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is credited with a long fanatical history dating back to antiquity, when, because of its ability to produce a red pigment it was described as having ‘masqueraded’ as blood (36).
In the 1970s, however, gentamicin resistance was observed in identified from 1974 through 1977 were gentamicin resistant and that the emergence of this resistance paralleled the overall increased use of gentamicin in the hospital. Active against Amp C chromosomal b-lactamase-producing strains but precluded for the treatment of ESBL-positive isolates. Maybe combined with third-generation cephalosporins for the treatment of UTI or combined with fourth-generation cephalosporins or carbapenems for the treatment of serious infection. Flow Diagram for Gram Neg Rods on BAP & Mac Conkey (NOT for stool isolates) Bush K, et al. Enterobacteriaceae Producing ESBLs in the Community: Are They a Real Threat?
is implicated in a wide range of serious infections including pneumonia (51), lower respiratory tract infection (112), urinary tract infection (53), bloodstream infection, wound infection and meningitis (72, 74).
The organism has also been described as an important cause of ocular infection with high incidence in contact lens-related keratitis (4, 21, 92).
In addition, clinical isolates display a selective advantage through their readiness to acquire and express many other antimicrobial resistance determinants.
In the past, agents such aminoglycosides, fluoroquinolones and third-generation cephalosporins comprised the mainstay of treatment of were invariably susceptible to aminoglycosides. Zhanel GG, Baudry PJ, Tailor F, Cox L, Hoban DJ, Karlowsky JA.
In keeping with its role as an agent of opportunistic infection, was traditionally associated with low intrinsic pathogenicity.
Whilst almost all isolates produce extracellular products such as DNase, chitinase, lecithinase, lipase, gelatinase and siderophores, it appears that in secrete a pore-forming haemolysin, Sh IA, that is associated with cell cytotoxicity and the release of inflammatory mediators.is rarely associated with primary invasive infection.It operates as a true opportunist producing infection whenever it gains access to a suitably compromised host.Patients most at risk include those with debilitating or immunocompromising disorders, those treated with broad-spectrum antibiotics and patients in ICU who are subjected to invasive instrumentation.The indwelling urinary catheter is a major risk factor for infection.Outbreaks of infection have been traced to medical equipment including nebulisers (87), bronchoscopes (82), electrocardiogram leads (100), laryngoscopes (20) and contaminated solutions such as inhalation medications (112), prefilled heparin syringes (8, 103), saline solutions (105), parenteral nutrition (3) and antiseptics (76).