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First report of extensively-drug-resistant Proteus mirabilis isolate carrying plasmid-mediated blaNDM-1 in a Tunisian intensive care unit
The rapid emergence of antibiotic resistance among Gram-negative bacilli is a serious threat to the management of infectious diseases. β-lactam antibiotics are the most commonly used antimicrobials for empirical therapy. Production of β-lactamases is one of the strategies adopted by bacteria to develop resistance to the β-lactam class of antibiotics [1]. Proteus mirabilis is an emerging cause of nosocomial infections, particular ly of wounds and the urinary tract. The infections caused by this enterobacterial species are difficult to treat because of acquisition of various resistance mechanisms, such as extended-spectru...
Source: International Journal of Antimicrobial Agents - June 26, 2018 Category: Drugs & Pharmacology Authors: Lamia Kanzari, Sana Ferjani, Mabrouka Saidani, Zeineb Hamzaoui, Ali Jendoubi, Sarra Harbaoui, Asma Ferjani, Amel Rehaiem, Ilhem Boutiba Ben Boubaker, Amine Slim Source Type: research

FIRST REPORT OF EXTREMELY DRUG RESISTANT PROTEUS MIRABILIS ISOLATE CARRYING PLASMID-MEDIATED blaNDM-1 IN A TUNISIAN INTENSIVE CARE UNIT
The rapid emergence of antibiotic resistance among Gram-negative bacilli is a serious threat to the management of infectious diseases. β-lactam antibiotics are the most frequently used antimicrobials for empirical therapy. Production of β-lactamases is one of the strategies adopted by bacteria to develop resistance to the β-lactam class of antibiotics [1]. P. mirabilis is an emerging cause of nosocomial infections, particularly of wounds and the urinary tract. The infections caused by this enterobacterial species are difficult to treat because of acquisition of various resistance mechanisms, such as Extended spectrum β...
Source: International Journal of Antimicrobial Agents - June 26, 2018 Category: Drugs & Pharmacology Authors: Kanzari Lamia, Ferjani Sana, Saidani Mabrouka, Hamzaoui Zeineb, Jendoubi Ali, Harbaoui Sarra, Ferjani Asma, Rehaiem Amel, Boutiba Ben Boubaker Ilhem, Slim Amine Tags: Themed Issue: Recent Advances in Antimicrobial and Bacterial Resistance Source Type: research

Fosfomycin Etest for Enterobacteriaceae: Interobserver and interlaboratory agreement
Fosfomycin was discovered as antibiotic agent in 1969 [1]. Its use has gained renewed interest due to increasing resistance against other antibiotics, especially in Enterobacteriaceae. (Source: International Journal of Antimicrobial Agents)
Source: International Journal of Antimicrobial Agents - June 26, 2018 Category: Drugs & Pharmacology Authors: S.P. van Mens, T. ten Doesschate, M.F.Q. Kluytmans –van den Bergh, J.W. Mouton, J.W.A. Rossen, C. Verhulst, M.J.M. Bonten, J.A.J.W. Kluytmans Tags: Short communication Source Type: research

MCR-1-positive colistin-resistant Escherichia coli in immunocompromised hospitalised patients
Antimicrobial-resistant infections in immunocompromised patients are a critical issue that has led to an increase in morbidity and mortality, particularly in hospital settings [1]. For severe human infections caused by multidrug-resistant Gram-negative bacteria, colistin has been considered a last-resort antibiotic. However, the global dissemination of plasmid-mediated colistin resistance, mostly encoded by the mcr-1 gene, has led to a therapeutic impasse [2]. Although polymyxin resistance may be mediated by mutations in several genes involved in lipid A modification, plasmid-mediated colistin resistance due to the mcr-1 g...
Source: International Journal of Antimicrobial Agents - June 23, 2018 Category: Drugs & Pharmacology Authors: Flavio A. Oliveira, T ânia R. Zaccariotto, Cristiane Piveta, Christian C. Hofling, Mariangela R. Resende, Carlos E. Levy, Fernanda Esposito, Miriam R. Fernandes, Louise Cerdeira, Nilton Lincopan Tags: Letter to the Editor Source Type: research

Diverse genetic alterations responsible for post-exposure colistin resistance in populations of the same strain of Klebsiella pneumoniae
The lack of effective antimicrobial agents against infections by gram-negative pathogens has led to a revival of treatment with polymyxins (polymyxin B and colistin) [1]. The modification of lipopolysaccharide (LPS) through cationic substitution is the most common mechanism of colistin resistance in many gram-negative pathogens, including K. pneumoniae [2]. LPS modification relies on the activation of the PhoPQ and PmrAB two-component signaling system [3, 4]. In Klebsiella pneumoniae, PmrD can mediate PhoP and PmrA activation, or activated PhoP can direct activate pbgP operon (or arnBCADTEF or pmrHFIJKLM) [5, 6]. (Source: ...
Source: International Journal of Antimicrobial Agents - June 23, 2018 Category: Drugs & Pharmacology Authors: Sun Ju Kim, Kwan Soo Ko Tags: Short Communication Source Type: research

MCR-1-positive colistin-resistant Escherichia coli in immunocompromised hospitalized patients
Antibiotic-resistant infections in immunocompromised patients are a critical issue that has led to an increase in morbidity and mortality, particularly in hospital settings [1]. For severe human infections caused by multidrug-resistant (MDR) Gram-negative bacteria, colistin has been considered a last-resort antibiotic. However, the global dissemination of plasmid-mediated colistin resistance (most encoded by the mcr-1 gene), has lead to therapeutic impasse [2]. Although polymyxin resistance has been mediated by mutations in several genes involved in lipid A modifications, plasmid-mediated colistin resistance due to the mcr...
Source: International Journal of Antimicrobial Agents - June 23, 2018 Category: Drugs & Pharmacology Authors: Flavio A. Oliveira, T ânia R. Zaccariotto, Cristiane Piveta, Christian C. Hofling, Mariangela R. Resende, Carlos E. Levy, Nilton Lincopan Tags: Letter to the Editor Source Type: research

Identification of CFE-2, a New Plasmid-Encoded AmpC β-Lactamase from a Clinical Isolate of Citrobacter freundii
Citrobacter species are Gram-negative, straight and facultative anaerobic bacilli. Many members of the Citrobacter sp. are naturally resistant to amoxicillin and early generation cephalosporins. Previous studies have proposed C. freundii is more resistant to many antimicrobial agents than other members of the Citrobacter sp. [1, 2]. Furthermore, isolates of C. freundii in recent years have demonstrated resistance not only to traditional agents such as ampicillin, carbenicillin, and cephalothin, but also to newer β-lactam agents such as third-generation cephalosporins, monobactams; and some C. (Source: International Journa...
Source: International Journal of Antimicrobial Agents - June 23, 2018 Category: Drugs & Pharmacology Authors: Chih-Ming Chen, Mei Huang, Hwa-Jene Wu, Ming-Kai Guo, Lii-Tzu Wu Tags: Short Communication Source Type: research

Vancomycin or linezolid empiric MRSA coverage with potential ventilator-associated pneumonia has no benefit or effect on outcomes: antibiotic stewardship implications
Clinically, meticillin-resistant Staphylococcus aureus (MRSA) ventilator-associated pneumonia (VAP) is rare. However, MRSA is a common colonizer of respiratory secretions in ventilated adults in intensive care units (ICUs). The classic clinical features of bona fide S. aureus pneumonia are well known from experience with S. aureus pneumonia with influenza. In a potential VAP (pVAP) ICU patient without the clinical findings of S. aureus pneumonia (i.e. otherwise unexplained new high fevers/chills, haemorrhagic tracheobronchitis, elastin fibres in bronchial secretions, hypotension, rapid cavitation, and thick-walled cavities...
Source: International Journal of Antimicrobial Agents - June 14, 2018 Category: Drugs & Pharmacology Authors: Burke A. Cunha, Nora Jaber, Sharon Blum Tags: Letter to the Editor Source Type: research

Metallo- β-lactamases and class D carbapenemases in south-east Tunisia: Implication of mobile genetic elements in their dissemination
The emergence and spread of multidrug-resistant Gram-negative bacterial infections constitute a major public health problem worldwide [1]. Indeed, several studies have shown an association between infections caused by multidrug-resistant Gram-negative bacteria and high mortality rate and long period of hospitalization [2]. (Source: International Journal of Antimicrobial Agents)
Source: International Journal of Antimicrobial Agents - June 14, 2018 Category: Drugs & Pharmacology Authors: Olfa DZIRI, Carla Andrea ALONSO, Raoudha DZIRI, Haythem GHARSA, Abderrahmen MARAOUB, Carmen TORRES, Chedly CHOUCHANI Tags: Themed Issue: Recent Advances in Antimicrobial and Bacterial Resistance Source Type: research

Metallo- β-lactamases and class D carbapenemases in South-East of Tunisia: Implication of mobile genetic elements in their dissemination
The emergence and spread of multi-drug resistant Gram-negative bacterial infections constitute a major public health problem worldwide [1]. Indeed, several studies have demonstrated an association of infections due to multidrug-resistant Gram-negative bacteria with a high mortality rate and a long period of hospitalization [2]. (Source: International Journal of Antimicrobial Agents)
Source: International Journal of Antimicrobial Agents - June 14, 2018 Category: Drugs & Pharmacology Authors: Olfa DZIRI, Carla Andrea ALONSO, Raoudha DZIRI, Haythem GHARSA, Abderrahmen MARAOUB, Carmen TORRES, Chedly CHOUCHANI Tags: Themed Issue: Recent Advances in Antimicrobial and Bacterial Resistance Source Type: research

Vancomycin or Linezolid Empiric MRSA Coverage with potential Ventilator Associated Pneumonia (pVAP) Has No Benefit or Effect on Outcomes: Antibiotic Stewardship Implications
Clinically, MRSA VAP is rare. However, MRSA is a common colonizer of respiratory secretions in ventilated adults in ICUs. The classic clinical features of bona fide S. aureus pneumonia are well known from experience with S. aureus pneumonia with influenza. In a pVAP ICU patient, without the clinical findings of S. aureus pneumonia, i.e., otherwise unexplained new high fevers/chills, hemorrhagic tracheobronchitis, elastin fibers in bronchial secretions, hypotension, rapidly cavitation, and thick walled cavities in one/both lungs [1,2]. (Source: International Journal of Antimicrobial Agents)
Source: International Journal of Antimicrobial Agents - June 14, 2018 Category: Drugs & Pharmacology Authors: Burke A. Cunha, Nora Jaber, Sharon Blum Tags: Letter to the Editor Source Type: research

Extensively-drug-resistant bacteria carriers among overseas travellers: one-third had not been hospitalized previously
Since the 2000s, the spread of extensively-drug-resistant bacteria (XDRB) has been a worldwide phenomenon that represents an important public health issue. Several studies have suggested a higher risk of infection in previously colonized patients [1,2], and a higher risk of morbidity and mortality [3,4], usually related to few antibiotic resources. (Source: International Journal of Antimicrobial Agents)
Source: International Journal of Antimicrobial Agents - June 12, 2018 Category: Drugs & Pharmacology Authors: Lou Macaux, Oulimata Ndoye, Hugues Cordel, Typhaine Billard Pomares, Delphine Seytre, Olivier Bouchaud, Yves Cohen, Jean-Ralph Zahar, Etienne Carbonnelle Source Type: research

Assessment of posaconazole salvage therapy in chronic pulmonary aspergillosis using predefined response criteria
Chronic pulmonary aspergillosis (CPA) is a slowly progressive infection mainly caused by Aspergillus fumigatus, characterized by inflammatory destruction of lung tissue with cavitation, pleural thickening and/or fibrosis, and associated with significant respiratory and constitutional symptoms [1 –3]. CPA usually affects patients with underlying structural airway disease with air-filled cavities or bullae, such as tuberculosis (TB), non-tuberculous mycobacterial infection, chronic obstructive pulmonary disease (COPD), allergic bronchopulmonary aspergillosis (ABPA), pneumothorax and sarcoid osis. (Source: International Jou...
Source: International Journal of Antimicrobial Agents - June 12, 2018 Category: Drugs & Pharmacology Authors: Isabel Rodriguez-Goncer, Chris Harris, Chris Kosmidis, Eavan G. Muldoon, Pippa J. Newton, David W. Denning Source Type: research

Assessment of posaconazole salvage therapy in chronic pulmonary aspergillosis by using predefined response criteria
Chronic pulmonary aspergillosis (CPA) is a slowly progressive infection mainly caused by Aspergillus fumigatus, characterized by inflammatory destruction of lung tissue with cavitation, pleural thickening and/or fibrosis, and associated with significant respiratory and constitutional symptoms [1 –3]. CPA usually affects patients with underlying structural airway disease with air-filled cavities or bullae, such as tuberculosis (TB), non-tuberculous mycobacterial infection, chronic obstructive pulmonary disease (COPD), allergic bronchopulmonary aspergillosis (ABPA), pneumothorax and sarcoid osis. (Source: International Jou...
Source: International Journal of Antimicrobial Agents - June 12, 2018 Category: Drugs & Pharmacology Authors: Isabel Rodriguez-Goncer, Chris Harris, Chris Kosmidis, Eavan G. Muldoon, Pippa J. Newton, David W. Denning Source Type: research

Resveratrol enhances the efficacy of aminoglycosides against Staphylococcus aureus
The rise of antibiotic resistant bacteria is causing concern worldwide regarding the potential inability to cure bacterial infections [1]. Clinical introduction of new antibiotics based on novel chemical scaffolds has been limited [2], which has necessitated a search for other approaches to counter the problems of antibiotic resistance. An approach suggested is to re-sensitize resistant bacteria by targeting mechanisms that aid bacteria to resist higher concentrations of an antibiotic [3]. Antibiotic resistance may arise due to acquisition of resistance genes, spontaneous mutations or the bacterium may be intrinsically res...
Source: International Journal of Antimicrobial Agents - June 12, 2018 Category: Drugs & Pharmacology Authors: Katrine N øhr-Meldgaard, Armen Ovsepian, Hanne Ingmer, Martin Vestergaard Source Type: research