Asunto(s)
Infecciones por Coronavirus/complicaciones , Síndrome de Guillain-Barré/etiología , Neumonía Viral/complicaciones , Anciano , Betacoronavirus , COVID-19 , Infecciones por Coronavirus/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/terapia , SARS-CoV-2 , Capacidad Vital , Adulto JovenRESUMEN
We report the emergence of VIM-1 MBL and CTX-M-15-producing K. pneumoniae isolates collected from patients at two acute care hospitals (I.R.C.C.S. "S. Matteo" and "Casa Sollievo della Sofferenza" Hospital) and a long-term rehabilitation facility in Northern Italy (I.R.C.C.S. "S. Maugeri"). Between February 2007 and October 2008, 30 K. pneumoniae strains showing decreased susceptibility to carbapenems were collected. PCR and sequencing experiments revealed the presence of blaVIM-1 gene in 14/30 isolates. All the above isolates carried the blaSHV-5 determinant as well; interestingly, 8/14 VIM positive isolates were also CTX-M-1- like producers. VIM-1 positive strains were present in all hospitals. PFGE genomic profiles of the 14/30 isolates showed that 2 different clones, A and B, were responsible for outbreaks. The coexistence in the same bacterial cell of compatible plasmids carrying epidemiologically important emerging resistance genes, such as MBLs and CTX-Ms, is worrisome since it could predict the generation and spread of pan-resistant bacteria and the consequent treatment option limitations that can lead to significant morbidity and mortality. Control measures should be applied to detect MBL-producing strains and to contrast the vertical and plasmidic diffusion of carbapenem-resistant K. pneumoniae in acute care and rehabilitation facilities.
Asunto(s)
Antiinfecciosos/farmacología , Carbapenémicos/farmacología , Infecciones por Klebsiella/microbiología , Klebsiella pneumoniae/aislamiento & purificación , beta-Lactamasas/genética , Infección Hospitalaria , ADN Bacteriano/química , ADN Bacteriano/genética , Farmacorresistencia Bacteriana Múltiple , Electroforesis en Gel de Campo Pulsado , Hospitales , Humanos , Italia/epidemiología , Infecciones por Klebsiella/epidemiología , Klebsiella pneumoniae/efectos de los fármacos , Klebsiella pneumoniae/enzimología , Klebsiella pneumoniae/genética , Pruebas de Sensibilidad Microbiana , Plásmidos/genética , Reacción en Cadena de la Polimerasa , Centros de Rehabilitación , beta-Lactamasas/metabolismoRESUMEN
Vulvovaginal candidiasis is a common mucosal infection caused by saprophytic and opportunistic yeasts belonging to the Candida genus. 518 vaginal swabs, with positive fungal culture were collected from unselected women attending the Sexually Transmitted Disease clinic of an Italian tertiary care hospital over a six year period to determine the pathogen prevalence in vulvovaginal candidiasis and to evaluate in vitro the antifungal susceptibilities of yeast recovered by Sensititre YeastOne antifungal panel plates according to CLSI document M27-A2. The isolates belonging to the genus Candida were 495 (95.5%) with Candida albicans percentage equal to 61.2%. Voriconazole was highly active (MIC50 0.008; MIC90 0.5 microg/ml), regardless of the species tested. On the contrary, fluconazole susceptibility was based upon the species. The intrinsic resistance to fluconazole of C. krusei was confirmed.
Asunto(s)
Antifúngicos/farmacología , Candida/efectos de los fármacos , Candidiasis Vulvovaginal/epidemiología , Candidiasis Vulvovaginal/microbiología , Servicio Ambulatorio en Hospital , Antifúngicos/uso terapéutico , Candida/aislamiento & purificación , Candidiasis Vulvovaginal/prevención & control , Farmacorresistencia Fúngica , Femenino , Fluconazol/farmacología , Fluconazol/uso terapéutico , Humanos , Italia/epidemiología , Pruebas de Sensibilidad Microbiana , Prevalencia , Pirimidinas/farmacología , Pirimidinas/uso terapéutico , Recurrencia , Triazoles/farmacología , Triazoles/uso terapéutico , Vagina/microbiología , VoriconazolRESUMEN
Forty-four nonreplicate clinical isolates of Pseudomonas aeruginosa that were resistant to extended-spectrum cephalosporins (ceftazidime and cefepime) and aztreonam, that putatively produced an acquired extended- spectrum beta-lactamase (ESBL), according to the results of a double-disk synergy test, and that had been involved in nosocomial outbreaks were obtained from six different hospitals in northern Italy and screened for the presence of bla(PER) ESBL determinants. Twenty isolates, associated with nine independent outbreaks that occurred in five hospitals in the Milan area and its surroundings during 1995-2000, were found to carry an acquired bla(PER-1) gene. PER-1 producers representative of the nine outbreaks exhibited a multidrug resistance (MDR) phenotype, including resistance to extended-spectrum cephalosporins, aztreonam, meropenem, aminoglycosides, and in most cases, imipenem and ciprofloxacin. An analysis of macrorestriction profiles of their genomic DNAs by pulsed-field gel electrophoresis revealed an overall clonal diversity of the PER-1 producers, although interhospital clonal spread was also observed. The bla(PER-1) gene was not transferable and appeared to be chromosomally located. An analysis of the EcoRI and EcoRV restriction fragment length polymorphisms of the bla(PER-1) locus revealed identical patterns for all isolates, and the characterization of a 1.9-kb region containing bla(PER-1) revealed a conserved structure in representatives of the various clonal lineages. The present findings indicate that MDR P. aeruginosa clones producing the PER-1 ESBL are endemic to this area of northern Italy, where they have been circulating since the mid-1990s and have been associated with several nosocomial outbreaks.
Asunto(s)
Farmacorresistencia Bacteriana Múltiple , Pseudomonas aeruginosa/efectos de los fármacos , beta-Lactamasas/genética , Secuencia de Aminoácidos , Secuencia de Bases , Datos de Secuencia Molecular , Pseudomonas aeruginosa/enzimología , beta-Lactamasas/biosíntesisRESUMEN
A microdilution test measuring imipenem MICs in the presence or absence of a mixture of EDTA plus 1,10-phenanthroline was developed and tested on 190 Pseudomonas aeruginosa isolates, including 18 VIM- and 4 IMP-type metallo-beta-lactamase (MBL) producers. The chelator mixture reduced by fourfold or more the imipenem MICs for MBL producers, while a lower effect or no effect was usually observed with MBL nonproducers.