Background: Streptococcus pneumonia (S.pneumoniae) is the main cause of acquired pneumonia in the community along with otitis media, sinusitis, septicemia and meningitis. Objectives: The study determined antimicrobial resistance and serotype distribution of Streptococcus pneumonia isolates from hospitalized children at Hai Phong Children's Hospital, Vietnam. Subjects and method: From June 2006 to September 2007, 80 pneumococccal isolates were tested for susceptibility to the 13 antibiotics and 84 pneumococcal isolates were serotyped. Results:Seventy-five percent of strains showed multi-drug resistance. Ninety percent of strains showed resistance to penicillin (48% intermediate and 42% fully resistant). In addition, 100% of isolates were resistant to cotrimoxazole, 74% of isolates were resistant to cephalexin; 71 % of isolates were resistant to erythroomycin and 58% were resistant to cefuroxxime. Almost all the isolates were susceptible to amoxicillin, cefotaxime, ceftriaxone, ceefepime, ofloxacin and 100% of isolates were susceptible to vancomycin. Among the 84 serotypes, 82% were included in the 23 valent pneumococcal polysaccharide vaccine including: 19F (30%), 23F (21 %), 14 (13%) and 6B (13%). Six other serotypes (13, 15C, 18, 11A, 15B and 6A) accounted for 12% of strains and 9 (11%) strains were untypeable. Conclusion: Pneumococcal antibiotics is spreading most rapidly among children in Vietnam, especially strains typs 19F and 23 F. Concerted efforts are necessary to prevent it spreading.\r\n", u'\r\n', u'
Antimicrobial resistance ; streptococcus pneumonia

Antibiotic resistance of urinary tract pathogens has increased worldwide. The purpose of this study is to provide information regarding local resistance pattern of urinary pathogens to the commonly used antibiotics. One hundred and seventeen cases of community-acquired urinary tract infections were studied. The most common group of patients was the uncomplicated acute cystitis in women. E. coli was the most common isolate. Overall, antimicrobial susceptibility test on the organisms isolated showed a resistance of 63.0% to ampicillin, 40.1% to sulfamethoxazole-trimethoprim (S-T), 14.3% to pipemidic acid, 8.6% to norfloxacin, 3.8% to cephalexin, 3.7% to amoxicillin-clavulanate, 1.0% to cefuroxime, and 1.0% to fosfomycin. Three out of five patients on ampicillin as well as two out of five patients on S-T were likely to be inadequately treated.
Cancer resistance to treatment ; Community ; Upper case tea ; Upper case ess ; Antimicrobial susceptibility

The recent emergence of Staphylococcus schleiferi in dogs with otitis externa or skin and soft tissue infections has become a significant zoonotic issues. In the current study, we investigated 1) the carriage rates of S. schleiferi among major staphylococci in healthy dogs and dogs with otitis externa, 2) antibiotic susceptibility profiles of S. schleiferi, particularly methicillin resistance (MR), and 3) virulence factors associated with skin and soft tissue infections such as ability to form biofilm, resistance to cationic antimicrobial peptides (CAMPs), and carriage of staphylococcal enterotoxin genes. Among the 21 S. schleiferi isolates, 5 isolates (24%) were determined to be methicillin-resistant (MRSS). Staphylococcal cassette chromosome mec (SCCmec) typing revealed the presence of SCCmec type V in 4 MRSS isolates and type VII in one MRSS. Higher levels of antibiotic resistance, especially multidrug resistance, were observed in MRSS isolates compared to the methicillin-susceptible S. schleiferi (MSSS) isolates. In addition, MRSS isolates exhibited enhanced ability to form biofilm under static condition and all the 5 MRSS isolates carried three or more enterotoxin genes. However, there were no significant differences in resistance to CAMPs between MRSS and MSSS isolates. These findings suggest that coagulase-negative S. schleiferi is becoming more prevalent in canine otitis externa cases. Our results also highlight the presence of multidrug-resistant MRSS isolates with enhanced biofilm production and carriage of multiple enterotoxins.
Animals ; Antimicrobial Cationic Peptides ; Biofilms ; Dogs ; Drug Resistance, Microbial ; Drug Resistance, Multiple ; Enterotoxins ; Methicillin Resistance ; Otitis Externa ; Otitis ; Skin ; Soft Tissue Infections ; Staphylococcus ; Virulence Factors ; Virulence

Microbial biofilm, a consortium of microbial cells protected by a self-produced polymer matrix, is considered as one main cause of current bacterial drug resistance. As a new type of antimicrobial agents, antimicrobial peptides provide a new strategy for the treatment of antibiotic resistant bacteria biofilm infections. Antimicrobial peptides have shown unique advantages in preventing microbial colonization of surfaces, killing bacteria in biofilms or disrupting the mature biofilm structure. This review systemically analyzes published data in the recent 30 years to summarize the possible anti-biofilm mechanisms of antimicrobial peptides. We hope that this review can provide reference for the treatment of infectious diseases by pathogenic microbial biofilm.
Anti-Bacterial Agents ; pharmacology ; Antimicrobial Cationic Peptides ; pharmacology ; Bacteria ; drug effects ; Biofilms ; drug effects ; Drug Resistance, Bacterial ; drug effects ; Microbial Sensitivity Tests ; Research ; trends

BACKGROUND: The modified Hodge test (MHT) was designed to detect carbapenemase-producing Enterobacteriaceae (CPE). This study evaluated variables to improve the performance of MHT. METHODS: Carbapenem-resistant Enterobacteriaceae isolated from November 2010 to March 2013 at the Asan Medical Center, were evaluated, including 33 metallo-beta-lactamase (MBL) producers and 103 non-CPEs. MHT was performed by using two carbapenem disks (ertapenem and meropenem; Becton Dickinson, USA), three media (Mueller-Hinton agar (MHA), MacConkey agar (MAC), and zinc-enriched MHA), and two inoculums (0.5-McFarland [McF] suspension and a 10-fold dilution of it.) PCR was performed to detect beta-lactamase genes of the MBL, AmpC, and CTX-M types. RESULTS: The sensitivity of MHT for detecting New Delhi metallo-beta-lactamase (NDM) producers was highest using ertapenem and 0.5-McF, 52.0% on MHA and 68.0% on MAC, respectively. NDM-producing Klebsiella pneumoniae (NDMKP) were detected with higher sensitivity on MAC (78.6%) vs. MHA (28.6%) (P=0.016), but VIM-producing Enterobacter, Citrobacter, and Serratia were detected with higher sensitivity on MHA (78.5%) vs. MAC (14.3%) (P=0.004). MBL producers were consistently identified with lower sensitivity using meropenem vs. ertapenem, 39.4% vs. 60.6% (P=0.0156), respectively. The effects of zinc and inoculum size were insignificant. Enterobacter aerogenes producing unspecified AmpC frequently demonstrated false positives, 66.7% with ertapenem and 22.2% with meropenem. CONCLUSIONS: The MHT should be adjusted for the local distribution of species and the carbapenemase type of MBL producers. MAC and ertapenem are preferable for assessing NDMKP, but MHA is better for VIM. Laboratory physicians should be aware of the limited sensitivity of MHT and its relatively high false-positive rate.
Anti-Bacterial Agents/pharmacology ; Carbapenems/pharmacology ; DNA, Bacterial/genetics/metabolism ; Disk Diffusion Antimicrobial Tests ; Drug Resistance, Bacterial ; Enterobacteriaceae/drug effects/*enzymology/isolation & purification ; Enterobacteriaceae Infections/microbiology ; Humans ; Multiplex Polymerase Chain Reaction ; Phenotype ; beta-Lactamases/genetics/*metabolism

We aimed to observe antimicrobial resistance patterns and integron carriage of Escherichia coli isolates causing community-acquired infections. Two hundred sixty-eight E. coli strains were obtained from outpatients with various infections at different polyclinics at the 82nd Year of State Hospital in Rize, Turkey. Susceptibility to antimicrobials was tested using a disk diffusion method. The presence of integrons was examined using PCR with specific primers. Positive PCR results were confirmed by sequencing. A broth mating method was used for conjugation assays. Extragenic palindromic-PCR was performed using the oligonucleotide primer BOXA1R. Resistance frequency for ampicillin, trimethoprim/sulfamethoxazole, and tetracycline was determined as 50.6%, 33.5%, and 36.8% respectively. No strains were resistant to amikacin. Seventy isolates were positive for the intI1 gene, of which 49 carried gene cassettes. Eleven isolates were positive for the intI2 gene, eight of which carried gene cassettes. Seven gene cassettes (dfrA1, dfrA5, dfrA7, dfrA17, aadA1, aadA5, and sat2) were predominantly harbored in integrons. We detected conjugative plasmids harboring integrons in two E. coli strains. Four strain clusters were yielded by BOX-PCR fingerprints showing that they were clonally related. No apparent relationship occurred among class 1 and 2 integron-carrying strains. We conclude that integrons are widespread in genetically variable E. coli strains and will continue to mediate dissemination of resistance genes in the community.
Anti-Bacterial Agents/*pharmacology ; Community-Acquired Infections/*microbiology ; Disk Diffusion Antimicrobial Tests ; Drug Resistance, Bacterial ; Escherichia coli/*drug effects/isolation & purification ; Escherichia coli Proteins/*genetics ; Humans ; Integrases/genetics ; Polymerase Chain Reaction ; Turkey

BACKGROUND: Group A streptococcus (GAS) is the most common cause of bacterial pharyngitis in children. Antibiotic resistance rates and emm genotypes of GAS isolated from patients with acute pharyngitis were studied in 2009. METHODS: Throat cultures were taken from 499 children with acute pharyngitis in Jinju, Korea, in 2008-2009. A total of 174 strains (34.9%) of GAS were isolated, and antimicrobial susceptibility testing was performed using the disk diffusion method. The phenotypes of macrolide resistance and macrolide resistance genes were determined. The emm genotypes were identified using PCR and sequencing. The data were compared with those acquired in 2002 in the same region. Data on the annual macrolide production were collected between 1999 and 2008. RESULTS: The resistance rates of GAS to erythromycin, clindamycin, and tetracycline were 4.6%, 2.9%, and 2.3%, respectively. The constitutive resistance rate was 62.5% for the erm(B) gene and 37.5% for the M phenotype of the mef(A) gene. emm4 was most frequently detected (28.2%), followed by emm89 (20.1%). Most of the erythromycin resistant strains had the emm28 genotype. We noted a gradual increase in macrolide production during the study period. CONCLUSIONS: The erythromycin resistance rate of GAS isolated from children with acute pharyngitis was significantly lower in 2009 (4.6%) than in 2002 (44.8%). We observed a remarkable change in the distribution of emm genotypes during the 7-yr period. The significant decline in erythromycin resistance in 2009 might be associated with a prominent decrease in the resistant genotype emm12 (3.4% in 2009 vs. 28.0% in 2002) rather than restriction of macrolide use.
Acute Disease ; Adolescent ; Anti-Bacterial Agents/*pharmacology ; Child ; Child, Preschool ; Disk Diffusion Antimicrobial Tests ; Drug Resistance, Bacterial/genetics ; Erythromycin/*pharmacology ; Female ; Genotype ; Humans ; Male ; Pharyngitis/drug therapy/*microbiology ; Phenotype ; Sequence Analysis, DNA ; Streptococcus pyogenes/*drug effects/*genetics/isolation & purification

BACKGROUND: Multidrug-resistant Enterobacteriaceae is a worldwide problem. Although various resistance mechanisms have been recognized with increasing frequency, only a few cases of triple resistance of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae have been reported. This study was designed to evaluate the coexistence of qnr (qnrA, qnrB, and qnrS) and 16S rRNA methylase (armA, rmtA, rmtB, and rmtC) in ESBL-producing K. pneumoniae. METHODS: We tested 44 isolates of ESBL-producing K. pneumoniae at Chungnam National University Hospital from March to September 2006. Antimicrobial susceptibilities were tested by broth microdilution method, and transconjugation test was performed using E. coli J53 with azide resistance. Search for qnr (qnrA, qnrB, and qnrS) and 16S rRNA methylase (armA, rmtA, rmtB, and rmtC) genes was conducted by PCR amplification, and the genotypes were determined by direct nucleotide sequence analysis of the amplified products. Epidemiologic study was performed by Enterobacterial repetitive intergenic consensus-PCR (ERIC-PCR). RESULTS: All ESBL-positive strains produced qnrB; however, armA was detected in 68.2%. The coproduction rate of qnrB and armA in ESBL-producing K. pneumoniae was 68.2%. Two types (A and B) were dominant in ERIC-PCR results. CONCLUSIONS: K. pneumoniae producing qnrB, armA, and ESBL are spreading widely.
Bacterial Proteins/biosynthesis/*genetics ; Disk Diffusion Antimicrobial Tests ; Drug Resistance, Bacterial/genetics ; Humans ; Klebsiella Infections/microbiology ; Klebsiella pneumoniae/drug effects/*genetics/isolation & purification ; Methyltransferases/biosynthesis/*genetics ; beta-Lactamases/biosynthesis/drug effects/*genetics

No abstract availble.
Anti-Bacterial Agents/therapeutic use ; Disk Diffusion Antimicrobial Tests ; *Drug Resistance, Bacterial ; Drug Therapy, Combination ; Helicobacter Infections/*drug therapy ; *Helicobacter pylori/drug effects/isolation & purification ; Humans ; Microbial Sensitivity Tests ; Peptic Ulcer/*drug therapy

BACKGROUND: Accurate and rapid detection of extended-spectrum beta-lactamases (ESBLs) is important in guiding proper antimicrobial therapy for infected patients. We evaluated the performance of MicroScan NegCombo Type 44 panel (Dade Behring, USA), which was developed to confirm ESBL-producing Enterobacteriaceae using ceftazidime/clavulanate and cefotaxime/clavulanate. METHODS: From August 30 to September 20, 2007, 206 non-duplicate clinical isolates, including 106 Escherichia coli, 81 Klebsiella pneumoniae, 11 Klebsiella oxytoca, and 8 Proteus mirabilis were subcultured and tested with Type 32 and Type 44 panels. The results were compared with those of the CLSI phenotypic confirmatory test (CLSI-PCT) and disk approximation test (DAT). Isolates not susceptible to cefotetan or flagged as "Possible ESBL, unable to interpret confirm test (Possible ESBL)" on Type 44 panel were tested with boronic acid disks to confirm AmpC beta-lactamases (AmpC) production. RESULTS: Of the 206 isolates tested, 44 (21.4%) produced ESBL by CLSI-PCT or DAT, including 27 E. coli, 14 K. pneumoniae, 2 K. oxytoca, and 1 P. mirabilis. Thirty-eight isolates flagged as "Confirmed ESBL" on Type 44 panel were all confirmed as ESBL-producers. Of 14 K. pneumoniae flagged as "Possible ESBL", 6 were confirmed as ESBL and AmpC co-producers and 8 as AmpC-producers. CONCLUSIONS: Type 44 panel showed an excellent performance in detecting ESBL-producing E. coli, Klebsiella spp., and P. mirabilis. When flagged as "Confirmed ESBL", no other confirmatory test was necessary to report as ESBL; however, "Possible ESBL" required a differential test for AmpC production.
Bacterial Proteins/*biosynthesis ; Cefotetan/pharmacology ; Disk Diffusion Antimicrobial Tests ; Drug Resistance, Bacterial ; Escherichia coli/*enzymology/isolation & purification ; Humans ; Klebsiella/*enzymology/isolation & purification ; Proteus mirabilis/*enzymology/isolation & purification ; Reagent Kits, Diagnostic ; Sensitivity and Specificity ; beta-Lactamases/*biosynthesis