Antimicrobial resistance problem in a university hospital

Kumarasinghe, Gamini; Chow, Chi-Ming; Koh, Bee L.; Chiang, Kok L.; Liew, Hong Y.; Ti, T. Y.

doi:10.1080/00313029500169502

Cited by 12 publications

(11 citation statements)

References 10 publications

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“…The recent SENTRY study on bloodstream infections found that the percentage of K. pneumoniae isolates that were resistant was 87% for penicillins, 14% for cephalosporins, 4% for penems, 5% for aminoglycosides, 4% for fluoroquinolones, 15% for tetracycline, and 15% for trimethoprim-sulfamethoxazole (35). In addition, hospital outbreaks of multiple-drug-resistant K. pneumoniae have been reported (26). As with other pathogens, the spread of resistance in K. pneumoniae requires the discovery and development of novel drug targets.…”

Section: Discussionmentioning

confidence: 99%

Tyrosine Aminotransferase Catalyzes the Final Step of Methionine Recycling in Klebsiella pneumoniae

1999

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An aminotransferase which catalyzes the final step in methionine recycling from methylthioadenosine, the conversion of α-ketomethiobutyrate to methionine, has been purified fromKlebsiella pneumoniae and characterized. The enzyme was found to be a homodimer of 45-kDa subunits, and it catalyzed methionine formation primarily using aromatic amino acids and glutamate as the amino donors. Histidine, leucine, asparagine, and arginine were also functional amino donors but to a lesser extent. The N-terminal amino acid sequence of the enzyme was determined and found to be almost identical to the N-terminal sequence of both the Escherichia coli and Salmonella typhimurium tyrosine aminotransferases (tyrB gene products). The structural gene for the tyrosine aminotransferase was cloned from K. pneumoniae and expressed in E. coli. The deduced amino acid sequence displayed 83, 80, 38, and 34% identity to the tyrosine aminotransferases from E. coli, S. typhimurium, Paracoccus denitrificans, andRhizobium meliloti, respectively, but it showed less than 13% identity to any characterized eukaryotic tyrosine aminotransferase. Structural motifs around key invariant residues placed the K. pneumoniae enzyme within the Ia subfamily of aminotransferases. Kinetic analysis of the aminotransferase showed that reactions of an aromatic amino acid with α-ketomethiobutyrate and of glutamate with α-ketomethiobutyrate proceed as favorably as the well-known reactions of tyrosine with α-ketoglutarate and tyrosine with oxaloacetate normally associated with tyrosine aminotransferases. The aminotransferase was inhibited by the aminooxy compounds canaline and carboxymethoxylamine but not by substrate analogues, such as nitrotyrosine or nitrophenylalanine.

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Section: Discussionmentioning

confidence: 99%

Tyrosine Aminotransferase Catalyzes the Final Step of Methionine Recycling in Klebsiella pneumoniae

1999

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“…Over the 3 years of the study, the percentage of resistance of S. aureus to methicillin ranged from 34% to 46%. 2 The subsequent rates of MRSA isolation in the hospital from all sites and proportions of S. aureus isolates that were resistant to oxacillin or methicillin are charted in Figures 1 and 2.…”

Section: Resultsmentioning

confidence: 99%

Methicillin-resistant Staphylococcus aureus Control at the National University Hospital, Singapore: A Historical Perspective

Pereira

Fisher

2008

Ann Acad Med Singap

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Singapore has a sophisticated healthcare system and is an important referral centre for Asia. Like much of the world, methicillin-resistant Staphylococcus aureus (MRSA) is now endemic across its health system. MRSA infection has been associated with considerable attributable mortality, morbidity plus personal and public cost. Nosocomial infections are potentially preventable and need to be considered an unacceptable complication rather than a tolerable byproduct of healthcare. Failure to introduce long-term sustainable infection control initiatives is not an option for responsible clinical leaders and managers. Control of MRSA transmission in Singapore is achievable but we need to accept the challenge and acknowledge that it will take perhaps a decade. It requires implementation of many varied infection control measures to be rolled out sequentially and across all health services. Our ambition, in Singapore, should be for hospitals to achieve an inpatient prevalence of <1% MRSA colonised patients. Identified transmission of MRSA should be regarded as a serious breech. Successful control will require extraordinary collaboration, support, resources, accountability and consistency of effort. Currently, efforts are evolving significantly and today, we have a good opportunity to embark on this difficult journey. Implementing infection control initiatives successfully over the next few years will save lives in the future. Key words: Colonisation, Infection, Infection control

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“…Antimicrobial resistance is becoming an important public health problem for both hospital and community acquired infections. In the hospital, infections caused by multiply antibiotic resistant pathogens including staphylococci have resulted in increasing morbidity, mortality and cost because of prolonged hospitalization and the use of more expensive antimicrobial agents 3 .…”

Section: Introductionmentioning

confidence: 99%

Untitled

2012

IJPSR

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Staphylococcus aureus (S. aureus) is one of the most serious gram-positive bacteria causing several infections. Because of its intrinsic ability to develop resistance to many antibiotics, nowadays only few drugs can be confidently mentioned for the treatment of S. aureus infections. The study aimed to investigate the antibiotics susceptibility pattern of S. aureus among patients. A cross-sectional study was conducted antibiotic susceptibility pattern of S. aureus among patients. A total of 323 wound and nasal swab specimens were collected and inoculated on mannitol salt agar (Oxoid) and incubated at 37 o C for 18 to 24 hours. For primary cultures with bacterial growth, Gramstaining and specific biochemical tests (catalase and coagulase) were used to identify the study organism. Sensitivity of the isolates to ten commonly used antibiotics was determined by modified Kirby-Bauer antibiotic sensitivity testing method. The isolates were found to be highly resistant to penicillin G and cephalothin (98.8%; each). Chloramphenicol, amoxicillin/clavulanic acid and oxacillin were also resisted by 53.1%, 50.6% and 38.3% of the isolates, respectively. Least resistance was obtained for ciprofloxacin, vancomycin and gentamycin. There was higher S. aureus prevalence for inpatient isolates than outpatients'. The isolates showed high resistance and multidrug resistance pattern to several combinations of the tested antibiotics.

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Antimicrobial resistance problem in a university hospital

Cited by 12 publications

References 10 publications

Tyrosine Aminotransferase Catalyzes the Final Step of Methionine Recycling in Klebsiella pneumoniae

Tyrosine Aminotransferase Catalyzes the Final Step of Methionine Recycling in Klebsiella pneumoniae

Methicillin-resistant Staphylococcus aureus Control at the National University Hospital, Singapore: A Historical Perspective

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