Two cases of infections due to multidrug-resistant Bacteroides fragilis group strains

Bacteroides fragilis group strains are still considered susceptible to most antimicrobial agents used for the treatment of infections caused by anaerobic organisms. We describe two cases of infections due to isolates simultaneously resistant to clindamycin, tetracycline, cefoxitin, piperacillin-tazobactam, and imipenem and, in one of the two cases, to metronidazole. Such infections, although still rare, do exist and tend to complicate treatment. Copyright © 2006, American Society for Microbiology. All Rights Reserved

Ongoing epidemic of bla_VIM-1-positive Klebsiella pneumoniae in Athens, Greece:A prospective survey

Objectives: To determine the current frequency and study the characteristics of VIM-1-producing Klebsiella pneumoniae isolates from bloodstream infections in Greek hospitals. Methods: All blood isolates of K. pneumoniae were prospectively collected during 2004–06 in three teaching hospitals located in Athens. MICs of antibiotics were determined by the Etest. Extended-spectrum- (ESBL) and metallo-b-lactamase (MBL) production was examined by clavulanate- and EDTA-based techniques, respectively. Isolates were typed by PFGE of XbaI-digested genomic DNA. Detection of blaVIM-1 and mapping of the VIM-1-encoding integrons were performed by PCR and sequencing. b-Lactamase activities were analysed by IEF and imipenem hydrolysis was assessed by spectropho-tometry. VIM-1-encoding plasmids were transferred to Escherichia coli by conjugation and transform-ation and characterized by Inc/rep typing and RFLP. Results: Sixty-seven (37.6%) of 178 K. pneumoniae blood isolates were blaVIM-1-positive (VPKP); 77.8% of these were from ICUs. All VPKP isolates were multidrug-resistant. The MICs of carbapenems for VPKP varied from the susceptible range to high-level resistance overlapping with those of MBL-negative isolates. The EDTA-imipenem synergy methods had reduced sensitivity in detecting VPKP isolates when the MICs were in the susceptible range. ESBL production was common among VPK

Prospective study of Klebsiella pneumoniae bacteremia:Risk factors and clinical significance of type VIM-1 metallo-beta-lactamases

The Swedish Road Administration wants to compile all the national road database data from The Swedish Mapping, Cadastral and Land Registration Authority using a Geographical Information System compiler in order to increase the efficiency of data flow between their respective databases. The objective of this master’s thesis has been to build a software solution containing changed private road data input from The Swedish Mapping, Cadastral and Land Registration Authority and processing it into the OpenTNF standard format. This would enable automatic processing and of private road data to the national road database at the Swedish Road Administration. The work is divided into four parts; 1. Researching standards for databases and version control. 2. Plan the methodology using different resources. 3. Development of a software solution. 4. Analysis. The chosen software is FME by Safe Software. A number of shortcomings such as lack of information on the practical input for the future ANDA system were discovered, therefor some assumptions and simplifications had to be made. Using the assumptions and examples, a functioning solution was created according to the OpenTNF and INSPIRE standards. The examples to fills that gap in knowledge and provide a greater understanding of the usage of the INSPIRE and OpenTNF standards for transport networks. An analysis and a discussion about the existing solution, bottlenecks, faults with the existing database and version management between the databases related to found research is presented. Workflows on different examples for the software solution can be seen in the results. The national road database suffers from low implementation rate and creates issues for making new applications and the ability to adapt to ever-changing nature of planning. Creating a software for automatic update on network data is crucial for the Swedish Road Administration for implementing technologies that are dependent on frequent updates, such as self-driving vehicles

PREVALENCE OF FLUOROQUINOLONE RESISTANCE IN EUROPE

Since 1984, when the first fluoroquinolone, norfloxacin, was marketed in Europe, there has been a marked increase in the usage of this class of drugs. In order to evaluate the influence of this drug usage on the prevalence of resistance to fluoroquinolones in clinical isolates of the family Enterobacteriaceae, Pseudomonas aeruginosa, Staphylococcuss aureus, coagulase-negative staphylococci and Enterococcus faecalis we reviewed the susceptibility data from four collaborative surveys conducted between 1983 and 1990 by the Study Group ‘Bacterial Resistance’ of the Paul-Ehrlich-Society for Chemotherapy. All participating laboratories used the same standardized methods. Miminal inhibitory concentrations were determined by the broth microdilution method. More than 20,000 bacterial strains were tested. The results are presented for ciprofloxacin, which is regarded as the representative of the fluoroquinolones. Using greater than or equal to 4 mg/l as a breakpoint for resistance to ciprofloxacin, the prevalence of resistant strains of the family Enterobacteriaceae in Central Europe between 1983 and 1990 remained below 1%. In contrast, the resistance rates in P. aeruginosa were 0.7%, 1.0%, 3.8% and 7.0%, in S. aureus 0%, 0.5%, 6.6% and 6.8%, and in E. faecalis 2.2%, 0.7%, 4.9% and 7.7% in 1983, 1986, 1989 and 1990, respectively. The latest study carried out in cooperation with 78 laboratories from 12 European countries revealed great differences in the prevalence of resistance to fluoroquinolones from one species to another ranging from 0% with Proteus vulgaris and Salmonella spp. to 26.7% with Providencia stuartii. The highest rates of resistance were recorded for oxacillin-resistant strains of S. aureus (70.6%) and oxacillin-resistant coagulase-negative staphylococci (51.2%). Resistance levels for individual species varied between countries, but they were consistently higher in Southern Europe than in Northwest and Central Europe. Resistance in S. aureus and E. faecalis was more prevalent in isolates from intensive care patients than in isolates from patients on normal wards. In addition, S. aureus isolates displayed a considerable difference in the resistance rates for blood (9.3%) and urine (34.4%)