High prevalence of NDM metallo-β-lactamase among ESBL-producing Escherichia coli İsolates

Resistance to β-lactams in Enterobacteriaceae has been increasing worldwide. This study aimed to determine the frequency of β-lactamase genes and antibiotic resistance rates of 140 extended-spectrum β-lactamase (ESBL)-producing Escherichia coli isolates obtained from urinary tract infection in Ordu Province, Turkey. Isolates were identified by classic methods and by automated system. ESBL production was confirmed by double disk synergy test and antimicrobial susceptibility was investigated by disk diffusion method. All isolates were screened for β-lactamase coding genes from three groups (A, B, and D) by polymerase chain reaction. The highest rate of susceptible isolates was observed for imipenem (IPM, 99.3%) and ertapenem (ETP, 97.9%), and the highest rate of resistant isolates was observed for cefuroxime (97.9%), ceftriaxone (97.2%), and cefazolin (90.7%). In our study, blaCTX-M1-like group was the most prevalent β-lactamase (n = 109), followed by blaTEM (n = 68), blaCTX-M2 (n = 22), and blaSHV (n = 2). By contrast to low resistance rate to IPM and ETP, we determined blaNDM in 31 isolates (22.1%). In co-prevalence of blaNDM-1 and ESBL-coding genes, a low carbapenem resistance was determined. We can confirm that blaCTX-M1-types are still the most frequent β-lactamase coding gene in Turkey. Our study showed the highest prevalence of blaNDM-1 metallo-β-lactamase coding gene in ESBL-producing E. coli

Brucellosis with rare complications and review of diagnostic tests: a case report

Abstract Background Brucellosis is one of the most common zoonotic diseases in the world. Osteoarticular complications, especially vertebral system involvement, are most commonly reported. However, reports and coreports of pulmonary complications and thoracal spondylodiscitis and epidural abscess are rare. Case presentation Spondylodiscitis was detected at the T11–12 vertebral level, followed by epidural and paravertebral abscess, and then empyema was detected in a 17-year-old Asian female patient without any additional disease. The patient had used various antibiotics and the disease could not be proven bacteriologically. Also, the Rose Bengal test was negative. However, serologically high titer Brucella positivity was detected in the blood and pleural fluid sample. Drainage was required for bilateral empyema. Disease duration prolonged due to multiple complications. The patient was cured with combined long-term treatment for brucellosis. Conclusions Although some are rare, brucellosis is a zoonotic disease that can cause many complications. The gold standard for diagnosis is the growth of bacteria in blood culture or tissue culture. However, isolation of the microorganism can be very difficult. Clinical suspicion and serological tests are important guides

Extended-Spectrum Beta-Lactamase Activity and In Vitro Efficiency of Ertapenem among Escherichia coli Strains Isolated from Urine Samples

Introduction: Urinary tract infections are the most common infections among community and hospital-acquired infections. Escherichia coli is the most frequently isolated pathogen of these infections. Despite the widespread use of antibiotics, especially beta-lactamase and extended-spectrum beta-lactamase (ESBL) producing strains continue to increase in number. Since these strains have evolved antimicrobial resistance, morbidity and mortality rates and treatment costs are increasing. The aim of this study was to investigate ESBL activity of E. coli strains isolated from the urine samples sent to microbiology laboratory, and in vitro efficacy of ertapenem which recently entered the clinical use. Materials and Methods: A total of 346 E. coli strains isolated from urinary specimens sent to clinical microbiology laboratory between September 2012 and September 2013 were included in the study. The samples were inoculated in 5% sheep blood agar and Eosin Methylene Blue Agar plates, and incubated in aerobic environment for 24-48 hours at 35°C for routine examination. Besides conventional methods, VİTEK 2 (bioMerieux, France) full automated system, was used for bacterial identification. Antibiotic sensitivity test of the identified bacteria was carried out by VITEK2 system, based on "Clinical and Laboratory Standards Institute (CLSI)" criteria. Results: Seventy (20.2%) of 346 E. coli strains isolated from urine samples were found to be ESBL producer. Of these 97.4% were sensitive to ertapenem and all ESBL negative E. coli strains were found to be susceptible to ertapenem. About 12.9% of ESBL positive E. coli strains were ertapenem-resistant. When we comparec sensitivity to ertapenem in ESBL positive and negative strains, the difference was statistically significantly (p< 0.05). Conclusion: Ertapenem is believed to be a good alternative of antimicrobial agent for the treatment of ESBL positive and negative E. coli infections with high sensitivity ratio and ease of single daily dose

Pneumonia Caused by Rhizobium radiobacter

Rhizobium spp. are aerobic, motile, non-spore forming, oxidase-positive, gram-negative rods. It has been shown that these microorganisms, which were not considered a pathogen initially, may lead to various infections. In particular, Rhizobium radiobacter, as opportunistic pathogens, have been found responsible in the development of many clinical presentations. This microorganism, encountered in infections in the presence of bacteremia and foreign bodies,should be considered when determined as the factor of pneumonia. A pneumonia case caused by R. radiobacter in a patient with a history of sarcoidosis and steroid use is presented in this article