ARMA

arma
  • 文章类型: Multicenter Study
    在希腊,鲍曼不动杆菌对多种临床上重要的抗菌药物的耐药性已增加到非常高的比例,使他们中的大多数过时。这项研究的目的是确定从希腊不同医院收集的鲍曼不动杆菌分离株的分子流行病学和敏感性。从血培养物中分离的单患者鲍曼不动杆菌菌株(n=271),来自19家医院,在6个月内(2020年11月至2021年4月)进行了碳青霉烯酶的最低抑制浓度测定和分子测试,16SrRNA甲基转移酶和mcr基因检测及流行病学评价。所有分离物中的98.9%产生碳青霉烯酶OXA-23。绝大多数(91.8%)的OXA-23生产者都拥有arma,并主要(94.3%)分配给序列组G1,对应于ICII。在≤16mg/L时,安普霉素(EBL-1003)是抑制100%分离物的最具活性的药物,其次是头孢地洛,对至少86%的人有活性。米诺环素,粘菌素和氨苄西林-舒巴坦仅表现出稀疏的活性(S<19%),埃拉环素的活性分别比米诺环素和替加环素高8倍和2倍,通过比较它们的MIC50/90值。产生国际克隆II的鲍曼不动杆菌的OXA-23-ArmA似乎是希腊该生物的流行流行病学类型。头孢地洛可以为难以治疗的革兰氏阴性感染提供有用的替代方案,而阿普霉素(EBL-1003),结构独特的氨基糖苷目前在临床开发中,可能是一种非常有前途的药物,可以对抗多药耐药的鲍曼氏菌感染,由于其高敏感率和低毒性。
    Resistance of Acinetobacter baumannii to multiple clinically important antimicrobials has increased to very high rates in Greece, rendering most of them obsolete. The aim of this study was to determine the molecular epidemiology and susceptibilities of A. baumannii isolates collected from different hospitals across Greece. Single-patient A. baumannii strains isolated from blood cultures (n = 271), from 19 hospitals, in a 6-month period (November 2020-April 2021) were subjected to minimum inhibitory concentration determination and molecular testing for carbapenemase, 16S rRNA methyltransferase and mcr gene detection and epidemiological evaluation. 98.9% of all isolates produced carbapenemase OXA-23. The vast majority (91.8%) of OXA-23 producers harbored the armA and were assigned mainly (94.3%) to sequence group G1, corresponding to IC II. Apramycin (EBL-1003) was the most active agent inhibiting 100% of the isolates at ≤16 mg/L, followed by cefiderocol which was active against at least 86% of them. Minocycline, colistin and ampicillin-sulbactam exhibited only sparse activity (S <19%), while eravacycline was 8- and 2-fold more active than minocycline and tigecycline respectively, by comparison of their MIC50/90 values. OXA-23-ArmA producing A. baumannii of international clone II appears to be the prevailing epidemiological type of this organism in Greece. Cefiderocol could provide a useful alternative for difficult to treat Gram-negative infections, while apramycin (EBL-1003), the structurally unique aminoglycoside currently in clinical development, may represent a highly promising agent against multi-drug resistant A. baumanni infections, due to its high susceptibility rates and low toxicity.
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  • 文章类型: Journal Article
    鲍曼不动杆菌(A.鲍曼不动杆菌)是引起广泛感染的最重要的医院病原体之一。
    本研究旨在调查编码氨基糖苷修饰酶(AME)的质粒基因的存在,16SrRNA甲基转移酶(RMT),以及从Taif收集的鲍曼不动杆菌临床分离株中sul1基因编码的二氢岩酸合成酶(DHPS)改变,沙特阿拉伯王国(KSA)。还研究了aac(6')-Ib和sul1基因的突变。
    研究了40株鲍曼不动杆菌临床分离株对10种抗生素的敏感性。提取质粒DNA并筛选除sul1基因之外的9个编码氨基糖苷抗性的基因。通过随机扩增多态性DNA(RAPD)-PCR确定克隆相关性。通过毛细管电泳测序(CES)检测aac(6')-Ib和sul1基因的突变。
    所有分离株均为鲍曼不动杆菌,其中42.5%表现出高水平的氨基糖苷抗性(HLAR)。最普遍的AME和RMT编码基因是aph(3')-VI,两个aac(6')基因变体[aac(6')-Ib和aac(6')-SL],蚂蚁(3\'\')-I,其中90%,87.5%,85%,45%的分离株检测呈阳性,分别。另一个研究了氨基糖苷抗性编码基因,即AAC(3)-II,aac(6')-II,和rmtB,未检测到。只有15%的分离株带有sul1基因。RAPD-PCR将40个分离株分为三个簇,其中簇II是主要簇。DNA测序显示,发现34.29%(12/35)的aac(6')-Ib测试呈阳性的分离株在102位具有常见的错义突变,表明一种名为aac(6')-SL的新等位基因变体。此外,DNA测序显示sul1基因中有三个错义突变。
    这是沙特首次研究鲍曼不动杆菌临床分离株中质粒携带的氨基糖苷和磺酰胺抗性基因。除了sul1基因中的新突变外,还检测到aac(6')-Ib的新等位基因变体。
    UNASSIGNED: Acinetobacter baumannii (A. baumannii) is one of the most important nosocomial pathogens responsible for a wide range of infections.
    UNASSIGNED: This study aimed to investigate the existence of the plasmidic genes encoding for aminoglycoside modifying enzymes (AMEs), 16S rRNA methyltransferases (RMT), and the altered dihydropetroate synthase (DHPS) encoded by the sul1 gene among A. baumannii clinical isolates collected from Taif, Kingdom of Saudi Arabia (KSA). The mutations in aac(6\')-Ib and sul1 genes were also investigated.
    UNASSIGNED: Forty A. baumannii clinical isolates were investigated for their susceptibility to ten antibiotics. The plasmid DNA was extracted and screened for nine genes encoding for aminoglycoside resistance in addition to the sul1 gene. The clonal relatedness was determined by random amplified polymorphic DNA (RAPD)-PCR. Mutation in aac(6\')-Ib and the sul1 genes were detected by capillary electrophoresis sequencing (CES).
    UNASSIGNED: All isolates were A. baumannii in which 42.5% of them exhibited a high level of aminoglycoside resistance (HLAR). The most prevalent AMEs and RMT encoding genes were aph(3\')-VI, the two aac(6\') gene variants [aac(6\')-Ib and aac(6\')-SL], ant(3\'\')-I, and armA in which 90%, 87.5%, 85%, and 45% of isolates tested positive, respectively. The other investigated aminoglycoside resistant encoding genes, namely aac(3)-II, aac(6\')-II, and rmtB, were not detected. Only 15% of isolates harbored the sul1 gene. RAPD-PCR classified the 40 isolates into three clusters in which cluster II was the main cluster. DNA sequencing revealed that 34.29% (12/35) of isolates tested positive for aac(6\')-Ib were found to harbor a common missense mutation in position 102 indicating a novel allelic variant named aac(6\')-SL. Also, DNA sequencing revealed three missense mutations in the sul1 gene.
    UNASSIGNED: This is the first Saudi study to investigate the plasmid borne aminoglycoside and sulfonamide resistance genes among A. baumannii clinical isolates. A novel allelic variant for aac(6\')-Ib was detected in addition to novel mutations in the sul1 gene.
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  • 文章类型: Journal Article
    UNASSIGNED: The aminoglycosides are widely used for the therapeutic management of infections caused by gram-negative bacteria, including the Acinetobacter baumannii strains. However, the resistance to the members of the aminoglycoside family, such as amikacin, gentamicin, and tobramycin, is increasingly being common among the clinical isolates.
    UNASSIGNED: This study aimed to investigate the presence of 16SrRNA methylases and aminoglycoside modifying enzymes (AMEs) genes among aminoglycoside resistant A. baumannii isolates and to study the genetic diversity of the clinical population of A. baumannii in local hospitals.
    UNASSIGNED: The 143 A. baumannii clinical strains were analyzed for antimicrobial susceptibility, genetic screening for enzymes conferring aminoglycosides resistance followed by the multilocus sequence typing.
    UNASSIGNED: The 133/143 (93%) isolates were non-susceptible to at least one of the tested aminoglycosides, including amikacin, gentamicin, and tobramycin. The MIC distribution has shown that 87.486.7% strains were resistant to amikacin and gentamicin, respectively. The aphA6, aadB, aacC1, and aphA1 were found in 74.1%, 59.4%, 16.1%, and 11.2% isolates, respectively, whereas the armA was found in 28% of the strains having a higher MIC value (MIC; ≥256µg/mL). The MLST data have shown that the ST589 and ST2 were the most common STs and corresponded to 51 (35.7%) and 38 (26.6%) isolates, respectively, and few of the isolates corresponding to these STs were found to harbor the armA gene with a variable genotypic profile for AMEs.
    UNASSIGNED: The study has reported the incidence of various enzymes conferring aminoglycoside resistance among the A. baumannii clones for the first time from Pakistan. The findings suggest the possibility of transmission of aminoglycoside resistance determinants through the lateral gene transfer as well as clonal dissemination.
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  • 文章类型: Journal Article
    Over half of cancer patients receive radiotherapy (RT) as partial or full cancer treatment. Daily quality assurance (QA) of RT in cancer treatment closely monitors the performance of the medical linear accelerator (Linac) and is critical for continuous improvement of patient safety and quality of care. Cumulative longitudinal QA measurements are valuable for understanding the behavior of the Linac and allow physicists to identify trends in the output and take preventive actions. In this study, artificial neural networks (ANNs) and autoregressive moving average (ARMA) time-series prediction modeling techniques were both applied to 5-year daily Linac QA data. Verification tests and other evaluations were then performed for all models. Preliminary results showed that ANN time-series predictive modeling has more advantages over ARMA techniques for accurate and effective applicability in the dosimetry and QA field.
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