- Dettagli della rivista
- Pubblicato per la prima volta
- 08 Aug 2013
- Periodo di pubblicazione
- 4 volte all'anno
- Accesso libero
Pagine: 317 - 326
Aim: The aim of the present study was to determine the frequency of shiga-like toxin (stx1 and stx2) and drug resistance profiles food-borne Escherichia coli O157:H7 in Hatay province, Turkey. Methods: The presence of the virulence genes (stx1, stx2, hlyA) in a total of 150 E.coli isolates were studied with multiplex PCR. Results: A total of 327 salad samples were analyzed. E. coli O157:H7 was detected in 150 (45.8 %) out of 327 analyzed samples. Of these 150 isolates, the presence of hly-A gene was detected in 32 (21.3%) E.coli isolates. A total of five (15.6%) isolates in this 32 hlyA positive isolates had stx2 gene, two (6.3%) of them had stx1 gene and one (3.1%) of the isolates was found to be positive for both stx1 and stx2 genes. It was found that all E.coli O157:H7 isolates were resistant to erythromycin. While the highest rate of antibiotic resistance was observed for ampicillin (68.8%), no antibiotic resistance against cefuroxime, ciprofloxacin and cephaperasone was identified. Conclusions: The results obtained in our province showed that E.coli strains isolated from salad samples were found to have some important virulence genes such as stx1, stx2, and hlyA. The stx2 frequency was found to be higher than stx1 frequency. Also, it was observed that there was not any significant correlation between drug resistance profiles and presence of toxin genes in E.coli O157:H7 strains. As a result, increasing frequency of STEC O157 serotype among foodborne pathogens is a growing public health problem.
- E.coli O157:H7
- Accesso libero
Comparison of virulence factors and antibiotic resistance of Pseudomonas aeruginosa strains isolated from patients with and without cystic fibrosis
Pagine: 327 - 334
Its rising incidence, virulence factors and antibiotic resistance rate makes it difficult to treat Pseudomonas aeruginosa infections. The aim of this study was to compare virulence factors and antibiotic resistance of P. aeruginosa isolates from cystic fibrosis (CF) and other lower respiratory tract infections. Isolates from patients (n=125) were divided into two groups. The isolates in the first group were from CF patients (n=64). And in the other group isolates were from lower respiratory tract samples, from patients that did not have CF (n=61). The antibiotic susceptibility tests were done by using disc diffusion method. As phenotypic tests; DNase, protease, elastase, hemolysis, and motility test were performed. The mucoid form of P. aeruginosa was detected in 29.7% of CF patients’ isolates, whereas in the other group (non-CF) this rate was 9.8% (p=0.011). Motility in the CF patients’ isolates was lower (84.4%) then the other group (96.7%). The presence of DNase was significantly low in CF patients’ isolates when compared to the other group (p=0.009). When the antibiotic resistance was compared; ceftazidime, imipenem and meropenem and piperacillin resistance was found significantly low in CF patients compared to isolates from the other group (p≤0.05). Information about virulence factor patterns and antibiotic resistance of P. aeruginosa isolates from patients with cystic fibrosis and the patients without cystic fibrosis can prevent the unnecessary usage of antibiotics and lead the way to new approaches in treatment.
- Antibiotic susceptibility
- Cystic fibrosis
- Pseudomonas aeruginosa
- Accesso libero
Pagine: 335 - 343
Alcohol based solutions are among the most convenient and wide spread aid in the prevention of nosocomial infections. The current study followed the efficacy of several types and isomers of alcohols on different bacterial species. Seven alcohols (ethyl, n-propyl, iso-propyl, n-butyl, iso-butyl, tert-butyl alcohol, and ethylene glycol) were used to evaluate their minimal inhibitory and bactericidal effects by microdilution method on bacteria that express many phenotypical characteristics: different cell-wall structure (Gram positive/negative bacteria), capsule production (Klebsiella pneumoniae), antibiotic resistance (MRSA vs MSSA) or high environmental adaptability (Pseudomonas aeruginosa). Results: The best inhibitory effect was noticed for n-propyl, followed by iso-propyl, n-butyl, and iso-butyl alcohols with equal values. Ethylene glycol was the most inefficient alcohol on all bacteria. In K. pneumoniae and P. aeruginosa, the bactericidal concentrations were higher than the inhibitory one, and to a level similar to that encountered for most of the Gram-positive bacteria. Among Gram-positive cocci, E. faecalis presented the lowest susceptibility to alcohols. Conclusions: All alcohols presented good effect on bacteria, even in low concentrations. Compared to ethanol as standard, there are better alternatives that can be used as antimicrobials, namely longer-chain alcohols such as propyl or butyric alcohols and their iso- isomers. Ethylene glycol should be avoided, due to its toxicity hazard and low antimicrobial efficacy. Bacterial phenotype (highly adaptable bacteria, biofilm formation) and structure (cell wall structure, presence of capsule) may drastically affect the responsiveness to the antimicrobial activity of alcohols, leading to higher bactericidal than inhibitory concentrations.
- antimicrobial activity
- bacterial resistance
- disinfectant and antiseptic
- Accesso libero
Epidemiological data and antifungal susceptibility in invasive fungal infections - a Romanian infectious diseases tertiary hospital’s experience. Preliminary report
Pagine: 345 - 353
Introduction: Invasive fungal infections have stood as an important research subject for the past 20 years, being considered as a crucial effect of advancing healthcare services. Low identification rates of invasive fungal infections in blood cultures and low sensibility of biomarkers determine empiric treatments which lead to a change in epidemiological data and antifungal susceptibility. The aim: The epidemiological evaluation of invasive fungal infections and the assessment of antifungal resistance related to this condition. Methods and material: An “antifungal stewardship” retrospective study was developed between January 2010 and April 2016. An epidemiological analysis was performed on 79 cases with proven invasive fungal infections in bloodstream, catheter, and cerebrospinal fluid. We considered: age, gender, HIV status, place of residence, and first option in medical practice of antifungal treatment. The laboratory analysis was performed by the Microbiology Laboratory at “Prof. Dr. Matei Bals” National Institute for Infectious Diseases, Bucharest. Minimum inhibitory concentrations (MIC’s) of 15 isolates were identified using colorimetric micro broth dilution panel YEASTONE ®YO10 and compared with susceptibilities obtained by VITEK2®C system. Candida parapsilosis ATCC 22019 was used as reference. Results: The incidence of invasive fungal infections was 3.7 on 1000 hospitalized patients. The age of the study population ranged between 12 and 83 years, and most were male (59%). The majority of subjects were from an urban area (84%), and 27% of them were HIV positive. The results obtained in VITEK2C® were similar with those from YEASTONE® YO10 for fluconazole, voriconazole, amphotericin B (100%), without any minor, major or very major errors. The fluconazole was the first option of treatment, followed by voriconazole, caspofungin, anidulafungin. In 37% of cases the first treatment option was replaced with a secondary antifungal therapy accordingly with antifungal breakpoints obtained by Vitek ®. Conclusions: No rates of resistance to fluconazole, amphotericin B, voriconazole were obtained. Fluconazole was the major first line antifungal therapy. Conclusions: No rates of resistance to fluconazole, amphotericin B, voriconazole were obtained. Fluconazole was the major first line antifungal therapy.
- invasive fungal infections
- antifungal stewardship
- Accesso libero
Non-invasive quantification of liver fibrosis regression following successful treatment of chronic hepatitis C with direct acting antivirals
Pagine: 355 - 363
Introduction. The past years have revolutionized the treatment of hepatitis C virus (HCV) infection, with high rates of sustained virologic response (SVR). Furthermore, liver fibrosis has recently been redefined as a dynamic, reversible process. Methods. We performed a prospective cohort study to assess the role of laboratory evaluations and non-invasive measurement of liver stiffness in establishing the right time for starting treatment and in assessing the regression of liver fibrosis in Romanian patients treated with direct acting antivirals (DAA) for genotype 1b chronic hepatitis C. Results. We present the results for 102 patients, with a mean age of 58.5 years, and a rate of SVR of 100%. Our study has ruled out older age (p=0.628), IL28B non-CC genotype (p=0.693), baseline viral load above the cutoff of 600,000 IU/mL (p=0.353), and the presence of diabetes mellitus (p=0.272) or baseline steatosis (p=0.706) as factors potentially influencing the regression of liver fibrosis following DAA treatment of HCV infection with the 3D regimen. The quantitative regression of liver stiffness was inversely correlated with the duration of HCV infection (p=0.017), suggesting that timely treatment might associate better outcomes in terms of liver fibrosis. Conclusion. Our study’s results point towards the need to start DAA treatment earlier in patients with HCV infection.
- liver fibrosis
- prognostic laboratory markers
- Accesso libero
Beta-lactam and quinolone resistance markers in uropathogenic strains isolated from renal transplant recipients
Pagine: 365 - 373
Our objectives were to investigate the extended-spectrum beta-lactamases (ESBLs) and carbapenemases (CR) genetic determinants and to assess the association between ESBL production and quinolone resistance in bacterial strains isolated from renal transplant recipients with urinary tract infections. Material and methods: A number of 30 isolates were recovered from urine specimens of patients with renal transplant from October 2015 to March 2016. The isolates were analyzed for ESBL production using double disc synergy test and for CR production by the Hodge test. Phenotypically confirmed isolates were screened by PCR for the identification of ESBL, CR and fluoroquinolone resistance genes. Results: The 30 clinical bacterial strains isolated from urinary tract infections in renal transplant recipients were identified as Klebsiella pneumoniae (17), Pseudomonas aeruginosa (7), Morganella morganii (2), Escherichia coli (2), Edwardsiella tarda (1) and Enterobacter cloacae (1). Out of them, 22 isolates were ESBL producers and 20 multi-drug resistant (MDR) (i.e., 13 K. pneumoniae and 7 P. aeruginosa strains). More than half of the ESBL clinical strains (14/22, 63.63%) revealed at least one ESBL gene, the most frequent being blaCTX-M type (18/22, 81.81%), either alone (4/22, 18.18%) or in combination with another ESBL gene (17/22, 77.27%), followed by blaTEM (13/22, 59.09%). The blaOXA-48 was present in 10 isolates (33.33%). The most frequent association of ESBLs and CR genes (5/14, 35.71%) was revealed by blaCTX-M- blaTEM - blaOXA-48, encountered particularly among K. pneumoniae isolates (4/17, 23.52%). The qnrB gene was identified in five strains, i.e. one P. aeruginosa ESBL isolate (expressing the blaCTX-M gene) and four K. pneumoniae ESBL isolates (harboring the blaCTX-M - blaTEM genes combination). Conclusions: The uropathogenic strains isolated from renal transplant recipients exhibited high rates of MDR and beta-lactam resistance. The selective pressure exerted by quinolones could enable uropathogenic bacteria to acquire resistance to this class of antibiotics.
- renal transplant recipients
- urinary tract infections ESBL producers
- bla genes
- quinolone resistance
- Accesso libero
Effect of long period treatment with erythropoiesis stimulating agents on clinically and laboratory parameters in hemodialysis autosomal dominant polycystic kidney disease patients
Pagine: 375 - 382
Introduction. The study of dialysis patients not needing erythropoiesis-stimulating agents (ESA) for long periods of time has gained interest lately. The aim of this study was to compare laboratory and clinical parameters in hemodialysis patients with autosomal dominant polycystic kidney disease (ADPKD) treated or not with ESA. Methods. Forty-six hemodialysis ADPKD patients were studied for 8 months and they were divided into: group 1- 29 patients who received ESA during the study period and group 2- 17 patients with no ESA treatment. The following parameters were determined: weekly treatment time, body mass index (BMI), pre-session diastolic blood pressure (DBP), pre-session systolic blood pressure (SBP), blood volume processed (BVD), interdialytic body weight gain (IBWG), spKt/V -K/DOQI formula (Kt/V), urea distribution volume (UDV), hemoglobin (Hb), ferritin, transferrin saturation (TSAT), serum phosphate, total serum calcium, normalized protein catabolic ratio (nPCR), albumin, and intact parathormone (PTH). Results. Patients not requiring ESA were more likely to be men, had higher Hb, albumin, total serum calcium levels, IBWG, UDV, BVP, and weekly treatment time. They had lower ferritin, TSAT, SBP. There was no difference regarding DBP, BMI, serum phosphate, PTH, Kt/V, and nPCR. Conclusion. Hemodialysis ADPKD patients not treated with ESA seem to be better nourished, with a slightly better SBP control, with longer dialysis time and increased Hb (despite lower iron loading markers), compared to hemodialysis ADPKD patients treated with ESA.
- autosomal dominant polycystic kidney disease
- erythropoiesis-stimulating agents
- Accesso libero
Pagine: 383 - 388