The Most Frequent Aminoglycoside Resistance Mechanisms--Changes with Time and Geographic Area: A Reflection of Aminoglycoside Usage Patterns?

Miller, George H.; Sabatelli, F.; Hare, R S; Glupczynski, Youri; Mackey, P; Shlaes, David M.; Shimizu, Keiichi; Shaw, Karen Joy

doi:10.1093/clinids/24.supplement_1.s46

Cited by 209 publications

(161 citation statements)

References 9 publications

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“…This phenomenon has been reported in similar situations, due to aminoglycoside-modifying enzyme N-acetyl transferase (ACC6'-[I]) that hydrolyses amikacin, tobramycin, and netlimicin, but not gentamicin. 16 There was an alarming increase in the level of resistance to ciprofloxacin in our hospital, as only 75% of the isolates were inhibited, compared to 94% in 1996.…”

Section: Discussionmentioning

confidence: 80%

Antibiotic Consumption and Development of Resistance among Gram-Negative Bacilli in Intensive Care Units in Oman

2000

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Since the discovery of antimicrobial agents, microorganisms have developed virtually unlimited resistance to them.1 Hospitals and particularly intensive care units are an important breeding ground for the development of antibiotic-resistant bacteria. This is the consequence of heavy antibiotic use. In addition, a high-density patient population in frequent contact with health care staff and the attendant risk of cross-infection contributes to the spread of antibiotic-resistant micro-organisms. This in turn increases the morbidity and mortality associated with infections, and contributes to rising costs of health care.2,3 The aim of this study was to investigate the prevalence of antibiotic resistance among gram-negative bacteria in relation to antibiotic use in the intensive care unit (ICU) at the Royal Hospital, the main referral hospital in Oman. Materials and MethodsThe Royal Hospital is a 630-bed tertiary care hospital consisting of major medical and surgical departments, in addition to specialized units such as intensive care, neonatal, renal, cardiac and oncology. The intensive care unit (ICU) at the Royal Hospital is a general unit admitting both medical and surgical patients, and has a capacity of 12 beds divided between adults and pediatrics. Specimen Collection and Identification of IsolatesOne hundred consecutive gram-negative bacterial isolates from different sites were collected from patients admitted to the adult ICU at the Royal Hospital. The clinical significance of the isolates was confirmed by analysis of patients' records and discussion with the treating clinician. All bacterial strains were identified by their colonial morphology, gram reaction, the oxidized and other biochemical reactions as performed by either API 20E, or API 20NE (bioMerieux, France). Susceptibility TestingThe susceptibilities of the strains to 12 antibiotics (co-amoxiclav, cefuroxime, cefotaxime, ceftriaxone, ceftazidime, aztreonam, piperacillin, piperacillin/tazobactam, imipenem, gentamicin, amikacin, and ciprofloxacin) were performed by determining the minimum inhibitory concentration (MIC), using the E-test (AB BIODISK, Sweden), with E. coli NCTC 10418 and P. aeruginosa NCTC 10662 as controls. The interpretation standards for MICs of the NCCLS were used to determine antibiotic susceptibilities. 4 To detect extended spectrum β-lactamases (ESBL), ceftazidime-resistant strains of E. coli and Klebsiella spp. were further tested against ceftazidime/clavulanic acid. Isolates with a reduction of ceftazidime MIC by >3 two-fold dilutions in the presence of clavulanic acid were considered ESBL producers, and thus resistant to other cephalosporins. Antibiotic ConsumptionThe quantities of antibiotics consumed in the ICU during the period of the study were obtained from the hospital pharmacy records, and the numbers of the patients discharged were obtained from the hospital records. The estimated days of antibiotic treatment were calculated from the antibiotic daily dose, the total amount consumed and the number of patients who lef...

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Section: Discussionmentioning

confidence: 80%

Antibiotic Consumption and Development of Resistance among Gram-Negative Bacilli in Intensive Care Units in Oman

2000

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“…The choice of the resistance genes to be studied was based on their relative importance, as observed in resistant E. coli isolates (5,6,13,20,21,27,35). Therefore, 28 genes coding for resistance to antimicrobials in six families (betalactams, aminoglycosides, tetracycline, phenicols, trimethoprim, and sulfonamides) were chosen to determine their distributions among O149:K91 ETEC isolates from pigs with diarrhea (Table 1).…”

Section: Resultsmentioning

confidence: 99%

Antimicrobial Resistance Genes in Enterotoxigenic Escherichia coli O149:K91 Isolates Obtained over a 23-Year Period from Pigs

Maynard

Fairbrother

Békal

et al. 2003

Antimicrob Agents Chemother

254

148

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A total of 112 Escherichia coli O149:K91 strains isolated from pigs with diarrhea in Quebec, Canada, between 1978 and 2000 were characterized for their genotypic antimicrobial resistance profiles. Tests for resistance to 10 antimicrobial agents were conducted. Resistance to tetracycline and sulfonamides was found to be the most frequent, but resistance to cefotaxime and ceftiofur was absent. An increase in the number of isolates resistant to at least three antimicrobials was observed over time. The distribution of 28 resistance genes covering six antimicrobial families (beta-lactams, aminoglycosides, phenicols, tetracycline, trimethoprim, and sulfonamides) was assessed by colony hybridization. Significant differences in the distributions of tetracycline [tet(A), tet(B), tet(C)], trimethoprim (dhfrI, dhfrV, dhfrXIII), and sulfonamide (sulI, sulII) resistance genes were observed during the study period (

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“…Piperacillin and gentamicin resistance in SUP36 is associated with class 1 integron gene cassettes. AAC(6')-I, an enzyme that confers resistance to tobramycin, netilmicin, amikacin, dibekacin, and kanamycin [44]. Tobramycin resistance in DBP19 is associated with Aac-(6')-I gene cassette.…”

Section: Discussionmentioning

confidence: 99%

Screening of Class 1 and Class 2 Integrons in Clinical Isolates of Pseudomonas aeruginosa Collected from Seven Hospitals in Turkey: A Multicenter Study

Çiçek¹,

Saral²,

Düzgün³

et al. 2013

OJMM

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Pseudomonas aeruginosa is one of the leading nosocomial pathogens worldwide, and their infections are difficult to treat due to acquired resistance to many antibiotics. This study aimed to detect class 1 and 2 integrons and antibiotic susceptibility of clinical isolates of P. aeruginosa. Two hundred and five P. aeruginosa strains were collected from the seven general state hospitals in Turkey. They were characterized by antimicrobial susceptibility testing, screened for class 1 and class 2 integrons, and evaluated for the association between antibiotic resistance phenotypes and the presence of integrons. intI gene was amplified in 10 isolates (4.87%) by PCR and in seven isolates of them (70%) were found different gene cassettes. The aadA gene integrated into the class 1 integrons was most frequently found and it was followed by aac genes and bla OXA family genes. Sequence analysis of variable regions of the class 1 integrons showed five gene cassette arrays;

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The Most Frequent Aminoglycoside Resistance Mechanisms--Changes with Time and Geographic Area: A Reflection of Aminoglycoside Usage Patterns?

Cited by 209 publications

References 9 publications

Antibiotic Consumption and Development of Resistance among Gram-Negative Bacilli in Intensive Care Units in Oman

Antibiotic Consumption and Development of Resistance among Gram-Negative Bacilli in Intensive Care Units in Oman

Antimicrobial Resistance Genes in Enterotoxigenic Escherichia coli O149:K91 Isolates Obtained over a 23-Year Period from Pigs

Screening of Class 1 and Class 2 Integrons in Clinical Isolates of Pseudomonas aeruginosa Collected from Seven Hospitals in Turkey: A Multicenter Study

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