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Article ; Online: Whole-Genome Sequence Analysis of Carbapenem-Heteroresistant Klebsiella pneumoniae and Escherichia coli Isolates

Sancak, Banu / Arı, Oğuz / Durmaz, Rıza

Curr Microbiol. 2022 Dec., v. 79, no. 12 p.384-384

2022

Abstract: Carbapenem-heteroresistant isolates can be misclassified as susceptible by in vitro susceptibility tests, leading to treatment failure. The underlying mechanisms of heteroresistance, where the bacterial isolate harbors both resistant and susceptible ... ...

Abstract	Carbapenem-heteroresistant isolates can be misclassified as susceptible by in vitro susceptibility tests, leading to treatment failure. The underlying mechanisms of heteroresistance, where the bacterial isolate harbors both resistant and susceptible subpopulations, are poorly understood. The aim of the current study was to clarify molecular mechanisms responsible for carbapenem heteroresistance. Whole-genome shotgun sequencing was performed for both resistant and susceptible subpopulations of three Klebsiella pneumoniae and one Escherichia coli blood isolates, which were identified as carbapenem-heteroresistant by the population analysis profile method. The software from the Center for Genomic Epidemiology was used to identify genomic similarities, antibiotic resistance genes, Multilocus Sequence Typing (MLST), and core-genome MLST(cgMLST). Both susceptible and resistant subpopulations of the E. coli strain had the same MLST profiles. MLST1/2 and cgMLST for E. coli were 46/736 and 119473, respectively. The susceptible and resistant subpopulations of each K. pneumoniae strain exhibited identical MLST profiles. The genetic background for antimicrobial resistance in three K. pneumoniae strains was almost similar between the colonies inside and outside the inhibition zone of each strain, however, there were remarkable differences between the three strains. The blaKPC-2 and blaOXA-48 genes were responsible for carbapenem resistance for E. coli and K. pneumoniae strains, respectively. This is the first study, which has demonstrated similar genotypic and resistant gene profiles in the resistant and susceptible subpopulations of each strain. Additional metabolic and transcriptomic investigations are needed to understand the mechanisms responsible for carbapenem heteroresistance.
Keywords	Escherichia coli ; Klebsiella pneumoniae ; antibiotic resistance ; blood ; carbapenems ; computer software ; epidemiology ; genes ; genetic background ; genomics ; multilocus sequence typing ; transcriptomics
Language	English
Dates of publication	2022-12
Size	p. 384.
Publishing place	Springer US
Document type	Article ; Online
ZDB-ID	134238-1
ISSN	1432-0991 ; 0343-8651
ISSN (online)	1432-0991
ISSN	0343-8651
DOI	10.1007/s00284-022-03087-x
Database	NAL-Catalogue (AGRICOLA)

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Article: Escherichia coli ve Klebsiella pneumoniae İzolatlarında Kolistin Duyarlılığının Belirlenmesinde ResaPolymyxin NP Testinin Kullanımı.

Beşli, Yeşim / Liste, Ümran / Kırbaş, Ekin / Sancak, Banu

Mikrobiyoloji bulteni

2022 Volume 56, Issue 2, Page(s) 349–356

Abstract: Colistin is used as the last choice of drug in multidrug resistant gram-negative bacilli infections; therefore, accurate detection of colistin susceptibility has gained critical importance. Unfortunately, many of the widely used and practical methods in ... ...

Title translation	The Use of Resapolymyxin NP Test in Determining the Sensitivity of Colistin in Escherichia coli, and Klebsiella pneumoniae Isolates.
Abstract	Colistin is used as the last choice of drug in multidrug resistant gram-negative bacilli infections; therefore, accurate detection of colistin susceptibility has gained critical importance. Unfortunately, many of the widely used and practical methods in the clinical laboratory have various limitations for the determination of colistin susceptibility. This situation has led researchers to search for new methods to determine colistin susceptibility. In this study, the performance of the ResaPolymyxin NP test, which was developed for the rapid detection of colistin susceptibility of Pseudomonas aeruginosa and Acinetobacter baumannii isolates, was evaluated for various Gram-negative bacteria for the determination of colistin susceptibility. For this purpose, the colistin MIC values of 105 Escherichia coli, and 196 Klebsiella pneumoniae isolates were determined by broth microdilution (BMD) using cation-adjusted Mueller-Hinton broth and then ResaPolymyxin NP test was applied for each isolate. While 242 (%80.4) of the isolates included in the study were found to be susceptible to colistin with BMD, 214 (71.1%) of the isolates were found as sensitive to colistin with the ResaPolymyxin NP test. The categorical agreement rate for the ResaPolymyxin NP test was 85.7% for E.coli isolates, and 92.3% for K.pneumoniae isolates. The major error rate was 14.7% for E.coli, 10.8% for K.pneumoniae, whereas the very major error rate was 1.8% for K.pneumoniae. For ResaPolymyxin NP test, sensitivity, specificity, positive and negative predictive values were %98,3; %88.0; %66.7; and %99.5. In contrast to the available data about the ResaPolymyxin NP test, both the categorical agreement rate with BMD, and the very major and major error rates varied according to the isolate type, and it was concluded that the test performed relatively better in E.coli and K.pneumoniae isolates. Since the data obtained in this study are quite different from the previously published data, more comprehensive and multicenter studies are needed to evaluate the test effectiveness in order to recommend the use of the ResaPolymyxin NP test in clinical microbiology laboratories.
MeSH term(s)	Anti-Bacterial Agents/pharmacology ; Colistin/pharmacology ; Escherichia coli ; Gram-Negative Bacteria ; Humans ; Klebsiella pneumoniae ; Microbial Sensitivity Tests
Chemical Substances	Anti-Bacterial Agents ; Colistin (Z67X93HJG1)
Language	Turkish
Publishing date	2022-04-27
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	985146-x
ISSN	0374-9096
ISSN	0374-9096
DOI	10.5578/mb.20229813
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Article ; Online: A twenty years' results of the antimicrobial resistance profile and multidrug resistance trend of invasive Streptococcus pneumoniae isolates recovered from adult patients in Turkey: A literature review.

Hascelik, Gulsen / Sancak, Banu / Kasikci, Merve

Indian journal of medical microbiology

2022 Volume 40, Issue 3, Page(s) 342–346

Abstract: Purpose: The aim of this study is to analyze antimicrobial resistance and multidrug (MDR)/extensively (XDR) resistance trend among Streptococcus pneumoniae isolates causing invasive disease in adult patients.: Methods: We analyzed antimicrobial ... ...

Abstract	Purpose: The aim of this study is to analyze antimicrobial resistance and multidrug (MDR)/extensively (XDR) resistance trend among Streptococcus pneumoniae isolates causing invasive disease in adult patients. Methods: We analyzed antimicrobial resistance and multidrug resistance trend among invasive S.pneumoniae isolates recovered from adult patients (≥18-years) in a tertiary University Hospital, Turkey between 1996 and 2018. The antibiotic susceptibility pattern was determined by using gradient-test for penicillin and cefotaxime and disk-diffusion method for other antibiotics. Results: A total of 272 isolates (74.3% from the bloodstream) of S. pneumoniae were collected during the study period. The highest non-susceptibility rate was obtained for tetracycline (63.5%), followed by trimethoprim/sulfamethoxazole (48%), penicillin-oral (30.4%), erythromycin (21.7%), clindamycin (15.8%), ciprofloxacin/levofloxacin (5.9%), penicillin-parenteral (5.5%), cefotaxime (2.2%), and rifampisin (1.8%), respectively. No resistance was observed against vancomycin during the years studied. Over the study period, a significant increase in the rate of antimicrobial resistance among invasive pneumococcal isolates was detected with a peak at period 2014-2018. Although there was an increase in the rates of non-susceptibility to penicillin oral, parenteral penicillin, cefotaxime, erythromycin and clindamycin in adult patients, the results were not statistically significant except erythromycin. Prevalence of MDR and XDR S. pneumoniae were 29% and 9.2% respectively. When the serotypes of MDR isolates were examined, it was noted that serotype 19F (35%) and 14 (12.5%) were the most common. Conclusions: Our study showed an overall increase in non-susceptibility rates of penicillin and erythromycin in invasive S.pneumoniae isolates recovered from Turkish adult patients. Although the prevalence of MDR showed fluctuation between years, the incidence of MDR remained stable. These data indicate the necessity for continuous monitoring and assessment of serotypes and antimicrobial resistance trends in S.pneumoniae in different age groups at both the national and the regional levels as it can be affected by the serotypes dominant in that region, rational use of antibiotics and the vaccination programs.
MeSH term(s)	Adult ; Anti-Bacterial Agents/pharmacology ; Cefotaxime ; Clindamycin ; Drug Resistance, Bacterial ; Drug Resistance, Multiple ; Erythromycin ; Humans ; Microbial Sensitivity Tests ; Penicillins ; Pneumococcal Infections/epidemiology ; Streptococcus pneumoniae ; Turkey/epidemiology
Chemical Substances	Anti-Bacterial Agents ; Penicillins ; Clindamycin (3U02EL437C) ; Erythromycin (63937KV33D) ; Cefotaxime (N2GI8B1GK7)
Language	English
Publishing date	2022-07-01
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1038798-5
ISSN	1998-3646 ; 0255-0857
ISSN (online)	1998-3646
ISSN	0255-0857
DOI	10.1016/j.ijmmb.2022.06.004
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Article ; Online: Whole-Genome Sequence Analysis of Carbapenem-Heteroresistant Klebsiella pneumoniae and Escherichia coli Isolates.

Sancak, Banu / Arı, Oguz / Durmaz, Rıza

Current microbiology

2022 Volume 79, Issue 12, Page(s) 384

Abstract	Carbapenem-heteroresistant isolates can be misclassified as susceptible by in vitro susceptibility tests, leading to treatment failure. The underlying mechanisms of heteroresistance, where the bacterial isolate harbors both resistant and susceptible subpopulations, are poorly understood. The aim of the current study was to clarify molecular mechanisms responsible for carbapenem heteroresistance. Whole-genome shotgun sequencing was performed for both resistant and susceptible subpopulations of three Klebsiella pneumoniae and one Escherichia coli blood isolates, which were identified as carbapenem-heteroresistant by the population analysis profile method. The software from the Center for Genomic Epidemiology was used to identify genomic similarities, antibiotic resistance genes, Multilocus Sequence Typing (MLST), and core-genome MLST(cgMLST). Both susceptible and resistant subpopulations of the E. coli strain had the same MLST profiles. MLST1/2 and cgMLST for E. coli were 46/736 and 119473, respectively. The susceptible and resistant subpopulations of each K. pneumoniae strain exhibited identical MLST profiles. The genetic background for antimicrobial resistance in three K. pneumoniae strains was almost similar between the colonies inside and outside the inhibition zone of each strain, however, there were remarkable differences between the three strains. The blaKPC-2 and blaOXA-48 genes were responsible for carbapenem resistance for E. coli and K. pneumoniae strains, respectively. This is the first study, which has demonstrated similar genotypic and resistant gene profiles in the resistant and susceptible subpopulations of each strain. Additional metabolic and transcriptomic investigations are needed to understand the mechanisms responsible for carbapenem heteroresistance.
MeSH term(s)	Humans ; Klebsiella pneumoniae/metabolism ; Carbapenems/pharmacology ; Escherichia coli/genetics ; Escherichia coli/metabolism ; Klebsiella Infections/microbiology ; Multilocus Sequence Typing ; beta-Lactamases/genetics ; beta-Lactamases/metabolism ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Escherichia coli Infections/drug therapy ; Microbial Sensitivity Tests ; Bacterial Proteins/genetics
Chemical Substances	Carbapenems ; beta-Lactamases (EC 3.5.2.6) ; Anti-Bacterial Agents ; Bacterial Proteins
Language	English
Publishing date	2022-11-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	134238-1
ISSN	1432-0991 ; 0343-8651
ISSN (online)	1432-0991
ISSN	0343-8651
DOI	10.1007/s00284-022-03087-x
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Article ; Online: What is the reason for conflicting results for vancomycin minimum inhibitory concentration values of methicillin-resistant Staphylococcus aureus?

Sancak, Banu

Scandinavian journal of infectious diseases

2014 Volume 46, Issue 2, Page(s) 158–160

MeSH term(s)	Anti-Bacterial Agents/pharmacology ; Humans ; Methicillin-Resistant Staphylococcus aureus/drug effects ; Methicillin-Resistant Staphylococcus aureus/isolation & purification ; Microbial Sensitivity Tests/methods ; Staphylococcal Infections/microbiology ; Vancomycin/pharmacology
Chemical Substances	Anti-Bacterial Agents ; Vancomycin (6Q205EH1VU)
Language	English
Publishing date	2014-02
Publishing country	England
Document type	Letter
ZDB-ID	390956-6
ISSN	1651-1980 ; 0036-5548
ISSN (online)	1651-1980
ISSN	0036-5548
DOI	10.3109/00365548.2013.847530
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Article: Staphylococcus aureus ve antibiyotik direnci.

Sancak, Banu

Mikrobiyoloji bulteni

2011 Volume 45, Issue 3, Page(s) 565–576

Abstract: After the report of first case of methicillin-resistant Staphylococcus aureus (MRSA) in 1961, MRSA become a major problem worldwide. Over the last decade MRSA strains have emerged as serious pathogens in nosocomial and community settings. Glycopeptides ( ... ...

Title translation	Staphylococcus aureus and antibiotic resistance.
Abstract	After the report of first case of methicillin-resistant Staphylococcus aureus (MRSA) in 1961, MRSA become a major problem worldwide. Over the last decade MRSA strains have emerged as serious pathogens in nosocomial and community settings. Glycopeptides (vancomycin and teicoplanin) are still the current mainstay of therapy for infections caused by MRSA. In the last decade dramatic changes have occurred in the epidemiology of MRSA infections. The isolates with reduced susceptibility and in vitro resistance to vancomycin have emerged. Recently, therapeutic alternatives such as quinupristin/dalfopristin, linezolid, tigecycline and daptomycin have been introduced into clinical practice for treating MRSA infections. Nevertheless, these drugs are only approved for certain indication and resistance has already been reported. In this review, the new information on novel drugs for treating MRSA infections and the resistance mechanisms of these drugs were discussed.
MeSH term(s)	Acetamides/pharmacology ; Acetamides/therapeutic use ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Daptomycin/pharmacology ; Daptomycin/therapeutic use ; Drug Resistance, Bacterial ; Humans ; Linezolid ; Methicillin-Resistant Staphylococcus aureus/drug effects ; Minocycline/analogs & derivatives ; Minocycline/pharmacology ; Minocycline/therapeutic use ; Oxazolidinones/pharmacology ; Oxazolidinones/therapeutic use ; Protein Synthesis Inhibitors/pharmacology ; Protein Synthesis Inhibitors/therapeutic use ; Staphylococcal Infections/drug therapy ; Staphylococcal Infections/microbiology ; Teicoplanin/pharmacology ; Teicoplanin/therapeutic use ; Vancomycin/pharmacology ; Vancomycin/therapeutic use ; Vancomycin Resistance ; Virginiamycin/pharmacology ; Virginiamycin/therapeutic use
Chemical Substances	Acetamides ; Anti-Bacterial Agents ; Oxazolidinones ; Protein Synthesis Inhibitors ; Virginiamycin (11006-76-1) ; quinupristin-dalfopristin (126602-89-9) ; Teicoplanin (61036-62-2) ; Vancomycin (6Q205EH1VU) ; tigecycline (70JE2N95KR) ; Minocycline (FYY3R43WGO) ; Linezolid (ISQ9I6J12J) ; Daptomycin (NWQ5N31VKK)
Language	Turkish
Publishing date	2011-07
Publishing country	Turkey
Document type	English Abstract ; Journal Article ; Review
ZDB-ID	985146-x
ISSN	0374-9096
ISSN	0374-9096
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Article ; Online: Resistance and heteroresistance to colistin among clinical isolates of Acinetobacter baumannii.

Çağlan, Ecem / Nigiz, Şeyma / Sancak, Banu / Gür, Deniz

Acta microbiologica et immunologica Hungarica

2020 Volume 67, Issue 2, Page(s) 107–111

Abstract: Colistin is one of the most effective alternatives for treating Acinetobacter baumannii infections. The aim of this study was to determine colistin resistance and heteroresistance rates in A. baumannii from clinical samples in Hacettepe University ... ...

Abstract	Colistin is one of the most effective alternatives for treating Acinetobacter baumannii infections. The aim of this study was to determine colistin resistance and heteroresistance rates in A. baumannii from clinical samples in Hacettepe University clinical microbiology laboratory between June 2016 and January 2017. A total of 200 isolates were included in the study. In vitro susceptibility to amikacin, gentamicin, ceftazidime, piperacillin/tazobactam, meropenem, ciprofloxacin, and tigecycline were determined by disk diffusion test. Most isolates were multiresistant as they exhibited resistance to aminoglycosides, β-lactams, and fluoroquinolones. Colistin susceptibility was determined by broth microdilution (BMD) test (EUCAST standards) and was compared with E-test (bioMérieux, France) in 120 isolates. In 14 blood isolates that were susceptible to colistin (MIC ≤ 2 mg/L), heteroresistance was investigated with the population analysis profile (PAP) method. Overall resistance (n = 200) to colistin was 28% by BMD. Among the 120 isolates where the two tests were compared, resistance to colistin was 25.8% versus 4.2% with BMD and E-test, respectively. Three blood isolates (21.4%) were heteroresistant to colistin. With E-test, a majority of the resistant isolates are overlooked and in vitro susceptibility to colistin should be determined with broth dilution method. This is the first study in Turkey reporting heteroresistance in A. baumannii isolates by the PAP method and emphasizes the need to test for heteroresistance in relation to clinical outcome in serious infections due to A. baumannii.
MeSH term(s)	Acinetobacter Infections/drug therapy ; Acinetobacter baumannii/drug effects ; Acinetobacter baumannii/genetics ; Acinetobacter baumannii/isolation & purification ; Aminoglycosides/pharmacology ; Anti-Bacterial Agents/pharmacology ; Colistin/pharmacology ; Disk Diffusion Antimicrobial Tests ; Drug Resistance, Multiple, Bacterial/genetics ; Fluoroquinolones/pharmacology ; Humans ; Tetracyclines/pharmacology ; Turkey ; beta-Lactams/pharmacology
Chemical Substances	Aminoglycosides ; Anti-Bacterial Agents ; Fluoroquinolones ; Tetracyclines ; beta-Lactams ; Colistin (Z67X93HJG1)
Language	English
Publishing date	2020-06-01
Publishing country	Hungary
Document type	Journal Article
ZDB-ID	918256-1
ISSN	1588-2640 ; 1217-8950
ISSN (online)	1588-2640
ISSN	1217-8950
DOI	10.1556/030.66.2019.021
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Article: Evaluation of a Commercial Broth Microdilution Panel for Colistin Susceptibility Testing of Clinical Isolates of Escherichia coli and Klebsiella pneumoniae.

Mirza, Hasan C / Bıçakçıgil, Asiye / Liste, Ümran / Sancak, Banu

Clinical laboratory

2021 Volume 67, Issue 5

Abstract: Background: Colistin is among the last resort antibiotics for the treatment of infections caused by multidrug-resistant Gram-negative pathogens. Antimicrobial susceptibility testing of colistin is challenging due to its physicochemical properties. Broth ...

Abstract	Background: Colistin is among the last resort antibiotics for the treatment of infections caused by multidrug-resistant Gram-negative pathogens. Antimicrobial susceptibility testing of colistin is challenging due to its physicochemical properties. Broth microdilution (BMD) is the recommended method for colistin susceptibility testing. However BMD is not practical for clinical microbiology laboratories as manual preparation of BMD plates is time-consuming and labor intensive. Recently, some more user-friendly BMD products with commercial panels have become available. Our objective was to evaluate the performance of a commercial broth microdilution (BMD) product [Sensititre (Thermo Fisher Scientific)] for colistin MIC determination by comparison with reference BMD method using a collection of E. coli and K. pneumoniae isolates. Methods: A total of 323 unique patient isolates (102 E. coli, 221 K. pneumoniae) were included in the study. Isolates were stored at -70°C and subcultured twice on sheep blood agar before testing. Colistin MICs of the isolates were determined using Sensititre (a premade BMD product with dried antibiotics) and an 'in-house prepared BMD panel prepared in accordance with CLSI guidelines' (reference method). MIC determination with Sensititre was performed according to manufacturer's instructions. The reference method was performed using untreated 96-well sterile polystyrene plates. Colistin MIC results were interpreted according to EUCAST breakpoints (susceptible, ≤ 2 mg/L; resistant, > 2 mg/L). Results: Overall susceptibility rate of isolates to colistin by reference BMD was 75.9%. Overall categorical agreement (CA), essential agreement (EA), very major error (VME), and major error (ME) rates for Sensititre were 98.5%, 72.5%, 3.8%, and 0.8%, respectively. The CA and EA between Sensititre and reference BMD for the isolates with reference colistin MICs close to the susceptibility breakpoint (2 - 8 mg/L) was 94.2% and 48.1%, respectively. Sensititre yielded a VME rate of 15% and ME rate of 0%, respectively, for this subset of isolates. Conclusions: In conclusion, Sensititre showed high CA but low EA with reference BMD for entire collection of isolates. The VME rate was just slightly above 3% and ME rate was acceptable. The rates of CA and EA were decreased and the rate of VME was increased when a subset consisting of more challenging isolates was used.
MeSH term(s)	Anti-Bacterial Agents/pharmacology ; Colistin/pharmacology ; Escherichia coli ; Humans ; Klebsiella pneumoniae ; Microbial Sensitivity Tests
Chemical Substances	Anti-Bacterial Agents ; Colistin (Z67X93HJG1)
Language	English
Publishing date	2021-05-12
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1307629-2
ISSN	1433-6510 ; 0941-2131
ISSN	1433-6510 ; 0941-2131
DOI	10.7754/Clin.Lab.2020.200822
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Article ; Online: Factors Associated with Gram-Negative Bacteremia and Mortality in Neutropenic Patients with Hematologic Malignancies in a High-Resistance Setting.

Ayaz, Caglayan Merve / Hazırolan, Gulsen / Sancak, Banu / Hascelik, Gulsen / Akova, Murat

Infectious diseases & clinical microbiology

2022 Volume 4, Issue 2, Page(s) 87–98

Abstract: Objective: Patients with hematological malignancies (HMs) have a substantial incidence of febrile neutropenic episodes. Gram-negative bacteremia (GNB) is still the major cause of these episodes. We evaluated the factors associated with GNB and mortality ...

Abstract	Objective: Patients with hematological malignancies (HMs) have a substantial incidence of febrile neutropenic episodes. Gram-negative bacteremia (GNB) is still the major cause of these episodes. We evaluated the factors associated with GNB and mortality of bacteremic patients with HMs in a high-resistance setting. Materials and methods: We conducted a prospective cohort study from March 2018 to June 2019 with 66 bacteremic and 132 non-bacteremic patients. Regression analyses were used to identify factors associated with GNB and 30-day mortality. Results: The mean age was 53.83±15.21 years, and 129 (65.2%) of the patients were male. In multivariable analysis, factors independently associated with GNB were male gender, duration of hospitalization and neutropenia before the febrile neutropenic episode, leukemias and allogeneic transplant recipients, radiotherapy, receiving glucocorticosteroids, colonization with resistant microorganisms. All-cause mortality and 30-day mortality were 47.0% and 30.3% in cases of GNB, compared to non-bacteremic controls 25.0% and 10.6%, respectively. Sepsis, duration of hospitalization before the febrile neutropenic episode, carbapenem-resistant GNB, and inappropriate empirical antibiotic treatment was found as factors associated with 30-day mortality. Prior antibiotic exposure particularly beta-lactamase inhibitor combinations and carbapenems during the past 30 days was more frequent in the bacteremic group. An increasing trend was observed in multidrug-resistant (MDR) bacteria ( Conclusion: By considering the risk factors associated with GNB and 30-day mortality that we detected in our study among neutropenic patients, a personalized approach for the management of febrile neutropenic patients can be designed by means of an effective antimicrobial stewardship program including the appropriate use of broad-spectrum antibiotics.
Language	English
Publishing date	2022-06-13
Publishing country	Turkey
Document type	Journal Article
ISSN	2667-646X
ISSN (online)	2667-646X
DOI	10.36519/idcm.2022.141
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Article ; Online: Molecular characteristics of Staphylococcus aureus strains isolated from nasal samples of sixth year medical students during their pediatric services practices.

Arıkan, Kamile / Karadag-Oncel, Eda / Aycan, Emre / Sancak, Banu / Ceyhan, Mehmet

Annals of clinical microbiology and antimicrobials

2021 Volume 20, Issue 1, Page(s) 25

Abstract: Background: Methicillin-resistant Staphylococcus aureus (MRSA) strains are prevalent in healthcare services. Medical students are at risk for MRSA carriage, subsequent infection and potential transmission of nosocomial infection.Few studies have ... ...

Abstract	Background: Methicillin-resistant Staphylococcus aureus (MRSA) strains are prevalent in healthcare services. Medical students are at risk for MRSA carriage, subsequent infection and potential transmission of nosocomial infection.Few studies have examined MRSA carriage among medical students. Methods: In this prospective cohort study, between July 2016 and June 2017, two nasal swab samples were taken per student 4 weeks apart during their pediatric internship. MRSA typing was performed by staphylococcal cassette chromosome mec (SCCmec) types, Panton Valentine leukocidin (PVL) encoding genes. Results: A total of 239 sixth year medical students, 164 (68.6%) male (M/F:2.1),with median age 25 years (min-max; 23-65 years) were included in this prospective cohort study. Among 239 students, 17 students (7.1%) were found to be colonized with methicillin-sensitive S. aureus (MSSA) at the beginning of pediatric internship. After 4 weeks, at the end of pediatric internship totally 52 students were found to be S. aureus colonized (21.8%). Three of 52 S. aureus isolates were MRSA (1.3%) and the rest was MSSA (20.5%), all were PVL gen negative. Two of three MRSA isolates were characterized as SCCmec type IV, one isolate was untypeable SCCmec. Nasal carriage of S. aureus increased from 7.1% to 21.5% (p < 0.001). Nasal S. aures colonization ratio was higher in students working in pediatric infectious disease service (p = 0.046). Smoking was found to be associated with a 2.37-fold [95% CI (1.12-5.00); p = 0.023] and number of patients in pediatric services was 2.66-fold [95% CI (1.13-6.27); p = 0.024] increase the risk of nasal S. aureus colonization. Gender was not found to increase risk of MRSA carriage. Conclusion: MSSA nasal carriage increased at the end of pediatric internship and significantly high in students working in pediatric infectious diseases services. Smoking and high number of patients in pediatric services significantly increase S.aureus colonization.
MeSH term(s)	Adult ; Aged ; Bacterial Toxins ; Child ; Cross Infection/microbiology ; Exotoxins ; Female ; Humans ; Leukocidins ; Male ; Methicillin-Resistant Staphylococcus aureus/genetics ; Methicillin-Resistant Staphylococcus aureus/isolation & purification ; Middle Aged ; Prospective Studies ; Staphylococcal Infections ; Staphylococcus aureus/genetics ; Staphylococcus aureus/isolation & purification ; Students, Medical ; Young Adult
Chemical Substances	Bacterial Toxins ; Exotoxins ; Leukocidins ; Panton-Valentine leukocidin
Language	English
Publishing date	2021-04-17
Publishing country	England
Document type	Journal Article
ZDB-ID	2097873-X
ISSN	1476-0711 ; 1476-0711
ISSN (online)	1476-0711
ISSN	1476-0711
DOI	10.1186/s12941-021-00429-8
Database	MEDical Literature Analysis and Retrieval System OnLINE

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