Background: <em>Raoultella planticola</em> is a gram-negative rod-shaped bacterium commonly found in water and soil and considered to be a rare and possibly underestimated cause of severe human infection. ...Background: <em>Raoultella planticola</em> is a gram-negative rod-shaped bacterium commonly found in water and soil and considered to be a rare and possibly underestimated cause of severe human infection. Its presence should be suspected in older patients with a history of cancer, immune suppression and recent exposure to traumatic injuries or invasive medical procedures. Case presentation: A 78-year-old male with a history of hypertension was diagnosed with pancreatic adenocarcinoma. Whipple procedure (pancreaticoduodenectomy) was performed afterwards. On the 8th day of surgery, the patient was admitted to our tertiary ICU with septic shock. His initial Sequential Organ Failure Assessment (SOFA) score was 12 with predicted mortality 95.7%. Empirical antibiotic therapy with colymicin, meropenem and teikoplanin was administered immediately and two sets of blood cultures were obtained. Patient developed refractory septic shock despite the addition of vasopressin and the patient’s condition continued to deteriorate. Patient died on the third day of sepsis. His blood culture was positive for <em>R.</em> <em>planticola</em>, which was identified using the VITEK-2 biochemical identification system. Conclusions: Clinicians should be aware of fatal unusual infections in immunocompromised patients.展开更多
The study is to identify trends and levels of antibiotic resistance of some common Gram-negative strains over time. The samples were collected from Vietnam Military Hospital 103 between 2014 and 2019. A total of 405 &...The study is to identify trends and levels of antibiotic resistance of some common Gram-negative strains over time. The samples were collected from Vietnam Military Hospital 103 between 2014 and 2019. A total of 405 <i>Acinetobacter baumannii</i>., 528 <i>Pseudomonas aeruginosa</i>, 741 <i>Escherichia coli</i>, and 352 <i>Klebsiella pneumoniae</i> strains were identified and antimicrobial susceptibility was by Vitek system and Etest method. The multi-drug resistance (MDR) was major proportion of four common bacteria. In particular, there is a tendency to shift from MDR to Extended drug resistance (XDR) or possibly Pan drug resistant (pPDR). <i>A. baumannii</i> had the highest level of antibiotic resistance, namely, carbapenem (61.5% - 82.5%) and cephalosporin (72.7% - 88.7%). <i>P. aeruginosa</i> resisted most of commonly antibiotics, ranging from 50% to 70%. <i>E. coli</i> had a high resistance with antibiotics like ampicillin (87.2% - 97.6%) and the 3rd generation cephalosporins (up to 79.6%). <i>K. pneumoniae</i> resisted carbapenem from 14.7% to 44.4%, and other antibiotics with the higher rate of 40%. The collected data will be a prerequisite for further studies on mechanisms and factors related to antibiotic resistant bacteria, in order to find out a rational and effective using strategy of antibiotics.展开更多
This paper explores one of the underappreciated reasons for lack of efficacy in certain cases of antimicrobial therapy, namely the occurrence of a non-genetic resistance to antimicrobial drugs due to a metabolic quies...This paper explores one of the underappreciated reasons for lack of efficacy in certain cases of antimicrobial therapy, namely the occurrence of a non-genetic resistance to antimicrobial drugs due to a metabolic quiescence of microorganisms. T</span><span style="font-family:Verdana;">his review has centered on those microorganisms of particular importance in obstetrics and gynecology and accordingly has reviewed the nature and extent of the persister phenotype in relation to infectious agents affecting women’s health. We show how the quiescent persister microbial phenotype represents the next significant issue that could compromise successful antibiotic therapy. A brief history of antimicrobial therapy is provided as context for the problem posed by the persister phenotype. This review has been focused on the current literature having relevance for physicians concerned with women’s health. The study of this phenotype has led to increasing understanding of the molecular mechanisms for this state which also provides ideas for rational development of drug candidates to interdict these organisms in human disease and explores the possibility of developing specifically targeted molecules to address persisters, research on screening botanicals, existing drugs and chemicals to discover novel approaches to the clinical consequence of microbial persisters. Of interest in this review, is the return to naturally occurring botanical substances, first to be used as anti</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">infectives, now being considered as possible agents to address persister microorganisms. Overall this paper aims to provide information tailored especially to the obstetrics and gynecology specialists.展开更多
Introduction: The prevalence of </span><i><span style="font-family:Verdana;">Klebsiella pneumoniae</span></i><span style="font-family:Verdana;"> has rapidly incr...Introduction: The prevalence of </span><i><span style="font-family:Verdana;">Klebsiella pneumoniae</span></i><span style="font-family:Verdana;"> has rapidly increased in recent years and the distribution differed greatly by region, We aimed to study the relationship between antibiotic resistance and </span><i><span style="font-family:Verdana;">K. pneumoniae</span></i><span style="font-family:Verdana;">, especially carbapenem-resistant </span><i><span style="font-family:Verdana;">Klebsiella pneumoniae</span></i><span style="font-family:Verdana;"> (CRKP) in our tertiary hospitals from 2014 to 2018.</span></span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">Methodology: The antibiotic consumption data of </span><i><span style="font-family:Verdana;">K. pneumoniae</span></i><span style="font-family:Verdana;"> were expressed as the defined daily dose (DDD) per 100 inpatient days</span></span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">(DDDs). </span><i><span style="font-family:Verdana;">K. pneumoniae</span></i><span style="font-family:Verdana;"> which isolated from clinical samples in</span><span style="font-family:Verdana;"> hospital between January 2014 and December 2018 were retrospectively analyzed, and the correlation between antibiotic resistance rate and antibiotic frequency was analyzed.</span></span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">Results: From 2014 to 2018, a total of 2295 strains of </span><i><span style="font-family:Verdana;">K. pneumoniae</span></i><span style="font-family:Verdana;"> were isolated, with the detection rates of 8.2%, 9.2%, 11.9%, 13.4% and 14.0%. There were 423 strains of CRKP, with the detection rates of 7.5%, 5.8%, 17</span></span><span style="font-family:Verdana;">.</span><span style="font-family:""><span style="font-family:Verdana;">8% 24.2% and 25.2% respectively. </span><i><span style="font-family:Verdana;">K. pne展开更多
An Antimicrobial Stewardship Program (ASP) is established to promote cost effective and safe use of antimicrobial agents. Basically, this approach directs the management of antimicrobials in terms of selection of appr...An Antimicrobial Stewardship Program (ASP) is established to promote cost effective and safe use of antimicrobial agents. Basically, this approach directs the management of antimicrobials in terms of selection of appropriate drugs, determination of administration routes and standardization of both medication dosage and treatment duration. The program involves, but is not limited to, Hospital Staff Education, Pharmacodynamics Dose Optimization, Computer-Assisted Decision Support Programs, Pharmacist-Driven Intravenous to Oral Switch Programs, Pharmacy Dosing Programs and Antibiotic Cycling. A study was conducted to determine effectiveness of the ASP in significantly improving patient outcomes (e.g. decrease morbidity and mortality from infection). This was undertaken by collecting restrospective data on patient length of hospital stay, bed turnover rate and antibiotic consumption over a period of 2 years since the ASP was initiated. Periodic data were then compared and interpreted based on its clinical, quality and financial implications in order to measure effectiveness of the program implementation.展开更多
Many organisms produce small proteins which exhibit antimicrobial activities. In recent decades, the biological role of antimicrobial peptides (AMP) has been recognized as the main factor in the defense mechanisms aga...Many organisms produce small proteins which exhibit antimicrobial activities. In recent decades, the biological role of antimicrobial peptides (AMP) has been recognized as the main factor in the defense mechanisms against a broad range of pathogenic microbes. The increased worldwide incidence of microbial resistance to antibiotics makes AMPs promising alternative for the control of microbial disease. Exploring the potential of AMPs in transgenic crops could lead to the development of new and improved cultivars which are resistant to various economically important diseases. In the present study, two fusion lytic peptide gene constructs coding for antimicrobial peptides were expressed in Nicotiana benthamiana tobacco plants and tested against three fungal pathogens, Sclerotinia sclerotiorum, Rhizoctonia solani, and Pythium sp. Detached-leaf bioassay was employed for the transgenic plants carrying the fusion lytic peptide constructs (ORF13 and RSA1), transgenic vector only control plants (1234), and wild-type control plants (WT) against the three fungal pathogens. Symptom area of each leaf was measured with high accuracy and data were recorded and processed by statistical analyses. The results showed that transgenic plant lines ORF13 and RSL1 have substantial resistance to Sclerotinia sclerotiorum infection, producing significantly smaller lesion areas compared to vector only plant line 1234 and wild type plants. These transgenic lines also provided resistance against Rhizoctonia solani, however, these lines were not effective against the other fungal pathogen Pythium sp.展开更多
Background: Many oral bacterial species forming the normal flora present as a biofilm in the oral cavity. Dental caries results when there is an imbalance of pathogenic bacteria within these biofilms. Aim: This study ...Background: Many oral bacterial species forming the normal flora present as a biofilm in the oral cavity. Dental caries results when there is an imbalance of pathogenic bacteria within these biofilms. Aim: This study sought to isolate and identify the bacterial species associated with extracted carious teeth and their susceptibility pattern towards commonly employed antimicrobial agents used at the Komfo Anokye Teaching Hospital (KATH). Methodology: A descriptive cross-sectional study carried out on thirty-three extracted carious teeth samples collected by convenient sampling from patients attending the Oral Health Directorate-KATH. All samples were collected from the 11th of March 2019 to the 6th of April 2019. Data was collected using 5 ml peptone water and a case study form. Analysis was done using SPSS version 25 and Microsoft Excel version 10. Results: Twenty (61%) samples were obtained from female patients and thirteen samples (39%) from male patients. Streptococcus spp had the highest occurrence (32.25%) with the least isolated being Pseudomonas and E. coli spp (6.45%). Antibiotic susceptibility test revealed Pseudomonas spp was resistant to all the eight antibiotics used in this study. All bacterial isolates were resistant to Cefuroxime and penicillin except Staphylococcus and Streptococcus spp. Conclusion: The commonest isolates associated with dental caries in KATH were Streptococcus, Bacillus and Staphylococcus spp. In this study most of the isolated species were resistant to common antibiotics employed in the Oral Health Directorate in KATH (amoxicillin/clavulanic, ampicillin and penicillin). From the current study the most effective antibiotic observed was meropenem (23%) with penicillin (3%) being least effective in treating infections of caries.展开更多
文摘Background: <em>Raoultella planticola</em> is a gram-negative rod-shaped bacterium commonly found in water and soil and considered to be a rare and possibly underestimated cause of severe human infection. Its presence should be suspected in older patients with a history of cancer, immune suppression and recent exposure to traumatic injuries or invasive medical procedures. Case presentation: A 78-year-old male with a history of hypertension was diagnosed with pancreatic adenocarcinoma. Whipple procedure (pancreaticoduodenectomy) was performed afterwards. On the 8th day of surgery, the patient was admitted to our tertiary ICU with septic shock. His initial Sequential Organ Failure Assessment (SOFA) score was 12 with predicted mortality 95.7%. Empirical antibiotic therapy with colymicin, meropenem and teikoplanin was administered immediately and two sets of blood cultures were obtained. Patient developed refractory septic shock despite the addition of vasopressin and the patient’s condition continued to deteriorate. Patient died on the third day of sepsis. His blood culture was positive for <em>R.</em> <em>planticola</em>, which was identified using the VITEK-2 biochemical identification system. Conclusions: Clinicians should be aware of fatal unusual infections in immunocompromised patients.
文摘The study is to identify trends and levels of antibiotic resistance of some common Gram-negative strains over time. The samples were collected from Vietnam Military Hospital 103 between 2014 and 2019. A total of 405 <i>Acinetobacter baumannii</i>., 528 <i>Pseudomonas aeruginosa</i>, 741 <i>Escherichia coli</i>, and 352 <i>Klebsiella pneumoniae</i> strains were identified and antimicrobial susceptibility was by Vitek system and Etest method. The multi-drug resistance (MDR) was major proportion of four common bacteria. In particular, there is a tendency to shift from MDR to Extended drug resistance (XDR) or possibly Pan drug resistant (pPDR). <i>A. baumannii</i> had the highest level of antibiotic resistance, namely, carbapenem (61.5% - 82.5%) and cephalosporin (72.7% - 88.7%). <i>P. aeruginosa</i> resisted most of commonly antibiotics, ranging from 50% to 70%. <i>E. coli</i> had a high resistance with antibiotics like ampicillin (87.2% - 97.6%) and the 3rd generation cephalosporins (up to 79.6%). <i>K. pneumoniae</i> resisted carbapenem from 14.7% to 44.4%, and other antibiotics with the higher rate of 40%. The collected data will be a prerequisite for further studies on mechanisms and factors related to antibiotic resistant bacteria, in order to find out a rational and effective using strategy of antibiotics.
文摘This paper explores one of the underappreciated reasons for lack of efficacy in certain cases of antimicrobial therapy, namely the occurrence of a non-genetic resistance to antimicrobial drugs due to a metabolic quiescence of microorganisms. T</span><span style="font-family:Verdana;">his review has centered on those microorganisms of particular importance in obstetrics and gynecology and accordingly has reviewed the nature and extent of the persister phenotype in relation to infectious agents affecting women’s health. We show how the quiescent persister microbial phenotype represents the next significant issue that could compromise successful antibiotic therapy. A brief history of antimicrobial therapy is provided as context for the problem posed by the persister phenotype. This review has been focused on the current literature having relevance for physicians concerned with women’s health. The study of this phenotype has led to increasing understanding of the molecular mechanisms for this state which also provides ideas for rational development of drug candidates to interdict these organisms in human disease and explores the possibility of developing specifically targeted molecules to address persisters, research on screening botanicals, existing drugs and chemicals to discover novel approaches to the clinical consequence of microbial persisters. Of interest in this review, is the return to naturally occurring botanical substances, first to be used as anti</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">infectives, now being considered as possible agents to address persister microorganisms. Overall this paper aims to provide information tailored especially to the obstetrics and gynecology specialists.
文摘Introduction: The prevalence of </span><i><span style="font-family:Verdana;">Klebsiella pneumoniae</span></i><span style="font-family:Verdana;"> has rapidly increased in recent years and the distribution differed greatly by region, We aimed to study the relationship between antibiotic resistance and </span><i><span style="font-family:Verdana;">K. pneumoniae</span></i><span style="font-family:Verdana;">, especially carbapenem-resistant </span><i><span style="font-family:Verdana;">Klebsiella pneumoniae</span></i><span style="font-family:Verdana;"> (CRKP) in our tertiary hospitals from 2014 to 2018.</span></span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">Methodology: The antibiotic consumption data of </span><i><span style="font-family:Verdana;">K. pneumoniae</span></i><span style="font-family:Verdana;"> were expressed as the defined daily dose (DDD) per 100 inpatient days</span></span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">(DDDs). </span><i><span style="font-family:Verdana;">K. pneumoniae</span></i><span style="font-family:Verdana;"> which isolated from clinical samples in</span><span style="font-family:Verdana;"> hospital between January 2014 and December 2018 were retrospectively analyzed, and the correlation between antibiotic resistance rate and antibiotic frequency was analyzed.</span></span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">Results: From 2014 to 2018, a total of 2295 strains of </span><i><span style="font-family:Verdana;">K. pneumoniae</span></i><span style="font-family:Verdana;"> were isolated, with the detection rates of 8.2%, 9.2%, 11.9%, 13.4% and 14.0%. There were 423 strains of CRKP, with the detection rates of 7.5%, 5.8%, 17</span></span><span style="font-family:Verdana;">.</span><span style="font-family:""><span style="font-family:Verdana;">8% 24.2% and 25.2% respectively. </span><i><span style="font-family:Verdana;">K. pne
文摘An Antimicrobial Stewardship Program (ASP) is established to promote cost effective and safe use of antimicrobial agents. Basically, this approach directs the management of antimicrobials in terms of selection of appropriate drugs, determination of administration routes and standardization of both medication dosage and treatment duration. The program involves, but is not limited to, Hospital Staff Education, Pharmacodynamics Dose Optimization, Computer-Assisted Decision Support Programs, Pharmacist-Driven Intravenous to Oral Switch Programs, Pharmacy Dosing Programs and Antibiotic Cycling. A study was conducted to determine effectiveness of the ASP in significantly improving patient outcomes (e.g. decrease morbidity and mortality from infection). This was undertaken by collecting restrospective data on patient length of hospital stay, bed turnover rate and antibiotic consumption over a period of 2 years since the ASP was initiated. Periodic data were then compared and interpreted based on its clinical, quality and financial implications in order to measure effectiveness of the program implementation.
文摘Many organisms produce small proteins which exhibit antimicrobial activities. In recent decades, the biological role of antimicrobial peptides (AMP) has been recognized as the main factor in the defense mechanisms against a broad range of pathogenic microbes. The increased worldwide incidence of microbial resistance to antibiotics makes AMPs promising alternative for the control of microbial disease. Exploring the potential of AMPs in transgenic crops could lead to the development of new and improved cultivars which are resistant to various economically important diseases. In the present study, two fusion lytic peptide gene constructs coding for antimicrobial peptides were expressed in Nicotiana benthamiana tobacco plants and tested against three fungal pathogens, Sclerotinia sclerotiorum, Rhizoctonia solani, and Pythium sp. Detached-leaf bioassay was employed for the transgenic plants carrying the fusion lytic peptide constructs (ORF13 and RSA1), transgenic vector only control plants (1234), and wild-type control plants (WT) against the three fungal pathogens. Symptom area of each leaf was measured with high accuracy and data were recorded and processed by statistical analyses. The results showed that transgenic plant lines ORF13 and RSL1 have substantial resistance to Sclerotinia sclerotiorum infection, producing significantly smaller lesion areas compared to vector only plant line 1234 and wild type plants. These transgenic lines also provided resistance against Rhizoctonia solani, however, these lines were not effective against the other fungal pathogen Pythium sp.
文摘Background: Many oral bacterial species forming the normal flora present as a biofilm in the oral cavity. Dental caries results when there is an imbalance of pathogenic bacteria within these biofilms. Aim: This study sought to isolate and identify the bacterial species associated with extracted carious teeth and their susceptibility pattern towards commonly employed antimicrobial agents used at the Komfo Anokye Teaching Hospital (KATH). Methodology: A descriptive cross-sectional study carried out on thirty-three extracted carious teeth samples collected by convenient sampling from patients attending the Oral Health Directorate-KATH. All samples were collected from the 11th of March 2019 to the 6th of April 2019. Data was collected using 5 ml peptone water and a case study form. Analysis was done using SPSS version 25 and Microsoft Excel version 10. Results: Twenty (61%) samples were obtained from female patients and thirteen samples (39%) from male patients. Streptococcus spp had the highest occurrence (32.25%) with the least isolated being Pseudomonas and E. coli spp (6.45%). Antibiotic susceptibility test revealed Pseudomonas spp was resistant to all the eight antibiotics used in this study. All bacterial isolates were resistant to Cefuroxime and penicillin except Staphylococcus and Streptococcus spp. Conclusion: The commonest isolates associated with dental caries in KATH were Streptococcus, Bacillus and Staphylococcus spp. In this study most of the isolated species were resistant to common antibiotics employed in the Oral Health Directorate in KATH (amoxicillin/clavulanic, ampicillin and penicillin). From the current study the most effective antibiotic observed was meropenem (23%) with penicillin (3%) being least effective in treating infections of caries.