Search

Introduction The objective of this study was to analyse the susceptibility to antibiotic of Citrobacter freundii, Klebsiella aerogenes, Enterobacter cloacae, Serratia marcescens, Providencia stuartii and Morganella morganii (CESPM group), detected in urine cultures. Methods Between 2006 and 2016, we analysed CESPM group Enterobacteria isolated from urine cultures from both primary health-care centres and Hospital Virgen de las Nieves (Granada). We studied the susceptibility to aminoglycosides, fosfomycin, nitrofurantoin, quinolones, piperacillin/tazobactam, cefepime, imipenem and trimethoprim/sulfamethoxazole following CLSI interpretation criteria. Results A total of 736 isolates were studied: 30.57% E. cloacae, 23.50% M. morganii, 20.38% K. aerogenes, 10.32% C. freundii, 8.83% S. marcescens and 6.38% P. stuartii. A significant decrease in the antibiotic susceptibility was observed. Gentamicin, ciprofloxacin, imipenem and cefepime showed susceptibility over 80%. Conclusions E. cloacae, M. morganii and K. aerogenes were the most common isolates. Cefepime and imipenem are still a good empiric therapeutic alternative given its activity in vitro.

Resumen Introduccion El objetivo fue la deteccion en urocultivos de Citrobacter freundii, Klebsiella aerogenes, Enterobacter cloacae, Serratia marcescens, Providencia stuartii y Morganella morganii (grupo CESPM) para el estudio de su perfil de sensibilidad a los antibioticos. Metodos Entre 2006 y 2016 se analizaron todos los aislados de enterobacterias del grupo CESPM de urocultivos de centros de atencion primaria o del complejo hospitalario Virgen de las Nieves (Granada). Se estudio la sensibilidad a aminoglucosidos, fosfomicina, nitrofurantoina, quinolonas, piperacilina/tazobactam, cefepime, imipenem y trimetoprim/sulfametoxazol, segun normas del CLSI. Resultados Se estudiaron 736 aislamientos (30,57% E. cloacae; 23,50% M. morganii; 20,38% K. aerogenes; 10,32% C. freundii; 8,83% S. marcescens y 6,38% P. stuartii). Se observo una disminucion significativa de la sensibilidad. Para gentamicina, ciprofloxacino, imipenem y cefepime presentaron sensibilidad superior al 80%. Conclusion E. cloacae, M. morganii y K. aerogenes fueron las especies mas frecuentemente aisladas. Cefepime e imipenem siguen siendo una buena alternativa terapeutica empirica por su actividad in vitro.

Background and objectives A study of the susceptibility to antimicrobials of the extended spectrum beta-lactamase phenotypes (ESBL) in Escherichia coli and Klebsiella spp. was performed to discover the evolution of this type of resistance from urinary tract infections. Material and method A retrospective study was carried out between 2012 and 2016. Susceptibility to ciprofloxacin, tobramycin, cefoxitin, fosfomycin, nitrofurantoin, co-trimoxazole, and carbapenems was analysed using MicroScan® system. Results A total of 95,399 samples were processed and 9772 E. coli, 1784 Klebsiella pneumoniae and 248 Klebsiella oxytoca were isolated. ESBL strains were more frequent in women, although they decreased during 2015 and 2016 (65.7–67.2%). The prevalence of K. pneumoniae ESBL increased annually (28.1% in 2016). The average prevalence of E. coli ESBL was 10.5% with few oscillations. Higher resistance occurred to ciprofloxacin and cotrimoxazole, 89.5 and 94.7% in 2015, respectively, and there was lesser resistance to imipenem. Fosfomycin and nitrofurantoin were very active on E. coli ESBL. Conclusions ESBL producing E. coli and K. pneumoniae were prevalent, especially the latter, with a significant resistance to ciprofloxacin and cotrimoxazole. Susceptibility to imipenem was high.

A study of the susceptibility to antimicrobials of the extended spectrum beta-lactamase phenotypes (ESBL) in Escherichia coli and Klebsiella spp. was performed to discover the evolution of this type of resistance from urinary tract infections.A retrospective study was carried out between 2012 and 2016. Susceptibility to ciprofloxacin, tobramycin, cefoxitin, fosfomycin, nitrofurantoin, co-trimoxazole, and carbapenems was analyzed using MicroScanA total of 95,399 samples were processed and 9,772 E. coli, 1,784 Klebsiella pneumoniae and 248 Klebsiella oxytoca were isolated. ESBL strains were more frequent in women, although they decreased during 2015 and 2016 (65.7-67.2%). The prevalence of K. pneumoniae ESBL increased annually (28.1% in 2016). The average prevalence of E. coli ESBL was 10.5% with few oscillations. Higher resistance occurred to ciprofloxacin and cotrimoxazole, 89.5 and 94.7% in 2015, respectively, and there was lesser resistance to imipenem. Fosfomycin and nitrofurantoin were very active on E. coli ESBL.ESBL producing E. coli and K. pneumoniae were prevalent, especially the latter, with a significant resistance to ciprofloxacin and cotrimoxazole. Susceptibility to imipenem was high.

In this work an "in house" rapid test based on the change in pH that is due to hydrolysis for detecting Enterobacteriaceae susceptible to cefotaxime is evaluated. The strains of Enterobacteriaceae from 1947 urine cultures were assessed using MicroScan panels and the "in house" test. This rapid test includes red phenol solution and cefotaxime. Using MicroScan panels, 499 Enterobacteriaceae isolates were evaluated, which included 27 isolates of Escherichia coli producing extended-spectrum beta-lactamases (ESBL), 16 isolates of Klebsiella pneumoniae ESBL and 1 isolate of Klebsiella oxytoca ESBL. The "in house" test offers the following values: sensitivity 98% and specificity 97%, with negative predictive value 100% and positive predictive value 78%. The "in house" test based on the change of pH is useful in our area for detecting presumptively cefotaxime-resistant Enterobacteriaceae strains.

Purpose. Acinetobacter baumannii and Pseudomonas aeruginosa are responsible for numerous nosocomial infections. The objective of this study was to determine the development of their susceptibility to ten antibiotics and the antibiotic consumption of patients with suspicion of urinary tract infection (UTI). Methodology. A retrospective study was conducted on the susceptibility profiles of A. baumannii and P. aeruginosa isolates from 749 urine samples gathered between January 2013 and December 2016, and on the consumption of imipenem, meropenem and piperacillin-tazobactam between 2014 and 2016. Results. Hospital patients were the source of 82 (91.1 %) of the 90 A. baumannii isolates detected and 555 (84.2 %) of the 659 P. aeruginosa isolates. Globally, the lowest percentage susceptibility values were found for fosfomycin, aztreonam and ciprofloxacin, while colistin continued to be the most active antibiotic in vitro. In 2016, the susceptibility of A. baumannii to carbapenem and piperacillin-tazobactam decreased to very low values, while the susceptibility of P. aeruginosa to carbapenem remained stable but its susceptibility to piperacillin-tazobactam decreased. There was a marked increase in the consumption of piperacillin-tazobactam. Conclusion. In our setting, it is no longer possible to use carbapenems and piperacillin-tazobactam for empirical treatment of UTI due to A. baumannii or to use piperacillin-tazobactam for empirical treatment of UTI due to P. aeruginosa. Colistin was found to be the most active antibiotic in vitro. There was a marked increase in the consumption of piperacillin-tazobactam.

Journal Article; English Abstract; Given the relevance of proper clinical validation of Streptococcus bovis, we here consider revising its presence in urine samples in order to determine its relative frequency and the pattern of antibiotic susceptibility. The susceptibility to antibiotics of 91 isolates of S. bovis from urine samples was retrospectively reviewed over a period of 4 years (2012-2015). The mean age of patients was 55 years, 81% of whom were women and 37.4% were hospitalized patients suffering from urological diseases (61%). Susceptibility to penicillin, vancomycin and teicoplanin was 97.8%. Due to the fact that S. bovis can be infrequent in urine isolates and given its presence in patients suffering from urological diseases, further pathogenic studies, showing the true ability of this group of bacteria to produce disease, are required. Yes Dada la importancia de la correcta validación clínica de los aislamientos de Streptococcus bovis, nos planteamos la revisión de su presencia en muestras de orina con el objetivo de conocer su frecuencia relativa y su patrón de sensibilidad antibiótica. Se revisó retrospectivamente la sensibilidad a los antibióticos de 91 aislados de S. bovis recuperados de muestras de orina durante un período de 4 anos ˜ (2012-2015). La media de la edad de los pacientes fue de 55 anos ˜ y en su mayoría fueron mujeres (81%). El 37,4% eran pacientes hospitalizados con enfermedades urológicas (61%). La sensibilidad a penicilina, vancomicina y teicoplanina fue del 97,8%. Aunque S. bovis puede ser poco común en los aislamientos de orina, su presencia en sujetos con enfermedades de base justifica la realización de estudios de patogenicidad que demuestren la verdadera capacidad de producir enfermedad de este grupo de bacterias.

Aims To determine the usefulness of the fluorescence parameters generated by Sysmex UF-1000i flow cytometer for the rapid diagnosis of urinary tract infection by bacilli or cocci. Methods and Results Urine samples (n=1924) were studied by culture and microbiology and subsequently by cytometry, using BACT Morph software and considering forward scattered light- (FSC) and fluorescent light scatter (FLH) fluorescence parameters. BACT-Morph software showed moderate diagnostic accuracy (78.4%) to detect rod-shaped bacteria, with sensitivity of 82.4% and specificity of 62.5%. Forward-scattered (B_FSC) values of the bacterial channel were significant higher for the Gram-positive cocci category (p