Melioidosis,a disease of public health importance in Southeast Asia and Northern Australia,of late has shown an increasing trend in India,particularly Southern India.We describe a ease of a 39-year-old diabetic patien...Melioidosis,a disease of public health importance in Southeast Asia and Northern Australia,of late has shown an increasing trend in India,particularly Southern India.We describe a ease of a 39-year-old diabetic patient with left elbow septic arthritis,multiple liver,splenic abscesses, pneumonia,pleural effusion,followed by sepsis syndrome.Blood cultures and culture of the joint aspirate yielded pure growth of Burkholderia psettdomallei(B.pesudomallei),sensitive to carbapenem,co-trimoxazole and resistant to ceftazidime.The patient was successfully treated with imipenem- cilastin.He was discharged on co-trimoxazole to complete the 24 weeks course and follow-up has continued to date.The patient continues to remain asymptomatic.The case re-emphasizes the need to monitor the trend of B.pseudomallei in India,particularly the development of ceftazidime resistance,which incidentally is the drug of choice.展开更多
A surveillance study was undertaken to identify prominent β-lactamase encoding genes in 131 carbapenem non-susceptible gram-negative clinical isolates at a New York City community hospital. KPC carbapenemases were de...A surveillance study was undertaken to identify prominent β-lactamase encoding genes in 131 carbapenem non-susceptible gram-negative clinical isolates at a New York City community hospital. KPC carbapenemases were detected in 89% of Enterobacteriaceae as well as additional TEM, SHV, and CTX-M class A enzymes. OXA-23 and OXA-24 were the prevalent class D carbapenemases identified in Acinetobacter species. One OXA-23 in M. morganii and one OXA-48 in K. pneumoniae were also identified. Among class C β-lactamases CMY, ACT/MIR, DHA, and FOX were detected. The in vitro activity of ceftazidime-avibactam by E-test methodology was tested with minimal inhibitory concentrations (MIC) of ≤3 μg/ml for 97.8% of all Enterobacteriaceae, MIC<sub>50/90</sub> of 16/>256 μg/ml for carbapenem non-susceptible Acinetobacter, and 3/6 μg/ml for carbapenem non-susceptible Pseudomonas aeruginosa. Periodic surveillance of isolates to characterize current and emerging β-lactamase genotypes present in local isolates may help identify outbreak situations, provide assistance to infection control and antibiotic stewardship programs, and potentially improve patient outcomes.展开更多
文摘Melioidosis,a disease of public health importance in Southeast Asia and Northern Australia,of late has shown an increasing trend in India,particularly Southern India.We describe a ease of a 39-year-old diabetic patient with left elbow septic arthritis,multiple liver,splenic abscesses, pneumonia,pleural effusion,followed by sepsis syndrome.Blood cultures and culture of the joint aspirate yielded pure growth of Burkholderia psettdomallei(B.pesudomallei),sensitive to carbapenem,co-trimoxazole and resistant to ceftazidime.The patient was successfully treated with imipenem- cilastin.He was discharged on co-trimoxazole to complete the 24 weeks course and follow-up has continued to date.The patient continues to remain asymptomatic.The case re-emphasizes the need to monitor the trend of B.pseudomallei in India,particularly the development of ceftazidime resistance,which incidentally is the drug of choice.
文摘A surveillance study was undertaken to identify prominent β-lactamase encoding genes in 131 carbapenem non-susceptible gram-negative clinical isolates at a New York City community hospital. KPC carbapenemases were detected in 89% of Enterobacteriaceae as well as additional TEM, SHV, and CTX-M class A enzymes. OXA-23 and OXA-24 were the prevalent class D carbapenemases identified in Acinetobacter species. One OXA-23 in M. morganii and one OXA-48 in K. pneumoniae were also identified. Among class C β-lactamases CMY, ACT/MIR, DHA, and FOX were detected. The in vitro activity of ceftazidime-avibactam by E-test methodology was tested with minimal inhibitory concentrations (MIC) of ≤3 μg/ml for 97.8% of all Enterobacteriaceae, MIC<sub>50/90</sub> of 16/>256 μg/ml for carbapenem non-susceptible Acinetobacter, and 3/6 μg/ml for carbapenem non-susceptible Pseudomonas aeruginosa. Periodic surveillance of isolates to characterize current and emerging β-lactamase genotypes present in local isolates may help identify outbreak situations, provide assistance to infection control and antibiotic stewardship programs, and potentially improve patient outcomes.
