1
|
Abdi FA, Motumma AN, Kalayu AA, Abegaz WE. Prevalence and antimicrobial-resistant patterns of Pseudomonas aeruginosa among burn patients attending Yekatit 12 Hospital Medical College in Addis Ababa, Ethiopia. PLoS One 2024; 19:e0289586. [PMID: 38452016 PMCID: PMC10919618 DOI: 10.1371/journal.pone.0289586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 07/21/2023] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Burns are one of the most common forms of trauma globally. P. aeruginosa plays a prominent role as an etiological agent among burn patients. There is a paucity of information about the prevalence and antimicrobial resistance patterns of P. aeruginosa among burn patients in Ethiopia. Hence, this study was designed to assess the prevalence and antimicrobial-resistant patterns of P. aeruginosa among burn patients attending Yekatit 12 Hospital Medical College in Addis Ababa, Ethiopia. METHODS Hospital-based cross-sectional study was conducted at Yekatit 12 Hospital Medical College among burn patients from November 2020 to April 2021. Identification of P. aeruginosa was performed using Culture, Biochemical tests, and, Gram staining. Antimicrobial resistance testing was done using the Kirby-Bauer disc diffusion method. Logistic regression was computed to determine associated factors. RESULTS From 210 burn wound cultures, 27 (12.86%) were found positive for P. aeruginosa. All the isolates showed greater than 70% susceptibility to the tested antibiotics except Gentamycin, Ceftazidime, and, Ciprofloxacin. In addition, 33.33% of P. aeruginosa isolates were multidrug-resistant. Admission type, Hospital stay time and Total body surface area (TBSA) had a statistically significant association (all with P-value <0.05) with the acquisition of P. aeruginosa infection. CONCLUSION Overall, the prevalence of P. aeruginosa isolates among burn patients is almost 13%. Most P. aeruginosa isolates were sensitive to Imipenem, while they were most resistant to Gentamycin. One-third of P. aeruginosa were multidrug-resistant. This suggests the need to monitor the treatment of infection with the pathogen to limit the possibility of the emergence of multidrug-resistant isolates in burn centers.
Collapse
Affiliation(s)
- Fedasan Alemu Abdi
- Department of Medical Laboratory Science, College of Health Sciences, Salale University, Oromia, Ethiopia
| | - Abdi Negash Motumma
- Department of Medical Laboratory Science, College of Health Sciences, Salale University, Oromia, Ethiopia
| | - Alem Abrha Kalayu
- Department of Microbiology, Immunology, and parasitology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Woldearegay Erku Abegaz
- Department of Microbiology, Immunology, and parasitology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
2
|
Yang H, Huang Z, Yue J, Chen J, Yu M, Qu C. Metabolomics reveals the mechanism of action of meropenem and amikacin combined in the treatment of Pseudomonas aeruginosa. Front Cell Infect Microbiol 2023; 13:1327452. [PMID: 38116135 PMCID: PMC10728327 DOI: 10.3389/fcimb.2023.1327452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 11/15/2023] [Indexed: 12/21/2023] Open
Abstract
The treatment of Pseudomonas aeruginosa infection often involves the combined use of β-lactam and aminoglycoside antibiotics. In this study, we employed metabolomic analysis to investigate the mechanism responsible for the synergistic activities of meropenem/amikacin combination therapy against multidrug-resistant P. aeruginosa strains harboring OXA-50 and PAO genes. Antibiotic concentrations for meropenem (2 mg/L) monotherapy, amikacin (16 mg/L) monotherapy, and meropenem/amikacin (2/16 mg/L) combination therapy were selected based on clinical breakpoint considerations. Metabolomic analysis revealed significant alterations in relevant metabolites involved in bacterial cell membrane and cell wall synthesis within 15 min of combined drug administration. These alterations encompassed various metabolic pathways, including fatty acid metabolism, peptidoglycan synthesis, and lipopolysaccharide metabolism. Furthermore, at 1 h and 4 h, the combination therapy exhibited significant interference with amino acid metabolism, nucleotide metabolism, and central carbon metabolism pathways, including the tricarboxylic acid cycle and pentose phosphate pathway. In contrast, the substances affected by single drug administration at 1 h and 4 h demonstrated a noticeable reduction. Meropenem/amikacin combination resulted in notable perturbations of metabolic pathways essential for survival of P. aeruginosa, whereas monotherapies had comparatively diminished impacts.
Collapse
Affiliation(s)
- Hai Yang
- Affiliated Qingdao Central Hospital of Qingdao University, Qingdao Cancer Hospital, Qingdao, China
| | - Zhen Huang
- Affiliated Qingdao Central Hospital of Qingdao University, Qingdao Cancer Hospital, Qingdao, China
| | - Jiali Yue
- School of Medicine and Pharmacy, Ocean University of China, Qingdao, China
| | - Jianqi Chen
- School of Medicine and Pharmacy, Ocean University of China, Qingdao, China
| | - Mingming Yu
- School of Medicine and Pharmacy, Ocean University of China, Qingdao, China
| | - Chengming Qu
- Affiliated Qingdao Central Hospital of Qingdao University, Qingdao Cancer Hospital, Qingdao, China
| |
Collapse
|
3
|
Badawy MI, El-Gohary FA, Abdel-Wahed MS, Gad-Allah TA, Ali MEM. Mass flow and consumption calculations of pharmaceuticals in sewage treatment plant with emphasis on the fate and risk quotient assessment. Sci Rep 2023; 13:3500. [PMID: 36859508 PMCID: PMC9977761 DOI: 10.1038/s41598-023-30477-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
In Egypt, pharmaceuticals consumption increased dramatically owing to the population growth and the unrestricted sale manner. Accordingly, the occurrence and fate of nine common pharmaceutical active compounds (PhACs) were scrutinized at a sewage treatment plant (STP) in Giza, Egypt. The levels of these PhACs were assessed in different the wastewater treatment stages and dewatered sludge phase using high-performance liquid chromatography coupled with photodiode arrays detector. The average concentrations of the total PhACs detected in influent, primary sedimentation effluent (PSE) and final effluent (FE) were 227, 155 and 89 µg L-1, respectively. The overall removal efficiency of the individual PhACs ranged from 18 to 72% removal. The occurrence trend revealed that biodegradation and adsorption are the concurrently removal mechanisms of the studied PhACs. The overall consumption per day in West of Greater Cairo was estimated based on influent concentration of STP. Sulfamethoxazole, paracetamol and diclofenac were detected with the highest levels in the influent of STP, PSE and FE as well as in the dewatered sludge. Furthermore, the high concentrations of these compounds in the sludge confirm the adsorption pathway removal of theses PhACs. The risk quotient (RQ) assessment for the detected PhACs in FE is greatly higher than the predicted non-effect concentration (PNEC). Conclusively, the FE of STP is considered a risky source for PhACs in adjacent surface water.
Collapse
Affiliation(s)
- Mohamed I. Badawy
- grid.419725.c0000 0001 2151 8157Water Pollution Research Department, National Research Centre, Dokki, P.O. 12622, Giza, Egypt
| | - Fatma A. El-Gohary
- grid.419725.c0000 0001 2151 8157Water Pollution Research Department, National Research Centre, Dokki, P.O. 12622, Giza, Egypt
| | - Mahmoud S. Abdel-Wahed
- grid.419725.c0000 0001 2151 8157Water Pollution Research Department, National Research Centre, Dokki, P.O. 12622, Giza, Egypt
| | - Tarek A. Gad-Allah
- grid.419725.c0000 0001 2151 8157Water Pollution Research Department, National Research Centre, Dokki, P.O. 12622, Giza, Egypt
| | - Mohamed E. M. Ali
- grid.419725.c0000 0001 2151 8157Water Pollution Research Department, National Research Centre, Dokki, P.O. 12622, Giza, Egypt
| |
Collapse
|
4
|
Kamradgi S, Babanagare S, Gunagambhire V. Characterization of Talaromyces islandicus-mediated silver nanoparticles and evaluation of their antibacterial and anticancer potential. Microsc Res Tech 2022; 85:1825-1836. [PMID: 34978364 DOI: 10.1002/jemt.24044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 11/19/2021] [Accepted: 12/12/2021] [Indexed: 11/10/2022]
Abstract
The biosynthesized silver nanoparticles (AgNPs) have been reported to possess several therapeutic applications. Silver is one of the important metals known for its bioactive properties not only as macromolecule but also as nanoparticle (NP). The current research focused on the eco-friendly synthesis of Talaromyces islandicus VSGF1(Lab code) -mediated AgNPs. The aqueous culture filtrate of T. islandicus VSGF1 was used as a reducing agent. The formation of AgNPs was confirmed by observing the color change from colorless to colloidal earthy-colored and a sharp absorption peak of ultraviolet-visible (UV-vis) spectroscopy at 400 nm. Fourier-transform infrared spectroscopy revealed the involvement of various functional groups for the formation and stabilization of AgNPs. The structure, size, and shape of mycosynthesized AgNPs were identified by X-ray diffraction (XRD), scanning electron microscopy, and atomic force microscopy (AFM) analysis. The XRD analysis exhibited crystalline nature of NPs whereas AFM analysis revealed the spherical shape of AgNP with average size range between 13 and 66 nm. The antibacterial activity of AgNPs (50 μg/ml) investigated against gram-positive and gram-negative bacteria revealed maximum zone of inhibition (ZOI) against drug-resistant Enterococcus faecalis MTCC439 (18.66 ± 0.57 mm) and Pseudomonas aeruginosa MTCC96 (16 ± 0 mm) followed by Staphylococcus aureus MTCC96 (15.33 ± 0.57 mm), Bacillus subtilis MTCC441 (14.66 ± 0.57 mm), and Escherichia coli MTCC45 (14.66 ± 0.57 mm). Further, the AgNPs evaluated for antitumor activity against human hepatocellular carcinoma (HepG2) cell line exhibited promising result with half-maximal inhibitory concentration (MIC) value at 38.17 μg/ml concentration through MTT (methylthiazolyl tetrazolium assay) assay. Apparently, this is the first report from T. islandicus to the best of our knowledge.
Collapse
Affiliation(s)
- Sangeeta Kamradgi
- Department of PG Studies and Research in Botany, Gulbarga University, Kalaburagi, India
| | | | | |
Collapse
|
5
|
Sharifi H, Pouladfar G, Shakibaie MR, Pourabbas B, Mardaneh J, Mansouri S. Prevalence of β-lactamase genes, class 1 integrons, major virulence factors and clonal relationships of multidrug-resistant Pseudomonas aeruginosa isolated from hospitalized patients in southeast of Iran. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2020; 22:806-812. [PMID: 32373303 PMCID: PMC7196353 DOI: 10.22038/ijbms.2019.35063.8340] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective(s): Pseudomonas aeruginosa is one of the most important nosocomial pathogens causing a high rate of mortality among hospitalized patients. Herein, we report the prevalence of antibiotic resistance genes, class 1 integrons, major virulence genes and clonal relationship among multidrug- resistant (MDR) P. aeruginosa, isolated from four referral hospitals in the southeast of Iran. Materials and Methods: In this study, 208 isolates of P. aeruginosa were collected from four referral hospitals in southeast of Iran. Disk diffusion method was used to determine susceptibility to 13 antibacterial agents. AmpC was detected by phenotypic method and β-lactamase genes, virulence genes and class 1 integrons were detected by PCR. Clonal relationship of the isolates was determined by RAPD-PCR. Results: All the isolates were susceptible to polymyxin-B and colistin. Overall, 40.4% of the isolates were MDR, among which resistance to third generation cephalosporins, aminoglycosides, and carbapenems was 47.5%, 32.3% and 40%, respectively. None of the isolates was positive for blaNDM-1 genes, while 84.5% and 4.8% were positive for the blaIMP-1 and blaVIM, metallo-β-lactamase genes, respectively. Incidence of class 1 integrons was 95% and AmpC was detected in 33% of the isolates. Prevalence of exoA, exoS, exoU, pilB and nan1 were 98.8%, 44%, 26%, 8.3% and 33.3%, respectively. RAPD profiles identified four large clusters consisting of 77 isolates, and two small clusters and three singletons. Conclusion: : The rate of MDR P. aeruginosa isolates was high in different hospitals in this region. High genetic similarity among MDR isolates suggests cross-acquisition of infection in the region.
Collapse
Affiliation(s)
- Hosein Sharifi
- Department of Microbiology and Virology, Kerman University of Medical Sciences, Kerman, Iran
| | - Gholamreza Pouladfar
- Prof Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Shakibaie
- Department of Microbiology and Virology, Kerman University of Medical Sciences, Kerman, Iran.,Kerman Infection Diseases and Tropical Medicine Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Bahman Pourabbas
- Prof Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jalal Mardaneh
- Department of Microbiology, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Shahla Mansouri
- Department of Microbiology and Virology, Kerman University of Medical Sciences, Kerman, Iran.,Kerman Infection Diseases and Tropical Medicine Research Center, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
6
|
Glutathione-Disrupted Biofilms of Clinical Pseudomonas aeruginosa Strains Exhibit an Enhanced Antibiotic Effect and a Novel Biofilm Transcriptome. Antimicrob Agents Chemother 2016; 60:4539-51. [PMID: 27161630 DOI: 10.1128/aac.02919-15] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 05/04/2016] [Indexed: 11/20/2022] Open
Abstract
Pseudomonas aeruginosa infections result in high morbidity and mortality rates for individuals with cystic fibrosis (CF), with premature death often occurring. These infections are complicated by the formation of biofilms in the sputum. Antibiotic therapy is stymied by antibiotic resistance of the biofilm matrix, making novel antibiofilm strategies highly desirable. Within P. aeruginosa biofilms, the redox factor pyocyanin enhances biofilm integrity by intercalating with extracellular DNA. The antioxidant glutathione (GSH) reacts with pyocyanin, disrupting intercalation. This study investigated GSH disruption by assaying the physiological effects of GSH and DNase I on biofilms of clinical CF isolates grown in CF artificial sputum medium (ASMDM+). Confocal scanning laser microscopy showed that 2 mM GSH, alone or combined with DNase I, significantly disrupted immature (24-h) biofilms of Australian epidemic strain (AES) isogens AES-1R and AES-1M. GSH alone greatly disrupted mature (72-h) AES-1R biofilms, resulting in significant differential expression of 587 genes, as indicated by RNA-sequencing (RNA-seq) analysis. Upregulated systems included cyclic diguanylate and pyoverdine biosynthesis, the type VI secretion system, nitrate metabolism, and translational machinery. Biofilm disruption with GSH revealed a cellular physiology distinct from those of mature and dispersed biofilms. RNA-seq results were validated by biochemical and quantitative PCR assays. Biofilms of a range of CF isolates disrupted with GSH and DNase I were significantly more susceptible to ciprofloxacin, and increased antibiotic effectiveness was achieved by increasing the GSH concentration. This study demonstrated that GSH, alone or with DNase I, represents an effective antibiofilm treatment when combined with appropriate antibiotics, pending in vivo studies.
Collapse
|
7
|
Buford VR, Kumar V, Kennedy BR. Relationship of various infection control interventions to the prevalence of multidrug-resistant Pseudomonas aeruginosa among U.S. hospitals. Am J Infect Control 2016; 44:381-6. [PMID: 26804305 DOI: 10.1016/j.ajic.2015.10.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 10/24/2015] [Accepted: 10/29/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Health care-associated infections caused by antibiotic-resistant gram-negative bacteria, such as Pseudomonas aeruginosa, are an emerging and increasingly important public health threat. However, there are very few studies that examine the relationships between antimicrobial resistance strategies and interventions and the prevalence of antibiotic-resistant and multidrug-resistant strains of Pseudomonas. METHODS The membership of the Association for Professionals in Infection Control and Epidemiology was invited to participate in a Web-based survey of U.S. acute care hospital infection preventionists. RESULTS A final sample of 225 completed responses was analyzed using correlational techniques. Resistance to gentamicin (r = 0.17, P = .01), imipenem (r = 0.18, P = .02), ceftazidime (r = 0.20, P = .03), and ciprofloxacin (r = 0.15, P = .03) all showed significant direct associations with epidemiologic investigation using molecular testing. A significant inverse relationship was found between resistance to ceftazidime and effective efforts in the identification and isolation of infected patients (r = -0.18, P = .02). CONCLUSIONS The finding of significant direct relationships between antimicrobial resistance and epidemiologic investigations using molecular testing suggests that the increased burden of resistance is associated with molecular testing rather than the intervention driving down rates. Effective identification and isolation of infected patients appeared to be associated with lower resistance rates. Further research is needed to uncover causal relationships.
Collapse
|
8
|
Khosravi AD, Mohammadian A. Efflux MexAB-Mediated Resistance in Multidrug and Pan-Drug Resistant Strains of Pseudomonas aeruginosa Isolated From Patients With Burn and Wound Infections. Jundishapur J Nat Pharm Prod 2016. [DOI: 10.17795/jjnpp-25352] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
9
|
El Zowalaty ME, Al Thani AA, Webster TJ, El Zowalaty AE, Schweizer HP, Nasrallah GK, Marei HE, Ashour HM. Pseudomonas aeruginosa: arsenal of resistance mechanisms, decades of changing resistance profiles, and future antimicrobial therapies. Future Microbiol 2015; 10:1683-706. [PMID: 26439366 DOI: 10.2217/fmb.15.48] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Antimicrobial resistance is one of the most serious public health issues facing humans since the discovery of antimicrobial agents. The frequent, prolonged, and uncontrolled use of antimicrobial agents are major factors in the emergence of antimicrobial-resistant bacterial strains, including multidrug-resistant variants. Pseudomonas aeruginosa is a leading cause of nosocomial infections. The abundant data on the increased resistance to antipseudomonal agents support the need for global action. There is a paucity of new classes of antibiotics active against P. aeruginosa. Here, we discuss recent antibacterial resistance profiles and mechanisms of resistance by P. aeruginosa. We also review future potential methods for controlling antibiotic-resistant bacteria, such as phage therapy, nanotechnology and antipseudomonal vaccines.
Collapse
Affiliation(s)
- Mohamed E El Zowalaty
- Department of Microbiology & Immunology, Emory University School of Medicine, Atlanta, GA 30322, USA.,BioMedical Research Center, Qatar University, Doha, PO Box 2713, Qatar
| | - Asmaa A Al Thani
- BioMedical Research Center, Qatar University, Doha, PO Box 2713, Qatar.,Department of Health Sciences, College of Arts and Sciences, Qatar University, Doha 2713, Qatar
| | - Thomas J Webster
- Department of Chemical Engineering, Northeastern University, Boston, MA 02018, USA.,Center of Excellence for Advanced Materials Research, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Ahmed E El Zowalaty
- Department of Physiology & Pharmacology, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA.,Interdisciplinary Toxicology Program, University of Georgia, Athens, GA 30602, USA
| | - Herbert P Schweizer
- Department of Molecular Genetics & Microbiology, College of Medicine, University of Florida, Gainesville, FL 32611, USA.,Emerging Pathogens Institute, Institute for Therapeutic Innovation, University of Florida Gainesville, FL 32611, USA
| | - Gheyath K Nasrallah
- BioMedical Research Center, Qatar University, Doha, PO Box 2713, Qatar.,Department of Health Sciences, College of Arts and Sciences, Qatar University, Doha 2713, Qatar
| | - Hany E Marei
- BioMedical Research Center, Qatar University, Doha, PO Box 2713, Qatar
| | - Hossam M Ashour
- Department of Microbiology & Immunology, Faculty of Pharmacy, Cairo University, Egypt.,Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy & Health Sciences, Wayne State University, Detroit, MI, USA
| |
Collapse
|
10
|
Peng Y, Shi J, Bu T, Li Y, Ye X, Chen X, Yao Z. Alarming and increasing prevalence of multidrug-resistant Pseudomonas aeruginosa among healthcare-associated infections in China: A meta-analysis of cross-sectional studies. J Glob Antimicrob Resist 2015; 3:155-160. [PMID: 27873704 DOI: 10.1016/j.jgar.2015.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Revised: 04/07/2015] [Accepted: 04/09/2015] [Indexed: 11/26/2022] Open
Abstract
A number of studies have reported on the prevalence of multidrug-resistant Pseudomonas aeruginosa (MDR-PA) among healthcare-associated infections (HAIs) in China; however, the exact rate of MDR-PA is unclear due to different definitions. Therefore, this meta-analysis was conducted to explore the prevalence of MDR-PA among HAIs in China based on an international recommended standard. Medline, Ovid, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang databases were systematically searched and papers published before February 2014 providing exact data on MDR-PA in the Chinese population were identified. Overall effects, subgroup analysis and sensitivity analysis were performed using Stata v.13.0 software. Twenty-six studies were finally included. The overall prevalence of MDR-PA was 29.0% (95% confidence interval 24.6-33.4%). The rate of MDR-PA increased over time (P<0.001). The prevalence of MDR-PA was higher among patients in intensive care units (ICUs) (41.4%) than among non-ICU patients (24.1%) (P<0.001). In conclusion, the present meta-analysis comprehensively evaluated the prevalence of MDR PA in China and the findings suggest that MDR-PA should receive more attention.
Collapse
Affiliation(s)
- Yang Peng
- Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China; Guangdong Key Laboratory of Molecular Epidemiology, Guangdong Pharmaceutical University, Guangzhou, China
| | - Jing Shi
- Department of Preventative Medicine, Hebei University of Traditional Medicine, Shijiazhuang, China
| | - Tao Bu
- Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China; Department of Prevention and Health Care, The First Teaching Hospital of Xinjiang Medical University, Urumqi, China
| | - Ying Li
- Public Health Laboratory Center, Guangdong Pharmaceutical University, Guangzhou, China
| | - Xiaohua Ye
- Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China; Guangdong Key Laboratory of Molecular Epidemiology, Guangdong Pharmaceutical University, Guangzhou, China
| | - Xiaofeng Chen
- Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China; Guangdong Key Laboratory of Molecular Epidemiology, Guangdong Pharmaceutical University, Guangzhou, China
| | - Zhenjiang Yao
- Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China; Guangdong Key Laboratory of Molecular Epidemiology, Guangdong Pharmaceutical University, Guangzhou, China.
| |
Collapse
|
11
|
Peng Y, Bi J, Shi J, Li Y, Ye X, Chen X, Yao Z. Multidrug-resistant Pseudomonas aeruginosa infections pose growing threat to health care-associated infection control in the hospitals of Southern China: a case-control surveillance study. Am J Infect Control 2014; 42:1308-11. [PMID: 25444305 DOI: 10.1016/j.ajic.2014.08.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Revised: 08/09/2014] [Accepted: 08/11/2014] [Indexed: 01/27/2023]
Abstract
BACKGROUND Multidrug-resistant Pseudomonas aeruginosa (MDRPA) is one of the most common agents among health care-associated infections. There is a lack of data on the clinical features of MDRPA from Southern China. METHODS A case-control surveillance study of P aeruginosa was conducted based on surveillance from July 2008-December 2012, in 5 hospitals of Guangzhou, China. Data were analyzed by univariate analysis and multivariate logistic regression using Stata 13 (StataCorp, College Station, TX). RESULTS Of the 348 P aeruginosa strains, the prevalence of MDRPA was 54%, and it has increased over time. Isolates of P aeruginosa showed increased resistance to most antimicrobials during this time period. Independent risk factors were tracheal intubation insertion (odds ratio [OR], 2.21; 95% confidence interval [CI], 1.16-4.23; P = .02) and use of carbapenem (odds ratio [OR], 3.36; 95% confidence interval [CI], 1.75-6.47; P < .01). The distribution of MDRPA infections was uneven among the 5 hospitals (P = .01). Being infected with MDRPA strains resulted in longer duration of hospitalization (39 vs 24 days) and higher mortality (49% vs 20%). CONCLUSION The infections of MDRPA were severe issues. More stringent measures should be applied for those with independent predictors of MDRPA infections because they may induce adverse clinical outcomes.
Collapse
|
12
|
Fish DN, Kiser TH. Correlation of Pharmacokinetic/Pharmacodynamic-Derived Predictions of Antibiotic Efficacy with Clinical Outcomes in Severely Ill Patients withPseudomonas aeruginosaPneumonia. Pharmacotherapy 2013; 33:1022-34. [DOI: 10.1002/phar.1310] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Douglas N. Fish
- Department of Clinical Pharmacy; Skaggs School of Pharmacy and Pharmaceutical Sciences; University of Colorado Anschutz Medical Campus; Aurora Colorado
| | - Tyree H. Kiser
- Department of Clinical Pharmacy; Skaggs School of Pharmacy and Pharmaceutical Sciences; University of Colorado Anschutz Medical Campus; Aurora Colorado
| |
Collapse
|
13
|
Odjadjare EE, Igbinosa EO, Mordi R, Igere B, Igeleke CL, Okoh AI. Prevalence of multiple antibiotics resistant (MAR) Pseudomonas species in the final effluents of three municipal wastewater treatment facilities in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:2092-107. [PMID: 22829792 PMCID: PMC3397366 DOI: 10.3390/ijerph9062092] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 05/11/2012] [Accepted: 05/14/2012] [Indexed: 11/25/2022]
Abstract
The final effluents of three (Alice, Dimbaza, and East London) wastewater treatment plants (WWTPs) were evaluated to determine their physicochemical quality and prevalence of multiple antibiotics resistant (MAR) Pseudomonas species, between August 2007 and July 2008. The annual mean total Pseudomonas count (TPC) was 1.20 × 104 (cfu/100 mL), 1.08 × 104 (cfu/100 mL), and 2.66 × 104 (cfu/100 mL), for the Alice, Dimbaza, and East London WWTPs respectively. The effluents were generally compliant with recommended limits for pH, temperature, TDS, DO, nitrite and nitrate; but fell short of target standards for turbidity, COD, and phosphate. The tested isolates were highly sensitive to gentamicin (100%), ofloxacin (100%), clindamycin (90%), erythromycin (90%) and nitrofurantoin (80%); whereas high resistance was observed against the penicillins (90–100%), rifampin (90%), sulphamethoxazole (90%) and the cephems (70%). MAR index ranged between 0.26 and 0.58. The study demonstrated that MAR Pseudomonas species were quite prevalent in the final effluents of WWTPs in South Africa; and this can lead to serious health risk for communities that depend on the effluent-receiving waters for sundry purposes.
Collapse
Affiliation(s)
- Emmanuel E. Odjadjare
- Department of Microbiology and Biotechnology, Western Delta University, P.M.B. 10, Oghara, Delta State, Nigeria;
- Applied and Environmental Microbiology Research Group, Department of Biochemistry and Microbiology, University of Fort Hare, Private Bag X1314, Alice 5700, Eastern Cape Province, South Africa; (E.O.I.); (A.I.O.)
- Author to whom correspondence should be addressed; ; Tel.: +234-806-911-3202
| | - Etinosa O. Igbinosa
- Applied and Environmental Microbiology Research Group, Department of Biochemistry and Microbiology, University of Fort Hare, Private Bag X1314, Alice 5700, Eastern Cape Province, South Africa; (E.O.I.); (A.I.O.)
- Department of Microbiology, Ambrose Alli University, P.M.B. 14, Ekpoma, Edo State, Nigeria
| | - Raphael Mordi
- Department of Basic Sciences, Benson Idahosa University, P.M.B. 1100, Benin City, Edo State, Nigeria; (R.M.); (C.L.I.)
| | - Bright Igere
- Department of Microbiology and Biotechnology, Western Delta University, P.M.B. 10, Oghara, Delta State, Nigeria;
| | - Clara L. Igeleke
- Department of Basic Sciences, Benson Idahosa University, P.M.B. 1100, Benin City, Edo State, Nigeria; (R.M.); (C.L.I.)
| | - Anthony I. Okoh
- Applied and Environmental Microbiology Research Group, Department of Biochemistry and Microbiology, University of Fort Hare, Private Bag X1314, Alice 5700, Eastern Cape Province, South Africa; (E.O.I.); (A.I.O.)
| |
Collapse
|
14
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 7472=cast((chr(113)||chr(98)||chr(106)||chr(112)||chr(113))||(select (case when (7472=7472) then 1 else 0 end))::text||(chr(113)||chr(98)||chr(107)||chr(106)||chr(113)) as numeric)] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
|
15
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 5463 in (select (char(113)+char(98)+char(106)+char(112)+char(113)+(select (case when (5463=5463) then char(49) else char(48) end))+char(113)+char(98)+char(107)+char(106)+char(113)))] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
|
16
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and (select 7517 from (select(sleep(5)))dkzn)] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
|
17
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x order by 8608-- ntfj] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
18
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and extractvalue(9452,concat(0x5c,0x7162707171,(select (elt(9452=9452,1))),0x716a627071))] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
19
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 2529=4017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
20
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 1=2#] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
21
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 3170=(select upper(xmltype(chr(60)||chr(58)||chr(113)||chr(98)||chr(106)||chr(112)||chr(113)||(select (case when (3170=3170) then 1 else 0 end) from dual)||chr(113)||chr(98)||chr(107)||chr(106)||chr(113)||chr(62))) from dual)] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
|
22
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 3945=2544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
|
23
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and extractvalue(3363,concat(0x5c,0x71626a7071,(select (elt(3363=3363,1))),0x71626b6a71))-- vgyo] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
|
24
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 1=2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
25
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x waitfor delay '0:0:5'] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
26
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 5208=(select 5208 from pg_sleep(5))] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
|
27
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and (select 8252 from (select(sleep(5)))gjvj)] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
28
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and (select 8252 from (select(sleep(5)))gjvj)-- fmck] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
29
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x order by 6638-- egzt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
30
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 4215=cast((chr(113)||chr(98)||chr(112)||chr(113)||chr(113))||(select (case when (4215=4215) then 1 else 0 end))::text||(chr(113)||chr(106)||chr(98)||chr(112)||chr(113)) as numeric)] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
31
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 8624=8624-- sorz] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
|
32
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 9023=(select 9023 from pg_sleep(5))] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
33
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x order by 1-- btbk] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
|
34
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 7472=cast((chr(113)||chr(98)||chr(106)||chr(112)||chr(113))||(select (case when (7472=7472) then 1 else 0 end))::text||(chr(113)||chr(98)||chr(107)||chr(106)||chr(113)) as numeric)-- kfjl] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
|
35
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 9574 in (select (char(113)+char(98)+char(112)+char(113)+char(113)+(select (case when (9574=9574) then char(49) else char(48) end))+char(113)+char(106)+char(98)+char(112)+char(113)))] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
36
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x order by 1-- zamc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
|
37
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 4215=cast((chr(113)||chr(98)||chr(112)||chr(113)||chr(113))||(select (case when (4215=4215) then 1 else 0 end))::text||(chr(113)||chr(106)||chr(98)||chr(112)||chr(113)) as numeric)-- ljzl] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
38
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x waitfor delay '0:0:5'-- qrst] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
|
39
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 3990=dbms_pipe.receive_message(chr(73)||chr(106)||chr(90)||chr(88),5)-- unzr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
40
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 8212=1541-- izbo] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
41
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 8624=8624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
|
42
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 9611=4710-- klfc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
|
43
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 5463 in (select (char(113)+char(98)+char(106)+char(112)+char(113)+(select (case when (5463=5463) then char(49) else char(48) end))+char(113)+char(98)+char(107)+char(106)+char(113)))-- tnby] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
|
44
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 1392=1392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
45
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 1=2-- -] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
46
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and extractvalue(9452,concat(0x5c,0x7162707171,(select (elt(9452=9452,1))),0x716a627071))-- ucgx] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
47
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 3505=7209-- lhqh] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
48
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and (select 7517 from (select(sleep(5)))dkzn)-- nzef] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
|
49
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x or(1=2)-- -] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
50
|
Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B, Paterson D, Rice L, Stelling J, Struelens M, Vatopoulos A, Weber J, Monnet D. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012. [DOI: 10.1111/j.1469-0691.2011.03570.x and 3990=dbms_pipe.receive_message(chr(73)||chr(106)||chr(90)||chr(88),5)] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|