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characteristics and risk factors for adverse outcome in multiresistant Gram-negative primary bacteremia of critically ill patient. Am. J. Infect. Control., 2011, 39 , 396–400. Pappas G

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Our study involved assessing new Hungarian multi-resistant apple cultivars (‘Artemisz’, ‘Hesztia’, ‘Rosmerta’, and ‘Cordelia’) and two commercial cultivars (‘Watson Jonathan’ and ‘Prima’). The samples were evaluated by a trained assessor panel applying computer supported profile analysis with 20 descriptive sensory parameters (using ProfiSens sensory assessment software). Beside the profiles of each cultivar we also showed the significant differences between the cultivars (LSD95%, LSD99%). The nutritional values were analysed using the MANOVA statistical method, the effects of significant factors on measured values were evaluated by using Tukey (P=0.05) post-hoc test, and we determined the homogeneous and heterogeneous groups based on that. Our study showed that PCA bi-plots containing sensory and instrumental value loadings together with the scores of apple cultivars make the complex relationships of each cultivar available for comparison. The results clearly showed that the intensity of the sour taste is inversely proportional to the carbohydrate-acid ratio determined by measurements. The flesh firmness and pectin content values obtained by instrumental measurements were found to be strongly correlated sensory parameters on crispness, texture, and ripeness. PCA plots proved to be very useful in demonstrating the parallelisms between instrumental-instrumental (TPC/FRAP) and sensory-sensory (shade/colour) parameter pairs, too. Our aggregated results show that the new Hungarian resistant apple cultivars have almost as good as or even better nutritional values than ‘Prima’ and ‘Jonathan’ (the latter dominated the Hungarian apple production for several decades). The new multi-resistant cultivars renew the range of apple cultivars available on the market, and they introduce new flavours to consumers.

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Acta Microbiologica et Immunologica Hungarica
Authors: Zahra Meshkat, Himen Salimizand, Yousef Amini, Davood Mansury, Abolfazl Rafati Zomorodi, Zoleikha Avestan, Azad Jamee, Jamal Falahi, Hadi Farsiani, and Azizollah Mojahed

, Dijkshoorn L , . Distribution of tetracycline resistance genes in genotypically related and unrelated multiresistant Acinetobacter baumannii strains from different European hospitals . Res Microbiol 2005 ; 156 : 348 – 55 . 10.1016/j.resmic.2004

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Hematológia–Transzfuziológia
Authors: Réka Ráhel Bicskó, Renáta Nyilas, Judit Szabó, Ádám Jóna, Ferenc Magyari, Mariann Szarvas, Árpád Illés, and Lajos Gergely

Absztrakt:

A multirezisztens kórokozók jelenléte világszerte egyre nagyobb gondot jelent a kórházakban. A túlzott és indokolatlan, vagy helytelenül megválasztott antibiotikum-kezelések hatására a rezisztens törzsek kiszelektálódnak, és súlyos infekciókat okoznak, ami az immunszuprimált betegekben sokkal kifejezettebb. E probléma megoldására indult 2013-ban a Debreceni Egyetem Klinikai Központ Belgyógyászati Intézet B épület Hematológiai Osztályán az antibiotikumok diverzifikálása. A monoton gyógyszerválasztás tudatos elkerülésének eredményeként egyes multirezisztens törzsek, így a kiterjedt spektrumú béta-laktamáz termelő Escherichia coli (2012-ben 16, 2016-ban 4 eset) és Klebsiella pneumoniae (2012-ben 27, 2016-ban 3 eset) előfordulása csökkent. Ugyanakkor új gond a vancomycinrezisztens Enterococcus spp. megjelenése (2012-ben 1, 2016-ban 6 pozitív tenyésztés), aminek hátterében valószínűleg a Clostridium difficile-infekció miatt kezelt esetek számának növekedése áll (2011-ben 2, 2015-ben 11 eset). A helytelen antibiotikum-felhasználás növeli az ápolási költségeket és rontja a fertőzések kimenetelét, ezért nagyon fontos az antibiotikumok tudatos és ésszerű alkalmazása mind egyéni, mind osztályos szinten. Ahhoz, hogy a multirezisztens kórokozók által okozott fertőzésekkel fel tudjuk venni a harcot, nem csak új antibiotikumokra van szükség, hanem új szemléletre is az infekciók kezelésében.

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Abstract  

99mTc(CO)3–Garenoxacin dithiocarbamate (99mTc(CO)3–GXND) complex was synthesized and biologically characterized in rats artificially infected with multiresistant Staphylococcus aureus (MDRSA) and penicillin-resistant Streptococci (PRSC). The characteristics of the 99mTc(CO)3–GXND complex was assessed in terms of radiochemical stability in saline, serum, in vitro binding with live and heat killed MDRSA and PRSC and biodistribution in rats artificially infected with MDRSA and PRSC. The complex showed maximum radiochemical stability at 30 min and remained more than 90% stable up to 240 min in normal saline after reconstitution. The complex was found stable in serum at 37 °C up to 16 h. The complex showed in vitro saturated binding with living MDRSA and PRSC. In rats infected with living MDRSA and PRSC the complex showed five higher up take in the infected muscle as compared to the inflamed and normal muscle. No significant difference in uptake of the complex in rats infected with heat killed MDRSA and PRSC was observed. The disappearance of the complex from the blood and appearance in the urinary system confirm the normal biological route of biodistribution and excretion. The high values of the radiochemical stability in normal saline, serum, saturated in vitro binding with living MDRSA and PRSC and significant infected to normal muscles ratios, the 99mTc(CO)3–GXND complex is recommended for the localization of soft tissue infection caused by living MDRSA and PRSC.

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The emergence of simultaneous resistance to multiple classes of antibiotics presents an increasing threat. Plasmid-borne multiresistance and integrative conjugative elements have been reported in Pasteurella multocida. We report an alternative strategy for the development of multiresistance observed in a P. multocida strain (Pm238) isolated from calf pneumonia. We identified genes integrated into the chromosomal DNA without known integrative and conjugative elements. These genes conferred resistance to streptomycin (strA), tetracycline (tetB), chloramphenicol (catAIII), and sulphonamides (sulII). We also detected mutation in the quinolone-resistance-determining regions of parC. No plasmids could be isolated from strain Pm238. These results suggest that P. multocida can accumulate multiple resistance determinants on the chromosome as single genes.

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We investigated the incidence of bloodstream infections (BSIs) in trauma emergency department (ED) and intensive care unit (ICU), to assess ED- and ICU-related predictors of BSI and to describe the most common bacteria causing BSI and their antimicrobial resistance markers. A prospective study was conducted in two trauma ICUs of the ED of Clinical Center of Serbia. Overall, 62 BSIs were diagnosed in 406 patients, of which 13 were catheter-related BSI (3.0/1,000 CVC-days) and 30 BSIs of unknown origin, while 15% were attributed to ED CVC exposure. Lactate ≥2 mmol/L and SOFA score were independent ED-related predictors of BSI, while CVC in place for >7 days and mechanical ventilation >7 days were significant ICU-related predictors. The most common bacteria recovered were Acinetobacter spp., Klebsiella spp., and Pseudomonas aeruginosa. All Staphylococcus aureus and coagulase-negative staphylococci isolates were methicillin-resistant, whereas 66% of Enterococcus spp. were vancomycin-resistant. All isolates of Enterobacteriaceae were resistant to third-generation cephalosporins, whereas 87.5% of P. aeruginosa and 95.8% of Acinetobacter spp. isolates were resistant to carbapenems. ED BSI contributes substantially to overall ICU incidence of BSI. Lactate level and SOFA score can help to identify patients with higher risk of developing BSI. Better overall and CVC-specific control measures in patients with trauma are needed.

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Escherichia coli and Klebsiella pneumoniae are frequently found resistance to aminoglycosides in Turkey. The aim of this study was to investigate aminoglycoside resistance in clinical isolates of E. coli and K. pneumoniae from Turkey using both phenotypic and genotypic methods and screening for the prevalence of gene coding for common aminoglycoside-modifying enzymes (AMEs) and 16S rRNA methylase genes. A total of 88 consecutive, non-duplicated E. coli (n = 65) and K. pneumoniae (n = 23) isolates showing resistance or intermediate resistance to amikacin and/or gentamicin were collected between October 2013 and May 2015 from clinical samples received at Gaziantep Dr. Ersin Arslan Training and Research Hospital. Seventeen isolates were obtained from Syrian patients. Isolates resistant to any of the two aminoglycosides were tested by PCR for seven AME genes, and 22 isolates with amikacin MIC ≥16 mg/L were also tested for 16S rRNA methylase genes. In E. coli isolates, the most frequent genes were aac(6′)-Ib (50 strains; 76.9%) and aac(3)-IIa (40 strains; 70.7%), followed by aph(3′)-Ia (5 strains; 7.6%) and ant(2″)-Ia (2 strains; 3.1%). Among the 23 resistant K. pneumoniae isolates, the most prevalent gene was aac(3′)-IIa (87.0%) followed by aac(6′)-Ib (73.9%) and aph(3′)-Ia (8.6%). The rmtC gene was detected in one K. pneumoniae isolate. Resistance to aminoglycosides in clinical isolates of E. coli and K. pneumoniae from our center is predominantly caused by AAC(6′)-Ib and AAC(3)-II enzymes, while the occurrence of 16S rRNA methylases is so far limited.

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Center for Epidemiology for the prevention of multiresistant pathogens 2016. [Országos Epidemiológiai Központ. Módszertani levél a multirezisztens kórokozók által okozott fertőzések megelőzéséről

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. Statistical analysis In order to test the independence between the prevalence of Gram-positive cocci and multiresistant isolates with sociobiological data (age group, gender, and origin), a χ 2 test was performed. A log-linear model was further

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