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antibiotic resistance

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43401. Methicillin-resistant Staphylococcus aureus prolongs intensive care unit stay in ventilator-associated pneumonia, despite initially appropriate antibiotic therapy. (Abstract)

Methicillin-resistant Staphylococcus aureus prolongs intensive care unit stay in ventilator-associated pneumonia, despite initially appropriate antibiotic therapy. To determine the impact of methicillin-resistant Staphylococcus aureus (MRSA) on length of stay in the intensive care unit (ICU) for patients with ventilator-associated pneumonia (VAP) and to control for the effect of initially inappropriate antibiotic treatment on outcomes by focusing only on persons who were given appropriate (...) antibiotic therapy for their infection.Retrospective analysis of pooled, patient-level data from multiple clinical trials in VAP.Multiple ICUs in France.Persons with bronchoscopically confirmed VAP due to either MRSA or methicillin-susceptible S. aureus (MSSA) and who received initially appropriate antibiotic treatment. All persons with MRSA VAP received vancomycin (15 mg/kg intravenously, twice daily).None.We compared patients with MRSA VAP to persons with MSSA VAP. ICU length of stay represented

2006 Critical Care Medicine

43402. Risk of emergence of Pseudomonas aeruginosa resistance to beta-lactam antibiotics in intensive care units. (Abstract)

Risk of emergence of Pseudomonas aeruginosa resistance to beta-lactam antibiotics in intensive care units. The emergence of Pseudomonas aeruginosa resistance to antimicrobial drugs is frequent in intensive care units and may be correlated with the use of some specific drugs. The purpose of our study was to identify a relationship between the use of various beta-lactam antibiotics and the emergence of resistance and to characterize the mechanism of resistance involved.We conducted an open (...) prospective study over a 3-yr period by including all patients in whom P. aeruginosa had been isolated from one or more specimens: bronchial aspiration, blood cultures, catheters, and urinary cultures.General intensive care unit.One hundred and thirty-two intensive care unit patients.The antibiotics studied were amoxiclav, piperacillin-tazobactam, cefotaxime, ceftazidime, cefepim, and imipenem. The mechanisms of resistance studied were production of penicillinase or cephalosporinase, nonenzymatic

2006 Critical Care Medicine

43403. Relationship of antimicrobial control policies and hospital and infection control characteristics to antimicrobial resistance rates. (Full text)

Relationship of antimicrobial control policies and hospital and infection control characteristics to antimicrobial resistance rates. Antibiotic misuse and noncompliance with infection control precautions have contributed to increasing levels of antimicrobial resistance in hospitals.To assess the extent to which resistance is monitored in infection control programs and to correlate resistance rates with characteristics of antimicrobial control policies, provider attitudes and practices (...) practice guidelines, observed hand hygiene behavior, or having an antibiotic use policy and resistance rates. In logistic regression analysis, higher scores on measures of systems-level efforts to implement the guideline were associated with lower rates of resistant S aureus and enterococci (P=.046).Organizational-level factors independent of the practices of individual clinicians may be associated with rates of antimicrobial resistance.

2007 American Journal of Critical Care PubMed abstract

43404. Cycling empirical antimicrobial agents to prevent emergence of antimicrobial-resistant Gram-negative bacteria among intensive care unit patients. (Abstract)

Cycling empirical antimicrobial agents to prevent emergence of antimicrobial-resistant Gram-negative bacteria among intensive care unit patients. To determine the impact of the rotation of antimicrobial agents on the rates of infection, intestinal colonization, and acquisition with antimicrobial-resistant Gram-negative bacteria.Pre- and postintervention design.A 19-bed, medical intensive care unit.Individuals admitted to the study unit for >48 hrs.After a 5-month baseline observation period (...) , four classes of antimicrobial agents with Gram-negative activity were cycled at 3- to 4-month intervals for 24 months.The primary outcome was the acquisition rate of antimicrobial resistance among Enterobacteriaceae and Pseudomonas aeruginosa obtained from rectal swab cultures performed on admission, weekly during the patients' stay, and at discharge. Rates and microbiology of nosocomial bloodstream infections and ventilator-associated pneumonia were also compared between baseline and cycling

2004 Critical Care Medicine

43405. The epidemic of antibiotic-resistant infections: a call to action for the medical community from the Infectious Diseases Society of America. (Full text)

The epidemic of antibiotic-resistant infections: a call to action for the medical community from the Infectious Diseases Society of America. The ongoing explosion of antibiotic-resistant infections continues to plague global and US health care. Meanwhile, an equally alarming decline has occurred in the research and development of new antibiotics to deal with the threat. In response to this microbial "perfect storm," in 2001, the federal Interagency Task Force on Antimicrobial Resistance (...) released the "Action Plan to Combat Antimicrobial Resistance; Part 1: Domestic" to strengthen the response in the United States. The Infectious Diseases Society of America (IDSA) followed in 2004 with its own report, "Bad Bugs, No Drugs: As Antibiotic Discovery Stagnates, A Public Health Crisis Brews," which proposed incentives to reinvigorate pharmaceutical investment in antibiotic research and development. The IDSA's subsequent lobbying efforts led to the introduction of promising legislation

2008 Clinical Infectious Diseases PubMed abstract

43406. Prevalence of the genes encoding extended-spectrum beta-lactamases, in Escherichia coli resistant to beta-lactam and non-beta-lactam antibiotics. (Abstract)

Prevalence of the genes encoding extended-spectrum beta-lactamases, in Escherichia coli resistant to beta-lactam and non-beta-lactam antibiotics. The prevalences of extended-spectrum beta-lactamases (ESBL) and their encoding bla genes, TEM, SHV and CTX_M, were investigated in isolates of Escherichia coli that were resistant to beta-lactam and/or non-beta-lactam antibiotics. Of the 250 E. coli isolates investigated, all of which came from patients in a major hospital in southern Lebanon, 61 (...) isolates indicated that 11 (18%) of the isolates carried both the TEM and SHV genes, 37 (61%) carried the TEM gene but not the SHV, and 13 (21%) had the SHV gene but not the TEM. None of the isolates carried the CTX_M gene. Of the 37 TEM-positive/SHV-negative isolates, 43% were resistant to fluoroquinolones and 37% to aminoglycosides. Increased resistance to non-beta-lactam antibiotics was observed in the isolates harbouring both the TEM and SHV genes, of which 54% were resistant to all of the tested

2005 Annals of Tropical Medicine and Parasitology

43407. Carriage by the housefly (Musca domestica) of multiple-antibiotic-resistant bacteria that are potentially pathogenic to humans, in hospital and other urban environments in Misurata, Libya. (Abstract)

resistant to at least 10 antimicrobial agents. Two isolates of Sta. aureus (both from flies collected in the hospital) were resistant to methicillin. The present study supports the belief that the housefly is a potential vector of multiple-antibiotic-resistant, pathogenic bacteria, including methicillin-resistant Sta. aureus, in the hospital environment. Given their mobility, it seems likely that houseflies carry such pathogens from hospitals to surrounding communities, and vice versa. (...) Carriage by the housefly (Musca domestica) of multiple-antibiotic-resistant bacteria that are potentially pathogenic to humans, in hospital and other urban environments in Misurata, Libya. Using standard microbiological procedures, bacteria that are potentially pathogenic to humans were isolated from 150 houseflies collected in the Libyan city of Misurata (50 flies each from the Central Hospital, streets and abattoir). Salmonella spp., Yersinia enterocolitica and Edwardsiella tarda were

2005 Annals of Tropical Medicine and Parasitology

43408. Carriage by the German cockroach (Blattella germanica) of multiple-antibiotic-resistant bacteria that are potentially pathogenic to humans, in hospitals and households in Tripoli, Libya. (Abstract)

% of the isolates of Enterobacteria recovered were each resistant to at least four antimicrobial agents, and 95% of the Pseudomonas isolates were each resistant to at least eight such agents. Cockroaches may play an important role in the spread of multiple-antibiotic-resistant, bacterial pathogens within the hospitals and surrounding communities of Tripoli and other, similar cities. The local health and environmental authorities need to be encouraged to treat B. germanica infestations seriously and to control (...) Carriage by the German cockroach (Blattella germanica) of multiple-antibiotic-resistant bacteria that are potentially pathogenic to humans, in hospitals and households in Tripoli, Libya. Using standard bacteriological procedures, 403 cockroaches (Blattella germanica) collected in Tripoli, from hospitals or the households surrounding the hospitals, were examined for bacteria that are potentially pathogenic to humans. Almost all of the cockroaches (96.1% of the 253 from hospitals and 98.7

2006 Annals of Tropical Medicine and Parasitology

43409. Antibiotic resistance of enterococci isolated from frozen foods and environmental water. (Abstract)

Antibiotic resistance of enterococci isolated from frozen foods and environmental water. We evaluated 239 isolates of enterococci (113 from frozen foods and 126 from environmental water) for their resistance to 8 antibiotics by agar disk diffusion method. Most isolates from both sources were resistant to tetracycline (64.1% food strains; 46.8% water strains) and ciprofloxacin (53.4% food strains; 48.4% water strains). A relatively high prevalence of chloramphenicol, trimethoprim (...) the two sources (p>0.05). This study shows a high prevalence of multidrug resistance among enterococci isolated from foods of animal origin and environmental water. This may serve as a potential transfer route of antibiotic-resistant bacteria and resistant genes into the human food-chain and environment which could potentially pose a health threat to humans in the future. The use of antibiotics for purposes other than human health, ie in animal feeds and in the treatment of infection in animals

2006 Southeast Asian Journal of Tropical Medicine and Public Health

43410. Antibiotic resistance patterns in children hospitalized for urinary tract infections. (Full text)

Antibiotic resistance patterns in children hospitalized for urinary tract infections. Children admitted to the hospital with urinary tract infections (UTIs) receive empirical antibiotic therapy. There is limited information on bacterial resistance to commonly prescribed intravenous antibiotics or on the risk factors for increased resistance in these patients.To determine the antibiotic resistance pattern in children admitted to the hospital with UTIs, and to determine if history of UTI (...) , antibiotic prophylaxis, or vesicoureteral reflux increases the risk of resistant organisms.We reviewed all of the cases of UTI in children up to 18 years of age who were admitted during a 5-year period to Children's Hospital of Wisconsin, Milwaukee. We recorded age, sex, culture and sensitivity results, imaging that was performed, and past medical history.We identified 361 patients with UTIs. Escherichia coli caused 87% of the infections, although E coli was significantly less common in children

2005 Archives of Pediatrics & Adolescent Medicine PubMed abstract

43411. Isolation of bacteria with antibiotic resistance from household cockroaches (Periplaneta americana and Blattella germanica). (Abstract)

Isolation of bacteria with antibiotic resistance from household cockroaches (Periplaneta americana and Blattella germanica). Cockroaches may harbor and disseminate microorganisms to the environment. In this study, Periplaneta americana and Blattella germanica were collected from 40 households in Kaohsiung City and Kaohsiung County, Taiwan. Cockroach infestation was found in 50% of the studied households and 226 cockroaches (123 P. americana and 103 B. germanica) collected by trapping. P (...) . americana was more often found in the kitchen (70.7%) whereas B. germanica in the storage room (51.5%) and kitchen (36.9%). There was no significant difference between the percentages of P. americana (99.9%) and B. germanica (98.0%) carrying bacteria. A total of 25 species of bacteria was isolated from P. americana and only 21 from B. germanica. Antibiotic resistance was found in Staphylococcus aureus, Enterococcus species, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Serratia

2005 Acta Tropica

43412. Fitness and dissemination of disinfectant-selected multiple-antibiotic-resistant (MAR) strains of Salmonella enterica serovar Typhimurium in chickens. (Full text)

Fitness and dissemination of disinfectant-selected multiple-antibiotic-resistant (MAR) strains of Salmonella enterica serovar Typhimurium in chickens. The aims of this study were to determine whether strains of Salmonella enterica serovar Typhimurium which had acquired low-level multiple antibiotic resistance (MAR) through repeated exposure to farm disinfectants were able to colonize and transmit between chicks as easily as the parent strain and, if such strains were less susceptible (...) treatment. Birds were regularly monitored for the presence of Salmonella in caecal contents. Replica plating was used to monitor for the selection of antibiotic-resistant strains.The parent strain was shown to be significantly fitter than the two mutants and was more rapidly disseminated to naive birds. Antibiotic treatment did not preferentially select for the two mutants or for resistant strains.The disinfectant-exposed strains, although MAR, were less fit, less able to disseminate than the parent

2007 Journal of Antimicrobial Chemotherapy PubMed abstract

43413. The importance of the development of antibiotic resistance in Staphylococcus aureus. (Full text)

The importance of the development of antibiotic resistance in Staphylococcus aureus. Hospital- and community-acquired Staphylococcus aureus infections pose a substantial burden in terms of morbidity, mortality and health care costs. The introduction of new antibiotics to counter this pathogen has frequently been closely followed by the emergence of resistant strains. Most significantly, S. aureus isolates resistant to beta-lactams have become common, and many of these are also resistant to beta (...) antibiotic classes, S. aureus resistance to glycopeptides did not emerge until nearly 40 years after their clinical introduction, and as a result this drug class has remained the mainstay of treatment for MRSA infections. However, a number of vancomycin-intermediate S. aureus isolates have emerged worldwide and four fully resistant S. aureus isolates have been reported in the USA. This raises the concern that the current first-line treatment for MRSA infection may become ineffective in an increasing

2006 Clinical Microbiology and Infection PubMed abstract

43414. Factors associated with multidrug-resistant bacteria in secondary peritonitis: impact on antibiotic therapy. (Full text)

Factors associated with multidrug-resistant bacteria in secondary peritonitis: impact on antibiotic therapy. Secondary peritonitis includes community-acquired and nosocomial peritonitis. These intra-abdominal infections have a common pathogenesis but some microbiological differences, particularly with respect to the type of bacteria recovered and the level of antimicrobial susceptibility. This report describes a prospective observational study of 93 consecutive patients with secondary (...) peritonitis during an 11-month period. Community-acquired peritonitis accounted for 44 cases and nosocomial peritonitis for 49 cases (post-operative in 35 cases). Fifteen multidrug-resistant (MDR) bacteria were recovered from 14 patients. In univariate analysis, the presence of MDR bacteria was associated significantly with pre-operative and total hospital lengths of stay, previous use of antimicrobial therapy, and post-operative antimicrobial therapy duration and modifications. A 5-day cut-off in length

2006 Clinical Microbiology and Infection PubMed abstract

43415. Decreasing rates of resistance to penicillin, but not erythromycin, in Streptococcus pneumoniae after introduction of a policy to restrict antibiotic usage in Taiwan. (Full text)

Decreasing rates of resistance to penicillin, but not erythromycin, in Streptococcus pneumoniae after introduction of a policy to restrict antibiotic usage in Taiwan. A 16% decline in rates of penicillin resistance in Streptococcus pneumoniae isolates in Taiwan between 1998--1999 (25%) and 2001 (9%) was associated with a 46% decrease in total penicillin and other cephalosporin usage in 2001 compared with 1999. However, erythromycin resistance in S. pneumoniae remained high (94%), despite a 45

2005 Clinical Microbiology and Infection PubMed abstract

43416. Report of the Consensus Conference on Antibiotic Resistance; Prevention and Control (ARPAC). (Full text)

Report of the Consensus Conference on Antibiotic Resistance; Prevention and Control (ARPAC). Antimicrobial resistance is a key public health concern in Europe. It is known that there are significant variations in the prevalence of resistance across Europe, and methods to reduce the problem are also assumed to vary significantly. The 'Antibiotic Resistance; Prevention and Control (ARPAC)' Concerted Action project was funded by the European Commission and conducted by four study groups (...) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID). The project established a network of European hospitals and collated data on antimicrobial resistance prevalence, antimicrobial susceptibility testing methods, typing methods employed, antimicrobial use, antibiotic policies and practices, and infection control policies and practices. The ARPAC Consensus Conference, entitled 'Control of antibiotic resistance in European hospitals-informing future evidence-based practice

2005 Clinical Microbiology and Infection PubMed abstract

43417. Antibiotic resistance: location, location, location. (Full text)

Antibiotic resistance: location, location, location. Antibiotic resistance surveys are published widely, citing percentage resistance rates, sometimes for vast transcontinental regions. Such data seem straightforward, but when one drills deeper, great complexity emerges. Rates for methicillin resistance among Staphylococcus aureus from bacteraemias vary from <1% to 50% among European countries, and vary greatly among both hospitals and hospital units. Methicillin-resistant S. aureus (MRSA (...) ) resistance rates are typically higher for tertiary-care hospitals and intensive care units than in general hospitals and wards, and lowest in single specialist centres. The likelihood of resistance also varies according to patient characteristics: those patients from nursing homes and with underlying disease, recent antibiotic treatment and hospitalisation are more likely to harbour resistant pathogens. Percentage rates themselves also may be misleading; they may be high only because the denominator

2007 Clinical Microbiology and Infection PubMed abstract

43418. Priorities for antibiotic resistance surveillance in Europe. (Full text)

surveillance studies. Moreover, current efforts are dispersed among many, mostly small, initiatives with different objectives. These studies must be tailored to the various reservoirs of antibiotic-resistant bacteria, such as hospitalised patients, nursing homes, the community, animals and food. Two studies that could serve as examples of tailored programmes are the European Antimicrobial Resistance Surveillance System (EARSS), which collects resistance data during the diagnosis of hospitalised patients (...) Priorities for antibiotic resistance surveillance in Europe. Antibiotic resistance is an increasing global problem. Surveillance studies are needed to monitor resistance development, to guide local empirical therapy, and to implement timely and adequate countermeasures. To achieve this, surveillance studies must have standardised methodologies, be longitudinal, and cover a sufficiently large and representative population. However, many fall short of these requirements that define good

2006 Clinical Microbiology and Infection PubMed abstract

43419. Changes in Escherichia coli resistance patterns during and after antibiotic therapy: a longitudinal study among outpatients in Germany. (Full text)

Changes in Escherichia coli resistance patterns during and after antibiotic therapy: a longitudinal study among outpatients in Germany. There is worldwide concern about the appearance and rise of bacterial resistance to commonly used antibiotics. Although the gut is an important reservoir for resistant Escherichia coli, data from large-scale epidemiological studies concerning the colonisation dynamics of the normal gut flora with resistant E. coli during and after antibiotic therapy are sparse (...) . Accordingly, a large community-based study was conducted to ascertain changes in the prevalence of resistant E. coli during and after antibiotic treatment. Stool samples before, during and after antibiotic therapy were obtained from 541 patients (aged >/=40 years) with a febrile infection who attended a general practitioner in southern Germany. The MICs of commonly prescribed antibiotics for E. coli isolates from the stools were determined. The prevalence of resistance to the corresponding antibiotics

2007 Clinical Microbiology and Infection PubMed abstract

43420. The effect of antibiotics on methicillin-resistant Staphylococcus aureus. (Full text)

The effect of antibiotics on methicillin-resistant Staphylococcus aureus. Antimicrobial drugs encourage the overgrowth of organisms resistant to the agents used. Acquisition and subsequent overgrowth of methicillin-resistant Staphylococcus aureus (MRSA) are particularly associated with beta-lactam antibiotics and quinolones. These drugs allow rapid proliferation of an organism that might have been merely colonizing the skin, leading to clinical infection, treatment difficulties and potential (...) transmission to others. In addition, there is increasing evidence that inappropriate antibiotics not only encourage overgrowth with MRSA but may also enhance pathogenicity. Such virulence is not necessarily due to simple expansion of MRSA across skin and mucosal surfaces; there appear to be molecular changes that facilitate mechanisms such as quorum sensing, adhesion, phage mobilization, exotoxin production, intracellular persistence and biofilm formation, all of which contribute towards more severe

2007 Journal of Antimicrobial Chemotherapy PubMed abstract

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