Susceptibility evolution to antibiotics of Enterobacter cloacae, Morganella morganii, Klebsiella aerogenes and Citrobacter freundii involved in urinary tract infections: An 11-year epidemiological surveillance study

Jiménez‐Guerra, Gemma; Borrego-Jiménez, Jaime; Gutiérrez-Soto, Blanca; Expósito-Ruíz, Manuela; Navarro-Marí, José María; Gutiérrez‐Fernández, José

doi:10.1016/j.eimce.2019.07.003

Cited by 13 publications

(16 citation statements)

References 13 publications

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“…Self-medication and non-compliance with dosage would also be factors, which could have considerably increased resistance in E. cloacae strains. However, in contrast to the findings of our study, in which the sensitivity to imipenem of the strains was only 20%, the sensitivity was above 80% in their study (12). According to Matsumoto and Muratani (26), imipenem has high antimicrobial activity against fresh urinary isolates such as E. cloacae.…”

Section: Discussioncontrasting

confidence: 93%

“…The World Health Organization (WHO) continues to raise the alarm about the severe handicap of antimicrobial resistance in managing infections such as UTIs. Some evidence shows an increasing resistance to conventional drugs among urinary tract pathogens (11,12). The high rates of resistance to antimicrobials often used to treat common infections such as UTIs indicate the limited number of effective ways to control these infections.…”

Section: Introductionmentioning

confidence: 99%

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Molecular Characterization of Enterobacter cloacae Isolated from Urinary Tract Infections

Dehkordi

Tajbakhsh

Momtaz

2022

Jundishapur J Microbiol

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Background: Urinary tract infections represent a major expensive, common public health problem worldwide due to their high prevalence and the difficulties associated with their management. Objectives: This study aimed to characterize the Enterobacter cloacae strains isolated from urinary tract infections in the medical diagnostic laboratories of Shahrekord, Iran. Methods: Urine samples from patients with urinary tract infections from the Shahrekord medical diagnostic laboratories located in Chaharmahal and Bakhtiari Province, Iran, were collected from June 2019 to February 2020. When the samples were cultured, the different isolates of E. cloacae were identified by biochemical tests. Biofilm production capacity was evaluated. Bacterial susceptibility to antibiotics was determined using the Kirby Bauer method, and antibiotic resistance genes were researched by the multiplex PCR technique. Results: In this study, 65 isolates of E. cloacae were obtained. The highest percentage of resistance was observed for co-trimoxazole (84.62%), ampicillin (76.93%), tetracycline (73.85%), and above half of the E. cloacae strain isolates (53,85%) were strongly involved in biofilm production. Some genes, including qnr A, qnr B, qnr S, tetA, tet B, sul1, bla CTXM, bla SHV, and(2)la, ant(3)la, and aac(3)IIa, were detected in the genome of these isolates. Conclusions: The strains are multi-resistant, and their resistance has already reached the carbapenem class. This requires further investigation, and urgent measures must be adopted.

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Section: Discussioncontrasting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Molecular Characterization of Enterobacter cloacae Isolated from Urinary Tract Infections

Dehkordi

Tajbakhsh

Momtaz

2022

Jundishapur J Microbiol

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“…9 Notably, P. stuartii inherently produces AmpC beta-lactamase, which causes it to be naturally resistant to penicillin and the first-and second-generation cephalosporins. 10 There has been increasing attention to P. stuartii in recent years, as ESBLexpressing and carbapenem-resistant isolates have become more common. [11][12][13] ESBLs are Ambler class A plasmidborne beta-lactamases.…”

Section: Drug Susceptibility Resultsmentioning

confidence: 99%

Clinical and drug resistance characteristics of Providencia stuartii infections in 76 patients

2020

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Objectives To investigate the clinical and drug resistance characteristics of Providencia stuartii infections in the Huainan region of Anhui and provide a reference for the clinical selection of antimicrobial agents. Methods This single-center retrospective analysis included 76 patients with P. stuartii infection in Huainan during the period from October 2018 to March 2020. The hospital department in which the patients were treated and the drug susceptibility characteristics of the P. stuartii isolates were recorded. Results Among the 76 patients, the lung was the most common site of infection, and intensive care unit was the main hospital department. Extended spectrum beta-lactamase screening revealed expression by all 76 isolates of P. stuartii. Of the 76 isolates, 92.1% exhibited multiple drug resistance or extensive drug resistance. P. stuartii isolates were sensitive to cefepime and imipenem, but not to other beta-lactam antibiotics. Twenty isolates were resistant to all 21 types of antibiotics. Of the 20 patients infected with extensively drug-resistant isolates, nine (45%) died. Conclusions Drug resistance is increasing in P. stuartii. The antimicrobial agent imipenem may be effective for treatment of P. stuartii infections. Fluoroquinolones, aminoglycosides, and fourth-generation cephalosporins are suitable options for antibiotic therapy.

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“…The expected profile for AmpC-producing isolates is susceptibility to ERT and FEP and resistance to FOX, and the present isolates were always susceptible to ERT and FEP. The expression of AmpC-type enzymes does not usually confer resistance to carbapenems or 4 th generation cephalosporins [ 27 ] except when the overexpression of these β-lactamases is combined with a reduction in porin number [ 28 , 29 ], when there may be a significant increase in the MIC value of carbapenems such as ERT or imipenem. One isolate was susceptible to FOX in the ChromID ESBL medium but showed resistance in the antibiogram based on microdilution.…”

Section: Discussionmentioning

confidence: 99%

Clinical Relevance of Antibiotic Susceptibility Profiles for Screening Gram-negative Microorganisms Resistant to Beta-Lactam Antibiotics

et al. 2020

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The increasing resistance to antibiotics is compromising the empirical treatment of infections caused by resistant bacteria. Rapid, efficient, and clinically applicable phenotypic methods are needed for their detection. This study examines the phenotypic behavior of β-lactam-resistant Gram-negative bacteria grown on ChromID ESBL medium with ertapenem, cefoxitin, and cefepime disks, reports on the coloration of colonies, and establishes a halo diameter breakpoint for the detection of carbapenemase-producing bacteria. We studied 186 β-lactam-resistant Gram-negative microorganisms (77 with extended spectrum beta lactamase (ESBL), 97 with carbapenemases, and 12 with AmpC β-lactamases (AmpC)). Susceptibility profiles of Gram-negative bacteria that produced ESBL, AmpC, and carbapenemases were similar to the expected profiles, with some differences in the response to cefepime of ESBL-producing microorganisms. Coloration values did not differ from those described by the manufacturer of ChromID ESBL medium. In the screening of carbapenemase production, inhibition halo diameter breakpoints for antibiotic resistance were 18 mm for Enterobacterales and ertapenem, 18 mm for Pseudomonas and cefepime, and 16 mm for Acinetobacter baumannii and cefepime. This innovative phenotypic approach is highly relevant to clinical laboratories, combining susceptibility profiles with detection by coloration of high-priority resistant microorganisms such as carbapenemase-producing A. baumannii, carbapenemase-producing Pseudomonas spp., and ESBL and/or carbapenemase-producing Enterobacterales.

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Susceptibility evolution to antibiotics of Enterobacter cloacae, Morganella morganii, Klebsiella aerogenes and Citrobacter freundii involved in urinary tract infections: An 11-year epidemiological surveillance study

Cited by 13 publications

References 13 publications

Molecular Characterization of Enterobacter cloacae Isolated from Urinary Tract Infections

Molecular Characterization of Enterobacter cloacae Isolated from Urinary Tract Infections

Clinical and drug resistance characteristics of Providencia stuartii infections in 76 patients

Clinical Relevance of Antibiotic Susceptibility Profiles for Screening Gram-negative Microorganisms Resistant to Beta-Lactam Antibiotics

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