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present situation of antimicrobial resistance in korea.resistance of bacteria to antimicrobial agents is a worldwide concern. in korea, resistant bacteria are more prevalent than in other industrialized countries. methicillin-resistant staphylococcus aureus, erythromycin-resistant streptococcus pyogenes, penicillin non-susceptible pneumococci, beta-lactamase-producing gonococci, extended-spectrum beta-lactamase (esbl)-producing escherichia coli and klebsiella pneumoniae, class c beta-lactamase-producing e. coli, fluoroquinolone-resistant e. coli, an ...200011810564
susceptibility to fluoroquinolones among commonly isolated gram-negative bacilli in 2000: trust and tsn data for the united states. tracking resistance in the united states today. the surveillance network.from january to may 2000, as part of the tracking resistance in the united states today (trust) surveillance initiative, clinical isolates of enterobacteriaceae (n=2519) and non-fermentative gram-negatives (n=580) were prospectively collected from 26 hospital laboratories across the united states. isolates were tested for susceptibility to three fluoroquinolones (ciprofloxacin, levofloxacin, gatifloxacin) and seven other agents. in addition, data for the same period were collected from the surve ...200211814764
in vitro activity of moxifloxacin against local bacterial isolates.the emergence of resistance to common antimicrobials in bacteria has been increasingly reported in various countries. empirical antimicrobial therapy of various infections would therefore need to be reviewed. the introduction of new fluoroquinolones has created an interest in the use of these as possible agents in the empirical treatment of respiratory tract infections.200111817288
multicenter surveillance of antimicrobial resistance of major bacterial pathogens in intensive care units in 2000 in taiwan.a susceptibility surveillance study of 1,274 bacterial isolates recovered from various clinical specimens from patients in intensive care units (icus) of five major teaching hospitals was carried out from march, 2000, to june, 2000, in taiwan. this study demonstrated a high rate (66%) of oxacillin resistance in staphylococcus aureus (orsa), a high rate of nonsusceptibility to penicillin (intermediate, 50% and highly resistant, 8%), and high rates of cefotaxime nonsusceptibility for s. pneumoniae ...200111822777
tiamulin activity against fastidious and nonfastidious veterinary and human bacterial isolates: initial development of in vitro susceptibility test methods.tiamulin is a pleuromutilin derivative used in veterinary practice for the control and specific therapy of infections in swine. this report summarizes studies to establish standardized susceptibility testing methods, interpretive criteria, and reagent details for use in veterinary methods recently developed by the national committee for clinical laboratory standards (nccls) (standards m31-a and m37-a, nccls, wayne, pa., 1999). a total of 636 fastidious and nonfastidious animal and human pathogen ...200211825957
evaluation of chlamydia pneumoniae and mycoplasma pneumoniae as etiologic agents of persistent cough in adolescents and adults.chlamydia pneumoniae and mycoplasma pneumoniae were evaluated as agents of persistent cough in adolescents and adults (n = 491). tests of 473 respiratory specimens by culture or pcr or both identified four episodes (0.8%) of m. pneumoniae-associated illness and no episodes of c. pneumoniae illness, suggesting that these bacteria do not frequently cause persistent cough.200211825984
community-acquired bacteremic acinetobacter pneumonia in tropical australia is caused by diverse strains of acinetobacter baumannii, with carriage in the throat in at-risk groups.acinetobacter isolates from eight subjects with community-acquired acinetobacter pneumonia (caap), a major cause of fatal community-acquired pneumonia in tropical australia, were phenotypically and genotypically confirmed by pulsed-field gel electrophoresis analysis to be broadly diverse acinetobacter baumannii strains. wet-season throat carriage of a. baumannii was found in 10% of community residents with excess levels of alcohol consumption, the major at-risk group for caap.200211825997
antimicrobial drug use and resistance in dogs.fifteen years (1984-1998) of records from a veterinary teaching hospital were analyzed to determine whether antimicrobial drug resistance in coagulase-positive staphylococcus spp. (s. aureus, s. intermedius) isolated from clinical infections in dogs has increased, and whether there has been a change in the species of bacteria isolated from urinary tract infections in dogs. in coagulase-positive staphylococcus spp., a complex pattern showing both increases and decreases of resistance to different ...200211842592
environmental contamination by multidrug-resistant acinetobacter baumannii in an intensive care unit.contamination in an intensive care unit caused by multidrug-resistant acinetobacter baumannii complex (mrab)-colonized patients was evaluated using environmental and patient cultures. mrab occurred in 21% of patients' cultures, 2.1% of 513 areas surrounding mrab-patients, and one of 372 common areas. no transmission to other patients occurred. barrier precautions and ethanol disinfection may prevent dissemination.200111842994
carbapenem-resistant acinetobacter and role of curtains in an outbreak in intensive care units.multiple-antibiotic-resistant acinetobacter baumanii, including meropenem resistance, was first isolated from a patient in the general intensive care unit of a tertiary-referral university teaching hospital in birmingham in december 1998. similar strains were subsequently isolated from 12 other patients, including those on another intensive care unit within the hospital. the outbreak followed an increase in the use of meropenem in both the units. environmental screening revealed the presence of ...200211846537
pharmacokinetics and pharmacodynamics of meropenem in critically ill patients.the pharmacokinetics and pharmacodynamics of meropenem were investigated in 14 critically ill patients with sepsis. patients with creatinine clearance (crcl) higher than 50 ml/min received 1 g meropenem three times daily (group i) and patients with crcl lower than 50 ml/min received 1 g meropenem twice daily (group ii). meropenum concentrations in plasma were determined by high performance liquid chromatography with uv detection. the pharmacokinetic parameters differed between the two groups as ...200211850162
topoisomerase ii and iv quinolone resistance-determining regions in stenotrophomonas maltophilia clinical isolates with different levels of quinolone susceptibility.the quinolone resistance-determining regions (qrdrs) of topoisomerase ii and iv genes from stenotrophomonas maltophilia atcc 13637 were sequenced and compared with the corresponding regions of 32 unrelated s. maltophilia clinical strains for which ciprofloxacin mics ranged from 0.1 to 64 microg/ml. gyra (leu-55 to gln-155, escherichia coli numbering), gyrb (met-391 to phe-513), parc (ile-34 to arg-124), and pare (leu-396 to leu-567) fragments from strain atcc 13637 showed high degrees of identit ...200211850246
in vitro activities of bal9141, a novel broad-spectrum pyrrolidinone cephalosporin, against gram-negative nonfermenters.the activities of bal9141 (formerly ro 63-9141), a novel pyrrolidinone-3-ylidenemethyl cephalosporin, against 244 strains of gram-negative nonfermenters were evaluated. the overall mic at which 50% of isolates are inhibited (mic50) and the overall mic90 were 2 and 64 microg/ml, respectively, which are similar to those of imipenem, lower than those of the other cephalosporins tested, amoxicillin, and the ticarcillin-clavulanic acid combination, and much higher than those of ciprofloxacin. bal9141 ...200211850276
activities of polymyxin b and cecropin a-,melittin peptide ca(1-8)m(1-18) against a multiresistant strain of acinetobacter baumannii.polymyxin b (pxb) and the cecropin a-melittin hybrid ca(1-8)m(1-18) (kwklfkkigigavlkvlttglpalis-nh2) were compared for antibiotic activity on reference and multiresistant acinetobacter baumannii strains. significant differences for both peptides were observed on their inner membrane interaction and inhibition by environmental factors, supporting the use of ca(1-8)m(1-18) as a potential alternative to pxb against acinetobacter:200211850277
in vitro activities of tigecycline (gar-936) against recently isolated clinical bacteria in spain.the antimicrobial activities of tigecycline (gar-936) were compared with those of other agents against 1,087 strains recently isolated in 12 spanish medical centers. tigecycline showed activity against a wide spectrum of aerobic and anaerobic bacteria, including strains such as methicillin-resistant staphylococcus aureus, coagulase-negative staphylococci, penicillin-resistant streptococcus pneumoniae, enterococcus faecium, acinetobacter baumannii, and stenotrophomonas maltophilia.200211850282
evaluation of the id 32e for the identification of gram-negative glucose-fermenting and glucose-non-fermenting bacilli.objective: to evaluate the id 32e bacterial identification system for accuracy in the identification of members of the family enterobacteriaceae, pseudomonas aeruginosa, stenotrophomonas maltophilia, and acinetobacter baumannii/iwoffii. methods: stock cultures of 497 enterobacteriaceae and 27 commonly encountered non-enteric gram-negative rods were tested in the id 32e system. for each isolate, the resulting 11-digit profile number was converted to an identification using the apilab plus softwar ...199911856267
the structure of the carbohydrate backbone of the lipopolysaccharide from acinetobacter baumannii strain atcc 19606.the chemical structure of the phosphorylated carbohydrate backbone of the lipopolysaccharide (lps) from acinetobacter baumannii strain atcc 19606 was investigated by chemical analysis and nmr spectroscopy of oligosaccharides obtained after deacylation or mild acid hydrolysis. from the combined information the following carbohydrate backbones can be deduced: where r1 = h and r2 = alpha-glcp-(1-->2)-beta-glcp-(1-->4)-beta-glcp-(1-->4)-beta-glcp-(1 as major and r1 = ac and r2 = h as minor products. ...200211856300
[activity of new fluoroquinolones against clinical isolates of acinetobacter baumannii].acinetobacter baumannii is an opportunistic pathogen associated with numerous nosocomial infections. in recent years it has shown extraordinary ease in developing resistance to most antimicrobial agents, which is a serious problem as it makes these infections difficult to treat. we determined the in vitro activity of eight quinolones, five betalactam agents and colistin in 160 clinical isolates of a. baumannii. in general, we observed a high rate of resistance to the quinolones (90%), excluding ...200111856982
infections in patients requiring ventilation in intensive care: application of a new classification.objective: to classify infections according to the carrier state determined by surveillance cultures of throat and rectum, rather than by the traditional criterion of the time of onset after admission. methods: an observational cohort study of 3 months' duration was performed in a mixed medical---surgical intensive care unit (icu) in a district general hospital of a subset of patients requiring mechanical ventilation for 3 days. surveillance cultures from throat and rectum were obtained on admis ...199811864293
the bactericidal activity of gatifloxacin in plasma and urine.objective: to investigate the bactericidal activity of gatifloxacin in serum and urine against relevant pathogens. methods: serum and urine samples obtained in a single rising dose pharmacokinetic study were investigated for bactericidal activity. the doses employed were placebo, and 200, 400, 600 and 800 mg of gatifloxacin. results: the titers obtained reflected the dose and susceptibility of the pathogen. in serum a titer of greater-than-or-equal1:8 was observed for escherichia coli for >24 h ...199811864354
activity of clinafloxacin, compared with six other quinolones, against acinetobacter baumannii clinical isolates.the in vitro activity of clinafloxacin was studied in comparison with ciprofloxacin, levofloxacin, moxifloxacin, nalidixic acid, sparfloxacin and trovafloxacin against acinetobacter baumannii clinical isolates. clinafloxacin showed a mic(90) of 4 mg/l, whereas the remaining quinolones showed a mic(90) equal to or higher than 16 mg/l. mic(50) determination in the presence of reserpine resulted in a two-fold decrease, except for trovafloxacin, which decreased four-fold, and for moxifloxacin and na ...200211864947
antibiotic resistance among clinical isolates of acinetobacter in the uk, and in vitro evaluation of tigecycline (gar-936).a survey was conducted of the antimicrobial susceptibilities of 595 acinetobacter spp. isolated from routine clinical specimens in 54 sentinel laboratories throughout the uk during 2000. isolates of the acinetobacter baumannii complex (genomic groups 2, 3 and 13tu; n = 443) were distinguished from other genomic groups (n = 152) by pcr fingerprinting of tdna spacer regions. mics of amikacin, cefotaxime, ceftazidime, ciprofloxacin, colistin, gentamicin, imipenem, meropenem, minocycline, piperacill ...200211864948
prospective study of antibacterial susceptibility, risk factors and outcome of 157 episodes of acinetobacter baumannii bacteremia in 1999 in slovakia.this study prospectively investigated all 157 cases of acinetobacter baumannii bacteremia occurring in major university hospitals or tertiary care institutions in slovakia during 1999 in order to determine the antimicrobial susceptibility, risk factors and outcome. resistance to meropenem was 7.4, gentamicin 35.6, amikacin 26.5, cefepime 20.4 and ciprofloxacin 32.7%, but was only 17.3% to cefoperazone/sulbactam or ampicillin/sulbactam. antimicrobial susceptibility of a. baumanii was lowest among ...200111868760
antibiotic policy: a tool for controlling resistance of hospital pathogens.multiresistant gram-negative bacilli, including strains of klebsiella pneumoniae, enterobacter spp, acinetobacter baumannii and pseudomonas aeruginosa, resistant to broad spectrum beta-lactams, aminoglycosides and fluoroquinolones, are recovered at increasing frequency from patients suffering from nosocomial infections, particularly from those receiving intensive care. the emergence and spread of resistant pathogens to endemic and epidemic levels has frequently been related in time and place to ...199911869273
effects of t4 lysozyme release from transgenic potato roots on bacterial rhizosphere communities are negligible relative to natural factors.rhizosphere bacterial communities of two transgenic potato lines which produce t4 lysozyme for protection against bacterial infections were analyzed in comparison to communities of wild-type plants and transgenic controls not harboring the lysozyme gene. rhizosphere samples were taken from young, flowering, and senescent plants at two field sites in three consecutive years. the communities were characterized in a polyphasic approach. cultivation-dependent methods included heterotrophic plate cou ...200211872484
novel pcr-probe assay for detection of and discrimination between legionella pneumophila and other legionella species in clinical samples. 200211880461
[effectiveness of contact isolation in the control of multiresistant bacteria in an intensive care service].to describe the frequency, characteristics and progression of critically ill patients admitted to the icu, for whom isolation is indicated due to detection of multiresistant pathogenic bacteria, and to study the effectiveness of precautionary measures to avoid dissemination of these microorganisms.200211886673
apoptotic cell death induced by acinetobacter baumannii in epithelial cells through caspase-3 activation.epithelial cell death induced by acinetobacter baumannii infection was investigated using in vitro assays. eight hours after live a. baumannii infection, hela cells exhibited detachment from the dish, rounding morphologies, high proportions of trypan blue-positive cells and extensive dna breakdown with faint apoptotic banding, which is indicative of cells undergoing apoptosis. the enzymatic activity of caspase-3 was increased in cells as early as 2 h after infection. in addition, apoptosis of he ...200111890571
antimicrobial resistance in gram-negative isolates from european intensive care units: data from the meropenem yearly susceptibility test information collection (mystic) programme.susceptibility data were collected for 6243 gram-negative isolates from 29 european icus participating in the meropenem yearly susceptibility test information collection (mystic) programme (1997-2000). the most commonly isolated bacteria were pseudomonas aeruginosa (22.5%), escherichia coli (19.8%), klebsiella pneumoniae (10.4%), and enterobacter cloacae (7.7%). the incidence of extended-spectrum beta-lactamase-producers was higher in turkish, russian and italian icus (27.9-39.6%) than in other ...200211892895
the cost of antibiotic resistance: effect of resistance among staphylococcus aureus, klebsiella pneumoniae, acinetobacter baumannii, and pseudmonas aeruginosa on length of hospital stay.to assess the effect of antimicrobial resistance on length of hospital stay, a case-control study compared infections due to four nosocomial pathogens. significantly increased lengths of stay were associated with infections due to methicillin-resistant staphylococcus aureus, extended-spectrum beta-lactamase-producing klebsiella pneumoniae, and carbapenem-resistant acinetobacter baumannii or pseudomonas aeruginosa. infections with resistant pathogens are associated with prolonged hospitalization.200211893146
current status of antimicrobial resistance in taiwan.while some trends in antimicrobial resistance rates are universal, others appear to be unique for specific regions. in taiwan, the strikingly high prevalence of resistance to macrolides and streptogramin in clinical isolates of gram-positive bacteria correlates with the widespread use of these agents in the medical and farming communities, respectively. the relatively low rate of enterococci that are resistant to glycopeptide does not parallel the high use of glycopeptides and extended-spectrum ...200211897063
bla(vim-2) cassette-containing novel integrons in metallo-beta-lactamase-producing pseudomonas aeruginosa and pseudomonas putida isolates disseminated in a korean hospital.we investigated the phenotypic and genetic properties of metallo-beta-lactamase-producing pseudomonas isolates collected at a tertiary-care hospital in korea since 1995. the prevalence of imipenem resistance among pseudomonas aeruginosa isolates reached 16% in 1997, when 9% of the resistant organisms were found to produce vim-2 beta-lactamase, a class b enzyme previously found only in p. aeruginosa isolates from europe. vim-2-producing isolates of pseudomonas putida were also detected. resistanc ...200211897589
effect of an efflux pump inhibitor on the mic of nalidixic acid for acinetobacter baumannii and stenotrophomonas maltophilia clinical isolates. 200211909848
how many nosocomial infections are associated with cross-transmission? a prospective cohort study in a surgical intensive care unit.to determine the percentage of cross-transmissions in an intensive care unit (icu) with high nosocomial infection (ni) rates according to the data of the german nosocomial infection surveillance system.200211918116
recent developments in carbapenems.carbapenems are beta-lactam antibiotics characterised by the presence of a beta-lactam ring with a carbon instead of sulfone in the 4-position of the thyazolidinic moiety. the first carbapenem to be utilised in therapy was imipenem, the n-formimidoyl derivative of thienamycin. imipenem is coadministered with cilastatin, an inhibitor of human renal dehydropeptidase i, as imipenem is hydrolysed by this enzyme. meropenem was the first carbapenem with a 1-beta-methyl group and 2-thio pyrrolidinyl mo ...200211922861
community-acquired acinetobacter baumannii bacteremia in adult patients in taiwan.we determined the clinical and microbiologic characteristics of community-acquired acinetobacter baumannii bacteremia in 19 adult patients. we found that malignancy was the most frequent underlying disease. the overall mortality rate was 58%. all 14 available isolates were identified as genomic species 2 (a. baumannii) by 16s ribosomal dna sequencing and were found to be genetically distinct by pulsed-field gel electrophoresis.200211923388
nontraditional dosing of ampicillin-sulbactam for multidrug-resistant acinetobacter baumannii meningitis.a 52-year-old man was admitted to a local hospital with headache, nausea, vomiting, dizziness, photophobia, and confusion after a sudden fall. progressive changes in neurologic function were noted despite neurosurgical intervention and broad-spectrum antimicrobial coverage. cerebral spinal fluid (csf) culture identified acinetobacter baumannii that was resistant to traditionally recommended therapies of amikacin and imipenem-cilastatin. the organism demonstrated minimum inhibitory concentrations ...200211939689
gastritis and hypergastrinemia due to acinetobacter lwoffii in mice.in mouse models and humans, helicobacter pylori is associated with an increase in serum gastrin and gastrin-expressing (g) cells with a concomitant decrease in somatostatin-expressing d cells. inflammation of the gastric mucosa can progress to metaplastic changes in the stomach and to decreased colonization by h. pylori and increased colonization by non-h. pylori organisms. in addition, about 20% of individuals with chronic gastritis are h. pylori negative, suggesting that other organisms may in ...200211953405
cerebrospinal fluid penetration and pharmacokinetic/pharmacodynamic parameters of intravenously administered colistin in a case of multidrug-resistant acinetobacter baumannii meningitis.described here is a case of meningitis caused by multidrug-resistant acinetobacter baumannii susceptible only to colistin, which was treated successfully with intravenous colistin sulfomethate sodium (5 mg/kg/day). the levels of colistin in serum and cerebrospinal fluid and the pharmacokinetic/pharmacodynamic parameters of colistin were determined. in this case, intravenously administered colistin penetrated cerebrospinal fluid (25% of serum levels) at levels sustaining bactericidal concentratio ...200211957024
origin and evolution of the ampc beta-lactamases of citrobacter freundii.to determine whether the widespread clinical use of beta-lactams has been selective for citrobacter freundii-derived alleles of plasmid ampc genes, we generated a bayesian consensus phylogeny of the published ampc sequences and compared the mics of 16 beta-lactam antibiotics for escherichia coli strains containing cloned copies of the c. freundii ampc alleles. we found that for the majority of compounds investigated, there has been essentially no increase in beta-lactam resistance conferred by t ...200211959544
characterization and movement of the class 1 integron known as tn2521 and tn1405.two putative transposons, tn2521 and tn1405, carrying determinants for the pse-4 beta-lactamase and for resistance to streptomycin, spectinomycin, and sulfonamides were previously isolated from the chromosome of pseudomonas aeruginosa dalgleish. detailed mapping and determination of the complete sequence of tn2521 revealed that it is a class 1 integron, here renamed in33, with a backbone structure identical to that of in4 from tn1696. in33 contains two gene cassettes, blap1 and aada1, replacing ...200211959558
[monitoring the incidence of multidrug-resistant bacteria in microbiology laboratories using bacterio software].since 1997, the microbiology laboratory of the hospital center in lens has monitored hospital ecology and epidemiology to provide rapid information that help to adapt probabilistic antibiotherapy and to estimate the impact of hygienic preventive measures on the incidence of multidrug-resistant bacteria (mrb).200211963375
candida dubliniensis infection, singapore. 200211971784
[post-marketing surveillance of antibacterial activities of cefozopran against various clinical isolates--ii. gram-negative bacteria].as a post-marketing surveillance, the in vitro antibacterial activities of cefozopran (czop), an agent of cephems, against various clinical isolates were yearly evaluated and compared with those of other cephems, oxacephems, penicillins, monobactams, and carbapenems. changes in czop susceptibility for the bacteria were also evaluated with the bacterial resistance ratio calculated with the breakpoint mic. twenty-five species (3,362 strains) of gram-negative bacteria were isolated from the clinica ...200211977920
corneal ulcer of the side port after phacoemulsification induced by acinetobacter baumannii.a 75-year-old man had clear corneal phacoemulsification using a temporal approach in the left eye. two months after surgery, a focal corneal epithelial defect developed with infiltration near the lower limbus on the site of the side-port incision. the culture of corneal scrapping grew acinetobacter baumannii, which is resistant to most ordinary antibiotics in sensitivity tests. after appropriate antibiotic treatment, the ulcer healed gradually with vessel ingrowth. acinetobacter baumannii is usu ...200211978475
[prevalance of nosocomial infections in tetraplegic upper extremity surgery. prospective study of twenty patients].many risk factors of nosocomial infection may be met with tetraplegic patients. the objective of this work was to study the prevalence of colonization by 3 multiresistants bacteria (methicillin resistant staphylococcus aureus (mrsa), klebsiella pneumoniae with widened spectrum beta lactamase or multi-resistant acinetobacter baumannii) on this population.200211980347
pro/con clinical debate: the use of a protected specimen brush in the diagnosis of ventilator associated pneumonia.although mechanical ventilation is instituted as a life-saving technique, it may lead to complications that can negatively impact on patients' morbidity and/or mortality. ventilator associated pneumonia (vap) is one such complication that is a common challenge to intensivists. although most experts would agree that early 'appropriate' antibiotic use is essential in patients who develop vap, the best diagnostic test to guide decision-making is far from clear. one diagnostic test that is capable o ...200211983035
molecular characterization of metallo-beta-lactamase-producing acinetobacter baumannii and acinetobacter genomospecies 3 from korea: identification of two new integrons carrying the bla(vim-2) gene cassettes.carbapenem-resistant acinetobacter spp. used to be rare, but are increasingly isolated in korea. among 28 isolates of imipenem-resistant acinetobacter spp. found in a korean hospital in 1998 and 1999, 14 produced metallo-beta-lactamases. the bla(vim-2) gene was detected, by pcr, in 11 and two isolates of acinetobacter baumannii and acinetobacter genomospecies 3, respectively, and bla(imp-1) in one isolate of a. baumannii. the mics of imipenem for the isolates were 8-32 mg/l. pfge analysis of sma ...200212003980
comparative studies of the acinetobacter genus and the species identification method based on the reca sequences.the reca gene is indispensable for a maintaining and diversification of the bacterial genetic material. given its important role in ensuring cell viability, it is not surprising that the reca protein is both ubiquitous and well conserved among a range of prokaryotes. previously, we reported acinetobacter genomic species identification method based on pcr amplification of an internal fragment of the reca gene with subsequent restriction analysis (rflp) with hinfi and mboi enzymes. in present stud ...200212005442
[incidence of colonization and infection by acinetobacter baumannii in an endemic seting (icu). analysis of risk factors by means of a surveillance study].our icu has witnessed a gradual increase in infections due to acinetobacter baumannii complex that has reached a level of stable endemia since 1995. this situation, aggravated by a high degree of resistance, has led to the present prospective study, designed to establish the incidence of acinetobacter colonization and to investigate the role of risk factors and their relation to environmental colonization.200212006255
molecular epidemiology of nosocomial infection associated with multi-resistant acinetobacter baumannii by infrequent-restriction-site pcr.acinetobacter baumannii was considered endemic in a university-affiliated tertiary hospital. a significant increase was noted in the proportion of nosocomial infections associated with this micro-organism from 1996 to 1999, although no apparent clusters could be found. between july 1998 and february 2000, 58 nosocomial isolates of a. baumannii were collected and characterized by antibiotyping and a genotyping method, infrequent-restriction-site pcr (irs-pcr). high resistance to the 14 antimicrob ...200212009817
hospital-acquired infections following the 1999 marmara earthquake.in this study, medical records of all casualties admitted to our hospital following the marmara earthquake, which struck northwest turkey and resulted in the destruction of several towns in the marmara region, were evaluated retrospectively. the time buried under the rubble, demographic data, type of medical and surgical therapies performed, type of injury and data on infection were analysed. between 17 august and 25 september 1999, 630 trauma victims were received at our hospital and 532 (84%) ...200212009820
3: community-acquired pneumonia.community-acquired pneumonia is caused by a range of organisms, most commonly streptococcus pneumoniae, mycoplasma pneumoniae, chlamydia pneumoniae and respiratory viruses. chest x-ray is required for diagnosis. a risk score based on patient age, coexisting illness, physical signs and results of investigations can aid management decisions. patients at low risk can usually be managed with oral antibiotics at home, while those at higher risk should be further assessed, and may need admission to ho ...200212013330
activity of novispirin g10 against pseudomonas aeruginosa in vitro and in infected burns.the emergence of multidrug-resistant microbes has serious implications for managing infection and sepsis and has stimulated efforts to develop alternative treatments, such as antimicrobial peptides. the objective of this study was to test a designer peptide, novispirin g10, against multidrug-resistant microorganisms. by two-stage radial diffusion assays, its activity against such organisms compared favorably with that of standard antibiotics and other antimicrobial peptides. it killed bacteria v ...200212019098
efficacy of colistin versus beta-lactams, aminoglycosides, and rifampin as monotherapy in a mouse model of pneumonia caused by multiresistant acinetobacter baumannii.the treatment of life-threatening infections due to carbapenem-resistant acinetobacter baumannii has become a serious challenge for physicians worldwide. often, only colistin shows in general good in vitro activity against these carbapenem-resistant strains, but its antibacterial efficacy in comparison with the antibiotics most used in clinical practice is not well known. we studied the efficacy of colistin versus those of imipenem, sulbactam, tobramycin, and rifampin in an experimental pneumoni ...200212019113
chromosome-encoded class d beta-lactamase oxa-23 in proteus mirabilis.ten nonrepetitive proteus mirabilis isolates, which were collected over 4 years (1996 to 1999) at the teaching hospital of clermont-ferrand, france, produced class d carbapenemase oxa-23. mics of imipenem were 0.25 to 0.5 microg/ml for these clinical isolates. molecular typing revealed that the 10 p. mirabilis isolates originated from the same clonal strain. hybridization of i-ceui-generated chromosome fragments with a bla(oxa-23) probe showed that the gene was chromosome encoded in the p. mirab ...200212019126
an outbreak due to multiresistant acinetobacter baumannii in a burn unit: risk factors for acquisition and management.to describe the investigation and management of an outbreak due to multiresistant acinetobacter baumannii and to determine risk factors for acquisition of the organism.200212026151
effects of antibiotics on protected specimen brush sampling in ventilator-associated pneumonia.the effects of antibiotic treatment on the results of protected specimen brushing (psb) in ventilator-associated pneumonia were prospectively assessed by performing this procedure before antibiotic treatment, and 12, 24, 48 and 72 h after initiation of antibiotic treatment, in 35 ventilated patients who developed pneumonia during mechanical ventilation. the number of micro-organisms isolated, their concentration (colony-forming units (cfu) ml(-1)), and the number of cases with a positive psb (> ...200212030737
characterization of unusual bacteria isolated from respiratory secretions of cystic fibrosis patients and description of inquilinus limosus gen. nov., sp. nov.using a polyphasic approach (including cellular protein and fatty acid analysis, biochemical characterization, 16s ribosomal dna sequencing, and dna-dna hybridizations), we characterized 51 bacterial isolates recovered from respiratory secretions of cystic fibrosis (cf) patients. our analyses showed that 24 isolates belong to taxa that have so far not (or only rarely) been reported from cf patients. these taxa include acinetobacter sp., bordetella hinzii, burkholderia fungorum, comamonas testost ...200212037065
pulmonary infiltrates in immunosuppressed patients: analysis of a diagnostic protocol.a diagnostic protocol was started to study the etiology of pulmonary infiltrates in immunosuppressed patients. the diagnostic yields of the different techniques were analyzed, with special emphasis on the importance of the sample quality and the role of rapid techniques in the diagnostic strategy. in total, 241 patients with newly developed pulmonary infiltrates within a period of 19 months were included. noninvasive or invasive evaluation was performed according to the characteristics of the in ...200212037077
[etiology of hospital-acquired infections in spanish hospitals (epine, 1990-1999)].clinical and demographic characteristics of patients, their interaction with pathogens and antimicrobial therapies are prompting changes in the epidemiology of hospital-acquired infections (hi). the knowledge of the etiology of hospital-acquired infections is valuable for the treatment of infected patients and for the prevention of hi.patients and method: we analyzed a series of 10 annual prevalence studies during the period 1990-1999 (epine project) in spanish hospitals. estimate of prevalence ...200212049704
multi-resistant acinetobacter baumannii on a burns unit--clinical risk factors and prognosis.burns patients are highly susceptible to infection, and preventing and treating infection are integral to the successful management of severe burns.multi-resistant acinetobacter baumannii (mr-ab) strains are becoming increasingly important in nosocomial infections. we conducted a retrospective study of all adult admissions to the singapore general hospital (sgh) national burns center over an 18-month period. the only independent risk factors for the acquisition of mr-ab were the apache ii score ...200212052373
pneumonia in multiple injured patients: a prospective controlled trial on early prediction using clinical and immunological parameters.in a prospective trial 266 multiple injured patients were included to evaluate clinical risk factors and immune parameters related to pneumonia.200212056515
blactx-m-2 is located in an unusual class 1 integron (in35) which includes orf513.examination of the bla(ctx-m-2) gene in plasmid pmar-12 by sequencing and pcr analysis revealed that the bla gene and the surrounding dna, which is closely related (99% homology) to the kluyvera ascorbata chromosomal dna that contains the bla(klua-1) gene, are located in a complex sul1-type integron, termed in35, that includes orf513. it is possible that bla(ctx-m-2) was acquired by plasmid pmar-12 through an uncharacterized recombinational event in which orf513 could be involved.200212069995
epidemic acinetobacter baumannii strain with mrsa-like behaviour carried by healthcare staff. 200212072949
a multi-resistant acinetobacter baumannii outbreak in a general intensive care unit.in an intensive care unit, three patients were found infected and two colonized with multiresistant acinetobacter baumannii within a period of one week. to identify the outbreak source, two surveillance studies were performed concerning patients and the environment. genotyping of isolates was performed by random amplification of polymorphic dna analysis (rapd). environmental sampling failed to yield a. baumannii, with the exception of a single sample from a trunking. rapd-fingerprinting yielded ...200212073770
epidemiological typing and prevalence of integrons in multiresistant acinetobacter strains.seventy-seven acinetobacter isolates were recovered from patients in a korean hospital during the period from november to december 1998. the isolates were genotyped using randomly amplified polymorphic dna (rapd) analysis for epidemiological relationship, and investigated for antibiotic susceptibility and presence of integrons. sixty-nine acinetobacter baumannii isolates were distributed into five groups by rapd profiles, with 5, 1, 60, 2 and 1 in each group. the major rapd group of 60 isolates ...200212076278
emerging carbapenemases in gram-negative aerobes.carbapenemases may be defined as beta-lactamases that significantly hydrolyze at least imipenem or/and meropenem. carbapenemases involved in acquired resistance are of ambler molecular classes a, b, and d. class a, clavulanic acid-inhibited carbapenemases are rare. they are either chromosomally encoded (nmc-a, sme-1 to sme-3, imi-1) in enterobacter cloacae and serratia marcescens, or plasmid encoded, such as kpc-1 in klebsiella pneumoniae and ges-2 in pseudomonas aeruginosa, the latter being a p ...200212084099
[interpretative reading of the non-fermenting gram-negative bacilli antibiogram].among non-fermenting gram-negative rods, the most clinically important species are pseudomonas aeruginosa, acinetobacter baumannii, and stenotrophomonas maltophilia, which are frequently multiresistant. p. aeruginosa resistance to beta-lactams depends on the production of chromosomal and plasmid-mediated beta-lactamases, altered permeability (loss of oprd porin is related to carbapenem-resistance) and active efflux pumps, particularly mexab-oprm. in aminoglycoside-resistant strains the main mech ...200212084355
plant-dependent genotypic and phenotypic diversity of antagonistic rhizobacteria isolated from different verticillium host plants.to study the effect of plant species on the abundance and diversity of bacterial antagonists, the abundance, the phenotypic diversity, and the genotypic diversity of rhizobacteria isolated from potato, oilseed rape, and strawberry and from bulk soil which showed antagonistic activity towards the soilborne pathogen verticillium dahliae kleb. were analyzed. rhizosphere and soil samples were taken five times over two growing seasons in 1998 and 1999 from a randomized field trial. bacterial isolates ...200212089011
outbreak of a susceptible strain of acinetobacter species 13 (sensu tjernberg and ursing) in an adult neurosurgical intensive care unit.between december 1999 and june 2000, an outbreak caused by acinetobacter emerged on the neurosurgical intensive care unit of our hospital. it was shown using automated ribotyping using eco ri and pulsed-field gel electrophoresis that the outbreak was caused by spread of a single strain, which was identified by ribotyping and amplified ribosomal dna restriction analysis as acinetobacter dna group 13tu (sensu tjernberg and ursing). the outbreak strain, which showed no antibiotic resistance, was id ...200212090795
antibiotic resistance as an indicator of bacterial chlorhexidine susceptibility.the antibiotic and chlorhexidine (chx) susceptibility of 70 distinct clinical isolates: escherichia coli, klebsiella pneumoniae, pseudomonas aeruginosa, acinetobacter baumannii, staphylococcus aureus (not mrsa), streptococcus pyogenes and enterococcus faecalis (10 of each) were tested using minimal bactericidal (mbc) and/or minimal inhibitory (mic) concentrations. non-fermentative bacteria tolerated chx at high concentrations; gram-positive cocci, especially s. pyogenes, were the most susceptibl ...200212090797
citywide clonal outbreak of multiresistant acinetobacter baumannii and pseudomonas aeruginosa in brooklyn, ny: the preantibiotic era has returned.carbapenems are important agents for treating nosocomial gram-negative infections. carbapenem-resistant bacteria have become increasingly problematic in certain regions. this study determined the citywide prevalence and molecular epidemiological features of carbapenem-resistant acinetobacter baumannii and pseudomonas aeruginosa in brooklyn, ny.200212090889
ruptured mycotic aneurysm of the iliac artery complicated by emphysematous psoas muscle abscess: report of two cases.emphysematous psoas muscle abscess has rarely been described and has not been reported to be associated with ruptured mycotic aneurysm. we report two cases of ruptured mycotic iliac arterial aneurysm complicated by emphysematous abscess of the left psoas muscle. case 1 occurred in a 70-year-old man and case 2 in a 63-year-old woman. both patients presented with fever for several weeks. clinical clues leading to the diagnosis included a palpable abdominal mass with (case 2) or without (case 1) pu ...200212099206
peritonitis in acute peritoneal dialysis in a university hospital.although acute peritoneal dialysis is a useful procedure, peritonitis is often a complication. when the patient is mainly at risk of peritonitis is controversial. the purpose of this study was to find the incidence time of peritonitis, the infecting microorganism, and risk factors.200212118495
comparative in-vitro activities of ertapenem against aerobic bacterial pathogens isolated from patients with complicated intra-abdominal infections.the in vitro activities of ertapenem, ceftriaxone, amoxicillin-clavulanate, ampicillin-sulbactam, and piperacillin-tazobactam were compared against 1018 aerobic bacterial pathogens isolated from 531 patients with complicated intra-abdominal infection. enterobacteriaceae accounted for 66.3% of the aerobic bacteria; escherichia coli was the most common isolate. the ertapenem minimal inhibitory concentration was < or = 2 microg/ml for 74.6% of isolates and > or = 8 microg/ml for 21.9% (including is ...200212120874
in-vitro activity of clinafloxacin compared to ciprofloxacin against acinetobacter baumannii strains isolated from intensive care unit patients.the activity of clinafloxacin was compared to that of ciprofloxacin against 154 acinetobacter baumannii strains isolated from patients treated in intensive care units. minimum inhibitory concentrations (mics) were determined by the epsilometer test method. the majority (87.6%) of the a. baumannii strains tested were resistant to ciprofloxacin (mic range 0.125->32, mic50 = >32, mic90 = >32). on the contrary, only 9.7% of the strains tested were resistant to clinafloxacin (mic range 0.023->4, mic5 ...200212120875
community-acquired bacterial meningitis in adults: the epidemiology, timing of appropriate antimicrobial therapy, and prognostic factors.between january 1986 and december 1999, 109 adult patients with culture-proven community-acquired bacterial meningitis were identified at kaohsiung chang gung memorial hospital. to compare changes over time, the appearance of disease among our patients was divided into two equal time periods: an earlier time period (1986-1992) and a later time period (1993-1999). in this study, there was a decreasing proportion of community-acquired bacterial meningitis compared with nosocomial bacterial meningi ...200212140104
pandrug-resistant acinetobacter baumannii causing nosocomial infections in a university hospital, taiwan.the rapid emergence (from 0% before 1998 to 6.5% in 2000) of pandrug-resistant acinetobacter baumannii (pdrab) was noted in a university hospital in taiwan. to understand the epidemiology of these isolates, we studied 203 pdrab isolates, taken from january 1999 to april 2000: 199 from 73 hospitalized patients treated at different clinical settings in the hospital and 4 from environmental sites in an intensive-care unit. pulsed-field gel electrophoresis analysis and random amplified polymorphic d ...200212141969
association between intensity of chlorhexidine use and micro-organisms of reduced susceptibility in a hospital environment.the potential for emergence of resistance to biocides has been a concern in recent years. this study tested whether an association exists between the intensity of chlorhexidine use and chlorhexidine susceptibility of micro-organisms isolated from patients in different clinical areas in an acute-care general hospital. organisms frequently involved in nosocomial infections in the hospital were chosen for study over a six week period: staphylococcus aureus (60 isolates), coagulase-negative staphylo ...200212144799
evaluation of a new etest for detecting metallo-beta-lactamases in routine clinical testing.several etest (ab biodisk, solna, sweden) gradient formats were developed for detection of metallo-beta-lactamases based on the reduction of imipenem (ip) or ceftazidime (tz) mics in the presence of edta or 2-mercaptopropionic acid (mpa). the etest metallo-beta-lactamase (etest mbl) strips consisted of a double-sided seven-dilution range of ip or tz (4 to 256 microg/ml) and ip or tz (1 to 64 microg/ml) overlaid with a constant concentration of edta or mpa. the prototype strips were evaluated on ...200212149325
genotyping of methicillin-resistant staphylococcus aureus by assaying for the presence of variable elements associated with meca.the region surrounding meca in methicillin-resistant staphylococcus aureus (mrsa) is highly variable. we describe an approach for the rapid genotyping of mrsa by assaying for the presence or absence of variable or mobile elements previously shown to be associated with the meca region.200212149390
distribution of beta-lactamases in acinetobacter baumannii clinical isolates and the effect of syn 2190 (ampc inhibitor) on the mics of different beta-lactam antibiotics.the distribution of beta-lactamases in a group of 20 epidemiologically well defined acinetobacter baumannii clinical isolates and the in vitro activity of syn 2190, a novel beta-lactamase ampc inhibitor, were determined. twenty-five per cent of the strains carried and expressed a tem-type beta-lactamase, whereas 35% had an oxa-type beta-lactamase. in nine out of 11 (82%) ceftazidime-resistant and four out of 13 (30.7%) cefepime-resistant strains, the mic of these beta-lactam antibiotics decrease ...200212161409
the resistance mechanisms of b-lactam antimicrobials in clinical isolates of acinetobacter baumannii.despite increasing importance of acinetobacter baumannii in nosocomial infections and rapid development of multi-antimicrobial resistance in this strain, the resistance mechanisms of beta-lactam antimicrobials in a. baumannii were not clearly defined. in order to observe the resistance mechanisms against beta-lactams and carbapenem, we characterized the production of beta-lactamases and outermembrane protein (omp) profiles for the 44 clinical isolates of a. baumannii.200212164097
quantitative culture of endotracheal aspirates in the diagnosis of ventilator-associated pneumonia in patients with treatment failure.to study the correlation of bacteriology between quantitative cultures of protected specimen brush (psb), bal, and quantitative endotracheal aspirate (qea) in ventilator-associated pneumonia (vap) patients with treatment failure.200212171848
identification and antimicrobial susceptibility testing of clinical isolates of nonfermenting gram-negative bacteria by the phoenix automated microbiology system.the phoenix automated microbiology system (becton dickinson, sparks, md) was evaluated for its ability to identify nonfermenting gram-negative pathogens and measure their drug susceptibility. isolates producing rare extended-spectrum beta-lactamases (per-1, imp-2, vim-1, and vim-2) were included in the study. species identification was compared to that given by the atb system (bio-mérieux, marcy l'etoile, france), whereas susceptibility results were compared to those produced by a reference brot ...200212173774
occurrence of antibiotic resistance gene cassettes aac(6')-ib, dfra5, dfra12, and erea2 in class i integrons in non-o1, non-o139 vibrio cholerae strains in india.molecular mechanisms of multidrug resistance in vibrio cholerae belonging to non-o1, non-o139 serogroups isolated during 1997 to 1998 in calcutta, india, were investigated. out of the 94 strains examined, 22 strains were found to have class i integrons. the gene cassettes identified were dfra1, dfra15, dfra5, and dfra12 for trimethoprim; aac(6')-ib for amikacin and tobramycin; aada1 and aada2 for streptomycin and spectinomycin; and erea2 for erythromycin resistance. to our knowledge, this is the ...200212183252
prospective survey of beta-lactamases produced by ceftazidime- resistant pseudomonas aeruginosa isolated in a french hospital in 2000.in 2000, at the université d'auvergne teaching hospital in clermont-ferrand, france, 44 (6.2%) strains of pseudomonas aeruginosa were found to be resistant to ceftazidime. after genotyping, 34 strains were selected. nine had an additional beta-lactamase: oxa-21 (n = 6), pse-1 (carb-2) (n = 2), or per-1 (n = 1). ceftazidime resistance was related solely to the overproduction of the cephalosporinase in 30 strains. sequencing of five bla(ampc) genes encoding cephalosporinases with different pis sho ...200212183264
efficacy of handrubbing with alcohol based solution versus standard handwashing with antiseptic soap: randomised clinical trial.to compare the efficacy of handrubbing with an alcohol based solution versus conventional handwashing with antiseptic soap in reducing hand contamination during routine patient care.200212183307
completely resistant acinetobacter baumannii strains.nosocomially acquired completely resistant acinetobacter baumannii strains are a major clinical concern. we identified completely resistant a. baumannii in 6 (4.9%) of 122 a. baumannii isolates in a retrospective chart review at two teaching hospitals. all of these patients had received broad-spectrum antibiotics and had severe underlying comorbid illnesses, long hospitalizations, or recent surgical procedures; 3 had been in the intensive care unit. five (83%) of the 6 patients were older than 7 ...200212186218
[evaluation of the rapid lumi 'eiken' using chemiluminescent assay for rapid antimicrobial susceptibility testing].one hundred ninety eight clinical isolates, including enterobacteriaceae (70 strains), pseudomonas aeruginosa (20 strains), acinetobacter baumannii (10 strains), staphylococci (50 strains), enterococci (20 strains), streptococcus pneumoniae (15 strains) and haemophilus influenzae (13 strains) were tested for their antimicrobial susceptibilities by using the rapid lumi 'eiken' (rl). as a reference method, broth microdilution method according to the national committee for clinical laboratory stand ...200212199112
detection of rickettsia prowazekii in body lice and their feces by using monoclonal antibodies.in order to identify rickettsia prowazekii in lice, we developed a panel of 29 representative monoclonal antibodies selected from 187 positive hybridomas made by fusing splenocytes of immunized mice with sp2/0-ag14 myeloma cells. immunoblotting revealed that 15 monoclonal antibodies reacted with the lipopolysaccharide-like (lps-l) antigen and 14 reacted with the epitopes of a 120-kda protein. only typhus group rickettsiae reacted with the monoclonal antibodies against lps-l. r. felis, a recently ...200212202579
basic microbiologic and infection control information to reduce the potential transmission of pathogens to patients via computer hardware.computer technology from the management of individual patient medical records to the tracking of epidemiologic trends has become an essential part of all aspects of modern medicine. consequently, computers, including bedside components, point-of-care testing equipment, and handheld computer devices, are increasingly present in patients' rooms. recent articles have indicated that computer hardware, just as other medical equipment, may act as a reservoir for microorganisms and contribute to the tr ...200212223502
measurement of endotoxin activity in critically ill patients using whole blood neutrophil dependent chemiluminescence.lipopolysaccharide (endotoxin) from the cell wall of gram-negative bacteria is a potent trigger for the release of host-derived inflammatory mediators. the relationship between endotoxaemia, gram-negative infection and the clinical syndrome of sepsis has been difficult to establish, in part because of the limitations of available endotoxin assays.200212225611
inducible ampc beta-lactamase of a new member enterobacteriaceae.extensive biochemical testing and 16s rrna and rpob sequence analysis revealed that clinical strain cf01ent1, initially identified as buttiauxella agrestis by the use of api 32 biochemical strips, is a new organism in the enterobacteriaceae family. it produced an inducible ampc-type beta-lactamase whose sequence shares 69 to 72% identity with those of the other ampc-type beta-lactamases of enterobacteriaceae: this enzyme exhibits an atypical high affinity for all beta-lactams tested.200212234870
efficient plastid transformation in tobacco using the apha-6 gene and kanamycin selection.here we report on the development of a new dominant selection marker for plastid transformation in higher plants using the aminoglycoside phosphotransferase gene apha-6 from acinetobacter baumannii. vectors containing chimeric apha-6 gene constructs were introduced into the tobacco chloroplast using particle bombardment of alginate-embedded protoplast-derived micro colonies or polyethylene glycol (peg)-mediated dna uptake. targeted insertion into the plastome was achieved via homologous recombin ...200212242495
diversity of endophytic bacterial populations and their interaction with xylella fastidiosa in citrus plants.citrus variegated chlorosis (cvc) is caused by xylella fastidiosa, a phytopathogenic bacterium that can infect all citrus sinensis cultivars. the endophytic bacterial communities of healthy, resistant, and cvc-affected citrus plants were studied by using cultivation as well as cultivation-independent techniques. the endophytic communities were assessed in surface-disinfected citrus branches by plating and denaturing gradient gel electrophoresis (dgge). dominant isolates were characterized by fat ...200212324338
ability of the microscan rapid gram-negative id type 3 panel to identify nonenteric glucose-fermenting and nonfermenting gram-negative bacilli.the microscan rapid neg id3 panel is designed for the identification of enterobacteriaceae and nonenteric glucose-fermenting and nonfermenting gram-negative bacilli. we evaluated this panel for its ability to identify gram-negative non-enterobacteriaceae bacteria. a total of 134 strains, representing 26 genera and 42 species, were taken from storage at -70(o)c, passaged three times before testing, and inoculated into the panels according to the manufacturer's directions before being inserted int ...200212354875
imipenem-edta disk method for differentiation of metallo-beta-lactamase-producing clinical isolates of pseudomonas spp. and acinetobacter spp.rapid detection of metallo-beta-lactamase (mbl)-producing gram-negative bacilli is necessary to prevent their dissemination. the method using a disk with imipenem plus 750 micro g of edta differentiated all mbl-producing pseudomonads, and the sensitivity and specificity for acinetobacters were 95.7 and 91.0%, respectively. the imipenem-edta disks were stable for 12 and 16 weeks at 4 and -20 degrees c, respectively.200212354884
nosocomial infections among hiv-positive and hiv-negative patients in a brazilian infectious diseases unit.some researchers observed that hiv-infected patients have a higher risk of acquiring nosocomial infections (ni). this study compared the incidence of ni among hiv-positive and hiv-negative inpatients.200212360143
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