Resistance Profile of the Isolated Bacterial Stems in Invasive Infections in Three Hospitals in the South-East of Romania

Antimicrobial resistance (AMR) represents a real burden for the modern medicine. One of the most frecvently isolated hospital acquired (HA) pathogens wordlwide, is Methicillin resistant Staphylococcus aureus (MRSA). Recently not only HA, but also community-acquired MRSA (CA-MRSA) infections have been reported. A prospective study was performed between February 2009 and October 2010, with the aim to investigate bacterial resistance of CA-MRSA and HA-MRSA. DNA microarray technology has been used for the detection of 4 AMR genes for the studied MRSA strains. A number of 218 HA- S.aureus strains have been isolated, from which 89 (40. 82%) were MRSA. In the community, 1.553 S.aureus strains were isolated, out of which, 356 (22. 92%) were MRSA. From these, a number of 17 HA and 12 CA �MRSA strains have been analyzed by DNA microarray technology. From 100% phenotypically described HA- MRSA, we identified mecA gene in 10 strains (58. 83%). Other 6 strains (35. 29%) have been erm(A) positive and 4 (23. 53%) - tet(O) positive. 83. 33% (10 strains) from the CA strains had mecA gene, only one (8. 33%) was erm(A) positive and 4 (33. 33%) were erm(C) positive. DNA microarray is a method allowing the concomitant scan of multiple genes and can be done within a few hours. That type of rapid and reliable methods for antimicrobial sensitivity tests are important to start an appropriate therapy.

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confidence: 99%

“…Often, HA-MRSA strains are resistant to many other classes of antimicrobial agents, being described as multidrug-resistant (MDR) or even extensively drugresistant (XDR), due to resistance genes encoded on mobile genetic elements, such as plasmids and transposons [3,4]. The rise of MDR/XDR-MRSA represents a real problem in terms of treatment and control [4,5].…”

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confidence: 99%

Microarray Technology for the Detection of Antimicrobial Resistance Genes Present in Hospital and Community Acquired Methicillin Resistant S.aureus Strains

Licker¹,

Anghel²,

Moldovan³

et al. 2017

“…The positive samples were used to create Gram-stained smears and subcultures to identify and test antibiotic sensitivity. The biochemical identification of the microbial agents was carried out by the means of classic methods, semi-automatic (RapID™) and automatic methods (Vitek2 Compact) [20]. However, the multiplication of the bacteria depends on a series of factors independent of the growth conditions; the density of the infectious agents and the occurrence of certain inhibiting substances in the blood [21,22].…”

Section: Methodsmentioning

confidence: 99%

The Role of Cytokine in the Diagnosis and Monitoring of Patients with Systemic Infections

Iancu¹,

Gurău²,

Dumitru³

et al. 2020

Self Cite

Sepsis is an immunologic disorder with a high rate of mortality which is caused by the exacerbation of the inflammatory response. The purpose of this study was to characterise the etiologic spectrum and the profile of the most significant pro-inflammatory and anti-inflammatory citokines in patients with sistemic infections, by analysing the relationship between the type of etiologic agents and the intensity of the inflammatory response. The study was carried out on a number of 33 patients with systemic infections who were hospitalized in the �Saint Parascheva �Infectious Diseases Clinic Hospital in Galati, Romania. The intensity of the inflammatory response was higher in the sepsis with Gram-negative Bacilli (BGN) as compared to the systemic infections produced by Gram-positive Cocci (CGP). In the case of the patients with bacterial etiology (CGP and BGN) there was evidence of an increase levels of analysed cytokines (TNF-a, IL-1, IL-4, IL-6, IL-10), while the fungal etiology was correlated with high serum concentrations of TNF-a. The levels of IL-4 and IL-6 were similar in all patients with systemic infections, regardless of their etiology. The Klebsiella pneumoniae sepsis has led to the occurrennce of high serum levels both in the case of pro-inflammatory and anti-inflammatory citokines. The obtained results outline the necessity of monitoring pro-inflammatory and anti- inflammatory cytokines in sepsis, which might provide clues about the intensity of the generalized inflammatory reaction, representing not only an important diagnosis criteria but also a useful guide in the therapeutic methods chosen and the monitoring of these severe infections.

“…The associations that require precautions are: oral anticoagulants, phenobarbital, phenytoin, 5-fluorouracil, busulfan, cyclosporine [1]. Metronidazole is usually administrated as tablets for nonsevere forms of illness while the intravenous way of administration is preffered for severe infections such as toxic megacolon [6]. Figure 2, is an intravenous glycopeptide for severe, active infection against grampositive bacteria such as staphylococci, streptococci, enterococci, pneumococci, considered as a reserve antibiotic, the oral form is only indicated in CDI, by the first intention.…”

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confidence: 99%

Comparative Effectiveness of Vancomycin and Metronidazole for the Initial Episode of Nonsevere Clostridium Difficle Infection

Baroiu¹,

Beznea²,

Condratovici³

et al. 2019

The infection with Clostridium difficile (CDI), which appeared at epidemic level, after acquiring the germ of some fluoroquinolone resistance genes, initially considered nosocomial infection and adverse effect post-antibiotic therapy, is affecting more and more people without risk factors and extending into the community. This paper proposes an analysis of the two main antibiotics used in therapy: metronidazole and vancomycin, the evidence of efficacy in the literature and the chemical stability of antibiotics in simulated gastrointestinal fluid. Based on UV-Vis absorption spectra, it can be considered that there are no major changes in the chemical structure of the investigated drugs in the presence of gastro-duodenal conditions. Clinical impact of comparative treatment with metronidazole and vancomycin has also been studied, in a group of 720 CDI patients hospitalized during the period 1.01.2017-31.12.2018 in the Clinical Hospital St. Parascheva of Infectious Diseases Galati. From this group, two subgroups were selected, one of 284 patients receiving oral vancomycin treatment and one group of 62 patients receiving oral metronidazole for an initial nonsevere episode of CDI. The number of days from the beginning of the treatment until the normalization of the stool, the length of hospitalization, the number of days of antibiotic treatment and the percentage of relapses were comparable in the two groups, the percentage of deaths in the first 30 days from the episode of CDI was higher in the vancomycin-treated group, probably due mainly to the severe comorbidities of these patients. The conclusion of the study is that the treatments with metronidazole and vancomycin, of the initial episode, nonsevere of CDI are comparable as a therapeutic response, provided that the patients treated with metronidazole do not associate hepatic, renal or neurological impairment due to the risk of adverse reactions.