Commensal Flora
Firza Alexander Gronthoud in Practical Clinical Microbiology and Infectious Diseases, 2020
Gallstones can lead to biliary stasis, bacterial overgrowth causing cholangitis and cholecystitis and bacterial translocation. Bacteria involved are predominantly Enterobacterales. Nasolacrimal duct obstruction can cause infection of the lacrimal sac, also called dacryocystitis. The main pathogens are S. pneumoniae and S. aureus.
Infection prevention and control
Nicola Neale, Joanne Sale in Developing Practical Nursing Skills, 2022
Enterobacterales are a large family of gram-negative bacteria which includes Escherichia coli, Klebsiella spp. and Enterobacter spp., which usually live harmlessly in the gastrointestinal tract of humans; however, they are also some of the most common cause of urinary tract, abdominal and blood stream infections.
Activity of ceftolozane-tazobactam, ceftazidime-avibactam, meropenem-vaborbactam, cefiderocol and comparators against Gram-negative organisms causing bloodstream infections in Northern Italy (2019–2021): emergence of complex resistance phenotypes
Published in Journal of Chemotherapy, 2022
Gabriele Bianco, Matteo Boattini, Sara Comini, Marco Iannaccone, Roberto Casale, Valeria Allizond, Anna Maria Barbui, Giuliana Banche, Rossana Cavallo, Cristina Costa
Cumulative antimicrobial susceptibility patterns for overall Enterobacterales isolates and for the four more common Enterobacterales species involved in this study were reported in Table 2. Among Enterobacterales isolates, CZA showed potent activity with MIC50/90 of ≤2/≤2 mg/L and achieved 2.6% of resistance. MEM (MIC50/90, ≤0.12/86 mg/L) and AK (MIC50/90, ≤8/≤8 mg/L) achieved resistance rates less than 10% (9.4% and 8.2%, respectively). CTZ (MIC50/90, ≤1/>4 mg/L) showed more activity than TAZ (MIC50/90, ≤8/>16 mg/L) with 14.2% vs. 25.5% of resistance, respectively. Resistance rates higher than 30% were observed for third generation cephalosporins (MIC50/90, ≤1/>32 mg/L), CP (MIC50/90, ≤0.06/>2 mg/L), and SXT (MIC50/90, ≤2/>4 mg/L). Considering the most common Enterobacterales species involved, significant discrepancies were observed in the antimicrobial susceptibility patterns (Table 2). K. pneumoniae achieved the most resistant cumulative antimicrobial susceptibility profile, showing higher percentages for all antimicrobials tested in comparison to E. coli, E. cloacae complex and Serratia marcescens isolates (P < 0.001). All S. marcescens isolates were susceptible to CTZ and CZA as well to all carbapenems.
Treatment of urinary tract infections in the era of antimicrobial resistance and new antimicrobial agents
Published in Postgraduate Medicine, 2020
Mazen S. Bader, Mark Loeb, Daniela Leto, Annie A. Brooks
The prevalence of outpatient UTIs due to ESBLs-Enterobacteriales is increasing [7–9]. Risk factors for UTIs due to ESBLs-Enterobacterales include age, comorbid condition, recent antibiotic exposure, recent hospitalization, and long-term facility residency [34]. Oral treatment options for ESBLs-E coli include nitrofurantoin, fosfomycin, pivmecillinam, amoxicillin-clavulanate, and sitafloxacin. Treatment oral options for ESBL- Klebsiella pneumoniae include pivmecillinam and fosfomycin [5,6]. Unfortunately, the level of resistance of ESBLs Enterobacteriales to trimethoprim-sulfamethoxazole and fluoroquinolones is very high and they have very limited role in the treatment of UTIs due to these organisms [7,35,36]. The role of amoxicillin/clavulanic acid in the treatment of UTIs due to ESBL-Enterobacteriales is very limited due to increasing rates of resistance, limited evidence for its clinical efficacy, and increased rates of drug-related adverse events and antibiotic-associated diarrhea [6,7,29]. However, a combination aztreonam, active on Metallo-β-Lactamase (MBLs) alone, with amoxicillin/clavulanic acid, inhibiting ESBLs if present, is an effective therapeutic option to treat infections caused by MBLs-producing Gram-negative bacteria [37].
Update on the epidemiology of carbapenemases in Latin America and the Caribbean
Published in Expert Review of Anti-infective Therapy, 2021
Juan Carlos García-Betancur, Tobias Manuel Appel, German Esparza, Ana C Gales, Gabriel Levy-Hara, Wanda Cornistein, Silvio Vega, Duilio Nuñez, Luis Cuellar, Luis Bavestrello, Paulo F. Castañeda-Méndez, Juan M. Villalobos-Vindas, María Virginia Villegas
All class A carbapenemases share a serine-residue at their active-site which confers the hydrolytic property to the enzyme. These are chromosomal and plasmid-located β-lactamases with a broad spectrum of hydrolytic activity against β-lactam antibiotics, including carbapenems. Class A carbapenemases are inhibited by new β-lactamase inhibitors such as avibactam and relebactam, while vaborbactam inhibits class A β-lactamases including the KPC-enzymes. Their location in mobile elements, allows them to be transferred and disseminated among a wide range of GNB [20]. These enzymes have predominantly been reported in several members of Enterobacterales, causing severe infections and outbreaks.
Related Knowledge Centers
- Enterobacter
- Enterobacteriaceae
- Escherichia Coli
- Gammaproteobacteria
- Salmonella Enterica
- Yersinia Pestis
- Gram-Negative Bacteria
- Facultative Anaerobic Organism
- Dickeya
- Pectobacterium