Sensitivity to beta-lactam antibiotics and production of beta-lactamase of gram-negative clinical isolates

1985 ◽  
Vol 51 (5-6) ◽  
pp. 600-602
Author(s):  
J. L. Hoekstra ◽  
A. W. Houben ◽  
E. E. Stobberingh ◽  
C. P. A. van Boven
Keyword(s):  
Clinical Isolates ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Gram Negative ◽  
Beta Lactam Antibiotics

Stigmasterol: An adjuvant for beta lactam antibiotics against beta-lactamase positive clinical isolates

Steroids ◽  
2017 ◽  
Vol 128 ◽  
pp. 68-71 ◽  
Author(s):  
Tong Woei Yenn ◽  
Muhammad Arslan Khan ◽  
Nur Amiera Syuhada ◽  
Leong Chean Ring ◽  
Darah Ibrahim ◽  
...  
Keyword(s):  
Clinical Isolates ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Beta Lactam Antibiotics

scholarly journals ESBL Producers in Gram Negative Isolates from Clinical Samples

2020 ◽  
Vol 14 (3) ◽  
pp. 2027-2032
Author(s):  
Mita D. Wadekar ◽  
J.V. Sathish ◽  
C. Pooja ◽  
S. Jayashree
Keyword(s):  
Treatment Options ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Gram Negative ◽  
Extended Spectrum Beta Lactamase ◽  
Beta Lactam Antibiotics ◽  
Esbl Producers

Resistance to beta lactam antibiotics is the most common cause for beta-lactamase production. Increasing number of extended spectrum beta-lactamase (ESBL) producers has reduced the treatment options which resulted in emergence of multidrug resistant strains, treatment failure and hence increased mortality. To detect phenotypically, ESBL producers in Gram negative isolates from different samples and to know their susceptibility pattern. A retrospective study of Gram negative isolates was conducted. Total of 521 isolates were isolated from various samples. They were processed and identified by standard procedures. The antibiotic susceptibility testing was performed by Kirby- Bauer disc diffusion method using CLSI guidelines. ESBL was detected by combination disk test. A total of 521 Gram negative isolates were isolated which included E. coli, Klebsiella pneumoniae, Citrobacter spp., Enterobacter spp., Proteus spp. and Acinetobacter spp. Pseudomonas aeruginosa. Of 521 isolates tested, ESBL was detected in 329 (63.1%) isolates. These isolates showed maximum susceptibility to piperacillin- tazobactam (86%) followed by imipenem (78.4%), amikacin (63.5%), cotrimoxazole (54.4%), ciprofloxacin (51%), amoxi-clav (44.9%), cefepime (44.1%), gentamicin (38.9%), cefoxitin (34.9%) and ampicillin (19.1%). ESBL producers which are resistant to beta lactam antibiotics have become a major problem. Detection of these beta-lactamase enzymes by simple disk method and its reporting will help clinicians in prescribing proper antibiotics.

scholarly journals Clinical Relevance of Antibiotic Susceptibility Profiles for Screening Gram-negative Microorganisms Resistant to Beta-Lactam Antibiotics

2020 ◽  
Vol 8 (10) ◽  
pp. 1555 ◽  
Author(s):  
Francisco Montiel-Riquelme ◽  
Elisabeth Calatrava-Hernández ◽  
Miguel Gutiérrez-Soto ◽  
Manuela Expósito-Ruiz ◽  
José María Navarro-Marí ◽  
...  
Keyword(s):  
Resistant Bacteria ◽  
Gram Negative Bacteria ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Gram Negative ◽  
Extended Spectrum Beta Lactamase ◽  
Beta Lactam Antibiotics ◽  
Clinical Laboratories ◽  
Phenotypic Methods ◽  
Susceptibility Profiles

The increasing resistance to antibiotics is compromising the empirical treatment of infections caused by resistant bacteria. Rapid, efficient, and clinically applicable phenotypic methods are needed for their detection. This study examines the phenotypic behavior of β-lactam-resistant Gram-negative bacteria grown on ChromID ESBL medium with ertapenem, cefoxitin, and cefepime disks, reports on the coloration of colonies, and establishes a halo diameter breakpoint for the detection of carbapenemase-producing bacteria. We studied 186 β-lactam-resistant Gram-negative microorganisms (77 with extended spectrum beta lactamase (ESBL), 97 with carbapenemases, and 12 with AmpC β-lactamases (AmpC)). Susceptibility profiles of Gram-negative bacteria that produced ESBL, AmpC, and carbapenemases were similar to the expected profiles, with some differences in the response to cefepime of ESBL-producing microorganisms. Coloration values did not differ from those described by the manufacturer of ChromID ESBL medium. In the screening of carbapenemase production, inhibition halo diameter breakpoints for antibiotic resistance were 18 mm for Enterobacterales and ertapenem, 18 mm for Pseudomonas and cefepime, and 16 mm for Acinetobacter baumannii and cefepime. This innovative phenotypic approach is highly relevant to clinical laboratories, combining susceptibility profiles with detection by coloration of high-priority resistant microorganisms such as carbapenemase-producing A. baumannii, carbapenemase-producing Pseudomonas spp., and ESBL and/or carbapenemase-producing Enterobacterales.

scholarly journals Monitoring of gram-negative bacteria and antibiotic resistance in osteomyelitis

2020 ◽  
Vol 26 (4) ◽  
pp. 544-547
Author(s):  
I.V. Shipitsyna ◽  
◽  
E.V Osipova ◽  
D.S. Leonchuk ◽  
A.S. Sudnitsyn ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Clinical Isolates ◽  
Gram Negative Bacteria ◽  
Beta Lactam ◽  
Gram Negative ◽  
Regular Monitoring ◽  
Beta Lactam Antibiotics ◽  
Bacterial Morphology ◽  
Acinetobacter Sp ◽  
Drug Resistant Strains

Introduction There is an urgent need for a surveillance system of regular monitoring of specific bacteria inducing various types of osteomyelitis to identify resistant isolates and optimize the use of antibiotics. Objective: monitoring of specific gram-negative bacteria and analysis of the antibiotic resistance of the strains isolated from osteomyelitis patients over a three-year period. Results and discussion P. aeruginosa was the first most common pathogen among gram-negative microorganisms isolated from the patients between 2017 and 2019. Prevalence of the isolates identified in 2019 decreased by 9.6 % as compared to 2017. Next frequently encountered clinical isolates were Enterobacter sp., Acinetobacter sp., Klebsiella sp. There was a twofold increase in K. pneumoniae strains isolated in 2019. Analysis of antibiotic susceptibility testing data revealed multiresistance of the Acinetobacter sp. strains in 2019 despite the total decrease in resistant isolates in 2017 and 2018. Among non-fermenting gram-negative rods, the species being resistant to imipenem were shown to increase by 5.4 times. Overall antibiotic resistance was on rise. Increased antimicrobial resistance to beta-lactam antibiotics also combined with BLaC inhibitors was observed in Enterobacteriaceae population. Meropenem was found to be effective against most bacteria with growing drug resistance observed as compared with recent years. The antibiotic resistance profiles of Klebsiella sp. strains appeared to be high at antimicrobial testing. Conclusion Diverse bacterial morphology of gram-negative species and increasing proportion of drug-resistant strains isolated in osteomyelitis cases have necessitated regular monitoring of multiresistant clinical isolates for adjustment of empirical antibiotic therapies.

scholarly journals A Cross-Canada Surveillance of Antimicrobial Resistance in Respiratory Tract Pathogens

1999 ◽  
Vol 10 (2) ◽  
pp. 128-133 ◽  
Author(s):  
Ross J Davidson ◽  
Canadian Bacterial Surveillance Network ◽  
Donald E Low
Keyword(s):  
Antimicrobial Resistance ◽  
Clinical Laboratory ◽  
Clinical Isolates ◽  
National Committee ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Minimal Inhibitory Concentrations ◽  
Beta Lactam Antibiotics ◽  
Significant Difference ◽  
High Level

OBJECTIVE: To determine the prevalence of antimicrobial resistance in clinical isolates ofStreptococcus pneumoniae, Haemophilus influenzaeandMoraxella catarrhalisfrom medical centres across Canada.METHODS: Fifty laboratories from across Canada were asked to collect up to 25 consecutive clinical isolates ofS pneumoniae,H influenzaeandM catarrhalisat some time between September 1994 and May 1995, and then again between September and December of 1996. A total of 2364S pneumoniae, 575H influenzaeand 200M catarrhalissamples were collected.H influenzaeandM catarrhalisisolates were tested for the production of beta-lactamase.S pneumoniaeisolates were characterized as penicillin susceptible, intermediately resistant or high level penicillin-resistant. Minimal inhibitory concentrations (MICs) were determined using a microbroth dilution technique described by the National Committee of Clinical Laboratory Standards.RESULTS: Between the two collection periods, there was a significant increase in highly penicillin-resistantS pneumoniaefrom 2.1% to 4.4% (P<0.05) and an increase in intermediately penicillin-resistant strains from 6.4% to 8.9% (P<0.05). A significant increase in high level penicillin-resistantS pneumoniaewas noted among paediatric isolates. No significant difference in the susceptibilities of comparator agents was detected. A significant increase in the number of beta-lactamase producingH influenzae, 34% to 43% (P<0.05) was observed. Ninety-five per cent ofM catarrhalisisolates were beta-lactamase producers in both time periods.CONCLUSIONS: During the course of this study, the incidence of penicillin resistance inS pneumoniaedoubled. As a result of this increase, infections due to this organism in sites where poor penetration of beta-lactam antibiotics occur may become increasingly difficult to manage.

Sulbactam/Ampicillin

1988 ◽  
Vol 9 (7) ◽  
pp. 323-327
Author(s):  
Francine R. Salamone
Keyword(s):  
Enzyme Inhibitor ◽  
The United States ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Beta Lactam Antibiotics ◽  
Development Of Resistance ◽  
Lactam Ring ◽  
Lactamase Inhibitor

Sulbactam/ampicillin was recently marketed for use in several infections caused by beta-lactamase-producing organisms. Sulbactam is the second beta-lactamase inhibitor to become available in the United States. Interest in inhibition of beta-lactamases arose in the late 1960s when a combination consisting of an antibacterial agent and an enzyme inhibitor was found effective in the treatment of certain resistant gram-negative infections. It is now well accepted that the addition of a beta-lactamase inhibitor to a beta-lactam antibiotic may expand its usefulness in a variety of infections.The penicillin derivatives, known as beta-lactam antibiotics, possess a four-membered ring (beta-lactam ring) fused to a second ring (Figure). It is the beta-lactam ring that is essential for the inhibition of bacterial cell wall synthesis and subsequent bactericidal activity of these agents. The development of resistance to beta-lactam antibiotics may occur by a number of mechanisms, although the most important is bacterial production of enzymes (beta-lactamases) that are capable of beta-lactam ring hydrolysis and inactivation.Sulbactam resembles the penicillin derivatives in structure (Figure) and is able to preserve their activity by its ability to inhibit the action of beta-lactamases, particularly those of the Richmond classes II-V (gram-negative) and the group A beta-lactamases (gram-positive). Sulbactam is referred to as a “suicide inhibitor” because while forming an irreversible complex with the enzyme, it is destroyed in the process. By virtue of its ability to render the beta-lactamases inactive, sulbactam has been combined with ampicillin in an effort to restore its activity against a number of pathogens that have developed resistance by this mechanism.

Current Perspectives on Extended-Spectrum Beta-Lactamase–Producing Gram-Negative Bacilli

2008 ◽  
Vol 21 (5) ◽  
pp. 338-345
Author(s):  
Brad M. Wright ◽  
Edward H. Eiland
Keyword(s):  
Patient Outcomes ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Gram Negative ◽  
Extended Spectrum Beta Lactamase ◽  
Beta Lactam Antibiotics ◽  
Poor Patient ◽  
Extended Spectrum ◽  
Care Costs ◽  
Selection Of

Beta-lactamase enzymes produced by gram-negative bacilli were identified before the first beta-lactam antibiotics were used to treat infections. As these enzymes adapted to available beta-lactam agents, newer beta-lactam agents were developed. Development and widespread use of the oxyimino-cephalosporins led to the emergence of extended-spectrum beta-lactamase enzymes that hydrolyze the penicillins, extended-spectrum cephalosporins, and aztreonam. There are now over 200 recognized ESBLs in a variety of gram-negative bacilli conferring resistance to penicillins, cephalosporins, a monobactam, and even carbapenems. The emergence of these enzymes is associated with poor patient outcomes, increased total health care costs, and more carbapenem use. Carbapenems should be selected judiciously to optimize outcomes while preventing further selection of extended-spectrum beta-lactamase resistance.

Features of resistance formation of gram-negative non-fermenting bacteria to antibiotics

2018 ◽  
Vol 22 (2) ◽  
pp. 253-256
Author(s):  
V.M. Kondratuk ◽  
Z.M. Prokopchuk ◽  
V.M. Burkot ◽  
I.M. Vovk
Keyword(s):  
Fourth Generation ◽  
Diffusion Method ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Antibacterial Drugs ◽  
Gram Negative ◽  
Beta Lactam Antibiotics ◽  
Development Of Resistance ◽  
Fermenting Bacteria

The problem of the antibiotic resistance development of pathogenic microorganisms to the main groups of antibacterial drugs has evolved from medical to socio-economic. There is a resistance increase of P.aeruginosa, A.baumannii belonging to the group of gram-negative non-fermenting bacteria (GNB), to antibiotics that are used in medicine. The possibility of acquiring GNB resistance to the main groups of antibacterial drugs is related to the ability of bacteria to acquire new genetic information. The production of metal-beta-lactamase by GNB become a widespread problem of resistance to beta-lactam antibiotics. Detection of resistance genes to beta-lactam antibiotics blaVIM, blaOXA 23, blaOXA 40, blaOXA 69 and blaOXA 100 was performed using real time polymerase chain reaction (PCR-RT). Sensitivity of isolated strains of microorganisms to antibiotics was investigated using the standard disco-diffusion method (DDM). Influence of meropenem on formation of microorganism resistance was investigated in vitro by method of microorganisms passage on meat-peptone broth (MPB) with increasing concentrations of antibiotics. In the process of research, 14 clinical strains of P. aeruginosa and 30 strains of A.baumannii were isolated and identified, almost all strains of these types of bacteria, characterized by resistance to antibiotics-carbapenems and third and fourth generation of cephalosporins. At the same time, the three strain-carries of markers of beta-lactamase products exhibited resistance to carbapenems, and one of the strains (P.aeruginosa No. 68) was capable of producing MBL, according to DDM, was sensitive to carbapenems and MCC was 31.2 μg / ml for it. Among the investigated strains of A.baumannii 18 (60%) out of 30 isolated ones were potential producers of beta-lactamases, capable of inactivating carbapenem antibiotics. In this case, only 6 out of 18 strains showed resistance to carbapenems according to DDM. Sensitivity to carbapenems revealed all strains of the beta-lactamase producers OXA 69 and OXA 100 and three strains – OXA 23. In this work, modern ideas about the mechanisms of development of resistance of GNB were described, isolated from patients of medical institutions (Vinnytsa city), the most common are producers of beta-lactamase types of OXA 23, OXA 69, OXA 100 and VIM.

scholarly journals Dissemination of IncF plasmids carrying beta-lactamase genes in Gram-negative bacteria from Nigerian hospitals

2013 ◽  
Vol 7 (05) ◽  
pp. 382-390 ◽  
Author(s):  
David Olusoga Ogbolu ◽  
Oluwole Adebayo Daini ◽  
Afolabi Ogunledun ◽  
Oyebode Armstrong Terry Alli ◽  
Mark Alexander Webber
Keyword(s):  
Gram Negative Bacteria ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Beta Lactam Antibiotics ◽  
Plasmid Analysis ◽  
Extended Spectrum Beta Lactamases ◽  
The Common ◽  
Replicon Type

Introduction: Production of beta-lactamases is the predominant cause of resistance to beta-lactam antibiotics in Gram-negative bacteria. We investigated the diversity of plasmid-borne beta-lactamase genes and replicon type of the plasmids carrying the respective genes in Gram-negative bacteria recovered from clinical infection in Nigerian hospitals. Methodology: A total of 134 Gram-negative bacteria of 13 species were analyzed for antimicrobial susceptibility, phenotypic and genotypic detection of various beta-lactamases, and plasmid analysis, including replicon typing. Results: Of the 134 isolates, 111 (82.8%) contained beta-lactamases, while 28 (20.9%) carried extended-spectrum beta-lactamases. PCR and sequencing identified TEM-1 in 109 isolates (81.3%), SHV-1 in 33 isolates (24.6%), OXA-1 in 15 isolates (11.2%) and CTX-M enzymes (24 CTX-M-15 and 1 CTX-M-3) in 25 isolates (18.7%). Multiplex PCR showed that 6 isolates carried plasmidic AmpCs (ACT-1, DHA-1 and CMY-2); these enzymes were detected only in isolates possessing CTX-M beta-lactamases. Of 13 (76.9%) representative plasmids investigated in detail, 9 (69.2%) were self-transferable when selected by a beta-lactam and the plasmids once transferred coded for beta-lactam resistance. Replicon typing indicated IncF as the common vector encoding for beta-lactamases. Conclusions: The study showed a diversity of beta-lactamase genes disseminated by conjugative IncF plasmids in Gram-negative bacteria; TEM-1, SHV-1, OXA-1, CTX-M-15, CTX-M-3and plasmidic AmpC enzymes are in common circulation in Nigeria.

scholarly journals Representing antibiotic relationships using measurements of efficacy against clinical isolates

2020 ◽  
Vol 4 ◽  
pp. 86
Author(s):  
Liam Shaw
Keyword(s):  
Inhibitory Concentration ◽  
Bacterial Isolate ◽  
Clinical Isolates ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Beta Lactam Antibiotics ◽  
Large Numbers ◽  
Pairwise Correlations ◽  
Visible Growth ◽  
Multiple Antibiotics

Introduction. Antimicrobial resistance (AMR) is a worrying and confusing problem for both patients and medical professionals. It is often difficult for non-specialists to understand how different antibiotics are related to one another. Here, I use experimental data from hundreds of thousands of clinical isolates to infer relationships between antibiotics and represent them with simple diagrams. Methods. The minimum inhibitory concentration (MIC) of a bacterial isolate for a given antibiotic is defined as the lowest concentration that prevents visible growth. Measuring MICs for multiple antibiotics using the same isolate implicitly records the relationships of the antibiotics for a given species. The basic principle is that antibiotics with similar mechanisms of action should give rise to similar mechanisms of resistance, so should have correlated MICs across large numbers of isolates. This information can then be used to calculate distances between antibiotics based on pairwise correlations of their rank-ordered MICs. I apply this approach to a large historical AMR surveillance dataset (the Pfizer ATLAS surveillance dataset, 2004-2017). Results. I demonstrate that clustering antibiotics in this way allows a simple visual comparison of how similar antibiotics are to each other based on their efficacy within a species. The resulting visualizations broadly recapitulate antibiotic classes. They also clearly show the dramatic effects of combining beta-lactam antibiotics with beta-lactamase inhibitors, as well as highlighting antibiotics which have unexpected correlations in MICs that are not predicted from their chemical similarities alone. Conclusion. Large AMR surveillance datasets can be used in a hypothesis-free manner to show relationships between antibiotics based on their real-world efficacy.

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