Antibiotic sensitivity of nonfermenting gram-negative bacteria

Antibiotic resistance of 132 strains of nonfermenting gram-negative bacteria (NGNB) was studied. 43, 20, 17, 14 and 12 of them belonged to Acinetobacter calcoaceticus (anitratus and lwoffi), Pseudomonas cepacia, Alcaligenes faecalis, P. stutzeri and P. maltophilia, respectively. With rare exceptions all the strains were resistant to benzylpenicillin, oxacillin, lincomycin, ampicillin and cephaloridine. Sensitivity to the other antibiotics varied within wide ranges. Amikacin (94.3 per cent) and tobramycin (90.8 per cent), as well as polymyxin, rifampicin and gentamicin (71.7-66.9 per cent) had the highest effect. The majority of the antibiotics had higher activity (p less than 0.01) against the tested NGNB as compared to their activity against P. aeruginosa. Antibioticograms of every of the tested species of NGNB revealed that P. cepacia and P. stutzeri were the most resistant species. The biovars of Acinetobacter varied in their antibiotic resistance: A. subsp. lwoffi was more sensitive to the majority of the antibiotics though some of them, i.e. doxycycline, carbenicillin, and polymyxin were more active against A. subsp. anitratus.     

Characterization of Nonfermentative Nonfastidious Gram Negative Bacteria encountered in Medical Bacteriology

More than 90 morphological and physiological characters of 546 strains of nonfermentative, nonfastidious, Gram negative bacteria isolated from clinical specimens were examined to determine those features most useful for the identification of these bacteria. The species examined included Moraxella osloensis, Mor. lacunata, Acinetobacter anitratum, Ac. haemolyticus subsp. haemolyticus, Ac. haemolyticus subsp. alcaligenes, Ac. Iwoffi, Alcaligenes faecalis, Alc. odorans var. viridans, Pseudomonas fluorescens, Ps. putida, Ps. pseudomallei, Ps. maltophilia, Ps. stutzeri, Ps. acidovorans, Ps. alcaligenes , and atypical strains of Ps. aeruginosa.     

Concerning the sensitivity of Acinetobacter calcoaceticus

The strains of Acinetobacter calcoaceticus, var. anitratus (A. c. a.) were isolated in the nosocomial environment as an opportune pathogen. The therapy of choice may be determined after in vitro tests. Our results show following therapeutical possibilities: beta-lactam antibiotics--cephalosporins of IIIrd generation (cefotaxime), also combinations of antimicrobials have shown good results: amoxycillin or ticarcillin with clavulanic acid. Best synergistic effect was found in combination ticarcillin-amikacin.     

Sensitivity to antibiotics of bacterial strains isolated from clinical specimens during the years 1985-1986

Sensitivity of 312 strains of staphylococci, 386 strains of streptococci and 1193 strains of aerobic gram-negative bacilli to the selected antibiotics was tested. These strains were isolated from the clinical material at the Clinical Hospital No. 1 in Warsaw within 1985-1986. Staphylococci were sensitive to pristinamycin, cefazolin, fusidic acid, oxacillin, and clindamycin. In 1986, a decrease in the number of strains sensitive to these antibiotics, except cefazolin, was seen. In case of streptococci the most active proved chloramphenicol and gentamicin but a significant decrease in the percentage of sensitive strains was also noted in 1986. The highest number of gram-negative bacilli was sensitive to amikacin, colistin, nalidixic acid, pipemidic acid, and gentamicin. In 1986, a decrease in the percentage of sensitive strains was noted. Amikacin and colistin were the most active against Pseudomonas spp. while amikacin and nalidixic and pipemidic acids--against Proteus spp. Comparison of the results with those obtained in 1981-1984 has shown that the sensitivity of staphylococci changed the most significantly and this change was unfavourable. Gentamicin and amikacin remained the most active against gram-negative bacilli while amikacin and colimycin against Pseudomonas spp. In case of anaerobes the majority of strains was sensitive to chloramphenicol, tetracycline and clindamycin. Metronidazole was active against high percentage of Clostridium spp. and all gram-negative bacilli while the percentage of gram-positive bacilli and cocci was sensitive to metronidazole.     

Presence of various Acinetobacter species in urinary tract infections

Species classification of 39 strains of Acinetobacter isolated from urinary tract infections (UTI) was performed by API 20NE tests. On the whole 24 biotypes were differentiated which formed 4 species and one biotype had no defined species classification. Acinetobacter baumani was most numerously represented. Seventy seven percent of strains were isolated from urine samples from women. About 90% of Acinetobacter strains were isolated as single pathogens. Sensitivity of these strains to 23 antibiotics and chemotherapeutics using ATB-UR and disc diffusion technique was evaluated. Of all cephalosporins tested ceftazidime was the most active. All strains tested were sensitive to imepenem. The high percentage of strains was sensitive to quinolones of IIIrd generation. The high percentage of strains was resistant to nitrofurantoin.     

Inactivation of some third-generation cephalosporins by β-lactamases of non-fermentative Gram-negative bacteria isolated from freshwater of a remote environment

Inactivation of cefotaxime, cefoperazone and ceftazìdime by β-lactamases from strains of Pseudomonas sp. and Acinetobacter calcoaceticus isolated from freshwater of a remote environment is demonstrated. Inactivation rates showed some relation-ship to susceptibility of the strains as a whole, but this relationship was absent for individual strains, probably because of some other resistance mechanisms. Inac-tivation was also observed with low inocula if incubation was prolonged. These β-lactamases seem to be coded by chromosomal genes, since no plasmids were found and they exhibited relatively high isoelectric points.     

In vitro antimicrobial activities of new quinolone antibiotics against Mycoplasma pneumoniae]

The antimicrobial activities against Mycoplasma pneumoniae of new quinolones (temafloxacin, ofloxacin, ciprofloxacin, enoxacin, and norfloxacin) and of tetracyclines and macrolides as controls were compared. Among new quinolones, temafloxacin, ofloxacin, and ciprofloxacin were more active than enoxacin and norfloxacin against fifty strains of Mycoplasma pneumoniae, giving MIC50 and MIC90 significantly lower than those of the latter two, by the agar-dilution method. The three more active antibiotics in the above assay were then determined for MICs and MBCs by the broth-dilution method. The MICs of every antibiotic except erythromycin determined by both the methods were very similar each other. The MICs of erythromycin determined by the broth-dilution method were ten-times higher than those determined by the agar-dilution method. Temafloxacin and ofloxacin gave MBCs only about four-times higher than MICs, whereas ciprofloxacin, minocycline, erythromycin and josamycin gave MBCs as much as 15 to 1,000-times higher than MICs. From the MICs and MBCs determined by the two assay methods, it is apparent that temafloxacin and ofloxacin, and to a less extent ciprofloxacin, have more potent mycoplasmacidal activities than do macrolides and tetracyclines.     

In Vitro Susceptibility of Brucella to Various Antibiotics

A series of 27 strains of six species of Brucella was tested for susceptibility in vitro to a representative cross section of antibiotics in current use. The activity against each species was plotted, with the cumulative per cent of strains inhibited indicated for each concentration. As a class, the tetracycline antibiotics were the most effective. Erythromycin, gentamicin, streptomycin, and kanamycin, as well as rifampin, were quite active. The penicillin-cephalosporin group, with the exception of ampicillin, was comparatively ineffective, as were the polypeptides and the miscellaneous group of chloramphenicol, lincomycin, cycloserine, and sulfadiazine. Species differences were noticeable, with some strains of B. canis being considerably more resistant to streptomycin and the tetracyclines than B. suis and B. abortus. B. melitensis, B. ovis, and B. neotomae were intermediate in antibiotic susceptibility.     

广州儿童医院重症监护病房感染病原菌的分布及耐药性分析

目的探讨儿科重症监护病房（PICU）感染病原菌的分布及耐药情况,为临床合理选用抗菌药提供参考。方法对广州市儿童医院PICU病房2003年11月-2005年10月各类感染标本所分离的病原菌的分布及耐药性进行回顾性分析。结果共检出295株病原菌,其中革兰阴性杆菌213株（72．2％）,主要为铜绿假单胞菌、不动杆菌等非发酵菌;革兰阳性球菌58株（19．7％）,主要为葡萄球菌;真菌24株（8．1％）。药敏结果提示铜绿假单胞菌及不动杆菌对亚胺培南、头孢哌酮／舒巴坦、环丙沙星及阿米卡星较为敏感,铜绿假单胞菌对头孢噻肟耐药率较高,而不动杆菌对头孢哌酮、氨曲南、庆大霉素耐药严藿。肠杆菌科细菌对氨苄西林、氨苄西林／舒巴坦、哌拉西林及多种头孢菌素耐药率较高而对亚胺培南、头孢哌酮／舒巴坦、阿米卡星等较敏感。葡萄球菌对青霉素、红霉素严重耐药,但对万古霉素、替考拉宁及阿米卡星敏感性高。结论铜绿假单胞菌等非发酵菌已成为PICU病房感染的主要病原菌。根据病原菌种类及药敏结果合理应用抗菌药是有效控制危重病患儿感染和减少耐药菌株产生的重要手段。     

Aminoglycoside-modifying enzymes in clinical isolates ofAcinetobacter calcoaceticus

Aminoglycoside-modifying enzymes were identified in clinical strains ofAcinetobacter calcoaceticus subsp.anitratus (Herellea vaginicola) isolated between 1971 and 1979. Resistance to kanamycin, neomycin, and lividomycin was explained by an aminoglycoside-3′-phosphotransferase enzyme. The resistance of gentamicin was due to an aminoglycoside 3N-acetyltransferase type I enzyme which had not previously been described in this species. Several strains producing both enzymes showed resistance to kanamycin, gentamicin, lividomycin, neomycin, and sisomicin and susceptibility to tobramycin and amikacin.     

Sensitivity of 56 strains of Streptococcus group B to 12 antibiotics: its determination by dilution and diffusion in agar

Sensitivity of 56 streptococcal strains of group B to 12 antibiotics was studied with the method of dilution in a special solid medium for cultivation of streptococci and with the method of agar diffusion in the same medium. All the strains were found to be sensitive to chloramphenicol, ristomycin and erythromycin. The predominating majority of the strains were sensitive to beta-lactam antibiotics and lincomycin. All the strains were resistant to aminoglycoside antibiotics, such as streptomycin and gentamicin. More than 85 per cent of the strains were resistant to tetracycline. Strains with multiple resistance to 2-7 antibiotics were detected. Satisfactory correlation between the two methods was observed. It was shown to be clinically advisable to determine the sensitivity of streptococci of group B to beta-lactam antibiotics, erythromycin and lincomycin.     

Long-term antibiotic susceptibility pattern of strains of Neisseria gonorrhoeae isolated in Czechoslovakia in the years 1957-1982

Over the past 25 years a total of 7492 strains of Neisseria gonorrhoeae have been isolated in Czechoslovakia, mainly in Prague (64%). All these strains have been tested for susceptibility to the following antibiotics: penicillin G, ampicillin, tetracycline, spectinomycin, erythromycin, doxycycline, kanamycin, rifampin, chloramphenicol, gentamicin, cephalothin, cephaloridine, lincomycin and clindamycin. In addition, seven derivatives of newer antibiotics of penicillin and cephalosporin series were tested in 1981. The study showed that in 1957 the MIC of 0.03 units of penicillin per ml was effective against 95% of strains, but in 1981 only 37% of isolates were sensitive to this concentration. The first gonococcal strains with the MIC value of 4.0 units/ml to penicillin were detected in 1981. This tendency towards decreased gonococcal susceptibility to benzylpenicillin is alarming. Over the last eight years there have been described sporadic isolations of strains relatively resistant to tetracycline (MIC = 8.0 mg/l). The susceptibility to spectinomycin has been tested in over 4000 gonococcal strains, since 1967. The test showed that this antibiotic remained highly effective against the gonococcal infection with over 95% of gonococci with the MIC value of 16.0 mg/l. No fully spectinomycin resistant strains have been found. Penicillin G as well as spectinomycin and cefotaxim are still considered the antibiotics of the first choice in the treatment of gonorrhoea. The alternative antibiotics may include cefuroxim, chloramphenicol and, in cases of sensitive strains, tetracyclines.     

Influence of an extended incubation period on values of minimum inhibitory concentrations of antibiotics in Stenotrophomonas maltophilia clinical strains

In 106 Stenotrophomonas maltophilia clinical strains the susceptibility to 19 kinds of antibiotics was tested by the broth dilution micromethod at 24 h and 48 h incubation. Isolated strains demonstrated the lowest frequency of resistance to cotrimoxazole (7.5% of resistant strains at 24 h incubation and 18.9% at 48 h), ofloxacin (13.2% and 30.2%), ciprofloxacin (19.8% and 50.9%) and to cefoperazone/sulbactam (20.8% and 37.7%). The smallest growth of the number of resistant strains after extended incubation was recorded in gentamicin (by 10.4%), ceftazidime (by 11.3%) and cotrimoxazole (by 11.4%). On the contrary, the largest growth of resistance was demonstrated in cefoperazone and ciprofloxacin (by 31.1%). Average values of the growth of minimum inhibitory concentrations (MICs) were lowest in ciprofloxacin and ofloxacin (2.3 times) and highest in piperacillin/tazobactam (4.5 times) and piperacillin (5.0 times). As far as the stability of MIC is concerned, the largest occurrence of strains with the MIC growth doubled as a maximum was found in ceftazidime (78.4%), ofloxacin (76.1%) and ciprofloxacin (75.3%), the smallest in piperacillin/tazobactam (43.2%) and piperacillin (38.9%). The importance of incubation extended to 48 h during the testing of S. maltophilia strains was noted for correctly setting their susceptibility to antibiotics.     

Antibiotic utilization and Pseudomonas aeruginosa resistance in intensive care units

Pseudomonas aeruginosa is one of the most frequent and dangerous pathogens involved in the etiology of severe nosocomial infections. A retrospective observational study was conducted at all intensive care units of the University Hospital in Olomouc, Czech Republic (155 ICU beds). Complete antibiotic utilization data of the ICUs in the period of 1999 to 2008 were processed according to ATC/DDD system and expressed in defined daily doses per 100 bed-days (DBD). Utilization of meropenem, imipenem, ciprofloxacin, ofloxacin, pefloxacin, gentamicin, amikacin, ceftazidime, cefoperazone, cefoperazone/sulbactam and piperacillin/tazobactam was measured. Pseudomonas aeruginosa strains were isolated from clinical material obtained from patients hospitalized in ICUs. During the ten-year period, utilization of the entire group of antibiotics monitored grew. It increased from 23.52 DBD in 1999 to 27.48 DBD in 2008 with a peak of 33.04 DBD in 2007. P. aeruginosa accounted for as much as 42% of pneumonias and 23% of surgical wound infections. Our results show that P. aeruginosa strains became gradually resistant to all antibiotics used in the treatment of the infections caused by them, with the exception of amikacin and piperacillin/tazobactam.     

Prevalence of multi-drug resistant Salmonella typhi among clinically diagnosed typhoid fever patients in Lagos, Nigeria

A total of 635 clinically diagnosed typhoid fever patients were bled from three different health institutions in the metropolis of Lagos, Nigeria over a period of 15 months, May 1997 to July 1998. Out of the total blood cultured, 101 (15.9%) isolates of Salmonella species were isolated of which 68 (67.3%) were S. typhi, 17 (16.8%) and 16 (15.8%) were S. paratyphi A. and S. arizonae respectively. The overall isolation rate of S. typhi among patients is 10.7%, with most isolates 45.9% found among the severely-ill young adults, age group 16-30 years. All isolates were subjected to anti-microbial susceptibility testing using 12 different antibiotics: chloramphenicol, ampicillin, cotrimoxazole, gentamicin, colistin sulfate, nalidixic acid, nitrofurantoin, cefotaxime, tetracycline, streptomycin, ofloxacin and ciprofloxacin. All the S. typhi and S. paratyphi A isolates showed resistance to two or more of the 10 of 12 antibiotics tested particularly the 3-first-line antibiotics commonly used (chloramphenicol, ampicillin and cotrimoxazole) in the treatment of typhoid fever in Nigeria. No isolate showed resistance to ofloxacin and ciprofloxacin, however, nalidixic acid and gentamicin showed a moderate and appreciable inhibition to most of our isolates.     

两株假单胞菌菌株的RAPD分析及分子生物学鉴定

根据DNA随机扩增多态性(RandomAmplifiedPolymorphicDNA,简RAPD)分子标记技术设计鉴别引物,建立一种快速、准确检测病人体内新发现的假单胞菌菌株的分子生物学方法.采用RAPD分析方法对该菌种的对照菌株AcinetobactercalcoaceticusKHW14(简称A.calcoaceticusKHW14)和新分离的菌株Acinetobactercalcoaceticus(简称A.calcoaceticus)进行指纹分析,依据两菌株的差异序列设计两对引物,并建立最佳的PCR扩增体系,产物经1.2%琼脂糖凝胶电泳得菌株特异性电泳图谱.此图谱可作为鉴定两菌株的标准图谱,RAPD分析方法具有良好的重复性,同时也进一步验证了两菌株的同源性.     

694株鲍曼不动杆菌的耐药性分析

目的了解大连市友谊医院临床分离的鲍曼不动杆菌的分布及耐药状况,为临床治疗鲍曼不动杆菌感染提供参考。方法对该院2007年至2009年住院患者送检的标本中分离到的694株鲍曼不动杆菌的分布及药敏结果做回顾性分析。结果鲍曼不动杆菌2007年检出112株（7．1％）,2008年检出210（11．3％）株,2009年检出372（14．7％）株;在所有临床送检的标本中,痰标本中的检出率最高,占88．7％;在对13种抗生素的药敏试验中,对美罗培南最为敏感,其次对头孢哌酮／舒巴坦较为敏感。结论鲍曼不动杆菌的检出率逐年增高,耐药率也逐年增高。     

Natural antimicrobial susceptibilities and biochemical profiles of Yersinia enterocolitica-like strains: Y. frederiksenii, Y. intermedia, Y. kristensenii and Y. rohdei

The natural susceptibility of 131 Yersinia strains of Y. frederiksenii (n=38), Y. intermedia (n=48), Y. kristensenii (n=26) and Y. rohdei (n=19) to 70 antibiotics was tested. Minimum inhibitory concentration (MIC) values were determined with a microdilution procedure in IsoSensitest broth (all strains) and cation-adjusted Mueller Hinton broth (some strains). All species were naturally sensitive or sensitive and of intermediate susceptibility to tetracyclines, aminoglycosides, acylureidopenicillins, numerous cephalosporins, carbapenems, aztreonam, quinolones, chloramphenicol, folate-pathway inhibitors, nitrofurantoin, and fosfomycin. Uniform natural resistance was found with penicillin G, oxacillin, several macrolides, lincosamides, streptogramins, glycopeptides, rifampicin and fusidic acid. Species-specific differences in susceptibility affecting clinical assessment criteria were seen with aminopenicillins (in the presence and absence of beta-lactamase inhibitors), ticarcillin and some cephalosporins. Major medium-dependent susceptibilities were found with fosfomycin. beta-Lactam MIC susceptibility patterns suggested that most strains of the species tested produce both class A and class C (AmpC) beta-lactamases that are characteristic for the species. The present study describes a database concerning the natural susceptibility of some Y. enterocolitica-like species to a wide range of antibiotics, which can be applied to validate forthcoming antibiotic susceptibility tests of these strains and might contribute to their identification. An evaluation of 30 biochemical tests that secured phenotypic identification to the Yersinia species level is presented.     

Sensitivity spectrum of Francisella tularensis to antibiotics and synthetic antibacterial drugs

Sensitivity of 6 F. tularensis strains to 57 antibiotics and synthetic antibacterial drugs was studied. It was shown that the strains were highly sensitive to aminoglycosides, tetracyclines, anzamycins, quinolones, chloramphenicol, nitrofurantoin, nitroxoline, novobiocin and fusidin and resistant to penicillins, cephalosporins, polypeptides, vancomycin and sulfanylamides. The interrace differences in F. tularensis could be detected only by sensitivity to erythromycin, oleandomycin and spiramycin. There was observed no cross resistance to streptomycin and other aminoglycosides in F. tularensis. Assay of F. tularensis sensitivity to antibacterial drugs of various groups with the rapid photometric procedure and the agar diffusion method revealed that the results were highly comparable.     

Occurrence of variants with temperature-dependent susceptibility (TDS) to antibiotics among Stenotrophomonas maltophilia clinical strains

Susceptibility to 20 antibiotics was tested in 104Stenotrophomonas maltophilia strains at 37 and 30°C by means of a dilution micromethod to verity the phenomenon of temperature-dependent susceptibility (TDS). Trimethoprim-sulfamethoxazole, pefloxacin and ofloxacin were the most active preparations at 37°C (93, 90, and 86% of susceptible strains, respectively), whilst trimethoprim-sulfamethoxazole, cefoperazone-sulbactam and pefloxacin performed best at 30°C (94, 94, and 76% of susceptible strains, respectively). Variants 37TDS (minimum inhibitory concentration, MIC, of tested antibiotics at least 4-times lower at 37 than at 30°C) occurred in 60%. Variants 30TDS (at least 4-times lower value of MIC at 30 than at 37°C) were found in 7.7%. Both variants in susceptibility to tested antibiotics appeared in 23.1%, whilst neither of them was observed in 9.6%. The 37TDS phenomenon was recorded most of all with gentamicin (51% of strains), amikacin (47), colistin (44) and tetracycline (34). The 30TDS phenomenon was found particularly with cefoperazone-sulbactam (16.0% of strains) and colistin (10.0%). The above phenomena may be due to changes in membrane permeability, temperature-dependent ribosomal changes, and insufficient adaptation to higher temperatures of some strains of the originally environmental speciesS. maltophilia. Presented at the10th European Congress of Clinical Microbiology and Infectious Diseases, Stockholm (Sweden), 28–31 May 2000.