Experience with epidemiologic studies of pyocyaneus infections. I. Feasibility of using serotypes and antibiotic resistance as a epidemiologic label for clinical strains]

The authors carried out serological typing of 98 Pseudomonas aeruginosa strains, isolated from patients of burn department of the Sklifosovsky First Aid Institute in January-July, 1974, and of 215 strains obtained from other sources; their sensitivity to 13 antibiotics was determined. Pseudomonas aeruginosa cultures isolated from the patients were typed with O-sera of 10 serological types. The presence of several hospital strains of Pseudomonas aeruginosa was found by means of serological typing; along with these there were revealed cultures of this causative agent sporadically appearing in the department. Sensitivity to some antibiotics could serve as an additional criterion for differentiation of Pseudomonas aeruginosa strains of the same serological type.     

Antibiotic sensitivity of Vibrio cholerae 01 isolated from environmental objects]

The sensitivity of 252 Vibrio cholerae-O1 strains isolated from environmental objects to antibiotics of various groups was assayed by the method of serial dilutions on solid media. The biological characteristics of the isolates are presented. The Vibrio cholerae isolates with serological variation were the most frequent (36.6 per cent), so are the cultures detected by their sensitivity to the specific phages (87.5 per cent). It was found that changes in some biological properties of the strains did not coincide with the changes in the antibiotic sensitivity. The isolates were highly sensitive to tetracycline, chloramphenicol, gentamicin, erythromycin and rifampicin and less sensitive to novobiocin and the other aminoglycosides. The sensitivity to the beta-lactams was the lowest. The resistance determinants were detected in single strains (6.3 per cent), the kanamycin and novobiocin resistance determinants being detected in 15 out of the 16 strains tested. The study showed that the cultures of Vibrio cholerae-O1 isolated from the environmental objects generally preserved their sensitivity to the diverse group antibiotics.     

Occurrence of Clostridium difficile in feces of children with dysfunction of the digestive tract and other disorders

Thousand and six hundred ninety two fecal samples from children of few weeks old up to over ten years were tested for the presence of Clostridium difficile. Most of them were treated with antibiotics and showed diarrhea symptoms. Hundred and twenty three strains of C-difficile were submitted to serological typing and their sensitivity to 10 selected antibiotics and chemotherapeutic agents was determined. Among 109 strains of C. difficile tested for enterotoxin production by latex test 82 strains (75.2%) were positive. Almost half (48%) of the isolated strains belonged to serotype C. Most of the strains were resistant to cefoxitin (88%) and clindamycin (76%). Over 90% of strains were sensitive to vancomycin and azlocillin and 86% to chloramphenicol and metronidazole. In the majority of patients with positive C. difficile cultures diarrhea was present, however, it was difficult to find a direct link between these symptoms and antibiotic therapy.     

Susceptibility to antimicrobial agents of bacteria isolated from pregnant, postpartum women, and newborns from zones with high irradiation risk]

Susceptibility of 350 strains of staphylococci, isolated from pregnant women, puerperal and newborns and of 170 strains, isolated from obstetrical hospital environment at the region with high risk of radiation after accident was determined. The tested bacterial strains were the following: 56--Staphylococcus aureus, 152--S. epidermidis, 142--S. saprophyticus, isolated from women and newborns; strains isolated from hospital environment included 120 strains of S. saprophyticus and 50 strains E. coli. The tested antimicrobial factors were the following: 22 antibiotics, 2 bioantibiotics of the breast milk and blood (lysozyme, betalysin) not separated from the substrate and tested on test-cultures of M. luteus and B. subtilis, and 5 desinfectants. Analysis was performed by common disk-diffusion method and by contact method elaborated before. High resistance of staphylococci to many antibiotics, bioantibiotics and disinfectants was demonstrated. The resistance is considered to be due to high radiation background because it is much higher than resistance frequency of the similar strains isolated at the safe areas. The resistance to antimicrobial factors was higher among the opportunistic and saprophyte staphylococci along with appearance of pathogenic factors and activation of persistence properties.     

Antibiotic sensitivity of the Salmonella isolated from children in Krasnodar]

The results of the comparative study of antibiotic sensitivity of 138 Salmonella strains isolated from children patients in Krasnodar are presented. The isolates belonged to 9 serological types and were classified into 4 serogroups. Salmonella fo group B prevailed. The highest sensitivity was found with respect to neomycin. Strains sensitive to levomycetin and streptomycin were rare. Single strains were sensitive to all antibiotics tested. A tendency to polyresistance in ever increasing numbers of the strains was noted, which should be taken into consideration in treatment of salmonellesis in children with antibacterial drugs.     

Antibiotic resistance of Staphylococcus aureus strains isolated in two different Warsaw hospitals]

S. aureus strains isolated in the same period from different specimens obtained from patients of two different hospitals were compared. The significant differences were observed in the frequency of resistance determinants between strains of these hospitals. The most important was the difference in the prevalence of MRSA. In the first hospital the percentage of MRSA was 40% whereas in the second one only 20%. The resistance to the other antibiotics was also compared, and independently from the compared group: MRSA, MSSA or all, the prevalence of resistance determinants was higher in the first hospital than in the second. Although the frequencies of MRSA in both investigated hospitals were relatively high comparing to the other European countries and in the first hospital even alarming, isolated MRSA strains are less resistant to other antibiotics than MRSA in other countries.     

侵袭性和非侵袭性肺炎链球菌耐药率的比较分析

目的研究侵袭性和非侵袭性肺炎链球菌的耐药谱的差异,指导合理应用抗生素及感染管理。方法回顾性统计分析2009至2011年来天台县人民医院就诊患者分离肺炎链球菌的标本来源及耐药性,比较侵袭性和非侵袭性肺炎链球菌耐药率之间的差异。结果共分离出肺炎链球菌642株,痰液中分离出584株,非痰液中分离出58株,其中血液中分离出32株,脑脊液中分离出20株,其他分离出6株,所有肺炎链球菌对万古霉素和利奈唑胺均敏感,对青霉素、红霉素、克林霉素、四环素及复方新诺明耐药严重,对左氧氟沙星、氯霉素比较敏感;侵袭性分离株对青霉素、红霉素、克林霉素、左氧氟沙星、四环素及氯霉素的耐药率显著高于非侵袭性肺炎链球菌。结论该院分离的肺炎链球菌主要来自痰液标本,耐青霉素肺炎链球菌的检出率高,大环内酯类耐药严重,存在一定比例的侵袭性感染,非侵袭菌株与侵袭性菌株耐药谱之间存在一定差异,临床治疗应该区别对待,系统的监测细菌耐药性,合理选择抗菌药物。     

Sensitivity to antibiotics and the disinfectant chloramine of Staphylococci isolated from healthy and sick persons

Five hundred and twenty seven strains of Staphylococcus aureus with massive contamination of at least 10(3) when estimated quantitatively were tested for their sensitivity to antibiotics and chloramine B. The staphylococcal strains were isolated from patients, air and stock of rooms in medical institutions, from medical personnel and healthy persons having no long-term contacts with hospital media i. e. from pregnant women and workers of confectionery plants. Among the isolates there were strains simultaneously sensitive to antibiotics and chloramine B (16.6 per cent), sensitive to antibiotics but resistant to chloramine B (5.5 per cent), resistant to antibiotics but sensitive to chloramine B (63.1 per cent) and resistant to antibiotics and chloramine B (15.3 per cent). Staphylococci resistant simultaneously to antibiotics and chloramine B were isolated from the persons of all the groups and from the air and stock of the rooms in the medical institutions. This showed the necessity of controlling sensitivity or staphylococci circulating in hospital media not only to antibiotics but also to disinfectants for providing more efficient prophylaxis of intrahospital infections.     

Isolation of the 1st strains of Legionella pneumophila in the USSR

For the first time L. pneumophila strains were isolated from pneumonia patients in the USSR. To isolate these strains, the material obtained from the patients was inoculated into charcoal-yeast agar with antibiotics or into guinea pigs with the subsequent inoculation of chick embryos. Both isolated strains were classified with serogroup 1 of L. pneumophila on the basis of their cultural, morphological, biochemical and serological properties.     

鲍曼不动杆菌的基因分型及耐药性分析

目的分析上海某综合性医院不同科室来源的鲍曼不动杆菌菌株的同源性及耐药状况,了解鲍曼不动杆菌院内感染流行情况。方法采用重复序列PCR技术（REP-PCR）,对51株临床分离的鲍曼不动杆菌菌株进行基因分型,并用纸片扩散法进行药敏试验。结果51株鲍曼不动杆菌分为13个基因型,其中A型16株,为主要流行型别;C型、D型各6株;M型有5株;E型、F型和G型各3株;B型、H型和K型各2株;I型、J型、L型各1株。药敏试验结果显示分离出的菌株对常用抗菌药呈现出多重耐药的现象。其中对阿米卡星和亚胺培南的耐药性最低,均为33.3%;对头孢唑啉耐药性最高,为100%。结论鲍曼不动杆菌基因的同源性分析表明,该院存在着以A型鲍曼不动杆菌为主的感染流行,估计该型菌株可能以克隆株的形式播散。鲍曼不动杆菌的耐药性很强,应加强其耐药性监测,合理使用抗菌药物。     

Sensitivity of antibiotic-resistant strains of Salmonella to new antibiotics and chemotherapeutic agents]

One hundred and sixty two antibiotic resistant strains of Salmonella isolated within 1984-1988 in Leningrad and the Leningrad Region were tested with respect to their sensitivity to new antibiotics and chemotherapeutics developed or being developed in the USSR. At the background of high numbers of circulating Salmonella strains resistant to the routinely used antibiotics such as doxycycline, streptomycin and gentamicin they appeared to be highly sensitive to amikacin, ciprofloxacin, pefloxacin and the 3rd generation cephalosporins i.e. ceftazidime and cefotaxime as well as to thienamycin. These modern antibacterial agents are possibly to be the drugs of choice in etiotropic treatment and chemoprophylaxis of septic acute intestinal infections due to Salmonella strains with multiple resistance. Resistance of individual Salmonella strains to cefotaxime and ceftazidime indicated that it was possible to use their property for additional labeling of the pathogens within a serological type of Salmonella while conducting epidemiological examinations during outbreaks of acute intestinal infections of Salmonella etiology.     

Comparison of the antibiotic sensitivity of lipophilic Corynebacterium sp. isolated from patients on the day of admission and during hospitalization

Lipophilic species of Corynebacterium are increasing problem in hospital infections. The aim of this study was to evaluate occurrence of these microorganisms in the materials taken from patients in the day of admission and during the hospitalization as well as comparison of their antibiotic sensitivity. The investigation included 65 strains isolated from hospitalized patients and 48 strains isolated from unchanged skin. Using Api Coryne test 5 species were identified. C. urealyticum dominated, the other were C. subsp. lipophilum and C. jeikeium. Among strains isolated from unchanged diseased skin the most C. jeikeium and C. accolens occurred. All strains were sensitive to glycopeptide, quinupristin/dalphopristin. The strains isolated from hospitalized patients were usually sensitive to fuside acid, doxycycline as well as tetracycline. Strains isolated from unchanged skin were sensitive to almost all tested antibiotics. In the group of 65 strains isolated from hospitalized patients 99.0% were multiresistant. In the group of strains isolated from unchanged skin only two strains were multiresistant. Differences in antibiotic sensitivity among analysed Corynebacterium sp. were confirmed. Majority of the "hospital strains" were characterized by multiresistance. Basing on these results it is possible to suppose, that multiresistance is main factor that favours lipophilic Corynebacterium species in the process of colonization of mucous membranes, skins as well as developing infections.     

Occurrence of Clostridium difficile in the digestive system of dogs]

This study was aimed at seeking strains of Clostridium difficile in feces and investigation of influence of antibiotics application on frequency of isolation and detection of toxing in vivo produced by this microorganism. Samples of feces were obtained from experimental dogs consisting of two groups. To groups I belonged 150 healthy dogs. Group II consisted of samples of feces received from four dogs before and after application of various antibiotics. Clostridium difficile was not isolated from group I dogs. From dogs belonging to group II, 28 strains were isolated. Production of toxing and classification to serological groups of the isolated strains were performed. Presence of this microorganism in feces of dogs is evident only after multiple application of antibiotics. Results of these studies suggest that dogs may constitute a reservoir of Clostridium difficile.     

呼吸道感染常见致病菌耐药趋势分析

目的：调查我院临床常见的G-致病菌在院内呼吸道感染病人的分布,并检测常用抗生素的种类对致病菌的效价情况,为呼吸道感染病人合理选用抗生素提供依据。方法：对来源于院内呼吸道感染病人的样本300个进行分离培养,用microscan au-toscan4（美国德灵半自动细菌分析仪）菌种鉴定及抗生素的药敏实验,回顾性分析肺部感染患者的痰细菌培养及药物敏感性测定结果。结果：从样本中分离获得825株主要致病菌,其中G＋致病菌389株,占47.2%,G-致病菌380株,占46.1%,真菌46株,占6.7%。G＋致病菌对检测10种抗生素的药敏性主要表现为传统的抗生素的疗效普遍偏低;而G-致病菌对检测的抗生素10种的药敏性情况表现出多元化态势。结论：院内呼吸道感染常见致病菌以革兰阴性菌为主,耐药性高,临床实践应重视病原学的监测,了解细菌的种类分布和耐药趋势,合理使用抗生素。     

Characteristics of hospital strains of Staphylococcus]

Some properties of hospital staphylococcal strains isolated from the patients with purulent postnatal mastitis were studied. It was found that all the strains of the phage type 80.81 widely distributed in the obstetric hospitals were polylysogenic and polyresistant to antibiotics. The resistance markers in most of the isolates were located on the plasmids. Elimination of the plasmids carrying the antibiotics resistance markers resulted in a simultaneous change in the strain lysogenic spectrum while the phage type and fermentative properties, such as production of plasmocoagulase, DNAase and lecithinase did not change. The capacity for hemotoxin production was lost simultaneously with antibiotic resistance in 1 out of 17 cultures tested.     

Species-specific sensitivity of coagulase-negative Staphylococci to single antibiotics and their combinations

The activity of beta-lactam antibiotics (oxacillin, cloxacillin, cephalotin), vancomycin, gentamicin and rifampicin applied in vitro individually and in combination against 37 nosocomial methicillin-resistant strains of coagulase-negative staphylococci (CNS) was assessed to demonstrate the heterogeneity of this group of bacteria and estimate the chance of the efficacy of such therapy. The strains belonged to four species: Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus cohnii, Staphylococcus hominis. They originated from a hospital environment and from the skin of medical staff of the intensive care unit of a paediatric ward at a university hospital. All strains were methicillin-resistant, according to CLSI standards, but individual strains differed in MIC(ox) values. Susceptibility to other tested antibiotics was also characteristic for the species. The increased susceptibility to antibiotics in combinations, tested by calculating the fractional inhibitory concentration (FIC) index, concerned 26 out of 37 investigated strains and it was a feature of a particular species. Combinations of vancomycin and cephalotin against S. epidermidis and oxacillin with vancomycin were significant, as well as cephalotin and rifampicin in growth inhibition of multiresistant S. haemolyticus strains.     

Prevalence and antibiotic resistance of <Emphasis Type="Italic">Escherichia coli</Emphasis> in tropical seafood

Summary The occurrence and antibiotic resistance of Escherichia coli in tropical seafood was studied. A 3-tube MPN method was used for determining the level of faecal contamination of fresh and processed seafood. Of the 188 samples tested which included finfish, shellfish, water and ice, 155 were positive for the presence of faecal coliforms following incubation at 44.5 °C. However, E. coli was isolated from only 47% of the samples positive for faecal coliforms. The antibiotic resistance of 116 strains isolated from seafood was tested using 14 different antibiotics including ampicillin, cephalothin, chloramphenicol, ciprofloxacin, gentamycin, nalidixic acid, streptomycin and vancomycin. Seven strains were resistant to more than five antibiotics of which one was resistant to eight antibiotics. The multiple drug resistant strains harboured plasmids of varying sizes. Antibiotic susceptibility studies revealed that seafood from India contains multiple antibiotic resistant strains of E. coli which may serve as a reservoir for antibiotic resistance genes in the aquatic environment. All the strains used in this study did not harbour any virulence genes commonly associated with pathogenic E. coli, when tested by polymerase chain reaction (PCR).     

Antibiotic resistance of Salmonella strains isolated from natural polluted waters

Resistance to 14 antibiotics was tested in 270 Salmonella strains isolated from different aquatic environments. All the strains were sensitive to nalidixic acid (30 micrograms) and cephalothin (30 micrograms) but more than 90% were resistant to tetracycline (30 micrograms). The percentage of strains resistant to other antimicrobial substances depended on the antibiotic and on the isolation source. Twenty-four resistance patterns were recorded in strains isolated from three environmental sources. The only multi-resistance detected in the three ecosystems was that of sulphadiazine and tetracycline (about 20%). The serotypes most frequently detected with multi-resistance to different antibiotics were Salmonella typhimurium and Salm. blockley.     

Antibiotic sensitivity of the microflora isolated in ENT diseases]

Sensitivity of beta-hemolytic streptococci of group A, Streptococcus viridans, Staphylococcus aureus, epidermal staphylococci, pneumococci, Proteus and Ps. aeruginosa isolated in 1975-1978 from patients with tonsillitis, otitis, sinusitis and other otorhinolaryngological diseases was studied with respect to 19 antibiotics. Data on comparison of the antibiotic sensitivity of the microflora isolated from the patients with otorhinolaryngological diseases in 1964-1974 and 1975-1978 are presented. It was shown that beta-hemolytic streptococci were highly sensitive to all the antibiotics tested except tetracycline. Among Streptococcus viridans the strains resistant to many antibiotics were more frequent than among beta-hemolytic streptococci. Most of the Staphylococcus aureus strains were sensitive to gentamycin, cephaloridin, oxacillin and resistant to the other antibiotics. The epidermal staphylococci were characterized by approximately the same antibiotic sensitivity as Staphylococcus aureus. Resistance of the predominating majority of the Pneumococcus strains to tetracycline was noted. Proteus and Ps. aeruginosa were resistant to all the antibiotics except aminoglycosides. The microflora isolated from the cases with otorhinolaryngological diseases in 1975-1978 were mainly characterized by lower antibiotic sensitivity than that isolated from the cases with the same diseases in 1964-1974. It is possible to suppose that the microorganisms isolated from the patients with otorhinolaringological diseases had no significant differences with respect to their antibiotic sensitivity from those isolated from the patients with other pathological processes.     

Transmissive drug resistance and virulence of "epidemic" strains of S. typhimurium]

A total of 59 "epidemic" strains of S. typhimurium and 52 cultures isolated from the cases with sporadic diseases were studied with respect to the nature of their resistance to 10 antibiotics and virulence for albino mice under conditions of subcutaneous and oral inoculation. The virulence of the cultures isolated from the cases with sporadic diseases was higher in the strains sensitive to antibiotics. The "epidemic" strains were characterized by the lowest virulence for the mice and resistance to 8-10 antibiotics simultaneously with the transmissive nature of resistance to 1-5 drugs. The transmissive nature of resistance to antibiotics and its spectrum may serve an additional epidemiological marker of the strains.