Rafael Canton

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..Decreased lung function improved after 1 year of azithromycin and inhaled 7%-hypertonic saline treatment...

..Dissemination of bla(VIM-1) class-1 integrons within highly transferable plasmids in a polyclonal population has potentially contributed to the maintenance and spread of CPE...

..The authors also focus on the spread of nonmetallo-β-lactamase carbapenemases, and likely risk factors for resistance...

..The authors also report new data on antibiotic prescribing in primary care and latest research in the development of novel antibiotics for the future...

..We utilize here systemic cytokine and antibody levels in evaluating differences in early immune response in both mild and severe patients infected with nvH1N1...

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..This growing body of evidence provides useful insights regarding the efficacy of daptomycin against enterococci in clinical settings...

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..Essential elements in the training of specialists in clinical microbiology are a close relationship between the laboratory and the clinical center and collaboration with other specialists...

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..If multiresistant P. aeruginosa is isolated, antimicrobial agents that retain activity are recommended and epidemiological control measures should be established...

..Antibacterial resistance was highest in the Far East. Telithromycin resistance was rare (0.12%). Appropriate alternative empirical first-line therapies may be required for treating community-acquired RTIs in the elderly...

..The interpretive reading of the antibiogram transcends the microbiologist's clinical role and is essential for clinical decisions...

..CTX-M enzymes with the IRT phenotype have not been detected to date. New studies of IRT enzymes, including population structure, association with virulence traits and plasmid dispersion, are needed...

..This phenotype resembles the production of an extended spectrum beta-lactamase. Like other Proteus species, P. penneri is resistant to tetracyclines and should be considered resistant to nitrofurantoin...

..A K1-producing K. oxytoca was misidentified by 10% of laboratories as an ESBL producer. The use of well-defined resistant strains is useful for improving proficiency in susceptibility testing in clinical laboratories...

..maltophilia isolates when compared with respiratory isolates from non-CF patients. Moreover, persistently recovered CF S. maltophilia isolates were more resistant than sporadic non-CF isolates...

..This review focuses on recent data that may help to understand the emergence and dissemination of multi-drug resistant bacilli and the current trend from epidemic to endemic situations...

..Emergence of a resistant bacterial subpopulation within a susceptible wild-type population can be restricted with a regimen using an antibiotic dose that is sufficiently high to inhibit both susceptible and resistant bacteria...

..Co-resistance and co-selection processes increase the opportunity for persistence of the bacteria and resistance genes and should be considered when designing strategies for decreasing antimicrobial resistance...

..Antimicrobial treatment in patients with bronchiectasis and P. aeruginosa colonization should be based on antimicrobial agents, alone or in combination, that do not lose activity when acting on biofilms...

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..All 78 erythromycin-resistant S. pneumoniae isolates collected from blood cultures in our hospital (2000-07) were studied and the population structure was analysed by using different mathematical diversity indexes...

..The aim of the study was to characterize plasmids that harbour blaESBL genes and their genetic environment in Escherichia coli and Klebsiella pneumoniae clones circulating in Spain...

..5 to 1 micro g/ml) found in four isolates. The low impact of these mutations on garenoxacin activity envisages the possible coverage of S. pneumoniae populations resistant to preexisting quinolones...

..However, this in vitro promise requires support from clinical studies...

..KPC carbapenemase-producing Klebsiella pneumoniae isolates have been increasingly detected in Europe. We report the first KPC-producing isolates characterized in Madrid, Spain...

..faecalis showed a cumulative increase in CDPD, whereas E. faecium did not. CDPD and CPR were useful for measuring the dynamics of intestinal colonization with enterococcal clones...

..We analysed all MRSA isolates recovered from respiratory secretions of patients attending our CF unit (1994-2006)...

..According to the present results, telithromycin and cethromycin offer a wide coverage against S. pyogenes isolates in a geographic area with a high incidence of resistance to currently used macrolides...

..Despite this situation, clonal expansion and/or gene dispersion was not observed, denoting the independent emergence of these enzymes...

..faecium isolates with different origins...

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..A polyclonal population structure was demonstrated within our Spanish mef-positive S. pneumoniae isolates, with few clonal complexes overrepresented within this collection...

..CLSI breakpoints should still be followed when intravenous tobramycin is used in CF patients, particularly during the course of exacerbations...

..These results suggest that H. influenzae bronchial colonization in CF patients is a dynamic process, but better-adapted clones can persist for long periods of time...

..coli ST10 complex carried five ESBLs and E. coli ST23 complex carried four ESBLs. A great diversity of MLST types was observed among Spanish ESBL-producing E. coli isolates...

..The possible therapeutic role of daptomycin is addressed in the light of Spanish susceptibility data...

..aeruginosa isolates recovered during early colonisation stages in CF patients supports early aggressive antimicrobial treatment guidelines in first P. aeruginosa-colonised CF patients...

..The chromID ESBL medium was reliable to screen ESBL fecal carriers with a general decrease in the laboratory workload. Time-to-time monitoring of ESBL fecal carriers is useful to ascertain current trend of ESBL epidemiology...

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..aeruginosa clones at high risk for epidemic spread, such as the Liverpool, Manchester, and Melbourne clones previously found in cystic fibrosis patients and ST235 in the nosocomial setting...

..Some integrons were identical to those found during decades worldwide, illustrating the preservation of the genetic elements carrying them...

..The 2nd nationwide study was developed in 2006 to investigate the evolution of this problem...

..The increase in the incidence of such isolates is mostly due to the dissemination of IncK plasmids among E. coli isolates of phylogroups A, B1, and D...

..Patients with community infections and members of their households represent a reservoir for ESBL producers, increasing dispersal of resistance in healthy people...

..To investigate whether telithromycin is a substrate for efflux pumps in Streptococcus pyogenes...

..This is the first report showing an extended-spectrum-beta-lactamase gene linked to a phage-related element...

..This suggests that in this context this mutation might be considered a primary site involved in resistance to broad-spectrum cephalosporins...

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..In summary, IR-CTX-M enzymes might evolve under exposure to BBLIs, and the probability is higher for enzymes belonging to the CTX-M-1 cluster. However, this process could be delayed by antagonistic pleiotropy...

..The presence of the TEM-24-producing E. aerogenes French clone in our institution also demonstrates the intercountry dissemination of ESBL-producing isolates...

..Time-kill studies demonstrated that the combination of both compounds was synergistic along the first 12 h, suppressing the regrowth observed after 3 to 6 h when colistin was tested alone...

..001). These findings reflect the importance of local environmental differences in the evolution of this CC, suggesting that the emergence of vancomycin resistance among AREF strains in Spain may be a question of time...

..To analyse all extended-spectrum-beta-lactamase (ESBL)-producing Klebsiella pneumoniae isolates recovered from 2001 to 2004 in our institution and to compare this period with that of 1989 to 2000...

..All these events might have contributed to the current pandemic CTX-M beta-lactamase scenario...

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..influenzae isolates for the detection of decreased susceptibilities to quinolones due to the acquisition of two amino acid changes in the QRDRs of GyrA and ParC (sensitivity, >95%; specificity, >80%)...

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..Most plasmids contained blaOXA-1, aac(6')-Ib-cr, and blaTEM-1. Worldwide dissemination of CTX-M-15 seems to be determined by clonal complexes ST131 and ST405 and multidrug-resistant IncFII plasmids...

..Knowledge of the complex epidemiology of bla(VIM-1) is necessary to control this emerging threat...

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..faecalis. Our novel MLST scheme provides an excellent tool for investigating local and short-term epidemiology as well as global epidemiology, population structure, and genetic evolution of E. faecalis...

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..In silico analysis of the amino acid changes present in the MutS proteins of these hypermutator strains in comparison with the normomutator isolates suggests that the cause of the defect in MutS might be a H683P amino acid change...

..This element constitutes one of the few examples of CR1-bearing class 1 integrons that has been fully characterized...

..In this work, we determined whether specific changes in PBPs were associated with specific MurM variants...

..The epidemiological distribution of extended-spectrum beta-lactamase (ESBL) types in Escherichia coli and Klebsiella pneumoniae was evaluated in various hospitals in Spain and compared with previous studies...

..Monitoring of antimicrobial use and knowledge of prescription habits are some of the strategies recommended to contain the resistance to antimicrobials in hospitals...

..We conclude that sequencing of the sodA gene was the most discriminatory method and that S. gallolyticus subsp. pasteurianus appears to have a higher genetic diversity than S. gallolyticus subsp. gallolyticus...

..The identical genetic surroundings of blaCTX-M-32 and blaCTX-M-1 and their locations on related 40-kb IncN plasmids indicate the in vivo evolution of this element...

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..New antimicrobials, including daptomycin, are less affected by these phenomena and should be considered as the treatment of choice when these events are demonstrated or suspected...

..The presence of bla(CTX-M-9) on broad-host-range IncP-1alpha plasmids might contribute to its dissemination to hosts that were not members of the family Enterobacteriaceae...

..We report a successful long-term aerosolized ampicillin treatment of a 14-year-old girl with chronic symptomatic S. aureus lung infection...

..This approach will lead to more accurate susceptibility testing results with better detection of resistance mechanisms, and allowing to reach the clinical goal of the antibiogram...

..06-0.25 mg/L) in Australia, Indonesia, Hungary, Austria, Germany, the Netherlands, Portugal, Sweden and Switzerland. Regardless of methicillin susceptibility, resistance to linezolid, teicoplanin or vancomycin was not apparent globally...

..A policy for preventing mixing human-originated and animal-originated bacteria with environmental organisms seems advisable...

..This study determines the prevalence of infections by carbapenem-resistant Acinetobacter baumannii (CRAB) in Spain, and identifies trends over time, geographical variations, and factors associated with resistance...

..However, few clones could be transmitted among different patients, yielding outbreak situations...

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..The purpose of this study was to define the presence of CC2 and CC9 among E. faecalis strains isolated in Spain...

..Resistance mechanisms in clinical isolates do not affect survival with any of the STS...

..faecium clones. This observation indicates that antibiotic-resistant variants may frequently arise under antibiotic selective pressure among esp-positive clones reaching ecological abundance in the nosocomial habitat...

..It also constitutes the first description of sequence type 258 (ST258) in Brazil, which was associated with a nosocomial hospital outbreak in Ribeirao Preto city...

..maltophilia mutant strains was not related to quinolone resistance determining region mutations. Highly effective efflux mechanisms might preserve topoisomerase targets from a ciprofloxacin challenge in S. maltophilia...

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..Estimate of prevalence of infection was calculated by means of the percent distribution of every organism regarding overall identified organisms and infections...