Objective: To investigate the clinical characteristics, serogroups and antimicrobial resistance of invasive non-typhoid Salmonella infection in children at Xiamen. Methods: Retrospective cohort study. The clinical manifestations, treatment, prognosis, serogroups and antimicrobial resistance of 29 hospitalized children with invasive non-typhoid Salmonella infection confirmed by blood, cerebrospinal fluid, bone marrow and other sterile body fluids or deep pus culture at the Department of Infectious Diseases, the Department of Orthopedics and the Department of General Surgery in Xiamen Children's Hospital from January 2016 to December 2021 were analyzed. According to the clinical diagnosis criteria, the patients were divided into sepsis group and non-sepsis group (bacteremia and local suppurative infection). The inflammatory markers, serogroups distribution and drug resistance were compared between the two groups. Comparison between groups using Mann-Whitney U test and χ² test. Results: Among the 29 cases, there were 17 males and 12 females, with an onset age of 14 (9, 25) months, and 10 cases (34%) of patients were younger than 1 year old, 15 cases (52%) under 1 to 3 years old, and 4 cases (14%) greater than or equal 3 years old. The onset time of 25 cases (86%) was from April to September. The diseases included 19 cases (66%) septicemia (2 of which were combined with suppurative meningitis), 10 cases (34%) non-sepsis group, including 7 cases bacteremia and 3 cases local suppurative infection (2 cases of osteomyelitis, 1 case of appendicitis with peritonitis). The clinical manifestations were fever in 29 cases (100%), diarrhea and abdominal pain in 18 cases (62%), cough and runny nose in 10 cases (34%). Eighteen cases (62%) were cured and 11 cases (38%) were improved by effective antibiotics treatment. C-reactive protein in sepsis group was significantly higher than that in non-sepsis group (25.2 (16.1, 56.4) vs. 3.4 (0.5, 7.5) mg/L, Z=-3.81, P<0.001).The serogroups of C, B and E were the most prevalent among non-typhoid Salmonella isolates, accounting for 10 cases (34%), 9 cases (31%) and 7 cases (24%) respectively. Antibacterial drug sensitivity test showed that the sensitivity rates of imipenem, ertapenem and piperaciratazobactam were all 100% (31/31), those of ceftazidime, ceftriaxone, and cefepime were 94% (29/31), 94% (29/31) and 97% (30/31) respectively. The drug resistance rates of ampicillin, ampicillin-sulbactam and trimethoprim-sulfamethoxazole were 51% (16/31), 48% (15/31) and 48% (15/31) respectively, those of cefazolin, cefotetan, tobramycin, gentamicin and amikacinwere all 100% (31/31). There were no significant differences in the drug resistance rates of ceftazidime, ceftriaxone, aztreonam, ampicillin-sulbactam, ampicillin, trimethoprim-sulfamethoxazole and ciprofloxacin between the sepsis group and the non-sepsis group (χ²=0.31,0.31,0.00,0.02,0.02,0.02,0.26, all P>0.05). Conclusions: Invasive non-typhoid Salmonella infection in children at Xiamen mainly occurred in infants younger than 3 years old.The main clinical manifestations are fever, abdominal pain and diarrhea. C-reactive protein can be served as the laboratory indicators for indicating sepsis. The third generation of cephalosporins is recommended as the first choice for treatment.
Infant ; Male ; Female ; Child ; Humans ; Child, Preschool ; Anti-Bacterial Agents/therapeutic use* ; Ceftriaxone/therapeutic use* ; Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use* ; Ceftazidime/therapeutic use* ; Retrospective Studies ; C-Reactive Protein ; Drug Resistance, Bacterial ; Salmonella Infections/microbiology* ; Ampicillin/therapeutic use* ; Salmonella ; Diarrhea/drug therapy* ; Bacteremia ; Abdominal Pain ; Microbial Sensitivity Tests

OBJECTIVE: To analyze the distribution and drug resistance of pathogens in oral mucositis associated with chemotherapy in hospitalized patients with malignant hematopathy, so as to provide scientific evidences for rational selection of antibiotics and infection prevention and control. METHODS: From July 2020 to June 2022, 167 patients with malignant hematopathy were treated with chemical drugs in the Department of Hematology, Hainan Hospital, and secretions from oral mucosal infected wounds were collected. VITEK2 COMPECT automatic microbial identification system (BioMerieux, France) and bacterial susceptibility card (BioMerieux) were used for bacterial identification and drug susceptibility tests. RESULTS: A total of 352 strains of pathogens were isolated from 167 patients, among which 220 strains of Gram-positive bacteria, 118 strains of Gram-negative bacteria and 14 strains of fungi, accounted for 62.50%, 33.52% and 3.98%, respectively. The Gram-positive bacteria was mainly Staphylococcus and Streptococcus, while Gram-negative bacteria was mainly Klebsiella and Proteus. The resistance of main Gram-positive bacteria to vancomycin, ciprofloxacin and gentamicin was low, and the resistance to penicillin, cefuroxime, ampicillin, cefotaxime, erythromycin and levofloxacin was high. The main Gram-negative bacteria had low resistance to gentamicin, imipenem and penicillin, but high resistance to levofloxacin, cefotaxime, cefuroxime, ampicillin and vancomycin. The clinical data of oral mucositis patients with oral ulcer (severe) and without oral ulcer (mild) were compared, and it was found that there were statistically significant differences in poor oral hygiene, diabetes, sleep duration less than 8 hours per night between two groups (P<0.05). CONCLUSION Gram-positive bacteria is the main pathogen of oral mucositis in patients with malignant hematopathy after chemotherapy. It is sensitive to glycopeptide antibiotics and aminoglycosides antibiotics. Poor oral hygiene, diabetes and sleep duration less than 8 hours per night are risk factors for oral mucositis with oral ulcer (severe).
Humans ; Vancomycin/therapeutic use* ; Cefuroxime ; Levofloxacin ; Oral Ulcer/drug therapy* ; Drug Resistance, Bacterial ; Anti-Bacterial Agents/adverse effects* ; Ampicillin ; Penicillins ; Cefotaxime ; Gram-Positive Bacteria ; Gram-Negative Bacteria ; Gentamicins ; Stomatitis/drug therapy*

Objective: To investigate the epidemiological characteristics of Yersinia enterocolitica in patients with diarrhea in Pudong New Area, Shanghai. Methods: Active surveillance of diarrhea was conducted in 14 sentinel hospitals (three tertiary-level hospitals, nine secondary-level hospitals, and two primary-level hospitals) from January 2013 to December 2019 in Pudong New Area of Shanghai, China base on their location, catchment area, and patient volume. Cold enrichment method was used to isolate Y. enterocolitica and further detection of bioserotype, virulence genes and antimicrobial susceptibility of the isolates were conducted. The difference of rates was determined using chi-square test or Fisher's exact test. Results: A total of 12 941 diarrhea cases were included, and 0.7% (88/12 941) cases were confirmed with Yersinia enterocolitica infection. 67.0% (59/88) cases were single infection, 33.0% (29/88) cases were mixed infections. Detection rates of Y. enterocolitica increased annually (0.3%-1.2%) and were highest in children<5 years of age (1.1%, 37/3 218) and in spring (1.1%, 32/2 998) (χ² were 18.64 and 9.76, respectively, P<0.05). 58.0% (51/88) cases had watery diarrhea, 15.9% (14/88) had fever and 14.8% (13/88) had vomiting. The predominant bioserotypes were 3/O:3 (53.4%, 47/88), followed by 1A/O:8 (15.9%, 14/88) and 1A/O:5(6.8%, 6/88), respectively. Bioserotype 3/O:3 counted for the highest proportions (89.2%, 33/37) in children <5 years of age. All the strains of bioserotype 3/O:3 harbored ail, ystA, yadA and virF genes, which encoded pathogenic Y. enterocolitica. 11/14 strain of 1A/O:8 and 4/6 strains of 1A/O:5 harbored ystB gene. Most strains were resistant to ampicillin (80.7%,71/88) and amoxicillin/clavulanic acid (71.6%,63/88), and 63.8% (56/88) strains were multidrug resistance (MDR). The difference of antimicrobial resistance rates between 3/O:3 and non 3/O:3 was statistically significant in ampicillin, cefoxitin, nalidixic acid, tetracycline and ampicillin/sulbactam (χ² was 14.68, 43.80, 41.86, 30.54 and 5.07, respectively, P<0.05). Conclusion: The detection rate of Yersinia enterocolitica was higher in children than in adults in Pudong New Area , Shanghai. The predominant bioserotype was pathogenic 3/O:3 with multidrug resistance.
Ampicillin ; Anti-Bacterial Agents/pharmacology* ; Child ; China/epidemiology* ; Diarrhea/epidemiology* ; Humans ; Yersinia enterocolitica

BACKGROUND: Antimicrobial resistant continues to pose a threat to public health. Therefore, rapid and accurate antimicrobial susceptibility testing is very important. The objectives of this study were to evaluate the performance of the MicroScan system (Beckman Coulter, USA) with newly developed Korean Antimicrobial Susceptibility Testing Panels (KSCM panels) for antimicrobial susceptibility testing (AST) against clinical isolates in South Korea. METHODS: Three KSCM panels were designed in this study. For the performance evaluation, a total of 1,325 clinical isolates including 1,027 of Gram-negative bacilli and 298 Gram-positive cocci collected from eight general hospitals in South Korea were used. The results by KSCM panels were compared with those by conventional methods. RESULTS: By KSCM-1 panel for Gram-positive cocci, the rates of categorical agreement (CA) were >90% in all the antimicrobials tested in this study. The rates of major error (ME) were also <3%, and only three very major error (VME) were identified; each of ampicillin, tetracycline, and quinupristin-dalfopristin in enterococcal isolates. By KSCM-2 panel for Enterobacteriaceae, the rates of CA were also above 90%, and those of ME and VME were less than 3% and 1.5%, respectively. KSCM-3 panels for glucose- non-fermenting Gram-negative bacilli, also showed good agreement rates, i.e., CA rates >90%, ME rates <3%, and VME rates <1.5%. CONCLUSION: The newly developed three KSCM panels for MicroScan system (Beckman Coulter) showed excellent performance in AST against a large number of clinical isolates, and they are applicable to clinical microbiology laboratories.
Ampicillin ; Enterobacteriaceae ; Gram-Positive Cocci ; Hospitals, General ; Hospitals, Teaching ; Korea ; Public Health ; Tetracycline

BACKGROUND: Salmonella is an important pathogen that causes gastroenteritis and sepsis in humans. Recently, changes in serotype prevalence and an increase in antimicrobial resistance have been reported. This study investigated the distribution of Salmonella serotypes and determined the antimicrobial susceptibility of various strains. METHODS: We collected 113 Salmonella isolates other than Salmonella serotype Typhi from 18 university hospitals in 2015. The serotypes were identified by Salmonella antisera O and H according to the Kauffman White scheme. Antimicrobial susceptibility tests for 12 antibiotics were performed using the disk diffusion method or E-test. RESULTS: We identified 22 serotypes. Serotype group B (44.2%) was the most common, followed by groups C (34.5%) and D (21.2%). Salmonella I 4,[5],12:i:- (23.0%), S. Enteritidis (16.8%), and S. Typhimurium (12.4%) were the most common species. Resistance rates for ampicillin, chloramphenicol, ceftriaxone, and trimethoprim/sulfamethoxazole were 46.9%, 18.5%, 8.8%, and 5.3%, respectively. The intermediate resistance rate to ciprofloxacin was 29.2%. Six isolates were extended-spectrum β-lactamase (ESBL) producers, including 5 bla(CTX-M-15) and 1 bla(CTX-M-55). CONCLUSION: There have been changes in the serotype prevalence and antimicrobial resistance of Salmonella in Korea, with a high prevalence of CTX-M 15-positive strains. Continuous monitoring of Salmonella serotypes and antimicrobial resistance is warranted.
Ampicillin ; Anti-Bacterial Agents ; Ceftriaxone ; Chloramphenicol ; Ciprofloxacin ; Diffusion ; Gastroenteritis ; Hospitals, University ; Humans ; Immune Sera ; Korea ; Methods ; Prevalence ; Salmonella ; Sepsis ; Serogroup ; Serotyping

ampicillin were 61.0%, amoxicillin/clavulanate, 63.6%; ciprofloxacin, 49.7%; imipenem, 65.2%; and vancomycin, 78.2%. The susceptibility rates of Pseudomonas aeruginosa and Acinetobacter spp. to imipenem were 77.4% and 36.7%, respectively.CONCLUSION: Enterococcus spp. with susceptibility to limited antibiotics was one of the main pathogens in Korean IAIs, along with E. coli and Klebsiella spp., which were highly susceptible to imipenem, amikacin, and piperacillin/tazobactam. Meanwhile, the low susceptibilities of E. coli or Klebsiella spp. to amoxicillin/clavulanate, advanced-generation cephalosporins, and ciprofloxacin should be considered when determining empirical antibiotic therapy in clinical practice.]]>
Acinetobacter ; Amikacin ; Ampicillin ; Anti-Bacterial Agents ; Cefotaxime ; Ceftazidime ; Cephalosporins ; Ciprofloxacin ; Cross Infection ; Enterococcus ; Epidemiology ; Escherichia coli ; Humans ; Imipenem ; Intraabdominal Infections ; Klebsiella ; Korea ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Pseudomonas aeruginosa ; Retrospective Studies ; Vancomycin

Lauraceae is a family medicinal plant whose tubers possesses antimicrobial, and cytotoxic, such as antiparasitic and anti-inflammatory special effects and has been used for the medicine in the cure of hepatitis and rheumatism. The antimicrobial activities of bioactive compounds including one neolignan; kunstlerone (1) and two alkaloids include isocaryachine (2) and noratherosperminine (3) as well as crude hexane, methanol and dichloromethane extracts were evaluated. Additionally, the effect of compounds 1, 2 and 3 were evaluated on A549, PC-3, A375, HT-29 and WRL-68 cell lines. In conclusion, kunstlerone 1 showed moderate cytotoxicity against various cancer cell lines such as A549, PC-3, A375, HT-29 and WRL-68, respectively with EC₅₀ values of 28.02, 26.78, 33.78, 33.65 and 16.46 µg/mL. The crude methanol extract showed antigrowth activity against S. pyogenes II and B. cereus, with MICs of 256 µg/mL. The compounds kunstlerone (1), isocaryachine (2) and noratherosperminine (3) showed complete inhibition against P. shigelloides, with MIC ≤60 µg/mL compare to ampicillin, as a positive control, which showed antigrowth activity against P. shigelloides at MIC 10 µg/mL.
Alkaloids ; Ampicillin ; Cell Line ; Hepatitis ; Humans ; Lauraceae ; Methanol ; Methylene Chloride ; Plants, Medicinal ; Plesiomonas ; Rheumatic Diseases

Infective endocarditis caused by Abiotrophia defectiva is rarely encountered. A 67-year-old male transferred from a local hospital presented with severe dyspnea and pulmonary edema. Preoperative transthoracic echocardiography revealed severe mitral regurgitation with large vegetation. Blood cultures grew A. defectiva, a gram positive, nutritionally deficient streptococcus variant. Emergent mitral valve replacement through right thoracotomy was performed, and after completing six weeks of antibiotic combination therapy (vancomycin, ampicillin, and gentamicin), the patient recovered fully. Because of the need for prompt surgical treatment and long-term antibiotic therapy and lack of laboratory experience with the organism, physicians and laboratory workers should pay close attention to the possibility of A. defectiva infective endocarditis when gram positive cocci are detected in blood cultures.
Abiotrophia ; Adult ; Aged ; Ampicillin ; Dyspnea ; Echocardiography ; Endocarditis ; Endocarditis, Bacterial ; Gram-Positive Cocci ; Humans ; Male ; Mitral Valve ; Mitral Valve Insufficiency ; Pulmonary Edema ; Streptococcus ; Thoracotomy

PURPOSE: We aimed to determine characteristics of host, causative organisms, and antibiotic susceptibility of bacteria in pediatric patients with UTI living in metropolitan area of Korea. METHODS: Retrospective investigation was done for the causative organisms of UTI in 683 pediatric cases treated at Ajou University Hospital from 2012 to 2017. Patients were classified into Escherichia coli and non-E.coli group, where E.coli group was subdivided into ESBL(+) and ESBL(−) groups based on whether the bacteria could produce extended spectrum beta-lactamase (ESBL). Antibiotic susceptibility of the causative organism was also determined. RESULTS: A total of 683 UTIs occurred in 550 patients, of which 463 (67.8%) were first-time infection and 87 (32.2%) were recurrent ones (2–7 recurrences, 2.52 average), and 64.9% were male and 35.1% were female. The most common causative organism was E.coli (77.2%) and ESBL(+) E.coli was found in 126 cases. The susceptibility of E.coli to 3rd or 4th generation cephalosporin was relatively higher than that to ampicillin or amoxicillin/clavulanic acid. ESBL(+) E.coli showed higher resistance rate to 3rd or 4th generation cephalosporin than ESBL(−) E.coli . CONCLUSION: New treatment guideline should be considered due to the incidence of ESBL(+) E.coli increased up to one quarter of UTI cases.
Ampicillin ; Bacteria ; beta-Lactamases ; Child ; Drug Resistance, Microbial ; Epidemiologic Studies ; Escherichia coli ; Female ; Humans ; Incidence ; Korea ; Male ; Recurrence ; Retrospective Studies ; Urinary Tract Infections ; Urinary Tract

PURPOSE: We studied the pathogens and trends in antibiotic sensitivity pattern in children with urinary tract infection (UTI) over 8 years in order to evaluate adequate treatment. METHODS: We performed a retrospective review of medical records of children with UTI from January 2009 to December 2016 in Daegu Fatima Hospital. Uropathogens and antibiotic sensitivity patterns were selected. Only 1 bacterial species with a colony count of ≥105 CFU/mL was considered a positive result. We compared 2 periods group (A: 2009~2012, B: 2013~2016) to investigate trends of antibiotic sensitivity pattern. RESULTS: During the 8 year period, 589 cases are identified (E. coli was cultured in 509 cases, 86.4%). Among all patients, this study investigated the antibiotic sensitivity of E. coli . Antimicrobial susceptibility to ampicillin was steadily low for both periods (A: 32.6%, B: 40.1%, P=0.125), and to amikacin was consistently high for both periods (A: 99.4%, B: 99.3%, P=1.000). Antibiotic sensitivity to third-generation cephalosporin decreased from period A to B (A: 91.7%, B: 75.5%, P=0.000). Antibiotic sensitivity to quinolone significantly decreased from A to B (A: 88.4%, B: 78.2%, P=0.003). The prevalence of extended-spectrum β-lactamase-producing E. coli increased from period A to B (A: 6.1%, B: 17.1%, P=0.000). CONCLUSION: This study showed that conventional antibiotic therapy for the treatment of pediatric UTI needs to be reevaluated. A careful choice of antibiotic is required due to the change in antibiotic sensitivity and the emergence of antibiotic-resistant bacteria.
Amikacin ; Ampicillin ; Bacteria ; Child ; Daegu ; Humans ; Medical Records ; Prevalence ; Retrospective Studies ; Urinary Tract Infections ; Urinary Tract