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Low-Level Antibiotic Resistance among Staphylococcus aureus and Gram-Negative Pathogens from Infected Skin and Soft Tissues in Rural Kenya
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作者 Justin Nyasinga Zubair Munshi +3 位作者 Lillian Musila Ephantus Mbugua Geoffrey Omuse Gunturu Revathi 《Open Journal of Medical Microbiology》 2024年第1期23-38,共16页
Introduction: Bacterial skin and soft tissue infections (SSTIs) are a cause of frequent inpatient and outpatient care visits whose causative agents are associated with a high antimicrobial resistance burden. For insig... Introduction: Bacterial skin and soft tissue infections (SSTIs) are a cause of frequent inpatient and outpatient care visits whose causative agents are associated with a high antimicrobial resistance burden. For insights on antimicrobial susceptibilities in a rural setting, we examined specimens from suspected SSTIs from two public health facilities in Kenya. We additionally assessed antibiotic use, appropriateness of empiric therapy and risk factors for SSTI. Methodology: Between 2021 and 2023, 265 patients at Kisii and Nyamira County Referral hospitals were enrolled. Wound swabs/aspirates were collected and processed following standard microbiological procedures. Identification and antimicrobial susceptibility were performed using the VITEK 2 Compact platform. Demographic, clinical, and microbiological data were analyzed with R Statistical software. Results: S. aureus was isolated in 16.2% (43/265) of patients with a methicillin resistance (MRSA) proportion of 14% (6/43). While 13/15 drugs elicited susceptibilities ranging from 84% - 100%, penicillin (16%) and trimethoprim-sulfamethoxazole [TMP-SXT] (23%) yielded the lowest susceptibilities. Escherichia coli (n = 33), Klebsiella pneumoniae (n = 8), Pseudomonas aeruginosa (n = 8), and Citrobacter species (n = 4) were the most commonly isolated gram-negative species. Gram-negative strains showed high susceptibilities to most of the tested drugs (71% - 100%) with the exception of ampicillin (18%), TMP-SXT (33%), and first and second generation cephalosporins. Conclusions: The low MRSA prevalence and generally high antibiotic susceptibilities for S. aureus and gram-negative bacteria present opportunities for antibiotic stewardship in the study setting. Diminished susceptibilities against penicillin/ampicillin and TMP-SXT accord with prevailing local data and add a layer of evidence for their cautious empiric use. 展开更多
关键词 S. aureus MRSA gram-negative Bacteria Antimicrobial resistance SSTIs Kenya
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Association between infections caused by multidrug-resistant gram-negative bacteria and mortality in critically ill patients 被引量:3
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作者 Elisabeth Paramythiotou Christina Routsi 《World Journal of Critical Care Medicine》 2016年第2期111-120,共10页
The incidence of gram-negative multidrug-resistant(MDR) bacterial pathogens is increasing in hospitals and particularly in the intensive care unit(ICU) setting. The clinical consequences of infections caused by MDR pa... The incidence of gram-negative multidrug-resistant(MDR) bacterial pathogens is increasing in hospitals and particularly in the intensive care unit(ICU) setting. The clinical consequences of infections caused by MDR pathogens remain controversial. The purpose of this review is to summarize the available data concerning the impact of these infections on mortality in ICU patients. Twenty-four studies, conducted exclusively in ICU patients, were identified through Pub Med search over the years 2000-2015. Bloodstream infection was the only infection examined in eight studies, respiratory infections in four and variable infections in others. Comparative data on the appropriateness of empirical antibiotic treatment were provided by only seven studies. In ten studies the presence of antimicrobial resistance was not associated with increased mortality; on the contrary, in other studies a significant impact of antibiotic resistance on mortality was found, though, sometimes, mediated by inappropriate antimicrobial treatment. Therefore, a direct association between infections due to gram-negative MDR bacteria and mortality in ICU patients cannot be confirmed. Sample size, presence of multiple confounders and other methodological issues may influence the results. These data support the need for further studies to elucidate the real impact of infections caused by resistant bacteria in ICU patients. 展开更多
关键词 Critically ILL patients INFECTIONS MULTIDRUG resistance gram-negative pathogens MORTALITY
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Immunogenomics for identification of disease resistance genes in pigs: a review focusing on Gram-negative bacilli
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作者 Shuhong Zhao Mengjin Zhu Hongbo Chen 《Journal of Animal Science and Biotechnology》 SCIE CAS 2013年第1期5-17,共13页
Over the past years, infectious disease has caused enormous economic loss in pig industry. Among the pathogens, gram negative bacteria not only cause inflammation, but also cause different diseases and make the pigs m... Over the past years, infectious disease has caused enormous economic loss in pig industry. Among the pathogens, gram negative bacteria not only cause inflammation, but also cause different diseases and make the pigs more susceptible to virus infection. Vaccination, medication and elimination of sick pigs are major strategies of controlling disease. Genetic methods, such as selection of disease resistance in the pig, have not been widely used. Recently, the completion of the porcine whole genome sequencing has provided powerful tools to identify the genome regions that harboring genes controlling disease or immunity. Immunogenornics, which combines DNA variations, transcriptorne, immune response, and QTL mapping data to illustrate the interactions between pathogen and host immune system, will be an effective genomics tool for identification of disease resistance genes in pigs. These genes will be potential targets for disease resistance in breeding programs. This paper reviewed the progress of disease resistance study in the pig focusing on Gram-negative bacilli. Major porcine Gram-negative bacilli and diseases, suggested candidate genes/pathways against porcine Gram-negative bacilli, and distributions of QTLs for immune capacity on pig chromosomes were summarized. Some tools for immunogenomics research were described. We conclude that integration of sequencing, whole genome associations, functional genomics studies, and immune response information is necessary to illustrate molecular mechanisms and key genes in disease resistance. 展开更多
关键词 PIG gram-negative bacteria Immunogenomics Disease resistance breeding
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Seafood as a Reservoir of Gram-negative Bacteria Carrying Integrons and Antimicrobial Resistance Genes in Japan 被引量:4
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作者 Ashraf M.Ahmed Akito Maruyama +2 位作者 Hazim O.Khalifa Toshi Shimamoto Tadashi Shimamoto 《Biomedical and Environmental Sciences》 SCIE CAS CSCD 2015年第12期924-927,共4页
PCR and DNA sequencing were used to screen and characterize integrons and resistance genes in Gram-negative bacteria isolated from seafood products in Japan.A total of 215 Gram-negative bacteria were isolated from loc... PCR and DNA sequencing were used to screen and characterize integrons and resistance genes in Gram-negative bacteria isolated from seafood products in Japan.A total of 215 Gram-negative bacteria were isolated from local and imported seafood samples collected from retail markets in Hiroshima Prefecture.Class 1 integrons containing gene cassettes encoding resistance to trimethoprim 展开更多
关键词 gene Seafood as a Reservoir of gram-negative Bacteria Carrying Integrons and Antimicrobial resistance Genes in Japan STR CMY
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Impact of Polymyxin Resistance on Virulence and Fitness among Clinically Important Gram-Negative Bacteria 被引量:1
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作者 Yuan Wang Qixia Luo +2 位作者 Tingting Xiao Yunying Zhu Yonghong Xiao 《Engineering》 SCIE EI CAS 2022年第6期178-185,共8页
Humanity is facing an enormous and growing worldwide threat from the emergence of multi-drug-resistant(MDR)Gram-negative bacteria such as Escherichia coli,Klebsiella pneumoniae,and Acinetobacter baumannii.Polymyxin B ... Humanity is facing an enormous and growing worldwide threat from the emergence of multi-drug-resistant(MDR)Gram-negative bacteria such as Escherichia coli,Klebsiella pneumoniae,and Acinetobacter baumannii.Polymyxin B and E(colistin)constitute the last-line therapies for treating MDR Gram-negative bacteria.Polymyxin is a cationic antibacterial peptide that can destroy the outer membrane of Gram-negative bacteria.With the increasing clinical application of polymyxin,however,there have been many reports of the occurrence of polymyxin-resistant Gram-negative bacteria.This resistance is mainly mediated by the modification or complete loss of lipopolysaccharide(LPS).LPS is also a virulence factor of Gram-negative bacteria,and alterations of LPS may correlate with virulence.Although it is generally believed that the biological costs associated with drug resistance may enable benign susceptible bacteria to overcome resistant bacteria when antibiotic pressure is reduced,some studies have shown that polymyxin-resistant bacteria are associated with higher virulence and greater fitness compared with their susceptible counterparts.To predict the development of polymyxin resis-tance and evaluate interventions for its mitigation,it is important to understand the relative biological cost of polymyxin resistance compared with susceptibility.The impact of polymyxin resistance mecha-nisms on the virulence and fitness of these three Gram-negative bacteria are summarized in this review. 展开更多
关键词 POLYMYXIN resistANCE VIRULENCE FITNESS gram-negative bacteria Acinetobacter baumannii Escherichia coli Klebsiella pneumoniae
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Risk factors and mortality rates of carbapenem-resistant Gram-negative bacterial infections in intensive care units
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作者 Tulay Orhan Kuloglu Gamze Kalin Unuvar +2 位作者 Fatma Cevahir Aysegul Ulu Kilic Emine Alp 《Journal of Intensive Medicine》 CSCD 2024年第3期347-354,共8页
Background The prevalence of hospital-acquired infections caused by carbapenem-resistant gram-negative bacteria(CRGNB)is increasing worldwide.Several risk factors have been associated with such infections.The present ... Background The prevalence of hospital-acquired infections caused by carbapenem-resistant gram-negative bacteria(CRGNB)is increasing worldwide.Several risk factors have been associated with such infections.The present study aimed to identify risk factors and determine the mortality rates associated with CRGNB infections in intensive care units.Methods This retrospective case-control study was conducted at Erciyes University Hospital(Kayseri,Turkey)between January 2017 and December 2021.Demographic and laboratory data were obtained from the Infection Control Committee data and record system.Patients who had CRGNB infection 48–72 h after hospitalization were assigned to the case group,while those who were not infected with CRGNB during hospitalization formed the control group.Risk factors,comorbidity,demographic data,and mortality rates were compared between the two groups.Results Approximately 1449 patients(8.97%)were monitored during the active follow-up period;of those,1171 patients were included in this analysis.CRGNB infection developed in 14 patients(70.00%)who had CRGNB colonization at admission;in 162(78.26%)were colonized during hospitalization,whereas 515(54.56%)were not colonized.There was no significant difference in age,sex(male/female)or comorbidities.The total length of hospital stay was statistically significantly longer(P=0.001)in the case group(median:24[interquartile range:3–378]days)than the control group(median:16[interquartile range:3–135]days).The rates of colonization at admission(25.5%;vs.10.6%,P=0.001)and mortality(64.4%vs.45.8%,P=0.001)were also significantly higher in the cases than in the control group,respectively.In the univariate analysis,prolonged hospitalization,the time from intensive care unit admission to the development of infection,presence of CRGNB colonization at admission,transfer from other hospitals,previous antibiotic use,enteral nutrition,transfusion,hemodialysis,mechanical ventilation,tracheostomy,reintubation,central venous catheter,arterial catheterization,chest tube,total parenteral nutrition,nasogastric tube use,and bronchoscopy procedures were significantly associated with CRGNB infections(P<0.05).Multivariate analysis identified the total length of stay in the hospital(odds ratio[OR]=1.02;95%confidence interval[CI]:1.01 to 1.03;P=0.001),colonization(OR=2.19;95%CI:1.53 to 3.13;P=0.001),previous antibiotic use(OR=2.36;95%CI:1.53 to 3.62;P=0.001),intubation(OR=1.59;95%CI:1.14 to 2.20;P=0.006),tracheostomy(OR=1.42;95%CI:1.01 to 1.99;P=0.047),and central venous catheter use(OR=1.62;95%CI:1.20 to 2.19;P=0.002)as the most important risk factors for CRGNB infection.Conclusions Colonization,previous use of antibiotics,and invasive interventions were recognized as the most important risk factors for infections.Future research should focus on measures for the control of these parameters. 展开更多
关键词 Multidrug resistance gram-negative bacteria INFECTION Intensive care units
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Detection of 16S rRNA Methylase Genes in Gram-Negative Bacilli Isolated from Hospitals in Changchun, China
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作者 Fan Zhao Hongyan Shi +2 位作者 Jinghua Li Jiaqi Zhou Yanbo Sun 《Advances in Infectious Diseases》 2013年第4期290-294,共5页
Methylation of 16S rRNA is an important mechanism of aminoglycoside resistance among gram-negative pathogens. In this report, 16S rRNA methylase genes were amplified using PCR among gram-negative bacillus isolates fro... Methylation of 16S rRNA is an important mechanism of aminoglycoside resistance among gram-negative pathogens. In this report, 16S rRNA methylase genes were amplified using PCR among gram-negative bacillus isolates from hospitals in the Changchun area of China and 16S rRNA methylase genotypes (armA, rmtB, rmtA, rmtC, rmtD, and npmA) were identified by direct sequencing. Fifty of the isolates (43.1%) harbored 16S rRNA methylase genes. The common 16S rRNA methylase genes were armA and rmtB (12.1% and 31.0%, respectively), whereas the rmtA, rmtC, rmtD, and npmA genes were absent from the sample. It suggests that the predominant 16S rRNA methylase genes among gramnegative bacilli in the Changchun area are armA and rmtB. 展开更多
关键词 16S RRNA Methylases gram-negative bacilli
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Detection of the Production of Klebsiella Pneumoniae Carbapenemase, New Delhi Metallo-Beta-Lactamase and Oxacillinase-48-Type Carbapenemases by Gram-Negative Bacilli in Resource-Limited Setting
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作者 Cecile Okalla Ebongue Gabin Gaël Simo +4 位作者 Jean Pierre Nda Mefo’o Grace Dalle Ngondi Emmanuel Roddy Mengue Guy Pascal Ngaba Dieudonne Adiogo 《Advances in Microbiology》 2021年第10期579-590,共12页
<b>Background:</b> The increasing resistance of bacteria to various antibiotics is a worldwide public health issue. Carbapenems that have elicited great hope in treating infections caused by multidrug-resi... <b>Background:</b> The increasing resistance of bacteria to various antibiotics is a worldwide public health issue. Carbapenems that have elicited great hope in treating infections caused by multidrug-resistant germs have seen their efficacy narrowed over time with the emergence of other novel resistance mechanisms, notably the production of Carbapenemases. <b>Methods:</b> A prospective cross-sectional study was conducted from May 2017 to May 2018 in Douala (Cameroon) to detect carbapenemase-producing Gram-negative bacilli. Isolated strains were identified using the Vitek2<sup>TM</sup> system. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method on agar plates with 20 selected commercially available antibiotic discs. The bacterial strains were tested for the production of three Carbapenemases (OXA-48, NDM, KPC), using an immuno-chromatographic technique, with the “RESIST-3 O.K.N. K-SeT” rapid detection kit. <b>Results:</b> During the study period, 1687 strains of Gram-negative bacilli were isolated in selected laboratories with a total of 200 multi-resistant strains identified (11.9%). Among the multi-resistant strains, <i>E. coli</i> was the species most represented in <i>Enterobacteriaceae</i> (27.5%) followed by <i>K. pneumoniae</i> (15.5%) and the non-fermenting Gram-negative bacilli were predominantly <i>P. aeruginosa</i> (20.5%). These strains mainly came from urine and pus, <i>i.e.</i> 41% and 32% respectively. Thirty-two (16%) strains produced one of the Carbapenemases with a higher frequency at the General Hospital (84%). NDM-type carbapenemase was the most frequently identified (8.5%), OXA-48 type 7.5%, and no KPC production was observed. Among the <i>Enterobacteriaceae</i> 22.9% produced Carbapenemases and only 5.1% of the non-fermenting bacilli produced these enzymes. The isolates strains were completely resistant to all antibiotics except Amikacin and Fosfomycin. The strains producing the NDM-type carbapenemase showed higher rates of resistance to almost all of the antibiotics tested. <b>Conclusion:</b> Multidrug-resistant strains are experiencing an increase in evolution. The apparition of strains producing Carbapenemases prominently, the NDM and OXA-48 favor this increase. The activities of antibiotics with high efficacies on these strains are low. 展开更多
关键词 CARBAPENEMASES gram-negative bacilli MULTIDRUG-resistANCE Cameroon
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Prevalence and Antimicrobial Resistance of Gram-Negative Bacteria Isolates in Shellfish Samples from Two River Estuaries in South-South Nigeria
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作者 Nsikan Samuel Udoekong Bassey Enya Bassey +2 位作者 Anne Ebri Asuquo Otobong Donald Akan Casmir Ifeanyichukwu Cajetan Ifeanyi 《Advances in Microbiology》 2021年第9期428-443,共16页
Antibiotic resistant bacteria pathogens remain the leading cause of shellfish borne diseases and a major health threat to humans worldwide. The objectives of this study were to isolate, identify, and determine the ant... Antibiotic resistant bacteria pathogens remain the leading cause of shellfish borne diseases and a major health threat to humans worldwide. The objectives of this study were to isolate, identify, and determine the antibiotic resistance patterns of Gram-negative bacteria from shellfish. We analyzed a total of 540 shellfish (117 clams, 88 oysters, and 136 periwinkles) samples collected from different vendors at Iko and Douglas Creeks in Akwa Ibom State, South-South Nigeria. Conventional cultural techniques, morphological, biochemical characteristics, and PCR amplification were used to identify the bacterial isolates. Antibiotic susceptibility tests (Kirby-Bauer disk diffusion method) and ESBL phenotype (disk) of the isolates were performed. One hundred and thirty-five (135) Gram-negative bacteria comprising 5 genera and 14 species were detected at a prevalence of: <i>Alcaligenes faecalis</i> <i><b>TRB</b></i>-7 38 (28.2%), <i>Pseudomonas oryzihabitans strain <b>KCB</i>005</b> 16 (11.9%), <i>Paenalcaligenes retgerii strain <b>B</i>5</b> 12 (8.9%) <i>Pseudomonas aeruginosa <b>JB</i>2</b> 10 (7.4%), <i>Providencia stuartii <b>DMC</i>-28b</b> 9 (6.7%), <i>Alcaligenes species <b>TLT</i>151</b> 8 (5.9%), <i>Pseudomonas aeruginosa <b>CIFRI DTSB</i>1</b> 7 (5.2%), <i>Paenalcaligenes species <b>UN</i>24</b> 7 (5.2%), <i>Alcaligenes faecalis <b>BT</i>10</b> 7 (5.2%), <i>Vibrio species strain <b>PrVy</i>108</b> 6 (4.4%), <i>Pseudomonas xiamenensis <b>C</i>10-2</b> 5 (3.7%), <i>Providencia vemicola <b>Bu</i>15_38</b> 4 (2.9%), <i>Pseudomonas anguillisceptica</i> <b>4029</b> 3 (2.2%), and <i>Pseudomonas aeruginosa <b>N</i>15-01092</b> 3 (2.2%). All tested isolates showed various degrees of resistance to the thirteen antimicrobials evaluated. High levels of resistance (100%) to cefepime and imipenem were expressed by all isolates except the <i>Providencia</i> species. For the EBSL indicators, all isolates apart from <i>Alcaligenes</i> species were resistant (100%) to ceftriaxone. All <i>Vibrio</i> species were susceptible to norfloxacin, nalidixic acid, and ceftazidime. The identification of antibiotic resistant Gram-negative bacteria (GNARB) from shellfish in this study highlights the risk of disseminated multi-drug resistance—a serious public health concern. 展开更多
关键词 SHELLFISH gram-negative Bacteria ESBL-Indicators Multi-Drug resistance Calabar
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Mechanisms of tigecycline resistance in Gram-negative bacteria:A narrative review
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作者 Wenya Su Wenjia Wang +5 位作者 Ling Li Mengge Zhang Hai Xu Chengzhang Fu Xiuhua Pang Mingyu Wang 《Engineering Microbiology》 2024年第3期54-61,共8页
Tigecycline serves as a critical“final-resort”antibiotic for treating bacterial infections caused by multidrug-resistant bacteria for which treatment options are severely limited.The increasing prevalence of tigecyc... Tigecycline serves as a critical“final-resort”antibiotic for treating bacterial infections caused by multidrug-resistant bacteria for which treatment options are severely limited.The increasing prevalence of tigecycline resistance,particularly among Gram-negative bacteria,is a major concern.Various mechanisms have been iden-tified as contributors to tigecycline resistance,including upregulation of nonspecific Resistance Nodulation Divi-sion(RND)efflux pumps due to mutations in transcriptional regulators,enzymatic modification of tigecycline by monooxygenase enzymes,and mutations affecting tigecycline binding sites.This review aims to consolidate our understanding of tigecycline resistance mechanisms in Gram-negative bacteria and offer insights and perspectives for further drug development. 展开更多
关键词 gram-negative bacteria TIGECYCLINE Tigecycline resistance resistance mechanisms RND efflux pump
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Isolation and Antibiotic-Resistant Pattern of Opportunistic Infectious Microbes from the Infected Sites of Oral Cancer Patients Compared to That of Healthy People Oral Microbiota 被引量:1
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作者 Zareen Nawar Samiha Ashreen +1 位作者 M. Mahboob Hossain Akash Ahmed 《Advances in Microbiology》 2021年第8期343-359,共17页
<b>Introduction:</b> Oral cancer is the third most prominent type of cancer in Bangladesh. During or after oral cancer treatment, immune-compromised cancer patients may be susceptible to an infection by mu... <b>Introduction:</b> Oral cancer is the third most prominent type of cancer in Bangladesh. During or after oral cancer treatment, immune-compromised cancer patients may be susceptible to an infection by multi-drug-resistant opportunistic microbes. This study aims to identify the prevalent microorganisms from the infected site of oral cancer patients and observe their antibiotic susceptibility pattern. <b>Materials and Methods:</b> Clinical samples were collected from the infected sites of oral cancer patients and healthy people. The swabs collected were placed on nutrient agar slant, then incubated for 24 hours at 37ºC. Bacteria from the slant were inoculated in several selective media (Mannitol Salt Agar Media, KF Streptococcus Agar media, Cetrimide Agar, Eosin Methylene Blue Agar). Several biochemical tests identified opportunistic microorganisms. Finally, the antibiotic susceptibility test was performed by the Kirby Bauer disc diffusion method. <b>Results:</b> The study found that 65.4% of microbes isolated from the patients’ oral cavities were Gram-negative bacteria, and 34.6% were Gram-positive bacteria. Among the patient group isolates (n = 55), the most prevalent organism was <i>Pseudomonas</i> spp. (30;54.54%). Others were <i>Klebsiella</i> spp. (27;49.09%), <i>Staphylococcus</i> spp. (24;43.63%), <i>E. coli</i> (14;25.45%), <i>Streptococcus</i> spp. (14;25.45%), <i>Proteus</i> spp. (12;21.8%) and <i>Enterococcus</i> spp. (6;10.90%). Both Gram-positive and Gram-negative microbes from the patient group have shown high resistance to the commonly used antibiotics. In the control group (n = 50), the most prevalent organism was <i>Staphylococcus</i> spp. (15;30%). Other organisms were <i>Streptococcus</i> spp. (6;12%), <i>Klebsiella</i> spp. (11;22%), <i>E. coli</i> (3;6%), <i>Streptococcus</i> spp. (14;25.45%), <i>Pseudomonas</i> spp. (8;16%). The microbes of the control group showed less resistance to the antibiotics and rather showed sensitivity to them. <b>Conclusion:</b> The study revealed a high prevalence of multi-drug-resistant opportunistic microbes on immune-compromised oral cancer patients compared to microbes isolated from healthy people’s oral cavity. 展开更多
关键词 Antibiotic resistance gram-negative Bacteria Gram-Positive Bacteria Immuno-Compromised Oral Cancer
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Metallo-β-lactamase producing nonfermentative gram-negative bacteria:An increasing clinical threat among hospitalized patients
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作者 Varsha Gupta Shailpreet Sidhu Jagdish Chander 《Asian Pacific Journal of Tropical Medicine》 SCIE CAS 2012年第9期718-721,共4页
Objective:To detect and evaluate the various methods for metallo-β-lactamases(MBL) production in Pseudomonas aeruginosa(P.aeruginosa) and Acinetobacter species.Methods:A total of 109 P.aeruginosa and 85 Acinetobacter... Objective:To detect and evaluate the various methods for metallo-β-lactamases(MBL) production in Pseudomonas aeruginosa(P.aeruginosa) and Acinetobacter species.Methods:A total of 109 P.aeruginosa and 85 Acinetobacter species were screened for imipenem resistance by Kirby- Bauer disc diffusion methods.Detection of MBL production was(lone by imipenem-EDTA combined disc test,double disc synerygy test(DDST) and imipenem-EDTA MBL E test.Results: A total of 63(57.8%) strains of P.aeruginosa and 46(54.1%) strains of Acinetobacter spp.were found to be resistant to imipenem.Of the 63 imipenem resistant P.aeruginosa tested for MBL production.44(69.89;) were found to be positive and among 46 imipenem resistant Acinetobacter. 19(41.3%) were shown to be the MBL producers.Conclusions:Imipenem-EDTA combined disc test and MBL E test are equally effective for MBL detection in both P.aeruginosa and Acinetobacter spp.,but given the cost-constraints,combined disc can be used as a convenient screening method in the clinical microbiology laboratory. 展开更多
关键词 Carbapenem-imipenem Metallo-β-lactamases Non fermentative gram-negative bacilli
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The Increased Frequency of Carbapenem Resistant Non Fermenting Gram Negative Pathogens as Causes of Health Care Associated Infections in Adult Cancer Patients
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作者 Hadir A. El-Mahallawy Rasha M. Abdel Hamid +2 位作者 Safaa Shawky Hassan Samah Radwan Magdy Saber 《Journal of Cancer Therapy》 2015年第10期881-888,共8页
Background and Aim: Multi drug resistant Non fermenting gram negative bacilli (NFGNB) have emerged as a major cause of health-care associated infections especially in immunocompromised hosts. The aim of the study was ... Background and Aim: Multi drug resistant Non fermenting gram negative bacilli (NFGNB) have emerged as a major cause of health-care associated infections especially in immunocompromised hosts. The aim of the study was to investigate the prevalence of NFGNB as a cause of health-care associated infections (HAI) in cancer patients and determine their resistance pattern. Patients and Methods: During the study period, 158 NFGNB isolates were collected. Microscan Walk Away 9 was used for identification and testing for the metallo-β-lactamases (MBLs) was done by Imipenem-EDTA combined disk synergy test (CDST-IPM). Results: NFGNB represented 29.0% of infections caused by gram negative organisms. Carbapenem resistance, the multi-drug resistant (MDR) phenotype, and MBL production were documented in 70%, 63%, and 59% of NFGNB isolates, respectively. MDR-NFGNB rates were significantly higher among hospitalized patients, medical department and those with longer duration of hospital stay (p = 0.034, 0.026, 0.019;respectively) than non MDR-NFGNB. Conclusion: A high level of carbapenem and multi-drug resistance were detected among the non-fermenter pathogens isolated from hospitalized cases and were more frequently encountered in high risk adult cancer patients requiring longer duration of hospitalization. The MDR-NFGNB are constituting important causes of health-care associated infections in cancer patients. 展开更多
关键词 Multi Drug resistant ORGANISMS (MDRO) Non-Fermenting Gram Negative bacilli (NF-GNB) Metallo-β-Lactamases (MBL) Surgical Site INFECTIONS (SSI)
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Overview of Multidrug-Resistant Pseudomonas aeruginosa and Novel Therapeutic Approaches
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作者 Marilyn Porras-Gomez Jose Vega-Baudrit Santiago Nunez-Corrales 《Journal of Biomaterials and Nanobiotechnology》 2012年第4期519-527,共9页
Gram-negative bacilli Pseudomonas aeruginosa is an important pathogen in hospitalized patients, contributing to their morbidity and mortality due to its multiple resistance mechanisms. Therefore, as therapeutic option... Gram-negative bacilli Pseudomonas aeruginosa is an important pathogen in hospitalized patients, contributing to their morbidity and mortality due to its multiple resistance mechanisms. Therefore, as therapeutic options become restricted, the search for new agents is a priority. Latterly an accelerated increase in frequency of multidrug-resistant clinical strains has severely limited the availability of therapeutic options. Several in vitro and in vitro studies evaluating the efficacy of different antimicrobials agents and development of vaccines against P. aeruginosa have been reported as novel approaches, such as inhibition of virulence factor expression or inhibition of their metabolic pathways. 展开更多
关键词 bacilli gram-negative Pseudomonas aeruginosa Multidrug resistance PATHOGEN resistance Mechanisms
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2022年沈阳市某三级甲等医院细菌耐药监测结果分析
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作者 郭丽洁 杨书桓 +3 位作者 李富顺 陈静静 王齐晖 褚云卓 《中国医科大学学报》 CAS 北大核心 2024年第5期458-463,共6页
目的分析2022年沈阳市某三级甲等医院病原菌分布及其耐药情况,为医院制定抗菌药物应用策略提供依据。方法收集从2022年沈阳市某三级甲等医院就诊患者中分离的病原菌,按照全国临床检验操作规程的要求进行菌株鉴定及药敏试验,使用Whonet ... 目的分析2022年沈阳市某三级甲等医院病原菌分布及其耐药情况,为医院制定抗菌药物应用策略提供依据。方法收集从2022年沈阳市某三级甲等医院就诊患者中分离的病原菌,按照全国临床检验操作规程的要求进行菌株鉴定及药敏试验,使用Whonet 5.6软件进行数据分析。结果2022年共分离4968株病原菌,其中前5位为大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、屎肠球菌和铜绿假单胞菌。大肠埃希菌和肺炎克雷伯菌对碳青霉烯药物耐药率分别为1.9%和17.7%,阴沟肠杆菌对亚胺培南和美罗培南耐药率分别为26.7%和25.0%。耐甲氧西林金黄色葡萄球菌(MRSA)分离率15.6%。万古霉素耐药屎肠球菌、利奈唑胺耐药粪肠球菌分离率分别为7.1%、11.6%。热带念珠菌对氟康唑耐药率>20%。结论该医院病原菌分布及耐药率与国内其他地区监测结果存在差异,有必要进行医院菌株的耐药监测,及时了解病原菌分布及耐药情况,为抗感染诊治提供依据。 展开更多
关键词 细菌耐药监测 药敏试验 碳青霉烯耐药革兰氏阴性杆菌
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2015—2021年CHINET儿童患者临床分离不发酵糖革兰阴性杆菌耐药性变迁
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作者 董方 吕志勇 +86 位作者 杨溪 杨洋 胡付品 朱德妹 徐英春 张小江 张朝霞 季萍 谢轶 康梅 王传清 王爱敏 徐元宏 黄颖 孙自镛 陈中举 倪语星 孙景勇 褚云卓 田素飞 胡志东 李金 俞云松 林洁 单斌 杜艳 郭素芳 魏莲花 邹凤梅 张泓 王春 胡云建 艾效曼 卓超 苏丹虹 郭大文 赵金英 喻华 黄湘宁 刘文恩 李艳明 金炎 邵春红 徐雪松 鄢超 王山梅 楚亚菲 张利侠 马娟 周树平 周艳 朱镭 孟晋华 胡芳芳 沈瀚 周万青 贾伟 李刚 吴劲松 卢月梅 李继红 段金菊 康建邦 马晓波 郑燕萍 郭如意 朱焱 陈运生 孟青 王世富 胡雪飞 沈继录 汪瑞忠 房华 俞碧霞 赵勇 龚萍 温开镇 张贻荣 刘江山 廖龙凤 顾洪芹 姜琳 贺雯 薛顺虹 冯佼 岳春雷 《中国感染与化疗杂志》 CAS CSCD 北大核心 2024年第2期152-161,共10页
目的了解CHINET中国细菌耐药性监测网儿童患者临床分离的不发酵糖革兰阴性杆菌的分布和耐药性变迁。方法按CHINET耐药监测统一方案使用纸片扩散法或商品化药敏试验自动测试仪进行药敏试验。按CLSI 2021年版标准判断结果。结果临床分离... 目的了解CHINET中国细菌耐药性监测网儿童患者临床分离的不发酵糖革兰阴性杆菌的分布和耐药性变迁。方法按CHINET耐药监测统一方案使用纸片扩散法或商品化药敏试验自动测试仪进行药敏试验。按CLSI 2021年版标准判断结果。结果临床分离不发酵糖革兰阴性杆菌26987株中,主要以假单胞菌属和不动杆菌属细菌为主,其他各菌属均有不等检出。下呼吸道标本占51.1%,居于首位,脓液及伤口分泌物占16.5%,尿液标本占9.2%。这些菌株主要分离于内科病房(38.1%)、儿科ICU(26.8%)和外科病房(18.9%)。铜绿假单胞菌对氨曲南耐药率最高,为22.7%,对碳青霉烯类抗生素耐药率为15.6%,对其他抗菌药物耐药率均低于10%。碳青霉烯类耐药鲍曼不动杆菌检出率54.1%,明显高于铜绿假单胞菌的15.6%,2020年和2021年出现下降趋势。碳青霉烯类耐药铜绿假单胞菌在新生儿期患儿的检出率(34.7%)高于其他患儿;碳青霉烯类耐药鲍曼不动杆菌随患儿年龄增长检出率逐渐增高(39.9%~65.4%)。结论儿童分离铜绿假单胞菌和鲍曼不动杆菌对各种抗菌药物的耐药率呈锯齿形变化,对大多抗菌药物的耐药率有下降趋势。不同年龄段患儿中碳青霉烯类耐药菌株的检出率不同。不发酵糖革兰阴性杆菌的分布特征和不同菌属菌株的耐药特征存在差异。因此,在儿科对此类菌进行耐药监测十分必要。 展开更多
关键词 抗菌药物 细菌耐药性 儿童 不发酵糖革兰阴性杆菌 铜绿假单胞菌 鲍曼不动杆菌
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2021-2023年某院碳青霉烯类耐药革兰阴性杆菌分布及耐药性分析
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作者 黄双旺 何宇巍 +2 位作者 梁珠薇 王楠 苏歆 《国际医药卫生导报》 2024年第7期1087-1090,共4页
目的分析广东省第二中医院临床分离碳青霉烯类耐药革兰阴性杆菌(Carbapenem resistant Gram-negative bacilli,CR-GNB)的分布情况和耐药性特点。方法选取广东省第二中医院2021年1月1日至2023年6月30日经临床分离鉴定检测的2754株CR-GNB... 目的分析广东省第二中医院临床分离碳青霉烯类耐药革兰阴性杆菌(Carbapenem resistant Gram-negative bacilli,CR-GNB)的分布情况和耐药性特点。方法选取广东省第二中医院2021年1月1日至2023年6月30日经临床分离鉴定检测的2754株CR-GNB;使用WHONET5.6软件分析CR-GNB的分布特征及药敏检测耐药性特点。结果临床分离筛选出CR-GNB 2754株,其中,碳青霉烯类耐药肺炎克雷伯氏菌(Carbapenem resistant Klebsiella pneumoniae,CRKP)843株(30.6%),碳青霉烯类耐药鲍曼不动杆菌(Carbapenem-resistant Acinetobacter baumannii,CRAB)765株(27.8%),碳青霉烯类耐药铜绿假单胞菌(Carbapenem-resistant Pseudomonas aeruginosa,CRPA)679株(24.7%),碳青霉烯类耐药大肠埃希菌(Carbapenem-resistant Escherichia coli,CREC)203株(7.4%),其他CR-GNB 264株(9.5%)。CR-GNB主要标本来源:痰液1702株(61.8%),尿液639株(23.2%),肺泡灌洗液232株(8.4%),血液78株(2.8%),分泌物71株(2.6%)。主要科室分布:呼吸与危重症医学科病区532株(19.3%),重症医学科病区365株(13.3%),针康一区病区325株(11.8%),针康七区病区181株(6.6%)。针康病区合计分离出1330株(48.9%)。CR-GNB普遍对抗生素存在多重耐药或泛耐药,对少数药物敏感率较高;CRKP对替加环素的敏感率是100.0%;CRAB对阿米卡星、妥布霉素、米诺环素的敏感率分别是73.9%、59.0%、49.3%;CRPA对阿米卡星、妥布霉素、多黏菌素B的敏感率分别为78.1%、75.5%、46.5%;CREC对替加环素的敏感率为100.0%。结论广东省第二中医院临床分离的CR-GNB以CRKP、CRAB、CRPA和CREC为主。CR-GNB呈多重耐药或泛耐药,可选择的治疗药物有限,临床需规范抗生素的使用,同时根据CR-GNB的耐药特点制定有效可行的治疗方案,防范CR-GNB在院内感染和传播。 展开更多
关键词 碳青霉烯类耐药革兰阴性杆菌 分布特点 耐药性
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2022年CHINET三级医院细菌耐药监测 被引量:3
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作者 郭燕 胡付品 +111 位作者 朱德妹 汪复 蒋晓飞 徐英春 张小江 张峰波 季萍 谢轶 肖玉玲 王传清 付盼 徐元宏 黄颖 孙自镛 陈中举 孙景勇 陈庆 褚云卓 田素飞 胡志东 李金 俞云松 林洁 单斌 许云敏 郭素芳 王艳艳 魏莲花 李可可 张泓 潘芬 胡云建 艾效曼 卓超 苏丹虹 郭大文 赵金英 喻华 黄湘宁 刘文恩 李艳明 金炎 邵春红 徐雪松 李威 王山梅 楚亚菲 张利侠 马娟 周树平 周艳 朱镭 孟晋华 董方 吕志勇 胡芳芳 沈瀚 周万青 贾伟 李刚 吴劲松 卢月梅 李继红 孙倩 段金菊 康建邦 马晓波 郑燕青 郭如意 朱焱 陈运生 孟青 王世富 胡雪飞 黄文辉 李娟 石泉贵 杨娟 热孜瓦古丽·阿不力米提 黄莉莉 邵雪君 任晓艳 李冬 张群 陈雪 黎日海 徐洁丽 高凯杰 徐璐 林琳 张卓 刘健龙 付敏 郭映辉 张文超 王增国 贾凯 夏云 孙珊 杨慧敏 苗艳 周明明 张诗海 刘红娟 陈楠 李婵 沈继录 门万琪 王鹏 张晓威 刘彦彦 安勇 《中国感染与化疗杂志》 CAS CSCD 北大核心 2024年第3期277-286,共10页
目的监测2022年CHINET三级医院临床分离菌对抗菌药物的敏感性。方法国内58所三级医院临床分离菌采用纸片扩散法或商品化药敏试验自动测试仪按CHINET统一监测技术方案进行抗菌药物敏感性试验。结果按CLSI M1002022年版折点标准判断。结... 目的监测2022年CHINET三级医院临床分离菌对抗菌药物的敏感性。方法国内58所三级医院临床分离菌采用纸片扩散法或商品化药敏试验自动测试仪按CHINET统一监测技术方案进行抗菌药物敏感性试验。结果按CLSI M1002022年版折点标准判断。结果收集2022年1月1日-12月31日上述医院临床分离菌共318013株,其中革兰阳性菌占29.5%,革兰阴性菌占70.5%。金黄色葡萄球菌、表皮葡萄球菌和其他凝固酶阴性葡萄球菌(除假中间葡萄球菌和施氏葡萄球菌外)中甲氧西林耐药株的检出率分别为28.3%、76.7%和77.9%。MRSA中有94.0%的菌株对甲氧苄啶-磺胺甲噁唑敏感;MRSE中有90.8%的菌株对利福平敏感,未发现万古霉素耐药株。肠球菌属中粪肠球菌对多数测试抗菌药物的耐药率均显著低于屎肠球菌,两者中均有少数万古霉素耐药株。2022年儿童和成人中分离的非脑膜炎肺炎链球菌中PSSP的检出率分别为94.2%和95.7%。除克雷伯菌属细菌对碳青霉烯类的耐药率范围为21.7%~23.1%外,其他细菌的耐药率多在13.1%以下。除天然耐药菌株外,其他肠杆菌目细菌对替加环素、黏菌素和多黏菌素B高度敏感,耐药率范围为0.1%~13.3%。铜绿假单胞菌对美罗培南的耐药率从2019年的23.5%下降至2022年的18.0%;鲍曼不动杆菌对美罗培南的耐药率亦从2019年的79.0%下降至2022年的72.5%。结论三级医院临床分离菌对常见抗菌药物的耐药率仍呈增长趋势,但碳青霉烯类耐药肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌等多种重要耐药细菌的检出率近年来呈现连续下降趋势,提示加强细菌耐药监测,开展多学科联动的方式对控制耐药细菌的流行播散是行之有效的。 展开更多
关键词 三级医院 细菌耐药监测 药物敏感性试验 碳青霉烯类耐药革兰阴性杆菌
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异基因造血干细胞移植后短期内死亡的危险因素分析 被引量:1
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作者 高思雨 姚莉红 +6 位作者 边志磊 张素平 李丽 范金鹏 秦菁 彭英楠 万鼎铭 《中国组织工程研究》 CAS 北大核心 2024年第13期2009-2016,共8页
背景:异基因造血干细胞移植是治愈各种血液病的有效甚至唯一手段,但患者移植后短期内死亡率较高。目的:探讨影响血液病患者异基因造血干细胞移植后短期(100 d)内总体生存的危险因素,旨在降低异基因造血干细胞移植后短期(100 d)内死亡率... 背景:异基因造血干细胞移植是治愈各种血液病的有效甚至唯一手段,但患者移植后短期内死亡率较高。目的:探讨影响血液病患者异基因造血干细胞移植后短期(100 d)内总体生存的危险因素,旨在降低异基因造血干细胞移植后短期(100 d)内死亡率及有效预防相关危险因素。方法:回顾性分析于2018-01-01/2021-06-30在郑州大学第一附属医院造血干细胞移植中心行异基因造血干细胞移植的585例血液病患者的临床资料,探究影响血液病患者异基因造血干细胞移植后100 d内总体生存的危险因素。结果与结论:共585例血液病患者行异基因造血干细胞移植,92例死于移植后100 d内,死亡率为15.7%(92/585),死亡时中位年龄为26.5岁(1-56岁),死亡病例的中位生存时间为48 d(0-97 d)。单因素分析显示,年龄≥14岁、发生急性移植物抗宿主病、Ⅳ度急性移植物抗宿主病、细菌血流感染及耐碳青霉烯类革兰阴性杆菌血流感染是影响异基因造血干细胞移植后100 d内总体生存的危险因素(P<0.05);多因素分析显示,年龄≥14岁、发生Ⅲ-Ⅳ度急性移植物抗宿主病、细菌血流感染及耐碳青霉烯类革兰阴性杆菌血流感染是影响异基因造血干细胞移植后100 d内总体生存的独立危险因素,相对危险度分别为1.77(95%CI 1.047-2.991),7.926(95%CI 3.763-16.695),2.039(95%CI 1.117-3.722),3.389(95%CI 1.563-7.347)。结果表明:异基因造血干细胞移植后短期内全因死亡率较高,对于移植后短期内合并细菌血流感染、Ⅲ-Ⅳ度急性移植物抗宿主病的患者需及时发现、给予有效治疗,从而改善异基因造血干细胞移植的疗效。 展开更多
关键词 异基因造血干细胞移植 急性移植物抗宿主病 血流感染 耐碳青霉烯类革兰阴性杆菌血流感染 危险因素
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耐碳青霉烯类革兰阴性菌抗菌药物治疗现状及进展
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作者 胡琪 杨诗语 +5 位作者 刘强 胡骁 陶雪 易辉 边原 龙恩武 《医药导报》 CAS 北大核心 2024年第10期1572-1577,共6页
随着碳青霉烯类抗菌药物的广泛使用,耐碳青霉烯类革兰阴性菌临床检出率呈明显上升态势。耐碳青霉烯类革兰阴性菌分离株通常具有广泛耐药性或全耐药性,导致抗微生物治疗选择有限且感染者病死率高,造成严重的公共卫生威胁。耐碳青霉烯类... 随着碳青霉烯类抗菌药物的广泛使用,耐碳青霉烯类革兰阴性菌临床检出率呈明显上升态势。耐碳青霉烯类革兰阴性菌分离株通常具有广泛耐药性或全耐药性,导致抗微生物治疗选择有限且感染者病死率高,造成严重的公共卫生威胁。耐碳青霉烯类革兰阴性菌的临床治疗包括单一或联合使用抗菌药,如多黏菌素、替加环素、磷霉素等,一些新的抗菌药物和治疗方法也在开发中。由于抗菌药物的选择有限,耐碳青霉烯类革兰阴性菌感染的临床治疗面临严峻的挑战。因此,该文通过综述耐碳青霉烯类革兰阴性菌的抗菌药物治疗现状及进展,以期为临床提供参考。 展开更多
关键词 碳青霉烯类 耐药 革兰阴性菌 治疗策略
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