Biochemical polymorphic systems in the migrant population of northeastern USSR. VI. Genetic structure of patients in separate nosological groups

Genotype frequency distribution for a number of polymorphic loci in patients differs significantly in different nosologic groups, in relation to each other and to a sample of healthy individuals. Genetic structure specificity of each nosologic group and different trends of genetic frequency variations, in relation to the sample of healthy individuals, leads to considerable decrease in genetic differences between the united group of pathology and healthy individuals' sample. Spatial differentiation of genetic structure of separate nosologic groups and healthy individuals' sample also confirms genetic isolation of each of these groups and, at the same time, reveals clearly nonspecific biological resistance of human organism.     

Environmental stress and antibiotic resistance in food-related pathogens

This study investigated the possibility that sublethal food preservation stresses (high or low temperature and osmotic and pH stress) can lead to changes in the nature and scale of antibiotic resistance (ABR) expressed by three food-related pathogens (Escherichia coli, Salmonella enterica serovar Typhimurium, and Staphylococcus aureus). The study found that some sublethal stresses significantly altered antibiotic resistance. Incubation at sublethal high temperature (45 degrees C) decreased ABR. Incubation under increased salt (>4.5%) or reduced pH (<5.0) conditions increased ABR. Some of the pathogens continued to express higher levels of ABR after removal of stress, suggesting that in some cases the applied sublethal stress had induced stable increases in ABR. These results indicate that increased use of bacteriostatic (sublethal), rather than bactericidal (lethal), food preservation systems may be contributing to the development and dissemination of ABR among important food-borne pathogens.     

Antibiotic resistance in Burkina Faso

Burkina Faso is one of the Subsaharan African nations. No national services for monitoring of antibiotic resistance are available, so the number of reports of resistance patterns among hospital pathogens are inconsistent. In order to evaluate antibiotic resistance, a total of 1998 valuable microrganisms were analysed during 2000 at the Medical Centre St. Camille of Ouagadougou, Burkina Faso's capital. They were isolated as follows: 1012 from urine-culture, 503 from tonsil swabs, 398 from pus, 53 from sputum and 32 from blood-cultures. Escherichia coli was the most isolated microrganism from urine (44%); Enterococcus faecalis from tonsil swabs (96.4%), Staphylococcus aureus from pus (17%) and K. pneumoniae (70%) from sputum. In general, resistance to the old antibiotics, such as aminopenicillins and cotrimoxazole was shown. The most active antibiotic was norfloxacin, a rarely used antibiotic in this country. In conclusion, our study shows that it is necessary to create antibiotic-resistance surveillance centers in the developing countries to adopt an accurate therapy to avoid exporting of antibiotic resistance to the developed countries linked to increased emigration.     

Environmental Stress and Antibiotic Resistance in Food-Related Pathogens

This study investigated the possibility that sublethal food preservation stresses (high or low temperature and osmotic and pH stress) can lead to changes in the nature and scale of antibiotic resistance (ABR) expressed by three food-related pathogens (Escherichia coli, Salmonella enterica serovar Typhimurium, and Staphylococcus aureus). The study found that some sublethal stresses significantly altered antibiotic resistance. Incubation at sublethal high temperature (45°C) decreased ABR. Incubation under increased salt (>4.5%) or reduced pH (<5.0) conditions increased ABR. Some of the pathogens continued to express higher levels of ABR after removal of stress, suggesting that in some cases the applied sublethal stress had induced stable increases in ABR. These results indicate that increased use of bacteriostatic (sublethal), rather than bactericidal (lethal), food preservation systems may be contributing to the development and dissemination of ABR among important food-borne pathogens.     

A Treatment Plant Receiving Waste Water from Multiple Bulk Drug Manufacturers Is a Reservoir for Highly Multi-Drug Resistant Integron-Bearing Bacteria

The arenas and detailed mechanisms for transfer of antibiotic resistance genes between environmental bacteria and pathogens are largely unclear. Selection pressures from antibiotics in situations where environmental bacteria and human pathogens meet are expected to increase the risks for such gene transfer events. We hypothesize that waste-water treatment plants (WWTPs) serving antibiotic manufacturing industries may provide such spawning grounds, given the high bacterial densities present there together with exceptionally strong and persistent selection pressures from the antibiotic-contaminated waste. Previous analyses of effluent from an Indian industrial WWTP that processes waste from bulk drug production revealed the presence of a range of drugs, including broad spectrum antibiotics at extremely high concentrations (mg/L range). In this study, we have characterized the antibiotic resistance profiles of 93 bacterial strains sampled at different stages of the treatment process from the WWTP against 39 antibiotics belonging to 12 different classes. A large majority (86%) of the strains were resistant to 20 or more antibiotics. Although there were no classically-recognized human pathogens among the 93 isolated strains, opportunistic pathogens such as Ochrobactrum intermedium, Providencia rettgeri, vancomycin resistant Enterococci (VRE), Aerococcus sp. and Citrobacter freundii were found to be highly resistant. One of the O. intermedium strains (ER1) was resistant to 36 antibiotics, while P. rettgeri (OSR3) was resistant to 35 antibiotics. Class 1 and 2 integrons were detected in 74/93 (80%) strains each, and 88/93 (95%) strains harbored at least one type of integron. The qPCR analysis of community DNA also showed an unprecedented high prevalence of integrons, suggesting that the bacteria living under such high selective pressure have an appreciable potential for genetic exchange of resistance genes via mobile gene cassettes. The present study provides insight into the mechanisms behind and the extent of multi-drug resistance among bacteria living under an extreme antibiotic selection pressure.     

儿科重症监护病房感染病原菌分布及耐药性分析

目的明确儿科重症监护病房感染病原菌的分布及耐药性,指导临床合理应用抗菌药物。方法对浙江大学医学院附属儿童医院内科ICU 2005年1月至2009年12月各类感染标本所分离的病原菌及其耐药状况进行回顾性分析。结果 5年间送检标本13 785份,共分离出病原菌1 989株。感染优势菌为肺炎克雷伯菌（312株占15.7%）,鲍曼醋酸钙不动杆菌（300株占15.1%）,表皮葡萄球菌（221株占11.1%）,真菌（180株占9.0%）,铜绿假单胞菌（119株占6.0%）及大肠埃希菌（89株占4.5%）。革兰阴性菌占58.6%,革兰阳性菌株占32.4%,真菌占9.0%。鲍曼醋酸钙不动杆菌的感染率及耐药率呈逐年上升趋势。革兰阳性球菌以凝固酶阴性葡萄球菌为主,药敏试验结果显示除万古霉素、利奈唑烷外,葡萄球菌对于其他抗菌药物的耐药程度非常高。结论 ICU细菌耐药形势严峻,监测病区感染及细菌耐药状况,依据病原学及耐药性资料合理选择抗菌药物非常重要。 更多还原     

Spatial and temporal variability of antibiotic resistance in freshwater bacterial assemblages

Abstract Spatial and temporal variability in antibiotic resistance was examined in bacterial assemblages from streams and ponds on the US Department of Energy's Savannah River Site (SRS) in South Carolina. Sites sampled have been impacted to varying degrees by contamination with organic compounds, heavy metals, and radioactive materials because of production of nuclear materials on the site. Antibiotic resistance in the culturable portion of the bacterial assemblage was determined from coloby formation on media containing antibiotics. Eight antibiotics, chloramphenicol, cycloserine, kanamycin, neomycin, novobiocin, rifampicin, streptomycin, and tetracycline, were used at concentrations of 50 and 200 μg ml⁻¹. Statistically significant differences in frequency of antibiotic resistance were observed among sites and among dates at a single site. Bacterial densities (total and culturable), dissolved organic carbon (DOC) concentration, and human impact also varied among sites but bore no overall relationship to resistance frequency. SRS operations did not have a detectable impact on antibiotic resistance.     

舟山地区2688例胆汁培养病原菌分布及耐药性分析

目的通过分析2007年到2010年舟山医院2 688例胆汁标本中病原菌的分布及耐药状况,为临床合理用药提供实验依据。方法对2 688例胆汁标本进行细菌培养、鉴定和药敏分析。结果 2 688例胆汁标本中共检出阳性标本611例(阳性率22.7%),其中革兰阴性菌占82.2%(502/611),革兰阳性菌占13.3%(81/611),真菌占4.6%(28/611)。主要的病原菌为大肠埃希菌(40.3%)、肺炎克雷伯菌(15.4%)、肠球菌(11.3%);阴沟肠杆菌(4.7%)等。大肠埃希菌和肺炎克雷伯菌的ESBLs阳性菌株的比例达到了21.0%和5.9%,其中ESBLs阴性菌株对头孢他啶、头孢吡肟、美罗培南和阿米卡星等药物较为敏感,而ESBLs阳性菌株只对美罗培南和亚胺培南敏感;革兰阳性菌对万古霉素、氨苄西林较敏感。结论舟山地区胆道感染以革兰阴性菌为主,大肠埃希菌产ESBLs的菌株有较高的比例,临床应加强对抗生素的合理使用。     

Effect of antibiotic resistance on the appearance of mutants in a culture of Streptomyces cremeus subsp. tobramycini producing an aminoglycoside complex

Possible formation of auxotrophs and changing of the antibiotic production property connected with resistance to antibiotics of different modes of action were studied in Streptomyces cremeus subsp. tobramycini producing the nebramycin complex of 2-desoxystreptamine derivatives. Four hundred and five spontaneous and 1800 gamma-radiation induced antibiotic resistant mutants of the culture were studied. The frequency of the auxotrophs was shown to be increasing. Correlation between formation of strains producing monocomponent aminoglycosides and antibiotic resistance was observed. The frequency of mutants with preferable synthesis of the tobramycin component among strr-, rifr- and rubr-mutants was 3--10 times higher than among the sensitive portion of the population when total selection was used. Therefore, the spontaneous mutation of antibiotic resistance is selective with respect to both isolation of auxotrophs and strains producing separate aminoglycoside antibiotics.     

The intestinal microbiota plays a role in Salmonella-induced colitis independent of pathogen colonization

The intestinal microbiota is composed of hundreds of species of bacteria, fungi and protozoa and is critical for numerous biological processes, such as nutrient acquisition, vitamin production, and colonization resistance against bacterial pathogens. We studied the role of the intestinal microbiota on host resistance to Salmonella enterica serovar Typhimurium-induced colitis. Using multiple antibiotic treatments in 129S1/SvImJ mice, we showed that disruption of the intestinal microbiota alters host susceptibility to infection. Although all antibiotic treatments caused similar increases in pathogen colonization, the development of enterocolitis was seen only when streptomycin or vancomycin was used; no significant pathology was observed with the use of metronidazole. Interestingly, metronidazole-treated and infected C57BL/6 mice developed severe pathology. We hypothesized that the intestinal microbiota confers resistance to infectious colitis without affecting the ability of S. Typhimurium to colonize the intestine. Indeed, different antibiotic treatments caused distinct shifts in the intestinal microbiota prior to infection. Through fluorescence in situ hybridization, terminal restriction fragment length polymorphism, and real-time PCR, we showed that there is a strong correlation between the intestinal microbiota composition before infection and susceptibility to Salmonella-induced colitis. Members of the Bacteroidetes phylum were present at significantly higher levels in mice resistant to colitis. Further analysis revealed that Porphyromonadaceae levels were also increased in these mice. Conversely, there was a positive correlation between the abundance of Lactobacillus sp. and predisposition to colitis. Our data suggests that different members of the microbiota might be associated with S. Typhimurium colonization and colitis. Dissecting the mechanisms involved in resistance to infection and inflammation will be critical for the development of therapeutic and preventative measures against enteric pathogens.     

老年患者血培养病原菌分布及耐药性调查

目的了解老年患者血液感染的病原菌种类以及对抗菌药物的耐药状况。方法对2290份老年住院患者血培养标本中186例培养阳性检出菌及药敏结果进行统计学分析。结果在分离的172株细菌中,革兰阴性菌、革兰阳性菌及真菌分别占54.7%、34.9%和10.5%;革兰阴性菌中以大肠埃希菌占绝对优势(20.9%),假单胞菌其次(10.5%),革兰阳性菌中以凝固酶阴性葡萄球菌(CNS)占绝对优势(20.9%),金黄色葡萄球菌仅为2.9%。药敏试验表明老年菌血症的病原菌对常用抗菌药物的耐药严重,尤其是CNS及假单胞菌属细菌表现为较高的耐药率及多重耐药性。结论老年菌血症病原菌以机会致病菌感染比例较高,致病菌耐药问题严重,及时监测老年致病菌的变迁和耐药发展趋势以指导临床用药至关重要。     

Modification of antibiotic resistance in microbial symbiosis

In antibiotic therapy it is necessary to use drugs active against the pathogen in its association with the host normal microflora. The aim of the study was to investigate modification of antibiotic resistance under conditions of the pathogen association with the representatives of the host normal microflora and to develop the microbiological criteria for determining effectiveness of antibacterials. Modification of microbial antibiotic resistance was investigated in 408 associations. Various changes in the antibiotic resistance of the strains were revealed: synergism, antagonism and indifference. On the basis of the results it was concluded that in the choice of the antibiotic active against Staphylococcus aureus and Streptococcus pyogenes the preference should be given to oxacillin, gentamicin and levomycetin, since the resistance of the pathogens to these antibiotics under the association conditions did not increase, which could contribute to their destruction, whereas the resistance of the normoflora increased or did not change, which was important for its retention in the biocenosis. The data on changeability of the antibiotic resistance of the microbial strains under the association conditions made it possible to develop microbiological criteria for determining effectiveness of antibiotics in the treatment of inflammatory diseases of microbial etiology (RF Patent No. 2231554).     

Etiologic profile and antimicrobial susceptibility of community-acquired urinary tract infection in two Cameroonian towns

ABSTRACT: BACKGROUND: Urinary tract infection (UTI) represents one of the most common diseases encountered in community medical practice. In resource poor settings, treatment is usually empiric due to the high cost and long duration required for reporting diagnosis by culture and antibiotic susceptibility testing. With the growing problem of drug resistance knowledge of antibiotic susceptibility pattern is pertinent for successful eradication of invading pathogens. Our study, the first of its kind in Cameroon, analyzed the distribution and antibiotic susceptibility of bacteria causing community-acquired urinary tract infection (CAUTI) in two towns (Bamenda and Buea) with a large number of young and middle aged persons, to provide data that could guide empiric treatment. FINDINGS: We cultured 235 urine specimens and analyzed the antibiotic susceptibility of isolates by the disc diffusion technique. Uropathogens were recovered from 137 (58.3%), with prevalence rates in Buea and Bamenda being 65.9% and 54% respectively. Predominant pathogens were Escherichia coli (31.4%), Klebsiella oxytoca (25.5%) and Staphylococcus spp (24.1%). Geographic variation in uropathogen distribution and antibiotic susceptibility was observed, and a significant difference in pathogen distribution with respect to gender. The 20-39 years age group had the highest prevalence of infection. All pathogens isolated were detected in this group. Isolates exhibited low susceptibility to antibiotics tested. Bamenda isolates generally exhibited lower susceptibility compared to those from Buea. CONCLUSION: Regional variation in etiology of CAUTI and antibiotic susceptibility observed in our study emphasizes the need to establish local and national antimicrobial resistance monitoring systems in Cameroon to provide information for the development of CAUTI treatment guidelines.     

重症监护病房呼吸机相关性肺炎中鲍曼不动杆菌耐药性的动态分析

目的探讨重症监护病房呼吸机相关性肺炎(VAP)中鲍曼不动杆菌(Acinetobacter baumannii,Ab)的分布特点和耐药性,为临床防治鲍曼不动杆菌感染提供依据。方法对机械通气>48 h的79例患者的气管抽吸物(ETA)进行细菌定量培养和药敏测定。结果回顾性分析79例VAP患者ETA培养出病原菌214株,其中鲍曼不动杆菌79株(36.9%)。鲍曼不动杆菌对常见抗菌药物的耐药率呈上升趋势,出现较多多重耐药和泛耐药菌株。头孢哌酮/舒巴坦和亚胺培南的耐药率分别是55.6%和68.4%,均呈上升趋势。结论鲍曼不动杆菌是VAP常见病原菌之一,鲍曼不动杆菌的耐药性呈上升趋势,特别是多重耐药和泛耐药菌株,应引起高度重视。     

Status of pathogens,antibiotic resistance genes and antibiotic residues in wastewater treatment systems

Pathogens are becoming nearly untreatable due to the rise in gaining new resistance against standard antibiotics. Coexistence of microbial pathogens, antibiotics and antibiotic resistant genes (ARGs) in wastewater treatment plants (WWTP) provide favourable conditions for the development of new antibiotic resistant bacteria (ARB); facilitate horizontal gene transfer among pathogens and may also serve as a hotspot for the spread of ARB and genes into the environment. In this study, the current status of wastewater treatment systems in the removal of pathogens, ARGs, and antibiotic residues are discussed. WWTP are efficient in removing pathogens and antibiotic residues to a greater extend during secondary and tertiary treatment processes. Recent studies, however, have shown high variations in the presence of pathogens including ARB as well as antibiotic resistance genes (ARG) in the final effluent. Prolonged sludge retention time (SRT) and hydraulic retention time (HRT) during secondary treatment will facilitate antibiotic removal by adsorption and biodegradation. However, the above conditions can also lead to the enhancement of antibiotic resistance process in microbes. Therefore, optimum conditions for the operation of conventional WWTP for the efficient removal of antibiotics are yet to be established. The removal of antibiotic residues can be accelerated by combining conventional activated sludge (CAS) process with an additional treatment technology involving dosing with ozone. The advanced biological treatment method using membrane bioreactors (MBR) in combination with coagulation reportedly has the best ARG removal efficiency, and removes both ARB and extracellular ARGs. While studies have predicted the fate for ARGs in wastewater treatment plants, the mechanisms of ARGs acquisition remains to be conclusively established. Thus, strategies to investigate the underlying mechanism of acquisition of ARGs within the WWTP are also provided in this review.     

Resistance of Shigella to antibiotics

Antibiotic sensitivity of 104 Shigella clinical strains and 104 Escherichia coli strains isolated from patients with acute dysentery not treated with antibiotics in 1986-1987 was studied. It was shown that 100 per cent of the dysentery pathogens and colon bacilli were antibiotic resistant. Strains resistant simultaneously to chloramphenicol, ampicillin, streptomycin, tetracycline, monomycin and kanamycin were the most frequent among the dysentery pathogens. Colon bacilli and dysentery pathogens isolated from the same patient had specific sets of antibiotic resistance markers. Pathogenetic therapy of dysentery and exclusion of antibiotic use for several years did not result in lower numbers of Shigella antibiotic resistant strains.     

水平基因转移介导抗菌素耐药性传播机制的研究进展

近几十年来,病原菌耐药性的出现和蔓延已上升为严峻的公共卫生问题。越来越多研究表明,抗菌素抗性基因(antibiotic resistance genes,ARGs)不仅仅见于临床所分离的病原体,而是包括所有的致病菌、共生菌以及环境中的细菌,它们都能在可移动遗传元件和噬菌体的作用下,通过水平基因转移(horizontal gene transfer,HGT)途径获得耐药性,进而形成抗菌素耐药基因簇(耐药基因组)。HGT可导致抗菌素的耐药性在环境共生菌和病原菌之间传播扩散,这可通过临床上一些重要的抗菌素耐药基因的传播证实。传统观念认为HGT的三种机制中,接合对ARGs的传播影响最大,最近研究表明转化和转导对ARGs播散起到不可忽视的作用。通过深入了解耐药基因组的传播及其在动员病原菌耐药中发挥的作用,对于控制这些基因的播散是至关重要的。将讨论耐药基因组的概念,提供临床相关的抗菌素抗性基因水平基因转移的例子,对当前已研究的促使抗菌素耐药性传播的各种HGT机制进行回顾。     

Resistance epidemiology of gramnegative nonfermenting pathogens of nosocomial infections in intensive care units and surgical departments]

Etiological structure, patterns and antibiotic resistance mechanisms of gramnegative nonfermenting pathogens of nosocomial infections isolated from patients in intensive care units and surgical departments were investigated. One hundred thirty one clinical isolates, including 86 (65.6%) isolates of Pseudomonas aeruginosa and 45 (34.4%) isolates of Acinetobacter baumannii were tested. Carbapenems and cefoperazone/sulbactam showed the highest activity against the tested isolates. Eleven carbapenem resistant strains of P. aeruginosa were detected. The strains were found to possess genetic determinants of the VIM group encoding metal beta-lactamases.     

Diversity and characterization of antagonistic bacteria from tropical estuarine habitats of Cochin, India for fish health management

Mortalities due to pathogenic bacteria are a major problem in aquaculture, especially in larval rearing systems. Use of antibiotics to overcome this problem is not an option any more due to the increasing antibiotic resistance among pathogens. The present study aims to understand the diversity of bacteria with antagonistic properties in the tropical estuarine habitats of Cochin, located along the southwest coast of India, and to use them as an alternative to antibiotics in aquaculture. Among the 4,870 isolates screened, approximately 1 % showed significant antibacterial activity against six common aquaculture pathogens belonging to the genera Aeromonas and Vibrio. The antagonistic bacteria were identified as Bacillus (81 %) and Pseudomonas (19 %) using biochemical and 16S rRNA gene sequence homology. The isolates showing stable and higher levels of antibacterial activity were subjected to enzymatic expression profile, antibiotic resistance pattern and abiotic stress tolerance assays. As a result, five Pseudomonas spp. and four Bacillus spp., were identified as promising antagonistic isolates that could be exploited as probionts or microbial products (MP's), to control bacterial diseases in aquaculture rearing systems.