Infection & chemotherapy最新文献

{"title":"Recurrence of Classic Scabies in a Patient Who had Unchanged Tie String of the T-Cannula.","authors":"Jiwon Jung,&nbsp;Jihye Jeong,&nbsp;Min Jee Hong,&nbsp;Eun Ok Kim,&nbsp;Min Jae Kim,&nbsp;Sung Eun Chang,&nbsp;Sung-Han Kim","doi":"10.3947/ic.2021.0082","DOIUrl":"https://doi.org/10.3947/ic.2021.0082","url":null,"abstract":"<p><p>A 64-year old woman who underwent lung transplantation and had T-cannula contracted classic scabies from her daughter. The patient was treated with 5% permethrin 10 times and had two consecutive negative follow-up microscopic examinations. However, the patient had recurrent symptoms and diagnosed with recurrent classic scabies 22 days after the last treatment. Unchanged tie string and unapplied topical agent around the T-cannula skin lesion may be reasons for recurrence. Thus, accurate application of topical treatment and changing the tie string of the t-cannula is needed to prevent a recurrence.</p>","PeriodicalId":520645,"journal":{"name":"Infection & chemotherapy","volume":" ","pages":"378-381"},"PeriodicalIF":4.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/26/19/ic-54-378.PMC9259923.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39761576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bloodstream Infections in Patients with Hematologic Diseases: Causative Organisms and Factors Associated with Resistance.","authors":"Hyeah Choi,&nbsp;Hyojin Ahn,&nbsp;Raeseok Lee,&nbsp;Sung-Yeon Cho,&nbsp;Dong-Gun Lee","doi":"10.3947/ic.2022.0069","DOIUrl":"https://doi.org/10.3947/ic.2022.0069","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patients with hematologic diseases are at high risk of bloodstream infections (BSIs). This study aimed to analyze clinical features and distributions of microorganisms in patients with hematologic diseases presenting at a tertiary care university-affiliated hospital in Korea.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;We retrospectively reviewed all BSI episodes recorded in patient medical records at two hematologic wards of the Catholic Hematology Hospital from January to December 2020. Our aim was to analyze demographic and clinical characteristics relevant to BSIs. We also described the antimicrobial resistance patterns of the major pathogens identified in this study, and evaluated risk factors for extended-spectrum beta-lactamase (ESBL) production in &lt;i&gt;Enterobacteriaceae&lt;/i&gt; isolates and for vancomycin resistance in enterococcal isolates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 380 BSI episodes were identified in 334 patients over the course of 1 year (monomicrobial BSI episodes, 86.1%; polymicrobial BSI episodes, 13.9%). Gram-negative bacteria accounted for 242 isolates (54.8%). The most frequently isolated Gram-negative bacteria isolates were &lt;i&gt;Escherichia coli&lt;/i&gt; (107 [24.2%]) followed by &lt;i&gt;Klebsiella&lt;/i&gt; spp. (72 [16.3%]), &lt;i&gt;Pseudomonas&lt;/i&gt; spp. (21 [4.8%]), and &lt;i&gt;Enterobacter&lt;/i&gt; spp. (12 [2.7%]). The most commonly identified Gram-positive bacteria were &lt;i&gt;Enterococcus&lt;/i&gt; spp. (72 [16.3%]) followed by viridans streptococci (54 [12.2%]), coagulase-negative staphylococci (CoNS) (24 [5.4%]), and &lt;i&gt;Corynebacterium&lt;/i&gt; spp. (22 [5.0%]). ESBL-producing &lt;i&gt;Enterobacteriaceae&lt;/i&gt; accounted for 25.1% of the total distribution. Among 54 &lt;i&gt;Enterococcus faecium&lt;/i&gt; isolates, 100.0% were resistant to ampicillin and 55.6% showed resistance to vancomycin, while 100.0% (n = 12) of &lt;i&gt;Enterococcus faecalis&lt;/i&gt; isolates were susceptible to ampicillin and vancomycin, respectively. Use of ciprofloxacin prophylaxis (odds ratio: 5.20; 95% confidence interval: 1.11 - 24.34; &lt;i&gt;P&lt;/i&gt; = 0.04) was an independent risk factor for ESBL production in &lt;i&gt;Enterobacteriaceae&lt;/i&gt; BSIs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Compared with the results of a previous study conducted at the same institution, our findings demonstrated that Gram-negative bacteria remained dominant pathogens in BSIs occurring in patients with hematologic diseases. Our findings also demonstrated a comparatively decreased prevalence of ESBL-producing &lt;i&gt;Enterobacteriaceae&lt;/i&gt; in the evaluated BSIs. However, the prevalence of enterococcal BSIs had not decreased, and the proportion of vancomycin-resistant &lt;i&gt;Enterococcus&lt;/i&gt; isolates from &lt;i&gt;E. faecium&lt;/i&gt; BSIs had increased. In addition, we found that ciprofloxacin prophylaxis was statistically significantly associated with ESBL production in &lt;i&gt;Enterobacteriaceae&lt;/i&gt; BSIs. We conclude that, in order to avoid critical complications and to reduce the burden of antimicrobial-resistant organisms in patients w","PeriodicalId":520645,"journal":{"name":"Infection & chemotherapy","volume":" ","pages":"340-352"},"PeriodicalIF":4.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2b/c9/ic-54-340.PMC9259903.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40476608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Roll-Out of A Coronavirus Disease 2019 Clinical Pathway for Standardized Qualified Care in Public Hospitals in Korea.","authors":"Mi Young Kwak,&nbsp;Eun Young Jo,&nbsp;BumSik Chin,&nbsp;Se Eun Park,&nbsp;Jun Yim,&nbsp;Jung Eun Lee,&nbsp;Kyung Eun Jo,&nbsp;Yeon-Sook Kim,&nbsp;Jeong Eun Lee,&nbsp;Young Kyung Yoon,&nbsp;Yu Bin Seo,&nbsp;Su Jin Jeong,&nbsp;Yu Min Kang,&nbsp;Eun-Jeong Joo,&nbsp;Jong Hyun Yoon,&nbsp;Sun Bean Kim,&nbsp;Ga Yeon Kim,&nbsp;Min-Kyung Kim","doi":"10.3947/ic.2022.0026","DOIUrl":"https://doi.org/10.3947/ic.2022.0026","url":null,"abstract":"<p><p>Despite the coronavirus disease 2019 (COVID-19) vaccination roll-out, variant-related outbreaks have occurred repeatedly in Korea. Although public hospitals played a major role in COVID-19 patients' care, difficulty incorporating evolving COVID-19 treatment guidelines called for a clinical pathway (CP). Eighteen public hospitals volunteered, and a professional review board was created. CPs were formulated containing inclusion/exclusion criteria, application flow charts, and standardized order sets. After CP roll-out, key parameters improved, such as increased patient/staff five-point satisfaction scores (0.41/0.57) and decreased hospital stays (1.78 days)/medical expenses (17.5%). The CPs were updated consistently after roll-out as new therapeutics drugs were introduced and quarantine policies changed.</p>","PeriodicalId":520645,"journal":{"name":"Infection & chemotherapy","volume":" ","pages":"353-359"},"PeriodicalIF":4.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/34/26/ic-54-353.PMC9259916.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40476609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply: Correspondence on Fluvoxamine Treatment of Patients with Symptomatic COVID-19.","authors":"Hyeonji Seo,&nbsp;Yong Pil Chong","doi":"10.3947/ic.2022.0045","DOIUrl":"https://doi.org/10.3947/ic.2022.0045","url":null,"abstract":"The correspondence article in this journal presents a recent meta-analysis of randomized clinical trials on fluvoxamine for the early treatment of coronavirus disease 2019 (COVID-19) [2], which included three randomized trials: STOP COVID 1 [3] and 2, and TOGETHER trial [4]. This meta-analysis results showed that patients receiving fluvoxamine compared with placebo had a 31.0% risk reduction in clinical deterioration or hospitalization (risk ratio [RR]: 0.69; 95% confidence interval [CI]: 0.54 – 0.88). In this meta-analysis, the TOGETHER trial (weight, 87.4%) with 1,497 patients was heavily weighted. The main difference between the TOGETHER trial and our study is the inclusion criteria of enrolled patients. In the TOGETHER trial, enrolled patients had at least one criterion for high risk; diabetes, systemic arterial hypertension requiring at least one medication, known cardiovascular diseases, symptomatic lung diseases, smoking, obesity, having had a transplant, chronic kidney disease, immunosuppressive therapy, history of cancer or aged 50 years or older. However, we enrolled adult patients admitted to a community treatment center, who usually had no or minimum comorbidities [5]. We excluded patients with severe underlying lung diseases, chronic liver diseases, congestive heart failure, chronic kidney disease, or those who were immunocompromised. As a result, 59.6% of patients had no preexisting medical conditions in our study. Therefore, we suggest that the discrepancy between our study and the others may have been associated with underlying diseases of the patients.","PeriodicalId":520645,"journal":{"name":"Infection & chemotherapy","volume":" ","pages":"370-371"},"PeriodicalIF":4.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1d/6c/ic-54-370.PMC9259909.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40476610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two Cases of SARS-CoV-2-Positive Mothers and Their Newborns in Korea.","authors":"Ju Hyun Jin,&nbsp;Yeejeong Kim,&nbsp;Jongha Yoo,&nbsp;Eui Hyeok Kim,&nbsp;Shin Won Yoon","doi":"10.3947/ic.2021.0027","DOIUrl":"https://doi.org/10.3947/ic.2021.0027","url":null,"abstract":"<p><p>It is unclear how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) affects pregnant women and their fetuses or newborns. We report two infants born to mothers with coronavirus disease 2019 (COVID-19) in Korea. The first case was a healthy female baby born at 39⁺³ weeks' gestation from a mother diagnosed with COVID-19. The second case was a female baby born at 38⁺⁰ weeks' gestation. The newborn in the second case had symptoms of respiratory distress immediately after birth, and nasal continuous positive airway pressure support was applied for 8 hours. Real-time polymerase chain reaction test results for SARS-CoV-2 using amniotic fluid, neonatal nasopharyngeal and oropharyngeal swabs, blood, urine, stool, and rectal swab were all negative in the 1st and 2nd days of life in both cases. Placental pathology showed acute necrotizing deciduitis and intervillous fibrin deposition with acute intervillositis. Although clinical evidence of vertical transmission was not found in our cases, with the possibility of placental inflammation, close monitoring of SARS-CoV-2 positive mothers and their newborn is required.</p>","PeriodicalId":520645,"journal":{"name":"Infection & chemotherapy","volume":" ","pages":"372-377"},"PeriodicalIF":4.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cc/d4/ic-54-372.PMC9259912.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39333995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Recurrent Severe Cellulitis with a Pill in Pocket Approach.","authors":"James B Doub","doi":"10.3947/ic.2021.0095","DOIUrl":"https://doi.org/10.3947/ic.2021.0095","url":null,"abstract":"<p><p>Cellulitis is a common condition that plagues healthcare systems and is associated with significant healthcare costs and resource allocations. With ample antimicrobial therapy this infectious syndrome can be easily treated but recurrence is common. Many conditions predispose patients to be at risk for recurrent cellulitis with chronic lymphoedema being a significant risk factor secondary to pooling of lymphatic fluid and impaired local immune responses. Moreover, patients with chronic lymphoedema can be at risk for acute onset of severe cellulitis requiring urgent medical evaluation and treatment. Consequently, to prevent recurrent cellulitis episodes, the use of long-term oral antibiotics has been advocated, but when recurrences occur despite long-term antibiotic use limited options are available. In this case report, a unique treatment approach for preventing severe cellulitis is discussed with a pill in the pocket approach with the use of oral tedizolid. This has thwarted the need for recurrent hospitalizations and reduced health care costs for this individual patient. Herein this treatment approach is discussed as is the rationale for using tedizolid instead of other antibiotics.</p>","PeriodicalId":520645,"journal":{"name":"Infection & chemotherapy","volume":" ","pages":"382-387"},"PeriodicalIF":4.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/eb/18/ic-54-382.PMC9259910.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39775062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Candida auris</i>: An Overview of the Emerging Drug-Resistant Fungal Infection.","authors":"Adekunle Sanyaolu,&nbsp;Chuku Okorie,&nbsp;Aleksandra Marinkovic,&nbsp;Abu Fahad Abbasi,&nbsp;Stephanie Prakash,&nbsp;Jasmine Mangat,&nbsp;Zaheeda Hosein,&nbsp;Nafees Haider,&nbsp;Jennifer Chan","doi":"10.3947/ic.2022.0008","DOIUrl":"https://doi.org/10.3947/ic.2022.0008","url":null,"abstract":"<p><p><i>Candida auris</i> is an invasive fungal pathogen that has been recognized globally as a serious health threat due to its extensive innate and acquired resistance to antifungal drugs. A growing number of emerging cases of <i>C. auris</i> have been reported with resistance to the standard antifungal treatments including azoles, echinocandins, and polyenes, making it difficult to treat. Unlike other <i>Candida</i> species, <i>C. auris</i> is challenging to diagnose using the standard laboratory methods and are typically prone to misidentification, resulting in inappropriate management. Consequently, <i>C. auris</i> infections have spread globally. The Centers for Disease Control and Prevention data showed that clinical cases of <i>C. auris</i> increased from 329 in 2018 to 1,012 in 2021. The incidence and prevalence of this invasive fungal infection are high in immunocompromised and hospitalized patients. Patients who had an organ transplant, are on immunosuppressive agents, are diabetic, recent antibiotic use, catheter use, and prolonged hospital or nursing homestays are vulnerable to <i>C. auris</i> infections. <i>C. auris</i> is rapidly spreading across healthcare settings globally and monitoring of its virulence as well as devising appropriate treatment approaches are thus highly required.</p>","PeriodicalId":520645,"journal":{"name":"Infection & chemotherapy","volume":" ","pages":"236-246"},"PeriodicalIF":4.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b5/06/ic-54-236.PMC9259907.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40476605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Age in Subclinical Atherosclerosis in Asian People Living with Human Immunodeficiency Virus.","authors":"Sunghee Park,&nbsp;Se Yoon Park,&nbsp;Eunjung Lee,&nbsp;Tae Hyong Kim,&nbsp;Eunyoung Lee","doi":"10.3947/ic.2022.0033","DOIUrl":"https://doi.org/10.3947/ic.2022.0033","url":null,"abstract":"<p><strong>Background: </strong>People living with human immunodeficiency virus (PLHIV) have an increased risk of atherosclerosis and cardiovascular disease, but specific guidance on when to suspect the onset of these diseases is limited.</p><p><strong>Materials and methods: </strong>We aimed to identify cardiovascular risk factors in PLHIV using carotid intima-media thickness (IMT) through a cross-sectional, retrospective cohort study that enrolled 217 PLHIV who underwent carotid IMT measurement at a teaching hospital in Korea. We compared clinical characteristics between PLHIV with subclinical atherosclerosis and PLHIV with IMT within the normal range, and used a receiver operating characteristic curve to determine the cut-off age for predicting subclinical atherosclerosis.</p><p><strong>Results: </strong>Among the study population, 115 participants (53.0%) had subclinical atherosclerosis. In logistic regression, age and dyslipidemia were significantly associated with increased carotid IMT even after adjusting for other variables (odds ratio [OR]: 1.11, 95% confidence interval [CI]: 1.06 - 1.15, <i>P</i> <0.001; OR: 3.92, 95% CI: 1.87 - 8.22, <i>P</i> <0.001, respectively). The cut-off age for predicting subclinical atherosclerosis was 39.5 years (area under the curve 0.78, 95% CI: 0.72 - 0.84, <i>P</i> <0.001).</p><p><strong>Conclusion: </strong>Conventional risk factors including age and dyslipidemia were associated with subclinical atherosclerosis in Asian PLHIV. In particular, Asian PLHIV older than 40 years had an increased risk of subclinical atherosclerosis and may benefit from carotid IMT screening.</p>","PeriodicalId":520645,"journal":{"name":"Infection & chemotherapy","volume":" ","pages":"308-315"},"PeriodicalIF":4.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ef/7d/ic-54-308.PMC9259902.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40476606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Patients Treated in Intensıve Care Due to COVID-19: A Retrospective Study.","authors":"Gökhan Kılınç,&nbsp;Aslı Akcan Atasoy","doi":"10.3947/ic.2022.0054","DOIUrl":"https://doi.org/10.3947/ic.2022.0054","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study is to report the demographic characteristics, clinical features, treatment protocols, comorbidities, imaging findings, prognosis and factors affecting mortality in critically ill patients with coronavirus disease 2019 (COVID-19) in the intensive care unit.</p><p><strong>Materials and methods: </strong>This retrospective cohort study consists of adult (≥18 years old) patients hospitalized in a tertiary hospital intensive care unit of with COVID-19. The independent effects of possible factors identified in previous analyzes on survival were analyzed using univariate and multivariate logistic regression analysis.</p><p><strong>Results: </strong>The mean age of all patients was 70.2 ± 13.9 years. Of the 200 patients, 139 (69.5%) had died. White blood cells (19.2 ± 76.1 × 10⁹ per L), neutrophil/lymphocyte ratio (15.4 ± 65.1), d-dimer (2,558.4 ± 4,574.2 ng/mL), ferritin (1,481.2 ± 4,447.4 μg/L) and C-reactive protein (CRP) (12.1 ± 11.9 mg/dL) levels were high at the time of admission. According to the results of univariate regression analysis; presence of additional disease (odds ratio [OR]: 3.837; <i>P</i> = 0.015), older age (OR: 1.027; <i>P</i> = 0.015), reverse transcriptase-polymerase chain reaction (RT-PCR) positivity (OR: 2.58; <i>P</i> = 0.019), higher heart rate (OR = 1.027; <i>P</i> = 0.028), higher APACHE II score (OR: 1.049; <i>P</i> = 0.012), higher sequential organ failure assessement (SOFA) score(OR: 1.479; <i>P</i> = 0.014), high d-dimer levels (OR: 3.180; <i>P</i> <0.001) and high CRP levels (OR: 1.035; <i>P</i> = 0.028) increases the risk of death. When patients with full data for all variables in the multivariate logistic regression model were evaluated; positive RT-PCR (OR=4.105; <i>P</i> = 0.005), older age (OR: 1.033; <i>P</i> = 0.024), higher heart rate (OR: 1.042; <i>P</i> = 0.006), higher (SOFA) score (OR: 1.477; <i>P</i> <0.001), high d-dimer levels at admission (OR: 3.459; <i>P</i> = 0.002) and diabetes mellitus (OR: 3.433; <i>P</i> = 0.035) increase the risk of death.</p><p><strong>Conclusion: </strong>Mortality of critically ill patients with COVID-19 pneumonia was high (69.5%). Older patients and acute respiratory distress syndrome were at higher risk of death. High SOFA score, high d-dimer at admission, and presence of diabetes mellitus were associated with high mortality.</p>","PeriodicalId":520645,"journal":{"name":"Infection & chemotherapy","volume":" ","pages":"328-339"},"PeriodicalIF":4.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/48/d5/ic-54-328.PMC9259901.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40476607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Prevalence of <i>bla</i>_CTX-M in Fecal Commensal <i>Escherichia coli</i> from Healthy Children.","authors":"Katherine Alcedo,&nbsp;Joaquim Ruiz,&nbsp;Theresa J Ochoa,&nbsp;Maribel Riveros","doi":"10.3947/ic.2021.0102","DOIUrl":"https://doi.org/10.3947/ic.2021.0102","url":null,"abstract":"<p><strong>Background: </strong>Antibiotic-resistant <i>Escherichia coli</i> can colonize the intestinal tract of healthy children, causing concern when antibiotic resistance is related to the presence of transferable mechanisms, such as extended-spectrum β-lactamases (ESBLs).</p><p><strong>Materials and methods: </strong>Fecal samples from 41 healthy children from two villages of rural Peru were cultured on ceftriaxone-disks. ESBL production was confirmed with double disk synergy. In all ESBL-produced isolates, antibiotic susceptibility to 12 antibacterial agents was established by disk diffusion, while clonal relationships were determined by repetitive extragenic palindromic-polymerase chain reaction (REP-PCR). Presence of ST131 was determined using PCR.</p><p><strong>Results: </strong>Ceftriaxone-resistant microorganisms were recovered from 39 samples belonging to 22 out of 41 children (53.7%). Of these, 80 ceftriaxone-resistant and two ceftriaxone-intermediate <i>E. coli</i> from inside ceftriaxone-halos were confirmed as ESBL-producers. All isolates were multidrug-resistant. In 79/80 (98.8%) ceftriaxone-resistant isolates, the presence of <i>bla</i>_CTX-M was detected alone (58 isolates, or together with other β-lactamase (<i>bla</i>_TEM, 17 isolates; <i>bla</i>_OXA-1<i>_-</i>_like, 3 isolates; <i>bla</i>_TEM + <i>bla</i>_OXA-1-like, 1 isolate), while in one isolate no such ESBL was identified. The two ceftriaxone-intermediate isolates recovered from the same sample, carried a <i>bla</i>_TEM and <i>bla</i>_SHV respectively. Thirty-four different clones were identified, with 4 clones being recovered from different samples from the same child. Twelve clones were disseminated among different children, including 5 clones disseminated between both villages. Two clones, accounting for 3 isolates and both recovered from the same children, belonged to <i>E. coli</i> ST131.</p><p><strong>Conclusion: </strong>This study demonstrates high prevalence of ESBL-carriers among healthy children living in a rural area of Peru, stressing the need for continuous surveillance and search for public health control measures.</p>","PeriodicalId":520645,"journal":{"name":"Infection & chemotherapy","volume":" ","pages":"59-69"},"PeriodicalIF":4.2,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e8/ea/ic-54-59.PMC8987167.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39775061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}