169 research outputs found
Diarrheagenic Escherichia coli
Conventionally, in Escherichia coli, phylogenetic groups A and B1 are associated with commensal strains while B2 and D are associated with extraintestinal strains. The aim of this study was to evaluate diarrheagenic (DEC) and commensal E. coli phylogeny and its association with antibiotic resistance and clinical characteristics of the diarrheal episode. Phylogenetic groups and antibiotic resistance of 369 E. coli strains (commensal strains and DEC from children with or without diarrhea) isolated from Peruvian children <1 year of age were determined by a Clermont triplex PCR and Kirby-Bauer method, respectively. The distribution of the 369 E. coli strains among the 4 phylogenetic groups was A (40%), D (31%), B1 (21%), and B2 (8%). DEC-control strains were more associated with group A while DEC-diarrhea strains were more associated with group D (P<0.05). There was a tendency (P=0.06) for higher proportion of persistent diarrhea (≥14 days) among severe groups (B2 and D) in comparison with nonsevere groups (A and B1). Strains belonging to group D presented significantly higher percentages of multidrug resistance than the rest of the groups (P>0.01). In summary, DEC-diarrhea strains were more associated with group D than strains from healthy controls
Azithromycin resistance levels and mechanisms in Escherichia coli
Despite azithromycin being used in some countries to
treat infections caused by Gram-negative pathogens, no
resistance breakpoint for Escherichia coli exists. The aim of
this study was to analyse the levels and mechanisms of
azithromycin resistance in E. coli. The presence of chromosomal
(rplD, rplV and 23S rRNA) mutations, 10 macrolide resistance
genes (MRGs) and efflux pump overexpression was determined in
343 E. coli isolates. Overall, 89 (25.9%) isolates had
MICs\xE2\x80\x89\xE2\x89\xA5\xE2\x80\x8932\xE2\x80\x89mg/L to
azithromycin, decreasing to 42 (12.2%) when assayed in the
presence of Phe-Arg-\xCE\xB2-Napthylamide, with 35 of these 42
possessing at least one MRG. Efflux pumps played a role in
azithromycin resistance affecting the Minimal Inhibitory
Concentration (MIC) levels of 91.2% isolates whereas chromosomal
alterations seem to have a minimal role. At least one MRG was
found in 22.7% of the isolates with mph(A) being the most
commonly found gene. The mph(A) gene plays the main role in the
development of azithromycin resistance and 93% of the
mph(A)-carrying isolates showed a MIC of 32\xE2\x80\x89mg/L. In
the absence of a specific resistance breakpoint our results
suggest a MIC of 32\xE2\x80\x89mg/L to be considered in order to
detect isolates carrying mechanisms able to confer azithromycin
resistance
oral Lactoferrin administration Does Not Impact the Diversity or Composition of the infant Gut Microbiota in a Peruvian Cohort
Previous studies have suggested that oral lactoferrin enhances diversity in the gut microbiota in infants while inhibiting the growth of opportunistic pathogens. However, the effect of lactoferrin on infant gut microbiota over time has yet to be thoroughly studied. Our study suggests that lactoferrin oral treatment in infants aged 12-18 months does not affect gut microbiome diversity and composition over time. to our knowledge, this is the first study to report the effect of lactoferrin on infant gut microbiome composition over time and helps elucidate its impact on infant health and its therapeutic potential
Virulence and Antimicrobial Resistance in Campylobacter spp. from a Peruvian Pediatric Cohort
The presence of virulence factors (VFs) and mechanisms of
quinolones and macrolide resistance was analyzed in
Campylobacter spp. from a pediatric cohort study in Lima. In 149
isolates (39 Campylobacter jejuni and 24 Campylobacter coli from
diarrheic cases; 57 C. jejuni and 29 C. coli from controls), the
presence of the cdtABC and cadF genes and iam marker was
established. Nalidixic acid, ciprofloxacin, erythromycin, and
azithromycin susceptibilities were established in 115 isolates
and tetracycline-susceptibility was established in 100 isolates.
The presence of mutations in the gyrA, parC, and 23S rRNA genes
was determined. The cadF gene and all genes from the cdtABC
operon were significantly more frequent among C. jejuni (P <
0.0001); the iam marker was more frequent in C. coli (P <
0.0001). No differences were observed in VFs between cases and
controls. Almost all isolates were tetracycline-resistant;
nalidixic acid and ciprofloxacin resistance reached levels of
90.4% and 88.7%, respectively. Resistance to macrolides was 13%
(C. jejuni 4.3%; C. coli 26.1%). Resistance to ciprofloxacin was
related to GyrA Thr86 substitutions, while 13 of 15
macrolide-resistant isolates possessed a 23S rRNA mutation
(A2075G). Differences in the presence of VFs and alarming levels
of resistance to tested antimicrobial agents were observed among
C. jejuni and C. coli
Pathogenic Acinetobacter species including the novel Acinetobacter dijkshoorniae recovered from market meat in Peru
Species of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex are important human pathogens which can be recovered from animals and food, potential sources for their dissemination. The aim of the present study was to characterise the Acinetobacter isolates recovered from market meat samples in Peru. From July through August 2012, 138 meat samples from six traditional markets in Lima were cultured in Lysogeny and Selenite broths followed by screening of Gram-negative bacteria in selective media. Bacterial isolates were identified by MALDI-TOF MS and DNA-based methods and assessed for their clonal relatedness and antimicrobial susceptibility. Twelve Acinetobacter isolates were recovered from calf samples. All but one strain were identified as members of the clinically-relevant Acinetobacter calcoaceticus-Acinetobacter baumannii complex: 9 strains as Acinetobacter pittii, 1 strain as A. baumannii, and 1 strain as the recently described novel species A. dijkshoorniae. The remaining strain could not be identified at the species level unambiguously but all studies suggested close relatedness to A. bereziniae. All isolates were well susceptible to antibiotics. Based on macrorestriction analysis, six isolates were further selected and some of them were associated with novel MLST profiles. The presence of pathogenic Acinetobacter species in human consumption meat might pose a risk to public health as potential reservoirs for their further spread into the human population. Nevertheless, the Acinetobacter isolates from meat found in this study were not multidrug resistant and their prevalence was low. To our knowledge, this is also the first time that the A. dijkshoorniae species is reported in Peru
Dissemination of a multidrug resistant CTX-M-65 producer Salmonella enterica serovar Infantis clone between marketed chicken meat and children
The objective of the present study was to characterize Salmonella enterica serovar Infantis isolated from chicken meat determining their clonal relationships with S. Infantis isolated from children with diarrhea. Fifteen meat-recovered S. Infantis were analyzed. Susceptibility levels to 14 antibacterial agents, the presence of ESBL and that of inducible plasmid-mediated AmpC (i-pAmpC) were determined by phenotypical methods. The presence of ESBL and pAmpC was confirmed by PCR, and detected ESBL-encoding genes were sequenced and their transferability tested by conjugation. The presence of gyrA mutations as well as Class 1 integrons was determined by PCR. Clonal relationships were established by REP-PCR and RAPD. In addition, 25 clinical isolates of S. Infantis were included in clonality studies. All meat-recovered S. Infantis were MDR, showing resistance to ampicillin, nitrofurans and quinolones, while none was resistant to azithromycin, ceftazidime or imipenem. ESBL (blaCTX-M-65) and i-pAmpC (blaDHA) were detected in 2 and 5 isolates respectively (in one case concomitantly), with blaCTX-M-65 being transferable through conjugation. In addition, 1 isolate presented a blaSHV gene. All isolates presented D87Y at GyrA, nalidixic acid active efflux pump and a Class 1 integron of ~1000 bp (aadA1). Clonal analysis showed that all isolates were related. Further they were identical to MDR blaCTX-M-65-producing S. Infantis isolates causing children diarrhea in Lima. The dissemination of MDR blaCTX-M-65-producing S. Infantis between marketed meat and children highlights a public health problem which needs be controlled at livestock level
Knowledge, attitudes and practices of parents towards antibiotic use in rural communities in Peru: a cross-sectional multicentre study
Background
The inappropriate use of antibiotics significantly contributes to the development of antibiotic resistance. There is limited information about the use of antibiotics among parents from rural areas in Peru. This study aimed to describe the knowledge, attitudes and practices towards antibiotics among parents of children < 5 years of age from rural communities in Peru; to explore the association between knowledge and attitudes towards antibiotics and to explore determinants of low knowledge and self-medicating his/her child with antibiotics.
Methods
Cross-sectional study in six rural primary health centres in Peru using a self-administered survey. Crude and adjusted Prevalence Ratios (PR), and 95% Confidence Intervals (95% CI) were calculated to explore determinants of low knowledge and of having self-medicated his/her child with antibiotics. Linear regression was used to explore the association between knowledge and attitudes.
Results
A total of 231 parents were included. The largest gap in knowledge was among 183 parents (79%) who did not know that antibiotics cannot cure viral infections. The largest gap in attitudes was among 185 participants (80%) that did not disagree with “If I want my child to receive antibiotics, I would not be satisfied if the doctor refuses to prescribe them”. More than half of parents (n = 120, 52%) reported having self-medicated his/her child with antibiotics. A positive correlation was found between knowledge and attitudes (Coefficient 0.53, 95% CI 0.38–0.68) after adjusting for the age and the education of the parent. Parents who were < 20 years old were more likely to have low knowledge about antibiotics (crude PR 2.39, 95% CI 1.32–4.34) compared to those aged > 40 years.
Parents who had self-medicated his/her child with antibiotics (n = 120, 52%) were more likely to have purchased antibiotics without prescription (aPR 2.70, 95% CI 1.74–4.19) and to have received antibiotics after the recommendation of a pharmacist (aPR 1.79, 95% CI 1.13–2.82).
Conclusions
Knowledge about antibiotics among parents from rural settings in Peru is limited and highlights the need for educational interventions. Public health policies to limit the acquisition of antibiotics without prescription should be implemented
Presencia de Enterobacteriaceae y Escherichia coli multirresistente a antimicrobianos en carne adquirida en mercados tradicionales en Lima
Objetivos. El objetivo del presente estudio fue describir la presencia de Enterobacteriaceae en muestras de carne recolectadas en mercados tradicionales de Lima y establecer los niveles de resistencia a antimicrobianos y la presencia de betalactamasas de espectro extendido (BLEE) y AmpC en Escherichia coli. Materiales y mĂ©todos. Se recolectaron un total de 138 muestras de carne, 64 (46,4 %) de pollo, 44 (31,9 %) de carne de res y 30 (21,7%) de carne de cerdo. Las bacterias aisladas pertenecieron a 17 gĂ©neros diferentes, y especĂficamente 14 fueron clasificados como Enterobacteriaceae. Se analizĂł la sensibilidad frente a diez agentes antimicrobianos mediante el mĂ©todo de difusiĂłn de disco Kirby-Bauer, se determinĂł la presencia de BLEE y AmpC mediante las pruebas de doble disco y de inducciĂłn de imipenem-ceftazidima, respectivamente. Resultados. Los niveles
de resistencia a los antimicrobianos fueron altos frente a trimetoprima-sulfametoxazol, ampicilina, tetraciclina, ácido nalidĂxico, ciprofloxacino y cloranfenicol. Existen diferencias significativas en los niveles de resistencia a los antibiĂłticos segĂşn el tipo de carne (pollo, carne de res y cerdo) (p <0,05). Los niveles de resistencia a mĂşltiples antimicrobianos (MDR) fueron particularmente altos en pollo y cerdo (98,2 % y 86,4 %, respectivamente). Además, la presencia de BLEE en Escherichia coli aisladas de carne de pollo fue del 59,4 %. Conclusiones. Los niveles de resistencia a los antimicrobianos fueron altos frente a los antibiĂłticos
usados frecuentemente en humanos, se destaca el pollo y la res como potenciales reservorios de Escherichia coli productoras de BLEE y pAmpC, respectivamente
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