No abstract available.
Citrobacter* ; Enterobacter*

No abstract available.
Cerebral Ventriculitis* ; Enterobacter aerogenes* ; Enterobacter* ; Pefloxacin*

No abstract available.
Enterobacter cloacae* ; Enterobacter* ; Pseudomonas aeruginosa* ; Pseudomonas*

Abstract: Sepsis is a common cause of morbidity and mortality among high risk neonates with intrauterine maternal history of infection. Objectives: The main objective of this study is to describe all potentially septic newborns in the neonatal care unit of the Baguio General Hospital and Medical Center (BGH) including identification of the maternal risk factors and clinico-bacteriologic profile of sepsis of this study population. Methods: This is a retrospective, descriptive study where medical records of all admitted potentially septic neonates from July 1, 2004 to June 30, 2006 were reviewed. Neonates who were preterm, asphyxiated, with congenital anomalies and with incomplete charts were excluded. Data such as demographics, maternal risk factors, and clinical course were recorded using a standardized clinical assessment form. Results: Out of 217 subjects, 74% (204) were included in the study. 53% were males, with birth weights of 2500 to (-) 3800 grams (85.29%) and delivered via normal, spontaneous delivery (63.24%). The more common maternal risk factor identified included premature rupture of membranes (77%), non-institutional delivery (9.2%), and maternal urinary tract infection (4.2%). 85.78% of subjects had culture negative results, while 14.22% had culture positive results . Among patients with culture negative results, 22.29% developed clinical signs of sepsis such as poor suck, pneumonia, fever, shock, and thrombocytopenia. In patients with culture positive results, the most common organisms isolated were Enterobacter aerogenes (55%), Acinetobacter baumanii (14%) and Coagulase negative staphylococcus (14%). Among these patients, 10 % presented with meningitis, pneumonia, and poor suck. Empiric antibiotics used at the time of study were Penicillin G and an aminoglycoside. 66% of the asymptomatic patients with culture negative results had 3 days duration of treatment. 94.6% went home improved. Conclusion Pediatricians should have a high index of suspicion for the possibility of sepsis guided by complete perinatal history, thorough physical examination, and laboratory work-up. Even with negative blood culture results, neonates with maternal risk factors can develop signs and symptoms of sepsis; and with the emergence of new pathogens that may cause early neonatal sepsis, it is prudent to do blood culture and sensitivity and start empiric antibiotics.
Neonatal Sepsis ; Enterobacter

Background:Resistance to antibiotics due to extended \ufffd?spectrum \ufffd?Lactamase (ESBL) which increased quickly, made treatment much more difficult. However, this matter was not enough to be concerned in our country. Objectives: To investigate the prevalence of ESBL producing among clinical isolates of E.coli, K.pneumoniae and Enterobacter spp and the classification of ESBLs gene by PCR. Subjects and method: 663 strains, including 248 E.coli, 393 K.pneumoniae, 22 Enterobacter spp, isolated from patients in Viet Tiep hospital (Hai Phong), Bach Mai and Pediatric hospital (Ha Noi). ESBLs were detected using modified double \ufffd?disc method. The classification of ESBLs producing strains was implemented by PCR. Results:the percentage of ESBL producing in E.coli, K.pneumoniae and Enterobacter spp is 20.2; 18.3 and 36.4%, respectively. The ESBLs producing strains were co \ufffd?resistant to most of the tested antibiotics. These strains were prevalent in intensive care units (sputum or respiratory fluid samples). TEM, SHV, CTX \ufffd?M, OXA were 87.7; 62.3; 24.6 and 12.3%, respectively. They were detected alone or in combination in the same strain. Conclusion: The rate of ESBLs producing strains is high. ESBLs were marker for multi \ufffd?drug resistance. TEM and SHV type ESBLs are most prevalent in the tested strains.
beta-Lactamases ; Klebsiella pneumoniae ; Enterobacter ; Escherichia coli ;

Diabetes Mellitus ; Enterobacter cloacae ; Humans ; Maxilla ; Osteonecrosis

Objectives: This aim of this research is to determine the clinical outcome of neonates with Enterobacter spp. positive blood culture and the antibiotic sensitivity pattern of these isolates at Cebu Doctors' University Hospital Neonatal Intensive Care Unit. Methods: This descriptive, cross-sectional, retrospective study retrieved the list of neonates admitted at Cebu Doctors' Hospital - Neonatal Intensive Care Unit (CDUH-NICU) from January 2005 to December 2008 whose bloods were taken for culture. The antibiotic sensitivity patterns of the Enterobacter positive cases were reviewed, along with broad-spectrum cephalosporin (BSC) resistant and multiresistant Enterobacter spp. (MRE) determination and clinical outcome. The relationship between outcome and MRE was analyzed using the Pearson Chi-square test. Conclusion: Most isolates were BSC-resistant while 24% were MRE. Enterobacter was most sensitive to Imipenem, Meropenem, Cefepime, and Piperacillin-Tazobactam.
Human ; Male ; Female ; Infant Newborn ; ENTEROBACTER ; SEPSIS ; BACTEREMIA

METHODS: We investigated and compared the epidemiologic characteristics of the E. cloacae isolation in the period of outbreak (April-June, 1998) with those in the control period (January-March, 1998). To identify the risk factors for E. cloacae sepsis, we retrospectively conducted a chart review for the patients who had E. cloacae sepsis during the period of outbreak. On the basis of these results, environmental culture was performed hospital wide. RESULTS: Ten clinical isolates E. cloacae were recovered from the blood of ten patients from April to June. 1998. Seven out of 10 patients recieved ERCP procedure just before E. cloacae sepsis. Hence, we performed surveillance study in the endoscopy room before and after the procedure. The survey showed that distilled water which was used for washing the endoscopy was contaminated with E. cloacae, which was suspected to be the common source of this outbreak. Therefore, we changed distilled water into sterilized distilled water on washing the endoscopy. After this correction was performed, the incidence of ERCP-associated E. cloacae sepsis declined markedly (P<0.011). CONCLUSION: We investigated an outbreak of ERCP-related E. cloacae sepsis and the outbreak was successfully controlled by removing the source of infection.
Cholangiopancreatography, Endoscopic Retrograde* ; Cloaca ; Endoscopy ; Enterobacter cloacae* ; Enterobacter* ; Humans ; Incidence ; Methods ; Retrospective Studies ; Risk Factors ; Sepsis* ; Water

BACKGROUND: Enterobacter species are frequent nosocomial pathogens and the proportion of beta-lactam resistant strains are on the increase. Extended spectrum beta-lactamases(ESBLs) were mainly investigated in Klebsiella pneumoniae and Escherichia coli in Korea. Recently, we experienced 4 strains of multidrug(including cephamycin)-resistant Enterobacter cloacae and characterized the ESBL types. METHODS: Multidrug-resistant E. cloacae strains were tested for ESBL production by double-disk synergy test and conjugation. The presence of TEM, SHV or IMP gene was determined by polymerase chain reaction. RESULTS: Of the four strains that revealed positive reaction in double-disk synergy test, ceftazidime- resistance was transferred in two and cefoxitin-resistance was transferred in four strains by conjugation. In the polymerase chain reaction, three out of four strains had both TEM and SHV genes and one strain had only TEM gene. Two ceftazidime transconjugants had both TEM and SHV genes. CONCLUSION: We should be aware of ESBL producing Enterobacteriaceae and the possible institutional spread of resistance genes.
beta-Lactams* ; Ceftazidime ; Cloaca ; Drug Resistance, Multiple ; Enterobacter cloacae* ; Enterobacter* ; Enterobacteriaceae ; Escherichia coli ; Klebsiella pneumoniae ; Korea ; Plasmids ; Polymerase Chain Reaction

BACKGROUND: Derepressed AmpC beta-lactamase producing Enterobacter cloacae, Citrobacter f reundii, and Serratia marcescens are important nosocomial pathogens and the infections are difficult to treat, because they are multi-drug resistant. The aim of this study was to determine the isolation rate and trend, and antimicrobial susceptibility of derepressed strains isolated from clinical specimens. METHODS: E. cloacae, S. marcescens, and C. f reundii isolated from 1996 through 2000 were enrolled in the study. Antimicrobial susceptibility was tested by NCCLS disk diffusion method. Derepressed strain was defined as strain non-susceptible to third generation cephalosporin. The isolation patterns of important gram-negative bacilli with the derepressed strains were analyzed with respect to years, patient's locations and specimens. RESULTS: Among the clinical isolates, the derepressed strains of E. cloacae, S. marcescens, and C. f reundii were 65%, 70%, and 56%. The proportion of the derepressed strains : E. cloacae increased from 68% in 1996 to 71% in 1998, however, decreased to 59% in 2000, S. marcescens increased from 68% in 1996 to 73% in 2000, C. f reundii decreased from 69% in 1996 to 41% in 2000. The proportion of the derepressed strains were high among the isolates from blood and respiratory specimens of inpatient and intensive care patient. The resistance rates of the depressed strains were 47~62% to third generation cephalosporin and aztreonam, 15~85% to aminoglycoside, 68% to cotrimoxazole, and 31% to levofloxacin. CONCLUSION: Among the clinical isolates of E. cloacae, S. marcescens, and C. f reundii, the derepressed strains were as high as 56~70%, and they were commonly isolated from blood and sputum specimens of inpatient and intensive care patient, and showed high resistance rates to the most antimicrobial agents.
Anti-Infective Agents ; Aztreonam ; beta-Lactamases* ; Citrobacter freundii ; Citrobacter* ; Cloaca ; Diffusion ; Enterobacter cloacae ; Enterobacter* ; Humans ; Inpatients ; Critical Care ; Levofloxacin ; Serratia marcescens ; Serratia* ; Sputum ; Trimethoprim, Sulfamethoxazole Drug Combination