Nisin production by Lactococcus lactis using two-phase batch culture

The MAR indexes of hospital isolates of Pseudomonas aeruginosa were determined with reference to nine different cephalosporins. The values for all the strains were higher than 0·2 suggesting their origin from a high risk source of contamination where antibiotics are often used. Emergence of MAR pathogenic strains of Ps. aeruginosa indicated possible nosocomial infection in the hospital environment. β-Lactamases produced by these organisms were tested and their inhibition by clavulanic acid was studied. β-Lactamase produced by one of these strains (Ps-1) could not be inhibited by clavulanic acid whereas β-lactamases of three other strains (Ps-2, Ps-3 and Ps-4) could be inhibited by clavulanic acid in the presence of cephalosporins, suggesting a possible use of clavulanic acid in combination with cephalosporins, to combat β-lactamase induced resistance in Ps. aeruginosa.     

Transferable amikacin and cefamandole resistance: Pseudomonas maltophilia and Acinetobacter strains as possible reservoirs of R plasmids

Three strains belonging to gramnegative non-fermenting rods, i.e. a Pseudomonas maltophilia strain and two strains of Acinetobacter, were tested, as representatives of different types of nosocomial strains, for transferability of their multiple drug resistance. As all of them posed difficulties in demonstrating the transferability of their resistance by conventional methods, a three-step procedure was developed that includes a transfer to rifampicin-resistant P. aeruginosa recipients, then to susceptible P. aeruginosa intermediate strains, and, finally, from these strains to rifampicin-resistant Enterobacteriaceae. In three strains studied three genetically different types of R plasmids have been demonstrated. P. maltophilia transferred Amikacin resistance, as well as resistance to other antibiotics, to P. aeruginosa and then to Enterobacteria. In contrast, an Amikacin-resistant Acinetobacter with quite identical multiple drug resistance spectrum transferred its resistance to P. aeruginosa only, but not to Enterobacteria. Finally, another Acinetobacter strain, resistant to Gentamicin but susceptible to Amikacin transferred this resistance directly to Enterobacteria (and, separately, to P. aeruginosa, too). All three strains transferred Cefamandole resistance together with other resistances. Non-fermenting rods, thus, might be a source of transmissible resistance to reserve antibiotics as Amikacin, and advanced-type Cephalosporins.     

Multi-drug resistant Pseudomonas aeruginosa: towards a therapeutic dead end?

Pseudomonas aeruginosa is a major hospital-associated pathogen that can cause severe infections, most notably in patients with cystic fibrosis or those hospitalized in intensive care units. In this context, the current increase in incidence of multi-drug resistant (MDR) isolates of P. aeruginosa (MDRPA) raises serious concerns. MDR in P. aeruginosa is defined as the resistance to 3 or 4 of the following antibiotic classes: penicillins/cephalosporins/monobactams, carbapenems, aminoglycosides, and fluoroquinolones. These strains constantly cumulate several resistance mechanisms as a consequence of multiple genetic events, i.e., chromosomal mutations or horizontal transfers of resistance genes. Involved mechanisms may include active efflux, impermeability resulting from porins loss, plasmid-encoded b-lactamases/carbapenemases or aminoglycosides-modifying enzymes, and enzymatic or mutation-associated changes in antibiotics targets. Antibiotic selection pressure represents the leading risk factor for MDRPA acquisition. Colistin (polymyxin E) remains active on virtually all MDRPA isolates, and increasingly appears as the last available option to treat infections caused by these strains. However, the emergence of colistin resistance has been reported in P. aeruginosa, which may announce the spread of pan-resistant strains in a close future.     

Antibiotic resistance in clinical strains of Pseudomonas aeruginosa isolated from 1979-1984

The levels and spectra of drug resistance were determined in 530 strains of P. aeruginosa isolated in hospitals of three cities of the USSR within 1979-1984. Their conjugative R plasmids were searched for and distribution of various type resistance determinants in the composition of these plasmids was investigated. The results were compared with the findings of analogous studies on clinical strains of P. aeruginosa isolated within 1976-1979. It was shown that there were a rise in the relative number of the strains resistant to kanamycin and a decrease in the occurrence of the P. aeruginosa strains resistant to streptomycin, tetracycline and sulfanilamides. The frequency of the kanamycin, carbenicillin and gentamicin resistance genes in the composition of the detected conjugative R plasmids increased. Hybridization of 32P-labeled probes containing various type antibiotic resistance determinants with strains of P. aeruginosa ML (PAO) containing conjugative R plasmids was indicative of wide spread of genes determining APH(3')II and APH(3") and determinants of classes A and C in the composition of the studied plasmids.     

Antibiotic resistance of Pseudomonas aeruginosa strains isolated from patients with infected burns

Sensitivity to 15 drugs of 248 P. aeruginosa strains isolated from patients with infected burns was studied by the method of agar dilution. All of the strains were resistant to polymyxin M, ceporin, erythromycin and oleandomycin. Most of the strains were resistant to streptomycin, monomycin, ampicillin and rifadin. Moderate resistance of the strains to carbenicillin, morphocycline, vibramycin, kanamycin, tetraolean and tetracycline was observed: the maximum concentrations of these antibiotics (128 microgram/ml) inhibited the growth of 85, 69, 63, 51.8, 43.6 and 41.2 per cent of the strains respectively. Gentamicin proved to be most active against the strains of P. aeruginosa and inhibited 87 per cent of the strains when used in the therapeutic doses. The study provided recomendation of the drugs for parenteral and local use in treatment of burns infected with P. aeruginosa.     

Environmental mutagens may be implicated in the emergence of drug-resistant microorganisms

The emergence of drug-resistant microorganisms is an important medical and social problem. Drug-resistant microorganisms are thought to grow selectively in the presence of antibiotics. Most clinically isolated drug-resistant microorganisms have mutations in the target genes for the drugs. While any of the many mutagens in the environment may cause such genetic mutations, no reports have yet described whether these mutagens can confer drug resistance to clinically important microorganisms. We investigated how environmental mutagens might be implicated in acquired resistance to antibiotics in clinically important microorganisms, which causes human diseases. We selected mutagens found in the environment, in cigarette smoke, or in drugs, and then exposed Pseudomonas aeruginosa to them. After exposure, the incidence of rifampicin- and ciprofloxacin-resistant P. aeruginosa strains markedly increased, and we found mutations in genes for the antibiotic-target molecule. These mutations were similar to those found in drug-resistant microorganisms isolated from clinical samples. Our findings show that environmental mutagens, and an anticancer drug, are capable of inducing drug-resistant P. aeruginosa similar to strains found in clinical settings.     

Complete genome sequences of three Pseudomonas aeruginosa isolates with phenotypes of polymyxin B adaptation and inducible resistance

Clinical "superbug" isolates of Pseudomonas aeruginosa were previously observed to be resistant to several antibiotics, including polymyxin B, and/or to have a distinct, reproducible adaptive polymyxin resistance phenotype, identified by observing "skipped" wells (appearance of extra turbid wells) during broth microdilution testing. Here we report the complete assembled draft genome sequences of three such polymyxin resistant P. aeruginosa strains (9BR, 19BR, and 213BR).     

Resistance emergence among P. aenrginosa in a rat thigh-abscess model. Comparison of imipenem and meropenem treatment

Resistance emergence to carbapenem antibiotics was studied in a rat-thigh abscess model. Abscesses were developed in three groups with a total of 15 P. aeruginosa strains (three rats per strain). Groups were assigned to imipenem or meropenem treatment while one was left antibiotic-free. Test strains were fully susceptible to these antibiotics and the "Mutant Preventing Concentrations" of imipenem and meropenem over these strains were comparable. Antibiotic serum levels, assessed by serum bioassay test, were similar among therats. After four days, rats (n=45) were sacrificed and carbapenem resistant mutants were selected on imipenem (4 mg/L) and meropenem (4 mg/L) supplemented agar plates. Resistant variants of three strains, from four abscesses, were detected; one in the meropenem group, two in the imipenem and one in the untreated group. The MICs of imipenem and meropenem for the mutants were increased fourfold times or even higher of their counterparts. Resistance emergence under antibiotic pressure in P. aeruginosa has been shown in various conditions. To our knowledge, however, resistance emergence in abscess and also the comparison of imipenem and meropenem in this regard has not been studied before.     

The threat of antibiotic resistance in Gram-negative pathogenic bacteria: beta-lactams in peril!

Beta-lactam antibiotics are the cornerstone of our antibiotic armamentarium. By inhibiting bacterial cell wall synthesis, they are highly effective against Gram-positive and Gram-negative bacteria. Unfortunately, bacteria have evolved sophisticated resistance mechanisms to combat the lethal effects of beta-lactam antibiotics. Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae are all able to evade killing by penicillins, cephalosporins and carbapenems. This multi-drug resistant phenotype that challenges health care workers worldwide is caused by an array of resistance determinants. These include altered expression of outer membrane proteins and efflux pumps, along with an increasing arsenal of beta-lactamases. Future strategies in beta-lactam design must take into account the complex nature of resistance in Gram-negative pathogens.     

铜绿假单胞菌医院感染分布及耐药性分析

目的探讨铜绿假单胞菌临床分离株的感染分布情况及其抗生素的耐药情况,指导临床合理用药。方法对我院2006年1月至2008年6月住院患者分离的铜绿假单胞菌进行抗生素敏感性测定,采用API系统及VITEK2系统进行细菌鉴定,用K-B法进行药敏试验及结果观察。结果216例院内感染铜绿假单胞菌病例中,从痰标本中分离的菌株最多,阳性率为45．4％;铜绿假单胞菌对头孢噻肟、复方新诺明、头孢哌酮的耐药率较高,分别为88％、86．1％和85．2％,对美洛培南的敏感性最高达到94％。结论铜绿假单胞菌是医院病原菌感染的主要致病菌之一,加强细菌和药敏监测,选择敏感性强的药物,避免广谱抗菌药物的长期应用,是延缓耐药菌株增加的有效办法。     

2014—2016年某院铜绿假单胞菌耐药性监测

摘要：目的 分析铜绿假单胞菌的分布和耐药性变化,为临床防治铜绿假单胞菌感染提供依据。方法 收集成都大学附属医院2014—2016年所分离的铜绿假单胞菌,采用VITEK 2-Compact全自动细菌鉴定系统进行鉴定和药敏试验,采用WHONET 5.6软件对数据进行分析。结果 3年间共分离出1 945株铜绿假单胞菌,多重耐药铜绿假单胞菌分离率为34.2%（666/1945）。标本来源以呼吸道为主,占82.2%（1598/1945）。科室分布以呼吸内科最多,ICU其次。铜绿假单胞菌对头孢曲松和头孢噻肟的耐药率最高,均＞57.0%;对阿米卡星耐药率最低,为2.0%。3年来铜绿假单胞菌对17种抗生素的耐药率呈整体上升的趋势。结论 铜绿假单胞菌对头孢曲松、头孢噻肟、亚胺培南耐药率较高,对阿米卡星耐药率较低。铜绿假单胞菌的耐药率呈整体上升的趋势,应重视细菌耐药性的监测,以延缓耐药性产生、促进临床合理用药。     

下呼吸道感染患者病原菌分布及耐药性

目的分析下呼吸道感染患者病原菌分布及耐药性,指导临床合理用药。方法收集我院2013年至2015年院内感染患者痰标本进行细菌培养和药物敏感性试验。结果 3年共收集下呼吸道痰液标本21 615份,分离病原菌5 621株,阳性率为26.0%;其中革兰阴性(G~-)菌4 249株,占75.6%,以铜绿假单胞菌居多(20.7%);真菌764株,占13.6%,以白假丝酵母居多(12.6%);革兰阳性(G~+)菌608株,占10.8%,以金黄色葡萄球菌居多(9.9%)。药物敏感试验结果显示:G~-杆菌对亚胺培南、美洛培南耐药率最低,对青霉素类、喹诺酮类和部分三代头孢类等抗菌药耐药率较高(50.0%)。G~+球菌对万古霉素、利奈唑胺耐药率为零,对青霉素类、喹诺酮类和红霉素等抗菌药耐药率较高(40.0%)。结论下呼吸道感染患者病原菌以G~-杆菌为主,耐药性呈增长趋势,临床应加大病原菌分布检测及其耐药性监测力度,及时调整抗菌药物用药。     

下呼吸道感染耐环丙沙星铜绿假单胞菌的分布与耐药性

目的了解耐环丙沙星铜绿假单胞菌的流行情况,分析耐环丙沙星铜绿假单胞菌的耐药性,比较耐环丙沙星铜绿假单胞菌与环丙沙星敏感铜绿假单胞菌的耐药性差异。方法选择贵阳医学院第三附属医院2011年6月至2014年11月下呼吸道感染标本中分离出的231株耐环丙沙星铜绿假单胞菌与环丙沙星敏感铜绿假单胞菌,按照《全国临床检验操作规程》进行微生物病原菌鉴定。采用Kirby-Bauer琼脂扩散法进行药敏试验,结果使用SPSS 17.0软件进行统计分析。结果下呼吸道感染标本中共分离出铜绿假单胞菌231株,其中耐环丙沙星铜绿假单胞菌检出率25.54%。从科室分布看,神经外科分离率最高,占47.46%,其次ICU、呼吸内科与消化内科分别占18.64%、13.56%、10.17%;下呼吸道感染耐环丙沙星铜绿假单胞菌菌株与环丙沙星敏感铜绿假单胞菌菌株对头孢曲松、阿米卡星、亚胺培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦等19种抗菌药物的耐药率分别为95.65%,71.83%;42.86%,7.69%;17.39%,2.70%;33.33%,11.02%;22.22%,8.00%。下呼吸道感染耐环丙沙星铜绿假单胞菌菌株耐药率明显高于环丙沙星敏感铜绿假单胞菌菌株,差异具有统计学意义(P0.05)。结论耐环丙沙星铜绿假单胞菌表现为多重耐药性,给临床治疗带来很大的困难。因此严格掌握抗菌药物的选用是延缓病原菌对抗菌药物耐药的有效方法。     

Incidence of R factors in coliform, fecal coliform, and Salmonella populations of the Red River in Canada.

Coliforms, fecal coliforms, and Salmonella were isolated from the Red River, Manitoba, Canada, and identified. These organisms were then examined for resistance to 12 antibiotics. Some fecal coliforms were resistant to all 12 antibiotics, and 18% of the Salmonella isolates were resistant to one or more antibiotics. A total of 52.9% of the fecal coliforms resistant to three or more antibiotics were able to transfer single or multiple resistance (R) determinants to the Salmonella recipient, and 40.7% could transfer R determinants to the Escherichia coli recipient. Of the resistant Salmonella, 57% transferred one or two determinants to the Salmonella recipient, and 39% transferred one or two determinants to the E. coli recipient. It was calculated that populations of fecal coliforms containing R factors were as high as 1,400 per 100 ml and that an accidental intake of a few milliliters of water could lead to transient or permanent colonization of the digestive tract. Consideration of data on bacteria with R factors should be made in future water quality deliberations and in discharge regulations.     

Environmental and clinical isolates of Pseudomonas aeruginosa show pathogenic and biodegradative properties irrespective of their origin

Virulence properties of pathogenic bacteria, as well as resistance to antibiotics, are thought to arise through a specialization process favoured by the strong selection pressure imposed in clinical treatments. Nevertheless, in the case of opportunistic pathogens, it is unclear whether strains can be classified into virulent and non-virulent isolates. Clones of the opportunistic pathogen Pseudomonas aeruginosa do not seem to be associated to a particular biovar or pathovar, which suggests that virulence characteristics in opportunistic pathogens may already be present in environmental (non-clinical) isolates. We have explored this possibility, studying environmental isolates (mainly from oil-contaminated soils) and clinical isolates (from bacteraemia and cystic fibrosis patients) of P. aeruginosa . All environmental strains were found to actively efflux quinolones, which are synthetic antibiotics not expected to be present in the environment. These strains contained multidrug resistance determinants, were capable of invading epithelial cells and presented genes from the quorum-sensing and type III secretion systems. Some of them expressed either haemolytic or proteolytic activities or both, characteristics considered to be typical of virulent strains. All the strains tested, of clinical or environmental origin, could use alkanes (oil hydrocarbons) as a carbon source. Our results suggest that clinical and non-clinical P. aeruginosa strains might be functionally equivalent in several traits relevant for their virulence or environmental properties. Selection of clinically relevant traits, such as antibiotic resistance or cellular invasiveness, in opportunistic pathogens present in soil ecosystems is discussed.     

Cefamandole resistance transfer in bacterial strains from two newborn units

Transfer of Cefamandole resistance was demonstrated from strains of Citrobacter freundii as well as from individual strains of Enterobacter cloacae, Acinetobacter anitratus and Klebsiella pneumoniae isolated from patients in two newborn units. In Citrobacter freundii, Cefamandole resistance was transferred always with Cephalotin resistance as well as with a TEM-like beta lactamase (conferring resistance to Ampicillin, Carbenicillin and Azlocillin). Citrobacter freundii strains from Hospital I were completely susceptible to gentamicin, while strains of other species, resistant to Cefamandole plus Cephalotin, were resistant to Gentamicin as well, and transferred this resistance, too. In one Enterobacter cloacae strain from Hospital I, Cefamandole resistance could be separated from resistance to Cephalotin, but only in clones selected with gentamicin and not with any of the cephalosporins. Acinetobacter anitratus strain was also resistant to Cefotaxime, but did not transfer this resistance. It might be concluded that special nosocomial bacteria may carry plasmids conferring a transferable type of resistance to Cefamandole together with resistance to classical cephalosporines. Second cycle of transfers, i.e. between two variants of E. coli K-12 strains confirmed the contransferability of Cefamandole and Cephalotin resistance.     

Gentamicin- and silver-resistant pseudomonas in a burns unit.

In 1977-8 gentamicin-resistant strains of Pseudomonas aeruginosa became very common in a burns unit, over 90% being resistant at the peak of the outbreak. Some strains were also resistant to silver nitrate, though silver resistance was not found in any other strains of Ps aeruginosa isolated. Unlike the gentamicin resistance, the silver resistance was unstable, and strains became sensitive on repeated subculture. All the gentamicin-resistant strains of Ps aeruginosa were of the same serotype (O:11, H:2,5). Though gentamicin resistance could be transferred in vitro from resistant strains of Ps aeruginosa to one sensitive strain of Ps aeruginosa, there was no evidence of in-vivo transfer of gentamicin resistance between strains of pseudomonas in the patients'' burns, nor was there evidence of transfer of gentamicin resistance between Ps aeruginosa and enterobacteria. Carbenicillin-resistant and gentamicin-resistant Ps aeruginosa were sometimes found in the same burns, but no gentamicin-carbenicillin (doubly) resistant strains were found among the 986 strains tested during the outbreak. The outbreak of gentamicin-resistant Ps aeruginosa from burns was not reduced by stopping treatment with gentamicin and its analogues but only by segregating all patients with Ps aeruginosa in one of the two wards of the unit and admitting new patients only to the other ward.     

VITEK－IMSGNS系列药敏卡对~（162）株绿脓杆菌的药敏分析

本文就临床标本中分离的１６２株绿脓杆菌,用ＶＩＴＥＫ－ＩＭＳ全自动微生物系统的ＧＮＳ－ＰＡ等四种药敏卡,共测定２３种抗生素药敏试验．该菌对亚胺硫霉素的敏感度（敏感和中度敏感）最高９７．７８％,其次是哌拉西林、替卡西林、丁胺卡那霉素、妥布霉素、环丙氟哌酸、头孢他啶和头孢哌酮,复方新诺明等八种抗生素耐药率均在９０％以上。分析该菌对１０种抗生素药敏结果发现,几种常用抗绿脓杆菌药物的最小抑菌浓度（ＭＩＣ）值普遍增高,并结合绿脓杆菌生物微膜形成和该菌对β－内酰胺类抗生素抗性机制作了讨论。     

Antibiotic resistance of Lactobacillus strains]

One hundred and thirty six Lactobacillus strains isolated from poultry and 23 Lactobacillus strains isolated from long-living persons were tested for their antibiotic sensitivity. Occurrence of some type determinants of resistance to aminoglycoside antibiotics and tetracyclines in the Lactobacillus strains resistant to these antibiotics was studied. The majority of the strains from the both collections were resistant to aminoglycosides (73 and 79 per cent, respectively). The isolates from the poultry were characterized by multiple resistance. The isolates from the long-living persons were most frequently resistant to one of two antibiotics. All the tested Lactobacillus strains isolated from the long-living persons were sensitive to tetracyclines. The species composition of the isolates was different. The antibiotic-resistant strains were detected in all the species involved in the study. By hybridization of Lactobacillus colonies with the probes containing various genes of the resistance it was shown that in 14 per cent of the antibiotic-resistant strains belonging to Lactobacillus the antibiotic resistance was controlled by the genes homologous to resistance genes widely distributed in gramnegative organisms. This indicated a possible wide exchange and heterologous expression of the antibiotic resistance determinants between microorganisms of various taxonomic groups.     

Multiresistant waterborne pathogens isolated from water reservoirs and cooling systems

Aims:  To determine the incidence of multiple antibiotic-resistant strains of the emergent human pathogens Legionella pneumophila , Pseudomonas aeruginosa and mesophilic Aeromonas species among those isolated from water reservoirs and industrial cooling systems.
Methods and Results:  Water from four natural water reservoirs and four industrial cooling towers was sampled for 1 year period. The total heterotrophs, mesophilic Aeromonas , Pseudomonas spp. and Legionella spp. counts were performed as recommended by standard procedures, and the sensitivity of the isolates to 27 antibiotics was tested. A total of 117 Aeromonas , 60 P. aeruginosa and 15  L. pneumophila strains were isolated and identified by means of biochemical tests and DNA probes. 46·4% of Aeromonas , and 100% of P. aeruginosa isolates presented multiple resistance. Legionella pneumophila strains were generally sensitive to the drugs used.
Conclusions:  Antibiotic-resistant pathogenic bacteria belonging to P. aeruginosa and mesophilic Aeromonas species are common in natural aquatic environments. Thus, the risk of waterborne diseases owing to domestic and industrial uses of freshwater should be re-examined from the increase of bacterial resistance point of view.
Significance and Impact of the Study:  These data confirm the emergence of bacteria resistant to antibiotics in aquatic environments.