Local survelance study on etiology of community-and hospital-acquired urinary tract infections (UTI) and antimicrobial susceptibility of uropathogens

This study was conduced during October 2010-March 2011 with the collaboration of the microbiology laboratory of International Evangelical Hospital (Voltri division) to identify the most frequent pathogens isolates from Urinary Tract Infections (UTI) and to evaluate their antibiotics susceptibility patterns. Overall, 780 consecutive, non duplicate strains were collected and sent to the coordinating laboratory. 143 strains were from Healthcare settings and 637 from comunity acqueired infections.The most rappresented pathogens was E. coli. In our region the epidemiological community landscape in terms of resistance, is getting closer to the nosocomial setting

Epidemiological study of pathogens isolated from blood in Liguria during 2011

Objectives. An epidemiological study addressed to identify the most represented pathogens isolated from blood and to evaluate their antibiotic susceptibility patterns, was conducted. Methods. Five clinical microbiology laboratories, homogenously distributed in Liguria, were required to collected all consecutive non-duplicates strains isolated from blood cultures during March 2011 to May 2011. the strains were sent to the reference laboratory (Section of Microbiology, DISC, University of Genoa, Italy). Results. A total of 159 microorganisms were enrolled, including 81 Gram positive, 69 Gram negative and 9 fungi.The most represented pathogens were: Escherichia coli (35), Staphylococcus aureus (26), S. epidermidis (20), S. hominis (10). Samples were collected mainly from medicine (59 isolates).Among the staphylococci, the most active molecules were: vancomycin (100% of susceptible strains), teicoplanin (93.4%), trimethoprim-sulfamethoxazole (83.8%) and tobramycin (61.6%). Enterococci showed rates of resistance to vancomycin of 25%. Enterobacteriaceae exhibited resistance to ampicillin (76.9%), ceftriaxone (44.4%), ciprofloxacin (43.3%), trimethoprim-sulfamethoxazole (36.6%) and ceftazidime (32.2%). Conclusions. The data show a higher incidence of Gram positive (51%) in comparison to Gram negative (43.4%). Gram-positive strains showed a high resistance level to fluoroquinolones (92.3%) while Gram-negative resulted resistant to ceftriaxone (44.4%) and fluoroquinolone (43.3%)

Epidemiological study of pathogens isolated from blood in Liguria (January-April 2010)

Objectives. An epidemiological study to identify the most represented pathogens isolated from blood and to evaluate their antibiotic susceptibility patterns, was conducted. Methods. Seven clinical microbiology laboratories, homogeneously distributed in the Ligurian area,were required to collected all consecutive non-duplicates strains isolated froom blood cultures during January 2010 to April 2010. The strains were sent to the reference laboratory (Sezione di Microbiologia del DISC, University of Genoa, Italy). Results. A total of 277 microorganisms were enrolled, including 155 Gram positive and 122 Gram negative.The most represented pathogens were: Escherichia coli (68), Staphylococcus aureus (57), Staphylococcus epidermidis (32), Staphylococcus hominis (17), Pseudomonas aeruginosa (15), Klebsiella pneumoniae (15), Enterococcus faecalis (11). Samples were collected mainly from medicine (66, 33.3%, of this number was determined by E. coli), intensive care units (33, 18.2% of this number consisted of S. epidermidis), surgery (24, 33.3% consisted of E. coli) and infectious diseases (20, of which S. aureus, E. coli and S. epidermidis equally represented 20.0%).Among the Staphylococci the most active molecules were: vancomycin and teicoplanin (100% of susceptible strains), chloramphenicol (92.3%) and trimethoprim-sulfamethoxazole (89.8%). Among the OXA-R Staphylococci (81/123, 65.9%) the most active molecules were: vancomycin and teicoplanin (100% of susceptible strains), chloramphenicol (93.8%) and trimethoprim-sulfamethoxazole (84.8%). Enterococci showed rates of resistance to vancomycin of 5.9%. Enterobacteriaceae exhibited resistance to ampicillin (77.5%), trimethoprim-sulfamethoxazole (42.6%), ciprofloxacin (41.2%), ceftriaxone (37.5%), ceftazidime (28.2%), cefepime (26.7%), cefoxitin (22.1%), piperacillintazobactam (20.4%), imipenem (4.7%) and amikacin (2.9%). The Gram negative non-Enterobacteriaceae showed rates of resistance of 100% to ceftriaxone, 81.3% to trimethoprim-sulfamethoxazole, 42.1% to ciprofloxacin and piperacillin-tazobactam, 33.3% to ceftazidime, 31.6% to cefepime, 27.8% to imipenem, 26.3 % to amikacin. Conclusions. The data show a higher incidence of Gram positive (56%) in comparison to Gram negative (44%).This confirms the high incidence of oxacillino-resistance in Staphylococci in our geographic area.Against Enterobacteriaceae rates of resistance were observed in excess of 20% for all drugs tested except imipenem (4.7%) and amikacin (2.9%). The proportion of imipenem-resistant isolates was constituted of strains of K. pneumoniae carbapenemase producers

Epidemiological study of pathogens collected from blood for a period of a year (2008-2009)

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Evaluation of a new automated cell analyzer (Sysmex UF-1000i) for bacteriological screening of urine

Introduction. Sysmex UF-1000 is a new flow cytometry for the analysis of urine based on a laser diode technology using specific compounds for the staining nucleic acids, characterized by a threshold of detection of bacteria equal to 1000 CFU/ml.The purpose of this study was to compare the positivity or negativity of the urine samples using standard procedures and with the response obtained from the instrument UF-1000i. Methods. During the period May and July 2011, 1024 urine samples obtained from the laboratory of the hospital in Genoa-Voltri were analyzed with the instrument Sysmex UF-1000i.The samples were stored at a temperature of 5°C during transport.The instrument after loading of the sample is able to assess the bacterial load in about 1 minute per sample. Results. 1024 samples were analyzed with Sysmex UF-1000 analyzed in parallel by the hospital laboratory in Genoa Voltri. 228 are positive results for Sysmex UF-1000 (bacterial loads in excess of 1000 CFU/ml).The data obtained were consistent with those recorded with traditional analysis. 18 samples were positive only for our instrument, but not with the traditional system used in the laboratory for comparison. Conclusion. The advantage of Sysmex UF-1000 is certainly due to obtain immediate results after the reading of each individual sample that is higher than any other instrument or method of analysis used. The slight discrepancy of the results obtained may be due to the extremely low calibration of UF-1000. This allows in a very short time to discard all negative samples with enormous saving of time and material. For positive samples and applies the criterion of the routine ie, the bacterial load has a meaning according to the type of patient considered, as in the case of pediatric or catheterized patient

Etiology and antibiotic susceptibility patterns of bacteria collected from urinary tract infections in the ASL3 in Genoa

An epidemiological study addressed to identify the pathogens collected from urine samples and their antibiotic susceptibility patterns was conducted. From January 2008 to May 2009 56,435 urine samples were processed in the Clinical Microbiological Laboratory of the ASL3 in Genoa. Materials and methods. Urine samples were firstly screened by automated equipment Uroquik (ALIFAX).All urine cultures with microbial ≥105 CFU / ml were seeded on Chromagar Orientation (BD) and incubated at 37 ° C °.The identification of the isolates and the evaluation of their susceptibility to antibiotics were determined by the automated system Vitek 2 (bioMérieux). Results. About 33% (18,543) of the urine samples gave positive results.The number and frequency of the microorganisms collected was: 13,379 (72%) Gram-negative including 9179 (69%) E.coli, 1382 (10%) Klebsiella spp, 1209 (9%) Proteus spp, 445 (3%) Pseudomonas spp, and other species 1164 (9%), 4942 (27%) Gram positive which included 3615 (73%) Enterococcus spp, 821 (17%) Staphylococcus spp, 506 (10% ) Streptococcus spp and 222 (1%) fungi. In E. coli the incidence of susceptible strains ranged between 90-96% for gentamicin, fosfomycin, nitrofurantoin, piperacillin-tazobactam, between 87-89% for the cefepime, cefotaxime, ceftazidime, about 70% for quinolones ciprofloxacin, norfloxacin, and trimethoprim-sulfamethoxazole, 62% for piperacillin, about 50% to ampicillin. For Klebsiella spp and Proteus spp the percentage of susceptible strains ranged from 95-99% to piperacillin-tazobactam, gentamicin, and respectively 93% and between 68-52% for third-generation cephalosporins cefotaxime and ceftazidime and fluoroquinolones ciprofloxacin and norfloxacin. Conclusions. Present findings indicate that among the Enterobacteriaceae, E. coli, cause most of UTI and in vitro resulted susceptible various antibiotics.There was an increased resistance to fluoroquinolones among community-acquired E. coli and Proteus spp.A periodical epidemiological study will be necessary to monitor the evolution toward resistance to antibiotics of the strains collected from urinary tract infections

Incidence of Acinetobacter baumannii and other pathogens isolated from Intensive Care Unit of the Hospital San Carlo, Genoa - Voltri

Acinetobacter baumannii is an emerging pathogen of great impact especially in nosocomial settings due to its complex epidemiology that makes its control very difficult. In this study the strains isolated from the Intensive Care Unite were analysed. Materials and methods. All the patients admitted into intensive care of San Carlo Hospital,Voltri, Genoa, Italy (ASL 3) in the period from May to December 2009 were considered.A total of 63 patients were studied including 31 women and 32 men, with an average of 73 years old.The study considered the following biological samples (N): bronchial aspirate and sputum (84), urine (55), blood (28), and other materials (36).The positive samples were processed for strain identification and evaluations of its antibiotic susceptibility pattern by standard VITEK2 system, following the Clinical and Laboratory Standard Institute Guidelines. Results and Conclusions. From samples taken into account, the prevalent percentage of bacterial species collected was registered by Gram negative (46.3%), followed by Gram positive (36.4%), and fungi (17.3%). Considering Gram negative isolates A. baumannii and Escherichia coli resulted among the prevalent pathogens (23.4 and 24.5% respectively). This microorganism was collected especially from bronchial aspirate (13) followed by urines (4), blood cultures (2) and other materials (3). On the basis of the analysis of the antibiotic susceptibility tests, colistin was active on the totality (100%) of A. baumannii, followed by tigecycline (96.77%).Amikacin resulted also active against a large proportion of these isolates (93.3%). Present findings confirm the great multidrug resistance phenotype of A. baumanii against the main classes of antimicrobial agents and its dangerous diffusion in the Intensive Care Units. For these reasons a continuous surveillance of the evolution of this pathogen toward antibiotic resistance is requested. In this contest it will be important an evaluation of antibiotic susceptibility following the guidelines suggested by EUCAST (European Committee on Antimicrobial Susceptibility Testing)

Epidemiological study of pathogens collected from blood for a period of a year (2008-2009)

Objectives. An epidemiological study, addressed to identify the pathogens isolated from blood, and their antibiotic susceptibility patterns, was conducted. Methods. 12 laboratories, homogeneously distributed in a Northern area of Italy, were required to collected all consecutive non-duplicated strains isolated from blood during February 2008 to February 2009 and sent them to the reference laboratory. Results. A total of 1092 microorganisms were collected, including 653 gram-positive, 385 gram-negative and 54 fungi. Escherichia coli 234, Staphylococcus epidermidis 205, S. aureus 142, S. hominis 87, Enterococcus faecalis 47, S. haemolyticus 33, Klebsiella pneumoniae 33, Pseudomonas aeruginosa 32, Candida albicans 28, Enterobacter cloacae 21 were the prevalent microrganisms found. Samples were collected mainly from medicine (255 strains), intensive care units (154), surgery (99), infectious diseases (93), paediatrics (62) and nephrology (62). Antibiotic resistance (in %) in staphylococci was 65.7 (methicillin), 33.5 (gentamicin), 61.8 (azithromycin), 59.6 (erythromycin), 45.2 (ciprofloxacin) 14.8 (chloramphenicol), 2.0 (teicoplanin), and 24.1 (trimethoprim-sulfamethoxazole) no vancomycin-resistant strain was found. Enterococci showed resistance to vancomycin (10.8), ampicillin (34.4), gentamycin (42.9), ciprofloxacin (42.2) teicoplanin (7.6), erythromycin (54.7) and chloramphenicol (17.5). Enterobacteriaceae exhibited resistance to ciprofloxacin(27.0), ampicillin (74.1), ceftazidime (15.8), cefoxitin (14.7), cefepime (13.3), ceftriaxone (15.0), both imipenem and amikacin (0.95), piperacillin-tazobactam (5.1) and trimethoprim-sulfamethoxazole (32.7). Non fermenting gram negative strains were found resistant to ciprofloxacin (27.3), ceftazidime (9.5), cefepime (14.6), ceftriaxone (81.6), both imipenem and amikacin (18.6), trimethoprim-sulfamethoxazole (65.2), and piperacillin-tazobactam (7.5). Conclusions.These data show a prevalent incidence of gram-positive (59.7 %) in comparison to gram-negative (35.3%) bacteria isolated from blood.A high percentage of methicillin-resistant staphylococci as well as ceftazidime-resistance among Enterobacteriaceae is also observed suggesting that this phenomenon requires periodically surveillance