OBJECTIVES: The beta-lactamases with extended spectrum of activity (ESBL) are medically one of the most important group of enzymes. Another group of beta-lactamases representing of Enterobacteriaceae is group of the AmpC-type cephalosporinases. The presented study provides identification and determination of the spectrum of resistance against different and clinically used antimicrobial drugs in the clinical isolates of Escherichia coli. METHODS: These isolates had origin in different departments of the L. Pasteur University Hospital in Košice. The goal was the detection of beta-lactamase production with extended-spectrum effect and testing of AmpC-type cephalosporinases by several phenotypic tests in clinical isolates. MALDI-TOF MS analysis was performed on a Microflex MALDI Biotyper. Samples were positively tested for ESBL with the use of the disc diffusion method. PCR were performed with a series of primers designed for the detection of Ambler class A, B and C beta-lactamase genes. RESULTS: For all 485 isolates, we determined the production of ESBL, which we detected in 166 E. coli isolates, which represents a 34.2% prevalence of ESBL production. It is clear from the results that the prevalence of ESBL-producing E. coli out of the total number of E. coli investigated reached 34.2%. In the monitored period, we confirmed at least one resistance gene from 485 E. coli in 188 positive isolates. CONCLUSIONS: We describe a complex ESBL epidemiology. The study revealed a high rate of ESBL-producing E. coli isolates; blaTEM and blaSHV enzymes dominated in ESBL-positive E. coli isolates in the L. Pasteur University Hospital in Košice.
- MeSH
- antibakteriální látky farmakologie MeSH
- antibiotická rezistence MeSH
- Bacteria MeSH
- beta-laktamasy genetika farmakologie MeSH
- Escherichia coli * genetika MeSH
- infekce vyvolané Escherichia coli * epidemiologie mikrobiologie MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Popisujeme prípad 50-ročnej imunokompetentnej ženy, ktorá bola hospitalizovaná s poruchou vedomia. Stav progredoval do bezvedomia s kvadruparézou, pričom ani laboratórne vyšetrenia ani opakované vyšetrenia likvoru z lumbálnej punkcie nezistili pôvodcu klinického stavu. Pacientka zomrela po osemdňovej hospitalizácii. Mikroskopicky a kultivačne bol po pitve ako etiologický agens zistený Cryptococcus, ktorý počas života viedol k ťažkej kryptokokovej meningoencefalitíde, ktorá bola príčinou smrti. Histologicky boli v tkanive mozgu prítomné nakopenia kryptokokov, ktoré vo farbení hematoxylínom-eozínom verne napodobovali erytrocyty a rozsiahle krvácania. Multifokálna obliterácia cievneho riečiska mozgu kvasinkami bola sprevádzaná rozvojom hypoxicko-ischemických zmien imitujúcich úrazové difúzne axonálne poškodenie mozgu.
In this article, we report the autopsy findings of a 50-year-old immunocompetent woman, who was hospitalized with an altered state of consciousness. Examinations, including cerebrospinal fluid analysis, carried out during hospitalization failed to identify the infectious agent causing progressive loss of consciousness and quadriparesis. The patient died within 8 days of admission to the hospital. Post-mortem microscopic and culture examination revealed Cryptococcus species. Death was attributed to cryptococcal meningoencephalitis. Histologic examination revealed accumulation of cryptococcus mimicking erythrocytes and extensive hemorrhage in hematoxylin and eosin-stained sections of the brain. Multifocal obliteration of the vascular bed by yeast was accompanied by hypoxic-ischemic brain injury mimicking traumatic diffuse axonal injury.
- MeSH
- akantolýza * diagnóza terapie MeSH
- diferenciální diagnóza MeSH
- elektronová mikroskopie MeSH
- fluorescenční mikroskopie MeSH
- imunohistochemie MeSH
- kůže anatomie a histologie MeSH
- lidé MeSH
- senioři nad 80 let MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- akantolýza * etiologie genetika patofyziologie MeSH
- genetická onemocnění kůže * dějiny diagnóza etiologie imunologie patofyziologie terapie MeSH
- klinický obraz nemoci MeSH
- lidé MeSH
- myeloidní sarkom MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
