Aminoglycosides and cephalosporins belong among antimicrobials with a pronounced effect on most gram-negative rods. In vitro susceptibility and resistance to gentamicin, tobramycin, amikacin, netilmicin, cefoxitin, cefotaxime, cefsulodin, cefoperazone in Klebsiella pneumoniae, Enterobacter spp., Proteus mirabilis, Escherichia coli and Pseudomonas aeruginosa was tested by the quantitative dilution micromethod. Selected, highly susceptible strains of the above species were furthermore compared for minimal inhibitory concentration (MBC) and minimal bactericidal concentration (MBC) values. Aminoglycosides tended to be the most effective drugs for susceptible strains. In view of their relative toxicity possibly optimal combinations of individual aminoglycosides with individual cephalosporins are discussed.

• MeSH
• aminoglykosidy farmakologie   MeSH
• antibakteriální látky farmakologie   MeSH
• cefalosporiny farmakologie   MeSH
• gramnegativní bakterie účinky léků   MeSH
• kombinovaná farmakoterapie MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Názvy látek
• aminoglykosidy MeSH
• antibakteriální látky MeSH
• cefalosporiny MeSH

Adequate treatment of microbial infections requires rapid and accurate identification of the etiological agent. In routine diagnostics, identification of bacteria conventionally relies on phenotypic testing, which can be hindered by phenotypic variations. Therefore, genotyping techniques should perform faster and more accurately. Recently, the technique of high-resolution melting analysis (HRMA) of PCR amplicons promises to provide a convenient and economic tool of genotypic identification. In our study, we performed prospective routine testing of a PCR-HRMA system that was recently published in a proof-of-the-principle study. The system was evaluated by analysing 275 clinical isolates of bacteria acquired from 65 patients suffering from cystic fibrosis or chronic obstructive pulmonary disease. Our results show that its routine use may result in partial worsening of its discriminatory power; however, it still outmatched conventional phenotyping in the group of non-fermentative Gram-negative rods. Moreover, when supplemented by rapid, simple and economic oxidase test, it can be even simplified for more economic performance.

• MeSH
• bakteriologické techniky metody   MeSH
• chronická obstrukční plicní nemoc komplikace   MeSH
• cystická fibróza komplikace   MeSH
• diagnostické techniky molekulární metody   MeSH
• DNA bakterií chemie   genetika   MeSH
• gramnegativní aerobní tyčinky a koky genetika   izolace a purifikace   MeSH
• gramnegativní bakteriální infekce diagnóza   mikrobiologie   MeSH
• infekce dýchací soustavy mikrobiologie   MeSH
• lidé MeSH
• polymerázová řetězová reakce metody   MeSH
• prospektivní studie MeSH
• tranzitní teplota MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Názvy látek
• DNA bakterií MeSH

BACKGROUND: This intercontinental study aimed to study gram-negative rod (GNR) resistance in hematopoietic stem cell transplantation (HSCT). METHODS: GNR bacteremias occurring during 6 months post-HSCT (February 2014-May 2015) were prospectively collected, and analyzed for rates and risk factors for resistance to fluoroquinolones, noncarbapenem anti-Pseudomonas β-lactams (noncarbapenems), carbapenems, and multidrug resistance. RESULTS: Sixty-five HSCT centers from 25 countries in Europe, Australia, and Asia reported data on 655 GNR episodes and 704 pathogens in 591 patients (Enterobacteriaceae, 73%; nonfermentative rods, 24%; and 3% others). Half of GNRs were fluoroquinolone and noncarbapenem resistant; 18.5% carbapenem resistant; 35.2% multidrug resistant. The total resistance rates were higher in allogeneic HSCT (allo-HSCT) vs autologous HSCT (auto-HSCT) patients (P < .001) but similar in community-acquired infections. Noncarbapenem resistance and multidrug resistance were higher in auto-HSCT patients in centers providing vs not providing fluoroquinolone prophylaxis (P < .01). Resistance rates were higher in southeast vs northwest Europe and similar in children and adults, excluding higher fluoroquinolone- and β-lactam/β-lactamase inhibitor resistance rates in allo-HSCT adults. Non-Klebsiella Enterobacteriaceae were rarely carbapenem resistant. Multivariable analysis revealed resistance risk factors in allo-HSCT patients: fluoroquinolone resistance: adult, prolonged neutropenia, breakthrough on fluoroquinolones; noncarbapenem resistance: hospital-acquired infection, breakthrough on noncarbapenems or other antibiotics (excluding fluoroquinolones, noncarbapenems, carbapenems), donor type; carbapenem resistance: breakthrough on carbapenem, longer hospitalization, intensive care unit, previous other antibiotic therapy; multidrug resistance: longer hospitalization, breakthrough on β-lactam/β-lactamase inhibitors, and carbapenems. Inappropriate empiric therapy and mortality were significantly more common in infections caused by resistant bacteria. CONCLUSIONS: Our data question the recommendation for fluoroquinolone prophylaxis and call for reassessment of local empiric antibiotic protocols. Knowledge of pathogen-specific resistance enables early appropriate empiric therapy. Monitoring of resistance is crucial. CLINICAL TRIALS REGISTRATION: NCT02257931.

• Klíčová slova
• antimicrobial resistance, bacteremia, gram-negative rods, hematopoietic stem cell transplantation,
• MeSH
• antibakteriální látky farmakologie   terapeutické užití   MeSH
• bakteriemie farmakoterapie   epidemiologie   mikrobiologie   MeSH
• dítě MeSH
• dospělí MeSH
• gramnegativní bakteriální infekce farmakoterapie   epidemiologie   mikrobiologie   MeSH
• gramnegativní bakterie účinky léků   MeSH
• internacionalita MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mnohočetná bakteriální léková rezistence * MeSH
• předškolní dítě MeSH
• příjemce transplantátu * statistika a číselné údaje   MeSH
• prospektivní studie MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• transplantace hematopoetických kmenových buněk * MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH
• Názvy látek
• antibakteriální látky MeSH

The authors examined the resistance to 13 antibiotics and chemotherapeutic agents by the diluting micromethod and the routine disk method in the group of 5375 gram-negative strains of 7 genera which prevailed in clinical material of an hospital (FN Olomouc) and in material of community (OHS Olomouc) provenance during the years 1992 and 1993. In the majority of cases, the resistance was more frequent in the strains isolated from the hospital material. The most remarkable differences were found in A cinetobacter sp. (9-76%), Enterobacter sp. (10-60%) and Citrobacter sp. (18-58%). In other examined species, the differences varied in the ranges 3-40% in E.coli, 2-33% in Klebsiella sp., 0-28% in P. vulgaris, 2-28% in P.mirabilis, 0-16% in M.morganii, and 0-13% in P. aeruginosa.

• MeSH
• antibiotická rezistence * MeSH
• gramnegativní bakterie účinky léků   izolace a purifikace   MeSH
• mikrobiální testy citlivosti MeSH
• Publikační typ
• časopisecké články MeSH

Procalcitonin (PCT) levels can distinguish between infectious and non-infectious systemic inflammatory response. However, there are some differences between Gram-negative (G-), Gram-positive (G+), and fungal bloodstream infections, particularly in different cytokine profiles, severity and mortality. The aim of current study was to examine whether PCT levels can serve as a distinguishing mark between G+, G-, and fungal sepsis as well. One hundred and sixty-six septic patients with positive blood cultures were examined on C-reactive protein (CRP) and PCT on the same date of blood culture evaluation. The median (interquartile range, IQR) of CRP and PCT in G+, G-, and fungal cohorts and comparison of measured values between groups were made using the Kruskal-Wallis test with subsequent Bonferroni's corrections, with p < 0.05. In 83/166 (50 %) of blood cultures, G+ microbes, 78/166 (47 %) G- rods, and 5/166 (3 %) fungi were detected. PCT concentrations (ng/ml) were significantly higher in G- compared to other cohorts: 8.90 (1.88; 32.60) in G-, 0.73 (0.22; 3.40) in G+, and 0.58 (0.35; 0.73) in fungi (p < 0.00001). CRP concentrations did not differ significantly in groups. Significantly higher PCT levels could differentiate G- sepsis from G+ and fungemia. In contrast to CRP, PCT is a good discriminative biomarker in different bloodstream infections.

• MeSH
• biologické markery krev   MeSH
• C-reaktivní protein analýza   MeSH
• diferenciální diagnóza MeSH
• gramnegativní bakteriální infekce diagnóza   patologie   MeSH
• grampozitivní bakteriální infekce diagnóza   patologie   MeSH
• kalcitonin krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mykózy diagnóza   patologie   MeSH
• peptid spojený s genem pro kalcitonin MeSH
• proteinové prekurzory krev   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• sepse diagnóza   etiologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH
• práce podpořená grantem MeSH
• Názvy látek
• biologické markery MeSH
• C-reaktivní protein MeSH
• CALCA protein, human MeSH Prohlížeč
• kalcitonin MeSH
• peptid spojený s genem pro kalcitonin MeSH
• proteinové prekurzory MeSH

Bacterial resistance surveillance is one of the main outputs of microbiological laboratories and its results are important part of antimicrobial stewardship (AMS). In this study, the susceptibility of specific bacteria to selected antimicrobial agents was tested. The susceptibility of 90 unique isolates of pathogens of critical priority obtained from clinically valid samples of ICU patients in 2017-2021 was tested. 50% of these fulfilled difficult-to-treat resistance (DTR) criteria and 50% were susceptible to all antibiotics included in the definition. 10 Enterobacterales strains met DTR criteria, and 2 (20%) were resistant to colistin (COL), 2 (20%) to cefiderocol (FCR), 7 (70%) to imipenem/cilastatin/relebactam (I/R), 3 (30%) to ceftazidime/avibactam (CAT) and 5 (50%) to fosfomycin (FOS). For Enterobacterales we also tested aztreonam/avibactam (AZA) for which there are no breakpoints yet. The highest MIC of AZA observed was 1 mg/l, MIC range in the susceptible cohort was 0.032-0.064 mg/l and in the DTR cohort (incl. class B beta-lactamase producers) it was 0.064-1 mg/l. Two (13.3%) isolates of Pseudomonas aeruginosa (15 DTR strains) were resistant to COL, 1 (6.7%) to FCR, 13 (86.7%) to I/R, 5 (33.3%) to CAT, and 5 (33.3%) to ceftolozane/tazobactam. All isolates of Acinetobacter baumannii with DTR were susceptible to COL and FCR, and at the same time resistant to I/R and ampicillin/sulbactam. New antimicrobial agents are not 100% effective against DTR. Therefore, it is necessary to perform susceptibility testing of these antibiotics, use the data for surveillance (including local surveillance) and conform to AMS standards.

• Klíčová slova
• Antimicrobial stewardship, Aztreonam/avibactam, Cefiderocol, Ceftazidime/avibactam, Ceftolozane/tazobactam, Colistin, Difficult-to-treat resistance, Fosfomycin, Imipenem/cilastatin/relebactam,
• MeSH
• antibakteriální látky * farmakologie   terapeutické užití   MeSH
• azabicyklické sloučeniny * MeSH
• aztreonam MeSH
• cefalosporiny * MeSH
• cefiderokol MeSH
• gramnegativní bakterie MeSH
• kolistin farmakologie   MeSH
• lidé MeSH
• mikrobiální testy citlivosti MeSH
• Pseudomonas aeruginosa MeSH
• retrospektivní studie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antibakteriální látky * MeSH
• avibactam MeSH Prohlížeč
• azabicyklické sloučeniny * MeSH
• aztreonam MeSH
• cefalosporiny * MeSH
• cefiderokol MeSH
• kolistin MeSH

In the period from January 1993 to June 1996 were at the Department of Microbiology of the University Hospital in Olomouc 122 strains of Gram-negative nonfermentative rod-shaped bacteria isolated from haemocultures. The majority represented the group of 51 strains of the genus Acinetobacter (41.8%), complex A. calcoaceticus-baumannii (Acb complex). The second largest group were 21 strains (17.2%) of Pseudomonas aeruginosa. These were followed by 17 strains (13.9%) of Stenotrophomonas maltophilia, 8 strains (6.6%) of non-Acb complex acinetobacters, 6 strains (4.9%) of Pseudomonas putida and 5 strains (4.1%) of Alcaligenes xylosoxidans. The remaining species were represented only by 1-2 strains. In three isolations was the identification impossible. The majority of strains (24.6%) were from the Department of Haematology of the University Hospital in Olomouc. The most frequent diagnoses in patients with positive haemocultures were leukemias and lymphomas (24.6%). The most effective tested antimicrobial agents were ceftazidime (93.4% of sensitive strains) and ofloxacin (91.7%). From the total number of 80 strains detected using the equipment BacT/Alert 120, 22 (27.5%) were isolated repeatedly confirming their role in the etiology of bacteriemic or septic episodes. Because only one blood sample was obtained in 34 cases (58.6%) of the remaining 58 only once detected strains, it was impossible to confirm their etiologic role by repeated isolation. (Tab. 6, Ref. 22.)

• MeSH
• antibiotická rezistence MeSH
• gramnegativní aerobní bakterie účinky léků   růst a vývoj   MeSH
• gramnegativní bakteriální infekce diagnóza   MeSH
• krev MeSH
• kultivační média MeSH
• lidé MeSH
• mikrobiální testy citlivosti MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• kultivační média MeSH

OBJECTIVES: We present here data on Gram-negative rods bacteremia (GNRB) rates, risk factors and associated mortality. METHODS: Data on GNRB episodes were prospectively collected in 65 allo-/67 auto-HSCT centers in 24 countries (Europe, Asia, Australia). In patients with and without GNRB, we compared: demography, underlying disease, HSCT-related data, center` fluoroquinolone prophylaxis (FQP) policy and accreditation status, and involvement of infection control team (ICT). RESULTS: The GNRB cumulative incidence among 2818 allo-HSCT was: pre-engraftment (pre-eng-allo-HSCT), 8.4 (95% CI 7-9%), post-engraftment (post-eng-allo-HSCT), 5.8% (95%CI: 5-7%); among 3152 auto-HSCT, pre-eng-auto-HSCT, 6.6% (95%CI: 6-7%), post-eng-auto-HSCT, 0.7% (95%CI: 0.4-1.1%). GNRB, especially MDR, was associated with increased mortality. Multivariate analysis revealed the following GNRB risk factors: (a) pre-eng-allo-HSCT: south-eastern Europe center location, underlying diseases not at complete remission, and cord blood source; (b) post-eng-allo-HSCT: center location not in northwestern Europe; underlying non-malignant disease, not providing FQP and never accredited. (c) pre-eng-auto-HSCT: older age, autoimmune and malignant (vs. plasma cell) disease, and ICT absence. CONCLUSIONS: Benefit of FQP should be explored in prospective studies. Increased GNRB risk in auto-HSCT patients transplanted for autoimmune diseases is worrying. Infection control and being accredited are possibly protective against bacteremia. GNRB are associated with increased mortality.

• Klíčová slova
• Bacteremia, Fluoroquinolone prophylaxis, Gram-negative, Mortality, Post-engraftment, Pre-engraftment, Risk factors, Stem cell transplantation,
• MeSH
• bakteriemie * epidemiologie   MeSH
• homologní transplantace MeSH
• lidé MeSH
• prospektivní studie MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• transplantace hematopoetických kmenových buněk * škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Asie MeSH
• Austrálie MeSH
• Evropa epidemiologie   MeSH
• východní Evropa MeSH

• MeSH
• gramnegativní aerobní bakterie izolace a purifikace   MeSH
• lidé MeSH
• metody MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

In the submitted paper the authors focused their attention on the characteristics of Gram-negative bacteria with a marginal sensitivity and resistance to ofloxacin (MIC > or = 2 mg.l-1) isolated from clinical materials in the Olomouc Faculty Hospital. They give an account of their sensitivity (based on assessment of the minimal inhibitory concentration-MIC) to 20 other antibiotics and chemotherapeutic agents and the percentage ratio of different species according to department, clinical material and diagnosis.

• MeSH
• antibiotická rezistence MeSH
• gramnegativní bakterie účinky léků   izolace a purifikace   MeSH
• lidé MeSH
• ofloxacin farmakologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Názvy látek
• ofloxacin MeSH