Antibiotic resistance patterns

O Antibiotic resistance patterns affect treatment options for bacterial upper respiratory tract infections. 

Table 2 Examples of studies on antibiotic resistance patterns in human commensal and environmental bacteria in urban waste water treatment plants. Unless otherwise stated,... 

Vaz-Moreira I, Nunes OC, Manaia CM (2011) Diversity and antibiotic resistance patterns of Sphingomonadaceae isolated from drinking water. Appl Environ Microbiol... 

Chloramphenicol remains a major treatment of typhoid and paratyphoid fever in developing countries. However, with increasing resistance to ampicillin, trimethoprim-sulfamethoxazole and, to some extent, chloramphenicol, fluoroquinolones and some third-generation cephalosporins (e.g., ceftriaxone) have become the drugs of choice. Salmonella infections, such as osteomyelitis, meningitis and septicemia, have also been indications for chloramphenicol use. Nevertheless, antibiotic resistance patterns can be a problem. As noted previously, nonty-phoidal salmonella enteritis is not benefited by treatment with chloramphenicol or other antibiotics. 

Butaye P, Devriese LA, Haesebrouck F. Differences in antibiotic resistance patterns of Enterococcus faecalis and Enterococcus faecium strains isolated from farm and pet animals. Antimicrob Agents Chemother 2001 45(5) 1374-8. 

In choosing appropriate antibiotic therapy, practitioners need to be cognizant of antibiotic resistance patterns, particularly to E. coli. Recently, trimethoprim-sulfamethoxazole has demonstrated diminished activity against E. coli in some areas of the country, with reported resistance up to 20%. 

Figures 6-8 illustrate antibiotic resistance patterns of E. faecium, E. faecalis, and E. durans isolates from Bryndza cheese. No one of the E. faecium, E. durans, and E. faecalis isolates were resistant to ampicillin, streptomycin, gentamicin, vancomycin, and teicoplanin. Thirty six percent of the E. faecium isolates and 22% of the E. faecalis isolates were resistant to erythromycin. E. faecium showed similar resistance to rifampicin (31%) as E. faecalis (29%). Both E. faecium and E. faecalis strains exhibited the same resistance to ciprofloxacin (2%). E. durans isolates showed very low level of resistance to rifampicin, erythromycin, ciprofloxacin, and nitrofurantoin (1 %). E. faecium, E. faecalis and E. durans were also found to be the predominant species recovered from naturally ripened European cheeses and...

Peters J, Mac K, Wichmann-Schauer H, Klein G, Ellerbroek L (2003) Species distribution and antibiotic resistance patterns of enterococci isolated from food of animal origin in Germany. Int J Food Microbiol 88 311-314... 

Resistance factors, particularly those carried on mobile elements, can spread rapidly within human and animal populations. Multidrug-resistant pathogens are mobile on a local and global scale, with newly introduced pathogens spreading rapidly in susceptible hosts. Antibiotic resistance patterns may vary locally and regionally, hence... 

Wiggins, B.A. (1996). Discriminant analysis of antibiotic resistance patterns in fecal streptococci, a method to differentiate human and animal sources of fecal pollution in natural waters. Appl. Environ. Microbiol. 35 379-386. 

Empirical therapy should be directed at the most likely pathogen (s) for a specific patient, taking into account age, risk factors for infection (including underlying disease and immune dysfunction, vaccine history, and recent exposures), CSF Gram stain results, CSF antibiotic penetration, and local antimicrobial resistance patterns. 

Treatment guidelines developed by the Sinus and Allergy Health Partnership reflect antibiotic choices that are likely to result in favorable clinical and bacteriologic outcomes based on pathogen distribution, spontaneous resolution rates, and nationwide resistance patterns.310 These guidelines (Figs. 69-3 and 69-4) stratify therapy based on severity of disease and risk of infection with resistant organisms, defined as mild disease in patients with prior antibiotic use within 4 to 6 weeks. Other risk factors for resistance include day-care attendance or frequent... 

Oral, narrow-spectrum antibiotic therapy with activity against Staphylococcus aureus and streptococcal species. Include coverage for MRSA (HA- or CA-MRSA) according to patient history and resistance patterns in the area. 

Biochemical tests are usually performed after pure cultures have been obtained. The standard indole, methyl red, Voges-Proskauer, citrate, and litmus milk tests may be used to show important physiological characteristics. To study the functional diversity of bacteria, the utilization of carbohydrates, amines, amides, carboxylic acids, amino acids, polymers, and other carbon and nitrogen sources can be tested.28 Dilution-based most-probable number (MPN) techniques with phospholipid fatty acids as biomarkers have been employed for studying different bacterial species in lakes.40 The patterns of antibiotic resistance in bacteria isolated from natural waters have been useful for identifying sources of water pollution.34... 

More recently, a range of other quality and safety issues have been recognised by consumers and now influence poultry meat and egg buying patterns and behaviour. Most importantly this includes (i) the routine use of antibiotics as growth promoters and curative medicines and the potential for development of transferable antibiotic resistance, (ii) risk associated with enteric pathogen (e.g. Salmonella and Campylobacter) and toxin (e.g. dioxin) contaminants of poultry products, (iii) the environmental impact of poultry production and (iv) the sensory and nutritional quality of eggs and poultry meat (Menzi et al., 1997 Hamm et al., 2002 Rodenburg et al., 2004 Horsted et al., 2005). 

Establish a protocol (eg, a preprinted order sheet) that standardizes antibiotic choice according to current published evidence, formulary availability, institutional resistance patterns, and cost,... 

Houndt T, Ochman H (2000) Long-term shifts in patterns of antibiotic resistance in enteric bacteria. Appl Environ Microbiol 66(12) 5406—5409... 

McArthur JV, Tuckfield RC (2000) Spatial patterns in antibiotic resistance among stream bacteria effects of industrial pollution. Appl Environ Microbiol 66(9) 3722-3726... 

The treatment of HP has become increasingly difficult due to the frequency of antibiotic resistance and recurrence after successful treatment. In Peru, the recurrence rate of the infection is as high as 73% even after successful eradication. In this instance, recurrence is not attributed to antibiotic resistance but to re-infection of patients. In the United States, resistant HP is also of concern. The Helicobacter pylori Antimicrobial Resistance Monitoring Program (HARP) is a multicenter US network that tracks HP patterns of resistance. In 2004, HARP reported that 34% of 347 HP isolates tested were resistant to one or more antibiotics commonly used to treat HP infections.In the US, most antibiotic resistance is associated with metronidazole and clarithromycin, both standard treatment options for HP. Thus, antibiotic resistance and high re-infection rates strongly argue for the development of new therapeutic modalities to prevent and treat HP infections worldwide. 

It may conceivably be argued that no one has proposed a complete ban on antibiotic usage, and that these studies would not be useful in evaluating the effects of restricted antibiotic use. However, the impact any restrictions would have on antibiotic resistance must be considered in evaluating the effectiveness of alternatives other than a complete ban. We have monitored the level and pattern of antibiotic resistance in enteric bacteria at periodic intervals during the past 13 years. Initially, the enteric bacteria of the two herds did not differ greatly in level or pattern of resistance. Though there had been no specifically planned use of antibiotics in these research herds and no one antibiotic had been used continuously at either location, antibiotics were used experimentally or as a swine producer would use them. 

Refractory ulcers Refractory ulcers in patients receiving antibiotic therapy for H. pylori eradication is often due to failure to successfully eradicate H. pylori infection. Resistance patterns, as well as noncompliance, and concurrent NSAID use may play a role in refractory cases. 

Local resistance patterns should guide the need for broader spectrum or multidrug regimens in severe nosocomial infections. In tertiary peritonitis, treatment of these resistant bacteria and Candida species with antibiotics and antifungals is still controversial, as the clinical outcome seems not to be altered. 

Table 41 Distribution pattern of multiple antibiotic resistance in test bacteria...

The result suggested that thioridazine was able to eliminate different antibiotic resistances singly or jointly in Escherichia coli strains and Shigella flexneri 6 BDC1 quite efficiently, but had a much weaker effect on Vibrio cholerae (Table 42). The pattern of elimination further indicated that penicillin, ampicillin, and amoxicillin were determined by a single plasmid in these bacteria. It seems that effective elimination depended on the curing concentrations, which were close to the MIC value of thioridazine for any... 

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