CLSI recommends the pefloxacin susceptibility as a surrogate marker for ciprofloxacin, ofloxacin and levofloxa-cin susceptibility for treatment of enteric fever susceptibility.. We analyzed
Trang 152 Abstracts / International Journal of Infectious Diseases 53S (2016) 4–163
Methods & Materials: A retrospective analysis of case
his-tories of patients with a clinical diagnosis of ARIs complicated
with community-acquired pneumonia in children Age of children
ranged from one month to five years Patients were treated in
viral diseases branch of municipal children’s infectious diseases
hospital in Astana Patient’s data of antibacterial records were
ana-lyzed in outpatient stage in order to monitor antibiotic therapy We
developed an antibiotic map which includes the data on antibiotics
obtained before entering the hospital for the last 3 months,
indi-cating the dose and duration of outpatient treatment, as well as
antibiotics that the patient received in the hospital, the dose and
duration This card was put into practice in the hospital from 2009
This allows us to track the quantitative and qualitative
characteriza-tion of antibacterial therapy in hospital Statistical data calculacharacteriza-tion
was performed using Excel 2010 software and SPSS Statistics 20.0
Results: We analyzed 395 cases patients in the viral
dis-ease branch with a clinical diagnosis of ARIs complicated with
community-acquired pneumonia The average age of studied
patients was - 20.48 +- 13.95 months The antibacterial card was
revealed that 57 (14.4%) patients out of 395 got antibiotics before
hospitalization At the time of admission, the period from the
beginning of illness averaged - 3.2+2.1 days Among the antibiotics
the most commonly used were semi-synthetic
aminopeni-cillin (40.3%), inhibitor protected semi-synthetic aminopeniaminopeni-cillin
(17.5%), macrolides (15.6%) 2-generation cephalosporins (12.3%),
3rd-generation cephalosporins (8.7%) During the appointment of
antibacterial therapy, physician will base on the obtained data in
order to avoid irrational use of antibiotics
Conclusion: The use of antibacterial cards, with the aim of
mon-itoring of used antibiotics in the hospital, allowed to improve the
quality of the causal treatment, to reduce significantly the time of
the patient’s stay in hospital and to reduce drug polypharmacy
http://dx.doi.org/10.1016/j.ijid.2016.11.133
19.054
Pefloxacin as a surrogate marker to determine
susceptibility to quinolones drugs in Salmonella
enterica Serovar Typhi: Structural and
molecular analysis
P Sharma ,∗, M Kumarb, S Dahiyac, P Kaurd, S
Soodc, B.K Dasc, A Kapilc
aAll India Institute of Medical Sciences,
Microbiology, Delhi, DELHI/IN
bAll India Institute of Medical Sciences, Biophysics,
NEW DELHI/IN
cAll India Institute of Medical Sciences,
Microbiology, NEW DELHI/IN
dAll India Institute of Medical Sciences, Biophysics,
New Delhi, DELHI/IN
Purpose: Quinolones remain the mainstay for enteric fever
treatment since past four decades after the emergence of MDR
strains of S Typhi CLSI recommends the pefloxacin susceptibility
as a surrogate marker for ciprofloxacin, ofloxacin and
levofloxa-cin susceptibility for treatment of enteric fever susceptibility We
analyzed the sensitivity and specificity of pefloxacin as a
surro-gate marker for all quinolones by using susceptibility analysis with
current CLSI guidelines, detection of molecular mechanisms of
resistance and drug target interactions by molecular docking
Methods & Materials: Antibiotic susceptibility to ciprofloxacin,
ofloxacin and levofloxacin were determined in 321 isolates of
S Typhi as per CLSI guidelines The correlational analysis was
done for pefloxacin zone of inhibition and MIC of ciprofloxacin,
ofloxacin and levofloxacin Temporal analysis was done by Chi-Square test for trend using SPSS ver 17.0 DNA sequencing was done for quinolone resistance determining region (QRDR) of gyrA, gyrB, parC and parE genes of target enzymes and mutations were compared to pefloxacin susceptibility Drug target interaction was studies by molecular docking Homology model of DNA gyrase-DNA complex was determined using templates 1AB4 and 2XCT
in prime modeling software Molecular docking of ciprofloxacin, ofloxacin, levofloxacin and pefloxacin drug molecules was done Binding mode and docking score were determined for each drug
Results: Pefloxacin susceptibility and resistance showed a
pre-dictive value of 0.99 and 1 respectively Most common mutations were Ser83 and Asp87 of gyrA gene No mutation was found in QRDR of pefloxacin susceptible strains Docking confirmation was same for all quinolones studied The binding was stabilized by stacking interaction of quinolone ring and aromatic base pairs
of DNA and carboxylate group interacts with the ser83 residue
of GyrA subunit Docking score for ciprofloxacin, ofloxacin, levo-floxacin and pelevo-floxacin were -11.666, -11.349, -11.348 and -8.269 respectively
Conclusion: The mode of binding and conformation of
pefloxacin is same as ciprofloxacin, levofloxacin and ofloxacin but binding affinity is less than all these three antibiotics as confirmed
by docking score It is concordant with the CLSI criteria that an iso-late susceptible with pefloxacin is automatically susceptible to all fluoroquinolones, hence it is a good surrogate marker for fluoro-quinolones susceptibility
http://dx.doi.org/10.1016/j.ijid.2016.11.134
19.056 Risk assessment of the exposure of people to methicillin-resistant Staphylococcus aureus (MRSA) from dogs
M.I Neves, J Pinto Ferreira, K Stärk∗ SAFOSO, Liebefeld/CH
Purpose: The purpose of this study was to assess the risk of
exposure of people to MRSA from dogs, via direct and indirect path-ways, with special emphasis on companion animal veterinarians This scenario was used as an example of cross-species spread of antimicrobial resistance genes
Methods & Materials: We conducted a risk assessment to
quan-tify the probability of exposure of people, specifically veterinarians
to MRSA Risk pathways included both direct and indirect (e.g environment) transmission A 24h-time period was considered
to estimate the probability of potential exposure Input data was collected through a literature review When information was not available, expert opinion was considered Palisade decision tools (@Risk 7.0.1 Pro edition) were used to construct the risk simulation model The outcome was the probability of exposure within the defined time window Repeated exposure and exposure load were not considered Sensitivity analysis was performed to quantify the relative significance of each of the model input parameters
Results: The risk of exposure to MRSA from dogs appears to be
low, for individuals with no occupational exposure (2.4x10-8) and one order of magnitude higher for companion animal veterinarians Most of the available literature focused on reporting cases where similar isolates of MRSA were found in dogs and humans, but there are important data gaps for parameters including exposure load
It is therefore currently not possible to reliably quantify the sig-nificance of the different transmission pathways or even to rank them
Trang 2Abstracts / International Journal of Infectious Diseases 53S (2016) 4–163 53
Conclusion: No significant exposure to MRSA and therefore no
indication of related adverse health effects from dog ownership or
occupational exposure of small animal veterinarians were
identi-fied However, we only considered a 24h-time period of potential
exposure In a scenario of prolonged colonization of an animal the
repeated daily contact will result in cumulative exposure Also,
exposure does not necessarily mean risk More work is needed
to understand the health consequences of exposure to resistance
genes, particularly MRSA
http://dx.doi.org/10.1016/j.ijid.2016.11.135
19.058
Uropathogens and antimicrobial susceptibility
patterns in urinary tract infections diagnosed in
the primary care setting in Singapore
M.X Tana,∗, K Mannathb, L.P Ngb, P.L Hub,
K.S.P Moeyb, K.T Tanb, Y.L.A Koongb, T.Y Tanc,
C.S Wonga, N.C Tanb
aTan Tock Seng Hospital, Institute of Infectious
Diseases and Epidemiology, Singapore/SG
bSingHealth Polyclinics, Singapore/SG
cChangi General Hospital, Singapore/SG
Purpose: Urinary tract infection (UTI) is a frequent condition
encountered in primary care Treatment is usually empirical
with-out urine culture or susceptibility testing because the causative
uropathogens and their antimicrobial susceptibility profiles are
considered to be predictable However, there is increasing evidence
of antimicrobial resistance in community-acquired uropathogens
This cross-sectional study aims to describe the distribution of
uropathogens and their antibiotic susceptibilities amongst patients
who were diagnosed with UTI in primary care clinics in Singapore
Methods & Materials: Patients with UTI diagnoses (by their
primary care physicians) were recruited from two public sector
primary care clinics under the SingHealth Polyclinics in Singapore
Upon enrolment, data on diagnosis, symptoms, risk factors for
antimicrobial resistance and antibiotics prescribed for this UTI
episode were collected Each patient provided a clean-catch
mid-stream sample for urine culture at the routine diagnostic laboratory
of Changi General Hospital in Singapore A positive urine culture
was defined as isolation of≥103 colony forming units (cfu)/ml
of primary urinary pathogens (Escherichia coli, Klebsiella spp
or Staphylococcus saprophyticus) in pure culture, or isolation of
≥105cfu/ml of these organisms as predominant growth The
signifi-cance cut-off for culture of other potential urinary pathogens were
≥105cfu/ml Susceptibility to antibiotics commonly used for UTI
was assessed using disc diffusion methods using standard cut-offs
Descriptive statistics on the prevalence of different
uropathogens and their antibiotic susceptibilities are presented,
with Pearson’s chi-square test used to assess differences between
subgroups
Results: Of 380 urine samples collected, 177 (46.2%) yielded
positive cultures There were no significant associations between
the urine cultures result and ethnicity or age group E.coli (n=135,
76.3%) and Klebsiella ssp (n=14, 7.9%) were the two most common
pathogens isolated, for all gender and age groups The E.coli strains
demonstrated high non-susceptibility to Amoxicillin (46.7%),
Cephalexin (60.7%), Ciprofloxacin (30.4%), Trimethoprim(29.6%)
and Trimethoprim-sulphamethoxazole (28.9%), while the Klebsiella
ssp strains showed 42.9% non-susceptibility to Nitrofurantoin
Sus-ceptibility to Augmentin and Fosfomycin remain high (at least 90%)
for both E Coli and Klebsiella ssp
Conclusion: While oral Amoxicillin, Cephalexin, Ciprofloxacin,
Trimethoprim-sulphamethoxazole and Nitrofurantoin are com-monly used for UTI treatment, increasing community-acquired resistance to these antibiotics in Singapore may complicate the efficacy of empirical treatment
http://dx.doi.org/10.1016/j.ijid.2016.11.136
19.059 Canine leishmaniosis: Serological comparison
of a commercial rapid test with a quantitative enzyme-linked immunosorbent assay test for detection of anti-Leishmania infantum antibodies
S Villanueva-Saz∗, M.T Verde-Arribas, D
Ripolles-Lopez Zaragoza University, Saragossa/ES
Purpose: The aim of this study was to evaluate a serological
immunochromatographic test for the detection of anti-Leishmania infantum canine antibodies
Methods & Materials: The rapid test was compared to
a reference quantitative serological technique: ELISA in-house (Enzyme-Linked Immunosorbent Assay) This quantitative ELISA in-house was used to define the sera as positive or negative One hundred canine serum samples were evaluated, 41 were consid-ered negative and 59 were considconsid-ered seropositive with different levels of anti-Leishmania antibodies: low levels (n=7), medium lev-els (n=28) and high levlev-els (n= 24) Based on these results, the FASTest®LEISH (Diagsnostik Megacor, Austria) was evaluated: sen-sitivity, specificity, positive predictive value, negative predictive value, Kappa index and accuracy were calculated
Results: The sensitivity and specificity were 0.97 and 0.98,
respectively In an endemic area to Leishmania infantum infection with a low seroprevalence (10%), the positive predictive value was 0.82 and the negative predictive value was 1.00 By contrast, for a high seroprevalence area (25%), the positive predictive value was 0.93 and the negative predictive value was 0.99 For the Kappa index, FASTest®LEISH obtained 0.95 and the accuracy for this qual-itative test was 0.97
Conclusion: The study showed that FASTest®LEISH is a reliable diagnostic test that complies with all requirements for a sensitive (relative sensitivity 97%) and specific (relative specificity 98%) rapid test Compared to other commercial tests the FASTest®LEISH is a commercial rapid test with high sensitivity and specificity for early detection infected dog with a reasonable cost-benefit balance http://dx.doi.org/10.1016/j.ijid.2016.11.137
19.060 Scenario-based assessment of decontamination methodology for biosafety and biosecurity applications
B Crook∗, J Farrant, C Makison-Booth, A
Beswick Health and Safety Executive, Science Division, Buxton/UK
Purpose: In laboratory biosafety and in public biosecurity, there
is the requirement to call upon effective methods to decontaminate occupied spaces following a biological release Not all methods will
be suitable for a specific environment or against a specific bioagent