Antibiotic Molecules Involved in Increasing Microbial Resistance

Abstract

Over the past two decades, the resistance to antibiotics, especially for Gram-negative bacteria, has increased at an alarming rate, requiring constant concern for resolving and controlling this extremely important therapeutic aspect in any medical department but in particular, in Anaesthesia and Intensive Care Units, in units of neonatology, paediatrics, neurosurgery, burned patients and immunosuppressed. Specialists note a particular concern for the resistance of Enterobacteriaceae to third-generation cephalosporins and aztreonam, with a resistance profile frequently associated with the expression of extended-spectrum �-lactamases (ESBL). The Enterobacter genus comprises 14 species, but two are of medical interest, Enterobacter aerogenes and E. cloacae, which are involved in inducing healthcare-associated infections such as urinary tract infections, pneumonia associated with mechanical ventilation, bacteremia, septicemia, etc. The purpose of the study was to highlight the antibiotic molecules in which microbial resistance of some circulating strains of enterobacteria was detected. A descriptive and retrospective study was conducted between 2012-2017, on a batch of 35 patients, admitted to the Sf. Maria Emergency Clinical Hospital for Children of Iasi, from whom various pathological products were collected to highlight the Enterobacter sp strains involved in the production of infections associated with the inpatient medical care. The antimicrobial sensitivity of each strain was determined by diffusimetric method, while the interpretation criteria were considered to be those of the laboratory standards. Most cases were reported in 2017 (31.42%). The majority were registered in new-borns (42.85%) and infants (25.71%). The Anaesthesia and Intensive Care Units and Neonatology Anaesthesia and Intensive Care Units departments were the most involved. Microbial antibacterial resistance of Enterobacter sp isolates showed that all manifested resistance to ampicillin, amoxicillin and clavulanic acid, 48.57% were resistant to Cefuroxime, 42.85% resistant to Ceftazidime and Ceftriaxone, 14.28% to ciprofloxacin, 11.42% to ertapenem, 5.71% to Meronem. Although it showed relatively few cases with infections associated with healthcare in which strains of Enterobacter sp. were isolated our study, which was carried out over a period of 5 years, provides useful indications regarding the prevalence of healthcare associated infections with Enterobacter sp in paediatric patients and guidelines for antibiotic therapy.

Current Challenges in the Treatment of the Omphalocele—Experience of a Tertiary Center from Romania

“…In terms of perinatal management, increasing the rate of antenatal diagnosis of severe associated malformations or giant omphalocele with abdominal-visceral disproportion will lead to therapeutic abortion and decreased postnatal mortality. Proper surgical treatment, careful monitoring of abdominal pressure, avoiding the use of empirical antibiotic therapy, and ensuring the strictest aseptic measures in neonatal intensive care units will prevent acute renal failure and sepsis and decrease morbidity and mortality in the case of omphalocele [ 2 , 3 , 32 ].…”

Urachal Carcinoma, An Unusual Possibility of Hematuria; Case Report and Literature Review

“…Partial or radical cystectomy has similar oncologic results, but partial cystectomy should be preferred because it ensures a better quality of life and has less complications. Complete tumor resection (negative surgical margins) is of great importance in partial cystectomy; postoperative care, bladder drainage, carefully chosen antibiotic therapy and psychological support of the patient must be carried out in a multidisciplinary team [ 10 , 34 , 83 ]. Thus, en bloc resection with complete removal of urachal remnant and the umbilicus should be the surgery performed for prolonged survival [ 34 ].…”

Omphalocele and Cardiac Abnormalities—The Importance of the Association

“…If the cardiac malformation requires open surgical intervention or catheter-based interventions, usually this must be performed before closing the abdominal wall defect, because reduction of the herniated viscera inside the peritoneal cavity may alter preload and afterload, leading to hemodynamic instability; additionally, if the liver is outside the abdomen, suprahepatic veins may be torsioned during the integration of the liver and cardiac, or liver insufficiency may appear. The need to perform several surgical interventions, parenteral nutrition, blood transfusion, mechanical ventilation, as well as prolonged hospitalization will favor the occurrence of nosocomial infections and will increase the morbidity rate [ 45 , 69 , 76 , 77 ]. In any case, the order of surgical interventions and case management will be established by a multidisciplinary team.…”