Salmonella genomic island 1) and acquisition of genes for drug resistance to trimethoprim or to quinolones. PFGE profile X1 was the most prevalent (74.5%) among DT104 isolates, indicating the need to use a more discriminatory subtyping method for such isolates. Global data from the NRC-Salm suggested that DT104 was the main cause of multidrug resistance in serotype Typhimurium from humans from at least 1997 to 2003, with a roughly stable prevalence during this period.

Bacteriophage Typing↗
PubMed1977

Isolation and characterization of a rough colony type of Neisseria gonorrhoeae.

A new colony type of Neisseria gonorrhoeae was detected in the primary cultures from 8 of 180 men with gonococcal urethritis. This colony type contrasts with those previously described by having a rough and irregular surface. In six of the eight cases, the rough form predominated. The distinctive morphology of the rough colony variant could be maintained indefinitely by selective subculture. By electron microscopy, organisms taken from rough colonies of each of the eight isolates were piliated. Antimicrobial susceptibilities of type 1 and rough clones derived from the same patients were identical for ampicillin, penicillin, tetracycline, and spectinomycin. After inoculation of rough colonies into subcutaneous chambers in mice and guinea pigs, type 1 colonies predominated in cultures of material obtained from the chambers. This new piliated colony type of N. gonorrhoeae may provide an opportunity to investigate factors other than pili that contribute to gonococcal virulence.

Animals↗
PubMed1999

Mutations altering the predicted secondary structure of a chloroplast 5' untranslated region affect its physical and biochemical properties as well as its ability to promote translation of reporter mRNAs both in the Chlamydomonas reinhardtii chloroplast and in Escherichia coli.

Random mutations were generated in the sequence for the 5' untranslated region (5'UTR) of the Chlamydomonas reinhardtii chloroplast rps7 mRNA by PCR, the coding sequence for the mutant leaders fused upstream of the lacZ' reporter in pUC18, and transformed into Escherichia coli, and white colonies were selected. Twelve single base pair changes were found at different positions in the rps7 5'UTR in 207 white colonies examined. Seven of the 12 mutant leaders allowed accumulation of abundant lacZ' message. These mutant rps7 leaders were ligated into an aadA expression cassette and transformed into the chloroplast of C. reinhardtii and into E. coli. In vivo spectinomycin-resistant growth rates and in vitro aminoglycoside adenyltransferase enzyme activity varied considerably between different mutants but were remarkably similar for a given mutant expressed in the Chlamydomonas chloroplast and in E. coli. The variable effect of the mutants on aadA reporter expression and their complete abolition of lacZ' reporter expression in E. coli suggests differences in the interaction between the 5'UTR of rps7 and aadA or lacZ' coding regions. Several rps7 5'UTR mutations affected the predicted folding pattern of the 5'UTR by weakening the stability of stem structures. Site-directed secondary mutations generated to restore these structures in the second stem suppressed the loss of reporter activity caused by the original mutations. Additional site-directed mutations that were predicted to further strengthen (A-U-->G-C) or weaken (G-C-->A-U) the second stem of the rps7 leader both resulted in reduced reporter expression. This genetic evidence combined with differences between mutant and wild-type UV melting profiles and RNase T1 protection gel shifts further indicate that the predicted wild-type folding pattern in the 5'UTR is likely to play an essential role in translation initiation.

5' Untranslated Regions↗
PubMed1986

Isolation and characterisation of intestinal spirochaetes.

Faeces or rectal swabs from 1527 subjects were examined for the presence of intestinal spirochaetes by anaerobic culture on blood agar incorporating spectinomycin (400 mg/l). Twenty three specimens (1.5%) were positive, and only one of these came from a patient with diarrhoea. All positive specimens came from either Asians or known homosexuals. Comparative tests showed a close phenotypic similarity between the human isolates and non-pathogenic porcine intestinal spirochaetes. These organisms differ from Brachyspira aalborgi, a spirochaete isolated from subjects with histologically confirmed intestinal spirochaetosis.

Adolescent↗
PubMed1978

Epidemiology and treatment of gonorrhoea caused by penicillinase-producing strains in Liverpool.

The epidemiological features are described of an outbreak of gonorrhoea caused by penicillinase-producing strains of gonococci in 76 patients in Liverpool between February and November 1976. Initially infections were confined to a socially deprived inner city area with a large immigrant population, and subsequent spread of infection remained circumscribed. The characteristics of those patients acquiring these infections were similar to those infected by gonococci of diminished sensitivity to benzylpenicillin, and showed a strong association with adverse social factors. A comparison of the clinical features of patients harbouring sensitive, less sensitive, and penicillinase-producing strains showed severe symptoms and signs in men and a greater involvement of multiple sites in women infected with penicillinase-producing gonococci. Treatment with penicillins failed. Tetracycline was satisfactory in men but was less so in women in whom gonococci persisted in the rectum. Cefuroxime and spectinomycin were effective.

Black or African American↗
PubMed1978

The antimicrobial susceptibility of Chlamydia trachomatis in cell culture.

The action of 22 antimicrobial agents against the SA2f strain of Chlamydia trachomatis has been studied by the use of a simple cell culture technique. Tests for bactericidal activity were undertaken with some of the agents, and latency of infection was demonstrated. The susceptibilities of 10 clinical strains of C. trachomatis and of SA2f to oxytetracyline, erythromycin, and spectinomycin in cell culture were found to be identical.

Anti-Bacterial Agents↗
PubMed1979

Pharyngeal colonisation by Neisseria gonorrhoeae and Neisseria meningitidis in black and white patients attending a venereal disease clinic.

Pharyngeal colonisation by Neisseria gonorrhoeae and Neisseria meningitidis was studies in 2000 patients attending a venereal disease clinic. Of these patients, 64% were white and 36% were black. The incidence of gonococcal infections was highest in the period from June to August. The incidence of genital or rectal infections or both was higher in the black patients. Pharyngeal colonisation by gonococci was present in 1.3% of the patients. There was no significant associations between pharyngeal colonisation and the pharyngeal symptoms, race, sex, or marital state of the patients. Pharyngeal colonisation was more frequent in patients with gonococcal infections at other sites. However, in 40.7% of the patients with pharyngeal colonisation, the pharynx was the only culture-positive site. There was no significant difference in the auxotypes or in the antibiotic susceptibility of the pharyngeal and the rectal-genital isolates except in the susceptibility to spectinomycin. Our findings do not indicate that gonococci isolated from the pharynx differ significantly from gonococci isolated from rectal or genital sites. It was notable that meningococcal colonisation of the pharynx was significantly more frequent in the white patients. This may be a genetically determined phenomenon.

Adult↗
PubMed1980

Auxotypes and antimicrobial susceptibilities of Neisseria gonorrhoeae in black and white patients.

Isolates of Neisseria gonorrhoeae from 100 white and 113 black patients attending a venereal disease clinic were examined for their susceptibility to ampicillin, penicillin, tetracycline, and spectinomycin. The isolates were also characterised by gonococcal auxotyping. Gonococcal isolates from black patients were more resistant to the antibiotics than those from white patients, since the former were infected with the more antibiotic-resistant auxotypes (Pro, Zero, and Arg) whereas the latter were infected with the more antibiotic-susceptible auxotypes (AHU and others). These data indicate a preferential infection by sub-populations of Neisseria gonorrhoeae in two racial groups.

Anti-Bacterial Agents↗
PubMed1980

Gonorrhea in Rotterdam caused by penicillinase-producing gonococci.

Recently the prevalence of strains of penicillinase-producing Neisseria gonorrhoeae (PPNG) in the Netherlands has increased. A study of demographic and clinical data from patients with gonorrhoea due to PPNG strains, and of the biological characteristics of the strains isolated in Rotterdam, show that Asian strains of PPNG seem at present to be endemic in the Netherlands. Spectinomycin was found to be effective in the treatment of patients with gonorrhoeea due to PPNG strains.

Female↗
PubMed1981

Susceptibility of Neisseria gonorrhoeae to cefotaxime and ceftizoxime.

Two hundred and thirty-nine penicillinase-positive and 240 penicillinase-negative strains of Neisseria gonorrhoeae were tested for their susceptibility to cefotaxime. All were susceptible to cefotaxime at a concentration of 0.062 micrograms/ml. Penicillinase-negative strains were less susceptible than penicillinase-positive strains. This is attributed to the use of prophylactic antibiotics by prostitutes, which has led to the selection of less susceptible penicillinase-negative strains but has not affected the susceptibility of penicillinase-positive strains. The minimum inhibitory concentrations of cefotaxime showed significant positive correlations with those of penicillin, ampicillin, tetracycline, and kanamycin but had a negative correlation with spectinomycin. The related cephalosporin, ceftizoxime, was found to be as effective as cefotaxime against penicillinase-positive and penicillinase-negative gonococci.

Cefotaxime↗
PubMed1982

In-vitro activity of 21 antimicrobial agents against Neisseria gonorrhoeae in Brussels.

The minimum inhibitory concentrations (MIC) of 21 antimicrobial agents was measured for 80 strains of Neisseria gonorrhoeae isolated in Brussels in 1978. Bimodal distributions were found for penicillin G, ampicillin, amoxycillin, carbenicillin, and cephalexin. Of the strains, 17.5% were relatively resistant to penicillin G (MIC greater than 0.08 microgram/ml) 27.5% to ampicillin (MIC greater than 0.16 microgram/ml), 23.8% to amoxycillin, and 43.3% to carbenicillin. Cefotaxime was the most active antibiotic, with MICs in the nanogram range; 3.8% and 5% of the strains were relatively resistant to cephaloridine and cephalexin respectively, but no strains were resistant to cefazolin, cefuroxime, or cefotaxime. Resistance to tetracycline, doxycycline, minocycline, erythromycin, and spiramycin (MIC greater than 1 microgram/ml) was found in 6.3%, 2.5%, 5%, and 51.3% of the strains respectively. A very good correlation was present between chloramphenicol and thiamphenicol, with 16.3% and 10% of relatively resistant strains respectively. Only two isolates showed an MIC greater than 1.25 microgram/ml for rifampicin, and 10% of the strains needed greater than or equal to 12 microgram/ml of spectinomycin for complete inhibition of growth. A very high energy was found for the 20 : 1 combination of sulphamethoxazole and trimethoprim, with only one isolate resistant to this combination. None of the strains tested produced beta-lactamase.

Anti-Bacterial Agents↗
PubMed1982

Characteristics of Haemophilus ducreyi. A study.

In a study of 13 local and four reference strains of Haemophilus ducreyi all grew well on a selective medium consisting of Bacto proteose No 3 agar (Difco), soluble starch, IsoVitalex, human blood, and vancomycin. All the strains reduced nitrate, were alkaline-phosphatase-positive, and (with one exception) used glucose, fructose, and mannose, beta-lactamase was produced by 12 local strains. Erythromycin was the the most effective antibiotic tested, followed by streptomycin, co-trimoxazole, and spectinomycin.

Anti-Bacterial Agents↗
PubMed1983

Penicillinase-producing Neisseria gonorrhoeae isolates from different localities in south east Asia. Susceptibility to 15 antibiotics.

Sixty four penicillinase-producing Neisseria gonorrhoeae (PPNG) and 24 non-penicillinase-producing (non-PPNG) strains isolated from six different south east Asian localities were tested by the agar dilution method against 15 antibiotics. All isolates were susceptible to spectinomycin and sulphamethoxazole-trimethoprim (19:1 ratio). A large proportion of both PPNG and non-PPNG strains showed, however, a decreased susceptibility to tetracycline, kanamycin, and erythromycin: 49% with minimum inhibitory concentrations (MICs) of tetracycline greater than or equal to 2 micrograms/ml, 34% with MICs of kanamycin greater than or equal to 32 micrograms/ml, and 80% with MICs of erythromycin greater than or equal to 2 micrograms/ml. These MIC cut-off values were chosen since they are close to the highest concentrations of these antibiotics attainable in serum after drug administration. Resistance to these antibiotics was not related to penicillinase production and does not appear to be confined to gonococci isolated from one particular locality. Strains showing resistance concurrently to two or three of these drugs were often isolated from different south east Asian countries. All eight cephalosporins tested were effective against both PPNG and non-PPNG strains. On a weight to weight basis the new cephalosporins--namely, moxalactam, cefoperazone, cefotaxime, and ceftriaxone--were the most effective. In contrast to those of cefoxitin, cefuroxime, moxalactam, and cefoperazone the MICs of cefamandole, cefotaxime, and ceftriaxone were significantly affected when the inoculum size was increased from 10(3) to 10(6) colony forming units (cfu).

Anti-Bacterial Agents↗
PubMed1983

Imported penicillinase producing Neisseria gonorrhoeae becomes endemic in London.

We review all cases of gonorrhoea caused by penicillinase producing Neisseria gonorrhoeae (PPNG) seen between 1976 and 1983 at the sexually transmitted disease (STD) clinic of this hospital, which accounted for 11% of all such cases reported in that period in the United Kingdom. While the overall incidence of gonorrhoea remained relatively stable in this clinic, that of PPNG rose to 4.4% of all such cases by 1982. Until last year, 75% of these cases were imported, mainly from Nigeria and Ghana, but a marked change was seen in the second half of 1982, when 71% of cases were indigenous in origin. Casual partners and prostitutes in London were mentioned as the source of infection by 34% of patients, a much higher percentage than that seen previously. Such sources are notoriously difficult to trace and these figures show a very disturbing trend. Although rectal infection tends to be asymptomatic, PPNG was isolated in rectal cultures from two of five homosexuals and 19 of 26 women. There is therefore a risk that PPNG could spread rapidly through the homosexual population. We suggest that spectinomycin should no longer be the first drug of choice in the treatment of gonorrhoea caused by PPNG but should be replaced by the newer cephalosporins.

Africa, Western↗
PubMed1984

Penicillinase producing Neisseria gonorrhoeae in Zurich, Switzerland.

Of 1031 consecutive isolates of Neisseria gonorrhoeae examined before 31 July 1982, 30 strains showed beta-lactamase activity. All the penicillinase producing N gonorrhoeae (PPNG) strains were imported, 23 of them from South East Asia. One PPNG strain was identified as coming from Antigua and one from Chile, the first PPNG strains to be reported from these two countries. In 28 strains, the minimum inhibitory concentration (MIC) of penicillin was greater than or equal to 4.0 mg/l, and 15 strains were insensitive to tetracycline (MIC greater than or equal to 2.0 mg/l). Four strains were less sensitive to spectinomycin (MIC = 30 mg/l), while the remaining 26 were highly sensitive to this antibiotic. The African plasmid was found in only one strain (that originating from Antigua), and all other PPNG strains contained the Asian plasmid. Twenty PPNG strains contained the resistance plasmid together with the transfer plasmid. Auxotype determination showed that 18 PPNG strains were prototrophic whereas 11 were proline requiring.

Anti-Bacterial Agents↗
PubMed1984

Cefoperazone (Cefobid) for treating men with gonorrhoea caused by penicillinase producing Neisseria gonorrhoeae.

The recent emergence of spectinomycin resistant penicillinase producing Neisseria gonorrhoeae (PPNG) and the high prevalence of PPNG strains among the gonococcal isolates in Seoul represent a grave challenge to the programme for controlling sexually transmitted disease (STD). Fifty men with uncomplicated gonococcal urethritis caused by PPNG strains were treated with a single intramuscular injection of 1 g cefoperazone. Forty two patients were followed up. All patients recovered including three who became reinfected and required further treatment. Two patients (4.8%) developed postgonococcal urethritis (PGU). The MIC90 of cefoperazone measured by an agar dilution susceptibility test was 0.12 mg/l.

Adult↗