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Trecarichi EM, Pagano L, Candoni A, et al. Current epidemiology and antimicrobial resistance data for bacterial bloodstream infections in patients with hematologic malignancies: an Italian multicentre prospective survey

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Antimicrobial resistance is a relevant “One Health” issue that shows the need of comparison of isolates of different origins. In this way, guidelines for antimicrobial-resistance evaluation in animals are relevant in relation to human sources. This work aims to compare antimicrobial-resistance results of animal isolates considering CLSI and EUCAST guidelines. The comparison shows considerable differences in the results, which include antibiotics used as primary options in hospital infections. EUCAST showed the higher number of samples with resistance profiles than CLSI that indicates a more efficient scenario to the EUCAST to screen antibiotic-resistant bacteria. EUCAST was more consonant to the expected phenotype for ESBL producers, with higher index of resistance to oxyimino-beta-lactam antibiotics. The study shows that there are differences in the interpretative results using different guidelines, where the susceptibility test results concerning Enterobacteriaceae of animal origin are not always coincident in CLSI and EUCAST. EUCAST has proved to be the most reliable alternative for profile screening of antibiotic resistance, when compared to CLSI. We might say the same with respect to the ESBL-producing Enterobacteriaceae, in which EUCAST has proved to be more efficient about the demonstration of expected resistance profiles for the ESBL producers. These differences show that guideline selection might influence the therapeutic option.

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resistance in Streptococcus pneumoniae: an overview. Clin Infect Dis 15 , 77-83 (1992). Antimicrobial resistance in Streptococcus pneumoniae: an overview Clin Infect Dis

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In the recent years, it has been noted that microorganisms with acquired resistance to almost all available potent antibiotics are increasing worldwide. Hence, the use of antibiotics in every clinical setup has to be organized to avoid irrational use of antibiotics. This study was aimed to establish the pattern of antibiotic sensitivity and relevance of antimicrobial resistance in aerobic Gram-negative bacilli. A total of 103 aerobic Gram-negative bacteria namely Escherichia coli, Klebsiella pne u moniae, E nterobacter spp., Citrobacter koserii, Proteus spp., and Pseudomonas aeruginosa were collected from tertiary care centers around Chennai. Kirby–Bauer Disk Diffusion test and study for genes of cephalosporin, carbapenem, and aminoglycoside resistance were done. A descriptive analysis of the data on altogether 103 clinical urine isolates was performed. All strains showed susceptibility to colistin. The frequency of genes encoding 16S rRNA methylases armA and rmtB were 7.8% and 6.8%, respectively. Among metallo-β-lactamases, bla VIM, bla IMP, and bla NDM-1 were detected in 6.8%, 3.8%, and 3.8%, respectively. One E. coli strain harbored bla SIM-1 gene. Cumulative analysis of data suggested that 30% of the strains carried more than one resistance gene. The current research evidenced the increasing frequency of resistance mechanisms in India. Combined approach of antibiotic restriction, effective surveillance, and good infection control practices are essential to overcome antibiotic resistance.

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The recommended use of doxycycline (DC) to broiler chicken is 100 mg/L via the drinking water and a 7-day withdrawal time (WDT). However, study of a higher dosage is desirable because of the possible increase of antimicrobial resistance and disease spectrum. Tissue DC residues exceeding the current maximum residue levels (MRL) was our major concern. Therefore, serum concentration and tissue depletion of DC hyclate after administration of 200 mg/L of DC in the drinking water for five consecutive days were studied. The steady-state DC concentration (8.3 ± 0.9 μg/mL) was reached on the third day of medication. The elimination constant (0.05 ± 0.01 1/h), half-life (14.9 ± 1.4 h), area under concentration versus time curve (81.0 ± 9.9 h·μg/mL) and mean residence time (22.7 ± 2.5 h) were obtained using a non-compartmental pharmacokinetic model. It was determined that the current 7-day WDT regulation was still legitimate for the kidney and liver as well as for the breast and leg muscles, which were estimated by linear regression analysis of the 99% upper distribution limit. The unregulated heart and gizzard were considered safe even when the lowest MRL of muscle (100 ng/g) was applied. While at the present time the extra-label use of drugs is only allowed under specific conditions, in the future it may become necessary to increase the general dosage of DC, and the current results suggest a safe range of DC hyclate in chicken; however, skin/fat tissue residues warrant further studies.

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Molecular epidemiology and genetic features of an extended-spectrum β-lactamase (ESBL) producing Klebsiella pneumoniae epidemic clone (KP-EC) with elevated ciprofloxacin MIC (minimum inhibitory concentration) values from multiple nosocomial outbreaks and sporadic cases between 2006 and 2008 in Hungary were investigated.

As a result of continuous monitoring of ESBL-producing KP-ECs, 27 isolates collected from five healthcare facilities were selected for macrorestriction profile analysis by PFGE (pulsed field gel electrophoresis). Of these, 12 strains were isolated from adult inpatients, while 15 strains were from newborns. The MIC values for several antibiotics were determined by agar dilution technique. Molecular typing was further performed by PCR (polymerase chain reaction) and sequencing of several antibiotic resistance genes, plasmid profile analysis, transfer of resistance determinants and multilocus sequence typing (MLST).

All isolates showed moderate resistance to ciprofloxacin (MICs ranged from 0.5 to 8 mg L−1). PFGE revealed the existence of only one genetic cluster defined as EC IV. PstI digestion of plasmid DNA revealed two highly diverse restriction patterns in “adult” and “newborn” isolates corresponding to plasmids from the Hungarian Epidemic Clone and plasmids isolated from a neonatal nosocomial outbreak in 1998, respectively. Sequence analysis of b-lactamase genes from plasmids of 14 selected isolates detected bla SHV-2a in strains isolated exclusively from newborns and bla CTX-M-15 in strains isolated exclusively from adult inpatients. MLST established that strains of the PFGE cluster belonged to a novel sequence type ST274.

ESBL-producing K. pneumoniae isolates belonging to the novel sequence type ST274 appeared in the newborn and adult hospital settings in Hungary and acquired SHV-2a or CTX-M-15 type enzymes, respectively. Thus, a new antimicrobial resistance strategy for successful conformation to distinct hospital settings was found.

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Zinn, C. S., Westh, H., Rosdahl, V. T., Sarisa study Group: An international multicenter study of antimicrobial resistance and typing of hospital Staphylococcus aureus isolates from 21 laboratories in 19

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2012 Mechanisms of antimicrobial resistance in bacteria; general approach Int J Pharma Med Biol Sci 1 2 166 187 . 4

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Acta Veterinaria Hungarica
Authors: Leila Ben Said, Raoudha Dziri, Nadia Sassi, Carmen Lozano, Karim Ben Slama, Imen Ouzari, Carmen Torres, and Naouel Klibi

. , Sørensen , A. H. and Guardabassi , L. ( 2008 ): Monitoring of antimicrobial resistance in healthy dogs: first report of canine ampicillin-resistant Enterococcus faecium clonal complex 17 . Vet. Microbiol. 132 , 190 – 196

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Orvosi Hetilap
Authors: Zoltán Juhász, Ria Benkő, Mária Matuz, Réka Viola, Gyöngyvér Soós, and Edit Hajdú

Costelloe, C., Metcalfe, C., Lovering, A., et al.: Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis. BMJ, 2010, 340, c2096

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