• A decline in the occurrence of Extended-spectrum β-Lactamase (ESBL)-producing Escherichia coli in retail chicken meat in the UK between 2013 and 2018.
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    A decline in the occurrence of Extended-spectrum β-Lactamase (ESBL)-producing Escherichia coli in retail chicken meat in the UK between 2013 and 2018.

    J Appl Microbiol. 2020 May 04;:

    Authors: Randall LP, Horton RH, Chanter JI, Lemma F, Evans S

    AIMS: The aim of this study was to report on the occurrence antimicrobial resistant (AMR) E. coli from retail chicken meat samples in the UK, with particular focus on AmpC and ESBL production and carbapenem resistance.
    METHODS AND RESULTS: Methods from EU protocols were used for selective isolation of AmpC-/ESBL-producing E. coli, carbapenem resistant E. coli and for performing MICs, but additional work not part of EU protocols included viable counts, detection by PCR of blaCTX-M , blaOXA, blaSHV and blaTEM genes in ESBL-phenotype E. coli and screening for mcr plasmid-mediated colistin resistance. From the 313/309 retail chicken meat samples tested in 2016/2018, carbapenem or mcr plasmid mediated colistin resistant E. coli were not detected. For 2016/2018 chicken samples, 141/42 (45.0/13.6), 90/23 (28.8%/7.4%), 48/16 (15.3%/5.2%) and 3/3 (1.0%/1.0%) were positive for ESBL- and/or AmpC-, ESBL- alone AmpC- alone and AmpC+ESBL-phenotype E. coli respectively. ESBL-producing E. coli were predominantly blaCTX-M-1 . All AmpC and or ESBL-phenotype E. coli were sensitive to colistin, ertapenem, imipenem, meropenem, temocillin and tigecycline, applying epidemiological cut-off values.
    CONCLUSIONS: A previous study in 2013/14 showed that 65.4% of retail chicken meat samples tested in the UK were positive for ESBL-producing (mainly CTX-M) E. coli. Since then the proportion of samples positive in the UK has dropped significantly to 7.4% in 2018.
    SIGNIFICANCE AND IMPACT OF STUDY: Significant reductions in antimicrobials used in the UK poultry meat sector between 2012 and 2016 may be linked to significant reductions in AmpC/ESBL-phenotype E. coli in retail chicken between 2013/14 and 2018.

    PMID: 32364269 [PubMed - as supplied by publisher]

Infección intraabdominal

Pie diabético

  • Interventions in the management of infection in the foot in diabetes: a systematic review.
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    Interventions in the management of infection in the foot in diabetes: a systematic review.

    Diabetes Metab Res Rev. 2020 Mar;36 Suppl 1:e3282

    Authors: Peters EJG, Lipsky BA, Senneville É, Abbas ZG, Aragón-Sánchez J, Diggle M, Embil JM, Kono S, Lavery LA, Malone M, Urbančič-Rovan V, Van Asten SA

    The optimal approaches to managing diabetic foot infections remain a challenge for clinicians. Despite an exponential rise in publications investigating different treatment strategies, the various agents studied generally produce comparable results, and high-quality data are scarce. In this systematic review, we searched the medical literature using the PubMed and Embase databases for published studies on the treatment of diabetic foot infections as of June 2018. This systematic review is an update of previous reviews, the first of which was undertaken in 2010 and the most recent in 2014, by the infection committee of the International Working Group of the Diabetic Foot. We defined the context of literature by formulating clinical questions of interest, then developing structured clinical questions (PICOs) to address these. We only included data from controlled studies of an intervention to prevent or cure a diabetic foot infection. Two independent reviewers selected articles for inclusion and then assessed their relevant outcomes and the methodological quality. Our literature search identified a total of 15 327 articles, of which we selected 48 for full-text review; we added five more studies discovered by means other than the systematic literature search. Among these selected articles were 11 high-quality studies published in the last 4 years and two Cochrane systematic reviews. Overall, the outcomes in patients treated with the different antibiotic regimens for both skin and soft tissue infection and osteomyelitis of the diabetic foot were broadly equivalent across studies, except that treatment with tigecycline was inferior to ertapenem (±vancomycin). Similar outcomes were also reported in studies comparing primarily surgical and predominantly antibiotic treatment strategies in selected patients with diabetic foot osteomyelitis. There is insufficient high-quality evidence to assess the effect of various adjunctive therapies, such as negative pressure wound therapy, topical ointments or hyperbaric oxygen, on infection related outcomes of the diabetic foot. In general, the quality of more recent trial designs are better in past years, but there is still a great need for further well-designed trials to produce higher quality evidence to underpin our recommendations.

    PMID: 32176437 [PubMed - as supplied by publisher]

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