China
Africa
Explore chapters and articles related to this topic
AmpC, Extended-Spectrum β-Lactamase and Carbapenemase Producers
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Chromosomal AmpC producers are generally sensitive to high-dose cefepime, unless other mechanisms of resistance are present, i.e. ESBL production. However, clinical failure with Enterobacter spp. and cefepime may occur if AmpC de-repressed mutants are selected, i.e. in high-inoculum infections. Clinical effectiveness of cefepime against plasmid-mediated AmpC producers is uncertain.
Nosocomial Pneumonia in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
In contrast with other potential “low virulence” pathogens, e.g., Enterobacter sp., Stenotropomonas sp., and Burkholderia sp., P. aeruginosa has a tropism for respiratory tract lining cells and is inherently virulent [3,13,15–17,23]. P. aeruginosa adheres to respiratory tract cells more avidly than other aerobic GNB. While P. aeruginosa is not the most common NP/VAP pathogen, it is the most virulent pulmonary pathogen causing NP/VAP. Accordingly, empiric therapy of NP/VAP should be directed primarily against P. aeruginosa, which also provides coverage against other GNB causes of NP/VAP (Table 17.4).
Microbiological control of raw materials
Published in R. M. Baird, S. F. Bloomfield, Microbial quality assurance in cosmetics, toiletries and non-sterile Pharmaceuticals, 2017
W. McClean (personal communication) found that, of 20 herbal remedies surveyed, only six were considered satisfactory, i.e. had total counts of less than 103 cfu per gram, with no pathogens. The most common pathogens found were Enterobacter spp, which contaminated half of the samples tested. In another study the most common contaminants were moulds (Aspergillus and Pencillium spp) and spore forming aerobic bacteria (Payne 1990, 1993). However, coliforms and other Gram-negatives were also often found, as shown in Table 3.1. The levels of microbial contamination are known to vary from 10 cfu/g to 106 cfu/g (W. McClean personal communication, Hitokoto 1978). This variability may be due to the factors discussed above with regard to the harvesting and storage, or to the non-homogeneity of the sample.
The interplay of gut microbiota between donors and recipients determines the efficacy of fecal microbiota transplantation
Published in Gut Microbes, 2022
Ruiqiao He, Pan Li, Jinfeng Wang, Bota Cui, Faming Zhang, Fangqing Zhao
To elucidate why patients suffering from different diseases exhibited similar enterotype clustering, we first measured the associations between enterotype and different clinical factors in patients, and found no significant difference in IBD patients (chi-square test, p > .2, Supplementary Figure S3), except for the factor “corticosteroids history” (chi-square test, p = .02, Supplementary Figure S3h). It indicates that some medications, like corticosteroids, may contribute to shaping patients’ enterotype as RCPT/B. We next explored the microbiota diversity between the two enterotypes, and found that alpha diversity was significantly lower in RCPT/E than in RCPT/B and healthy donors regardless of disease category (Wilcoxon test, p < .005) (Figure 1f), indicating a much more disturbed microbiota in RCPT/E patients. By exploring the differential abundances of the 14 enterotype-characteristic bacteria conserved across diseases, we found that certain bacteria (e.g. Enterobacter and Citrobacter) tended to be present in the upper gastrointestinal tract, featuring lower pH and higher oxygen levels,37 and they were enriched in RCPT/E instead of RCPT/B (Figure 1g), which have been reported to be associated with diarrheal symptoms.38,39 Taken together, these results illustrate that enterotype-based analyses can be used to characterize and differentiate the gut microbiota of different IBD and CDI patients.
Mortality associated with third generation cephalosporin-resistance in Enterobacteriaceae infections: a multicenter cohort study in Southern China
Published in Expert Review of Anti-infective Therapy, 2021
Jiancong Wang, Mouqing Zhou, Therese Hesketh, Evangelos I. Kritsotakis
Our competing risks analysis also allowed a better understanding of the differential clinical impact of other important factors, such as the site and the origin of the infection. We found that bloodstream infection and, to a lesser degree, lower-respiratory tract infection caused by Enterobacteriaceae were independently and significantly associated with increased risk of in-hospital death (regardless of their resistance profile). By contrast, lower-respiratory tract infection and, to a lesser degree bloodstream infection, were independently associated with increased risk of prolonged hospital stay (though the effect was not statistically significant for the latter). Urinary tract infections had no effect on hospital mortality, but were associated with significantly increased chances of longer hospitalization. Although not explicitly studied, differential effects by site of infection were implied in previous studies on the same topic. For example, Oliveira et al [1] found that a primary site of infection other than UTI was independently associated with all-cause hospital mortality in patients who presented with a 3GCR-EB infection upon hospital admission. Similarly, Kang et al [13] noted that presentation with septic shock and an identified primary site of infection were independent risk factors of 30-day mortality in patients with Enterobacter bacteremia.
Emergence of colistin resistance in Enterobacter aerogenes from Croatia
Published in Journal of Chemotherapy, 2018
Branka Bedenić, Mirna Vranić-Ladavac, Carolina Venditti, Arjana Tambić-Andrašević, Nada Barišić, Marija Gužvinec, Natalie Karčić, Nicola Petrosillo, Ranko Ladavac, Antonino di Caro
Colistin [also known as polymyxin E] is a multi-component polypeptide antibiotic discovered in the 1950s.1 It interacts with lipopolysaccharides and phospholypides present at the surface of the outer membrane and cytoplasmic membrane to disturb membrane permeability. Currently colistin represents the last-resort antibiotic for the treatment of multidrug-resistant Gram-negative infections. Owing to its significant high activity against Gram-negative bacteria including carbapenem-resistant Enterobacteriaceae [CRE] and extended-spectrum ß-lactamases [ESBLs] positive Enterobacteriaceae, colistin is now being administered as a salvage therapy in patients in whom none of other antibiotics are active.1 The emergence of polymyxin-resistant Enterobacteriaceae has been repeatedly reported and is a matter of major concern. Enterobacter aerogenes is a common causative agent of hospital-acquired infections with significant adaptive capability. Its ability to easily acquire resistance to β-lactam antibiotics during therapy is well-known.2 Less frequent are the cases of acquired resistance to colistin.3