Incidence, risk factors and clinical outcome of multidrug-resistant organisms after heart transplantation

BACKGROUND Transplant recipients commonly harbor multidrug-resistant organisms(MDROs),as a result of frequent hospital admissions and increased exposure to antimi-crobials and invasive procedures.AIM To investigate the impact of patient demographic and clinical characteristics on MDRO acquisition,as well as the impact of MDRO acquisition on intensive care unit(ICU)and hospital length of stay,and on ICU mortality and 1-year mortality post heart transplantation.METHODS This retrospective cohort study analyzed 98 consecutive heart transplant patients over a ten-year period(2013-2022)in a single transplantation center.Data was collected regarding MDROs commonly encountered in critical care.RESULTS Among the 98 transplanted patients(70%male),about a third(32%)acquired or already harbored MDROs upon transplantation(MDRO group),while two thirds did not(MDRO-free group).The prevalent MDROs were Acinetobacter baumannii(14%),Pseudomonas aeruginosa(12%)and Klebsiella pneumoniae(11%).Compared to MDRO-free patients,the MDRO group was characterized by higher body mass index(P=0.002),higher rates of renal failure(P=0.017),primary graft dysfunction(10%vs 4.5%,P=0.001),surgical re-exploration(34%vs 14%,P=0.017),mechanical circulatory support(47%vs 26%P=0.037)and renal replacement therapy(28%vs 9%,P=0.014),as well as longer extracorporeal circulation time(median 210 vs 161 min,P=0.003).The median length of stay was longer in the MDRO group,namely ICU stay was 16 vs 9 d in the MDRO-free group(P=0.001),and hospital stay was 38 vs 28 d(P=0.006),while 1-year mortality was higher(28%vs 7.6%,log-rank-χ2:7.34).CONCLUSION Following heart transplantation,a predominance of Gram-negative MDROs was noted.MDRO acquisition was associated with higher complication rates,prolonged ICU and total hospital stay,and higher post-transplantation mortality.

Monitoring and Analysis on Multi Drug Resistance of Escherichia coli from Captive Population Amur Tiger

In order to investigate the multi drug resistance to Escherichia coli from captive population Amur tiger,E. coli strains were isolated from the fecal samples of tiger in Heilongjiang Amur Tiger Park in Harbin. The sensitivity of E. coli isolates to 14 antibiotics was determined by scrip diffusion method. The results indicated that all the isolates varied in drug resistance to different antibiotics; the isolates gave high resistance to ampicillin,with a drug fast rate of 100%; over80% of the isolates were resistant to tetracycline and Paediatric Compound Sulfamethoxazole Tablets(SMZ- TMP),and over 70% of the isolates were sensitive to aztreonam,amoxicillin /potassium clavulanate. Most of the isolates had high sensitive to aztreonam and amoxicillin / clavulanate acid.

4th National Anti-tuberculosis Drug Resistance Survey in Kenya

Introduction： Recently rapid development of drug resistant TB, particularly MDR TB （Multi Drug Resistant TB） and XDRTB （Extensively Drug-Resistant TB） possess a major threat to control of tuberculosis globally. Information on the extent of MDR-TB from Kenya is largely limited due to several factors. Monitoring of development of resistance is a vital tool in providing critical information for effective planning for TB control and in management of patients infected with TB. Methods： Cross-sectional with cluster design. Results： A total of 2,171 participants recruited into the study from 50 selected clusters. Prevalence of rifampicin resistance for new cases was 1.3% [95% CI, 0.8-2.0] and INH resistance was 5.5% [95% CI, 4.5-6.7]. MDR TB was found in 0.67% of new cases and 2.1% amongst previously treated TB cases. Discussion： Resistance to isoniazid in Kenya has been on the decline due to introduction of rifampicin in combined therapy. There was increase of MDR TB among new cases by 24% and decline in previously treated cases due to lethal impact of HIV. Conclusions： Although drug resistance TB is a growing problem in Kenya, resistance to isoniazid and rifampicin MDR TB is less than previously estimated. The country should continue to monitor drug resistance and ensure effective use of anti TB medicines.

Prevalence of Mycobacterium tuberculosis Strains Isolated from Both Pulmonary and Extra Pulmonary Samples and Their Resistance to Rifampicin: A Study from Kolkata and Surrounding Suburbs

Tuberculosis (TB) is one of the major causes of morbidity and mortality worldwide. In India, nearly 1.8 million new cases of TB are reported annually, which accounts for a fifth of new cases in the world—greater than in any other country. Anti-tubercular drugs (ATDs) have been used for decades, and widespread resistance to them is a very serious public health concern in any part of the world. Aim of this study was to determine the prevalence of Rifampicin (the first line Anti-TB drug) resistance among both pulmonary and extra-pulmonary samples tested positive for Mycobacterium tuberculosis and thereby predict the prevalence of Multi-drug resistant (MDR) tuberculosis in Kolkata and its Suburban regions. All 331 randomly collected clinical samples (both Pulmonary and Extra Pulmonary) were initially screened by Zeihl-Neelsen AFB staining followed by culture on BacT/Alert 3D system and on Lowenstein-Jensen medium and the positive samples were subjected to detection of Mycobacterium tuberculosis complex (MTBC) and simultaneous analysis of Rifampicin resistance by Xpert MTB/RIF assay. Out of the 51 (15.40%) culture positive samples, 13.7% of pulmonary samples and 9.09% of extra-pulmonary samples were Rifampicin resistant. The prevalence of Rifampicin resistant TB in our study is high and the possible reasons can be mixing of new as well as retreatment cases and smaller sample size but, yet it can help Government and public health regulatory bodies to formulate adequate strategies to fight against drug resistant tuberculosis, especially in this part of the world.

Low Efficiency of the Commonly Prescribed Drugs against Klebsiella pneumonia, Escherichia coli and Acinetobacter Species as the Causative Agents of Blood Stream Infection in Malabo, Equatorial Guinea

The prevalence of multi drug resistant gram-negative bacteria to commonly first line drugs in blood is a serious problem in Equatorial Guinea and other world. This is the first study describing antibiotic resistance analysis of blood stream infection in Equatorial Guinea. Our study presents alarming rate of inefficiency of the most commonly prescribed drugs to treatment Klebsiella pneumoniae, Escherichia coli and Acinetobacter species isolates as the most frequency etiologic agents in blood stream infection. Out of 1849 blood culture the bacterial etiological agents were isolated from 196 (10.6%) samples. E. coli (n = 22), K. pneumonia (n = 39) and Acinetobacter (n = 17) represent 71.6% of all gram negative bacterial isolates. Almost all isolates of K. pneumonia and Acinetobacter sp. (92.1% and 100%, respectively) and about 50% of E. coli strains possessed extended-spectrum β-lactamase activity. Alarming level of multi drug resistant gram negative strains was observed. E. coli and K. pneumonia and Acinetobacter isolates demonstrated low sensitivity to all commonly prescribed drugs such as Ampicillin, Trimethoprim/Sulfamethoxazole, Doxycycline, Gentamycin Amoxicicline/Clavulanic Acid, Cefuroxime, Ciprofloxacine. It is especially worth noting the low efficiency of third generation cephalosporins (Cefrtiaxon) against Acinetobacter and Klebsiella with their resistance rate of 94.7% and 100% respectively. Moreover, the alarming level of low sensitivity to Piperacilin/Tazobactam of K. pneumonia (22%) and Acinetobacter (29.4%) was been found. The 17.6% of Acinetobacter isolated was carbomenem resistant. Just Imipenem and Amikacin were the most sensitive drug against these bacterial strains.

MDR1 Haplotypes and G2677T/A Polymorphism Predict Imatinib Response in Tunisian Patients with Chronic Myeloid Leukemia

Background: The role of human multidrug resistance gene (MDR1) SNPs in the interindividual variability of imatinib mesylate (IM) response has received considerable attention. We aimed to study the association between SNPs of the MDR1 gene (C1236T, G2677T/A, C3435T) and IM response in chronic myeloid leukemia (CML) patients. Method: A retrospective case-control study was conducted on 48 patients with CML undergoing IM therapy. All patients were genotyped using PCR-RFLP method. Results: The genotype and allele frequencies of C1236T and C3435T were not significantly different between CML patients responders and non-responders to IM (p > 0.05). The frequencies of 2677T allele and 2677TT genotype were significantly increased in CML patients IM responders which as compared with IM non-responders (50% vs 26.9%, p = 0.013 and 27.3% vs 3.8%, p = 0.029 respectively). Whereas the 2677AA genotype and CAC haplotype were found only in CML patients IM non-responders (15.4%). Conclusion: Pretreatment genotyping of G2677A/T appears to be useful for predicting IM resistance, which may allow the best choice of drug treatment for CML patients.

A New Evaluation Method for Antibiotic-Resistant Bacterial Groups in Environment

In the present manuscript it was presented whether spreading of antibiotic resistant bacterial groups in environment could be monitored by our newly developed method by enumerating antibiotic resistant bacterial groups in various biological wastes and composts. Although the numbers were not so high, diverse kinds of colistin resistant bacteria (25 mg·L-1) were included in row cattle feces (1.78 × 104 MPN g-1) and cattle feces manure (>3.84 × 104 MPN g-1). Compost originated from leftover food (>44.8 × 104 MPN g-1) and shochu lee (>320 × 104 MPN g-1) included higher numbers of chlortetracycline resistant Pseudomonas sp., (25 mg·L-1), and row cattle feces included higher numbers of chlortetracycline resistant Enterobacteriacea (15.7 × 104 MPN g-1), which mostly consisted from Pantoea sp. or Xenorhobdus doucetiae. Numbers of multi drug resistant bacteria, resistant to 25 mg·L-1 of ciprofloxacin, streptomycin, chloramphenicol, and ampicillin, were the highest in row cattle feces (>143.6 × 104 MPN g-1), followed by cattle feces manure (4.19 × 104 MPN g-1), and shochu lee (0.36 × 104 MPN g-1), which included diverse kinds of bacterial group. The present results indicated that higher numbers of multi drug resistant bacteria were typically found in row cattle feces, and the method was found suitable to enumerate and identify them. These results suggested that the method might become their environmental risk evaluation method.

Expression of heat shock protein 90 β in human gastric cancer tissue and SGC7901/VCR of MDR type gastric cancer cell line

Objective To examine the expression of heat shock protein (HSP) 90 β in human gastric cancer tissue and SGC7901/VCR of MDR type gastric cancer cell line Methods Immunohistochemical staining and in situ hybridization methods Results Heat shock protein 90 β was mainly located in the cell cytoplasma and weakly expressed in non cancerous gastric mucosa The expression rates of HSP90 β in normal gastric mucosa, gastritis and para cancer tissues were 11 76%, 13 04% and 11 42% respectively,and there were no significant differences between them ( P >0 05) The expression of HSP90 β was increased in gastric cancer The positive rate of HSP90 β in gastric cancer tissue was 30 00%, and was higher than non cancerous gastric mucosa ( P <0 05) The expression rates of HSP90 β in well differentiated, moderately differentiated, poorly differentiated gastric cancer and mucinous carcinoma were 15 38%, 31 25%, 33 33%, and 42 85% respectively The expression of HSP90 β in SGC7901/VCR of MDR type gastric cell line was higher than in its parental cell line SGC7901 In situ hybridization showed that the positive signal of HSP90 β was mainly located in the cell cytoplasma Conclusions The expression of HSP90 β was higher in gastric cancer tissue than in non cancerous gastric mucosa In gastric cancer tissue, the expression of HSP90 β was greater in poorly differentiated cancer tissue, and in SGC7901/VCR of MDR type gastric cancer cell line the expression of HSP90?β was higher than that in its parental cell line SGC7901