Abstract Objective Evaluation of 6 patients presenting with tubo-ovarian mass or infertility with multi drug resistant (MDR) female genital tuberculosis (FGTB). Study Design It was an observational ...study in a tertiary referral centre, India on subjects with MDR FGTB on clinical examination and investigations. All patients were given category IV drugs using kanamycin (intramuscular), levofloxacin, pyrazinamide, cycloserine, ethionamide and ethambutol (or para aminosalicylic acid PAS if ethambutol resistance) for 6 months intensive phase followed by oral levofloxacin, cycloserine, ethionamide and ethambutol (or PAS for ethambutol resistance) for 18 months continuation phase. Patients were evaluated for primary end points (complete cure, partial response, no response, treatment completed) and secondary end points (recurrence rate, pregnancy rate) during treatment. Results There were 2 (33.3%) primary MDR FGTB patients and 4 (66.6%) secondary MDR FGTB (three pulmonary MDR and one MDR lymphadenitis) patients. Mean age was 23.6 years. Presenting features were menstrual dysfunction in all patients (100%) especially oligomenorrhea in 4 (66.6%) patients, weight loss in all the patients (100%), cough with expectoration in three patients (50%), tubo-ovarian masses in five (83.3%) patients. Endometrial biopsy showed positive culture for AFB with rifampicin and isoniazid (INH) resistance in both primary MDR FGTB patients and in two secondary MDR FGTB patients where it was done. In secondary MDR FGTB, three pulmonary MDR patients had positive sputum AFB culture, while the patient with MDR lymphadenitis had lymph node aspirate for AFB culture positive with all showing resistance to rifampicin and isonioazid. Gene Xpert on endometrial biopsy or sputum was positive in 5 (83.3%) patients where it was done. Three (50%) patients (one primary and two secondary) have completed therapy while other 3 (50%) are in continuation phase. All patients are symptomatic with one having 12 weeks ongoing successful pregnancy. Conclusion MDR FGTB should be thought of in women of FGTB with tubo- ovarian masses who are not responding to first line drugs. Gene Xpert can be used in early diagnosis of MDR FGTB.
Bacteria are the leading cause of infections after solid organ transplantation. In recent years, a progressive growth in the incidence of multidrug-resistant (MDR) and extensively-drug-reistant (XDR) ...strains has been observed. While methicillin-resistant Staphylococcus aureus (MRSA) infection is declining in non-transplant and SOT patients worldwide, vancomycin-resistant enterococci, MDR/XDR Enterobacteriaceae and MDR/XDR non-fermenters are progressively growing as a cause of infection in solid organ transplant (SOT) patients and represent a global threat. Some SOT patients develop recurrent infections, related to anatomical defects in many cases, which are difficult to treat and predispose patients to the acquisition of MDR pathogens. As the antibiotics active against MDR bacteria have several limitations for their use, which include less clinical experience, higher incidence of adverse effects and less knowledge of the pharmacokinetics of the drug, and, in most cases, are only available for parenteral administration, it is mandatory to know the main characteristics of these drugs to safely treat SOT patients with MDR bacterial infections. Nonetheless, preventive measures are the cornerstone of controlling the spread of these pathogens. Thus, applying the Center for Disease Control and Prevention’s and the European Society of Clinical Microbiology and Infectious Diseases’s recommended antibiotic policies and strategies to control the transmission of MDR strains in the hospital setting is essential for the management of SOT patients.
The worldwide incidence of multi-drug-resistant tuberculosis (MDR-TB) is rapidly increasing, and it has emerged as a pressing public health issue in Iran. Nevertheless, there is a scarcity of ...up-to-date research on the prevalence of MDR-TB in individuals with pulmonary TB in the country. In this cross-sectional study, we gathered a total of 1216 respiratory samples, each corresponding to a unique patient, from five distinct regional TB laboratories in Iran. We identified clinical isolates as Mycobacterium tuberculosis using the IS6110-based PCR assay and Xpert MTB/RIF. Drug susceptibility testing (DST) was conducted using the conventional proportion method. Out of the collected specimens, 448 tested positive for M. tuberculosis. Among these isolates, 445 (99.4%) exhibited susceptibility to the tested drugs, while 3 (0.6%) were found to be MDR. The findings from this recent study indicate that the prevalence of MDR in Iran stands at 0.6%. The absence of recently approved treatment protocols in various regions of Iran, along with inadequately equipped laboratories lacking DST capabilities, could contribute significantly to the rise in TB/MDR-TB prevalence in Iran. Therefore, the implementation of enhanced treatment management strategies and the adoption of innovative technologies are essential steps towards improving the current situation.
SETTING: Niger National Tuberculosis Programme. Regions supported by the Damien Foundation. OBJECTIVE: To evaluate the effectiveness of a shortcourse standardised treatment regimen for patients with ...proven multidrug-resistant tuberculosis (MDR-TB) previously untreated with second-line drugs. METHODS: Prospective study including all patients enrolled from 2008 to 2010. The 12-month standardised regimen comprised high doses of gatifloxacin, clofazimine, ethambutol and pyrazinamide throughout, supplemented by kanamycin, prothionamide and mediumhigh doses of isoniazid during the intensive phase of a minimum of 4 months. Patients were monitored using sputum smear and culture at start of treatment and every 2 months. Cured patients were followed up 6-monthly for 24 months. RESULTS: Sixty-five patients with MDR-TB were included and analysed. One of 58 patients tested for human immunodeficiency virus (1.7%) infection was positive. Twenty-five patients (39.7%) were severely affected (body mass index < or =, slant 16 kg/m super(2)). Cure was achieved in 58 patients (89.2%, 95%CI 81.7-96.7), 6 died and 1 defaulted. All 49 patients assessed at the 24-month follow-up after cure remained smear- and culture-negative. The main adverse events were vomiting (26.2%) and hearing impairment (20%), but no treatment had to be stopped. CONCLUSION: Standardised 12-month treatment for MDR-TB was highly effective and well tolerated in patients not previously exposed to second-line drugs in Niger.
Abstract Background: Pseudomonas aeruginosa is one of the most prevalent nosocomial pathogenic microorganisms that affect and cause a life-threatening situation. Objective: The study aimed to ...investigate the synergistic effect of silver nanoparticles (NPs) with amoxicillin/clavulanic acid antibiotic on P. aeruginosa growth. Materials and Methods: A total of 220 clinical samples were collected. A sample has been subjected to isolation and identification by standard microbiological procedures. The extract of Citrus aurantium was used to synthesize silver NPs. The characterization of silver NPs was achieved at the University of Tehran, by using UV–visible spectrophotometry, X-ray diffraction (XRD), and transmission electron microscope (TEM). The antibacterial activity of AgNPs and combination with amoxicillin/clavulanic acid antibiotic were tested against bacteria using the agar well diffusion method. Results: Out of the 220 samples collected, 33 (15%) isolates were positive for P. aeruginosa . Highest resistance of P. aeruginosa was found to amoxicillin/clavulanic acid in percentage of 100. NPs have been characterized by a UV–visible spectrometer which revealed a broad peak at 426 cm -1 . XRD showed the purity of the prepared silver NPs that the particle size was equal to 21.26 nm. TEM measurement showed the presence of sphere-like structures with sizes of 20 nm for regular particles and 40 nm for irregular particles. AgNPs, amoxicillin/clavulanic acid, and mixture (amoxicillin/clavulanic acid + AgNPs) have high inhibition activity of P. aeruginosa in concentration of 100 µg/mL and recorded 21.33 ± 3.06, 13.00 ± 0.00, and 22.00 ± 3.46 mm, respectively. Conclusion: The results supported a green synthesis approach for the synthesis of AgNPs with antimicrobial. P. aeruginosa has synergistic combinations of AgNPs with amoxicillin/clavulanic acid, with a great inhibitory effect on the growth of the bacteria.
Introdução/Objetivos: Staphylococcus aureus é um patógeno de grande relevância clínica, destacando-se as cepas MRSA (Methicillin-resistant S. aureus), que estão relacionadas a presença do gene mecA. ...É importante ressaltar o surgimento de cepas multidroga resistentes (MDR), que representam uma grave ameaça à saúde pública. O objetivo deste estudo foi caracterizar amostras de S. aureus isoladas em um Hospital Universitário do Rio de Janeiro durante um período de 6 meses, de diferentes materiais clínicos (abscessos, biópsias, líquido sinovial, aspirado traqueal, etc.). Métodos: Coletadas de forma consecutiva, 24 amostras de S. aureus foram submetidas ao teste de disco-difusão para determinação do perfil de susceptibilidade aos antimicrobianos. Amostras caracterizadas como MRSA foram submetidas à PCR para detecção do gene mecA. Resultados: A maioria das amostras (17/24; 70,8%) foi isolada de indivíduos do sexo masculino, e a média de idade foi de 48,4 anos (± 22,3 anos). Do total, 14 amostras foram associadas à infecção de pele e partes moles (58,3%), nove à infecções respiratórias (37,5%) e uma à infecção de ossos e articulações (4,2%). Todas as amostras foram suscetíveis à daptomicina, linezolida, teicoplanina, tigeciclina, trimetoprima-sulfametoxazol e vancomicina. Entretanto, observamos uma alta taxa de isolamento de cepas MRSA (33,3%), todas mecA+. Altas taxas de resistência foram encontradas para eritromicina (66,7%), ciprofloxacino (66,7%) e clindamicina (54,2%). Além disso, foram observadas taxas de resistência à gentamicina (33,3%), ceftarolina (16,6%), mupirocina e rifampicina (8,3%). Vale ressaltar que cerca de 54% das amostras apresentaram perfil MDR, caracterizado pela resistência à três ou mais classes de antimicrobianos, independente da presença do gene mecA. Além disso, a resistência à gentamicina, eritromicina e clindamicina esteve relacionada a amostras MSSA (Methicillin-susceptible S. aureus) (p-valor < 0,05). Conclusão: A alta taxa de isolamento de cepas MRSA, e a ocorrência de cepas MDR, independente da presença do gene mecA, aponta uma possível disseminação da resistência antimicrobiana entre S. aureus isolados de pacientes atendidos no hospital de estudo. Logo, concluímos que é de extrema importância a vigilância constante da resistência antimicrobiana, a fim de auxiliar e possivelmente propor medidas de controle e prevenção de infecções por S. aureus em nosso hospital de estudo.
A multidrug-resistant clone of the animal and human pathogen Rhodococcus equi, MDR-RE 2287, has been circulating among equine farms in the United States since the 2000s. We report the detection of ...MDR-RE 2287 outside the United States. Our finding highlights the risk for MDR-RE spreading internationally with horse movements.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Antibiotic resistance is increasing among Gram-negative bacteria, prompting the development of new antibiotics as well as alternative treatment approaches. Klebsiella pneumoniae Carbapenemases (KPC) ...has become a major concern in the treatment of infections, since KPC-producing bacteria are resistant to a number of β -lactam and non β-lactam antibiotics in addition to hydrolyzing carbapenemases. The aim of this study is to examine the synergistic effect of human Glucose-dependent Insulinotropic Polypeptide (GIP) on KPC producer. The K. pneumoniae isolates were identified by using biochemical tests and PCR genotyping. The disc diffusion method was used to assess the antimicrobial susceptibility of each isolate, and the modified Hodge test (MHT) was used to find carbapenemases. Agar well diffusion and minimum inhibitory concentration (MIC) assays were used to validate the synergistic effect of GIP against Klebsiella species. MIC values of chosen antimicrobial compounds demonstrated a considerable synergism impact when combined with human GIP, particularly against KPC strains. The antibacterial activity of the antimicrobial compounds was boosted by 4 to 16 times due to human GIP, reducing the MIC values. The fractional inhibitory concentration (FIC) ranged from 0.032 to 0.25 for examined antibiotics. Thus, GIP can be considered an antibacterial adjuvant with the potential to supplement the current antibiotic spectrum.Antibiotic resistance is increasing among Gram-negative bacteria, prompting the development of new antibiotics as well as alternative treatment approaches. Klebsiella pneumoniae Carbapenemases (KPC) has become a major concern in the treatment of infections, since KPC-producing bacteria are resistant to a number of β -lactam and non β-lactam antibiotics in addition to hydrolyzing carbapenemases. The aim of this study is to examine the synergistic effect of human Glucose-dependent Insulinotropic Polypeptide (GIP) on KPC producer. The K. pneumoniae isolates were identified by using biochemical tests and PCR genotyping. The disc diffusion method was used to assess the antimicrobial susceptibility of each isolate, and the modified Hodge test (MHT) was used to find carbapenemases. Agar well diffusion and minimum inhibitory concentration (MIC) assays were used to validate the synergistic effect of GIP against Klebsiella species. MIC values of chosen antimicrobial compounds demonstrated a considerable synergism impact when combined with human GIP, particularly against KPC strains. The antibacterial activity of the antimicrobial compounds was boosted by 4 to 16 times due to human GIP, reducing the MIC values. The fractional inhibitory concentration (FIC) ranged from 0.032 to 0.25 for examined antibiotics. Thus, GIP can be considered an antibacterial adjuvant with the potential to supplement the current antibiotic spectrum.
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