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The occurrence and removal of 19 antibiotics (including four macrolides, eight sulfonamides, three fluoroquinolones, three tetracyclines, and trimethoprim) were investigated in two ecological (constructed wetland (CW) and stabilization pond (SP)) and two conventional wastewater treatment processes (activated sludge (AS) and micro-power biofilm (MP)) in a county of eastern China. All target antibiotics were detected in the influent and effluent samples with detection frequencies of >90%. Clarithromycin, ofloxacin, roxithromycin and erythromycin-H2O were the dominant antibiotics with maximum concentrations reaching up to 6524, 5411, 964 and 957 ng/L, respectively; while the concentrations of tiamulin, sulfamerazine, sulfathiazole, sulfamethazine, sulfamethizole and sulfisoxazole were below 10 ng/L. Although the mean effluent concentrations of target antibiotics were obviously lower than the influent ones (except ciprofloxacin), their removals were usually incomplete. Principal component analysis showed that the AS and CW outperformed the MP and SP processes and the AS performed better than the CW process in terms of antibiotics removal. Both the AS and CW processes exhibited higher removal efficiencies in summer than in winter, indicating biological degradation could play an important role in antibiotics removal. Because of the incomplete removal, the total concentration of detected antibiotics increased in the mixing and downstream sections of a local river receiving the effluent from a typical wastewater treatment facility practicing AS process. Nowadays, ecological wastewater treatment processes are being rapidly planned and constructed in rural areas of China; however, the discharge of residual antibiotics to the aquatic environment may highlight a necessity for optimizing or upgrading their design and operation.
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Of 500 stool cultures, 24 (4.8%) samples were positive for Shigella. There was a high percentage of resistance to ampicillin (88%), tetracycline (83%), and sulfamethoxazole-trimethoprim (75%). Also, there was a moderate percentage of resistance to chloramphenicol (46%), streptomycin (42%), ceftazidime (33%), and cefotaxime (25%). A lower percentage of resistance was recorded for amikacin, nalidixic acid (17% each), and ofloxacin (7%), while no resistance was found to ciprofloxacin (0%). Twenty-one of the isolates (88%) were resistant to at least three different antimicrobial groups (indicating MDR). The average number of antimicrobial agents to which the Shigella isolates were resistant was 4.3±1.4, while it was 3.4±1.5 in the same locality in 1994.
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This study compared the activity of finafloxacin, a novel fluoroquinolone which shows enhanced activity under acidic pH, and that of ciprofloxacin against Acinetobacter baumannii under standard conditions (pH 7.2) and at a pH of 5.8. Overall, finafloxacin demonstrated superior activity to ciprofloxacin under acidic conditions. Furthermore, finafloxacin showed comparable activity to ciprofloxacin at pH 7.2. Hence, finafloxacin could be a promising new antimicrobial agent for the treatment of A. baumannii infections at acidic body compartments.
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DDS testing detected ESBLs in 27 (10.2%) of the 264 isolates. The most common type of ESBL was CTX-M-15 (N=14), followed by CTX-M-3 (N=8) and CTX-M-14 (N=6). All of the ESBL-producing isolates were resistant to ciprofloxacin. PCR experiments detected genes encoding DHA-1 and CMY-10 AmpC beta-lactamases in one and two isolates, respectively. Also isolated were 5 isolates harboring 16S rRNA methylases, 2 isolates harboring Qnr, and 19 isolates harboring AAC(6')-Ib-cr. Most ESBL-producing isolates clustered within phylogenetic groups B2 (N=14) and D (N=7).
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The total number of P. aeruginosa strains isolated at the medical facilities was 549,746 and that at clinical laboratories was 640,232. Strains resistant to carbapenems, fluoroquinolones (ciprofloxacin or levofloxacin) and amikacin were defined as multidrug-resistant (MDR) strains, and strains resistant to two of these drugs were defined as two-drug-resistant (TDR) strains. The percentage of MDR at medical facilities and clinical laboratories was 2.4% and 1.1%, respectively, and that of TDR isolates was 6.4% and 4.2%, respectively. MDR and TDR isolates were found nationwide. No MDR isolates were found at approximately one-third of the medical facilities each year. The percentages of MDR and TDR isolates increased significantly from 2003 to 2005. P. aeruginosa strains were obtained mainly from the respiratory and urinary tracts, and the percentages of MDR and TDR isolates were particularly increased in the urinary tract during these years.
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Urinary tract infections (UTI) are the most common bacterial infections during pregnancy and these infections. Untreated UTI can be associated with serious obstetric complications. This cross-sectional study was carried out to determine the prevalence of UTI among symptomatic and asymptomatic pregnant women attending Bugando Medical centre (BMC) in Mwanza, Tanzania. A total of 247 pregnant women were enrolled, of these 78 (31.5%) were symptomatic and 169 (68.4%) asymptomatic. UTI was diagnosed using mid stream urine (MSU) culture on standard culture media and urinalysis was done using rapid dip stick. The prevalence of bacteriuria among symptomatic and asymptomatic pregnant women were 17.9% and 13.0% respectively, with no significant difference between the two groups (p = 0.307). Using univariate analysis there was no association of parity (p = 0.825), gestational age (p = 0.173), education (p = 0.615), age (p = 0.211) and marital status (p = 0.949) with bacteriuria. The sensitivity and specificity of urine dipstick was 38.9% and 86.7% respectively. Escherichia coli (47.2%) and Enterococcus spp (22.2%) were the most commonly recovered pathogens. The rate of resistance of Escherichia coli to ampicillin, tetracycline, sulfamethaxazole/trimethoprim, gentamicin, ciprofloxacin, nitrofurantoin, ceftriaxone, and imipenem were 53%, 58.8%, 64.7%, 5.9%, 11.8%, 5.9%, 29.4% and 0%, respectively. In conclusion, asymptomatic bacteriuria among pregnant women is prevalent in our setting and majority of Escherichia coli are resistant to ampicillin, tetracycline, SXT and ceftriaxone. Due to low sensitivity of rapid dip stick, routine urine culture and susceptibility testing is recommended to all pregnant women at booking.
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Orthopedic patients who immunocompromised, hypoproteinemia and accompanied by open wounds and contaminated wound susceptible to infect Bacillus cereus; sensitive antimicrobial drugs should be selected on the basis of supplement albumin, symptomatic and supportive treatment.
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Fosfomycin resistance occurs rapidly with monotherapy. This study systematically investigated bacterial killing and emergence of fosfomycin resistance with fosfomycin combinations against Pseudomonas aeruginosa.
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According to the epidemiological cut-off value (ECOFF) issued by the European Committee on Antimicrobial Susceptibility Testing (EUCAST), our results indicate that over three-quarters of the strains tested would be susceptible to FO treatment, especially if combined with another antimicrobial. The FO/ciprofloxacin combination had a synergistic effect on 40% of the clinical isolates, while for FO/amikacin this effect was only observed in 12% of the isolates.
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The aim of this study was to assess the Staphylococcus aureus nasal carriage rate in healthy children all over Hungary and to specify some risk factors, the antibiotic resistance patterns of the bacteria, and their genetic relatedness. In total, 878 children (aged 3-6 years) were screened at 21 day-care centers in 16 different cities in Hungary, between February 2009 and December 2011. Samples taken from both nostrils were cultured on blood agar, and suspected S. aureus isolates were identified by β-hemolysis, catalase positivity, clump test, and nucA PCR. Methicillin-resistant strains were screened by mecA and mecC PCR. Antibiotic susceptibility was determined by agar dilution or gradient test strips. Pulsed-field gel electrophoresis was used for genotyping. S. aureus carriage rate was found to be 21.3%, which correlates well with international data. We found no statistically significant correlation between the gender or the sibling status and S. aureus carriage. All isolates were sensitive to oxacillin, trimethoprim-sulfamethoxazole, and mupirocin. The resistance rates for erythromycin, ciprofloxacin, clindamycin, gentamicin, and tetracycline were 7.5%, 0.5%, 1.1%, 3.7%, and 4.3%, respectively. The isolates showed very high genetic diversity. In summary, carried S. aureus isolates are more sensitive to antibiotics compared with clinical isolates in Hungary, and methicillin-resistant S. aureus carriage rate is very low yet.
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The aim of this study was to assess in vitro antimicrobial susceptibility of Brucella melitensis isolates isolated from naturally infected sheep cases in an area where human brucellosis is endemic, focusing on rifampin (RIF), streptomycin (SM), ciprofloxacin (CPFX), trimethoprim/sulfamethoxazole (TMP/SMZ), gentamicin (GM) and tetracycline (TC) and on 11 other antimicrobials. The identification and typing of Brucella isolates were carried out using standard classification tests and polymerase chain reaction (PCR) methods. Antimicrobial susceptibility testing was carried out on Mueller-Hilton agar. The resistance to SM, CPFX and GM was determined at the rate of 7.3% and to RIF at the rate of 9.7%. The highest (46.3%) resistance was determined against TMP/SMZ. All strains were found to be sensitive to TC at the rate of 100.0%. In conclusion, ovine origin B. melitensis strains evaluated in this study were resistant to at least one antimicrobial (51.2%) that is commonly used in human clinical medicine against brucellosis.