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The present study aimed to evaluate antimicrobial activity of tigecycline against 84 multidrug resistant (MDR) Acinetobacter spp. strains by disc diffusion and E-test methods. The results of disc diffusion test were compared according to two different interpretation ways. In addition, E-test results and the disc diffusion results that interpreted by both the methods were checked for compatibility. According to the disc diffusion test, 3 strains (3.57%) were found resistant to tigecycline when considering breakpoints suggested by Food and Drug Administration (FDA). On the other hand, none of the strains was found resistant to the evaluation criteria recommended by Jones et al. (2007). Considering E-test results of tigecycline, MIC₅₀ and MIC₉₀ values of tigecycline for Acinetobacter spp. were 0.75 and 1 mg/l, respectively. Based on FDA defined breakpoints for Enterobacteriaceae, any resistant isolate was detected. In conclusion, although there are some differences in the results, tigecycline was found quite effective on Acinetobacter spp. isolates with reference to the both disc diffusion and the E-test methods.
Infections related to modern surgical procedures present a difficult problem for contemporary medicine. Infections acquired during surgery represent a risk factor related to therapeutical interventions. Eradication of microorganisms from hospital operating theatre environment may contribute to reduction of infections as the laminar flow air-conditioning considerably reduces the number of microorganisms in the hospital environment. The objective of the study was to evaluate the occurrence of fungi in air-conditioned operating theatre rooms. The study was carried out in one of the hospitals in Kraków during December 2009. Indoor air samples and imprints from the walls were collected from five operating theatre rooms. A total of fifty indoor air samples were collected with a MAS-100 device, and twenty five imprints from the walls were collected using a Count Tact method. Fungal growth was observed in 48 air samples; the average numbers of fungi were within the range of 5–100 c.f.u. in one cubic metre of the air. Fungi were detected only in four samples of the wall imprints; the number of fungi was 0.01 c.f.u. per one square centimetre of the surface. The mould genus Aspergillus was most frequently isolated, and the species A. fumigatus and A. versicolor were the dominating ones. To ensure microbiological cleanness of hospital operating theatre, the air-conditioning system should be properly maintained. Domination of the Aspergillus fungi in indoor air as well as increase in the number of moulds in the samples taken in evenings (p<0.05) may suggest that the room decontamination procedures were neglected.
Nosocomial infections caused by multi-drug resistant Acinetobacter pose a serious problem in many countries. This study aimed at determining the antibiotic susceptibility patterns and prevalence of different classes of integrons in isolated Acinetobacter. In addition, the association between production of specific bands in PCR assay and magnitude of multi-drug resistance was investigated. In total, 88 Acinetobacter strains were isolated from patients from October 2008 through September 2009. The Minimal inhibitory concentration (MIC) of 12 antibiotics conventionally used in clinics against the isolates, was determined by E-test method. The existence of integron classes was investigated by PCR assay through the amplification of integrase genes. The most effective antibiotic against Acinetobacter was colistin with 97.7% activity, followed by imipenem (77.3%) and meropenem (72.7%). The presence of integron classes 1 and 2 in 47 (53.4%) isolates was confirme, However, no class 3 was detected. The proportion of class 1, compared with class 2, was high (47.7% vs. 3.4%). The association between multi-drug resistance to norfloxacin, ceftazidime, gentamicin, ciprofloxacin, cefepime and amikacin and the presence of integrons was statistically significant. However, the association was not remarkable in many of the isolates which exhibited resistance to the rest of antibiotics. This may imply that in addition to integrons, other resistance determinants such as transposon and plasmid may also contribute to resistance. To reduce the pressure on sensitive isolates, comprehensive control measures should be implemented. Furthermore, wise application of effective antibiotics could help alleviate the situation. Colistin is the most effective antibiotic in vitro against Acinetobacter.
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The paper is a part of a general mycological monitoring study of nosocomial infections. Differences in the species composition and drug resistance of fungi isolated from in-patients and out-patients prompted an analysis of this topic. The studies were conducted with fungi from the collection of the Department of Mycology, University of Warmia and Mazury in Olsztyn, that were isolated from the oral cavity, sputum, bronchoscopic fluid, anus and skin from 100 in-patients and 100 out-patients. Laboratory analyses, including species categorization of fungi, were performed according to routine mycological diagnostics. Drug sensitivity to fluconazole and nystatin was tested with the disc diffusion method. In the group of in-patients, a wider taxonomic diversity of fungi (12 species) was found in comparison with the out-patients (7 species) and 31 cases of multifocal infections were recorded, while in the second group the number of the latter was only six. In all patients, C. albicans were predominant, constituting the largest proportion in focal infections in all patients and in multifocal infections in the in-patients. In the latter, over a half of the examined individuals were resistant to fluconazole (C. glabrata and C. krusei – 80%, C. tropicalis and S. capsularis – 60%, C. guilliermondii – 50%) and nystatin (T. beigelii – 80%, C. krusei and C. tropicalis – 50%). Substantially lower drug resistance of fungi was recorded in the out-patients. The hospital environment is an abundant reservoir of different fungal species with significantly greater expansiveness and aggressiveness compared to the environment outside a hospital.
In search of an effective DNA typing techniaue for Acinetobacter baumannii strains for hospital epidemiology use, the performance and convenience of a new target seauence was evaluated. Using known genomic seauences of Acinetobacter baumannii strains AR 319754 and ATCC 17978, we developed single-locus variable-number direct-repeat analysis using polymerase chain reaction-restriction fragment length polymorphism (DR-PCR/RFLP) method. A total of 90 Acinetobacter baumannii strains isolated from patients of the Clinical Hospital in Bydgoszcz, Poland, were examined. Initially, all strains were typed using macrorestriction analysis of the chromosomal DNA by pulsed-field gel electrophoresis (REA-PFGE). Digestion of the chromosomal DNA with the Apal endonuclease and separation of the fragments by PFGE revealed 21 uniaue types. Application of DR-PCR/RFLP resulted in recognition of 12 clusters. The results showed that the DR-PCR/RFLP method is less discriminatory than REA-PFGE, however, the novel genotyping method can be used as an alternative techniaue for generating DNA profiles in epidemiological studies of intra-species genetic relatedness of Acinetobacter baumannii strains.
The aim of this study was to evaluate methicillin resistance detection methods currently used when studying coagulase-negative staphylococci (CoNS). The resistance to oxacillin of 142 strains from seven species of CoNS isolated from the Intensive Care Unit environments was tested. The methods used were: disc diffusion test with cefoxitin (FOX₃₀) and oxacillin (OX₁), oxacillin agar screen test with 6 mg/l of oxacillin (MHOXA), latex test for PBP2a (LA) and detection of mecA via PCR. One hundred and one isolates were methicillin-resistant in at least one of methods used, but only 74 were mecA -positive. Of the 68 mecX-negative strains: two were positive by OX₁, the LA and MHOXA methods; three by the LA and MHOXA; and 22 only by OX₁, test. Most of these strains were from the novobiocin-resistant CoNS group. The results obtained for all tested strains using FOX₃₀ showed complete concordance with the presence of the mecA gene.
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Nosocomial infections represent an increasing threat to public health. In most cases, they concern patients with risk factors such as taken radio- and chemotherapy, those whose immune system might be suppressed and those who might be HIV-positive. Most studies of the incidence of nosocomial infections ignore parasitic infestations. Based on data from 1,265 intensive care units in 75 countries, it was found that the proportion of parasites in nosocomial infections was 0.48% overall, and 0.25% in Western Europe. An analysis of the available literature indicates an increase in the number of hospital parasitoses.
Proteus mirabilis isolates (n=177), collected between 1996 and 2000 in four hospitals in the West Pomeranian area of Poland, were characterized by antibiotype and pulsed-field gel electrophoresis (PFGE). The selected isolates were collected from different wards (intensive care unit, surgery, internal medicine, and urology). The strains were cultured from various specimen types, mostly from urine, wound samples, bronchial exudates and sputa. The identification was done by biochemical test ID 32E ATB (bioMerieux). Analysis of PFGE patterns was based on comparison of the banding patterns obtained by PFGE of chromosomal DNA digested with SHI enzyme. Among all P. mirabilis isolates tested three major genotypes A (A1-A7), B (B1-B4), C (C1-C5) and 71 unique patterns were identified. The same genotypes were obtained from different patients, treated in different wards and hospitals during a 5-year period. The strains which belonged to the genotypes A and B were multiresistant and most of them produced ESBL; genotype C was more sensitive to antibiotics.
A total of 90 Pseudomonas aeruginosa strains isolated from 4 hospitals in the west-north region of Poland were studied by arbitrarily primed polymerase chain reaction (AP-PCR). AP-PCR results revealed the presence of 11 main groups of patterns (A-K) and 5 unique patterns among isolates. Generally, they were characterized by high resistance to antibiotics tested and significant differences in serogroups and types of growth on Cetrimide Agar medium. It was observed that clonally related strains were isolated from patients within the same ward, among different wards as well as in distant hospitals.
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