喹诺酮类和β－内酰胺类抗菌药物对老年人感染中耐药菌抗菌活性比较

通过１８种抗菌药物对老年感染患者中分离耐药菌４５０株的抗菌活性比较表明：第三代头孢菌素对氨苄青霉素耐药菌具有较强抗菌活性，其中对氨苄耐药的大肠杆菌、克雷白菌和产气肠杆菌的耐药率均低于８％。对于高度耐药菌，亚胺培南与氟喹诺酮类抗菌药物均显示较好的抗菌作用。亚胺培南浓度为８ｍｇ／Ｌ时，可抑制９３．８％高度耐药菌，环丙沙星与氧氟沙星分别在２ｍｇ／Ｌ和４ｍｇ／Ｌ时可抑菌９０．６％。     

喹诺酮类和β—内酰胺类抗菌药物对老年人感染中耐药菌抗菌…

通过１８种抗菌药物对老年感染患者中分离耐药菌４５０株的抗菌活性比较表明：第三代头孢菌素对氨苄青霉素耐药菌具有较强抗菌活性，其中对氨苄耐药的大肠杆菌、克雷白菌和产气肠杆菌的耐药率均低于８％。对于高度耐药菌，亚胺培南与氟喹诺酮类抗菌药物均显示较好的抗菌作用。亚胺培南浓度为８ｍｇ／Ｌ时，可抑制９３．８％高度耐药菌，环丙沙星与氧氟沙星分别在２ｍｇ／Ｌ和４ｍｇ／Ｌ时可抑菌９０．６％。     

医院检出阴沟肠杆菌耐药性及耐药基因

目的了解临床分离阴沟肠杆菌耐药性与耐药基因情况,为临床合理选用抗菌药物提供理论依据。方法收集赣南医学院第一附属医院临床分离的阴沟肠杆菌40株,琼脂稀释法与纸片扩散法检测常用抗菌药物的敏感性,采用PCR方法对12种耐药基因进行检测。将该院检出的40株阴沟肠杆菌作为研究样本,采用琼脂稀释法与纸片扩散法行药敏试验,而后采用序列分析法与PCR(聚合酶反应)对12种耐药相关基因进行分析。结果经分析后的药物敏感结果显示,40株阴沟肠杆菌标本对头孢吡肟耐药率以15.0%为最低,而对美罗培南与亚胺培南敏感率均为100%,其他抗菌耐药率范围为42.0%~92.5%;耐药基因共8类,分别为sull、Int I 1、aac(3,')-I、Amp C、CTX-M-9、CTX-M-3、SHV-2a、TEM-1,sull+Int I1为大部分菌株所携带;耐药谱分为9型(A-I),其中以A、D占比较高,且基因分型与其分型存在一定的相关性。结论阴沟肠杆菌有高度与多重耐药性特征,其耐药机制较为复杂且为多种耐药机制共同作用。     

阴沟肠杆菌耐药及ampC基因表达状况研究

目的 了解144株阴沟肠杆菌的耐药现状及ampC基因的表达。方法 通过纸片扩散法检测阴沟肠杆菌的药敏情况。聚合酶链反应（PCR）法检测ampC基因，克隆测序分析其特异性，并根据耐药表型对ampC基因表达状况进行分析。结果 144株阴沟肠杆菌对亚胺培南的敏感率高达98.6%，对头孢吡肟和头孢哌酮/舒巴坦的敏感率分别为65.9%和63.9%，但对阿莫西林/克拉维酸，头孢呋辛和头孢噻肟等抗菌药物的敏感率较低。120株ampC基因阳性（占83.3%)，其中36株高水平表达（占30.0%),45株诱导表达（占37.5%),未表达或低水平表达的有39株（占32.5%)，有56株合并产超广谱β-内酰胺酶（ESBLs)（占46.7%)，单纯诱导产AmpC酶的菌株除对阿莫西林/克拉维酸和头孢呋辛敏感率低外，对其他抗菌药物的敏感率均在90%以上；而单纯高产AmpC酶的菌株仅对亚胺培南和头孢吡肟的敏感率在85%以上，如合并产ESBLs，则对头孢吡肟的敏感率下降。结论 阴沟肠杆菌耐药状况严重。明确ampC基因的表达状况有助于临床抗菌药物的选用。     

头孢西丁耐药肠杆菌科高产AmpC酶的细菌研究

目的 研究头孢西丁耐药肠杆菌科细菌高产头孢菌素酶（AmpC酶）菌株的分离、分布及耐药现状。方法 无重复收集临床分离头孢西丁耐药肠杆菌科细菌86株,酶提取物三维试验检测高产AmpC酶,纸片扩散法测定菌株对12种常用抗菌药物的敏感性。结果 头孢西丁耐药肠杆菌科细菌高产AmpC酶阳性率为23．3％（20／86）,以阴沟肠杆菌最高,达39．4％（13／33）。在常用β-内酰胺类抗生紊中,除亚胺培南和头孢吡肟外,高产AmpC酶菌株的耐药率显著高于非产酶株。结论 细菌高产AmpC酶是对头孢西丁耐药的主要原因之一;高产AmpC酶菌株的多重耐药和交叉耐药现象相当严重,应高度重视高产AmpC酶细菌的监测与控制。     

2004-2005年卫生部全国革兰阴性菌细菌耐药性监测

目的 建立全国性细菌耐药监测网,了解我国细菌耐药流行情况.方法 以标准平皿二倍稀释法测定抗菌药物最低抑菌浓度(MIC),并按国家临床实验室标准委员会2004年标准计算细菌敏感度与耐药率.结果 按照监测方案,收集2004年10月1日至2005年9月30日全国15座城市17家医院的4 075株临床分离致病菌,行MIC测定.其中革兰阴性菌3 150株,占77.3%.肠杆菌科细菌对碳青霉烯类抗生素保持较高敏感度,拉氧头孢、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦和头孢吡肟等具有较好的抗菌活性,耐药率<10%.非发酵革兰阴性菌中铜绿假单胞菌和鲍曼不动杆菌对亚胺培南的耐药率分别为10.6%和10.4%,酶抑制剂复方制剂和氟喹诺酮类药物也有较强抗菌作用.结论 大肠埃希菌和鲍曼不动杆菌耐药率增长明显,喹诺酮及氨基糖苷类药物对肠杆菌科细菌抗菌作用并不高,应引起广泛关注.     

渭南地区1103株革兰阴性杆菌耐药状况监测分析

目的:了解渭南地区革兰阴性杆菌的分布情况和耐药现状,为临床合理使用抗生素提供依据。方法:对分离得到的1 892例菌株中的1 103株革兰氏阴性杆菌,采用API系列鉴定,K-B方法药敏纸片进行药敏试验,判断常用抗生素的耐药情况。结果:1 103株革兰氏阴性杆菌占全部分离菌株的58.30%(1 103/1 892),其中,检出率最高的是大肠埃希菌28.92%(319株),其他常见菌依次为铜绿假单胞菌17.68%(195株),肺炎克雷伯菌12.33%(136株),鲍曼不动杆菌11.51%(127株),产酸克雷伯菌5.08%(56株),产气肠杆菌3.81%(42株),阴沟肠杆菌3.80%(41株),嗜麦芽窄食单胞菌3.17%(35株),洛菲不动杆菌2.17%(24株)。分离出的主要肠杆菌科细菌对头孢他啶、阿米卡星、头孢吡肟、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦耐药率低,大肠埃希菌、肺炎克雷伯菌、产气肠杆菌对以上几种药物的耐药率低于22%,阴沟肠杆菌对以上几种药物的耐药率略高但也低于40%。分离出的主要肠杆菌细菌未检到对亚胺培南和美罗培南耐药的耐药株。铜绿假单胞菌对头孢他啶、头孢吡肟、亚胺培南、美罗培南、头孢哌酮/舒巴坦、阿米卡星的耐药率较低,低于30%。鲍曼不动杆菌对亚胺培南、美罗培南、头孢哌酮/舒巴坦的耐药率较低,低于30%。产ESBLs大肠埃希菌、肺炎克雷伯菌、产酸克雷伯菌的检出率分别为36.99%、21.32%、17.86%。结论:由于常见菌株的耐药现象严重且耐药率不断增高,应当加强病原菌的耐药性监测,合理规范使用抗菌药物。     

2010～2011年我院住院患者肠杆菌科细菌感染情况及耐药性分析

目的了解医院临床分离肠杆菌科细菌的分布及对常用药物的耐药情况。方法对2010年3月～2011年9月临床分离的378株肠杆菌科细菌应用法国生物梅里埃公司VITEK-32微生物分析仪进行菌株鉴定,采用K-B法进行药物敏感试验。结果鉴定为大肠埃希菌173株、肺炎克雷伯菌120株、肠杆菌属67株,阴沟杆菌9株,产酸克霉伯菌4株,其他肠杆菌6株;大肠埃希菌对哌拉西林/舒巴坦、头孢哌酮/舒巴坦的耐药率分别为98.41%和94.97%,肺炎克雷伯菌对氨苄西林耐药率最高(100.00%),肠杆菌属对亚胺培南的耐药率最低(0)。结论目前我院住院患者肠杆菌科细菌感染以大肠埃希菌和肺炎克雷伯菌为主,且对常用抗菌药物耐药严重;临床应加强对耐超广谱β-内酰胺酶(ESBLs)细菌及其对抗菌药物的耐药性监测,以指导临床医师合理应用抗菌药物、避免多药耐药菌株的产生,从而控制医院感染的发生。     

2011年呼吸科患者院内感染病原菌及耐药分析

目的 总结2011年呼吸科患者院内感染病原菌及对各种抗菌药物的耐药情况,为临床感染性疾病的抗菌药物选择提供实验室依据.方法 采用法国梅里埃的compact全自动微生物鉴定分析仪进行细菌的鉴定和药敏分析实验,应用WHONET5.3软件对数据进行分析.结果 2011年我院呼吸科共收集致病菌1192 株.革兰阴性杆菌945 株占总分离率的79.3 %:鲍曼不动杆菌居首位246株(26.1 %);其次为铜绿假单胞菌198株(20.9 %);肺炎克雷伯菌181株(19.1 %);大肠埃希菌133株(14.1 %);阴沟肠杆菌72株(7.6 %);粘质沙雷菌64株(6.8 %);产气肠杆菌31株(3.3 %).革兰阳性球菌112株占总分离率的9.4%,主要是金黄色葡萄球菌,占6.5%.真菌135株占11.3%以白色假丝酵母菌为主.几种临床常见病原菌对常用抗菌药物的耐药率均较高.鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌对哌拉西林的耐药率在85%以上.革兰阴性杆菌中,除鲍曼不动杆菌对亚胺培南和美罗培南的耐药率在70%以上,其他病原菌对亚胺培南和美罗培南的耐药率均较低.结论 2011年我院呼吸科常见病原菌耐药情况较严重,应加强耐药菌的监测,合理选用抗生素.     

老年科下呼吸道感染病原菌耐药性分析

目的了解我院老年科下呼吸道感染常见病原菌的感染现状及耐药性规律。方法采用API鉴定系统鉴定细菌及真菌,纸片扩散法测定细菌药物敏感性,Rosco纸片法测定真菌药物敏感性,WHONET 5.4软件进行统计分析。结果我院老年科痰培养阳性率为15.7%,检出率最高的前3位病原菌是铜绿假单胞菌、肺炎克雷伯菌及不动杆菌。葡萄球菌属未发现万古霉素耐药株,但对其他多种抗菌药物耐药;肠杆菌科细菌对美洛培南、亚胺培南、头孢哌酮舒巴坦和哌拉西林他唑巴坦较敏感,但大肠埃希菌及阴沟肠杆菌对喹诺酮类药物敏感性下降;非发酵菌中铜绿假单胞菌对药物的敏感性为美洛培南、亚胺培南〉头孢他定〉哌拉西林他唑巴坦〉头孢哌酮舒巴坦,未检出耐碳青霉烯类的鲍曼不动杆菌。结论我院老年科下呼吸道感染病原菌以杆菌为主,对多种抗菌药物耐药率较高,应引起重视并合理选择抗菌药物。     

武汉地区临床分离菌耐药性监测

目的调查武汉地区临床分离菌对抗菌药物的耐药状况。方法收集１９９６年武汉地区１３所医院临床分离的致病菌，药敏试验采用ＫＢ法，用ＷＨＯＮＥＴ３计算机软件完成数据分析。结果１９９６年共收集致病菌４６３９株，包括革兰阳性球菌１３４５株（２９％），革兰阴性杆菌３２９４株（７１％）。致病菌以大肠杆菌、金黄色葡萄球菌、铜绿假单胞菌、克雷白菌属最多见。１７％金黄色葡萄球菌和２５％凝固酶阴性葡萄球菌耐苯唑西林，也耐其他抗菌药物。亚胺培南、阿米卡星、头孢他啶、环丙沙星对革兰阴性杆菌（包括肠杆菌科细菌和非发酵菌）的抗菌作用最强。结论临床细菌耐药性日益严重，应在不同地区开展细菌耐药性监测，强调临床合理应用抗菌药物     

PROTEKT 1999-2000: a multicentre study of the antimicrobial susceptibility of respiratory tract pathogens in Japan.

DESIGN: A six-centre study in Japan during the winter of 1999-2000 assessed the in vitro activity of >20 antimicrobial agents against the common respiratory pathogens Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae, and Moraxella catarrhalis. The minimum inhibitory concentrations (MIC) of each antimicrobial was determined against these isolates using National Committee for Clinical Laboratory Standards (NCCLS) methodology. RESULTS: Among S. pneumoniae isolates, 44.5% were penicillin resistant. The macrolide resistance rate was 77.9% with 90.5% of penicillin-resistant strains also being macrolide resistant. Resistance mechanisms in macrolide-resistant isolates were identified as mef(A) or erm(B) in 42.5% and 52.5%, respectively. Of the fluoroquinolone-resistant isolates (1.3%), most were also penicillin and macrolide resistant. All strains were inhibited by telithromycin at 相似文献   

Three-year surveillance study of nosocomial bacterial resistance in Argentina. The Antimicrobial Committee; and the National Surveillance Program (SIR) Participants Group.

INTRODUCTION: A national surveillance program (SIR) was introduced in 1996 in Argentina by the Antimicrobial Committee of the Argentinean Society for Microbiology to assess bacterial resistance. The present study reports the rates of nosocomial bacterial resistance found by this program. METHODS: A 2-month point-prevalence study was conducted twice yearly (i.e., April-May and October-November) from 1996 to 1998, by 27 Argentinean centers. Susceptibility testing was carried out by the disk diffusion method following the National Committee for Clinical Laboratory Standards guidelines. RESULTS: In all, 6343 isolates recovered from 5603 inpatients (> or =48-hr hospitalization) were included. Methicillin resistance was 58% and 56% in Staphylococcus aureus and coagulase-negative staphylococci (CNS), respectively. Although no vancomycin resistance was found in staphylococci, 2% and 8% of the S. aureus and CNS strains, respectively, proved resistant to teicoplanin. No ampicillin resistance was displayed by Enterococcus faecalis. High-level gentamicin and streptomycin resistance in enterococci were 33% and 37%, respectively. Acquired glycopeptide resistance in enterococci emerged in 1997 (2%). Imipenem resistance in Acinetobacter spp and Pseudomonas aeruginosa was 9% and 21%, respectively. Among Enterobacteriaceae, 1% and 5% of the Klebsiella pneumoniae and Enterobacter cloacae isolates, respectively, proved resistant to imipenem. Ceftazidime and cefepime resistance was found in 63% and 33% of the E. cloacae strains. Resistance to extended-spectrum cephalosporins was shown by 48%, 26%, and 8% of the K. pneumoniae, Proteus mirabilis, and Escherichia coli isolates, respectively. CONCLUSIONS: The alarming rates of resistance found in this study provide compelling evidence of the need for more rational use of antimicrobial agents in Argentina.     

2002年上海地区医院细菌耐药性监测

目的　了解上海地区医院 2 0 0 2年临床分离菌株的耐药情况。方法　使用Kirby Bauer法将 2 0 0 2年 1月～ 12月上海 11家医院临床分离菌 2 2 84 9株进行 34种抗菌药物的敏感性试验。结果　 2 2 84 9株细菌中 ,革兰阳性球菌 6 94 0株 ( 30 .4 % ) ,革兰阴性菌 15 90 9株 ( 6 9.6 % )。葡萄球菌中耐药甲氧西林耐药金黄色葡萄球菌 (MRSA)和甲氧西林耐药凝固酶阴性葡萄球菌 (MRCNS)的检出率分别为 6 8.2 %和 75 .3% ;肺炎链球菌中青霉素不敏感株 (PISP PRSP)的发生率儿童组为 4 0 % ,成人组 7.5 % ,已出现对第 3代头孢菌素头孢曲松的耐药株 ( 2 8.9% )。万古霉素对革兰阳性球菌的抗菌活性最强 ,未发现万古霉素中度敏感金黄色葡萄球菌 (VISA)、万古霉素高度耐药金黄色葡萄球菌(VRSA)和万古霉素耐药肠球菌 (VRE)菌株。对革兰阴性杆菌的抗菌活性以亚胺培南最强。大肠埃希菌ESBLs产生株检出率为 2 4 % ,克雷伯菌中的检出率为 35 .2 %。住院患者临床分离株对多数抗菌药物的耐药率较门诊患者为高 ,且差异有显著性。结论　本组资料对临床合理选用抗菌药物具有重要参考价值     

Drug-resistant bacteria isolated from pharyngeal swab cultures and urine in acutely or chronically febrile elderly nursing home inmates

AIM: Patients in nursing homes are becoming more and more elderly and also prone to infectious diseases. It is important to select proper antimicrobial agents in treating such patients because of the increase in drug-resistant bacteria in recent years. METHODS: Pathogenic aerobic bacteria were isolated from cultures of the pharyngeal swab obtained from patients with acute febrile episodes and those with chronic febrile conditions with a repetition of fever or continuing low-grade fever. Isolation of pathogens was also carried out in patients with a urinary tract infection that was resistant to treatment. Isolated bacteria were tested for sensitivity to commonly used antimicrobial agents. RESULTS: Pathogenic bacteria were isolated from 33% of the patients with acute febrile episodes, while they were isolated from 75% of the patients with chronic febrile conditions. The number of major pathogenic bacteria from 85 isolates were methicillin-resistant staphylococcus aureus (MRSA) 13, methicillin-sensitive staphylococcus aureus (MSSA) 6, Streptococcus pneumoniae 8, beta-hemolytic streptococcus 5, Klebsiella pneumoniae 10, and Enterobacter cloacae 6. Only two isolates of Streptococcus pneumoniae were penicillin-sensitive (PSSP), while the others were penicillin-resistant (PRSP) (1) or penicillin-insensitive (PISP) (5). Among these 8 isolates, 5 were resistant to levofloxacin (LVFX). Escherichia coli was isolated from the pharyngeal swab of 2 patients, one of the 2 isolates being resistant to LVFX. Escherichia coli was isolated from 5 patients with urinary tract infection and 5 of the 6 isolates were resistant to LVFX; with one of them being extended spectrum beta-lactamases (ESBL). CONCLUSION: The frequency of isolation of antimicrobial-resistant pathogens was extremely high among elderly patients in our nursing home compared to values reported from a nation-wide survey recently carried out in Japan. In particular, attention should be focused on the resistance of bacteria to fluoroquinolones.     

2009年山东大学附属省立医院细菌耐药性监测及分析

目的了解山东大学附属省立医院2009年临床分离菌株分布及耐药谱。方法收集山东大学附属省立医院2009年首次非重复分离株1 821株,细菌鉴定采用VITEK鉴定系统,药敏试验采用纸片扩散法,数据采用WHONET 5.4软件进行统计分析。结果大肠埃希菌和肺炎克雷伯菌对碳青霉烯类药物最敏感;柠檬酸杆菌属、沙雷菌属对碳青霉烯类药物敏感率较高,肠杆菌属和柠檬酸杆菌属对头孢西丁的耐药率分别为98.6%和85.7%,而沙雷菌属耐药率仅为30%;铜绿假单胞菌对哌拉西林/他唑巴坦、头孢吡肟、哌拉西林、头孢他啶、美罗培南、亚胺培南和头孢哌酮/舒巴坦较敏感,对其他药物敏感率均〈70%;鲍曼不动杆菌对亚胺培南、美罗培南敏感率为82.3%、73.2%,对头孢哌酮/舒巴坦耐药率为11.6%,对其他药物耐药率在15.0%~67.8%;葡萄球菌对万古霉素和利奈唑胺100%敏感,耐甲氧西林金黄色葡萄球菌和耐甲氧西林凝固酶阴性葡萄球菌检出率分别为45.0%和86.8%;屎肠球菌和粪肠球菌对万古霉素和利奈唑胺最敏感。结论肠杆菌科细菌对碳青霉烯类药物仍最为敏感,但不发酵糖菌对其耐药率升高;葡萄球菌属中均未发现耐万古霉素菌株。     

Present situation of national surveillance of antimicrobial resistance in bacteria isolated from farm animals in Japan and correspondence to the issue

The Japanese Veterinary Antimicrobial Resistance Monitoring System (JVARM) was formed in 1999 in response to international concerns about the impact of antimicrobial resistance on public health. The aim of the present investigation was to provide insight into the occurrence of antimicrobial resistance among bacterial strains isolated from cattle, swine and poultry on farms across Japan. In this paper, we summarize a nationwide investigation (1999-2003) on antimicrobial susceptibility of the targeted bacterial species for the JVARM, namely Salmonella, Campylobacter, Enterococcus and Escherichia coli, isolated from the feces of healthy domestic animals. Minimum inhibitory concentrations (MICs) of 10-18 antimicrobial agents including the major generic groups were determined using an agar dilution method according to the international NCCLS guideline in principle. The outline of present results is as follows: (1) A total of 307 Salmonella, 3,225 Escherichia coli, 2,822 Enterococcus and 1,122 Campylobacter were isolated from healthy domestic animals and examined for antimicrobial susceptibility. (2) The isolates of all targeted bacterial species represent high rates of antimicrobial resistance to both oxytetracycline (OTC) and dihydrostreptomycin (DSM). (3) Among the isolates of Campylobacter and E. coli, the frequency of isolation of resistance to fluoroquinolones ranged from 14 to 24% and 2 to 3%, respectively. (4) Resistance to fluoroquinolones was not observed among the isolates of Salmonella or Enterococcus. Continious investigation at the nation level of antimicrobial resistance among the isolates from healthy domestic animals remains a high priority for the JVARM program. Furthermore, appropriate and prudent use of antimicrobials for diseased animals should be considered essential.     

A case of sepsis caused by Enterobacter cloacae producing both type SHV-12 and type CTX-M-14 ESBLs in a post bone-marrow transplantation patient

Third-generation cephalosporin-resistant Enterobacter cloacae was isolated from the blood culture of a 31-year-old woman after bone-marrow transplantation. Since this strain was resistant to third-generation cephalosporins, the production of extended-spectrum beta-lactamases (ESBLs) was suspected. PCR and a sequence analysis confirmed two ESBL genes, bla(SHV-12) and bla(CTX-M-14). No bacteria were detected after meropenem was administered, and symptoms abated. This is, to our knowledge, the first report in Japan of E. cloacae clinical isolates simultaneously producing both SHV-12 and CTX-M-14 ESBL. In cases where chromosomal AmpC over-production of E. cloacae concomitantly produces ESBL, caution should be exercised due to the potential development of resistance against extended-spectrum beta-lactam agents.     

Multidrug-resistant urinary tract isolates of escherichia coli from Ribeir?o Preto, S?o Paulo, Brazil.

Multiple resistances to antimicrobial drugs arising in Escherichia coli isolates may complicate therapeutic management of urinary tract infection (UTI) by this organism. In order to assess the multidrug resistance (MDR) among urinary E. coli isolates, we have tested 11 antimicrobial drugs against 67 isolates from outpatients attended in a tertiary-care teaching hospital and of 78 isolates from a municipal health unit, respectively in Ribeir?o Preto, State of S?o Paulo, Brazil. Seventy-six percent and 22% of the isolates from the tertiary-care hospital and the municipal unit, respectively, were resistant to three or more different classes of agents, and were considered to present MDR. Among the isolates from the hospital patients, 73.0%, 65.0%, 58.0%, 58.0% and 31.0% were resistant to tetracycline, ampicillin, cephalothin, trimethoprim-sulfamethoxazole (TMP/SMX) and norfloxacin, respectively; resistance from the municipal unit patients were 31.0%, 37.0%, 8.0%, 29.0% and 12.0% respectively, to the same drugs. The predominant phenotype among the MDR isolates presented is ampicillin, TMP/SMX and tetracycline resistance. The high prevalence of drug resistance among UTI patients calls for continuous surveillance to assure effective control of this infection.     

Detection of blaOXA-23 in Acinetobacter spp. isolated from patients of a university hospital

IntroductionAcinetobacter spp. have emerged as notorious pathogens involved in healthcare-associated infections. Carbapenems are important antimicrobial agents for treating infections due to multidrug resistant Acinetobacter spp. Different mechanisms may confer resistance to these drugs in the genus, particularly production of class D carbapenemases. OXA-23-like family has been pointed out as one of the predominant carbapenamases among Acinetobacter. The present work aimed to investigate the occurrence of OXA-23-like carbapenemases among Acinetobacter isolates recovered from patients of a university hospital in Niterói, RJ, Brazil.MethodsAntimicrobial susceptibility profiles were determined by disk-diffusion. Imipenem resistant isolates were submitted to Modified Hodge Test in order to screen for carbapenemase production, and later to polymerase chain reaction (PCR) to investigate the presence of bla_OXA-23.ResultsImipenem and meropenem resistance rates were 71.4% and 69.7%, respectively. The Modified Hodge Test revealed carbapenemase production among 76 (89.4%) of the 85 imipenem resistant isolates analyzed; according to PCR results, 81 isolates (95.4%) carried the bla_OXA-23 gene.ConclusionsOXA-23-like enzymes may be an important mechanism of carbapenem resistance among isolates present in the hospital studied.