1
|
Salem ME, Abdelhamid IA, Elwahy AH, Ragheb MA, Alqahtani AS, Zaki ME, Algethami FK, Mahmoud HK. Novel hybrid thiazoles, bis-thiazoles linked to azo-sulfamethoxazole: Synthesis, docking, and antimicrobial activity. Heliyon 2024; 10:e31082. [PMID: 38813143 PMCID: PMC11133767 DOI: 10.1016/j.heliyon.2024.e31082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 05/03/2024] [Accepted: 05/09/2024] [Indexed: 05/31/2024] Open
Abstract
The reaction of sulfamethoxazolehydrazonoyl chloride with thiosemicarbazones, bis-thiosemicarbazones, or 4-amino-3-mercapto-1,2,4-triazole in dioxane in the presence of triethylamine as a basic catalyst at reflux resulted in the regioselective synthesis of thiazoles and bis-thiazoles linked to azo-sulfamethoxazole as novel hybrid molecules. The structures of the new compounds were confirmed using a range of spectra. Each compound's antibacterial properties were evaluated using the agar well-diffusion technique, and most of them demonstrated significant potency. In silico investigations revealed that the described compounds had strong interactions with the binding sites of MurE ligase, tyrosyl-tRNA synthetase, and dihydropteroate synthase, demonstrating inhibitory activity.
Collapse
Affiliation(s)
- Mostafa E. Salem
- Department of Chemistry, College of Science, Imam Mohammad Ibn Saud Islamic University(IMSIU), P.O. Box, 90950, Riyadh, 11623, Saudi Arabia
- Department of Chemistry, Faculty of Science, Cairo University, Giza, 12613, Egypt
| | - Ismail A. Abdelhamid
- Department of Chemistry, Faculty of Science, Cairo University, Giza, 12613, Egypt
| | - Ahmed H.M. Elwahy
- Department of Chemistry, Faculty of Science, Cairo University, Giza, 12613, Egypt
| | - Mohamed A. Ragheb
- Department of Chemistry (Biochemistry Division), Faculty of Science, Cairo University, Giza, 12613, Egypt
| | - Arwa sultan Alqahtani
- Department of Chemistry, College of Science, Imam Mohammad Ibn Saud Islamic University(IMSIU), P.O. Box, 90950, Riyadh, 11623, Saudi Arabia
| | - Magdi E.A. Zaki
- Department of Chemistry, College of Science, Imam Mohammad Ibn Saud Islamic University(IMSIU), P.O. Box, 90950, Riyadh, 11623, Saudi Arabia
| | - Faisal K. Algethami
- Department of Chemistry, College of Science, Imam Mohammad Ibn Saud Islamic University(IMSIU), P.O. Box, 90950, Riyadh, 11623, Saudi Arabia
| | - Huda Kamel Mahmoud
- Department of Chemistry, Faculty of Science, Cairo University, Giza, 12613, Egypt
| |
Collapse
|
2
|
Ragheb MA, Mohamed FG, Diab HM, Ragab MS, Emara M, Elwahy AHM, Abdelhamid IA, Soliman MH. Novel Bis(2-cyanoacrylamide) Linked to Sulphamethoxazole: Synthesis, DNA Interaction, Anticancer, ADMET, Molecular Docking, and DFT Studies. Chem Biodivers 2024; 21:e202301341. [PMID: 38314957 DOI: 10.1002/cbdv.202301341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 01/27/2024] [Accepted: 02/01/2024] [Indexed: 02/07/2024]
Abstract
In the light of advancement and potential extensive use of medication design and therapy, new bis(cyanoacrylamides) incorporating sulphamethoxazole derivatives (7 a-7 f) were synthesized and confirmed by different spectral tools. In vitro anticancer activity towards different human cancer cells (HCT116, MDA-MB-231 and A549) was assessed using MTT assay. Among all derivatives, 4C- and 6C-spacer derivatives (7 e and 7 f) had the most potent growth inhibitory activities against HCT116 cells with IC50 values of 39.7 and 28.5 μM, respectively. 7 e and 7 f induced apoptosis and suppressed migration of HCT116 cells. These compounds also induced a significant increase in caspase-3 and CDH1 activities, and a downregulation of Bcl2 using ELISA. pBR322 DNA cleavage activities of cyanoacrylamides were determined using agarose gel electrophoresis. Furthermore, 7 e and 7 f showed good DNA and BSA binding affinities using different spectroscopic techniques. Furthermore, molecular docking for 7 e and 7 f was performed to anticipate their binding capabilities toward various proteins (Bcl2, CDH1 and BSA). The docking results were well correlated with those of experimental results. Additionally, density functional theory and ADMET study were performed to evaluate the molecular and pharmacokinetic features of 7 e and 7 f, respectively. Thus, this work reveals promising antitumor lead compounds that merit future research and activity enhancement.
Collapse
Affiliation(s)
- Mohamed A Ragheb
- Department of Chemistry (Biochemistry Division), Faculty of Science, Cairo University, Giza, 12613, Egypt
| | - Fatma G Mohamed
- Department of Chemistry (Biochemistry Division), Faculty of Science, Cairo University, Giza, 12613, Egypt
| | - Hadeer M Diab
- Department of Chemistry, Faculty of Science, Cairo University, Giza, 12613, Egypt
| | - Mona S Ragab
- Department of Chemistry, Faculty of Science, Cairo University, Giza, 12613, Egypt
| | - Marwan Emara
- Center for Aging and Associated Diseases, Zewail City of Science, Technology and innovation, 12578-, Giza, Egypt
| | - Ahmed H M Elwahy
- Department of Chemistry, Faculty of Science, Cairo University, Giza, 12613, Egypt
| | - Ismail A Abdelhamid
- Department of Chemistry, Faculty of Science, Cairo University, Giza, 12613, Egypt
| | - Marwa H Soliman
- Department of Chemistry (Biochemistry Division), Faculty of Science, Cairo University, Giza, 12613, Egypt
| |
Collapse
|
3
|
Ku JH, Bruxvoort KJ, Salas SB, Varley CD, Casey JA, Raphael E, Robinson SC, Nachman KE, Lewin BJ, Contreras R, Wei RX, Pomichowski ME, Takhar HS, Tartof SY. Multidrug Resistance of Escherichia coli From Outpatient Uncomplicated Urinary Tract Infections in a Large United States Integrated Healthcare Organization. Open Forum Infect Dis 2023; 10:ofad287. [PMID: 37426945 PMCID: PMC10326677 DOI: 10.1093/ofid/ofad287] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 05/19/2023] [Indexed: 07/11/2023] Open
Abstract
Background Urinary tract infections (UTIs) cause significant disease and economic burden. Uncomplicated UTIs (uUTIs) occur in otherwise healthy individuals without underlying structural abnormalities, with uropathogenic Escherichia coli (UPEC) accounting for 80% of cases. With recent transitions in healthcare toward virtual visits, data on multidrug resistance (MDR) (resistant to ≥3 antibiotic classes) by care setting are needed to inform empiric treatment decision making. Methods We evaluated UPEC resistance over time by care setting (in-person vs virtual), in adults who received outpatient care for uUTI at Kaiser Permanente Southern California between January 2016 and December 2021. Results We included 174 185 individuals who had ≥1 UPEC uUTI (233 974 isolates) (92% female, 46% Hispanic, mean age 52 years [standard deviation 20]). Overall, prevalence of UPEC MDR decreased during the study period (13% to 12%) both in virtual and in-person settings (P for trend <.001). Resistance to penicillins overall (29%), coresistance to penicillins and trimethoprim-sulfamethoxazole (TMP-SMX) (12%), and MDR involving the 2 plus ≥1 antibiotic class were common (10%). Resistance to 1, 2, 3, and 4 antibiotic classes was found in 19%, 18%, 8%, and 4% of isolates, respectively; 1% were resistant to ≥5 antibiotic classes, and 50% were resistant to none. Similar resistance patterns were observed over time and by care setting. Conclusions We observed a slight decrease in both class-specific antimicrobial resistance and MDR of UPEC overall, most commonly involving penicillins and TMP-SMX. Resistance patterns were consistent over time and similar in both in-person and virtual settings. Virtual healthcare may expand access to UTI care.
Collapse
Affiliation(s)
- Jennifer H Ku
- Correspondence: Jennifer H. Ku, PhD, MPH, Department of Research and Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles, 2nd Floor, Pasadena, CA 91101 ()
| | - Katia J Bruxvoort
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - S Bianca Salas
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Cara D Varley
- Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA
- Oregon Health & Science University-Portland State University, School of Public Health, Portland, Oregon, USA
| | - Joan A Casey
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington, USA
| | - Eva Raphael
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Sarah C Robinson
- Center for Health Systems Research, Sutter Health, Walnut Creek, California, USA
| | - Keeve E Nachman
- Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Bruno J Lewin
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
- Kaiser Permanente Southern California and Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA
| | - Richard Contreras
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Rong X Wei
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Magdalena E Pomichowski
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Harpreet S Takhar
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | | |
Collapse
|
4
|
Kim SI, Jung SH, Yhim HY, Jo JC, Song GY, Kim M, Ahn SY, Ahn JS, Yang DH, Kim HJ, Lee JJ. Real-world evidence of levofloxacin prophylaxis in elderly patients with newly diagnosed multiple myeloma who received bortezomib, melphalan, and prednisone regimen. Blood Res 2022; 57:51-58. [PMID: 35197371 PMCID: PMC8958375 DOI: 10.5045/br.2021.2021176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/03/2021] [Accepted: 12/29/2021] [Indexed: 11/29/2022] Open
Abstract
Background Although survival outcomes of multiple myeloma (MM) have improved with the development of new and effective agents, infection remains the major cause of morbidity and mortality. Here, we evaluated the efficacy of levofloxacin prophylaxis (in a real-world setting) during bortezomib, melphalan, and prednisone (VMP) therapy in elderly patients with newly diagnosed MM. Methods This study retrospectively analyzed the records of patients with newly diagnosed MM treated with the VMP regimen between February 2011 and September 2020 at three institutes of the Republic of Korea. Results Of a total of 258 patients, 204 (79.1%) received levofloxacin prophylaxis during VMP therapy. The median number of levofloxacin prophylaxis cycles was 4 (range, 1‒9), but 10 patients did not complete the planned prophylaxis because of side effects. Sixty-six patients (25.5%) experienced severe infections during VMP therapy, most of which (74.7%) occurred within the first four cycles of VMP therapy regardless of levofloxacin prophylaxis status. Early severe infection was significantly associated with poor survival. In multivariate analysis, levofloxacin prophylaxis was significantly associated with a lower risk in early severe infection. Conclusion Our findings suggest that levofloxacin prophylaxis should be considered at least during the first four cycles of VMP therapy in elderly patients with newly diagnosed MM.
Collapse
Affiliation(s)
- Su-In Kim
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, Hwasun, Korea
| | - Sung-Hoon Jung
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, Hwasun, Korea
| | - Ho-Young Yhim
- Jeonbuk National University Hospital, Jeonbuk National university Medical School, Jeonju, Korea
| | - Jae-Cheol Jo
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Ga-Young Song
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, Hwasun, Korea
| | - Mihee Kim
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, Hwasun, Korea
| | - Seo-Yeon Ahn
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, Hwasun, Korea
| | - Jae-Sook Ahn
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, Hwasun, Korea
| | - Deok-Hwan Yang
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, Hwasun, Korea
| | - Hyeoung-Joon Kim
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, Hwasun, Korea
| | - Je-Jung Lee
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, Hwasun, Korea
| |
Collapse
|
5
|
Dobbyn D, Zeggil T, Kudrowich B, Beahm NP. Ciprofloxacin Resistances Rates in Escherichia coli Across Canada (CREAC): A Longitudinal Analysis 2015-2019. Int J Antimicrob Agents 2022; 59:106532. [DOI: 10.1016/j.ijantimicag.2022.106532] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 01/12/2022] [Accepted: 01/19/2022] [Indexed: 11/05/2022]
|
6
|
Mohamed MF, Saddiq AA, Al-Shaikh TM, Ibrahim NS, Abdelhamid IA. Computational studies and sever apoptotic bioactivity of new heterocyclic cyanoacrylamide based p-fluorophenyl and p-phenolic compounds against liver carcinoma (Hepg2). Bioorg Chem 2021; 114:105147. [PMID: 34246114 DOI: 10.1016/j.bioorg.2021.105147] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 06/10/2021] [Accepted: 07/01/2021] [Indexed: 01/05/2023]
Abstract
An efficient route for the preparation of new heterocyclic cyanoacrylamides based p-fluorophenyl and p-phenolic compounds was depicted. All structures were confirmed based on the different spectral tools and elemental analyses. MTT assay for the novel synthesized series was performed against four different cell lines (A549, MCF7, Hepg2, and Wi38). Among all tested groups, the p-phenolic compound 10 (207.1 µg/ml) and the corresponding p-fluorophenyl derivative 6 (325.7 µg/ml) were selected for further simulation and molecular studies against liver carcinoma. Compounds 6 and 10 were investigated theoretically to different protein sets as (cdk2, Bcl2-xl, cIAP1-BIR3, and MDM2) and they illustrated different binding affinities. The computational studies and different molecular techniques (e.g. cell cycle analysis, DPA assay, relative gene expression, and ELISA assay) were utilized in this report.
Collapse
Affiliation(s)
- Magda F Mohamed
- Department of Chemistry, College of Science and Arts at Khulais, University of Jeddah, Jeddah, Saudi Arabia; Department of Chemistry (Biochemistry Branch), Faculty of Science, Cairo University, Giza 12613, Egypt.
| | - Amna A Saddiq
- Department of Biology, College of Science and Arts at Khulais, University of Jeddah, Jeddah, Saudi Arabia
| | - Turki M Al-Shaikh
- Department of Biology, College of Science and Arts at Khulais, University of Jeddah, Jeddah, Saudi Arabia
| | - Nada S Ibrahim
- Department of Chemistry (Biochemistry Branch), Faculty of Science, Cairo University, Giza 12613, Egypt
| | - Ismail A Abdelhamid
- Chemistry Department, Faculty of Science, Cairo University, Giza 12613, Egypt.
| |
Collapse
|
7
|
Rosarior VL, Lim PS, Wong WK, Yue CS, Yam HC, Tan SA. Antioxidant-rich Clove Extract, A Strong Antimicrobial Agent against Urinary Tract Infections-causing Bacteria in vitro. Trop Life Sci Res 2021; 32:45-63. [PMID: 34367514 PMCID: PMC8300942 DOI: 10.21315/tlsr2021.32.2.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Clove (Syzygium aromaticum) is an exotic culinary spice that has been used for centuries due to its known antimicrobial and antioxidant properties. The main aim of this study is to compare the antimicrobial activity and antioxidant capacity of clove ethanolic extract (CEE) and commercial clove essential oil (CEO) at a standardised eugenol content. Disk diffusion assay showed that CEE (2000 μg) was able to exhibit broad-spectrum inhibition against both Gram negative and Gram positive Urinary Tract Infections (UTIs)-causing pathogens: Proteus mirabilis (19.7 ± 0.6 mm) > Staphylococcus epidermidis (18 mm) > Staphylococcus aureus (14.7 ± 0.6 mm) > Escherichia coli (12.7 ± 0.6 mm) > Klebsiella pneumoniae (12.3 ± 0.6 mm) (according to the size of inhibition zone). Interestingly, the comparison between CEE and commercial CEO revealed that the former demonstrated stronger antimicrobial and antioxidative properties at similar eugenol concentration. The EC50 of DPPH (1,1-diphenyl-2-picrylhydrazyl), ABTS (2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) and reducing power assay for CEE were determined as 0.037 mg/mL, 0.68 mg/mL and 0.44 mg/mL, respectively. Besides eugenol, High Performance Liquid Chromatography (HPLC) analyses identified the presence of kaempferol, gallic acid and catechin in CEE. As a conclusion, we concluded that there was a possible synergistic effect between eugenol and the others active compounds especially kaempferol which led to the observed bioactivities in CEE.
Collapse
Affiliation(s)
- Vanessa Lee Rosarior
- Department of Bioscience, Faculty of Applied Sciences, Tunku Abdul Rahman University College, Jalan Genting Kelang, 53300 Setapak, Kuala Lumpur, Malaysia
| | - Pei Shan Lim
- Department of Bioscience, Faculty of Applied Sciences, Tunku Abdul Rahman University College, Jalan Genting Kelang, 53300 Setapak, Kuala Lumpur, Malaysia
| | - Wei Kit Wong
- Department of Bioscience, Faculty of Applied Sciences, Tunku Abdul Rahman University College, Jalan Genting Kelang, 53300 Setapak, Kuala Lumpur, Malaysia
| | - Chen Son Yue
- Department of Physical Science, Tunku Abdul Rahman University College, Jalan Genting Kelang, 53300 Setapak, Kuala Lumpur, Malaysia
| | - Hok Chai Yam
- Faculty of Applied Sciences, UCSI University Kuala Lumpur Campus (South Wing), No.1, Jalan Menara Gading, UCSI Heights, Taman Connaught, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Sheri-Ann Tan
- Department of Bioscience, Faculty of Applied Sciences, Tunku Abdul Rahman University College, Jalan Genting Kelang, 53300 Setapak, Kuala Lumpur, Malaysia
| |
Collapse
|
8
|
Bazaid AS, Saeed A, Alrashidi A, Alrashidi A, Alshaghdali K, A Hammam S, Alreshidi T, Alshammary M, Alarfaj A, Thallab R, Aldarhami A. Antimicrobial Surveillance for Bacterial Uropathogens in Ha'il, Saudi Arabia: A Five-Year Multicenter Retrospective Study. Infect Drug Resist 2021; 14:1455-1465. [PMID: 33888997 PMCID: PMC8057796 DOI: 10.2147/idr.s299846] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/12/2021] [Indexed: 11/23/2022] Open
Abstract
Objective Urinary tract infections (UTIs) are among the most common infections that require antibiotic intervention. Antibiotic surveillance programs are crucial to assess resistance patterns of microorganisms associated with UTIs and to tailor antibiotic therapy accordingly. Therefore, the aim of the current study is to investigate the prevalence of uropathogens and their antimicrobial susceptibility patterns in Ha’il region. Methods We conducted a retrospective study in two main hospitals in Ha’il over a 5-year period (January 2015 to December 2019). Laboratory reports and clinical data of patients with a positive urine culture (≥105 CFU/mL) were included in the study. Results A total of 428 patients were included in this study. The majority of positive cultures belonged to female patients (94.4%), adults (76.9%) and outpatients (74.3%). Generally, Escherichia coli was the most common pathogen (45%), followed by Klebsiella pneumoniae (17%) and Staphylococcus aureus (12%). Extended-spectrum β-lactamase (ESBL) strains of E. coli (15.7%) and K. pneumoniae (19.7%) showed resistance to most tested antibiotics, while almost all Gram-negative uropathogens including ESBL strains presented low resistance to cefoxitin, imipenem and meropenem. Most strains of Staphylococcus aureus and Enterococcus faecalis were resistant to trimethoprim/sulfamethoxazole including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecalis (VRE), whereas the activity of linezolid was monitored against almost all different strains of Gram-positive uropathogens. Conclusion This surveillance study which was conducted over a 5-year period in the Ha’il region revealed that the most common UTI-associated pathogen was E. coli. Based on the current sensitivity profiles obtained from this surveillance, carbapenems and linezolid can be considered as a first therapeutic choice treating UTIs in Ha’il caused by Gram-negative and positive uropathogens, respectively. Frequent targeted surveillance programs for antibiotic-resistant pathogens and their susceptibility profiles are crucial to enable tailored empirical treatment for patients.
Collapse
Affiliation(s)
- Abdulrahman S Bazaid
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Ha'il, Ha'il, Saudi Arabia
| | - Amir Saeed
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Ha'il, Ha'il, Saudi Arabia.,Department of Medical Microbiology, Faculty of Medical Laboratory Sciences, University of Medical Sciences & Technology, Khartoum, Sudan
| | - Abdulaziz Alrashidi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Ha'il, Ha'il, Saudi Arabia
| | - Abdulkarim Alrashidi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Ha'il, Ha'il, Saudi Arabia
| | - Khalid Alshaghdali
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Ha'il, Ha'il, Saudi Arabia
| | | | | | | | - Abdullah Alarfaj
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Ha'il, Ha'il, Saudi Arabia
| | - Rawan Thallab
- Department of Statistics, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdu Aldarhami
- Department of Medical Microbiology, Qunfudah Faculty of Medicine, Umm Al-Qura University, Al-Qunfudah, 28814, Saudi Arabia
| |
Collapse
|
9
|
TEKİN M, UZUN ND, UZUN F, SANMAK E. Retrospective analysis of urine culture results in our clinic: determination of pathogen types and antibiotic resistance in our region. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.801682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
10
|
Mohamed MF, Elhakim HK, Saddiq AA, Abdelhamid IA. A novel inhibitor, 2-cyano-3-(1-phenyl-3-(thiophen-2-yl)-pyrazol-4-yl)acrylamide linked to sulphamethoxazole, blocks anti-apoptotic proteins via molecular docking and strongly induced apoptosis of HCT116 cell line by different molecular tools. ARAB J CHEM 2020. [DOI: 10.1016/j.arabjc.2020.04.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
|
11
|
Rasane RK, Centeno Coleoglou AA, Horn CB, Torres MB, Nohra E, Zhang Q, Bochicchio KM, Ilahi ON, Mazuski JE, Bochicchio GV. Inadequate Antibiotic Therapy Results in Higher Recurrence Rate after Drainage of Complicated Peri-Rectal Abscess. Surg Infect (Larchmt) 2020; 21:823-827. [PMID: 32175822 DOI: 10.1089/sur.2019.308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Recommended treatment for complicated peri-rectal abscess is incision and drainage (I&D) in conjunction with antibiotics. However, there is no standard antibiotic regimen for post-operative therapy described in the published literature. Our hypothesis was that appropriate post-operative antibiotic therapy after emergency I&D of complicated peri-rectal abscess will improve patient outcomes. Methods: Data from 58 patients with complicated peri-rectal abscess who underwent emergency I&D were analyzed retrospectively. Demographic, microbiologic, and antibiotic data were abstracted. Adequateness of antibiotics was judged by susceptibility data when available or by comparing the antibiotic spectrum with the type of organisms grown in culture when susceptibility data were not available. The Student t-test and χ2 test were used to analyze continuous and categorical variables, respectively. Multivariable analysis was used to adjust for confounding variables influencing recurrence rates. Results: Of the 58 patients reviewed, 12 were excluded because there was no culture information available or the culture showed no growth. Of the remaining 46 patients, 33 (72%) were male and 29 (63%) were African American. The mean age was 39.4 ± 16.4 years and the Body Mass Index was 28.4 ± 6.6 kg/m2. Culture data revealed mixed aerobic/anaerobic organisms in 17 (37%), mixed aerobic organisms in 15 (32.6%), gram-positive organisms in 9 (19.6%), gram-negative organisms in 2 (4.4%), and other organisms in 3 (6.6%). Twenty-five patients (54.4%) received adequate antibiotic coverage with the remainder inadequately covered. The inadequate antibiotic therapy cohort had a higher re-admission rate for abscess recurrence (n = 6 [28.6%] versus n = 1 [4%]; p = 0.021). More than half were readmitted 30 days or more after the index procedure. There were no differences in length of stay (LOS), intensive care unit LOS, or Charlson Comorbidity Index between the groups. Conclusion: Inadequate antibiotic coverage after I&D of complicated peri-rectal abscess resulted in a six-fold increase in the re-admission rate. A standard oral protocol combining antibiotics covering typical gram-positive, gram-negative, and anaerobic organisms should provide adequate coverage after surgical drainage. Additional prospective studies are needed to elucidate the optimal antibiotic regimen for these patients.
Collapse
Affiliation(s)
- Rohit K Rasane
- Department of Surgery, Washington University in Saint Louis, St. Louis, Missouri, USA
| | | | | | - Marlon Barboza Torres
- Department of Surgery, University of Iowa Hospital and Clinics, Iowa City, Iowa, USA
| | - Eden Nohra
- Department of Surgery, Florida Atlantic University, Boca Raton, Florida, USA
| | - Qiao Zhang
- Department of Surgery, Washington University in Saint Louis, St. Louis, Missouri, USA
| | - Kelly M Bochicchio
- Department of Surgery, Washington University in Saint Louis, St. Louis, Missouri, USA
| | - Obeid N Ilahi
- Department of Surgery, Washington University in Saint Louis, St. Louis, Missouri, USA
| | - John E Mazuski
- Department of Surgery, Washington University in Saint Louis, St. Louis, Missouri, USA
| | - Grant V Bochicchio
- Department of Surgery, Washington University in Saint Louis, St. Louis, Missouri, USA
| |
Collapse
|
12
|
Abdelmoniem AM, Abdelrahman MGM, Ghozlan SAS, Abdelhamid IA. Synthesis of novel hexahydroquinolines and 6‐amino‐2‐oxopyridine‐3,5‐dicarbonitriles incorporating sulfamethoxazole via [3 + 3] annulation. J Heterocycl Chem 2019. [DOI: 10.1002/jhet.3737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
13
|
Sroor FM, Abdelmoniem AM, Abdelhamid IA. Facile Synthesis, Structural Activity Relationship, Molecular Modeling and In Vitro Biological Evaluation of New Urea Derivatives with Incorporated Isoxazole and Thiazole Moieties as Anticancer Agents. ChemistrySelect 2019. [DOI: 10.1002/slct.201901415] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Farid M. Sroor
- Organometallic and Organometalloid Chemistry DepartmentNational Research Centre 12622 Cairo Egypt
| | | | | |
Collapse
|
14
|
Alanazi MQ. An evaluation of community-acquired urinary tract infection and appropriateness of treatment in an emergency department in Saudi Arabia. Ther Clin Risk Manag 2018; 14:2363-2373. [PMID: 30584311 PMCID: PMC6287421 DOI: 10.2147/tcrm.s178855] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Urinary tract infection (UTI) is a serious health problem affecting millions of people every year. Inappropriate antibiotic prescriptions put patients at risk and lead to bacterial resistance and elevated costs. Aims Study aims were to assess the prevalence and antibiotic-treatment patterns of community acquired UTIs, prevalence and types of antibiotic-prescribing errors, and the cost of inappropriate antibiotic use. Methods This was a retrospective cross-sectional study conducted over a 3-month period in an emergency department in Saudi Arabia. Results During the study period, 1,449 patients were diagnosed with UTIs, including pediatric (18.6%), adult (59.2%), and elderly (22.2%) patients. The overall prevalence of UTIs was 9.9% of total visits. Broad-spectrum antibiotics were prescribed for 85% of patients. Three main antibiotics were prescribed: cephalosporin (39%), penicillin (26%), and fluoroquinolone (22%). The overall prevalence of inappropriate antibiotic prescription with at least one type of error was 46.2% (pediatrics 51%, adults 46%, elderly 47%). Errors were dose (37%), duration (11%), frequency (6%), and antibiotic selection (2.4%). Dose error was significantly greater in pediatric patients (P=0.001). Duration error was higher among adults and the elderly (P=0.014). Significantly more inappropriate cephalosporin prescriptions were seen in adults (P=0.001), while penicillin had significantly higher errors in pediatric patients. Positive urine culture was seen in 34.9% of patients, and the most common microorganism was Escherichia coli (51%). The mean cost of care for one episode of UTI was US$134.56±$31.34 (95% CI $132.94-$136.17). Treatment of UTI was more costly in women (63.9% of total cost), adults (59.2%), and those using broad-spectrum antibiotics (86.5%). There were statistically significant associations among sex, age, spectrum of antibiotic, category of antibiotic, and inappropriate cost. Conclusion The results revealed a significant level of inappropriate use of antibiotics in the treatment of UTIs in the emergency department.
Collapse
Affiliation(s)
- Menyfah Q Alanazi
- Drug Policy and Economic Center, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia, .,King Abdullah International Medical Research Center (KAIMRC), King Saud Bin-Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,
| |
Collapse
|
15
|
Koksal E, Tulek N, Sonmezer MC, Temocin F, Bulut C, Hatipoglu C, Erdinc FS, Ertem G. Investigation of risk factors for community-acquired urinary tract infections caused by extended-spectrum beta-lactamase Escherichia coli and Klebsiella species. Investig Clin Urol 2018; 60:46-53. [PMID: 30637361 PMCID: PMC6318201 DOI: 10.4111/icu.2019.60.1.46] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 10/21/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose The aim of this study was to determine the prevalence and risk factors for community-acquired urinary tract infections (CA-UTIs) caused by extended-spectrum β-lactamase (ESBL) producing Escherichia coli and Klebsiella species. Materials and Methods The patients diagnosed with CA-UTIs caused by E. coli or Klebsiella spp. were included in the study. All of the patients were compared to demographic characteristics, underlying diseases, urinary tract pathology, history of hospitalization, use of antibiotics according to ESBL positivity. Results A total of 322 urine isolates were studied. Sixty-six patients (37.1%) of a total of 178 patients were ESBL positive E. coli and Klebsiella spp. Being over the age of sixty (odds ratio [OR], 1.90; p=0.03), history of renal stone (OR, 3.00; p=0.03), urinary tract anatomical of physiological disorder (OR, 2.17; p=0.01), urologic intervention (OR, 3.43; p<0.001), history of urinary tract surgery (OR, 3.10; p=0.01), history of urinary catheterization (OR, 3.43; p<0.001), and hospitalization for last 1 year (OR, 3.70; p=0.01) and antibiotic usage in the last 3 months (OR, 1.90; p=0.04) were found as significant risk factors for the producing of ESBL. However, gender and underlying disease were not related for ESBL production. Conclusions In present study, high rate of ESBL positivity was detected in CA-UTIs. The increasing of infections caused by ESBL positive E. coli and Klebsiella spp. are bringing together a lot of the problem, such as antibiotic resistance and reducing treatment options for outpatients. Identification of underlying risk factors would be important for the development of preventive strategies.
Collapse
Affiliation(s)
- Eda Koksal
- Department of Infectious Diseases and Clinical Microbiology, Samsun Training and Research Hospital, Health Sciences University, Samsun, Turkey
| | - Necla Tulek
- Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Health Sciences University, Ankara, Turkey
| | - Meliha Cagla Sonmezer
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University, Ankara, Turkey
| | - Fatih Temocin
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayıs University, Samsun, Turkey
| | - Cemal Bulut
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Training and Researh Hospital, Ankara, Turkey
| | - Cigdem Hatipoglu
- Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Health Sciences University, Ankara, Turkey
| | - Fatma Sebnem Erdinc
- Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Health Sciences University, Ankara, Turkey
| | - Gunay Ertem
- Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Health Sciences University, Ankara, Turkey
| |
Collapse
|
16
|
Yurt F, Ersöz OA, Harputlu E, Ocakoglu K. Preparation and evaluation of effect on Escherichia coli
and Staphylococcus aureus
of radiolabeled ampicillin-loaded graphene oxide nanoflakes. Chem Biol Drug Des 2018; 91:1094-1100. [DOI: 10.1111/cbdd.13171] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 01/04/2018] [Accepted: 01/13/2018] [Indexed: 12/23/2022]
Affiliation(s)
- Fatma Yurt
- Department of Nuclear Applications; Institute of Nuclear Science; Ege University; Bornova, Izmir Turkey
| | - Onur Alp Ersöz
- Department of Nuclear Applications; Institute of Nuclear Science; Ege University; Bornova, Izmir Turkey
| | - Ersan Harputlu
- Advanced Technology, Research and Application Center; Mersin University; Mersin Turkey
| | - Kasim Ocakoglu
- Advanced Technology, Research and Application Center; Mersin University; Mersin Turkey
- Department of Energy Systems Engineering; Faculty of Technology; Mersin University; Mersin Turkey
| |
Collapse
|
17
|
Alanazi MQ, Alqahtani FY, Aleanizy FS. An evaluation of E. coli in urinary tract infection in emergency department at KAMC in Riyadh, Saudi Arabia: retrospective study. Ann Clin Microbiol Antimicrob 2018; 17:3. [PMID: 29422058 PMCID: PMC5806437 DOI: 10.1186/s12941-018-0255-z] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Accepted: 02/01/2018] [Indexed: 11/23/2022] Open
Abstract
Background Urinary tract infection (UTIS) is a common infectious disease in which level of antimicrobial resistance are alarming worldwide. Therefore, this study aims to describe the prevalence and the resistance pattern of the main bacteria responsible for UTIS Escherichia coli (E. coli). Methods Retrospective chart review for patients admitted to emergency department and diagnosed with UTIS at KAMC, in Riyadh, Saudi Arabia between January to March 2008 was performed. Antimicrobial susceptibility to ampicillin, augmentin (amoxicillin/clavulanate), cefazolin, co-trimoxazole (sulfamethoxazole/trimethoprim), ciprofloxacin, and nitrofurantoin, and cefpodoxime was determined for 101 E. coli urinary isolates. Results Escherichia coli was the most prevalent pathogen contributing to UTIS representing 93.55, 60.24, and 45.83% of all pathogen isolated from urine culture of pediatric, adult, and elderly, respectively. High rates of resistance to ampicillin (82.76, 58, and 63.64%) and co-trimoxazole (51.72, 42, and 59.09%), among E. coli isolated from pediatric, adult and elderly respectively. Nitrofurantoin was the most active agent, followed by ciprofloxacin, augmentin and cefazolin. 22.77% of E. coli isolates exhibited multiple drug resistance (MDR). Among 66 and 49 isolates resistant to ampicillin and co-trimoxazole, respectively, 34.84 and 42.85% were MDR. In contrast, all isolates resistant to augmentin and nitrofurantoin were MRD, while 72.7 and 82.4% of isolates resistant to ciprofloxacin and cefazolin were MDR. Conclusions High resistance was observed to ampicillin and co-trimoxazole which commonly used as empirical treatments for UTIS, limiting their clinical use. This necessitates continuous surveillance for resistance pattern of uropathogens against antibiotics.
Collapse
Affiliation(s)
- Menyfah Q Alanazi
- Clinical Pharmacy Practice, Drug Policy and Economics Center, King Abdulaziz Medical City, Ministry of National Guard, Health Affairs, Riyadh, 22490, Saudi Arabia.
| | - Fulwah Y Alqahtani
- Department of PharmaceUTIscs, College of Pharmacy, King Saud University, Riyadh, 22452, Saudi Arabia
| | - Fadilah S Aleanizy
- Department of PharmaceUTIscs, College of Pharmacy, King Saud University, Riyadh, 22452, Saudi Arabia
| |
Collapse
|
18
|
Hoody J, Alverson JB, Keshipeddy S, Barney PA, Walker L, Anderson AC, Wright DL, Priestley ND. Pharmaceutical analysis of a novel propargyl-linked antifolate antibiotic in the mouse. J Chromatogr B Analyt Technol Biomed Life Sci 2017; 1051:54-59. [PMID: 28314188 DOI: 10.1016/j.jchromb.2017.02.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 01/16/2017] [Accepted: 02/25/2017] [Indexed: 11/26/2022]
Abstract
Antimicrobial resistance to current antibiotics is a significant public health problem and the need for new antibiotics is a compelling one. We have been developing a new series of antibiotics, propargyl-linked diaminopyrimidines, based on the structure of trimethoprim. To date we have discovered compounds that are effective inhibitors of dihydrofolate reductase (the target of trimethoprim), that are potent antibiotics in vitro against a range of Gram-positive pathogens including methicillin-resistant S. aureus, and that are non-toxic in mammalian cell culture. In this study we report the development of an LC-MS-based protocol for the quantification of our lead antibiotic 37D1-UCP1099 and the application of this assay to follow the concentration of the compound in mouse plasma after intraperitoneal administration. Extraction of 37D1-UCP1099 from mouse plasma was achieved through a liquid-liquid extraction with ethyl acetate. Separation was performed utilizing a reverse-phase C18 column with a ten minute isocratic elution using 47:53 (v/v) 10mM NH4HCO3:acetonitrile. The lower limit of quantitation for 37D1-UCP1099 was 50ngmL-1 and the assay showed a dynamic range of 50-4000ngmL-1 with good linearity (r2≥0.996 for all fits). Intra-day and inter-day precision and accuracy were within 11.3% (%RSD) and 6.6% (%RE) respectably. We have demonstrated that the compound is stable under the assay procedures. The compound was shown to have a mean residence time of 26.2±1.0min and a half-life of 18.2±0.7min after intraperitoneal delivery at 5mgkg-1. These studies now form the foundation of our work to develop additional analogs of 37D1-UCP1099 with improved pharmacokinetic properties.
Collapse
Affiliation(s)
- John Hoody
- Department of Chemistry and Biochemistry, The University of Montana, Missoula, MT 59812, United States
| | - Jeremy B Alverson
- Department of Chemistry and Biochemistry, The University of Montana, Missoula, MT 59812, United States
| | - Santosh Keshipeddy
- Department of Pharmaceutical Sciences, University of Connecticut, 69 N. Eagleville Road, Storrs, CT 06269, United States
| | - Patrick A Barney
- Department of Chemistry and Biochemistry, The University of Montana, Missoula, MT 59812, United States
| | - Larissa Walker
- Department of Chemistry and Biochemistry, The University of Montana, Missoula, MT 59812, United States
| | - Amy C Anderson
- Department of Pharmaceutical Sciences, University of Connecticut, 69 N. Eagleville Road, Storrs, CT 06269, United States
| | - Dennis L Wright
- Department of Pharmaceutical Sciences, University of Connecticut, 69 N. Eagleville Road, Storrs, CT 06269, United States
| | - Nigel D Priestley
- Department of Chemistry and Biochemistry, The University of Montana, Missoula, MT 59812, United States.
| |
Collapse
|
19
|
Perrault L, Dahan S, Iliza AC, LeLorier J, Zhanel GG. Cost-Effectiveness Analysis of Fosfomycin for Treatment of Uncomplicated Urinary Tract Infections in Ontario. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2017; 2017:6362804. [PMID: 28316632 PMCID: PMC5337864 DOI: 10.1155/2017/6362804] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 01/31/2017] [Indexed: 11/29/2022]
Abstract
Background and Objective. Bacterial resistance to antibiotics traditionally used to treat uncomplicated urinary tract infections (uUTIs) is rising in Canada. We compared the cost-per-patient in Ontario of including fosfomycin (an antibiotic with a low resistance profile) as an option for first-line empirical treatment of uUTIs with current cost of treatment with sulfonamides, fluoroquinolones, and nitrofurantoin. Methods. A decision-tree model was used to perform a cost-minimization analysis. All possible outcomes of a uUTI caused by bacterial species treated with either sulfonamides, fluoroquinolones, nitrofurantoin, or fosfomycin were included. Results. In the base case analysis, the cost-per-patient for treating uUTI with fosfomycin was $105.12. This is similar to the cost-per-patient for each of the other currently reimbursed antibiotics (e.g., $96.19 for sulfonamides, $98.85 for fluoroquinolones, and $99.09 for nitrofurantoins). The weighted average cost-per-patient for treating uUTI was not substantially elevated with the inclusion of fosfomycin in the treatment landscape ($98.41 versus $98.29 with and without fosfomycin, resp.). The sensitivity analyses revealed that most (88.34%) of the potential variation in cost was associated with the probability of progressing to pyelonephritis and hospitalization for pyelonephritis. Conclusion. Fosfomycin in addition to being a safe and effective agent to treat uUTI has a low resistance profile, offers a single-dose treatment administration, and is similar in cost to other reimbursed antibiotics.
Collapse
Affiliation(s)
- Louise Perrault
- International Market Access Consulting, Montreal, QC, Canada
- University of Montréal, Faculty of Medicine, Montréal, QC, Canada
| | | | - Ange Christelle Iliza
- University of Montréal, Faculty of Medicine, Montréal, QC, Canada
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Jacques LeLorier
- University of Montréal, Faculty of Medicine, Montréal, QC, Canada
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - George G. Zhanel
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| |
Collapse
|
20
|
Antimicrobial Resistance Among Uropathogens That Cause Childhood Community-acquired Urinary Tract Infections in Central Israel. Pediatr Infect Dis J 2017; 36:113-115. [PMID: 27741093 DOI: 10.1097/inf.0000000000001373] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In this retrospective study 829 positive urine cultures were analyzed. Escherichia coli bacterium was the leading uropathogen (86%). Almost 60% were resistant to ampicillin and first generation cephalosporins, and about 30% of them resistant to amoxicillin-clavulanic acid and trimethoprim-sulfamethoxazole. Almost none of them were resistant to second and third generation cephalosporins, aminoglycosides, ciprofloxacin or nitrofurantoin.
Collapse
|
21
|
Azevedo AS, Almeida C, Melo LF, Azevedo NF. Impact of polymicrobial biofilms in catheter-associated urinary tract infections. Crit Rev Microbiol 2016; 43:423-439. [PMID: 28033847 DOI: 10.1080/1040841x.2016.1240656] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Recent reports have demonstrated that most biofilms involved in catheter-associated urinary tract infections are polymicrobial communities, with pathogenic microorganisms (e.g. Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae) and uncommon microorganisms (e.g. Delftia tsuruhatensis, Achromobacter xylosoxidans) frequently co-inhabiting the same urinary catheter. However, little is known about the interactions that occur between different microorganisms and how they impact biofilm formation and infection outcome. This lack of knowledge affects CAUTIs management as uncommon bacteria action can, for instance, influence the rate at which pathogens adhere and grow, as well as affect the overall biofilm resistance to antibiotics. Another relevant aspect is the understanding of factors that drive a single pathogenic bacterium to become prevalent in a polymicrobial community and subsequently cause infection. In this review, a general overview about the IMDs-associated biofilm infections is provided, with an emphasis on the pathophysiology and the microbiome composition of CAUTIs. Based on the available literature, it is clear that more research about the microbiome interaction, mechanisms of biofilm formation and of antimicrobial tolerance of the polymicrobial consortium are required to better understand and treat these infections.
Collapse
Affiliation(s)
- Andreia S Azevedo
- a Department of Chemical Engineering, Faculty of Engineering , Laboratory for Process Engineering, Environment, and Energy and Biotechnology Engineering (LEPABE), University of Porto , Porto , Portugal
| | - Carina Almeida
- a Department of Chemical Engineering, Faculty of Engineering , Laboratory for Process Engineering, Environment, and Energy and Biotechnology Engineering (LEPABE), University of Porto , Porto , Portugal.,b Institute for Biotechnology and Bioengineering (IBB), Centre of Biological Engineering, Universidade do Minho , Braga , Portugal
| | - Luís F Melo
- a Department of Chemical Engineering, Faculty of Engineering , Laboratory for Process Engineering, Environment, and Energy and Biotechnology Engineering (LEPABE), University of Porto , Porto , Portugal
| | - Nuno F Azevedo
- a Department of Chemical Engineering, Faculty of Engineering , Laboratory for Process Engineering, Environment, and Energy and Biotechnology Engineering (LEPABE), University of Porto , Porto , Portugal
| |
Collapse
|
22
|
Lombardo MN, G-Dayanandan N, Wright DL, Anderson AC. Crystal Structures of Trimethoprim-Resistant DfrA1 Rationalize Potent Inhibition by Propargyl-Linked Antifolates. ACS Infect Dis 2016; 2:149-56. [PMID: 27624966 DOI: 10.1021/acsinfecdis.5b00129] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Multidrug-resistant Enterobacteriaceae, notably Escherichia coli and Klebsiella pneumoniae, have become major health concerns worldwide. Resistance to effective therapeutics is often carried by class I and II integrons that can confer insensitivity to carbapenems, extended spectrum β-lactamases, the antifolate trimethoprim, fluoroquinolones, and aminoglycosides. Specifically of interest to the study here, a prevalent gene (dfrA1) coding for an insensitive dihydrofolate reductase (DHFR) confers 190- or 1000-fold resistance to trimethoprim for K. pneumoniae and E. coli, respectively. Attaining inhibition of both the wild-type and resistant forms of the enzyme is critical for new antifolates. For several years, we have been developing the propargyl-linked antifolates (PLAs) as effective inhibitors against trimethoprim-resistant DHFR enzymes. Here, we show that the PLAs are active against both the wild-type and DfrA1 DHFR proteins. We report two high-resolution crystal structures of DfrA1 bound to potent PLAs. The structure-activity relationships and crystal structures will be critical in driving the design of broadly active inhibitors against wild-type and resistant DHFR.
Collapse
Affiliation(s)
- Michael N. Lombardo
- Department
of Pharmaceutical Sciences, University of Connecticut, 69 North
Eagleville Road, Storrs, Connecticut 06269, United States
| | - Narendran G-Dayanandan
- Department
of Pharmaceutical Sciences, University of Connecticut, 69 North
Eagleville Road, Storrs, Connecticut 06269, United States
| | - Dennis L. Wright
- Department
of Pharmaceutical Sciences, University of Connecticut, 69 North
Eagleville Road, Storrs, Connecticut 06269, United States
| | - Amy C. Anderson
- Department
of Pharmaceutical Sciences, University of Connecticut, 69 North
Eagleville Road, Storrs, Connecticut 06269, United States
| |
Collapse
|
23
|
Quorum sensing activity of Citrobacter amalonaticus L8A, a bacterium isolated from dental plaque. Sci Rep 2016; 6:20702. [PMID: 26860259 PMCID: PMC4748228 DOI: 10.1038/srep20702] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 01/11/2016] [Indexed: 12/21/2022] Open
Abstract
Cell-cell communication is also known as quorum sensing (QS) that happens in the bacterial cells with the aim to regulate their genes expression in response to increased cell density. In this study, a bacterium (L8A) isolated from dental plaque biofilm was identified as Citrobacter amalonaticus by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry (MS). Its N-acylhomoserine-lactone (AHL) production was screened by using two types of AHL biosensors namely Chromobacterium violaceum CV026 and Escherichia coli [pSB401]. Citrobacter amalonaticus strain L8A was identified and confirmed producing numerous types of AHL namely N-butyryl-L-homoserine lactone (C4-HSL), N-hexanoyl-L-homoserine lactone (C6-HSL), N-octanoyl-L-homoserine lactone (C8-HSL) and N-hexadecanoyl-L-homoserine lactone (C16-HSL). We performed the whole genome sequence analysis of this oral isolate where its genome sequence reveals the presence of QS signal synthase gene and our work will pave the ways to study the function of the related QS genes in this bacterium.
Collapse
|
24
|
Azevedo AS, Almeida C, Pereira B, Melo LF, Azevedo NF. Impact of Delftia tsuruhatensis and Achromobacter xylosoxidans on Escherichia coli dual-species biofilms treated with antibiotic agents. BIOFOULING 2016; 32:227-241. [PMID: 26901701 DOI: 10.1080/08927014.2015.1124096] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Recently it was demonstrated that for urinary tract infections species with a lower or unproven pathogenic potential, such as Delftia tsuruhatensis and Achromobacter xylosoxidans, might interact with conventional pathogenic agents such as Escherichia coli. Here, single- and dual-species biofilms of these microorganisms were characterized in terms of microbial composition over time, the average fitness of E. coli, the spatial organization and the biofilm antimicrobial profile. The results revealed a positive impact of these species on the fitness of E. coli and a greater tolerance to the antibiotic agents. In dual-species biofilms exposed to antibiotics, E. coli was able to dominate the microbial consortia in spite of being the most sensitive strain. This is the first study demonstrating the protective effect of less common species over E. coli under adverse conditions imposed by the use of antibiotic agents.
Collapse
Affiliation(s)
- Andreia S Azevedo
- a Laboratory for Process Engineering, Environment, and Energy and Biotechnology Engineering (LEPABE), Faculty of Engineering, Department of Chemical Engineering , University of Porto , Porto , Portugal
- b Nucleic Acid Center, Department of Physics, Chemistry and Pharmacy , University of Southern Denmark , Odense M , Denmark
| | - Carina Almeida
- a Laboratory for Process Engineering, Environment, and Energy and Biotechnology Engineering (LEPABE), Faculty of Engineering, Department of Chemical Engineering , University of Porto , Porto , Portugal
- c Institute for Biotechnology and Bioengineering (IBB), Centre of Biological Engineering , Universidade do Minho , Braga , Portugal
| | - Bruno Pereira
- a Laboratory for Process Engineering, Environment, and Energy and Biotechnology Engineering (LEPABE), Faculty of Engineering, Department of Chemical Engineering , University of Porto , Porto , Portugal
| | - Luís F Melo
- a Laboratory for Process Engineering, Environment, and Energy and Biotechnology Engineering (LEPABE), Faculty of Engineering, Department of Chemical Engineering , University of Porto , Porto , Portugal
| | - Nuno F Azevedo
- a Laboratory for Process Engineering, Environment, and Energy and Biotechnology Engineering (LEPABE), Faculty of Engineering, Department of Chemical Engineering , University of Porto , Porto , Portugal
| |
Collapse
|
25
|
Ahmed MN, Vannoy D, Frederick A, Chang S, Lawler E. First-Line Antimicrobial Resistance Patterns of Escherichia coli in Children With Urinary Tract Infection in Emergency Department and Primary Care Clinics. Clin Pediatr (Phila) 2016; 55:19-28. [PMID: 26040907 DOI: 10.1177/0009922815588822] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To identify risk factors for antibiotic resistance to Escherichia coli (E. coli) in children with urinary tract infections (UTIs) in emergency room and primary care clinics. METHOD This is a cross-sectional study of children 0 to 18 years of age reported to have E coli-positive UTIs whose medical and laboratory records were systematically reviewed. RESULT Compared with girls, boys were 2.29 times (confidence interval [CI] = 1.30-4.02) more likely to have E coli isolates resistant to ampicillin and 2 times more likely (CI = 1.13-3.62) to have isolates resistant to trimethoprim-sulfamethoxazole (TMP/SMX). Patients with genitourinary abnormalities were 1.57 times more likely to be resistant to ampicillin (CI = 1.03-2.41) and 1.86 times to TMP/SMX (CI = 1.18-2.94). CONCLUSION Higher rates of ampicillin and TMP/SMX resistant urinary E coli isolates were observed among boys and children with a history of genitourinary abnormality. Age and recent antibiotic prescription are also potential risk factors for resistance.
Collapse
Affiliation(s)
- M Nadeem Ahmed
- Carle Foundation Hospital, Urbana, IL, USA University of Illinois College of Medicine, Urbana, IL, USA
| | | | | | - Sandy Chang
- University of Illinois College of Medicine, Urbana, IL, USA
| | - Elisabeth Lawler
- Southern Illinois University Medical Center, Springfield, IL, USA
| |
Collapse
|
26
|
Ayeni FA, Gbarabon T, Andersen C, Norskov-Lauritsen N. Comparison of identification and antimicrobial resistance pattern of Staphylococcus aureus isolated from Amassoma, Bayelsa state, Nigeria. Afr Health Sci 2015; 15:1282-8. [PMID: 26958032 PMCID: PMC4765414 DOI: 10.4314/ahs.v15i4.30] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Staphylococcus aureus is often responsible for fatal infections and recent upsurge of resistant strains has resulted in therapeutic failure. The identification of this microorganism is a major challenge to medical microbiologists in developing countries. METHODS One hundred and eighty five isolates which had been previously isolated from the nares of 185 healthy college students' volunteers in Amassoma, Bayelsa State, South Nigeria were identified by MALDI TOF mass spectrometry, and PCR amplification of the spa gene. The identified isolates were compared with presumptive identities obtained by growth on MSA, tube coagulation and slide agglutination tests. Antimicrobial susceptibility testing of S. aureus isolates was performed by Kirby Bauer technique while MRSA was screened for by growth on chromlDTM MRSA plate and confirmed by PCR-amplification of mecA/mecC genes. RESULTS From the 185 staphylococci that grew with yellow colonies on MSA, 24 were positive in the slide coagulase test, while 17 were positive in the tube coagulase test; MALDI TOF mass spectrometry and PCR amplification of the spa gene showed excellent concordance with the tube test, as all tube coagulase-positive strains were identified as S. aureus, while tube coagulase-test negative isolates in all cases were designated as other staphylococcal species by MALDI-TOF mass spectrometry and were spa PCR test negative. All S. aureus isolates were susceptible to clindamycin, vancomycin, fusidic acid, rifampicin and linezolid, while observed resistance to penicillin and trimethoprim were high. Only one MRSA strain was detected. CONCLUSION The study confirms that the tube coagulase test is an accurate diagnostic method for identification of S. aureus, while growths on MSA and slide agglutination tests are inaccurate. We found a low prevalence of MRSA and a high rate of trimethroprim-resistance in the studied population.
Collapse
Affiliation(s)
- Funmilola Abidemi Ayeni
- University of Ibadan, Faculty of Pharmacy, Department of Pharmaceutical Microbiology. Ibadan, Nigeria
| | - Tombari Gbarabon
- Niger Delta University, Faculty of Pharmacy, Department of Pharmaceutical Microbiology, Amassoma, Nigeria
| | - Camilla Andersen
- Aarhus University Hospital, Department of Clinical Microbiology, Aarhus, Denmark
| | | |
Collapse
|
27
|
Plasmid-Mediated OqxAB Is an Important Mechanism for Nitrofurantoin Resistance in Escherichia coli. Antimicrob Agents Chemother 2015; 60:537-43. [PMID: 26552976 DOI: 10.1128/aac.02156-15] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 11/03/2015] [Indexed: 11/20/2022] Open
Abstract
Increasing consumption of nitrofurantoin (NIT) for treatment of acute uncomplicated urinary tract infections (UTI) highlights the need to monitor emerging NIT resistance mechanisms. This study investigated the molecular epidemiology of the multidrug-resistant efflux gene oqxAB and its contribution to nitrofurantoin resistance by using Escherichia coli isolates originating from patients with UTI (n = 205; collected in 2004 to 2013) and food-producing animals (n = 136; collected in 2012 to 2013) in Hong Kong. The oqxAB gene was highly prevalent among NIT-intermediate (11.5% to 45.5%) and -resistant (39.2% to 65.5%) isolates but rare (0% to 1.7%) among NIT-susceptible (NIT-S) isolates. In our isolates, the oqxAB gene was associated with IS26 and was carried by plasmids of diverse replicon types. Multilocus sequence typing revealed that the clones of oqxAB-positive E. coli were diverse. The combination of oqxAB and nfsA mutations was found to be sufficient for high-level NIT resistance. Curing of oqxAB-carrying plasmids from 20 NIT-intermediate/resistant UTI isolates markedly reduced the geometric mean MIC of NIT from 168.9 μg/ml to 34.3 μg/ml. In the plasmid-cured variants, 20% (1/5) of isolates with nfsA mutations were NIT-S, while 80% (12/15) of isolates without nfsA mutations were NIT-S (P = 0.015). The presence of plasmid-based oqxAB increased the mutation prevention concentration of NIT from 128 μg/ml to 256 μg/ml and facilitated the development of clinically important levels of nitrofurantoin resistance. In conclusion, plasmid-mediated oqxAB is an important nitrofurantoin resistance mechanism. There is a great need to monitor the dissemination of this transferable multidrug-resistant efflux pump.
Collapse
|
28
|
Huang Y, Zhang L, Tiu L, Wang HH. Characterization of antibiotic resistance in commensal bacteria from an aquaculture ecosystem. Front Microbiol 2015; 6:914. [PMID: 26441859 PMCID: PMC4561822 DOI: 10.3389/fmicb.2015.00914] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 08/20/2015] [Indexed: 12/03/2022] Open
Abstract
The objective of the study was to improve the understanding of antibiotic resistance (AR) ecology through characterization of antibiotic-resistant commensal isolates associated with an aquaculture production system. A total of 4767 isolates non-susceptible to sulfamethoxazole/trimethoprim (Sul/Tri), tetracycline (Tet), erythromycin (Erm), or cefotaxime (Ctx), originated from fish, feed, and environmental samples of an aquaculture farm with no known history of antibiotic applications were examined. Close to 80% of the isolates exhibited multi-drug resistance in media containing the corresponding antibiotics, and representative AR genes were detected in various isolates by PCR, with feed isolates had the highest positive rate detected. Identified AR gene carriers involved 18 bacterial genera. Selected AR genes led to acquired resistance in other bacteria by transformation. The AR traits in many isolates were stable in the absence of selective pressure. AR-rich feed and possibly environmental factors may contribute to AR in the aquaculture ecosystem. For minimum inhibitory concentration test, brain heart infusion medium was found more suitable for majority of the bacteria examined than cation-adjusted Mueller Hinton broth, with latter being the recommended medium for clinical isolates by standard protocol. The data indicated a need to update the methodology due to genetic diversity of microbiota for better understanding of the AR ecology.
Collapse
Affiliation(s)
- Ying Huang
- Department of Food Science and Technology, The Ohio State University, Columbus, OHUSA
| | - Lu Zhang
- Department of Food Science and Technology, The Ohio State University, Columbus, OHUSA
| | - Laura Tiu
- South Centers, The Ohio State University, Piketon, OHUSA
| | - Hua H. Wang
- Department of Food Science and Technology, The Ohio State University, Columbus, OHUSA
- Department of Microbiology, The Ohio State University, Columbus, OHUSA
- School of Biological Sciences, Fudan University, Yangpu, ShanghaiChina
| |
Collapse
|
29
|
Ahmed I, Sajed M, Sultan A, Murtaza I, Yousaf S, Maqsood B, Vanhara P, Anees M. The erratic antibiotic susceptibility patterns of bacterial pathogens causing urinary tract infections. EXCLI JOURNAL 2015; 14:916-25. [PMID: 26648826 PMCID: PMC4669912 DOI: 10.17179/excli2015-207] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 06/17/2015] [Indexed: 11/21/2022]
Abstract
Increasing trend of antibiotic resistance and expression of Extended Spectrum Beta Lactamases (ESBLs) are serious threats for public health as they render the treatment ineffective. Present study was designed to elucidate the antibiotic-susceptibility patterns of ESBL and non-ESBL producing E. coli and K. pneumoniae causing urinary tract infections so that the ineffective antibiotics could be removed from the line of treatment. The bacterial isolates obtained from the urine of patients visiting a tertiary health care facility were cultured for strain identification using API20E. Antimicrobial susceptibility and ESBL detection were done by Kirby-bauer diffusion technique. Almost 53.4 % isolates of E. coli and 24.5 % isolates of K. pneumoniae were found to be ESBL producers. The ESBL producing bacteria were found to be more resistant towards various antibiotics. The most effective drugs against E. coli ESBL isolates were imipenem (99.54 %), ampicillin-sulbactam (97.48 %), piperacillin-tazobactam (96.86 %), fosfomycin (94.51 %), amikacin (92.26 %) and nitrofurantoin (90.68 %). The most effective drugs against K. pneumoniae ESBL isolates were imipenem (97.62 %), piperacillin-tazobactam (95.35 %), ampicillin-sulbactam (90.48 %) and amikacin (88.37 %). The antibiotics having the highest resistance, particularly by the ESBL producers were amoxicillin clavulanic acid, sulphamethoxalzole/ trimethoprim, cefuroxime, cefpirome, ceftriaxone and ciprofloxacin. Most of the isolates showed multi drug resistance (MDR). High frequency of ESBL producing E. coli and K. pneumoniae were observed as compared to previous data. Penicillins, cephalosporins and some representatives of fluoroquinolones were least effective against the common UTIs and are recommended to be removed from the line of treatment.
Collapse
Affiliation(s)
- Iftkhar Ahmed
- Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Muhammad Sajed
- Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Aneesa Sultan
- Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Iram Murtaza
- Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Sohail Yousaf
- Department of Environmental Sciences, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Bushra Maqsood
- Department of Medicine Unit 2, Holy Family Hospital, Rawalpindi, Pakistan
| | - Petr Vanhara
- Department of Histology and Embryology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Mariam Anees
- Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan ; Institute of Health and Management Sciences, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
| |
Collapse
|
30
|
Crystal structures of Klebsiella pneumoniae dihydrofolate reductase bound to propargyl-linked antifolates reveal features for potency and selectivity. Antimicrob Agents Chemother 2014; 58:7484-91. [PMID: 25288083 DOI: 10.1128/aac.03555-14] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Resistance to the antibacterial antifolate trimethoprim (TMP) is increasing in members of the family Enterobacteriaceae, driving the design of next-generation antifolates effective against these Gram-negative pathogens. The propargyl-linked antifolates are potent inhibitors of dihydrofolate reductases (DHFR) from several TMP-sensitive and -resistant species, including Klebsiella pneumoniae. Recently, we have determined that these antifolates inhibit the growth of strains of K. pneumoniae, some with MIC values of 1 μg/ml. In order to further the design of potent and selective antifolates against members of the Enterobacteriaceae, we determined the first crystal structures of K. pneumoniae DHFR bound to two of the propargyl-linked antifolates. These structures highlight that interactions with Leu 28, Ile 50, Ile 94, and Leu 54 are necessary for potency; comparison with structures of human DHFR bound to the same inhibitors reveal differences in residues (N64E, P61G, F31L, and V115I) and loop conformations (residues 49 to 53) that may be exploited for selectivity.
Collapse
|
31
|
Effect of levofloxacin prophylaxis for prevention of severe infections in multiple myeloma patients receiving bortezomib-containing regimens. Int J Hematol 2014; 100:473-7. [PMID: 25212681 DOI: 10.1007/s12185-014-1672-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 09/02/2014] [Accepted: 09/03/2014] [Indexed: 10/24/2022]
Abstract
Fluoroquinolone is recommended as a prophylactic antibiotic for high-risk patients with profound neutropenia. We previously reported that multiple myeloma (MM) patients who received bortezomib-based regimens were at higher risk of severe infections (30.9%) associated with lymphocytopenia. In the study, we evaluated whether severe infectious complications can be prevented by prophylactic administration of oral levofloxacin in MM patients treated with bortezomib-based regimens. A total of 80 patients received oral levofloxacin 500 mg daily during the median four cycles of treatment. The prophylactic group (n = 80) with levofloxacin showed significantly decreased severe infections compared to a historical control group (n = 139) without levofloxacin prophylaxis during treatment of bortezomib-based regimens (17.5 vs. 30.9%, P = 0.037). In the prophylactic group, two patients (2.5%) died of pneumonia and septic shock. Four patients (5%) stopped levofloxacin due to side effects that consisted of gastrointestinal discomfort (2.5%), itching sense (1.25%), and QTc prolongation (1.25%). In conclusion, prophylaxis with levofloxacin may be effective in the prevention of severe infection in MM patients receiving bortezomib-based regimens. A prospective randomized study is needed to test the prophylactic effect of levofloxacin in MM patients treated with bortezomib-based regimens.
Collapse
|
32
|
Gomes LC, Silva LN, Simões M, Melo LF, Mergulhão FJ. Escherichia coli adhesion, biofilm development and antibiotic susceptibility on biomedical materials. J Biomed Mater Res A 2014; 103:1414-23. [PMID: 25044887 DOI: 10.1002/jbm.a.35277] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 06/22/2014] [Accepted: 07/09/2014] [Indexed: 11/11/2022]
Abstract
The aim of this work was to test materials typically used in the construction of medical devices regarding their influence in the initial adhesion, biofilm development and antibiotic susceptibility of Escherichia coli biofilms. Adhesion and biofilm development was monitored in 12-well microtiter plates containing coupons of different biomedical materials--silicone (SIL), stainless steel (SS) and polyvinyl chloride (PVC)--and glass (GLA) as control. The susceptibility of biofilms to ciprofloxacin and ampicillin was assessed, and the antibiotic effect in cell morphology was observed by scanning electron microscopy. The surface hydrophobicity of the bacterial strain and materials was also evaluated from contact angle measurements. Surface hydrophobicity was related with initial E. coli adhesion and subsequent biofilm development. Hydrophobic materials, such as SIL, SS, and PVC, showed higher bacterial colonization than the hydrophilic GLA. Silicone was the surface with the greatest number of adhered cells and the biofilms formed on this material were also less susceptible to both antibiotics. It was found that different antibiotics induced different levels of elongation on E. coli sessile cells. Results revealed that, by affecting the initial adhesion, the surface properties of a given material can modulate biofilm buildup and interfere with the outcome of antimicrobial therapy. These findings raise the possibility of fine-tuning surface properties as a strategy to reach higher therapeutic efficacy.
Collapse
Affiliation(s)
- L C Gomes
- LEPABE - Department of Chemical Engineering, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, Porto, Portugal
| | | | | | | | | |
Collapse
|
33
|
Trivedi D, Jena PK, Seshadri S. Colicin E2 Expression in Lactobacillus brevis DT24, A Vaginal Probiotic Isolate, against Uropathogenic Escherichia coli. ISRN UROLOGY 2014; 2014:869610. [PMID: 24649377 PMCID: PMC3932652 DOI: 10.1155/2014/869610] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 11/14/2013] [Indexed: 06/01/2023]
Abstract
Novel therapeutic approaches are needed to combat the urinary tract infection in women. During menstruation elevated protein concentration and increase in oxygen and carbon dioxide concentrations with decrease in vaginal Lactobacilli all together contribute to urinary tract infections. Lactobacillus species are a predominant member of the vaginal microflora and are critical in the prevention of a number of urogenital diseases. In order to increase antimicrobial potential of vaginal Lactobacilli, bacteriocin colicin E2 which has specific activity against uropathogenic Escherichia coli has been overexpressed in vaginal probiotic Lactobacillus brevis DT24. Recombinant Lactobacillus brevis DT24 expressing colicin E2 showed much higher inhibitory activity against uropathogenic Escherichia coli than wild type L. brevis DT24 in vitro. Efficacy of probiotic Lactobacillus brevis DT24 expressing colicin E2 protein is required for further in vivo evaluation.
Collapse
Affiliation(s)
- Disha Trivedi
- Institute of Science, Nirma University, Sarkhej-Gandhinagar Highway, Chharodi, Ahmedabad, Gujarat 382481, India
| | - Prasant Kumar Jena
- Institute of Science, Nirma University, Sarkhej-Gandhinagar Highway, Chharodi, Ahmedabad, Gujarat 382481, India
| | - Sriram Seshadri
- Institute of Science, Nirma University, Sarkhej-Gandhinagar Highway, Chharodi, Ahmedabad, Gujarat 382481, India
| |
Collapse
|
34
|
Teh AHT, Wang Y, Dykes GA. The influence of antibiotic resistance gene carriage on biofilm formation by two Escherichia coli strains associated with urinary tract infections. Can J Microbiol 2014; 60:105-11. [DOI: 10.1139/cjm-2013-0633] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Urinary tract infections (UTI) caused by uropathogenic Escherichia coli are one of the most common forms of human disease. In this study, the effect of the presence of newly acquired antibiotic resistance genes on biofilm formation of UTI-associated E. coli strains was examined. Two clinical UTI-associated E. coli strains (SMC18 and SMC20) carrying different combinations of virulence genes were transformed with pGEM-T, pGEM-T::KmΔAmp, or pGEM-T::Km to construct ampicillin-resistant (KmSAmpR), kanamycin-resistant (KmRAmpS), or ampicillin- and kanamycin-resistant (KmRAmpR) strains. Transformed and wild-type strains were characterized for biofilm formation, bacterial surface hydrophobicity, auto-aggregation, morphology, and attachment to abiotic surfaces. Transformation with a plasmid carrying an ampicillin resistance gene alone decreased (p < 0.05) biofilm formation by SMC18 (8 virulence marker genes) but increased (p < 0.05) biofilm formation by SMC20 (5 virulence marker genes). On the other hand, transformation with a plasmid carrying a kanamycin resistance gene alone or both ampicillin and kanamycin resistance genes resulted in a decrease (p < 0.05) in biofilm formation by SMC18 but did not affect (p > 0.05) the biofilm formation by SMC20. Our results suggest that transformation of UTI-associated E. coli with plasmids carrying different antibiotic resistance gene(s) had a significant impact on biofilm formation and that these effects were both strain dependent and varied between different antibiotics.
Collapse
Affiliation(s)
- Amy Huei Teen Teh
- School of Science, Monash University, Jalan Lagoon Selatan, Bandar Sunway 46150, Selangor Darul Ehsan, Malaysia
| | - Yi Wang
- School of Science, Monash University, Jalan Lagoon Selatan, Bandar Sunway 46150, Selangor Darul Ehsan, Malaysia
| | - Gary A. Dykes
- School of Science, Monash University, Jalan Lagoon Selatan, Bandar Sunway 46150, Selangor Darul Ehsan, Malaysia
| |
Collapse
|
35
|
Antibiotic-resistant Escherichia coli in women with acute cystitis in Canada. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2014; 24:143-9. [PMID: 24421825 DOI: 10.1155/2013/547848] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Trimethoprim-sulfamethoxazole (TMP-SMX) has been a traditional first-line antibiotic treatment for acute cystitis; however, guidelines do not recommend TMP-SMX in regions where Escherichia coli resistance exceeds 20%. While resistance is increasing, there are no recent Canadian estimates from a primary care setting to guide prescribing decisions. METHODS A total of 330 family physicians assessed 752 women with suspected acute cystitis between 2009 and 2011. Physicians documented clinical features and collected urine for cultures for 430 (57.2%) women. The proportion of resistant isolates of E coli and exact binomial 95% CIs were estimated nationally, and compared regionally and demographically. These estimates were compared with those from a 2002 national study. RESULTS The proportion of TMP-SMX-resistant E coli was 16.0% nationally (95% CI 11.3% to 21.8%). This was not statistically higher than 2002 (10.9% [P=0.14]). TMP-SMX resistance was increased in women ≤50 years of age (21.4%) compared with older women (10.7% [P=0.037]). In women with no antibiotic exposure in the previous three months, TMP-SMX-resistant E coli remained more prevalent in younger women (21.8%) compared with older women (4.4% [P=0.003]). The proportion of ciprofloxacin-resistant E coli was 5.5% nationally (95% CI 2.7% to 9.9%), and was increased compared with 2002 (1.1% [P=0.036]). Ciprofloxacin resistance was highest in British Columbia (17.7%) compared with other regions (2.7% [P=0.003]), and was increased compared with 2002 levels in this province (0.0% [P=0.025]). Nitrofurantoin-resistant E coli levels were low (0.5% [95% CI 0.01% to 2.7%). DISCUSSION The proportion of TMP-SMX-resistant E coli causing acute cystitis in women in Canada remains below 20% nationally, but may exceed this level in premenopausal women. Ciprofloxacin resistance has increased, notably in British Columbia. Nitrofurantoin resistance levels are low across the country. These observations indicate that TMP-SMX and nitrofurantoin remain appropriate empirical antibiotic agents for treating cystitis in primary care settings in Canada.
Collapse
|
36
|
Karlowsky JA, Adam HJ, Desjardins M, Lagace-Wiens PRS, Hoban DJ, Zhanel GG, Zhanel GG, Hoban DJ, Adam HJ, Karlowsky JA, Baxter MR, Nichol KA, Lagace-Wiens PRS, Walkty A. Changes in fluoroquinolone resistance over 5 years (CANWARD 2007-11) in bacterial pathogens isolated in Canadian hospitals. J Antimicrob Chemother 2013; 68 Suppl 1:i39-46. [DOI: 10.1093/jac/dkt025] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
|
37
|
Afsharpaiman S, Bairaghdar F, Torkaman M, Kavehmanesh Z, Amirsalari S, Moradi M, Safavimirmahalleh M. Bacterial Pathogens and Resistance Patterns in Children With Community-Acquired Urinary Tract Infection: A Cross Sectional Study. ACTA ACUST UNITED AC 2012. [DOI: 10.17795/compreped-7078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
38
|
Zaffiri L, Gardner J, Toledo-Pereyra LH. History of antibiotics. From salvarsan to cephalosporins. J INVEST SURG 2012; 25:67-77. [PMID: 22439833 DOI: 10.3109/08941939.2012.664099] [Citation(s) in RCA: 111] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Infections have represented for a long time the leading cause of death in humans. During the 19th century, pneumonia, tuberculosis, diarrhea and diphtheria were considered the main causes of death in children and adults. Only in the late 19th century did it become possible to correlate the existence of microscopic pathogens with the development of various diseases. Within a few years the introduction of antiseptic procedures had begun to reduce mortality due to postsurgical infections. Sanitation and hygiene played a significant role in the reduction of the mortality due to several infectious diseases. The introduction of the first compounds with antimicrobial activity succeeded in conquering many diseases. In this review we analyzed, from a historical perspective, the development of antibiotics and the circumstances that led to their discovery. The first compound with antimicrobial activity was introduced in 1911 by Erlich. He focused his research activity on the discovery of a "magic bullet" to treat syphilis. Afterwards, Foley and colleagues brought penicillin to the forefront. Streptomycin represents the first drug discovered for the treatment of tuberculosis, and its development included the first use of clinical trials. Finally, with the development of cephalosporins, the introduction of new antimicrobial compounds with broad activity against gram-positive and also some gram-negative bacteria began.
Collapse
Affiliation(s)
- Lorenzo Zaffiri
- Michigan State University, Kalamazoo Center for Medical Studies, Kalamazoo, Michigan 49008, USA
| | | | | |
Collapse
|
39
|
Baral P, Neupane S, Marasini BP, Ghimire KR, Lekhak B, Shrestha B. High prevalence of multidrug resistance in bacterial uropathogens from Kathmandu, Nepal. BMC Res Notes 2012; 5:38. [PMID: 22260454 PMCID: PMC3296586 DOI: 10.1186/1756-0500-5-38] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Accepted: 01/19/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Urinary Tract Infection (UTI) is one of the most common infectious diseases and people of all age-groups and geographical locations are affected. The impact of disease is even worst in low-resource developing countries due to unaware of the UTIs caused by multidrug-resistant (MDR) pathogens and the possibility of transfer of MDR traits between them. The present study aimed to determine the prevalence of MDR bacterial isolates from UTI patients, the antibiotic resistance pattern and the conjugational transfer of multidrug resistance phenotypes in Escherichia coli (E. coli). RESULTS Two hundred and nineteen bacterial isolates were recovered from 710 urine samples at Kathmandu Model hospital during the study period. All samples and isolates were investigated by standard laboratory procedures. Among the significant bacterial growth (30.8%, 219 isolates), 41.1% isolates were MDR. The most prevailing organism, E. coli (81.3%, 178 isolates) was 38.2% MDR, whereas second most common organism, Citrobacter spp. (5%, 11 isolates) was found 72.7% MDR. Extended-spectrum β-lactamase (ESBL) production was detected in 55.2% of a subset of MDR E. coli isolates. Among the 29 MDR E. coli isolates, plasmids of size ranging 2-51 kb were obtained with different 15 profiles. The most common plasmid of size 32 kb was detected in all of the plasmid-harbored E. coli strains. The majority of E. coli isolates investigated for the multidrug resistance transfer were able to transfer plasmid-mediated MDR phenotypes along with ESBL pattern with a frequency ranging from 0.3 × 10-7 to 1.5 × 10-7 to an E. coli HB101 recipient strain by conjugation. Most of the donor and recipient strain showed high levels of minimum inhibitory concentration (MIC) values for commonly-used antibiotics. CONCLUSIONS The high prevalence of multidrug resistance in bacterial uropathogens was observed. Particularly, resistance patterns were alarmingly higher for amoxycillin, co-trimoxazole, flouroquinolones and third-generation cephalosporins, which necessitate the re-evaluation of first and second line therapies for UTI. In addition, conjugational co-transfer of MDR phenotypes with ESBL-positive phenotypes was observed in MDR E. coli.
Collapse
Affiliation(s)
- Pankaj Baral
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal.
| | | | | | | | | | | |
Collapse
|
40
|
The management of acute uncomplicated cystitis in adult women by family physicians in Canada. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2011; 19:287-93. [PMID: 19436509 DOI: 10.1155/2008/404939] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2008] [Accepted: 05/26/2008] [Indexed: 11/18/2022]
Abstract
INTRODUCTION There are few Canadian studies that have assessed prescribing patterns and antibiotic preferences of physicians for acute uncomplicated cystitis. A cross-Canada study of adult women with symptoms of acute cystitis seen by primary care physicians was conducted to determine current management practices and first-line antibiotic choices. METHODS A random sample of 2000 members of The College of Family Physicians of Canada were contacted in April 2002, and were asked to assess two women presenting with new urinary tract symptoms. Physicians completed a standardized checklist of symptoms and signs, indicated their diagnosis and antibiotics prescribed. A urine sample for culture was obtained. RESULTS Of the 418 responding physicians, 246 (58.6%) completed the study and assessed 446 women between April 2002 and March 2003. Most women (412 of 420, for whom clinical information about antibiotic prescriptions was available) reported either frequency, urgency or painful urination. Physicians would have usually ordered a urine culture for 77.0% of the women (95% CI 72.7 to 80.8) and prescribed an antibiotic for 86.9% of the women (95% CI 83.3 to 90.0). The urine culture was negative for 32.8% of these prescriptions. The most commonly prescribed antibiotic was trimethoprim/sulfamethoxazole (40.8%; 95% CI 35.7 to 46.1), followed by fluoroquinolones (27.4%; 95% CI 22.9 to 32.3) and nitrofurantoin (26.6%; 95% CI 22.1 to 31.4). CONCLUSION Empirical antibiotic prescribing is standard practice in the community, but is associated with high levels of unnecessary antibiotic use. While trimethoprim/sulfamethoxazole is the first-line empirical antibiotic choice, fluoroquinolone antibiotics have become the second most commonly prescribed empirical antibiotic for acute cystitis. The effect of current prescribing patterns on community levels of quinolone-resistant Escherichia coli may need to be monitored.
Collapse
|
41
|
Community-acquired antibiotic resistance in urinary isolates from adult women in Canada. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2011; 17:337-40. [PMID: 18382648 DOI: 10.1155/2006/791313] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2006] [Accepted: 06/08/2006] [Indexed: 11/17/2022]
Abstract
BACKGROUND There are currently limited data regarding the prevalence of antimicrobial-resistant organisms causing community-acquired urinary tract infections among adult women in Canada. Trimethoprim-sulfamethoxazole (TMP-SMX) is the recommended first-line empirical antibiotic treatment, unless resistance of Escherichia coli to TMP-SMX exceeds 20%. OBJECTIVE To assess current levels of TMP-SMX-resistant E coli in community-acquired cases of urinary tract infection in adult women. METHOD Assessment of urine culture reports obtained from 21 laboratories across Canada, submitted by family physicians for women aged 16 years and older. RESULTS In 2199 adult women with a positive urine culture, 1079 (49.1%) of pathogens isolated were resistant to at least one antibiotic and 660 (30.0%) were multidrug-resistant (resistant to two or more antibiotics). TMP-SMX resistance was seen in 245 of 1613 (15.2%) E coli isolates (95% CI 13.5 to 17.0). This proportion was higher in women 50 years of age and older (155 of 863 isolates [18.0%]; P=0.001), in British Columbia (70 of 342 isolates [20.5%]) and in Ontario (62 of 370 isolates [16.8%]) when compared with eastern provinces (65 of 572 isolates [11.4%]; P=0.001). Fluoroquinolone-resistant E coli occurred in 107 of 1557 (6.9%) isolates (95% CI 5.7 to 8.2), with the highest level found in British Columbia (54 of 341 isolates [15.8%]; P=0.001). CONCLUSION TMP-SMX continues to be appropriate as first-line empirical treatment of acute cystitis in adult women in Canada, as resistance remains below 20%. However, TMP-SMX resistance is higher in older women and in some provinces. The level of fluoroquinolone-resistant E coli is highest in British Columbia.
Collapse
|
42
|
Uropathogen antibiotic resistance in adult women presenting to family physicians with acute uncomplicated cystitis. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2011; 15:266-70. [PMID: 18159504 DOI: 10.1155/2004/947026] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2004] [Accepted: 08/20/2004] [Indexed: 11/18/2022]
Abstract
BACKGROUND Increasing rates of trimethoprim-sulfamethoxazole (TMP-SMX) resistance among uropathogens have raised concerns about its continued role in empirical treatment of acute uncomplicated cystitis in adult women. OBJECTIVE To determine current rates of antibiotic resistance among uropathogens in the community. METHODS Urine culture reports from adult women with symptoms of cystitis attending the offices of family physicians from across Canada were examined. Antibiotic sensitivities and the total number of antibiotics an organism was resistant to was determined. RESULTS In 446 women, 235 (61.4%) positive urine cultures were identified. Of these, 38.2% were resistant to at least one antibiotic and 21.5% were resistant to two or more antibiotics. The rate of ampicillin resistance was 34.1%. For TMP-SMX, resistance was reported in 10.8% of samples. Antibiotic resistance was higher in British Columbia (55%) and western provinces (48%), compared with Ontario (33.3%) and the eastern provinces (26.3%, P=0.04, Fisher's exact test). Multidrug resistance was also higher in western Canada (33.9%) than in eastern Canada (16.6%, P=0.007). CONCLUSIONS TMP-SMX resistance in Canada remains within current recommended guidelines, allowing for its continued use as a first line empirical treatment for acute cystitis in adult women. The reasons for higher rates of antibiotic resistance in western Canada merit further study.
Collapse
|
43
|
Antimicrobial resistance in urinary tract pathogens in Canada from 2007 to 2009: CANWARD surveillance study. Antimicrob Agents Chemother 2011; 55:3169-75. [PMID: 21537027 DOI: 10.1128/aac.00066-11] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
From January 2007 to December 2009, an annual Canadian national surveillance study (CANWARD) tested 2,943 urinary culture pathogens for antimicrobial susceptibilities according to Clinical and Laboratory Standards Institute guidelines. The most frequently isolated urinary pathogens were as follows (number of isolates, percentage of all isolates): Escherichia coli (1,581, 54%), enterococci (410, 14%), Klebsiella pneumoniae (274, 9%), Proteus mirabilis (122, 4%), Pseudomonas aeruginosa (100, 3%), and Staphylococcus aureus (80, 3%). The rates of susceptibility to trimethoprim-sulfamethoxazole (SXT) were 78, 86, 84, and 93%, respectively, for E. coli, K. pneumoniae, P. mirabilis, and S. aureus. The rates of susceptibility to nitrofurantoin were 96, 97, 33, and 100%, respectively, for E. coli, enterococci, K. pneumoniae, and S. aureus. The rates of susceptibility to ciprofloxacin were 81, 40, 86, 81, 66, and 41%, respectively, for E. coli, enterococci, K. pneumoniae, P. mirabilis, P. aeruginosa, and S. aureus. Statistical analysis of resistance rates (resistant plus intermediate isolates) by year for E. coli over the 3-year study period demonstrated that increased resistance rates occurred only for amoxicillin-clavulanate (from 1.8 to 6.6%; P < 0.001) and for SXT (from 18.6 to 24.3%; P = 0.02). For isolates of E. coli, in a multivariate logistic regression model, hospital location was independently associated with resistance to ciprofloxacin (P = 0.026) with higher rates of resistance observed in inpatient areas (medical, surgical, and intensive care unit wards). Increased age was also associated with resistance to ciprofloxacin (P < 0.001) and with resistance to two or more commonly prescribed oral agents (amoxicillin-clavulanate, ciprofloxacin, nitrofurantoin, and SXT) (P = 0.005). We conclude that frequently prescribed empirical agents for urinary tract infections, such as SXT and ciprofloxacin, demonstrate lowered in vitro susceptibilities when tested against recent clinical isolates.
Collapse
|
44
|
Molecular characterization and antimicrobial susceptibility testing of Escherichia coli isolates from patients with urinary tract infections in 20 Chinese hospitals. J Clin Microbiol 2011; 49:2496-501. [PMID: 21525216 DOI: 10.1128/jcm.02503-10] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A total of 222 urinary Escherichia coli isolates from 20 tertiary hospitals in 15 different provinces and 4 municipalities in mainland China were characterized by antimicrobial susceptibility, phylogrouping, and the presence of plasmid-mediated quinolone resistance genes. A subset of 138 suspected extended-spectrum cephalosporinase (ESC) producers were examined for genes encoding cephalosporin resistance. Forty-three isolates harboring bla(CTX-M-14) or bla(CTX-M-15) were analyzed by pulsed-field gel electrophoresis (PFGE), and plasmids containing these genes were typed using PCR-based replicon typing (PBRT). Thirteen phylogroup B2 bla(CTX-M-14)- and bla(CTX-M-15)-positive isolates were analyzed by multilocus sequence typing (MLST). A frequent occurrence of resistance (>46%) was observed toward cephalosporins, gentamicin, and fluoroquinolones. Among the 222 isolates, 4 qnrS1, 4 qepA, and 16 aac(6')-Ib-cr genes were confirmed. Four major phylogroups (A, B1, B2, and D) and nontypeable isolates (NTs) were found among the isolates, with phylogroup D (54%) being the most common phylogroup. A total of 110 (80%) of the 138 screened isolates harbored bla(CTX-M) genes, with bla(CTX-M-14) (71%) and bla(CTX-M-15) (24%) being the most prevalent of these genes. Nine of the 13 CTX-M-15- or CTX-M-14-containing B2 isolates belonged to ST131. PFGE typing showed a high level of diversity, and plasmid analysis indicated a very large pool of different resistance plasmids mediating the spread of bla(CTX-M) genes in mainland China. An equally very high frequency of resistance and equally high levels of diversity in phylogroups, PFGE types, and plasmids were observed among community- and hospital-acquired E. coli isolates, indicating the presence of a large reservoir in the community and a long-term spread of cephalosporin resistance in China.
Collapse
|
45
|
Monroy C, Mañas MD, Santamaría A, Clemente MI. [Antibiotic resistance in urinary tract infection and identification of associated risk factors]. Rev Clin Esp 2010; 210:589-90. [PMID: 20961537 DOI: 10.1016/j.rce.2010.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2010] [Revised: 04/28/2010] [Accepted: 05/03/2010] [Indexed: 11/16/2022]
|
46
|
Wootton M, Walsh TR, Macfarlane L, Howe RA. Activity of mecillinam against Escherichia coli resistant to third-generation cephalosporins. J Antimicrob Chemother 2009; 65:79-81. [DOI: 10.1093/jac/dkp404] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
47
|
Empiric antibiotic therapy in acute uncomplicated urinary tract infections and fluoroquinolone resistance: a prospective observational study. Ann Clin Microbiol Antimicrob 2009; 8:27. [PMID: 19852849 PMCID: PMC2770515 DOI: 10.1186/1476-0711-8-27] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2009] [Accepted: 10/24/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aims of this study were to determine the antimicrobial susceptibility patterns of urinary isolates from community acquired acute uncomplicated urinary tract infections (uUTI) and to evaluate which antibiotics were empirically prescribed in the outpatient management of uUTI. METHODS Among the patients which were admitted to outpatient clinics of Ankara University Medical Faculty, Ibni-Sina Hospital during 2005-2006, a total of 429 women between the age of 18 and 65 years old who were clinically diagnosed with uUTI and to whom prescribed empirical antibiotics were enrolled in this prospective observational study. Patients' demographical data, urine culture results, resistance rates to antimicrobial agents and prescribed empiric antimicrobial therapy were analyzed. RESULTS Totally 390 (90.9%) patients among all study population were requested for urine culture by their physicians. 150 (38.5%) of these urine cultures were positive. The most common isolated uropathogen was Escherichia coli (E. coli) (71.3%). The variations of uropathogens according to age and menopause status were not significantly different.The resistance rates of E. coli isolates for ampicillin, ampicillin-sulbactam, amoxicillin-clavulonate, cefuroxime, ceftriaxone, fluoroquinolones (FQ), co-trimoxazole (TMP-SMX) and gentamicin were 55.1%, 32.7%, 32.7%, 23.4%, 15.9%, 25.2%, 41.1%, 6.1% respectively. FQ were the most common prescribed antibiotics (77.9%) (P < 0.001), followed by TMP-SMX (10.7%), fosfomycin (9.2%), nitrofurantoin (2.1%). Treatment durations were statistically longer than the recommended 3-day course (P < 0.001). CONCLUSION Empirical use of FQ in uUTI should be discouraged because of increased antimicrobial resistance rates.
Collapse
|
48
|
Risk Factors for Quinolone-Resistant Escherichia coli Urinary Tract Infection. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2009. [DOI: 10.1097/ipc.0b013e3181a4c728] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
49
|
Inhibition of uropathogens by lactic acid bacteria isolated from dairy foods and cow's intestine in western Nigeria. Arch Microbiol 2009; 191:639-48. [PMID: 19529917 DOI: 10.1007/s00203-009-0492-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2009] [Revised: 04/17/2009] [Accepted: 05/28/2009] [Indexed: 11/27/2022]
Abstract
A total of 96 lactic acid bacteria (LAB) were isolated from African indigenous fermented products and cow's intestines to study their inhibitory capability against multi-drug-resistant uropathogens. Escherichia coli accounted for approximately 45% of isolated uropathogens, followed by Staphylococcus spp. (20%). The Gram negative uropathogens were highly resistant to quinolones, co-trimoxazole, teicoplanin and some beta-lactams, while the Staphylococcus spp. showed high resistance to aminoglycosides, beta-lactams and macrolides. Twenty-four LAB isolates were selected based on their antimicrobial activity against two uropathogenic Staphylococcus aureus strains and bacteriocin production. LAB strains showing antimicrobial activity were grouped into smaller groups through amplified ribosomal DNA restriction analysis (ARDRA). Representative strains were identified as Weissella spp., Enterococcus faecium, Lactococcus lactis and Lactobacillus brevis through sequencing of 16S rDNA. The Weissella spp. and L. brevis strains demonstrated remarkable inhibitory activity against seven strains of Gram negative uropathogens. Two strains of L. lactis produced a bacteriocin-like inhibitory substance active against Lactobacillus sakei. In this study, an unusual high rate of co-trimoxazole, quinolones and macrolides resistance among uropathogens from south west Nigeria was discovered. Based on their sensitivity to Weissella spp., there is a potential for using these LAB as a natural approach for the protection against the uropathogens assayed.
Collapse
|
50
|
Zhao L, Chen X, Zhu X, Yang W, Dong L, Xu X, Gao S, Liu X. Prevalence of virulence factors and antimicrobial resistance of uropathogenic Escherichia coli in Jiangsu province (China). Urology 2009; 74:702-7. [PMID: 19362346 DOI: 10.1016/j.urology.2009.01.042] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2008] [Revised: 12/23/2008] [Accepted: 01/19/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To determine the prevalence of virulence factors and the antimicrobial susceptibilities of uropathogenic Escherichia coli isolates in Jiangsu province, China. METHODS A total of 202 uropathogenic E. coli isolates were characterized for O serogroups, virulence factor genes, the antimicrobial susceptibilities, and the phylogenetic groups. The antibiotic-resistance phenotypes in relation to virulence factor genes were assessed by statistical analysis. RESULTS O1 was the most prevalent serogroup, and D and B2 were the most frequent phylogenetic groups. Of the 33 tested virulence genes, feoB and fimH were the most prevalent. Of the 15 antimicrobial agents tested, resistance to nalidixic acid, mezlocillin, ampicillin, and tetracycline was the most frequent. All isolates were multiresistant, and 73% were resistant to trimethoprim-sulfamethoxazole. Cefotaxime-, cefoxitin-, chloramphenicol-, and nitrofurantoin-resistant isolates had reduced virulence factor genes compared with susceptible strains. CONCLUSIONS In Jiangsu province, the problem of antibiotic resistance for uropathogenic E. coli is rather serious and empiric treatment of urinary tract infections with all the antibiotics we tested is no longer appropriate. Cefotaxime-, cefoxitin-, chloramphenicol-, and nitrofurantoin-resistant isolates have a reduced virulence factor genes compared with susceptible strains.
Collapse
Affiliation(s)
- Lixiang Zhao
- Animal Infectious Disease Laboratory, College of Veterinary Medicine, Yangzhou University, Yangzhou, Jiangsu, China
| | | | | | | | | | | | | | | |
Collapse
|