The Prevalence of Esbl-Producing Strains of E.coli, Isolated from Calves with Colibacilosis - Preliminary Remarks

The animals producing food have become an increasing reservoir of extended spectrum beta-lactamase producing Enterobacteriaceae. The calves and cows are exposed to a greater quantity of antibiotics, but the data concerning the prevalence of ESBL-producing Enterobacteriaceae are not enough, in comparison with other species of animals used for human consumption, such as birds (Hordijk et al., 2013).The aim of this study was to determine the prevalence of ESBL-producing E. coli involved in some episodes of colibacilosis in calves. Faeces samples were collected from 33 calves with the age ranging between 1-2 weeks and that presented clinical signs of colibacilosis. The samples were collected in a sterile medium for the taxonomic isolation and identification of the etiological agent involved, the ESBL screening being conducted subsequently using the ESBL Agar Oxoid Brilliance chromogenic medium. The phenotypic confirmation of the ESBL-producing strains was conducted in accordance with the CLSI (2014) standard through the combined disc method. Following the tests conducted, out of the 33 strains of isolated E. coli, 9 (27, 27%) were phenotypically confirmed as being ESBL strains.The studies that were previously conducted on the dairy farms have pointed out that the young calves rapidly acquire bacterial strains resistant to antibiotics that are often ESBL strains (Hordijk et al., 2013). The prevalence obtained by us, as well as an insufficient quantity of information concerning the antimicrobial resistance on this segment of species of animals used for the human consumption, support conducting a more thorough study, as well as the identification of ESBL resistance genes, but also of the plasmids that encode the transmission of these genes

Characterisation of Extended β-Lactamases and Plasmid Mediated Quinolones Resistancein Escherichia Coli from Shelter Dogs

The aim of this study was to determine the prevalence of β-lactamase (TEM, SHV, OXA), extended-spectrum β-lactamase (ESBL) and genes encoding plasmid mediated resistance to quinolones (PMQR) in extended spectrum cephalosporin (ESC)-resistant Escherichia coli isolated from dog faeces from two shelters in the North-East of Romania. Eighty-eight faecal samples from healthy dogs were analysed by cultivation on Brilliance ESBL medium (Oxoid, UK), followed by phenotipic ESBL screening using combination disc test (CDT). Identification of the E. coli strains was performed by uidA/uspA gene PCR. Susceptibility testing was performed on Mueller-Hinton Agar, with β-lactam and non-β-lactam agents. Identification of β-lactamase genes (blaCTX-M, blaTEM, blaSHV, blaOXA) and PMQR genes (qnrA, qnrB and qnrS) was performed by PCR as previously described. Twenty eight ESC-resistant E. coli (31.81%) were obtained and (n=21/28, 75%) of these were confirmed as ESBLs and showed resistance to cefpodoxime (n=21/28, 75%), amoxicillin/clavulanic acid (n=19/21; 90.48%), and enrofloxacin (n=8/21; 38.09%). Predominant ESBL types were CTX-M-1 (n=15/17, 88.24%) and CTX-M-9 (n=2/17, 11.76%) enzymes. TEM and SHV enzymes were identified in 17.86% and 14.29% of the ESC-resistant isolates, whilst some isolates (n=4) carried only blaTEM and blaSHV. The prevalence of PMQR genes was 28.57% of the 28 ESC resistant isolates, consisting of qnrS (62.5%) and qnrB (37.5%). These findings indicate a high prevalence of ESBLs and PMQR associated resistance E. coli in the normal faecal microbiota of dogs from shelters, which carries the risk for dissemination of these resistance genes to other animals, human or the environment

Investigations on lymphocytes blastization mechanism as a result of stimulation with a specific antigen

In this scientific paper are reflected the results of the investigation on the lymphocytes blastization mechanism aspects as result of stimulation with anti-anthrax antigen and protein purified derivative. The aim of the scientific research was to study the lymphocytes blastization mechanism as a result of stimulation with a specific antigen in order to determine the immunity of the vaccinated and unvaccinated animals. The study was made on twenty bovines using the method of lymphoblastic transformation test. The evaluations take part of a preliminary study in order to identify the transformation process of lymphocytes in macrophages cells determined by nucleus and cytoplasm cells increasing. The obtained results reveal that the majority percentage of the macrophages at this stage of cultivation is determined by the reduced phagocytic activity. As a result of visualization the preparations, there were observed macrophages young cells without vacuoles, with basophilia in the cytoplasm and well-defined contours of nucleus. The lymphocytic stimulation intensity was evaluated by the percentage determination of the blasts from the population, procedure known as morphological method of evaluation the blasts transformation. The active transformations of the macrophages after revaccination of young animals constituted 15,5% of blasts, compared to control group, where the index of stimulation constituted 3,5%

Characterisation of the Resistance Patterns to Non Beta-Lactam Antimicrobials in Esbl-Producing Enterobacteriaceae Isolated from Dogs and Their Owners

Enterobacteriaceae producing extended-spectrum beta-lactamase (ESBL) enzymes are resistant to beta-lactam agents and are also commonly multidrug resistant being associated with the resistance to other classes of antibiotics. The aim of our study was to characterise resistance patterns in non-beta-lactam antibiotics of ESBL-producing Enterobacteriaceae strains isolated from faecal matter of pets and owners. The study was carried out on 63 samples of faecal matter (42 from pets and 21 from owners). The ESBL screening was carried out using the Brilliance ESBL Oxoid chromogenic medium. The isolated strains that generated characteristic presumptive ESBL-producing colonies were cultivated on 5% sheep blood medium for the extraction of bacterial DNA using the boiled preps technique. The confirmation of E. coli species was performed molecularly based on the detection of blauidA and blauspA genes. Other Enterobacteriaceae species were identified based on the minimum biochemical characteristics using the MIU and TSI medium. The phenotypical confirmation of presumptive ESBL-producing strains was carried out using the Double Disc Synergy Test (DDST) using a combination of 3rd generation cephalosporins and beta-lactamase inhibitor agents. The determination of the resistance degree in other classes of antibiotics was carried out through the Kirby-Bauer diffusimetric method, and the results were interpreted according to the CLSI standard. Following the species investigation of isolates, 60/63 (95.28%) belonged to the E. coli species and 3/63 (4.72%) to the K. pneumoniae species. Animal isolates were resistant to sulphonamides (54.76% resistance to SXT), fluoroquinolones (45.23% resistance to ENR) and tetracyclines (54.75% resistance to TE). In addition to strains of animal origin for isolates of human origin, an increased resistance has been noticed to phenicols and aminoglycosides. This study has identified a high prevalence of ESBL-producing Enterobacteriaceae strains and associated with multidrug resistance for pets and their owners

Resistance Phenotypes of Pseudomonas Aeruginosa Strains of Human Origin in Î’ - Lactamases

The use of β - lactam antibiotics is of utmost importance in medical practice. The natural resistance of Ps. aeruginosa strains to β-lactamases is important for clinical reasons, however, acquired resistance is very common (Pilly et al., 2006). Acquired resistance comprises either enzymatic mechanisms or non-enzymatic ones (Strateva T et al., 2009)The aims it is to identifying β-lactam profiles of resistance to Ps. aeruginosa strains and the last objective of this study is to evaluate the reliability and accuracy of the VITEK-2 Compact (Biome´rieux) automated identification and susceptibility testing system.The batch studied included 793 multi-resistant strains of Ps. aeruginosa, which were isolated from the Institute of Cardiovascular Diseases in Iași during 2013 - 2014, the isolates being taken from sputa, urine, pus and blood. Those isolates have passed susceptibility test that resistant to one or more antibiotic from third generation cephalosporin and/or resistant to aztreonam and/or intermediate or resistant to one or more antibiotic from carbapenem class.The results were interpreted with the help of the Vitek2 system, 61 beta-lactam resistance profiles being defined. Sputum is the primary source of isolates with almost 60%, the rest are from other sources i.e. urine, pus, blood, etc.As a result of the investigations we carried out, out of the total of 793 strains isolated and identified as multi-resistant Ps. aeruginosa, 61 strains were confirmed as having beta-lactam resistance profile. The result of this study confirmed that anyone could be infected by β- lactams resistance profile regardless their age, gender, and clinical manifestation

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London