The frequency of antibiotic resistance among Salmonella enterica serovar Typhimurium has increased due to the transfer of multiple resistance factors. We detected the 13 antibiotic resistance genes by multiplex-PCR and compared with the results of phage typing and antibiotic disk diffusion for 49 S. typhimurium isolated from food-poisoning outbreaks in Seoul from 1999 to 2002. Resistance genes for tetracycline, streptomycin, ampicillin, sulfonamide, amino-glycoside-modifying enzyme, chloramphenicol, kanamycin, and trimethoprim were detected in 67.3%, 57.1%, 26.5%, 8.1%, 8.1%, 5%, 2.0%, and 0% of isolates, respectively. Overall 28 isolates (57.1%) possessed two or more antibiotic resistance genes. Class 1 integron carrying multidrug resistace genes, ant(3")-IaB, blaPSE, qacE delta1/sul, and tet G were amplified especially in only DT104 isolates. Among the related resistance genes for same antibiotics, strA and strB for streptomycin resistance were simultaneously detected but tetA and tetB for tetracycline were sporadically detected. DT 104 isolates contained only aadA2 and tetG.
Ampicillin ; Anti-Bacterial Agents ; Bacteriophage Typing ; Chloramphenicol ; Diffusion ; Disease Outbreaks ; Drug Resistance, Microbial ; Humans ; Integrons ; Kanamycin ; R Factors ; Salmonella enterica* ; Salmonella* ; Seoul* ; Streptomycin ; Tetracycline ; Trimethoprim

The aim of this study is to characterize the epidemiological features of typhoid fever, categorized as class 1 notifiable disease in Korea and to analyze the recent change of antimicrobial resistance of Salmonella enterica serotype Typhi isolated nationwide. We retrospectively analyzed the 1,692 culture-proven cases from 1992 to 2000, using the data of the Korean National Institute of Health. The overall incidence of culture-proven typhoid fever was 0.41 per 100,000 population. It occurred all over the country, but the southeastern part of Korean peninsula had the higher incidence rate than other areas. There were several outbreaks suspected, of which two outbreaks were confirmed. The resistance rate against chloramphenicol showed mild increase, but the ampicillin, trimethoprim/sulfamethoxazole, kanamycin, or nalidixic acid resistance remained at the similar levels for the past 9 yr. There were 21 (1.3%) multidrug-resistant (MDR) strains isolated since 1992, and the number of those has increased. Two strains resistant to ciprofloxacin were first identified in Korea.
Ampicillin/pharmacology ; Anti-Bacterial Agents/pharmacology ; Chloramphenicol/pharmacology ; *Drug Resistance, Microbial ; Drug Resistance, Multiple ; Human ; Kanamycin/pharmacology ; Korea ; Nalidixic Acid/pharmacology ; Retrospective Studies ; Salmonella Infections/*epidemiology ; Salmonella enterica/*metabolism ; Seasons ; Serotyping ; Support, Non-U.S. Gov't ; Time Factors ; Trimethoprim/pharmacology

OBJECTIVETo investigate the molecule epidemic for 7 genes interrelated penicillin, erythromycin, tetracycline, vancomycin resistance of isolated Streptococcus pneumoniae (SP) in children at Suzhou area.

METHODS(1) Thirty-one pneumococcal isolates were collected from respiratory tract secretions of children with respiratory diseases from Nov 2002 to Apr 2003 at the Children's Hospital of Suzhou University (reference strain ATCC49619). (2) Penicillin susceptibility was determined by E-test, while erythromycin, tetracycline, vancomycin were determined by K-B disk. (3) The detecting of pbp2B, ermA/B, mefA, tetM, vanA, vanB genes by PCR, Sequencing pbp2B genes, Contrasting pbp2B DNA sequences among pneumococcal isolates and SP R6 [penicillin sensitive (www.ncbi.nlm.gov/nucleotide, NC-003098)].

RESULTSOf thirty-one isolates studied, the results were shown as follows; (1) Penicillin sensibility 38.7% (n = 12), penicillin resistance 61.3% (n = 19), pbp2B mutation 64.5% (n = 20); (2) Erythromycin sensibility 9.7% (n = 3), erythromycin resistance 90.3% (n = 28), ermA/B 71% (n = 22), mefA 32.1% (n = 10), ermA/B + mefA 87.1% (n = 27); (3) Tetracycline sensibility 9.7% (n = 3), tetracycline resistance 90.3% (n = 28), tetM 90.3% (n = 28); (4) Vancomycin sensibility 100% (n = 31), vanA, vanB all 0%.

CONCLUSIONAmong pneumococcal isolates at our area, penicillin, erythromycin, tetracycline resistance were high, vancomycin was sensitive. Detecting 7 genes interrelated penicillin, erythromycin, tetracycline, vancomycin resistance expressed genotypies for antibiotic resistances in pneumococcal isolates.

Anti-Bacterial Agents ; pharmacology ; Child ; China ; epidemiology ; DNA, Bacterial ; genetics ; Drug Resistance, Multiple, Bacterial ; genetics ; Erythromycin ; pharmacology ; Female ; Humans ; Male ; Microbial Sensitivity Tests ; Molecular Epidemiology ; Penicillin Resistance ; genetics ; Pneumococcal Infections ; epidemiology ; microbiology ; Streptococcus pneumoniae ; drug effects ; genetics ; isolation & purification ; Tetracycline Resistance ; genetics ; Vancomycin ; pharmacology

BACKGROUND: Impetigo is mostly caused by either Staphylococcus aureus(S. aureus) or group A beta-hemolytic Streptococcus(Streptococcus pyogenes). As the relative preponderance of each microorganism varies greatly, so reports have been contradictory. Recently, S. aureus has been reported as the principal causative microorganism of impetigo and shown variable degrees of antimicrobial resistance. OBJECTIVE: The purpose of this study is to find out the main causative microorganism and the antibiotic susceptibility of causative organism in impetigo. METHOD: Bacterial cultures and antimicrobial susceptibility test were done in 55 patients with impetigo. RESULTS: S. aureus was cultured from 49 patients of 55 patients(89.1%), and the remains were coagulase negative Staphylococcus, Streptococcus, Citrobacter braakii and Klebsiella. The resistant rates of S. aureus against antibiotics were as follows ; penicillin: 98.0%, gentamicin: 69.2%, tobramycin: 65.0%, tetracycline: 62.5%, erythromycin: 57.1%, piperacillin: 36.0%, clindamycin: 17.4%, cefazolin: 9.5%, ciprofloxacin: 8.1%, imipenem: 5.0%, oxacillin: 3.9%, trimethoprim-sulfamethoxazole: 3.7%, cefuroxime: 0%, nobobiocin: 0%, teicoplanin: 0%, and vancomycin: 0%. Methicillin-resistant S. aureus(MRSA) and oxacillin-resistant S. aureus(ORSA) were cultured in three of 20 patients(15%) and one of 26 patients(3.9%), respectively. The resistant rates of MRSA or ORSA against other antibiotics were as follows ; cefazolin, ciprofloxacin, erythromycin, and penicillin: 100%, tobramycin: 67%, trimethoprim-sulfamethoxazole: 25%, and teicoplanin, vancomycin, and nobobiocin: 0%. CONCLUSION: S. aureus was the most prominent pathogen in impetigo in this study and sensitive to cefuroxime, nobobiocin, teicoplanin, vancomycin and oxacillin, but not to penicillin, gentamicin, tobramycin, tetracycline and erythromycin. The effective antibiotics in the treatment of MRSA or ORSA were vancomycin, nobobiocin, teicoplanin and trimethoprim-sulfamethoxazole.
Anti-Bacterial Agents ; Cefazolin ; Cefuroxime ; Ciprofloxacin ; Citrobacter ; Clindamycin ; Coagulase ; Erythromycin ; Gentamicins ; Humans ; Imipenem ; Impetigo* ; Klebsiella ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Oxacillin ; Penicillins ; Piperacillin ; Staphylococcus ; Staphylococcus aureus ; Streptococcus ; Teicoplanin ; Tetracycline ; Tobramycin ; Trimethoprim, Sulfamethoxazole Drug Combination ; Vancomycin

BACKGROUND: Impetigo is mostly caused by either Staphylococcus aureus(S. aureus) or group A beta-hemolytic Streptococcus(Streptococcus pyogenes). As the relative preponderance of each microorganism varies greatly, so reports have been contradictory. Recently, S. aureus has been reported as the principal causative microorganism of impetigo and shown variable degrees of antimicrobial resistance. OBJECTIVE: The purpose of this study is to find out the main causative microorganism and the antibiotic susceptibility of causative organism in impetigo. METHOD: Bacterial cultures and antimicrobial susceptibility test were done in 55 patients with impetigo. RESULTS: S. aureus was cultured from 49 patients of 55 patients(89.1%), and the remains were coagulase negative Staphylococcus, Streptococcus, Citrobacter braakii and Klebsiella. The resistant rates of S. aureus against antibiotics were as follows ; penicillin: 98.0%, gentamicin: 69.2%, tobramycin: 65.0%, tetracycline: 62.5%, erythromycin: 57.1%, piperacillin: 36.0%, clindamycin: 17.4%, cefazolin: 9.5%, ciprofloxacin: 8.1%, imipenem: 5.0%, oxacillin: 3.9%, trimethoprim-sulfamethoxazole: 3.7%, cefuroxime: 0%, nobobiocin: 0%, teicoplanin: 0%, and vancomycin: 0%. Methicillin-resistant S. aureus(MRSA) and oxacillin-resistant S. aureus(ORSA) were cultured in three of 20 patients(15%) and one of 26 patients(3.9%), respectively. The resistant rates of MRSA or ORSA against other antibiotics were as follows ; cefazolin, ciprofloxacin, erythromycin, and penicillin: 100%, tobramycin: 67%, trimethoprim-sulfamethoxazole: 25%, and teicoplanin, vancomycin, and nobobiocin: 0%. CONCLUSION: S. aureus was the most prominent pathogen in impetigo in this study and sensitive to cefuroxime, nobobiocin, teicoplanin, vancomycin and oxacillin, but not to penicillin, gentamicin, tobramycin, tetracycline and erythromycin. The effective antibiotics in the treatment of MRSA or ORSA were vancomycin, nobobiocin, teicoplanin and trimethoprim-sulfamethoxazole.
Anti-Bacterial Agents ; Cefazolin ; Cefuroxime ; Ciprofloxacin ; Citrobacter ; Clindamycin ; Coagulase ; Erythromycin ; Gentamicins ; Humans ; Imipenem ; Impetigo* ; Klebsiella ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Oxacillin ; Penicillins ; Piperacillin ; Staphylococcus ; Staphylococcus aureus ; Streptococcus ; Teicoplanin ; Tetracycline ; Tobramycin ; Trimethoprim, Sulfamethoxazole Drug Combination ; Vancomycin

The global emergence and spread of multidrug resistant bacterial infections in communities and hospitals has become an important issue in public health. The resistance rate of gram-positive cocci to vancomycin and the resistance rate of several gram-negative bacilli against cefotaxime and carbapenem have been continuously increasing. Surveillance of antimicrobial resistance is essential for providing information on the magnitude of and trend in multidrug resistance. Therefore, beginning 2011, more robust and effective management is to be legally required for six multidrug-resistant bacteria that have been linked to healthcare-related infections: vancomycin-resistant Staphylococcus aureus (VRSA), vancomycin-resistant enterococci (VRE), methicillin-resistant S. aureus (MRSA), multidrug-resistant Pseudomonas aeruginosa (MRPA), multidrug-resistant Acinetobacter baumannii (MRAB), and carbapenem-resistant Enterobactericeae (CRE). We have also performed laboratory-based sentinel surveillance for VRSA/VISA since 2002 and carbapenemase-producing Enterobacteriaceae since November, 2010. This article reviews the national surveillance programs, and molecular epidemiology of multidrug-resistant bacteria.
Acinetobacter baumannii ; Bacteria ; Bacterial Infections ; Cefotaxime ; Drug Resistance, Multiple ; Enterobacteriaceae ; Gram-Positive Cocci ; Methicillin Resistance ; Molecular Epidemiology ; Nitriles ; Pseudomonas aeruginosa ; Public Health ; Pyrethrins ; Sentinel Surveillance ; Staphylococcus aureus ; Vancomycin

The present study was done to scrutinize the possible relation between infective genes and antimicrobial resistance in Enterococcus faecalis and Enterococcus faecium. Considering the fact that the presence of recognized infective determinants among clinical isolates may promote the emergence of infections and persistence of Enterococci in hospital settings, which can lead to an increase in antimicrobial resistance. 175 E. faecalis and 67 E. faecium isolated from clinical specimens were used. The isolates were identified, and then antibiotic susceptibility testing was performed. The MIC of vancomycin and teicoplanin were determined by broth microdilution method. The presence of infective genes esp, hyl and asa₁ was scrutinized using PCR. Of the 280 enterococcal isolates, 175 (62.5%) isolates were identified as E. faecalis, 67 (24%) as E. faecium and 38 (13.5%) as Enterococcus spp. The results of the antibiotic susceptibility testing showed resistance rates of 5% and 73% to vancomycin and teicoplanin in E. faecalis and E. faecium isolates, respectively. The statistical analysis showed that the esp infective gene has significant associations with ciprofloxacin, erythromycin and tetracycline in E. faecium and with chloramphenicol in E. faecalis strains; the hyl with teicoplanin and vancomycin in E. faecium strains; and also asa₁ with vancomycin in E. faecium and with ampicillin and chloramphenicol in E. faecalis strains. Regarding the relationships between virulence genes and antibiotic resistance in strains of E. faecalis and E. faecium, detection of infective factors associated with invasive diseases has become a major issue of concern.
Ampicillin ; Anti-Bacterial Agents ; Chloramphenicol ; Ciprofloxacin ; Drug Resistance, Microbial ; Enterococcus ; Enterococcus faecalis ; Enterococcus faecium ; Erythromycin ; Iran ; Methods ; Polymerase Chain Reaction ; Teicoplanin ; Tetracycline ; Vancomycin ; Virulence

Recent reports have described an increasing incidence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in patients who do not exhibit established risk factors for healthcare exposure. We report two cases of CA-MRSA bacteremia complicated by vertebral osteomyelitis. Both of CA-MRSA isolates were resistant to beta-lactam agents, but susceptible to clindamycin, trimethoprim-sulfamethoxazole, gentamicin, ciprofloxacin, and tetracycline. Both isolates carried staphylococcal cassette chromosome mec (SCCmec) type IVA, and were identified as sequence type (ST) 72 by mlultilocus sequence typing (MLST). However, the Panton-Valentine leukocidin (PVL) gene was not identified.
Bacteremia ; Bacterial Toxins ; Ciprofloxacin ; Clindamycin ; Delivery of Health Care ; Exotoxins ; Gentamicins ; Humans ; Incidence ; Leukocidins ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Osteomyelitis ; Risk Factors ; Tetracycline ; Trimethoprim, Sulfamethoxazole Drug Combination

Recent reports have described an increasing incidence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in patients who do not exhibit established risk factors for healthcare exposure. We report two cases of CA-MRSA bacteremia complicated by vertebral osteomyelitis. Both of CA-MRSA isolates were resistant to beta-lactam agents, but susceptible to clindamycin, trimethoprim-sulfamethoxazole, gentamicin, ciprofloxacin, and tetracycline. Both isolates carried staphylococcal cassette chromosome mec (SCCmec) type IVA, and were identified as sequence type (ST) 72 by mlultilocus sequence typing (MLST). However, the Panton-Valentine leukocidin (PVL) gene was not identified.
Bacteremia ; Bacterial Toxins ; Ciprofloxacin ; Clindamycin ; Delivery of Health Care ; Exotoxins ; Gentamicins ; Humans ; Incidence ; Leukocidins ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Osteomyelitis ; Risk Factors ; Tetracycline ; Trimethoprim, Sulfamethoxazole Drug Combination

BACKGROUND: Impetigo is a common bacterial infection caused by Staphylococcus aureus, and group A beta-hemolytic Streptococcus or both. Recently, S. aureus has been reported as the most frequently isolated pathogen of impetigo and the incidence of methicillin-resistant S. aureus (MRSA) among patients with impetigo has increased. OBJECTIVE: To investigate the predominant microorganism and the antibiotic susceptibility of the impetigo causative pathogen. METHODS: Bacterial culture and antimicrobial susceptibility testing were performed in patients with impetigo from June 2006 to May 2012. RESULTS: Of 164 patients, bacteria were cultured from 139 patients. Among them, S. aureus was isolated from 114 (82%) patients. The others were Acinetobacter baumannii, Enterobactercloacae, Enterococcus species, Enterococcus faecium, Enterococcus faecalis, Klebsiella oxytoca, and Candida albicans. The resistance rates of S. aureus against antibiotics were as follows: penicillin, 95.6%; erythromycin, 43.9%; fusidicacid, 38.1%; clindamycin, 24.5%; gentamycin, 21%; tetracycline, 12.3%; trimethoprim-sulfamethoxazole, 0.9%; ciprofloxacin, 0%; habekacin, 0%; linezolid, 0%; teicoplanin, 0%; and vancomycin, 0%. Thirty-four (29.8%) S. aureus isolates were MRSA, and the prevalence of MRSA increased during the 6-year period. CONCLUSION: The most predominant pathogen in impetigo was S. aureus, which was sensitive to ciprofloxacin, habekacin, linezolid, trimethoprim-sulfamethoxazole, teicoplanin, and vancomycin. An increase in the prevalence of MRSA was observed during the 6-year period, and the effective antibiotics for MRSA were trimethoprim-sulfamethoxazole, teicoplanin and vancomycin.
Acetamides ; Acinetobacter baumannii ; Anti-Bacterial Agents ; Bacteria ; Bacterial Infections ; Candida albicans ; Ciprofloxacin ; Clindamycin ; Dibekacin ; Enterococcus ; Enterococcus faecalis ; Enterococcus faecium ; Erythromycin ; Gentamicins ; Humans ; Impetigo ; Incidence ; Klebsiella oxytoca ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Oxazolidinones ; Penicillins ; Prevalence ; Staphylococcus aureus ; Streptococcus ; Teicoplanin ; Tetracycline ; Trimethoprim, Sulfamethoxazole Drug Combination ; Vancomycin ; Linezolid