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Post-appendectomy pelvic abscess with extended-spectrum beta-lactamase producing Escherichia coli : A case report and review of literature

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World Journal of Clinical Cases 2018年第16期6卷 1175-1181页

作者： Andrew Tse Rajkumar Cheluvappa Selwyn Selvendran Department of Surgery St George Public Hospital St George and Sutherland Clinical School University of New South Wales BN Program Discipline of Nursing and Midwifery University of Canberra

BACKGROUND Appendicitis, the inflammation of the appendix, is the most common abdominal surgical emergency requiring expedient surgical intervention. Extendedspectrum beta-lactamases(ESBLs) are bacterial enzymes that catalyse the degradation of the betalactam ring of penicillins and cephalosporins(but without carbapenemase activity), leading to resistance of these bacteria to beta-lactam antibiotics. Recent increases in incidence of ESBL-producing bacteria have caused alarm worldwide. Proportion estimates of ESBLEnterobacteriaceae hover around 46% in China, 42% in East Africa, 12% in Germany, and 8% in the United *** SUMMARY The impact of ESBL-producing bacteria on appendiceal abscesses and consequent pelvic abscesses are yet to be examined in depth. A literature review using the search words "appendiceal abscesses" and "ESBL Escherichia coli(E. coli)" revealed very few cases involving ESBL E. coli in any capacity in the context of appendiceal abscesses. This report describes the clinical aspects of a patient with appendicitis whodeveloped a postoperative pelvic abscess infected with ESBL-producing E. coli. In this report, we discuss the risk factors for contracting ESBL E. coli infection in appendicitis and post-appendectomy pelvis abscesses. We also discuss our management approach for postappendectomy ESBL E. coli pelvic abscesses, including drainage, pathogen identification, and pathogen characterisation. When ESBL E. coli is confirmed, carbapenem antibiotics should be promptly administered, as was done efficaciously with this patient. Our report is the first one in a developed country involving ESBL E. coli related surgical complications in association with a routine laparoscopic *** Our report is the first involving ESBL E. coli and appendiceal abscesses, and that too consequent to laparoscopic appendectomy.

关键词： Appendectomy Appendiceal abscess Appendicitis beta-Lactam Antibiotic resistance beta-lactamase Carbanepem Cephalosporin Escherichia coli Extended-spectrum beta-lactamase Infection Pelvic abscess Penicillin Case report

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Detection of beta-lactamase and Extended-Spectrum beta-lactamase of Pathogens Isolated from Pig and Chicken and Their Antibiotic Susceptibility Test

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Agricultural Sciences in China 2005年第11期4卷 877-882页

作者： HU Gong-zheng ZHANG Chun-hui YUAN Li YANG Yu-rong LIANG Jun Faculty of Animal Husbandary and Veterinary Science Henan Agricultural University Zhengzhou 450002 P.R.China Zhengzhou College of Animal Husbandary Engineering Zhengzhou 450006 P.R.China

The antibacterial activity of beta-lactam antibiotics or their combinations with inhibitor sulbactum against non-lactamase- producing strains, lactamase-producing and ESBLs-producing isolates was evaluated with twofold dilution method after pathogens isolated from pigs and chickens were detected, respectively, for beta-lactamase and extended-spectrum beta- lactamases （ESBLs）, The results revealed that most of 43 clinically isolated strains could produce beta-lactamase and 3 strains of shigella isolated from chicken samples produced ESBLs. All of 30 lactamase-producing strains isolated and only one of 16 non-lactamase-producing strains were resistant to amoxicillin and ampicillin. MICs of ampicillin against lactamaseproducing isolates decreased 10-40 and 10-20 times respectively, when it was conbined with sulbactam at ration of 1：2 and 1：4. All clinical isolates were susceptible to third-generation cephalosporins. The MICs of third-generation cephalosporins against lactamase-producing isolates did not change when they were conbined with sulbactam. MICs of ceftiofur and ceftriaxone against ESBLs-producing isolates decreased 2-4 times when they were conbined with sulbactam.

关键词： beta-lactamase Extended-spectrum beta-lactamase Inhibitor Antibiotic susceptibility test

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Diagnostic Validity of Cica beta Test 1 for the Detection of Extended Spectrum beta-lactamase (ESBL) Producing Gram Negative Bacteria by Comparing with Phenotypic Method

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Advances in Infectious Diseases 2019年第1期9卷 39-48页

作者： Mostaqimur Rahman Hafiza Sultana Abdullahil Mosawuir Latifa Akhter Abdullah Yusuf Department of Microbiology Rangpur Medical College Rangpur Bangladesh Department of Physiology Rangpur Medical College Rangpur Bangladesh Department of Skin & VD Rangpur Medical College Rangpur Bangladesh Department of Microbiology National Institute of Neuroscience & Hospital Dhaka Bangladesh

Background: Detection of extended spectrum beta lactamase producing bacteria is an important issue in the clinical settings. Objective: The purpose of the present study was to validate the Cica beta Test 1 for detection of extended spectrum beta-lactamase (ESBL) producing bacteria. Method: This analytical type of cross-sectional study was carried out in the Department of Microbiology and Immunology at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from January 2006 to December 2006 for a period of one (01) year. All the patients presented with the clinical features of urinary tract infection and surgical as well as burn wound infection at any age with both sexes were selected as study population. All bacteria were isolated and identified by their colony morphology, staining characters, pigment production, motility and other relevant biochemical tests. Phenotypic confirmation of ESBLs producing isolates were done by inhibitor potentiated disc diffusion test according to CLSI recommendation. The Cica beta Test 1 was performed according to the manufacturer’s instructions. Result: A total number of 288 Gram negative bacteria were isolated. Among these isolates Cica beta test 1 was positive in 97 strains and phenotypic confirmatory test was positive in 89 strains. The test sensitivity of Cica beta Test 1 was 100% (95% CI 95.9% to 100.0%). Specificity of the test was 96.0% (95% CI 92.2% to 98.2%). The positive predictive value (PPV) and negative predictive value (NPV) were 92.7% (95% CI 84.5% to 95.7%) and 100.0% (95% CI 98.0% to 100.0%) respectively. The accuracy of the test was 97.2% (95% CI 95.1% to 99.1%). Area under ROC curve = 0.980 (95% CI 0.964 to 0.996);p value 0.0001. Conclusion: In conclusion, Cica beta Test 1 is very high sensitivity and specificity for the detection of ESBL from Gram negative bacteria.

关键词： Diagnostic Validity Cica beta Test 1 Extended Spectrum beta-lactamase ESBL Gram Negative Bacteria Phenotypic Method

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Prevalence of multi-drug resistant uropathogenic Escherichia coli in Potohar region of Pakistan

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Asian Pacific Journal of Tropical Biomedicine 2016年第1期6卷 60-66页

作者： Ihsan Ali Zara Rafaque Safia Ahmed Sajid Malik Javid Iqbal Dasti Department of Microbiology Qauid-i-Azam University Department of Animal Sciences Qauid-i-Azam University

Objective:To scrutinize patterns of multi-drug-resistant uropathogenic Escherichia coli(UPEC) strains and particularly of fluoroquinolone-resistance this is an alternative choice for the treatment of urinary tract ***:Bacterial samples(n = 250) were collected from out-patients from August 2012 to August 2014 *** susceptibility profiling and determination of minimum inhibitory concentrations(MICs) and minimum bactericidal concentrations were performed according to the guidelines of Clinical and Laboratory Standards Institute(CLSI,2012).Genes,qnrA,qnrB and qnrS were identified by DNA amplification and ***:The highest percentage of UPEC isolates were resistant to co-trimoxazole(82%) followed by cephalothin(80%),2nd Gen,3rd Gen and 4th Gen cephalosporins,*** against gentamicin,amikacin remained 29% and 4%.For other drugs including nitrofurantoin,tetracycline,carbapenem and beta-lactam inhibitors remained below 10%.Altogether,59% of the isolates were resistant to at least three antibiotics including one ***,MICs for ciprofloxacin remained(MIC≥256 μg/mL) and for levofloxacin(MIC≥16 μg/mL and 32 μg/mL).No significant differences were observed regarding MIC values of extended spectrumβ-lactamase(ESBL) and non-ESBL *** qnrS and qnrB positive isolates MICs remained above 32 μg/*** of UPEC was significantly higher among females and 40% of the isolates were ESBL ***:Higher percentages of ESBL producing UPEC were associated with urinary tract ***,the majority of these isolates were multi-drug resistant and fluoroquinolone-resistant.

关键词： Fluoroquinolone-resistant Uropathogenic E.coli Multi-drug resistant Extended spectrum beta-lactamase

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Health care associated infections, antibiotic resistance and clinical outcome: A surveillance study from Sanandaj, Iran

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World Journal of Clinical Cases 2016年第3期4卷 63-70页

作者： Jafar Soltani Bahman Poorabbas Neda Miri Jalal Mardaneh Department of Pediatrics Faculty of Medicine Kurdistan University of Medical Sciences Alborzi Clinical Microbiology Research Center Nemazee Hospital Shiraz University of Medical Sciences Besat Tertiary Hospital Kurdistan University of Medical Sciences

AIM: To study the antibiotic susceptibility patterns of gram-negative healthcare associated bacterial infections at two tertiary hospitals in the Sanandaj city, Kurdistan Province, ***: From January 2012 to December 2012, all positive cultures from potentially sterile body fluids were gathered. They sent to professor Alborzi clinical microbiology center in Shiraz for further analysis and susceptibility testing. The antibiotic susceptibility was determined using the Kirby-Bauer method(disk diffusiontechnique). The Results were interpreted according to Clinical and Laboratory Standards Institute guidelines against a series of antimicrobials. World Health Organization definitions for Healthcare associated infections were ***: Seven hundred and thirty-two positive cultures were reported from both hospitals. Seventynine isolates/patients fulfilled the study criteria for healthcare associated gram-negative infections. The most frequent bacterial cultures were from the pediatric wards(52%). Serratia marcescens(S. marcescens)(38%) Escherichia coli(E. coli)(19%), Klebsiella pneumoniae(K. pneumoniae)(19%), Acinetobacter baumannii(6%), Enterobacter species(6%), Serratia odorifera(4%) and Pseudomonas species(5%) were the most frequently isolated organisms. The susceptibility pattern of common isolates i.e., S. marcescens, E. coli and K. pneumoniae for commonly used antibiotics were as follows: Ampicillin 3.3%, 6.7%, 20%; gentamicin 73.3%, 73.3%, 46.7%; ceftazidim 80%, 73.3%, 33.3%; cefepim 80%, 86.7%, 46.7%; piperacillin/tazobactam 90%, 66.7%, 86.7%; ciprofloxacin 100%, 73.3%, 86.7%; imipenem 100%, 100%, 100%, respectively. CONCLUSION: The most effective antibiotics against gram-negative healthcare associated infections are imipenem followed by ciprofloxacin. The resistance rate is high against ampicillin and cephalothin. The high mortality rate(46.1%) associated with S. marcescens is alarming.

关键词： Escherichia coli Klebsiella pneumoniae Serratia marcescens Extended-spectrum beta-lactamase Nosocomial infections Antibiotic susceptibility

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我国2013-2014年肠杆菌科细菌中blaNDM-1基因流行病学特征

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中华微生物学和免疫学杂志 2017年第2期37卷 125-131页

作者：王珊李耘薛峰刘健张佳宋运佳徐丹吕媛北京大学第一医院临床药理研究所 100191

目的了解我国2013—2014年肠杆菌科细菌中blaNDM-1基因的流行病学特征.方法由中国细菌耐药监测研究从全国19家三甲医院收集2577株肠杆菌科细菌.采用PCR方法筛查肠杆菌科细菌中含blaNDM-1基因的菌株.blaNDM-1基因阳性的菌株用API细菌鉴... 详细信息

目的了解我国2013—2014年肠杆菌科细菌中blaNDM-1基因的流行病学特征.方法由中国细菌耐药监测研究从全国19家三甲医院收集2577株肠杆菌科细菌.采用PCR方法筛查肠杆菌科细菌中含blaNDM-1基因的菌株.blaNDM-1基因阳性的菌株用API细菌鉴定系统及16S rRNA基因测序进行细菌种属鉴定,并用琼脂二倍稀释法测定抗菌药物的最低抑菌浓度（MIC）.用多位点序列测定及脉冲场凝胶电泳检测菌株的同源性.结果在2577株肠杆菌科细菌中筛选出来自8个不同省市的24株blaNDM-1基因阳性菌,分别为11株肺炎克雷伯菌,4株阴沟肠杆菌,3株雷氏普罗维登斯菌,2株大肠埃希菌,2株弗劳地枸橼酸杆菌,1株产酸克雷伯菌和1株粘质沙雷菌,均为多重耐药菌.肺炎克雷伯菌的主要序列型分别为ST17（5株,45.45%）和ST20（3株,27.27%）,且两者分别具有相似的克隆型.PFGE显示来自南京的3株雷氏普罗维登斯菌为同一克隆株.结论2013—2014年肠杆菌科细菌中blaNDM-1基因的检出率为0.93%,与2009—2010年（0%）、2011—2012年（0.32%）结果相比显著升高.其中1株细菌为国内第1株检测到blaNDM-1基因的粘质沙雷菌.本研究产NDM-1细菌多重耐药严重,产NDM-1的肺炎克雷伯菌占主要地位（45.83%）,且有暴发流行趋势,值得重视.

关键词： β-内酰胺酶NDM-1 肠杆菌科细菌流行病学 beta-lactamase NDM-1

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Detection of Extended Spectrum β-lactamase Producing Klebsiella pneumoniae and Escherichia coli in Two Hospitals in the Federal Capital Territory, Abuja, Nigeria

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Open Journal of Medical Microbiology 2013年第4期3卷 207-212页

作者： Bolaji Oluwatosin Akanbi Benjamin Destiny Ojonuba Remi Njoku Department of Biological Sciences University of Abuja Nigeria University of Abuja Teaching Hospital Abuja Nigeria

In this study, the prevalence of Extended Spectrum beta-lactamase (ESBL) producing Klebsiella pneumoniae and Escherichia coli isolates from the University of Abuja Teaching Hospital and the National Hospital was determined. A total of two hundred and fifteen (215) clinical isolates were examined, of which 60% were E. coli and 40% K. pneumoniae respectively. The isolates were collected from various samples namely: Stool, Urine, Pus, High Vagina Swab, Sputum and Wound swab. Out of these isolates, 54 of K. pneumoniae were screened to be ESBL negative and 32 as ESBL positive isolates, while 88 and 40 E. coli were also screened as ESBL negative and ESBL positive isolates respectively. These represent 37.9% of all K. pneumoniae isolates and 31.25% of E. coli isolates respectively. The prevalence of ESBL among the species was not however statistically different (p > 0.05). Multiple resistance in these isolates was common and there is the need for routine screening of ESBL in our hospitals to guide rational and effective use of antibiotics.

关键词： Extended Spectrum beta-lactamase Klebsiella pneumoniae Escherichia coli Nigeria Multidrug Resistance

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beta-Lactam Antibiotic Resistance among <i>Enterobacter</i>spp. Isolated from Infection in Animals

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Advances in Microbiology 2012年第2期2卷 129-137页

作者： Melissa S. Wilberger Kate E. Anthony Sasha Rose Matt McClain Luiz E. Bermudez Department of Biomedical Sciences College of Veterinary Medicine Oregon State University Corvallis USA Department of Biomedical Sciences College of Veterinary Medicine Oregon State University Corvallis USA Department of Microbiology College of Science Oregon State University Corvallis USA Information Technology College of Veterinary Medicine Oregon State University Corvallis USA

Nosocomial infections are frequent complications of hospitalization, caused by opportunistic pathogens that gain access to hosts undergoing invasive procedures, such as surgery, intubation, and placement of deep vein lines. Nosocomial infections in animal hospitals can infect other animals, as well as be transmitted to human personnel. Enterobacter is a genus of common gram-negative bacteria, which can be associated with antibiotic resistant hospital infections. Because of an outbreak in antibiotic resistance in the genus, we decided to investigate five years of Enterobacter infections in the Large Animal Services of the Lois Bates Acheson Veterinary Teaching Hospital (LBAVTH) at Oregon State University. The demographics from 37 Enterobacter-infected patients of the LBAVTH were obtained from charts and analyzed. The identified clusters of infections suggested possible patient-environment sources of infection. The environment of the hospital was sampled in an attempt to determine the source of infection. Although Enterobacter was not isolated, three of the collected samples contained bacteria with resistance to third-generation cephalosporins. Enterobacter isolates from six of the 37 patients were further analyzed for presence of specific ESBL resistance genes. All six of the isolates harbored multiple extended-spectrum beta-lactamase genes, i.e., CTX-M-15, TEM-80, SHV-2 and AmpC. In summary, Enterobacter infection in the veterinary hospital was caused by beta-lactam-resistant strains, carrying ESBL-resistant genes. Veterinary hospital personnel should be aware of the potential for transmission, to both humans and animals, of ESBL-gene-containing bacteria.

关键词： Enterobacter spp. Extended-Spectrum beta-lactamase Cephalosporin Epidemiology Veterinary Medicine

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Prevalence and Resistance Pattern of <i>Pseudomonas aeruginosa</i>Isolated from Surface Water

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Advances in Microbiology 2015年第1期5卷 74-81页

作者： Marufa Nasreen Animesh Sarker M. A. Malek Md. Ansaruzzaman Mahububur Rahman Department of Biotechnology and Genetic Engineering Mawlana Bhashani Science and Technology University Santosh Tangail Bangladesh Department of Microbiology University of Dhaka Dhaka Bangladesh International Centre for Diarrheal Diseases Research Dhaka Bangladesh

Pseudomonas aeruginosa is one of the most common pathogenic bacteria, frequently found in different environmental samples. The prevalence of multidrug resistant isolates has become an alarming concern for both patients and their surroundings. The present study was carried out to record prevalence of P. aeruginosa in surface water of Dhaka city and to screen their antibiotic resistance pattern. The study was also extended to typing of resistant isolates according to extended spectrum beta lactamase production. Hereby, Kirby-Bauer method was applied to test antibiotic sensitivity according to Clinical and Laboratory Standards Institute. Then, the Ampicillin resistant isolates were screened for ESBL production by Double Disk Synergy Test (DDST). In these prospects, 52 water samples were tested, of which 32 were found positive for P. aeruginosa isolates. Hundred percent of the positive isolates were found to Ampicillin (AMP) resistant followed by 93.7% to both Tetracycline and Gentamycin and 71.8% to Co-triimoxazole. P. aeruginosa is completely susceptible to third generation antibiotics ciprofloxacin, Imipenem and Aztreonam followed by moderately susceptible to Polymyxin-B (78.2%) and Colistin (87.5%). According to DDST, all of the susceptible isolates were found positive for AMC type beta-lactamase production. It is evident from this study that the surface water is contaminated with antibiotic resistant P. aeruginosa and that through the water systems antibiotic resistance can be transferred to humans and animals. So, appropriate and rationale use of antibiotic should be applied to minimize the emergence of multidrug isolates to environment.

关键词： P. aeruginosa beta-lactamase DDST Multidrug Resistant

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Distribution of extended-spectrum β-lactamase genes in antibiotic-resistant strains of Pseudomonas aeruginosa obtained from burn patients in Ahvaz, Iran

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Journal of Acute Disease 2019年第2期8卷 53-57页

作者： Saeed Khoshnood Azar Dokht Khosravi Nabi Jomehzadeh Effat Abbasi Montazeri Moloudsadat Motahar Fatemeh Shahi Morteza Saki Sakineh Seyed-Mohammadi Infectious and Tropical Diseases Research Center Health Research InstituteAhvaz Jundishapur University of Medical SciencesAhvazIran Student Research Committee Ahvaz Jundishapur University of Medical SciencesAhvazIran Department of Microbiology Faculty of MedicineAhvaz Jundishapur University of Medical SciencesAhvazIran

Objective: To evaluate the drug susceptibility profiles and the frequency of beta-lactamase encoding genes in Pseudomonas aeruginosa (P. aeruginosa) obtained from burn patients. Methods: Totally 93 non-duplicate clinical isolates of P. aeruginosa were recovered from burn patients of Taleghani Burn Hospital of Ahvaz. Antibiotic susceptibility testing was conducted by disk diffusion method according to the CLSI 2017 recommendations. PCR assay was performed by to find beta-lactamase encoding genes. Results: In this study, most clinical specimen was obtained via wound swabs [65 (69.9%)], followed by blood [14 (15.1%)] and biopsy (7 (7.5%))Forty-two (45.16%) patients were male and 51(54.84%) were female. High resistance was observed for most of antibiotics especially for gentamicin and ciprofloxacin (Up to 85%), whereas the highest susceptibility was reported for colistin (100.0%), followed by ceftazidime (66.7%). According to PCR results, 16.1% (15), 9.7% (9) and 14.0% (13) of isolates carried blaDHA, blaVEB and blaGES genes, respectively. It also revealed that the blaVEB gene was found to coexist within 2 isolates (2.2%). Conclusions: Antibacterial resistance is high among P. aeruginosa isolates. Colistin is highly active against multi-drug resistant P. aeruginosa isolates. Antimicrobial susceptibility testing can confine indiscriminate uses of antibiotics and resistance increase, and can improve management of treatment.

关键词： Pseudomonas aeruginosa Burn patients Drug sensitivity Extended-spectrum beta-lactamase

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